USA

2015 will be remembered as the year legalization hit bumps most supporters never anticipated.

For pro-health advocates that oppose marijuana legalization, it was a year of fantastic victories! Here are the top 10:

10. Big Marijuana is Real — and People are Writing About It.

When we started talking about Big Marijuana in 2013, many people laughed. Could marijuana even be compared with Big Tobacco in any credible way? But now, that’s ancient history. Several articles – even in legalization-friendly blogs like this one – mention the term. And the term is not just rhetoric — the most senior federal legalization lobbyist in the country resigned in protest because, in his words, “industry was taking over the legalization movement.” Not only was that heroic of him, it was historic for us.

9. Continuing Positive Press Coverage of Groups Opposing Legalization. 

With the exception of some very pro-pot columnists, this year represented one in which our side was represented just a little bit better than in the past. A profile of SAM was featured in the International Business Times, and other articles continued to broadcast our message to new audiences.

With the hiring of a new Communications Director in 2016, you can bet we won’t let up on this next year.

8. Several States Resisted Full-Blown Legalization. 

We entered 2014 after setbacks in Alaska and Oregon; but we stuck to winning messages and formed coalitions in a bloc of New England states that were all under attack in the early part of 2015. From Maine to Massachusetts to New Hampshire to Rhode Island, our partners and affiliates fought back —- and not one state legalized via legislature as the legalizers had promised. We’ll be taking this momentum into 2016.

7. Lawyering Up.

 Many of our friends made strong statements in court — “Colorado and other states cannot legalize in the face of federal law,” they argue. Of course we know they are right, and we know that regardless of legal outcomes the statement they sent was loud and clear. (We’re also happy that the Justice Department, in its opposition to the suit, solely argued against it on procedural grounds — they did not substantively come out in favor of legalization to the Solicitor General). The plaintiff’s bar should take notice—just like Big Tobacco became a big target for lawsuits, Big Marijuana and those who sell the drug will, too.

6. Marijuana Stores Banned in California, Washington, Colorado, Oregon, Michigan, and Elsewhere. 

Despite legalization in some states, we know that local ordinances are one of the key strategies to keeping marijuana out of communities. The majority of towns in most weed-friendly states have indeed banned stores altogether. Even in Detroit, up to half of Detroit’s roughly 150 medical marijuana dispensaries could close following a Detroit City Council vote to approve a restrictive zoning ordinance. We will keep pushing hard for more bans in 2016.

5. Legalizers Made No Gains in Congress This Year
.

 For the past decade, it seemed that every year we lost a little more in Congress. Not in 2015. Despite the most aggressive lobbying effort yet by pro-marijuana folks, they made no progress on key provisions:

· They wanted to give tax breaks to pot shops—just like Big Tobacco lobbies to lower taxes on cigarettes.

  • They wanted to allow pot businesses to leverage Wall Street money through the banking system.
  • They wanted to stop the Justice Department from enforcing the law in states with legalized recreational marijuana.
  • They wanted to give pot to our most vulnerable citizens to “treat” PTSD — even though science says marijuana makes PTSD, as well as other mental illness, worse.
  • They wanted Washington, DC, to become a mecca for Big Marijuana.

And we won – on every issue.

4. Continued Support from ONDCP, DEA, and NIDA.

2015 was a transitional year for key federal drug policy agencies. A new ONDCP Director was appointed — and even though we are still waiting for the Obama Administration to enforce federal law, it is clear where Director Botticelli’s heart is. Right after getting into office, the Director sat down with me for a one-to-one on-the-record interview where he blasted legal pot. And only a few weeks ago, he was featured on 60 Minutes talking about the harms of marijuana and the harms of the industry.

Additionally, we saw the appointment of a new DEA Administrator — this time from the FBI. Administrator Rosenberg has been an excellent leader by moving to support legitimate medical research over faux claims of “medical” marijuana.

And we continue to receive support from NIDA Director Nora Volkow, who headlined SAM’s summit last year, for her unwavering support of public health above profits. 

3. Real Progress on Researching the Medical Components of Marijuana.

 I’m proud that SAM took a bold stand this year to defend the legitimate research of medical components of marijuana. And our ground-breaking report paid off. The federal government has already adopted two of the report’s provisions — eliminating the Public Health Service review and getting rid of onerous CBD handling requirements. We will continue to fight for legitimate marijuana research, and to separate it from faux medicine-by-ballot-initiative. 

2. No States Legalized “Medical” Marijuana in 2015.

This is a big one, given where the country is on the “medical” marijuana issue. No state legalized the drug for medical purposes this year, despite several tries in key states. Even in Georgia, where legalizers have been emboldened by a few pot-friendly legislators, a government-convened panel voted to follow science and impose sensible restrictions on the drug. 

1. Ohio! 

Of course, the victory in Ohio tops the field. Despite being outspent 12-to-1, our affiliates and partners brought us a huge victory in November. We plan to build on this for 2016, but we need your help.

Despite the nonstop talking point of “inevitability,” we know that the 8% of Americans who use pot don’t speak for 92% of Americans that don’t want to see Big Tobacco 2.0, don’t want to worry about another drug impairing drivers on the road, and don’t want to think about keeping things like innocuous-looking “pot gummy bears” away from their kids. We know that the pot lobby will work hard for things like not only full-blown legalization in several more states next year, but also things like on-site pot smoking “bars” (they are really proposing these in Alaska and Colorado as we speak) and an expansion of pot edibles.

In 2016, let’s nip Big Marijuana in the bud.

Source: https://www.huffingtonpost.com/kevin-a-sabet-phd/top-10-antimarijuana-lega_b_8879338.html

Legalizing opioids may give Americans greater freedom over their decision-making, but at what cost? One painful aspect of the public debates over the opioid-addiction crisis is how much they mirror the arguments that arise from personal addiction crises.

If you’ve ever had a loved one struggle with drugs — in my case, my late brother, Josh — the national exercise in guilt-driven blame-shifting and finger-pointing, combined with flights of sanctimony and ideological righteousness, has a familiar echo. The difference between the public arguing and the personal agonizing is that, at the national level, we can afford our abstractions.

When you have skin in the game, none of the easy answers seem all that easy. For instance, “tough love” sounds great until you contemplate the possible real-world consequences. My father summarized the dilemma well. “Tough love” — i.e., cutting off all support for my brother so he could hit rock bottom and then start over — had the best chance of success. It also had the best chance for failure — i.e., death. There’s also a lot of truth to “just say no,” but once someone has already said “yes,” it’s tantamount to preaching “keep your horses in the barn” long after they’ve left.

But if there’s one seemingly simple answer that has been fully discredited by the opioid crisis, it’s that the solution lies in wholesale drug legalization. In Libertarianism: A Primer, David Boaz argues that “if drugs were produced by reputable firms, and sold in liquor stores, fewer people would die from overdoses and tainted drugs, and fewer people would be the victims of prohibition-related robberies, muggings and drive-by-shootings.”

Maybe. But you know what else would happen if we legalized heroin and opioids? More people would use heroin and opioids. And the more people who use such addictive drugs, the more addicts you get. Think of the opioid crisis as the fruit of partial legalization. In the 1990s, for good reasons and bad, the medical profession, policymakers, and the pharmaceutical industry made it much easier to obtain opioids in order to confront an alleged pain epidemic. Doctors prescribed more opioids, and government subsidies made them more affordable. Because they were prescribed by doctors and came in pill form, the stigma reserved for heroin didn’t exist. When you increase supply, lower costs, and reduce stigma, you increase use.

And guess what? Increased use equals more addicts. A survey by the Washington Post and the Kaiser Family Foundation found that one-third of the people who were prescribed opioids for more than two months became addicted. A Centers for Disease Control study found that a very small number of people exposed to opioids are likely to become addicted after a single use. The overdose crisis is largely driven by the fact that once addicted to legal opioids, people seek out illegal ones — heroin, for example — to fend off the agony of withdrawal once they can’t get, or afford, any more pills. Last year, 64,000 Americans died from overdoses. Some 58,000 Americans died in the Vietnam War.

Experts rightly point out that a large share of opioid addiction stems not from prescribed use but from people selling the drugs secondhand on the black market, or from teenagers stealing them from their parents. That’s important, but it doesn’t help the argument for legalization. Because the point remains: When these drugs become more widely available, more people avail themselves of them. How would stacking heroin or OxyContin next to the Jim Beam lower the availability? Liquor companies advertise — a lot. Would we let, say, Pfizer run ads for their brand of heroin? At least it might cut down on the Viagra commercials. I think it’s probably true that legalization would reduce crime, insofar as some violent illegal drug dealers would be driven out of the business.

I’m less sure that legalization would curtail crimes committed by addicts in order to feed their habits. As a rule, addiction is not conducive to sustained gainful employment, and addicts are just as capable of stealing and prostitution to pay for legal drugs as illegal ones. The fundamental assumption behind legalization is that people are rational actors and can make their own decisions. As a general proposition, I believe that. But what people forget is that drug addiction makes people irrational. If you think more addicts are worth it in the name of freedom, fine. Just be prepared to accept that the costs of such freedom are felt very close to home.

Source: http://www.nationalreview.com/article/453304/opioid-crisis-legalization-not-solution

 

by  Elizabeth Stuyt, MD

For the past 27 years, working as an addiction psychiatrist, I have struggled with big industries that push their products more for their financial gain rather than the best interests of the clients they serve. The most disconcerting piece occurs when physicians or other treatment providers or governmental entities appear to be influenced by big industry, touting the party line and minimizing any downsides to the product. I have experienced this with the tobacco industry, the pharmaceutical industry and now with the marijuana industry.

It is clear to me that wherever it happens, the push to legalize medical marijuana is simply a back-door effort, by industry, to legalize retail marijuana. However, the lack of any regulations on the potency of THC in marijuana or marijuana products in Colorado has allowed the cannabis industry to increase the potency of THC to astronomical proportions, resulting in a burgeoning public health crisis.

The potency of THC in currently available marijuana has quadrupled since the mid-1990s. The marijuana of the 1980s had <2% THC, 4.5% in 1997, 8.5% in 2006 and by 2015 the average potency of THC in the flower was 17%, with concentrated products averaging 62% THC.

Sadly, the cannabidiol (CBD) concentrations in currently available marijuana have remained the same or decreased. CBD is the component of marijuana that appears to block or ameliorate the effects of THC. Plants that are bred to produce high concentrations of THC cannot simultaneously produce high CBD. Higher-potency THC has been achieved by genetically engineering plants to product more THC and then preventing pollination so that the plant puts more energy into producing cannabinoids rather than seeds. This type of cannabis is referred to as sinsemilla (Spanish for without seed). (It has also been referred to as “skunk” due to its strong smell.)

In my view, this is no different than when the tobacco industry increased the potency of nicotine by genetically engineering tobacco plants to produce more nicotine and then used additives like ammonia to increase the absorption of nicotine. Industry’s efforts to increase the potency of an addictive substance seem to be done purely with the idea of addicting as many people as possible to guarantee continued customers. This certainly worked for the tobacco industry. And we have increasing evidence that high potency THC cannabis use is associated with an increased severity of cannabis dependence, especially in young people.12

Although marijuana has been used for thousands of years for various medical conditions, we have no idea if the benefit comes from the THC or CBD or one of the other multiple cannabinoids present in marijuana, or a combination. And we have no idea how much is needed or how often. Most of the research indicates that it is likely the CBD that is more helpful but we obviously need research on this. There is no evidence that increasing the potency of THC has any medical benefits. In fact, a study on the benefits of smoked cannabis on pain actually demonstrated that too high a dose of THC can cause hyperalgesia – similar to what is seen with high dose opiates – meaning that the person becomes more sensitive to pain with continued use. They found that 2% THC had no effect on pain, 4% THC had some beneficial effects on chronic pain and 8% resulted in hyperalgesia.3

The discovery of the “active component” in marijuana that makes it so desirable is a fairly recent phenomenon. THC and CBD were first discovered in 1963 in Israel.4

Because cannabis was made a DEA schedule I drug in 1970, very little research has been done on cannabis in the United States and most of the indications for medical marijuana have very little good research backing up the use. The chemical that is made by the body and fits the receptor which accommodates THC was discovered in 1992.5

The researcher named the chemical anandamide which means “supreme joy” in Sanskrit.  However, it turns out that the endocannabinoid system plays a very significant role in brain development that occurs during childhood and adolescence. It controls glutamate and GABA homeostasis and plays a role in strengthening and pruning synaptic connections in the prefrontal motor cortex. The consequences of using the high potency THC products during this period, especially without the protective benefits of CBD, are multifaceted and include disturbance of the endocannabinoid system, which can result in impaired cognitive development, lower IQ and increased risk of psychosis.

There is also evidence that marijuana use contributes to anxiety and depression. A very large prospective study out of Australia tracked 1600 girls for 7 years and found that those who used marijuana every day were 5 times more likely to suffer from depression and anxiety than non-users.6

Teenage girls who used the drug a least once a week were twice as likely to develop depression as those who did not use. In this study, cannabis use prior to age 15 also increased the risk of developing schizophrenia symptoms.

While there definitely are people who can use marijuana responsibly without any untoward effects, similar to how some people can drink alcohol responsibly and not have any problems, there are people who are very sensitive to the effects of THC, and its use can precipitate psychosis. The higher the potency of THC the more likely this may happen and we have no idea how to predict who will be affected. In one of the first double blind randomized placebo controlled trials on smoked cannabis (maximum of 8% THC) for the treatment of pain, a cannabis naïve participant had a psychotic reaction to the marijuana in the study and this then required that all future study participants have some experience with smoking marijuana.7

This kind of makes it difficult to have “blind” unbiased participants.

A 2015 study out of London analyzed 780 people ages 18-65, 410 with first episode psychosis and 370 healthy controls, and found that users of high potency (“skunk-like”) cannabis (THC > 15%) are three times as likely to have a psychotic episode as people who never use cannabis, and the risk is fivefold in people who smoke this form of the drug every day.89 There was no association of psychosis with THC levels < 5%. Most of the marijuana in the U.S. is of the high-THC variety. Many retailers in Colorado sell strains of weed that contain 25 percent THC or more.

Sadly, Colorado has now joined several other states in approving PTSD as an indication for the use of medical marijuana. Marijuana does not “treat” PTSD any more than benzodiazepines or opiates “treat” PTSD. All these addictive drugs do is mask the symptoms, allowing the person to continue life unaffected by the memory of the trauma. However, the psychological trauma is never resolved and the individual has to continue to use the substance in order to cope. This sets the individual up for the development of addiction to the substance or the use of other addictive substances. There is absolutely no good research to support the use of marijuana for PTSD, and there is observational data that this would be a bad idea unless this use was supported by a lot more (and better-designed) longitudinal research.

In an excellent longitudinal, observational study from 1992 to 2011, 2,276 Veterans admitted to specialized VA treatment programs for PTSD had their symptoms evaluated at intake and four months after discharge.10

They found that those who never used marijuana or quit using while in treatment had the lowest levels of PTSD symptoms, while those who continued to use or started using marijuana after treatment had worse symptoms of PTSD. Those who started using the drug during treatment had higher levels of violent behavior too.

Those of us working in the trenches in Colorado are seeing the downsides of what our governor has called “one of the great social experiments of the 21st century.” Emergency room physicians are seeing a significant increase in people experiencing consequences from marijuana use since it was legalized. One such physician wrote a very poignant piece about his experience returning to his home town of Pueblo, Colorado where he is now practicing.11

His experiences are totally supported by the Rocky Mountain High Intensity Drug Trafficking Report, volume 4 from September 2016 which documents significant increases in marijuana related emergency department visits (49%) and hospitalizations related to marijuana (32%) compared to rates prior to retail legalization. This report also documents significant increases in the use of marijuana by youth, with Colorado youth “past month marijuana use” for 2013/2014 being 74% higher than the national average, compared with 39% higher in 2011/2012.

 

In Pueblo, Colorado, where I practice, it has developed into a perfect storm. According to the Healthy Kids Colorado Survey in 2015, we have the highest incidence of youth marijuana use in the state, with 30.1% reporting using marijuana in the last 30 days. The legalization of retail marijuana seems to be reflected in the increased abuse of opiates and heroin too. In addition to the highest rates of marijuana use by youth, Pueblo has the highest rates of heroin-related deaths in the state.

 

This is a very disturbing correlation that needs attention. I have definitely seen in my practice that marijuana acts as a gateway drug to opiates, and to relapse to opiates after treatment if the person goes back to using marijuana. The Smart Approaches to Marijuana status report, which assesses state compliance with federal marijuana enforcement policy, following what is known as the Cole memo, documents that Colorado, four years after legalization, has failed to meet the specific DOJ requirements on controlling recreational marijuana production, distribution and use. This report documents a significant increase in drugged driving crashes, youth marijuana use, a thriving illegal black market and unabated sales of alcohol, which supports the idea that people are not using marijuana instead of alcohol but rather in addition to alcohol.

In spite of all this information, powerful people in the government of Colorado have publicly minimized the consequences. Larry Wolk, MD, the Chief Medical Officer for the Colorado Department of Public Health and Environment, has reported that he has “not seen any significant problems” with the legalization of marijuana.

Governor Hickenlooper’s response to Attorney General Sessions recent questions about compliance with the Cole Memo minimized the adolescent use of marijuana by saying that youth marijuana use in Colorado has “remained stable since legalization.” This is not true for Pueblo, but in any event, any use of marijuana by youth in Colorado should not be minimized and should be a major concern for future generations.

While there are people who believe we need to enforce federal law and go back to making marijuana illegal, I am afraid the horse is already out of the barn and cannot be put back in as we already have several states with “legal” retail marijuana and multiple more with “medical marijuana.” I cannot conceive of any way this could be reversed at this point, when the majority of society supports the legalization of marijuana.

Solutions to our marijuana problems have to be realistic to our current situation/environment. The number one solution is more education. Many people seem to lack a true understanding of the drug and all the potential negative consequences of the higher-potency THC. This is why education is so important. Adults should have the right to make their own decisions but they need informed consent, just like with any drug.

The biggest concern is with adolescent use and the developing brain. This requires a lot more education and increased efforts at prevention, early intervention and treatment. I believe society would be truly served by a federal ban on all advertising of addicting drugs including alcohol, tobacco and marijuana, as well as all pharmaceutical drugs. The decision to use a pharmaceutical medication should be between the patient and the medical professional, not influenced by big industry. We clearly have the big industries— alcohol, tobacco and marijuana—doing everything they can to influence the public and convince them to use their product.

Since we only have anecdotal evidence at this point that marijuana can aid any medical condition, I recommend eliminating “medical marijuana” and just have retail marijuana with limits on THC and regulations similar to alcohol and tobacco. This could help take away the perception, which adolescents and others have, that because is it “medical” it must be “safe.” In order to be able to say it is medical, it should go through the same standards for testing the safety and efficacy of any prescription drug.

In this vein, I believe we do need more research and that marijuana should be reclassified as a schedule II drug so this can occur. Since marijuana has been used medicinally for thousands of years, I believe that the plant deserves some true research to determine if and what parts of the plant are helpful medicinally. The reports that marijuana use resulted in less than 10% becoming addicted to it were done back in the 1990s when THC levels were <5%. Since we are seeing significant increases in people developing marijuana use disorder with the higher doses of THC, perhaps the limits on THC should be <5%. Editor’s note: for more information, see the pdf of the author’s talk on this topic.     Show 11 footnotes

Source:  https://www.madinamerica.com/2017/09/unintended-consequences-colorado-social-experiment/  11th September 2017

Mathias B. Forrester and Ruth D. Merz

Hawaii Birth Defects Program, Honolulu, Hawaii, USA

Extracts from Study 

The literature on the association between prenatal illicit drug use and birth defects is inconsistent. The objective of this study was to determine the risk of a variety of birth defects with prenatal illicit drug use.

Data were derived from an active, population based adverse pregnancy outcome registry. Cases were all infants and foetuses with any of 54 selected birth defects delivered during 1986–2002.

The prenatal methamphetamine, cocaine, or marijuana use rates were calculated for each birth defect and compared to the prenatal use rates among all deliveries.

Among all deliveries, the prenatal use rate was 0.52% for methamphetamine,0.18% for cocaine, and 0.26% for marijuana.

Methamphetamine rates were significantly higher than expected for 14 (26%) of the birth defects.

Cocaine rates were significantly higher than expected for 13 (24%) of the birth defects.

Marijuana rates were significantly higher than expected for 21 (39%) of the birth defects. Increased risk for the three drugs occurred predominantly among birth defects associated with the central nervous system, cardiovascular system, oral clefts, and limbs. There was also increased risk of marijuana use among a variety of birth defects associated with the gastrointestinal system. Prenatal uses of methamphetamine, cocaine, and marijuana are all associated with increased risk of a variety of birth defects.

The affected birth defects are primarily associated with particular organ systems.

DISCUSSION

Using data from a Statewide, population-based registry that covered over 300,000 births and a 17-yr period, this investigation examined the association between over 50 selected birth defects and maternal use of methamphetamine, cocaine, or marijuana during pregnancy. Much of the literature on prenatal illicit drug use and birth defects involved case reports, involved a small number of cases, were not population-based, or focused on only one or a few particular birth defects.

There are various limitations to this investigation. The number of cases for many of the birth defects categories was relatively small, limiting the ability to identify statistically significant differences and resulting in large confidence intervals.

In spite of this, a number of statistically significant analyses were identified. Some statistically significant results might be expected to occur by chance. If 1 in every 20 analyses is expected to result in statistically significant differences solely by chance, then among the 162 analyses performed in this study, 8 would be expected to be statistically significant by chance. However, 48 statistically significant differences were identified. Thus, not all of the statistically significant results are likely to be due to chance.

This study included all pregnancies where methamphetamine, cocaine, or marijuana use was identified through either report in the medical record or positive toxicology test. This was done because neither self-report nor toxicology testing is likely to identify all instances of prenatal illicit drug use (Christmas et al., 1992).

In spite of using both methods for determining prenatal illicit drug use, all pregnancies involving methamphetamine, cocaine, or marijuana were not likely to have been identified. The degree of under ascertainment is unknown. A previous study examined the maternal drug use rate around the time of delivery in Hawaii during 1999 (Derauf et al., 2003). This study found 1.4% of the pregnancies involved methamphetamine use and 0.2% involved marijuana use. Among 1999 deliveries, the HBDP identified a prenatal methamphetamine use rate of 0.7% and a marijuana use rate of 0.4%. However, comparisons between the 2 studies should be made with caution because the previous study collected data from a single hospital during only a 2-mo period.

Another limitation is that the present study did not control for potential confounding factors such as maternal demographic characteristics, health behaviors, and prenatal care. Increased risk of birth defects has been associated with inadequate prenatal care (Carmichael et al., 2002), maternal smoking (Honein et al., 2001), and maternal alcohol use (Martinez-Frias et al., 2004).

These factors are also found with maternal illicit drug use (Cosden et al., 1997; Hutchins, 1997; Norton-Hawk, 1997). Thus the increased risk of selected birth defects with illicit drug use in this study might actually be due to one of these other underlying factors. Unfortunately, informationon some of the potential confounding factors such as socioeconomic status are not collected by the HBDP. Information collected on some other factors such as smoking and alcohol use is suspect because of negative attitudes toward their use during pregnancy. Moreover, the small number of cases among many of the birth defects groups would make controlling for these factors difficult.

Finally, this investigation included use of the illicit drugs at any time during the pregnancy. Most birth defects are believed to occur at 3–8 wk after conception (Makri et al., 2004; Sadler, 2000). In a portion of the cases, the drug use might have occurred at a time when it could not have caused the birth defect. Furthermore, this study does not include information on dose; however, teratogenicity of a substance may depend on its dose (Werler et al., 1990). In spite of the various potential concerns of the present study, data may suggest future areas of investigation where the limitations inherent in the present one are excluded.

This investigation found significantly higher than expected rates for prenatal use of methamphetamine, cocaine, and marijuana among a number of specific birth defects. Although not identical, there were general similarities between the three illicit drugs and the birth defects with which they were associated. Increased rates for methamphetamine, cocaine, and marijuana occurred predominantly among birth defects affecting the central nervous system, cardiovascular system, oral clefts, and limbs. There were also increased rates of marijuana use with a variety of birth defects associated with the gastrointestinal  system. With the exception of marijuana and encephalocele, none of illicit drugs were associated with neural-tube defects (anencephaly, spina bifida, encephalocele). The rates of use for the three illicit drugs were not significantly elevated with eye defects other than anophthalmia/microphthalmia, genitourinary defects, and musculoskeletal defects aside from limb defects.

In the majority of instances, the associations between particular illicit drugs and birth defects were found whether or not those cases involving use of multiple types of drugs were included.

Of the 14 significant associations between methamphetamine and specific birth defects, 10 (71.4%) remained once multiple drug cases were excluded. Corresponding rates were 61.5% (8 of 13) for cocaine and 81.0% (17 of 21) for marijuana.

The similarities in the patterns of birth defects with which methamphetamine, cocaine, and marijuana are associated might suggest that the three drugs exert similar effects on embryonic and foetal development. This might not be expected, considering that the three illicit drugs differ in their mechanisms of action and clinical effects (Leiken & Paloucek, 1998).

Some of the associations between methamphetamine, cocaine, and marijuana observed in the present investigation were previously reported. Other studies observed similar associations, or lack thereof, of methamphetamine or amphetamine with neural-tube defects (Shaw et al., 1996) and cardiovascular and musculoskeletal defects (McElhatton et al., 2000); cocaine with neural-tube defects (Shaw et al., 1996), cardiovascular defects (Lipshultz et al., 1991), ventricular septal defect and atrial septal defect (Ferencz et al., 1997c; Martin & Edmonds, 1991), tricuspid atresia (Ferencz et al., 1997d), craniosynostosis (Gardner et al., 1998), and situs inversus (Kuehl & Loffredo, 2002); and marijuana with neural-tube defects (Shaw et al., 1996), single ventricle (Steinberger et al., 2002), ventricular septal defect (Williams et al., 2004), tricuspid atresia (Ferencz et al., 1997d), and gastroschisis (Torfs et al., 1994).

In contrast, this study differed from other research with respect to their findings regarding methamphetamine or amphetamine and gastroschisis (Torfs et al., 1994); cocaine and microcephaly (Martin & Edmonds, 1991), conotruncal defects (Adams et al., 1989), endocardial cushion defect (Ferencz et al., 1997b), situs inversus (Ferencz et al., 1997a), oral clefts (Beatyet al., 2001), and genitourinary defects (Abe et al., 2003; Battin et al., 1995; Martin & Edmonds, 1991); and marijuana and conotruncal defects (Adams et al., 1989), Ebstein anomaly (Ferencz et al., 1997e; Correa-Villasenor et al., 1994), and oral clefts (Beaty et al., 2001).

The inconsistent findings between this and the other studies could be due to differences in study methodology, case classification, or number of cases. The mechanisms by which methamphetamine, cocaine, and marijuana might contribute to the rates for birth defects is currently unknown. Any potential explanation would have to take into account the observation that each of the illicit drugs was associated with a variety of specific birth defects affecting different organ systems. This might suggest that these three drugs would need to influence a basic, common factor involved in embryonic development.

Folic acid is involved in nucleic acid synthesis and cellular division (Scholl & Johnson, 2000) and thus would play an important role in the early growth and cellular proliferation of the embryo. Folic acid has been found to prevent a variety of birth defects (Forrester & Merz, 2005). Thus, anything that interferes with the activity of folic acid might be expected to increase the risk for these birth defects. Many of these birth defects were associated with methamphetamine, cocaine, and/or marijuana in the present study.

However, two of the birth defects most closely affected by folic acid—anencephaly and spina bifida—were not associated with any of the three illicit drugs. Vascular disruption has been suggested as a potential cause for a variety of different birth defects such as intestinal atresia/stenosis, limb reduction defects, and gastroschisis.

Since cocaine is a vasoconstrictor, it has been hypothesized that cocaine use could increase the risk of these vascular disruption defects (Hume et al., 1997; Martin et al., 1992; Hoyme et al., 1983; de Vries, 1980). Although this investigation found an association between cocaine and limb reduction deformities, no association was found with intestinal atresia/stenosis or gastroschisis.

In conclusion, this study found that prenatal use of methamphetamine, cocaine, or marijuana were associated with increased risk of a variety of birth defects. The affected birth defects were primarily associated with particular organ systems. Because of various limitations of the study, further research is recommended.

Source:  Journal of Toxicology and Environmental Health, Part A, 70: 7–18, 2007

St. Petersburg, FL – Thursday, August 31, 2017 – Drug Free America Foundation today introduced a first-of-its-kind Opioid Tool Kit in an effort to help address the opioid epidemic gripping the United States.

The Opioid Tool Kit was unveiled in conjunction with International Overdose Awareness Day, a global event held on August 31st each year that aims to raise the awareness of the problem of drug overdose-related deaths.

“With more than 142 people dying each day, drug overdoses are now the leading cause of death for Americans under the age of 50,” according to Calvina Fay, Executive Director of Drug Free America Foundation. “Moreover, deaths from drug overdose are an equal opportunity killer, with no regard to race, religion or economic class,” she said.

“While alcohol and marijuana still remain the most common drugs of abuse, the nonmedical use of prescription painkillers and other opioids has resulted in a crisis-level spike in drug overdose deaths,” said Fay.

The Opioid Tool Kit has been designed to educate people about the opioid epidemic and offer strategies that can be used to address this crisis. “The Tool Kit is also intended to encourage collaboration with different community sectors and stakeholders to make successful and lasting change,” Fay continued.

The Opioid Tool Kit is a comprehensive guide that defines what an opioid is, examines the scope of the problem, and addresses why opioids are a continuing health problem.  The Tool Kit also provides strategies for the prevention of prescription drug misuse and overdose deaths and includes a community advocacy and action plan, as well as additional resources.

Fay emphasized that the best way to prevent opioid and other drug addiction is not to abuse drugs in the first place.  “The chilling reality is that the long-term use and abuse of opioids and other addictive drugs rewire the brain, making recovery a difficult and often a life-long struggle,” she concluded. The Opioid Tool Kit can be found on Drug Free America Foundation’s website at https://dfaf.org/Opioid%20Toolkit.pdf.

Source:   https://dfaf.org/Opioid%20Toolkit.pdf..  August 2017

Background

On August 29, 2013, the U.S. Department of Justice (DOJ) issued guidelines to Federal prosecutors and law enforcement officials regarding where to focus their drug enforcement efforts in states that have passed laws legalizing the retail sales of marijuana. The so-called “Cole Memo” directs enforcement officials to focus resources, including prosecutions, “on persons and organizations whose conduct interferes with any one or more of [eight] priorities, regardless of state law.”

Per the memorandum, the eight DOJ priorities are:

● Preventing distribution of marijuana to minors

● Preventing marijuana revenue from funding criminal enterprises, gangs or cartels

● Preventing marijuana from moving out of states where it is legal

● Preventing use of state-legal marijuana sales as a cover for illegal activity

● Preventing violence and use of firearms in growing or distributing marijuana

● Preventing drugged driving or exacerbation of other adverse public health consequences associated with marijuana use

● Preventing growing marijuana on public lands

● Preventing marijuana possession or use on federal property

According to the Department of Justice, the Federal “hands-off” approach to marijuana enforcement enumerated in the Cole Memo is contingent on its expectation that “states and local governments that have enacted laws authorizing marijuana-related conduct will implement strong and effective regulatory and enforcement systems that will address the threat those state laws could pose to public safety, public health, and other law enforcement interests.

A system adequate to that task must not only contain robust controls and procedures on paper, it must also be effective in practice.”

Unfortunately, since Colorado and Washington became the first states to legalize the recreational sale of marijuana in 2012, evidence has emerged that regulations intended to control the sale and use of marijuana have failed to meet the promises made by advocates for legalization.

For example, states with legal marijuana are seeing an increase in drugged driving crashes and youth marijuana use. States that have legalized marijuana are also failing to shore up state budget shortfalls with marijuana taxes, continuing to see a thriving illegal black market, and are experiencing an unabated sales of alcohol, despite campaign promises from advocates promising that marijuana would be used as a “safer” alternative instead.

Moreover, state regulatory frameworks established post-legalization have failed to meet each of the specific DOJ requirements on controlling recreational marijuana production, distribution, and use.

While long-term studies and research on the public health and safety impacts of marijuana legalization are ongoing, this report provides a partial census of readily available information that demonstrates how Colorado, Oregon, and Washington State –

the jurisdictions with the most mature regulatory markets and schemes – have not fulfilled the requirements of the Cole Memo.

DOJ Guideline 1: “Preventing distribution of marijuana to minors”

● According to the nation’s largest and most comprehensive survey of drug use trends in the nation, past-month use of marijuana among 12 to 17-year-olds in Colorado increased significantly – from 9.82% to 12.56% after marijuana retail sales began (Colorado legalized marijuana in 2012 and implemented legal marijuana stores in 2014).

The same study notes that teens and adults in Colorado now use marijuana at a higher rate than the rest of the country. No other representative sample of drug users in Colorado has contradicted this sample.

● A 2017 study from the University of Colorado found that marijuana-related emergency room visits and visits to its satellite urgent care centers by teens in Colorado more than quadrupled after the state legalized marijuana.

● In Colorado, a new report from the state’s public safety agency reveals that after the state legalized the drug, marijuana-related arrests for black and Hispanic youth rose by 58% and 29% respectively, while arrest rates for white kids dropped by eight percent. School Resource Officers in Colorado have reported a substantial increase in marijuana-related offenses in Colorado schools after the state commercialized the drug.

● According to data from the State of Washington, there have been over 240 violations of legal marijuana sales to minors and of minors frequenting restricted marijuana sales areas as of July 2017. ● Youth use – among 8th and 10th graders at least – is increasing in Washington State. According to a special analysis of teenage drug use published in the peer-reviewed, highly regarded Journal of American Medical Association Pediatrics, the perceived  harmfulness of marijuana in Washington declined 14.2% and 16.1% among eighth and 10th graders, respectively, while marijuana use increased 2.0% and 4.1% from 2010-2012 to 2013-2015.

● According to the Washington State Office of the Superintendent of Public Instruction during 2013-2014, 48 percent of statewide student expulsions were for marijuana in comparison to alcohol, tobacco, and other illicit drugs. During the 2014-2015 school year, statewide student expulsions for marijuana increased to 60 percent. Marijuana related suspensions for the 2013-2014 school year reported 42 percent and for the 2014-2015 school year, suspensions increased to 49 percent.

● In Washington State, youth (12-17) accounted for 64.9% of all state marijuana seizures in 2015 as compared to 29.9% in 2010, according to data from the National Incident Based Reporting System (NIBRS).

● From 2012 to 2016, reported exposure calls for marijuana increased 105 percent in Washington. According to the 2016 Annual Cannabis Toxic Trends Report, of exposures related to children under the age of five, 73 percent occurred in those one to three years of age. The counties with the highest reported exposures for both 2015 and 2016 were: King, Spokane, Snohomish, and Pierce.

DOJ Guideline 2: “Preventing revenue of the sale of marijuana from going to criminal enterprises, gangs, and cartels”

● In June 2017, Colorado Attorney General Cynthia Coffman announced a takedown of a massive illegal marijuana trafficking ring in Colorado. The bust is the largest since legalization and indicted 62 individuals and 12 businesses in Colorado. The operation stretched into other states including Kansas, Texas, Nebraska, Ohio and Oklahoma.

● In March 2017, a leaked report from the Oregon State Police uncovered evidence from state officials that the black market for marijuana continues to thrive in the state. The 39-page report noted that, “The illicit exportation of cannabis must be stemmed as it undermines the spirit of the law and the integrity of the legal market…it steals economic power from the market, the government, and the citizens of Oregon, and furnishes it to criminals, thereby tarnishing state compliance efforts.”

Washington State Office of the Superintendent of Instruction. (2016, Jan. 26). Behavior Report. http://www.k12.wa.us/SafetyCenter/Behavior/default.aspx

Washington State Poison Center – Toxic Trends Report: 2016 Annual Cannabis Report

● In 2016, Seattle Police spokesman Sean Whitcomb noted that “large-scale illegal grow operations… are still prevalent in Seattle, and we do come across those with a degree of frequency.” DOJ Guideline 3: “Preventing the diversion of marijuana from states where it is legal under state law in some form to other states”

● In 2014, two states – Nebraska and Oklahoma – sued their neighbor state of Colorado by citing evidence of increased marijuana flowing into those states. Law enforcement officials have reported a substantial increase in marijuana flow across state borders into neighboring states.

● In 2016, there were multiple raids conducted by state law enforcement in Colorado, leading authorities to seize more than 22,0000 pounds of marijuana intended for sales outside of Colorado.

● According to the Oregon State Police, the state has an “expansive geographic footprint” on marijuana exports across the U.S. Several counties in Oregon including Jackson, Multnomah, Josephine, Lane, Deschutes and Washington “lead the way” in supplying marijuana to states where it is not legal.

● According to the Rocky Mountain High Intensity Drug Trafficking Area task force, “there were 360 seizures of marijuana in Colorado destined for other states. This is nearly a 600% increase in the number of individual stops in a decade, seizing about 3,671 pounds in 2014. Of the 360 seizures reported in 2014, 36 different states were identified as destinations, the most common being Kansas, Missouri, Illinois, Oklahoma and Florida.”

● Law enforcement officials report that since legalization in 2012, Washington State marijuana has been found to be destined for 38 different states throughout the United States. Between 2012 and 2017, 8,242.39 kilograms (18,171.35 pounds) have been seized in 733 individual seizure events across 38 states. From 2012 to 2016, 470 pounds of marijuana have been seized on Washington State highways and interstates. Since 2012, 320 pounds of Washington State-origin marijuana have been seized during attempted parcel diversions. DOJ Guideline 4: “Preventing state-authorized marijuana activity from being used as a cover or pretext for the trafficking of other illegal drugs or other illegal activity”

● According to Jorge Duque from the Colorado Department of Law, cartels operating in Colorado are now “trading drugs like heroin for marijuana,” and the trade has since opened the door to drug and human trafficking. Duque also explains that money 5 laundering is a growing problem as “cartels are often disguising their money through legally purchasing marijuana or buying houses and growing marijuana in it.”

● In June 2017, a former Colorado marijuana enforcement officer and a Denver-based marijuana entrepreneur were indicted for running a statewide marijuana trafficking ring that illegally produced and sold “millions of dollars worth of marijuana across state lines.” This trafficking organization obtained 14 marijuana licenses in order to present their activities as protected business endeavors, despite “never ma[king] a single legal sale of cannabis in their two years of operation.”

● In Oregon, State Police officials report that criminals are exploiting Oregon’s legal marijuana industry for financial crimes and fraud. In one example, according to the Oregon State Police report, “Tisha Silver of Cannacea Medical Marijuana Dispensary falsified licensing to solicit investors and worked with Green Rush Consulting to locate unwitting investors. Silver exploited the burgeoning cannabis industry in the state to entice investors to back an illegitimate company, securing a quarter of a million dollars in fraudulent gains. According to some analysts, cannabis investors fell prey to ‘pump and dump’ schemes and lost up to $23.3 billion in 2014 alone.”

● Officials in Oregon note that the U.S. Postal Service is being exploited to ship marijuana products and revenue. According to former Attorney General Eric Holder, “The Postal Service is being used to facilitate drug dealing,” a clear violation of federal law and a violation of the sanctity of the U.S. mailing system.

DOJ Guideline 5: “Preventing violence and the use of firearms in the cultivation and distribution of marijuana”

● While crime rates dropped or remained stable in many of the nation’s largest cities, Colorado’s crime rate increased. There has been an increase in rape, murder, robbery and auto thefts. While it is not possible to link legalization to a direct change in crime rates, officials in Colorado cited marijuana legalization as one of the reasons behind the rise.

● In Colorado, prosecutors are reporting an increase in marijuana-related homicides since the state legalized the drug.  This situation is detailed here: http://www.oregonlive.com/marijuana/index.ssf/2016/07/state_slaps_portland_dispensar.h tml.

Other instances of fraud have been discussed here: Sapient Investigations Newsletters (2015, Feb. 10) “High Times for Fraud,” available online at https://sapientinvestigations.com/spi-news/high-times-for-fraud/

● In Oregon, state police report that, “Cannabis is a lucrative target for robbery. As recently as December 2016, a state-licensed cannabis producer was targeted for a violent armed robbery. In the aforementioned case, a well-known cannabis grower in Jackson County was assaulted, bound, and his harvest was taken by armed assailants.”

● In Prince George’s County Maryland, Police Chief Henry Stawinski noted a significant rise in marijuana-related homicides since neighboring D.C. legalized the drug. Stawinski said 19 homicides in 2016 were related to marijuana.

DOJ Guideline 6:  “Preventing drugged driving and the exacerbation of other public health consequences associated with marijuana use”

● Drugged driving has increased in states with legal marijuana sales. According to a study published by the American Automobile Association, fatal drugged driving crashes doubled in Washington State after the state legalized marijuana. The Governors Highway Safety Association also notes a disturbing rise in drugged driving crashes even as alcohol-related crashes are declining.

● A Denver Post analysis found the number of marijuana-impaired drivers involved in fatal crashes in Colorado more than doubled since 2013, the year after the state voted to legalize recreational marijuana use. Colorado saw a 145 percent increase in the number of marijuana-impaired drivers involved in fatal crashes between 2013 and 2016. Marijuana is also figuring into more of Colorado’s fatal crashes overall: in 2013, marijuana-impaired drivers accounted for 10 percent of all fatal crashes, but by 2016 it reached 20 percent.

● According to a study published in the Annals of Emergency Medicine, poison control calls for children more than tripled after marijuana legalization. Much of this is linked to a boom in the sale of marijuana “edibles.” THC concentrate is mixed into almost any type of food or drink, including gummy candy, soda, and lollipops. Today, these edibles comprise at least half of Colorado’s marijuana market.

● In Washington State, the number of marijuana-involved DUIs are increasing with 38 percent of total cases submitted in 2016 testing above the five nanogram per milliliter of blood legal limit for those over the age of twenty-one. In addition, 10 percent of drivers involved in a fatal accident from 2010 to 2014 were THC-positive.

● A study by the Highway Loss Data Institute reveals that Colorado, Oregon, and Washington have experienced three percent more collision claims overall than would ( NWHIDTA Drug Threat Assessment For Program Year 2018)  have been expected without legalization.

Colorado witnessed the largest jump in claims. The state experienced a rate 14 percent higher than neighboring states.

● In Washington State, from 2012 to 2016, calls to poison control centers increased by 79.48%. Exposures increased 19.65% from the time of marijuana commercialization in 2014 to 2016. Of the marijuana calls answered by the Poison Center in 2016, youth under the age of 20 accounted for almost 40% of all calls.

According to the 2016 Annual Cannabis Toxic Trends Report, 42% of the calls reported were for persons aged 13 to 29. Additionally, among exposures related to children under the age of five, 73% involved children one to three years of age. The counties with the highest reported number of exposures for 2015 remained in the top four for 2016: King, Spokane, Snohomish, and Pierce.

DOJ Guideline 7: “Preventing the growing of marijuana on public lands and the attendant public safety and environmental dangers posed by marijuana on public lands”

● In Washington State, 373,778 marijuana plants were found growing illegally on public and private lands between 2012 and 2016. Of the illegal marijuana plants eradicated in 2016, 60% were being cultivated on state land, and the 58,604 illegal marijuana plants eradicated in 2016 consumed an estimated 43.2 million gallons of water over a full growing season (120-day cycle).

More than 400 pounds of fertilizers, chemicals, and pesticides were removed from illegal marijuana growing operations in 2016, and Furadan, a neurotoxin that is extremely dangerous to humans, was found in an illegal marijuana growing operation the same year.

● In June 2017, Colorado officials found more than 7,000 illegal plants on federal land in the state’s San Isabel National Forest. This was the fifth illegal grow found in that area alone since the year marijuana legalization passed, demonstrating legalization has not curbed the problem of grows exploiting public lands.

● In Oregon, the legalization of marijuana in the state has failed to eliminate illegal growing operations and public lands continue to be exploited despite a legal market. According to a report from state officials, “To date in Oregon, cannabis legalization has not had a noticeable influence on Mexican National [Drug Trafficking Organizations] illicit cannabis cultivation operations on public lands… leaving a lasting scar on Oregon’s unique ecosystems.

Illicit cannabis grows employ excessive amounts of pesticides, rodenticides, and herbicides, thereby threatening local wildlife habitats. Additionally, many illicit grow sites clear-cut timber, furthering soil erosion and water contamination. Research on the environmental impact of illicit cannabis grows indicates that grows tend to be bunched near water sources, resulting in disproportionate impacts on ecologically important areas…

Oregon is robbed of roughly 122 Olympic swimming pools 8 worth of water annually, or roughly 442,200 gallons of water daily during the growth season.”

DOJ Guideline 8: “Preventing marijuana possession or use on federal property”

● Advocates for legal marijuana frequently flout federal laws by possessing and using marijuana on federal properties purportedly in acts of civil disobedience. In January 2017, one group gave away free marijuana in Washington, D.C. to smoke on the National Mall during the inauguration of President Trump. On April 24, 2017, four activists were arrested after purposely flouting federal law and publicly using marijuana on U.S. Capitol grounds.

Conclusion and Key Recommendations

Federal resources should target the big players in the marijuana industry. Individual marijuana users should not be targeted or arrested, but large-scale marijuana businesses, several of which now boast of having raised over $100 million in capital, and their financial backers, should be a priority. These large businesses are pocketing millions by flouting federal law, deceiving Americans about the risks of their products, and targeting the most vulnerable.

They should not have access to banks, where their financial prowess would be expanded significantly, nor should they be able to advertise or commercialize marijuana.

These businesses target many of the marijuana products they sell toward kids, such as pot candies, cookies, and ice cream. And despite state regulations, these products continue to have problems with contamination. Recently, one of the largest, most sophisticated manufacturers of these pot “edibles” was forced to recall a number of products because they contained non-food-grade ingredients.

Additionally, the black market continues unabated in legalized states. A leaked report from Oregon police showed that at least 70 percent of that state’s marijuana market is illegal, despite legalization. In June 2017, Colorado Attorney General Cynthia Coffman said, “The black market for marijuana has not gone away since recreational marijuana was legalized in our state, and in fact continues to flourish.”

Further, state-legal businesses have acted as top cover for these illegal operations, as recent large-scale arrests in Colorado have shown. These large marijuana operations, which combine the tactics of Big Tobacco with black marketeering, should form the focus of federal law enforcement, not individual users.  Recalls are becoming more commonplace because of pesticides, moulds, and other issues.

See The Denver Post for news stories related to these recalls in legalized states: http://www.thecannabist.co/tag/marijuana-recall/

At the same time, the federal government along with non-government partners should implement a strong, evidence-based marijuana information campaign, similar to the truth ® campaign for tobacco, which alerts all Americans about the harms of marijuana and the deceitful practices of the marijuana industry.

Arrests are up. We still have a black market. And people are in danger.

Last week, Senator Cory Booker introduced the Marijuana Justice Act in an effort to legalize marijuana across the nation and penalize local communities that want nothing to do with this dangerous drug. This is the furthest reaching marijuana legalization effort to date and marks another sad moment in our nation’s embrace of a drug that will have generational consequences.

Our country is facing a drug epidemic. Legalizing recreational marijuana will do nothing that Senator Booker expects. We heard many of these same promises in 2012 when Colorado legalized recreational marijuana.

In the years since, Colorado has seen an increase in marijuana related traffic deaths, poison control calls, and emergency room visits. The marijuana black market has increased in Colorado, not decreased. And, numerous Colorado marijuana regulators have been indicted for corruption.

In 2012, we were promised funds from marijuana taxes would benefit our communities, particularly schools. Dr. Harry Bull, the Superintendent of Cherry Creek Schools, one of the largest school districts in the state, said, “So far, the only thing that the legalization of marijuana has brought to our schools has been marijuana.”

In fiscal year 2016, marijuana tax revenue resulted in $156,701,018. The total tax revenue for Colorado was $13,327,123,798, making marijuana only 1.18% of the state’s total tax revenue. The cost of marijuana legalization in public awareness campaigns, law enforcement, healthcare treatment, addiction recovery, and preventative work is an unknown cost to date.

Senator Booker stated his reasons for legalizing marijuana is to reduce “marijuana arrests happening so much in our country, targeting certain communities – poor communities, minority communities.” It’s a noble cause to seek to reduce incarceration rates among these communities but legalizing marijuana has had the opposite effect.

According to the Colorado Department of Public Safety, arrests in Colorado of black and Latino youth for marijuana possession have increased 58% and 29% respectively after legalization. This means that Black and Latino youth are being arrested more for marijuana possession after it became legal.

Furthermore, a vast majority of Colorado’s marijuana businesses are concentrated in neighborhoods of color. Leaders from these communities, many of whom initially voted to legalize recreational marijuana, often speak out about the negative impacts of these businesses.

Senator Booker released his bill just a few days after the Washington Post reported on a study by the Review of Economic Studies that found “college students with access to recreational cannabis on average earn worse grades and fail classes at a higher rate.” Getting off marijuana especially helped lower performing students who were at risk of dropping out.

Since legalizing marijuana, Colorado’s youth marijuana use rate is the highest in the nation, 74% higher than the national average, according to the Rocky Mountain High Intensity Drug Trafficking Area Report. This is having terribly negative effects on the education of our youth.

If Senator Booker is interested in serving poor and minority communities, legalizing marijuana is one of the worst decisions. There is much work to be done to reduce incarceration and recidivism, but flooding communities with drugs will do nothing but exacerbate the problems.

The true impact of marijuana on our communities is just starting to be learned. The negative consequences of legalizing recreational marijuana will be felt for generations. I encourage Senator Booker to spend time with parents, educators, law enforcement, counsellors, community leaders, pastors, and legislators before rushing to legalize marijuana nationally. We’ve seen the effects in our neighborhoods in Colorado, and this is nothing we wish upon the nation.

Jeff Hunt is the Vice President of Public Policy at Colorado Christian University. Follow him on Twitter: @jeffhunt.

Source:  https://www.usatoday.com/story/opinion/2017/08/07/marijuana 

The Advocates for Substance Abuse Prevention (ASAP) coalition serves the top two counties of the northern panhandle of West Virginia. The coalition got creative and utilized trending youth activities to draw youth to prevention work.

The coalition is located only a half hour from Pittsburgh, PA, and roughly three hours from Columbus, Ohio.  Based on a 2015 United States Census, the total population served is 53,165 combined for Brooke and Hancock counties.  One of the largest cities, Weirton, resides in both counties and has always had a proud tradition of steel making and industrial employment.  Unfortunately, this tradition has seen many declines in recent years and the increase in unemployment has hit the area hard, causing many families and young adults to move or have long commutes to find decent work.

Hancock County borders a major interstate where drug trafficking occurs easily between three states.  The local news reports multiple drug arrests in the Ohio Valley almost daily with incidents involving drug trafficking, abuse, and death, as is illustrated by the story of four heroin overdoses in Weirton in one weekend.  The ASAP coalition started as a small committee who met to discuss the drug problems in the area in 1996 and grew to where they are today.  The coalition’s main focus remains towards community youth with the mission of “working together to reduce substance abuse in the Brooke and Hancock communities, focusing on youth and families, by means of prevention efforts in community education, mobilization, and the change of values and beliefs.”

In 2014, ASAP found a group of youth to form a new committee called the Youth Council.  Thanks to these youth, they have gained new insight about how they should be hosting and promoting alternate activities to community youth, and actually get them to participate.  They have seen a vast increase in participation at events targeted towards youth. One such activity, that has become an instant hit, is the ASAP Youth Council Video Game Tournament.

Youth focused activities are hard for any group, but thanks to the ASAP Youth Council, the coalition has been having success getting youth involved.

“Their input is invaluable, and when you have youth telling you “don’t advertise you are doing drug prevention to kids or they won’t come,” you listen,” said Mary Ball, ASAP Coordinator. “Their ideas were simple, focus on what kids like to do, then use that as a way into their world.  So, we did.  The first event we held was a video game tournament that we used for multiple purposes.  First, it was a great fundraiser for the kids.  Second, it was the perfect draw to get youth to show up.  Third, it was fun!  We chose a game everyone, young and old could play (Smash Bros.) and changed how we promoted the event to word-of-mouth, flyers where kids hang out, and utilized social media promotions.  The response was amazing.  But nothing in the advertising said anything about substance abuse prevention.  We had over 50 attendees at our first event, which was a small miracle compared to the 10-12 we normally got, if we were lucky.“

To incorporate the message of prevention, displays were placed at the event and announcements dispersed, reminding attendees about the dangers of sharing prescriptions; where to dispose of prescriptions; and pointing out how much fun they were having at an alcohol-free event.

The event not only drew youth, but the parents, friends, grandparents of the youth who participated, did not leave.  They stayed for the entire thing to cheer those competing in the tournament on, expanding the audience from the target of just youth, to all ages.  The success of this program led the coalition to try other things, such as taking advantage of the Pokémon Go game to bring people to ASAP by hosting a “Lure Party.”  The coalition got creative and added a cosplay contest to the video game tournament and increased participation by almost 10 percent. The coalition even designed pop culture prevention buttons that kids snag off the prevention tables because they want to wear that message.

“Listen to your youth members.  They are smart, they know what other kids want to see and will participate in,” advises Ball. “Do not be closed off to stepping out of your adult-zone and entering their world.  If we want kids to listen to our messages, we need to go to them and not expect them to come to us.”

Source: http://www.cadca.org/resources/coalitions-action-asap-coalition-uses-smash-creativity-engage-youth   8th Aug.2017

Kevin Sabet, the president and CEO of Virginia-based Smart Approaches to Marijuana, has become arguably the most influential critic of marijuana legalization in the United States. But in an extended interview on view below, he fights against the perception that he’s a one-dimensional prohibitionist along the lines of U.S. Attorney General Jeff Sessions.

Sabet stresses that he and his organization, shorthanded as SAM, take what he sees as a sensible approach to cannabis by arguing in favor of treatment rather than jail time for users in trouble and advocating for greater study of the substance to determine the best ways to utilize it medically.

We first spoke to Sabet in January 2013, just prior to SAM’s launch in Denver, when he appeared alongside co-founder Patrick Kennedy, a former congressman from Rhode Island and a member of the Kennedy political dynasty. Sabet’s background is similarly stocked with connections to heavyweights. The author of Reefer Sanity: Seven Great Myths About Marijuana, he served stints in the Clinton and Bush administrations and spent two years as senior adviser to President Barack Obama’s drug-control director before taking on the SAM cause.

In the more than four years since then, he’s made countless media appearances while lobbying behind the scenes to try and stop the momentum generated by the pot legalization bandwagon.

Sabet, who says SAM’s funding mainly comes from small donors and grants as opposed to hard-core drug-war groups or Big Pharma, doesn’t think it’s too late to accomplish this goal, in part because only a relatively small percentage of the populace actually uses marijuana. Moreover, he feels that plenty of those who abstain will more actively fight against pot’s normalization if public use (and its attendant smoke and scent) becomes more prevalent in cities such as Denver, which he sees as having been demonstrably harmed by legalization. He blames cannabis for turning the 16th Street Mall into a homeless haven that visitors actively avoid and suspects that in his heart of hearts, Governor John Hicklenlooper knows legalization was a terrible mistake but can’t admit it publicly because the right to toke is enshrined in the state constitution.

Likewise, Sabet considers it inarguable that the marijuana industry is targeting young people with colorfully packaged pot edibles and argues that simply keeping cannabis away from kids isn’t enough. He cites studies showing that the brains of 25-30 year olds are still developing — and can still be harmed by weed.

Continue to learn more about Sabet’s cause and the arguments he makes to support it.

Westword: SAM recently put out a release about the amount of tax revenue Colorado has collected as a result of the marijuana industry [in reference to a VS Strategies report estimating that the state has generated more than $500 million in cannabis revenue since legalization]. In it, you talk about how drug use and its consequences cost taxpayers $193 billion per year, with Colorado’s annual share being approximately $3.3 billion. But that’s for all drugs, correct?

Kevin Sabet: Oh, yeah, absolutely. But you need to look at the fact that marijuana is used far more than any of the other drugs, and look at the costs associated with driving, crashing, mental illness — and long-term costs we’re not able to account for. Marijuana isn’t correlated with mental illness overnight. If often takes time. And so the cost of that can’t be calculated in any way. There was a study done a few weeks ago by the Canadian Centre on Substance Abuse and Addiction finding that just in

Canada alone, a much smaller country than the U.S. in population, marijuana-related car crashes cost a billion dollars. That’s just the car crashes, and those were directly related to marijuana. And the report came from a government think tank, not any kind of anti-drug group.

I honestly think it isn’t surprising coming from this group [VS Strategies]. It’s an industry group that wants to basically make money from marijuana — much more money than the State of Colorado will make after you account for costs. When you look at the actual number and context of just education alone, the marijuana revenue is barely newsworthy. The Department of Education in Colorado says they need $18 billion in capital construction funds alone. The reality is, the Colorado budget deficit is actually rising, not falling. This isn’t plugging a hole in the deficit. It’s actually costing money. There’s one area where I’d agree with [former Colorado Director of Marijuana Coordination] Andrew Freedman: You don’t do this for the money. But it’s a great talking point, and it polls well, just like the talking point of it being safer than alcohol polls well. This polls well, too, so you’re going to have an industry group that thrives off commercialization touting the numbers. That’s not surprising at all.

SAM is usually described as an anti-marijuana organization. Is that an accurate description from your viewpoint? Or is it pejorative in some way?

I wouldn’t necessarily say it’s pejorative, but I think it’s overly simplistic. It’s true that we don’t want to see the legalization of another illegal substance. We think that our experience with pharmaceuticals, which are, of course, legal, as well as alcohol and tobacco, has been an utter disaster from a public cost and public-policy point of view. We’ve never regulated those drugs in a responsible way. Lobbyists and special interests own the rule-making when it comes to these drugs. And what we’re saying is, do we really want to repeat history once again? It just happens to be marijuana. It really could have been any substance. And we will be talking about the legalization of other drugs if marijuana goes through. Because it doesn’t stop with marijuana in terms of the policy goals of many of these organizations. So I think it is overly simplistic. And we’re very concerned about commercialization.

Also, we don’t want to see a return to an enforcement-heavy policy that throws everybody behind bars or saddles young people, especially, with criminal records that prevent them from getting a job or being able to access public benefits or being able to go to school. We want to see people given another chance. But we also want to see this treated as a health issue, and you don’t treat marijuana as a health issue by ignoring it or facilitating its use. You do brief interventions if they’re needed, treatment if it’s needed. I don’t think everyone who uses marijuana needs treatment, just like everyone who drinks or uses other drugs doesn’t need treatment. But some people are using it in a way that is problematic, and they need an early intervention, perhaps, to prevent them from moving on to a substance-use disorder — or they need more intense treatment. It really just depends.

We also want to see research into components of marijuana that may have therapeutic value. We don’t want to see people needlessly suffering. But if Perdue Pharma or Pfizer said tomorrow that they have a new blockbuster drug but they don’t want it to go through the FDA and instead want to put it up to a vote, we’d be up in arms. And rightfully so. Everybody would be up in arms. And we don’t think marijuana should get a free pass because there are stories of it helping people. I don’t doubt that it helps some people — things like cannabidiol oil, etc., or even smoking marijuana to relieve pain. I don’t doubt that it helps some people. But we don’t want to turn back the clock to pre-FDA days, where we had snake-oil salesmen and wild claims about drugs. We want to put it through the same system, and if that system is problematic and difficult, then let’s look at what those barriers are and resolve them.

So I think we are a sensible organization that takes our cues from science. That’s why, on our board, you don’t see people benefiting from the policy position that we take. If anything, people like the doctors from Boston Children’s Hospital who are on our advisory board, or Harvard professors, they’re going to have more business if marijuana is legal, because they’re going to have people with more problems. We’re working counter to their self-benefit, if you think about it. That’s why we’re led by the science. And the reason we started this…. I left the White House and saw there was a huge disconnect between the public’s understanding of marijuana and what was being told to them by various sources, and we’re trying to bridge that gap. Many of the things you just touched upon are on the four items in the “What We Do” section of your website. But some things, such as “To promote research on marijuana in order to obtain FDA-approved, pharmacy-based cannabis medications,” we don’t hear your organization talking about very often. Is that the fault of the media, because they’re only focusing on the legalization-is-bad angle? Are you giving equal weight to some of these other goals?

I think that’s just people looking through the glasses they want to look through. I think the legalization groups are threatened by a sensible organization led by Harvard doctors that doesn’t want to put people in prison, so they want to paint us as the most irrational dinosaurs from the Stone Age on these issues. The reality is, we spend a lot of our time on all of these issues. In fact, we have released the most comprehensive document that any policy organization has released, I think, on the hurdles of medical marijuana research. That’s right on our website — the six-point plan. And we’ve also done a CBD guide — everything you need to know about CBD. After the guide to everything you need to know about CBD, we did a report on research barriers, and we got a lot of people from both extremes that didn’t like it. John Walters, my former boss, wrote a scathing editorial, saying we were off the mark in calling for more research. When we get criticized from multiple angles, I think people can decide for themselves whether that’s credible or not….

It’s just not sexy, though. I can’t remember the last time that someone from USA Today or Huffington Post said, “Oh, we want to cover the fact that you released a wonky policy document aimed at FDA senior scientists with ten letters after their name.” They’re not banging on the door to get that story. Instead, they’re banging on the door to say, “The governor of Nevada has just declared a state of emergency on pot. What do you think?”

I’m not going to say it’s the fault of the media. I think that’s overused these days. But we’re doing our best, and whether it’s noticed by USA Today or the Huffington Post or the Washington Post or not, that doesn’t matter as much. We’re getting it out there, and I know that hundreds of lawmakers have read it. In fact, three out of our six recommendations have been adopted since we released that report. I don’t think we’re the only reason they’ve been adopted, but I think us pushing and prodding and putting it down on paper gave some political cover to some people who may not have supported it in the past, and I’m very proud of that. I know it doesn’t satisfy Medical Marijuana Inc. or these hundreds of CBD manufacturers who are selling God knows what because they don’t get it looked at by the FDA; they’re not going to be happy about that. But I think the science speaks for itself, and scientists and others have noticed. That’s why they’ve asked to join my advisory board — top researchers who want to be part of this team not because we’re zealots, but because we look at the science and are able to get it out there….

Another of the talking points on your website says, “Alcohol is legal. Why shouldn’t marijuana be legal?” How do you answer that question?

To me, saying, “Alcohol is bad and it’s legal, so why shouldn’t marijuana be legal?” is like saying, “My headlights are broken, so why don’t we break the taillights, too?” It doesn’t make much sense. First of all, alcohol and marijuana are apples and oranges in many ways. They’re different just because of their biology and their pharmacology, but they’re also different in their cultural acceptance and prevalence in Western society. Alcohol has been a fixed part in Western civilization since before the Old Testament. The reason alcohol prohibition didn’t work — and that’s debatable….

What’s the debate?

If you look at scholars who studied Prohibition much more than I have, there is a vigorous debate. Alcohol use fell during Prohibition, harm fell as well. Cirrhosis of the liver, which is a top-ten killer of white men, wasn’t a top-ten killer. Organized crime had been in place, and obviously it was strengthened from Prohibition, although it isn’t like it caused it, and it certainly didn’t go away when Prohibition ended…. But it’s very difficult to prohibit something that 60 to 70 percent of the population are doing on a regular basis. Marijuana is still used by fewer than 10 percent of the population monthly, and so the idea that it’s the same in terms of acceptance is wrong. Right now, those 10 percent of users have convinced 55 percent of Americans that this is a good idea.  HOW

That also points to the fact that I think support for marijuana is very soft. I think the industry has overplayed its hand about things like public nuisance, public use, secondhand smoke, car crashes. Once these things become greater in prevalence, which they inevitably will if more states legalize and commercialize, then I think you’re going to have the backlash I think will come, and it will come because of the increased problems….

Alcohol is such an accepted part of society. We accept the negative consequences. Alcohol is not legal because it’s safe. Alcohol isn’t legal because it’s so good for you. Alcohol is legal because it’s been a fixed part of Western civilization for millennia. Marijuana has not been. Of course it was used thousands of years ago. Was it used by certain cultures? Absolutely. But there’s no comparison, complete apples and oranges, when it comes to alcohol’s culture acceptability. So that’s why alcohol is legal — not because we love the effects it has on society. No parent, no teacher, no police officer, says, “I’d be better if I was drinking all the time.” No police officer says, “Man, I wish more people drank.” No parent says, “I wish my kid drank more.” That’s not why it’s legal, because it’s so great.

And alcohol has done very little for our tax base. One of the reasons Prohibition was repealed was because the industrialists were convinced that it would help eliminate or mitigate the corporate tax or even the personal income tax. That’s laughable today. It doesn’t do that at all. Instead it costs us way more money than any revenue we bring in. I think marijuana would be the same story. It affects our bodies differently.

Alcohol affects the liver, marijuana affects the lungs. Alcohol is in and out of your system quite rapidly, but marijuana lingers in the system longer, and according to studies, the effects also linger for longer. They affect different parts of the brain. So they’re different in many ways, but in some respects, they’re the same. They’re both intoxicants, and unlike tobacco, they specifically cause changes in behavior. And that’s a difference with tobacco, another legal drug. Tobacco isn’t correlated with paranoia or obsessiveness or mental illness and car crashes, and obviously, marijuana is.

In some ways, legal drugs offer an interesting example. I think they offer an example of the sort of social and financial consequences that would come with legalizing other drugs.

Source:  http://www.westword.com  14th August 2017

Just a few miles from where President Trump will address his blue-collar base here Tuesday night, exactly the kind of middle-class factory jobs he has vowed to bring back from overseas are going begging.

It’s not that local workers lack the skills for these positions, many of which do not even require a high school diploma but pay $15 to $25 an hour and offer full benefits. Rather, the problem is that too many applicants — nearly half, in some cases — fail a drug test.

The fallout is not limited to the workers or their immediate families. Each quarter, Columbiana Boiler, a local company, forgoes roughly $200,000 worth of orders for its galvanized containers and kettles because of the manpower shortage, it says, with foreign rivals picking up the slack.

“Our main competitor in Germany can get things done more quickly because they have a better labor pool,” said Michael J. Sherwin, chief executive of the 123-year-old manufacturer. “We are always looking for people and have standard ads at all times, but at least 25 percent fail the drug tests.”

Source:   https://mobile.nytimes.com/2017/07/24/business/economy/drug-test-labor-hiring.html

Legalizing marijuana not only harms public health and safety, it places a significant strain on local economies and weakens the ability of the American workforce to compete in an increasingly global marketplace.

Today, a growing class of well-heeled lobbyists intent on commercializing marijuana are doing everything they can to sell legal weed as a panacea for every contemporary challenge we face in America. Over the past several years we’ve been barraged by claims that legal pot can cure the opioid crisis, cure cancer, eliminate international drug cartels, and even solve climate change.

One seemingly compelling case made by special interest groups is that legal marijuana can boost our economy too: after all, marijuana businesses create jobs and bring in millions of dollars in much-needed tax revenue.

Yet, a closer look at the facts reveals a starkly different reality. The truth is, a commercial market for marijuana not only harms public health and safety, it also places a significant strain on local economies and weakens the ability of the American workforce to compete in an increasingly global marketplace.

We already know that drug use costs our economy hundreds of millions of dollars a year in public health and safety costs. The last comprehensive study to look at costs of drugs in society found that drug use cost taxpayers more than $193 billion – due to lost work productivity, health care costs, and higher crime. A new study out of Canada found that marijuana-impaired driving alone costs more than $1 billion. Laws commercializing marijuana only make this problem worse and hamper local communities’ ability to deal with the health and safety fallout of increased drug use.

“So far in Colorado, marijuana taxes have failed to shore up state budget shortfalls. The budget deficit there doubled in the last few years, despite claims that pot taxes could turn deficit into surplus.”

This isn’t just a theory – it’s already happening. As marijuana use has increased in states that have legalized it, so has use by employees, both on and off the job. Large businesses in Colorado now state that after legalization they have had to hire out-of-state residents in order to find employees that can pass a pre-employment drug screen, particularly for safety-sensitive jobs like bus drivers, train operators, and pilots.

And now drug using employees – supported by special interest groups – are organizing to make drug use a “right” despite the negative impacts we know it will have on employers and the companies that hire them.

And what about that promised tax revenue? So far in Colorado, marijuana taxes have failed to shore up state budget shortfalls. The budget deficit there doubled in the last few years, despite claims that pot taxes could turn deficit into surplus.

Collected pot taxes only comprise a tiny fraction of the Colorado state budget— less than one percent. After costs of enforcement and regulation are subtracted, the remaining revenue used for public good is very limited.

Even viewed solely in the context of Colorado’s educational needs, pot revenue is not newsworthy. The Colorado Department of Education indicates their schools require about $18 billion in capital construction funds alone. Marijuana taxes do not even make a dent in this gap.

In Washington State, half of the $42 million of marijuana tax money legalization advocates promised would reach prevention programs and schools by 2016 never materialized. We’ve seen this movie before: witness our experience with gambling, the lottery, and other vices.

We should also care about the human fallout of increased marijuana acceptance. Recent evidence demonstrates that today’s marijuana isn’t the weed of the 1960s. It is addictive and harmful to the human brain, especially when used by adolescents.

Moreover, in states that have already legalized the drug, there has been an increase in drugged driving crashes and youth marijuana use. States that have legalized marijuana also continue to see a thriving black market, and are experiencing a continued rise in alcohol sales despite arguing users will switch to a “safer” drug.

Over the past several months, the Trump Administration has signaled it is considering a crackdown on marijuana in states where it is legal. We don’t yet know what this policy change may look like, but one thing we know for sure is that incarcerating low-level, nonviolent offenders in federal prisons is not the answer. Individual users need incentives to encourage them to make healthy decisions, not handcuffs.

But we do need to enforce federal law. Indeed, by reasserting federal control over the exploding marijuana industry, we know we can make a positive difference in preventing the commercialization of a drug that will put profits over public health and fight every regulation proposed to control its sale and use. Marijuana addiction is real, and simply ignoring this health condition will only cost us down the road. We should assess marijuana users for drug use disorders as well as mental health problems, and assist those into recovery. This can’t happen in a climate that promotes use.

Source:  http://www.cnbc.com/2017/07/27/trump-should-crackdown-on-legal-weed-commentary.html

As the U.S. is facing its most challenging drug epidemic in history, the need to prevent adolescence drug misuse is imperative. For the past two years, Mentor Foundation USA and George Washington University have piloted an innovative drug prevention peer-to-peer initiative at three high schools in Columbia County, NY. The program, which engages youth through social media is showing some promising results in terms of shifts in attitudes towards drugs and intent to use.

The interactive “multi-media” initiative is called Living the Example (LTE), a program that incorporates messages for prevention specifically designed to counteract the misinformation adolescents have about drugs and alcohol.  Messages are framed to promote the benefits of prevention behaviors. “This approach to branding, an alternative, healthy behavior, or ‘counter-marketing’ as it has been termed in tobacco control, has been highly effective and is recognized as one of the main elements in successful prevention programs, such as in tobacco control,” says Principal Investigator, Dr. Doug Evans, a pioneer in the use of this strategy. Dr. Evans is a Professor of Prevention and Community Health & Global Health, with Milken Institute School of Public Health at George Washington University.

Youth Ambassadors are trained to create LTE branded prevention messages, disseminate them via social media platforms, and engage peers in their preferred social networks, with the intention of increasing peer interaction around the brand’s core messaging.  Positive receptivity to LTE messages was associated with some evidence of reduced self-reported drug use intentions, specifically for marijuana use, and reports of intent to use any drug. Among youth who reported exposure and receptivity to LTE, they reported a significant decrease in marijuana use intentions. The most common overall reason for drug use among all respondents was family stress (81.3%), boredom (40%) and academic stress (40%).

“Findings from the study suggest that peer-to-peer substance use prevention via social media is a promising strategy, especially given the low cost and low burden as an intervention channel, which schools, communities, and prevention programs can use as an approach, even in low resource settings,” says Michaela Pratt, President of Mentor Foundation USA. “Through our international network, Mentor Foundation shares over 20 years of global experience in best prevention practices, and Mentor Foundation USA has always been a pioneer in empowering young people to become their own advocates for drug prevention.”

This program was generously supported by The Conrad N. Hilton Foundation, Rip Van Winkle Foundation, among local foundations in Columbia County. Mentor Foundation USA is a member affiliate of Mentor International, which was founded in 1994 by Her Majesty Queen Silvia of Sweden and the World Health Organization and is the largest network of its kind for evidence based programs that prevent drug abuse among youth. Collectively, Mentor has implemented projects in over 80 countries impacting more than 6 million youth.  Mentor Foundation USA is a Delaware registered 501(c)3 non-profit organization.

SOURCE http://www.prnewswire.com/news-releases/200-dc-high-school-students-shatter-the-myths-around-substance-abuse-in-an-innovative-proven

Blue Cross Blue Shield issued a report on the opioid crisis with their data from all members in their commercial plans.  Early in the document, they report a pair of striking numbers.

First, that 21% of members filled a prescription for an opioid in 2015. I’ve heard these kinds of numbers before, but I never get numb. That’s 1 in 5 members, despite growing attention to excessive prescribing of opioids.

Second, a 493% increase in diagnosis of opioid use disorders over 7 years. My reaction is that this has to reflect changes in coding or diagnostic practices rather than the population. It’s implausible that there was an increase this large in the number of people with an opioid use disorder.

The document then devotes a great deal of attention to opioid prescribing.

Toward the end, there are a couple of graphics that caught my attention.

First, a map showing rates of opioid use disorders.

 

Then, this:

Though critical to treating opioid use disorder, the use of medication-assisted treatments (e.g., methadone) does not always track with rates of opioid use disorder (compare Exhibits 10 and 11). For example, New England leads the nation in use of medication-assisted treatments but it has lower levels of opioid use disorder than other parts of the country

 

So . . . they note that New England has average rates of opioid use disorders, yet they have high rates of utilization of medication-assisted treatment. This caught my attention because New England has higher rates of overdose, as depicted in the CDC graphics below.

Number and age-adjusted rates of drug overdose deaths by state, US 2015

 

Statistically significant drug overdose death rate increase from 2014 to 2015, US states

(It’s worth noting that BCBS is not among the top 3 insurers in Maine or New Hampshire, but they are the biggest in Massachusetts and Vermont.)

It begs questions about what the story is, doesn’t it?

I don’t presume to know the answers.

§ What was the sequence of events for the high OD rates and the utilization of MAT? And, what impact, if any, has the expansion of MAT had on overdose rates?

§ Is the BCBS data representative? (This brand new SAMHSA report suggest that the data about use is representative.)

§ We know that opioid maintenance meds reduce risk of OD, but we also know that people stop taking these meds at high rates. Does this imply that, in the real world, these meds end up providing less OD protection than hoped?

§ What are the policies and practices of the other insurers in the state?  (For example, we know that Anthem [the largest insurer in Maine and Vermont] recently ended prior authorization requirements for MAT. It’s not clear how restrictive they had been. They also are attempting to institute reformsto address the fact that, “only about 16 to 19 percent of the members taking the medications for opioid use disorder also were getting the recommended in-person counseling.”)

§ Are there regional differences in drug potency that explain this?

Let’s hope that more insurers follow suit and share their data.

Source:   https://addictionandrecoverynews.wordpress.com/2017/07/16/blue-cross-blue-shield-publishes-major-opioid-report/

 

In the first 5 months of this year,  nine children had been treated at the Colorado Children’s Hospital in Aurora for ingesting marijuana.  Seven of these children were in intensive care.    By August, at least 3 more children had been in emergency treatment for marijuana at the same hospital.

The first stores for recreational marijuana opened in January, 2014.  Marijuana overdoses in children began October, 2009, when medical marijuana suddenly exploded in Colorado.  There were no such incidences recorded between 2005 and 2009, according to Dr.George Wang, head of emergency services at Colorado Children’s Hospital.  He explained the problem in a Colorado Public Radio interview last year.   Colorado’s medical marijuana was approved by voters in 2000, but the expansion of medical marijuana in 2009 caused the new problem.  The pace doubled this year, as a commercialized marijuana industry started selling new products.  “Legalizing creates greater promotion…. and also legitimizes the drug,” according to Bob Doyle, who was featured in a video we shared.

In response to two deaths from edible marijuana, the governor signed legislation to regulate marijuana in May.  The laws will go into effect in 2016.  Edible pot will require child-proofing, as is required for pharmaceutical and over-the-the-counter medicine.

Despite labels, many of the children who have been hospitalized were too young to read.

A TV investigation showed that most children can’t tell the difference between the “adult candies” and those that are only for children.  Previously, we published pictures of commercial pot candies available in Colorado, and in California.  Here’s an additional sampling.

Even when parents try to keep it away from them, children go for sweets.  Cartoon-like characters and bright colors will always attract children.   It’s logical that school-age children could be so attracted to the packaging that they would not bother to read.

Both the manufacturing of marijuana sweets and the packaging make them so appealing.  Edible pot processors make products that closely imitate familiar products, like Cap’N Crunch cereal and Pop Tarts. One company’s Pot-tarts are hard to distinguish from Kellogg’s Pop-tarts.

The Hershey Co. has filed a trademark infringement lawsuit against Tincture Belle, a Colorado marijuana edibles company, claiming it makes four pot-infused candies that too closely resemble iconic products of the chocolate maker.

The specific products which mimic the look of Hershey’s candies are: Ganja Joy, like Almond Joy; Hasheath, which looks like Heath Bars; Hashees which resemble Reese’s peanut cups, and Dabby Patty, made to look like York peppermint patties.  The company’s website says its products “diabetic safe and delicious” and helpful with a variety of issues, including pain, headaches and insomnia.

Hershey says the products are packaged in a way that will confuse consumers, including children. The lawsuit alleges that Tincture Belle “creates a genuine safety risk with regard to consumers” who may inadvertently eat them thinking they are ordinary chocolate candy.   Other pot candies that look like Kit Kats, Milky Ways, Nestle’s Crunch and Butterfingers.  Will other candy companies like Nestles or Mars file a lawsuits, also?

Source:  http://www.poppot.org/2014/08/24/new-marijuana-candy-tricks-kids/

Today’s Reality

Even if you smoked pot 20+ years ago without harm, today’s situation is different.  We want our children to avoid marijuana because they care about the risks in marijuana itself.

Here’s the facts for raising your children today:

* Marijuana has been modified since 1994. The THC, which gives the high, is 3-10x stronger in the plants of today.  If a child begins using today’s pot , it’s like to learning to drink with grain alcohol, instead of beer or wine.  Also, youth today frequently use the potent “dabs” “wax” and “budder.”  These are extractions can have 40-80% THC.

* Marijuana is addictive, contrary to a popular myth, particularly with today’s stronger strains of pot.

* In states with medical marijuana, teen usage is much higher than in other states, and many teens who use pot get it from some marijuana cardholders.

* Those who begin in adolescence or their teens, have an addiction rate of 17 percent, as opposed to 9 percent for those who begin using marijuana as an adult. *Emergency Department hospitalizations from marijuana rose from 281,000 to 455,000 between 2004 and 2011, making it 2nd amongst the illegal drugs causing ER treatment.

* Individuals responses to marijuana can be vary greatly, and the potential for paranoia and psychotic reactions are real side effects, omitted in the pot propaganda.

* Marijuana is fat soluble and stays in the body for weeks, which is why some people have flashbacks.

* The  brain, which is 1/3 fat, isn’t fully developed until age 25 or later, and until it is, marijuana can cause irreversible damage.

* Marijuana is not as widely used as alcohol,  6-7% of the adult population, vs.  66% who drink, one reason the comparison doesn’t work. * Marijuana usage causes traffic deaths and it is not safe to combine with driving.

* More teens seek substance abuse treatment for pot than any other legal or illegal substance. * Marijuana is a gateway drug,  because nearly every young person who develops a drug addiction begins with marijuana.  Early pot users such as Robert Downey, Jr. (age 9), and Cameron Douglas  (age 13), prove that the stranglehold of drug addiction lasts for years.

* A multi-year study out of New Zealand, tracking marijuana users and through their mid-30s showed IQs decrease an 6-8 percentage points over time.  Again, we point to the medical studies summarized on this webpage.

* In a recent study, schizophrenics who have used marijuana had an onset of the disease 2-1/2 years earlier than those who did not use marijuana. * Marijuana can trigger psychotic symptoms and/or mental illness, and cognitive decline in youth, more quickly than alcohol, while tobacco does not.

* Since marijuana usage increases the odds of developing a mental illness, expansion of pot will expand mental health treatment needs.

* Efforts to legalize for age 21+  hide the motivation to attract young users and build big profits.  Legal pot mean more young users.

* Marijuana usage is associated with greater risk for testicular cancer in males.

* With universal health care, all of us will pay for the increase in medical care for those needing help from pot abuse.

* The number of pot-related hospitalizations in Colorado accelerated in 2009 and went out of control in the first half of 2014.

* Existing mental health issues, such as ADHD, anxiety and depression, greatly increase the use of drugs for self-medication.

Mental Health, Physical Health Alike

“We cannot promote a comprehensive system of mental health treatment and marijuana legalization, which increases permissiveness for a drug that directly contributes to mental illness,”  states former Congressman Patrick Kennedy, who fought tirelessly on behalf of parity for mental health treatment. Kennedy and policy expert Kevin Sabet promote  Smart Approaches to Marijuana.

* The National Alliance for Mental Illness lists four illegal drugs which cause psychosis: cannabis, LSD, methamphetamine and heroin and two classes of legal drugs, amphetamines and steroids. Pharmaceutical drugs are sold with warnings, while marijuana isn’t.

Sharon Levy, Chairwoman of the American Academy of Paediatrics committee on substance abuse, said “We’re losing the public health battle” and policy is being made by legalization advocates who might be misinformed about marijuana’s dangers.”

Source:  http://www.poppot.org/2016/08/08/latest-child-dangers-marijuana-edibles/

Mass Illness from Marijuana Edibles in San Francisco There’s more potential for overdose from edibles than smoked marijuana, although the teen in Seattle who jumped to his death last December did it after smoking pot for the first time.  Two shocking incidents in California suggest that overdose emergencies will increase if that states vote to legalize marijuana in November.  Here’s a summary of recent cases of toxicity from edibles:

· 19 people were hospitalized in San Francisco on August 7 from THC, after attending a quinceañera party.  The source is believed be marijuana-infused candies, perhaps gummy bears. Several children were among those poisoned, one as young as six.  A 9-year-old had severe difficulty breathing.

· Pot brownies sent a bachelorette party to the emergency room in South Lake Tahoe over the weekend of July 30-31. Eight of the 10 women were admitted to the hospital according to the City of South Lake Tahoe’s website.

· A JAMA Paediatrics article explains the dramatic rise in children’s hospitalizations related to marijuana in Colorado since legalization.  In 10 cases, the product was not in a child-resistant container; in 40 scenarios (34%) there was poor child supervision or product storage.  Edible products were responsible for 51 (52% ) of exposures.  The report claimed that child-resistant packaging has not been as effective in reducing kids’ unintended exposure to pot as hoped.

· The report mentions the death of one child, an 11-month-old baby.  Nine of the children had symptoms so serious that they ended up in the intensive care unit of Colorado Children’s Hospital.  Two children needed breathing tubes.

· The state of Washington has a similar problem with edibles, as reported on the King County Health Department’s website.  From 2013 to May 2015, there were 46 cases of children’s intoxications related to marijuana edibles reported in Washington.  However, reporting is voluntary and the state estimates that number could be much higher.

·  In May, a father plead guilty to deliberately giving his 4-year-old daughter marijuana-laced cake in Vancouver, Washington.  He was sentenced to two years in prison.

Intoxication from marijuana edibles has risen steadily since legalization. Source: King County Department of Health. Top photo: AP

· In Hingham, MA, there was a 911 related to teen girl who ingested marijuana edibles.  The candies were in a package labelled Conscious Creations, which didn’t disclose ingredients.   Massachusetts has a medical marijuana program, but it is not clear how or to whom they were sold or dispensed.

 

· July, 2016: Two California teens were hospitalized after eating a marijuana-laced cookie. The teens reported purchasing the cookie from a third teenager who was subsequently arrested.

· July, 2016: A California man was arrested for giving candy laced with marijuana to a 6-year-old boy and an 8-year-old boy; the 6-year-old was hospitalized for marijuana poisoning.

· July, 2016: Police in Arizona arrested a mother for allegedly giving her 11- and 12-year-old children gummy candy infused with marijuana. Police say the marijuana-infused candy was originally purchased by an Arizona medical marijuana user, but was illegally transferred to the mother in question.  (State medical marijuana programs have poor track records of assuring the “medicine” goes to whom it is intended.)

· On April 27, a Georgia woman was arrested after a 5- year-old said he ate a marijuana cake for breakfast.  The child was taken to the hospital for treatment following the incident; according to officials, his pulse was measured at over 200 beats per minute.

· Last year there were more than 4,000 treatments at hospitals and poison center treatments in the US related to marijuana toxicity in children and teens.

Growth of marijuana edibles intoxication by age. Source: King County, Washington

Edible marijuana poses a “unique problem,” because “no other drug is infused into a palatable and appetizing form” – such as cookies, brownies and candy.    Many household items cause poisonings, but marijuana edibles are different because they’re made to look appealing and they appeal to children.

 

Source:  http://www.poppot.org/2016/08/08/latest-child-dangers-marijuana-e

A volunteer non-partisan coalition of people from across the US and Canada who have come to understand the negative local-to-global public health and safety implications of an organized, legal, freely-traded, commercialized and industrialized marijuana market. Here’s What’s Coming to Your Back Yard — A tour of a Colorado Commercial Marijuana Operation

Our colleague,  Jo McGuire, in Denver was recently asked to accompany a group of delegates from other states investigating commercial marijuana legalization on a tour of the Colorado marijuana industry. Here’s her account of what they observed:

A delegation from out of state came to Denver in late April to see how the Colorado marijuana industry is working. I was asked to help guide the tour and ask questions of the industry leaders.

This was an all-day experience, so I will give you the highlights that stand out to me.

After the delegation heard a bit about my experience and area of expertise in safe & drug free workplaces, we were given a presentation by two officers of the Marijuana Enforcement Division (MED) in Colorado.

They started off the presentation by repeating how utterly impossible it is to regulate marijuana and keep all the rules and know all the enforcement measures they are supposed to follow (these are the people overseeing enforcement for the whole state.) They bragged that they now have 98 people in their office overseeing regulation but later in the day admitted that only 25% of those do on-site inspections statewide (3,000 facilities), the rest are trying to keep up with paperwork.

They cannot get to every site in the state for inspections (again – impossible) so they respond to complaints, spot-check and rely on other community entities to report anything they may find or see. The largest amount of complainants come from other MJ facilities trying to get their competition shut-down.

The greatest violations are: 1. Using pesticides banned in the U.S. 2. Not using the proper inventory tracking system 3. Waste disposal violations 4. Circumventing the required video-monitoring system

They were asked how potency of marijuana is determined and they said, “It is impossible to determine potency.” When challenged – they were adamant that it is not possible.

When asked how their office is paid for (marijuana money? state coffers?) they did not know. (It’s state coffers – I was on the committee.)

After their presentation, we headed to a marijuana grow facility in downtown Denver. You could smell it from a block away. They grow over 600,000 plants at this one location.

Guards with guns let us into the gate and gave us security badges, telling us that no photos were allowed and we would be on-camera at all times, escorted out if we broke any rules.

First we were shown a tray of baby plants with no tags. There is supposed to be a seed-to-sale tracking system. They said, “Well you can’t track every single one, so we track them in batch numbers when they are less than 8 inches high and then they get individual tags after that.” (More on that later).

This facility does not use “seeds” anyway. They clone their grows from mother plants – so their system is completely different.

They ship dirt over from Sri Lanka because the coconut shells are natural fertilizer for marijuana. So they have a huge room that smells like elephant poo with pallets of dirt “squares” stacked 20 feet high. What else is in it? Is it subject to inspection? No one knew. We were told, “If there were harmful bugs, we would find out eventually.”

Into the first state-of-the-art grow room. There were plants labelled “REC” and “MED”. When asked the difference between recreational and medical marijuana the grower said, “The tags and the tax rates.”

There was an environmental researcher on the tour who asked if the …. 6 gallons of water per plant per day …. is being recycled. The grower said they could not possibly store the massive thousands of gallons it would take to recycle the water. The researcher asked if Denver has any plan in place to test the water for contaminants because many contaminants have been found at both legal and illegal grow sites in northern California and the Enforcement Officers said, “We hadn’t really thought about that.”

When asked if they recycle the dirt, the grower said, “No way. My quality of production ensures every plant has fresh dirt.”

(A side note – the researcher told us later that he expects the contaminants from marijuana will impact our communities for generations on a level similar to DDT exposure.) His research is another story for another day.

Next we passed through the processing area where the trimmers, dryers and baggers were working. Employees are mostly young or people who can’t find jobs elsewhere. They used to have to pass a federal background check (no felonies allowed) but the enforcement guys said, “That was too hard, so we don’t have that requirement anymore.”

An employee perk is “highly discounted product“. They make minimum wage with no benefits, but “everyone is happy”. They discourage Work Comp claims (trimmers get carpal tunnel) because “they would melt the drug cup.” He said they have very high employee turn-over. Some were wearing hazard gear and some were not. Some were wearing protective gear and some were not. This owner also keeps his 11 locations under 11 separate LLC’s so that he can maintain “Eleven separate small businesses” so that he is not to subject to requirements that large employers must meet for employee volume.

I saw rolls of un-printed bags and asked how they determine the potency of their weed. This owner voluntarily sends random samples (of each strain) to a 3rd party lab twice a year. When the lab tells him the approximate potency – correct within 4 nanograms – they print their labels according to that potency until the next random sample is sent in.

GET THIS: He has had product labelled at 18% but the next batch came back at 30%. He said that people know it’s a guessing game and you don’t expect accuracy in

the labelling – just that it’s labelled and it may or may not be close. Also – the product in the package doesn’t necessarily have to be what is printed on the label, as long as he is volunteering for the lab spot checks.

Not all facilities submit to the spot checks that regularly. Remember – we are at this particular place because this business owner is cream-of-the-crop. And by the way, ALL products in the state to include edibles are only subject to random spot checks for quality and potency. That having been said, each brand begins with a lab analysis in order to create the initial labels – but once the creation has been approved – they move full steam ahead with mass production, inspection free (unless it’s voluntary quality checks or complaints are filed).

Also – the labs are not state-owned or run. They are independently owned and operated by “other marijuana industry investors” and they just choose who is cheapest and fastest. For quality checks.

Next we went into the drying room and I asked about how he prevents mould. He doesn’t. It happens. They remove it by hand when they find it. (Pesticides to remove it are illegal and lights are ineffective). At one point he took a few of us down a row to see the dried buds in hundreds of rows of trays … where the labels went from individual plants back to mass batches. Why is this important? Voters believe in “seed-to-sale” tracking but no one knows how much one plant will produce. Will it produce 10 buds or 50 buds? 50 buds cannot have “one” label so this goes in batches. How do you know if buds come up missing from the tracking system? You don’t.

As we were asking these questions and I was curious about some of his branding – he speaks in a very low voice to us while we were rows away from the enforcement team. “Listen, you’re safe in my facility because I am the one that follows the rules – thus why you are here, right? But if you go to any other place, don’t touch anything, don’t go near any equipment and be careful of anything that could contaminate you“. This business is filthy, dirty, scummy, underhanded and full of cheaters, liars and the majority of this industry is shady as hell. Just be careful.”

On to the BIG grow room ….

I thought I had seen and heard everything up to this point.

We walked into one of the rooms where mature “plants” (TREES) are growing and I saw buds that were the length of my entire forearm. He said, “That’s nothing, I’ve got some as big as your whole arm!” And these trees have so many of these HUGE, heavy buds, they are drooping down and propped-up with dozens of bamboo sticks. One bud by itself can bring in hundreds of dollars … and the seed-to-sale tracking system has loopholes bigger than the buds.

One of the enforcement officers shared, “Now these are labelled with THC-A … which is not impairing and has no euphoric effect unless and until it’s smoked.” (I am not sure what comment to place here … but imagine every policy maker outside of our state getting this “sell”.)

I asked a lot of questions to make sure that what I say in my presentations are accurate – I had heard natural marijuana could not grow over 22% – he said he regularly grows it at 33% with no additives. I have been told that I was lying when I said “it is impossible to test every single product that is sold” and this young man laughed and said, “Here is my card, I will go with you and tell them you are right and back you up all the way. If you want them to hear it straight from my mouth – call me.”

Onto the retail store where two ATM’s sit side-by-side in the lobby. This is a cash only business and banking is not allowed, no credit-cards or checks, etc. So the “work-around” is that the Marijuana Facilities take the cash they get from customers and load-up their own ATM’s so electronic transactions go to their separate non-marijuana LLC

and they can deal through the banking system that way. In law enforcement circles this is called money laundering.

The store products ranged from stash devices to pipes and rigs, to intimacy “helpers”, candies, gums, mints and apparel, to a filled syringe and a 90% THC wax product, etc. There are pictures on my FB page … you should check them out.

The store staff are extremely friendly, proud of their work, answer all questions without hesitation and often let slip very damning information without even realizing it’s coming out of their mouth. So interesting.

When we returned to the van, there were people who were stunned to near tears because they truly didn’t believe what they had heard – how it really doesn’t and cannot work successfully, but we are simply doing the best we can at lightning speed. The shock was palpable. Some were extremely angry.

Another interesting tidbit: Colorado just outlawed gummy bears because they are too attractive to children. So we asked what the new rule means for the production of gummy candies. “That’s easy – you can’t use shapes of people, animals or fruit – but vegetables are o.k. because kids hate those and geometric designs are o.k. You know, like Lucky Charms!” They have a year to “sell” all of the candies “attractive to children” before they have to get them off the shelves.

As an aside, I discovered later that evening that I had broken out in hives wherever my skin was exposed and itched terribly for days after this trip.

I know that many other states are “new” to legal pot and if any of your states delegations here for this same tour – PLEASE – make sure I am notified and either I, or one of my colleagues, accompany them. Jo McGuire jo@jomcguire.org

Source:  http://marijuana-policy.org/heres-whats-coming-back-yard-tour-colorado-commercial-marijuana-operation/   2nd July 2017

La Porte, Ind. – Authorities with the La Porte County Sheriff’s Office say 11 teens from Fishers were hospitalized after eating gummy bears laced with THC, an active ingredient found in marijuana.

Police began investigating the incident just before midnight on Thursday after they were dispatched on a medical call to the 5200 N block of CR 325 W.

A 19-year-old male at the scene told a deputy that he became ill after ingesting drugs, and he needed to go to the hospital. He said he was in the area camping with friends, and they also ingested the drugs.

Several more sheriff’s deputies arrived and found 10 other teens that all said they were suffering from a rapid heart rate, pain in their legs, blurred vision, and hallucinations.

According to the sheriff’s office, a deputy determined that they each ate one half of a gummy bear that supposedly contained THC.

Three ambulances arrived at the scene to transport all 11 teens to two local hospitals.

All of the teens were from Fishers, and they are believed to have been staying at a relative’s home. Nine of the teens are 18-years-old and two were 19-years-old; six were males and five were females. Two of the patients were tested and were found to have high levels of THC in their system.

Police are still trying to determine where the teens got the drugs.

Source: http://fox59.com/2017/07/07/police-11-fishers-teens-hospitalized-after-eating-thc-laced-gummy-bears/

Cannabis has recently been legalised in many US states

Cannabis itself is harmful to cardiovascular health and increases the chance of early death regardless of related factors such as smoking tobacco, new research reveals.

Data taken from more than 1,000 US hospitals found that people who used the drug had a 26 per cent higher chance of suffering a stroke than those who did not, and a 10 per cent higher chance of having a heart attack.

The findings held true after taking into account unhealthy factors known to affect many cannabis smokers, such as obesity, alcohol misuse and smoking.

‘This leads us to believe that there is something else going on besides just obesity or diet-related cardiovascular side effects’ Dr Aditi Kalla, Einstein Medical Center, Philadelphia

They indicate there is something intrinsic about cannabis which can damage the proper functioning of the human heart.

“Even when we corrected for known risk factors, we still found a higher rate of both stroke and heart failure in these patients, so that leads us to believe that there is something else going on besides just obesity or diet-related cardiovascular side effects,” said Dr Aditi Kalla, Cardiology Fellow at the Einstein Medical Center in Philadelphia and the study’s lead author.

“It’s important for physicians to know these effects so we can better educate patients.”

Previous research in cell cultures has shown that heart muscle cells have cannabis receptors relevant to contractility, or squeezing ability, suggesting that those receptors might be one mechanism through which marijuana use could affect the cardiovascular system.

The research team analysed more than 20 million records of young and middle-aged patients aged between 18 and 55 who were discharged from 1,000 hospitals in 2009 and 2010, when marijuana use was illegal in most states.

It identified 316,000 patients – 1.5 per cent – where marijuana use was diagnosed in the notes.  Their cardiovascular disease rates were compared to those who shunned the drug.

The research was published yesterday at a meeting of the American College of Cardiology in Washington DC.

Source:  http://www.telegraph.co.uk/science/2017/03/09/cannabis-boosts-risk-stroke-heart-attack-independent-tobacco/  

It comes as no surprise that the prevalence of marijuana use has significantly increased over the last decade. With marijuana legal for recreational use in four states and the District of Columbia and for medical use in an additional 31 states, the public perception about marijuana has shifted, with more people reporting that they support legalization. However, there is little public awareness, and close to zero media attention, to the near-doubling of past year marijuana use nationally among adults age 18 and older and the corresponding increase in problems related to its use. Because the addiction rate for marijuana remains stable—with about one in three past year marijuana users experiencing a marijuana use disorder—the total number of Americans with marijuana use disorders also has significantly increased. It is particularly disturbing that the public is unaware of the fact that of all Americans with substance use disorders due to drugs other than alcohol; nearly 60 percent are due to marijuana. That means that more Americans are addicted to marijuana than any other drug, including heroin, cocaine, methamphetamine, and the nonmedical use of prescription drugs.

Stores in Colorado and Washington with commercialized marijuana sell innovative marijuana products offering users record-high levels of THC potency. Enticing forms of marijuana, including hash oil used in discreet vaporizer pens and edibles like cookies, candy and soda are attractive to users of all ages, particularly those underage. The legal marijuana producers are creatively and avidly embracing these new trends in marijuana product development, all of which encourage not only more users but also more intense marijuana use.

Yet despite the expansion of state legal marijuana markets, the illegal market for marijuana remains robust, leaving state regulators two uncomfortable choices: either a ban can be placed on the highest potency—and most enticing—marijuana products which will push the legal market back to products with more moderate levels of THC, or the current evolution to ever-more potent and more attractive products can be considered acceptable despite its considerable negative health and safety consequences. If tighter regulations are the chosen option, the illegal market will continue to exploit the desire of marijuana users to consume more potent and attractive products. If state governments let the market have its way, there will be no limit to the potency of legally marketed addicting marijuana products.

The illegal marijuana market thrives in competition with the legal market by offering products at considerably lower prices because it neither complies with regulations on growth and sale, nor pays taxes on sales or their profits. Unsurprisingly, much of the illegal marijuana in the states with legalized marijuana is diverted from the local legal marijuana supply. It is troubling that in response to the decline in demand for Mexican marijuana, Mexican cartels are increasing the production of heroin, a more lucrative drug.

When alcohol prohibition ended in 1933, bootlegged alcohol gradually and almost completely disappeared. Those who favour drug legalization are confident that the same will occur in the market for drugs; they argue that legalizing drugs will eliminate the illegal market with all its negative characteristics including violence and corruption. The initial experience with marijuana legalization shows that this is dangerous, wishful thinking. Why doesn’t legalization now work for marijuana as it did for alcohol 80 years ago? One obvious reason is that there is little similarity between the bootleg industry of alcohol production that existed during prohibition and contemporary drug trafficking organizations. Today’s illegal drug production and distribution system is deeply entrenched, highly sophisticated, and powerfully globalized. Traffickers are resourceful and able to rapidly to adjust to changes in the market, including competing with legal drugs.

The legalization of marijuana or any other drug is making a bargain with the devil. All drugs of abuse, legal and illegal, including marijuana, produce intense brain reward that users value highly—so highly that they are willing to pay high prices and suffer serious negative consequences for their use. Marijuana users’ brains do not know the difference between legal and illegal marijuana, but, as with other drugs, the brain prefers higher potency products. Drug suppliers, legal and illegal, are eager to provide the drugs that users prefer.

The challenge of drug policy today is to find better ways to reduce drug use by using strategies that are cost-effective and compatible with modern values. Legalization fails this test because it encourages drug use. Most of the costs of drug use are the result of the drug use itself and not from efforts to curb that use. It is hard to imagine a drug user who would be better off with having more drugs available at cheaper prices. Supply matters. More supply means more use. Drug legalization enhances drug supply and reduces social disapproval of drugs.

Our nation must prepare itself for the serious negative consequences both to public health and safety from the growth of marijuana use fuelled by both the legal and the illegal marijuana markets.

Source: http://www.rivermendhealth.com/resources/marijuana-legalization-led-use-addiction-illegal-market-continues-thrive/    June 2017  Author: Robert L. DuPont, M.D.

Cannabis Use, Gender and the Brain

Cannabis is the most widely used illicit drug in the U.S. and, as a result of legalization efforts for both medical remedy and for recreational use, is now the second leading reason (behind alcohol) for admission to addiction treatment in the U.S. The health consequences, cognitive changes, academic performance and numerous neuroadaptations have been debated ad nauseam. Like other drugs and medications, effects are different if exposure occurs in the young vs. the old or in males vs. females. Exposure in utero, early childhood, adolescence-young adult, adult and elderly may have different effects on the brain and outcomes. Yet the best available independent research shows that marijuana use is associated with consistent regionally specific alterations to important brain circuitry in the striatum and pre-frontal and post orbital regions. In this study, Chye and colleagues have investigated the association between marijuana use and the size of specific brain regions that are vitally important in goal-directed behavior, focus and learning within in the orbitol frontal cortex (OFC) and caudate. This investigation suggests that marijuana dependence and recreational use have distinct and region-specific effects.

Why Does This Matter?

This is an important finding, but distinction between cannabis use, abuse and dependence is not always clear, objective, linear or well understood. However, dependence-related medial OFC volume reduction was robust and highly significant. Lateral OFC volume reduction was associated with monthly marijuana use. Greater reductions in brain volume of specific regions were stronger among females who were marijuana dependent. This finding correlates with previous evidence of gender-dependent differences towards the various physiological, behavioral and the reinforcing effect of marijuana for both recreational use and addiction.

The results highlight important neurological distinctions between occasional cannabis use and addiction. Specifically, Chye and colleagues found that smaller medial OFC volume may be driven by marijuana addiction-related mechanisms, while smaller lateral OFC volume may be due to ongoing exposure to cannabinoids. The results highlight a distinction between cannabis use and dependence and warrant future examination of gender-specific effects in studies of marijuana use and dependence.

Source: http://www.rivermendhealth.com/resources/cannabis-use-gender-brain/   June 2017  Author: Mark Gold, MD

Author: Mark Gold, MD

Mortality resulting from opioid use (over 33,000 in 2015) is now epidemic in the U.S., exceeding drug-related deaths from all other intoxicants. Dr. Ted Cicero of Washington University, Dr. William Jacobs, Medical Director of Bluff Plantation, and I discussed the opioid over-prescribing and switch to heroin at DEA Headquarters on November 17, 2015. Things have gone from bad to worse. In a recent JAMA article (March 2017), Dr. Bertha Madras, Professor in the Department of Psychiatry at Harvard Medical School, offers compelling analysis and recommendations to rein in this crisis.

Physicians have increasingly prescribed opioids for pain since the AMA added pain as the “fifth vital sign,” which, like blood pressure, mandated assessment during each patient encounter. As a result of this and acceptance of low-quality evidence touting opioids as a relatively benign remedy for managing both acute and chronic pain, prescriptions for opioids have risen threefold over the past two decades.

Addiction, overdose and mortality resulting directly from opioid misuse increased rapidly. In addition, the influx of cheap heroin, often combined with homemade fentanyl analogues, became increasingly popular as prescription opioids became harder to attain and cost prohibitive on the streets. Consequently, a proportion of prescription opioid misusers transitioned to cheaper, stronger and more dangerous illicit opioids.

Opioid Mortality

The breakdown in mortality was confirmed by surveys (2015) revealing a disproportionate rise in deaths specifically attributable to: fentanyl/analogs (72.2%) and heroin (20.6%) compared with only prescription opioids, at less than eight percent. The unprecedented rise in overdose deaths and association with the heroin trade catalyzed the formation of federal and state policies to reduce supply and increase the availability of treatment and of a life saving opioid antagonist overdose medication Naloxone, a short-acting, mu 1, opioid receptor antagonist. Naloxone quickly reverses the effect of opioids and acute respiratory failure provoked by overdose.

Yet, according to Dr. Madras, the current federal and state response is woefully inadequate. She writes: “Of more than 14,000 drug treatment programs in the United States, some funded by federal block grants to states, many are not staffed with licensed medical practitioners. An integrated medical and behavioral treatment system, under the supervision of a physician and substance abuse specialist, would foster comprehensive services, provide expedient access to prescription medicines, and bring care into alignment with current medical standards of care.”

Why Does This Matter?

As baby boomers age and live longer, chronic non-cancer pain is highly prevalent. Opioids for legitimate non-cancer pain are not misused or abused by most patients under proper medical supervision. Yet there is no effective, practical means in this managed care climate whereby Primary Care Physicians (PCPs) can determine who is at risk for abuse and addiction and who is not. And frankly, addicts lie to their doctors to get opioids. Without proper training, physicians, who genuinely want to help their patients, get in over their heads and don’t know how to respond.

Further complicating the issue is that many of the affordable treatment programs do not employ medical providers who are trained and Board Certified in Addiction and Pain

Medicine, not to mention addiction psychiatry, or addiction medicine physicians. Thus the outcomes are dismal, which fosters doubt and mistrust of treatment.

Lastly, the lack of well-trained providers is due, in part, to the lack of training for medical doctors in addiction and behavioral medicine. At the University of Florida, we developed a mandatory rotation for all medical students in “the Division of Addiction Medicine.” We also started Addiction as a sub-specialty within psychiatry, where residents and post-doctoral fellows were immersed in both classroom and clinical training.

Since 1990, many other similar fellowship programs have started, yet few are training all medical students in the hands-on, two-week clerkship experience in Addiction Medicine like they have in obstetrics. We took this a step further when we developed a jointly run Pain and Addiction Medicine evaluation and treatment program which focused on prevention and non-opioid treatments. Many more are needed, as well as increased CME in addictive disease for physicians in any specialty.

Source:   http://www.rivermendhealth.com/resources/chronic-pain-opioid-use-consequences   June 2017

Today, Dr. Kevin Sabet, president of Smart Approaches to Marijuana (SAM), a national group promoting evidence-based marijuana laws, issued the following statement regarding medical marijuana legislation introduced by Senators Booker (D-NJ) and Gillibrand (D-NY) and Rep. Steve Cohen (D-TN):

“No one wants to deprive chronically ill patients of medication that could be helpful for them, but that’s not what the legislation being introduced today is about. We wouldn’t allow Pfizer to bypass the FDA – why would we let the marijuana industry? This bill would completely undermine the FDA approval process, and encourage the use of marijuana and marijuana products that have not been proven either safe or effective. The FDA approval process should set the standard for smart, safe, and sound healthcare in our country, so we can be sure that patients are receiving the best treatments that do more help than harm,” said SAM President and former senior White House drug policy advisor Kevin Sabet.

“Raw marijuana is not medicine, so marijuana in crude form should not be legal, but the medicinal components properly researched, purified, and dosed should be made available through compassionate research programs, as outlined in SAM’s six-point plan entitled “Researching Marijuana’s Medical Potential Responsibly.” We understand the FDA process can seem cumbersome to those suffering from intractable diseases, but early access programs to drugs in development are already available.

“Also, while FDA approval is the long-term goal, seizure patients shouldn’t have to go to the unregulated market to get products full of contaminants. Responsible legislation that fast-tracks these medications for those truly in need should be supported, rather than diverting patients to an unregulated CBD market proven to be hawking contaminated or mislabeled products as medicine, as this bill would endorse. In 2015 and 2016 the FDA sent multiple warning letters to numerous CBD manufacturers, outlining these concerns. We support the development of FDA-approved CBD medications, like Epidolex, which is in the final stages of approval.”

News media requesting a one-one-one interview with a representative from SAM can contact anisha@learnaboutsam.org.

 About SAM

Smart Approaches to Marijuana (SAM) is a nonpartisan, non-profit alliance of physicians, policy makers, prevention workers, treatment and recovery professionals, scientists, and other concerned citizens opposed to marijuana legalization who want health and scientific evidence to guide marijuana policies. SAM has affiliates in more than 30 states. For more information about marijuana use and its effects, visit http://www.learnaboutsam.org.

DATE: June 1, 2017

DISTRIBUTION: All First Responders

ANALYST: Ralph Little/904-256-5940

SUBJECT: Grey Death compound in Jacksonville & Florida

NARRATIVE:  The compound opioid known as Grey Death has been detected for the first time in North Florida. Although Purchased in March in St. Augustine, the basic drugs were from Jacksonville and may have been purchased pre-mixed.  Other  samples have occurred from March through May. Delays are due to testing requirements.  Grey Death has been detected in Florida since November 2016 in four counties south of NFHIDTA. Palm Beach reported a related death on May 19th.  Grey Death has been reported in the Southeast, with overdoses and at least  two deaths in Alabama and Georgia. It has  also been found in Ohio, Pennsylvania and Indiana. The compound is  a mixture of U-47700, heroin and fentanyl. Overall, different fentanyls, including carfentanil, have been detected and the amount of each ingredient varies.  The substance’s appearance is similar to concrete mixing powder with a varied texture from fine powder to rock-like. While grey is most common and is the color seen in St. Augustine, pictures indicate tan as well. The potency is much higher than heroin and can be administered via injection, ingestion, insufflation and smoking.

DANGER: Grey Death ingredients and their concentrations are unknown to users, making it particularly lethal. Because these strong drugs can be absorbed through the skin, touching or the accidental inhalation of these drugs  can result in absorption. Adverse effects, such as disorientation, sedation, coughing, respiratory distress or cardiac  arrest can occur very rapidly, potentially within minutes of exposure. Any concoction containing U-47700 may not respond to Narcan, depending on its relative strength in the mix.   Light grey powder in a test tube.

CONCLUSION: Responders are advised to employ protective gear to prevent skin absorption or inhalation. Miniscule (grains) of this substance are dangerous. Treat any particles in the vicinity of scene or potentially adhering to your or victim outer clothing or equipment as hazardous.

Source:  HIDTA Intelligence brief.   1st June 2017

Sirs,

I believe that a state’s Attorney General and Secretary of State have the obligation to reject any petition that is obviously in violation of any law.

Whether a ballot initiative is properly worded or not, if it proposes, facilitates or allows the violation of any law – it is illegal.

EXCERPT:  “In an opinion dated Tuesday and released Wednesday, Rutledge said the ballot title of the proposal is ambiguous and “that a number of additions or changes” are needed “to more fully and correctly summarize” the proposal.

“The proposal [to legalize recreational marijuana use in the state] by Larry Morris of West Fork would allow for the cultivation, production, distribution, sale and possession of marijuana for recreational use in Arkansas.”:

As you can readily see, Mr. Morris’ proposal would violate federal law and place persons who engage in any of those activities at risk of federal prosecution or other liability.

I draw to your attention a  LEGAL PRIMER(BELOW) ON: ENFORCING THE CONTROLLED SUBSTANCE ACT IN STATES THAT HAVE COMMERCIALIZED MARIJUANA by Mr. David Evans, Esq. in which he concludes that: “Anyone who participates in the growing, possession, manufacturing, distribution, or sales of marijuana under state law or aids or facilitates or finances such actions is at risk of federal prosecution or other liability.”

I ask that you continue to reject these illegal proposals to legalize marijuana in any form in our state of Arkansas.

I reiterate, it is your job to UPHOLD the LAW, not facilitate LAWBREAKING.

Jeanette McDougal

Board Member, Drug Watch, Intl.

Director, NAHAS – National Alliance of Health and Safety dems8692@aol.com

HUNTINGTON, W.Va. — Officer Sean Brinegar arrived at the house first — “People are coming here and dying,” the 911 caller had said — and found a man and a woman panicking. Two people were dead inside, they told him.

Brinegar, 25, has been on the force in this Appalachian city for less than three years, but as heroin use has surged, he has seen more than his fair share of overdoses. So last Monday, he grabbed a double pack of naloxone from his gear bag and headed inside.

A man was on the dining room floor, his thin body bluish-purple and skin abscesses betraying a history of drug use. He was dead, Brinegar thought, so the officer turned his attention to the woman on a bed. He could see her chest rising but didn’t get a response when he dug his knuckle into her sternum.

Brinegar gave the woman a dose of injected naloxone, the antidote that can jumpstart the breathing of someone who has overdosed on opioids, and returned to the man. The man sat up in response to Brinegar’s knuckle in his sternum — he was alive after all — but started to pass out again. Brinegar gave him the second dose of naloxone.

Maybe on an average day, when this Ohio River city of about 50,000 people sees two or three overdoses, that would have been it. But on this day, the calls kept coming.

Two more heroin overdoses at that house, three people found in surrounding yards. Three overdoses at the nearby public housing complex, another two up the hill from the complex.

From about 3:30 p.m. to 7 p.m., 26 people overdosed in Huntington, half of them in and around the Marcum Terrace apartment complex. The barrage occupied all the ambulances in the city and more than a shift’s worth of police officers.

By the end of it, though, all 26 people were alive. Authorities attributed that success to the cooperation among local agencies and the sad reality that they are well-practiced at responding to overdoses. Many officials did not seem surprised by the concentrated spike.

“It was kind of like any other day, just more of it,” said Dr. Clay Young, an emergency medicine doctor at Cabell Huntington Hospital.

But tragic news was coming. Around 8 p.m., paramedics responded to a report of cardiac arrest. The man later died at the hospital, and only then were officials told he had overdosed. On Wednesday, authorities found a person dead of an overdose elsewhere in Cabell County and think the death could have happened Monday. They are investigating whether those overdoses are tied to the others, potentially making them Nos. 27 and 28.

It’s possible that the rash of overdoses was caused by a particularly powerful batch of heroin or that a dearth of the drug in the days beforehand weakened people’s tolerance. But police suspect the heroin here was mixed with fentanyl, a synthetic opioid that is many times more potent than heroin. A wave of fatal overdoses signaled fentanyl’s arrival in Huntington in early 2015, and now some stashes aren’t heroin laced with fentanyl, but “fentanyl laced with heroin,” said Police Chief Joe Ciccarelli. Another possibility is carfentanil, another synthetic opioid, this one used to sedate elephants. Police didn’t recover drugs from any of the overdoses, but toxicology tests from the deaths could provide answers.

A battle-scarred city

In some ways, what happened in Huntington was as unremarkable as the spurts in overdoses that have occurred in other cities. This year, fentanyl or carfentanil killed a dozen people in Sacramento, nine people in Florida, and 23 people in about a month in Akron, Ohio. The list of cities goes on: New Haven, Conn.; Columbus, Ohio; Barre, Vt.

But what happened in Huntington stands out in other ways. It underlines the potential of a mysterious substance to unleash wide-scale trauma and overwhelm a city’s emergency response. And it suggests that a community that is doing all the right things to combat a worsening scourge can still get knocked back by it.

“From a policy perspective, we’re throwing everything we know at the problem,” said Dr. James Becker, the vice dean for governmental affairs and health care policy at the medical school at Marshall University here. “And yet the problem is one of those that takes a long time to change, and probably isn’t going to change for quite a while.”

Surrounded by rolling hills packed with lush trees, Huntington is one of the many fronts in the fight against an opioid epidemic that is killing almost 30,000 Americans a year. But this city, state, and region are among the most battle-scarred. West Virginia has the highest rate of fatal drug overdoses of any state and the highest rate of babies born dependent on opioids among the 28 states that report data. But even compared with other communities in West Virginia, Huntington sees above-average rates of heroin use, overdose deaths, and drug-dependent newborns. Local officials estimate up to 10 percent of residents use opioids improperly.

The heroin problem emerged about five years ago when authorities around the country cracked down on “pill mills” that sent pain medications into communities; officials here specifically point to a 2011 Florida law that arrested the flow of pills into the Huntington area.

As the pills became harder to obtain and harder to abuse, people turned to heroin. It has devoured many communities in Appalachia and beyond.

In Huntington, law enforcement initially took the lead, with police arresting hundreds of people. They seized thousands of grams of heroin. But it wasn’t making a dent. So in November 2014, local leaders established an office of drug control policy.

“As far as numbers of arrests and seizures, we were ahead of the game, but our problem was getting worse,” said Jim Johnson, director of the office and a former Huntington police officer. “It became very obvious that if we did not work on the demand side just as hard as the supply side, we were never going to see any success.”

The office brought together law enforcement, health officials, community and faith leaders, and experts from Marshall to try to tackle the problem together.

Changes in state law have opened naloxone dissemination to the public and protected people who report overdoses. But the city and its partners have gone further, rolling out programs through the municipal court system to encourage people to seek treatment. One program is designed to help women who work as prostitutes to feed their addiction. Huntington has eight of the state’s 28 medically assisted detox beds, and they’re always full.

Also, in 2014, a center called Lily’s Place opened in Huntington to wean babies from drugs. Last year, the local health department launched this conservative state’s first syringe exchange. The county, health officials know, is at risk for outbreaks of HIV and hepatitis C because of shared needles, so they are trying to get ahead of crises seen in other communities afflicted by addiction.

“Huntington just happens to have taken ownership of the problem, and very courageously started some programs … that have been models for the rest of the state,” said Kenneth Burner, the West Virginia coordinator for the Appalachia High Intensity Drug Trafficking Areas program.

‘A revolving door’

While paramedics in the area have carried naloxone for years, it was this spring that Huntington police officers were equipped with it. Just a few officers have administered it, but Monday was Brinegar’s third time reviving overdose victims with naloxone.

Paramedics, who first try reviving victims by pumping air with a bag through a mask, had to administer another 10 doses of naloxone Monday. Three doses went to one person, said Gordon Merry, the director of Cabell County Emergency Services. During the response, ambulances from stations outside Huntington were called into the city to assist the eight or so response teams already deployed.

Merry was clearly proud of the response, but also frustrated. He was tired, he said, of people whom emergency crews revived going back to drugs. Because of the power of their disease, saving their lives didn’t get at the root of their addiction.

“It’s a revolving door. We’re not solving the problem past reviving them,” he said. “We gave 26 people another chance on life, and hopefully one of those 26 will seek help.”

In the part of town where half the overdoses happened, some homes are well-kept, with gardens, bird feeders, and American flags billowing. “Home Sweet Home,” read an engraved piece of wood above one front door; in another front yard, a wooden sculpture presented a bear holding a fish with “WELCOME” written across its body.

But many structures are decrepit and have their windows blacked out with cardboard and sheets. At one boarded-up house, the metal slats that once made up an overhang for the front porch split apart and warped as they collapsed, like gnarled teeth. On the plywood that covered a window frame was a message spelled out in green dots: GIRL SCOUTS RULE.

In and around the public housing complex, which is made up of squat two-story brick buildings sloping up a hill, people either said they did not know what had happened Monday, or that “lowlifes” in another part of the complex sparked the problem. Even as paramedics were responding to the overdoses, police started raiding residences as part of their investigation, including apartments at the complex, the chief said.

Just up the hill, a man named Bill was sitting on a recliner on his front porch with his cat. He said he saw the police out in the area Monday, but doesn’t pay much attention to overdoses anymore. They are so frequent.

Bill, who is retired, asked to be identified only by his first name because he said he has a son in law enforcement. He has lived in that house for five decades and started locking his door only in recent years. His neighbors’ house had been broken into, and he had seen people using drugs in cars across the street from his house. He called the police sometimes, he said, but the users were always gone by the time the police arrived.

“I hate to say this, but you know, I’d let them die,” Bill said. “If they knew that no one was going to revive them, maybe they wouldn’t overdose.”

Even here, where addiction had touched so many lives, it’s not an uncommon sentiment. Addiction is still viewed by some as a bad personal choice made by bad people.

“Some folks in the community just didn’t care” that 26 of their fellow residents almost died, said Matt Boggs, the executive director of Recovery Point.  Recovery Point is a long-term recovery program that teaches “clients” to live a life without drugs or alcohol. Boggs himself is a graduate of the program, funded by the state and donations and grants.

The clients live in bunk rooms at the facility for an average of more than seven months before graduating. The program says that about two-thirds of graduates stay sober in the first year after graduation, and about 85 percent of those people are sober after two years.

Local officials praise Recovery Point, but like many other recovery programs, it is limited in what it can do. It has 100 beds for men at its location in Huntington, and is expanding at other sites in the state, but Boggs said there’s a waiting list of a couple hundred people.

Mike Thomas, 30, graduated from the main part of the program a month ago and is working as a peer mentor there as he transitions out of the facility. Thomas has been clean since Oct. 15, 2015, but has dreams about getting high or catches himself thinking he could spare $100 from his bank account for drugs.

Thomas hopes to find a full-time job helping addicts. His own recovery will be a lifelong process, one that can be torn apart by a single bad decision, he said. He will always be in recovery, never recovered.    “I’m not cured,” he said.

 

A killer that doesn’t discriminate

As heroin has bled into communities across the country, it has spread beyond the regular drug hotbeds in cities. On a 2004 map of drug use in Huntington — back then, mostly crack cocaine — a few blocks of the city glow red. Almost the entire city glows in yellows and reds on the 2014 map.

In 2015, there were more than 700 drug overdose calls in Huntington, ranging from kids in their early teens to seniors in their late 70s. In 2014, it was 272 calls; in 2012, 146. One bright spot: fatal overdoses, which stood at 58 in 2015, have ticked down so far this year.

“I used to be able to say, ‘We need to focus here,’” said Scott Lemley, a criminal intelligence analyst at the police department. “I can’t do that anymore.”

Heroin hasn’t just dismantled geographic barriers. It has infiltrated every demographic “It doesn’t discriminate.   Prominent businessmen, their child. Police officers, their child. Doctors, their child,” Merry said. “The businessman and police officer do not have their child anymore.”

The businessman is Teddy Johnson. His son, Adam, died in 2007 when he was 22, one of a dozen people who died in a five-month period because of an influx of black-tar heroin. The drug hadn’t made its full resurgence into the region yet, but now, Johnson sees the drug that killed his son everywhere.

 

Teddy Johnson lost his son, Adam, in 2007 to a heroin overdose. He has several tattoos dedicated to Adam’s memory.  He runs a plumbing, heating, and kitchen fixture and remodelling business. From his storefront, he has witnessed deals across the street.

Adam, who was a student at Marshall, was a musician and artist who hosted radio shows. He was the life of any party, his dad said.

Johnson was describing Adam as he sat at the marble countertop of a model kitchen in his business last week. With the photos of his kids on the counter, it felt like a family’s home. Johnson explained how he still kept Adam’s bed made, how he kept his son’s room the same, and then he began to cry.

“The biggest star in the sky we say is Adam’s star,” he said. “When we’re in the car — and it can’t be this way — but it always seems to be in front of us, guiding us.”

Adam’s grave is at the top of a hill near the memorial to the 75 people — Marshall football players, staff, and fans — who died in a 1970 plane crash. It’s a beautiful spot that Johnson visits a few times each week, bringing flowers and cutting the grass around his son’s grave himself. Recently a note was left there from a couple Johnson knows who

just lost their son to an overdose; they were asking Adam to look out for their son in heaven.

But even here, at what should be a respite, Johnson can’t escape what took his son. He said he has seen deals happen in the cemetery, and he recently found a burnt spoon not more than 20 feet from his son’s grave.

Johnson keeps fresh flowers on his son’s grave and cuts the grass around the grave himself.

“I’ve just seen too much of it,” he said.

If Huntington doesn’t have a handle on heroin, at least the initiatives are helping officials understand the scale of the problem. More than 1,700 people have come through the syringe exchange since it opened, where they receive a medical assessment and learn about recovery options. The exchange is open one day a week, and in less than a year, it has distributed 150,000 clean syringes and received 125,000 used syringes.

But to grow and sustain its programs, Huntington needs money, officials say. The community has received federal grants, and state officials know they have a problem. But economic losses and the collapse of the coal industry that fueled the drug epidemic have also depleted state coffers.

“We have programs ready to launch, and we have no resources to launch them with,” said Dr. Michael Kilkenny, the physician director of the Cabell-Huntington Health Department. “We’re launching them without resources, because our people are dying, and we can’t tolerate that.”

In some ways, Huntington is fortunate. It has a university with medical and pharmacy schools enlisted to help, and a mayor’s office and police department collaborating with public health officials. But what does that herald then for other communities?

“If I feel anxious about what happens in Huntington and in Cabell County, I cannot imagine what it must be like to live in one of these other at-risk counties in the United States, where they don’t have all those resources, they don’t have people thinking about it,” said Dr. Kevin Yingling, the dean of the Marshall University School of Pharmacy.

Yingling, Kilkenny, and others were gathered on Friday afternoon to talk about the situation in Huntington, including the rash of overdoses. But by then, there was already a different incident to discuss.

A car had crashed into a tree earlier that afternoon in Huntington. A man in the driver seat and a woman in the passenger seat had both overdosed and needed naloxone to be revived. A preschool-age girl was in the back seat.

Source:    https://www.statnews.com/2016/08/22/heroin-huntington-west-virginia-overdoses/ 22.08.16

Drug trade’s efforts to launder profits by creating agricultural land results in loss of millions of acres, researchers say.

A hillside in Jocotán, eastern Guatemala, damaged by deforestation. Photograph: Marvin Recinos/AFP/Getty Images

Cocaine traffickers attempting to launder their profits are responsible for the disappearance of millions of acres of tropical forest across large swaths of Central America, according to a report. The study, published on Tuesday in the journal Environmental Research Letters, found that drug trafficking was responsible for up to 30% of annual deforestation in Nicaragua, Honduras and Guatemala, turning biodiverse forest into agricultural land.

The study’s lead author, Dr Steven Sesnie from the US Fish and Wildlife Service, said: “Most of the ‘narco-driven’ deforestation we identified happened in biodiverse moist forest areas, and around 30-60% of the annual loss happened within established protected areas, threatening conservation efforts to maintain forest carbon sinks, ecological services, and rural and indigenous livelihoods.”

The research, which used annual deforestation estimates from 2001 to 2014, focuses on six Central American countries – Guatemala, El Salvador, Honduras, Nicaragua, Costa Rica and Panama. It estimates the role of drug trafficking, as opposed to drug cultivation, in deforestation for the first time.

“As the drugs move north their value increases and the traffickers and cartels are looking for ways to move this money into the legal economy. Purchasing forest and turning it into agricultural land is one of the main ways they do that,” said Sesnie. He said the US-led crackdown on drug cartels in Mexico and the Caribbean in the early 2000s concentrated cocaine trafficking activities through the Central American corridor.

“Now roughly 86% of the cocaine trafficked globally moves through Central America on its way to North American consumers, leaving an estimated $6bn US dollars in illegal profits in the region annually.”

This had led to the loss of millions of acres of tropical forest over a decade as drugs cartels laundered their profits, Sesnie said.

“Our results highlight the key threats to remaining moist tropical forest and protected areas in Central America,” he said, adding that remote forest areas with “low socioeconomic development” were particularly at risk.

The report calls for drugs and environment policy – nationally and internationally – to be integrated “to ensure that deforestation pressures on globally significant biodiversity sites are not intensified by … supply-side drug policies in the region”.

Source:  https://www.theguardian.com/environment/2017/may/16/drug-money-traffickers-destroying-swaths-forest-central-america    

 

Addiction Advocacy Needs A Bill Gates, David Geffen, Warren Buffett, Or Tom Steyer

Addiction doesn’t need someone to put their name on a building, or name a research institute. Addiction desperately needs bold philanthropists who want to leverage the people power of the grassroots. Addiction and drug overdoses claim one life every four minutes in America. In the time it takes to order a latte, someone dies—from an illness that is highly treatable. The addiction crisis is the result of social prejudice; criminal justice policies that incarcerate people with addiction instead of giving them treatment; health care policies that make it difficult or impossible to get medical help for substance use disorders; ignorance; and “abstinence-only” drug policies that are ineffective and backwards.

The fact is, people who struggle with substance use disorder are treated like second-class citizens. Admitting there’s a problem can mean losing your job, home, and custody of your children. That makes addiction a civil rights issue. And, thanks to the work of advocates across the nation, it’s finally being recognized as a moral issue, as well. Thought leaders like Tom Steyer are helping to drive this message home. I first met Tom during the Democratic National Convention. I had just shared my experience with addiction and recovery when Tom approached me. I was taken aback by the story he shared. He, too, lost someone very dear to him due to addiction: his best friend, who struggled with addiction for decades. His friend contracted HIV and Hepatitis C through drug use, and died of medical complications due to his illnesses. A few months later, Tom joined me at the Facing Addiction in America summit in Los Angeles, where we invited him to share his story on stage with the U.S. Surgeon General. As Tom talked, tears filled my eyes. He said, “We must embrace our shared humanity and recognize that addiction is a deadly, chronic illness, not a personal failing.” I’d lost friends, too. I was at risk, too. It was time to bridge the gap between policies and public awareness.

People like Tom Steyer and other pioneering philanthropists, who give tens of millions to progressive causes such as medical research, environmental causes, and water quality, must also step up to end the addiction crisis in America. Our fight is America’s fight. The sooner they do, the quicker we can heal this nation from our generation’s most urgent public health crisis.

Working alongside lobbyists, nonprofit groups, social organizers, and peer recovery groups, they can help fill the gaps left by policies and laws that omit or punish people with substance use disorder. As the current administration takes steps toward a health care bill that will leave people suffering from addiction without medical care, these philanthropic giants are in a unique position to help. Why? Because their involvement would not be tied to political party or personal gain. Rather, they would focus on the solution, plain and simple.

Addiction should be one of the issues on the list of social problems we urgently address, next to finding a cure for cancer and ending childhood hunger. Addiction permeates the social fabric of America. Nobody is exempt. As many people suffer from addiction as diabetes; more people use pain medications than tobacco products. For every person who’s developed full blown substance use disorder, another dozen are on the road to addiction. Substance use disorder affects every corner of society, including our collective health, family unity, the economy, workplace productivity, and our reliance on social programs. It also keeps jails full of people who may struggle to find jobs to support their families once they’re released, and will never be able to vote again.

The recovery advocacy movement has been built slowly, through the efforts of individuals and highly fragmented groups. We have an incredible grassroots movement that addresses an issue that directly impacts one in every three families in America, and indirectly touches all of us. But fundraising for recovery advocacy has been largely through family and friend donations—which, although heartfelt, aren’t sufficient to fund serious research, create desperately needed social infrastructure, or provide education about the true nature of addiction. While organizations dedicated to battling cancer, heart disease, and diabetes raise hundreds of millions of dollars annually, the “addiction field,” such as it is, raises perhaps $25 million from private sources. This is unconscionable.

Gates, Geffen, Buffett, Steyer, and other philanthropic giants have the potential to be visionaries in this space. They could quickly stem the addiction epidemic without waiting for policy makers to hammer out yet another law that places people’s recovery at risk. They could find the solution that keeps families intact. With their help, nobody will lose another friend to this disease or the health problems that come with it. Bob and Suzanne Wright demonstrated the power and possibility of this kind of giving when they funded Autism Speaks. Their philanthropy helped move autism front and center: why not do the same for addiction?

What will our society, our culture, be like when we finally take addiction out of the equation? For many people, and their families, the answer is coming much too slowly.

It’s time to apply our knowledge, build a coalition, and offer the solutions our country so desperately needs. It’s time to change the framework of this crisis and confront our deepest values. Instead of punishment, we need to help the people who are sick—dying from this illness. It’s time to work together and end America’s addiction crisis for good.

What we need now is for America’s philanthropic visionaries to step up to help us dramatically accelerate the pace of progress in this urgent effort. Addiction doesn’t need someone to put their name on a building, or name a research institute. Addiction desperately needs bold philanthropists who want to leverage the people power of the grassroots. Ryan Hampton is an outreach lead and recovery advocate at Facing Addiction, a leading nonprofit dedicated to ending the addiction crisis in the United States.

Source:  http://www.huffingtonpost.com/entry/addiction-advocacy-needs-a-bill-gates-david-geffen_us_592ddfaae4b075342b52c0f5   30th May 20127

As Cpl. Kevin Phillips pulled up to investigate a suspected opioid overdose, paramedics were already at the Maryland home giving a man a life-saving dose of the overdose reversal drug Narcan.

Drugs were easy to find:  a package of heroin on the railing leading to a basement; another batch on a shelf above a nightstand.

The deputy already had put on gloves and grabbed evidence baggies, his usual routine for canvassing a house.  He swept the first package from the railing into a bag and sealed it; then a torn Crayola crayon box went from the nightstand into a bag of its own.  Inside that basement nightstand:  even more bags, but nothing that looked like drugs.

Then—moments after the man being treated by paramedics come to—the overdose hit.

“My face felt like it was burning.  I felt extremely lightheaded.  I felt like I was getting dizzy,” he said.  “I stood there for two seconds and thought, ‘Oh my God, I didn’t just get exposed to something.’ I just kept thinking about the carfentanil.”

Carfentanil came to mind because just hours earlier, Phillips’ boss, Harford County Sheriff Jeffrey Gahler, sent an e-mail to deputies saying the synthetic opioid so powerful that it’s used to tranquilize elephants had, for the first time ever, showed up in a toxicology report from a fatal overdose in the county.  The sheriff had urged everyone to use extra caution when responding to drug scenes.

Carfentanil and fentanyl are driving forces in the most deadly drug epidemic the United States has ever seen.  Because of their potency, it’s not just addicts who are increasingly at risk—it’s those tasked with saving lives and investigating the illegal trade.  Police departments across the U.S. are arming officers with the opioid antidote Narcan.  Now, some first responders have had to use it on colleagues, or themselves.

The paramedic who administered Phillips’ Narcan on May 19 started feeling sick herself soon after;  she didn’t need Narcan but was treated for exposure to the drugs.

Earlier this month, an Ohio officer overdosed in a police station after bushing off with a bare hand a trace of white powder left from a drug scene.  Like Phillips, he was revived after several doses of Narcan.  Last fall, SWAT officers in Hartford, Connecticut, were sickened after a flash-bang grenade sent particles of heroin and fentanyl airborne.

Phillips’ overdose was eye-opening for his department, Gahler said.  Before then, deputies didn’t have a protocol for overdose scenes; many showed up without any protective gear.

Gahler has since spent $5,000 for 100 kits that include a protective suit, booties, gloves, and face masks.  Carfentanil can be absorbed through the skin and easily inhaled. and a single particle is so powerful that simply touching it can cause an overdose, Gahler said.  Additional gear will be distributed to investigators tasked with cataloguing overdose scenes—heavy-duty gloves and more robust suits.

Gahler said 37 people have died so far this year from overdoses in his county, which is between Baltimore and Philadelphia.  The county has received toxicology reports on 19 of those cases, and each showed signs of synthetic opioids.

“This is all a game-changer for us in law enforcement,” Gahler said.  “We are going to have to re-evaluate daily what we’re doing.  We are feeling our way through this every single day . . . we’re dealing with something that’s out of our realm.  I don’t want to lose a deputy ever, but especially not to something the size of a grain of salt.”

Source:  – Erie Times-News, Erie, Pa. – May 28, 2017 – www.goerie.com  The Associated Press

Ohio had the most overdose fatalities in the United States in 2014 and 2015.

A newspaper’s survey of county coroners has painted a grim picture of fatal overdoses in Ohio: more than 4,000 people died from drug overdoses in 2016 in the state badly hit by a heroin and opioid epidemic.

At least 4,149 died from unintentional overdoses last year, a 36 percent climb from the previous year, or a time when Ohio had the most overdose fatalities in the United States so far.

“They died in restaurants, theaters, libraries, convenience stores, parks, cars, on the streets and at home,” wrote The Columbus Dispatch in its report revealing the findings.

Survey Findings

It’s likely getting worse, too, as coroners warned that overdose deaths this year are fast outpacing these figures brought on by overdoses from heroin, synthetic opioids fentanyl and carfentanil, and other drugs.

The Dispatch obtained the number by getting in touch with coroners’ offices in all 88 Ohio counties. Coroners in six smaller counties, according to the paper, did not provide the requested figures.

Leading the counties in rapid drug overdose rises are counties such as Cuyahoga, where there were 666 deaths in 2016, as well as Franklin, Hamilton, Lucas, Montgomery, and Summit.

The devastation, added the survey, did not discriminate against big or small cities and towns, urban or rural areas, and rich and poor enclaves.

“It’s a growing, breathing animal, this epidemic,” said Medina County coroner and ER physician Dr. Lisa Deranek, who has sometimes revived the same overdose patients a few times each week.

Fentanyl Overdoses

Cuyahoga County, which covers Cleveland, had its death toll largely blamed on fentanyl use. Heroin remains a leading killer, but the autopsy reports reflected the major role of fentanyl, a synthetic opiate 50 times stronger than morphine, and animal tranquilizer carfentanil.

“We’ve done so much, but the numbers are going the other way. I don’t see the improvement,” said William Denihan, outgoing CEO of Cuyahoga County Alcohol, Drug Addiction and Mental Health Services Board.

Cuyahoga County had 400 fentanyl-linked deaths from Nov. 21 in 2015 to Dec. 31 last year, more than double related deaths of all previous years in combination. The opioid crisis, too, no longer just affected mostly white drug users, but also minority communities.

Dr. Thomas Gilson, medical examiner of Cuyahoga County, warned that cocaine is now getting mixed into the fentanyl distribution and fentanyl analogs in order to bring the drugs closer to the African-American groups.

Plans And Prospects

The state’s Department of Mental Health and Addiction Services stated that the overdose death toll back in 2015 would have been higher if not for the role of naloxone, an antidote use for opioid overdose cases. It has been administered by family members, other drug users, and friends to revive dying individuals.

State legislature moved to make naloxone accessible in pharmacies without a prescription. Ohio topped the nation’s drug overdose death numbers in 2014 and 2015. In the latter year, it was followed by New York, according to an analysis by the Kaiser Family Foundation using statistics from the U.S. Centers for Disease Control and Prevention.

Experts are pushing for expanding drug prevention as well as education initiatives from schoolkids to young and middle-aged adults, which also make up the bulk of dying people.

And while the state pioneered in crushing “pill mills” that issue prescription painkillers, health officials warned that this sent addicts to heroin and other stronger substances.

Naloxone, too, is merely an overdose treatment and not a cure for the growing addiction. Last May 22 in Pennsylvania, two drug counselors working to help others battle their drug addiction were found dead from opioid overdose at the addiction facility in West Brandywine, Chester County.

Source:  http://www.techtimes.com/articles/208540/20170529/ohio-leads-in-nations-fatal-drug-overdoses-with-4-000-dead-in-2016-survey.htm  29.05.17

SAN FRANCISCO – Visits by teens to a Colorado children’s hospital emergency department and its satellite urgent care centers increased rapidly after legalization of marijuana for commercialized medical and recreational use, according to new research being presented at the 2017 Paediatric Academic Societies Meeting in San Francisco.

The study abstract, “Impact of Marijuana Legalization in Colorado on Adolescent Emergency Visits” on Monday, May 8 at the Moscone West Convention Center in San Francisco.

Colorado legalized the commercialization of medical marijuana in 2010 and recreational marijuana use in 2014. For the study, researchers reviewed the hospital system’s emergency department and urgent care records for 13- to 21-year-olds seen between January 2005 and June 2015.

They found that the annual number of visits with a cannabis related diagnostic code or positive for marijuana from a urine drug screen more than quadrupled during the decade, from 146 in 2005 to 639 in 2014.

Adolescents with symptoms of mental illness accounted for a large proportion (66%) of the 3,443 marijuana-related visits during the study period, said lead author George Sam Wang, M.D., FAAP, with psychiatry consultations increasing from 65 to 442. More than half also had positive urine drug screen tests for other drugs. Ethanol, amphetamines, benzodiazepines, opiates and cocaine were the most commonly detected.

Dr. Wang, an assistant professor of paediatrics at the University of Colorado Anschutz Medical Campus, said national data on teen marijuana use suggest rates remained roughly the same (about 7%) in 2015 as they’d been for a decade prior, with many concluding no significant impact from legalization. Based on the findings of his study, however, he said he suspects these national surveys do not entirely reflect the effect legalization may be having on teen usage.

“The state-level effect of marijuana legalization on adolescent use has only begun to be evaluated,” he said. “As our results suggest, targeted marijuana education and prevention strategies are necessary to reduce the significant public health impact of the drug can have on adolescent populations, particularly on mental health.”

Dr. Wang will present the abstract, “Impact of Marijuana Legalization in Colorado on Adolescent Emergency Department (ED) Visits,” from 8 a.m. to 10 a.m. Numbers in this news release reflect updated information provided by the researchers. The abstract is available at https://registration.pas-meeting.org/2017/reports/rptPAS17_abstract.asp?abstract_final_id=3160.11.

The Paediatric Academic Societies (PAS) Meeting brings together thousands of individuals united by a common mission: to improve child health and well-being worldwide. This international gathering includes paediatric researchers, leaders in academic paediatrics, experts in child health, and practitioners. The PAS Meeting is produced through a partnership of four organizations leading the advancement of paediatric research and child advocacy: Academic Paediatric Association, American Academy of Paediatrics, American Paediatric Society, and Society for Paediatric Research. For more information, visit the PAS Meeting online at www.pas-meeting.org, follow us on Twitter @PASMeeting and #pasm17, or like us on Facebook. For additional AAP News coverage, visit http://www.aappublications.org/collection/pas-meeting-updates.

Source:   http://www.aappublications.org/news/2017/05/04/PASMarijuana050417

 A New Agenda to  Turn Back the Drug Epidemic

Robert L. DuPont, MD, President , Institute for Behavior and Health, Inc.

A. Thomas McLellan, PhD, Senior Strategy Advisor , Institute for Behavior and Health, Inc.  May 2017

Institute for Behavior and Health, Inc. , 6191 Executive Blvd , Rockville, MD 20852 , www.IBHinc.org 1

Background 

The Institute for Behavior and Health, Inc. (IBH) is a 501(c)3 non-profit substance use policy and research organization that was founded in 1978. Non-partisan and non-political, IBH develops new ideas and serves as a force for change.

Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs and Health was published in November 2016. Four months later, in March 2017, IBH held a meeting of 25 leaders in addiction treatment, health care, insurance, government and research to discuss the scope and implications of this historic document. The US Surgeon General, VADM Vivek H. Murthy, MD, was an active participant in the meeting. The significance of this new Surgeon General’s Report is analogous to the historic 1964 Surgeon General’s report, Smoking and Health, a document that inspired an extraordinarily successful public health response in the United States that has reduced the rates of cigarette smoking by over 64% and continues its impact even today, more than 50 years following its release.

The following is a summary of the discussion at the March 2017 meeting and the conclusions and recommendations that were developed.

Introduction: The 2016 Surgeon General’s Report 

The two primary objectives of the US Surgeon General’s Report of 2016 are first to provide scientific evidence that shows that in addition to nicotine, other substance misuse and addiction issues (e.g., alcohol, opioids, marijuana, etc.) also are best understood and addressed as public health problems; and second to encourage the inclusion of addiction – its prevention, early recognition and intervention, treatment and active long-term recovery management – into the mainstream of American health care. At present these elements are not integrated either as a stand-alone continuum or within the general medical system. As is true for other widespread illnesses, addiction to nicotine, alcohol, marijuana, opioids, cocaine and other substances is a serious chronic illness. This perspective is contrary to the common perception that addiction reflects a moral failing, a personal weakness or poor parenting. Such opinions have stigmatized individuals who are suffering from these often deadly substance use disorders and have led to expensive and ineffective public policies that segregate prevention and treatment outside of mainstream medical care. A better public health approach encourages afflicted individuals and their family members to seek and receive help within the current health care system for these serious health problems.

An informed public health approach to reducing the prevalence and the harms associated with substance use disorders requires more than the brief treatment of serious cases. Particularly important are substance use prevention programs in schools, healthcare and in all other parts of the community to protect adolescents (ages 12 – 21), the group most at risk for the initiation of substance-related harms and substance use disorders.  Importantly, abundant tragic experience and accumulating science show that substance use disorders are not effectively treated with only short-term care. Because substance use disorders produce 2 significant long-lasting changes in the brain circuits responsible for memory, motivation, inhibition, reward sensitivity and stress tolerance, addicted individuals remain vulnerable to relapse years following specialized treatment.1, 2, 3 Thus, as is true for all other chronic illnesses, long periods of personalized treatment and monitoring are necessary to assure compliance with care, continued sobriety, and improved health and social function. In combination, science-based prevention, early intervention, continuing care and monitoring comprise a modern continuum of public health care. The overall goals of this continuum comport well with those of other chronic illnesses:

1 US Department of Health and Human Services (HHS), Office of the Surgeon General. (2016). Chapter 2. The Neurobiology of Substance Use, Misuse, and Addiction. In: Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Washington, DC: HHS. Available: https://addiction.surgeongeneral.gov/

2 US Department of Health and Human Services (HHS), Office of the Surgeon General. (2016). Chapter 5. Recovery: The Many Paths to Wellness. In: Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Washington, DC: HHS. Available: https://addiction.surgeongeneral.gov/

3 Betty Ford Institute Consensus Panel. (2007). What is recovery? A working definition from the Betty Ford Institute. Journal of Substance Abuse Treatment, 33(3), 221-228.

4 White, W. L. (2012). Recovery/remission from substance use disorders: An analysis of reported outcomes in 415 scientific reports, 1868-2011. Philadelphia, PA: Philadelphia Department of Behavioral Health and Intellectual Disability Services.

· sustained reduction of the cardinal symptom of the illness, i.e., substance use;

· improved general health and function; and,

· education and training of the patient and the family to self-manage the illness and avoid relapses.

In the addiction field achieving these goals is called “recovery.” This word is used to describe abstention from the use of alcohol, marijuana and other non-prescribed drugs as well as improved personal health and social responsibility.3,4 Over 25 million formerly addicted Americans are in stable, long-term recovery of a year or longer.4 Understanding how to consistently accomplish the life-saving goal of recovery must inform health care decisions.

The 2016 Surgeon General’s Report offers a science-informed vision and path to recovery in response to the nation’s serious addiction problem, including specifically the opioid overdose epidemic. Research shows that it is possible to prevent or delay most cases of substance misuse; and to effectively treat even the most serious substance use disorders with recovery as an expectable result of comprehensive, continuous care and sustained monitoring. To do this, substance use disorders must be recognized as serious, chronic health conditions that are both preventable and treatable. The nation must integrate the short-term siloed episodes of specialty treatment that now are isolated from mainstream healthcare into a fully integrated continuum of care comparable to that currently available to those with other chronic illnesses such as diabetes, hypertension, asthma and chronic pain.

Meeting Discussion and Conclusions 

The Surgeon General’s Report and the meeting convened by the Institute for Behavior and Health, Inc. (IBH) to promote its recommendations are significant responses to the expanding epidemic of opioid 3 and other substance use disorders, an epidemic that struck nearly 21 million Americans aged 12 and older in 2015 alone.5 That year saw more than 52,000 overdose deaths.6 This drug epidemic has devastated countless families and communities throughout the US. Unlike earlier and smaller drug epidemics, the current opioid epidemic is not limited to a few regions or communities or a narrow range of ethnicities or incomes in the United States. Instead it afflicts all communities and all socioeconomic groups; its impacts include smaller communities and rural areas as well as suburban areas and inner cities. Fuelled by the suffering of countless grieving families, the nation is in the early stages of confronting the new epidemic. A growing national determination to turn back this deadly epidemic has opened the door to innovation that is sustained by strong bipartisan political support for new and improved efforts in both prevention and treatment of substance use disorders.

5 Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50). Available: http://www.samhsa.gov/data/

6 Rudd, R. A., Seth, P., David, F., & Scholl, L. (2016, December 30). Increases in drug and opioid-involved overdose deaths – United States. Morbidity and Mortality Weekly Report, 65(50-51), 1445-1452. Available: https://www.cdc.gov/mmwr/volumes/65/wr/mm655051e1.htm

7 Levy, S. J., Williams, J. F., & AAP Committee on Substance Use and Prevention. (2016). Substance use screening, brief intervention, and referral to treatment. Pediatrics, 138(1), e20161211. Available: http://pediatrics.aappublications.org/content/138/1/e20161211

8 US Department of Health and Human Services (HHS), Office of the Surgeon General. (2016). Chapter 3. Prevention Programs and Policies. In: Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Washington, DC: HHS. Available: https://addiction.surgeongeneral.gov/

Abstinence is an Achievable Goal, both for Prevention and for Treatment 

Embracing and synthesizing the 30 years of science supporting the findings of the 2016 Surgeon General’s Report, the group discussed a single goal for the prevention of addiction: no use of alcohol, nicotine, marijuana or other non-prescribed drugs by youth for reasons of health. This goal should be the core prevention message to all children from a very young age. Health care professionals, educators and parents should understand the importance of this simple, clear health message. They should continue to reinforce this message of no-use for health as children grow to adulthood. Even when prevention fails, it is possible for parents, other family members, friends, primary care clinicians, educators and others to identify and to intervene quickly to stop youth substance use from becoming addiction.7

The science behind this ambitious but attainable prevention goal is clear. Alcohol, nicotine products, marijuana and other non-prescribed drug use is uniquely harmful to the still-developing brains of adolescents. Thus any substance “use” among youth must be considered “misuse” – use that may harm self or others. The goal of no substance use is not just for the purpose of preventing addiction, though that is one clear and important by product of successful prevention. Addiction is a biological process that can take years to develop. In contrast, even a single episode of high-dose use of alcohol or other substance could immediately produce an injury, accident or even death. While it is true that most episodes of substance misuse among adults do not produce serious problems, it is also true that substance misuse is associated with 70% or more of the injuries, disabilities and deaths of young people.8 These figures are even higher for minority youth. Many adolescent deaths are preventable 4 because most are related to substance use – including substance-related motor vehicle crashes and overdose.9

9 Subramaniam, G. A., & Volkow, N. D. (2014). Substance misuse among adolescents. To screen or not to screen? JAMA Pediatrics, 168(9), 798-799. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4827336/

10 Data analyzed by the Center for Behavioral Health Statistics and Quality. CBHS. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15- 4927, NSDUH Series H-50).

11 2014 data obtained by IBH from the Monitoring the Future study. For discussion of data through 2013 see DuPont, R. L. (2015, July 1). It’s time to re-think prevention; increasing percentages of adolescents understand they should not use any addicting substances. Rockville, MD: Institute for Behavior and Health, Inc. Available: https://www.ibhinc.org/s/IBH_Commentary_Adolescents_No_Use_of_Substances_7-1-15.pdf

Youth who use any one of the three most common “gateway” substances, i.e., alcohol, nicotine and marijuana, are many times more likely than those who do not use that single drug to use the other two substances as well as other illegal drugs.10 The use of any drug opens the door to an endless series of highly risky decisions about which drugs to use, how much to use, and when to use them. This perspective validates the public health goal for youth of no use of any drug.

Complete abstinence from the use of alcohol or any other drug among adolescents is not simply an idealistic goal – it is a goal that can be achieved. Data were presented at the meeting from the nationally representative Monitoring the Future study showing that 26% of American high school seniors in 2014 reported no use of alcohol, cigarettes, marijuana or other non-prescribed drugs in their lifetimes. 11 This is a remarkable increase from only 3% reported by American high school seniors in 1983. Moreover, in the same survey, 50% of high school seniors had not used any alcohol, cigarettes, marijuana or other non-prescribed substance in the past 30 days, up from 16% in 1982. These largely overlooked and important findings show that youth abstinence from any substance use is already widespread and steadily increasing.

In parallel with the goal of abstinence for prevention, the recommended goal for the treatment of those who are addicted is sustained abstinence from the use of alcohol and other drugs, with the caveat, explicitly acknowledged by the group, that individuals who are taking medications as-prescribed in the treatment of substance use disorders (e.g., buprenorphine, methadone and naltrexone) and who do not use alcohol or other non-prescribed addictive substances – are considered to be abstinent and ”in recovery.” Abstinence from all non-prescribed substance use is the scientifically-informed goal for individuals in addiction treatment. This treatment goal is widely accepted in the large national recovery community. The long-lasting effects of addiction to drugs are easily seen among cigarette smokers: smoking only a single cigarette is a serious threat to the former smoker, even decades after smoking the last cigarette. There is incontrovertible evidence from brain and genetic research showing the long-term effects of substance misuse on critical brain regions.2 It is unknown when or if these brain changes will return to being entirely normal following cessation of substance use; however, it is known that the recovering brain is particularly vulnerable to the effects of return to any substance use, often leading to overdose or rapid re-addiction. 5

Participants in the IBH meeting supported the idea that abstinence is the high-value outcome in addiction treatment; and that while any duration of abstinence is valuable, longer-term, stable abstinence of 5 years is analogous to the widely-used standard in cancer treatment of 5-year survival. The scientific basis for the value of sustained recovery is validated by the experience of the estimated 25 million Americans now in recovery. This increasingly visible recovery community is a remarkable and very positive new force in the country.

Measuring and Attaining these Goals 

The mantra from the IBH meeting was, if you don’t measure it, it won’t happen. The group of leaders recognized the paucity of current models for systematic integration of addiction treatment and general healthcare. The group encouraged the identification of promising models and the promotion of innovation to achieve the goal of sustained recovery. Even programs that include fully integrated care of other diseases, managed care and other comprehensive health programs do not reliably achieve the goal of sustained or even temporary recovery for substance use disorders. The meeting participants noted the absence of long-term outcome studies of the treatment of substance use disorders and encouraged all treatment programs not only to extend the care of discharged patients but also to systematically study the trajectories of discharged patients to improve their long-term treatment outcomes. The increasing range of recovery support services after treatment is an important and promising new trend that is now actively promoting sustained recovery.

Meeting participants noted one particularly promising model of public health goal measurement and attainment – the 90-90-90 goals for the treatment of HIV/AIDS: 90% of people with HIV will be screened to know their infection status; 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy; and 90% of all patients receiving antiretroviral therapy will have viral suppression (i.e., zero viral load).12 These measurable goals provide an operational definition of public health success for the country, states and individual healthcare organizations.

12 UNAIDS. (2014). 90-90-90: An Ambitious Treatment Target to Help End the AIDS epidemic. Geneva, Switzerland: Joint United Nations Programme on HIV/AIDS. Available: http://www.unaids.org/sites/default/files/media_asset/90-90-90_en_0.pdf

With this model as background, the IBH group concluded that a similar public health approach and similarly specific numeric goals should be established for preventing and treating substance use disorders. Examples of parallel national prevention goals could include 90% rates of screening for substance misuse among adolescents; 90% provision of interventions and follow-up for those screening positive; and 90% total abstinence rates among youth aged 12-21. While these are admittedly ambitious prevention goals, adoption of them could incentivize families, schools and communities to increase the percentage of youth who do not use any alcohol, nicotine, marijuana or other drugs every year.

A similar approach was adopted by the IBH group to improve the impact of addiction treatment. Again, there would be significant public health value if the US adopted the following goals: 90% of individuals aged 12 or older receive annual screening for substance misuse and substance use disorders; 90% of those who receive a diagnosis of a substance use disorder are referred and meaningfully engaged (at 6 least three sessions) in some form of addiction treatment; and 90% of those engaged in treatment achieve sustained abstinence as measured by drug testing, during and for six months following treatment.

Source:  IBH-Report-A-New-Agenda-to-Turn-Back-the-Drug-Epidemic  May 2017

In Southern Ohio, the number of drug-exposed babies in child protection custody has jumped over 200%.  The problem is so dire that workers agreed to break protocol to invite a reporter to hear their stories.  Foster care placements are at record levels, and the number of drug-exposed newborns in their custody has jumped over 200% in the past decade

Inside the Clinton County child protection office, the week has been tougher than most.

Caseworkers in this thinly populated region of southern Ohio, east of Cincinnati, have grown battle-weary from an opioid epidemic that’s leaving behind a generation of traumatized children. Drugs now account for nearly 80% of their cases. Foster-care placements are at record levels, and the number of drug-exposed newborns in their custody has jumped over 200% in the past decade. Funding, meanwhile, hasn’t budged in years.

“Many of our children have experienced such high levels of trauma that they can’t go into traditional foster homes,” said Kathi Spirk, director of Clinton County job and family services. “They need more specialized care, which is very expensive.”

The problem is so dire that workers agreed to break protocol and invite a reporter to camp out in a conference room and hear their stories. For three days, they relived their worst cases and unloaded their frustrations, in scenes that played out like marathon group therapy, for which they have no time. Many agreed that talking about it only made them feel worse, yet still they continued, one after another.

Hence the bad week.

Given the small size of their community, they asked that their names be changed out of concern for their own safety and the privacy of the children.

The caseworkers, like most, are seasoned in despair. Many worked in the 1990s when crack cocaine first arrived, followed by crystal meth in the early 2000s. In 2008, after the shipping giant DHL shuttered its domestic hub here in Wilmington and shed more than 7,000 jobs, prescription pill mills flourished while the economy staggered. Back then, a typical month saw 30 open cases, only a few of them drug-related. But the flood of cheap heroin and fentanyl, now at its highest point yet, has changed everything. A typical month now brings four times as many cases, while institutional knowledge has been flipped on its head.

“At least with meth and cocaine, there was a fight,” said Laura, a supervisor with over 20 years of experience. “Parents used to challenge you to not take their kids. And now you have them say: ‘Here’s their stuff. Here’s their formula and clothes.’ They’re just done. They’re not going to fight you any more.”

Heroin has changed how they approach every step of their jobs, they said, from the first intake calls to that painstaking decision to place a child into temporary foster care or permanent custody. Intake workers now fear what used to be routine.

“Occasionally, we’d get thrown a dirty house, something easy to close and with little trauma to the child,” said Leslie, another worker. “We’re not getting those any more.

Now they’re all serious, and most of them have a drug component. So you may get a dirty house, but it’s never just a dirty house.”

‘I had a four-year old whose mom had died in front of her and she described it like it was nothing’ Children come into the system in two ways. The first is through a court order after caseworkers deem their environment unsafe, and if no friends or family can be found.

Because of the added trauma, removing a child is always the last option, caseworkers said. But in a county with only 42,000 people spread out over 400 square miles, the magnitude of the epidemic has compromised an already delicate safety net. Relatives are overwhelmed financially. Multiple generations are now addicted, along with cousins, uncles, and neighbors. In many cases, a safe house with a grandparent or other relative will eventually attract drug activity.

Law enforcement will also bring children in, usually after parents overdose. These cases often reveal the most horrendous neglect: a three-year old who needed every tooth pulled because he’d never been made to brush them, or kids found sleeping on bug-infested mattresses, going to the toilet in buckets because the water had been shut off. Children are coming in more hardened, they said, older than their years.

“I had a four-year-old whose mom had died in front of her and she described it like it was nothing,” said Bridgette, another caseworker. “She knew how to roll up a dollar bill and snort white powder off the counter. That’s what she thought dollar bills were for.” She added that many of the children could detail how to cook heroin. One foster family had a five-year-old boy who put his medicine dropper in his shoe. “Because that’s where daddy hid his needles,” she said.

“The kids are used to surviving in that mess,” added Carole, another veteran. “Now all the sudden the system is going in and saying it’s not safe. All their survival instincts are taken away and they go ballistic. They don’t know what to do.”

During the first weeks of foster care, meltdowns, tantrums, and violence are common as children navigate new landscapes and begin to process what they’ve experienced.

One afternoon, the caseworkers brought in a foster couple who’d taken in two sisters, an infant born drug-exposed, and her four-year old sister. The baby had to be weaned off opioids and now suffered chronic respiratory problems. Part of her withdrawal had included non-stop hiccups. The older girl had lived with her parents in a drug house and displayed clear signs of post-traumatic stress. Once, a family friend sitting next to her in a car had overdosed and turned purple. She’d witnessed domestic abuse, and one day a neighbor shot and killed her dog while she watched (she’d let the dog out). After a meltdown at a classmate’s pool party, over a year after entering foster care, she revealed having seen a toddler drown in a pond while adults got high. Through therapy, she’d also revealed sexual assault. The foster mother described how the girl suffered flashbacks, triggered by stress and certain anniversaries, like the day of her removal, and other seemingly random events. When this happened, she slipped into catatonic seizures.

“Her eyes are closed and you can’t wake her,” she said. “It’s like narcolepsy, a deep, unconscious sleep. We later discovered it was a coping mechanism she’d developed in order to survive.”

Despite what they’ve endured, most children wish desperately to return to their parents. Many come to see themselves as their parents’ caretakers and feel guilty for being taken away, especially if they were the ones to report an overdose, as in the case of a four-year-old girl who climbed out of a window to alert a neighbor. “She asked me: if I took her away, who was going to take care of mommy?” Bridgette remembered.

For caseworkers, reunification is the endgame. After children enter temporary foster care, the agency spends up to two years working closely with the family while the parents try to stay sober. The only contact with their children comes in the form of twice-weekly visits held in designated rooms here at the office. Each contains a tattered sofa and some second-hand toys. Currently, the agency runs about 200 visits each week. The encounters are monitored through closed-circuit cameras. For everyone involved, it can be the most trying period.

Many parents use the time to build trust and re-establish bonds. “During those first four years, a child gets such good stuff from their parents,” said Sherry, the caseworker who monitors the visits. “The kids are just trying to get that back.” Some parents bring doughnuts and pictures, while others need more guidance. Caseworkers hold parenting classes. Some moms lost newborns at the hospital after they tested positive for drugs; workers teach them how to feed and hold the child, and encourage them to bring outfits to dress their babies.

For other children, the visits trigger a storm of emotion that churns up the trauma of removal. “We had one girl who’d scream and wail at the end of every visit,” Laura, the supervisor, remembered. “Each time she thought she’d never see her mother again. We’d have to pry her out of mom’s arms and carry her down the hallway.”

“We’d sit in our offices and just sob,” added another worker. “But that girl’s cries weren’t enough to keep Mom off heroin.”

The number of available foster families is dwindling, while the cost of supporting them has never been higher

Perhaps the greatest difference with heroin and opioids, caseworkers said, is their iron grasp. Staying sober is a herculean task, especially in this rural community short on resources, where the nearest treatment facilities are over 30 miles away in Dayton, Cincinnati, or Columbus. At some point, nearly every parent falls off the wagon. They disappear and miss visits, leaving children to wait. One of the hardest parts of the job is telling a child that mom or dad isn’t coming, or that they can’t even be found.

“You see the hurt in their eyes,” Sherry said. “It’s a look of defeat, and it just breaks your heart.” She remembered a mother who’d failed to show up for months, then made it for her twin boys’ birthday. “The next day she overdosed and died.”

A tally sheet is used to track how many times prospective clients waiting to enter the program call a detox center, in Huntington, West Virginia. Photograph: Brendan Smialowski/AFP/Getty Images

When parents fail drug screenings during the 18-month period, caseworkers use discretion. Parents might be doing better in other areas like landing a job, or finding secure housing, so workers help them to get back on the wagon. “It’s all about showing progress,” Laura said. Some parents make it 16, 17 months sober and fully engaged. “And they’re the toughest cases, because we’ve been rooting for them this whole time and helping them. We’re giving kids pep talks, saying: ‘Mom’s doing great, she’s getting it together!’ They’re so happy to be going home. And then it all falls apart.”

With heroin, defeat is something the workers have learned to reckon with. Lately they’ve started snapping photos of parents and children during their first visit together, getting medical histories and other vital information – something they used to do much later. “Because we know the parents probably aren’t going to make it,” Laura admitted. “And if we never see them again, this is the info we need.” When asked how many opioid cases had ended in reunification, only two workers raised their hands.

The repeated disappointments come as resources and morale have reached their tipping point. The number of available foster families is dwindling, they said, while the cost of supporting them – over $1.5m a year – has never been higher.

Spirk, the agency’s director, said that all the agency’s budget was paid for with federal dollars and a county tax levy, although they’ve been flat-funded for nearly 10 years. The state contributes just 10%. When it comes to investing in child protection, Ohio ranks last in the country – despite having spent nearly $1bn fighting its opioid problem in 2016 alone.

The Ohio house of representatives recently passed a new state budget with an additional $15m for child protective services, but the state senate has yet to pass its own version. The only bit of hope came in March, when the Ohio attorney general’s office announced a pilot program that will give Clinton County, along with others, additional resources to help treat children for trauma, and to assist with drug treatment. It starts in October.

The epidemic’s unrelenting barrage has also taken a toll on mental health. “Our caseworkers are experiencing secondary trauma and frustration at not being able to reunify children with their parents because of relapses,” Spirk said.

Almost every caseworker said they had experienced depression or some form of PTSD, although no one had sought professional help. The privacy of their cases also means that few can speak openly with friends or family members. Some chose to drink, while others leaned on their faiths. But most said coping mechanisms they once relied on had failed.

“I used to have a routine on my drive home,” Laura said. “I’d stop in front of a church, roll down my window, and throw out all the day’s problems. The next morning I’d pick them back up. These days, I can’t do that anymore.”

“There’s no more outlet,” added Shelly, another supervisor. “You think you’re able to separate but you can’t let it go anymore. You try to eat healthy, do yoga, whatever they tell you to do. But it’s just so horrific now, and it keeps getting worse.”

At some point, the inevitable happens. When a parent can’t stay sober, or stops showing progress, the decision is made to place the child into permanent custody and put them up for adoption. For everyone, including caseworkers, it’s the most wrenching day.

The final act of every case is the “goodbye visit”, held in one of the nicer conference rooms. It’s a chance for parents to let their children know they love them and will miss them, and that it’s time to move on. Adoptive parents can choose to stay in contact, but it isn’t mandatory.

To make the time less stressful, Sherry, the worker who monitors the visits, has them draw pictures together, which she scans and gives to them as mementoes. She also tapes the meetings for them to keep. Watching from her tiny room full of TV screens, she can’t help but cry. “What people don’t realize is that when a baby comes into our custody, they’re still in a carrier seat. By the time the case is over, we’ve helped to potty train them. Two years is a very long time with a child. So in a way, it’s like my goodbye visit, too.”

Caseworkers have started making “life books” for kids once they come into the system. It’s where they put the photos they’ve taken, plus any pictures of birth parents or relatives they can find, report cards, ribbons and medals – the souvenirs of any childhood.  “It’s their history,” Sherry said, “so that one day they can make sense of their lives.”   She noted that one kid, after turning 18, tore his to pieces, taking with him only the good memories.

Source:  https://www.theguardian.com/us-news/2017/may/17/ohio-drugs-child-protection-workers

Addiction is treatable. So why aren’t more people receiving quality care?

The crisis is well documented and reported: More people are dying of drug overdose than any other non-natural cause—more than from guns, suicide, and car accidents. Politicians have held press conferences, formed commissions and task forces, and convened town-hall meetings. Vivek Murthy, the Surgeon General under President Obama (fired by Donald Trump), issued an historic report on America’s drug-use and addiction crises. Pharmaceutical companies have been blamed. Drug cartels. Physicians who hand out pain pills like Skittles.

In the meantime, the problem worsens. In 2015, 52,000 people died because of overdose, including 33,000 on OxyContin, heroin, and other opioids. Almost three times that number died of causes related to the most-used mood-altering addictive drug, alcohol. The 2016 and 2017 overdose numbers are predicted to be higher. Currently, fentanyl deaths are skyrocketing. If not politicians, to whom can we turn to address the crisis? Since addiction is a health problem, the logical answer would be the addiction-treatment system, but it’s in disarray.

Currently most people who enter treatment are subjected to archaic care, some of which does more harm than good. Only about 10 percent of people who need treatment for drug-use disorders get any whatsoever. Of those who do, a majority enter programs with practices that would be considered barbaric if they were common in treatment systems for other diseases.

Many programs reject science and employ one-size-fits-all-addicts treatment. Patients are often subjected to a slipshod patchwork of unproven therapies. They pass talking sticks and bat horses with Nerf noodles. In some programs, patients are subjected to confrontational therapies, which may include the badgering of those who resist engaging in 12-Step programs, participation in which is required in almost every program. These support groups help some people, but alienate others. When compulsory, they can be detrimental.

Patients are routinely kicked out of programs for exhibiting symptoms of their disease (relapse or breaking rules), which is unconscionable. They are denied life-saving medications by practitioners who don’t believe in them—as Richard Rawson, PhD, research professor, UVM Center for Behavior and Health, says, “this is tantamount to a doctor not believing in Coumadin to prevent heart attacks or insulin for diabetes.”

Patients are put in programs for arbitrary periods of time. Three or five days of detox isn’t treatment. Many residential programs last for twenty-eight days, but research has shown that a month is rarely long enough to treat this disease. Some of those who enter residential treatment do get sober, but they relapse soon after they’re discharged, with, as addiction researcher Thomas McLellan, PhD, sums, “a hearty handshake and instructions to go off to a church basement someplace.” As he says, “It just won’t work.” Finally, people afflicted with this disease are almost never assessed and treated for co-occurring psychiatric disorders, in spite of the fact they almost always accompany and underlie life-threatening drug use. If both illnesses aren’t addressed, relapse is likely.

The disastrous state of the system suggests that addiction-medicine specialists don’t know how to treat substance-use disorders (or even if they can be treated). It’s not the case. The National Institute on Drug Abuse (NIDA) and organizations of addiction-care professionals like the American Society of Addiction Medicine (ASAM) and American Association of Addiction Psychiatry (AAAP) have identified effective treatments. There’s no easy cure for many complex diseases, including addiction. However, cognitive-behavior therapy, motivational interviewing, and addiction medications, often used in concert with one another and in concert with assessment and treatment dual diagnoses, are among many proven treatments. However, most patients are never offered these treatments because of a fatal chasm between addiction science and practitioners and programs.

Fixing the system requires modeling it on the one in place for other serious illnesses. Most people enter the medical system in their primary-care doctors’ offices, health clinics, or emergency rooms. Currently, most doctors in these settings have had little or no education about addiction. A recent ASAM survey of two thirds of U.S. medical schools found that they require an average of less than an hour of training in addiction treatment.

Doctors must be taught to recognize substance-use disorders and treat them immediately—the archaic “let them hit bottom” paradigm has been discredited. They should offer or refer for brief interventions. A program called SBIRT (Screening, Brief Intervention and Referral to Treatment), which seeks to identify risky substance use and includes as few as three counselling sessions, has proven effective in many cases, and may be implemented in general healthcare settings.

Primary-care doctors should be trained and certified to prescribe buprenorphine, a medication that decreases craving and prevents overdose on opioids. Currently, there are limitations on the number of patients doctors can treat. Still, in Vermont, for example, almost 50 percent of opioid users in treatment receive care in their doctors’ offices- they don’t have to go to addiction specialists or intensive treatment programs to receive care.

When a patient requires a higher level of care, doctors must refer them to addiction specialists, which excludes many current practitioners whose only qualification to treat addiction is their own experience in recovery. Instead, patients must be seen by psychiatrists and psychologists trained to diagnose and treat the wide range of substance use disorders. There’s a shortage of these doctors; there needs to be a concerted effort to fill the void.

According to Larissa Mooney, MD, director of the UCLA Addiction Medicine Clinic, “Individuals entering treatment should be presented with an informed discussion about treatment options that include effective, research-based interventions.  In our current system, treatment recommendations vary widely and may come with bias; medication treatments are either not offered or may be presented as a less desirable option in the path to recovery. Treatment should be individualized, and if the same form of treatment has been repeated over and over with poor results (i.e. relapse), an alternative or more comprehensive approach should be suggested.”

When determining if a patient should be treated in physicians’ offices, intensive-outpatient, or residential setting, doctors should rely on ASAM guidelines, not guesses. The length of treatment must be determined by necessity, not insurance. If a patient relapses, is recalcitrant, or breaks rules, treatment should be re-evaluated. They may need a higher level of care, but sick people should never be put out on the street. In addition, all practitioners must reject the archaic proscriptions against medication-assisted treatment; Rawson says that failing to prescribe addiction medications in the case of opioid addiction “should be considered malpractice.”

Programs must also address the fact that a majority of people with substance-use disorders have interrelated psychiatric illnesses. Patients should undergo clinical evaluation, which may include psychological testing. Those with dual diagnoses must be treated for their co-occurring disorders. Finally, initial treatments must be followed by aftercare that’s monitored by an addiction psychiatrist, psychologist, or physician. In short, the field must adopt gold-standard, research-based best practices.

People blame politicians, drug dealers, and pharmaceutical companies for the overdose crisis. However, that won’t help the millions of addicted Americans who need treatment now. Even the most devoted and skilled addiction professionals must acknowledge that they’re part of a broken system that’s killing people. No one can repair it but them.

Source:https://www.psychologytoday.com/blog/overcoming-addiction/201705/sobering-truth-about-addiction-treatment-in-america  May 2017

COLUMBUS, Ohio — It’s being called “gray death” — a new and dangerous opioid combo that underscores the ever-changing nature of the U.S. addiction crisis.

Investigators who nicknamed the mixture have detected it or recorded overdoses blamed on it in Alabama, Georgia and Ohio. The drug looks like concrete mix and varies in consistency from a hard, chunky material to a fine powder.

The substance is a combination of several opioids blamed for thousands of fatal overdoses nationally, including heroin, fentanyl, carfentanil – sometimes used to tranquilize large animals like elephants – and a synthetic opioid called U-47700.

“Gray death is one of the scariest combinations that I have ever seen in nearly 20 years of forensic chemistry drug analysis,” Deneen Kilcrease, manager of the chemistry section at the Georgia Bureau of Investigation, said.  Gray death ingredients and their concentrations are unknown to users, making it particularly lethal, Kilcrease said. In addition, because these strong drugs can be absorbed through the skin, simply touching the powder puts users at risk, she said.

Last year, the U.S. Drug Enforcement Administration listed U-47700 in the category of the most dangerous drugs it regulates, saying it was associated with dozens of fatalities, mostly in New York and North Carolina. Some of the pills taken from Prince’s estate after the musician’s overdose death last year contained U-47700.

Gray death has a much higher potency than heroin, according to a bulletin issued by the Gulf Coast High Intensity Drug Trafficking Area. Users inject, swallow, smoke or snort it.

Georgia’s investigation bureau has received 50 overdose cases in the past three months involving gray death, most from the Atlanta area, said spokeswoman Nelly Miles.

In Ohio, the coroner’s office serving the Cincinnati area says a similar compound has been coming in for months. The Ohio attorney general ‘s office has analyzed eight samples matching the gray death mixture from around the state.

The combo is just the latest in the trend of heroin mixed with other opioids, such as fentanyl, that has been around for a few years.  Fentanyl-related deaths spiked so high in Ohio in 2015 that state health officials asked the federal Centers for Disease Control and Prevention to send scientists to help address the problem.

The mixing poses a deadly risk to users and also challenges investigators trying to figure out what they’re dealing with this time around, said Ohio Attorney General Mike DeWine, a Republican.

“Normally, we would be able to walk by one of our scientists, and say ‘What are you testing?’ and they’ll tell you heroin or ‘We’re testing fentanyl,’” DeWine said. “Now, sometimes they’re looking at it, at least initially, and say, ‘Well, we don’t know.’”

Some communities also are seeing fentanyl mixed with non-opioids, such as cocaine. In Rhode Island, the state has recommended that individuals with a history of cocaine use receive supplies of the anti-overdose drug naloxone.

These deadly combinations are becoming a hallmark of the heroin and opioid epidemic, which the government says resulted in 33,000 fatal overdoses nationally in 2015. In Ohio, a record 3,050 people died of drug overdoses last year, most the result of opioid painkillers or their relative, heroin.

Most people with addictions buy heroin in the belief that’s exactly what they’re getting, overdose survivor Richie Webber said.  But that’s often not the case, as he found out in 2014 when he overdosed on fentanyl-laced heroin. It took two doses of naloxone to revive him. He’s now sober and runs a treatment organization, Fight for Recovery, in Clyde, about 45 miles (72 kilometers) southeast of Toledo.

A typical new combination he’s seeing is heroin combined with 3-methylfentanyl, a more powerful version of fentanyl, said Webber, 25. It’s one of the reasons he tells users never to take drugs alone.

“You don’t know what you’re getting with these things,” Webber said. “Every time you shoot up you’re literally playing Russian roulette with your life.”

Source:  https://www.statnews.com/2017/05/04/opioid-gray-death-overdoses/  4th May 2017

The opioid epidemic has led to the deadliest drug crisis in US history – even deadlier than the crack epidemic of the 1980s and 1990s.

Drug overdoses now cause more deaths than gun violence and car crashes. They even caused more deaths in 2015 than HIV/AIDS did at the height of the epidemic in 1995.

A new study suggests that we may be underestimating the death toll of the opioid epidemic and current drug crisis. The study, conducted by researchers at the Centers for Disease Control and Prevention (CDC), looked at 1,676 deaths in Minnesota’s Unexplained Death surveillance system (UNEX) from 2006 – 2015. The system is meant to refer cases with no clear cause of death to further testing and analysis. In total, 59 of the UNEX deaths, or about 3.5 percent, were linked to opioids. But more than half of these opioid-linked deaths didn’t show up in Minnesota’s official total for opioid related deaths.

It is unclear how widespread of a problem this is in other death surveillance systems and other states, but the study’s findings suggest that the numbers we have so far for opioid deaths are at best a minimum. Typically, deaths are marked by local coroners or medical examiners through a system; if the medical examiner marks a death as immediately caused by an opioid overdose, the death is eventually added to the US’s total for opioid overdose deaths. But there is no national standard for what counts as an opioid overdose, so it’s left to local medical officials to decide whether a death was caused by an overdose or not. This can get surprisingly tricky – particularly in cases involving multiple conditions or for cases in which someone’s death seemed to be immediately caused by one condition, but that condition had a separate underlying medical issue behind it.

For example, opioids are believed to increase the risk of pneumonia. But if a medical examiner sees that a person died of pneumonia, they might mark the death as caused by pneumonia, even if the opioids were the underlying cause for the death. “In early spring, the Minnesota Department of Health was notified of an unexplained death: a middle-aged man who died suddenly at home. He was on long-term opioid therapy for some back pain, and his family was a little bit concerned that he was abusing his medication,” said Victoria Hall, one of the study’s authors.

“After the autopsy, the medical examiner was quite concerned about pneumonia in this case, and that’s how the case was referred to the Minnesota Department of Health unexplained deaths program. Further testing diagnosed an influenza pneumonia, but also detected a toxic level of opioids in his system. However, on the death certificate, it only listed the pneumonia and made no mention of opioids.”

Since this is just one study of one surveillance system in one state, it’s unclear just how widespread this kind of underreporting is in the United States. But the data suggests that there is at least some undercounting going on – which is especially worrying, as this is already the deadliest drug overdose crisis in US history. “It does seem like it is almost an iceberg of an epidemic,” said Hall. “We already know that it’s bad. And while my research can’t speak to what percent we’re underestimating, we know we are missing some cases.” In 2015, more Americans died of drug overdoses than any other year on record – more than 52,000 deaths in just one year. That’s higher than the more than

38,000 who died in car crashes, the more than 36,000 who died from gun violence, and the more than 43,000 who died due to HIV/AIDS during that epidemic’s peak in 1995.

See more: • The Changing Face of Heroin Use in the US study • Today’s Heroin Epidemic – CDC

Source:  Prevention Weekly. news@cadca.org  May 2017

Challenges Top Marijuana Lobbyist to Answer Four Questions

[Alexandria, VA, May 2, 2017] – Today, Smart Approaches to Marijuana (SAM), a national organization committed to promoting evidence-based marijuana laws at the Federal, state, and local levels, released the following statement in reaction to the admission by Rob Kampia, the Executive Director of the Marijuana Policy Project, that the special interest group is actively soliciting financial contributions from the tobacco industry in exchange for shaping their marijuana legalization initiatives. MPP is the lead lobbying group responsible for funding and organizing every state-based marijuana commercialization campaign in the U.S.

“Rob Kampia’s shameless solicitation for contributions from the tobacco industry is quid pro quo special interest politics at its worst,” said Dr. Kevin Sabet, President and CEO of SAM. “Marijuana laws in our country should be informed by science and evidence, not the financial interests of the tobacco industry or a growing for-profit marijuana industry.  When the head of the lobbying group responsible for every single marijuana legalization initiative in America asks tobacco companies, ‘what do you want?’ it should send chills down the spine of every public health and safety official in America.

This is an outrage and we challenge the Marijuana Policy Project to immediately disclose any and all ties to the tobacco industry so that communities in Michigan and across the country considering changes to marijuana laws can see through the haze of what’s really driving pro-marijuana legalization campaigns in America.”

Kampia’s admission was published last week in the Marijuana Business Daily in a story entitled, “MPP Chief Ready to Barter For Marijuana Campaign Donations.” According to the Daily:

The executive director of Marijuana Policy Project, Kampia called Marijuana Business Daily on Thursday after reading an MJBizDaily story about negotiations in Michigan over a likely ballot measure to legalize recreational cannabis in the state.

He solicited tobacco business interests in Michigan in search of campaign donations to run what will likely be a multimillion-dollar, 19-month endeavor, but he said he was largely unsuccessful.

“It’s the kind of thing where I actually go out and I try to court well-funded constituencies and philanthropists, and say, ‘What do you want, what do you hate, what’s going to turn you off so I can’t actually ask you for money later,’ and sometimes you get so far as to say … ‘Is there something that we put something in here that would cause you to immediately escalate your commitment?'” Kampia explained…

In response to Kampia’s latest comments, SAM also challenged MPP to answer four questions regarding MPP’s ties to the tobacco industry:

1. How much total money has MPP taken from the tobacco industry since the organization was established in 1995?

2. Which state-based marijuana ballot initiatives led by MPP have been influenced by input from the tobacco industry?

3. What specific changes to marijuana legislation or ballot initiatives has the tobacco industry proposed in exchange for financial contributions to MPP?

4. Has MPP disclosed its ties to the tobacco industry with Members of Congress it is currently lobbying in support of Federal legislation that would incentivize the commercialization of marijuana in the United States?

Evidence demonstrates that marijuana – which has skyrocketed in average potency over the past decades – is addictive and harmful to the human brain, especially when used by adolescents. Moreover, in states that have already legalized the drug, there has been an increase in drugged driving crashes and youth marijuana use. States that have legalized marijuana have also failed to shore up state budget shortfalls with marijuana taxes, continue to see a thriving black market, and are experiencing a continued rise in alcohol sales.

Source:  learnaboutsam.org.  2nd May 2017

A new study released today by JAMA Psychiatry found that rates of marijuana use and marijuana addiction increased significantly more in states that passed medical marijuana laws as compared to states that have not. Examining data from 1992 to 2013, researchers concluded that medical marijuana laws likely contributed to an increased prevalence of marijuana and marijuana-addicted users.

“Politicians and pro-pot special interests are quick to tout the benefits of medical marijuana legalization, but it’s time to see through the haze —     medical marijuana has gone completely unregulated,” said SAM President Kevin Sabet. “More people in these states are suffering from an addiction to marijuana that harms their lives and relationships, while simultaneously more have begun using marijuana. No one wants to see patients denied something that might help them, but this study underscores the fact that “medical” and “recreational” legalization are blurred lines. Smoked marijuana is not medicine, and has not been proven safe and effective as other FDA-approved medications have.”

The study’s researchers wrote that increases in marijuana use in states with medical marijuana laws “may have resulted from increasing availability, potency, perceived safety, [or] generally permissive attitudes.” They conclude that “changing state laws (medical or recreational) may also have adverse public health consequences.”  Evidence demonstrates that marijuana —     which has skyrocketed in average potency over the past decades —     is addictive and harmful to the human brain, especially when used by adolescents. Moreover, in states that have already legalized the drug, there has been an increase in drugged driving crashes and youth marijuana use. States that have legalized marijuana have also failed to shore up state budget shortfalls with marijuana taxes, continue to see a thriving black market, and are experiencing a continued rise in alcohol sales.

Source:  http://www.learnaboutsam.org.  Alexandria, VA, April 26, 2017

About SAM

Smart Approaches to Marijuana (SAM) is a nonpartisan, non-profit alliance of physicians, policy makers, prevention workers, treatment and recovery professionals,  scientists, and other concerned citizens opposed to marijuana legalization who want health and scientific evidence to guide marijuana policies. SAM has affiliates in more than 30 states. For more information about marijuana use and its effects, visit http://www.learnaboutsam.org.

Alzheimer’s and Marijuana ?

An estimated 200,000 people in the United States under age 65 are living with younger-onset Alzheimer’s disease. And hundreds of thousands more are coping with mild cognitive impairment, a precursor to Alzheimer’s and other dementias.

“It’s beyond epidemic proportions. There truly is a tidal wave of Alzheimer’s disease,” said Dr. Vincent Fortanasce, a clinical professor of neurology in Southern California who is also a renowned Catholic bioethicist, author and radio host.

Fortanasce, a member of Legatus’ San Juan Capistrano Chapter, for several years has studied Alzheimer’s disease, its underlying causes and treatments. Through his research, he believes there may be a link between chronic use of marijuana — especially when started at a young age — and Alzheimer’s.

Finding the link

Fortanasce notes that medical research shows chronic users of marijuana, in particular the kind with high quantities of THC, have reduced volume in the hippocampus, the region of the brain responsible for memory and learning. In Alzheimer’s disease, Fortanasce said, medical researchers have also noticed reduced hippocampus volume with increased B-amyloid plaques and neurofibrillary tangles.

Taking into account other factors, such as skyrocketing obesity rates and lack of exercise, Fortanasce argues that chronically smoking marijuana and consuming products laced with cannabis are harming the long-term mental health of millions of young Americans. He is trying to convince the American Academy of Neurology to conduct a major survey to see if people diagnosed with dementia have also smoked marijuana.

Source: :  http://legatus.org/kicking-pot-curb/  April 9th 2017

In 2014, recreational cannabis use was legalized in Colorado, and seven other states have since followed suit. With an ever-expanding part of the population using marijuana to cure a number of ailments, researchers at Colorado State University have investigated its effects on mood. The researchers – led by Lucy Troup, assistant professor in the university’s Department of Psychology – publish their findings in the journal PeerJ.

They note that the “relationship between cannabis use and symptomatology of mood and anxiety disorders is complex,” adding that although “a great deal of research exists and continues to grow, the evidence remains contradictory.” Troup and colleagues point to a large international survey published in 2013, in which 5.2 percent of respondents reported that they used cannabis to alleviate depressive symptoms. Meanwhile, a survey of medical marijuana users in California revealed that 26.1 percent of participants reported therapeutic benefits for depression, and 37.8 percent reported benefits for anxiety.

“This trend of self-medication for conditions other than the one prescribed is too large to ignore when investigating the associations between cannabis use and mood disorders,” write the Colorado State University researchers.

They add that this increases “the need to include recreational users for research, especially when the casual user group are most likely recreational users and seem to sustain the greatest deficits in mood.”

Is cannabis used correctly for self-medication? For their study, Troup and colleagues wanted to focus on Colorado, which was the first state to legalize recreational marijuana.

As such, they conducted an in-depth, questionnaire-based study of 178 legal cannabis users who were aged 18-22.

They divided their participants into three groups based on self-reported use: a control group who never used cannabis, a casual user group, and a group of chronic users.

Interestingly, the participants who were categorized with subclinical depression, and who also used cannabis to treat their depressive symptoms, scored lower on anxiety symptoms than on their depressive symptoms. In short, they were more depressed than anxious.

The researchers also say that the self-reported anxiety sufferers were found to be more anxious than depressed.

Study co-author Jacob Braunwalder, a researcher in Troup’s laboratory, says that “if they were using cannabis for self-medication, it wasn’t doing what they thought it was doing.”

The questionnaire used in the study was developed by co-author Jeremy Andrzejewski. Called the Recreational Cannabis Use Evaluation, the questionnaire delved into users’ habits, including whether they smoked cannabis or used stronger products such as hash oils or edibles.

The researchers say that inconsistencies in previous studies are better understood when considering how cannabis use is reported. “Phytocannabinoid type and strength is not consistent between studies,” they say, “and there have been significant changes in the strength of these products post-legalization.”

‘Infrequent users have stronger relationship with negative mood’

Troup and colleagues say that it is important to point out that they looked at the residual effects of cannabis use, not administration of specific doses.

However, they do note that their results “suggested that cannabis use had an effect on measurements of mood disorder symptomatology. In particular, those who used cannabis less frequently, the casual user group, had the strongest correlations with overall score and negative effect on the CES-D [Center for Epidemiological Studies depression scale].”

Interestingly, the researchers did not observe a relationship with pre-anxiety symptoms in the cannabis user groups, compared with controls.

The researchers emphasize that their study does not conclude that cannabis causes depression or anxiety. It also does not show that cannabis cures these conditions. However, they add that their analysis displays a need for further study regarding how cannabis affects the brain.

Andrzejewski adds that “there is a common perception that cannabis relieves anxiety,” but this has not been fully backed by research.

“It is important not to demonize cannabis, but also not to glorify it,” adds Troup. “What we want to do is study it, and understand what it does. That’s what drives us.”

Concluding their study, the researchers write:

“Our data indicate that infrequent users have a stronger relationship with negative mood. Our data suggested that those that use cannabis casually scored higher on the CES-D scale for depression, and consequently could be at greater risk for developing pre-depression symptomology compared to both chronic users and controls.”

It is important to note that the study has limitations, including:

  •  Sample size
  •  Control for phytocannabinoids in terms of strength and type
  •  Confounding variables such as multiple drug use and alcohol consumption
  •  The self-report design
  • A limited interpretation of depression due to lack of clinical evaluation.

Still, the researchers say that their study “provides a starting point from which to design controlled experiments to further investigate the relationship between mood and cannabis use in a unique population.”

Source:  http://www.medicalnewstoday.com/articles/314823.php   Dec. 2014

A disturbing majority of businesses in the U.S. are being negatively impacted by prescription painkiller abuse and addiction among employees.

A survey recently released by the National Safety Council reveals more than 70 percent of workplaces are feeling the negative effects of opioid abuse. Nearly 40 percent of employers said employees are missing work do to painkiller abuse, with roughly the same percent reporting employees abusing the drugs on the job. Despite the prevalence of addiction in offices across the country, employers are doing little to mitigate risk. Record pill abuse in workplaces is coming at a time when Americans are taking more opioids than ever before, reports The Washington Post.

A recent survey from Truven Health Analytics and NPR reveals more than half of the U.S. population reports receiving a prescription for opioids at least once from their doctor, a 7 percent increase since 2011. Data released by the Centers for Disease Control and Prevention (CDC) Friday reveals that almost half of non-cancer patients prescribed opioids for a month or more are still dependent on the pills a year later.

Experts say that current opioid and heroin abuse is driven in large part by the over-prescribing of pain pills from doctors. Despite the problems opioid abuse is causing in the workplace, many employee drug tests do not look for the substance. Fifty-seven percent of businesses test for drugs, but 41 percent of those businesses do not test for opioids.

“Employers must understand that the most dangerously misused drug today may be sitting in employees’ medicine cabinets,” Deborah Hersman, president and CEO of the National Safety Council, said in a statement. “Even when they are taken as prescribed, prescription drugs and opioids can impair workers and create hazards on the job.”

Among people not currently taking opioids, nearly half view addiction as the biggest threat from using painkillers. Among current patients on opioids, fears over unwanted side effects still dwarf fears about long-term dependence and addiction. Medical professionals say doctors need to start by prescribing the least potent and least addictive pain treatment option, and then cautiously go from there.

Experts also say the patient must take greater responsibility when they visit their doctor and always ask “why” before accepting a prescription.

Addicts may begin with a dependence on opioid pills before transitioning to heroin after building up a tolerance that makes pills too expensive. States hit particularly hard by heroin abuse are beginning to crackdown on doctors liberally doling out painkillers.

“When four out of five new heroin users are getting their start by abusing prescription drugs, you have to attack the problem at ground zero – in irresponsibly run doctors’ offices,” New Jersey Attorney General Porrino said in a statement March 1. “Physicians who grant easy access to the drugs that are turning New Jersey residents into addicts can be every bit as dangerous as street-corner dealers. Purging the medical community of over-prescribers is as important to our cause as busting heroin rings and locking up drug kingpins.”

A record 33,000 Americans died from opioid related overdoses in 2015, according to the CDC. Opioid deaths contributed to the first drop in U.S. life expectancy since 1993 and eclipsed deaths from motor vehicle accidents in 2015. Combined, heroin, fentanyl and other opiate-based painkillers account for roughly 63 percent of drug fatalities, which claimed 52,404 lives in the U.S. in 2015.

Source:  http://dailycaller.com/2017/03/19/opioid-addiction-is-infiltrating-a-majority-of-us-workplaces/

“We should all be dead,” said Jonathan Goyer one bright morning in January as he looked across a room filled with dozens of his co-workers and clients. The Anchor Recovery Community Center, which Goyer helps run, occupies the shell of an office building in Pawtucket, Rhode Island. Founded seven years ago, Anchor specializes in “peer-to-peer” counselling for drug addicts. With state help and private grants, Anchor throws everything but the kitchen sink at addiction. It hosts Narcotics Anonymous meetings, cognitive behavioral therapy sessions, art workshops, and personal counselling. It runs a telephone hotline and a hospital outreach program. It has an employment center for connecting newly drug-free people to sympathetic hirers, and banks of computers for those who lack them. And all the people who work here have been in the very pit of addiction—shoplifting to pay for a morning dose, selling their bodies, or dragging out their adult lives in prison. Some have been taken to emergency rooms and “hit” with powerful anti-overdose drugs to bring them back from respiratory failure.

That is how it was with Goyer. His father died of an overdose at forty-one, in 2004. His twenty-nine-year-old brother OD’d and died in 2009. When he was shooting heroin he slept on the floor of a public garage. He would pick up used hypodermic needles if they were new enough that the volume gauges inked on the outside hadn’t been rubbed off with use. He OD’d several times before getting clean in 2013. Now he visits people after overdoses and tells them, “I was right where you’re at.”

There have always been drug addicts in need of help, but the scale of the present wave of heroin and opioid abuse is unprecedented. Fifty-two thousand Americans died of overdoses in 2015—about four times as many as died from gun homicides and half again as many as died in car accidents. Pawtucket is a small place, and yet 5,400 addicts are members at Anchor. Six hundred visit every day. Rhode Island is a small place, too. It has just over a million people. One Brown University epidemiologist estimates that 20,000 of them are opioid addicts—2 percent of the population.

Salisbury, Massachusetts (pop. 8,000), was founded in 1638, and the opium crisis is the worst thing that has ever happened to it. The town lost one young person in the decade-long Vietnam War. It has lost fifteen to heroin in the last two years. Last summer, Huntington, West Virginia (pop. 49,000), saw twenty-eight overdoses in four hours. Episodes like these played a role in the decline in U.S. life expectancy in 2015. The death toll far eclipses those of all previous drug crises.

And yet, after five decades of alarm over threats that were small by comparison, politicians and the media have offered only a muted response. A willingness at least to talk about opioid deaths (among other taboo subjects) surely helped Donald Trump win last November’s election. In his inaugural address, President Trump referred to the drug epidemic (among other problems) as “carnage.” Those who call the word an irresponsible exaggeration are wrong.

Jazz musicians knew what heroin was in the 1950s. Other Americans needed to have it explained to them. Even in the 1960s and 1970s, with bourgeois norms and drug enforcement weakening, heroin lost none of its terrifying underworld associations. People weren’t shooting it at Woodstock. Today, with much of the discourse on drug addiction controlled by medical bureaucrats, it is common to speak of addiction as an “equal-opportunity disease” that can “strike anyone.” While this may be true on the pharmacological level, it was until quite recently a sociological falsehood. In fact, most of the country had powerful moral, social, cultural, and legal immunities against heroin

and opiate addiction. For 99 percent of the population, it was an adventure that had to be sought out. That has now changed.

America had built up these immunities through hard experience. At the turn of the nineteenth century, scientists isolated morphine, the active ingredient in opium, and in the 1850s the hypodermic needle was invented. They seemed a godsend in Civil War field hospitals, but many soldiers came home addicted. Zealous doctors prescribed opiates to upper-middle-class women for everything from menstrual cramps to “hysteria.” The “acetylization” of morphine led to the development of heroin. Bayer began marketing it as a cough suppressant in 1898, which made matters worse. The tally of wrecked middle-class families and lives was already high by the time Congress passed the Harrison Narcotics Tax Act in 1914, threatening jail for doctors who prescribed opiates to addicts. Americans had had it with heroin. It took almost a century before drug companies could talk them back into using drugs like it.

If you take too much heroin, your breathing slows until you die. Unfortunately, the drug sets an addictive trap that is sinister and subtle. It provides a euphoria—a feeling of contentment, simplification, and release—which users swear has no equal. Users quickly develop a tolerance, requiring higher and higher amounts to get the same effect. The dosage required to attain the feeling the user originally experienced rises until it is higher than the dosage that will kill him. An addict can get more or less “straight,” but approaching the euphoria he longs for requires walking up to the gates of death. If a heroin addict sees on the news that a user or two has died from an overly strong batch of heroin in some housing project somewhere, his first thought is, “Where is that? That’s the stuff I want.”

Tolerance ebbs as fast as it rises. The most dangerous day for a junkie is not the day he gets arrested, although the withdrawal symptoms—should he not receive medical treatment—are painful and embarrassing, and no picnic for his cellmate, either. But withdrawals are not generally life-threatening, as they are for a hardened alcoholic. The dangerous day comes when the addict is released, for the dosage he had taken comfortably until his arrest two weeks ago may now be enough to kill him.

The best way for a society to avoid the dangers of addictive and dangerous drugs is to severely restrict access to them. That is why, in the twentieth century, powerful opiates and opioids (an opioid is a synthetic drug that mimics opium) were largely taboo—confined to patients with serious cancers, and often to end-of-life care. But two decades ago, a combination of libertarian attitudes about drugs and a massive corporate marketing effort combined to instruct millions of vulnerable people about the blessed relief opioids could bring, if only mulish oldsters in the medical profession could get over their hang-ups and be convinced to prescribe them. One of the rhetorical tactics is now familiar from debates about Islam and terrorism: Industry advocates accused doctors reluctant to prescribe addictive medicines of suffering from “opiophobia.”

In 1996, Purdue Pharmaceuticals brought to market OxyContin, an “extended release” version of the opioid oxycodone. (The “-contin” suffix comes from “continuous.”) The time-release formula meant companies could pack lots of oxycodone into one pill, with less risk of abuse, or so scientists claimed. Purdue did not reckon with the ingenuity of addicts, who by smashing or chewing or dissolving the pills could release the whole narcotic load at once. That is the charitable account of what happened. In 2007, three of Purdue’s executives pled guilty to felony misbranding at the time of the release of OxyContin, and the company paid $600 million in fines. In 2010, Purdue brought out a reformulated OxyContin that was harder to tamper with. Most of Purdue’s revenues still come from OxyContin. In 2015, the Sackler family, the company’s sole owners,

suddenly appeared at number sixteen on Forbes magazine’s list of America’s richest families.

Today’s opioid epidemic is, in part, an unintended consequence of the Reagan era. America in the 1980s and 1990s was guided by a coalition of profit-seeking corporations and concerned traditional communities, both of which had felt oppressed by a high-handed government. But whereas Reaganism gave real power to corporations, it gave only rhetorical power to communities. Eventually, when the interests of corporations and communities clashed, the former were in a position to wipe the latter out. The politics of the 1980s wound up enlisting the American middle class in the project of its own dispossession.

OxyContin was only the most commercially successful of many new opioids. At the time, the whole pharmaceutical industry was engaged in a lobbying and public relations effort to restore opioids to the average middle-class family’s pharmacopeia, where they had not been found since before World War I. The American Pain Foundation, which presented itself as an advocate for patients suffering chronic conditions, was revealed by the Washington Post in 2011 to have received 90 percent of its funding from medical companies.

“Pain centers” were endowed. “Chronic pain” became a condition, not just a symptom. The American Pain Society led an advertising campaign calling pain the “fifth vital sign” (after pulse, respiration, blood pressure, and temperature). Certain doctors, notoriously the anaesthesiologist Russell Portenoy of the Beth Israel Medical Center, called for more aggressive pain treatment. “We had to destigmatize these drugs,” he later told the Wall Street Journal. A whole generation of doctors was schooled in the new understanding of pain. Patients threatened malpractice suits against doctors who did not prescribe pain medications liberally, and gave them bad marks on the “patient satisfaction” surveys that, in some insurance programs, determine doctor compensation. Today, more than a third of Americans are prescribed painkillers every year.

Very few of them go on to a full-blown addiction. The calamity of the 1990s opioid revolution is not so much that it turned real pain patients into junkies—although that did happen. The calamity is that a broad regulatory and cultural shift released a massive quantity of addictive drugs into the public at large. Once widely available, the supply “found” people susceptible to addiction. A suburban teenager with a lot of curiosity might discover that Grandpa, who just had his knee replaced, kept a bottle of hydrocodone on the bedside table. A construction boss might hand out Vicodin at the beginning of the workday, whether as a remedy for back pain or a perquisite of the job. Pills are doseable—and they don’t require you to use needles and run the risk of getting AIDS. So a person who would never have become a heroin addict in the old days of the opioid taboo could now become the equivalent of one, in a more antiseptic way.

But a shocking number of people wound up with a classic heroin problem anyway. Relaxed taboos and ready supply created a much wider appetite for opioids. Once that happened, heroin turned out to be very competitively priced. Not only that, it is harder to crack down on heavily armed drug gangs that sell it than on the unscrupulous doctors who turned their practices into “pill mills.” Addicts in Maine complain about the rising price of black-market pharmaceutical pills: They have risen far above the dollar-a-milligram that used to constitute a kind of “par” in the drug market. An Oxy 30 will now run you forty-five bucks. But you can shoot heroin when the pills run out, and it will save you money. A lot of money. Heroin started pouring into the eastern United States a decade ago, even before the price of pills began to climb. Since then, its price

has fallen further, its purity has risen—and, lately, the number of heroin deaths is rising sharply everywhere. That is because, when we say heroin, we increasingly mean fentanyl.

Fentanyl is an opioid invented in 1959. Its primary use is in transdermal patches given to people for end-of-life care. If you steal a bunch of these, you can make good money with them on the street. Addicts like to suck on them—an extremely dangerous way to get a high. Fentanyl in its usual form is about fifty times as strong as street heroin. But there are many different kinds of fentanyl, so the wallop it packs is not just strong but unpredictable. There is butyrfentanyl, which is about a quarter the strength of ordinary fentanyl. There is acetylfentanyl, which is also somewhat weaker. There is carfentanil, which is 10,000 times as strong as morphine. It is usually used as an animal tranquilizer, although Russian soldiers used an aerosol version to knock out Chechen hostage-takers before their raid on a Moscow theater in 2002. A Chinese laboratory makes its own fentanyl-based animal tranquilizer, W-18, which finds its way into Maine through Canada.

China manufactures a good deal of the fentanyl that comes to the U.S., one of those unanticipated consequences of globalization. The dealers responsible for cutting it by a factor of fifty are unlikely to be trained pharmacists. The cutting lab may consist of one teenager flown up from the Dominican Republic alone in a room with a Cuisinart and a box of starch or paracetamol. It takes considerable skill to distribute the chemicals evenly throughout a package of drugs. Since a shot of heroin involves only the tiniest little pinch of the substance, you might tap into a part of the baggie that is all cutting agent, no drug—in which case you won’t get high. On the other hand, you could get a fentanyl-intensive pinch—in which case you will be found dead soon thereafter with the needle still sticking out of your arm. This is why fentanyl-linked deaths are, in some states, multiplying year on year. The federal CDC has lagged in reporting in recent years, but we can get a hint of the nationwide toll by looking at fentanyl deaths state by state. In Maryland, the first six months of 2015 saw 121 fentanyl deaths. In the first six months of 2016, the figure rose to 446.

Sometimes arrested or hospitalized users are surprised to find that what they thought was heroin was actually fentanyl. But there are addicts who swear they can tell what’s in the barrel of their needles. One in Rhode Island, whom we’ll call Gilberto, says heroin has a pleasant caramel brown tint, like the last sip of Coca-Cola in a glass. Fentanyl is clear. And many addicts claim they can recognize the high. “Fentanyl just hits you. Hard,” Gilberto says. “But it’s got no legs on it. It lasts about two hours. Heroin will hold you.” This makes fentanyl a distinctly inconvenient drug, but many addicts prefer it. All dealers, at least around Rhode Island, describe their heroin as “the fire,” in the same way all chefs describe their ribs as so tender they just fall off the bone.

“I knew we were screwed, as a state and as a country,” Jonathan Goyer says, “when I had a conversation with a kid who was going through withdrawals.” Although he had enough money to get safer drugs, the kid was going to wait through the sweats and the diarrhea and the nausea until his dealer came in at 5 p.m. That would allow him to risk his life on fentanyl.

Those in heroin’s grip often say: “There are only two kinds of people—the ones I get money from and the ones I give money to.” A man who is dead to his wife and his children may be desperate to make a connection with his dealer. They don’t buy much besides heroin—perhaps a plastic cup of someone else’s drug-free urine on a day when they need to take a drug test for a hospital or employer. This will set them back twenty or thirty dollars. In addiction, as in more mainstream endeavors, the lords of hedonism

are the slaves of money. Gilberto in Rhode Island claims to have put a million dollars into each of his needle-pocked arms, at the rate of three fifty-bag “bricks” of heroin a day.

Dealers are businessmen and behave like businessmen, albeit heavily armed ones. They may “throw something” to a particularly reliable customer—that is, give him enough heroin from time to time to allow him to deal a bit on his own account and stay solvent. An addict who discovers that the 10mg pills he is paying $18 each for in Maine are available for $10 in Boston, a three-hour drive away, may be tempted to sell them to support his own habit. The line between users and pushers blurs, rendering impractical the policy that most people prefer—be merciful to drug users, but come down hard on dealers.

Addicts wake up “sick,” which is the word they use for the tremulous, damp, and terrifying experience of withdrawal. They need to “make money,” which is their expression for doing something illegal. Some neighborhood bodegas—the addicts know which ones—will pay 50 cents on the dollar for anything stolen from CVS. That is why razor blades, printer cartridges, and other expensive portable items are now kept under lock and key where you shop. Addicts shoplift from Home Depot and drag things from the loading docks. They pull off scams. They will scavenge for thrown-out receipts in trash cans outside an appliance store, enter the store, find the receipted item, and try to return it for cash. On the edge of the White Mountains in Maine, word spread that the policy at Hannaford, the dominant supermarket chain, was not to dispute returns of under $25. For a while, there was a run on the big cans of extra virgin olive oil that sold for $24.99, which were brought to the cash registers every day by a succession of men and women who did not, at first sight, look like connoisseurs of Mediterranean cuisine. Women prostitute themselves on Internet sites. Others go into hospital emergency rooms, claiming a desperately painful toothache that can be fixed only with some opioid. (Because if pain is a “fifth vital sign,” it is the only one that requires a patient’s own testimony to measure.) This is generally repeated until the pain-sufferer grows familiar enough to the triage nurses to get “red-flagged.”

The population of addicts is like the population of deer. It is highest in rustic places with access to urban supplies. Missouri’s heroin problem is worst in the rural counties near St. Louis. New Hampshire’s is worst in the small cities and towns an hour or so away from the drug markets of Massachusetts: Lawrence, Lowell, and Boston. But the opioid epidemic of the past decade is unusually diverse. Anchor’s emergency room clients are 82 percent white, 9 percent Hispanic, and 6 percent black. The state of Rhode Island is 85 percent white, 9 percent Hispanic, and 5 percent black. “I try to target outreach,” Goyer says, “but the demographics are too random for that.”

Drug addiction used to be a ghetto thing. Now Oxycodone has joined shuttered factories and Donald Trump as a symbol of white working-class desperation and fecklessness. The reaction has been unsympathetic. Writes Nadja Popovich in The Guardian: “Some point to this change in racial and economic demographics as one reason many politicians have re-evaluated the tough ‘war on drugs’ rhetoric of the past 30 years.”

The implicit accusation is that only now that whites are involved have racist authorities been roused to act. This is false in two ways. First, authorities have not been roused to act. Second, when they do, they will have epidemiological, and not just tribal, grounds for doing so. A plague afflicting an entire country, across ethnic groups, is by definition more devastating than a plague afflicting only part of it. A heroin scourge in America’s housing projects coincided with a wave of heroin-addicted soldiers brought back from Vietnam, with a cost peaking between 1973 and 1975 at 1.5 overdose deaths per 100,000. The Nixon White House panicked. Curtis Mayfield wrote his soul ballad

“Freddie’s Dead.” The crack epidemic of the mid- to late 1980s was worse, with a death rate reaching almost two per 100,000. George H. W. Bush declared war on drugs. The present opioid epidemic is killing 10.3 people per 100,000, and that is without the fentanyl-impacted statistics from 2016. In some states it is far worse: over thirty per 100,000 in New Hampshire and over forty in West Virginia.

In 2015, the Princeton economists Angus Deaton and Anne Case released a paper showing that the life expectancy of middle-aged white people was falling. Prominent among the causes cited were “the increased availability of opioid prescriptions for pain” and the falling price and rising potency of heroin. Census figures show that Case and Deaton had put the case mildly: Life expectancy was falling for all whites. Although they are the only racial group to have experienced a decline in longevity—other races enjoyed steep increases—there are still enough whites in the United States that this meant longevity fell for the country as a whole.

Bill Clinton alluded to the Case-Deaton study often during his wife’s presidential campaign. He would say that poor white people are “dying of a broken heart.” Heroin has become a symbol of both working-class depravity and ruling-class neglect—an explosive combination in today’s political climate.

Maine’s politicians have taken the opioid epidemic as seriously as any in the country. Various new laws have capped the maximum daily strength of prescribed opioids and limited prescriptions to seven days. The levels are so low that they have led some doctors to warn that patients will go onto the street to get their dosages topped off. “We were sad,” State Representative Phyllis Ginzler said in January, “to have to come between doctor and patient.” She felt the deadly stakes of Maine’s problem gave her little alternative.

Paul LePage, the state’s garrulous governor, has been even more direct. Speaking of drug dealers at a town hall in rural Bridgton in early 2016, he said: “These are guys with the name D-Money, Smoothie, Shifty, these types of guys. They come from Connecticut and New York, they come up here, they sell their heroin, they go back home. Incidentally, half the time they impregnate a young white girl before they leave.” This is what the politics of heroin threatens to become nationwide: To break the bureaucratic inertia, one side will go to any rhetorical length, even invoking race. To protect governing norms, the other side will invoke decency, even as the damage mounts. It is what the politics of everything is becoming nationwide. From town to town across the country, the correlation of drug overdoses and the Trump vote is high.

The drug problem is already political. It is being reframed by establishment voices as a problem of minority rights and stigmatization. A documentary called The Anonymous People casts the country’s 20 million addicts as a subculture or “community” who have been denied resources and self-respect. In it, Patrick Kennedy, who was Rhode Island’s congressman until 2011 and who was treated for OxyContin addiction in 2006, says: “If we can ever tap those 20 million people in long-term recovery, you’ve changed this overnight.” What’s needed is empowerment. Another interviewee says, “I refuse to be ashamed of what I am.”

This marks a big change in attitudes. Difficult though recovery from addiction has always been, it has always had this on its side: It is a rigorously truth-focused and euphemism-free endeavor, something increasingly rare in our era of weasel words. The face of addiction a generation ago was that of the working-class or upper-middle-class man, probably long and intimately known to his neighbors, who stood up at an AA meeting in a church basement and bluntly said, “Hi, I’m X, and I’m an alcoholic.”

The culture of addiction treatment that prevails today is losing touch with such candour. It is marked by an extraordinary level of political correctness. Several of the addiction professionals interviewed for this article sent lists of the proper terminology to use when writing about opioid addiction, and instructions on how to write about it in a caring way. These people are mostly generous, hard-working, and devoted. But their codes are neither scientific nor explanatory; they are political.

The director of a Midwestern state’s mental health programs emailed a chart called “‘Watch What You Call Me’: The Changing Language of Addiction and Mental Illness,” compiled by the Boston University doctor Richard Saltz. It is a document so Orwellian that one’s first reaction is to suspect it is a parody, or some kind of “fake news” dreamed up on a cynical website. We are not supposed to say “drug abuse”; use “substance use disorder” instead. To say that an addict’s urine sample is “clean” is to use “words that wound”; better to say he had a “negative drug test.” “Binge drinking” is out—“heavy alcohol use” is what you should say. Bizarrely, “attempted suicide” is deemed unacceptable; we need to call it an “unsuccessful suicide.” These terms are periphrastic and antiscientific. Imprecision is their goal. Some of them (like the concept of a “successful suicide”) are downright insane. This habit of euphemism and propaganda is not merely widespread. It is official. In January 2017, less than two weeks before the end of the last presidential administration, drug office head Michael Botticelli issued a memo called “Changing the Language of Addiction,” a similarly fussy list of officially approved euphemisms.

Residents of the upper-middle-class town of Marblehead, Massachusetts, were shocked in January when a beautiful twenty-four-year-old woman who had excelled at the local high school gave an interview to the New York Times in which she described her heroin addiction. They were perhaps more shocked by her description of the things she had done to get drugs. A week later, the police chief announced that the town had had twenty-six overdoses and four deaths in the past year. One of these, the son of a fireman, died over Labor Day. At the burial, a friend of the dead man overdosed and was rushed to the hospital. One fireman there said to a mourner that this was not uncommon: Sometimes, at the scene of an overdose, they will find a healthy- and alert-looking companion and bring him along to the hospital too, assuming he might be standing up only because the drug hasn’t hit him yet. In communities like this, concerns about “hurtful” words and stigma can seem beside the point.

Former Bush administration drug czar John Walters and two other scholars wrote last fall, “There is another type of ‘stigma’ afflicting drug users—that their crisis is somehow undeserving of the full resources necessary for their rescue.” Walters is talking largely about law enforcement. As he said more recently: “If someone were getting food poisoning from cans of tuna, the whole way we’re doing this would be more aggressive.”

Which is not the direction we’re going. In state after state, voters have chosen to liberalize drug laws regarding marijuana. If you want an example of mass media–induced groupthink, Google the phrase “We cannot arrest our way out of the drug problem” and count the number of politicians who parrot it. It is true that we cannot arrest our way out of a drug problem. But we cannot medicate and counsel our way out of it, either, and that is what we have been trying to do for almost a decade.

Calling addiction a disease usefully describes certain measurable aspects of the problem—particularly tolerance and withdrawal. It fails to capture what is special and dangerous about the way drugs bind with people’s minds. Almost every known disease is something people wish to be rid of. Addiction is different. Addicts resist known cures—even to the point of death. If you do not reckon with why addicts go to such

lengths to continue suffering, you are unlikely to figure out how to treat them. This turns out to be an intensely personal matter.

Medical treatment plays an obvious role in addressing the heroin epidemic, especially in the efforts to save those who have overdosed or helping addicts manage their addictions. But as an overall approach, it partakes of some of the same fallacies as its supposed opposite, “heartless” incarceration. Both leave out the addict and his drama. Medicalizing the heroin crisis may not stigmatize him, but it belittles him. Moral condemnation is an incomplete response to the addict. But it has its place, because it does the addict the compliment of assuming he has a conscience, a set of thought processes. Those thought processes are what led him into his artificial hell. They are his best shot at finding a way out.

In 1993, Francis F. Seeburger, a professor of philosophy at the University of Denver, wrote a profound book on the thought processes of addicts called Addiction and Responsibility. We tend to focus on the damage addiction does. A cliché among empathetic therapists, eager to describe addiction as a standard-issue disease, is that “no one ever decides to become an addict.” But that is not exactly true, Seeburger shows. “Something like an addiction to addiction plays a role in all addiction,” he writes. “Addiction itself . . . is tempting; it has many attractive features.” In an empty world, people have a need to need. Addiction supplies it. “Addiction involves the addict. It does not present itself as some externally imposed condition. Instead, it comes toward the addict as the addict’s very self.” Addiction plays on our strengths, not just our failings. It simplifies things. It relieves us of certain responsibilities. It gives life a meaning. It is a “perversely clever copy of that transcendent peace of God.”

The founders of Alcoholics Anonymous thought there was something satanic about addiction. The mightiest sentence in the book of Alcoholics Anonymous is this: “Remember that we deal with alcohol—cunning, baffling, powerful!” The addict is, in his own, life-damaged way, rational. He’s too rational. He is a dedicated person—an oblate of sorts, as Seeburger puts it. He has commitments in another, nether world.

That makes addiction a special problem. The addict is unlikely ever to take seriously the counsel of someone who has not heard the call of that netherworld. Why should he? The counsel of such a person will be, measured against what the addict knows about pleasure and pain, uninformed. That is why Twelve Step programs and peer-to-peer counselling, of the sort offered by Goyer and his colleagues, have been an indispensable element in dragging people out of addiction. They have authority. They are, to use the street expression, legit.

The deeper problem, however, is at once metaphysical and practical, and we’re going to have a very hard time confronting it. We in the sober world have, for about half a century, been renouncing our allegiance to anything that forbids or commands. Perhaps this is why, as this drug epidemic has spread, our efforts have been so unavailing and we have struggled even to describe it. Addicts, in their own short-circuited, reductive, and destructive way, are armed with a sense of purpose. We aren’t. It is not a coincidence that the claims of political correctness have found their way into the culture of addiction treatment just now. This sometimes appears to be the only grounds for compulsion that the non-addicted part of our culture has left.

Christopher Caldwell is a senior editor at the Weekly Standard.

Source:  https://www.firstthings.com/article/2017/04/american-carnage

Substance use disorders affect businesses in surprising ways. Although there are obvious signs that an employee is struggling with a substance use disorder, there are other factors affecting their workplace performance that may be less obvious. Unfortunately, a survey from the National Safety Council found that employers underestimate how prescription drug abuse affects their businesses. Employers may not realize some of the facts illuminated in the study, such as:

• Employees with substance use disorders miss nearly 50 percent more days than their peers and up to six weeks of work annually.

• Healthcare costs for employees who misuse or abuse prescription drugs are three times the costs for an average employee.

• Getting an employee into treatment can save an employer up to $2,607 per worker annually.

The survey serves as a reminder that although some employees need support, they may not ask for it. “Businesses that do not address the prescription drug crisis are like ostriches sticking their head in the sand,” said Deborah A.P. Hersman, president and CEO of the National Safety Council. “The problem exists and doing nothing will harm your employees and your business.”

The National Safety Council alongside NORC at the University of Chicago and Shatterproof created a tool to show how the substance use disorder crisis can affect your workplace.

The Substance Use Cost Calculator is a quick and easy way to track the potential cost of substance use disorders. Employers input basic statistics about their workforce, such as industry, location, and number of employees. The tool then calculates the estimated prevalence of substance use disorders among employees and dependents. Once you have all that information on hand, you can figure out a way to prioritize helping those who are struggling with a substance use disorder. If you are worried about addressing such a difficult problem, remember that leaders ask how they can help others and utilize subject-matter resources.

Source:  https://images.magnetmail.net/images/clients/CADCA/attach/SubstanceUseCosts.pdf April 2017

Filed under: Economic,Social Affairs,USA :

[Alexandria, VA, April 20, 2017]

Today, a group of national drug policy leaders, elected officials, and public health experts convened in Atlanta to coordinate the opposition to marijuana legalization in the U.S. and advance evidence-based marijuana laws. Held in conjunction with the National Rx Drug Abuse & Heroin Summit, the 4th Annual Smart Approaches to Marijuana (SAM) Summit featured keynote speakers including Former Clinton Drug Czar Barry McCaffrey and Arizona Governor Doug Ducey. The day-long program highlighted concerns about the special interest marijuana lobby and empowered concerned citizens with grassroots advocacy strategies to protect public health and safety in their local communities.

“So far, 2017 has been a bad year for the pro-marijuana special interests looking to profit off the next big addictive industry,” said SAM President and CEO Kevin A. Sabet. “More states are realizing that marijuana legalization produces more costs than benefits, so this momentum gives our summit new significance as we look to energize our base and move the needle toward evidence-based marijuana policy that puts people over profit.”

“Smart drug policy starts with science and research, not ideology or profit,” said SAM Honorary Advisor and Former Drug Czar General Barry McCaffrey. “SAM embodies this belief by advocating for common-sense laws that protect American families and communities from the social and health consequences of marijuana legalization. I continue to be concerned about the serious problems around drug abuse and its effects on our country, so I’m proud to stand up for SAM’s health first agenda today.”

“Last year, Arizonans went to the ballot and soundly rejected the misguided and harmful proposal to legalize marijuana,” said Arizona Governor Doug Ducey. “This vote shows that Arizonans don’t want the harmful consequences of legalizing this drug that have been seen in other states, like drugged driving incidents and more kids using marijuana. I am honored to stand with SAM today in support of the message that the health and safety of our communities must come first.”

Evidence shows that marijuana – which has skyrocketed in average potency over the past decades – is addictive and harmful to the human brain, especially when used by adolescents. Moreover, in states that have already legalized the drug, there has been an increase in drugged driving crashes and youth marijuana use. States that have legalized marijuana have also failed to shore up state budget shortfalls with marijuana taxes, continue to see a thriving black market, and are experiencing a continued rise in alcohol sales.

Source:  anisha@learnaboutsam.org   20th April 2017 About SAM Smart Approaches to Marijuana (SAM) is a nonpartisan, non-profit alliance of physicians, policy makers, prevention workers, treatment and recovery professionals, scientists, and other concerned citizens opposed to marijuana legalization who want health and scientific evidence to guide marijuana policies. SAM has affiliates in more than 30 states. For more information about marijuana use and its effects, visit http://www.learnaboutsam.org.

Formerly inconceivable ideas—like providing drug users a safe place to inject—are gaining traction.

America’s opioid problem has turned into a full-blown emergency now that illicit fentanyl and related synthetic drugs are turning up regularly on our streets. This fentanyl, made in China and trafficked through Mexico, is 25 to 50 times as potent as heroin. One derivation, Carfentanil, is a tranquilizer for large animals that’s a staggering 1,000 to 5,000 times as powerful.

Adding synthetic opioids to heroin is a cheap way to make it stronger—and more deadly. A user can die with the needle still in his arm, the syringe partly full. Traffickers also press these drugs into pills that they sell as OxyContin and Xanax. Most victims of synthetic opioids don’t even realize what they are taking. But they are driving the soaring rate of overdose—a total of 33,091 deaths in 2015, according to the Centers for Disease Control and Prevention.

Hence the ascendance of a philosophy known as “harm reduction,” which puts first the goal of reducing opioid-related death and disease. Cutting drug use can come second, but only if the user desires it. As an addiction psychiatrist, I believe that harm reduction and outreach to addicts have a necessary place in addressing the opioid crisis. But as such policies proliferate—including some that used to be inconceivable, such as providing facilities where drug users can safely inject—Americans shouldn’t lose sight of the virtues of coerced treatment and accountability.

What does harm reduction look like? One example is Maryland’s Overdose Survivor Outreach Program. After an overdose survivor arrives in the emergency room, he is paired with a “recovery coach,” a specially trained former addict. Coaches try to link patients to treatment centers. Generally this means counseling along with one of three options: methadone; another opioid replacement called buprenorphine, which is less dangerous if taken in excess; or an opioid blocker called naltrexone. Overdose survivors who don’t want treatment are given naloxone, a fast-acting opioid antidote. Coaches also stay in touch after patients leave the ER, helping with court obligations and social services.

Similar programs operate across the country. In Chillicothe, Ohio, police try to connect addicts to treatment by visiting the home of each person in the county who overdoses. In Gloucester, Mass., heroin users can walk into the police station, hand over their drugs, and walk into treatment within hours, without arrest or charges. It’s called the Angel Program. Macomb County, Mich., has something similar called Hope Not Handcuffs.

Another idea gaining traction is to provide “safe consumption sites,” hygienic booths where people can inject their own drugs in the presence of nurses who can administer oxygen and naloxone if needed. No one who goes to a safe consumption site is forced into treatment to quit using, since the priority is reducing risk.

In Canada, staffers at Vancouver’s consumption site urge patrons to go into treatment, but they also distribute clean needles to reduce the spread of viruses such as HIV and hepatitis C. Naloxone kits are on hand in case of overdose. One study found that opening the site has reduced overdose deaths in the area, and more than one analysis showed reduced injection in places like public bathrooms, where someone can overdose undiscovered and die.

There are no consumption sites in the U.S., but in January the board of health in King County, Wash., endorsed the creation of two in the Seattle area. A bill in the California

Assembly would allow cities to establish safe consumption sites. Politicians, physicians and public-health officials have called for them in Baltimore; Boston; Burlington, Vt.; Ithaca, N.Y.; New York City; Philadelphia and San Francisco. Drug-war-weary police officers and harm reductionists would rather see addicts opt for treatment and lasting recovery, but they’ll settle for fewer deaths.

When all else fails, handcuffs can help, too. A problem with treatment is that addicts often stay with the program only for brief periods. Dropout rates within 24 weeks of admission can run above 50%, according to the National Institute on Drug Abuse. Courts can provide unique leverage. Many drug users are involved in addiction-related crime such as shoplifting, prescription forgery and burglary. Shielding them from the criminal-justice system often is not in society’s best interests—or theirs.

Drug courts, for example, keep offender-patients in treatment through immediately delivered sanctions (e.g., a night in jail) and incentives (e.g., looser supervision). Upon successful completion of a 12- to 18-month program, many courts erase the criminal record. This seems to work. The National Association of Drug Court Professionals reports that 75% of drug court graduates nationwide “remain arrest-free at least two years after leaving the program.”

What’s more, if the carrot-and-stick method used by drug courts is scrupulously applied, treatment may not always be necessary. This approach, called “swift, certain and fair,” has been successful with methamphetamine addicts in Hawaii and alcoholics in South Dakota. Some courts in Massachusetts and New Hampshire have now adopted it with opioid addicts. I predict that the combination of anti-addiction medication plus “swift, certain, and fair” will be especially effective.

With synthetic drugs similar to fentanyl turbocharging the opioid problem, the immediate focus should be on keeping people safe and alive. But for those revived by antidotes and still in a spiral of self-destruction, the criminal-justice system may be the ultimate therapeutic safety net.

Source:  https://www.wsj.com/articles/saving-lives-is-the-first-imperative-in-the-opioid-epidemic-1491768767  April 9, 2017

Marijuana Legalization Proposals Die in Committee

[Alexandria, VA, April 12, 2017] –  Yesterday, an alliance of concerned citizens, public health experts, and safety officials soundly defeated two marijuana legalization bills in Maryland. The bills, which would have permitted commercial pot shops in communities throughout the state, died without a vote in the Maryland Senate last night. SAM Executive Vice President Jeff Zinsmeister and Maryland-based neuroscientist and SAM Science Advisor Dr.Christine Miller testified in Annapolis last month, urging the legislature to reject marijuana legalization and commercialization. AAA Mid-Atlantic also testified against the bills, citing traffic safety concerns due to drugged driving increases in states that have legalized marijuana.

“This is a major victory in the effort to put public health and common sense before special interests,” said SAM Executive Vice President Jeff Zinsmeister. “The costs of legalization, including more stoned drivers on the roads causing fatalities, more people being driven into treatment for addiction, and higher regulatory costs far outweighed any benefit Maryland would see. The Big Marijuana lobbyists came into Maryland touting the notion that marijuana legalization would fix our criminal justice system and rake in millions – but Maryland smartly concluded that legalization actually exacerbates these issues. All they had to do was look to Colorado, where more minority youth are being arrested for marijuana and the state deficit is growing.”

“We believe that science and research, not profit, should drive what marijuana laws look like in our state,” said Dr. Christine Miller, a Maryland neuroscientist and member of SAM’s Science Advisory Board.  “The pro-marijuana lobby was looking to profit by selling a harmful, addictive substance that would harm our communities and endanger public safety. I’m proud that evidence-based policy putting health first prevailed in Maryland yesterday.”

Evidence demonstrates that marijuana – which has skyrocketed in average potency over the past decades – is addictive and harmful to the human brain, especially when used by adolescents. Moreover, in states that have already legalized the drug, there has been an increase in drugged driving crashes and youth marijuana use. States that have legalized marijuana have also failed to shore up state budget shortfalls with marijuana taxes, continue to see a thriving black market, and are experiencing a continued rise in alcohol sales.

Source: info@learnaboutsam.org  April 2017

Abstract

Cannabis use remains a critical issue in the United States.  In 2014, an estimated 22 million US residents used cannabis,1 double the number from 10 years age.

As of December 2016, 28 states and the District of Columbia have implemented or have voted to authorize medical cannabis programs, and 8 states and the District of Columbia have legalized recreational cannabis.

Health care professionals often are concerned about whether cannabis use will lead to psychiatric illnesses such as substance use disorders, anxiety disorders, or mood disorders among their patients. Many stakeholders are concerned that an association between cannabis use and psychiatric illnesses will lead to a steady increase in these illnesses as more states implement medical or recreational cannabis legalization policies. Given these trends and concerns, it has become increasingly important to obtain longitudinal data to clarify the relationship between cannabis use and subsequent psychiatric disorders.

Source:  JAMA. 2017;317(10):1070-1071. doi:10.1001/jama.2016.19706

HARRISBURG, Pa. (AP) – They’re the tiniest and most innocent victims of the heroin addiction crisis but it doesn’t spare them their suffering.

They cry relentlessly at a disturbing pitch and can’t sleep. Their muscles get so tense their bodies feel hard. They suck hungrily but lack coordination to successfully feed. Or they lack an appetite. They sweat, tremble, vomit and suffer diarrhea. Some claw at their faces.

It’s because they were born drug-dependent and are suffering the painful process of withdrawal. “It’s very sad,” says Dr. Christiana Oji-Mmuo, who cares for them at Penn State Hershey Children’s Hospital. “You would have to see a baby in this condition to understand.”

As the heroin and painkiller addiction epidemic gripping Pennsylvania and the whole country worsens, the number of babies born drug dependent has surged.   Geisinger Medical Center in Danville, Pa. saw two or three drug-dependent babies annually when Dr. Lauren Johnson-Robbins began working there 17 years ago. Now Geisinger cares for about twice that many per month between its neonatal intensive care unit in Danville and the NICU at Geisinger Wyoming Valley Medical Center in Wilkes-Barre.

Penn State Children’s Hospital is averaging about 20 per year, although it had cared for 18 through last June, with the final 2016 number not yet available, says Oji-Mmuo.

PinnacleHealth System’s Harrisburg Hospital also sees about 20 per year. That’s less than a few years ago, but only because a hospital that used to transfer drug dependent babies to Harrisburg Hospital equipped itself to care for them. “Now everybody is facing it and trying to deal with it one way or another,” says Dr. Manny Peregrino, a neonatologist involved with their care.

The babies suffer from neonatal abstinence syndrome, or NAS, which results from exposure to opioid drugs while in the womb. An estimated 1 in 200 babies in the United States are born dependent on an opioid drug. More than half end up in a NICU, which care for unusually sick babies.

In 2015, 2,691 babies received NICU care in Pennsylvania as the result of a mother’s substance abuse, according to the Pennsylvania Health Care Cost Containment Council. That’s up from 788 in 2000, or a 242 percent increase in 15 years.

Nearly all babies born to opioid-addicted moms suffer withdrawal. The severity varies. About 60 percent need an opioid such as morphine or methadone to ease them through withdrawal. These babies typically spend about 25 days in the hospital.

Often, the only way to calm them is to hold them for long periods – so long that many hospitals enlist volunteer “cuddlers.” ”It really is a whole village. Everybody pitches in,” Peregrino says.

Giving medications to newborns can lead to other problems, so the preference is to get them through withdrawal without it. A scale based on their symptoms is used to determine which ones need medication. In cases where withdrawal isn’t so severe,

symptoms can be managed by keeping the baby away from noise and bright light, cuddling them, and using devices such as mechanical swings to sooth them.

Logan Keck of Carlisle feared the worst upon learning what her baby might face. The 23-year-old became addicted to heroin several years ago. She says it was prominent in her circle of high school classmates, and she became “desensitized” to the danger, figuring it couldn’t be as bad as some claimed.   Keck has been in recovery for more than two years with the help of methadone, a prescription drug used to prevent withdrawal and craving. She was a few weeks away from being fully tapered off methadone when Keck learned she was pregnant.

She was told stopping methadone during pregnancy would put her at risk of miscarriage. Keck further learned her baby might be born addicted. She gave birth on Feb. 1 at Holy Spirit-Geisinger in Cumberland County.

Her baby had difficulty latching on during breastfeeding and vomited milk into her lungs, but seemed fine otherwise. Keck expected she and her baby would go home soon after delivery.  But after a few days, withdrawal became obvious. Keck knows how withdrawal feels. “That’s when it really hit home for me – seeing her feel it,” she says.  Then she was hit again: she was discharged, but her baby remains in the NICU, possibly for several more weeks.

The opioid addiction epidemic affects people of all backgrounds and regions – rich, poor, urban, suburban. It’s prevalent in economically-stressed areas, including many of Pennsylvania’s rural counties.

Geisinger has found a bit of brightness within the 30-plus rural counties it serves. Some of the region’s doctors realized there was little access to methadone, which is dispensed from clinics usually located in more populated areas. That meant pregnant rural women lacked access to a legal drug that could keep them away from the risks of street drugs while also getting them onto the road to recovery. So the doctors became licensed to prescribe buprenorphine, another drug that staves off withdrawal and cravings for opioids. As a result, the majority of mothers of NAS babies at Geisinger have been taking buprenorphine during pregnancy, according to Johnson-Robbins.

Geisinger doctors have been pleased to find that buprenorphine, while it does cause NAS, withdrawal isn’t as severe as with methadone. It also impacts another major concern surrounding NAS babies: that the mother will continue to struggle with addiction and live a lifestyle that will prevent her from properly caring for her baby. Most Geisinger moms, being in recovery for a while, are better-equipped to care for their baby.

Still, there’s great concern about what happens to NAS babies after they leave the hospital. The mother might go back to heroin and become unable to properly care for her baby – there have been many news reports of addicted parents or fathers who neglected or otherwise hurt their babies, including a Pennsylvania woman who rolled over and suffocated her baby while high on opioids and other drugs. The mother might lack adequate housing or other means of having a stable home. There might be criminal activity in the home.

Delaware County woman says she didn’t know their whereabouts until news reports of their hospitalizations for alleged severe abuse.

“We are sending children out into compromised environments,” says Dr. Lori Frasier, who leads the division of child abuse paediatrics at Penn State Hershey Children’s Hospital. Those babies often return to the hospital as victims of abuse or neglect, Frasier says.

Another cause for worry is the fact that NAS babies can remain unusually fussy after leaving the hospital, potentially putting extra stress on a parent already dealing with the stress of addiction. “We know that crying, fussy babies can be triggers for abuse,” Frasier says. Cathleen Palm, founder of the Pennsylvania-based Center for Children’s Justice, said much more needs to done to provide help for mothers of NAS babies, and to monitor and protect the babies. “We have really been trying to get policy makers to understand the nuances,” she says.

Keck goes to Holy Spirit-Geisinger daily to breastfeed and hold her baby for one to two hours. Her time is limited by distance and the fact the baby’s father needs their only car for work. Looking forward, Keck says she’s in a stable relationship with the baby’s father, who is not an addict and accompanies her to the hospital. They have family support, and a Holy Spirit program will provide additional help.

Ultimately, Keck’s pregnancy and motherhood have taught her things that might have inspired her to make a different choice regarding heroin, including the fact it caused her newborn to suffer and forced her to go home without her baby. She agreed to be interviewed out of desire to get others to think and talk about such realities. “I want people to understand it’s something that’s not pretty,” Keck said. “It’s something that’s important to talk about.”

Source:  http://www.washingtontimes.com/news/2017/feb/18/born-addicts-opioid-babies-in-withdrawal

Researchers who tested marijuana sold in Northern California found multiple bacterial and fungal pathogens that can cause serious infections. The study was published this month in the journal Clinical Microbiology and Infection.

The mould and bacteria was so widespread and potentially dangerous that the UC Davis academics concluded that they cannot recommend smoking raw or dried weed. “We cannot recommend inhaling it,” says George Thompson III, an associate professor of clinical medicine at the university who helped conduct the cannabis research.

The findings might also apply to indoor, hydroponic marijuana popular at Southern California collectives, according to Thompson. Using pot in baked goods such as brownies might be “theoretically” safer because the products could be heated enough to kill bacteria and fungus, he says.

Asked if concentrates such as wax, honey oil, dabs and shatter would be safe because heat is involved in the production process of “butane extraction,” Thompson says he isn’t sure.

The key finding of the research  is that patients with weak immune systems, such as those with HIV or cancer, should avoid smoking raw and dried pot. Though Thompson told the Sacramento Bee that “for the vast majority of cannabis users, this is not of great concern,” he stresses that there really isn’t a safe way to smoke marijuana buds, even for those who are healthy.

He says it’s possible that filters used with tobacco cigarettes could help with marijuana: Tobacco and all natural plant products have these kinds of bacterial and fungal issues. Irradiated marijuana, though unappealing, also could be an answer, he adds.

Researchers sampled weed samples from Northern California dispensaries and found they tested positive for the fungi Cryptococcus, Mucor and Aspergillus, and for the bacteria E. coli, Klebsiella pneumoniae and Acinetobacter baumannii. The academics said these can lead to serious and lethal illness, noting that smoking the mould and bacteria can embed them directly where they can do the most damage — the lungs.

“Infection with the pathogens we found in medical marijuana could lead to serious illness and even death,” Joseph Tuscano, a professor of internal medicine at UC Davis, said in a statement. “Inhaling marijuana in any form provides a direct portal of entry deep into the lungs, where infection can easily take hold.” The state Department of Public Health is working on guidelines for marijuana testing with the goal that both medical and recreational pot sold next year at permitted dispensaries would be labelled as safe. It’s not clear how this research will affect those guidelines. Thompson says he has reached out to state officials to share his findings.

“We are aware of the study, and while it’s certainly concerning, this is exactly why we need regulation,” Alex Traverso, spokesman for the state Bureau of Medical Cannabis Regulation, said via email. “The Bureau is working with the Department of Public Health to develop strong standards for testing because patient safety is extremely important to us all.”

Source: http://www.laweekly.com/news/marijuana-is-not-safe-to-smoke-researchers-say-7927826 Wednesday, Feb. 14, 2017

During her pregnancy, Stacey never drank alcohol or had a cigarette. But nearly every day, then 24, she smoked marijuana.

With her fiancé’s blessing, she began taking a few puffs in her first trimester to quell morning sickness before going to work at a sandwich shop. When sciatica made it unbearable to stand during her 12-hour shifts, she discreetly vaped marijuana oil on her lunch break.

“I wouldn’t necessarily say, ‘Go smoke a pound of pot when you’re pregnant,’” said Stacey, now a stay-at-home mother in Deltona, Fla., who asked that her full name be withheld because street-bought marijuana is illegal in Florida. “In moderation, it’s O.K.”

Many pregnant women, particularly younger ones, seem to agree, a recent federal survey shows. As states legalize marijuana or its medical use, expectant mothers are taking it up in increasing numbers — another example of the many ways in which acceptance of marijuana has outstripped scientific understanding of its effects on human health.

Often pregnant women presume that cannabis has no consequences for developing infants. But preliminary research suggests otherwise: Marijuana’s main psychoactive ingredient — tetrahydrocannabinol, or THC — can cross the placenta to reach the foetus, experts say, potentially harming brain development, cognition and birth weight. THC can also be present in breast milk.

“There is an increased perception of the safety of cannabis use, even in pregnancy, without data to say it’s actually safe,” said Dr. Torri Metz, an obstetrician at Denver Health Medical Center who specializes in high-risk pregnancies. Ten percent of her patients acknowledge recent marijuana use. In the federal survey, published online in December, almost 4 percent of mothers-to-be said they had used marijuana in the past month in 2014, compared with 2.4 percent in 2002. (By comparison, roughly 9 percent of pregnant women ages 18 to 44 acknowledge using alcohol in the previous month.)

Stacey’s son just had his first birthday. He’s walking, talking and breast-feeding, and she isn’t worried about his development. Credit Jennifer Sens for The New York Times

Young mothers-to-be were particularly likely to turn to marijuana: Roughly 7.5 percent of 18- to 25-year-olds said they had used pot in the past month in 2014, compared with 2 percent of women ages 26 to 44.

Evidence on the effects of prenatal marijuana use is still limited and sometimes contradictory. Some of the most extensive data come from two sets of researchers, in Pittsburgh and in Ottawa, who have long studied children exposed to THC in the womb.

In Pittsburgh, 6-year-olds born to mothers who had smoked one joint or more daily in the first trimester showed a decreased ability to understand concepts in listening and reading. At age 10, children exposed to THC in utero were more impulsive than other children and less able to focus their attention.

Most troubling, children of mothers who used marijuana heavily in the first trimester had lower scores in reading, math and spelling at age 14 than their peers.

“Prenatal exposure can affect the adolescent pretty significantly,” said Dr. Lauren M. Jansson, the director of paediatrics at the Center for Addiction and Pregnancy at the Johns Hopkins University School of Medicine.

Several studies have found changes in the brains of foetuses, 18 to 22 weeks old, linked to maternal marijuana use. In male foetuses that were exposed, for instance, researchers have noted abnormal function of the amygdala, the part of the brain that regulates emotion.

“Even early in development, marijuana is changing critical circuits and neurotransmitting receptors,” said Dr. Yasmin Hurd, a neuroscientist and the director of the addiction center at Icahn School of Medicine at Mount Sinai in Manhattan. “Those are important for regulation of emotions and reward, even motor function and cognition.”

It is already well documented that the developing brains of teenagers can be altered with regular marijuana use, even eventually reducing I.Q.

“The effects are not dramatic, but that doesn’t mean they are not important,” said Jodi Gilman, an assistant professor of psychiatry at Harvard Medical School who studies adolescent users of cannabis. “It could make the difference between getting an A and getting a B.”

“You could imagine that a similar subtle effect may be present in those who were exposed prenatally to marijuana,” she added. The American Academy of Paediatrics and the American College of Obstetricians and Gynaecologists both advise against prenatal cannabis use because of its links to cognitive impairment and academic underachievement. But many state and federal agencies avoid the topic.

Of five federal agencies, only the National Institute on Drug Abuse had any information about prenatal marijuana use on its website as of last February, according to a study published online in December in the journal Substance Abuse. Only 10 state health departments did. Until recently, the Centers for Disease Control and Prevention offered nothing.

“I don’t think public health officials should be alarming people,” said Marian Jarlenski, the study’s lead author and an assistant professor at the University Of Pittsburgh Graduate School Of Public Health. “They just have to say, ‘There have been studies done, and there is some risk.’”

In a statement, C.D.C. officials expressed concern about memory and attention problems among children exposed to THC in utero.

“While current evidence on health consequences is inconsistent, some studies have found risks associated with marijuana use during pregnancy, such as low birth weight or preterm birth,” the agency said. Dr. Marie McCormick, a paediatrician and the chairwoman of a new report on cannabis from the National Academies of Sciences, Engineering and Medicine, said smoking cannabis “does confer, in terms of birth weight, the same risk as cigarettes.”

Some of the gathering evidence is reassuring. So far, prenatal cannabis exposure does not appear to be linked to obvious birth defects. “That’s why some providers and lay

people alike think there’s no effect,” said Dr. Erica Wymore, a neonatologist at Children’s Hospital Colorado. But she warned, “Just because they don’t have a major birth defect or overt withdrawal symptoms doesn’t mean the baby’s neurological development is not impacted.”

Most research in this area was done when the drug was far less potent. Marijuana had 12 percent THC in 2014, while in 1995 it was just 4 percent, according to the National Institute on Drug Abuse.

“All those really good earlier studies on marijuana effects aren’t telling us what we need to know now about higher concentration levels,” said Therese Grant, an epidemiologist and director of the University of Washington’s foetal alcohol and drug unit. “We need to do a whole lot more research now.”

There are two additional problems with studies of maternal cannabis use. Research is often based on reports by pregnant women — instead of, say, tests of urine or the umbilical cord — and they consistently underreport their use. (Researchers know of underreporting because samples reveal discrepancies.) And pregnant women who roll joints also tend to smoke tobacco or drink alcohol; it can be hard to tease out the risks of cannabis itself.

Few realize that THC is stored in fat and therefore can linger in a mother’s body for weeks, if not months. It’s not known whether the foetus’s exposure is limited to the hours a woman feels high.

The American College of Obstetricians and Gynaecologists advises clinicians to ask pregnant women about marijuana use and to urge them to quit. To find out whether that’s happening, Dr. Judy Chang, an obstetrician-gynaecologist at the University of Pittsburgh, and her colleagues recorded more than 450 first visits with pregnant patients.

Medical staff were more likely to warn patients that child protective services might be called if they used marijuana, the researchers found, than to advise them of potential risks. When mothers-to-be admitted to marijuana use, almost half of obstetric clinicians did not respond at all.  Pregnant women aren’t eager to discuss it, either, because they are afraid of legal repercussions or a lecture. Depression, anxiety, stress, pain, nausea and vomiting were the most common reasons women reported using marijuana in a 2014 survey of low-income mothers getting federal nutrition help in Colorado. Roughly 6 percent were pot users; a third were pregnant. “Women are thinking of this as medical marijuana in that they are treating some condition,” said Elizabeth Nash, a policy analyst at the Guttmacher Institute who researches substance abuse in pregnancy.  “If you’re going to consider it like medicine,” she said, “then treat it like medicine and talk to your doctor about it.” Stacey’s son just had his first birthday. He’s walking, talking and breast-feeding, and she isn’t worried about his development.  She still smokes pot — indeed, her son plays on a rug emblazoned with a marijuana leaf. But the severe cramps that plagued her before pregnancy are easing now.  “I don’t have to smoke as much anymore,” she said.

Source: https://www.nytimes.com/2017/02/02/health/marijuana-and-pregnancy.

I totally agree that we all need to let Attorney General Jeff Sessions know that the majority of Americans suffer because of marijuana …. whether they choose to use it or not.  It is a factor in crime, physical and mental health, academic failure, lost productivity, et al.  American cannot be great again if we continue to allow poison to be grown and distributed to the masses.

The President has taken a position that “medical marijuana” should be a State’s right, because he is not yet enlightened on the reality of what that means.  If asked to define “medical marijuana” that has helped his friends, I doubt that he would say gummy bears, Heavenly brownies and other edibles with 60 to 80% potency, sold in quantities that are potentially lethal; smoked pot at 25% THC content; or waxes and oils used for dabbing and vaping that are as high as 98% potency that cause psychotic breaks, mental illness, suicides, traffic deaths and more.

Further, if states are to have a right to offer “medical marijuana”, it has to be done under tightly controlled conditions and the profit motive eliminated.  Privately owned cultivation and dispensaries must be banned … including one’s ability to grow 6 plants at home.  6 plants grown hydroponically with 4 harvests a year could generate 24 lbs of pot, the equivalent of about 24,000 joints. That obviously would not be for personal use.  We would just have thousands of new drug dealers, with more crime, more child endangerment, more BHO labs blowing up, more traffic deaths, et al.

Source:   Letter from Roger Morgan to DrugWatch International  Feb. 2017

SACRAMENTO (KPIX 5) – Did the medicine contribute to the patient’s death? That was the question facing doctors when a California man died from a relatively rare fungal infection.

“It started with a couple patients that were undergoing very intensive chemotherapy and a stem cell therapy, and those patients were very immune compromised,” explained Dr. Joseph Tuscano of the University of California, Davis Cancer Center.  Those patients were already in a very serious cancer fight when that fight suddenly became much more complicated with a relatively rare but particularly lethal fungal infection.

“We thought it was strange to have cases of such a bad fungal disease in such a short amount of time,” said Dr. George Thompson, a fungal infection expert with UC Davis Medical Center.

The patients were relatively young, in winnable cancer battles. For one of them, it was the fungal infection that proved deadly. So the doctors set out to find that killer, and right away, they had a suspect.

“What struck me is both of these gentlemen were at least medicinal marijuana users, that helped them with nausea and appetite issues that come with the treatment,” said Tuscano, who joined with Thompson to investigate further.  Only problem, federal law prohibited them from doing that research at UC Davis, so they joined forces with Steep Hill Laboratories in Berkeley.

“We kind of go on the credo of  ‘do no harm,’” said Dr. Donald Land, who has been analyzing contaminated marijuana for over a decade.

“We sometimes see 20 or 30 percent of our samples coming through the lab significantly contaminated with molds,” said Land, who had plenty of experience finding mold and fungus strains, but this time, he and his team went deeper.

They gathered 20 samples of medical marijuana from across California and took them apart, pulling out a range of dangerous bacteria and fungi which they analyzed right down to their DNA.  Even Land was surprised by the results. “We were a little bit startled that ninety percent of those samples had something on them. Some DNA of some pathogen,” he told KPIX 5.

These weren’t just any pathogens, they were looking at the very fingerprints of a killer. “The cannabis was contaminated with many bacteria and fungi, some of which was compatible with the infections that I saw in my patients,” Tuscano said.

“Klebsiella, E.coli, Pseudomonas, Acinetobacter, these are all very serious infections for anybody in the hospital. But particularly in that population, the cancer population,” Thompson.

One of questions this raises is whether the risk is made worse by smoking, which could send pathogens directly into the lungs, which are particularly vulnerable.  Truth is, there’s really isn’t much research on any of this.  “But we think now,” Thompson says, “with some of these patients, it’s really unknowingly self-inflicted form cannabis use.”

Cannabis, labelled medicinal, that could pose a lethal threat to already vulnerable patients.

When this research is published it will suggest more warnings for patients with weakened immune systems, because, as Dr. Tuscano explains, “the problem in my opinion is that there’s this misconception that these dispensaries produce products that have been tested to be safe for patients, and that’s not necessarily the case.”

Source: sanfrancisco.cbslocal.com/2017/02/06/medical-marijuana-fungus-death-uc-davis-medical-center/  6th Feb. 2017

UC Davis researcher Dr. George Thompson advises cancer patients and others with weakened immune systems to avoid vaping or smoking marijuana.

In uneasy news for medical marijuana users, UC Davis researchers have identified potentially lethal bacteria and mold on samples from 20 Northern California pot growers and dispensaries, leading the doctors to warn patients with weakened immune systems to avoid smoking, vaping or inhaling aerosolized cannabis.

“For the vast majority of cannabis users, this is not of great concern,” said Dr. George Thompson, professor in the UC Davis Department of Medical Microbiology and Immunology. But those with weakened immune systems – such as from leukemia, lymphoma, AIDS or cancer treatments – could unwittingly be exposing themselves to serious lung infections when they smoke or vape medical marijuana.

“We strongly advise them to avoid it,” Thompson said.

The study’s findings were published online in a research letter in the journal Clinical Microbiology and Infection.  It comes as California and a majority of states have eased laws on medical and recreational marijuana use, and a majority of U.S. doctors support the use of medical marijuana to relieve patients’ symptoms, such as pain, nausea and loss of appetite during chemotherapy and other treatments.

Typically, patients with lower-functioning immune systems are advised to avoid unwashed fruits or vegetables and cut flowers because they may harbor potentially harmful bacteria and mold, or fungi. Marijuana belongs in that same risk category, according to Thompson.

“Cannabis is not on that list and it’s a big oversight, in our opinion,” Thompson said. “It’s basically dead vegetative material and always covered in fungi.”

The study began several years ago after Dr. Joseph Tuscano, a UC Davis blood cancer specialist, began seeing leukemia patients who were developing rare, very severe lung infections. One patient died.

Suspecting there might be a link between the infections and his patients’ use of medical marijuana, Tuscano teamed with Thompson to study whether soil-borne pathogens might be hiding in medical marijuana samples.

The marijuana was gathered from 20 Northern California growers and dispensaries by Steep Hill Labs, a cannabis testing company in Berkeley. It was distilled into DNA samples and sent to UC Davis for analysis, which found multiple kinds of bacteria and fungi, some of which are linked to serious lung infections.

There was a “surprisingly” large number of bacteria and mold, said Donald Land, a UC Davis chemistry professor who is chief scientific consultant for Steep Hill Labs. The analysis found numerous types of bacteria and fungi, including organic pathogens that can lead to a particularly deadly infection known as Mucor.

“There’s a misconception by people who think that because it’s from a dispensary, then it must be safe. That’s not the case,” said UC Davis’ Tuscano. “This is potentially a direct

inoculation into the lungs of these contaminated organisms, especially if you use a bong or vaporization technique.”

Patients with compromised immune systems are especially susceptible to infections, usually acquired in their environment or in the hospital. But given the testing results, Tuscano said, it’s possible that even some of the more common infections, such as aspergillus, could also be attributed to contaminated medical marijuana.   Tuscano emphasized that until more research is done, he can’t be 100 percent assured that contaminated cannabis caused the infections, but “it’s highly suspicious.” Under California’s Proposition 64, the voter-approved initiative that eased restrictions on personal marijuana use, the state is expected to have cannabis testing regulations in place for medical marijuana by Jan. 1.

“Patient safety is one of our chief concerns in this process,” said Alex Traverso, spokesman for the state Bureau of Medical Cannabis Regulation, in an email. He said the state’s new medical-marijuana testing standards will soon be available for public review. “We welcome everyone’s input to ensure that testing standards are as strong as we need them to be.”

Until then, consumers are largely on their own.  The vast majority of cannabis sold in California is not tested, according to Land.

“You can’t tell what’s in (a marijuana product) by looking at it, smelling it, feeling it, or a person in a dispensary telling you it’s safe or clean,” he said. “The only way to ensure you have a safe, clean product is to test it and be sure it’s handled according to good manufacturing practices.”

Some medical marijuana clinics already do voluntary testing of their products. Kimberly Cargile, director of A Therapeutic Alternative, a medical marijuana clinic in Sacramento, said a sample from every incoming pound of pot is sent to a local, independent testing lab.

“It’s for consumer protection. It’s a healthy first step,” Cargile said.

To avoid the risk of exposure to severe lung infections, Thompson and Tuscano advise cancer patients and others with hampered immune systems to avoid smoking, vaping or inhaling aerosolized cannabis altogether. Cannabis edibles, such as baked cookies or brownies, could be a safer alternative.  Theoretically, Thompson said, the consumption of cooked edibles seems safer than smoking or vaping, but it’s not scientifically proven.

“I give that advice with a caveat: We don’t know it’s safer; we think it probably is,” he said.

For patients heeding the UC Davis advice to avoid smoking or vaping medical marijuana, “it’s always better to err on the side of caution,” said medical marijuana advocate Cargile. There are plenty of alternatives, she noted, including cannabis salves, lotions, sprays, tinctures and suppositories.

Source:  http://www.sacbee.com/news/local/health-and-medicine/article131391629.html Feb.2017

Outdoor cannabis cultivation in northern California has damaged forestlands and their inhabitants. Will legalization of recreational marijuana make things worse or better?

A visit to a marijuana farm in Willow Creek, the heart of northern California’s so-called Emerald Triangle feels like strolling through an orchard. At 16 feet high and eight feet around, its 99 plants are too overloaded with cannabis buds to stand on their own. Instead each plant has an aluminium cage for support.

Welcome to America’s “pot basket.” The U.S. Drug Enforcement Administration estimates 60 percent of cannabis consumed nationwide is grown in California. According to the Department of Justice, the bulk of that comes from the three upstate counties of the Emerald Triangle: Mendocino, Humboldt and Trinity. Conditions here are said to be perfect for outdoor marijuana cultivation. But that has proved to be a very mixed blessing for the region, bringing with it a litany of environmental disturbances to local waterways and wildlife. Creek diversions threaten fish habitat and spur toxic algal blooms. Road building and clear-cuts erode soil and cloud streams. Deep within, illegal “guerilla grows” pepper forestlands with banned rodent poisons that are intended to eradicate crop pests but are also fatal to other mammals.

On November 8 voters in four states—Massachusetts, Maine, California and Nevada—legalized recreational marijuana. These states join Colorado, Washington, Oregon and Alaska, along with the District of Columbia, where one can already legally buy the drug for recreational use. Will this expanded market mean more environmental damage? Or will legalization pave the way for sounder regulation?

In 1996 California legalized marijuana for medical use, providing the first legal space for pot cultivation since the federal government’s blanket ban on the crop some 60 years before. As grow operations in the state flourished, California Department of Fish and Wildlife biologist Scott Bauer analyzed satellite imagery to examine the impact of cultivation on water levels in four Emerald Triangle watersheds. His study, published in PLoS ONE in 2015, found that in three of the four watersheds, “water demand for marijuana cultivation exceeds stream flow during the low-flow [summer] periods.”

The real problem is not marijuana’s overall water consumption, which still falls far short of California staples like walnuts or almonds, explains environmental scientist Van Butsic of the University of California, Berkeley. Rather it is an issue of where and when pot is

grown. Analyzing aerial imagery of 4,428 grow sites in 60 Humboldt county watersheds, Butsic found that one in 20 grow sites sat within 100 meters of fish habitat and one in five were located on steep land with a slope of 17 degrees or more. “The problem is that cannabis is being grown in the headwaters, and much of the watering is happening in the summer,” Butsic says.

If that arrangement goes on unchecked, U.C. Berkeley ecologist Mary Powers warns, summer plantations could transform local rivers from cool and “salmon-sustaining” to systems full of toxic cyanobacteria. Over eons of evolution native salmon species have adapted to “deluge or drought” conditions, she says. But the double whammy of climate change and water extraction could prove to be a game-changer.

Powers spelled out the unprecedented stresses in a 2015 conference paper focused on the Eel River that flows through Mendocino and southern Humboldt. She and her team found riverbed-scouring floods in winter, followed by dry, low-flow conditions in summer, led to warm, stagnant, barely connected pools of water. That is bad news for salmon, but ideal for early summer algal blooms. The algae then rot, creating an oxygen-deficient paradise for toxic cyanobacteria, which have been implicated in the poisoning deaths of 11 dogs along the Eel River since 2002.

Dogs are not the only terrestrial creatures endangered by the grow operations. Between 2008 and 2013 Mourad Gabriel, then a doctoral candidate at the University of California, Davis, Veterinary Genetics Lab, carried out a study of the American fisher, a small carnivorous mammal that is a candidate for the endangered species list. He wanted to suss out the threats to fisher populations in northern California. So he radio-tagged fishers from Trinity County’s Hoopa Valley Reservation and public lands near Yosemite National Park to track their movements. Between 2006 and 2011, 58 of the fishers Gabriel and his team tracked turned up dead. Gabriel studied the necropsies and found that 46 of the animals had been exposed to anticoagulant rodenticides—rat poisons that block liver enzymes, which enable blood clotting. Without the enzyme the exposed mammals bled to death from flesh wounds.

The finding puzzled Gabriel at first, because rat poison is more common in agricultural and urban settings than in remote forests. But then he started visiting the remnants of guerilla grows that had been busted under the guidance of lawmen such as Omar Brown, head of the Narcotics Division at the Trinity County Sheriff’s Office. “We have found [anticoagulant rodenticides] carbofuron on grows in the national forest,” Brown reports. “These are neurotoxin-laced pesticides that have been banned in the U.S. since 2011. And even for allowed pesticides, we’ve found instances where trespass grows are using them in illegally large quantities.” The poisons hit female fishers particularly hard, because the early, pest-prone phase of marijuana cultivation coincides with the fishers’ nesting season, when pregnant females are actively foraging.

Gabriel, now director of the Integral Ecology Research Center based in Humboldt County, says other states may be dealing with rodenticides, water diversions and other problems from guerilla grows, too. “The climate in Colorado, Oregon and Washington is conducive for marijuana cultivation,” he observes. But “there just isn’t the scientific data to prove whether other states have these problems because there has not been research funding put towards answering these questions.”

In California headwater ecosystems could get a reprieve if a greatly expanded legalized pot industry moves to the Central Valley, where production could take place indoors and costs would be less. In pot-growing pioneer states like Colorado or Washington much of the production has moved indoors, where temperatures can be more closely managed. But other factors may hinder that move. “Bud and pest problems are always worse indoors, which biases farmers toward a chemically intensive regime,” says Marie

Peterson of Downriver Consulting, a Weaverville, Calif.–based firm that helps growers fill out the paperwork for state and county permits as well as assesses water management plans for their plantations. And besides, the Central Valley already suffers from prolonged drought.

Of the eight states that legalized the cultivation of recreational marijuana, only Oregon and California allow outdoor grows. But regulating open-air pot plantations in these states remains challenging, even though legal operations for medical marijuana have been around since 1998 and 1996, respectively. In 2015 California passed the Medical Marijuana Regulation and Safety Act, which calls on the state’s departments of Food and Agriculture, Pesticide Regulation, and Fish and Wildlife, along with the state’s Water Board—to oversee environmental impacts of the industry. The board came up with a list of requirements for a marijuana plantation water permit, which in turn became a necessary condition for a license to grow medical pot in any of the three Emerald Triangle counties. Counties have until January 2018 to decide whether to create similar stipulations for recreational marijuana growing permits.

Butsic is optimistic about a more regulated future for the marijuana industry in California. “I think five years from now things will be more sustainable. Permitting shows growers that the state is interested in water use and their crop.”

Source:  https://www.scientificamerican.com/article/burgeoning-marijuana-market-prompts-concerns-about-crop-rsquo-s-environmental-impact/  2nd Feb. 2017

Since the state legalized marijuana for recreational use, the Colorado Department of Public Health and Environment has issued a report on marijuana and health every two years. Colorado legalized recreational pot in 2012 to go into effect in 2014. This is the second health report. The report contains a huge amount of data. An executive summary appears on pages 1-6. The most startling data about the consequences of legalization are the number of marijuana-related hospitalizations that have occurred from 2000, the year Colorado legalized marijuana for medical use to September 2015, 21 months after recreational legalization began. A graph showing rates of these hospitalizations by age is pictured below. They are rates per 100,000 and have nearly doubled among adolescents and quintupled among young adults. A graph of the data broken down by race on page 291 of the report are equally stunning. Read report here.

Source:  http://themarijuanareport.org/  Feb.2017

The letter below speaks of the heroin epidemic in the USA.  The figure of heroin and opioid addiction that has destroyed countless families and killed more than 50,000 Americans in 2015 alone is salutary.

A chronicle of President Barack Obama’s tenure must include the heroin epidemic that he leaves us with. Our nation is plagued with a systemic heroin and opioid addiction that has destroyed countless families and killed more than 50,000 Americans in 2015 alone. This one-year death toll is greater than the total number of Americans killed in action during the Vietnam War.

The opioid casualty count only tells part of the story. More than half a million Americans admit to being addicted to heroin, and each of them has a very difficult, if not impossible, road to recovery. Yet, heroin flows into our nation every day and is readily available for $5 a bag 24/7 on street corners throughout the cities and suburbs of America.

How was this level of accessibility not reason enough for President Obama to make slowing our porous borders a priority?  Obama, in his final days as president is now becoming more vocal about the epidemic he leaves behind. However, this is too little, too late in the extreme. His record-setting pardoning and lessening of drug dealer sentences, which have included heroin dealers, further erodes his record on the heroin epidemic. Classifying a heroin dealer as a nonviolent criminal in the face of the American opioid death toll is nonsense.

Perhaps Obama was one of the lucky ones that didn’t have a close friend or relative addicted or taken by heroin and he just didn’t notice the plague that took root under his watch.

Robert Cochran Stafford

Source:  http://www.app.com/story/opinion/readers/2017/01/14/letter-obama-legacy-includes-drug-addiction-epidemic/96557686/

FRAMINHAM, Mass. – A Framingham middle school student was hospitalized Monday after he and another student ate a marijuana edible on the school bus, according to a letter released by Fuller Middle School.   School officials are trying to find out who brought the edibles on the bus and how to make sure it doesn’t happen again.

Stacy Velasquez says her 12-year-old son was riding the bus to school Monday morning when he found a container of gummy bears that got him very sick.   He called her crying.

“He said, ‘I ate something.’ I said, ‘what did you eat?’ He said candy. Where did you get it? He said he found it on the bus,” Velasquez explained.   When she arrived at Fuller Middle School, she says he was in a trance-like state, barely able to speak. She rushed him to the emergency room, snapping a video of his behavior.

“Once the tox screen came back, they said they’d never seen this before in a child so small, like an overdose so to speak of marijuana, but basically it would run its course and he would sleep it off.  And that’s what he did last night,” said Velasquez.

The district superintendent says they have no comment in regards to what happened, just that the police are now investigating.   Though marijuana is now legal in the state of Massachusetts, it’s not legal for anyone under the age of 21 to handle or ingest the drug.

“I would just like someone to make sure the school is doing their part and the bus drivers are doing their part to make sure the children get to and from school safely and that something like this doesn’t happen to someone else’s child,” Velasquez said. “I think the teenager involved [should be charged], because right now, it’s expected to be one of the high schoolers.”

Velasquez said her son is doing fine, he’s just embarrassed about what happened.   As for possible charges, police are looking through video taken on the bus to see who the edibles link back to.

Source:  http://www.fox25boston.com/news/framingham-middle-schooler-hospitalized-after-eating-marijuana-edible-on-school-bus/483211673?utm_source=January 11th 2017

The United States surgeon general’s landmark report on alcohol, drugs and health entitled “Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health,” concludes that alcohol and drug misuse, disorders and addiction are among America’s most pressing public health concerns. As noted in the report, nearly 21 million Americans – more than the number of people who have all cancers combined – suffer from substance use disorders.

The exhaustive report’s chapter dedicated to prevention programs concludes that evidence-based prevention interventions, carried out before the need for treatment, are critical because they can delay early use and stop the progression from use to addiction resulting in costly individual, social and public health consequences. As the study states, “The good news is that there is strong scientific evidence supporting the effectiveness of prevention programs and policies.”

The report concludes that interventions for adolescents ages 10 to 18 have been shown to affect either the initiation or escalation of substance use. D.A.R.E.’s “keepin’ it REAL” curriculum is among a number of select programs the surgeon general identifies as building social, emotional, cognitive and substance refusal skills that provide children with accurate information on rates and amounts of peer substance use.

D.A.R.E. America formed an alliance in 2008 with Pennsylvania State University for adoption of the curriculum as the D.A.R.E. middle school program. The program was developed by PSU with support from the National Institute on Drug Abuse, utilizing rigorous longitudinal scientific evaluations to create this evidence-based program. D.A.R.E. adopted the “keepin’ it REAL” middle-school curriculum that same year and its elementary school curriculum in 2013. D.A.R.E.’s “keepin’ it REAL” Elementary and Middle School Curricula adhere to relevant National Institute of Health’s Lessons from Prevention Research principles.

In 2014, Scientific American magazine commended D.A.R.E.’s Keepin’ it REAL curricula in its article, The New D.A.R.E. Program — This One Works. The “keepin’ it REAL” substance-abuse curriculum focuses on elementary and middle-school students’ decisions, not drugs (www.scientificamerican.com/article/the-new-d-a-r-e-program-this-one-works/).

Source:   http://www.flyergroup.com/news/surgeon-general-commends-efficiency-of-d-a-r-e-program/article_d202095f-e269-5f43-ac12-b7d271f6f225.html

This Report reviews what we know about substance use and health and how we can use that knowledge to address substance misuse and related health consequences.

First, a general Introduction and Overview of the Report (PDF | 1.5 MB) describes the extent of the substance use problem in the United States. Then it lays a foundation for readers by explaining what happens in the brain of a person with an addiction to these substances.

Chapter 2 – The Neurobiology of Substance Use, Misuse, and Addiction (PDF | 6.0 MB) describes the three main circuits in the brain involved in addiction, and how substance use can “hijack” the normal function of these circuits. Understanding this transformation in the brain is critical to understanding why addiction is a health condition, not a moral failing or character flaw.  Few would disagree with the notion that preventing substance use disorders from developing in the first place is ideal. Prevention programs and policies are available that have been proven to do just that.

Chapter 3 – Prevention Programs and Policies (PDF | 1.5 MB) describes a range of programs focused on preventing substance misuse including universal prevention programs that target the whole community as well as programs that are tailored to high-risk populations. It also describes population-level policies that are effective for reducing underage drinking, drinking and driving, spread of infectious disease, and other consequences of alcohol and drug misuse.

If a person does develop a substance use disorder, treatment is critical. Substance use disorders share some important characteristics with other chronic illnesses, like diabetes. Both are chronic conditions that can be effectively managed with medications and other treatments that focus on behavior and lifestyle.

Chapter 4 – Early Intervention, Treatment, and Management of Substance Use Disorders (PDF | 629 KB) describes the clinical activities that are used to identify people who have a substance use disorder and engage them in treatment. It also describes the range of medications and behavioral treatments that can help people successfully address their substance use disorder.

As with other chronic conditions, people with substance use disorders need support through the long and often difficult process of returning to a healthy and productive life.

Chapter 5 – Recovery: The Many Paths to Wellness (PDF | 335 KB) describes the growing array of services and systems that provide this essential function and the many pathways that make recovery possible.  Responsive and coordinated systems are needed to provide prevention, treatment, and recovery services. Traditionally, general health care and substance use disorder treatment have been provided through distinct and separate systems, but that is now changing.

Chapter 6 – Health Care Systems and Substance Use Disorders (PDF | 1.3 MB) explains why integrating general health care and substance use services can result in better outcomes and describes policies and activities underway to achieve that goal.

The final chapter, Chapter 7 – Vision for the Future: A Public Health Approach (PDF | 255 KB), provides concrete recommendations on how to reduce substance misuse and related harms in communities across the United States.

Source:  https://addiction.surgeongeneral.gov/executive-summary/report

Governor says other states should learn from Colorado’s example, noting that state initially failed to regulate edibles strongly enough

States preparing to legalize cannabis for recreational use in 2017 have been warned to impose strong regulations on edible products, in order to help prevent children mistaking the drug for candy. John Hickenlooper, governor of Colorado, which pioneered legal cannabis for recreational use in 2014, said other states should learn from his state’s example.

“We didn’t regulate edibles strongly enough at first,” he said this week, at a gathering of the Western Governors’ Association.  Colorado has seen a rise in numbers of children taken to the hospital after eating marijuana products. California, Massachusetts, Nevada and Maine are the latest states to legalize recreational cannabis, after voters passed ballot measures in the November elections.

Recreational use is currently legal in Colorado, Washington, Oregon, Alaska and the District of Columbia. More than half of the 50 states now allow marijuana for medical use.  Los Angeles could become the weed capital of the world, one industry insider has predicted, estimating that the southern California city already generated close to $1bn in annual medical marijuana sales.

The whole of Colorado had just under $1bn in sales in 2015, on which the industry paid $135m in taxes and fees to the state. Revenues are likely to grow to $1.3bn in 2017, according to the state department of revenue. Hickenlooper, who said he had been fielding calls from governors asking for his advice, California’s Jerry Brown among them, opposed legalizing recreational pot. The drug nonetheless became legal for leisure use in Colorado in January 2014. The state has since been forced to toughen regulations, particularly on edible products, because many emerged that looked exactly like non-cannabis-containing products such as gummy bears, lollipops, brownies, cookies and chocolates. Lawmakers in Colorado passed rules requiring manufacturers to improve child-proofing on packaging and use better labelling,  including stamps on food to say it contains pot.  Recent measures will prohibit animal and fruit-shaped edibles. The state also started a public education campaign aimed at teens and children.  Hickenlooper, speaking in California, said that in a few cases children had died. There are, however, no confirmed statistics or details available for the state.

Hickenlooper spokeswoman Holly Shrewsbury told the Guardian there have been no such deaths of under-18s and the governor was including young adults in his reference to children, without citing exact numbers. A study by the University of Colorado published last July reported that in 2015, 16 children under the age of 10 were admitted to the emergency room of the Children’s Hospital of Colorado, in Aurora, with edible-related complaints.

In the same year, state poison control authorities received 47 calls about children falling sick after taking pot. Around half of those incidents involved edibles. In 2009, there were nine such calls to poison control.  It’s more regulated than plutonium at this stage but I’m in favour of common sense rules backed by science, not fear.  Most children affected became drowsy and recovered after a few hours. A small number became seriously ill and ended up in intensive care.

Julie Dooley, who owns Julie’s Natural Edibles, a Denver company that makes cannabis-infused granola, echoed the governor’s advice that states should regulate better from the start of legalization, rather than bring in laws retroactively.

“It’s important to regulate ahead of time,” she said. “We’ve just gone through our fourth round of regulation since legalization and it’s very expensive having to change the labelling and packaging all the time.   “It’s more regulated than plutonium at this stage, but I’m in favour of common sense rules, backed by science, not fear.”

Dooley said it was incumbent on parents to store cannabis and cannabis products safely away from children, but said the state should do “a lot more” to educate the public.  Hickenlooper said that if he could have had a magic wand in 2013, he would have reversed Colorado’s legalization vote.

“Now if I have that magic wand, I probably wouldn’t,” he said. “I would wait and see if we can make a better system.”  He described America’s wider policy of waging a law enforcement “war on drugs” as “a train wreck”.  “It didn’t work, so it remains to be seen whether the new system is actually going to be better,” he said.

Last week, Colorado announced $2.35m in funding for research grants to look into the effects of cannabis on driving ability and cognitive functioning.  Henny Lasley, executive director of Smart Colorado, an advocacy group that campaigns for better protections from cannabis for youth, said: “Cannabis products should not look like candy, or like anything a child would pick up and eat.”

She called for more research and data at the state level and warned about the strength of highly concentrated pot coming on to the market for recreational use.  “I would like states to limit the potency of the products,” she said.

Source:   https://www.theguardian.com/us-news/2016/dec/18/recreational-marijuana-legalization-states-edibles-candy

Fentanyl is a painkiller that is 50 times stronger than heroin. It has already killed thousands, including Prince. Chris McGreal reveals why so many are playing Russian roulette with this lethal drug Natasha Butler had never heard of fentanyl until a doctor told her that a single pill had pushed her eldest son to the brink of death – and he wasn’t coming back. “The doctor said fentanyl is 100 times more potent than morphine and 50 times more potent than heroin. I know morphine is really, really powerful. I’m trying to understand. All that in one pill? How did Jerome get that pill?” she asked, her voice dropping to a whisper as the tears came. “Jerome was on a respirator and he was pretty much unresponsive. The doctor told me all his organs had shut down. His brain was swelling, putting pressure on to the spine. They said if he makes it he’ll be a vegetable.”

Painkiller addiction claims more lives in the US than guns, cutting across class, race and region

The last picture of Jerome shows him propped immobile in a hospital bed, eyes closed, sustained only by a clutch of tubes and wires. Natasha took the near impossible decision to let him die.  “I had to remove him from life support. That’s the hardest thing to ever do. I had him at 15 so we grew together. He was 28 when he died,” she said. “I had to let him die but after that I needed some answers. What is fentanyl and how did he get it?” That was a question asked across Sacramento after Jerome and 52 other people in and around California’s capital overdosed on the extremely powerful synthetic opioid, usually only used by hospitals to treat patients in the later stages of cancer, over a few days in late March and early April 2016. Twelve died.

Less than a month later, this mysterious drug – largely unheard of by most Americans – killed the musician Prince and burst on to the national consciousness. Fentanyl, it turned out, was the latest and most disturbing twist in the epidemic of opioid addiction that has crept across the United States over the past two decades, claiming close to 200,000 lives. But Prince, like almost all fentanyl’s victims, probably never even knew he was taking the drug.

“The number of people overdosing is staggering,” said Lieutenant Tracy Morris, commander of special investigations who manages the narcotics task force in Orange County, which has seen a flood of the drug across the Mexican border. “It is truly scary. They don’t even know what they’re taking.” The epidemic of addiction to prescription opioid painkillers, a largely American crisis, sprung from the power of big pharmaceutical companies to influence medical policy. Two decades ago, a small family-owned drug manufacturer, Purdue Pharma, unleashed the most powerful prescription painkiller yet sold over the pharmacist’s counter. Even though it was several times stronger than anything else on the market, and bore a close relation to heroin, Purdue claimed that OxyContin was not addictive and was safe to treat even relatively minor pain. That turned out not to be true.

It spawned an epidemic that in the US claims more lives than guns, cutting across class, race and geographic lines as it ravages communities from white rural Appalachia and Mormon Utah to black and Latino neighbourhoods of southern California. The prescription of OxyContin and other painkillers with the same active drug, oxycodone, became so widespread that entire families were hooked. Labourers who wrenched a back at work, teenagers with a sports injury, just about anyone who said they were in pain

was put on oxycodone. The famous names who ended up as addicts show how indiscriminate the drug’s reach was; everyone from politician John McCain’s wife Cindy to Eminem became addicted.

Clinics staffed by unscrupulous doctors, known as “pill mills”, sprung up churning out prescriptions for cash payments. They made millions of dollars a year. By the time the epidemic finally started to get public and political attention, more than two million Americans were addicted to opioid painkillers. Those who finally managed to shake off the drug often did so only at the cost of jobs, relationships and homes.

After the government finally began to curb painkiller prescriptions, making it more difficult for addicts to find the pills and forcing up black market prices, Mexican drug cartels stepped in to flood the US with the real thing – heroin – in quantities not seen since the 1970s. But, as profitable as the resurgence of heroin is to the cartels, it is labour intensive and time-consuming to grow and harvest poppies. Then there are the risks of smuggling bulky quantities of the drug into the US.

The ingredients for fentanyl, on the other hand, are openly available in China and easily imported ready for manufacture. The drug was originally concocted in Belgium in 1960, developed as an anaesthetic. It is so much more powerful than heroin that only small quantities are needed to reach the same high. That has meant easy profits for the cartels. The Drug Enforcement Administration (DEA) has said that 1kg of heroin earns a return of around $50,000. A kilo of fentanyl brings in $1m.

At first the cartels laced the fentanyl into heroin to increase the potency of low-quality supplies. But prescription opioid painkillers command a premium because they are trusted and have become increasingly difficult to find on the black market. So cartels moved into pressing counterfeit tablets.  But making pills with a drug like fentanyl is a fairly exact science. A few grammes too much can kill. “It’s very lethal in very small doses,” said Morris. “Even as little as 0.25mg can be fatal. One of our labs had a dime next to 0.25mg and you could barely see it. It’s about the size of the head of a pin. Potentially that could kill you.”

The authorities liken buying black market pills to playing Russian roulette. “These pills sold on the street, nobody knows what’s in them and nobody knows how strong they are,” said Barbara Carreno of the DEA.

After Prince died, investigators found pills labelled as prescription hydrocodone, but made of fentanyl, in his home, suggesting he bought them on the black market. The police concluded he died from a fatal mix of the opioid and benzodiazepine pills, a particularly dangerous combination. It is likely Prince did not even know he was taking fentanyl.  Others knowingly take the risk. In his long battle with addiction, Michael Jackson, used a prescription patch releasing fentanyl into his skin among the arsenal of drugs he was fed by compliant doctors. Although it was two non-opioids that killed him, adding fentanyl into the mix was hazardous.

Jerome Butler, a former driver for Budweiser beer who was training to be a security guard, thought he was taking a prescription pill called Norco. His mother’s voice breaks as she recounts what she knows of her son’s last hours. Natasha said she was aware he used cannabis, but had no idea he was hooked on opioid painkillers. She said her son at one time had a legitimate prescription and may have become addicted that way. She has since discovered he was paying a doctor, well known for freely prescribing opioids, to provide pills.  “I didn’t even know,” she said. “You find stuff out after. It’s killing me because they’re saying, ‘Well, yeah, Jerome was taking them pills all the time.’ And I’m like, ‘He was doing what?’”

Jerome may have had a prescription, but like many addicts he will have needed more and more. The pill that killed him was stamped M367, a marking used on Norco pills made of an opioid, hydrocodone. It was a fake with a high dosage of fentanyl.   This is fentanyl. The first time you take it you’re not coming back. You’re gone

“If Jerome had known it was fentanyl he would never have took that,” said Natasha. “This ain’t like crack or a recreational drug that people been doing for so many years and survived it but at 60 or 70 die from a drug overdose because their heart can’t take it no more. This is fentanyl. The first time you take it you’re not coming back. You’re gone.”

That wasn’t strictly true of the batch that hit Sacramento. It claimed 11 other lives. The youngest victim was 18-year-old George Berry from El Dorado Hills, a mostly white upscale neighbourhood. The eldest was 59. But others survived. Some were saved by quick reactions; doctors were able to hit them with an antidote before lasting damage was done. Others swallowed only enough fentanyl to leave them seriously ill but short of death.

It was a matter of luck. When investigators sent counterfeit pills seized after the Sacramento poisonings for testing at the University of California, they found a wide disparity in the amount of fentanyl each contained. Some pills had as little as 0.6mg. Others were stuffed with 6.9mg of the drug, which would almost certainly be fatal. The DEA thinks the difference was probably the result of failing to mix the ingredients properly with other powders, which resulted in the fentanyl being distributed unevenly within a single batch of counterfeit pills.

That probably explains the unpredictable mass overdosing popping up in cities across the US. In August, 174 people overdosed on heroin in six days in Cincinnati, which has one of the fastest-growing economies in the Midwest. Investigators suspect fentanyl because the victims needed several doses of an antidote, Naloxone, where one or two will usually suffice with heroin. The same month, 26 people overdosed on fentanyl-laced heroin in a four-hour period in Huntington, a mostly white city in one of the poorest areas of West Virginia. In September seven people died from fentanyl or heroin overdoses in a single day in Cuyahoga County, Ohio.

The US authorities don’t know for sure how many people fentanyl kills because of the frequency with which it is mixed with heroin, which is then registered as the cause of death. The DEA reported 700 fatalities from fentanyl in 2014 but said it is an underestimate, and rising. In 2012, the agency’s laboratory carried out 644 tests confirming the presence of fentanyl in drug seizures. By 2015, the number of positive tests escalated to 13,002.

The police did not have to look far for the source of the drug that killed Jerome. He and his girlfriend were staying at the house of her aunt, Mildred Dossman, while they waited for their own place to live. Jerome was smoking cannabis and drinking beer with Dossman’s son, William. Shortly before 1am, William went to his mother’s bedroom and came back with the fake Norco pill. Jerome took it and said he was going to bed.  Jerome’s girlfriend was in jail after being arrested for an unpaid traffic fine and so he was alone with their 18 month-old daughter, Success, lying next to him.

“The doctors explained to me that within a matter of minutes he went into cardiac arrest,” said his mother. “Then as he lay there that’s when time progressed for the organs to be poisoned by fentanyl. He was dying with his daughter next to him.” Natasha said other people in the house heard her son in distress, complaining his heart was hurting. But they did nothing because they were afraid that calling an ambulance would also bring the police.

It was not until 10 hours later that the Dossmans finally sought help from a neighbour who knew Jerome. He tried CPR and then called the medics. The police came, too, and in time Mildred Dossman, 50, was charged with distributing fentanyl and black market opioid painkillers. She was the local dealer.

The DEA is tightlipped about the investigation into the Sacramento deaths as its agents work on persuading Dossman to lead them to her suppliers. But it is likely she was getting the pills from Mexican cartels using ingredients from labs in China where production of fentanyl’s ingredients is legal.  Carreno said some Mexican cartels have long relationships with legitimate Chinese firms which for years supplied precursor chemicals to make meth amphetamine.

Packages of fentanyl are often moved between multiple freight handlers so their origins are hard to trace. Larger shipments are smuggled in shipping containers. Last year, six Chinese customs officials fell ill, one of them into a coma, after seizing 72kg of various types of fentanyl from a container destined for Mexico. American police officers have faced similar dangers. In June, the DEA put out a video warning law enforcement officers across the US that fentanyl was different to anything they have previously encountered and they should refrain from carting seizures back to the office.   “A very small amount ingested, or absorbed through the skin, can kill you,” it said.   A New Jersey detective appears in the video after accidentally inhaling “just a little bit of fentanyl puffed into the air” during an arrest: “It felt like my body was shutting down… I thought that was it. I thought I was dying.”

Along with the Mexican connection, a home-grown manufacturing industry has sprung up in the US. Weeks after Jerome died, agents arrested a married couple pressing fentanyl tablets in their San Francisco flat.

Candelaria Vazquez and Kia Zolfaghari made the drug to look like oxycodone pills. They sold them across the country via the darknet using Bitcoin for payment – on one occasion Zolfaghari cashed in $230,000. The couple shipped the drugs through the local post office. Customers traced by the DEA thought they were buying real painkiller pills. The couple ran the pill press in their kitchen. According to a DEA warrant, a dealer said Zolfaghari made large numbers of tablets: “He could press 100 out fast as fuck.”

The pair made so much money that agents searching their flat found luxury watches worth $70,000, more than $44,000 in cash and hundreds of “customer order slips” which included names, amounts and tracking numbers. The flat was stuffed with designer goods. The seizure warrant described Vazquez’s shoe collection as “stacked virtually from floor to ceiling”. Some still had the $1,000 price tags on them. Zolfaghari was arrested carrying a 9mm semi-automatic gun and about 500 pills he was preparing to post. The dealers made so much money that their flat was stuffed with luxury goods and cash.

Even as Americans are getting their heads around fentanyl, it is being eclipsed. In September, the DEA issued a warning about the rise of a fentanyl variant that is 100 times more powerful – carfentanil, a drug used to tranquilise elephants.

“Carfentanil is surfacing in more and more communities,” said the DEA’s acting administrator, Chuck Rosenberg. “We see it on the streets, often disguised as heroin. It is crazy dangerous.”

The drug has already been linked to 19 deaths in Michigan. Investigators say that with its use spreading, it is almost certainly claiming other lives. Dealers are also getting it from China, where carfentanil is not a controlled drug and can be sold to anyone.

Natasha Butler is still trying to understand the drug that killed her son. She wants to know why it is that it took Jerome’s death for her to even hear of it. She accuses the authorities of failing to warn people of the danger, and politicians of shirking their responsibilities.   A bill working its way through California’s legislature stiffening sentences for fentanyl dealing died in the face of opposition from the state’s governor, Jerry Brown, because it would put pressure on the already badly crowded prisons.

“I’m so dumbfounded. How does that happen?” says Natasha. Her tears come frequently as she sits at a tiny black table barely big enough to seat three people. She talks about Jerome and the tragedy for his three children, including Success, who she is now raising.

But some of the tears are to mourn the devastating impact on her own life. “Look where I’m at. I was in Louisiana. I had a house. I had a job. I had a car. I had a life. I worked every day. I was a manager for a major company. I came here, I became homeless. I had to move into this apartment to help out my granddaughter,” she said. “You see me. This is what my kitchen table is. My son is dead. He had three kids and those two mothers of those kids are depending on me to be strong. I want answers and help. I say, you got the little fish. Where did they get it from? How did they get it here? You are my government. You are supposed to protect us.”

Source:  https://www.theguardian.com/global/2016/dec/11/pills-that-kill-why-are-thousands-dying-from-fentanyl-abuse–

States with Lax Marijuana Laws Also Show Higher Marijuana “Edible” Use than Other States

[WASHINGTON, DC] – The nation’s annual school survey of drug use, Monitoring the Future (MTF), shows marijuana use among adolescents, including heavy marijuana use, remaining stubbornly high and higher than ten years ago — despite reductions across the board among other drugs. Past year and past month marijuana use among high school seniors is up versus last year, and marijuana use among almost all categories is higher than ten years ago. And students in states with lax marijuana laws are much more likely to use marijuana in candy or edible form than students in other states.

“Why would marijuana use not be falling like the use of other substances? The answer is likely marijuana commercialization and industrialization, spurred by legalization initiatives,” said Dr. Kevin A. Sabet, a former White House drug policy advisor and President of Smart Approaches to Marijuana (SAM). “It also might explain why six percent of high school seniors use marijuana daily. Moreover, this study does not include kids who have dropped out of school — and are thus more likely to be using drugs than the study’s sample.”

Additionally, the MTF showed differences between students in states with loose marijuana laws and students in other states. Students in lax policy states were much more likely to use marijuana, and also more likely to use edibles. Among 12th graders reporting marijuana use in the past year, 40.2 percent consumed marijuana in food in states with medical marijuana laws compared to 28.1 percent in states without such laws.

“While drug, cigarette, and alcohol use are falling almost across the board, due to decades of work and millions of taxpayer dollars, kids are turning more and more to marijuana,” said Jeffrey Zinsmeister, SAM’s Executive Vice President. “It’s unsurprising now that the marijuana industry — following in the footsteps of the tobacco industry — is pouring millions into marketing kid-friendly edible products like pot candy to maximize their profits.”

According to statements from the American Medical Association, American Academy of Child and Adolescent Psychiatry, American Society of Addiction Medicine, and the American Psychiatric Association, marijuana use, especially among youth, should be avoided, and legalization efforts opposed.

“Medical research is very clear that marijuana is both addictive and harmful,” noted Dr. Stu Gitlow, immediate past president of the American Society of Addiction Medicine. “One in six adolescents that use marijuana develop an addiction, and use is associated with lower IQ, lower grades, and higher dropout rates in that same population. It is therefore of significant concern that this year’s study may actually underreport marijuana use and downplay its impact.”

Meanwhile, the toll of legalized marijuana continues to climb in Colorado and Washington. For example, the AAA Foundation reported earlier this year that the percentage of fatal crashes in the state of Washington linked to drivers who had recently used marijuana more than doubled the year marijuana retail sales were authorized. Similarly, cases of marijuana poisonings are up 108% in Colorado after legalization, and up 206% among children ages 0 to 8 years old. (More data on these trends is available in SAM’s recent report on legalization in both states.)

Source:  jeff@learnaboutsam.org  Dec. 2016  For more information about marijuana use and its effects, see http://www.learnaboutsam.org.

Cannabinoid AMB-FUBINACA in New York

ABSTRACT

BACKGROUND

New psychoactive substances constitute a growing and dynamic class of abused drugs in the United States. On July 12, 2016, a synthetic cannabinoid caused mass intoxication of 33 persons in one New York City neighborhood, in an event described in the popular press as a “zombie” outbreak because of the appearance of the intoxicated persons.

METHODS

We obtained and tested serum, whole blood, and urine samples from 8 patients among the 18 who were transported to local hospitals; we also tested a sample of the herbal “incense” product “AK-47 24 Karat Gold,” which was implicated in the outbreak. Samples were analyzed by means of liquid chromatography–quadrupole time-of-flight mass spectrometry.

RESULTS

The synthetic cannabinoid methyl 2-(1-(4-fluorobenzyl)-1H-indazole-3-carboxamido)-3-methylbutanoate (AMB-FUBINACA, also known as MMB-FUBINACA or FUB-AMB) was identified in AK-47 24 Karat Gold at a mean (±SD) concentration of 16.0±3.9 mg per gram. The de-esterified acid metabolite was found in the serum or whole blood of all eight patients, with concentrations ranging from 77 to 636 ng per milliliter.

CONCLUSIONS

The potency of the synthetic cannabinoid identified in these analyses is consistent with strong depressant effects that account for the “zombielike” behavior reported in this mass intoxication. AMB-FUBINACA is an example of the emerging class of “ultrapotent” synthetic cannabinoids and poses a public health concern. Collaboration among clinical laboratory staff, health professionals, and law enforcement agencies facilitated the timely identification of the compound and allowed health authorities to take appropriate action.

Source: New England Journal of Medicine;  10.1056/NEJMoa1610300

Examining the data closely and correctly.

By:  By DAVID W. MURRAY, BRIAN BLAKE, JOHN P. WALTERS

The closing reports on the Obama administration’s drug policy were delivered this week. Drug-induced deaths for the year 2015 were reported by the Centers for Disease Control (CDC) on December 8, and the youth school survey of drug use for 2016, Monitoring the Future (MTF), was just released by the National Institutes on Drug Abuse (NIDA). The findings document Obama’s eight years of unbroken failure.

Simply put, it appears inescapable that the two sets of findings are related, in that the flood of commercial, high-potency marijuana unleashed by legalization in the states has served as a “gateway” to the opioid problem, both by priming greater drug use by those who initiate with heavy, developmentally early marijuana use, and further by empowering the illicit drug market controlled by criminal cartels.

Both data releases were somewhat muddled in the offering, neither of them being presented with public briefings at venues such as the National Press Club, as was common in the past.

Instead, the MTF data were only presented in a teleconference for reporters, while the CDC at the last minute determined that the official data for drug overdoses would not be ready until next year, instead directing researchers and the press to their online data system, WONDER, where searchers could uncover them for themselves.

These data releases are bookends—the youth survey showing us the likely future patterns of drug misuse as the high-school-aged cohort ages through adulthood, while the CDC overdose death data are retrospective, revealing where the worst drug epidemic in American experience was more than a year ago.

Data on deaths for 2016, which by all indications from states and municipalities are accelerating upward even more sharply, have not even been analyzed yet (their release is scheduled for December 2017), and will no doubt surface as a further shock in a succeeding administration.

Because there has yet to be a formal report of 2015 final numbers, the precise CDC figures for overdoses by drug remain troublingly vague. That said, the increases are shocking. There were 52,404 overall drug-induced deaths for 2015. That figure has climbed from about 38,000 (and stable) as recently as 2008. For 2015, fully 33,091 deaths were attributable to the opioids, alone (up from 28,647 in 2014, the toll rising most steeply dating from 2010).

Regarding the recent increase, the head of death statistics at the CDC stated; “I don’t think we’ve ever seen anything like this. Certainly not in modern times.”

For the MTF survey, marijuana use rose between 2015 and 2016. High school seniors saw their past month (or current) use rise to a rate of 23 percent, (up from 21 percent in 2015), while past year use rose to 36 percent (up from 35 percent). For the past year category, the rise since 2007 exceeds a 12 percent increase, but most of that rise took place earlier in the Obama years, peaking in 2011-2012 and then stabilizing at the higher level.

Somewhat surprisingly, given the anticipated impact of commercial legalization of marijuana in some states in 2014, with yet other states being added in this last election cycle, the overall impact on youth marijuana use appears modest, especially when compared to the wider data showing steep increases in young adults and those 26 and older, from other national surveys.

There are two immediate cautions in reading these data, however. The first is that many teens are now consuming marijuana in forms other than smoking; that is, as edibles and drinks, which this survey has difficulty detecting. In other words, there may be a hidden dimension of use of what is now a drug of unprecedented potency and availability. The second caveat is the known impact of marijuana use on high-school drop-out rates, pushing them higher. The effect is that the very students most at risk of heavy use are no longer captured in this school-based survey, which might be systematically understating actual prevalence increases because we have lost our ability to capture them.

The real drug use stunner lies elsewhere, largely in the CDC overdose data. The United States is in the grip of a wide and deepening drug use crisis, the most visible alarm being the opioid overdose contribution to the overall drug-induced death data, which by 2015 were sufficient to show up in general health data as driving a decrease in American life-expectancy tables.

Moreover, it is clear that the situation will worsen quickly, for both opioids and for newly resurgent cocaine use, which also registered as an increase in drug overdose deaths, and in recent measures of college-age youth, where use of cocaine, after steep declines, suddenly shot up 63 percent in a single year, 2013-2014, and remained high.

Coupled with the nationwide spread of adult commercial marijuana use and the still surging methamphetamine crisis, the situation is dire across all the major illicit drugs.

The opioid crisis has two dimensions, only one of which has received administration attention. The epidemic has been driven by misuse of prescription opioids, which climbed steadily for several years, and by the emergence of surging illicit drugs, both heroin and new synthetics like fentanyl and its analogs, from illicit rogue labs and smuggled into the United States.

Curiously, even though production increases of heroin and of cocaine have shot up in source countries such as Mexico and Colombia, and as synthetic opioid seizures have rocketed up in border seizures, the administration and the press seem seized by the prescription overdose dimension, which has begun to slow and even abate.

For instance, outlets such as the Washington Post continue to misstate the actual data. In a recent editorial, they insist that “the prescription opioid category accounted for the largest share of deaths, at 17,536.” Accordingly, they urge further policy attention to doctor prescribing practices.

But the latest data show otherwise. According to the CDC WONDER database, there were 19,885 deaths from illicit opioid production, heroin/illicit fentanyl and analogs. And that latter category is the one surging, rising 23 percent for heroin and a stunning 73 percent for synthetics from 2014 to 2015, while strictly prescription deaths rose only 4 percent.

Apparently, the blind spot for the administration (and the press) is that to address the real engine of overdose deaths, they must confront international and cross-border production and smuggling, an understanding of the problem that the Obama administration has abjured, since it requires the forces of law enforcement, national security, and reductions in illicit drug supply.

Two final notes on the 2015 opioid data, which are but harbingers for the hurricane of use and deaths already being seen in the states for 2016.

First, the steep line of ascent for overdose deaths can be closely paralleled by the administration’s mainstay, the insistent distribution and use of naloxone, the opioid overdose antidote medication. Without that reversal drug being deployed, the true death toll would be much worse. But it also means that simply giving out more and more naloxone cannot be a solution to the crisis, as deaths have accelerated away in spite of a reliance on such measures, which prove ineffectual in the long run and faced with new potencies.

The second sobering realization can be found in an analysis we published on the crisis in November, where we noted that for 2014, heroin overdose deaths were now comparable to those from gun homicides nationwide, both standing at 10,500 per year. The point may have been an inspiration for the Washington Post article on CDC WONDER data for 2015, proclaiming that heroin overdoses now exceeded gun homicide deaths (12,989 to 12,979, respectively).

The fact is true, but what is remarkable is the deep parallel in the rise of the respective figures in a single year, both keeping pace by climbing at a nearly identical rate.

It’s almost as if the trafficking in heroin driving the overdoses is itself tied to the emergent gun homicide crisis surging in our major cities. Those who lived through the violent 1980s and early 1990s will remember the connection well.

The Obama drug policy began with unilateral executive action opening the floodgates to marijuana commercial legalization and it is closing with never-before-seen death rates from drug use. The Trump administration faces a drug death epidemic worse than the crisis the Reagan administration inherited from President Jimmy Carter—and that contributed to even greater levels of violence and addiction before the Carter legacy was reversed.

David W. Murray and Brian Blake are senior fellows at Hudson Institute’s Center for Substance Abuse Policy Research; both served in the Office of National Drug Control Policy during the George W. Bush administration. John P. Walters is Hudson’s chief operating officer and former director of drug control policy for President George W. Bush.

Source:  WEEKLY STANDARD  DEC 15, 2016

By Robert Charles

The Christmas carol is poignant – reminder of Christmas, and beyond.  “What child is this, who, laid to rest …” the carol begins.  “Whom angels greet with anthems sweet, while shepherds watch are keeping?” it continues.  The stanza ends, “Haste, haste ….”  Lovely, lilting, full of promise – like the birth of a child.  Here, a special child – but also every child.

In a season of joy, it is a message of joy.  But the mind wanders, to our mortal world.  New numbers on drug addiction and drugged driving death, so many lost souls – mitigate the joy.   They caught me off guard this week. My brother, a high school teacher, shared with me the loss of another student, another fatal crash, as drugged driving numbers rise.  What is the season for heartbroken parents – but a season of loss?  Each year, upwards of 100,000 parents lose a child to drug abuse.

What child is this?  It is America’s child, and America’s childhood.  How is it that we have, collectively, forgotten to keep watch over those entrusted to our watch – especially from high office?  Last year, 47,055 Americans, most of them young, were lost to drug abuse – just statistics now.  Why?

In part, because so many Americans have heard a mixed message from their leaders – with devastating effects. Led to believe drugs are “recreation,” something not different from beer or wine, kids try and die.  Synthetic opioids, heroin, cocaine, high potency marijuana – then to ER, or not even, and mortuary. Numbers do not lie.

Drugged driving is now another epidemic.  Drivers and helpless passengers are all at risk, along with everyone on the road.  Near home, not long ago, several kids died in a terrible car crash.  They missed a bend and hit a tree.  The sister of a child known to my son was almost in that car – but courageously declined the ride.  She knew the driver was compromised.  That decision saved her life.  Unfortunately, the searing truth caught others off guard.  Drugged driving is death on wheels, period.  Drug legalization is the unabashed promoter of that death.  So, where are the shepherds?  Where are the outspoken leaders, why silent?

What child is this, who starts with marijuana, soon is addicted, ends overdosing on opiates or as a roadside cross?  What child is this, who needed knowledge from someone they trusted – but got misinformation?  What child is this, who is force-fed popular lies, that drug abuse is “recreation?”

And what child is this, “greeted by angels,” who was forsaken here – by leaders for political advantage?  “Laid to rest” by parents’ inconsolable hands?  Where were those leaders, a thoughtful president, governor, congressman, legislator, mayor?  How could we, in a blink, give up 50,000 souls – this year, again?  Silence is not just holy – it can also be complicit.  Permitting legal expansion of drug abuse, legalized money laundering, an insidious tax grab, or turning a Federal blind eye – comes at the expense of young lives.  That is the truth.

Needed in this season of change are new national and community leaders, who are unafraid to say:   Do not compromise your future.  Do not risk everything for nothing.  Do not break faith with yourself, or those who are counting on you.   The mind wanders … from a Christmas carol to those not here to celebrate.  To parents, siblings, friends and teachers sadly asking “what if…”  And bigger questions:  What if the legalization pabulum and knowing disinformation were stopped?  What if drugs sure to addict and kill were less available?  What if policy indifference turned to saving young lives, not putting them at risk?

Said Henry David Thoreau, every child is an “empire.”  But today, these empires are falling fast.  Risk is inherent in our indifference, disinformation, disregard for truth, and treating death as recreation.  Addiction’s darkness comes on so fast, too.  A life soon narrows, ambitions die, dependence rises, users feel boxed in, relationships and functions are degraded, nightmares start, and then an awful and big question – who cares?

These days, few seem to – not this President, Congress, many of our State “leaders.”  They just go along.  Meantime, more families are drained and left alone – victims of accelerating drug abuse, drugged driving, drug-related crime, and life-changing addiction.  The Trump team has a chance:  To say enough, this experiment is over.  That would help American families stop grieving, save kids from this unparalleled dance with false information and societal indifference.  That would be real leadership – and long overdue.  So, pull the Drug Czar back up to Cabinet rank, put Federal resources and smart people into enforcing the law, and re-educate the country.

“What child is this?”  It is America’s child.  With new hope and real leadership, may we have no more compromises with evil.  Instead, truth spoken to power, power asserted by well-informed people.  Let us stand watch, shepherds for young America.  “Haste, haste …” in this, and in all seasons.  Here may be a resolution for the new year.

Robert Charles is a former Assistant Secretary of State for International Narcotics and Law Enforcement under George W. Bush, former Naval Intelligence Officer and litigator, who served in the Reagan and Bush 41 White Houses.  He wrote the book “Narcotics and Terrorism,” and writes widely on national security and law.

Source: townhall.com/columnists 10th December 2016

After three tours in Iraq and Afghanistan, C. J. Hardin wound up hiding from the world in a backwoods cabin in North Carolina. Divorced, alcoholic and at times suicidal, he had tried almost all the accepted treatments for post-traumatic stress disorder: psychotherapy, group therapy and nearly a dozen different medications. “Nothing worked for me, so I put aside the idea that I could get better,” said Mr. Hardin, 37. “I just pretty much became a hermit in my cabin and never went out.”

Then, in 2013, he joined a small drug trial testing whether PTSD could be treated with MDMA, the illegal party drug better known as Ecstasy.  “It changed my life,” he said in a recent interview in the bright, airy living room of the suburban ranch house here, where he now lives while going to college and working as an airplane mechanic. “It allowed me to see my trauma without fear or hesitation and finally process things and move forward.”

Based on promising results like Mr. Hardin’s, the Food and Drug Administration gave permission Tuesday for large-scale, Phase 3 clinical trials of the drug — a final step before the possible approval of Ecstasy as a prescription drug.   If successful, the trials could turn an illicit street substance into a potent treatment for PTSD.   Through a spokeswoman, the F.D.A. declined to comment, citing regulations that prohibit disclosing information about drugs that are being developed.

“I’m cautious but hopeful,” said Dr. Charles R. Marmar, the head of psychiatry at New York University’s Langone School of Medicine, a leading PTSD researcher who was not involved in the study. “If they can keep getting good results, it will be of great use. PTSD can be very hard to treat. Our best therapies right now don’t help 30 to 40 percent of people. So we need more options.”  But he expressed concern about the potential for abuse. “It’s a feel-good drug, and we know people are prone to abuse it,” he said. “Prolonged use can lead to serious damage to the brain.”

The Multidisciplinary Association for Psychedelic Studies, a small non-profit created in 1985 to advocate the legal medical use of MDMA, LSD, marijuana and other banned drugs, sponsored six Phase 2 studies treating a total of 130 PTSD patients with the stimulant. It will also fund the Phase 3 research, which will include at least 230 patients.

Two trials here in Charleston focused on treating combat veterans, sexual assault victims, and police and firefighters with PTSD who had not responded to traditional prescription drugs or psychotherapy. Patients had, on average, struggled with symptoms for 17 years.

After three doses of MDMA administered under a psychiatrist’s guidance, the patients reported a 56 percent decrease of severity of symptoms on average, one study found. By the end of the study, two-thirds no longer met the criteria for having PTSD. Follow-up examinations found that improvements lasted more than a year after therapy.

“We can sometimes see this kind of remarkable improvement in traditional psychotherapy, but it can take years, if it happens at all,” said Dr. Michael C. Mithoefer, the psychiatrist who conducted the trials here.   “We think it works as a catalyst that speeds the natural healing process.”  The researchers are so optimistic that they have applied for so-called breakthrough therapy status with the Food and Drug Administration, which would speed the approval process. If approved, the drug could be available by 2021.

Under the researchers’ proposal for approval, the drug would be used a limited number of times in the presence of trained psychotherapists as part of a broader course of therapy. But even in those controlled circumstances, some scientists worry that approval as a therapy could encourage more illegal recreational use.

“It sends the message that this drug will help you solve your problems, when often it just creates problems,” said Andrew Parrott, a psychologist at Swansea University in Wales who has studied the brains of chronic Ecstasy users. “This is a messy drug we know can do damage.”

Allowing doctors to administer the drug to treat a disorder, he warned, could inadvertently lead to a wave of abuse similar to the current opioid crisis.  During initial studies, patients went through 12 weeks of psychotherapy, including three eight-hour sessions in which they took MDMA. During the sessions, they lay on a futon amid candles and fresh flowers, listening to soothing music.

Dr. Mithoefer and his wife, Ann Mithoefer, and often their portly terrier mix, Flynn, sat with each patient, guiding them through traumatic memories.  “The medicine allows them to look at things from a different place and reclassify them,” said Ms. Mithoefer, a psychiatric nurse. “Honestly, we don’t have to do much. Each person has an innate ability to heal. We just create the right conditions.”

Research has shown that the drug causes the brain to release a flood of hormones and neurotransmitters that evoke feelings of trust, love and well-being, while also muting fear and negative emotional memories that can be overpowering in patients with post-traumatic stress disorder. Patients say the drug gave them heightened clarity and ability to address their problems.

For years after his combat deployments, Mr. Hardin said he was sleepless and on edge. His dreams were marked with explosions and death. The Army gave him sleeping pills and antidepressants. When they didn’t work, he turned to alcohol and began withdrawing from the world.

Ed Thompson, a former firefighter, took part in a study of Ecstasy as a treatment for PTSD. Without the drug, “he’d be dead,” his wife said.  “I just felt hopeless and in the dark,” he said. “But the MDMA sessions showed me a light I could move toward. Now I’m out of the darkness and the world is all around me.”  Since the trial, he has gone back to school and remarried.

The chemist Alexander Shulgin first realized the euphoria-inducing traits of MDMA in the 1970s, and introduced it to psychologists he knew. Under the nickname Adam, thousands of psychologists began to use it as an aid for therapy sessions. Some researchers at the time thought the drug could be helpful for anxiety disorders, including PTSD, but before formal clinical trails could start, Adam spread to dance clubs and college campuses under the name Ecstasy, and in 1985, the Drug Enforcement Administration made it a Schedule 1 drug, barring all legal use.

Since then, the number of people seeking treatment for PTSD has exploded and psychiatry has struggled to keep pace. Two drugs approved for treating the disorder worked only mildly better than placebos in trials. Current psychotherapy approaches are often slow and many patients drop out when they don’t see results. Studies have shown combat veterans are particularly hard to treat.

In interviews, study participants said MDMA therapy had not only helped them with painful memories, but also had helped them stop abusing alcohol and other drugs and put their lives back together.

On a recent evening, Edward Thompson, a former firefighter, tucked his twin 4-year-old girls into bed, turned on their night light, then joined his wife at a backyard fire. “If it weren’t for MDMA …” he said   “He’d be dead,” his wife, Laura, finished.   They both nodded.

Years of responding to gory accidents left Mr. Thompson, 30, in a near constant state of panic that he had tried to numb with alcohol and prescription opiates and benzodiazepines.  By 2015, efforts at therapy had failed, and so had several family interventions. His wife had left with their children, and he was considering jumping in front of a bus.

A member of a conservative Anglican church, Mr. Thompson had never used illegal drugs. But he was struggling with addiction from his prescription drugs, so he at first rejected a suggestion by his therapist that he enter the study. “In the end, I was out of choices,” he said.

Three sessions with the drug gave him the clarity, he said, to identify his problems and begin to work through them. He does not wish to take the drug again.  “It gave me my life back, but it wasn’t a party drug,” he said. “It was a lot of work.”

Correction: November 29, 2016

An earlier version of this article misstated the year that the Multidisciplinary Association for Psychedelic Studies was founded. It was 1985, not 1986. A picture caption misspelled the surname of a psychiatrist and his wife, a psychiatric nurse, who studied the use of Ecstasy. They are Dr. Michael C. Mithoefer and Ann Mithoefer, not Mitheofer.

Source:  http://www.nytimes.com/2016/11/29/us/ptsd-mdma-ecstasy.html

Hippocampus, the brain’s key memory and learning center, has the lowest blood flow in marijuana users suggesting higher vulnerability to Alzheimer’s. As the U.S. races to legalize marijuana for medicinal and recreational use, a new, large scale brain imaging study gives reason for caution. Published in the Journal of Alzheimer’s Disease, researchers using single photon emission computed tomography (SPECT), a sophisticated imaging study that evaluates blood flow and activity patterns, demonstrated abnormally low blood flow in virtually every area of the brain studies in nearly 1,000 marijuana compared to healthy controls, including areas known to be affected by Alzheimer’s pathology such as the hippocampus.

All data were obtained for analysis from a large multisite database, involving 26,268 patients who came for evaluation of complex, treatment resistant issues to one of nine outpatient neuropsychiatric clinics across the United States (Newport Beach, Costa Mesa, Fairfield, and Brisbane, CA, Tacoma and Bellevue, WA, Reston, VA, Atlanta, GA and New York, NY) between 1995-2015. Of these, 982 current or former marijuana users had brain SPECT at rest and during a mental concentration task compared to almost 100 healthy controls.

Predictive analytics with discriminant analysis was done to determine if brain SPECT regions can distinguish marijuana user brains from controls brain. Low blood flow in the hippocampus in marijuana users reliably distinguished marijuana users from controls.

The right hippocampus during a concentration task was the single most predictive region in distinguishing marijuana users from their normal counterparts. Marijuana use is thought to interfere with memory formation by inhibiting activity in this part of the brain.

According to one of the co-authors on the study Elisabeth Jorandby, M.D., “As a physician who routinely sees marijuana users,  what struck me was not only the global reduction in blood flow in the marijuana users brains, but that the hippocampus was the most affected region due to its role in memory and Alzheimer’s disease.

Our research has proven that marijuana users have lower cerebral blood flow than non-users. Second, the most predictive region separating these two groups is low blood flow in the hippocampus on concentration brain SPECT imaging.

This work suggests that marijuana use has damaging influences in the brain – particularly regions important in memory and learning and known to be affected by Alzheimer’s.”

Dr. George Perry, Editor in Chief of the Journal of Alzheimer’s Disease said, “Open use of marijuana, through legalization, will reveal the wide range of marijuana’s benefits and threats to human health.  This study indicates troubling effects on the hippocampus that may be the harbingers of brain damage.”

According to Daniel Amen, M.D., Founder of Amen Clinics, “Our research demonstrates that marijuana can have significant negative effects on brain function. The media has given the general impression that marijuana is a safe recreational drug, this research directly challenges that notion.  In another new study just released, researchers showed that marijuana use tripled the risk of psychosis. Caution is clearly in order.”

Source: Press http://content.iospress.com/articles/journal-of-alzheimers-disease/jad160833 – DOI: 10.3233/JAD-160833

A recognized deficiency: Inadequate protective protocols

An evaluation of risk applied to marijuana products for medical purposes concludes that advanced mitigation strategies and new protective delivery protocols are necessary to adequately protect the public from harm. The Risk Evaluation and Mitigation Strategies (REMS) program is already an approved protocol in the United States (US) by the US Food and Drug Administration and in Canada a similar controlled distribution program is in place including RevAid®.1,2    These programs are intended to assure patients are monitored to prevent or minimize major side effects and or reactions.   There are a number of medications that fall into existing REMS restrictions include thalidomide, clozapine, isotretinoin, and lenilidomide.  In both of these programs only prescribers and pharmacists who are registered or patients who are enrolled and who have agreed to meet all the conditions of the program are given access to these drugs.1,2

Current Government-approved Cannabinoid Products

Dronabinol (Marinol®, generic), nabilone (Cesamet®, generic) are synthetic cannabinoids to mimic delta-9-THC and nabiximols (Sativex®) is a combination of delta-9-THC and cannabidiol. They all lack the pesticides, herbicides and fungicides placed on marijuana plants during growth.

The longest approved agents, dronabinol and nabilone are indicated for short term use in nausea and vomiting due to chemotherapy and appetite stimulation.3,4  Nabiximols is used as a buccal spray for multiple sclerosis and as an adjunct for cancer pain.5  The maximum delta-9-THC strengths available are 10 mg for dronabinol and 2.7 mg/spray of nabiximols.3,5  Cannabidiol (CBD), a non-psychoactive compound, is one of many cannabinoids found in marijuana.   CBD is currently available for free from the U.S. National Institute of Health in government-sponsored clinical trials as potential treatment of resistant seizures (Dravet’s Syndrome and Lennox-Gastaut Syndrome).6

‘Medical’ Marijuana products

All marijuana products, including marijuana for medical purposes, fit the prerequisites for a REMS program. The average potency of marijuana more than doubled between 1998 and 2009.7 In 2015 common leaf marijuana averaged 17.1% THC in Colorado.8  Examples of oral marijuana products contain 80 mg of THC in chocolates, cookies and drinks and even 420 mg of THC in a “Dank Grasshopper” bar.9  Butane hash oil (BHO) is a concentrated THC product used in water bongs and/or e- cigarettes and contains upwards of 50 – 90% THC with a Colorado average of 71.7 % THC.8   One “dab” (280 mg) of 62.1% BHO is equal to 1 gram of 17% THC in marijuana leaf form.8  These extremely elevated levels of THC make true scientific research with these products incapable of passing Patient Safety Committee standards.10

The Thalidomide Parallel

The risks are so severe for thalidomide, in terms of use in pregnancy that a special protocol that educates, evaluates, mitigates and monitors has been made obligatory.11

Thalidomide (Contergan®) was developed by a German company, Chemie Gruenenthal, in 1954 and approved for the consumer market in 1957.12 It was available as an over-the-counter drug for the relief of “anxiety, insomnia, gastritis, and tension” and later it was used to alleviate nausea and to help with morning sickness by pregnant women. Thalidomide was present in at least 46 countries under a variety of brand names and was available in “sample tablet form” in Canada by 1959 and licensed for prescription on December 2, 1961. Although thalidomide was withdrawn from the market in West Germany and the UK by December 2, 1961, it remained legally available in Canada until March of 1962. It was still available in some Canadian pharmacies until mid-May of 1962.12

Canada had permitted the drug onto the Canadian market when many warnings were already available

An association was being made in 1958 of phocomelia (limb malformation) in babies of mother’s using thalidomide.  A trial conducted in Germany against Gruenenthal, for causing intentional and negligent bodily injury and death, began in 1968 ending in 1970 with a claim of insufficient evidence.  Later, the victims and Gruenenthal settled the case for 100 million dollars.11

In 1962 the American pharmaceutical laws were increased by the Kefauver-Harris Drug Amendment of 1962 and proof for the therapeutic efficiency through suitable and controlled studies would be required for any government approved medication.13 According to paragraph 25 of the Contergan foundation law, every 2 years a new report is required to determine if further development of these regulations are necessary.13

In 1987 the War Amputations of Canada established The Thalidomide Task Force, to seek compensation for Canadian-born thalidomide victims from the government of Canada.12

In 1991, the Ministry of National Health and Welfare (the current Health Canada) awarded Canadian-born thalidomide survivors a small lump-sum payment.12

In 2015 the Canadian government agreed on a settlement of $180 million dollars to 100 survivors of thalidomide drug exposure and damage.14 Through Rona Ambrose, in her capacity as the Health Minister for the government of Canada at the time of the negotiations, an attempt was made to involve the drug companies related to the thalidomide issue in the survivor’s settlement agreement. Negotiations with the drug companies failed.  The Canadian taxpayer alone paid to amend the survivors by way of monetary award.

Thalidomide continues to be sold under the brand name of Immunoprin®, among others in a REMS program. It is an immunomodulatory drug and today, it is used mainly as a treatment of certain cancers (multiple myeloma) and leprosy.11

Question: If the drug thalidomide included psychotropic properties and offered the “high” of marijuana would it be prudent or responsible to allow it to be legally sold and marketed for non-medical purposes – acknowledging thalidomide’s record for toxicity in pregnancy?

Marijuana Risk Assessment and Government Acknowledgement

Risks demonstrated in the scientific literature include genetic and chromosomal damage.15, 16

When exposure occurs in utero, there is an association with many congenital abnormalities including cardiac septal defects, anotia, anophthalmos, and gastroschisis. Marijuana use can disrupt foetal growth and the development of organs and limbs and may result in mutagenic alterations in DNA. Cannabis has also been associated with foetal abnormalities in many studies including low birth weight, foetal growth restriction, preterm birth spontaneous miscarriage, spina bifida and others.15

Phocomelia has been shown in testing in a similar preclinical model (hamster) to that which revealed the teratogenicity of thalidomide.15

THC has the ability to interfere with the first stages in the formation of the brain of the fetus; this event occurs two weeks after conception.  Exposure to today’s high potency marijuana in early pregnancy is associated with anencephaly, a devastating birth defect in which infants are born with large parts of the brain or skull missing.15

The existence of specific health risks associated with marijuana products are acknowledged by national and various local governments and a plethora of elected officials in both Canada and the United States.16, 17, 18

Warnings and the contraindications for use by specific populations and in association with identified conditions, have been publicized by the Federal Government of Canada and the Federal Government of the United States of America through their respective health agencies.16, 17, 18

A government of Canada leaflet produced by Health Canada and updated in December 2015: Consumer Information – Cannabis (Marihuana, marijuana) reads19:

“The use of this product involves risks to health, some of which may not be known or fully understood. Studies supporting the safety and efficacy of cannabis for therapeutic purposes are limited and do not meet the standard required by the Food and Drug Regulations for marketed drugs in Canada.”19

“Using cannabis or any cannabis product can impair your concentration, your ability to think and make decisions, and your reaction time and coordination. This can affect your motor skills, including your ability to drive. It can also increase anxiety and cause panic attacks, and in some cases cause paranoia and hallucinations.”19

“When the product should not be used: under the age of 25, are allergic to any cannabinoid or to smoke, have serious liver, kidney, heart or lung disease, have a personal or family history of serious mental disorders such as schizophrenia, psychosis, depression, or bipolar disorder, are pregnant, are planning to get pregnant, or are breast-feeding, are a man who wishes to start a family, have a history of alcohol or drug abuse or substance dependence.”19

“A list of health outcomes related to long term use includes the following:

Increased risk of triggering or aggravating psychiatric and/or mood disorders (schizophrenia, psychosis, anxiety, depression, bipolar disorder), decrease sperm count, concentration and motility, and increase abnormal sperm morphology. Negatively impact the behavioural and cognitive development of children born to mothers who used cannabis during pregnancy.”19

In Canada, the College of Family Physicians has issued guidelines for issuing marijuana prescriptions.20

“Dried cannabis is not appropriate for patients who: a) Are under the age of 25 (Level II) b) Have a personal history or strong family history of psychosis (Level II) c) Have a current or past cannabis use disorder (Level III) d) Have an active substance use disorder (Level III) e) Have cardiovascular disease (angina, peripheral vascular disease, cerebrovascular disease, arrhythmias) (Level III) f) Have respiratory disease (Level III) or g) Are pregnant, planning to become pregnant, or breastfeeding (Level II)”20

“Dried cannabis should be authorized with caution in those patients who: a) Have a concurrent active mood or anxiety disorder (Level II) b) Smoke tobacco (Level II) c) Have risk factors for cardiovascular disease (Level III) or d) Are heavy users of alcohol or taking high doses of opioids or benzodiazepines or other sedating medications prescribed or available over the counter (Level III)”20

In February 2013 The College of Family Physicians of Canada issued a statement advancing the position that physicians should sign a declaration rather than write a prescription as the potential liability, as well as the ethical obligations, for health professionals prescribing marijuana for medical purposes appears not to have been adequately addressed by Health Canada. 21

“In our view, Health Canada places physicians in an unfair, untenable and to a certain extent unethical position by requiring them to prescribe cannabis in order for patients to obtain it legally. If the patient suffers a cannabis-related harm, physicians can be held liable, just as they are with other prescribed medications. Physicians cannot be expected to prescribe a drug without the safeguards in place as for other medications – solid evidence supporting the effectiveness and safety of the medication, and a clear set of indications, dosing guidelines and precautions.”21

Representatives of the government of the United States held a press conference at the Office of National Drug Policy (ONDCP) in 2005. Mental health experts and scientists joined high-ranking government officials to discuss an emerging body of research that identified clear links between marijuana use and mental health disorders, including depression, suicidal thoughts and schizophrenia.22

The US Substance Abuse and Mental Health Service Administration (SAMHSA) report about the correlation between age of first marijuana use and serious mental illness; and an open letter to parents on “Marijuana and Your Teen’s Mental Health,” signed by twelve of the Nation’s leading mental health organizations, ran in major newspapers and newsweeklies across the country.23

Included were the following announcements:

“Regular use of the drug has appeared to double the risk of developing a psychotic episode or long-term schizophrenia.”23

“Research has strongly suggested that there is a clear link between early cannabis use and later mental health problems in those with a genetic vulnerability – and that there is a particular issue with the use of cannabis by adolescents.” 23

“Adolescents who used cannabis daily were five times more likely to develop depression and anxiety in later life.” 23

In 2016 the Obama Administration steadfastly opposes legalization of marijuana and other drugs because legalization would increase the availability and use of illicit drugs, and pose significant health and safety risks to all Americans, particularly young people.24 The US government still maintains marijuana is classified as a Schedule I drug, meaning it has a high potential for abuse and no currently accepted medical use in treatment in the United States.17, 18

Risk Evaluation and Mitigation Strategy for Marijuana Products

The dispensing of marijuana for medical purposes must follow a strict dispensing and monitoring protocol; no less arduous than that used for the delivery of drugs such as thalidomide.

Recommendation – The implementation of a REMS for marijuana products (REMSMP).

1. The first order for a government is to protect the public. As such, it befits a government approving marijuana for medical purposes to implement a REMS program.

2. Medical cannabis/marijuana dispensaries/stores/delivery systems will be       required to comply with all necessary components of a rigorous REMS program prior to selling and dispensing marijuana products.

3. Governmental regulatory organizations must be responsible for the cannabis/marijuana for medical purposes programs and obtain the required evaluations [(i.e. laboratory tests (pregnancy, HCG, etc.), physical and mental health examination documentation], signed patient consent, provider contract and education forms – performed in the required time frames both before initiation, during and after continued usage of marijuana products for medical purposes.

4. Quarterly audits will be performed, by the government regulatory organization, on each medical marijuana/cannabis dispensary for compliance.  Failure to comply with the REMSMP program will result in fines and other appropriate penalties to the marijuana dispensaries.

A REMS for Marijuana Product Potential Framework:

EMBRYO-FETAL TOXICITY & BREASTFEEDING

* Marijuana causes DNA damage in male and female patients.15  If marijuana is used during conception or during pregnancy, it may cause birth defects, cancer formation in the offspring, Downs Syndrome or embryo-fetal death.15, 16, 18

* Pregnancy must be ruled out before the start of marijuana treatment.  Pregnancy must be prevented by both the male and female patients during marijuana treatment by the use of two reliable methods of contraception.

* When there is no satisfactory alternative treatment, females of reproductive potential may be treated with marijuana provided adequate precautions are taken to avoid pregnancy.

* Females of Reproductive Potential: Must avoid pregnancy for at least 4 weeks before beginning marijuana therapy, during therapy, during dose interruptions and for at least 4 weeks after completing therapy.  Females must commit to either abstain continuously from heterosexual intercourse or use two methods or reliable birth control as mentioned.  They must have two negative pregnancy tests prior to initiating marijuana therapy and monthly pregnancy test with normal menses or two months with abnormal menses and for at least 1 month after stopping marijuana therapy.

* Males (all ages): DNA damage from marijuana is present in the semen of patients receiving marijuana.15 Therefore, males must always use a latex or synthetic condom during any sexual contacts with females of reproductive potential while using marijuana and for up to at least 28 days after discontinuing marijuana therapy, even if they have undergone a successful vasectomy.  Male patients using marijuana may not donate sperm.

* Blood Donation: Patients must not donate blood during treatment with marijuana and for at least 1 month following discontinuation of marijuana because the blood might be given to a pregnant female patient whose fetus should not be exposed to marijuana.

* Marijuana taken by any route of administration may result in drug-associated DNA damage resulting in embryo-fetal toxicity. Females of reproductive potential should avoid contact with marijuana through cutaneous absorption, smoke inhalation or orally.

* If there is contact with marijuana products topically, the exposed area should be washed with soap and water.

* If healthcare providers or other care givers are exposed to body fluids of a person on marijuana, the exposed area should be washed with soap and water.  Appropriate universal precautions should be utilized, such as wearing gloves to prevent the potential cutaneous exposure to marijuana.

* Several psychoactive cannabinoids in marijuana are fat soluble and are found to concentrate in breast milk.  Nursing mothers must not be receiving marijuana.16 Consult the primary care provider about how long to be off of marijuana before considering breast feeding.

NON-SEMINOMA TESTICULAR GERM CELL CARCINOMA

* Marijuana use is a known risk factor in the development of non-seminoma testicular germ cell carcinoma in males.25 – 28

* The presence of non-seminoma testicular germ cell carcinoma must be excluded before the start of marijuana treatment.  The patient’s primary care provider must perform a testicular examination and review the patient’s human chorionic gonadotropin (HCG) blood test before starting marijuana.  Male patients must perform weekly testicular self-evaluations while receiving marijuana.  They are also required to have their primary care provider perform a testicular evaluation and a HCG blood test performed every 4 months while receiving marijuana.29, 30

MENTAL HEALTH:

* Short term high dose and chronic marijuana usage is a known risk factor for the development of multiple mental health disorders.16, 18, 20, 31 – 34  Depression, paranoia, mental confusion, anxiety, addiction and suicide potential are all associated with acute and chronic exposure to marijuana.16, 18   Decline in intelligence is a potential risk of adolescent-onset marijuana exposure. 16, 18, 35

The presence of these mental health disorders must be evaluated by a licensed psychiatrist or psychologist by use of the Mini International Neuropsychiatric Interview or equivalent validated diagnostic instrument before marijuana is started.  The diagnostic mental health evaluation tool will be completed every 1month by an independent licensed psychiatrist or psychologist for a minimum of 6 months until unchanging and then every 4 months thereafter while receiving marijuana ending 4 months after the last exposure to marijuana.36

PSYCHIATRIC EVALUATIONS:

History of Substance Abuse Disorder: As the prevalence of substance use disorders amongst those patients requesting medical authorization of marijuana products is known to be extremely high the patient population must be screened prior to dispensing marijuana products for risk of a substance use disorder.  Substance use must be monitored prior to onset of marijuana with the World Health Organization, Smoking and Substance Involvement Screening Test (WHO-ASSIST, V3.0), and repeated at monthly intervals until unchanging and every 3 months thereafter while receiving marijuana, ending 6 months after the last exposure to marijuana.37

Conclusion

The evidence that thalidomide and tobacco products were harmful was known to the manufacturers/distributors before government and the populous acknowledged these dangers.

To date, there continue to be legal repercussions to said manufacturers/distributors/government for knowingly placing the public at risk.  We believe that the same will happen for marijuana products and that it is our responsibility to assist the Canadian government to protect the public from a similar outcome.

Since the government is fully aware of the marijuana harms, the  government must not be complicit in risking Canadian health/lives, but rather must mitigate any and all such risk to current and future generations.38, 39

The REMSMP program described assists in providing patient education, provider education and required patient monitoring before any marijuana products are allowed to be dispensed.  The program also requires on-going data collection and analysis, to determine the actual hazards from marijuana use and whether the program should even continue.  As the stewards of the country’s human and financial resources, it is critical that government protect the public from potential irreversible harm and itself from litigation risk by harmed individuals knowing that, in the context of marijuana use, harm is not only possible but probable.

Source:  Pamela McColl,  National Director,  Smart Approaches to Marijuana Canada and The Marijuana Victims’ Association,    Vancouver BC Canada    August  2016

Endorsements

Philip Seeman, M.D. Ph.D., O.C. Departments of Pharmacology and Psychiatry University of Toronto,   Nobel Prize nominee (Science)

Elizabeth Osuch, M.D. Associate Professor Rea Chair of Affective Disorders, University of Western Ontario Schulich School of Medicine and Denistry,  London, Ontario

Ray Baker, M.D., FCFP, FASAM, Associate Clinical Professor, University of British Columbia Faculty of Medicine,  Vancouver, British Columbia

Pamela McColl, Smart Approaches to Marijuana – Canada.  Board Member Campaign for Justice Against Tobacco Fraud

Robert L. DuPont, MD,  President, Institute for Behavior and Health, Inc. Clinical Professor of Psychiatry, Georgetown University School of Medicine,  First Director, National Institute on Drug Abuse,  Second US White House Drug Chief

Bertha K Madras, PhD Professor of Psychobiology, Department of Psychiatry,Harvard Medical School

Phillip A. Drum Pharm. D., FCSHP.    Smart Approaches to Marijuana – USA

Professor Gary Hulse, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, Australia

Grainne Kenny, Dublin, Ireland Co-founder and Hon. President of EURAD ,Brussels, Belgium

Peter Stoker Director, National Drug Prevention Alliance, United Kingdom

Mary Brett, BSc (Hons), Chair of Charity Cannabis Skunk Sense (CanSS) www.cannabisskunksense.co.uk ,United Kingdom

Deidre Boyd, CEO: DB Recovery Resources, Editor: Recovery Plus UK

References  1. Accessed on 7/28/16:http://www.fda.gov/Drugs/DrugSafety/Postmarket DrugSafetyInformationforPatients andProviders/ucm2008016.htm#rems  2. Accessed on 7/28/16: https://www.revaid.ca  3. Accessed on 7/31/16: http://www.fda.gov/ohrms/dockets/dockets/05n0479/05N-0479-emc0004-04.pdf

4. Accessed on 7/31/16: https://www.cesamet.com/pdf/Cesamet_PI_50_count.pdf

5. Accessed on 7/31/16: http://www.ukcia.org/research/SativexMonograph.pdf

6. Accessed on 7/28/16:https://clinicaltrials.gov/ct2/results?term=CBD+and+ epilepsy&Search=Search

7. National Center for Natural Products Research (NCNPR), Research Institute of Pharmaceutical Sciences. Quarterly Report, Potency Monitoring Project, Report 107, September 16, 2009 thru December 15, 2009. University, MS: NCNPR, Research Institute of Pharmaceutical Sciences, School of Pharmacy, University of Mississippi (January 12, 2010).

8. Orens A, et al. Marijuana Equivalency in Portion and Dosage. An assessment of physical and pharmacokinetic relationships in marijuana production and consumption in Colorado. Prepared for the Colorado Department of Revenue. August 10, 2015.

9. Accessed on7/30/16: https://weedmaps.com/dispensaries/tree-house-collective-dispensary-san-marcos

10.  Personal conversation with Marilyn Huestis, NIH researcher, June 2015.

11. Accessed on 8/4/16:http://www.contergan.grunenthal.info/grt-ctg/GRT-CTG/Die_Fakten/Chronologie/152700079.jsp

12. Accessed on 7/28/16: http://www.thalidomide.ca/the-canadian-tragedy/ 13. Accessed on 7/28/16:  http://www.fda.gov/Drugs/NewsEvents/ucm320924.htm 14. Accessed on 7/29/16: http://news.gc.ca/web/article-en.do?nid=945369&tp=1

15. Reece AS, Hulse GK. Chromothripsis and epigenomics complete causality criteria for cannabis- and addiction-connected carcinogenicity, congenital toxicity and heritable genotoxicity. Mutat Res. 2016;789:15-25. 16. Accessed on 7/28/16: http://www.hc-sc.gc.ca/dhp-mps/marihuana/med/ infoprof-eng.php 17. Accessed on 1/8/16:  https://www.whitehouse.gov/ondcp/frequently-asked-questions-and-facts-about-marijuana#harmless 18. Accessed on 1/8/16:  https://www.whitehouse.gov/ondcp/marijuana  19. Accessed on 7/20/16: http://www.hc-sc.gc.ca/dhp-mps/marihuana/info/cons-eng.php

20. College of Family Physicians of Canada. Authorizing Dried Cannabis for Chronic Pain or Anxiety: Preliminary Guidance from the College of Family Physicians of Canada. Mississauga, ON: College of Family Physicians of Canada; 2014.

21. Accessed on 3/8/16:http://www.cfpc.ca/uploadedFiles/Health_Policy/CFPC _Policy_Papers_and_Endorsements/CFPC_Policy_Papers/Medical%20Marijuana%20Position%20Statement%20CFPC.pdf 22. Accessed on 6/31/16 http://www.ovguide.com/john-p-walters-9202a8c040 00641f8000000 0003d9c0b

23. Accessed 8/1/2016: http://www.prnewswire.com/news-releases/white-house-drug-czar-research-and-mental-health-communities-warn-parents-that-marijuana-use-can-lead-to-depression-suicidal-thoughts-and-schizophrenia-54240132.html

24. Accessed on 2/8/2016. https://www.whitehouse.gov/ondcp/marijuana

25. Accessed on 8/1/2016: https://www.drugabuse.gov/news-events/nida-notes/2010/12/marijuana-linked-testicular-cancer

26. Lacson JCA, et al. Population-based case-control study of recreational drug use and testis cancer risk confirms an association between marijuana use and nonseminoma risk. Cancer. 2012;118(21):5374-5383.

27. Daling JR, et al. Association of marijuana use and the incidence of testicular germ cell tumors. Cancer. 2009;115(6):1215-1223.

28. Gurney J, et al. Cannabis exposure and risk of testicular cancer: a systematic review and meta-analysis. BMC Cancer 2015;15:1-10.  29. Accessed on 7/30/16:http://www.cancer.org/cancer/testicularcancer/ detailedguide/testicular-cancer-diagnosis

30. Takizawa A, et al. Clinical Significance of Low Level Human Chorionic Gonadotropin in the Management of Testicular Germ Cell Tumor. J Urology. 2008;179(3):930-935.

31. Moore TH, et al. Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. Lancet. 2007;370:319-328.

32. Large M, et al., Cannabis use and earlier onset of psychosis: a systematic meta-analysis. Arch Gen Psychiatry. 2011;68(6):555-61.

33. Ashton CH and Moore PB. Endocannabinoid system dysfunction in mood and related disorders. Acta Psychiatr Scand, 2011;124: 250-261.

34. Ranganathan M and D’Souza DC. The acute effects of cannabinoids on memory in humans: a review. Psychopharmacology. 2006;188: 425-444, 2006.

35. Accessed on 8/1/2016:https://www.drugabuse.gov/publications/drug facts/marijuana

36. Sheehan D, et al. Mini International Neuropsychiatric Interview, DSM-IV English Version 5.0.0 2006.

37.  Accessed on 8/1/2016: http://www.who.int/substance_abuse/activities/assist/ en/

38. Accessed on 8/1/16: http://news.gc.ca/web/article-en.do?nid=844329 39. Accessed on 8/3/16: http://www.healthlinkbc.ca/healthtopics/content.asp? hwid=abl2153

Homeless people in the streets are a staple of the landscape in downtown areas of Colorado Springs, Denver and most other Colorado communities. Visitors from other states are struck by the dilemma, even when visiting from large cities on the coasts. Experts on homelessness point to marijuana.

The Department of Housing and Urban Development on Thursday confirmed a homeless phenomenon anyone can see.

HUD ranks Colorado fourth behind California, Washington and the District of Columbia for its absolute increase in the homeless population this year. All four jurisdictions have legalized recreational pot.

Colorado’s growth in homeless veterans leads the nation, at 24 percent. Other states averaged a decrease of 17 percent in veteran homeless populations. They are leaving other states and moving to Colorado.

To put this in perspective, compare Colorado and New York. Colorado has a general population of 5.4 million. New York has general population of 20 million. The number of homeless veterans is nearly identical in the two states.

“While most states saw their homeless veteran populations drop an average of 17 percent in the past year to a total of 39,471, Colorado was one of only eight states going in the opposite direction with increasing numbers,” explained The Denver Post.

Daniel Warvi, spokesman for the Department of Veterans Affairs, told the Post how veterans come to Colorado hoping to work in the marijuana industry. Few come here knowing they must prove a year of residence before the law allows them to work in marijuana-related jobs.

“They don’t have a plan B,” Warvi told the Post. Those who find employment typically cannot afford the state’s soaring housing costs.

Larry Smith, executive director of Catholic Charities of Denver, said his staff sees “a direct correlation” between marijuana migration and increasing homelessness. Smith oversees the 380-bed Samaritan House homeless shelter, three other major homeless shelters in northern Colorado, single-family shelters and multiple food pantries and soup kitchens.

“It’s epidemic,” Smith told The Gazette. “We’ve never seen the kind of street living, and camping, that we’re seeing. It is exploding this year, and it is a different type of homeless population. They won’t come in. They won’t take a bed and a shelter, and there are beds available. It’s a different behavior and mentality. They are more aggressive, much more agitated. A large part of that is due to marijuana. This is insanity.”

Even impassioned advocates of legalization should be concerned when professionals link marijuana to increasing homelessness. If the connection is proved, the marijuana industry should take responsibility for some of the social costs.

When states determined the tobacco industry strained Medicaid resources, Big Tobacco agreed to mitigate burdens associated with its trade. In a settlement, states won a minimum $206 billion settlement and concessions that curtail the industry’s marketing practices.

Colorado has long attracted the homeless, for reasons it attracts other demographics. It would be a stretch to blame all new homelessness on legal marijuana. It is reasonable to heed the increasingly impassioned warnings of social workers who say marijuana plays a big role in the recent surge.

When the General Assembly convenes in January, legislators should cooperate to commission a nonpartisan study that assesses the suspected link between marijuana and homelessness. From there, non-profits, politicians and businesses can determine the scope of a constructive and compassionate response.

The Gazette editorial board

Source:  http://gazette.com/editorial-experts-link-homeless-surge-to-pot/article/1590734 Nov. 22nd  2016

The new data confirms mounting body of scientific evidence highlighting problems with rising marijuana use; SAM Honorary Advisor Patrick Kennedy to speak as part of report’s official release

[ALEXANDRIA, VA] – A new report, released today by the office of the U.S. Surgeon General, adds to the mounting body of scientific evidence highlighting the dangers of marijuana use and emphasizing prevention as essential for protecting youth. It also stands as a further warning of the large impending public health costs of marijuana legalization policies, which permit the marijuana industry to profit from the patterns of heavy marijuana use that pose the greatest threat to public health and safety.

Among the report’s findings:

* Long-term health consequences of marijuana use:  mental health problems, chronic cough, frequent respiratory infections, increased risk for cancer, and suppression of the immune system.

* Other serious health-related issues stemming from marijuana use: breathing problems; increased risk of cancer of the head, neck, lungs, and respiratory tract; possible loss of IQ points when repeated use begins in adolescence; babies born with problems with attention, memory, and problem solving (when used by the mother during pregnancy).

* Increased risk for traffic accidents:  Marijuana use “is linked to a roughly two-fold increase in accident risk.”

* Increased risk of schizophrenia:  “[T]he use of marijuana, particularly marijuana with a high THC content, might contribute to schizophrenia in those who have specific genetic vulnerabilities.

* Increased risk of addiction from high-potency marijuana available in legalized states:  “Concern is growing that increasing use of marijuana extracts with extremely high amounts of THC could lead to higher rates of addiction among marijuana users.”

* Permanent Loss of IQ:  “One study followed people from age 13 to 38 and found that those who began marijuana use in their teens and developed a persistent cannabis use disorder had up to an eight point drop in IQ, even if they stopped using in adulthood.”

“Once again, the scientific community has spoken loud and clear on the numerous, and serious health risks of marijuana,” said Kevin Sabet, President of SAM. “The more we know about marijuana, the worse it appears for public health and safety. Policymakers, especially those in the incoming Presidential administration and Congress, should read this report closely and heed the advice of the scientific community.”

“In particular, the Surgeon General’s report underscores the serious problems with patterns of heavy marijuana use — the same patterns that furnish the pot industry with the vast majority of its revenues,” commented Jeffrey Zinsmeister, SAM’s Executive Vice President. “As we seek to avoid the mistakes we made with Big Tobacco, we should be aware that the pot industry profits off of the very types of marijuana use that most harm public health and safety.”

Source:     http://www.learnaboutsam.org.  Press release  17th Nov.2016   Email: austin.galovski@curastrategies.com

Ben Cort, an addiction treatment specialist from Colorado, speaks in opposition to Proposition 64 during a panel about the legalization of marijuana at the Anaheim Convention Center.

An addiction expert from Colorado, where marijuana is legal, Cort is drowning in a sea of concern over Proposition 64, California’s ballot initiative that would allow recreational weed.

Once an addict himself, Cort can’t believe the Golden State appears on the verge of legalizing something that terrifies him. Though he’s no fan of pot, it’s not so much the plant that scares Cort. What worries him is that science allows THC – the active ingredient in marijuana that gets you high – to become nuclear-charged.

A little THC wax or oil, he cautions, can go a very long way, especially when it’s ingested.

“We’re the canary in the coal mine,” says Cort, a manager with the University of Colorado Hospital’s rehab program. “We’re treating more addicts for cannabis than we are for opiates.”

Cort says he’s seen THC levels in so-called gummy bears 20 times higher than levels that are legal in Oregon, another state where recreational marijuana is law but where THC percentages are controlled.

Prop. 64, Cort says, will legalize dangerously high THC. That’s not Snoop Dogg cool. That’s emergency room serious.

The federal National Institute on Drug Abuse reports, “These extracts can deliver extremely large amounts of THC to users, and their use has sent some people to the emergency room.” Such high THC levels, institute officials warn, also can turn what many consider a relatively benign drug into something addictive.

UNICORN PROMISES

While writing about marijuana, I’ve interviewed doctors, lawyers, pot growers, medical marijuana dispensary owners, officials with the National Organization for the Reform of Marijuana Laws and patients in pain.

Until I attended a two-hour informational panel discussion Tuesday sponsored by the Anaheim Police Department, I figured I knew all about pot. Speakers included Cort; Police Chief John Jackson of the Greenwood Village, Colo., Police Department; Chief Justin Nordhorn of the Washington State Liquor and Cannabis Board; Attorney Robert Bovett of Oregon Counties Legal Counsel; Lauren Michaels, legislative affairs manager

for the California Police Chiefs’ Association; and Nate Bradley, executive director of the California Cannabis Industry Association.

When a speaker asked who had read Prop. 64, only one hand went up and it wasn’t mine. So to prepare for this column I also read – OK, I skimmed some chunks – all 62 pages. A lot of Prop. 64 is wonky and details who can do what and where. But some reads more like dreams of fairies and unicorns than reality.

“Incapacitate the black market,” the proposal promises “and move marijuana purchases into a legal structure with strict safeguards against children accessing it.”

Untrue, said Jackson, who stressed that illegal sales continue in Colorado.

“Revenues will,” Prop. 64 predicts, “provide funds to invest in public health programs that educate youth to prevent and treat serious substance abuse.”

Wrong, Jackson said. More teens in Colorado are being sent to emergency rooms because of THC-laced edibles.

Revenues will pay to “train local law enforcement to enforce the new law with a focus on DUI enforcement.”

Incorrect again. Jackson said his department is busier than ever dealing with more drivers high on weed and handling more THC-related traffic fatalities.

Other parts of Prop. 64 are just dumb and dumberer.   Like allowing radio and television advertising.

“Make no mistake,” Jackson said of Prop. 64. “This whole thing is about money.

“A drug dealer in a suit is still a drug dealer.”

‘NECESSARY REFORM’

Once marijuana became legal in Washington in 2012, Nordhorn said, children and teens considered it less harmful, and that had ripple effects.

With the advent of vaping, for example, young people inhale THC without anyone knowing if they are taking in an innocent type of e-juice or marijuana.

“Legal marijuana,” Nordhorn said, “is not a silver bullet to get rid of marijuana problems.”

Bovett echoed other panelists, saying that Oregon also has seen an increase in impaired driving, although he added that has been going up since the state approved medical marijuana.

The Oregon Poison Center also reports increases in marijuana-related calls.

Even Bradley, the lone pro-Prop. 64 voice on the panel, admitted he’s concerned about edibles.

Instead of THC levels, Bradley focused on dollars. He said the initiative will take $100 million out of the hands of criminals and the measure will generate $300 million for law enforcement to focus on such things as protecting children.

Bradley has plenty of backers. Among the most visible are Gavin Newsom, lieutenant governor, and Rep. Dana Rohrabacher, R-Costa Mesa. Our local representative has said, “Current marijuana laws have undermined many of the things conservatives hold dear – individual freedom, limited government and the right to privacy.”

Rohrabacher went on to say, “This measure is a necessary reform which will end the failed system of marijuana prohibition in our state, provide California law enforcement the resources it needs to redouble its focus on serious crimes while providing a policy blueprint for other states to follow.”

‘SEED TO SALE’

The most sobering speaker was Michaels of the chiefs’ association. She simply defended California’s newly revamped medical marijuana policies.

Called “seed to sale,” three new laws inked last year shoot down the need for Prop. 64, Michaels said. She stated California now has an enhanced working system to distribute medicinal marijuana legally.

California, Michaels said, already allows local control, protects current producers and includes checkpoints at distribution.

In contrast, she said, Prop. 64 is vertically integrated, favors big business and independent distribution, appoints the state as sole actor for operating licenses and ensures regulatory confusion. Research, learn, vote. Contact the writer: dwhiting@scng.com

Source:   http://www.ocregister.com/articles/marijuana-731244-thc-prop.html   5th October 2016

A synthetic opioid known as “pink” is legal in most states, even though it is almost eight times stronger than morphine, CNN reports.

The drug, also known as U-47700, is responsible for dozens of deaths nationwide, the article notes. Adam Kline, Police Chief of White Lake, Michigan, told CNN the drug can be legally purchased on the “dark web” in the form of a powder, pill or nasal spray. Last month, the Drug Enforcement Administration told NBC News it is aware of confirmed deaths associated with the drug in New Hampshire, North Carolina, Ohio, Texas and Wisconsin. The drug, along with other synthetic opioids, is being shipped into the United States from China and other countries.

Source:  thepartnership@drugfree.org  2nd Nov.  2016

October 19, 2016 2.02am BST

Currently 25 states and the District of Columbia have medical cannabis programs. On Nov. 8, Arkansas, Florida and North Dakota will vote on medical cannabis ballot initiatives, while Montana will vote on repealing limitations in its existing law.

We have no political position on cannabis legalization. We study the cannabis plant, also known as marijuana, and its related chemical compounds. Despite claims that cannabis or its extracts relieve all sorts of maladies, the research has been sparse and the results mixed. At the moment, we just don’t know enough about cannabis or its elements to judge how effective it is as a medicine.

What does the available research suggest about medical cannabis, and why do we know so little about it?

What are researchers studying?

While some researchers are investigating smoked or vaporized cannabis most are looking at specific cannabis compounds, called cannabinoids.

From a research standpoint, cannabis is considered a “dirty” drug because it contains hundreds of compounds with poorly understood effects. That’s why researchers tend to focus on just one cannabinoid at a time. Only two plant-based cannabinoids, THC and cannabidiol, have been studied extensively, but there could be others with medical benefits that we don’t know about yet. THC is the main active component of cannabis. It activates cannabinoid receptors in the brain, causing the “high” associated with cannabis, as well as in the liver, and other parts of the body. The only FDA-approved cannabinoids that doctors can legally prescribe are both lab produced drugs similar to THC. They are prescribed to increase appetite and prevent wasting caused by cancer or AIDS.

Cannabidiol (also called CBD), on the other hand, doesn’t interact with cannabinoid receptors. It doesn’t cause a high. Seventeen states have passed laws allowing access to CBD for people with certain medical conditions.

Our bodies also produce cannabinoids, called endocannabinoids. Researchers are creating new drugs that alter their function, to better understand how cannabinoid receptors work. The goal of these studies is to discover treatments that can use the body’s own cannabinoids to treat conditions such as chronic pain and epilepsy, instead of using cannabis itself.

Cannabis is promoted as a treatment for many medical conditions. We’ll take a look at two, chronic pain and epilepsy, to illustrate what we actually know about its medical benefits.

Is it a chronic pain treatment? Research suggests that some people with chronic pain self-medicate with cannabis. However, there is limited human research on whether cannabis or cannabinoids effectively reduce chronic pain. Research in people suggest that certain conditions, such as chronic pain caused by nerve injury, may respond to smoked or vaporized cannabis, as well as an FDA-approved THC drug. But, most of these studies rely on subjective self-reported pain ratings, a significant limitation. Only a few controlled clinical trials have been run, so we can’t yet conclude whether cannabis is an effective pain treatment.

An alternative research approach focuses on drug combination therapies, where an experimental cannabinoid drug is combined with an existing drug. For instance, a recent study in mice combined a low dose of a THC-like drug with an aspirin-like drug. The combination blocked nerve-related pain better than either drug alone.

In theory, the advantage to combination drug therapies is that less of each drug is needed, and side effects are reduced. In addition, some people may respond better to one drug ingredient than the other, so the drug combination may work for more people. Similar studies have not yet been run in people.

Well-designed epilepsy studies are badly needed Despite some sensational news stories and widespread speculation on the internet, the use of cannabis to reduce epileptic seizures is supported more by research in rodents than in people. In people the evidence is much less clear. There are many anecdotes and surveys about the positive effects of cannabis flowers or extracts for treating epilepsy. But these aren’t the same thing as well-controlled clinical trials, which can tell us which types of seizure, if any, respond positively to cannabinoids and give us stronger predictions about how most people respond.

While CBD has gained interest as a potential treatment for seizures in people, the physiological link between the two is unknown. As with chronic pain, the few clinical studies have been done included very few patients. Studies of larger groups of people can tell us whether only some patients respond positively to CBD.

We also need to know more about the cannabinoid receptors in the brain and body, what systems they regulate, and how they could be influenced by CBD. For instance, CBD may interact with anti-epileptic drugs in ways we are still learning about. It may also have different effects in a developing brain than

in an adult brain. Caution is particularly urged when seeking to medicate children with CBD or cannabis products.

Cannabis research is hard

Well-designed studies are the most effective way for us to understand what medical benefits cannabis may have. But research on cannabis or cannabinoids is particularly difficult. Cannabis and its related compounds, THC and CBD, are on Schedule I of the Controlled Substances Act, which is for drugs with “no currently accepted medical use and a high potential for abuse” and includes Ecstasy and heroin.

In order to study cannabis, a researcher must first request permission at the state and federal level. This is followed by a lengthy federal review process involving inspections to ensure high security and detailed record-keeping.

In our labs, even the very small amounts of cannabinoids we need to conduct research in mice are highly scrutinized. This regulatory burden discourages many researchers.

Designing studies can also be a challenge. Many are based on users’ memories of their symptoms and how much cannabis they use. Bias is a limitation of any study that includes self-reports. Furthermore, laboratory-based studies usually include only moderate to heavy users, who are likely to have formed some tolerance to marijuana’s effects and may not reflect the general population. These studies are also limited by using whole cannabis, which contains many cannabinoids, most of which are poorly understood.

Placebo trials can be a challenge because the euphoria associated with cannabis makes it easy to identify, especially at high THC doses. People know when they are high. Another type of bias, called expectancy bias, is a particular issue with cannabis research. This is the idea that we tend to experience what we expect, based on our previous knowledge. For example, people report feeling more alert after drinking what they are told is regular coffee, even if it is actually decaffeinated. Similarly, research participants may report pain relief after ingesting cannabis, because they believe that cannabis relieves pain. The best way to overcome expectancy effects is with a balanced placebo design, in which participants are told that they are taking a placebo or varying cannabis dose, regardless of what they actually receive.

Studies should also include objective, biological measures, such as blood levels of THC or CBD, or physiological and sensory measures routinely used in other areas of biomedical research. At the moment, few do this, prioritizing self-reported measures instead.

Cannabis isn’t without risks

Abuse potential is a concern with any drug that affects the brain, and cannabinoids are no exception. Cannabis is somewhat similar to tobacco, in that some people have great difficulty quitting. And like tobacco, cannabis is a natural product that has been selectively bred to have strong effects on the brain and is not without risk. Although many cannabis users are able to stop using the drug without problem, 2-6 percent of users have difficulty quitting. Repeated use, despite the desire to decrease or stop using, is known as cannabis use disorder.

As more states more states pass medical cannabis or recreational cannabis laws, the number of people with some degree of cannabis use disorder is also likely to increase.

It is too soon to say for certain that the potential benefits of cannabis outweigh the risks. But with restrictions to cannabis (and cannabidiol) loosening at the state level, research is badly needed to get the facts in order.

Source: https://theconversation.com/what-do-we-know-about-marijuanas-medical-benefits-two-experts-explain-the-evidence-64200   Oct.2016

Two 13-year-old boys in the ski town of Park City, Utah died within 48 hours of each other in September, likely overdosing on a powerful heroin substitute that had been delivered — legally — to their homes by the U.S. mail, and is now turning up in cities across the nation.

Ryan Ainsworth was found dead on his couch two days after his best friend Grant Seaver passed away. “I wish I had been better warned,” sang one of their friends at a massive memorial service. “But now it’s too late.”

The death toll could have been worse, say investigators, since as many as 100 Park City students had apparently been discussing the drug “Pink” on SnapChat and other social media.

“This stuff is so powerful that if you touch it, you could go into cardiac arrest,” Park City Police Chief Wade Carpenter told NBC News. “The problem is if you have a credit card and a cell phone, you have access to it.”

One toxicology lab has linked 80 deaths to the synthetic opioid known as Pink. DEA

Pink, better known by chemists as U-47700, is eight times stronger than heroin, and is part of a family of deadly synthetic opioids, all of them more powerful than heroin, that includes ifentanyl, carfentanil and furanyl fentanyl. By themselves or mixed with other drugs, in forms ranging from pills to powder to mists, they’re killing thousands of people across the country, say law enforcement and health officials. The powerful, ersatz opioids are part of a surge of synthetic drugs, including bath salts and mock-ups of ecstasy, being shipped into the U.S. from China and other nations.

So far, however, only four states have made Pink illegal. It can still be ordered legally on-line and delivered to your home. The internet has many websites a Google search away where the drug is available for as little as $5 plus shipping.

Melissa Davidson, mother of a Park City teen who had friends in common with the dead boys, showed NBC News on her home computer screen how easy it was to find the drug for sale with just a few keystrokes. “Look! There are like pages and pages that you can buy this stuff online.”

According to the U.S. Centers for Disease Control, total opioid overdose deaths nearly quadrupled between 1999 and 2014, rising from 8,050 to 28,647. The portion of those deaths caused by synthetic opioids, however, rose almost twice as fast, from just 730 in 1999 to 5,544 in 2014.

Because of the surge in opioid-related deaths, and the regular appearance of new synthetics on the market, there is a time lag in toxicology reports from coroners, and the possibility that some deaths are mistakenly linked to other, better known substances.

But Pink, a relative newcomer among the synthetics, has been implicated in 80 deaths across the country in just the past nine months, according to Pennsylvania-based NMS Labs, which conducts forensic toxicology tests.

The Drug Enforcement Administration said it is aware of confirmed fatalities associated with U-47700 in New Hampshire, North Carolina, Ohio, Texas, and Wisconsin. Though its own tally is only 15 deaths, an agency spokesperson said the number was probably higher because of challenges and delays in reporting.

On Sept. 7, the DEA took initial steps toward banning the drug nationally by giving notice of its intent to schedule the synthetic opioid temporarily as a Schedule 1 substance under the federal Controlled Substances Act.

Some states aren’t waiting for a permanent federal ban. In late September, Florida Attorney General Pam Bondi signed an emergency order outlawing the drug after it was tied to eight deaths in recent months. Florida joins Ohio, Wyoming and Georgia in outlawing the compound and other states are looking to do the same.

In some states, law enforcement is just learning about a threat that is especially challenging because so many transactions are done by computer and through the mail. And the chemists who manufacture the drugs can invent new variants as fast as the states can outlaw them.

“The hardest part is when something new comes up, and no one in the country or world has seen it in a forensic setting yet and trying to decide what that actual structure or drug is,” said Bryan Holden, senior forensic scientist with the Utah Department of Public Safety. “Sometimes we have had cases where the substance sat for months and months — no one had ever seen it before, and until someone else sees it or manufactures it then we kind of know what it is.”

The DEA has been using so-called temporary bans more and more often to combat designer synthetic drugs have made their way into the U.S. from China and other parts of the world. The U47700 ban allows them three years to research whether something should be permanently controlled or whether it should revert back to non-controlled status.

But experts say the most effective prevention may start in the home, at the computer and the mailbox.

“I’m worried about you,” Melissa Davidson told her 17-year-old daughter Jane.

Jane, however, was worried about her friends at school. “I can’t imagine the kids I’m in math class with, just not being there one day. One bad decision can have permanent consequences.”

Source:  http://www.nbcnews.com/storyline/americas-heroin-epidemic/pink-stronger-heroin-legal-most-states-n666446     15th Oct.2016

Filed under: Internet,Synthetics,USA :

This November, several states will vote on whether to legalize marijuana for recreational use, and the proponents of legalization have seized on a seemingly clever argument: marijuana is safer than alcohol.  The Campaign to Regulate Marijuana Like Alcohol, an effort of the Marijuana Policy Project (or MPP), has taken this argument across the country.  Their latest strategy is labelled Marijuana vs. Alcohol.  It is a very misleading, even dangerous, message, based on bad social science and sophistic public deception. Citing out-of-date studies that go back ten years and more, even using that well-known scientific journal, Wikipedia, the MPP never references current research on the harms of today’s high potency and edible marijuana, studies that come out monthly if not more frequently.  Indeed, their Marijuana vs. Alcohol page concludes with a 1988 statement about the negligible harms of marijuana—but that is a marijuana that simply does not exist anymore, neither in mode nor potency.  Today’s marijuana is at least five times more potent, and sold in much different form.  And the science of marijuana and its effects on the brain have come some distance since 1988 as well.

So out-of-date is the science and knowledge of marijuana from thirty years ago, it would be malpractice in any other field to suggest that kind of information about a drug having any contemporary relevance at all.  One almost wonders if the MPP thinks public health professors still instruct their students on how to use microfiche to perform their research as they prepare to write their papers on 5k memory typewriters.

It is simply misleading in a public health campaign to cite dated research while at the same time ignore a larger body of current evidence that points in the opposite direction of a desired outcome.  At great potential peril to our public health, political science (in the hands of the marijuana industry) is far outrunning medical science.  But the danger is clear: with the further promotion, marketing, and use of an increasingly known dangerous substance, public health and safety will pay the price.

Consider three basic problems with the industry’s latest campaign:

I.  Comparisons of relative dangers of various drugs are simply impossible and can often lead to paradoxical conclusions.  It is impossible to compare a glass of chardonnay and its effects on various adults of various weights and tolerance levels with the inhalation or consumption of a high-potency marijuana joint or edible.  Is the joint from the 5 percent THC level or the 25 percent level?  How about a 30 mg—or stronger—gummy bear?  A glass of wine with dinner processes through the body in about an hour and has little remaining effect.  A marijuana brownie or candy can take up to 90 minutes to even begin to take effect.

Consider a consumer of a glass of wine who ate a full meal and waited an hour or more before driving and a consumer of a marijuana edible taking the wheel of a plane, train, automobile, or anything else.  The wine drinker would likely be sober, the marijuana consumer would just be getting high, and, given the dose, possibly very high at that.

True, marijuana consumption rarely causes death, but its use is not benign.  Last year, an ASU professor took a standard dose of edible marijuana, just two marijuana coffee beans. The effect?  “Episodes of convulsive twitching and jerking and passing out” before the paramedics were called.  Such episodes are rare for alcohol, but they are increasingly happening with marijuana.

Beyond acute effects, the chronic impact of marijuana is also damaging.  Approximately twice the percentage of regular marijuana users will experience Marijuana Use Disorder than will alcohol users experience Alcohol Use Disorder—both disorders categorized by the Diagnostic Statistics Manual (DSM).[1]   Marijuana is also the number one substance of abuse for teens admitted to treatment, far higher than the percentage who present with alcohol problems.  In fact, the most recent data out of Colorado shows 20 percent of teens admitted for treatment have marijuana listed as their primary substance of abuse compared to less than one percent for alcohol.

Still, the Campaign persists in its deceptions—as if they have not even read their own literature.  One online marketing tool it recently deployed was the “Consume Responsibly” campaign.  Delve into that site and you will find this warning: “[Smoked marijuana] varies from person to person, you should wait at least three to four hours before driving a vehicle.”  And: “Edible marijuana products and some other infused products remain in your system several hours longer, so you should not operate a vehicle for the rest of the day after consuming them.”  Who has ever been told that they should not operate a vehicle for four hours, much less for the rest of the day, if they had a glass of wine or beer?  Safer than alcohol?  This is not even true according to the MPP’s own advice.

Beyond unscientific dose and effect comparisons, there is a growing list of problems where marijuana use does, indeed, appear to be more harmful than alcohol.  According to Carnegie Mellon’s Jonathan Caulkins: “Marijuana is significantly more likely to interfere with life functioning” than alcohol and “it is moderately more likely to create challenges of self-control and to be associated with social and mental health problems.” Additionally, a recent study out of UC Davis revealed that marijuana dependence was more strongly linked to financial difficulties than alcohol dependence and had the same impacts on downward mobility, antisocial behavior in the workplace, and relationship conflict as alcohol.

II.  The marijuana industry pushes and promotes the use of a smoked or vaped substance, but never compares marijuana to tobacco.  Indeed, the two substances have much more in common than marijuana and alcohol, especially with regard to the products themselves and the method of consumption (though we are also seeing increasing sales of child-attractive marijuana candies).  But why is the comparison never made?  The answer lies in the clear impossibility.

Consider: Almost every claim about marijuana’s harms in relation to alcohol has to do with the deaths associated with alcohol.  But, hundreds of thousands more people die from tobacco than alcohol.  Based on their measures of mortality, which is safer: alcohol or tobacco?  Can one safely drink and drive?  No.  Can one smoke as many cigarettes as one wants while driving?  Of course. So, what’s the more dangerous substance?  Mortality does not answer that question.

Alcohol consumption can create acute problems, while tobacco consumption can create chronic problems.  And those chronic problems particularly affect organs like the lungs, throat, and heart.  But what of the chronic impact on the brain?  That’s the marijuana risk, and, seemingly, society is being told that brains are less important than lungs.  Nobody can seriously believe that, which is why these comparisons simply fail scrutiny.

This illustrates but one of the problems in comparing dangerous substances. As Professor Caulkins recently wrote:

The real trouble is not that marijuana is more or less dangerous than alcohol; the problem is that they are altogether different….The country is not considering whether to switch the legal statuses of alcohol and marijuana. Unfortunately, our society does not get to choose either to have alcohol’s dangers or to have marijuana’s dangers. Rather, it gets to have alcohol’s dangers…and also marijuana’s dangers. Further, marijuana problems are associated with alcohol problems.  New research out of Columbia University reveals that marijuana users are five times more likely to have an alcohol abuse disorder.  Society doesn’t just switch alcohol for marijuana—too often, one ends up with use of both, compounding both problems.

The larger point for voters to understand:  The marijuana legalization movement is not trying to ban or end alcohol sales or consumption; rather, it wants to add marijuana to the dangerous substances already available, including alcohol.  This is not about marijuana or alcohol, after all.  It’s about marijuana and alcohol. We can see this effect in states like Colorado, with headlines such as “Alcohol sales get higher after weed legalization.”  And, according to the most recent federal data [2], alcohol use by teens, as well as adults, has increased in Colorado since 2012 (the year of legalization). If alcohol is the problem for the MPP, in their model state–Colorado–alcohol consumption has increased with marijuana legalization.  Legalizing marijuana will, in the end, only make alcohol problems worse. III.  The legalization movement regularly cites to one study in the Journal of Scientific Reports to “prove” that marijuana is safer than alcohol.  But this study leads to odd conclusions in what the authors, themselves, call a “novel risk assessment methodology.”  For instance, the researchers find that every drug, from cocaine to meth to MDMA to LSD, is found to be safer than alcohol. (See this graph).  By the MPP standard, we should thereby make these substances legal as well.  But, seeing such data in its full light, we all know this would be nonsensical.

Further, the authors specifically write that they only looked at acute effects and did not analyze “chronic toxicity,” and cannot judge marijuana and “long term effects.”  Indeed, they specifically write in their study the toxicity of marijuana“may therefore be underestimated” given the limitations of their examination.  Yet legalizers ignore these statements.  Always.  It simply does not fit their narrative. What long-term effects are we talking about?  To cite the New England Journal of Medicine: “addiction, altered brain development, poor educational outcomes, cognitive impairment,” and “increased risk of chronic psychosis disorders.”  Now think about what it will mean to make a drug with those adverse effects more available, and for recreational use.

Finally, the very authors of the much-cited Journal of Scientific Reports study specifically warn their research should be “treated carefully particularly in regard to dissemination to lay people….especially considering the differences of risks between individuals and the whole population.”  But this is precisely what commercialization is about—not individual adult use but making a dangerous drug more available to “the whole population.”

Given what we know in states like Colorado, we clearly see that legalization creates more availability which translates into more use, affecting whole populations—Colorado college-age use, for example, is now 62 percent higher than the national average. [See FN2, below]. And the science is coming in, regularly.  Indeed, the same journal the MPP points to in its two-year old “novel” study, just this year published another study and found:

Neurocognitive function of daily or near daily cannabis users can be substantially impaired from repeated cannabis use, during and beyond the initial phase of intoxication. As a consequence, frequent cannabis use and intoxication can be expected to interfere with neurocognitive performance in many daily environments such as school, work or traffic.

That is why these comparisons of safety and harm are—in the end—absurd and dangerous.  In asking what is safer, the true answer is “neither.”  And for a variety of reasons.  But where one option is impossible to eliminate (as in alcohol), society should not add to the threat that exists:  One doesn’t say because a playground is near train tracks you should also put a highway there.  You fence off the playground.

That, however, is not the choice the MPP has given us.  They are not sponsoring legislation to reduce the harms of alcohol, they are, instead, saying that with all the harms of alcohol, we should now add marijuana.  But looking at all the problems society now has with substance abuse, the task of the serious is to reduce the problems with what already exists, not advance additional dangers.

If the MPP and its Campaigns to Regulate Marijuana Like Alcohol are serious about working on substance abuse problems, we invite them to join those of us who have labored in these fields for years.  One thing we do know: adding to the problems with faulty arguments, sloppy reasoning, and questionable science, will not reduce the problems they point to.  It will increase them.  And that, beyond faulty argument and sloppy reasoning, is public policy malfeasance. [1] See http://archpsyc.jamanetwork.com/article.aspx?articleid=2464591 compared to http://archpsyc.jamanetwork.com/article.aspx?articleid=2300494

Source:  http://amgreatness.com/2016/09/25/lie-travels-comparing-alcohol-marijuana/  Sept 25th 2016

Please share this post with every concerned parent you know! Spread the Word about Pop Pot!

Pew Research released a new poll from late August and early September that shows 57% of American voters favor marijuana legalization.  Based on the question and the article, the poll probably means that 57% of the voters favor marijuana decriminalization.   Next time the poll should be more specific in its meaning.  The same day this poll was released, a headline from the Cape Cod News in supposedly “liberal” Massachusetts read Support Scarce for Legal Pot.   There could not be a bigger difference in meaning  between these headlines.  Why the difference?

Despite this poll, all 5 states with ballots for marijuana legalization this November poll at less than 57% in favor of legalization.  There is a disparity between the survey question and legalization in practice. Legalization creates a new industry expected to make a lot of money for investors.   It is the reason that Weed Maps, ArcView group  and Soros-funded groups contribute to the ballots.  There’s a big difference between legalization and decriminalization.  Did those conducting the survey explain what legalization means?

prop-64s-money-trail-1024x1004

Since the Sacramento Bee made this chart, at least $10 million more has been raised by  California’s Yes on 64 campaign. With the business Weed Maps, MJ Freeway and George Soros funding so much, it’s obviously a good business venture.  George Soros gave at least $4 million.

Legalization creates commercial marijuana stores regulated by the state .   Administering and implementing it is very difficult to do.   Pot sales are taxed at various levels and earn some money.  But as Colorado marijuana director, Andrew Freedman said, it’s not worth legalizing for the benefit of tax revenues.

When presented with facts, voters are  sceptical of commercialization and don’t want more impaired drivers.  The cost of regulation is  high.   On October 1 in Colorado, new rules began,  and the packaging must make it more difficult for children to access. Gummy candies in the shape of animals are now forbidden. The number of hospitalizations and overdose deaths from marijuana edibles which make up nearly 50% of the market necessitated these changes.

Opting out of commercial pot is very tough, too.  Dealing with inconsiderate neighbors who grow a lot of pot plants is difficult.  In Colorado, city governments are often greedy for tax money while residents say no to pot.  When voters want to ban dispensaries, other forces such as the marijuana industry fight them.   It’s one of the reasons Colorado now has buyer’s remorse

map-of-colorado-1024x636

Why Marijuana Decriminalization ?

Decriminalization means that marijuana is not treated as a crime but as a mistake; offenders are charged with a small fine, like a speeding ticket.   In legal terms, it’s the difference between a misdemeanor and a felony.  The marijuana lobbyists have successfully convinced Americans that large numbers of people go to jail for marijuana possession only.

The only people who go to jail for marijuana possession charges have committed other crimes and have plea bargained to get convicted of lesser charges.   Other crimes include drug dealing, transportation of drugs or possession of a large amount of drugs that indicates intent to sell.  Selling drugs is not a victimless crime.

Marijuana lobbyists omit information about drug courts which allows users an alternative and provides addiction treatment.

The reason that marijuana possession is a felony crime in some states is so that it can be used as evidence to convict when there are more serious crimes.  Drugs and drug paraphernalia become supporting evidence when other crimes may be harder to prove.

How are Minorities Really Affected by Drug Laws?

Minorities have the most to lose by using marijuana.  Daily or near daily use of marijuana by teens nearly doubles the risk of dropping out of high school.   Dropping out of high school makes future education and job prospects dim.  Furthermore, a study of long-term marijuana users in New Zealand over a 25-year period found an average 7-point drop in IQ by age 38.   People who complain that this study did not adjust for IQ differences as reflected by socio-economic class should realize that IQ differences resulting from socio-economic factors are in play seen before age 13, when participants first entered the study.

A recent study from UC Davis showed how chronic marijuana users faced more downward mobility than chronic alcohol users.  In the US, the disproportionate arrest of minorities may reflect concern about dropping out of school and what that means for the future. The higher conviction rate for minorities is probably a reflection of income disparity and poverty.  A disproportionate number of black and Hispanic drug dealers go to jail.   Minorities are less likely to be able to afford the legal fees that allow wealthy white drug dealers to get less time in jail or wiggle their way out of going to jail.  Justice reform should not be centered on legalizing drugs, but on giving minorities better legal representation. Retired Judge Arthur Burnett, National Executive Director of the  National African-American Drug Policy Coalition, says that  African-American communities already suffer from a liquor store on every corner. Black voters know commercial marijuana would prey on their communities at a much higher rate.  “Do we really want to substitute mass incapacitation for mass incarceration?” he asked.

There’s a strong misconception that people go to jail just for having a joint.   (The threat of jail is not the reason to tell kids not to use pot, but defense of your brain is!)   There’s also a misconception that inequities in the justice system would be solved by legalization.

Maybe next time Pew Research present the polls with a bunch of different options between decriminalization, allowing home grows only or commercialization.   Or Pew Research should a better job at explaining what they mean by legalization.

Source:  http://www.poppot.org/2016/10/13/pew-research-poll-actually-reflects-pot-decriminalization   OCTOBER 13, 2016 EDITOR

Drug cartels are selling lethal doses of fentanyl disguised as street heroin and counterfeit OxyContin pills, two U.S. government agencies are warning.

The Drug Enforcement Administration and the Department of Justice are cautioning people who buy illegal drugs and painkillers on the street or in Tijuana, Mexico, that cartels are using fentanyl because they can produce it more cheaply. Just a few grains of fentanyl can be lethal, the agencies said. In September, authorities confiscated more than 70 pounds of fentanyl and 6,000 counterfeit pills, NBC 7 reports.

“It’s extremely profitable for the cartels. They aren’t having to wait for harvest. They aren’t having to harvest the poppy plants. They’re not having to manufacture that paste into heroin. They are literally just getting a chemical from China,” DEA spokeswoman Amy Roderick told NBC 7.

Source:  www.thepartnership@drugfree.org  13th October 2016

Filed under: Economic,Heroin/Methadone,USA :

The “bud tender” had shoulder length black hair, a deep well of patience and a connoisseur’s pride in his wares as he spread tray after tray of marijuana-based products on the glass counter top.

There were fruit gums, chocolate caramels, granola packets, medicated sugar to drop in your coffee or tea in the morning, Rosemary Cheddar Crackers for a savoury taste, a bath soak and even sensual oil for the bedroom, Charles Watson explained.

Then he moved on to his dozen jars of green, frosted-looking marijuana lumps for smoking, all grown legally in Denver and all named and labelled with a percentage breakdown of their chemical composition to indicate their potency and character.

How marijuana changed Colorado

Mr Watson, a salesman for the prominent Colorado marijuana chain Native Roots, explained that he had a higher tolerance than most users to his products’ effects. For a novice he suggested Harlequin, which would be similar to the cannabis you would have found in the Sixties or early Seventies. It was milder than something like Alien OG with its sky-high THC, or tetrahydrocannabinol, content. “Even smoking a tiny bit of that can get you nice and elevated,” Mr Watson said.

Almost anywhere else in the world Native Roots would be considered an unusually well-stocked drug den and Mr Watson could be facing time in jail. In Colorado, where sales of recreational marijuana to adults over 21 have been legal since January 2014, he is one of more than 27,000 people licensed to work in a booming new industry with global ambitions.

“We’re trying to show the world you can sell and regulate it in a responsible manner,” Mr Watson said. His clients are not only stereotypical stoners — they include everyone from the healthy guy that’s just run a marathon to wheelchair users who are inhaling oxygen.

Colorado’s governor, John Hickenlooper, opposed legalisation at the time of the vote in 2012 and subsequently said that he wished he could wave a magic wand and abolish it. In May, however, he changed his tune. “If I had that magic wand now, I don’t know if I would wave it,” he said. “It’s beginning to look like it might work.”

By the end of this year, if a series of state referendums fall in favour of legalisation, recreational marijuana could be approved in nine states, including California, whose economy was the sixth largest in the world last year.

Colorado raised $135 million from marijuana fees, licences and taxes last year, a fraction of the overall state budget of $27 billion but welcome revenue all the same.

Recreational and medical marijuana customers pay a 2.9 per cent regular Colorado sales tax charge and any local taxes. Recreational consumers are also charged an additional 10 per cent state marijuana sales tax and the price of their marijuana includes a 15 per cent excise tax paid by the retailer when purchasing his wares from the grower. The revenue feeds into a state schools building programme. If it is legalised in California, voters will decide whether a portion of the taxes from recreational marijuana sales will go towards tackling the state’s homelessness problem.

There are still marijuana-related crimes in Colorado, for example where the supplier is unlicensed or the customer is under 21 but there are far fewer than previously. The total number of marijuana-related prosecutions fell by more than 8,000 a year between 2012 and 2015, and was down 69 per cent among the 10-17 age group.

Violent crime fell by 6 per cent and property crime dropped by 3 per cent between 2009 and 2014, the first year of the experiment, debunking pessimistic forecasts made before legalisation.

The state’s senior law enforcement official, Stan Hilkey, the executive director of the Colorado Department of Public Safety, said he was surprised by the results. “During the debate there was a ‘sky is gonna fall’ mentality from a lot of us, including me,” he said. “I haven’t seen that.” He said, however, that after three decades as a police officer he found it difficult “to shed my cop glasses”. Asked if legalisation had brought any benefits to the public or to law enforcement, he said: “None that I’m aware of.”

In May the state’s county sheriffs, prosecutors and police chiefs wrote to Colorado legislators to complain about the extra workload foisted on them by legalisation. They called for a two-year break from the constant tweaks to the regulation of

medical and recreational marijuana. Their letter said that there had been 81 bills on the subject introduced in the previous four years.

They wrote: “Industry forces are working constantly to chip away at regulations put in place to protect public health and safety.”

Mr Hilkey added that legalisation had failed to defeat the black market, which continues to thrive because its product is cheaper and not restricted by age. It has also created new problems, including the illegal export of licensed and unlicensed marijuana to neighbouring states and almost certainly brought greater profits to organised crime activity in Colorado.

The ban on marijuana sales at national level means that officially at least, banks will not open accounts for marijuana growers or vendors, so the industry remained a cash business, he said. Therefore this made it ripe for criminals.

There were 2,538 licensed marijuana businesses in Colorado last December, many of which hire security to protect against armed robberies.

Last month a former Marine Corps veteran working as a guard at the Green Heart dispensary in Aurora, near Denver, was shot dead in a botched robbery, the first killing at a licensed marijuana business, though not the first robbery.

Two days later a small group of Republicans in Congress blocked a measure backed by both parties that would have effectively opened the banking system to marijuana businesses.

You get dirty looks if you smoke a cigarette in the street but people barely think twice if they smell weed

A spokesman for Blue Line Protection Group, one of the largest companies competing to provide security and compliance services to the new industry, said that it was a myth that there was no banking. In practice some local banks and credit agencies now feel comfortable offering services to the marijuana industry but the national chains are still waiting for approval from the federal government.

Andrew Freedman, the governor’s director of marijuana coordination, said that if California voters passed recreational legalisation, the federal government would feel compelled to step in to open up legitimate banking for the industry.

Mr Freedman, a lawyer who refuses to give a personal opinion on legalisation, said that Colorado had succeeded in creating a heavily regulated marijuana industry where consumers could safely buy a healthier product than was available on the black market.

He said that it was too early to answer many of the most pressing questions about legalisation, including what impact it had on alcohol, tobacco and opioid usage although he had been pleasantly surprised by how few tragedies there had been through marijuana overdoses.

His greatest worry is that over time people’s comfort with legalisation could make radically different patterns of marijuana use socially acceptable.

That may be happening already though. Evan Borman, 33, an architect who lives down the street from a medical marijuana shop, said attitudes in the state were shifting, though he claimed that he smoked “no less and no more” than he did before legalisation. He said: “You get dirty looks if you smoke a cigarette in the street but people barely even think twice if they smell weed.”

Source: http://www.thetimes.co.uk/article/yes-it-s-legal-but-the-law-s-still-a-drag-j8rdh3nbj    August 22nd 2016

No on Prop 205 highlights dangers of edible marijuana

PHOENIX (Oct 4) – In states where recreational marijuana has been legalized, accidental marijuana ingestion by kids has risen by 600 percent, according to a study of the National Poison Data system. Poison Control centers across the country reported more than 4,000 children exposed to marijuana in 2015. Watch more here.

Perhaps that’s because, in states like Colorado, almost half of the marijuana market is the sale of highly-concentrated edibles – packaged to look like your kids’ favorite after-school treat.

Of the many disturbing provisions buried in Proposition 205, one of the most troubling is not only that it would allow the production and sale of edible marijuana in Arizona, but also would allow such with no restriction on potency.

Edible marijuana in the form of candies, gummies, cookies, and sodas would be blatantly advertised and sold out of current medical marijuana dispensaries, as detailed in the proposition language.

This is what today’s marijuana looks like:

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In Colorado, lawmakers recently banned the production of edible marijuana in the shape of animals or people, so as to diminish its marketability toward youth. Due to the Voter Protection Act paired with Prop 205’s sneaky language, Arizona wouldn’t be able to protect our kids by limiting edibles in any way.

Poison Control centers across the country reported more than 4,000 children exposed to marijuana in 2015. Watch more here.

Source: https://noprop205.com/marijuana-marketed-kids/   4th Oct.2016

Avoiding a New Tobacco Industry

SummaryPoints

• The US states that have legalized retail marijuana are using US alcohol policies as a model for regulating retail marijuana, which prioritizes business interests over public health.

• The history of major multinational corporations using aggressive marketing strategies to increase and sustain tobacco and alcohol use illustrates the risks of corporate domination of a legalized marijuana market.

• To protect public health, marijuana should be treated like tobacco, not as the US treats alcohol: legal but subject to a robust demand reduction program modelled on successful evidence-based tobacco control programs.

• Because marijuana is illegal in most places, jurisdictions worldwide (including other US states) considering legalization can learn from the US experience to shape regulations that prioritize public health over profits.

Introduction

While illegal in the United States, marijuana use has been increasing since 2007 [1]. In response to political campaigns to legalize retail sales, by 2016 four US states (Colorado, Washington, Alaska, and Oregon) had enacted citizen initiatives to implement regulatory frameworks for marijuana, modelled on US alcohol policies [2], where state agencies issue licenses to and regulate private marijuana businesses [2,3,4]. Arguments for legalization have stressed the negative impact marijuana criminalization has had on social justice, public safety, and the economy [5].

Uruguay, an international leader in tobacco control [6], became the first country to legalize the sale of marijuana in 2014, and, as of July 2016, was implementing a state monopoly for marijuana production and distribution [7]. None of the US laws [2], or pending proposals in other states [8], prioritize public health. Because marijuana is illegal in most places, jurisdictions worldwide (including other US states) considering legalization can learn from the US experience to shape regulations that favor public health over profits.

PLOS Medicine | DOI:10.1371/journal.pmed.1002131 September 27, 2016 1 / 9a11111

OPEN ACCESS

Citation: Barry RA, Glantz S (2016) A Public Health

Framework for Legalized Retail Marijuana Based on

the US Experience: Avoiding a New Tobacco

Industry. PLoS Med 13(9): e1002131. doi:10.1371/

journal.pmed.1002131

Published: September 27, 2016

Copyright: © 2016 Barry, Glantz. This is an open

access article distributed under the terms of the

Creative Commons Attribution License, which permits

unrestricted use, distribution, and reproduction in any

medium, provided the original author and source are

credited.

Funding: This work was supported in part by

National Cancer Institute grant CA-061021 and UCSF

funds from SG’s Truth Initiative Distinguished Professorship. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests: The authors have declared that no competing interests exist.

Provenance: Not commissioned; externally peer reviewed

In contrast, while legal, US tobacco use has been declining [1]. To protect public health,

marijuana should be treated like tobacco, legal but subject to a robust demand reduction program modelledon evidence-based tobacco control programs [9] before a large industry (akin to tobacco [10]) develops and takes control of the market and regulatory environment [11].

Likely Effect of Marijuana Commercialization on Public Health.

While the harms of marijuana do not currently approach those of tobacco [12], the extent to which legal restrictions on marijuana may have functioned to limit these harms is unknown. Currently, regular heavy marijuana use is uncommon, and few users become life time marijuana smokers [13]. However, marijuana use is not without risk. The risk for developing marijuana dependence (25%) is lower than for nicotine addiction (67%) and higher than for alcohol dependence (16%) [14], but is still substantial, with rising numbers of marijuana users in high income countries seeking treatment [15]. Reversing the historic pattern, in some places, marijuana has become a gateway to tobacco and nicotine addiction [15]. This situation will likely change as legal barriers that have kept major corporations out of the market [10] are removed. Unlike small-scale growers and marijuana retailers, large corporations seek profits through consolidation, market expansion, product engineering, international branding, and promotion of heavy use to maximize sales, and use lobbying, campaign contributions, and public relations to create a favorable regulatory environment [2,11,16,17,18,19]. By 2016, US marijuana companies had developed highly potent products [15] and were advertising via the Internet [11] and developing marketing strategies to rebrand marijuana for a more sophisticated audience [20].Without effective controls in place, it is likely that a large marijuana industry, akin to tobacco and alcohol, will quickly emerge and work to manipulate regulatory frameworks and use aggressive marketing strategies to increase and sustain marijuana use [10,11] with a corresponding increase in social and health costs.

Public perception of the low risk of marijuana [21] is discordant with available evidence.

Marijuana smoke has a similar toxicity profile as tobacco smoke [22] and, regardless of whether marijuana is more or less dangerous than tobacco, it is not harmless [2]. The California Environmental Protection Agency has identified marijuana smoke as a cause of cancer [23], and marijuana smokers are at increased risk of respiratory disease [24,25]. Epidemiological studies in Europe have found associations between smokingmarijuana and increased risk of cardiovascular disease, heart attack, and stroke in young adults [15,26]. One minute of exposure to marijuana smoke significantly impairs vascular function in a rat model [27]. In humans, impaired vascular function is associated with adverse cardiovascular outcomes including atherosclerosis and myocardial infarction [27,28,29].

Acute risks associated with highly potent marijuana products (i.e., cannabinoid concentrates, edibles) include anxiety, panic attacks, and hallucinations [15]. Other health risks associated with use include long-lasting detrimental changes in cognitive function [13,15], poor educational outcomes, accidental childhood ingestion and adult intoxication [26], and auto fatalities [30,31]. US Alcohol Policy Is Not a Good Model for Regulating Marijuana The fact that US marijuana legalization is modelled on US alcohol policies is not reassuring. In 2014, 61% of US college students (age 18–25) reported using alcohol in the past 30 days, compared to 19% for marijuana and 13% for tobacco

[32]. Binge drinking is a serious problem, with 41% of young Americans reporting heavy episodic drinking in the past year [33].

Aggressive alcohol marketing likely contributes to this pattern [34]. Even though the alcohol industry’s voluntary rules prohibit advertising on broadcast, cable, radio, print, and digital communications if more than 30% of the audience is under age 21, this standard permits them to advertise in media outlets with substantial youth audiences [35], including Sports Illustrated and Rolling Stone, resulting in American youth (ages 12–20) being exposed to 45% more beer

and 27% more spirits advertisements than legal drinking-aged adults [36]. If such alcohol marketing regulations were applied universally to marijuana, consumption would likely be higher, not lower, than it is now [26].

Using a Public Health Framework from Evidence-Based Tobacco Control to Regulate Retail Marijuana

Table 1 compares the situation in the four US states that have legalized retail marijuana to a public health standard based on successes and failures in tobacco and alcohol control. A public health framework for marijuana legalization would designate the health department as the lead agency with, like tobacco, a mandate to protect the public by minimizing all (not just youth) use. The health department would implement policies to protect nonusers, prevent initiation, and encourage users to quit, as well as regulate the manufacturing, marketing, and distribution of marijuana products, with other agencies (such as tax authorities) playing supporting roles.

Because public health regulations are often in direct conflict with the interests of profit driven corporations [19], it is important to protect the policy process from industry influence. In contrast to what states that have legalized retail marijuana have done to date, a public health framework would require that expert advisory committees involved in regulatory oversight and public education policymaking processes consist solely of public health officials and experts and limit the marijuana industry’s role in decision-making to participation as a member of the “public.” Including the tobacco industry on advisory committees when developing tobacco regulations blocks, delays, and weakens public health policies [37].

TheWorld Health Organization Framework Convention on Tobacco Control, a global public health treaty ratified by 180 parties as of April 2016, recognizes the need to protect the policymaking process from industry interference:

“[Governments] should not allow any person employed by the tobacco industry or any entity working to further its interests to be a member of any government body, committee or advisory group that sets or implements tobacco control or public health policy.” [37, Article 5.3]”

A marijuana regulatory framework that prioritizes public health would have similar provisions. A public health framework would avoid regulatory complexity that favors corporations with financial resources to hire lawyers and lobbyists to create and manipulate weak or unenforceable policies [11]. To simplify regulatory efforts, including licensing enforcement, implementation of underage access laws, prevention and education programs, and taxation, a public health framework would create a unitary market, in which all legal sales, regardless of whether use is intended for recreational or medical purposes, follow the same rules [38]. Unlike Colorado, Oregon, and Alaska, in 2015,Washington State accomplished this public health goal when it merged its retail and medical markets [39].

Earmarked funds to support comprehensive prevention and control programs over time,  hich are not included in the four US states’ regulatory regimes, will be critical to reduce marijuana prevalence, marijuana-related diseases, and costs arising from marijuana use. A public health framework would set taxes high enough to discourage use and cover the full cost of legalization, including a broad-based marijuana prevention and control program. Using a public health approach, the prevention program would implement social norm change strategies, modelled on evidence-based tobacco control programs, aimed at the population as a whole—not just users or youth [9].

Key: ✓ Required by law or regulation; X Not required by law or regulation; –Pending legislative approval or rulemaking process Demand reduction strategies applied to marijuana would include:

1) countering pro-marijuana business influence in the community;

2) reducing exposure to secondhand marijuana smoke and aerosol and other marijuana products (including protecting workers vulnerable to these exposures);

3) controlling availability of marijuana and marijuana products;

4) promoting services to help marijuana users quit.

A public health framework would protect the public from second hand smoke exposure by including marijuana in existing national and local smoke free laws for tobacco products, including e-cigarettes. Local governments would have authority to adopt stronger regulations than the state or nation. There would be no exemptions for indoor use in hospitality venues, marijuana retail stores, or lounges, including for “vaped” marijuana. To protect the public from industry strategies to increase and sustain marijuana use, a public health framework would prohibit or severely restrict (within constitutional limitations) marketing and advertising, including prohibitions on free or discounted samples, the use of cartoon characters, event sponsorship, product placement in popular media, cobranded-merchandise, and therapeutic claims (unless approved by the government agency that regulates such claims).Marketing would be prohibited on television, radio, billboards, and public transit and restricted in print and digital communications (e.g., internet and social media) with the percentage of youth between ages 12 and 20 as the maximum underage audience composition for permitted advertising (roughly 15% in the US) [35]. These advertising restrictions are justified and would likely pass US Constitutional muster because they are implemented for important public health purposes, are evidence-based[35], and have worked to promote similar goals in other contexts. Legal sellers of the newly legal  marijuana products would be permitted to communicate relevant product information to their legal adult customers.

A scenario in which a public health regulatory framework is applied to marijuana would require licensees to pay for strong licensing provisions for retailers, with active enforcement and license revocation for underage sales. As has been done in the four US states (Table 1), outlets would be limited to the sale of marijuana only to avoid the proliferation and normalization of sales in convenience stores or “big box” retailers. No retailer that sold tobacco or alcohol would be granted a license to sell marijuana products. Based on best public health practices for tobacco retailers [40], marijuana retail stores would be prohibited within 1,000 feet of underage- sensitive areas including postsecondary schools, with limits on new licenses in areas that already have a significant number of retail outlets. Electronic commerce, including internet, mail order, text messaging, and social media sales, would be prohibited because these forms of non traditional sales are difficult to regulate, age-verification is practically impossible [41], and they can easily avoid taxation [42].

Central to a public health framework would be assigning the health department with the authority to enact strong potency limits, dosage, serving size, and product quality testing for marijuana and marijuana products (e.g., edibles, tinctures, oils), with a clear mission to protect public health. Additives that could increase potency, toxicity, or addictive potential, or that would create unsafe combinations with other psychoactive substances, including nicotine and alcohol, would be illegal. Unlike US restrictions on marijuana products, flavors (that largely appeal to children), would be prohibited.

A public health model applied to marijuana would include health warning labels that follow state-of-the-art tobacco requirements implemented in several countries outside of the United States, including Uruguay, Brazil, Canada, and Australia [43]. Public health-oriented labels would:

1) be large, (at least 50% of packaging) on front and back and not limited to the sides,

prominently featured, and contain dissuasive imagery in addition to text;

2) be clear and direct and communicate accurate information to the user regarding health risks associated with marijuana use and secondhand exposure; and

3) use language appropriate for low-literacy adults.

Health messages would include risk of dependence [2], cardiovascular [2,44,45], respiratory [25], and neurological disease [46], and cancer [23], and would warn against driving a vehicle or operating equipment, as well as the risks of co-use with tobacco or alcohol. While there is already adequate scientific evidence to raise concern about a wide range of adverse health effects, there is more to learn. Earmarked funds from marijuana taxes would also provide an ongoing revenue stream for research that would guide marijuana prevention and control efforts and mitigate the human and economic costs of marijuana use, as well as better define medical uses as the basis for proper regulation of marijuana for therapeutic purposes.

Avoiding a Private Market

Privatizing tobacco and alcohol sales leads to intensified marketing efforts, lower prices, more effective distribution, and an industry that will aggressively oppose any public health effort to control use [47,48]. Avoiding a privatized marijuana market and the associated pressures to increase consumption in order to maximize profits would likely lead to lower consumer demand, consumption, and prevalence, even among youth, and would reduce the associated public health harm [49].

Governments may avoid marijuana commercialization by implementing a state monopoly over its production and distribution, similar to Uruguay’s regulatory structure for marijuana [3,50] and to the Nordic countries’ alcohol control systems [51], which are designed to protect public health over maximizing government revenue. The state would have more control over access, price, and product characteristics (including youth-appealing products or packaging, potency, and additives) and would refrain from marketing that promotes increased use [3,52].

In cases where national laws cause concern about local authority’s ability to adopt government monopolies, a public health authority could be used as an alternative [53].

It is important to avoid intrinsic conflicts of interest created by state ownership. As is the case with state-ownership of tobacco, without specific policies to prioritize public health, a state’s desire to increase revenue often supersedes public health goals to minimize use [51,52]. Beyond mitigating potential conflicts of interest inherent in state monopolies, a public health framework for marijuana would instruct the government agency that manages the monopoly to minimize individual consumption in order to maximize public health at the population level. (Similar public health goals are explicit in Nordic alcohol monopolies [51].)

While a state monopoly is an effective approach to protect public health [51,54], in practice, however, even the strongest government monopolies for alcohol (i.e., Nordic Countries) have been eroded over time by multinational companies that argue such controls are illegal protectionism under international and regional trade agreements [4,51].While trade agreements have been used to threaten tobacco control and other public health policies [55], clearly identifying protection of public health as the goal of the state monopoly would make it more difficult to challenge these controls, especially if sales revenues were used to help fund evidence-based demand reduction policies [49] (Table 1).

Conclusion

It is important that jurisdictions worldwide learn from the US experience and implement, concurrently with full legalization, a public health framework for marijuana that minimizes consumption to maximize public health (Table 1). A key goal of the public health framework would be to make it harder for a new, wealthy, and powerful marijuana industry to manipulate the policy environment and thwart public health efforts to minimize use and associated health problems.

Acknowledgments

This paper is based on an invited presentation at the Marijuana and Cannabinoids: A Neuroscience Research Summit held at the National Institutes of Health onMarch 22–23, 2016.

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PLOS Medicine | DOI:10.1371/journal.pmed.1002131 September 27, 2016 9 / 9

Source:  http://journals.plos.org/plosmedicine/article?id=10.1371%2Fjournal.pmed.1002131

As a parent and grandparent, I believe legalizing recreational marijuana would result in serious harm to public health and safety, and urge my fellow Californians to vote “No” on Proposition 64 on Nov. 8.

Marijuana is a complicated issue. I support its medicinal use and have introduced federal legislation to make it easier to research and potentially bring marijuana-derived medicines to the market with FDA approval.

I also recognize that our nation’s failure to treat drug addiction as a public health issue has resulted in broken families and overcrowded prisons. That’s why I support the sentencing reform that would reduce the use of mandatory minimum sentences in certain drug crimes, give judges more flexibility to set sentences and promote treatment programs to address the underlying addiction.

But Proposition 64 would allow marijuana of any strength to be sold. It could make it easier for children to access marijuana and marijuana-infused foods. It could add to the already exorbitant costs of treating addiction. And it does not do enough to keep stoned drivers, including minors, off the roads.

With 25 million drivers in our state, that should set off alarm bells. While we do not fully understand how marijuana affects an individual’s driving ability, we do know that it significantly impacts judgment, motor coordination and reaction time.

In Washington, deaths in marijuana-related car crashes have more than doubled since legalization. In Colorado, 21 percent of 2015 traffic deaths were marijuana-related, double the rate five years earlier – before marijuana was legalized.

In California, even without recreational legalization, fatalities caused by drivers testing positive for marijuana increased by nearly 17 percent from 2005 to 2014. While the presence of marijuana does not prove causation, these numbers are concerning. A study on drugged driving and roadside tests to detect impairment required by Proposition 64 should be completed before, not after, legalization goes into effect.

Proposition 64 does not limit the strength of marijuana that could be sold. Since 1995, levels of THC – the psychoactive component of marijuana – have tripled. Increased strength can increase the risk of adverse health effects, ranging from hallucinations to uncontrollable vomiting.

We’ve already seen examples of harm. This summer in San Francisco, 13 children, one only 6 years old, were taken to hospitals after ingesting marijuana-infused candy – a product permitted under Proposition 64.

The combination of unlimited strength and the ability to sell marijuana-edibles should concern all parents. So should the risk of increased youth access. Age restrictions don’t prevent youths from using alcohol; marijuana will not be any different.

Nearly 10 million Californians are under age 18. Studies show that marijuana may cause damage to developing brains, and one in six adolescents who uses marijuana becomes addicted.

While more research on prolonged use is needed, a large-scale study found that people who began using heavily as teens and developed an addiction lost up to eight IQ points, which were not recoverable.

This means that a child of average intelligence could end up a child of below-average intelligence, a lifelong consequence.

The proposition could also allow children to see marijuana advertisements, making it more enticing for them to experiment.

In fact, Superior Court Judge Shelleyanne Chang ruled that Proposition 64 “could roll back” the prohibition of smoking ads on television. Even though it is against federal law, the proposition explicitly permits television and other advertisements, provided that three in four audience members are “reasonably expected” to be adults.

We need criminal justice reform and a renewed focus on treatment. But legalizing marijuana is not the answer, particularly in the nation’s largest state. Proposition 64 fails to adequately address the public health and safety consequences associated with recreational marijuana use.

Sen. Dianne Feinstein is the senior senator from California.

Source:  http://www.sacbee.com/opinion/op-ed/article104501076.html#storylink=cpy

Born in Massachusetts, our son started out life with a very bright future.  As a toddler he was interested in things with wheels, and anything his big sister was doing. As he got older, Lego was his obsession. In his early school days he tended to get really into a subject, even those of his own choosing. For a while it was Russian language and then it was the Periodic Table.  He begged me to buy him a 2½-inch thick used Chemistry textbook before he was a pre-teen. I did.

I was able to be a stay-at-home parent until our son was 8. I tried to do all the right things. We played outside, limited screen time, and got together with other little ones and their moms for play groups. I read to him and his sister every night until they both reached middle school and wouldn’t let me anymore. Our son routinely tested in the 99th percentile on standardized tests and at least 3 grade levels above. Now, at age 17, he has dropped out of high school.

My husband and I both have Master’s degrees, and my husband is a public school administrator. His father is a retired architect. My mother is a retired elementary school teacher. Our family believes in education, we believe in learning and growing.     When asked why he continues to use drugs, mostly marijuana, my son said, “I think it’s because of the people we’re around.”

In reflecting back on “What happened?”   I blame marijuana. We now live in Colorado, where marijuana is legal and widely available to everyone.  What if we had never moved here?

How it All Began

My son’s first time using was in 7th grade when marijuana was legal only if used medicinally with a “Red Card,” if recommended by a physician.   Coloradans voted on legalization in November 2012 and marijuana stores opened in January, 2014. But back in 2012, he and some buddies got it from a friend’s older brother who had a Red Card.  From what I can tell, the use just kept escalating until his junior year in high school when he was using at least once a day…and when he attempted suicide.

Between that first incident in 2012 and the suicide attempt in 2015, his father and I waged an all-out battle on the drug that was invading our home. We grounded him; I took to sleeping on the couch outside his bedroom because he was sneaking out in the middle of the night; we yelled and screamed; I cried, we cajoled and tried to reason with him: ”You have a beautiful brain! Why are you doing things that will hurt your brain?”

We did weekly drug tests, we enlisted the school’s support, we enlisted our family’s support and we even tried talking to his friends.

But nothing worked. Our son was in love with marijuana. Our sweet, smart, funny, sarcastic, irreverent, adorable boy was so enamoured with this drug that nothing we did — NOTHING — made any difference. And we slowly lost him.

At the same time I was battling marijuana at home, I was also leading a group in our community to vote against legalizing it in our small town.  I had teamed with a local business-owner and a physician and the three of us got the support of many prominent community members, including the school superintendent, the police chief, and the fire chief. We ran a full campaign, complete with a website where you could donate money, a Facebook page, and yard signs.

Why does he continue to use marijuana? “I think it’s because of the people we’re around.”

My son’s use isn’t the reason I got involved. I had started advocating against marijuana legalization long before I even realized he had a problem. My background is in health communication and I work in the hospital industry.  I sit on our local Board of Health, so allowing retail stores to sell an addictive drug just doesn’t make any sense. I did think about my children; what I was modeling for them; what kind of community we were raising them in, and the kind of world I envisioned for their future. Those are the reasons I got involved. My son’s use is actually the reason that I’ve pulled away from any sort of campaigning.

Unfortunately, we lost our fight. So in 2014, it became legal in our small town to purchase pot without a Red Card. And the following year, his junior year, he almost slipped away from us forever.

It Got Scarier and Scarier

His use by then had escalated to daily (and I suspect often more than once a day). Pot seemed to be everywhere! We found it hidden all over the house — in the bathroom, on top of the china cabinet, in his closet, outside, even in his sister’s bedroom. It’s a hard substance to hide because of the strong smell. Even in the “pharmacy” bottles and wrapped in plastic bags, the skunk stench still manages to seep out. But it sure seemed easy for a young boy to get!

He started leaving school in the middle of the day, or skipping school altogether, and his grades plummeted. Where he was once an A/B student and on the varsity cross-country team, he was now failing classes and not involved in anything. This boy who had tested in the 99th percentile was failing high school. And this boy who had once been the levity in our home, who used to make me laugh like no one else could or has since, this boy became a stranger.

Our son withdrew from everything except his beloved drug. His circle of friends (never big in the first place), was reduced to only those who could supply him with marijuana.

His relationship with his older sister all but disappeared. And his relationship with his father has been strained beyond almost all hope of repair.

Then in late 2015 our son attempted suicide. He was hospitalized, first overnight at the very hospital where I work, and then for a 3-day locked psychiatric unit stay. I remember very little from this difficult (and surreal) time except learning that it wasn’t his first attempt, and that he blamed us for how awful he felt. He started taking an antidepressant and after he was released we took him to a drug counselor for a total of three visits but after that he refused to go — he threatened to jump out of the car if we tried to take him. We tried a different counselor and that only lasted for one visit.

Changing Strategies and a Truce

At this point I convinced my husband that we had to approach things differently, because obviously what we were doing wasn’t working. We stopped the weekly drug tests (we knew he was using so there seemed to be no point anyway). We stopped yelling and punishing. And basically my husband stopped talking to our son altogether — they are both so angry and hurt that any communication turns toxic very quickly. He refused to go back to school so we agreed that he could do online classes.

More and more, our son is feeling isolated from the rest of his family.

There is an uneasy truce in our home right now. Now it just feels like waiting. Waiting for what will happen next. Waiting for the other shoe to drop.

Our son, 17, still lives with us.  His sister left for college this past summer. I acknowledge that he uses pot and doesn’t want to quit, but I continue sending the message that it’s not good for his brain. The one thing my husband and I won’t bend on is no drugs on our property. He has started five different online classes, but has so far finished only one. He doesn’t feel any pressure to finish school — he says he’ll get a GED, but hasn’t made any effort towards that end. He doesn’t drive and doesn’t express any desire to learn, which is probably good because I doubt he could be trusted to drive sober. He started working at a local restaurant recently and has been getting good feedback from his managers, which I take to be a positive sign.   (I’ll take any positive signs at this point!)

Trying Something Else and Blacking Out

I don’t know if the suicide attempt and hospitalization were rock bottom for our family, but I suspect not. Just this past weekend our son came home and I could tell he was on something — and it wasn’t marijuana or alcohol. I checked him periodically throughout the night and in the early morning he was awake and asked me how much trouble he was in. I replied that it depended on what he had taken. He said Xanax. He also said that he had blacked out and couldn’t remember anything that had happened from about an hour after he took it.

Later in the morning, when we were both more awake, I asked him about the Xanax (he got it from someone at the restaurant) and the pot use and what he saw for his future. He has no plans to stop using, but said that he probably wouldn’t take Xanax again (he didn’t like blacking out). He said that he’s very happy with his life right now, that he knows a lot of people who didn’t go to college who work two or three jobs and live in little apartments, and that he’s happy with that kind of future for himself.

I tried not to cry.  Imagine that as the goal for a boy who started life with so much curiosity and such a desire to learn.

It’s not that I don’t think he can have a good and decent life without a college education. But I know that he’ll have a much harder life. Statistically, Americans with fewer years of education have poorer health and shorter lives (partly due to lack of adequate health insurance), and Americans without a high school diploma are at greatest risk.   It’s not just life without a college education, but it is life with a brain that has been changed by marijuana.  Will he be able to give up pot?  If he does give up pot, will he recover the brain he had at one time?  Will he lose motivation?

I asked him why he used pot when he knew how his father and I felt about it and when we had tried so hard to steer him in a different direction.

He said: “I think it’s because of the people we’re around. And all the drugs that are around.”

I’ve finally accepted that his use is not in the range of normal teenage experimentation, and I’m barely surviving on the hope that he’ll eventually grow out of it…and that he doesn’t do any permanent damage.  In the meantime, I’m sorry that we ever moved here.

Parents Opposed to Pot is totally funded by private donations, rather than industry or government. If you have an article to submit, or want to support us, please go to Contact or Donate page.

Source:  http://www.poppot.org/2016/09/19/colorado-move-larger-forces-she-cant-control/#comments

By Celia Vimont

September 21st, 2016

There are many misperceptions about MDMA, also known as Ecstasy or Molly, according to a researcher on substance abuse at the University of South Florida. One of the most common myths is that Molly is a pure form of Ecstasy, says Khary Rigg, PhD.  In fact, Molly is simply a powder or crystal form of MDMA, while Ecstasy is the pill form, said Dr. Rigg, who spoke about MDMA at the recent National Prevention Network annual conference. “Molly has a reputation for being a pure form of MDMA, but it is often as adulterated as Ecstasy is,” he said.

“I became interested in Molly when I was watching the 2013 MTV Video Music Awards, and noticed Miley Cyrus was singing a song and one of the lyrics was bleeped out,” Dr. Rigg recalled. “I looked it up and realized she had made a reference to Molly in the song.” That is when Dr. Rigg first realized that Molly had crossed over into mainstream popular culture. Before that, Molly and Ecstasy were mostly used by gay men and fans of electronic dance music. “Now it’s being used more widely, including in minority communities,” he said. Dr. Rigg recently completed a study on MDMA use among African Americans and will be publishing his findings in the next few months.

Molly, short for molecule, first became popular in the early 2000’s, but figuring out exactly how many Americans use Molly hasn’t been easy. “It has been difficult to get national data on the popularity of Molly because national surveys have only asked about people’s use of Ecstasy,” said Dr. Rigg. This has recently changed, however, and surveillance systems such as the National Survey on Drug Use and Health have started including Molly in their definition of MDMA. Molly is typically sold in capsules or in a baggie and is usually swallowed, although it can also be snorted.

In recent years, MDMA overdoses at concerts and music festivals have been receiving headlines. But Dr. Rigg warns that, “Many so-called overdoses of Molly or Ecstasy are not really overdoses. When we call them overdoses, the real causes of these deaths are obscured. MDMA deaths are almost never due to taking too much of the drug. The real culprits are heatstroke, hydration issues, and having a pre-existing health condition.”

Many people who take Molly believe that drinking water makes it safe. “You’ll hear that Molly can dehydrate you, and that’s true, but it can also cause you to retain water. So, while it’s important to remain hydrated, people should also be careful not to drink too much water. As a rule of thumb, you only need to replenish the water that you sweat out,” Dr. Rigg says. Certain health conditions are also to blame for some MDMA deaths. Dr. Rigg cautions, “Using MDMA can be dangerous and even fatal for people with conditions such as high blood pressure, heart disease, and seizure disorder.” Organizations like Dance Safe are trying to reduce the number of MDMA deaths at electronic music festivals and clubs by distributing educational materials about the risks of MDMA. They also provide free water and electrolytes to prevent dehydration and heatstroke, and offer drug-testing kits that instantly indicate whether there are “unknown and potentially more dangerous adulterants” in powder and tablets. Dr. Rigg says that this harm-reduction approach to MDMA use is more widespread in other countries, particularly in Europe, but is gaining traction in the United States.

There is some question about whether MDMA can cause Parkinson’s disease. “Some research indicates that prolonged Ecstasy use can damage the brain’s ability to produce dopamine which could hasten the onset of the disease,” he notes. “An underlying cause of Parkinson’s is a decreased ability to produce dopamine, so there could be a link, but we need more research to say for sure.” Dr. Rigg points out that because of its Schedule I status, research on MDMA is heavily restricted in the U.S. which has hampered how much is known about the long-term effects of the drug.

Dr. Rigg says that before MDMA was banned in 1985, some therapists would give the drug to clients during counseling sessions, because they found it helped them talk about their feelings. Currently, there are several clinical trials taking place to evaluate the potential of using MDMA to help treat PTSD and anxiety.

Despite misinformation surrounding MDMA, Dr. Rigg expects use of the drug to continue rising. He notes that Molly’s popularity has soared in hip-hop/rap music and is now being endorsed by top artists as a sexual enhancer. MDMA use is also being depicted in many popular television shows and movies which serves to normalize use of the drug. He says that for prevention efforts to be effective, we must go beyond simple “just say no” messages, and incorporate aspects of supply reduction, drug education, and harm reduction.

Source: http://www.drugfree.org/news-service/many-myths-surround-molly-ecstasy-expert/   21st Sept. 2016

Filed under: Ecstasy,Synthetics,USA :

In the spring of 2013, Neighborhoods Against Substance Abuse, Inc. (NASA) in Greenfield, Indiana, knew that it had an escalating problem on its hands. Alcohol, tobacco, prescription and over-the-counter (OTC) drugs, and marijuana use were all on the rise among its youth in Hancock County, the coalition’s service area. One major concern was the inconsistent enforcement of underage drinking laws and school policies countywide. So NASA decided to create an Underage Drinking Task Force, a partnership of law enforcement agencies, schools, probation, judges, the prosecutor’s office, and the coalition to help rectify the situation.

“Together we examined the problem from the perspective of each of the stakeholders, and then we developed common goals and practices,” explains Tim Retherford, Executive Director of NASA. “What this did was to unify the County’s underage drinking efforts so that it was treated consistently.”

With a population of 72,000, Hancock County consists of several small cities and towns; Greenfield, the County Seat has 21,000 residents. The county also has four public school corporations, including four public high schools with about 4,000 students. Although Hancock County is just 30 minutes from Indianapolis, it is primarily a rural, farmland community.

With reducing underage drinking as its primary goal, the Task Force created a broad range of initiatives.  Among them:

* An MOU signed by all eight law enforcement departments, making policies dealing with underage drinking uniform countywide; Indiana State Police signed the MOU as well.

* The Underage Drinking Task Force established a group of police officers (from the eight departments and the State Police) who work overtime to enforce underage drinking in Hancock County

* Enforcement of underage drinking laws now uniformly imposed, including zero tolerance laws

* Overtime payment for Underage Drinking Task Force police paid for by local funds and by Justice Assistance Grants (JAGs) from the state of Indiana

* Regular “Party Patrols” by Underage Drinking Task Force police across the county

* Agreement by Hancock County’s school corporations to impose consistent consequences and penalties for youth caught drinking

* For youth caught drinking, County Probation Department requires them to attend an alcohol educational class and complete community service and a brief assessment is conducted by a treatment professional (if it is determined necessary) who is a probation officer and who can recommend further treatment by a local alcohol treatment office

Data shows that enormous progress has been made. For example, in a study prepared by the Indiana Prevention Resource Center at Indiana University, in June of 2013, 34.1 percent of Hancock County’s high school seniors, said that they had consumed alcohol during the previous 30 days, compared with 22.3 percent in 2014; 21.1 percent in 2015; and 19.7 percent in 2016. Furthermore, from 2013-14, there were 123 Underage Drinking Task Force arrests, and from 2015-16, there were just 52.

NASA is also working on many other fronts, including involving youth to develop innovative ways to communicate its substance use messages.

“Our Youth Council is one important key to our continued success, as they know best how to design messages to their peers,” Retherford says. “For example, they let us know they want to learn in a fun, interactive way.”

So NASA has brought entertaining, motivational speakers to the middle and high schools. Among them was Craig Tornquist, an Indiana stand-up comic. Dressed in his best “Elvis” garb for part of his presentation, he talked to students about the dangers and consequences of alcohol and drugs, and how substance use can ruin lives, calling attention to celebrities such as Robin Williams, Prince, and Whitney Houston.

The teens also coordinated a “being in the majority campaign.” As a part of that, they designed baseball card-size cards with statistics about the numbers of students who don’t do drugs or drink alcohol.

The coalition also uses different strategies to communicate its message to adults in Hancock County. For this population, it has developed a traditional media campaign using TV and print ads in the local newspaper. One TV ad featured a dozen teenagers saying individually, “I am one.” The camera then pulls out to reveal the entire group, and they all say, “We’re one of 65 percent of the youth in our community who don’t use drugs.”

Recently, the coalition also brought a representative from the Rocky Mountain High Intensity Drug Trafficking Area to Greenfield to meet with professionals in the county to discuss the effect legalization of marijuana has had on Colorado. “We are doing everything we can,” added Retherford. “Beginning with working with so many partners in our community, to create a safer place to raise our families.”

Source:  http://www.cadca.org/resources/coalitions-action-thinking-outside-box-rural-indiana   22nd September 2016A

Filed under: Education Sector,Parents,USA :

States that have legalized marijuana are contending with a new criminal tactic — smugglers who grow and process it for export to states where it’s illegal and worth a lot more.

Colorado is the epicenter of the phenomenon, although it’s popping up in Oregon and Washington too. Now as Maine, Massachusetts and Canada consider legalizing recreational marijuana, the question arises — will the Northeast see a wave of new-age bootleggers?

During the Prohibition era, it was whiskey being run from Canada or Mexico to the U.S. Now it’s marijuana that’s being smuggled — from Colorado, where it has been fully legal since 2014, to neighboring states and beyond.

“It’s probably our No. 1 concern.” says Andrew Freedman, who directs marijuana policy for Colorado Gov. John Hickenlooper.

Freedman says organized criminals are exploiting legal loopholes by collecting home-grow licenses that allow for as many as 99 marijuana plants each. And more generally, he says, criminals are using the state’s fully legalized pot economy as cover.

“Different ways you can use Amendment 20 and 64, the medical and the recreational, to kind of cloak yourself in legitimate growing. Unfortunately there are a lot of people who want to do that in order to sell out of state because there’s a huge economic incentive to want to sell out of state right now,” he says.

As in, a pound of pot, worth, say, $1,500 at the counter of a legal Colorado marijuana shop is worth $3,000 or more when it crosses the state border, instantly transmuted into a prized black-market commodity. And criminal gangs are moving in, creating a headache for Colorado law enforcement, danger to public safety and a field day for the media.

The U.S. Drug Enforcement Administration says last year, state highway patrols intercepted more than 3,500 pounds of marijuana that was destined for states beyond Colorado’s border. That’s just a tenth, they estimate, of the actual cross-border market, making it, conservatively, a $100 million-plus proposition. Those numbers do not include busts of some pretty big syndicates, many of them recently involving Cuban nationals shipping product to Florida.

And for Colorado’s neighboring states, it’s a doubly-frustrating problem, because it’s not of their own making.

“In Nebraska, Colorado’s become ground zero for marijuana production and trafficking,” says Jon Bruning, Nebraska’s attorney general, who with his counterpart in Oklahoma is trying to sue Colorado and force it to overturn its marijuana laws. “This contraband has been heavily trafficked in our state. While Colorado reaps millions from the production and sale of pot, Nebraska taxpayers have to bear the cost. Virtually every aspect of Nebraska’s criminal justice system has experienced increased expense to deal with the interdiction and prosecution of Colorado marijuana trafficking.” One Nebraska study found that border counties saw gradual increases in pot-related arrests, jailings and costs since medicinal marijuana was legalized in Colorado, and a surge in 2014, when the recreational pot law went into effect. But the U.S. Supreme

Court recently declined to review the complaint by Colorado’s neighbors, which are looking for other venues to pursue their case.

Meanwhile, here on the East Coast, voters in Massachusetts and Maine are considering full legalization on the November ballot, and Canada Prime Minister Justin Trudeau is calling for legalization there. If those measures are all approved, police in New Hampshire are wondering what it would be like to be nearly surrounded by legal pot territory.

Andrew Shagoury is Tuftonboro’s chief of police, and the New Hampshire Chiefs of Police Association’s point-man on pot. If Maine or Massachusetts does go for legalization, he expects that at the least, problems such as small-scale smuggling and intoxicated driving will spill over the border.

“If more does spill over, the direct effect I suspect will be more accidents with people under the influence — obviously that would be a public safety concern. And I think politically you’d see more pressure for it to pass here too,” he says.

And Massachusetts Attorney General Maura Healy expects organized crime to open up new fields of operation.

“What’s going to stop a drug cartel from purchasing property, renting property here and running an operation at the property? And that’s something that could be situated next to a school, next to a hospital, in a suburban neighborhood. That’s a real problem,” she says.

But some note that Colorado neighbors such as Nebraska and Omaha have relatively strict marijuana laws, creating a strong incentive for smugglers there. In New England there is a more relaxed culture around marijuana — every state in the region, except for New Hampshire, has decriminalized possession of small amounts of pot and allowed use of medicinal marijuana, perhaps reducing potential black-market demand.

Essentially, says Vermont Attorney General William Sorrell, Vermonters are already growing enough pot to meet most of their smoking needs. But Sorrell is worried about the introduction of edible marijuana products into the regional marketplace.

“And I really think the regulators have to do a lot more effective work on quality control so that buyers know what is the THC content, what is a legitimate serving or portion because I think there has been and will continue to be a problem with over ingestion of marijuana,” he says.

There are specific parts of the measures in Maine and Massachusetts that could make it harder for criminals to aggregate licenses for big grow operations. And advocates of ending pot prohibition point to what they believe would be the most effective way to end the black market economy — to legalize marijuana in every state.

Source: http://mainepublic.org/post/will-legalizing-marijuana-create-modern-bootlegger 21st Sept.2016

Meeting held to discuss ways to improve and enhance U.S.-China joint drug investigations

This week the heads of the national drug-control agencies for the United States and the People’s Republic of China, Drug Enforcement Administration (DEA) Acting Administrator Chuck Rosenberg and Director General (DG) Hu Minglang from the Narcotics Control Bureau (NCB) of the Ministry of Public Security, met at DEA Headquarters in Arlington, Virginia to discuss ways to stop the flow from China to the United States of deadly synthetic drugs.  This meeting follows an announcement by America’s President Obama and China’s President Xi Jingping during the G20 Summit held earlier this month in Hangzhou, China that the U.S. and China will continue to work together to address the illicit supply of fentanyl and its compounds.

Chemical makers in China are the United States’ primary source of synthetic drugs such as fentanyl and its compounds.  They are smuggled into the country either directly from China by Americans who order them over the Internet or from Mexico by cartels that purchase the drugs in bulk and then smuggle them, alone or mixed with heroin, across America’s Southwest Border.  When China controlled 116 chemicals, including certain fentanyl-related compounds, in October of 2015, seizures of those drugs here in the United States dropped significantly.

Recently, the DEA and the NCB have seen an increased level of cooperation andintelligence sharing.  Last month, at the invitation of the NCB, a senior-level DEA delegation travelled to China to learn about their drug control efforts and examine steps to further bilateral cooperation.

Fentanyl, a synthetic opiate painkiller, and related compounds are often mixed with heroin to increase its potency, but dealers and buyers may not know exactly what they are selling or ingesting. These drugs are deadly at very low doses and come in several forms, including powder, blotter paper, tablets, and spray.  Overdoses in the U.S. due to these drugs have increased exponentially in recent years, and DEA has issued national warnings about the danger.    More information about fentanyl and other dangerous synthetic opiates can be found at www.dea.gov.

Source:  U.S. Drug Enforcement Administration: dea@public.govdelivery.com Press Release 29th Sept.2016  

As of 2015, almost half of US states allow medical marijuana, and 4 states allow recreational marijuana. To our knowledge, the effect of recreational marijuana on the paediatric population has not been evaluated.

Objective:

To compare the incidence of paediatric marijuana exposures evaluated at a children’s hospital and regional poison center (RPC) in Colorado before and after recreational marijuana legalization and to compare population rate trends of RPC cases for marijuana exposures with the rest of the United States.

Design, Setting and Participants:

Retrospective cohort study of hospital admissions and RPC cases between January 1, 2009, and December 31, 2015, at Children’s Hospital Colorado, Aurora, a tertiary care children’s hospital. Participants included patients 0 to 9 years of age evaluated at the hospital’s emergency department, urgent care centers, or inpatient unit and RPC cases from Colorado for single-substance marijuana exposures.

EXPOSURE:

Marijuana.

MAIN OUTCOMES AND MEASURES:

Marijuana exposure visits and RPC cases, marijuana source and type, clinical effects, scenarios, disposition, and length of stay.

RESULTS:

Eighty-one patients were evaluated at the children’s hospital, and Colorado’s RPC received 163 marijuana exposure cases between January 1, 2009, and December 31, 2015, for children younger than 10 years of age. The median age of children’s hospital visits was 2.4 years (IQR, 1.4-3.4); 25 were girls (40%) . The median age of RPC marijuana exposures was 2 years (IQR, 1.3-4.0), and 85 patients were girls (52%). The mean rate of marijuana-related visits to the children’s hospital increased from 1.2 per 100 000 population 2 years prior to legalization to 2.3 per 100,000 population 2 years after legalization (P = .02). Known marijuana products involved in the exposure included 30 infused edibles (48%). Median length of stay was 11 hours (interquartile range [IQR], 6-19) and 26 hours (IQR, 19-38) for admitted patients. Annual RPC paediatric marijuana cases increased more than 5-fold from 2009 (9) to 2015 (47). Colorado had an average increase in RPC cases of 34% (P < .001) per year while the remainder of the United States had an increase of 19% (P < .001). For 10 exposure scenarios (9%), the product was not in a child-resistant container; for an additional 40 scenarios (34%), poor child supervision or product storage was reported. Edible products were responsible for 51 exposures (52%).

CONCLUSIONS AND RELEVANCE:

Colorado RPC cases for paediatric marijuana increased significantly and at a higher rate than the rest of the United States. The number of children’s hospital visits and RPC case rates for marijuana exposures increased between the 2 years prior to and the 2 years after legalization. Almost half of the patients seen in the children’s hospital in the 2 years after legalization had exposures from recreational marijuana, suggesting that legalization did affect the incidence of exposures.

Source:  JAMA Pediatr. 2016 Sep 6;170(9):e160971. doi: 10.1001/jamapediatrics.2016.0971. Epub 2016 Sep 6. Pub.Med

These are some of the voices (videos) from attendees at a conference in Colorado

who are speaking about legalization of marijuana in Colorado and what it is doing to their youth.  The negative impact has been appalling for many neighbourhoods – children are hospitalized from using edibles,  youth in schools are using in classrooms and their grades are dropping dramatically.   Big money has commercialized this substance to the detriment of the local population and in particular the children and youth.

http://smartcolorado.org/community-voices/ Sept 2016

 

By Christopher Ingraham

Source: Washington Post

USA — An appeals court ruled last week that a federal law prohibiting medical marijuana cardholders from purchasing guns does not violate their Second Amendment rights, because marijuana has been linked to “irrational or unpredictable behavior.”

The ruling came in the case of a Nevada woman who attempted to purchase a handgun in 2011, but was denied when the gun store owner recognized her as a medical marijuana cardholder, according to court documents. S. Rowan Wilson maintained that she didn’t actually use marijuana, but obtained a card to make a political statement in support of liberalizing marijuana law.

Federal law prohibits gun purchases by an “unlawful user and/or an addict of any controlled substance.” In 2011, the Bureau of Alcohol, Tobacco and Firearms clarified in a letter that the law applies to marijuana users “regardless of whether [their] State has passed legislation authorizing marijuana use for medicinal purposes.” Though a growing number of states are legalizing it for medical or recreational use, marijuana remains illegal for any purpose under federal law, which considers the drug to have a high potential for abuse and no accepted medical use.

The U.S. Circuit Court of Appeals for the 9th Circuit ruled that the federal law passes muster with the Constitution, as “it is beyond dispute that illegal drug users, including marijuana users, are likely as a consequence of that use to experience altered or impaired mental states that affect their judgment and that can lead to irrational or unpredictable behavior.”

The court then concluded that it is reasonable to assume that a medical marijuana cardholder is a marijuana user, and hence reasonable to deny their gun purchase on those grounds.

From a legal standpoint, the nexus between marijuana use and violence was established by the U.S. Court of Appeals for the 4th Circuit in Virginia, in the 2014 case of United States v. Carter. That case cited a number of studies suggesting “a significant link between drug use, including marijuana use, and violence,” according to the 9th Circuit’s summary.

In the words of the 4th Circuit, those studies found that: “Probationers who had perpetrated violence in the past were significantly more likely to have used a host of drugs — marijuana, hallucinogens, sedatives, and heroin — than probationers who had never been involved in a violent episode.”

“Almost 50% of all state and federal prisoners who had committed violent felonies were drug abusers or addicts in the year before their arrest, as compared to only 2% of the general population.”

“Individuals who used marijuana or marijuana and cocaine, in addition to alcohol, were significantly more likely to engage in violent crime than individuals who only used alcohol.”

Among adolescent males, “marijuana use in one year frequently predicted violence in the subsequent year.” The 4th Circuit argued that, on the link between drug use and violence, the question of correlation vs. causation doesn’t matter: “Government need not prove a causal link between drug use and violence” to block firearms purchases by drug users. A simple link between drug use and violence, regardless of which way the causality runs, is grounds enough. Still, the 9th Circuit did suggest causation was part of its decision, saying that irrational behavior can be “a consequence” of marijuana use.

This argument — that substance use increases risky behavior — applies to plenty of other drugs, too, and not just illegal ones. For instance, drug policy researchers Mark Kleiman, Jonathan Caulkins and Angela Hawken have pointed out that tobacco users also are more likely to engage in crime relative to the general population. “Compared with nonsmokers, cigarette smokers have a higher rate of criminality,” they wrote in their 2011 book Drugs and Drug Policy: What Everyone Needs to Know. “Smoking in and of itself does not lead to crime, but within the population of smokers we are more likely to find individuals engaged in illicit behavior.”

The authors also point out that there’s a much stronger link between violent behavior and alcohol than there is for many illegal drugs: “There is a good deal of evidence showing an association between alcohol intoxication and pharmacologically induced violent crime,” they write. They added: “There is little direct association between marijuana or opiate use and violent crime. … it is also possible that for some would-be offenders, the pharmacological effect of certain drugs (marijuana and heroin are often given as examples) may actually reduce violent tendencies.”

Christopher Ingraham writes about politics, drug policy and all things data. He previously worked at the Brookings Institution and the Pew Research Center.

Source: Washington Post (DC) September 7, 2016: 

NATIONAL FAMILIES IN ACTION RELEASES
WHITE PAPER ON LEGALIZED MARIJUANA

national-families-in-action

 

Paper Addresses Impact of Legalized Marijuana on Employers


Atlanta, Ga.– What effect will legalized marijuana have on employers? National Families in Action, a drug policy and education organization, is releasing a White Paper that examines problems employers are facing in states that have legalized marijuana for medical or retail use.

The paper addresses how marijuana laws are changing, how these laws will affect employers’ ability to conduct business, and what employers can do to protect that ability.It was written by Sue Rusche, president and CEO of National Families in Action and Kevin Sabet, PhD, president and cofounder of SAM (Smart Approaches to Marijuana). Guided by an advisory group of experts representing diverse fields, from employment law to occupational nursing to company executives to drug policy, the White Paper asks tough questions informed by events transpiring in legal marijuana states.

The paper addresses issues such as:
• Will employers be able to maintain a drug-free workplace?
• How will employers accommodate employees who use medical marijuana?
• How can employers with employees in multiple states comply with drug laws
that differ from state to state?
• Will employers be able to shift employees who use marijuana to other jobs?
• Will employers have an adequate supply of qualified workers?

Lawsuits have already begun in states with legalized marijuana as employees try to establish various rights that clash with employers’ commitments to maintain drug-free workplaces mandated by federal funding and federal contracts, to conduct business with conflicting laws from state to state, and to protect employees and the public from the consequences of increased marijuana use and related problems.

The White Paper examines some of these lawsuits and provides a scientific evaluation of the consequences of marijuana use to alert employers about what lies ahead if marijuana is fully legalized. It also suggests steps employers can take to protect safety, productivity, and the bottom line.

What Will Legal Marijuana Cost Employers can be found on National Families in Action’s website here.

Source: http://nationalfamilies.org/reports/What_Will_Legal_Marijuana_Cost_Employers

March 30, 2015

At Californian methadone clinics, group education sessions led by a nurse and focused on the risks of aggravating hepatitis infection led to the same substantial reductions in drinking as one-to-one or group motivational interviewing conducted by highly trained counsellors, offering a cost-effective means to reduce alcohol-related risks.

Summary Many methadone-maintained patients drink excessively, a particular concern among those infected with hepatitis C for whom drinking may accelerate disease progression. Motivational interviewing is the most popular counselling approach found to reduce drinking, but so far no studies have tested it among patients treated for opioid dependence in methadone maintenance programmes.

The featured study aimed to start to fill this gap in the research and at the same time (given the dominance of group counselling in US treatment services) compare one-to-one motivational interviewing with the less familiar group version, and with a nurse-led group education programme focused on the relation between drinking and disease related to hepatitis C infection.

Each of the three approaches occupied three fortnightly one-hour sessions over the first six weeks after patients started methadone treatment. Interventions were guided by set protocols and delivered by staff trained in these approaches and supervised to help ensure they delivered them as intended. Patients were paid $5 for each session they attended.

Group and individual motivational sessions were generally conducted by different counsellors. Sessions explored the impact of drinking on health and risky behaviours and while focusing on life goals, worked through ambivalence about cutting drinking. Sessions were open, meaning that patients who had not completed three sessions in their original group could join a later one. Instead of a motivational approach, the nurse-led (assisted by a hepatitis-trained research assistant) hepatitis health promotion programme adopted an educational format. Sessions focused on the progression of hepatitis infection and culturally-sensitive strategies to prevent liver damage. Content included the dangers of drinking while infected with hepatitis, strategies for avoiding drinking and drug use, diet, the dangers of reinfection with hepatitis C if patients inject, other infection routes, consistently looking after one’s health, and seeking social support and building self-esteem.

After these sessions patients suitable for this started a course of hepatitis A and B vaccinations, concluding at the same time as a six-month follow-up interview.

Participants in the study were 256 adult drinkers starting methadone treatment at five Californian clinics who scored as moderate or heavy drinkers on a baseline questionnaire. They were randomly allocated to the three approaches to reducing drinking. Typically they were black or Latino men. On entering treatment about half had drunk at least 90 US standard drinks in the past month. On average 87% of the patients completed all three of the study’s counselling/education sessions and 91% completed the six-month follow-up.

Main findings

The main outcome tested by the study was the proportion of patients who cut their drinking by half from the month before they started treatment to the month before the six-month follow-up. On this yardstick, and on the yardstick of total abstinence, there were not only no statistically significant differences between patients allocated to the three interventions, but also no substantial differences. In each group about half the patients halved their drinking, ranging from 54% after group motivational sessions to 49% after hepatitis education and 47% after one-to-one motivational sessions, and from 20–23% had not drunk at all in the past month.

Once other variables had been taken in to account, across the three sets of patients the strongest predictor of which patients would halve their drinking was how much they drank before treatment; the more they drank, the more likely they were to halve it. Women were more likely to halve their drinking than men as were better educated patients and those who took at least one dose of vaccine, while less likely were those whose partners were also drug users or who had recently used cannabis.

The authors’ conclusions

The major finding of this study was that all three interventions were followed by roughly equally substantial reductions in drinking at the six-month follow-up. Delivered by trained therapists, group and one-to-one motivational interviewing sessions neither differed in effectiveness from each other nor from a nurse-led group hepatitis education programme focused on reducing drinking.

For services the implications are that the cost-saving group format can be used without detriment to effectiveness and that costs may also be saved by implementing programmes led by nurses rather than therapists, with the potential added benefit that such programmes can be integrated within more comprehensive health promotion. Research nurses also administered the vaccines, receipt of which was associated with drinking reductions, perhaps partly because of the extra time and attention required to explain the vaccine.

It should be acknowledged that any differences between the interventions may have been obscured by differences between the staff implementing them, and that patients had volunteered for a research study rather than being counselled during routine practice.

Source:  Drug and Alcohol Dependence: 2010, 107(1), p. 23–30.Reported in Findings.org.uk

Filed under: Alcohol,Treatment,USA :

In Illinois in the USA, randomly allocating towns to enforce laws against youth smoking in public led not just to fewer youth smoking but also fewer drinking or using and being offered illegal drugs – did anti-tobacco policing spill-over to create an environment unfriendly to drinking and illegal drug use?

Summary The featured report drew its data from a study which randomly assigned 24 towns in the US state of in Illinois to either more vigorously enforce laws prohibiting under-age possession and use of tobacco, or to continue with existing low-level enforcement practices, a study which showed the intended effects on youth smoking. The issue addressed by the featured report was whether this spilled over to affect other forms of substance use and availability.

The towns selected for and which (via their officials) agreed to participate in the study were also all engaged in a state-sponsored programme intensifying enforcement of the ban on commercial tobacco sales to youngsters under the age of 18. The difference in the 12 towns allocated to enhanced enforcement was that this was supplemented by intensified enforcement of laws against young people having or using tobacco, in particular by levying civic fines against minors caught using or possessing tobacco in public. By design, at the start of the study all the towns only infrequently enforced these laws, a situation continued in the 12 control towns not allocated to enhanced enforcement.

Assignment had the intended effect; over the four years of the study, the average yearly number of anti-tobacco citations issued to minors was significantly higher (17 v. 6) in towns assigned to enhanced enforcement than in control towns.

Earlier reports on the study also showed the intended impact on youth smoking, which increased at a significantly slower rate for adolescents in towns where enforcement was extended. The researcher-administered, confidential surveys of school pupils which established this also asked about current (past 30 days) and ever use of substances other than tobacco. The key statistics for the study were the total number of different types of drugs the student had recently or ever used, averaged over pupils in the same town to assess the impacts on youth in the town as a whole. Pupils were also asked how many times over the past year someone had tried to give or sell them illegal drugs. These surveys were administered in four succeeding years to students from grade seven (age 12–13) up to grade ten in 2002, 11 in 2003, and 12 in 2004 and 2005, meaning that in each year some of the same pupils but also many new ones were sampled.

Across the four waves of data collection 52,550 pupils were eligible to be surveyed of whom 29,851 (57%) completed at least one survey. From these were selected only the 25,404 pupils (who completed 50,725 surveys) living in the 24 towns in the study.

Main findings

At the start of the study towns in the two sets of 12 did not differ in the number of substances currently or ever used by their pupils. As the different tobacco enforcement policies were implemented, over the succeeding three years the number of different drugs that a pupil currently or had ever used increased significantly less steeply in towns assigned to enhanced tobacco enforcement. There was a similar and also statistically significant result for offers of illicit drugs.

Use of substances other than tobacco was dominated by alcohol, so a further analysis focused on this substance alone. Again, increases in the average proportions of pupils who had recently or ever drank alcohol were significantly less steep in towns assigned to enhanced tobacco enforcement.

Though differences between the two sets of towns were statistically significant they were modest, and in both sets most substances had or were being used by few pupils.

The authors’ conclusions

In this study, towns allocated to heightened enforcement of laws prohibiting youth possession and use of tobacco experienced relatively lower increases in the probability that their young people had or were using a number of different substances or had been exposed to an offer of illicit drugs, providing preliminary evidence that police efforts to reduce specific substance use behaviours might have a positive spill-over effect on other high-risk activities. Given the co-occurrence of different forms of substance use, strategies that strengthen community norms against youth tobacco use might work synergistically to help reduce youth drug use and illicit drug offers.

How did an enforcement effort focused exclusively on tobacco affect use and availability of other substances? There are several possible explanations. Being punished for tobacco-related crimes might deter individual children from possessing and using other drugs, and the knowledge that police in enforcement towns approach youngsters to enforce anti-tobacco laws may deter young people and even adults from selling drugs in these communities. Possibly relevant too is the ‘broken window’ approach to enforcement, supported by studies which have shown that enforcement of laws against lower-level crimes can deter more serious offences. According to this theory, creating an environment where youth cigarette use is not tolerated might create an unfavourable environment for drug use. More directly, greater contact between young people and police enforcing underage tobacco laws might give police more chances to search for and confiscate illegal drugs.

Police believe that publicly smoking cigarettes acts as a signal to drug dealers that a young person might also be in the market for drugs. If so, making youth smoking less visible in a town may also make that town less attractive to dealers. Reduced visibility may also minimise the perception that illegal behaviour is normal and acceptable in that community. The effect could be to reduce sales attempts by make potential young customers less obvious and by making the entire town seem an undesirable dealing location. Alternatively, the findings might reflect reduced offers of alcohol or other drugs from friends rather than drug dealers, because reductions in use of tobacco spread to other substances, especially alcohol.

However, alcohol not illegal drugs might account for the bulk of the findings. Use of tobacco and alcohol tend to go together, so if police crack down on tobacco, they might also discourage drinking.

Source: Journal of Community Psychology: 2010, 38(1), p. 1–15.

Beverages Target Youth

Alcohol Justice reported this week that an updated version of the alcopop Buzzballz is once again targeting youth. Buzzballz, with its bright colors and candy-like flavors packs a punch. The beverage has a 60-proof, or 30 percent alcohol by volume. That’s an additional 10-15 percent more alcohol than the original product that debuted several years ago.

The product is sold in a 750ml container of pre-mixed cocktails and a shot glass attached to the bottle.

The original flavored, colored, spirits-in-a-ball was created by a former high school teacher, who got the idea for a beverage that would be non-breakable and safe while sitting by the pool. According to the creator, Buzzballz is all meant to be fun, and not meant to be a harmful beverage.

Health advocates say the product is anything but harmless, and, in fact, appeals to youth. Flavors include Lemon Squeeze, Chocolate Caramel Cake, Red Hot Cinnamon Shot, Jalapeño Lime and Licorice Bomb.

To learn more about the dangers of alcopops and other flavored alcoholic beverages, see Alcohol Justice’s recent report.

 

Source:  http://www.cadca.org/resources/re-branded-buzzballz  28th Jan.2016

Filed under: Alcohol,USA,Youth :

More than 200 people in Colorado who smoked synthetic marijuana during a 1-month period last summer developed altered mental status severe enough to require emergency care, according to a state public health investigation.

 

The investigation was prompted by several hospitals that contacted the Colorado Department of Public Health and Environment (CDPHE). Increasing numbers of patients had come to their emergency departments with aggression, agitation, confusion, and other symptoms after smoking the synthetic drug. The CDPHE asked all Colorado emergency departments to report through a Web-based system any patients treated with altered mental status who used synthetic marijuana between August 21 and September 18.

Source:   JAMA. 2014;311(5):457. doi:10.1001/jama.2014.47.

Imagine for a minute a world in which marijuana is available in a vending machine or corner grocery store near you — like any other snack machine — pot-infused lollipops, gummy candies, baked goods and beverages available at the push of a button.

As futuristic as this farfetched tale sounds, this is Colorado’s reality, a state with the dubious distinction of becoming the first to legalize marijuana, which has helped spawn legalization efforts across the U.S., including in New Jersey.   And while Colorado’s experiment has sparked heated debate over drug legalization, a critical and unbiased look at the data clearly shows that marijuana legalization has serious and far-reaching consequences that far outweigh any of its alleged benefits.

Strong emotions on both sides of this issue should not obscure the facts. Marijuana is an addictive substance that is harmful to users, especially to its younger users. As a teen’s brain development is disturbed by chronic marijuana use, the risk for physical and psychological dependency grows exponentially.

In addition to permanently affecting brain functioning, marijuana use can lead to a wide array of negative consequences, ranging from lower grades and isolation from family to an increased risk of psychotic symptoms, depression and suicide.

According to the Office of National Drug Control Policy, legalization will cause a substantial increase in economic and social costs.  The expansion of drug use will increase crime committed under the influence of drugs, as well as family violence, vehicular crashes, work-related injuries and a variety of health-related problems. These new costs will far outweigh any income from taxes on drugs.

Few would argue that a drug that can cause such destruction is something that we should counsel people to avoid. However, legalization efforts do just the opposite. In fact, experience has shown that when drugs are legalized, drug use increases because the perception of harm is reduced.

Moreover, the Drug Enforcement Agency has estimated that legalization could double or even triple the amount of marijuana users.

While it is hard to fathom the societal impact of an additional 17 million to 34 million marijuana users, it is safe to assume that those who profit from legalization have calculated the impact on their bottom line.

Those in favor of legalization often fail to tell you that levels of drug use have gone down substantially since the 1970s when the “war” on drugs began. This is not to say that our drug laws, including those governing marijuana, are not in need of reform.

For instance, the effort to place more drug users into treatment instead of prison is a positive development, both for those struggling with addiction and for taxpayers.

However, reforming and improving our drug laws does not mean we should abandon our fight against the use of illegal drugs like marijuana.

On the contrary, the more we learn about effective methods of combating drug use, the more we learn that legalization is not the answer, and is, in fact, very much part of the problem.

Source:  Source:  www.njassemblyrepublicans.com  Daily Record 13 Apr 2014

 

On July 28 and July 29, agents of the Humboldt County Sheriff’s Office assisted by the Campaign Against Marijuana Planting (CAMP) and the United States Forest Service (USFS) responded to USFS property on Brush Mountain, Gainor Peak and Oak Knob in eastern Humboldt County after sighting marijuana being cultivated on USFS land. The deputies were also accompanied by three scientists, two from Integral Ecology Research Center, and one associated with UC Davis and Hoopa Tribal Wildlife Ecologist.

During the two days deputies seized 3,760 marijuana plants ranging in size from 18 inches to four feet. Deputies and scientists located water diversion, mounds of trash and 24 pounds of rodenticides, of which nine pounds were peanut butter flavored and 15 pounds were second generation rodenticide. Malathion and fertilizers were also located at the scenes. No suspects were located in the area of the trespass marijuana grows, however deputies obtained evidence from the scenes that is being processed and the investigation is ongoing.

The spring fed water sources, which had been diverted and used to water marijuana plants, flow into the South Fork of the Trinity River. The springs were part of a network of subterranean water sources. The scientists reported that impacts from the water diversions and chemicals used on the grows could affect Coho salmon, Chinook salmon, steelhead, foothill yellow-legged frogs and the western pond turtles.

The scientists reported the rodenticides could potentially kill fishes, Northern spotted owls, American black bears, black tailed deer and Humboldt martens.

Below are some quotes from Dr. Mourad Gabriel of the UC Davis Wildlife Ecologist/Integral Ecology Research Center, who was present with the deputies and USFS agents.

“The removal of this massive amount of killing agents within prime spotted owl and fisher habitat is pertinent for the conservation of these species.”                                                        

“The illegal diversion of this amount of water prohibits the flow of cool water into tributaries that support our salmon populations.”

In light of the current drought and high water temperatures, this represents another blow to our already taxed watersheds.”

“The remediation efforts are crucial in protecting our forest ecosystems.”

Anyone with information for the Sheriff’s Office regarding this case or related criminal activity is encouraged to call the Sheriff’s Office at 707-445-7251 or the Sheriff’s Office crime tip line at 707-268-2539.

Redwood Times  Posted:   08/11/2014

http://www.redwoodtimes.com/news/ci_26315593/trespass-grows-found-usfs-land

 

 

 

The California National Guard on Monday joined more than a dozen other agencies to help the Yurok tribe combat rampant marijuana grows that have threatened the reservation’s water supply, harmed its salmon and interfered with cultural ceremonies.

Law-enforcement officers began serving search warrants at about 9 a.m. in the operation, which came at the request of Yurok officials and targeted properties in and near the reservation along the Klamath River.

The Humboldt County Sheriff’s Drug Enforcement Unit coordinated the raid and was joined by, among others, the Bureau of Indian Affairs, Bureau of Land Management, California Department of Justice’s North State Marijuana Investigation Team, and Yurok police.

State environmental scientists were standing by to enter the properties and survey for damage once the sites were secured.

Yurok Tribal Chairman Thomas O’Rourke joined officers as they staged at a hillside fire station Monday morning and thanked them for assisting in what was dubbed “Operation Yurok.”

“They’re stealing millions and millions of gallons of water and it’s impacting our ecosystem,” he told the officers. “We can no longer make it into our dance places, our women and children can’t leave the road to gather. We can’t hunt. We can’t live the life we’ve lived for thousands of years.”

California’s largest tribe has sought help combating marijuana grows in the past but until now never received such a vigorous response. Then the drought hit.

The strains on dual water systems that serve 200 households and rely entirely on surface water became apparent last summer, when residents began complaining of plummeting pressure.

When tribal staff surveyed the land from a U.S. Coast Guard helicopter, they were startled at the number of grows. By this summer they had tripled, officials estimated. And when the marijuana crop was planted in late spring, community water gauges once again swung low.

This time, creeks ran dry.

“Streams I’ve seen in prior years with more severe droughts where water ran, there’s no water now,” said O’Rourke.

To strengthen its enforcement abilities, the tribal council last fall approved a new controlled-substance ordinance that allow for civil forfeiture in circumstances where cultivation has harmed the environment.

(All growing on the reservation is illegal, as the Yurok tribe does not honor state medical-marijuana law.)

The breakthrough came in April when staffers from the governor’s office were discussing the drought with tribal officials. Gov. Jerry Brown, tribal officials were told, had pressed for California National Guard assistance with marijuana eradication and specifically urged the Office of the Adjutant General to assist in the Yurok operation, said Capt. Pat Bagley, operations officer in charge at the scene.

He was expecting to haul out two miles of irrigation hose at one grow alone.

For the Yurok, the damage is broad. Sediment and chemical runoff have suffocated juvenile fish, and warmer, shallower water has triggered an increase in the parasite Ceratomyxa shasta, which targets salmon.

Rodenticide has poisoned the Humboldt marten and weasel-like fisher, which the Yurok consider sacred. The danger of encroaching on a guarded grow site has made it unwise to gather medicine, acorns and materials for baskets, or to prepare sites for ceremonial dances.

Source:  www.seattletimes.com  21st July 2014

 

Given that the health of American youth is in question and that so many states base their policies on reports issued by the State of Colorado, it is important to understand what the 2015 Healthy Kids Colorado Survey (HKCS) actually tells us.

The survey’s results are gleaned from voluntarily self-reported information collected every other year from Colorado middle-school and high-school students. It is produced by a partnership of the Colorado Department of Education, Colorado Department of Human Services, the Colorado Department of Public Health and the Environment and the University of Colorado.



News organizations tracking the impact of marijuana on Colorado since voters sanctioned the drug for medical and recreational use are understandably quick to report the survey’s findings — but they’re unfortunately just as quick to deliver inaccurate and misleading information. Coverage of the 2015 survey results was especially poor. Dozens of news organizations — including The Denver PostFox News, the Washington PostTimeScientific American and Reuters — should correct and clarify their work.

Why? Because for many reasons, the 2015 survey’s data do not support claims that marijuana use among Colorado teenagers has remained flat or has declined. Examination of the survey’s aggregate data, segmented by grade and geographic region, tells a different story than the Marijuana Infographic and some passages of the executive summary distributed by state officials.

New reporting should inform the public about youth marijuana use rates in several Colorado regions — particularly where marijuana is most heavily commercialized.

Here are some important things to know about the 2015 survey:

Because of its methodology and sample size, this survey is a snapshot in time that represents no one other than the Colorado youth who took it. It is inaccurate to present or describe the 2015 survey as a “state survey” or to present its findings as average use rates among Colorado youth. The 2015 survey does not include data from El Paso County (home to the state’s second largest city, Colorado Springs), Jefferson and Douglas counties (home to two of the state’s largest school districts) and Weld County. It is also important to note that Colorado’s private and parochial schools do not participate in this survey and that only students attending school are surveyed. Students with drug problems are less likely to be in school — and, therefore, less likely to be surveyed.

Differences in methodology make it difficult to compare the 2015 survey to previous HKC surveys. The randomly selected sample size dropped from 40,206 in 2013 to 15,970 in 2015. Similarly, the high school response rate dropped from 58 percent in 2013 to 46.5 percent in 2015. Counties participating in the survey also changed from 2013 to 2015. Clearly, something in the survey methods changed from 2013 to 2015, making direct comparisons risky. But if state officials and journalists insist on making these direct comparisons, there are significant increases in youth marijuana use to report from 2013 to 2015 — as detailed below. They should report this information to the public.

Because of differences in methodology, Colorado survey results should not be directly compared to other national studies of adolescent marijuana-use rates, such as the Centers for Disease Control’s Youth Risk Behavior Survey (YRBS). These surveys are different. For example, the YRBS requires a response rate of at least 60 percent. If student responses fall below that mark, the YRBS states the results “represent only the students participating in the survey.” Of note, the HKCS did not reach this threshold for high school students in either 2013 or 2015. Therefore, direct comparisons of the two studies is risky. Such differences in methodology also make it risky to compare the Colorado data and other national studies, such as the Substance Abuse and Mental Health Service Administration’s National Survey on Drug Use and Health and the Monitoring the Future (MTF), a survey from the National Institute on Drug Abuse run by contract through the University of Michigan. Further, the 2015 state report’s comparisons to a “national average” of youth marijuana use are also problematic. Please review explanations here and here from David Murray, a former chief scientist of the White House Office of National Drug Control Policy, who now serves as a senior fellow analyzing drug policy at the Hudson Institute. Among his observations:

“What is the possible source for deriving that ‘national average’? There is one genuinely national sample of youth drug use, that from the National Survey on Drug Use and Health (NSDUH) that covers all states. But this cannot be the basis for the (State of Colorado’s) claim. In their latest 2014 estimates, NSDUH reported that 7.2 percent of adolescents aged 12 to 17 across the nation used marijuana in the past month – that figure, not 21.7 percent, would be the youth ‘national average.’ Moreover, the NSDUH specifically declared that Colorado had the nation’s highest rates. Adolescent marijuana use ranged from 4.98 percent in Alabama to 12.56 percent in Colorado. Worse, the NSDUH showed for youth that from 2009, when medical marijuana took off in Colorado, there has been a stunning rise of 27 percent through 2014 (from 9.91 percent to 12.56 percent). So Colorado youth use rates in the NSDUH are not only higher than the national average, but, after freer access to marijuana, have been steeply climbing.”

To examine drug-use trends from year to year and make comparisons between states, the NSDUH is more reliable (not perfect, but more reliable). The NSDUH interviews youth who are in and out of school. It is conducted in every state — and, unlike the current version of the Colorado Healthy Kids survey, it has data from before 2013. Unfortunately, as Murray notes above, this survey shows the prevalence of past-month marijuana use among Colorado youth has increased, with Colorado ranked first among 12-17 year olds in 2014.

One strength of the HKCS is that it offers some county-level data. It is helpful to have a fine-grain look at what is happening at a local level. So, if we must compare 2013 and 2015 survey results, it is best to limit comparisons to the responses of specific regions as defined by the survey. You can find a map of those regions here. Because there are many differences between high school freshmen and seniors, combining their class data — especially given that 18-year-olds in Colorado can purchase medical marijuana legally — can give false impressions about “teen use” rates. So, it is important to segment students by grade for a more accurate look at marijuana use rates.

Remember: Because of significant differences in methodology and sample size, the 2015 HKCS shouldn’t be compared to its 2013 predecessor or any national survey — but if state officials and journalists insist on doing so, let’s all consider this closer look at student respondents by grade and region. It suggests adolescent marijuana use rates has reached levels worth considering a serious health problem in some parts of the state.

For a full breakdown of the regional data, please see this chart (produced with the significant help of Christine Miller, a Ph.D. pharmacologist and Colorado native). Among the findings:


Region 16 (Boulder, Broomfield): High school seniors in this region reported the highest rate of past-month use among 12th graders in the state. In 2015, 42.2 percent of high school seniors reported past-month use, versus 28.5 in 2013. That’s a 48.1 percent increase. The use rate among high school juniors in this region jumped from 22.3 percent to 33.4 percent, a 49.8 percent increase.

Region 20 (Denver): Use among high school seniors increased from 30 percent in 2013 to 33 percent in 2015, a jump of 10 percent. Among juniors, the use rate increased from 29 percent to 37.7 percent, an increase of 30 percent.

Region 12: Western Corridor (Summit, Eagle-Vail): Use among high school seniors increased 90 percent from 20.1 percent in 2013 to 38.2 percent in 2015. As a curious side note, this region also reported a 2.3 percent decrease in past-month marijuana use among high school juniors and a 54.7 percent increase among its high school sophomores.

Region 11: Northwest (Steamboat Springs, Craig): Marijuana use among this region’s high school students rose in grades 9-12. Among seniors the rate increased 57.3 percent from 22.5 percent in 2013 to 35.4 percent in 2015. Among juniors, use rose 18.8 percent from 18.1 percent to 21.5 percent. Among sophomores, use rose 72 percent from 8.2 percent in 2013 to 14.1 percent in 2015. Among freshmen, use rose 22.2 percent from 8.1 to 9.9 percent.

Region 19: (Mesa County/Grand Junction): Use among freshmen jumped to 13.7 percent, an increase of 57.5 percent from 2013. Use among sophomores increased 50.6 percent from 26.2 percent from 17.4 percent in 2013. The use rate among high school seniors rose to 24.4 percent, an increase of 20.8 percent.

Region 7: Pueblo: Although there was little change in use rates, the rates remain stubbornly high. They are higher than the state average for all grades; ranges from double the state average for high school freshmen to 31 percent greater than the state average for high school seniors.

A common theme among these regions is a high level of marijuana commercialization in the forms of retail and medical stores. Other commonalities should be investigated to determine the most appropriate interventions.

Analysis of the 2015 survey also found some good news — particularly in regions 8 (San Luis Valley), 10 (West Central, including Gunnison, Hinsdale and Montrose ) and 17 (Central, including Gilpin and Teller).The reasons for these reported declines in past-month use should be explored. For example, are the declines because of an effective intervention, or are they related to a change in the survey methodology from 2013 to 2015? Based on the findings, protocols for prevention and intervention should be implemented to encourage similarly favorable results in other school districts throughout the state.

This entry for DrThurstone.com was co-written by Dr. Christian Thurstone and Christine Tatum. He is an associate professor of addiction psychiatry and the director of medical training of the addiction psychiatry fellowship program at the University of Colorado. She is a longtime journalist, former national president of the Society of Professional Journalists and Dr. Thurstone’s wife. Together, they also wrote Clearing the Haze: Helping Families Face Teen Addiction(Rowman & Littlefield, 2015).

 

Source:  http://drthurstone.com/healthy-kids-colorado-survey-2015/    5th July 2016

A study that followed children from birth to midlife found that heavy marijuana users who smoked for years often fared worse as adults than their parents: Many ended up in jobs that paid less, required fewer skills and were less prestigious.

That wasn’t so much the case for other people.

“The rest of the people in the study who were not regular and persistent cannabis users ended up in a higher social class than their parents,” said Magdalena Cerda, lead investigator and associate professor at the University of California, Davis.

The study, published Wednesday in the journal Clinical Psychological Science, also found that marijuana users who smoked at least four times a week experienced more financial difficulties, such as problems with debt and food insecurity, than their parents. Their lives were fraught with more social problems, too.

“They experienced more antisocial behaviour at work such as lying to get a job or stealing money and more relationship problems such as intimate partner violence or controlling behaviour towards their partner,” Cerda said.

Other studies have associated heavy and persistent marijuana use with problems in adulthood but haven’t always ruled out other factors. This research tried to do that by tracking and comparing variables such as intelligence, family structure, gender, ethnicity, parental substance abuse, criminal convictions and antisocial behaviour and depression in childhood.

In accounting for so many variables, researchers made the study’s conclusions stronger, Cerda said, acknowledging that there may be unknown factors that they didn’t track.

Dr. Colin Roberts, a paediatric neurologist at Oregon Health & Science University and a member of Oregon’s Cannabis Research Task Force created to study medical marijuana, said the findings are worth considering.

“It’s a good study,” Roberts said. “They established an association that’s pretty compelling.”

The study’s sample size, almost 950 people, also gives it heft, he said.

The study is based on four decades of data collected in New Zealand, where marijuana is illegal. Investigators have been following people born between 1972 and 1973 in Dunedin, the second largest city on the South Island. The participants in the study come from a range of socio-economic classes, from professionals to unskilled labourers, who had physical, psychological, social and financial assessments at birth and ages 3, 5, 9, 11, 13, 15, 18, 21, 26, 32 and 38.

“There was a large number of people that were looked at which is really important,” Roberts said. “We can’t do studies like this in the U.S. because it’s really hard to collect information on people over that period of time. We don’t have a central source for people’s medical records.”

The study analyzed the data from the childhood evaluations to determine pre-existing conditions that might cause financial or social problems later in life. Then it evaluated the marijuana use of people starting at age 18 through 38 and financial and social problems at age 38. It found that 15 percent were frequent users, which they defined as smoking marijuana four or more times a week.

The longer those people smoked, the worse their problems in midlife.

That’s consistent with what professionals like Dr. Kevin Hill see in their practices. He’s the author of “Marijuana: The Unbiased Truth about the World’s Most Popular Weed” and an addiction psychiatrist at McLean Hospital, an affiliate of Harvard Medical School in Massachusetts.

“This paper supports what we see clinically,” Hill said. “If you’re using at a level that’s consistent with cannabis addiction, you will have problems in multiple spheres – work, school and relationships.”

Not everyone who smoked marijuana four times or more a week for years experienced downward mobility and not everyone who abstained fared better than their parents. But a higher proportion of the former group – nearly 52 percent – had a worse outcome compared with 14 percent of the latter.

The study also looked at alcohol use. Those with an alcohol dependency experienced more social problems than their parents and landed lower-paying jobs. But the marijuana users who were dependent on the drug had even more financial worries than those addicted to alcohol.

“Those of us in the field know that cannabis is potentially dangerous but the same argument should be made with alcohol,” Hill said. “We have 22 million Americans who used cannabis last year and yet we rarely talk about cannabis being dangerous and we should.”

Yet he cautioned that people who are dependent on marijuana remain in the minority, just as those who abuse alcohol are.

Alcohol remains the bigger problem because it’s more widespread, Cerda said, but she added that the increasing acceptance of marijuana could increase the cost to society. Oregon is one of 23 states where marijuana is legal for medical use and four states that have approved recreational marijuana use.

The study points to a need for investment in prevention and treatment, she said.

“If we do that, it may have long-term consequences for the potential burden that this may place on communities, families and on the broader social welfare system,” Cerda said.

Source:  http://www.oregonlive.com/marijuana   23rd March 2016

 

Pot for the poor! That could be the new slogan of marijuana legalization advocates.

In 1996, California became the first state to legalize the use of medical marijuana. There are now 25 states that permit the use of marijuana, including four as well as the District of Columbia that permit it for purely recreational use.

Colorado and Washington were the first to pass those laws in 2012. At least five states have measures on the ballot this fall that would legalize recreational use. And that number is only likely to rise with an all-time high (no pun intended) of 58 percent of Americans (according to a Gallup poll last year) favoring legalization.

The effects of these new laws have been immediate. One study, which collected data from 2011-12 and 2012-13, showed a 22 percent increase in monthly use in Colorado. The percentage of people there who used daily or almost daily also went up. So have marijuana-related driving fatalities. And so have incidents of children being hospitalized for accidentally ingesting edible marijuana products.

But legalization and our growing cultural acceptance of marijuana have disproportionately affected one group in particular: the lower class.

A recent study by Steven Davenport of RAND and Jonathan Caulkins of Carnegie Mellon notes that “despite the popular stereotype of marijuana users as well-off and well-educated . . . they lag behind national averages” on both income and schooling.

For instance, people who have a household income of less than $20,000 a year comprise 19 percent of the population but make up 28 percent of marijuana users. And even though those who earn more than $75,000 make up 33 percent of the population, 25 percent of them are marijuana users. Having more education also seems to make it less likely that you are a user. College graduates make up 27 percent of the population but only 19 percent of marijuana users.

The middle and upper classes have been the ones out there pushing for decriminalization and legalization measures, and they have also tried to demolish the cultural taboo against smoking pot. But they themselves have chosen not to partake very much. Which is not surprising. Middle-class men and women who have jobs and families know that this is not a habit they want to take up with any regularity because it will interfere with their ability to do their jobs and take care of their families.

But the poor, who already have a hard time holding down jobs and taking care of their families, are more frequently using a drug that makes it harder for them to focus, to remember things and to behave responsibly.

Legalization and our growing cultural acceptance of marijuana have disproportionately affected one group in particular: the lower class.

The new study, which looked at use rates between 1992 and 2013, also found that the intensity of use had increased in this time. The proportion of users who smoke daily or near daily has increased from 1 in 9 to 1 in 3. As Davenport tells me, “This dispels the idea that the typical user is someone on weekends who has a casual habit.”

Sally Satel, a psychiatrist and lecturer at Yale, says that “it is ironic that the people lobbying for liberalized marijuana access do not appear to be the group that is consuming the bulk of it.” Instead, it’s “daily and near-daily users, who are less educated, less affluent and less in control of their use.”

In fact, the typical user is much more likely to be someone at the bottom of the socioeconomic ladder, whose daily life is driven, at least in part, by the question of how and where to get more marijuana. Just consider the cost. Almost a third of users are spending a tenth of their income on marijuana. And 15 percent of users spend nearly a quarter of their income to purchase the drug. The poor have not only become the heaviest users, but their use is making them poorer.

To all the middle-class professionals out there reading this: Do you know anyone who spends a quarter of their income on pot? Of course not. But these are the people our policies and attitudes are affecting.

As the authors of the study note, marijuana use today actually more closely resembles tobacco use than alcohol use. Cigarette smoking has completely fallen off among the educated and well-off, while the poor and working class have continued their habits. Even as far back as 2008, a Gallup poll found that the rate of smoking among people making less than $24,000 a year was more than double that of those making $90,000 or more.

But at least the rates have been going down for everyone. Thanks to a cultural shift on the acceptability of smoking, awareness campaigns about its dangers and a variety of legal measures regarding smoking in public facilities, smoking is significantly less popular. You could object to some of these public policies on the grounds that the government should mind its own business. But the truth is that Americans across all incomes are now less likely to suffer from the harmful effects of smoking.

Maybe the upper classes in this country have some romantic notion of what marijuana can do to the mind (though we once thought cigarettes were terribly classy too). But it is time to get over such silliness and consider the real effects of our attitudes.

As Manhattan Institute fellow and psychiatrist Theodore Dalrymple says, this is like the 1960s all over again. He tells me, “I’m afraid I can’t hear all that stuff about ‘tune in, drop out’ without being infuriated because the people affected really deleteriously [are] people at the bottom.”

Source: http://nypost.com/2016/08/20/legalized-pot-is-making-americas-lower-class-poorer-and-less-responsible/

Problems resulting from abuse of opioid drugs continue to grow

JUL 22 (WASHINGTON) – Hundreds of thousands of counterfeit prescription pills, many containing deadly amounts of fentanyl and fentanyl-related compounds, have made their way into the U.S. drug market, according to a DEA intelligence report released today.  Law enforcement nationwide report higher fentanyl availability, seizures, and known overdose deaths than at any other time since the drug’s creation in 1959.

Fentanyl is a synthetically produced opioid that, when produced and administered legitimately, is used to treat severe pain. Overseas labs in China are mass-producing fentanyl and fentanyl-related compounds and marketing them to drug trafficking groups in Mexico, Canada and the United States.

In addition to being deadly to users, fentanyl poses a grave threat to law enforcement officials and first responders, as a lethal dose of fentanyl can be accidentally inhaled or absorbed through the skin. DEA recently released a Police Roll Call video nationwide to warn law enforcement about this danger. The video can be accessed at www.DEA.gov.  Other findings from the report:

* Fentanyl and fentanyl-related compounds are traditionally mixed into or sold as heroin, or on its own, oftentimes without the customer’s knowledge. Since 2014, U.S. law enforcement agencies have been seizing a new form of fentanyl—counterfeit prescription opioid pills containing fentanyl or fentanyl-related compounds. The counterfeit pills often closely resemble the authentic medications they were designed to mimic, and the presence of fentanyl is only detected upon laboratory analysis.

* Fentanyl traffickers have been successful at expanding the fentanyl market and introducing new fentanyl-laced drug products to the U.S. drug market. The DEA National Forensic Laboratory Information System (NFLIS) reported that there were 13,002 fentanyl exhibits tested by forensic laboratories across the country in 2015 (the latest year for which data is available), which is a 65 percent increase from the 7,864 fentanyl exhibits in 2014. There were approximately eight times as many fentanyl exhibits in 2015 as there were during the 2006 fentanyl crisis, clearly demonstrating the unprecedented threat and expansion of the fentanyl market.

* The rise of counterfeit pills that contain fentanyl in the illicit drug market will likely result in more opioid-dependent individuals, overdoses, and deaths. There were over 700 fentanyl-related deaths reported in the United States between late 2013 and 2014. During 2013-2014, the Centers for Disease Control (CDC) reported that deaths from synthetic opioids increased 79 percent, from 3,097 to 5,544. Although the synthetic opioid category does contain other opioids, this sharp increase coincides with a sharp increase in fentanyl availability, and the CDC reports that a substantial portion of the increase appears to be related to illicit fentanyl.

* In March 2016, law enforcement officers in Lorain County, Ohio, seized 500 pills that visually appeared to be oxycodone. The pills were blue and had “A 215” markings, consistent with 30 milligram oxycodone pills. Laboratory analysis indicated that the pills did not contain oxycodone, but were instead the research chemical U-47700.  U-47700 is an unscheduled synthetic opioid

not studied for human use that has caused at least 17 overdoses and several deaths in the United States.

* Many Chinese laboratories illicitly manufacturing synthetic drugs, such as fentanyl and their precursors, also manufacture legitimate chemicals for purchase by U.S. companies. This means that laboratories responsible for supplying fentanyl in counterfeit pills can also run legitimate businesses. Although Chinese clandestine laboratories may be contributing to the fentanyl supply, legitimate laboratories may also be sources of supply.

* Traffickers can typically purchase a kilogram of fentanyl powder for a few thousand dollars from a Chinese supplier, transform it into hundreds of thousands of pills, and sell the counterfeit pills for millions of dollars in profit. If a particular batch has 1.5 milligrams of fentanyl per pill, approximately 666,666 counterfeit pills can be manufactured from 1 kilogram of pure fentanyl. The entire intelligence brief, “Counterfeit Prescription Pills Containing Fentanyls: A Global Threat” can be accessed at www.DEA.gov.

Source:  https://www.dea.gov/divisions/hq/2016

Colorado’s marijuana industry, brought into being by a state ballot initiative, stopped citizens from floating a public-health initiative by paying companies hundreds of thousands of dollars NOT to collect signatures for it. The initiative, Amendment 139, would have limited THC potencies and required health warnings on labels and child protective packaging.

Background

Some 26 states and the District of Columbia allow citizens to write laws and take them to voters. Americans who live in the other 24 states are generally not aware of how the ballot initiative process works.

In his book, Democracy Derailed: Initiative Campaigns and the Power of Money, journalist David Broder, now deceased, revealed how political campaigns and moneyed special interest groups are threatening our democracy.

“Government by initiative is not only a radical departure from the Constitution’s system of checks and balances,” he wrote, “it is also a big business, in which lawyers and campaign consultants, signature-gathering firms, and other players sell their services to affluent interest groups or millionaire do-gooders with private policy and political agendas.” Many don’t live in the states whose laws they are writing.

Signature-gathering firms? To place an initiative on the ballot, most initiative states require proponents to collect signatures from a given percent of people who voted in the last election. The standard is five percent, but it can vary from state to state.

There are actually businesses whose single purpose is to pay people, usually from $2 to $5 per signature, to go out and collect them. In fact, all of the ballot initiatives that have legalized marijuana for medical or recreational use, have succeeded because proponents were able to pay millions of dollars to collect enough signatures to get their measures on the ballot and then pay millions more to promote them to voters in TV commercials.

With the exception of Florida last year, opponents of these measures have been unable to come close to matching proponents’ riches, raising only thousands vs millions of dollars. Where’s the check and balance in that?

Amendment 139

Last week, we reported that a court decision gave a group of Colorado citizens, Healthy Colorado, clearance to begin collecting signatures for Amendment 139.

Colorado’s marijuana industry claimed that 139’s THC cap would shut down the industry. It took the issue to the state Supreme Court to challenge the initiatives and reduce the amount of time proponents had to collect signatures. But the Court ruled in Healthy Colorado’s favor two months later.

With polls showing widespread support for the amendment, the marijuana industry struck back by paying signature-gathering firms NOT to gather signatures for Amendment 139.

“The 139 opponents went out and bought up some of the most important circulators in the state, and without them we didn’t have the ability to get it to the ballot,” said a 139 spokesman. “They went out and paid these circulating firms to not circulate petitions for 139.”

Last Friday, July 8, Healthy Colorado withdrew Amendment 139.

Said Ali Pruitt, a Denver mother and a designated representative of Amendment 139, “As concerned moms, dads, teachers and friends, we simply couldn’t keep up with the financial costs brought on by the underhanded tactics and baseless delays used by the marijuana industry to keep us off of the ballot. The marijuana industry built a wall of money between us and the November ballot that we simply couldn’t break through.”

Added Healthy Colorado member Jo McGuire, “Unlimited THC has allowed the marijuana industry to create marijuana by-products that pose a public health and safety risk. THC potencies as high as 80 to 90 percent have not only caused an upsurge in Colorado ER visits and hospitalizations, but also have caused psychotic episodes that have led to death. The industry has refused to hear voters’ concerns by disabling the very process by which it introduced legalization in Colorado in 2012.”

Charlotte’s Web Maker Targets Broader Market with CBD from Domestic Hemp

Here’s another Colorado marijuana company that refuses to play by the rules.

Marijuana is illegal under the federal Controlled Substances Act. But an entirely different federal law makes it illegal to market a medicine to the public before it has been approved as safe and effective by the Food and Drug Administration.

A lack of FDA approval hasn’t stopped Colorado’s Stanley Brothers from marketing Charlotte’s Web CBD Oil to parents of children with epilepsy throughout the United States. CBD is cannabidiol, one of more than 100 cannabinoids found in marijuana along with some 400 more chemicals, few of which have been studied.

Made famous by Dr. Sanjay Gupta’s CNN specials Weed, Weed II, and Weed III, in which Dr. Gupta declared marijuana is medicine, the brothers claim the oil is a “low THC, high CBD” marijuana product.

But on their Facebook pages and in their non-profit Realm of Caring private patient portal, there is much discussion about how much THC parents should add to Charlotte’s Web to quell their children’s seizures. This is deeply troubling because THC damages the developing brain.

Now the brothers are re-branding their company name and its products. CW Botanicals, their old company, is now CW Hemp, their new one. Same company, different name.

Because an amendment to the federal farm bill a few years ago enabled state universities and agricultural departments to legally grow hemp for research, the brothers believe it is legal to skip research, skip FDA approval, skip the US Controlled Substances Act, and ship Charlotte’s Web Oil to all 50 states. Sales have grown to $1 million a month in the past few months.

Not content with Charlotte’s Web as a medicine for epilepsy, CW Hemp is now marketing Charlotte’s Web Hemp Extract to veterans who suffer PTSD and as a general wellness product. This expands its market from half a million children suffering intractable seizures to hundreds of millions of Americans who care about being healthy.

The company also is raising funds for a survey of current and retired NFL players to build a case for CW Hemp as a cure for Chronic Traumatic Encephalopathy (CTE), the progressive degenerative disease of the brain found in people with a history of repetitive brain trauma.

While little to no scientific evidence supports any of the Stanleys’ claims, GW Pharmaceuticals has spent years developing and testing a new drug, Epidiolex. This drug is currently going through FDA Phase III clinical trials to treat intractable seizures.

What’s the difference between Charlotte’s Web and Epidiolex? Plenty.

Charlotte’s Web contains about 20 percent CBD and “low” levels of THC. Epidiolex contains 98 percent CBD and only trace amounts of THC. GW worked hard to eliminate all but trace amounts of THC from Epidiolex because of THC’s effect on the brain.

Further, Epidiolex has been:

* Extracted from marijuana grown in greenhouses without pesticides

* Purified

* Tested in animals to make sure it’s safe to give to humans

* Tested in randomized controlled clinical trials involving patients who have been given informed consent, meaning they have been told all known harms of the drug before consenting to participate in the trials

* Is expected to be approved by FDA in 2017.

If so, doctors will be able to prescribe, rather than recommend, Epidiolex. Pharmacists will be able to dispense it, rather than budtenders. Insurance companies will likely cover its cost. Charlotte’s Web?

* None of the above.

Also underway is a top secret, million-dollar research and development project to help CW Hemp compete with legitimate companies like GW Pharmaceuticals.

It would be nice if CW Hemp would devote its research and development towards obtaining FDA approval for the good of its patients rather than using it to find ways to compete with companies that play by the rules and comply with federal law.

Maybe then, Colorado epilepsy specialists would no longer “have to be at the bedside of children having severe dystonic reactions and other movement disorders, developmental regression, intractable vomiting, and worsening seizures that can be so severe they have to put the child into a coma to get the seizures to stop,” as the American Epilepsy Society reports. It explains that no one knows whether these severe side-effects result from contaminants or unregulated, artisanal CBD products, like Charlotte’s Web.

Only research and testing on the road to FDA approval can tell us that – as well as whether artisanal CBD products have any positive effect at all.

Source:  The Marijuana Report 13th July 2016 The Marijuana Report is a weekly e-newsletter published by National Families in Action in partnership with SAM (Smart Approaches to Marijuana).

Subscribe to The Marijuana Report and visit our website, The Marijuana Report.Org, to learn more about the marijuana story unfolding across the nation. About National Families in Action (NFIA) NFIA consists of families, scientists, business leaders, physicians, addiction specialists, policymakers, and others committed to protecting children from addictive drugs. Our vision is: * Healthy, drug-free kids * Nurturing, addiction-free families * Scientifically accurate information and education * A nation free of Big Marijuana * Smart, safe, FDA-approved medicines developed from the cannabis plant (and other plants)  * Expanded access to medicines in FDA clinical trials for children with epilepsy About SAM (Smart Approaches to Marijuana)  SAM is a nonpartisan alliance of lawmakers, scientists and other concerned citizens who want to move beyond simplistic discussions of “incarceration versus legalization” when discussing marijuana use and instead focus on practical changes in marijuana policy that neither demonizes users nor legalizes the drug. SAM supports a treatment, health-first marijuana policy.  SAM has four main goals:  * To inform public policy with the science of today’s marijuana. * To reduce the unintended consequences of current marijuana policies, such as lifelong stigma due to arrest.

* To prevent the establishment of “Big Marijuana” – and a 21st-Century tobacco industry that would market marijuana to children. * To promote research of marijuana’s medical properties and produce, non-smoked, non-psychoactive pharmacy-attainable medications.

COBURG, Ore.  Serenity Lane says they’re seeing a growing number of people battling “Marijuana Use Disorder.” Many people have become habitual users to start their day by using the drug In Oregon, marijuana is legal for recreational and medical use, but one local drug rehab facility is concerned about pot addiction. Serenity Lane is an alcohol and drug treatment facility in Coburg.  Staff members said they’re seeing an increase in people with what they call “Marijuana Use Disorder.”

Manager Jerry Gjesvold at Serenity Lane said they see addiction trends years in advance. “Just like the opioid epidemic”, Gjesvold , “said we are seeing the beginning stages of a growing marijuana addiction”.

“Well, we know now that in the DSM-5, which is the manual that’s used to diagnose substance use disorders, there’s a specific marijuana use disorder diagnosis,” said Gjesvold.   Gjesvold said they see more patients as young as 18 years old even though the legal age for recreational marijuana use is 21.

“[Marijuana use] has become a much more acceptable, and because of that there’s more people that are using it,” Gjesvold said.   He said youth tend to be at higher risk for addiction. It’s because they use devices like vaping and assortments of marijuana like hash oil.

Products with higher THC concentration are more dangerous, but are easier to hide from parents.  “The universal response on the part of parents is that, ‘I had no clue,'” Gjesvold said.

The interim medical director, Paul Steier, at Serenity Lane says highly concentrated levels of THC can have a negative impact on the developing brains of young people. “They have trouble sequencing, doing numbers, word recollection,” Steier said.

Steier said in some cases it creates schizophrenic types of behavior. He said side effects from marijuana use disorder persist for a minimum of five months.  “But there clearly is a withdrawal experience from cannabis, especially in the habitual users, who are the people who sort of wake and bake,” said Steier.

Steier said the withdrawal experience is the same as other addictions causing changes in heart rate, blood pressure, and body temperature.

Source:  http://kval.com/news/local/rehab-facility-says-more-people-are-battling-marijuana-use-disorder    11th July 2016

NEW YORK — More than two dozen people were sickened in an apparent mass drug overdose on a New York City street corner, sparking warnings from police and health officials about the dangers of using K2, also known as synthetic marijuana.

Calls started coming in Tuesday morning that numerous people appeared to be overdosing in the Bedford-Stuyvesant neighbourhood of Brooklyn. Witnesses reported seeing victims lying on the sidewalk, shaking and leaning against trees and fire hydrants.

Thirty-three people were taken to area hospitals with non-life-threatening injuries, police said. It was not immediately clear what drugs the victims had ingested, but police said some of the victims had been smoking K2.

Dennis Gonzalez of Bushwick told WNBC-TV that K2 use in that part of Brooklyn is out of control.

“It’s gotten out of hand,” Gonzalez said. “They even sleep in the street, we have to walk around them. It’s just too much to keep under control.”

The Health Department issued a statement Tuesday saying it “recorded a spike in K2-related emergency room visits” connected to the incident in Brooklyn. The department said it’s investigating and monitoring emergency rooms across the city.

“We remind New Yorkers that K2 is extremely dangerous,” the Health Department said in its statement. “The city’s public awareness efforts and aggressive enforcement actions over the past year have contributed to a significant decline in ER visits related to K2.”

Though K2 affects the same area of the brain as marijuana, it contains chemicals made in laboratories and sprayed onto dry leaves. These chemicals are not derived from the marijuana plant, according to the Health Department.

K2 can cause extreme anxiety, confusion, paranoia, hallucinations, rapid heart rate, vomiting, fainting, kidney failure and reduced blood supply to the heart.

The production and sale of the drug was outlawed in New York City in October 2015.

Source: http://www.ctvnews.ca/health/33-sick-after-apparent-mass-drug-overdose-in-new-york-city-1.2984643    13th July 2016

Filed under: Health,Synthetics,USA :

SPICE IN THE CITY: NEW YORK DEA LEADS HUGE ATTACK

AGAINST SYNTHETIC DRUG TRAFFICKERS

Money flow from synthetic drug sales to Yemen, Syria, Lebanon and Jordan continues

 Contact: DEA Public Affairs   (202) 307-7977

MANHATTAN, N.Y.- DEA, NYPD and a host of other state, local and federal agencies today announced a massive takedown that targeted the local sale of dangerous designer synthetic drugs manufactured in China.  The scheme, which operated in all five boroughs of New York City, allegedly involved the unlawful importation of at least 100 kilograms of illegal synthetic compounds, an amount sufficient to produce approximately 1,300 kilograms of dried product, or approximately 260,000 retail packets.  As part the operation, five processing facilities were searched, as well as warehouses used to process, store, and distribute the drugs. In addition, over 80 stores and bodegas around New York City were searched.

Communities, families, and individuals across the United States have experienced the scourge of designer synthetic drugs, which are often marketed as herbal incense, bath salts, jewellery cleaner, or plant food. These dangerous drugs have caused significant abuse, addiction, overdoses, and emergency room visits. Those who have abused synthetic drugs have suffered vomiting, anxiety, agitation, irritability, seizures, hallucinations, tachycardia, elevated blood pressure, and loss of consciousness. They have caused significant organ damage as well as overdose deaths. Over the past several years, DEA has identified over 400 designers drugs from eight different structural classes, the vast majority of which are manufactured in China. Smoke able synthetic cannabinoids (SSC) represent the most common class of designer drugs. In addition, DEA cases involving synthetic drugs often reveal the movement of drug proceeds from the United States to Middle East countries such as Yemen, Syria, Lebanon and Jordan. ……..

DEA Special Agent in Charge James J. Hunt said:  “There is a misconception that synthetic cannabinoids, known on the street as ‘synthetic marijuana,’” ‘K2,’ and ‘spice,’ are safe.  Synthetic cannabinoids are anything but safe.  They are a toxic cocktail of lethal chemicals created in China and then disguised as plant material here in New York City. Today’s arrests represent law enforcement’s efforts to combat this emerging public threat.  By investigating and arresting manufacturers and distributors of ‘spice’ in the city, we have cut off the accessibility for those feeding the beast.”

Manhattan U.S. Attorney Preet Bharara said:  “Today, we launch an aggressive assault on a public health crisis that is reaching epidemic proportions: the scourge of dangerous new drugs that are killing people and sending thousands upon thousands to emergency rooms in New York City and around the country.  Despite sometimes being called synthetic marijuana, this is not marijuana – it can have unpredictably severe and even lethal effects.  What is more, use of these drugs aggravates all manner of other societal ills: it is entering prisons; preying on the homeless; burdening our hospitals and emergency rooms; fuelling addiction; exacerbating mental health problems; and increasing risks to cops who must deal with people high on this poison.  Synthetic cannabinoids are a deadly serious problem that demands an equally serious response.  Today’s collective action is just the start of that response, one that will not end until this poison in a packet no longer endangers our community.”

NYPD Commissioner William Bratton said:  “This is a scourge on our society, affecting the most disadvantaged neighbourhoods and our most challenged citizens. It affects teenagers in public housing, homeless in the city shelter system, and it’s quite literally flooding our streets. This is marketed as synthetic marijuana, some call it K2. It is sold by the names of Galaxy, Diamond, Rush, and Matrix. But its real name is poison.”

HSI Acting Special Agent in Charge Glenn Sorge said:  “Synthetic marijuana is rapidly becoming a huge problem in our communities.  It is cheap and dangerous, especially for our teens and young adults.  We are working side by side with our law enforcement partners both here and abroad to combat the sale of this hazardous alternative to marijuana.”

Sheriff Joseph Fucito said:  “The Sheriff’s Office stands ready with our partners in law enforcement in addressing the sudden proliferation of synthetic drugs sales in licensed retail locations throughout New York City. Owners and operators of licensed locations have an obligation to keep illegal and highly dangerous substances out of the hands of our children. The Sheriff’s Office is committed to agency partnerships and enforcement strategies that advance this goal.”

…….The SSC retail packets were sold under names such as “AK-47,” “Blue Caution,” “Green Giant,” “Geeked Up,” “Psycho,” “Red Eye,” and “Black Extreme,” each containing between approximately three and six grams of product, and sometimes marked “not for human consumption,” or “potpourri.”  The illegal SSC retail packets were sold to individual customers for approximately $5 per packet.

.SSC are widely accessible because they are inexpensive and commonly sold at otherwise legitimate retail locations.  The colorful logos used on the SSC retail packets and the flavors used, such as lime, strawberry, and blueberry, make SSC attractive to teenagers and young adults.  Physical effects of SSC include agitation, rapid heart rate, confusion, dizziness, nausea and vomiting, paranoia, panic attacks, and acute kidney injury.  In addition, SSC products have inconsistent potencies, often containing more than one synthetic compound, and are sometimes laced with other toxic chemicals.  In a recent two-month period, use of SSC resulted in 2,300 emergency room visits in New York State.  Nationally, calls to poison centers in the United States related to synthetic cannabinoid use between January and May 2015 increased 229% over the same period in 2014.

 Source:  Press Release   US Drug Enforcement Administration.  16th Sept. 2016

 

 

 

The public is lately inundated with stories about “non-violent” drug offenders who have been sent to prison. One case-in-point is the story of Larry Duke, allegedly a fine upstanding citizen and “non-violent drug offender” who received two life sentences for a 1989 conviction involving 14,000 pounds of marijuana.

Please read the original story at the link below and then read the additional facts not contained in the first article. As you will see, the pro-pot people are happy to lie to the American public to gain sympathy for “non-violent” drug offenders who are anything but.

http://blogs.ajc.com/news-to-me/2013/11/14/non-violent-life-sentences/

Here’s the rest of the story.

Duke originally wanted 18,000 pounds but settled on 16,000 (8 tons) at a wholesale price of over $7 million.

During the undercover operation, Duke was described as the “largest marijuana dealer on the eastern seaboard.” In recorded conversations, Duke admitted that he had marijuana warehouses across the country and boasted that he recently moved 70,000 pounds (35 tons) in four days. Duke stressed that the money and the dope should never be in the same place.

After being convicted at trial, the court determined that Duke was a habitual offender since this was Duke’s third felony drug conviction. One of those convictions involved 18 tons of pot (36,000 pounds) which was smuggled into Canada in 1983.

The bottom line is this:

Multiple tons of pot do not get manufactured, harvested,  imported, transported, packaged and sold unless there are a lot of guns around to protect the dope and the money.

The pro-pot lobbyists lie about the statistics because it furthers their claim that a lot of non-violent drug users are going to prison. Besides being untrue, they couldn’t have picked a worse person to highlight than Mr. Duke.

Source: email to DrugWatch International from  Monte Stiles   2014

Hospital maternity units and new-born care nurseries would have to report the number of infants born addicted to drugs under a bill headed to Ohio’s governor. The state Senate unanimously passed the measure Wednesday, and Gov. John Kasich was expected to sign it.

The measure is one of several aimed at reducing the state’s prescription painkiller addiction epidemic. Supporters say tracking the number of drug-addicted babies will help the state monitor Ohio’s progress in fighting drug addiction.

The facilities would be required to report the information to the state Health Department every three months. Patients would not be identified, and the information could not be used for law enforcement purposes. Should a maternity unit, maternity home or new-born care nursery fail to comply with the requirement, the state could impose a fine or revoke or suspend its license.

Overdose drug deaths have been the leading cause of accidental death in Ohio since 2007, surpassing car crashes. Many of those deaths are from painkillers and heroin.

Opiates and narcotics taken by the mother during pregnancy can pass through the placenta through the baby, causing the infant to be born dependent on harmful drugs. The babies experience neonatal abstinence syndrome and face an array of health complications, said state Sen. Shannon Jones, a Springboro Republican.

“These new-borns are thrown into painful withdrawal symptoms, such as rapid breathing, vomiting and seizures immediately following their birth,” she said.  Jones told her colleagues on the Senate floor that she had witnessed children withdrawing. “It is the most horrifying thing that I have personally experienced,” she said.

Caring for the drug-addicted new-borns and mothers, who are often on Medicaid, can be costly to the system.  Jones said officials hope to use the information to help measure opiate and illegal drug abuse across the state and better target resources to help women and babies struggling from addiction.

Source:    www.sfgate.com Wednesday, April 2, 2014

When The Baltimore Sun ran an editorial about the Maryland mall shooter, who killed two people and then himself, the newspaper said that mental health problems need to be identified sooner. But it failed to breathe a word about killer Darion Aguilar’s admitted marijuana use. Dr. Christine Miller, a semi-retired molecular neuroscientist living in Maryland, was not too surprised by the omission. She says the liberal media tend to ignore the relationship between marijuana and mental illness.

 

“I know that the editors are aware of the marijuana-psychosis connection because I have corresponded in the past with one of their journalists who was unable to get them interested in a story on the topic,” she told Accuracy in Media. “They did publish one letter I wrote to their local Towson Times affiliate.”

Miller has researched the cause of schizophrenia for many years, and is working to stave off marijuana legalization in Maryland. “Though none of my work involved the study of marijuana use, I became aware of the growing body of literature showing its association with the onset of schizophrenia, and I now regard those numerous reports as the most well-replicated finding in schizophrenia research,” she says.

In a case in Colorado, where marijuana has been legalized, the national news media recently aired a video of a man stealing an SUV with a 4-year-old boy inside, but did not emphasize his history of drug abuse, including marijuana. The Denver Post reported that a pickup truck he had stolen earlier was found with drug paraphernalia, including empty syringes, five pipes containing residues believed to be of methamphetamine and marijuana, as well as 2.1 grams of pot.

 

In another sensational case, in Tennessee, a woman who said she smoked marijuana all day and all night drove her car into a church and stabbed her husband. Church Hill Police Department Chief Mark Johnson told The Kingsport Times News that the woman stated that God had told her to stab her husband for “worshipping” NASCAR. The woman said, “I smoke a bunch of weed. I love to smoke it. Sometimes when I do, I start seeing things that others don’t. Isn’t God good? He told me that this would happen, and just look, I am okay.”

 

In the Washington, D.C. area, The Baltimore Sun isn’t the only paper reluctant to examine the marijuana link to mental illnesses, including schizophrenia and psychosis. After Dr. Miller testified to the Maryland House Judiciary Committee about the marijuana-psychosis connection, she was contacted by Frederick Krunkel of The Washington Post, asking for a phone interview. She said, “I replied, along with my phone number and a time to call, but they never called.”

“It turns out that 15 percent of marijuana users experience psychosis, half of whom will go on to become schizophrenic if they don’t stop using,” she told AIM. “Fortunately, many do stop if they aren’t addicted already, because paranoia is no fun.” She says some people are under the misimpression that if someone is psychotic due to marijuana, it comes from what the marijuana is laced with. “In fact,” she says, “the converse is true—a large study out of Finland last year shows that in acute substance-induced psychosis cases, the cannabis users convert to schizophrenia spectrum disorder at the highest rate.”

Incredibly, however, the Maryland House of Delegates passed Del. Cheryl Glenn and Del. Dan Morhaim’s medical marijuana bill in a 127-9 vote. The dope lobby, known as the Marijuana Policy Project, is saying, “Maryland may finally become the 21st state with an effective medical marijuana law!”   In attempting to explain the media’s failure to cover both sides of this debate, Miller said, “I think we are losing our journalistic standards.” She believes that papers like the Post no longer have the “depth of talent” from reporters who understand how to cover scientific evidence in controversies like this.

 

Another factor, she said, is that there’s a “giddy rush” by the media to jump on the “progressive bandwagon,” which views the marijuana movement as fashionable. In this regard, she singled out CNN’s Dr. Sanjay Gupta, who has been promoting “medical marijuana” without taking into account the serious mental health problems associated with its use. She said liberal reporters are also influenced by the perception that too many members of minority groups are being punished for drug use.

 

Despite the rush to legalize marijuana for various purposes, Miller said the media will eventually be forced to cover the link between marijuana use and mental illness because of the growing number and severity of violent incidents involving schizophrenic individuals using the drug. Those whose schizophrenia manifests in the context of drug use are much more likely to be violent. She also says that in the wake of its legalization in Colorado, data is coming out of that state about impaired driving associated with the increasing use of marijuana.

Source:   http://www.aim.org/aim-column/media-continue-cover-up-of-marijuana-induced-mental-illness/   27th March 2014

When an award-winning movie star recently lost his battle with substance abuse and addiction, the headlines and tributes were ubiquitous, and mostly without moral judgment. He was a sick man and his tragedy became our tragedy, because we knew him through his work.

Do we have the same relationship with mostly unknown people throughout our communities, who cannot be free of the scourge of their addiction even during pregnancy? Are we as understanding and supportive of their struggles, of the consequences to the foetuses they carry and the children they bear?

We should be. For their struggles with drugs, and with children born addicted to or affected by the drugs their mothers could not stop taking even during pregnancy, are our struggles, too. If they are to get well and even have a chance at healthy, productive lives, they need medical attention and education and more. They require treatment and other help in a state that continues to be plagued by too many long-term problems and too few long-term solutions.

Courier-Journal Reporter Laura Ungar has visited the life- and resource-shredding issues of substance abuse, addiction and pregnancy several times in recent years. Her latest instalment was a special report in Sunday’s C-J, which outlined the surge of hospitalizations of drug-addicted babies in Kentucky. That surge is attributed in large part to the availability and use of heroin that has filled the vacuum left by the recent crackdown on prescription pain-killers.

Ungar reported that those hospitalizations have increased 30-fold from 2000 to 2012, and that Kentucky is on track for more than 900 for last year — up from 824 in 2012.  Kentucky fares badly in national statistics, with one health official saying that this state has one of the nation’s worst problems with drug-dependent babies.

“The latest national statistics come from a 2012 study in the Journal of the American Medical Association, which said hospitalizations for drug-dependent babies rose 330 percent from 2000 to 2009. Kentucky’s hospitalizations rose more than 1,400 percent during that same time,” Ms. Ungar wrote.

State officials are well aware of the epidemic. The restrictions placed on prescription pain pills were an attempt to curb access to addictive drugs, but heroin has filled the gap left by them. And a recent $32 million settlement the state won with two drug companies has been a windfall for cash- and resource-strapped drug-treatment programs throughout Kentucky, including $1 million dedicated to treatment centres for pregnant addicts.

But $1 million is still not nearly enough — not for the women who struggle with addiction while pregnant, not for the people who try to care for them, not for the drug-dependent babies who are born with a variety of symptoms ranging from low weight, vomiting, inconsolability, hyperactivity, poor feeding and seizures; not for the taxpayers who cover millions in costs associated with the spike in hospitalizations.

Which is why Kentuckians ought to ramp up the same interest in the women and babies struggling with heroin and addiction in our communities as they managed to muster for a tragic movie star whose life ended with a needle hanging from his arm.

That means demanding more up-front education about drugs and their dangers to girls and boys before they start dabbling or using. That means educating their parents, or other caring adults, on the signs and symptoms of drug use in children.  That means demanding more funding for current facilities, and more drug-treatment centers for pregnant women who want help, but often can’t get it; Kentucky’s 55 such centers, most of them outpatient, are not nearly enough, either.

“Ultimately,” Kentucky Attorney General Jack Conway said, “it’s an issue that affects all of society.” So it is. And so it does.

Source: www.harlandaily.com  March 2014

Seven years ago, Barbara Theodosiou, then a successful entrepreneur building a women’s business mentoring group, stopped going to meetings, leaving the house and taking care of herself. She grew increasingly distraught.

“You almost wake up and get this haunting feeling, this horrible feeling that my God, I just wish I wasn’t going to live today,” said Theodosiou, a mother of four from Davie, Florida. “Not that you would take your life but you’re so scared.” Petrified, really, but not for herself. For her children.  Theodosiou learned two of her four kids were addicted to drugs.

“I found out within six months that both my sons were addicts and like every other mother, I just wanted to go into bed and never get out.”  Her older son, Peter, now 25, took prescription drugs and then escalated to heroin. Her younger son, Daniel, now 22, started what’s called robotripping, where he would take large quantities of cough medicine to get high.

Barbara Theodosiou first noticed her son Daniel might have a problem with drugs when he was 16.  She says she first noticed signs of problems when her younger son was 16.  “I was taking Daniel to school one day and he was just like almost choking. I thought he was having a panic attack,” she said. A short time later, the school called and said staff members thought Daniel was on drugs.  “I was like, ‘There’s no way.’ … I have talked to my children my whole life about drugs.” 

Within just months, after a call from her son Peter’s roommate, her husband went to his house and found needles all over the place.  “If you know about addiction then when you find this out, you realize not only are you in for the fight of your life, but this is not something that gets fixed in six months. This could go on,” she said.

Barbara Theodosiou’s son Peter was addicted to heroin. He has been in recovery for 3½ years. “It’s like having someone punch you in the stomach. … You’re never the same from the second you find out.”

How does the mother of an addict cope? How does she juggle the incomprehensible challenge between supporting a loved one and not enabling their habit? And how does she deal with the stigma of having a child who is an addict?

In my in-depth interviews with Theodosiou and other mothers of addicts across the country, they made it very clear that being the mother of an addict is an incredibly lonely and isolating place, and that often the only people who understand what they’re going through are other mothers who are going through it themselves.

The fear of getting the call  

Theodosiou’s son Daniel overdosed three times that first year she realized he was using and nearly died each time.  One day, she returned to her house and saw police officers out front. “I remember pulling up and my heart was beating … I was just going to faint right there.”The police officer asked if she was Daniel’s mother. “For sure, I thought he was going to tell me Daniel was dead, and it ended up Daniel overdosed again, and again he was in the hospital.”

Melva Sherwood’s son Andrew died from a heroin overdose in October 2012. He was 27. 

Melva Sherwood of Vermilion, Ohio, got that unimaginable call on October 3, 2012. Her son Andrew, 27 at the time, died of an overdose of heroin. It was his son’s fifth birthday. “It was 11:30 at night. I was sound asleep and it was October. All the windows were open, and the entire neighborhood knew what had happened,” said Sherwood, who says she screamed “at the reality of it, that it was over, that it was done.”  “I have a friend who lives down the street, and she said it was horrifying to hear.”

The blame game 

Many mothers immediately beat up on themselves when they learn their children are battling addiction.  Brenda Stewart with her sons Richard and Jeremy, who both battled addiction and are now doing well.

Brenda Stewart of Worthington, Ohio, says it was heartbreaking realizing two of her three kids were addicts. Her son Jeremy, now 29, used prescription drugs and then heroin, and the drug of choice for Richard, now 31, was crystal meth, she said.

“I’ve been going to counseling for years to figure out what I did wrong. It’s just like, ‘What did I do?'” said Stewart, who has adopted Jeremy’s two children, ages 5 and 7. “And then you come to find out through tons of counseling and parents’ groups and everything else that this is something you didn’t do to your children. And that’s the hardest thing to get away from because you always feel responsible.”

 

Debbie Gross Longo’s son started taking prescription drugs at 15.  Debbie Gross Longo, whose son started using drugs at 13 and taking prescription drugs at 15, says the powerlessness of being an addict’s mom is worse than people might imagine. “As a mother, it’s been hell,” said the mom of four in Stony Brook, New York. “It’s like having a child that you cannot help and sitting on the edge of your seat all at the time because you know something might happen.” 

Viewing addiction as a disease was instrumental, many mothers say, in helping understand they didn’t cause their child’s addiction and couldn’t fix it either.  “When you really start to understand that it is a disease … you can start looking at your child in a different way, loving them for who they are and hating the disease,” said Stewart.

Sadly, the stigma of having a child with addiction is all too real and incredibly painful. Announce to your community your child has a disease like cancer and people will jump to help, said mothers I interviewed. Not so when you tell them your child is an addict.”There are no little girls selling cookies for addiction. Nobody has bumper stickers on their car,” said Theodosiou.  Her son Daniel was in the church group. “When they found out he was an addict, the entire church shunned him. He was completely not invited anywhere.”

‘The hardest thing in the entire world’ 

Every mom I spoke with talked about the intense struggle between supporting their addicted child or children and not enabling their destructive habit.   It is “the hardest thing in the entire world,” said Theodosiou, who said it was only after seven years and 30-plus stints in rehab that she knew she had to make a drastic change.  “All of these people were telling me you have to stop enabling Daniel. You need to let Daniel go. You need to just stop. … I had to actually face leaving Daniel on the street,” she said.  “I finally spoke to a pastor and an addiction specialist who told me that … the last person in the world who could ever help Daniel is me.”

 

Melva Sherwood’s son Aaron works full-time in marketing and sales and may pursue a career in nutrition.  Sherwood, who lost one son to a drug overdose and has another son who battled drug addiction, said she was never able to cut off her children completely, but she set limits.

“As far as enabling, I think you need to lay it on the table for them. This is what you can do. Here are your options but I’m not going to sit here and let you take advantage of me and lie to me,” said Sherwood, who is a registered nurse and the owner of a business providing caregivers for in-home assisted living.

Stewart, whose two sons were addicts, said she eventually realized the longer she enabled her children, the longer they weren’t going to face the consequences.  “It took the line in the sand, telling them I love them and if they were ever ready to get the help and really wanted it that I’m here for them … but I’m not going to set up another appointment,” she said.   But the enabling isn’t just about the addicts, said Stewart. Parents need to realize they are enabling themselves and are risking losing everything by thinking they can save their children.

“There are moms losing their lives to save their children. … They’re spending their whole paycheck trying to take care of their child. They’re not taking care of themselves. That’s just a ripple effect.”

Finding support from other moms 

Theodosiou went through the range of emotions that most mothers of addicts experience: the guilt followed by the intense sadness and then the anger.

“It’s just a very, very sad and a very lonely place,” she said.

Then, one day about a year and a half into her new kind of normal with two sons who were addicted, she had a conversation with God.  “I said, you know, God, if my sons are going to be living this life and be destroyed by this, I’m going to tell every mother and help every mother I can think of. I’m not going to keep it a secret.”

She headed to Facebook and started a group called The Addict’s Mom in 2008.

Her friend thought she was insane.  “She was like, ‘Are you crazy? You are going to go on Facebook and say that you are an addict’s mom?’ And I said, ‘You know what, I am and I know there have to be a million mothers just like me who are addicts’ moms.'”

CNN”s Kelly Wallace did lengthy interviews with mothers across the country whose children battled addiction.

Six years later, The Addict’s Mom, with its Facebook group, its fan page and its online community, has more than 20,000 members, with chapters in every state. Stewart is the state coordinator in Ohio for The Addict’s Mom.

“It’s given me a place that I feel at home, a place that I feel I can give back,” she said. “I also understand the parent’s pain and for me if I can help one parent ease that pain, then I’ve done something.”  Sherwood, who’s an administrator for the Facebook group, said the online community was an “unbelievable eye opener.”

“It was just like somebody turned on the light in the closet,” she said. “It gave me such comfort to … be able to put something out there online at any time during the day and have 20 people respond back with, ‘Hey, we know. We’ve been where you’re at. We feel for you. We’re praying for you.’ ”  “It definitely was a life-changing experience.”

‘If you can’t afford it, jail is your treatment’ 

Besides providing invaluable comfort and support, The Addict’s Mom is a resource center with information on low and no-cost rehabs, psychologists and sober living environments. This month, the group is launching weekly online video meetings where mothers can call in from all over the country and talk with experts on addiction.

The group has also launched offshoots, including The Addict’s Mom Healthy Moms, where the focus is solely on helping the mom live a healthy life (“We don’t even talk about the addict there,” said Theodosiou) and The Addict’s Mom Grieving Moms for mothers who lost children to addiction. It’s also started The Addict’s Dad for fathers and a group called The Addict for the addicts to talk directly with each other.

A big focus now, the moms I interviewed said, is raising awareness about the problem of drug addiction and finding affordable solutions.

“There is treatment if you’re rich and if you can afford it,” said Theodosiou. “If you can’t afford it, jail is your treatment.”  The Addict’s Mom is starting programs in states including New York, Kentucky and Ohio, where moms go into schools and educate students about addiction. The member moms are also flexing their lobbying muscles, advocating for laws such as legislation that allows a judge to order a person into treatment if a family member feels that person is a danger to himself or others.

“Our children are dying and at such an alarming rate,” said Theodosiou, noting how the day before our conversation there were two posts on The Addict’s Mom with reports that two children died.  “We are seeing an alarming rate of death in our society. We have to break the stigma. It’s a disease,'” said Theodosiou. “They are not bad people. We have to get the word out.”

Looking forward  

Raising awareness and helping other mothers drives members of The Addict’s Mom, but they are also always mindful of the lifelong battle their children are facing.  Sherwood’s surviving son is doing well, she said, working full-time in marketing and sales, and planning to take a nutritional coaching course for a possible career in nutrition.

“Today, I have my son back as he learns and implements the plan he has put into place with nutrition, exercise and being with those that truly love him and support his journey toward a better life,” said Sherwood. “What more could a parent ask for!”

Stewart’s son Jeremy has been in recovery for over two years. He’s engaged, is getting ready to buy a house and is very active with his two children. “Our hope is that in the very near future they are back with their father,” said Stewart, who currently cares for her son’s kids. Her older son, Richard, is also doing well, and has been in treatment since the end of June.

Gross Longo’s son, now 25, had been in recovery for six months and just recently relapsed. He entered a detox program and is starting again on the road to recovery, his mother said. “I am once again heartbroken,” she said. “(My son) is doing what he needs to do to get well, but do you understand how this is a day-to-day, year-to-year fight?”  Before her son’s relapse, Gross Longo told me she was so pleased about his recovery but also very cautious.

“They could change on a dime,” she said. “They could be doing wonderful for five years … and then one evening it’s gone.”  Theodosiou’s older son, Peter, has been in recovery for 3½ years and is a recent college graduate. He will soon begin a master’s program in speech pathology.  Her younger son, Daniel, had been in rehab for five weeks — his longest time ever in treatment — but recently relapsed, breaking the condition of his release from jail so he is back behind bars.   “I am really sad about Daniel,” said Theodosiou.

Despite her son’s setback, she continues to advocate for other moms of addicts, but also gets some much needed help for herself.   A few days before our conversation, a member of The Addict’s Mom called her and expressed concern.

“She said, ‘Barbara, we’re worried about you.’ And I said, ‘Why?’ And she said, ‘Because you have to take care of yourself. You help so many other people.  I still struggle with being OK and with my own issues and they help by reminding me, by being there, by being able to talk to them, by sharing resources and supporting me.”

Source:   http://edition.cnn.com/2014/08/26/living/addiction-parents/  26th August 2014

How goes Colorado’s experience with legal marijuana? Spend some time on social media or on numerous blogs and you’ll read headlines like “Revenue Up, Crime Down!” or “Youth Use Declining After Legalization.” In this short blog series, I will tackle different topics that have been the subject of myth and misinformation. 

First up: crime.

Lately legalization advocates have been cheering numbers that show a decline in crime. There are literally hundreds of articles that have been written with this narrative. But an honest look at the statistics shows an increase — not decrease — in Denver crime rates.

Crime is tracked through two reporting mechanisms: the National Incident Based Reporting System (NIBRS), which examines about 35 types of crime, and the FBI Uniform Crime Reports (UCR). The FBI UCR only captures about 50 percent of all crimes in Denver, so the NIBRS is generally regarded as more credible. The Denver Police Department (DPD) uses NIBRS categories to examine an array of crime statistics, since it is the more detailed and comprehensive source of numbers.

The Denver Police statistics show that summing across all crime types — about 35 in all — the crime rate is up almost 7 percent compared with the same period last year. Interestingly, crimes such as public drunkenness are up 237 percent, and drug violations are up 20 percent.

So why are advocates claiming a crime drop? Easy: They blended part of the FBI data with part of the DPD/NIBRS data to cook up numbers they wished to see. When one picks the Part I data from UCR and uses DPD/NIBRS property-crime numbers only while studiously avoiding the DPD/NIBRS data on all other crimes, one can indeed manufacture the appearance of a decline. As one can see here, even when using the FBI UCR numbers — in their entirety — crime has risen.

A report commissioned by the National Association of Drug Court Professionals puts it nicely:

When a closer look at the data is undertaken, a different picture — something other than “crime is down” — appears to emerge. …

Legalization proponents should not infer causality regarding the downward trend observable when isolating just the UCR’s Part I crime index.

When I asked the president of the Colorado Drug Investigators Association, Ernie Martinez, about these statistics, he urged me to look at the crimes that have been happening in connection to marijuana — even after legalization:

Across the Front Range, we are experiencing more and more butane explosions due to hash extraction methods, calls for service on strong smells, and calls to ER’s on adverse effects after either ingestion or smoked use. Black-market continues to exist unabated, availability of black market marijuana is ever present and cheaper than legalized MJ. Medical marijuana registrants continue to rise due to many factors such as more quantity allowed and more plants allowed, all due to Physician recommendations.

So if crime is up, can we blame legal pot? We do not know whether legalization has anything to do with it. But we do know that reputable news organizations should stop relying on the Big Marijuana lobby for statistics. They wouldn’t blindly trust coal-industry statistics on the environmental effects of strip mining, and they should bring similar skepticism to propaganda claims disseminated by this new industry.

Source:  www.twitter.com/kevinsabet   8th November 2014

 

I continue to be puzzled by an attitude that if something is difficult to enforce then we should abandon attempts and just legalize it. That is apparently the attitude of Oregon’s politicians (Republican and Democrat alike) and is reflected in the comments of the official spokesman for the government elites – The Oregonian – in its August 23 edition:

“Oregon has had a wink-wink, nudge-nudge relationship with recreational marijuana use since 1998, when legalization for medical purposes created a wide, open system that distributes pot cards to just about anyone with a vague medical claim and the signature of a compliant physician. We’re not suggesting that marijuana has no palliative value to those with genuine medical problems. But let’s be honest: Recreational marijuana is all but legal in Oregon now and has been for years. Measure 91, which deserves Oregonians’ support, would eliminate the charade and give adults freer access to an intoxicant that should not have been prohibited in the first place.”

There it is. The marijuana advocates foisted a canard on Oregonians by exploiting the plight of those benefiting from the use of medical marijuana. Having convinced Oregonians that those is need should not be denied, they set up a system that guaranteed abuses and then urged others to look the other way when the abuses became obvious and widespread. Wink, wink, nod, nod. There’s a solid foundation for change. (For those of you forced to endure a teachers union led education in Portland public schools, that is what is meant by “sarcasm”.)

And now the second canard is upon us with the assertion that “everyone is already doing it” and that recreational marijuana is not harmful. When the push began, those supporting it chanted “nobody has ever died from marijuana.” And that folks, is just plain bulls—t.

A New York Times article on May 31, 2014, noted:

“Five months after Colorado became the first state to allow recreational marijuana sales, the battle over legalization is still raging.

“Law enforcement officers in Colorado and neighboring states, emergency room doctors and legalization opponents increasingly are highlighting a series of recent problems as cautionary lessons for other states flirting with loosening marijuana laws.

“There is the Denver man who, hours after buying a package of marijuana-infused Karma Kandy from one of Colorado’s new recreational marijuana shops, began raving about the end of the world and then pulled a handgun from the family safe and killed his wife, the authorities say. Some hospital officials say they are treating growing numbers of children and adults sickened by potent doses of edible marijuana. Sheriffs in neighboring states complain about stoned drivers streaming out of Colorado and through their towns.”

On May 24, 2014, Newsweek reported:

“Wednesday’s move in Colorado to tighten rules on edible goods made with pot comes after two adult deaths possibly linked to such products. Meanwhile, a Colorado children’s hospital said it has seen an uptick in the number of admissions of children who ingested marijuana-laced foods since the start of the year.

“’Since the … legalization of recreational marijuana sales, Children’s Colorado has treated nine children, six of whom became critically ill from edible marijuana,’ the statement from Colorado Children’s Hospital said.”

And The Raw Story reported on April 2, 2014:

“A Wyoming college student visiting Colorado on spring break is the first reported death related to the legal sale of recreational marijuana.

“Levy Thamba, a student at Northwest College, fell to his death last month from the balcony of a Holiday Inn in Denver.

“Autopsy results released Monday showed the 19-year-old Thamba, who was also known as Levi Thamba Pongi, died from multiple injuries caused by the fall. But the coroner also listed ‘marijuana intoxication’ from a pot-infused cookie as a significant contributor to the student’s death.”

And finally, CBS reported from Seattle on February 4, 2014:

“According to a recent study, fatal car crashes involving pot use have tripled in the U.S.

‘Currently, one of nine drivers involved in fatal crashes would test positive for marijuana,’ Dr. Guohua Li, director of the Center for Injury Epidemiology and Prevention at Columbia, and co-author of the study told HealthDay News.”

But the Oregonian is undeterred by the mounting evidence of harm:

“Opponents of the measure are right about a couple of things. Allowing retail sales of recreational marijuana inevitably will make it easier for kids to get their hands on the stuff, as will Measure 91′s provision allowing Oregonians to grow their own. It’s also true that outright legalization will increase the number of people driving under the influence, which is particularly problematic given the absence of a simple and reliable test for intoxication. There is no bong Breathalyzer.

“As real as these consequences are, Oregonians should support outright legalization. . .”

We have imposed safety requirements on a whole host of things including guns, automobiles, golf carts, children’s toys and food products that have a lower incident rate of death and injury than is being currently compiled by the unrestricted use of marijuana. Oregon is now tying itself in knots trying to eliminate the use of genetically modified organisms (GMO) with no scientific evidence of harm and only a speculation as to what might become. But there is no apparent concern about the modification of marijuana to increase its potency which has resulted in numerous adverse health issues with children and adults alike.

And while the Oregonian acknowledges that there is no “simple and reliable test for marijuana intoxication” it fails to note that there is similarly no simple and reliable test for testing potency. There are no labeling requirements and no guidelines as to the limits of consumption and impairment. Contrast that with the liquor industry that has defined limits and labeling on the alcohol content of various beers, wine and liquors. There are exacting studies that demonstrate the effects of alcohol on a person given weight variations.

And yet the Oregonian ignores that in favor of addressing it sometime in the future – maybe.

And Oregon’s politicians are even less helpful because they are fixated on tax revenue opportunities from the unrestricted use of marijuana. Little thought is

being given to the problems that will be caused. Their sole focus is upon using regression analysis to determine how high the tax can be without seriously reducing the volume of consumption – it is the same myopic view used when determining the tax on tobacco. That amount of tax will increase over time as the use becomes more widespread and the dependency becomes more pronounced and as state government becomes more dependent on the revenue generated, the ability to correct the abuses of marijuana will be marginalized – just like tobacco.

In the end, this is all about the “me generation” and that pervasive attitude that “if it feels good, do it.” It furthers the myth of life without consequences. The only upside is for those who eschew getting high in favor of getting hired – your prospects for getting a good job and routine promotion are greatly enhanced.

Source: www.oregoncatalyst.com 27th August 2014

Daily marijuana use among college students is the highest it’s been in more than three decades, and 51 percent of all full-time college students have admitted to smoking pot at some point in their lives.

The group of University of Michigan scientists who conduct the nationwide Monitoring the Future study says illicit drug use has been rising gradually among American college students since 2006, when 34 percent indicated that they used some illicit drug in the prior year.  By 2013, that rate was up to 39 percent, meaning that 429 of the 1,100 students surveyed said they had used one or more drugs in the 12 months preceding the survey.

The study pointed out that daily or near-daily use of marijuana – defined as 20 or more occasions of use in the prior 30 days – has been on the rise. The recent low was 3.5 percent in 2007, but the rate had risen to 5.1 percent by 2013.  “This is the highest rate of daily use observed among college students since 1981 – a third of a century ago,” Lloyd Johnston, the principal investigator of the MTF study, said in a statement.

“In other words, one in every 20 college students was smoking pot on a daily or near-daily basis in 2013, including one in every 11 males and one in every 34 females. To put this into a longer-term perspective, from 1990 to 1994, fewer than one in 50 college students used marijuana that frequently.”

The survey is part of the long-term MTF study, which also tracks substance use among the nation’s secondary students and older adults under research grants from the National Institute on Drug Abuse.

Marijuana has remained the most widely used illicit drug over the 34 years that MTF has tracked substance use by college students, but the level of use has varied considerably over time.  In 2006, 30 percent of the nation’s college students said they used marijuana in the prior 12 months, whereas in 2013 nearly 36 percent indicated doing so.

Nonmedical use of the amphetamine Adderall, used by some students to stay awake and concentrate when preparing for tests or trying to finish homework, ranks second among the illicit drugs being used in college.  According to the study, 11 percent of college students in 2013 indicated some Adderall use without medical supervision in the prior 12 months.

The use of psycho-stimulants, including Adderall and Ritalin, has nearly doubled since the low point in 2008, but their illegal use remained steady between 2012 and 2013.

The next most frequently used illegal drugs by college students are ecstasy, hallucinogens and narcotic drugs other than heroin. About 5 percent of college students reported they had used one of these in the prior 12 months.

Ecstasy use, after declining considerably between 2002 and 2007, from 9.2 percent annual prevalence to 2.2 percent, has made somewhat of a comeback on campus, the study showed.

Nearly 6 percent of students – 5.8 percent – said they had used ecstasy in the prior 12 months in 2012, and was at 5.3 percent in 2013. Hallucinogen use among college students has remained at about 5 percent since 2007, following an earlier period of decline.

The use of narcotic drugs other than heroin, like Vicodin and OxyContin, peaked in 2006, with 8.8 percent of college students indicating any past-year use without medical supervision. Past-year use of these dangerous drugs by college students has since declined to 5.4 percent in 2012, where it remained in 2013.

Use of synthetic marijuana – which used to be legally available and was sold over the counter in convenience stores and other shops – ranked fairly high in 2011 with past-year use at more than 7 percent of college students that year. Just over 2 percent admitted use in 2013.

Fewer than 1 percent of college students in 2013 admitted to using inhalants, crack cocaine, heroin, methamphetamine, “bath salts,” GHB and ketamine in the previous 12 months.

Conversely, alcohol use has declined some on campuses in recent years. In 2008, 69 percent of students said they had at least one drink in the prior 30 days, whereas in 2013 that number had dropped to 63 percent.

Similarly, the percent indicating that they got drunk during that period fell from a recent high of 48 percent in 2006 to 40 percent by 2011, where it then remained through 2013.

Overall, about three quarters – 76 percent – of college students indicated drinking at least once in the past 12 months, and 58 percent sad they had gotten drunk at least once in that period.

Source:  http://www.mlive.com/    8th Sept. 2014

Others see a regulated, licensed dispensary model, perhaps with medical supervision. But misuse of opiate pharmaceuticals already represents the second-largest illicit drug threat in America. Would there be political corruption in the quest for those dispensary licenses? Perhaps, as with marijuana in Colorado, the state itself will run the show. What are the political implications of a state-regulated market for drugs? I have witnessed one such scheme, in Amsterdam, with the state-controlled distribution of heroin. The physician in charge presided over a clean, well-lit facility, clinical and efficient, where every morning that day’s clients entered her facility for their supervised heroin injections. The Dutch called their scheme “daycare.” 

Come evening, the clients were discharged back into the streets. What if these drug users decided to continue their career of crime and seek illicit heroin to supplement their state-supported allotment? “Oh, that doesn’t happen,” the doctor assured me with a chilling smile. “If so, we simply withhold their heroin.” This state has a nanny, indeed, and I fear that her clients are no longer free. They are wards of the state, and they are kept on a tight leash. 

Controlled addiction happens elsewhere in the world, too. There is evidence that, in some places, suicide bombers, youth warriors, child sex slaves and even manual laborers are given drugs to keep them captive. Criminal drug dealers have long used such leverage to “own” their clientele. 

For the addicted, the price exacted to maintain their dose may be bottomless, and can entail betrayals of self and others. The “clients” of Amsterdam are no longer active citizens, nor are they even willing actors, for they have contracted a disease that threatens their self-governance and gives whoever controls their drug of choice undue power over them. Do we want to hand the government that leash? 

To be sure, some libertarians would stop at legalizing marijuana. But it’s hard to see how that will last. Marijuana is addictive (responsible for three-fifths of illicit drug abuse according to a 2012 National Survey on Drug Use and Health), and is a gateway to other drugs. Already, in parts of Europe and even Canada, cocaine, meth and opiates are legally used, with heroin distribution state-sponsored. This is not a conjectural debate.

And the political risks are already evident. All these marijuana users that are reliable supporters of pro-legalization candidates in their state campaigns—that donate their money and pledge their votes—how would we feel if they were all heroin users, compelled by their disease to support a particular political candidate? The fact that the United States is currently experiencing a surge in heroin makes this a question worth asking. Even President Obama, whose administration has facilitated marijuana legalization, himself asked the logical follow-up question: “[What if] we’ve got a finely calibrated dose of meth, it isn’t going to kill you or rot your teeth, are we OK with that?”  

Are we? 

How does a libertarian abide the threat that today’s congressman might become tomorrow’s party functionary in charge of dispensing or withholding the desperately needed dose? If an essential predicate of libertarian society is the willing, rational actor, capable of weighing and understanding consequences, what’s left when this condition is absent?  Such a state is not the attainment of liberty, but rather its end. 

John P. Walters, director of drug control policy for President George W. Bush, is chief operating officer of the Hudson Institute.  

Source: http://www.politico.com/magazine/story/2014/06/why-libertarians-are-wrong-about-drugs-107896_Page2.html#ixzz3D2I5DxCy   16th June 2014

Filed under: Cannabis/Marijuana,USA :

I live in Denver, where marijuana dispensaries outnumber pharmacies, liquor stores, McDonald’s and Starbucks. When I walk and drive the streets of this beautiful Rocky Mountain city, I often encounter the smell of marijuana smoke. Marijuana users are not allowed to smoke openly and publicly, but a bench in the front yard is considered private property, allowing the smell to pollute the clean mountain air. 

The problems in Colorado began 14 years ago with the passage of Amendment 20 legalizing medical marijuana. Abuse and fraud flourished under its provisions because medical marijuana became easily available for recreational use.

In November, Florida voters will be faced with the choice to legalize marijuana for “medical use.” Voters should instead ask themselves whether they want marijuana legalized in Florida for recreational use. That’s essentially what Amendment 2 will do. The amendment is so flawed that if it passes, medical marijuana will be readily available for anyone who wants to obtain it.

Like Colorado, Florida’s Amendment 2 allows “Medical Marijuana Treatment Centers” to develop edibles. These food products have been developed intentionally to allow discreet consumption of marijuana in public places, at schools and in the workplace, and to introduce the product to a larger – younger – consumer base.

In Colorado, marijuana is sold in soda, salty snacks like nuts, granola bars, breakfast cereals, cookies, rice cereal treats, cooking oil and even salad dressing. Some companies buy commercially available children’s candies like Swedish fish, Sour Patch Kids, lollipops or lemon drops and infuse them with marijuana. Others make chocolate bars, Tootsie Rolls and truffles.   So now in Colorado, parents who once taught their children not to take candy from a stranger must tell their children not to take candy from a friend because it could very well contain marijuana. Our emergency rooms report a striking increase in children who have unintentionally ingested marijuana edibles and require medical treatment.

Florida’s Amendment 2 allows for any medical condition, not just terminal, chronic or debilitating conditions, to qualify for marijuana treatment, as long as “a physician believes that the medical use of marijuana would likely outweigh the potential health risks for a patient.” This exception will result in patients who use marijuana to get high, despite the stated intention of the amendment to prohibit such conduct.

Colorado’s marijuana patient registry statistics show that only 1 percent of patients list HIV/AIDS; 2 percent, seizures; and 3 percent, cancer. A whopping 94 percent of those using “medical marijuana” claim to have “severe pain,” a subjective and unverifiable condition.

Sixty-six percent of users are male with an average age of 41, despite severe pain being a condition more closely associated with older, female patients. In Denver, it is common to see young, 20-something able-bodied men flocking to medical marijuana centers Friday and Saturday nights to get their “medicine.”  Since outright legalization in 2012 for all persons 21 or older, Colorado has seen an explosion of medical marijuana patients between 18-20 years old.

Moreover, the long-term health implications from youth marijuana use are troubling. A longitudinal study found an association between weekly marijuana use by persons under the age of 18 and permanent decline in IQ.

You might think Florida won’t go as far as Colorado and Washington, but it will be one step closer. Every state that passes medical marijuana laws believes they will be able to correct the errors of those who have paved the way. This has yet to be accomplished.

The Colorado experiment is failing our children, and so will Florida’s. Coloradans may not be able to go back in time, but you can stop yours before it starts.

Rachel O’Bryan is a Colorado resident and an attorney who spent 18 months serving at the request of Governor John Hickenlooper and the Colorado Department of Revenue to aid in the development of recreational marijuana legislation and regulation. She is a founding member of SMART Colorado, a citizen-led nonprofit that protects Colorado kids from the unintended negative consequences of legalizing marijuana for recreational use.

Source:  http://www.pnj.com/story/opinion/2014/09/13/viewpoint-colorado-going-pot-let-florida/15534781/

The proportion of marijuana-positive drivers involved in fatal motor vehicle crashes in Colorado has increased dramatically since the commercialization of medical marijuana in the middle of 2009, according to a study. The study raises important concerns about the increase in the proportion of drivers in a fatal motor vehicle crash who were marijuana-positive since the commercialization of medical marijuana in Colorado, particularly in comparison to the 34 non-medical marijuana states. 

ShapeThe proportion of marijuana-positive drivers involved in fatal motor vehicle crashes in Colorado has increased dramatically since the commercialization of medical marijuana in the middle of 2009, according to a study by University of Colorado School of Medicine researchers.

With data from the National Highway Traffic Safety Administration’s Fatality Analysis Reporting System covering 1994 to 2011, the researchers analyzed fatal motor vehicle crashes in Colorado and in the 34 states that did not have medical marijuana laws, comparing changes over time in the proportion of drivers who were marijuana-positive and alcohol-impaired.

 The researchers found that fatal motor vehicle crashes in Colorado involving at least one driver who tested positive for marijuana accounted for 4.5 percent in the first six months of 1994; this percentage increased to 10 percent in the last six months of 2011. They reported that Colorado underwent a significant increase in the proportion of drivers in a fatal motor vehicle crash who were marijuana-positive after the commercialization of medical marijuana in the middle of 2009. The increase in Colorado was significantly greater compared to the 34 non-medical marijuana states from mid-2009 to 2011. The researchers also reported no significant changes over time in the proportion of drivers in a fatal motor vehicle crash who were alcohol-impaired within Colorado and comparing Colorado to the 34 non-medical marijuana states.

Stacy Salomonsen-Sautel, Ph.D, who was a postdoctoral fellow in the Department of Pharmacology, is the lead author of the study, which is available online in the journal Drug and Alcohol Dependence. Christian Hopfer, MD, associate professor of psychiatry, is the senior author. 

Salomonsen-Sautel said the study raises important concerns about the increase in the proportion of drivers in a fatal motor vehicle crash who were marijuana-positive since the commercialization of medical marijuana in Colorado, particularly in comparison to the 34 non-medical marijuana states. While the study does not determine cause and effect relationships, such as whether marijuana-positive drivers caused or contributed to the fatal crashes, it indicates a need for better education and prevention programs to curb impaired driving.

Source:. Trends in fatal motor vehicle crashes before and after marijuana commercialization in Colorado. Drug and Alcohol Dependence, 2014; DOI: 10.1016/j.drugalcdep.2014.04.008

Many of the Op-Eds on the subject of the legalisation or otherwise of cannabis are written by journalists or protagonists of one or other point of view. The following links give scientific evidence from scientist and medics in the USA, and do not support the use of cannabis.

 

Medical organisations in the USA do not support smoked pot or edibles

   
   

Authoritative organisations which do not support smoked pot or edibles as a legitimate form of medication, listed by:

Rethinkpot.org:

American Medical Association,

American Cancer Society,

National Multiple Sclerosis Society, 

American Glaucoma Society,

American Academy of Pediatrics, 

National Institute of Drug Abuse (NIDA),

Substance Abuse and Mental Health Service Association (SAMHSA),

Food and Drug Association  (FDA),

American Academy of Ophthalmology,

Drug Enforcement Agency (DEA),

American Society of Addiction Medicine,

Epilepsy Foundation.

 

News coverage about marijuana legalization is fairly predictable. If there’s even a toehold to support driving this addictive substance into the country, count on splashy headlines. Today’s breathless summaries of President Barack Obama’s remarks on the subject to The New Yorker were no exception.

The chief narrative spinning out at this hour boils down to this one quote from the President: “I don’t think it (marijuana) is more dangerous than alcohol.”

Cue the sampling of headlines appearing this evening on a Google search:

Fox News: “Marijuana no more dangerous than alcohol”
USA Today: “Obama: Pot no more dangerous than alcohol”
CNN: Obama says marijuana ‘no more dangerous than alcohol’
Huffington Post: “Obama: Marijuana no more dangerous than alcohol’
Time’s Swampland: “Obama says marijuana can be less dangerous than alcohol”
The (U.K.) Telegraph: “Barack Obama says smoking marijuana less dangerous than alcohol”
NPR: Marijuana is ‘not more dangerous than alcohol’

(Check out how this article conveniently lops off the President’s most critical remarks about marijuana — and asks readers to click over to The New Yorker to see those.)

Then there’s this from Time: “Obama on Marijuana Legalization: ‘It’s important for it to go forward.’”

Now, take a look at the full passage to which these news organizations — and many others — were reacting. It appears at the bottom of this post. The President expresses a fair amount of skepticism about marijuana legalization — but you wouldn’t know that if you’re just skimming the headlines and stories rocketing around the world at this hour.

Why no headlines screaming that the President called the case for marijuana legalization “overstated?” Why aren’t news organizations trumpeting that he called marijuana use a “bad idea, a waste of time, not very healthy.” Where are the headlines about the President’s acknowledgement that marijuana legalization could lead to a slippery slope of negotiated doses of cocaine and finely calibrated doses of meth?

After all, the President has to know the nation’s largest marijuana-advocacy groups already are laying the groundwork for full-scale recreational drug legalization that includes psychedelics, meth and cocaine. This is no secret. They’ve been at it for decades. Just a few months ago, Ethan Nadelmann, executive director of the Drug Policy Alliance, led what amounted to a pep rally for recreational drug lovers. Among his rah rah sis boom bah:

What is it we’re fighting for? Is it simply to legalize it all … some of us, yes, some of us, yes. Some of us believe deeply in our hearts that the best way to treat every drug is the way we treat alcohol and cigarettes today. And we may in fact be right. But what I also know is that to make that argument to the broader public, the public who has engaged and accepted that marijuana should be legally regulated, that we need to hold their hands and engage them into a different basis.”

Nadelmann followed up with this: “We’re not just a movement or people who like marijuana and relish our psychedelics … all the other drugs we enjoy, and we do so responsibly.”

Let’s ask President Obama what he thinks about all of that — and let’s demand the clear and straight answers we’re not getting from him.

While reporters eager to make the case that using weed is much like having a glass of wine or craft beer with a meal spin like tops, far more astute observers see very clearly what’s going on here: the President is playing both sides of a fence. Even some staunch legalization advocates bemoaned his waffling remarks, calling his position on marijuana “incoherent.” Again, judging from today’s giddy and incredibly myopic news coverage, you’d think he was crystalline.

Similarly, smart and responsible journalists will stop the cheerleading for weed — and the stenography — and doggedly question the President’s easy-breezy comparisons of marijuana and alcohol. He’s got opinions, but does current, reputable science support them? Not really, especially if we’re talking child health. Today’s marijuana is at least 10 times more potent than the strains the President recalls using when he was a teenager and young adult. The President — and everyone else basing their opinions on their experiences in the 1960s, ’70s, ’80s and ’90s — must also stop to consider highly concentrated and increasingly popular forms of marijuana called “hash oil.” Doses of that oil often exceed 80 percent THC. That’s a far cry from the weed of Woodstock, which contained 1-3 percent THC, and the marijuana of around 8 percent THC the President used in the 1980s. This is obvious, and it’s worth mentioning.

Also worth mentioning? Kids take their cues from adults — especially adults they admire, like President Obama. So, when he says he doesn’t think marijuana is more dangerous than alcohol, is he stopping to consider what our nation’s health — specifically our nation’s child health — would look like if adolescent marijuana use rates caught up with youths’ use rates of alcohol? The rest of us should certainly stop to think about that — and let’s not wait for news organizations to get around to the reporting. Review the University of Michigan’s Monitoring the Future study for yourself. In 2013, 22.7 percent of high school seniors reported past-month use of marijuana compared to 39.2 percent of seniors who said they used alcohol in the previous 30 days.

Another elephant in this room? The President’s senior drug policy advisors at the White House Office of National Drug Control Policy and the National Institute on Drug Abuse are not on board with marijuana legalization — and it sure would be interesting to know what they make of the President’s comparison of marijuana and alcohol. Similarly, it would be great to know what they think of the President’s remark that it’s “important” for efforts to legalize recreational marijuana in Colorado and Washington — which he also said would be “a challenge” — to move forward. When is it also going to be just as important for these states to pull the plugs on their grand experiments? How much death and destruction must be recorded to make those determinations? Whatever those limits are, it’s probably safe to say the President will be out of office when our country faces them.

At least President Obama makes clear he wants to reform laws that perpetuate racial and ethnic disparities and punish addiction more than treat it. That, too, is a case wildly overstated by marijuana supporters — and the President, having very easy access to public records and advisors who routinely present this information to communities across the country, probably knows this, too. But good for him. Many drug-prevention groups — such as Smart Approaches to Marijuana, or Project SAM — stand with him there. I strongly suspect the President knows marijuana legalization is not at all necessary to make those reforms — so it’s worth asking him what he’s waiting for. Why not champion reform now? We can certainly make changes without compromising the interests of public health and safety.

On the issue of marijuana legalization, President Obama needs to get serious because, whether he likes it or not, pot — especially as the drug harms American youth in greater numbers — is fast becoming a very big part of his legacy and grossly undermining his stated goals for reforming healthcare and education. He needs to lead — and that guidance for our nation must be rooted in much, much more than his opinions and personal experience.

Christine Tatum is a former staff writer for The Denver Post, Chicago Tribune, (Arlington Heights, Ill.) Daily Herald and (Greensboro, N.C.) News & Record. She was elected to serve as 2006-07 national president of the Society of Professional Journalists.

Global reaction:

The United States has staggering problems with alcohol and is failing to control its use and harm — which is all the more reason marijuana legalization is a bad idea for the U.S. and the world, writes Sven-Olov Carlsson, intentional president of IOGT International, in this open letter to President Obama. The IOGT is the world’s largest body of drug-prevention-and-policy advocates.

The President’s remarks on marijuana legalization as reported by The New Yorker:

When I asked Obama about another area of shifting public opinion—the legalization of marijuana—he seemed even less eager to evolve with any dispatch and get in front of the issue. “As has been well documented, I smoked pot as a kid, and I view it as a bad habit and a vice, not very different from the cigarettes that I smoked as a young person up through a big chunk of my adult life. I don’t think it is more dangerous than alcohol.”

Is it less dangerous? I asked.

Obama leaned back and let a moment go by. That’s one of his moves. When he is interviewed, particularly for print, he has the habit of slowing himself down, and the result is a spool of cautious lucidity. He speaks in paragraphs and with moments of revision. Sometimes he will stop in the middle of a sentence and say, ‘Scratch that,’ or, ‘I think the grammar was all screwed up in that sentence, so let me start again.’

Less dangerous, he said, ‘in terms of its impact on the individual consumer. It’s not something I encourage, and I’ve told my daughters I think it’s a bad idea, a waste of time, not very healthy.’ What clearly does trouble him is the radically disproportionate arrests and incarcerations for marijuana among minorities. ‘Middle-class kids don’t get locked up for smoking pot, and poor kids do,’ he said. ‘And African-American kids and Latino kids are more likely to be poor and less likely to have the resources and the support to avoid unduly harsh penalties.’ But, he said, ‘we should not be locking up kids or individual users for long stretches of jail time when some of the folks who are writing those laws have probably done the same thing.’ Accordingly, he said of the legalization of marijuana in Colorado and Washington that ‘it’s important for it to go forward because it’s important for society not to have a situation in which a large portion of people have at one time or another broken the law and only a select few get punished.’

As is his habit, he nimbly argued the other side. ‘Having said all that, those who argue that legalizing marijuana is a panacea and it solves all these social problems I think are probably overstating the case. There is a lot of hair on that policy. And the experiment that’s going to be taking place in Colorado and Washington is going to be, I think, a challenge.’ He noted the slippery-slope arguments that might arise. ‘I also think that, when it comes to harder drugs, the harm done to the user is profound and the social costs are profound. And you do start getting into some difficult line-drawing issues. If marijuana is fully legalized and at some point folks say, Well, we can come up with a negotiated dose of cocaine that we can show is not any more harmful than vodka, are we open to that? If somebody says, We’ve got a finely calibrated dose of meth, it isn’t going to kill you or rot your teeth, are we O.K. with that?’”

Source: Dr.Thurstone.com Jan.19th 2014

Powdered alcohol was approved by a government agency on Tuesday, The Washington Post reports. The product, called “Palcohol,” could arrive in stores this summer. Last year the Alcohol and Tobacco Tax and Trade Bureau (TTB) approved labels for powdered alcohol. It then said the approval had been a mistake.

Lipsmark, the company that makes Palcohol, plans to sell four powdered products: cosmopolitan, margarita, a vodka and a rum, the article notes. The product will be sold in foil pouches that can be used as a glass. A person pours in five ounces of water, zips up the bag and shakes it until the powder dissolves.

Several states, including Louisiana, South Carolina and Vermont, have banned the use/sale of powdered alcohol, and a number of other states are considering similar legislation.

U.S. Senator Charles Schumer of New York introduced a bill last year to ban powdered alcohol. Last May Schumer urged the Food and Drug Administration (FDA) to prevent federal approval of powdered alcohol. He said it could become “the Kool-Aid of teen binge drinking.” Schumer noted the product can be mixed with water, sprinkled on food or snorted. He asked the FDA to investigate the potential harmful effects of the product.

In a statement released last May, Mothers Against Drunk Driving (MADD) said it agreed with Schumer. “This product is the latest in a long list of specialty alcohol fads,” MADD said. “As with anything ‘new,’ this product may be attractive to youth. … In the case of Palcohol, we share Senator Schumer’s view that the U.S. Food and Drug Administration should carefully review this product as it would seem to have the potential to increase underage drinking.” The FDA approved powdered alcohol last summer, the article notes.

Source: www.drugfree.org 12th March 2015

Filed under: Alcohol,Legal Sector,USA :

Shootings in New York City have gone up nearly 20 percent in the past year, NYPD Commissioner Bill Bratton announced on March 3, saying that marijuana legalization and the loosening of restrictions across the United States are partly to blame.

Bratton referred to marijuana as “the seemingly innocent drug that’s been legalized around the country,” and says that yes, it’s connected to a rise in shootings. He’s not off the mark. In Colorado, Pueblo County Sheriff Kirk Taylor in Colorado noticed an uptick in crimes, and he’s now tracking the link between crimes and marijuana.

In New York City, marijuana is not legalized, but it has been decriminalized to some degree and the NYPD has stopped arresting people with small amounts of marijuana on their person.

It is ironic that in a city which is a transfer point for huge amounts of drugs . . . heroin, cocaine, hallucinogens, that one drug [that] is actually the causal factor in so much of our shootings and murder is marijuana,” Bratton said. “We just see marijuana everywhere when we make these arrests, and get the guns off the street.”

Watch WABC’s report, along with Bratton’s remarks, in the video.

Murders revolving around marijuana occur in Washington and Colorado. A week ago in Steamboat Springs, a man with an indoor marijuana grow was robbed and murdered. Two have been charged. The black markets are also alive and well in both Washington and Colorado, as a New York Times article explains.

Please share this post with every concerned parent you know! Spread the Word about Pop Pot! Parents Opposed to Pot is a non-partisan grassroots campaign started by parents concerned about the commercial pot industry and its devastating impact on youth and communities. We write anonymously to explore these important issues and protect the privacy of our bloggers. We are totally funded by private donations, rather than industry or government. If you have an article to submit, or want to support us, please go to Contact or Donate page

Source: http://www.poppot.org/2015/03/09 9th March 2015

Marijuana use remains stubbornly high, survey of high school students shows Fewer Colorado high school students view regular marijuana use as risky behavior, according the Healthy Kids Colorado Survey (HKCS), which was released today. Only 48 percent of high school students surveyed saw marijuana use as risky in 2015, compared to 54 percent of those surveyed in the HKCS survey two years earlier. While youth tobacco use has declined, high school marijuana use inched up, the HKCS data shows. Twenty one percent of Colorado high school students used marijuana at least once in the last month, the HKCS shows. Even more troubling, high school use is reported as high as 30.1 percent in some parts of Colorado, according to the HKCS. Meanwhile, only 9 percent of Colorado high schools students reported smoking a cigarette at least once in the last 30 days.   The HKCS collects health information every odd year from Colorado public school students. The data released today was collected in 2015. While the HKCS says Colorado high school youth marijuana use is in line with national data, Colorado ranks first in the nation for past month marijuana usage by those 12-17 years old, according to National Surveys on Drug Use and Health data released in December by the federal Substance Abuse and Mental Health Services Administration. “Colorado voters were promised marijuana would be kept out of the hands of Colorado kids.  And yet, after  three and half years of commercialized recreational marijuana and after over six years of commercialized medical marijuana, that has yet to happen,” said Diane Carlson, a co-founder of Smart Colorado. “Meanwhile, the perception of harm from consuming marijuana for high school students is on the decline according to the Healthy Kids Colorado Survey, which is deeply concerning as much of  Colorado’s marijuana has become an increasingly different, harder, stronger drug,” Carlson added. “Youth marijuana use can have lifelong implications.  The risks, which include psychosis, suicide, drug addiction and lower IQs, have been reported based on research on much lower THC potencies than are typically sold on Colorado’s commercial market. That means the risks and harms for Colorado kids using today’s pot are far more serious and potentially long lasting. And yet too few Colorado kids are aware of just how harmful and risky today’s high-potency pot can be.”

Source:    www.smartcolorado.com  June 2016

Roll Call Video Advises Law Enforcement to Exercise Extreme Caution

DEA has released a Roll Call video to all law enforcement nationwide about the dangers of improperly handling fentanyl and its deadly consequences.  Acting Deputy Administrator Jack Riley and two local police detectives from New Jersey appear on the video to urge any law enforcement personnel who come in contact with fentanyl or fentanyl compounds to take the drugs directly to a lab.

“Fentanyl can kill you,” Riley said. “Fentanyl is being sold as heroin in virtually every corner of our country. It’s produced clandestinely in Mexico, and (also) comes directly from China. It is 40 to 50 times stronger than street-level heroin. A very small amount ingested, or absorbed through your skin, can kill you.”

Two Atlantic County, NJ detectives were recently exposed to a very small amount of fentanyl, and appeared on the video.

Said one detective: “I thought that was it. I thought I was dying. It felt like my body was shutting down.”

Riley also admonished police to skip testing on the scene, and encouraged them to also remember potential harm to police canines during the course of duties.

“Don’t field test it in your car, or on the street, or take if back to the office. Transport it directly to a laboratory, where it can be safely handled and tested.”

The video can be accessed at: http://go.usa.gov/chBWW

More on Fentanyl:

On March 18, 2015, DEA issued a nationwide alert on fentanyl as a threat to health and public safety.

Fentanyl is a dangerous, powerful Schedule II narcotic responsible for an epidemic of overdose deaths within the United States. During the last two years, the distribution of clandestinely manufactured fentanyl has been linked to an unprecedented outbreak of thousands of overdoses and deaths. The overdoses are occurring at an alarming rate and are the basis for this officer safety alert.

Fentanyl, up to 50 times more potent than heroin, is extremely dangerous to law enforcement and anyone else who may come into contact with it. As a result, it represents an unusual hazard for law enforcement.

Fentanyl, a synthetic opiate painkiller, is being mixed with heroin to increase its potency, but dealers and buyers may not know exactly what they are selling or ingesting. Many users underestimate the potency of fentanyl.

The dosage of fentanyl is a microgram, one millionth of a gram – similar to just a few granules of table salt. Fentanyl can be lethal and is deadly at very low doses.

Fentanyl and its analogues come in several forms including powder, blotter paper, tablets, and spray.

Risks to Law Enforcement

Fentanyl is not only dangerous for the drug’s users, but for law enforcement, public health workers and first responders who could unknowingly come into contact with it in

its different forms. Fentanyl can be absorbed through the skin or accidental inhalation of airborne powder can also occur. DEA is concerned about law enforcement coming in contact with fentanyl on the streets during the course of enforcement, such as a buy-walk, or buy-bust operation.

Just touching fentanyl or accidentally inhaling the substance during enforcement activity or field testing the substance can result in absorption through the skin and that is one of the biggest dangers with fentanyl. The onset of adverse health effects, such as disorientation, coughing, sedation, respiratory distress or cardiac arrest is very rapid and profound, usually occurring within minutes of exposure.

Canine units are particularly at risk of immediate death from inhaling fentanyl.

In August 2015, law enforcement officers in New Jersey doing a narcotics field test on a substance that later turned out to be a mix of heroin, cocaine and fentanyl, were exposed to the mixture and experienced dizziness, shortness of breath and respiratory problems.

If inhaled, move to fresh air, if ingested, wash out mouth with water provided the person is conscious and seek immediate medical attention.

Narcan (Naloxone), an overdose-reversing drug, is an antidote for opiate overdose and may be administered intravenously, intramuscularly, or subcutaneously. Immediately administering Narcan can reverse an accidental overdose of fentanyl exposure to officers. Continue to administer multiple doses of Narcan until the exposed person or overdose victim responds favorably.

Field Testing / Safety Precautions

Law enforcement officers should be aware that fentanyl and its compounds resemble powered cocaine or heroin, however, should not be treated as such.

If at all possible do not take samples if fentanyl is suspected. Taking samples or opening a package could stir up the powder. If you must take a sample, use gloves (no bare skin contact) and a dust mask or air purifying respirator (APR) if handling a sample, or a self-contained breathing apparatus (SCBA) for a suspected lab.

If you have reason to believe an exhibit contains fentanyl, it is prudent to not field test it. Submit the material directly to the laboratory for analysis and clearly indicate on the submission paperwork that the item is suspected of containing fentanyl. This will alert laboratory personnel to take the necessary safety precautions during the handling, processing, analysis, and storage of the evidence. Officers should be aware that while unadulterated fentanyl may resemble cocaine or heroin powder, it can be mixed with other substances which can alter its appearance. As such, officers should be aware that fentanyl may be smuggled, transported, and/or used as part of a mixture.

Universal precautions must be applied when conducting field testing on drugs that are not suspected of containing fentanyl. Despite color and appearance, you can never be certain what you are testing. In general, field testing of drugs should be conducted as appropriate, in a well ventilated area according to commercial test kit instructions and training received. Sampling of evidence should be performed very carefully to avoid spillage and release of powder into the air. At a minimum, gloves should be worn and the use of masks is recommended. After conducting the test, hands should be washed with copious amounts of soap and water. Never attempt to identify a substance by taste or odor.

Historically, this is not the first time fentanyl has posed such a threat to public health and safety. Between 2005 and 2007, over 1,000 U.S. deaths were attributed to fentanyl – many of which occurred in Chicago, Detroit, and Philadelphia.

The current outbreak involves not just fentanyl, but also fentanyl compounds. The current outbreak, resulting in thousands of deaths, is wider geographically and involves a wide array of individuals including new and experiences abusers.

In the last three years, DEA has seen a significant resurgence in fentanyl-related seizures. In addition, DEA has identified at least 15 other deadly, fentanyl-related compounds. Some fentanyl cases have been significant, particularly in the northeast and in California, including one 12 kilogram seizure. During May 2016, a traffic stop in the greater Atlanta, GA area resulted in the seizure of 40 kilograms of fentanyl – initially believed to be bricks of cocaine – wrapped into blocks hidden in buckets and immersed in a thick fluid. The fentanyl from these seizures originated from Mexican drug trafficking organizations.

Recent seizures of counterfeit or look-a-like hydrocodone or oxycodone tablets have occurred, wherein the tablets actually contain fentanyl. These fentanyl tablets are marked to mimic the authentic narcotic prescription medications and have led to multiple overdoses and deaths.

According to DEA’s National Forensic Lab Information System, 13,002 forensic exhibits of fentanyl were tested by labs nationwide in 2015, up 65 percent from the 2014 number of 7,864.  The 2015 number is also about 8 times as many fentanyl exhibits than in 2006, when a single lab in Mexico caused a temporary spike in U.S. fentanyl availability.  This is an unprecedented threat

Source:  U.S. Drug Enforcement Administration dea@public.govdelivery.com  11th June 2016

bud-busters

Amy Reid followed three Surrey teens as they took a stand against pot and bumped heads with the Prince of Pot

From left, Surrey teens Jordan Smith with twins Connor and Duncan Fesenmaier at the Vancouver Art Gallery on April 20. The high school students were protesting the use and legalization or marijuana. (Photos: AMY REID)

VANCOUVER — There were the inquisitive stoners, the happy-go-lucky potheads and the young punks yelling “smoke weed everyday.”

As thousands flocked to the Vancouver Art Gallery on April 20 for the 21st year, in celebration of the unofficial stoner’s holiday, it was the usual scene. Bags of blunts right out in the open, people sparking joints everywhere you look and plenty of cookies and other edibles with the green stuff baked right in.

But there was a new voice at the ganja gathering this year: Three Surrey high school students weren’t there to light up. Wearing anti-pot T-shirts and sporting gas masks, twins Duncan and Connor Fesenmaier and Jordan Smith from Princess Margaret Secondary took the trek to Vancouver to protest the use of marijuana and spread their anti-legalization message.

As one man quite accurately dubbed them, they’re the “bud busters.” I hooked up with the guys at King George SkyTrain station. On the train ride, I asked what they thought would happen at the rally. Connor wasn’t sure. “The VPD (Vancouver Police Department) didn’t want us to go,” he said. “They said it wasn’t the smartest thing, that it could start a riot or start a problem.”

As we got off the SkyTrain at Granville, the boys opened up their bag and put on their gas masks. “They’re the good ones,” said Connor. On the street, people recognized the boys from the news, where they spoke out after they say their vice-principal at Princess Margaret Secondary told them to remove the shirts while at school. Some pointed and laughed, others were more aggressive.

“You have to recognize you can’t change the opinion of some people,” Connor said. “You have to let it bounce off like rubber.” The closer we get to the art gallery, the stronger the smell of pot – and the insults – becomes.

“Are you ready for some abuse?” asked a cop as we were steps away from entering the event. And they were.

The boys took all kinds of nasty verbal abuse throughout the day. Many people took to toking up in front of them and blowing smoke in their faces. It didn’t seem to faze them. Polite and diplomatic all the way through, they talked to anyone who would listen.

The hate is something they’ve already experienced online, both through their Facebook page Canadians Against the Legalization of Marijuana and also via email, where they were slammed with insults and even death threats.

“Everyone thinks it’s all passive, free-loving hippies… but they’re angry,” said Connor. Pamela McColl is a director on the advisory council of Smart Approaches to Marijuana Canada, an anti-marijuana-legalization group. She said she’s proud of what the boys were doing.

“We had hesitation because of safety,” she said of having the boys come out to protest 420. “But they’re young people who want to have a voice – and they should have a voice.” In the mid-afternoon, Connor noticed people were getting angry toward them.

“The police presence definitely keeps them at bay a bit,” he said.“I do feel scared, I do feel scared in the sense of watching my back.”

Connor, the unofficial spokesperson of the trio, said when he was first offered a joint, he said ‘no,’ wanting to arm himself with knowledge before trying it. After doing some research, including through the National Institute on Drug Abuse, a U.S. government research institute, he said he knew where he stood.

“They had tons of research and facts and it was all done scientifically,” he said. “It was scary.” All three boys are with SAMC, which believes legalization will usher in Canada’s new version of big tobacco, that use will increase and that public and social costs will well outweigh the tax revenues the government receives.

DEBATING EMERY

Shortly before 4:20 p.m., the “Prince of Pot” himself found his way to Connor, where the two took to debating facts on marijuana as a crowd formed around them.

“You’re presuming marijuana impairs people,” Marc Emery said after hearing Connor’s stance. “Getting high… is being self-aware. That’s why people get enhanced sounds of music and enhanced sounds of nature when they’re high.” Connor argued the negatives outweigh the positives.

“But how do you know?” Emery fired back. “You’re believing a government study, right? This is the same government that’s lied to us consistently about every war, about the effects of drugs, about their secrecy, about their surveillance.”

Connor said many argue it’s not addictive and it’s not dangerous, adding, “you don’t need to die for something to be dangerous.”

Emery said Connor sounded like a “pompous, sanctimonious teenager,” while Connor told Emery he sounded like a “self-indulged hippie.” While the parties didn’t agree on much, they shook hands before parting.

Emery said he doesn’t understand the boys’ protest. “What they’re doing is laying a judgment trip on people, telling them what they’re doing with their own body is bad. I don’t know if anybody has a right to really go around doing that,” he said.

“Marijuana is extremely unique in that it’s useful for dozens and dozens of applications, medical, fibre, euphoria, soaps, lotions, it’s just incredible. There’s really nothing else like it on the planet. So for them to choose marijuana to come here and protest against shows that they’re just not well informed.”

Emery said he’s never seen pot protestors at the event before.

“You’re allowed to not smoke pot every day of the year. There’s only one day for us and it’s this day. We’re here just to ask for the dignity of being treated like first-class citizens and not second-class citizens.

“He’s here judging us and I think he’s wrong.”

Connor said he’s glad he got to debate marijuana with Emery. “I was kind of hoping I would. I think it went well, but of course he had his entourage with him.”

And after all was said and done, the boys were all glad they went, with plans to return next year. “We’re definitely a strong force,” said Connor. “We know our science, we know we’re right and we just have to put that out there.”

areid@thenownewspaper.com

By Jeanette McDougal, MM, CCDP, Chair
William R. Walluks, Member Hemp Committee, Drug Watch Intl.
August 2000

Fiber Cannabis hemp seed, though containing tetrahydrocannabinol (THC, the main psychoactive ingredient in hemp/marijuana) and other cannabinoid residue, is being heavily marketed and promoted by the hemp industry as a source of food, nutraceuticals, and cosmetics. The harmful effects of THC on humans and other animals is well documented. Hemp advocates, however, mimicking the tactics of tobacco industry apologist, challenge and “call into question” every statement substantiating harm caused by the use of Cannabis sativa L. hemp. (Where used in this paper, the term hemp refers to cannabis sativa, aka marijuana, and not to any of the numerous other plant fibers also commonly referred to as hemp.)

The campaign to use hemp fiber for paper, biomass, textiles, etc. has largely failed because hemp is neither economically viable nor technically feasible. However, because the handling, storage, and processing of hemp seed is more adaptable to present technologies than for hemp fiber, hemp seed production and products are now being aggressively promoted.

Low THC Cannabis sativa hemp that contains less than .3% (w/w) THC became legal to grow in Canada in March, 1998. THC and the other cannabinoids are found in food and other products made from fiber hemp seed. According to Canada’s national health department, Health Canada, “In theory the ripened seeds of Cannabis contain no detectable quantity of THC. However, because of the nature of the material it is almost impossible to obtain the seeds free from extraneous THC in the form of residues arising from other parts of the plant which are in close proximity to the seeds. Although it is required for the seeds to be cleaned before any subsequent use, the resinous nature of some of the material makes complete cleaning extremely difficult.” [1]

Since THC and the over 60 other cannabinoids are fat-soluble, i.e., store themselves in the fatty tissues of the brain and body, even a very small amount may be damaging, especially if ingested regularly. Fat-soluble substances accumulate in the body.

THC has a half-life of about seven days, meaning that one-half of the THC ingested or inhaled stays in the brain and body tissue for seven days. Traces can stay in body tissues for a month or more. The only important substance that exceeds THC in fat solubility is DDT. [2]

A risk assessment done for Health Canada states that, “New food products and cosmetics made from hemp – the marijuana plant – pose an unacceptable risk to the health of consumers. It also says that hemp products may not be safe because even small amounts of THC may cause developmental problems. “Those most at risk,” the study says, “are children exposed in the womb or through breast milk, or teen-agers whose reproductive systems are developing.” [3]

Hazards associated with exposure to THC include acute neurological effects and long-term effects on brain development, the reproductive system and the immune system,” the study says. “Overall, the data considered for this assessment support the conclusions that inadequate margins of safety exist between potential exposure and adverse effect levels for cannabinoids (the bio-active ingredients) in cosmetics, food and nutraceutical products made from hemp.” [3]

The study reviewed the results of existing tests on lab animals. Health Canada may require warning labels or new regulations that could stop some products from being sold. It is considering new animal studies to examine the effects of low-level exposure to THC over several generations. [3]

To cast further doubt about safety, the Journal of Immunology (July 2000) recently reported that THC, the major psychoactive component of marijuana (hemp), “can promote tumor growth by impairing the body’s anti-tumour immunity system.” [4]

Another unknown is hemp as forage for animals. According to Stan Blade, a director of crop diversification for Alberta Agriculture, a program that will test hemp over the next year as feed for livestock is being considered in Canada. Forage hemp will be tested on cattle against a more traditional mixture of oats and barley. [5]

Buffalo, the common dairy animal of Pakistan, are allowed to graze on Cannabis sativa (hemp), which, after absorption, is metabolized into a number of psychoactive agents. These agents are ultimately excreted through the urine and milk, making the milk, used by the people of the region, subject to contamination. Depending on the amount of milk ingested and the degree of contamination, the milk could result in a low to moderate level of chronic exposure to THC and other metabolites, especially among the children raised on this milk. Analysis from the urine obtained from children who were being raised on the milk from these animals, indicated that 29% of them had low levels of THC-COOH (THC-carboxylixc acid, which is a major metabolite for THC) in their urine. This study indicates that the passive consumption of marijuana through milk products is a serious problem in this region where wild marijuana grows unrestricted, and that children are likely to be exposed more than adults.” [6]

Hemp use could compromise drug testing. In his book, “Fats that Heal, Fats that Kill,” Udo Erasmus warns that people whose jobs require mandatory drug screening should avoid the use of hemp products, since THC residues in hemp products can show up in urine tests. 7. THC-positive urine tests from hemp product use were also reported in the August 1997 Journal of Analytical Toxicology. 8. For drug-testing reasons, the U.S. Air Force, the Air Force National Guard, the New York Police Dept., and the U.S. Coast Guard have banned the use of hemp foods and health supplements by their personnel. [8. & 9]

Dr. Hugh Davis, Acting Head of Microbiology and Cosmetics at Health Canada, is quoted as saying that he has been looking at studies on hemp and has found research showing hemp (i.e., fat soluble cannabinoids) is accumulative in the body because of its long half-life and has the same adverse physiological (but not hallucinatory) effects that smoking marijuana does. One study states that cannabinoids may postpone puberty. There are 60 known cannabinoids, only three of which have been widely studied. This means that the potential harmful aspects of the remaining 57 cannabinoids, when used in a cream or shampoo, are unknown.” [10]

John Bailey, Microbiology and Cosmetics Division, US-FDA, (US-Federal Drug Administration) is concerned as well, stating that there is no definitive information about THC in food and cosmetics. [10]

Dr. Mohmoud ElSohly, Ph.D., Marijuana Project Director, NIDA (National Institute of Drug Abuse), states that “Fiber hemp can have significant potential for narcotic application….The threshold THC concentration (below which Cannabis would have no significant psychoactive properties) has not been determined.” [11] [Emphasis added] Dr. Roy H. Hart, Clinical Psychiatrist and research chemist (ret.), asserts that it is possible to experience chronic intoxication without being high. [12]

In addition to THC, there are other bioactive, but non-psychoactive, cannabinoids [cannabinol (CBN), cannabidiol (CBD), and cannabigerol (CG)] in Cannabis sativa marijuana(hemp). [13] David West, Ph.D., pro-hemp activist (HI), claims that CBD blocks the effects of THC in the nervous system. [14] However, Dr. Carlton Turner, Director of the Federal NIDA Marijuana Project (1970-1981) and former US Drug Czar (1980s) counters that “CBD is abundant in hashish and if CBD blocked THC’s action, why would hashish be so popular? I know of no known definitive study that shows that CBD blocks THC’s affects. Fiber cannabis is rich in CBD with little THC. However, naive users can sometimes get high but regular users will not.” [15]

The non-psychoactive cannabinoids may be even more toxic than THC. According to Dr. Roy Hart, “Cannabidiol (CBD) exerts an important effect on the hippocampus which is part of the limbic system of the brain, a collection of inter-functioning units concerned with emotion. CBD produces a depression of hippocampal function…Thus far experimental evidence indicates that CBD is even more toxic to tissues than THC.” [16] [Emphasis added] Dr. Gabriel Nahas, Research Professor, New York University, states that cannabionids other than THC (CBN and CBD) also impair dividing cells, and “are even more potent than THC when it comes to inhibiting DNA production.” [17]

Dr. Hart further states that “Both the psychoactive and non-psychoactive cannabinoids occurring in nature interfere with protein synthesis, deoxyribonucleic acid (DNA) synthesis, and ribonucleic acid (RNA) synthesis. This is without doubt the most important statement to be made about marijuana(hemp) and is based upon the burgeoning literature of basic and applied research into cannabis. Cell-tissue-organ damage follows inevitably from these alternations occurring at the molecular level.” [18]

Longtime and internationally renowned Cannabis researcher, Dr. Gabriel Nahas says that research has shown that the most serious adverse consequences of consumption of THC and other cannabinoids have been observed at the earliest state of reproductive function, on the “gametes” or germ cells of man. These drugs cause damage to the genetic information contained in DNA, causing apoptosis (programmed cell death and deletion). This threatens future generations before they are conceived. [19]

A 1996 study conducted in the Ukraine (formerly Russia) showed that there are no varieties that completely lack(ed) cannabinoids. A rather high content of these substances (cannabinoids) was found in some varieties. The results obtained have shown that hemp cultivated in more northerly areas is naturally rich in cannabinoids. [20]

European Union (EU) hemp regulations for the year 2000 state that hemp subsidies will be paid on condition the farmer uses certified seed of hemp varieties with a THC content of less than 0.3%. From the years 2001/02, that upper limit will be lowered to 0.2%. [21]

The European Union (EU) too is concerned about any inclusion of hemp products’ in food, stating in their regulations, “…Hemp seed has one traditional but limited application as food for fish and birds. The oil from hemp seed can be used for specialist cosmetics applications. The use of hemp seed or the leafed parts of the plant for human consumption would, however, even in the absence of THC, contribute towards making the narcotic use of cannabis acceptable and, in any event, there is no nutritional justification for this. [Emphasis added] None of these products should be encouraged in their own right by Community aid….Moreover, the International Narcotics Control Board (INCB, a United Nations body) states that: ‘while illicit cannabis cultivation (sic) have soared, a considerable market for food products and beverages produced with cannabis has developed in the European Union (…). The health effects of these products have not been adequately researched.’(…) [Emphasis added] The wide and unrestricted availability of such products in shops, where cannabis candy bars can be sold to minors without restriction, contribute to the overall benign image of cannabis, a drug under international control.” [OICS note of 12.3.1999.] [21]

It is therefore important to remain vigilant and step up controls to ensure that illegal crops do not tarnish the reputation of the sector producing hemp for fibre. To avert such dangers, the cultivation of hemp for fibre must be strictly controlled, which means the area cultivated will have to be restricted, and the uses to which it is put must NOT include human nutrition.” [Emphasis added] These EU regulations apply from July 1, 2000. [21]

The findings of the previously mentioned Health Canada THC Assessment are quite alarming from a consumer health and safety standpoint. Two key areas of health hazards to humans were reviewed, and the potential for risks from consumption of hemp products was characterized. [22]

One health area was neuroendocrine disruption during developmental states (perinatal, pre-pubertal and pubertal) that leads to permanent adverse effects on the brain and reproductive systems. The second area was neurological impairment manifested as deficits in cognitive and motor skills’ performance. [22]

The study could not, due to data gaps, develop definitive conclusions regarding the degree of potential risk from ingesting THC through hemp products. However, even without considering the bio-accumulative hazard potential of THC through repeated or multiple-product use, or the risk from chemicals other than THC in Cannabis sativa hemp, it nevertheless came to the following conclusions:

CHARACTERIZATIONS OF RISKS FROM THC
IN HEMP PRODUCTS FOR HUMAN USE & CONSUMPTION
HEALTH CANADA STUDY (DRAFT of November 23, 1999)

HEALTH RISK/ PRODUCT FOOD COSMETICS NUTRACEUTICALS
RISK OF
NEUROENDOCRINE
DISRUPTION *
LIKELY POSSIBLE LIKELY
RISK OF NEUROLOGICALIMPAIRMENT ANDPSYCHOACTIVITY LIKELY, PARTICULARLYFOR CHILDREN
(also risk ofpsychoactivity for children)
UNLIKELY, THOUGH CANNOT BE EXCLUDED ENTIRELY DUE TO LIMITATIONS OF STUDY POSSIBLE,PARTICULARLY IN CHILDREN.

*Developing fetus, nursing infant, and prepubertal/pubertal child are at greatest risk of long-term effects. THC is rapidly transferred from mother to fetus within minutes of exposure. THC accumulates and is transferred via breast-milk. [22]

The in-depth Health Canada Risk Assessment on THC and Other Cannabinoids (in products) Made with Industrial Hemp (11/23/99) warns “On the basis of currently available data it is concluded that the present Canadian limit of 10ug/g (i.e.,10 ppm) THC in raw materials and products made from industrial hemp (Cannabis sativa cultivars with less than 0.3% THC) would likely not protect the Canadian consumer using industrial hemp-based food, cosmetic and personal care, and nutraceutical products from potential health risks of neurological impairment and neuroendocrine disruption associated with low level exposure to THC and other cannabinoids.” [22]

In the United States even salad oils must be examined and certified by the US-FDA as “generally recognized as safe.” This has not been done for hemp.

Allowing or introducing toxic chemicals in our food and cosmetic systems through use of THC-containing industrial hemp products is unthinkable. To do so would jeopardize public health and safety. U.S. citizens and government agencies and officials should do everything possible to prevent this from happening, thus protecting future generations from both known and unknown health and genetic hazards.

REFERENCES: THC in Food and Cosmetics

1. Industrial Hemp Technical Manual, Health Canada, Standard Operating Procedures for Sampling and Testing Methodology Basic Method for determination of THC in hempseed oil, 1998.

2. Hart, R.H.: Bitter Grass, The Bitter Truth About Marijuana, April 1980,13-14.

3. Mcilroy, A.: “Health Canada study says THC poses health risk,” Globe and Mail, Ottawa Canada, July 27, 1999.

4. Zhu,LX., Sharma,S., Stolina,M., Gardner,B., Roth,MD., Tashkin,DP., Dubinett,SM., -9-Tetrahydrocannabinol Inhibits Antitumor Immunity by a CB2 Receptor-Mediated, Cytokine-Dependent Pathway, The Journal of Immunology, 2000, 165: 373-380.

5. “Alberta Farmers Slow To Try Growing Hemp,” Calgary Herald, Calgary Canada, August 14, 1999.

6. Ahmad, GR; Ahmad, N., “Passive consumption of marijuana through milk: a low level chronic exposure to Delta-9-tetrahydrocannabinol (THC)., Journal of Toxicology, Clinical Toxicology, 1990,28:2,255-260;ref.

7. Erasmus, U., Fats that Heal, Fats that Kill, Alive Books, 1993, p. 287.

8. Pulley, J., Air Force Snuffs Out Hemp-Seed Extract, Air Force Times, 2/8/99.

9. Cooper, M., New Police Policy Takes On Hemp Oil!, New York Times, 7/22/99.

10. Begoun, P., “Hemp Claims Can’t be Confirmed,” Tampa Tribune (FL), February 4, 2000.

11. Report to the (KY) Governor’s Hemp and Related Fiber Crops Task Force, June 13, 1995, Letter from Mahmoud A. Elsohly, Project Director, NIDA, Marijuana Project, University of Mississippi, to Prof. M. Scott Smith, Ph.D., University of Kentucky College of Agriculture, 1995.

12. Hart, R.H.: Bitter Grass, The Bitter Truth About Marijuana, April 1980, p 17

13. Ibid, p 17.

14. West, DP., Hemp and Marijuana: Myths & Realities, North American Industrial Hemp Council, Inc., 1998, p5.

15. Personal Correspondence from: Carlton Turner, Ph.D., Carrington Laboratories, Inc., Irving, TX., March 22, 1999, to: Jeanette McDougal.

16. Hart, R.H.: Bitter Grass, The Bitter Truth About Marijuana, April 1980, p 18.

17. Nahas, GG, M.D., PhD., D.Sc., Keep Off The Grass; Paul S. Ericksson, Publisher, 1990, p148

18. Hart, R.H.: Bitter Grass, The Bitter Truth About Marijuana, April 1980, p 17.

19. Nahas, GG, M.D., PhD.,D.Sc., Keep Off The Grass; Paul S. Ericksson, Publisher, 1990, p282. and Stedman’s Medical Dictionary, Lippincott Williams & Wilkins, Baltimore 2000.

20. Virovets, V.G.: Selection for Non-Psychoactive Hemp Varieties (Cannabis sativa L.) In the CIS (former USSR), 1996, Journal of the International Hemp Association 3(1): 13-15.

21. Community preparatory acts, Document 599PC0576(02): Http://europe.eu.int/eur- lex/en/com/dat/1999/en_599PC0576_02.html

22. Tetrahydrocannabinol (THC) and Other Cannabinoids in Foods, Cosmetics and Nutraceuticals Made with Industrial Hemp – A risk Assessment – (Draft) Prepared for Health Canada, November 23, 1999 (available through Access of Information, Canada). Final Report due fall of 2000, available through Health Canada.

Source: www.drugwatch.org/resources Aug.2000

Introduction

This essay is about the drug problem in society, particularly in the United States. By “drug” I mean alcohol, tobacco, and illegal drugs such as marijuana, hallucinogens, stimulants, depressants, and opiates. In regard to youth, inhalants (household chemicals inhaled to get a “high”) are also included.

This is not about the struggles faced by individuals who are addicted, or who struggle with any of the many life problems that can arise from drug use. Others are well addressing those issues in the treatment programs they offer and the publications they write. That society should be more diligent in ensuring availability of treatment for all who need it has been well stated by others. This essay is not about people’s drug problems so much as society’s drug problem.

The problem is that drugs are significantly decreasing our collective quality of life: decreasing our capacity to solve the problems that we collectively face in living. Whether you turn to issues of economics, health, social justice, family life, or the strength of the work force, the magnitude of the damage done by drugs is striking:

  • The number of deaths due to drugs in the United States alone each year exceeds 400,000 from tobacco, 100,000 from alcohol, and 35,000 from other drugs.
  • The most recent estimate of cost to U.S. society (not to users) of alcohol and other drug abuse was 246 billion dollars: 148 billion from alcohol abuse and 98 billion from other drug abuse.
  • A large percentage of health problems and health care costs are due to alcohol or other drugs.
  • Substance abuse in a single year costs American businesses 37 billion dollars due to premature deaths and another 44.6 billion dollars due to employee illness. Drug dependence and alcohol together cost businesses 200 billion dollars. A majority of the alcohol problems are caused by light and moderate drinkers, rather than alcoholics.
  • A high percentage of child abuse and neglect is associated with parental AOD (alcohol or other drug) abuse.
  • A recent study of teen marijuana users found they were 4 times more likely than non-users to attack someone, 3 times more likely to destroy others’ property, and 5 times more likely to have stolen things.
  • The combination of alcohol-related accidents, assaults, and suicides makes alcohol the leading risk factor for adolescent death and injury.

Whether or not you have directly experienced a drug problem in your life, society’s drug problem is shared by all of us. Most of the people who are aware of the impact of drugs on families and other relationships would argue forcefully one person’s drug use hurts more than just that person. The issue may be debatable in the case of any single individual, but collectively there can be no doubt: the drug problem is a problem for all of us.

In the twelve years I have worked in drug prevention, I have learned a lot about how drug use develops, and how it can be prevented. I have discovered that there is tremendous energy and potential in drug prevention, but progress has sometimes been slow, for good reason. The reason is that the general public, and in some cases even prevention professionals, hold some core assumptions about the drug problem that are actually incorrect. As a result, much of the effort put into prevention strays slightly, but significantly, from what is needed.

This essay is an attempt to identify, describe, and correct those faulty assumptions. This is not a “how to” book on prevention. I have written such a book (Best Practices in ATOD Prevention, 1997), with much help. But having the right tools are not enough to become a builder. To be successful with “how to,” you have to start with, “what’s that?” This essay is about understanding the drug problem: what causes it and what is needed to stop it. The application of this knowledge is up to each reader. I hope you find some valuable insights here, or perhaps find support for some of your own observations.

I am convinced that if we stop going down dead-end streets, we can really get places in prevention. Thanks for letting me share the results of my explorations in drug prevention.

Fallacy #1: The primary target of drug prevention should be hard-core drug abuse.

This fallacy has three main parts: (a.) which drugs are the problem, (b.) which drug users are the problem, and (c.) the relation of addiction to drug abuse.

a. “Shouldn’t crack, speed, and heroin be our number one concern?”

No. Ounce for ounce these drugs are certainly among the most potent, but they are (or should be) of secondary concern to drug prevention because of the developmental nature of drug abuse, the limitations of prevention, and the greater amount of societal problems associated with other drugs.

Development of Drug Abuse

It is exceedingly rare for an adult who has never used any drug to use drugs like cocaine or heroin. Nearly as rare is a youth or adult who uses one of these drugs without a history of use of at least one, and often all three, “gateway” drugs: alcohol, tobacco, and marijuana.

Don’t misunderstand the gateway drug phenomenon: obviously not all people who use alcohol, tobacco, or marijuana progress to other drug use. But, the odds of other drug use depend on gateway use because those who don’t use gateway drugs are so extremely unlikely to use other drugs.

The gateway phenomenon includes two other notable features in addition to the issue of whether or not gateway drugs are used. One is that the younger a person is when they begin gateway use, the greater their likelihood of drug problems (with gateway and other drugs) later in life. The other is that people who use two or three gateway drugs are more likely to progress to other drugs than people who use one (use of all three is most significant).

So alcohol, tobacco, and marijuana are truly “gateways” to other drug use. Although most of the people who go through the gate don’t do on to other drug use, nearly everyone who goes on to other drugs passes first through the threshold of gateway use. This alone doesn’t conclude the case for where to direct drug prevention, but sets the stage for two other two facts.

Limitations of Prevention

Prevention is just one of the major strands of anti-drug efforts. The other two are treatment and legal restrictions (regarding use, possession, and sale of drugs). To a great extent the target population for prevention and the target for treatment are opposite. By the time people go through gateway use and begin using other drugs, they have become (due to some combination of self-selection and the results of earlier gateway use) fairly habituated to drugs. In many cases they are already addicted. The habit formed from regular drug use is hard to break. When addiction is also present, the strong forces involved are not only psychological but also bio-chemical. We like to think our minds are in control, but addiction can rule behavior at a level so deep and powerful that rational thought pales in comparison.

As a result, prevention efforts that may be appropriate for youth who are non-users or experimenters with drugs are simply not effective with more committed users, and certainly not with addicts. Addiction calls for drug treatment: prevention is inadequate for those trying to back away from heavy drug use.

On the other hand, treatment is not appropriate for first-time experimenters. The treatment process is not designed for that population, and the cost of providing such intensive services is neither justified for the individual drug experimenter nor remotely available for the whole population of experimenters. For them and for those who are yet to experiment, prevention is the key.

Of those who use gateway drugs, some require treatment (or cessation aid, in the case of tobacco), but most do not. Of those who use other drugs, a large proportion requires treatment, and few would benefit from prevention. This strengthens the case for targeting gateway drugs in prevention, and leads to the third point.

Societal Cost of Gateway Drug Problems

Recall that ounce per ounce, gateway drugs are not as destructive as crack, crank, and heroin. But the scope of any one drug’s impact on society depends on the amount of use (including number of users and degree of use by each) as well as the drug’s dangers. Unlike crack and heroin, gateway drugs are used by a large portion of the population. And, though gateway drugs seem less dangerous than so called “hard” drugs, research and bitter experience have shown that the gateway drugs are dangerous enough:

  • Tobacco kills four times as many Americans as does alcohol, and alcohol kills three times as many as all illegal drugs combined.
  • Alcohol seems to be the leading cause of teen deaths, based on the high percent of instances in which alcohol is a major factor in car crashes, suicides, homicides, drownings, and other unintended injuries.
  • Marijuana combines the cancer potential of tobacco with the cognitive impairment of alcohol, except that impaired thought lasts longer after each marijuana use than after each alcohol use.

As a result, the benefit to society of cutting gateway drug use in half would be much greater than cutting other drug use in half. Combine this point with the point about prevention’s limits and the point about the development of drug abuse, and you get a strong case for making gateway drug use (particularly by youth) the prime target of prevention.

b. Shouldn’t prevention always target “high risk” youth?

No. Although it may be appropriate to devote extra preventive effort to some groups of youth, conceiving ATOD prevention in only those terms is problematic for reasons that include the breadth of risk, the importance of environmental risk, and the need for different approaches according to the nature of different risk conditions.

Breadth of Risk

While some characteristics act as “risk factors” for youth ATOD use, the absence of those risk factors doesn’t guarantee a drug-free youth. To some extent, everyone is at risk. The older a persons gets without using, the lower the risk that they will use. Furthermore, while the primary aim of ATOD prevention is to prevent use, an important secondary function is to help prepare all youth for addressing the drug problem in society: as family members, co-workers, or citizens. We are currently a society at risk.

This is not to say that community risk conditions shouldn’t be considered, nor that “selective” ATOD prevention efforts can’t be done for groups of medium risk youth or families. I use the term “medium risk” to refer to youth who haven’t begun ATOD use, but whose family or personal characteristics include some risk factors (e.g., poverty, low academic achievement, parental drug use or addiction, etc.) for youth ATOD use. But these efforts are a supplement to prevention efforts for all youth, rather than a replacement.

Environmental Risk

Preoccupation with risk profiles of individual youths, or even groups of youths, diverts attention away from the strongest influences of whether most youth will try drugs or avoid drugs. The combination of youths’ peer social environment, family environment, school environment, media environment, and their community’s adult social environment account for the vast majority of variation in youth drug behavior. A “low risk” youth who enters a “high risk” environment (e.g., a “no-use” youth who moves to a school where drinking is the norm) is no longer low risk.

Prevention planners who only look at what’s “inside” youth can miss the environmental factors (including media influences) that shape youths’ attitudes. If not directly addressed, these environmental factors can misdirect youths’ attitudes and behaviors as fast or faster than youth-focused programs can positively affect them.

Different Risks – Different Approaches

The risk factor that is most important to the largest number of youth in regard to initiation of gateway drug use is their perception of peer attitudes about drugs, as will be discussed in regard to “Fallacy #3.” However, for a smaller number of youth other factors play a major role. For example, children raised in households with parental violence, neglect, or addiction are more likely than average to develop their own problems with alcohol or other drugs. The number of children in this kind of situation, though much larger than it should be, is small compared to the overall number of children and families.

For a child in a household with parental violence (domestic violence and/or child abuse), what happens to that violence may be the most important “risk factor” for their future mental health, including their relation to drugs. Their greatest need may have little to do with drug prevention, and everything to do with appropriate resolution of the violence.

For a youth failing school, the greatest need may be assistance with whatever is interfering with school achievement.

In each case, the most effective form of drug prevention may be to resolve the problem(s) that increase risk for drug use, rather than to directly address the issue of drugs. On the other hand, a youth who has started to experiment with drugs may need intervention services, sometimes called “indicated prevention”, but actually more closely akin to some forms of substance abuse treatment counseling. In all these instances, the kinds of programs that constitute “universal” drug prevention programs may be less relevant. So, these kinds of “high risk” youth need more focused and intensive assistance than is available through what I am calling drug prevention, i.e. programs designed to impact the gateway drug attitudes and behaviors of large groups of youth. They may be helped somewhat by such programs, and so should not be excluded, but to limit participation in prevention programs only to such “high risk” youths is probably not appropriate, particularly given the risk of a norm of gateway drug use arising among program participants if all are “high risk.”

c. Isn’t addiction prevention the main goal of substance abuse prevention?

No. Addiction is one major outcome of drug use, but the impairment of rational thought, the plethora of anti-social and injurious behaviors caused or heightened by that impairment, and the direct toxic effects of drugs are all substantial societal problems worthy of prevention. Addiction increases these other problems, but a person need not be addicted in order to seriously injure of kill themselves or others while impaired, typically due to negligence (as in DUI crashes) rather than violent intent.

Further, since the number of alcohol or other drug users at any given point in time far exceeds the number of addicts (including alcoholics), the societal damage done by non-addicted persons can cumulatively exceed the damage done by addicts. Even though individual addicted persons are more problematic to society than individual non-addicted AOD (alcohol and other drug) users, the much larger number of non-addicted users makes them a major part of societal AOD problems.

Efforts to make the public more aware of realities of addiction should continue, but preventing addiction is one main goal of drug prevention: not the main goal.

Fallacy # 2: Alcohol and other drug problems are mainly a result of other problems, and drug prevention can best be accomplished by addressing those other problems.

Drug abuse has multiple causative factors: this has become an oft stated truism. Unfortunately, people tend to notice and magnify the causative strand that is most evident in their personal or professional experience. Their observations are strengthened by studies which demonstrate the connection between each of a variety of “risk factors” and drug abuse, but which fail to consider the larger context of the societal drug problem, including which of the many risk factors play the most important roles within the largest numbers of people. Rather than starting with convergence on the most prevalent and powerful risks, people therefore tend to diverge into various less central issues:

  • Persons who focus on poverty see poverty as the main root of drug problems.
  • Persons concerned with stimulating positive youth development see their work as the best form of drug prevention.
  • Persons familiar with dysfunctional family systems see family dysfunction as the main root of drug problems.

Attention to this whole range of negative factors may be appropriate, but mistaking any one of these for the “main” cause of drug problems is not. One person or subgroup may be profoundly influenced by one of these factors, but the prevalence of each factor in the population is far less than the prevalence of drug problems.

Family Dysfunction: Major dysfunction (such as family violence) greatly heightens the chance of youth drug problems, but the majority of youth AOD users (and hence, most of the future AOD abusers) do not come from dysfunctional families. Dysfunctional family life is a potent risk factor but not a prevalent one, in comparison to the scope of youth AOD problems.

Poverty: Poverty makes drug problems more likely, but only slightly more likely: a large number of well-to-do people are among those who children use and abuse alcohol and other drugs.

Positive Youth Development: Policies that empower youth development are a good idea, but aren’t sufficient to prevent youth drug use. The notion that positive youth development can substitute for specific attention to drug prevention is similar to the 1970’s notion that good self-esteem is the key to drug prevention. Unfortunately, ignoring drug prevention in favor of self-esteem tends to produce drug users with high self-esteem. Self-esteem doesn’t protect from the destructive effects of drugs. Youth development programs can be an important aid for youths who lack key developmental assets, but will only impact drug use if:

  1. anti-drug norms are already present in the lives of those youth, or
  2. the youth development program includes building anti-drug norms as part of its mission.

Two kinds of problems arise from the mis-attribution of heightened importance of these factors as causes of substance abuse:

  1. More global causes of ATOD problems, such as youths’ and parents’ attitudes about drug use, may be glossed over in the design of prevention strategies. In other words, potentially efficacious approaches to prevention may be ignored in favor of less broadly effective approaches.
  2. Parents may believe that avoiding family dysfunction is sufficient to prevent youth drug problems.

The worst instances of this fallacy in action have parents or other adults allowing and enabling youth alcohol or other drug use under the misguided notion that only troubled individuals abuse substances. Statements like, “It’s no big deal,” or “They’re just going through a phase,” or “It’s part of growing up” tend to be evidence of this. While it’s true that troubled youth are more likely to develop a drug problem, also true is that alcohol or other drug use can cause a person to become troubled – especially if addiction is involved.

Youth alcohol and other drug use is a bad idea no matter how positive an individual’s circumstances. Youth with substantial personal or family problems are more likely to experience significant problems with drugs, but the initial absence of personal disturbance is no insurance policy against addiction or other ATOD problems. And, although family problems constitute a risk factor for youth ATOD use, family wellness is not a sufficient protective factor to counter other negative influences on youth ATOD decisions. Parents who don’t have general problems with family management can take steps (particularly in regard to monitoring youth activities) to decrease their children’s likelihood of ATOD use, but just being a “good” parent isn’t a cure-all. Drug prevention needs to go beyond the foundation of healthy families and positive youth development, to build attitudes and behaviors that especially counter ATOD influences in society.

Fallacy #3: The main essence of successful drug prevention is communication about the dangers of drugs.

This very common misperception probably sidetracks more prevention efforts than any other single error. Actually the essence of success in preventing youth use of gateway drugs is making drug use unpopular: destroying the myth that peers approve of drug use. This can be supplemented by fact-based approaches and parent programs, but the most basic reason youth as a whole start gateway drug use is because they believe their peers approve of it. No matter how dangerous they are told drug use may be, if they think many others are doing it they will tend to do the same, unless they consistently see very negative effects on those believed to be using.

There are two reasons I see for the continuing strength of Fallacy #3 in spite of evidence to the contrary. The first is our nature as human beings. We like to think we are logical, sensible beings. To some extent we are, but most of us, and especially children and youth, base our actions first on what we observe from those around us, and only secondly on what we believe.

Remember that we are talking about society as a whole here: there are certainly some people who are less prone to be influenced by others (psychology calls them “field independent” as opposed to field dependent), and all of us vary in our susceptibility. But as a whole, we’re just not as logical as we like to think. To be human is to be influenced by our observations of others.

The second reason for the fallacy is a more complex one having to do with the nature of scientific studies of youth alcohol and other drug use. Common scientific method in the social sciences involves looking for things that go together in large populations. The question is what “factors” tend to go with, and particularly to predict, youth ATOD use. A basic premise is that correlation does not necessarily equate to causation, especially in cross-sectional one-time studies. However, when a factor such as “perception of harm” is closely matched with drug use over a period of years, as has been the case in the national “Monitoring the Future” study, observers are hard pressed to ignore the likely conclusion that changing perception of harm is the key to prevention.

The problem is, how does one change perception of harm? The common assumption is that you do this by communicating drug dangers. Often overlooked is that there is an equally strong association with perceived peer approval or disapproval for use of drugs: what youth believe their peers think of drugs. I think that, contrary to common assumptions, the perception of peer attitude drives youths’ own attitudes about drugs (both perceived harmfulness and intent to use). Perception of harm then ends up being a strong indicator of whether a youth will use a drug, especially because it is probably also affected by other risk factors. But the route to turning around perception of harm usually has to go through perceptions of peer approval/ disapproval. When we present logical facts about drug dangers to youth, if they think most of their peers approve of drug use, and indeed use drugs, then the warnings seem ungrounded and are easily ignored.

I base this point on a variety of research, but some of the most striking and easiest to communicate is research about what works in prevention. Of all the things that have been tried in prevention curricula for young teens, the most powerful is simply to correct their typically exaggerated assumptions about how many peers use drugs. When they are shown that far fewer than thought peers use, their attitudes change to a degree not seen with mere truth about drugs.

This is not to say that education about drug dangers is not important for youth: it is! These facts back up the facts about peer attitudes, and may be especially important for some youth who are able to base their behavior on rational truth about drug dangers. Even if this weren’t the case, it would simply not be right to let youth grow up in this society without exposing them to the truth about drugs. But to assume that exposure is the key element of prevention is to severely limit the effectiveness of one’s prevention efforts.

One of the important implications of this is that the images presented by mass media, especially in regard to images of youth attitudes and behaviors, should be a vital concern of prevention. We all like to think that we are too sophisticated to be influenced by the images of television and other media, but it’s just not so. We are influenced. That’s why advertising works. While any one youth may be more influenced by their parents than by the media, youth as a whole are dramatically influenced (as has been demonstrated by studies showing that youth smoke those cigarette brands that are most heavily advertised to youth). Media plays the role of a “super-peer,” playing directly into the heart of youth decisions by telling them what is cool and what isn’t. Prevention cannot afford to ignore this. Luckily, the same principles currently used by alcohol and tobacco advertisers to snare youth users can also be used in prevention. But, first we have to get past this fallacy that drug facts are the key.

Fallacy # 4: Making and enforcing laws against the use of drugs, and against underage use of alcohol and tobacco, is contrary to prevention and treatment of drug use.

This premise has been advanced by legalization groups, claiming all would be well if we did away with laws against drug use and relied solely on prevention and treatment. But the truth is that prevention, treatment, and legal barriers to use all depend on each other for effectiveness. The kind of “prevention” touted by legalization groups is not prevention of use but facilitation of “safe” use, called “harm reduction.” The role of prevention in this scenario is to teach people how to use drugs safely. The problem with this is that the laws against each particular drug are enacted because its use is inherently unsafe. An analogy would be explosives manufacturers lobbying to take the funds used to enforce laws against possessing bombs and instead just teaching youth how to use them “safely,” and of course not until they were 18 or 21. Would the public stand for that? Would even the most avid libertarians be crazy enough to support it? Legalizers suggest that drugs hurt only the user, but impacts of our society’s drug problem go far beyond the circle of users, as was discussed earlier.

Even if, after legalization, the current drug-free message of prevention were maintained, a country that tolerates drug use would be giving a strange message that would undercut any such “no-use” message. “Drugs are dangerous and hurt society, but you can go ahead and do them if you want.” Use would soon rise, not so much from drug-free adults starting use but from every new generation of teens becoming more and more enmeshed in drug use, in spite of any legal age restrictions. This is what has happened when legalization has been tried. Similarly, the number of people entering treatment, cooperating with treatment, and avoiding relapse would be far less without the force of law to compel users to quit.

High quality drug prevention and treatment are currently vital to our society, but their success would be lessened, not increased, if legal sanctions against use were eliminated. The specific workings of the legal and criminal justice system in regard to drug use can always be examined for improvement, but most groups who currently call for drug law “reform” are using the term as a euphemism for legalization.

Fallacy # 5: Marijuana is not dangerous.

We tend to think of drugs as poisons to the body, and measure the potency of a drug by how fast and how completely it can interfere with physical health. We are less quick to recognize that the most crucial characteristics of drugs are their “psychoactive” effect: their alteration of thought, feelings, and behavior. Measured by physical effects only, marijuana is not as dangerous as many other drugs (though it has the potential to kill as many people as tobacco does, if it were as popular as tobacco). But, examined for its behavioral effect, marijuana is quite potent. The subtlety with which it alters behavior, typically over a period of weeks or months, makes it all the more effective as a behavioral change agent. The data that has begun to emerge as younger teens and pre-teens smoke more potent marijuana shows a devastating effect on the social functioning of many users. Some users may have been self-centered when they began use, but marijuana heightens that characteristic, killing the empathy and capacity for altruism that embody the best qualities of society. What is left is a person addicted to marijuana and concerned about marijuana, but not so much about relationships, achievement, or even obeying the law. People sometimes discount the effects of marijuana because many users do not seem to be greatly impaired, but the luck of some in warding off clear impairment is a poor balance to the studies and accumulated life experiences of those who have been severely changed by marijuana use.

Fallacy # 6: Anti-drug laws and anti-drug law enforcement is driven by national bureaucracy and the zealousness of federal officials.

People who travel in a sub-culture of drug tolerance tend to perceive the government’s anti-drug actions as being out of touch with the populace, but polls show that a large majority of the American (and other) public opposes drug legalization. The greatest passion in favor of enforcing drug laws comes not from any government but from families that have seen the worst that drugs do. The proper balance between society’s interest in stopping drugs and the freedom of individuals becomes clear when one has witnessed a family or community ravaged by drug use and addiction. The social value of drugs is far below zero. Any loosening of restrictions on drug use has tended to lead to a cycle of increased use, increased damage to society, and a resulting determination to toughen enforcement of laws against drug use. Ultimately, the source of calls for strict enforcement of laws against drugs come not from any one group but from the power of drugs to damage people, and damage society.

Alan Markwood is the Prevention Projects Coordinator at Chestnut Health Systems, Inc. in Bloomington, Illinois. Responsibilities include:

  • Participating in prevention research, development, and training projects as a contractor to the Illinois Department of Human Services.
  • Directing prevention coalitions in three counties, funded by the federal Center for Substance Abuse Prevention and the Illinois Department of Human Services under grants he wrote.

Mr. Markwood is the principal author of the Best Practices in ATOD Prevention Handbook (1997), and has managed a series of statewide studies on youth substance use in Illinois. He served as InTouch Area 14 Prevention Coordinator at Chestnut Health Systems from 1987 until promoted to his current position in 1995. Prior to his work in prevention, he worked as a School Psychologist for seven years in Illinois and Massachusetts. He has a Master of Arts degree in Psychology from Alfred University and a Certificate of Advanced Graduate Study in Education from Boston University.

Source: www.drugwatch.org Sept.1999

 

 

 

 

 

 

 

 

 

 

Ethan Nadelmann is the founder and executive director of the Drug Policy Alliance (DPA), the nation’s richest drug legalization organization with a budget of some $45 million last year. It has financed ballot initiatives in states to legalize first “medical,” now “recreational” marijuana.

Ethan Nadelmann is the founder and executive director of the Drug Policy Alliance (DPA), the nation’s richest drug legalization organization with a budget of some $45 million last year. It has financed ballot initiatives in states to legalize first “medical,” now “recreational” marijuana

Riding high on his success of fully legalizing pot in four states and D.C., Mr. Nadelmann cannot resist applying the DPA legalization strategy to other drugs now.

“Marijuana, cocaine, heroin, and methamphetamine are global commodities,” he told his TED audience. “Legally regulating and taxing most of the drugs that are now criminalized would radically reduce crime, violence, corruption, and black markets.” He cites no evidence to support this statement, perhaps because there is none.

Nonetheless, he says he has dedicated his life “to building an organization and a movement of people who believe we need to turn our backs on the failed prohibitions of the past and embrace new drug policies based on science, compassion, health, and human rights.”

Who doesn’t want drug policies based on those admirable goals? But commercializing heroin, methamphetamine, and cocaine–the end result of legalization, as we are seeing in Colorado with marijuana–won’t get us there. Mr.Nadelmann also asserts that “our desire to alter our consciousness may be as fundamental as our desire for food, companionship, and sex.”

We don’t argue that the desire for food, companionship, and sex is universal, but the desire to be stoned?

  • 7.5% of Americans ages 12 or older used marijuana in the past month, according to the most recent National Survey on Drug Use and Health. That means 92.5% of Americans didn’t.

  • 0.6% used cocaine in the past month; 99.4% didn’t.

  • 0.2% used methamphetamine; 99.8% didn’t.

  • 0.1% used heroin, the drug that now kills more Americans than traffic crashes; 99.9% didn’t.

Ethan Nadelmann may find the desire to be stoned as fundamental as food and sex, but please, Ethan, leave the rest of us out of it! Dedicate your life to something else.

See Mr. Nadelmann’s TED Talk here.

Wouldn’t it be simpler for the USA to not legalise so-called medical marijuana and so-called recreational pot? (drug taking is not recreational !). Freely available marijuana will lead to more use by youth and research has shown that 10% of users will need treatment for addiction and mental health issues. 10% of a larger number of users will result in a larger number requiring treatment – with the inevitable increase in financial costs of treatment.

ACLU Calls Legislature’s Plans to Raid Pot Taxes “Dangerously Shortsighted and Unwise”

  

pot-tax

Pot Tax

In 2012, voters approved spending marijuana taxes on public health. Now, Republicans and Democrats want to grab that cash for other needs. 

Budget negotiations in the state legislature are not going well. House Democrats want taxes; Senate Republicans don’t.

Now, Republicans are telling Democrats to hand their tax proposals over to the Republican-controlled senate (where leaders promise no new taxes) before the two sides start negotiating. As the Seattle Times reports, the Democrats are like, uh, no thanks.

So negotiations are stalled and a special session seems likely.

One of the many efforts that hangs in the balance is the Republican-controlled senate’s plan to raid almost $300 million in expected marijuana tax revenue to pay for K-12 education. (House Democrats also want that money. Their budget keeps most of the 2012 initiative’s earmarks, but redirects some of them to non-marijuana-related needs like life skills training in schools and home visitation programs for new parents.) As I’ve explained before, marijuana tax dollars are—according to the initiative 56 percent of Washington voters supported in 2012—supposed to pay for public health efforts, like drug use prevention, treatment, research, public education campaigns about using marijuana safely, and healthcare. Not only does diverting those funds run counter to the vision of public-health-focused legalization that was sold to the voters. It also has some experts worried about negative impacts on public health.

In its second letter to lawmakers this month, the ACLU of Washington is joined by a long list of substance abuse prevention advocates in pleading with legislators to stop trying to snatch marijuana tax revenues to balance their budgets.

“Using I-502-earmarked funds to fill a budget hole now is dangerously shortsighted and unwise from both a public health and a cost-benefit perspective,” the group writes. “Reduced funding for prevention and drug education programs today means increased substance abuse tomorrow, which translates directly to lost productivity and more health care costs down the line. The increased costs of these outcomes in the years to come will make today’s supposed savings pale by comparison.”

The letter also points out a recent University of Washington survey of 115 low-income families of teens attending Tacoma middle schools, in which only 57 percent of parents knew the legal age for consumption and 63 percent knew home grows are illegal.

“To combat this misinformation,” the letter reads, “the legislature must invest in prevention and drug education, which is known to work—for example, youth initiation of tobacco use was cut in half when tobacco litigation settlement dollars went to prevention programs.Now is not the time to cut funding for programs that prevent marijuana use and abuse by youth.”

Here are the guys who wrote the senate budget plan, which redirects almost all of the tax revenue: Republican Andy Hill (andy.hill@leg.wa.gov) and Democrat Jim Hargrove (jim.hargrove@leg.wa.gov).

And here are those who sponsored the house proposal, which is less dramatic in its redirecting, but still opposed by the ACLU: Ross Hunter (ross.hunter@leg.wa.gov), Timm Ormsby (timm.ormsby@leg.wa.gov), Pat Sullivan (pat.sullivan@leg.wa.gov), Mia Gregerson (mia.gregerson@leg.wa.gov), Chris Reykdal (chris.reykdal@leg.wa.gov).

Here’s the full letter:

April 15, 2015
Re: Reallocation of Initiative-502 tax revenue in SSB 6062/SSB 5077 and 2SHB 2136/SHB 1106

Dear Lawmakers,

The undersigned organizations and individuals, representing Washington State’s substance abuse prevention, treatment, and public health communities, along with the ACLU of Washington, are greatly concerned about legislation currently under consideration that seeks to reallocate earmarked tax revenue in Initiative 502 (I-502). Diverting these funds would directly contradict the will of Washington voters, who made it clear in passing I-502 that they wanted a well-regulated and public health-oriented approach to marijuana policy rather than just legalization without more. And these funds provide resources for substance abuse prevention and treatment programming, drug education for youth and adults, community health care services, academic research, and evaluation, all of which are currently grossly underfunded.

Reallocating money from I-502’s original earmarks defies the will of Washington’s voters. By eliminating the Dedicated Marijuana Fund, the relevant Senate proposals, SSB 6062 and SSB 5077, would effectively eliminate I-502’s earmarks, ignoring the Initiative’s intent to “[g]enerate[] new … tax revenue for … health care, research, and substance abuse prevention.” Initiative 502 (2012), Part I – Intent – available athttp://www.newapproachwa.org/sites/newapproachwa.org/files/I-502%20bookmarked.pdf. The House proposals, 2SHB 2136 and SHB 1106, are not as sweeping as the Senate’s, but would still redirect money away from prevention programs to other non-marijuana-related programs. In moving forward with this cash grab, the legislature would be risking the interests and health of both Washington’s youth and its adults—the former would not get the benefit of participating in evidence-based prevention programs, and the latter will not get sufficient education about risky marijuana use. Neither is a good outcome for Washington. I-502 won by a large margin, receiving almost 56% support, and won in 20 of Washington’s 39 counties (including 5 east of the Cascades)—the legislature should respect the clearly expressed will of Washington’s voters.

Using I-502-earmarked funds to fill a budget hole now is dangerously shortsighted and unwise from both a public health and a cost-benefit perspective. Reduced funding for prevention and drug education programs today means increased substance abuse tomorrow, which translates directly to lost productivity and more health care costs down the line. The increased costs of these outcomes in the years to come will make today’s supposed savings pale by comparison.

As the Washington State Institute for Public Policy has shown repeatedly, the benefits from evidence-based public health/prevention and substance programs far outweigh the costs. WSIPP – Benefit-Cost Results – available at http://www.wsipp.wa.gov/BenefitCost 
Washington voters also enacted a measure that was to have been robustly evaluated by the Washington State Institute for Public Policy. RCW 69.50.550 Independent, reliable cost-benefit evaluation of the impacts of I-502 is critical to ensuring the legislature has solid data to inform future decisions about funding priorities that protect and promote public health and safety. SSB 6062 repeals the provisions mandating and funding these evaluations, which is unwise from a policy and public health perspective. Under the Senate proposal, funding for marijuana related research at the University of Washington and Washington State University would also be cut.

I-502 is still a new law and the general public is unfamiliar with its features—making this a crucial time for public education about the law. According to research from the University of Washington, “only 57 percent of Washington parents surveyed knew the legal age for recreational marijuana use.” UW Today, Deborah Bach, Study Shows Teens and Adults Hazy on Washington Marijuana Law, March 9, 2015, available athttp://www.washington.edu/news/2015/03/09/study-shows-teens-and-adults-hazy-on-washington-marijuana-law/. One of the study’s authors indicated it “convincingly points out that people don’t have good information about the new law.” Id. To combat this misinformation, the legislature must invest in prevention and drug education, which is known to work—for example, youth initiation of tobacco use was cut in half when tobacco litigation settlement dollars went to prevention programs. Now is not the time to cut funding for programs that prevent marijuana use and abuse by youth.

Lawmakers should not defy the will of the voters by reallocating I-502 tax revenue away from substance abuse prevention and treatment programming, drug education for youth and adults, community health care services, academic research, and evaluation. Please leave I-502’s critical earmarks intact.

Sincerely,

Carolyn Bernhard, Co-Chair, Prevention Works in Seattle Coalition
Kimberlee R. Brackett, President and CEO Science and Management of Addictions (SAMA)
Julie Campbell, Director, Ballard Coalition
Mark Cooke, Campaign Policy Director, ACLU of Washington
Brittany Rhoades Cooper, PhD Assistant Professor, Human Development, Graduate Faculty in Prevention Science, Extension Specialist, Washington State University
Shelley Cooper-Ashford, Executive Director, Center for MultiCultural Health
Josh Daniel, Content Inventions
Norilyn de la Pena, concerned parent, Federal Way
Aileen De Leon, Executive Director, WAPI Community Services
Rep. Mary Lou Dickerson (ret.), Initiative 502 Co-Sponsor
Dennis M. Donovan, Ph.D., Member, Board of Directors, Science and Management of Addictions (SAMA) Foundation
Sinivia Driggers, President, Samoan Nurses of Washington
Derek Franklin, Washington Association for Abuse & Violence Prevention (WASAVP)
Tracie Friedman, Youth Program Volunteer, Lau Khmu Association of Seattle
John Gahagan, Vice Chair, Science and Management of Addictions (SAMA) Foundation
Mike Graham-Squire, Washington Association for Abuse & Violence Prevention (WASAVP)
Gary Goldbaum, MD, MPH, Snohomish County Health Officer & Director
Kevin Haggerty, MSW, Ph.D., Director, Social Development Research Group
Mona T. Han, Executive Director, Coalition for Refugees from Burma
Patty Hayes, Interim Director, Public Health-Seattle & King County
Laura G. Hill, Professor and Chair, Department of Human Development, Interim Director of the Prevention Science PhD program, Washington State University
Alison Holcomb, National Director, Campaign to End Mass Incarceration at ACLU
Renee Hunter, Executive Director, Chelan-Douglas TOGETHER for Youth
Elaine Ishihara, Director, APICAT for Healthy Communities
Mark Johnson, Johnson Flora, Initiative 502 Co-Sponsor
Ramona Leber, Washington Association for Abuse & Violence Prevention (WASAVP)
Priscilla Lisicich, Executive Director, Safe Streets Campaign – Pierce County
Inga Manskopf, Prevention WINS coalition member
Marcos Martinez, Executive Director, Entre Hermanos
John L. McKay, Visiting Professor of Law Seattle University, Initiative 502 Co-Sponsor
Michael McKee, Health Services & Community Partnership Director,
International Community Health Services
Delton Mosby, Mental Health and Chemical Dependency Professional, Therapeutic Health Services
Sal Mungia, Gordon Thomas Honeywell, Initiative 502 Co-Sponsor
Adrienne Quinn, Director, Department of Community and Human Services, King County
Roger Roffman, Ph.D., Professor Emeritus, School of Social Work, University of Washington
Andrew J. Saxon, MD, Science and Management of Addictions (SAMA) Board Chair, Professor Department of Psychiatry & Behavioral Sciences, University of Washington
Lorena Silva, community member, Yakima Valley
Rick Steves, Guidebook author and travel TV host, Rick Steves’ Europe, Initiative 502 Co-Sponsor
Jennifer Stuber, Associate Professor, University of Washington
Val Thomas-Matson, Program Manager, Health King County Coalition
Linda J. Thompson, Executive Director, Greater Spokane Substance Abuse Council (GSSAC)
Leslie R. Walker, MD, Chief, Division of Adolescent Medicine, University of Washington Department of Pediatrics & Seattle Children’s Hospital
Paul Weatherly, Bellevue College Alcohol/Drug Counseling Program
Leondra Weiss, Nurse Manager, Harborview Women’s Clinic
Robert W. Wood, M.D., Clinical Professor of Medicine, University of Washington, Initiative 502 Co-Sponsor
The Washington State Psychiatric Association

Filed under: Political Sector,USA :

April 20, 2015

For Immediate Release

For More Information Contact: Lana Beck (727) 828-0211 or (727) 403-7571

Weeds 3: A Documentary Showcasing Legitimate Scientific Research or an Infomercial to Legalize Marijuana?

(St. Petersburg, FL) Drug Free America Foundation stands with other major medical associations whose positions support the research into the medical efficacy of marijuana. These associations include: the American Medical Association, American Society of Addiction Medicine, American Academy of Pediatrics and the American Psychiatric Association. However, Dr. Sanjay Gupta’s documentary blurs the lines between legitimate research and propaganda. The important take-a-way from the show was that research on the potential benefits of marijuana is taking place today without the rescheduling of the drug. Unfortunately, the show failed to point out the multitude of harms of marijuana use and the impacts in states that have determined medicine by popular vote.

Two things about the documentary that really upset me as a medical professional are that Sanjay Gupta had a chance to drive home the point that because research is underway on the potential benefits of components in marijuana, there is no need to legalize it through referenda where dosages can’t be controlled and various strains can’t be cloned. Nor is it necessary to reschedule the drug,” said Dr. Eric Voth, an expert on drug policy and Chair of the Institute on Global Drug Policy.

The other disappointing aspect about this show is the lack of discussion about the myriad of scientific research out there that shows the other side of marijuana that is harmful and addictive,” continued Voth. “If we are going to have open dialogue about marijuana research, then Gupta shouldn’t muddy the water by sending an incomplete message to the public about the right and the wrong way to approach true scientific research. I think this was an intentionally missed opportunity by Gupta to further a less-than-scientific agenda,” concluded Voth.

By ignoring the potential harms of marijuana use and not acknowledging the big problems that Colorado and California have experienced since marijuana has been legalized in those states, CNN and Dr. Gupta failed to cover this issue honestly,” said Amy Ronshausen, Deputy Director of Drug Free America Foundation, Inc. and Save Our Society From Drugs. “This show failed to cover Colorado’s increases in drugged driving fatalities and emergency room visits because of marijuana use. Nor did the show discuss the alarming trend surrounding high potency marijuana edibles sold as ‘medicine’ and marketed to be appealing to youth,” continued Ronshausen. “There was a lot of discussion about how marijuana may help PTSD symptoms, but none about the mounting research on how the drug exacerbates psychotic symptoms,” concluded Ronshausen.

Source: Press Release DFAF 20th April 2015

The impact that so-called medical marijuana and later the legalisation of marijuana in Colorado, USA has had serious consequences, a few are show in snippets below.  The items shown are taken from the Rocky Mountain High Intensity Drug Trafficking Area Report.  The complete report can be found at:

http://www.rmhidta.org/default.aspx/MenuItemID/687/MenuGroup/RMHIDTAHome.htm.

The Legalization of Marijuana in Colorado: The Impact Vol. 3 Preview 2015 

Medical Marijuana Registry Identification Cards 

December 31, 2009 – 41,039

December 31, 2010 – 116,198

December 31, 2011 – 82,089

December 31, 2012 – 108,526

December 31, 2013 – 110,979

December 31, 2014 – 115,467

Colorado: 

505 medical marijuana centers (“dispensaries”)1

322 recreational marijuana stores1

405 Starbucks coffee shops2

227 McDonalds restaurants3

Denver: 

198 licensed medical marijuana centers (“dispensaries”)1

117 pharmacies (as of February 12, 2015

  • In one year, from 2013 to 2014 when retail marijuana businesses began operating, there was a 167 percent increase in explosions involving THC extraction labs.

 

 

 

Findings 

There has been an upward trend of marijuana-related emergency room visits and hospitalizations since medical marijuana was commercialized in 2009.

There has also been a significant increase in both categories in the first six months of 2014 when retail marijuana businesses began operating

It is important to note that, for purposes of the debate on legalizing marijuana in Colorado, there are three distinct timeframes to consider. Those are:

The early medical marijuana era (2000 – 2008), the medical marijuana commercialization era (2009 – current) and the recreational marijuana era (2013 – current).

2000 – 2008: In November 2000, Colorado voters passed Amendment 20 which permitted a qualifying patient and/or caregiver of a patient to possess up to 2 ounces of marijuana and grow 6 marijuana plants for medical purposes. During that time there were between 1,000 and 4,800 medical marijuana cardholders and no known dispensaries operating in the state.

2009 – Current: Beginning in 2009 due to a number of events, marijuana became de facto legalized through the commercialization of the medical marijuana industry. By the end of 2012, there were over 100,000 medical marijuana cardholders and 500 licensed dispensaries operating in Colorado. There were also licensed cultivation operations and edible manufacturers.

2013 – Current: In November 2012, Colorado voters passed Constitutional Amendment 64 which legalized marijuana for recreational purposes for anyone over the age of 21. The amendment also allowed for licensed marijuana retail stores, cultivation operations and edible manufacturers.

Findings 

Youth (ages 12 to 17 years) Past Month Marijuana Use,

2013 o National average for youth was 7.15 percent

o Colorado average for youth was 11.16 percent

Colorado was ranked 3rd in the nation for current marijuana use among youth (56.08 percent higher than the national average)

In 2006, Colorado ranked 14th in the nation for current marijuana use among youth

In just one year when Colorado legalized marijuana (2013), past month marijuana use among those ages 12 to 17 years increased 6.6 percent.

It’s the largest cash crop in the United States…

Bigger than corn, bigger than wheat, and bigger than cotton.

From 2013 to 2014, it experienced a growth rate of 77%, and an estimated 700% growth rate is anticipated by 2018.

I’m talking about cannabis, and if you’re a regular reader of these pages, you know I’m extremely bullish on the potential of this burgeoning market.

That being said, we’re still in the earliest stages, and right now there are a lot more pitfalls than profits — one of which is the direct result of the federal government’s labelling of marijuana as a schedule 1 substance.

As a schedule 1 substance, it is illegal for any person to manufacture, distribute, or dispense marijuana. As a result, almost every bank in the nation refuses to do business with the cannabis industry due to fear of being shut down by the feds.

So because of the federal government’s insistence on continuing the drug war and denying citizens the right to medicate and recreate as they wish, marijuana dispensaries and growers are unable to conduct business with commercial banks. All transactions must be done in cash, and security companies must be used to move and store this cash. This impediment alone is one of the biggest hurdles for the industry. But if and when that hurdle can be crossed, prepare to see the cannabis market get a major shot of steroids.

Sin is in!

A few months back, while attending a cannabis investment summit, groups of lawyers, accountants, and entrepreneurs devoted hours upon hours to discussing possible solutions to this problem. There was a lot of head scratching and a lot of frustration.

To be honest, after conducting a few interviews, I was at a loss as to how this problem could be rectified in the absence of the federal government re-scheduling marijuana.

But then, last week, a potential solution was found. And it was found in a place where out-of-the-box thinking spawned an oasis of wealth creation and greed.

 

I’m talking about Nevada, home of legalized gambling and legalized prostitution — two “sin” industries that have turned risk-taking entrepreneurs into multimillionaires. And now, it looks like the Silver State may be ready to facilitate the growth of the marijuana industry by creating new banks that could solve a lot of the banking issues dispensaries and growers face today.

Change the rules

Right now there’s an amendment to a mortgage lending bill that, according to Marijuana Business Daily, would change the rules so savings and loan companies wouldn’t have to obtain insurance from the Federal Deposit Insurance Corporation.

The legislation would also remove a provision from state law that limits the operation of savings and loan companies (called “thrifts” in the banking world) to those that received a license prior to 1997:

Thrifts could potentially become the go-to financial institutions for cannabis companies – and if the experiment works in Nevada, other states might adopt similar legislation.

Under the amendment, thrifts would be allowed to seek deposit insurance from private insurers rather than the FDIC, and more closely resemble credit unions than traditional banks.

To be sure, non-traditional banking hasn’t exactly been the saviour for cannabis companies, as some credit unions have failed at attempts to work within the industry. They must also have in place agreements with the U.S. Federal Reserve to take their cash, which can prove problematic.

Still, if they work as well as the amendment’s co-sponsors hope, savings and loan companies could potentially alleviate a very large problem for cannabis businesses that are about to open in the state since banks aren’t openly taking deposits from marijuana companies.

Mark my words: If this works out, other states will follow. And so, too, will savvy investors.

Source: THECHERRYCREEKNEWS.COM 10th June 2015

The young woman was shocked when the addiction-treatment clinic’s drug test showed extraordinary levels of THC in her system. She knew she had a drug problem. But she wasn’t like those acquaintances who sat around smoking pipes, bongs and joints all day.

“We asked how she could have had such an extremely high level of THC in her system,” explained Joanie Lewis, founder of Insight Services, an outpatient addictions treatment facility in Colorado Springs. “We learned her parents were preparing almost all of their food in a marijuana butter. You got the feeling they didn’t really consider it drug abuse. But her level of intoxication was much higher than if she had been a traditional user who sat down and smoked pot several times a day. The impairment crept up on her slowly but profoundly. This kind of thing may be why we’re seeing more impairment, more addiction and more serious withdrawals.”

The proliferation of foods infused or coated with THC has become a growing concern, even among some marijuana advocates. Several high-profile marijuana crimes and deaths involve consumption of edible THC products.

“When THC is available in food, it’s even harder for people to see it as a drug,” Lewis said. “But it is a drug. It is a depressant, a hallucinogen and an addictive substance that changes chemistry in the brain. Research shows all of the above.”

Given the United States’ hard-fought and continuing battles against tobacco and illness caused by its use, Americans would rebuff sales of lemon drops, cookies and soda pops infused with nicotine. Yet, the marijuana industry — quickly emerging as Big Tobacco 2.0 — infuses child-friendly snacks and drinks with doses of mind-
altering and brain-damaging THC up to 50 times stronger than 1960s-era pot.

“Practically nobody had even heard of THC concentrates until after Colorado voted to legalize marijuana, and, honestly, this state had no idea what it was unleashing before it made that decision,” said Dr. Ken Finn, a Colorado Springs physician who is board certified in pain medicine. “Even today, a lot of people don’t seem to understand how potent and addictive this drug is or how easily it is concealed.”

When voters enacted Amendment 64, which sanctioned marijuana for recreational use, many did not envision a cookie more potent than dozens of Woodstock joints. Concealed in Amendment 64’s definitions of “marijuana” and “marihuana” is the phrase “marihuana concentrate.” It means the law allows sale, transport, possession and use of up to one1 ounce of leafy marijuana. It also means one 1 ounce of any form of THC concentrate, which can compare to 50 ounces or more of traditional pot that is smoked.

“I would appreciate it very much if people would send me links to news stories or government-sponsored communications explaining the THC levels that were established by Amendment 64,” Dr. Christian Thurstone, an associate professor of psychiatry at the University of Colorado who treats adolescent addiction and serves on the board of Safe Approaches to Marijuana, wrote on his website in February 2013. “I am unaware of any attempt of this nature to educate the public before Election Day, Nov. 6, 2012.”

Now the threats THC concentrates pose to public health and safety loom large. A new study from researchers at Ohio’s Nationwide Children’s Hospital finds more American children are exposed to marijuana before reaching their fifth birthday. The report, published in the peer-reviewed journal Clinical Pediatrics, found that between 2006 and 2013, the marijuana exposure rate rose 147.5 percent among children age 5 and under. In that same period, the rate rose nearly 610 percent in states that sanctioned medical marijuana before 2000, the year Colorado followed suit.

While consequences of most exposures reportedly were minor, the study’s researchers found 17 marijuana-exposed children fell comatose and 10 had seizures.

In Colorado, the number of exposures to THC-infused edibles in young children increased fourfold in one year, from 19 cases in 2013 to 95 in 2014, according to the Rocky Mountain Poison and Drug Center.

Experts overwhelmingly attribute spikes in marijuana exposure among children to THC-infused “edibles.” The drug-laced food is the most promising aspect of Big Marijuana’s economic future. Edibles make up about 45 percent of Colorado’s marijuana sales, based on state figures, and are projected to quickly surpass the sale of THC products that are smoked.

Advocates for edibles say the products provide a healthy alternative to inhaling smoke. Others go further, marketing drug-infused foods and drinks as health food.

“Here comes the Whole Foods-
ification of Marijuana,” states the headline for a story published by Fast Company, a news organization founded by former editors of Harvard Business Review, touting its focus on “ethical economics.” . The report describes the author’s experience with ordering front-door delivery of a jar of “organic, sun-grown marijuana from farmers Casey and Amber in Mendocino, Calif.”

“There’s a whole industry being built around the upscale branding of weed,” author Ariel Schwartz explains. “Marijuana is now something that should be organic, grown by friendly farmers…”

For marijuana sellers, edibles mean a potentially boundless market share. “Edibles are the future of the industry due to their familiarity,” explains an article on a website that markets “The Stoner’s Cookbook.” “Non-smokers are not inclined to medicate with a joint, but an infused cookie is something familiar that they’re comfortable ingesting.”

Indeed, THC-infused foods and drinks — all fashioned from marijuana the state doesn’t yet test for contaminants — are sold in hundreds of store-front establishments throughout the state. They are shared and traded on the campuses of middle schools and high schools, where young users with developing brains are especially susceptible to addiction. They are stowed in lunch boxes in the workplace.

Employers, law enforcement officials, educators and addiction treatment providers say Colorado has cooked up a poorly regulated THC-food fiasco that crisscrosses the country with the ease of exporting gummy bears in glove compartments, pockets and handbags. For taxpayers, the growing edibles market means an array of social costs — including hospitalizations, traffic accidents, school dropouts and lost work productivity — that state and federal officials haven’t fully investigated, estimated and made public.

Known as hash oil, wax, dabs, and shatter, concentrates deliver a high so fast and intense many users refer to them as “green crack.” One ounce of the highest potency THC concentrate can yield 560 average tokes on an electronic cigarette. In edibles, Colorado law defines an average serving of THC as 10 milligrams.

“That average serving size? That’s a political number, not anything rooted in real, reputable science,” said Kevin Sabet, a former senior White House drug policy advisoer and co-founder of Smart Approaches to Marijuana, an organization opposed to marijuana legalization and supported by several of the country’s top addiction treatment experts.

The 10-milligram serving size established by Colorado lawmakers means one1 ounce of high-potency THC oil — the amount one adult is allowed to buy or possess at any given time — also can equal 2,800 average servings. That’s a well-stocked bakery.

“I don’t need scientific evidence to show me that students are completely zoned out and that more stoned kids are showing up for class,” said Kelly Landen, a high school teacher in Denver. “If they’ve smoked marijuana, you smell it on them. But students also show up with candy and cookies and whatever … and there’s no way to know for certain what’s in that food. They could be eating (THC) right in front of me.”

Unregulated by the U.S. Food and Drug Administration, concentrated THC is practically undetectable. There is no pill. Unlike alcohol and cigarettes, there is no smell. Users can get high on food and beverages while hiding in plain sight in almost any location.

“There is great danger in how easy these food products are to conceal,” said Frank Szachta, director of The Cornerstone Program, an adolescent addiction treatment center in Centennial. “Someone could do this drug in front of you, or in front of a teacher, in front of the boss. … No one would have to know.”

Colorado legislators have grappled with the problem of people — particularly children and adolescents — consuming marijuana in common snacks that land them in emergency rooms with panic attacks and hallucinations. Authorities have linked at least three deaths in Colorado, including a murder, to excessive consumption of THC-laced foods.

When ingested through the stomach, the user may not experience effects for an hour or more. The delayed effect is blamed in part for new users becoming impatient and eating too much.

“Like a bottle of vodka, you can’t just drink the entire bottle. You have to take it slow and understand what you’re doing,” said Julie Berliner in a YouTube video. She’s the founder of Sweet Grass Kitchen, an edibles manufacturing company in Denver.

But edibles are not like a bottle of vodka in important ways. The vodka’s contents are exactly known, and drinks can be measured precisely. The label on a THC-infused brownie or candy bar might state “servings per package: 10,” but the maker can’t say whether the consumer will ingest all of those servings in one small bite. The folly is akin to cutting a cupcake into tenths and presuming each piece contains exactly one serving of vanilla extract.

Making matters worse, said Lewis of Insight Services, is that many people are not inclined to follow recommended serving sizes.

“The state says a serving size is 10 milligrams, so that’s how much THC you might find in one small piece of candy,” she said. “But very few people sit down with a bag of candy and eat only one piece.”

State lawmakers’ efforts to regulate edibles and their packaging have done little to stop accidental overdoses and deter underage use — in part because they haven’t applied to homemade goods infused with THC, health professionals say. State law also is undermined when someone removes the contents of a package and stores the THC-infused food in a bowl, jar or other container.

A law enacted in 2014 instructs the Colorado Department of Public Health and the Environment to devise standards and procedures that will make unpackaged, commercial food products easily stand out if they contain THC. It’s a tall order when dealing with small pieces of food — such as crumbs of granola — and the agency continues to grasping for a solution.

Since legalization and the mass marketing of highly potent, THC foods began, Colorado addiction treatment providers have reported increasing levels of toxicity among clients, more severe addiction and poorer prognoses for recovery from substance use disorders.

For example, the average level of THC found in the urine of about 5,000 adolescents ages 13-19 by researchers at the University of Colorado jumped from 358 nanograms per milliliter in 2007 through 2009 — just before the state’s boom in medical marijuana dispensaries — to 536 milliliters from 2010 through 2013.

The rapidly widening scope of THC-infused food is shaping up to be a recipe for great losses for individuals, families and the entire state, Lewis said.

“People are coming to us later in the addiction cycle than they used to,” she said. “When people get high on food, there is the perception that they’re not really using a drug. It seems less harmful than taking pills or smoking. By the time they realize there’s a problem, some of them are quite a ways further into the addiction than if they had been smoking it.”

Source: http://m.gazette.com/clearing-the-haze-thc-extracts-concentrate-problems/article/1554097   June 2015

Two years ago, the Georgia Legislature tried but failed to legalize artisanal cannabidiol (CBD) oils for children suffering from epilepsy. Artisanal CBD oils are products marijuana growers are making in states that have legalized marijuana for medical use. No grower in these states has submitted its CBD product to FDA for approval as a safe or effective medicine.

In contrast, two pharmaceutical companies, GW Pharmaceuticals of Great Britain and Insys Therapeutics of the US, are developing pharmaceutical-grade CBD oils. GW’s version, Epidiolex, is in FDA Phase III clinical trials and Insys Therapeutics is about to undergo FDA testing. The Insys drug is 100% synthesized CBD, meaning it is an exact chemical duplicate of cannabidiol found in the marijuana plant but is made of pure chemicals to eliminate impurities and contaminants. Epidiolex is an extract of marijuana that has been purified to remove impurities and contaminants and is 98% CBD with trace amounts of THC and other cannabinoids. Both drugs must be tested in animals to ensure safety before companies can apply to FDA for permission to test their drugs in humans.

Artisanal CBD oils offer no such protections to patients. Random tests have shown that many contain THC, which can cause seizures, contaminants, and in some cases little to no CBD.

When the Georgia bill failed last year, Governor Nathan Deal formed a partnership with GW to conduct clinical trials of Epidiolex in Georgia as well as a statewide FDA expanded access program for children not able to enroll in the clinical trials. Both programs are up and running.

Despite this, the legislature came back with a bill this year to legalize artisanal CBD oils not only for childhood epilepsy but also for seven other diseases. Moreover, this bill permits possession of up to 20 ounces of CBD oil containing up to 5% THC. The bill passed and the governor signed it in April. It provides immunity from prosecution to those who possess CBD and calls for a special commission to recommend how best to grow marijuana, process it into CBD oils, and distribute it to patients.

Like the researchers whose work is published in JAMA today, specialists who treat epilepsy also are beginning to speak out. The NBC-TV affiliate in Atlanta interviewed several this week. Dr. Yong Park, who is helping run the clinical trials in Georgia, says doctors don’t know what the drug interactions are or what the side effects might be because they don’t have the evidence yet. Nor do they know how many pesticides artisanal CBD oils may contain nor what the long-term effects of daily exposure on the brain might be.

Under the new state law, when doctors sign a letter approving patients for the state registry that allows them to possess CBD oils, says Atlanta pediatrician Cynthia Wetmore, M.D., Ph.D., “they are required to keep track of the patients. But how do we know what dose to recommend? The oil patients have access to is not standardized. Each batch can be different. There’s a lot of variability in each batch. What side effects is it causing, if any? We have to report to the state on each patient, quarterly. It will be hard to know if it’s helping or hurting.”

Perhaps the most haunting concerns come from Dr. Amy Brooks-Kayal, a Colorado pediatric neurologist and president of the American Epilepsy Society. The Atlanta NBC-TV affiliate published her letter to a Pennsylvania representative who held hearings a few months ago on a similar bill in his state. In part, she writes:

The families and children coming to Colorado are receiving unregulated, highly variable artisanal preparations of cannabis oil prescribed, in most cases, by physicians with no training in pediatrics, neurology, or epilepsy. As a result, the epilepsy specialists in Colorado have been at the bedside of children having severe dystonic reactions and other movement disorders, developmental regression, intractable vomiting, and worsening seizures that can be so severe they have to put the child into a coma to get the seizures to stop. Because these products are unregulated, it is impossible to know if these dangerous adverse reactions are due to the CBD or because of contaminants found in these artisanal preparations. The Colorado team has also seen families who have gone into significant debt, paying hundreds of dollars a month for oils that do not appear to work for the vast majority. For all these reasons not a single pediatric neurologist in Colorado recommends the use of artisanal cannabis preparations. Possibly of most concern is that some families are now opting out of proven treatments, such as surgery or the ketogenic diet, or newer antiseizure medications because they have put all their hope in CBD oils.

All three epilepsy specialists want parents to know that giving artisanal CBD oils to children exposes them to risks that cannot be defined. They urge parents instead to enroll their children in clinical trials or expanded access programs that are testing pharmaceutical-grade CBD where doctors can monitor the children closely.

Read Atlanta story and full text of Dr. Brooks-Kayal’s letter here

Source:

http://us2.campaign-archive2.com/?u=2138d91b74dd79cbf58e302bf&id=71df2f126e&e=7ee41d6c49

The photos below show just how the marijuana business in the USA is targeting the youth market. Young children who would hesitate to smoke a joint are encouraged by the packaging to believe these products are safe.

All these ‘edibles’ are on sale openly. Look