Understanding motives for cannabis use is important for addiction prevention and intervention

Source: https://health.ucdavis.edu/news/headlines/teens-use-cannabis-for-coping-enjoyment/2023/12

11 December 2023

Source: https://doi.org/10.1038/d41586-023-03860-3

In its 2023 Annual Report, the International Narcotics Control Board:

– finds that online drug trafficking has increased the availability of drugs on the illicit market;

– warns that patient safety is at risk from illicit Internet pharmacies selling drugs without a prescription directly to the consumer;

– highlights the daunting task facing law enforcement authorities to monitor and prosecute online drug activities;

– sees opportunities to use the Internet and social media for drug use prevention campaigns and to improve access to drug treatment services;

– encourages governments to use the full range of INCB tools and programmes to assist in their efforts to counter exploitation of the Internet for drug trafficking; and

– voices concern about the persistent regional disparities in availability and consumption of licit drugs for the treatment of pain.

VIENNA, 5 March (UN Information Service) – The evolving landscape of online drug trafficking is presenting new challenges to drug control, says the International Narcotics Control Board (INCB) in its Annual Report. There are also opportunities to use the Internet for drug use prevention and treatment to safeguard people’s health and welfare, the Board says.

The increased availability of illicit drugs on the Internet, the exploitation by criminal groups of online platforms including social media, and the increased risk of overdose deaths due to the online presence of fentanyl and other synthetic opioids are some of the key challenges for drug control in the Internet era.

“We can see that drug trafficking is not just carried out on the dark web. Legitimate e-commerce platforms are being exploited by criminals too. We encourage governments to work with the private sector and INCB projects to prevent and detect trafficking of drugs and other dangerous substances online,” said Jallal Toufiq, the President of INCB.

Using social media and other online platforms means drug traffickers can advertise their products to large global audiences. Various conventional social media platforms are being used as local marketplaces and inappropriate content is widely accessible to children and adolescents.

Encryption methods, anonymous browsing on the darknet and cryptocurrencies are commonly used to avoid detection, posing difficulties for prosecuting online trafficking offences. Offenders can move their activities to territories with less intensive law enforcement action or lighter sanctions or base themselves in countries where they can evade extradition. The sheer scale of online activity is an added complication. In one case in France, law enforcement authorities collected more than 120 million text messages from 60,000 mobile phones.

Patient safety is at risk from illicit Internet pharmacies which sell drugs without a prescription directly to consumers. It is impossible for consumers to know whether the drugs are counterfeit, unapproved or even illegal. The global trade in illicit pharmaceuticals is estimated to be worth 4.4 billion USD.

Opportunities for drug treatment and prevention

The Board sees opportunities to use online platforms to prevent non-medical use of drugs, raise awareness about the harms of drug use and support public health campaigns. Governments can use social media platforms to conduct drug use prevention campaigns to prevent substance misuse among young people in particular.

“There are opportunities to use social media and the Internet to prevent drug use, raise awareness of its harms and improve access to drug treatment services,” said INCB President Toufiq, “At the same time we are concerned about the increasing use of social media to market drugs including to children and the ways that criminals are exploiting online platforms for illicit activities.”

Telemedicine and Internet pharmacies could improve access to healthcare and help reach patients with drug use disorders and deliver drug treatment services to more people. Online platforms could also be used for sharing information about adverse consequences of drug use and communicating warnings of adulterated drugs which could save lives.

International cooperation essential to tackle this growing trend

The global nature of online platforms makes collaborative efforts vitally important for identifying new threats and developing effective responses.

INCB is encouraging voluntary cooperation between governments and online industries to tackle the misuse of legitimate e-commerce platforms for drug trafficking. Its initiatives such as the GRIDS programme have led to drug seizures and arrests as well as criminal networks being dismantled.

The manufacturing, marketing, movement and monetization industries are particularly vulnerable to being exploited by those trafficking in dangerous substances. The Board says that increased cooperation is needed between governments, international organizations, regulatory authorities and the private sector to meet these evolving challenges.

Persistent disparities in access to medicines for the treatment of pain

In many parts of the world there is not enough affordable morphine available to meet medical needs. These persistent regional disparities in opioid analgesics used for pain treatment are not due to a shortage of opiate raw materials but rather in part due to inaccurate estimates of the actual medical needs of their populations. Levels of consumption of pain relief medicine remain highest in Europe and North America.

There was an acute need for medicines containing internationally controlled substances in 2023 for people caught up in natural disasters and emergencies related to climate change and conflict. INCB urges governments to use simplified control procedures in such situations to ensure unimpeded availability of these medicines.

Notable developments in illicit drug supply

In Afghanistan, illicit opium poppy cultivation and heroin production declined dramatically. INCB says that alternative livelihoods need to be offered to affected farmers who may not have other sources of income.

The opioid crisis continues to have serious consequences in North America with the number of deaths that involved synthetic opioids other than methadone continuing to increase, reaching more than 70,000 in 2021.

Drug trafficking organizations continue to expand their operations in the Amazon Basin into illegal mining, illegal logging and wildlife trafficking.

Record levels of illicit coca bush cultivation were recorded in Colombia and Peru, rising by 13 percent and 18 per cent respectively. Seizures of cocaine reached a record level in 2021 in West and Central Africa, a significant transit region for cocaine.

Several European countries have continued to establish regulated markets for cannabis for non-medical purposes. These programmes do not appear to be consistent with the drug control conventions.

South Asia appears to be increasingly being targeted for the trafficking of methamphetamine illicitly manufactured in Afghanistan to Europe and Oceania.

Pacific island States have transformed from solely transit sites along drug trafficking routes to destination markets for synthetic drugs. This is posing significant challenges to communities and their public health systems.

Precursors report

As part of international efforts to prevent illicit drug manufacturers from replacing certain controlled chemicals with closely related substitutes, the Board is recommending that a total of 16 amphetamine-type stimulant precursors (two series of closely related chemicals) are put under international control.

Two fentanyl precursors have also been assessed and recommended for international control by INCB, following a request made by the United States. The Precursors report also shows a surge in non-controlled fentanyl precursors in North America in 2023.

The Commission on Narcotic Drugs will vote at its session in March on placing all 18 substances under international control, through placement in Table I of the 1988 Convention.

INCB is concerned about the lack of audits and inspections in certain free trade zones which are susceptible to misuse for illicit activities. The Board calls on governments to ensure proper oversight over these zones to prevent them being exploited for precursor trafficking.

***

INCB is the independent, quasi-judicial body charged with promoting and monitoring Government compliance with the three international drug control conventions: the 1961 Single Convention on Narcotic Drugs, the 1971 Convention on Psychotropic Substances, and the 1988 Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances. Established by the Single Convention on Narcotic Drugs of 1961, the thirteen members of the Board are elected in a personal capacity by the Economic and Social Council for terms of five years. 

Source: https://unis.unvienna.org/unis/en/pressrels/2024/unisnar1481.html

The laboratory Millennium Health said 60% of patients whose urine samples contained fentanyl last year also tested positive for methamphetamine. Cocaine was detected in 22% of the fentanyl-positive samples.

Millennium officials said the report represents the impact of the “fourth wave” of the nation’s overdose epidemic, which began over a decade ago with the misuse of prescription opioids, then came a heroin crisis and more recently an increase in the use of illicit fentanyl. The study found that people battling addiction are increasingly using illicit fentanyl along with other substances, including stimulants such as methamphetamine and cocaine.

The report suggests heroin and prescription opioids are being abused less often than they were a decade ago. Of the urine samples containing fentanyl analyzed in the report, 17% also contained heroin and 7% showed the presence of prescription opioids.

The Millennium report is based on analyses of urine samples collected from more than 4.1 million patients in 50 states from Jan. 1, 2013, to Dec. 15, 2023. The samples were collected in doctors’ offices and clinics that see patients for pain, addiction and behavioral health treatment.

Overall, 93% of fentanyl samples tested positive for at least one other substance, a concerning finding, said Dr. Nora Volkow, director of the National Institute on Drug Abuse.

“I did not expect that number to be so high,” she said.

Overdose deaths climb

Drug overdose deaths in the United States surged past 100,000 in 2021 and increased again in 2022. Provisional data from the Centers for Disease Control and Prevention showed overdose deaths through September 2023 increased about 2% compared with the year before.

Other reports show that stimulants, mostly methamphetamine, are increasingly involved in fentanyl overdoses. In 2021, stimulants were detected in about 1 in 3 fentanyl overdose deaths, compared with just 1 in 100 in 2010.

The finding of methamphetamine in so many samples is especially concerning, said Eric Dawson, vice president of clinical affairs Millennium Health.

“Methamphetamine is more potent, more pure and probably cheaper than it’s ever been at any time in this country,” Dawson said. “The methamphetamine product that is flooding all of our communities is as dangerous as it’s ever been.”

Methamphetamine has no rescue drugs, treatments

As methamphetamine use appears to play a larger role in the addiction crisis, the medical community does not have the same tools to counter its misuse.

Naloxone and similar overdose reversal medications counteract opioid overdoses by blocking opioid receptors in the brain to quickly reverse the effects of an overdose. Narcan, a nasal spray version of naloxone, can be purchased and is kept in stock by public health departments, schools, police and fire departments and federal agencies nationwide. Chain retailers such as CVS, Walgreens, Rite Aid and Walmart began selling Narcan over the counter without a prescription.

But there is no medication approved by the Food and Drug Administration for overdoses involving stimulants such as methamphetamine.

Opioid substitute medications such as methadone and buprenorphine are used to reduce cravings and ease withdrawal symptoms from opioids. There are no equivalent medications, however, for people who are dependent on methamphetamine or other stimulants, Dawson said.

That deficit is glaring, Dawson said: “We need effective treatments for stimulant-use disorder.”

Meth samples more common in the West

The Millennium report also found that drug use differed by region, and methamphetamine samples were detected more frequently in the western U.S.

Methamphetamine was detected in more than 70% of fentanyl-positive urine samples in the Pacific and Mountain West states. Meth showed up least often in fentanyl-positive samples in the mid- and south-Atlantic states, the report said.

Cocaine appeared to be more prevalent in the eastern U.S. More than 54% of fentanyl-positive samples in New England also had cocaine. By comparison, fewer than 1 in 10 of the samples showed cocaine in the mountain region of the West, the report said.

Other findings from the report:

∎ The presence of cocaine samples in fentanyl-positive specimens surged 318% from 2013 to 2023.

∎ The presence of heroin in fentanyl-positive specimens dropped by 75% after a peak in 2016.

∎ The presence of prescription opioids in fentanyl-positive specimens dropped to an all-time low in 2023, which researchers cite as evidence that the U.S. addiction crisis has shifted from pain medications.

Nationwide, the addiction epidemic has evolved to a phase in which people are often using multiple substances, not just fentanyl, Volkow said. This polysubstance abuse complicates matters for public health authorities seeking to slow the nation’s overdose deaths.

Volkow said reports such as Millennium Health’s are important because they give researchers a snapshot of the nation’s evolving drug use and provide more timely data than death investigations from overdoses can offer.

Source: https://eu.usatoday.com/story/news/health/2024/02/21/methamphetamine-plays-increasing-role-in-addiction-crisis/72661430007/

Source: https://www.anacortesnow.com/news/health/5285-washington-tribes-look-to-iceland-for-help-getting-teens-off-drugs

“I never imagined that sports could do this”: UNODC celebrates the power of sports in preventing violence, crime, and drug use among youth on the International Day of Sports

Alice*, a 15-year-old living in a rural area in Nigeria, was struggling. Feeling lonely at home, subjected to punishment for the smallest of reasons, she had tried everything in an effort to cope. Running away from home. Cutting her wrists with a razor in a failed suicide attempt. Drinking alcohol. Taking too many sleeping pills.

Her drug use, once discovered by her father, threatened to further derail her young life, for he would delay paying her school fees, claiming her education had been a wasted investment. Cut off from her friends, Alice’s isolation deepened.

Eventually, Alice returned to school, where she was enrolled in the United Nations Office on Drugs and Crime (UNODC)’s “Line Up Live Up” (LULU) programme. LULU uses sports-based life skills training to empower youth and enhance their resilience to violence, crime, and drug use.

The programme struck a chord with Alice, who reported that the “LULU programme gave me a whole new meaning and understanding of life.” Alice recalled several lessons that stuck out for her during LULU, including one which required the students to run to the opposite side of the hall without being hit by balls flying from all directions. Each time the students were struck, they would have to start all over again.

Alice noted that at first, she was embarrassed each time a ball would hit her. It reminded her of the shame she had felt facing her friends after her father reported her drug use to the school. “I kept having to start all over again,” she said, but “I succeeded at the tail end and it taught me to never give up.”

Youth face many challenges that make them vulnerable to crime, violence, and victimization. Sports can offer vulnerable youth a sense of identity and belonging while also enhancing their physical and mental health and wellbeing. When used in an intentional, well-designed manner, sports can serve as a useful vehicle for cognitive, social, and emotional learning and key life skills. They can challenge harmful stereotypes and normative beliefs linked to violence and crime, including gender-based violence. Finally, sports can create safe spaces for young people and local communities to positively interact, promote tolerance, and contribute to building safe, just, and fair societies.

The UNODC Global Initiative on Youth Crime Prevention through Sport promotes the effective use of sport as a tool for addressing known risk and protective factors to youth violence and crime in order to reduce juvenile delinquency and offending and prevent drug use. It also supports the design and delivery of tailored sport-based interventions to prevent youth victimization and recruitment by organized criminal groups, including from gangs and violent extremist groups.

Alice’s principal attested to the transformation she witnessed among her students. “I thought that the LULU programme would be targeting drugs and academics,” she said. “Little did I know that this knowledge could be transferred to other, deeper personal and social life situations. The program digs for the biggest problems in the student’s lives and helps them solve them in their own ways.

Truly, I never imagined that sports could do this.”

Source: https://www.unodc.org/conig/en/stories/i-never-imagined-that-sports-could-do-this_-unodc-celebrates-the-power-of-sports-in-preventing-violence–crime–and-drug-use-among-youth-on-the-international-day-of-sports.html

Source:  https://www.wbaa.org/health-and-science/2024-03-13/school-substance-use-prevention-efforts-are-crucial-the-question-is-how-to-do-it

Source: https://www.conservativewoman.co.uk/roger-morgan-trump-must-clamp-marijuana-america-doomed/ October 2017

Foreword
The National Institute on Drug Abuse (NIDA) is pleased to publish in its Research Monograph series the proceedings of the 48th Annual Scientific Meeting of the Committee on Problems of Drug Dependence, Inc. (CPDD). This meeting was held at Tahoe City, Nevada, in June 1986.

The scientific community working in the drug abuse area was saddened by the untimely death of one of its very productive and active leaders: Joseph Cochin, M.D., Ph.D. Joe was a talented scientist who was greatly admired by his students and colleagues. For the past five years, Joe had served as the Executive Secretary of the CPDD. This monograph includes papers from a symposium on “Mechanisms of Opioid Tolerance and Dependence,” dedicated to his memory. These papers were presented by many of his friends and colleagues, who took the opportunity to express their high esteem for Joe.
The CPDD is an independent organization of internationally recognized experts in a variety of disciplines related to drug addiction. NIDA and the CPDD share many interests and concerns in developing knowledge that will reduce the destructive effects of abused drugs on the individual and society. The CPDD is unique in bringing together annually at a single scientific meeting an outstanding group of basic and clinical investigators working in the field of drug dependence. This year, as usual, the monograph presents an excellent collection of papers. It also contains progress reports of the abuse liability testing program funded by NIDA and carried out in conjunction with the CPDD. 

This program continues to represent an example of a highly successful government/private sector cooperative effort. I am sure that members of the scientific community and other interested readers will find this volume to be a valuable “state-of-the art” summary of the latest research into the biological, behavioral, and chemical bases of drug abuse.

Charles R. Schuster, Ph.D.
Director
National Institute on Drug Abuse

For the full contents, please go to: 

Source: https://babel.hathitrust.org/cgi/pt?id=ien.35557000188076&seq=11 This version September 2023

Abstract

Cannabis is harmful to the lungs, but in a different way to tobacco, causing significant respiratory symptoms such as bronchitis with evidence to suggest it can result in destructive lung disease – sometimes referred to as ‘bong lung’ – in heavy cannabis users.

These are the key findings from a review of research on the effects of smoking cannabis on the lungs undertaken by respiratory specialists, Professor Bob Hancox, from the University of Otago’s Department of Preventive and Social Medicine and Dr Kathryn Gracie, from Waikato Hospital’s Respiratory Department.

Cannabis is the second-most commonly smoked substance after tobacco and the most widely-used illicit drug world-wide. Although cannabis remains illegal in most countries, many countries – like New Zealand – are considering decriminalising or legalising its use.

Professor Hancox explains that much of the debate about legalising cannabis appears to revolve around the social and mental health effects. Both he and Dr Gracie believe policies around the liberalisation of cannabis should consider the wider health effects of smoking cannabis.

“The potential for adverse effects on respiratory health from smoking cannabis has had much less attention than the social and mental health effects,” Professor Hancox says.

“We believe policies around the liberalisation of cannabis should consider the potential impacts on the lungs.

“Whether liberalising availability will lead to further increases in cannabis use remains to be seen, but it is likely that patterns of cannabis use will change, with resulting health consequences.”

Because cannabis has been an illegal and unregulated substance and the fact most cannabis users also smoke tobacco, making the effects difficult to separate, Dr Gracie explains that it has been difficult to carry out research on cannabis and its direct impact on the lungs.

“Perhaps, most importantly, the individuals who are extremely heavy users of cannabis may not be well represented in the existing epidemiological research. Most case reports of cannabis-related destructive lung disease document very heavy cannabis consumption.

“Despite these limitations there is sufficient evidence that cannabis causes respiratory symptoms and has the potential to damage both the airways and the lungs.”

“Cannabis may also increase the risk of lung cancer, but there is not enough evidence to be sure of this yet,” Dr Gracie says.

Professor Hancox says there is still a lot to learn about cannabis, but there is sufficient evidence to show that smoking cannabis is not harmless to the lungs.

A combination of smoking both cannabis and tobacco is likely to result in poorer health outcomes.

“Many people smoke both cannabis and tobacco and are likely to get the worst of both substances.”

Source: https://www.otago.ac.nz/news/news/smoking-cannabis-causes-bronchitis-and-changes-to-lung-function May 2020

In 2017 Iceland received word-wide attention for having dramatically reversed the course of teenage substance use. From 1998 to 2018, the percentage of 15-16-year-old Icelandic youth who were drunk in the past 30 days declined from 42% to 5%; daily cigarette smoking dropped from 23% to 3%; and having used cannabis one or more times fell from 17% to 5%. The core elements of the model are: 1) long-term commitment by local communities; 2) emphasis on environmental rather than individual change; 3) perception of adolescents as social attributes. This presentation describes how the Iceland prevention model is built upon collaboration between policy makers, researchers, parent organizations, and youth practitioners. These groups have created a system whereby youth receive the necessary guidance and support to live fun and productive lives without reliance on psychoactive substances. The Model is being replicated in 35 municipalities within 17 countries around the globe. The Icelandic Model: Evidence Based Primary Prevention – 20 Years of Successful Primary Prevention Work was featured for the past two years at the Special Session of the United Nations General Assembly on the World Drug Problem.

Source: https://www.researchgate.net/publication/330347576_Perspective_Iceland_Succeeds_at_Preventing_Teenage_Substance_Use February 2019

US DRUG CZAR EXPLAINS CAUSES AND RSDT TOOL TO PREVENT TEEN DRUG USE AND OVERDOSE DEATH INTERVIEW WITH U.S. DRUG CZAR JOHN WALTERS

Introduction:  In response to recent news of a huge increase in drug overdose deaths and arrests for drug trafficking among Fairfax County youths, Fox News TV5 reporter Sherri Ly interviewed U.S. Drug Czar John Walters for his expert views on the cause and potential cure for these horrific family tragedies.  Following is a transcript of that half-hour interview with minor editing for clarity and emphasis added.  The full original interview is available through the 11/26/08 Fox5 News broadcast video available at link:

WALTERS:  Well, as this case shows, while we’ve had overall drug use go down, we still have too many young people losing their lives to drugs, either through overdoses, or addiction getting their lives off track.  So there’s a danger.  We’ve made progress, and we have tools in place that can help us make more progress, but we have to use them. 

Q 1:  You meet with some of these parents whose children have overdosed.  What do they tell you, and what do you tell them?

WALTERS:  It’s the hardest part of my job; meeting with parents who’ve lost a child.  Obviously they would give anything to go back, and have a chance to pull that child back from the dangerous path they were on.  There are no words that can ease their grief.  That’s something you just pray that God can give them comfort.  But the most striking thing they say to me though is they want other parents to know, to act.  And I think this is a common thing that these terrible lessons should teach us.

Many times, unfortunately, parents see signs: a change in friends, sometimes they find drugs; sometimes they see their child must be intoxicated in some way or the other.  Because it’s so frightening, because sometimes they’re ashamed – they hope it’s a phase, they hope it goes away – they try to take some half measures.  Sometimes they confront their child, and their child tells them – as believably as they ever can – that it’s the first time.  I think what we need help with is to tell people; one, it’s never the first time.  The probability is low that parents would actually recognize these signs – even when it gets visible enough to them – because children that get involved in drugs do everything they can to hide it.  It’s never the first time.  It’s never the second time.  Parents need to act, and they need to act quickly.  And the sorrow of these grieving parents is, if anything, most frequently focused on telling other parents, “Don’t wait: do anything to get your child back from the drugs.”

Secondly, I think it’s important to remember that one of the forces that are at play here is that it’s their friends.  It’s not some dark, off-putting stranger – it’s boyfriends, girlfriends.  I think that was probably a factor in this case.  And it’s also the power and addictive properties of the drug.  So your love is now being tested, and the things you’ve given your child to live by are being pulled away from them on the basis of young love and some of the most addictive substances on earth.  That’s why you have to act more strongly.  You can’t count on the old forces to bring them back to safety and health.

Q 2:  When we talk about heroin – which is what we saw in this Fairfax County drug ring, alleged drug ring – what are the risks, as far as heroin’s concerned?  I understand it can be more lethal, because a lot of people don’t know what they’re dealing with?

WALTERS:  Well it’s also more lethal because one, the drug obviously can produce cardiac and respiratory arrest.  It’s a toxic substance that is very dangerous.  It’s also the case that narcotics, like heroin – even painkillers like OxyContin, hydrocodone, which have also been a problem – are something that the human body gets used to.  So what you can frequently get on the street is a purity that is really blended for people who are addicted and have been long time addicted.  So a person who is a new user or a naïve user can more easily be overdosed, because the quantities are made for people whose bodies have adjusted to higher purities, and are seeking that effect that only the higher purity will give them in this circumstance.  So it’s particularly dangerous for new users.  But we also have to remember, it almost never starts with heroin.  Heroin is the culmination here.  I think some of the – and I’ve only seen press stories on this — some of these young people may have gotten involved as early as middle school.

We have tools so that we don’t have to lose another young woman like this– or young men.  We now have the ability to use Random Student Drug Testing (RSDT) because the Supreme Court has, in the last five years, made a decision that says it can’t be used to punish.  It’s used confidentially with parents.  We have thousands of schools now doing it since the president announced the federal government’s willingness to fund these programs in 2004.  And many schools are doing it on their own.  Random testing can do for our children what it’s done in the military, what it’s done in the transportation safety industry– significantly reduce drug use.

First, it is a powerful reason not to start.  “I get tested, I don’t have to start.”  We have to remember, it’s for prevention and not a “gotcha!”  But it’s a powerful reason for kids to say, even when a boyfriend or girlfriend says come and do this with me, “I can’t do it, I get tested.  I still like you, I still want to be your friend; I still want you to like me, but I just can’t do this,” which is very, very powerful and important.  And second, if drug use is detected the child can be referred to treatment if needed.

Q 3:  Is the peer pressure just that much that without having an excuse, that kids are using drugs and getting hooked?

WALTERS:  Well one of the other unpleasant parts of my job is I visit a lot of young people in treatment; teenagers, sometimes as young as 14, 15, but also 16, 17, 18.  It is not uncommon for me to hear from them, “I came from a good family.  My parents and my school made clear what the dangers were of drugs.  I was stupid.  I was with my boyfriend (or girlfriend) and somebody said hey, let’s go do this.  And I started, and before I knew it, I was more susceptible.”

We have to also understand the science, which has told us that adolescents continue to have brain development up through age 20-25.  And their brains are more susceptible to changes that we can now image from these drugs.  So it’s not like they’re mini-adults.  They’re not mini-adults.  They’re the particularly fragile and susceptible age group, because they don’t have either the experience or the mental development of adults.  That’s why they get into trouble, that’s why it happens so fast to them, that’s why it’s so hard for them to see the ramifications.

So what does RSDT do?  It finds kids early–­ if prevention fails.  And it allows us to intervene, and it doesn’t make the parent alone in the process.  Sometimes parents don’t confront kids because kids blackmail them and say “I’m going to do it anyway, I’m going to run away from home.”  The testing brings the community together and says we’re not going to lose another child.  We’re going to do the testing in high school – if necessary, in middle school.  We’re going to wrap our community arms around that family, and get those children help.  We’re going to keep them in school, not wait for them to drop out.  And we’re certainly not going to allow this to progress until they die.

Q 4:  And in a sense, if you catch somebody early, since you’re saying the way teenagers seem to get into drug use is a friend introduces it to a friend, and then next thing you know, you have a whole circle of friends doing it.  Are you essentially drying that up at the beginning, before it gets out of hand?

WALTERS:  That is the very critical point.  It’s not only helping every child that gets tested be safer, it means that the number of young people in the peer group, in the school, in the community that can transfer this dangerous behavior to their friends shrinks.  This is communicated like a disease, except it’s not a germ or a bacillus.  It’s one child who’s doing this giving it behaviorally to their friends, and using their friendship as the poison carrier here.  It’s like they’re the apple and the poison is inside the apple.  And they trade on their friendship to get them to use.  They trade on the fact that people want acceptance, especially at the age of adolescence.  So what you do is you break that down, and you make those relationships less prone to have the poison of drugs or even underage drinking linked to them.  And of course we also lose a lot of kids because of impaired driving.

Q 5:  And how does the drug testing program work, then, in schools– the schools that do have it.  Is it completely confidential?  Are you going to call the police the minute you find a student who’s tested positive for heroin or marijuana or any other illicit drug?

WALTERS:  That’s what is great about having a Supreme Court decision.  It is settled – random testing programs cannot be used to punish, to call law enforcement; they have to be confidential.  So we have a uniform law across the land.  And what the schools that are doing RSDT are seeing is that it’s an enormous benefit to schools for a relatively small cost.  Depending on where you are in the country, the screening test is $10-40.  It’s less than what you’re going to pay for music downloads in one month for most teenage kids in most parents’ lives.  And it protects them from some of the worst things that can happen to them during adolescence.  Not only dying behind the wheel, but overdose death and addiction.

 Schools that have done RSDT have faced some controversy; so you have to sit down and talk to people; parents, the media, young people.  You have to engage the community resources.  You’re going to find some kids and families that do have treatment needs.  But with RSDT you bring the needed treatment to the kids.

I tell, a lot of times, community leaders – mayors and superintendents, school board members – that if you want to send less kids into the criminal justice system and the juvenile justice system, drug test — whether you’re in a suburban area or in an urban area.

What does the testing do?  It takes away what we know is an accelerant to self-destructive behavior: crime, fighting in school, bringing a weapon, joining a gang.  We have all kinds of irrefutable evidence now – multiple studies showing drugs and drinking at a young age accelerate those things, make them worse, make them more violent, as well as increasing their risks of overdose deaths and driving under the influence.  So drug testing makes all those things get better.  And it’s a small investment to make everything else we do work better.

Again, drug testing is not a substitute for drug education or good parenting or paying attention to healthy options for your kid.  It just makes all those things work better.

Q 6:  And I know you’ve heard this argument before, but isn’t that big brother?  Aren’t there parents out there who say to you, “I’m the parent: why are you going to test my child for drugs in school; that’s my job?” 

WALTERS:  I think that is the critical misunderstanding that we are slowly beginning to change by the science that tells us substance abuse is a disease.  It’s a disease that gets started by using the drug, and then it becomes a thing that rewires our brain and makes us dependent.  So instead of thinking of this as something that is a moral failing, we have to understand that this is a disease that we can use the kind of tools for public health – screening and interventions – to help reduce it.

Look, let me give you the counter example.  It’s really not big brother.  It’s more like tuberculosis.  Schools in our area require children to be tested for tuberculosis before they come to school.  Why do they do that?  Because we know one, they will get sicker if they have tuberculosis and it’s not treated.  And we can treat them, and we want to treat them.  And two, they will spread that disease to other children because of the nature of the contact they will have with them and spreading the infectious agent.  The same thing happens with substance abuse.  Young people get sicker if they continue to use.  And they spread this to their peers.  They’re not secretive among their peers about it; they encourage them to use them with them.  Again, it’s not spread by a bacillus, but it’s spread by behavior.

If we take seriously the fact that this is a disease and stop thinking of it as something big brother does because it’s a moral decision that somebody else is making, we can save more lives.  And I think the science is slowly telling us that we need to be able to treat this in our families, for adults and young people.  We have public health tools that we’ve used for other diseases that are very powerful here, like screening – and that’s really what the random testing is.  We’re trying to get more screening in the health care system.  So when you get a check up, when you bring your child to a pediatrician, we screen for substance abuse and underage drinking.  Because we know we can treat this, and we know that we can make the whole problem smaller when we do. 

Q 7:  You have said there were about 4,000 schools across the country now that are doing this random drug testing.  What can we see in the numbers since the Supreme Court ruling in 2002, as far as drug use in those schools, and drug use in the general population?

WALTERS:  Well, what a number of those schools have had is of course a look at the harm from student drug and alcohol use.  Some of them have put screening into place, random testing, because they’ve had a terrible accident; an overdose death; death behind the wheel.  What’s great is when school districts do this, or individual schools do this, without having to have a tragedy that triggers it.  But if you have a tragedy, I like to tell people, you don’t have to have another one.  The horrible thing about a tragic event is that most people realize those are not the only kids that are at risk.

There are more kids at risk, obviously, in our communities in the Washington, DC area where this young woman died.  We know there’s obviously more children who are at risk of using in middle school and high school.  The fact is those children don’t have to die.  We cannot bring this young lady back.  Everybody knows that.  But we can make sure others don’t follow her.  And the way we can do that is to find, through screening, who’s really using.  And then let’s get them to stop – let’s work with their families, and let’s make sure we don’t start another generation of death.  So what you see in these areas is an opportunity to really change the dynamic for the better.

Q 8:  Now, although nationally drug use among our youth is going down – what does it say to you – when I look at the numbers specific to Virginia, the most recent that I could find tells me that 3% of 12th graders, over their lifetime, have used a drug like heroin?  What does it say to you?  To me, that sounds like a lot.

WALTERS:  Yeah, and it’s absolutely true.  I think the problem here is that when you tell people we are taking efforts that are making progress nationwide, they jump to the conclusion that that means that we don’t have a problem anymore.  We need to continue to make this disease smaller.  It afflicts our young people.  It obviously also afflicts adults, but this is a problem that starts during adolescence — and pre-adolescence in some cases — in the United States.  We can make this smaller.  We not only have the tools of better prevention but also better awareness and more recognition of addiction as a disease.  We need to make that still broader.  We need to use random testing.  If we want to continue to make this smaller, and make it smaller in a permanent way, random testing is the most powerful tool we can use in schools.

We want screening in the health care system.  We have more of that going on through both insurance company reimbursement and public reimbursement through Medicare and Medicaid for those who come into the public pay system.  That needs to grow.  It needs to grow into Virginia, it’s already being looked at in DC; it needs to grow into Maryland and the other states that don’t have it.  We are pushing that, and it’s relatively new, but it’s consistent with what we’re seeing – the science and the power of screening across the board.

We need to continue to look at this problem in terms of also continuing to push on supply.  We’re working to reduce the poisons coming into our communities, which is not the opposite of demand; that we have to choose one or the other.  They work together.  Keeping kids away from drugs and keeping drugs away from kids work together.  And where we see that working more effectively, we’ll save more lives.  So again, we’ve seen that a balanced approached works, real efforts work, but we need to follow through.  And the fact that you still have too many kids at risk is an urgent need.  Today, you have kids that could be, again, victims that you have to unfortunately tell about on tonight’s news, that we can save.  It’s not a matter we don’t know how to do this.  It’s a matter of we need to take what we know and make it reality as rapidly as possible.

Q 9:  Where are these drugs coming from?  Where’s the heroin that these kids allegedly got coming from?

WALTERS:  We do testing about the drugs to figure out sources for drugs like heroin.  Principally, the heroin in the United States today has come from two sources.  Less of it’s coming out of Colombia.  Colombia used to be a source of supply on the East Coast, but the Colombian government, as a part of our engagement with them on drugs, has radically reduced the cultivation of poppy and the output of heroin.  There still is some, but it’s dramatically down from what it was even about five years ago.  Most of the rest of the heroin in the United States comes from Mexico.  And the Mexican government, of course, is engaged in a historic effort to attack the cartels.  You see this in the violence the cartels have had as a reaction.  So we have promising signs.  There are dangerous and difficult tasks ahead, but we can follow through on that as well.

Most of the heroin in the world comes from Afghanistan; 90% of it.  And we are working there, of course, as a part of our effort against the Taliban and the forces of terror and Al Qaeda, to shrink that.  The good news is that last year we had a 20% decline in cultivation and a 30% decline in output there.  Most of that does not come here, fortunately.  But it has been funding the terrorists.  It’s been drained out of most of the north and the east of the country.  It’s focused on the area where we have the greatest violence today, in the southwest.  We’re working now – you see Secretary Gates talking to the NATO allies about bringing the counter-insurgency effort together with the counter-narcotics effort to attack both of these cancers in Afghanistan.  We have a chance to change heroin availability in the world in a durable way by being successful in Afghanistan.  We’ve started that path in a positive way.  Again, it’s a matter of following through as rapidly as possible.

Q 10:  Greg Lannes, the father of the girl in Fairfax County who died, told me that one of his main efforts, as you imagined, was to let people know that those drugs, they’re coming from where it is produced, outside our country; that they’re getting all the way down to the street level and into our neighborhoods– something that people don’t realize.  So when you hear that they busted a ring of essentially teenagers who have been dealing, using and buying heroin, what does that say to you as the man in charge of combating drugs in our country?

WALTERS:  Well again, we have tools that can make this smaller.  But we have to use those tools.  And we have multiple participants here.  Yes we need to educate.  And we need to make sure that parents know they need to talk to their children, even when their children look healthy and have come from a great home.  Drugs – we’ve learned, I think, over the last 25 years or more, drugs affect everybody; rich or poor, middle class, lower class or upper class.  Every family’s been touched by this, in my experience, by alcohol or drugs.  They know that reality– we don’t need to teach them that.

What we need to teach them is the tools that we have that they can help accelerate use of.  Again, I think – there is no question in my mind that had this young woman been in a school, middle school or high school that had random testing – since that’s where this apparently started, based on the information I’ve seen in the press – she would not be dead today.  So again, we can’t go back and bring her to life.  But we can put into place the kind of screening that makes the good will and obvious love that she got from her parents, the obvious good intentions that I can’t help but believe were a part of what happened in the school, the opportunities that the community has to have a lot of resources that she didn’t get when she needed them.  And now she’s dead.  Again, we can stop this: we just have to make sure we implement that knowledge in the reality of more of our kids as fast as possible.

Q 11:  Should anyone be surprised by this case?  And that such a hardcore drug like heroin is being used by young people?

WALTERS:  We should never stop being surprised when a young person dies.  They shouldn’t die.  They shouldn’t die at that young age, and we should always demand of ourselves, even while we know that’s sometimes going to happen today, that every death is a death too many.  I think that it is very important not to say we’re going to accept a certain level.  Never accept this.  Never!  That’s my attitude, and I know that’s the president’s  attitude as well here.  Never accept that heroin’s going to get into the lives of our teenagers.  Never accept that our children are going to be able to use and not be protected.  It’s our job to protect them.  They have a role, also, obviously in helping to protect themselves.  But we need to give them the tools that will help protect them.

When I talk to children and young adults in high school or college, they know what’s going on among their peers.  And in some ways, when you get them alone and they feel they can talk candidly, they tell us they don’t understand why we, as adults who say this is serious, don’t act.  They know that we see children who are intoxicated; they know that we must see signs of this, because as kid’s lives get more out of control, they show signs of it.  They want to know why we don’t act.

We can use the tools of screening, and we can use the occasion of a horrible event like this to bring the community together and say it’s time for us to use the shock and the sorrow for something positive in the future.  I haven’t met a parent of a child who’s been lost who doesn’t say I just want to use this now for something positive.  And that’s understandable, and I think we ought to honor that wish.

Q 12:  Well, I guess I’m not asking should we accept that this is in our schools, but is it naïve for people not to understand or realize that these hardcore drugs are in our schools, and in our communities, and in our neighborhoods. 

WALTERS:  Yeah.  Where it is naïve, I think, is to not recognize the extent and access that young people have to drugs and alcohol.  I think we sometimes think that because they come from a home where this isn’t a part of their lives now, that it’s not ever going to be part of their lives.  Look, your viewers should go on the computer.  Type marijuana into the Google search engine and see how many sites encourage them to use marijuana, how to get marijuana, how to grow marijuana, the great fun of marijuana.  Go on YouTube and type in marijuana, and see how many videos come up using marijuana, joking around about marijuana.  And then when you start showing one, of course the system is designed to show you similar things.  Type in heroin.  See what kind of sites come up, and see what kind of videos come up on these sites.  Young people spend more time on these sites than they do, frequently, watching television.  Remember, there is somebody telling your children things about drugs.  And if it’s not you, the chances are they’re telling them things that are false and dangerous.  So there is a kind of naiveté about what the young peoples’ world, as it presents itself to them, tells them about these substances.  It minimizes the danger, it suggests that it’s something that you can do to be more independent, not be a kid anymore. 

We, from my generation — because I’m a baby boomer — unfortunately have had an association of growing up in America with the rebellion that’s been associated with drug use.  That’s been very dangerous, and we’ve lost a lot of lives.  We have to remember that it’s alive and well, and has become part of the technological sources of information that young people have.  I also see young people in treatment centers who got in a chat room and somebody offered them drugs or offered them to come and buy them alcohol and flattered them, and got them involved in incredibly self-destructive behavior.  The computer brings every predator and every dangerous influence into your own child’s home – into their bedroom in some cases, if that’s where that computer exists.  You wouldn’t let your kids go out and play in the park with drug dealers.  If you have a computer and it’s not supervised, those drug dealers are in that computer.  Remember that.  And they’re only a couple of keystrokes away from your child.

Q 13:  And you talk about the YouTube and the computers and all those things.  What about just the overall societal image?  Because we have this whole image with heroin, of heroin chic.  How much does that contribute to the drug use, and how difficult does it make your job, when a drug is being made out to be cool in society by famous people?

WALTERS:  There are still some elements of that.  It was more prominent a number of years ago.  I would say you see less of that now glamorized in the entertainment industry, or among people who are celebrities in and out of entertainment.  You see more cases of real harm.  But it’s still out there.  The one place that I think is replacing that, just to get people ahead of the game here, is prescription pharmaceuticals.  Those have been marketed to kids on the internet as a safe high.  They falsely suggest that you can overcome the danger of an overdose because you can predict precisely the dosage of OxyContin, hydrocodone, Vicodin.  And there are sites that suggest what combination of drugs to use.  We’ve seen prescription drug use as the one counter example of a category of drug use going up among teens.  We’re trying to work on that as well, but that’s something that’s in your own home, because many people get these substances for legitimate medical care.  Young people are going to the medicine cabinet of family or friends, taking a few pills out and using those.  And those are as powerful as heroin, they’re synthetic opioids, and they have been a source of overdose deaths. 

So let’s not forget – while this Fairfax example reminds us of the issues of heroin chic and of the heroin that’s in our communities, the new large problem today is a similar dangerous substance in pill form in our own medicine cabinets.  Barrier to access is zero.  They don’t have to find a drug dealer; they just go find the medicine cabinet.  They don’t have to pay a dime for it because they just take it and they share that with their friends.  We need to remember, that’s another dimension here.  Keep these substances out of reach – under our control when we have them in our home.  Throw them away when we’re done with them.  Make sure we talk to kids about pills.  Because people, again, are telling them that’s the place to go to avoid overdose death, is to take a pill.

Q 14:  When you see a lot of these celebrities checking in and out of rehab, does it sort of glamorize it for kids?  And teach them hey, you can use, you can check into rehab, you can come back, you can – you know.  Is there a mixed message there?

WALTERS:  There is.  Some young people interpret it the way you describe; of it’s something you do and you can get away with it by going into rehab.  We do a lot of research on young people’s attitudes for purposes of helping shape prevention programs in the media, as well as in schools and for parents.  We do a lot with providing material to parents.  I would say that compared to where we’ve been in the last 15 or 20 years, there’s less glamorization today.

I think we should also remember the positive, because we reinforce that.  A lot of young people – obviously not all or we wouldn’t have this death – believe that taking drugs makes you a loser.  They’ve seen that a lot of those celebrities are showing their careers going down the toilet because they can’t get away from the pills and the drugs and the alcohol.  And I think they see that even among some of their peers.  That’s a good thing.  We should reinforce that as parents: teaching our kids that drug and alcohol use may be falsely presented to you as something you do that would make you popular, make you seem like you should have more status in society generally.  But actually, look at a lot of these people; they’ve had enormous opportunities, enormous gifts, and they can’t stop themselves from throwing them away.  And they may not stop themselves from throwing away their lives. 

I think you could use these events as a teachable moment.  It can go two ways.  Help your child understand what the truth is here.  And I tell young people – and I think parents have to start this more directly – this is the way this is going to come to you:  Somebody you really, really want to like you; somebody you really, really like; someone you may even love — or think you love — they’re going to say come and do this with me.  If you can’t find any other reason to not do this with them, say, “Before we do this, let’s go to a treatment center.  Let’s go talk to people who stood where we stood and said it’s not going to happen to me.”  If everybody, when they got the chance to start, thought of an addict or somebody who was dead, they wouldn’t start.  The fact is that does not enter their mind. 

Many people in treatment centers understand that part of the task of recovery is helping other people avoid this.  So they’re willing to talk about it.  In fact, that’s part of their path of staying clean and sober, which not many kids are going to be able to do on their own.  But it makes them think that what presents itself as something overwhelmingly attractive has behind it a horrible dimension, for their friends as well as for themselves.  And more and more, I think kids understand this.

We can use the science of this as a disease, and the experience of many families.  Remember, uncle Joe didn’t used to be like this.  Especially Thanksgiving, when we have families getting together and all of a sudden mom’s going to get loaded and become ugly in the corner.  We also have to remember we have an obligation to reach out to those people, and to get them help.  We can treat them.  Nobody gets sober, in my experience, by themselves.  They have to take responsibility.  But you have to overcome the pushback, and addiction and alcoholism have, as a part of the disease, denial.  When you tell somebody they have a problem, they get angry with you.  They don’t say hey thanks, I want your help.  They don’t hit bottom and become nice.  That’s a myth.  They need to be grabbed and encouraged and pushed.  Almost everybody in treatment is coerced – by a family member, by an employer, sometimes by the criminal justice system.

So remember that, when you find your child using and they want to lie to you up down and sideways saying, “It’s the first time I’ve ever done it.”  No, no, no, no, no, that’s the drugs talking.  That shows you, if anything, you have a bigger problem than you realized and you need to reach out, get some professional help.  But don’t wait!

Source:    National Institute of Citizen Anti-drug Policy (NICAP)

DeForest Rathbone, Chairman, Great Falls, Virginia, 703-759-2215, DZR@prodigy.net

Abstract

Source: https://www.samhsa.gov/blog/samhsas-20th-prevention-day-leading-with-science-improving-lives

Source: https://www.unodc.org/unodc/en/frontpage/2024/March/twenty-three-new-substances-precursors-placed-under-international-control-four-resolutions-passed-at-67th-session-of-the-commission-on-narcotic-drugs.html

Source: https://www.cbsnews.com/news/us-drug-overdose-deaths-2022-record/

In This Article

Source:  https://www.addictiongroup.org/resources/addiction-statistics/#:~:text=An%20estimated%2048.7%20million%20Americans%20aged%2012%20or,substance%20use%20disorder%20%28SUD%29%20in%20the%20past%20year

Nowadays, teaching your child to make healthy choices is crucial for their development and well-being. Understanding the importance of nutritious eating and an active lifestyle can set the foundation for a lifetime of health and happiness. This article, which has been developed by www.recoveryproud.com  links to a number of sites which can help young people to keep control of their lifestyles. Additionally, a large body of generic information can be derived by visiting the National Drug Prevention Alliance. 

Create a Supportive Environment for Healthy Choices

Make your home a haven for healthy choices. Keep nutritious snacks within easy reach and involve your child in meal preparation. This not only makes healthy eating more appealing but also instills a sense of responsibility and appreciation for wholesome food. It’s a practical way to teach them about nutrition and the benefits of eating well. By letting them assist in simple cooking tasks and making choices about the meals, you empower them with knowledge and skills that foster a lifetime of healthy eating habits.

 Talking to Your Child About Substance Abuse

 Talking to your kids about drugs is a crucial aspect of parenting that can help safeguard their future. Engaging in open and honest conversations about the dangers of drug use builds a foundation of trust and awareness. It empowers children with the knowledge to make informed decisions and resist peer pressure. This dialogue should be age-appropriate, focusing on the health risks, legal implications, and the impact on mental and emotional well-being. By fostering a supportive environment where children feel comfortable discussing their fears and curiosities about drugs, parents can guide their children towards healthy choices and provide them with coping strategies for dealing with life’s challenges.

Champion Physical Activity Over Screen Time

Limiting screen time is more crucial now than ever. Encourage your child to embrace physical activities, which are essential for their health and happiness. Present alternatives that divert their attention from screens, like outdoor adventures or sports. This not only fosters physical well-being but also teaches them to value real-world experiences over digital engagements.

 Nurture a Mindful Approach to Nutrition

Instilling the value of good nutrition in your child’s mind is vital. Explain how choosing foods wisely fuels both their body and brain, supporting their growth, learning, and play. This foundation of understanding encourages them to make healthy decisions that contribute to their overall well-being. By discussing the roles of different nutrients and how they affect the body, you can make the concept of eating well more tangible and engaging for them.

Don’t Forget to Declutter

 Teaching your kids about decluttering offers numerous benefits that extend well beyond a tidy home. It instills in them the value of organization and cleanliness, fostering an environment where they can think clearly and focus better on their tasks. So the next time you’re cleaning, get your kids involved. This process also nurtures decision-making skills, as children learn to differentiate between what is necessary and what is superfluous. Additionally, decluttering with your kids encourages mindfulness and appreciation for what they have, promoting a lifestyle of minimalism and sustainability. By understanding the importance of decluttering, children can develop healthier habits that contribute to their overall well-being and success in life.

Make Hydration a Habit

Water is the body’s best friend. It keeps everything running smoothly, from digestion to maintaining a healthy temperature. Encouraging kids to drink water throughout the day is pivotal to their overall health. Simple reminders and having water easily accessible can make all the difference.

 Embrace the World of New Foods

Encouraging your child to explore new foods is a journey of discovery. Introduce them to the diverse world of fruits, vegetables, and whole grains, highlighting how each contributes to their health. This exploration is not just about tasting new flavors; it’s about teaching them the benefits of a varied diet, rich in nutrients, that powers their body and mind. By making this journey exciting, you help them develop a love for foods that are good for them.

 Establish Restorative Sleep Routines

A consistent bedtime routine is key to your child’s health. Establish rituals that promote relaxation and signal to their body that it’s time to rest. Emphasizing the importance of quality sleep can help them understand how it supports their growth and readiness for daily activities, ensuring they prioritize it as part of their healthy lifestyle. This can include activities like dimming the lights, reading a story together, or practicing some gentle yoga, which can all aid in transitioning from the day’s excitement to a peaceful night’s sleep. 

Teaching healthy choices to kids lays the foundation for a lifetime of wellness. By leading by example and fostering an environment where making healthy decisions is both encouraged and celebrated, parents can significantly influence their children’s habits. This journey, while requiring patience and consistency, promises a rewarding outcome for the entire family.

Further guidance can be obtained by referring to www.recoveryproud.com  and to the National Drug Prevention Alliance.

Source: www.recoveryproud.com

Source: https://nypost.com/2024/04/02/us-news/oregon-recriminalizes-drugs-after-upswing-in-overdose-deaths/

At the 67th session of the UN’s Commission on Narcotic Drugs (CND), member states met to take stock of progress made in implementing the 2019 Ministerial Declaration on drug policy commitments and to adopt a number of resolutions on specific aspects of drug policy. Despite the adoption of a political declaration by consensus, states did not maintain consensus-based decision-making throughout the meeting, heralding long overdue progress towards more humane and effective drug policies, particularly in the area of harm reduction. Despite this historic step forward, the future direction of the international drug policy debate remains uncertain.

In the run-up to the CND meeting, held in Vienna from 14 to 22 March 2024, it was not clear that member states would be able to reach a consensus on the outcome of the review, reflecting growing challenges to multilateralism. However, after more than 120 hours of negotiations since January 2024, states seemed to keep the UN in Vienna’s usual cooperative spirit alive by adopting a declaration. They committed to broadly agreed compromises to address the ‘world drug problem’ (although many states no longer refer to drugs as a ‘problem’) in accordance with the principles of the UN Charter and international human rights law, and expressed concern about the proliferation and harm of synthetic drugs.  

Although consensus was reached, two statements were subsequently issued outlining starkly opposing approaches to drug policy from different sides of the camp. One, delivered by Colombia and representing 62 countries, including most of Europe and the Americas, called for a review and reassessment of the international drug control system, and supported human rights. The other, delivered by Russia and supported by 40 countries, criticized the legalization of cannabis and called for a ‘society free of drug abuse’, echoing an approach to drug policy that prevailed before the UN General Assembly’s landmark special session on drugs in 2016.  

The apparent consensus on the declaration was reflected in the fact members showed near unanimity in adding a number of substances to be controlled under the conventions. However, the deeper current of polarization on drug policy seen in the two opposing statements would resurface with dramatic effect when two of the session’s resolutions failed to reach consensus and had to be put to a vote, breaking with longstanding practice in Vienna.  

A paradigm shift on harm reduction 

Only two of the four resolutions managed to bypass the political drama. The first was a resolution tabled by Chile on promoting recovery and related support services for people with drug-use disorders. The second was a resolution tabled by Belgium, on behalf of the EU, on promoting awareness raising, education, training and data collection to ensure the availability of and access to controlled substances for medical and scientific purposes, while preventing their diversion to illicit channels and non-medical use. Despite extensive debate, both resolutions were adopted by consensus on the penultimate day. 

The other two resolutions were put to a vote on the final day. A resolution on alternative development, tabled by Germany, Thailand and Peru, which sought to build on previous efforts (including its predecessor, the resolution adopted in 2023), faced resistance and attempts to change the agreed language. It was held hostage mainly by Iran’s opposition to the inclusion of language on gender and technology transfer (a common dividing line in UN-based processes), as well as attempts to insert language opposing sanctions. The resolution was adopted by a majority vote during the final plenary session. 

A resolution on overdose prevention and harm reduction, tabled by the US, received the most attention and resulted in a monumental shift in CND practice, approach and policy. The term ‘harm reduction’, which is recognized by the World Health Organization and widely used throughout the UN system, has long been opposed by states with a more conservative approach to drug policy and was therefore the main obstacle to achieving consensus on the resolution.  

The US, which had traditionally opposed the use of the term, introduced the resolution in the context of its opioid crisis, stressing the importance of implementing effective measures and initiatives to minimize the negative public health and social consequences of the non-medical use of synthetic drugs. After lengthy discussions, during which the text was significantly watered down, the resolution was put to a vote, as it was made clear that countries leading advocacy for both sides of the debate would accept a compromise. Russia, who led the opposition to including the term, criticized the adoption process, claiming that it deviated from the norms of the CND. China reiterated its reservations on harm reduction and emphasized the need for a comprehensive approach to global drug issues, highlighting the lack of consensus in the international community on this issue. Most members of the commission (38 out of 53) supported the resolution – including some unexpected states, such as Singapore, Indonesia and Saudi Arabia, all of which take a hard line on drug policy. China and Russia voted against it but were unable to bring more ‘middle ground’ countries into their camp.  

The positions of African countries on this resolution were remarkably divided, with the more progressive drug policy environments – represented by Morocco, Ghana and South Africa – voting in favour, but Nigeria and Kenya (two of the most active African delegations in Vienna) choosing not to take part in the vote. Algeria, which has a drug policy and political-ideological stance more in line with China and Russia, chose to abstain. The outcome shows how realpolitik played a key role in the voting process, alongside genuine views on drug policy.  

The use of the term ‘harm reduction’ in a resolution is a landmark achievement in drug policy and represents a clear and overdue shift towards a public-health approach to drugs at the UN. This opens the door for more progressive approaches to drugs to be considered by the CND, as the ‘Vienna spirit’ (whereby UN resolutions are adopted by consensus) has clearly held back progress on drug policy.  However, the wider implications for drug policy and for the broader range of decision-making forums in Vienna are still unclear, and there will undoubtedly be efforts by opponents of progressive drug policy to organize pushback.   

The different perspectives were also reflected in the politics of civil society representation at the CND. The Vienna NGO Committee on Drugs held elections that ended up shifting the composition of its committee towards a more conservative representation, moving in the opposite direction to member states. This change is clearly due to political coordination in this committee, rather than a shift in opinion in civil society as a whole. But these divisions, and the way civil society on both sides of the debate respond to them, carry the risk that the growing differences between member states will be magnified by disagreements within civil society groupings, potentially exacerbating polarization at the CND. 

All eyes on synthetics 

Besides this resolution, the priority attention given by the US to address the harms caused by synthetic drugs was tangible during this session. Prior to the meeting, the US highlighted its priority of placing two additional fentanyl precursor chemicals under international control, which the commission unanimously adopted, and the US-led Global Coalition to Address Synthetic Drug Threats was heavily promoted during the meeting, including through the presence of US Secretary of State Anthony Blinken, who addressed member states to condemn the harm caused by synthetic opioids and pledge support to combat illicit synthetic drug threats around the world. Other member states organized several events on the topic, demonstrating a growing level of attention to this issue.  

This strong focus is a good indicator of how worrying these substances are becoming in the eyes of member states. The rapid increase in the production, trafficking and use of synthetic drugs in recent years, and particularly in the last two, has caught many states by surprise. The results of the 2023 Global Organized Crime Index show that 187 of the 193 UN member states have a domestic market for synthetic drugs – more than the number of countries with a heroin market. Synthetic drugs are proving to be the future of illicit drug economies, and CND member states are quickly recognizing this, as well as the fact that they are currently ill-prepared to respond to the threats that these substances pose to public health and security.  

Increased focus on human rights  

The CND also made progress in advancing the agenda on the impact of drug policies on human rights. For the first time, a UN High Commissioner for Human Rights, Volker Türk, attended the meeting in person. Türk urged member states to adopt a transformative stance on drug policy, highlighting the serious human rights consequences of the ‘war on drugs’, the challenges facing member states (as addressed in his 2023 report to the UN Human Rights Council), and the need to focus on the right to health of people who use drugs and the right of women to equal access to services. 

Türk also welcomed the positive steps taken by countries such as Portugal and Switzerland to adopt health- and rights-based approaches to drug policy, and the renewed commitment to human rights in the declaration adopted by the CND. At the meeting, several side events focused on the human rights implications of punitive approaches to drug policy, including in relation to the enjoyment of economic, social and cultural rights (such as the right to work, and an adequate standard of living and housing). This would indicate evidence of a growing trend to consider the relationship between human rights in general and the impact of drug policy, rather than focusing solely on the right to health and life, as has been the norm.   

A step forward, but what next? 

The headline results of the CND were not only due to the politics of drug policy. This outcome came about because of widespread frustration among Western and other countries with Iran’s strong-arm tactics across the board in the UN’s sessions in Vienna. Their exploitation of the ‘Vienna spirit’ ultimately led to its demise, and prompted coordination and common cause among various delegations from different regional groups – with a coming together of Colombian, US and European interests in the CND.   

Once the dust settles, it is uncertain how member states will respond to these changes, but it is clear that the contours of the drug policy debate have fundamentally shifted and the facade of consensus has visibly crumbled after years of slow but steady erosion. This should come as no surprise and will be seen by many as a natural conclusion, confirming how far the debate has moved on and matured. There will undoubtedly be moves from both sides of the debate to capitalize on votes to advance particular policies and to push back on issues that pass through the CND without consensus.  

While progress towards agreeing on more humane approaches to global drug markets and use at the CND is a great step in the right direction, it also formalizes and deepens the different stances dividing the opposing camps. This points to an uncertain and polarized future for international drug policy when the harms of associated illicit markets, such as synthetics, require coordinated action.

Source: https://globalinitiative.net/analysis/uncertain-future-drug-policy-commission-narcotic-drugs-united-nations/

How families can help prevent teen substance use disorder

If you or someone you know is in immediate need of help for substance use, or any mental health crisis, the national 988 Lifeline is the best place to start. You can call or text 988 from any phone, or connect via webchat.

Recent studies, both nationally and at Michigan Medicine, report that alcohol, cannabis and nicotine vaping are the most commonly used substances among teens.

Aside from cannabis and prescription drug misuse, teens report relatively low use of illicit substances. Despite this, teen drug overdose deaths have been on the rise in recent years. Monthly overdose deaths among youth aged 10-19 more than doubled from 2019 to 2021.

Parents and caregivers should actively be on the lookout for signs and symptoms of substance use. Addressing substance use early on can help prevent addiction or other problems later in life.

An expert from the University of Michigan Addiction Center recently spoke about the impacts of teen substance use and what families can do to help youth who may be at risk or showing signs of addiction.

Trends in teen substance use

Meghan Martz, Ph.D., a research assistant professor of psychiatry, explains concerning trends surrounding adolescent substance use. Although levels have stabilized in recent years, there are new factors for parents to consider.

When it comes to alcohol use, binge drinking remains the leading concern. This harmful consumption pattern can lead to blackouts, vomiting, overdose and mental and physical health problems.

Vaping nicotine products also remains popular among teens. Martz says the flavored products cater directly to its young audience, posing a serious risk of addiction for adolescents.

As cannabis legalization has become widespread, perceptions of harm have decreased, and rates of cannabis use have increased tremendously. In 2023, 29% of 12^th graders reported cannabis use in the past year.

“The level of THC is much stronger in cannabis products used today, and there is a direct link between higher potency and risk for disordered use,” Martz said, describing the substance in cannabis that causes most of the “high” sensation that users feel.

Parents should particularly monitor for opioids, even if the use rates are lower than other substances. Due to drugs laced with fentanyl, a highly potent synthetic opioid, there has been a recent surge in overdose deaths.

Risk factors

The exact reasons for substance use can vary, “but teens are the most vulnerable population for disordered use,” Martz said.

It all starts with a curiosity about substances. Ten percent of 9- and 10-year-olds reported curiosity to use alcohol and nicotine, according to research Martz led. The desire to fit in socially can significantly influence the decision to try substances, and teens tend to overestimate the prevalence of substance use among their peers.

Factors that can lead to substance use in teens include:

• A family history of substance use.
• Associating with substance using peers.
• Coping with mental health issues like anxiety, depression or ADHD.
• Low parental monitoring.
• Lack of school connectedness.

The adolescent brain

It’s important to remember that “the risk factors present in teens are associated with the development of the adolescent brain,” said Martz.

Three key functions of the brain are associated with substance use: reward, emotion and cognitive control.

The reward circuit involves the release of dopamine, a naturally occurring chemical attributed to feelings of pleasure. People become hooked to this false sense of happiness and develop an addiction to the drug supplying it.

Similarly, drugs can influence the emotion circuit by reducing feelings of anxiety, irritability and unease. The addiction is reinforced through a cycle of withdrawal symptoms that can range from mild discomfort to life-threatening complications.

But for adolescents, it is the cognitive control circuit that makes them most susceptible to substance use. This brain function is responsible for thinking, planning and problem solving.

“The cognitive control circuit is the last part of the brain to mature,” Martz said.

“This makes youth more prone to act on impulse and engage in risky behaviors, including substance use.”

Teens are also less likely to experience immediate consequences of substance use – such as hangovers – leading to greater consumption and more damaging neurotoxic effects.

Advice for families

Substance use and addiction prevention starts in the home. Parents are the first line of defense against potential drug use disorders.

There is no guarantee that your child won’t use substances, but it is less likely to happen if you:

• Bring it up early – kids are curious from a young age.
• Talk early and often about the dangers of substance use.
• Set rules about substance use.
• Focus on the biological impact to the brain and body, rather than moral or legal considerations.

“As a parent, you may not be able to control the external influences, but you can certainly start the conversation early and set firm boundaries to protect your child from substance use,” Martz said.

Source: https://www.michiganmedicine.org/health-lab/what-parents-should-know-about-teen-drug-and-alcohol-use

Teenagers across America were invited to submit 30-60 second video public service announcements that capture their unique voice in order to communicate the opioid epidemic as a national crisis.

The second-annual video challenge is a part of a joint nationwide education initiative titled Operation Prevention that educates students about the science behind addiction and its impact on the brain and body. Available at no cost, the initiative’s resources help promote lifesaving discussions in the home and classroom.

Teens are agents of change, and their actions speak volumes to peers. Together, we can work toward raising awareness, and most importantly, prevention, among our youth population, said Acting Administrator Robert W. Patterson.   The video below was one of the entries and was powerful and instructive.

  Source:  https://www.operationprevention.com/competition/video/archives/2019  

Cannabis and cannabinoids are implicated in multiple genotoxic, epigenotoxic and chromosomal-toxic mechanisms and interact with several morphogenic pathways, likely underpinning previous reports of links between cannabis and congenital anomalies and heritable tumours. However the effects of cannabinoid genotoxicity have not been assessed on whole populations and formal consideration of effects as a broadly acting genotoxin remain unexplored. Our study addressed these knowledge gaps in USA datasets. Cancer data from CDC, drug exposure data from National Survey of Drug Use and Health 2003–2017 and congenital anomaly data from National Birth Defects Prevention Network were used. We show that cannabis, THC cannabigerol and cannabichromene exposure fulfill causal criteria towards first Principal Components of both: (A) Down syndrome, Trisomies 18 and 13, Turner syndrome, Deletion 22q11.2, and (B) thyroid, liver, breast and pancreatic cancers and acute myeloid leukaemia, have mostly medium to large effect sizes, are robust to adjustment for ethnicity, other drugs and income in inverse probability-weighted models, show prominent non-linear effects, have 55/56 e-Values > 1.25, and are exacerbated by cannabis liberalization (P = 9.67 × 10 –43 ,2.66 × 10 –15 ). The results confirm experimental studies showing that cannabinoids are an important cause of community-wide genotoxicity impacting both birth defect and cancer epidemiology at the chromosomal hundred-megabase level.

Source: https://www.nature.com/articles/s41598-021-93411-5.epdf July 2021

Kratom, in powder form, can be taken in capsules or brewed into a tea.

A kratom leaf, the source of an herbal supplement that users say can provide pain relief and relieve insomnia, among other uses.

Vivian Allen sought chronic pain relief.

A car wreck left the 55-year-old grandmother immobilized. Six subsequent back surgeries led to severe nerve damage. A doctor advised implanting a morphine pump but Allen, from Walker, Louisiana, worried about the southern climate. A morphine pump implant could not withstand 90-degree heat and could kill her.

She felt desperate.

When a friend from a Facebook group suggested kratom, the herbal supplement derived from leaves of a Southeast Asian tree, Allen decided to try it.

“I couldn’t believe it,” she said. “It alleviated my symptomatic problems and it helped me have a functional life without having to get the implant.”

Kratom, which she began taking in 2015, also allowed her to wean herself from the Xanax pills she’d been prescribed for more than two decades.

“People take kratom because they need it,” she said. “It’s that simple. Very few people take it recreationally.”

But if lawmakers have their way, Allen and other kratom users throughout Louisiana could be out of luck.

A bill set to criminalize kratom in Louisiana was passed several weeks ago.

The legislation, prompted by a Louisiana Department of Health (LDH) report and pushed through by state Rep. Chris Turner, R-Ruston, was passed unanimously by the Senate and the House and signed into law June 11 by Gov. John Bel Edwards.

Kratom will be banned under the act if the U.S. Drug Enforcement Administration (DEA) categorizes it as a Schedule I drug. The category, which includes drugs like heroin, ecstasy and peyote, indicates a lack of medical use and suggests a high potential for abuse.

This move to classify kratom as Schedule I has been attempted before. In 2016, the DEA listed kratom as a “drug and chemical of concern” and temporarily banned it. It’s currently illegal in Alabama, Arkansas, Indiana, Rhode Island, Vermont, and Wisconsin. Other states, including Colorado, Nevada, Illinois and Florida, have outlawed kratom in certain jurisdictions.

The U.S. Food and Drug Administration (FDA) hasn’t approved kratom for human consumption either. In June, the FDA expressed disdain when addressing kratom distributors in Folsom, California and Wilmington, North Carolina for making false medical assertions.

“Despite our warnings, companies continue to sell this dangerous product and make deceptive medical claims that are not backed by science or any reliable scientific evidence,” FDA Commissioner Ned Sharpless said in a statement. “As we work to combat the opioid crisis, we cannot allow unscrupulous vendors to take advantage of consumers by selling products with unsubstantiated claims that they can treat opioid addiction or alleviate other medical conditions.”

The FDA continued to state that “substances” in kratom have opioid properties “that expose users to the risks of addiction, abuse and dependence.”

“There are no FDA-approved uses for kratom, and the agency has received concerning reports about the safety of kratom,” the statement said. “The FDA encourages more research to better understand kratom’s safety profile, including the use of kratom combined with other drugs.”

The FDA also has recommended classifying kratom as a Schedule I drug.

So what exactly is kratom?

Originating from a Southeast Asian evergreen tree, kratom (Mitragyna speciosa) leaves contain mitragynine and 7-a-hydroxymitragynine, organic compounds that target opioid receptors in the brain. It can be taken in capsule or powder form or brewed into a tea. There are several strains including Maeng Da, which is said to boost energy; Red Vein Kali, commonly taken for sedation; and Green Vein Kali, known to treat pain.

Although they work on the same receptors as opiates, they don’t have the same chemical properties.

Wesley Nance, 26, a singer who lives in New Orleans and works at The Herb Import Company in Mid-City, said he used two strains of kratom to ease scoliosis pain.

He took 2 grams of Green Vein Kali in the morning for his aching, and 2 grams of Red Vein Kali at night so he could sleep without discomfort.

“It made my pain go away,” he said. “I was amazed.”

Nance was wary of pharmaceutical drugs after seeing his mother’s addiction to opioids, he said. “Kratom helped me change the family history,” he said. “It helped me heal naturally.”

Scott Ploof, 35, publisher of Big Easy Magazine, began using it after the death of his grandfather.

“It helped me alleviate anxiety and depression in a natural way,” he said.

Ploof believes a partisan political climate is undermining the reality of the drug’s benefits and possible risks. “Politics is getting in the way of reason,” he said. “Kratom is a safe, natural, herbal alternative supplement that can be used to treat a variety of issues and is better than a lot of what else is out there.”

Kratom also has been praised by former opioid users.

Neal Catlett, 39, of Lexington, Kentucky, became hooked on oxycodone and morphine in 2015 after a shoulder injury. He credits kratom with helping him kick the prescription medications by easing withdrawal symptoms and physical pain.

“It’s a lifesaver for those who suffer from drug addiction,” he told Gambit. “It’s an amazing plant.”

The LDH, however, outlined different results of kratom use. The department’s 14-page report, released in February, points to dangers.

In 2017, the FDA reported 44 to 47 deaths related to kratom use, with one caused by “pure kratom.” The rest resulted from mixing other drugs with kratom, including fentanyl, diphenhydramine, caffeine, and morphine. Kratom also was associated with a national salmonella outbreak from January 2017 to May 2018 that affected 199 people ranging from 1 to 75 years old. No deaths were recorded but one-third of the individuals needed hospitalization, the report said.

“Heavy users of kratom often lose weight, become tired and suffer constipation,” the report said. “Facial redness may also occur. Repeated doses of 10 to 25 grams of dried leaves cause perspiration, dizziness, nausea, and dysphoria (a state of unease or generalized dissatisfaction with life), which become quickly replaced by a state of calm, euphoria and a dreaming state which may last up to six hours. The LDH concluded by advocating for a ban.

“Kratom currently has no accepted medical uses,” it goes onto say. “Therefore, the Louisiana Department of Health recommends that kratom be banned from general consumption in the state, with exceptions made only in the context of well-designed scientific studies with appropriate oversight, data safety monitoring boards and regulatory approval.”

LDH spokeswoman Mindy Faciane told Gambit the decision was made with consumer well-being in mind. “The Louisiana Department of Health supports any efforts that help make Louisiana residents safer,” Faciane said.

Kratom has been a boon for New Orleans businesses that sell it, despite any risks. Uxi Duxi in Mid-City and Mushroom New Orleans in Uptown sell kratom products to loyal customers.

Ashley Daily, who owns the Euphorbia Kava Bar in Riverbend, said kratom accounts for more than 50 percent of her business. A ban “wouldn’t shut me down,” she said, “but it would make me very broke and it would affect my employees.”

After five years in business, she is making a profit for the first time, largely because of kratom — but Daily said it’s about more than commerce. “It’s what [a ban] would do to my customers who depend on kratom,” she said. “Twenty percent of my clientele use it as a natural painkiller. Other ex-users get off opioids with it and it truly helps them.”

Christopher Hummel, owner of Mushroom New Orleans, began selling kratom about seven years ago but only saw a sales uptick in the past two years.

“People are now trying to avoid prescription painkillers, and they take kratom so they don’t have to [take them],” he says. “Banning it would cause a major health issue.”

Reza Hardinata, 20, a native of Pontianak, Indonesia, told Gambit kratom is his family’s main source of income. His father harvests it and Hardinata sells kratom to local companies that export the substance each month. “Kratom is very helpful in terms of health, addiction and pain relief and also improves the economy of my family and also the community,” he said. “This [ban] is very unfortunate.”

Others who study the science behind kratom believe the FDA is amplifying adverse effects while ignoring empirical data. Marc T. Swogger, an associate professor in the Department of Psychiatry at the University of Rochester Medical Center, conducted peer-reviewed research on kratom. Although no clinical trials to examine kratom’s benefits have been directed in America, he said, “observational studies” in the United States and Southeast Asia have been “compelling.”

“Across samples, people report pain relief, relief of anxiety or depressed mood, and the utility of kratom to serve as an opioid replacement, easing symptoms of opioid withdrawal,” he said.

Swogger believes criminalization would set up a “new and vibrant black market” for kratom.

“In addition to being ineffective, a kratom ban would be wrong,” he said. “People are using kratom to help with difficult conditions and reporting success. For some of them, lack of access to kratom would lead to the increased use of classical opioids, setting the stage for yet more overdoses.”

The Kratom Information & Resource Center (KIRC) last week launched a campaign to get journalists to cover kratom with “fair and balanced” reporting. 

“This is a legal product that is being used by informed adults in the privacy of their homes and dedicated commercial establishments,” KIRC spokesman Max Karlin said in a statement. “If kratom were as much of a problem as it has been made out by some organizations engaging in reckless ‘Leafer Madness’ rhetoric, America’s hospitals and ERs would be choked. … Instead, experts can’t agree whether there has been even one kratom-related death in the U.S.”

McClain “Mac” Haddow, senior fellow on public policy at the American Kratom Association (AKA), agrees, and believes the approximately 5 million kratom users in the U.S. should have access to a regulated product.

That’s why Haddow and the AKA are working with politicians to enact the Kratom Consumer Protection Act, which aims “to regulate preparation, distribution, and sale of kratom products” to prohibit adulterated or contaminated kratom. He believes selling to people over 18 and ensuring the purity of the kratom would be more helpful than a ban.

“If you ban it, people in the kratom community will die,” he says.

Instead, he believes in regulatory measures and thinks kratom advocates in Louisiana will prevail in the end.

“The Louisiana ban is not as bad as it sounds,” he said. “We’re pretty comfortable on the federal side that there is movement. We’re more and more confident that we’re being heard.”

Haddow said he plans to work with Rep. Turner’s office to enact the Kratom Consumer Protection Act in Louisiana during the next legislative session.

Allen, who testified in a June judiciary hearing in Baton Rouge about kratom use, said passing the act would be the most effective compromise. “Having the Kratom Consumer Protection Act is the best thing for Louisiana,” she says. “Consumers need to be protected but they shouldn’t lose what helps them. Mine is only one of 5 million stories. People shouldn’t be denied the ability to heal.”

Source:  https://www.theadvocate.com/gambit/new_orleans/news/the_latest/article_b6261ece-b23e-11e9-8739-6f4af0786d5a.html   5 Aug. 2019

Nearly half of all U.S. citizens now live in a state where they can purchase cannabis from a recreational market, and all but 13 states have legalized medical use.  These state-level policies have all been developed and adopted under a federal prohibition, which may be changing soon as lawmakers in both the House and the Senate are developing federal proposals to legalize cannabis.

A new USC Schaeffer Center white paper shows how state-level cannabis regulations have weak public health parameters compared to other countries, leaving consumers vulnerable. Federal legalization is an opportunity to implement regulations that better protect consumers and promote reasonable use. Regulations policymakers should consider include placing caps on the amount of the main intoxicant (THC) allowed in products sold in the marketplace and placing purchase limits on popular high-potency cannabis products, like edibles and vape cartridges, as has been done in other legalized jurisdictions abroad.  

“Allowing the industry to self-regulate in the U.S. has generated products that are more potent and diverse than in other countries and has led to a variety of youth-oriented products, including cannabis-infused ice cream, gummies and pot tarts,” says Rosalie Liccardo Pacula, a senior fellow at the USC Schaeffer Center and Elizabeth Garrett Chair in Health Policy, Economics & Law at the USC Price School of Public Policy. “Current state regulations and public advisories are inadequate for protecting vulnerable populations who are more susceptible to addiction and other harm.”

High-potency cannabis products have been linked to short-term memory and coordination issues, impaired cognitive functions, cannabis hyperemesis syndrome, psychosis, and increased risks of anxiety, depression and dependence when used for prolonged periods. Acute health effects associated with high-potency products include unexpected poisonings and acute psychosis.

Policies should discourage excessive cannabis use

Product innovation within the legal cannabis industry has outpaced state regulations and our knowledge of health impacts of nonmedical, adult-use cannabis, write Pacula and her colleagues.  Cannabis concentrates and extracts can reach concentrated THC levels of 90% in certain cases – many, many times more potent than dried flower that ranges between 15-21%. These products are also increasingly popular – sales for concentrates like vape pens rose 145% during the first two years of legalization in Washington state.

But state approaches to regulation have insufficiently considered quantity and potency limits. Just two states, Vermont and Connecticut, have set potency limits on both flower and concentrates. Most states base sales limits on product weight and product type, an approach that allows individuals to purchase excessive amounts of high-potency products in a single transaction.

An individual in most states can purchase 500 10-milligram servings of concentrates in a single transaction. Six states allow purchases that exceed 1,000 servings. By comparison, a full keg of beer, which usually requires registration, provides 165 servings of alcohol.

“Voters in many of these states supported legalization because they were told we would regulate cannabis like alcohol, but in reality, when it comes to product innovation, contents and standard serving sizes, the cannabis market has largely been left on its own,” says Seema Pessar, a senior health policy project associate at the USC Schaeffer Center. “And that is what is concerning for public health.”

“We are seeing evidence of real health consequences from this approach, especially among young adults,” explains Pacula. For example, studies show a rise cannabis-related emergency department visits for acute psychiatric symptoms and cyclical vomiting in states that legalize recreational cannabis.

Key policies to support responsible cannabis use

To better regulate legal cannabis markets and products, researchers find four policy areas in which state laws and federal proposals can do more to encourage responsible use.

• Placing limits on the amount of THC in legal products sold: Setting clear and moderate caps on flower, concentrates and extracts.
• Instituting potency-based sales limits: Restricting the amount of cannabis that a retailer can sell to an individual in a single transaction or over a period of time, based on the THC amount in the product.
• Designing a tax structure based on the potency of products: Taxing cannabis in a manner similar to alcohol, based on intoxicating potential rather than by container weight or retail price.
• Implementing seed-to-sale data-tracking systems: Allowing regulatory agencies to view every gram of legal cannabis that is cultivated and watch it as it migrates throughout supply chain, including the comprehensive monitoring of ingredients added to products that are eventually purchased in stores.

While generating tax revenue and reversing damages from prohibition are important, so is prioritizing public health — and prolonged use of high-potency cannabis products has health consequences, the researchers write.

“It is difficult to implement restrictive health regulations in markets that are already operating, generating jobs and revenue,” Pacula says. “Now is when the federal government has the best chance of ensuring a market that fully considers public health.”

Source: Cannabis Regulations Inadequate Given Rising Health Risks of High-Potency Products – USC Schaeffer July 2022

Abstract

Drug Free America Foundation is launching its new digital advertisement campaign targeting viewers in Illinois. The digital animated ad is the second in a series titled “Marijuana…Know the Truth” and discusses the real dangers of marijuana use.  

As you know, Illinois is a state that is considering legalizing recreational marijuana this year. We hope this ad campaign will help address the misconceptions about the real dangers of marijuana use

This digital advertising campaign will utilize banner ads to drive viewers to our website where they can view the 2-minute ad. We are excited to say that through a generous donation, this campaign will provide over 10 million digital impressions in Illinois. We are hopeful that through additional donations, we are able to expand this campaign to other states and continue to spread the word on the dangers of marijuana.

Email from Drug Free America Foundation https://www.dfaf.org/ March 2019

Summary

A pilot study by Addiction Switzerland traced the alcohol incentives on the routes of 16 to 19-year-old adolescents in everyday life and in social networks. On average, the test subjects in the five largest Swiss cities encountered an alcohol incentive every five minutes. Alcohol was also omnipresent in social networks, transported by friends and influencers, who are often paid for it. The study showed the frightening normality of alcohol in the everyday life of adolescents.

 Alcohol marketing is aimed strongly at young people, as they are the customers of tomorrow. A pilot study by Addiction Switzerland , financed by the Federal Customs Administration, looked into the question of how much adolescents are actually exposed to alcohol stimuli. The study layout was partly based on an earlier study on tobacco marketing : Here, too, the typical routes and activities taken by young people in everyday life and when going out in Geneva, Lausanne, Bern, Basel and Zurich were traced. All alcohol incentives encountered were systematically recorded. In addition, the alcohol incentives encountered by the young people in social networks were recorded.

At least half of the incentives are intentional

On average, the distances (including activities such as sports, cinema, restaurant, etc.) were covered within six hours each. 73 alcohol stimuli were recorded per trip, which means, on average, a reminder of the alcohol every five minutes! It should be said that the investigation in autumn 2020 came at a time when the Covid measures were becoming stricter again and the exit bars were closing again, and fewer events were taking place in public spaces. It can be assumed that advertising activity has been reduced accordingly during this period.

Half of the stimuli recorded related to alcohol advertising or the promotion of alcoholic beverages. The other half consisted of apparently random alcohol stimuli: Empty bottles and cans in public spaces, depictions of where alcohol plays a role (e.g. an occasion where people drink), what is offered on a menu card, etc.

In addition, all perceived prevention messages should be recorded. But it turned out that these were almost completely absent on the paths of the young people.

On social media: the power of images and influencers

Alcohol marketing has partly shifted to the internet. 85% of young people between the ages of 12 and 19 spent an hour or more per day on the Internet in 2019 , the majority of them are also on social networks, which has probably increased during the pandemic . On Snapchat, Instagram and Tiktok in particular, they receive numerous pictures and messages from friends and acquaintances who have alcohol as their topic. The alcohol advertising by influencers is also noticeable.

A society banalizing alcohol does not protect its youth

The results of this pilot study impressively show how strongly young people are already confronted with alcohol. It becomes normal for them to include alcohol. This is alarming in view of the around 400 young people who are admitted to hospital in Switzerland every year because of alcohol poisoning. A large part of these alcohol stimuli is consciously placed or at least it is tolerated that adolescents are also advertised. Sucht Switzerland therefore calls for the measures to be taken to protect young people to be stepped up. These include the restriction of alcohol advertising and thus the reduction in the attractiveness of alcohol among young people.

Source:   mportner-helfer @ suchtschweiz.ch May 2021

Highlights

Aaron Hernandez was supposed to be the epitome of the American Dream—overcoming childhood setbacks to earn a spot in the NFL on the New England Patriots. Millions of kids across America wish they could be so lucky. But the 2020 documentary on Netflix, “Killer Inside: The Mind of Aaron Hernandez,” takes a deep dive into his life to investigate how his dream unraveled into a nightmare. Convicted of murdering his friend Odin Lloyd and accused of killing two other men (but found not guilty), Hernandez took his own life in a prison suicide in 2017. He was only 27.
The compelling docuseries explores many of the factors that could have contributed to the tragic end of such a promising life—childhood abuse, unstable parenting, hidden bisexuality. And then there was his brain. The docuseries delivers a fascinating look at his troubled brain, but it misses one key factor that may have contributed to Hernandez’ brain dysfunction.

The Brain of Aaron Hernandez
After Hernandez’s death, his brain was delivered to Boston University, where researchers made razor-thin slices for examination. Their findings? His brain was “riddled” with Stage 3 chronic traumatic encephalopathy (CTE). This neurodegenerative disease, which has 4 stages, has been found in athletes like football players, boxers, and soccer players who endure repeated concussions and other blows to the head. It has been associated with memory loss, cognitive dysfunction, and suicidal thoughts and behavior.
A Boston University publication reported that Ann McKee, director of BU’s Chronic Traumatic Encephalopathy Center, said that his brain was the worst case of CTE ever seen in someone so young. “Especially in the frontal lobes, which are very important for decision-making, judgment, and cognition, we could see damage to the inner chambers of the brain,” she said. The frontal lobes are also involved in impulse control, empathy, and learning from past experiences.
The documentary focuses heavily on CTE and the significant role it likely played in Hernandez’ downfall, and for good reason. The filmmakers also hone in on another aspect of his life that may have contributed to his troubles—cannabis use. It is reported that the football player began smoking marijuana regularly in high school and continued to smoke throughout his pro career. The docuseries calls him a “chainsmoker” with a serious habit, but it neglects to connect the dots between marijuana use and brain dysfunction.

Marijuana and the Brain
A growing body of evidence shows that marijuana use impairs brain activity. In the largest known brain imaging study, which appeared in the Journal of Alzheimer’s Disease, scientists from Amen Clinics, Google, Johns Hopkins University, UCLA, and the UC San Francisco evaluated 62,454 brain SPECT scans of more than 30,000 individuals (ages 9 months to 105 years) to investigate factors that accelerate brain aging. SPECT (single-photon emission computed tomography) is a brain imaging technology that measures brain activity and blood flow. The study found that a number of brain disorders and behaviors predicted accelerated aging. Of all the disorders and behaviors analyzed, cannabis abuse ranked as the second-highest brain ager, topped only by schizophrenia.
The study, which included brain scans from 1,000 cannabis users, 25,168 non-cannabis users, and 100 healthy controls, showed reduced cerebral blood flow among the cannabis users compared to non-users and healthy controls. A significant decrease in blood flow was noted specifically in the right hippocampus, an area of the brain that helps with memory formation. This part of the brain is severely affected in those that suffer from Alzheimer’s disease.

Healthy SPECT Scan

Marijuana Affected SPECT Scan

Other research has concluded that marijuana harms the teenage brain in numerous ways. For example, a 2019 review found that it increases the risk of depression and suicidal thoughts and behaviors. And marijuana use at a young age has also been associated with increased impulsivity.
Although pot promoters would argue that most people who smoke marijuana don’t become murderers and don’t die by suicide, it’s important to understand that in vulnerable people it may have negative impacts on brain function that contribute to unhealthy behaviors. Sadly, considering that Hernandez’s brain was so damaged by CTE, marijuana use was likely only making bad brain function worse.

You Can Change Your Brain
Unfortunately, this information is too late to help Hernandez, but it isn’t too late for other football players who have endured years of helmet-to-helmet tackles. A study at Amen Clinics on 30 retired professional football players who had suffered head trauma showed that after following a brain healthy program for 6 months, 80% showed significant improvement in blood flow to the frontal lobes, as well as improvements in overall cognitive functioning, processing speed, attention, reasoning, and memory. Hall of Fame quarterback Terry Bradshaw spoke openly about his own brain rehabilitation after suffering multiple concussions. 
Likewise, it isn’t too late for people who grew up in traumatic households. See how a man named Kevin overcame his traumatic upbringing to enhance his brain health using a variety of innovative therapies. And it isn’t too late for people who have been bad to their brain with drug use. Find out how Arnie broke free from the chains of addiction. It’s never too late to start enhancing brain function.
The world’s largest database of brain scans related to behavior—over 160,000 and growing —shows that when you adopt a brain health program, you can change your brain and change your life for the better.
At Amen Clinics, we take a unique brain-body approach that gets to the root cause of your symptoms. Our comprehensive evaluations include brain SPECT imaging, as well as laboratory testing and assessing other important factors that could be contributing to symptoms. By getting to the root cause of your symptoms, we can create a more effective, personalized treatment plan for you.
If you want to join the tens of thousands of people who have already enhanced their brain health, overcome their symptoms, and improved their quality of life at Amen Clinics, speak to a specialist today at 888-288-9834. If all our specialists are busy helping others, you can also schedule a time to talk.

Source: What the Aaron Hernandez Documentary Missed About His Brain | Amen Clinics Amen Clinics February 2020

Abstract

Background:

Cardiovascular anomalies are the largest group of congenital anomalies and the major cause of death in young children, with various data linking rising atrial septal defect incidence (ASDI) with prenatal cannabis exposure.

Objectives / Hypotheses:

Is cannabis associated with ASDI in USA? Is this relationship causal?

Methods:

Geospatio/temporal cohort study, 1991–2016. Census populations of adults, babies, congenital anomalies, income and ethnicity.

Drug exposure data on cigarettes, alcohol abuse, past month cannabis use, analgesia abuse and cocaine taken from National Survey of Drug Use and Health (78.9% response rate). Cannabinoid concentrations from Drug Enforcement Agency. Inverse probability weighted (ipw) regressions.

Analysis conducted in R.

Results:

 ASDI rose nationally three-fold from 27.4 to 82.8 / 10,000 births 1991–2014 during a period when tobacco and alcohol abuse were falling but cannabis was rising. States including Nevada, Kentucky, Mississippi and Tennessee had steeply rising epidemics (Time: Status β-estimate = 10.72 (95%C.I. 8.39–13.05), P < 2.0 × 10 − 16). ASDI was positively related to exposure to cannabis and most cannabinoids.

Drug exposure data was near-complete from 2006 thus restricting spatial modelling from 2006 to 2014, N = 282. In geospatial regression models cannabis: alcohol abuse term was significant (β-estimate = 19.44 (9.11, 29.77), P = 2.2 × 10 − 4 ); no ethnic or income factors survived model reduction.

Cannabis legalization was associated with a higher ASDI (Time: Status β-estimate = 0.03 (0.01, 0.05), P = 1.1 × 10 -3). Weighted panel regression interactive terms including cannabis significant (from β-estimate = 1418, (1080.6, 1755.4), P = 7.3 × 10 -15). Robust generalized linear models utilizing inverse probability weighting interactive terms including cannabis appear (from β-estimate = 78.88, (64.38, 93.38), P = 1.1 × 10 -8).

Marginal structural models with machine-aided Super Learning association of ASDI with high v. low cannabis exposure R.R. = 1.32 (1.28, 1.36). Model e-values mostly > 1.5.

Conclusions:

ASDI is associated with cannabis use, frequency, intensity and legalization in a spatiotemporally significant manner, robust to socioeconomic demographic adjustment and fulfilled causal criteria, consistent with multiple biological mechanisms and similar reports from Hawaii, Colorado, Canada and Australia. Not only are these results of concern in themselves, but they further imply that our list of the congenital teratology of cannabis is as yet incomplete, and highlight in particular cardiovascular toxicology of prenatal cannabinoid and drug exposure.

Albert Stuart Reece and Gary Kenneth Hulse

Source:  BMC Pediatrics volume 20, Article number: 539 (2020) https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-020-02431-z November 2020

One way to deter harmful recreational drug use by teenagers is to treat them like adults. Rather than simply tell them to “Just Say No” to alcohol, tobacco or illicit drugs, it may be more helpful to explain how these substances create unique risks for them risks that arise due to the changing state of the adolescent brain.

It’s an approach recommended by Dr. Robert DuPont, the first director of the National Institute of Drug Abuse, the second White House “drug czar” and the current head of the Institute for Behavior and Health.

Scientists have long recognized that people who use alcohol, tobacco, marijuana and other drugs while adolescents are far more likely to use more dangerous drugs in their 30s and 40s. Back in 1984, researchers writing in the American Journal of Public Health reported that “the use of marijuana is a good predictor of the use of more serious drugs only if it begins early” and that early drinking is a similar “predictor of marijuana use.”

It should come as no surprise, then, that Americans in their 30s and 40s who used recreational drugs as teenagers are the group most severely affected by opioid overdoses today.

Unfortunately, neither the media nor popular culture adequately informs young people about the neurological damage alcohol, nicotine, and marijuana can inflict on the brain. On the contrary, despite strong evidence that early recreational drug use increases the likelihood of future drug addiction, the media and today’s culture often describe marijuana use as an “organic,” “natural” approach to anxiety and stress management. Indeed, Northern Michigan University launched the nation’s first medicinal plant chemistry major, offering students the chance to focus on marijuana-related studies. What message does that send to the still-developing minds of college students?

One group is taking a non-traditional approach to convincing students otherwise.

One Choice is a drug prevention campaign developed for teenagers by the Institute for Behavior and Health. It relies on cutting-edge neuroscience to encourage young Americans to make decisions that promote their brain health.

Pioneered by Dr. DuPont, One Choice specifically advocates that adolescents make “no use of any alcohol, nicotine, marijuana or other drugs” for health reasons. The theory is that adolescents who make the decision not to use alcohol, nicotine, or marijuana at all that make “One Choice” to avoid artificial, chemical brain stimulation are far less likely to wind up addicted to drugs such as opioids later on.

The One Choice approach is evidence-based. In 2017, scientists at Mclean Hospital and Harvard Medical School published their findings on the impact of early substance use on cognitive development. They explained that the brains of teenagers are still developing and can be negatively impacted by substance use. Adolescent brains are still forming the communication routes that regulate motivation, stress and habit-formation well into adulthood. As such, it is easier for substances to hijack and alter those routes in developing brains than in adult brains.

Hindering the vital attributes of habit formation, stress management and motivational behavior can drastically affect a young person’s academic performance. Collectively, and in the long run, that can impair the competitiveness of a national economy. Thus, it is crucial that young Americans learn to prioritize brain health.

The timing for the innovative One Choice approach is propitious. Today’s young Americans are more interested in biology, psychology and health sciences than ever before. According to the National Center for Education Statistics, the field of “health professions and related programs” is the second most popular major among college students, with psychology and biological or biomedical sciences following as the fourth and fifth most popular, respectively. By explaining developmental neuroscience to teenagers, One Choice engages young people on a topic of interest to them and presents the reality of a pressing public health issue, instead of throwing moral platitudes and statistics at them.

Pro-marijuana legalization organizations, such as the Drug Policy Alliance, agree: “The safest path for teens is to avoid drugs, doing alcohol, cigarettes, and prescription drugs outside of a doctor’s recommendations.” And certainly honesty, along with scientific accuracy, is critical if we are to persuade adolescents not to use drugs.

Brain health is critical to the pursuit of happiness. And leveraging scientifically accurate presentations and testimonies to convince young Americans to prioritize their own brain health early on can prevent future substance abuse.

Source: Using Neuroscience to Prevent Drug Addiction Among Teenagers | The Heritage Foundation January 2019

Just one or two joints seem to change the structure of the brain, say researchers from universities around the world, led by senior author and University of Vermont professor of psychiatry Hugh Garavan, PhD, and first author and former UVM postdoctoral fellow Catherine Orr, PhD.
 
The study is part of a long-term European effort called IMAGEN, which has collected brain images from 2,000 children in Ireland, France, and Germany, starting when they were age 14 and continuing through age 23.
 
Researchers compared the brain images of 46 children age 14 who reported having used marijuana once or twice with those of children that age who had not used the drug. The images of the marijuana triers showed greater brain volume in areas with cannabinoid receptors. The biggest differences were in the amygdala, involved in fear and other emotions, and the hippocampus, the site of memory development and spatial abilities.
 
“You’re changing your brain with just one or two joints. Most people would likely assume that one or two joints would have no impact on the brain,” says Dr. Garavan.
 
It is unclear what the extra gray matter in these brain areas means. Normally at age 14, the brain is refining its synaptic connections to make it thinner, not thicker. Dr. Garavan says one possibility is that initial marijuana use in this age group may be disrupting that “pruning” process.
 
The new findings open a new area of focus for future research.
 
Read study abstract here.

Source:  The Marijuana Report  16.01.2019

Abstract

The increasing use of marijuana by women of childbearing age raises a concern for potential adverse outcomes in the offspring (Ryan et al., 2018). There have been numerous studies of the consequences of maternal cannabis use in humans or Δ9-tetrahydrocannabinol (THC) administration during pregnancy in animals (Abel, 1980; Fried, 2002; Huizink, 2014; Trezza et al., 2008), but little or no attention has been paid to the role of paternal exposure for adverse consequences to the developing fetus or child. Animal studies where both males and females were exposed to THC in adolescence identified persistent changes in gene methylation in association with neurobehavioral anomalies in the offspring (Szutorisz and Hurd, 2018) ; however, these did not distinguish whether there was a specific paternal contribution, which would presumably involve epigenetic changes in sperm. Indeed, recent work found that cannabis exposure in humans, or THC exposure in rats, produces persistent changes in sperm DNA methylation, including the genes that were affected by combined paternal and maternal exposure, as well as genes associated with risk of autism spectrum disorder (Murphy et al., 2018; Schrott et al., 2020). The effects in rats were associated with long-lasting attentional impairment in the offspring (Levin et al., 2019).

In the present study, we provide one of the first demonstrations that paternal THC administration, prior to mating, results in abnormalities of offspring brain development, specifically targeting acetylcholine (ACh) systems, which provide essential inputs for learning, memory, reward, and mood. We exposed male rats for 28 days to THC at doses commensurate with moderate cannabis use in humans, mated them to drug-naïve females, and then assessed biomarkers of ACh synaptic function in the offspring. We conducted our evaluations longitudinally from adolescence through adulthood, so as to capture early and late stages of brain development and function, and made our assessments in brain regions comprising all the major ACh projections and their corresponding cell bodies. We evaluated the concentration of presynaptic high-affinity choline transporters (hemicholinium-3 [HC3] binding), the activity of choline acetyltransferase (ChAT), and the concentration of α4β2 nicotinic ACh receptors (nAChRs). High-affinity choline transporters and ChAT are both constitutive components of ACh nerve terminals but they differ in their regulatory mechanisms and hence in their functional significance. Choline acetyltransferase is the enzyme that synthesizes ACh, but is not regulated by nerve impulse activity, so that its presence provides an index of the density of ACh innervation (Slotkin, 2008). In contrast, HC3 binding to the choline transporter is directly responsive to neuronal activity (Klemm and Kuhar, 1979), so that comparative effects on HC3 binding and ChAT enable the characterization of both the concentration of ACh terminals and presynaptic impulse activity. We then calculated the HC3/ChAT ratio as an index of presynaptic activity relative to the number of cholinergic nerve terminals (Slotkin, 2008). Finally, the α4β2 nAChR is the most abundant subtype in the mammalian brain and regulates the ability of ACh systems to release other neurotransmitters involved in reward, cognition, and mood (Dani and De Biasi, 2001). These indices have been used successfully to characterize the impact of diverse neurotoxicants and diseases on ACh systems: neuroactive pesticides (Slotkin et al., 2013, 2019b), nicotine or tobacco smoke (Slotkin et al., 2015), polycyclic aromatic hydrocarbons (Slotkin et al., 2019a), and glucocorticoids (Slotkin et al., 2013); and terminal stages of Alzheimer’s disease (Slotkin et al., 1994).

Source: https://doi.org/10.1093/toxsci/kfaa004 February 2020

A new report from Montreal public health indicates a new drug that’s stronger than fentanyl has hit the city’s streets.

MONTREAL — A new drug that is even more powerful than fentanyl is circulating on Montreal’s streets, according to public health officials.

Isotonitazene, a chemically manufactured opioid, has killed at least one person in Montreal. Jean-Francois Mary of harm reduction organization Cactus Montreal said similar drugs are often made in illegal labs, where cross-contamination and dosage size are risky variables.

Mary said he believes part of the solution the problem posed by opioids is legalization.

“People die because drug traffickers have had to divert into substances that are more portent and more profitable, but this potency kills,” he said. “Look in the pharmacy, there are very dangerous substances that are prescribes, they are given and people sometimes abuse them. But we don’t have so many deaths from because the quantity is controlled. Even when people abuse them, they can know how much they took.”

He said illegally-made pills don’t let users know how much Isotonitazene or fentanyl they’re ingesting.

Montreal public health seized 2,000 astonishment pills in August and is advising users that naloxone can be used to reverse the effects of an overdose.

Naloxone kits are available at most pharmacies. Anyone calling 911 to report an overdose has immunity from simple drug possession charges under the Good Samaritans Rescuing Overdose Victims Act.  

Source: New drug on Montreal’s streets even more potent than fentanyl: public health | CTV News November 2020

Source: Oregon recriminalizes drugs after upswing in overdose deaths (nypost.com)