2024 June

The following detailed report to members of DrugWatch International was produced by John Coleman, President of the Board of Directors.

Dear friends,

Yesterday, April 16, 2024, the Select Committee on the Strategic Competition Between the United States and the Chinese Communist Party, a committee comprised of members of the House of Representatives that describes itself as “committed to working on a bipartisan basis to build consensus on the threat posed by the Chinese Communist Party and develop a plan of action to defend the American people, our economy, and our values,” issued a 64-page report titled, “The CCP’s Role in the Fentanyl Crisis.”

I’ve attached a copy of the report.

Among the Committee’s findings are the following:

The PRC government, under the control of the CCP:

  1. Directly subsidizes the manufacturing and export of illicit fentanyl materials and other synthetic narcotics through tax rebates.
  2. Gave monetary grants and awards to companies openly trafficking illicit fentanyl materials and other synthetic narcotics.
  3. Holds ownership interest in several PRC companies tied to drug trafficking.
  4. Fails to prosecute fentanyl and precursor manufacturers.
  5. Allows the open sale of fentanyl precursors and other illicit materials on the extensively monitored and controlled PRC internet.
  6. Censors content about domestic drug sales but leaves export-focused narcotics content untouched.
  7. Strategically and economically benefits from the fentanyl crisis.

No one reading this email should be surprised about any of these findings as they have been known and written about in books and scholarly papers for years. That said, having the imprimatur of a congressional committee is important and may help to move the ball closer to the goalpost.

Regrettably, Mike Gallagher, the Committee’s chairman and a four-term Representative of Wisconsin’s 8th Congressional District, has surprisingly and suddenly decided to resign from Congress. In two days, on April 19, 2024, Gallagher will leave his job in Congress to join Palantir Technologies Inc., a global software company serving the analytic needs of the intelligence community. It was founded by billionaire and conservative activist Peter Thiel, co-founder of PayPal and several other highly successful companies.

The Committee’s report provides the reasoning and grounds to support the findings mentioned above. None of it should be surprising because all of it has been known for decades. The Committee is to be commended for putting this material together in one comprehensive and relatively brief document.

Ironically, the Committee’s report may be more important not for what it says or suggests but, instead, for what it ignores and fails to address.

At the conclusion of the report’s Executive Summary is a list of recommendations:

  1. Establish a Joint Task Force – Counter Opioids (JTF-CO) that concentrates all non-military elements of state power and executes a coordinated strategy to target the weak points in the global illicit fentanyl supply chain.
  2. Provide law enforcement and intelligence officials with the statutory authorities, tools, and resources they need to execute their responsibilities, including through enhancing international law enforcement cooperation, appropriately prioritizing fentanyl and antimony laundering in intelligence and enforcement efforts; and recruiting and retaining top talent to combat the fentanyl threat.
  3. Strengthen U.S. sanctions authorities and use those authorities in an aggressive and coordinated manner against entities involved in the fentanyl trade.
  4. Enact and use trade and customs enforcement measures to restrict fentanyl trafficking.
  5. Close regulatory and enforcement gaps exploited by PRC money launderers and fentanyl traffickers.

These recommendations are what we used to call “blue sky” proposals, ideas that one would like to see implemented, assuming ceteris paribus – if all other relevant things remain unaltered. The “real” world, however, is a dynamic cesspool of interests that makes folly of most, if not all, of these recommendations.

I’m reminded of the late Janet Reno who, when she was Attorney General, would give very nice speeches about what the government needed to do to reduce crime. For some reason, it never dawned on Reno that she was the government and could indeed do or attempt to do what she was demanding to be done by the government.

It’s the same here. The Committee could have proposed and even presented legislation to accomplish some of its recommendations but decided not to do so. In addition, the conditions described in the Committee’s report did not occur spontaneously but were allowed to develop incrementally over time. Why?

When recommendations like these are simply reported-out without assignment, they go unnoticed by the organs of government empowered to act on them. Indeed, a closer reading of these recommendations might suggest that some have already been tried – as described, or with modest modifications.

Let’s look at the scoreboard. The 2016 National Drug Control Strategy presented to Congress by President Barack Obama said this about China’s role in the drug trade:

China remains the source of many raw chemical compounds used to manufacture NPS. The United States and China have intensified cooperation between law enforcement agencies through enhanced intelligence exchanges, increased cooperation on investigations, and a series of technical exchanges on precursor chemicals, NPS, and related topics. On October 1, 2015, China placed 116 chemicals – primarily NPS – under national control. This action is expected to have a significant impact on the export of NPS products to the United States.

[…]

Fentanyl used for illicit purposes comes from several sources including pharmaceutical fentanyl diverted from legal medical use, which accounts for a small percentage of the fentanyl in the illicit market, and clandestine fentanyl that is manufactured in Mexico or China and smuggled into the United States through a variety of means. Fentanyl is extremely dangerous and deadly. Between 2013 and 2014, at least 700 deaths in the United States were attributed to fentanyl and its analogues, although the actual number is likely higher. [internal references omitted]

The number of fentanyl deaths – noted here as 700 between 2013 and 2014 – has risen more than tenfold to 73,000, according to yesterday’s congressional report. Despite this, our National Drug Control Strategies, regardless of which administration is in power, call for little more than assessing the problem and its impact on our nation, pointing the finger at China, but doing little else.

Our latest 2022 National Drug Control Strategy updates this insouciance with the following stated principle that could have been copied and pasted from just about any earlier strategy in the last 20 years:

  1. Work with the PRC to strengthen control of the production, diversion, and transshipment of illicit synthetic drugs and their precursors. (Agencies Involved: DHS; DOD; DOJ; DOS; HHS; IC/NSC; Treasury; USAID; USPIS)

A significant volume of non-fentanyl opioids and precursor chemicals used to produce fentanyl, fentanyl analogues, and other synthetic drugs originate in the People’s Republic of China (PRC). This assessment is supported by seizure evidence, law enforcement investigations, internet sales information, and judicial actions in the United States, PRC, and Mexico. Increased collaboration with the PRC on shared drug priorities can disrupt drug trafficking networks, along with the corrupt or compromised systems that support them, and reduce the availability of dangerous synthetic drugs in the United States. The United States will continue engagement with the PRC to reduce diversion of uncontrolled precursor chemicals to the illicit production and trafficking of synthetic drugs destined for markets in the United States, while also working with impacted third countries

Yesterday’s congressional report, like all the ONDCP National Drug Control Strategy reports for the past quarter century, does little but describe the problem and provide hand-wringing solutions tied to increased cooperation and international square-dancing. Do you think that Mike Gallagher is leaving Congress because he knows this? Gallagher’s exit remains a mystery. A former combat Marine who served in Iraq, and a graduate of Princeton University with three graduate degrees, including a doctorate in government and international relations from Georgetown University, Gallagher may have realized that the geopolitical and economic significance of China in today’s world makes doing anything about the fentanyl traffic impossible.

We are in a different world and a different time today. There is no Richard Nixon dispatching an “eyes only” telegram to Ambassador Bill Handley in Ankara on July 9, 1970, ordering him to return to Washington “at the request of the President for consultations, and stating that the President places the highest priority on the drug problem notwithstanding the defense and political components.”  [Ref: Declassified White House papers of Henry Kissinger, July 10, 1970]

This order to Handley followed an earlier entreaty by Under-Secretary Elliot Richardson in a Secret “eyes only” telegram on May 6, 1970, in which Richardson explained that his job and Handley’s job were at risk if they didn’t succeed in getting Turkey out of the opium business: “It is now perfectly clear, as a result, that the Department, the Embassy, the Foreign Service and you and I are definitely on the spot to produce results.” [Ref: Declassified DOS Telegram State 068968, Amembassy Ankara, 6 May 70]

This unpublished de facto drug control strategy worked and within two years, Turkey was out of the opium business, the French Connection was history, and we as a nation were ready to tackle the next drug problem. Or were we?

Realistically, it would be foolhardy to think that President Biden or even President Trump would or could replicate the doings of Nixon and Kissinger and how they handled America’s heroin problem more than a half-century ago. It’s often said and dubiously attributed to Winston Churchill that “Generals are always prepared to fight the last war.” But what worked in the last war may not work in the next one and that seems to be the situation in which we find ourselves when it comes to dealing with China and the fentanyl crisis.

So, the mission becomes thus: can we do more than simply describe the problem and offer recommendations that have little likelihood of being adopted and even less likelihood of working should they be adopted? The agencies designed to protect public health against such dangers have been compromised by succumbing to something surprisingly and shockingly like the Stockholm Syndrome. After combatting the Harm Reduction forces for many years, our Department of Health and Human Services (HHS) and the Office of National Drug Control Policy are squarely nowadays in the Harm Reduction camp.

Our most recent National Drug Control Strategy issued by President Biden in 2022 mentions China three times but the phrase “harm reduction” appears 198 times. In December 2021, HHS announced its Harm Reduction Grant Program and would begin accepting grant applications for a program funded to the tune of $29.250 million.

Maybe Gallagher knows something we don’t!

John Coleman

To access this paper:

  1. Please click the link below:

  2. When you click on this link an image of the cover of the report will appear; click on this to access the full text of the report.

 

Filed under: Fentanyl,Others (International News),Political Sector :

BOBBY P. SMYTH, PH.D., JOSEPH BARRY, M.D.
Department of Public Health & Primary Care,
Trinity College Dublin,
Dublin, Ireland

Dear Editor:
In recent years, authors of editorials in the Journal of
Studies on Alcohol and Drugs have taken a strong position
in highlighting and objecting to potential conflicts of interest
regarding alcohol policy (e.g., Babor, 2017). Given that there
is now a legal cannabis industry in some countries, we will
need to be vigilant in monitoring that industry’s efforts to
influence cannabis policy (Humphreys et al., 2018). Beyond
industry, we have become increasingly concerned regarding
the very powerful influence of a small number of extremely
wealthy individuals who are pushing for an end to the U.N.
drug treaties and for the commercialization of drug use.
Although debate is to be welcomed, we are concerned that
one side of the discussion is being drowned out by a highly
coordinated and very well-resourced campaign for liberalization of policy. Following its success in North and South
America, its influence is becoming increasingly evident in
Europe.
In May 2018, the Green Party became the first Irish political party to embrace a policy of cannabis legalisation, which
included support for commercial production, distribution,
and sale of cannabis. The party backed up its proposal with
a well-constructed policy document that referenced 11 reports (Green Party–Ireland, 2017). In nine cases, the sole or
principal funder of the entities that produced the referenced
material was the Open Society Foundations (OSF). This
demonstrates the success that OSF has had in capturing the
political narrative—of one party at least—while remaining
very much in the background itself, as none of the reports
were published in its own name.
OSF is George Soros’s philanthropic vehicle, and it
supports an array of social initiatives globally. Many of
these initiatives are very admirable and backed up by solid
scientific evidence, such as its support for increased access
to medication-assisted treatment of opioid dependence. Mr.
Soros authored an opinion piece in The Wall Street Journal
in 2010 titled, “Why I support legal marijuana” (Soros,
2010), in which he outlined his views on the advantages of
regulating and taxing marijuana. Forbes magazine described
Mr. Soros as the biggest drug reformer in the United States (Sorvino, 2014). That seems to be a major understatement
of his global reach.
Transparify is an organization that evaluates think tanks
on fiscal transparency. When assessing OSF, it was categorized as “highly opaque” (Transparify, 2016, p. 16).  Their
report describes organizations in this lowest category of
transparency as those that “still consider it acceptable to take
money from hidden hands behind closed doors” (p. 6).		 OSF has established a phenomenal and powerful network
of connections in support of Mr. Soros’s drug policy goals.
In Britain, there is an All Party Parliamentary Group for
Drug Policy Reform (2017). We noticed that OSF is the first
of just two funders of this group of MPs, thereby nurturing
influence at the very heart of British Parliament. The grandly
titled “Global Commission on Drugs Policy” is supported by
OSF. It largely comprises retired very senior politicians, and
they advocate for liberalization of drug policies.
A non-exhaustive list of other nongovernmental organizations and academic institutions funded by OSF to produce
reports on drug policy includes Transform, Release, the International Drug Policy Consortium, the International Drug
Policy Unit in the London School of Economics, the Centre
for Public Health and Human Rights at Johns Hopkins, the
University of Essex’s Institute for Social and Economic
Research, the Independent Committee on Drugs (recently
rebranded as Drug Science), Health Poverty Action, Swansea
University’s Global Drug Policy Observatory, and the Ana
Liffey Drug Project (in Ireland).
If Forbes is correct in stating that Mr. Soros had given
more than $200 million to drug liberalization campaigns
globally before 2014, does the influence bought with that
phenomenal sum not merit some debate and discussion
within the scientific community and in leading addiction
science journals (Sorvino, 2014)? Certainly, there has been
no such open discussion to date.
We realize that many policy analysts and academics believe that Mr. Soros is correct on this issue. However, even
those groups should be concerned that a single tremendously
wealthy individual has been able to successfully buy the policy and academic narrative so comprehensively. Perhaps the
next multi-billionaire might take a notion that vaccination is bad for public health and fund the “anti-vax” movement.
Would that not be a concern (World Health Organization,
2019)? Mr. Soros’s money provides a financial incentive for
scholars, institutions, and nongovernmental organizations
to support his agenda. This appears to constitute the type of
conflict of interest previously highlighted in editorials in the
Journal of Studies on Alcohol and Drugs (e.g., Babor, 2017).
As such, we argue that it should be clearly declared in all
instances, and this has certainly not been happening to date. 

FOOTNOTE:

The above letter was released to a wider readership, being considered worthy of greater exposure, by Shane W. Varcoe, Executive Director of the Dalgarno Institute, Australia.

 

Source: www.dalgarnoinstitute.org.au

Filed under: Australia,Political Sector :

UNIVERSITY OF BATH, UK – Last updated on Tuesday 26 March 2024

There is no evidence that CBD products reduce chronic pain, and taking them is a waste of money and potentially harmful to health, new research finds.

CBD oil may be popular for treating pain but taking it appears to be a waste of money

There is no evidence that CBD products reduce chronic pain, and taking them is a waste of money and potentially harmful to health, according to new research led by the University of Bath.CBD (short for cannabidiol) is one of many chemicals found naturally in the cannabis plant. It’s a popular alternative treatment for pain and is readily available in shops and online in the form of oils, tinctures, vapes, topical creams, edibles (such as gummy bears) and soft drinks.However, consumers would do well to steer clear of these products, according to the new study.“CBD presents consumers with a big problem,” said Professor Chris Eccleston, who led the research from the Centre for Pain Research at Bath. “It’s touted as a cure for all pain but there’s a complete lack of quality evidence that it has any positive effects.”

He added: “It’s almost as if chronic pain patients don’t matter, and that we’re happy for people to trade on hope and despair.”

For their study, published this week in The Journal of Pain, the team – which included researchers from the Universities of Bath, Oxford and Alberta in Canada – examined research relevant to using CBD to treat pain and published in scientific journals up to late 2023.

They found:

  • CBD products sold direct to consumers contain varying amounts of CBD, from none to much more than advertised.
  • CBD products sold direct to consumers may contain chemicals other than CBD, some of which may be harmful and some illegal in some jurisdictions. Such chemicals include THC (tetrahydrocannabinol), the main psychoactive component of the cannabis plant.
  • Of the 16 randomised controlled trials that have explored the link between pain and pharmaceutical-grade CBD, 15 have shown no positive results, with CBD being no better than placebo at relieving pain.
  • A meta-analysis (which combines data from multiple studies and plays a fundamental role in evidence-based healthcare) links CBD to increased rates of serious adverse events, including liver toxicity.

Medical vs non-medical CBD

In the UK, medical cannabis is the only CBD product that is subject to regulatory approval. It’s occasionally prescribed for people with severe forms of epilepsy, adults with chemotherapy-related nausea and people with multiple sclerosis.

Non-medical CBD is freely available in the UK (as well as in the US and many European countries) so long as it contains negligible quantities of THC or none at all. However, CBD products sold on the retail market are not covered by trade standards, meaning there is no requirement for them to be consistent in content or quality.

Most CBD products bought online – including popular CBD oils – are known to contain very small amounts of CBD. Moreover, any given product may be illegal to possess or supply, as there’s a good chance it will contain forbidden quantities of THC.

Chronic pain

An estimated 20% of the adult population lives with chronic pain, and sufferers are often desperate for help to alleviate their symptoms. It’s no surprise then that many people reach for CBD products, despite their high price tag and the lack of evidence of their effectiveness or safety.

Dr Andrew Moore, study co-author and former senior pain researcher in the Nuffield Division of Anaesthetics at the University of Oxford, said: “For too many people with chronic pain, there’s no medicine that manages their pain. Chronic pain can be awful, so people are very motivated to find pain relief by any means. This makes them vulnerable to the wild promises made about CBD.”

He added that healthcare regulators appear reluctant to act against the spurious claims made by some manufacturers of CBD products, possibly because they don’t want to interfere in a booming market (the global CBD product market was estimated at US$3 billion in 2021 or £2.4 billion and is anticipated to reach US$60 billion by 2030 or £48 billion) especially when the product on sale is widely regarded as harmless.

“What this means is that there are no consumer protections,” said Dr Moore. “And without a countervailing body to keep the CBD sellers in check, it’s unlikely that the false promises being made about the analgesic effects of CBD will slow down in the years ahead.”

The study’s authors are calling for chronic pain to be taken more seriously, with consumer protection becoming a priority.

“Untreated chronic pain is known to seriously damage quality of life, and many people live with pain every day and for the rest of their lives,” said Professor Eccleston. “Pain deserves investment in serious science to find serious solutions.”

 

Source: https://www.bath.ac.uk/announcements/cbd-products-dont-ease-pain-and-are-potentially-harmful-new-study-finds/

Filed under: Cannabis/Marijuana,Drug Specifics,Drug use-various effects,Europe :

By Grace Deng – Journalist, Washington State Standard –

Washington tribal leaders are looking at an overseas model to combat the rise in opioid use among teens.

It’s called the Icelandic Prevention Model, and it’s helped slash alcohol use among Icelandic 15- and 16-year-olds from 77% to 35% in 20 years.

“There’s no other model in the world that has that kind of turnaround in the community,” said Nick Lewis, councilmember of the Lummi Nation and chairman of the Northwest Portland Area Indian Health Board.

Washington has dubbed its effort the “Washington Tribal Prevention System” and the Health Care Authority, along with five tribes, will partner with Planet Youth, a non-profit bringing the Icelandic Prevention Model to other places.

The model involves re-thinking how to discourage drug use by placing responsibility on the community, rather than the individual. Instead of asking kids to “just say no,” the Icelandic Prevention Model calls on the adults in a child’s life to create an environment without drugs and alcohol, said Margrét Lilja Guðmundsdóttir, chief knowledge officer at Planet Youth.

“The child should never be responsible for the situation in the community,” Guðmundsdóttir said.

The Washington Tribal Prevention System officially kicked off its ten-year pilot program with the ceremonial signing of contracts on Feb. 14. The five tribal governments participating are Jamestown S’Klallam Tribe, Lummi Nation, Tulalip Tribes, Swinomish Indian Tribal Community and Colville Tribes.

In Washington, American Indian and Alaska Native residents have the highest rate of death from opioid overdoses, far outpacing other races and ethnicities, according to state Department of Health data. 

“Our stories might be different,” Lewis said. “But if they can turn things around, we can too.”

The first two years, the Health Care Authority officials said, are just administrative planning, which will cost $2 million to $3 million a year. Gov. Jay Inslee has called for $1 million for the project in his supplemental budget proposal this year, and the rest of the money would come from federal grants.

Whether lawmakers will provide the $1 million Inslee requested or some other amount for the program will become clearer in the days ahead as the Legislature irons out budget legislation.

When the program moves out of the planning phase – scheduled to happen in its third year – costs are expected to go up dramatically. But Aren Sparck, tribal affairs administrator for the Health Care Authority, said he’s optimistic about finding funding from both private and public entities because of how much interest there is in the model.

Sparck also said the program could be adopted by other tribes and communities. “I think this is going to be a test for the entire state,” he said.

What exactly is the Icelandic model?

In Iceland, youth, parents, schools, the government and other community members work in tandem to create an environment that discourages drug use.

For example, the country has free after-school activities funded by the government. Kids are bussed directly to those activities. Youth councils help shape what activities happen, so teens are actually interested. It’s about making drug-use prevention a lifestyle, said Loni Greninger, tribal vice chair at Jamestown.

Last year, Health Care Authority officials and several tribal delegations visited Iceland to see the model for themselves. Sparck said he was skeptical at first — but when he saw the model in person, “jaws were on the floor.” The way Iceland has managed to make its model just a part of daily life, Sparck said, is exactly what he wants to see in Washington.

“I was talking to some of the youth and asking them, ‘What’s it like to be in the world’s most successful prevention model? And they asked us, ‘What’s the Icelandic Prevention Model?’” Sparck said.

Sparck said one of the things he learned about was a large dance party that young people in Iceland helped plan. Students invited one of the well-known DJs in Europe and policed each other, ensuring there were no drugs and alcohol at the event.

“What we saw was empowering the youth to make their decisions together. So they own this, and they’re a part of it and invested in it,” Sparck said.

Putting trust in youth to help create an alcohol and drug-free environment is also a big part of the model, officials said.

“A child wants a healthy environment,” Lewis said. “A child wants to grow up and be healthy. You never hear a child say ‘I want to grow up and be a drug addict.’”

The tribal model

The Icelandic Prevention Model relies on cultural practices within Iceland. Planet Youth works with its partners to translate the model into their own cultures, Guðmundsdóttir said.

While this is the first time Planet Youth has worked with tribal governments, Guðmundsdóttir and tribal leaders said Iceland and Washington’s tribes share a lot of values in common — namely the belief that it takes a community to raise a child.

“You’re literally wrapping your arms around these kids in everything prevention and wellness,” Greninger said about Iceland’s model.

“That’s what we tribes aspire to do,” she said. “But when you are working with separate entities, we all have our own visions and missions and agendas, we’re all busy every single day. It’s hard to line up all of that.”

Planet Youth — and efforts to implement Iceland’s model in other places — are relatively new, and it took Iceland decades to get where it is now. But there’s already research suggesting Iceland’s model is transferable.

“It’s not a quick fix,” Guðmundsdóttir said. “It’s a never-ending story. You will always have new kids, new parents, new kinds of substances.”

“It’s not a one-year project. It’s a long-term way of thinking,” she added.

When Lummi Nation policymakers presented the Iceland Prevention Model to Lewis, he said he recognized it as just another name for what his tribe is already doing, but without the resources they need to implement it at the level Iceland has.

According to Lewis, it’s often difficult to get funding for tribal drug treatment practices because they aren’t always considered evidence-based — and it’s almost impossible to gather enough proof that a tribal practice works because tribal populations are so small.

The Icelandic Prevention Model, to Lewis, proves that what tribes have already been trying to do works when it’s fully resourced. He hopes using Iceland’s model will help raise the funding needed and remove the silos between different efforts in Washington.

“If we’re going to break this cycle, we need to go back to creating healthy environments and get back to the values that bring people together,” Lewis said.

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

Filed under: Prevention and Intervention,USA :
Barry Ewing JUNE 23RD, 2024

A friend called me today and informed me the federal Minister for Mental Health and addictions stated the “minister believes fear and stigma are driving criticism of the government’s decision to support prescribing pharmaceuticals to drug users to combat the country’s overdose crisis…”

After reading the article I realized there will be no hope of taking control of this drug crisis while the Liberals are in power, or any other government that supports harm reduction.

The feds have allowed B.C. to experiment with Canadian lives in that province, pushing experimental policies on the population which have failed, increasing fatal overdoses, not reducing them. How many more thousands of people must die before you admit your policies are a failure?

In 2003, due to overdoses from heroin, Vancouver introduced the first safe injection site on the continent, but after 20 years the evidence is clear that harm reduction practices only magnify the issues. Instead of admitting failure, they have blamed many other factors  for why fatal overdoses, the numbers of addicts, mental health issues, crime and homelessness continue to increase. Instead of dramatically increasing mental health and addiction treatment, they pump billions of taxpayer and donor dollars into programs that encourage and enable addicts, and even their safe consumption sites now fail to offer any assistance for treatment. They have decriminalized small amounts of drugs, and hand out prescribed safe supply illegal drugs now made in B.C., such as cocaine, morphine, MDMA (ecstasy) and heroin, and the interview process for these exempted controlled drugs includes minors. 

Minors do not need parental consent and parents will not be informed. This is how insane the federal government has become, allowing B.C. to progress into the abyss with these wild experiments that have taken thousands of lives, with no end in sight as fatal overdoses increase every year.

B.C. has over 32 safe consumption sites (SCS), and with all the radical programs they have been allowed to employ, they still have more fatal overdoses per capita than Alberta, Saskatchewan or Manitoba.

Barry Ewing – Lethbridge Herald

Source: https://lethbridgeherald.com/commentary/letters-to-the-editor/2024/02/28/theres-no-hope-of-fixing-drug-crisis-through-harm-reduction/

 

Filed under: Canada,Drug Specifics,Drugs and Accidents,Mental Health,Political Sector,Social Affairs,Treatment and Addiction :
MURRAY, Ky. — Around 200 people gathered Tuesday in Wrather Hall on the campus of Murray State University for a roundtable discussion about the drug epidemic locally and across the country.

The event was sponsored by the School of Nursing and Health Professions, and featured speakers from the law enforcement, legal, political, and healthcare communities

Jim Carroll is the former director of the White House Office of National Drug Control Policy — informally known as the U.S. Drug Czar — and said the three biggest factors in dealing with the drug epidemic locally and nationally is enforcement, treatment, and prevention.

“It’s the only way to really tackle this issue is one, reducing the availability of drugs in our community, recognizing that there are people who are suffering from addiction and that recovery is possible that if we can get them in to help, that they can recover,” Carroll said. “It’s important to do all three; it’s possible to reduce the number of fatalities.”

Carroll said the issue is getting worse, with the number of fentanyl deaths going up 50% in the last four years, up to around 115,000 from around 70,000 in 2019.

Uttam Dhillon is the former acting director of the Drug Enforcement Agency, and said that the reason the drug epidemic has become such a serious issue is because of the crisis at the southern border.

“The two biggest cartels are the Sinaloa cartel and the…CJNG, and they fight for territory and the ability to bring precursor chemicals in from China to make methamphetamine and fentanyl, and then transport those drugs into the United States,” Dhillon said. “The battle between the cartels is actually escalated and they are now actually using landmines in Mexico… so this is a brutal war in Mexico between the cartels.”

Dhillon said the reason the stakes are so high in Mexico is because the demand for illicit drugs in the United States is so large.

“Basically every state in the union has activity from the drug cartels in Mexico in them, and that’s really important to understand, because that’s why we are being flooded by drugs,” Dhillon said. “We never declared Mexico a narco state during the Trump Administration, but as I stand here today, I would say in my opinion, Mexico is a narco state.”

In terms of dealing with the nation’s drug epidemic, Dhillon said we first have to start by enforcing the law, which in part begins at the southern border.

Increased enforcement at the border, however, does not fully solve America’s drug epidemic. That is where the panel said local partners in prevention and recovery come in.

Kaitlyn Krolikowski is the director of administrative services at the Purchase District Health Department and said that prevention and treatment is about more than keeping people out of jail.

In January and February, there have been four overdoses in west Kentucky, according to the McCracken County coroner.

“Dead people don’t recover,” Krolikowski said. “We are here to help people recover and to help our community.  For our community to prosper, we need healthy community members and the way that we’re going to get that is by offering them treatment, saving lives, and giving them the resources that they need to be members of our community that we’re proud of.”

While many members of the audience were police officers, non-nursing students, and community leaders, the event was designed to help give clinicians more context about the world they will practice in after graduation.

Dina Byers is the dean of the School of Nursing and Health Professions at MSU, and said that its important to hear what is going on at the national, state, and local level when it comes to illicit drugs.

“It was important that they hear what’s going on,” Byers said. “And that was the purpose of this event was to provide a collaborative effort, a collaborative panel discussion around many topics today.”

If you or someone you know is struggling with addiction, you can call the police without fear of being arrested, or call your local health department to get resources that can help saves lives.

Filed under: Drug use-various effects,Prevention and Intervention,Treatment and Addiction,USA :

By Zara Abrams    Date created: March 1, 2024. 14 min read

For years, students in middle and high schools across the country were urged to “just say no” to drugs and alcohol. But it’s no secret that the Drug Abuse Resistance Education (D.A.R.E.) program, which was typically delivered by police officers who urged total abstinence, didn’t work. A meta-analysis found the program largely ineffective and one study even showed that kids who completed D.A.R.E. were more likely than their peers to take drugs (Ennett, S. T., et al., American Journal of Public Health, Vol. 84, No. 9, 1994; Rosenbaum, D. P., & Hanson, G. S., Journal of Research in Crime and Delinquency, Vol. 35, No. 4, 1998).

“We know that the ‘Just Say No’ campaign doesn’t work. It’s based in pure risks, and that doesn’t resonate with teens,” said developmental psychologist Bonnie Halpern-Felsher, PhD, a professor of pediatrics and founder and executive director of several substance use prevention and intervention curriculums at Stanford University. “There are real and perceived benefits to using drugs, as well as risks, such as coping with stress or liking the ‘high.’ If we only talk about the negatives, we lose our credibility.”

Partially because of the lessons learned from D.A.R.E., many communities are taking a different approach to addressing youth substance use. They’re also responding to very real changes in the drug landscape. Aside from vaping, adolescent use of illicit substances has dropped substantially over the past few decades, but more teens are overdosing than ever—largely because of contamination of the drug supply with fentanyl, as well as the availability of stronger substances (Most reported substance use among adolescents held steady in 2022, National Institute on Drug Abuse).

“The goal is to impress upon youth that far and away the healthiest choice is not to put these substances in your body, while at the same time acknowledging that some kids are still going to try them,” said Aaron Weiner, PhD, ABPP, a licensed clinical psychologist based in Lake Forest, Illinois, and immediate past-president of APA’s Division 50 (Society of Addiction Psychology). “If that’s the case, we want to help them avoid the worst consequences.”

While that approach, which incorporates principles of harm reduction, is not universally accepted, evidence is growing for its ability to protect youth from accidental overdoses and other consequences of substance use, including addiction, justice involvement, and problems at school. Psychologists have been a key part of the effort to create, test, and administer developmentally appropriate, evidence-based programs that approach prevention in a holistic, nonstigmatizing way.

“Drugs cannot be this taboo thing that young people can’t ask about anymore,” said Nina Christie, PhD, a postdoctoral research fellow in the Center on Alcohol, Substance Use, and Addictions at the University of New Mexico. “That’s just a recipe for young people dying, and we can’t continue to allow that.”

Changes in drug use

In 2022, about 1 in 3 high school seniors, 1 in 5 sophomores, and 1 in 10 eighth graders reported using an illicit substance in the past year, according to the National Institute on Drug Abuse’s (NIDA) annual survey (Monitoring the Future: National Survey Results on Drug Use, 1975–2022: Secondary School Students, NIDA, 2023 [PDF, 7.78MB]). Those numbers were down significantly from prepandemic levels and essentially at their lowest point in decades.

Substance use during adolescence is particularly dangerous because psychoactive substances, including nicotine, cannabis, and alcohol, can interfere with healthy brain development (Winters, K. C., & Arria, A., Prevention Research, Vol. 18, No. 2, 2011). Young people who use substances early and frequently also face a higher risk of developing a substance use disorder in adulthood (McCabe, S. E., et al., JAMA Network Open, Vol. 5, No. 4, 2022). Kids who avoid regular substance use are more likely to succeed in school and to avoid problems with the juvenile justice system (Public policy statement on prevention, American Society of Addiction Medicine, 2023).

“The longer we can get kids to go without using substances regularly, the better their chances of having an optimal life trajectory,” Weiner said.

The drugs young people are using—and the way they’re using them—have also changed, and psychologists say this needs to inform educational efforts around substance use. Alcohol and cocaine are less popular than they were in the 1990s; use of cannabis and hallucinogens, which are now more salient and easier to obtain, were higher than ever among young adults in 2021 (Marijuana and hallucinogen use among young adults reached all-time high in 2021, NIDA).

“Gen Z is drinking less alcohol than previous generations, but they seem to be increasingly interested in psychedelics and cannabis,” Christie said. “Those substances have kind of replaced alcohol as the cool thing to be doing.”

Young people are also seeing and sharing content about substance use on social media, with a rise in posts and influencers promoting vaping on TikTok and other platforms (Vassey, J., et al., Nicotine & Tobacco Research, 2023). Research suggests that adolescents and young adults who see tobacco or nicotine content on social media are more likely to later start using it (Donaldson, S. I., et al., JAMA Pediatrics, Vol. 176, No. 9, 2022).

A more holistic view

Concern for youth well-being is what drove the well-intentioned, but ultimately ineffective, “mad rush for abstinence,” as Robert Schwebel, PhD, calls it. Though that approach has been unsuccessful in many settings, a large number of communities still employ it, said Schwebel, a clinical psychologist who created the Seven Challenges Program for treating substance use in youth.

But increasingly, those working to prevent and treat youth substance use are taking a different approach—one that aligns with principles Schwebel helped popularize through Seven Challenges.

A key tenet of modern prevention and treatment programs is empowering youth to make their own decisions around substance use in a developmentally appropriate way. Adolescents are exploring their identities (including how they personally relate to drugs), learning how to weigh the consequences of their actions, and preparing for adulthood, which involves making choices about their future. The Seven Challenges Program, for example, uses supportive journaling exercises, combined with counseling, to help young people practice informed decision-making around substance use with those processes in mind.

“You can insist until you’re blue in the face, but that’s not going to make people abstinent. They ultimately have to make their own decisions,” Schwebel said.

Today’s prevention efforts also tend to be more holistic than their predecessors, accounting for the ways drug use relates to other addictive behaviors, such as gaming and gambling, or risky choices, such as fighting, drag racing, and having unprotected sex. Risk factors for substance use—which include trauma, adverse childhood experiences, parental history of substance misuse, and personality factors such as impulsivity and sensation seeking—overlap with many of those behaviors, so it often makes sense to address them collectively.

[Related: Psychologists are innovating to tackle substance use]

“We’ve become more sophisticated in understanding the biopsychosocial determinants of alcohol and drug use and moving beyond this idea that it’s a disease and the only solution is medication,” said James Murphy, PhD, a professor of psychology at the University of Memphis who studies addictive behaviors and how to intervene.

Modern prevention programs also acknowledge that young people use substances to serve a purpose—typically either social or emotional in nature—and if adults expect them not to use, they should help teens learn to fulfill those needs in a different way, Weiner said.

“Youth are generally using substances to gain friends, avoid losing them, or to cope with emotional problems that they’re having,” he said. “Effective prevention efforts need to offer healthy alternatives for achieving those goals.”

Just say “know”

At times, the tenets of harm reduction and substance use prevention seem inherently misaligned. Harm reduction, born out of a response to the AIDS crisis, prioritizes bodily autonomy and meeting people where they are without judgment. For some harm reductionists, actively encouraging teens against using drugs could violate the principle of respecting autonomy, Weiner said.

On the other hand, traditional prevention advocates may feel that teaching adolescents how to use fentanyl test strips or encouraging them not to use drugs alone undermines the idea that they can choose not to use substances. But Weiner says both approaches can be part of the solution.

“It doesn’t have to be either prevention or harm reduction, and we lose really important tools when we say it has to be one or the other,” he said.

In adults, harm reduction approaches save lives, prevent disease transmission, and help people connect with substance use treatment (Harm Reduction, NIDA, 2022). Early evidence shows similar interventions can help adolescents improve their knowledge and decision-making around drug use (Fischer, N. R., Substance Abuse Treatment, Prevention, and Policy, Vol. 17, 2022). Teens are enthusiastic about these programs, which experts often call “Just Say Know” to contrast them with the traditional “Just Say No” approach. In one pilot study, 94% of students said a “Just Say Know” program provided helpful information and 92% said it might influence their approach to substance use (Meredith, L. R., et al., The American Journal of Drug and Alcohol Abuse, Vol. 47, No. 1, 2021).

“Obviously, it’s the healthiest thing if we remove substance use from kids’ lives while their brains are developing. At the same time, my preference is that we do something that will have a positive impact on these kids’ health and behaviors,” said Nora Charles, PhD, an associate professor and head of the Youth Substance Use and Risky Behavior Lab at the University of Southern Mississippi. “If the way to do that is to encourage more sensible and careful engagement with illicit substances, that is still better than not addressing the problem.”

One thing not to do is to overly normalize drug use or to imply that it is widespread, Weiner said. Data show that it’s not accurate to say that most teens have used drugs in the past year or that drugs are “just a part of high school life.” In fact, students tend to overestimate how many of their peers use substances (Dumas, T. M., et al., Addictive Behaviors, Vol. 90, 2019; Helms, S. W., et al., Developmental Psychology, Vol. 50, No. 12, 2014).

A way to incorporate both harm reduction and traditional prevention is to customize solutions to the needs of various communities. For example, in 2022, five Alabama high school students overdosed on a substance laced with fentanyl, suggesting that harm reduction strategies could save lives in that community. Other schools with less reported substance use might benefit more from a primary prevention-style program.

At Stanford, Halpern-Felsher’s Research and Education to Empower Adolescents and Young Adults to Choose Health (REACH) Lab has developed a series of free, evidence-based programs through community-based participatory research that can help populations with different needs. The REACH Lab offers activity-based prevention, intervention, and cessation programs for elementary, middle, and high school students, including curricula on alcohol, vaping, cannabis, fentanyl, and other drugs (Current Problems in Pediatric and Adolescent Health Care, Vol. 52, No. 6, 2022). They’re also working on custom curricula for high-risk groups, including sexual and gender minorities.

The REACH Lab programs, including the comprehensive Safety First curriculum, incorporate honest discussion about the risks and benefits of using substances. For example: Drugs are one way to cope with stress, but exercise, sleep, and eating well can also help. Because many young people care about the environment, one lesson explores how cannabis and tobacco production causes environmental harm.

The programs also dispel myths about how many adolescents are using substances and help them practice skills, such as how to decline an offer to use drugs in a way that resonates with them. They learn about the developing brain in a positive way—whereas teens were long told they can’t make good decisions, Safety First empowers them to choose to protect their brains and bodies by making healthy choices across the board.

“Teens can make good decisions,” Halpern-Felsher said. “The equation is just different because they care more about certain things—peers, relationships—compared to adults.”

Motivating young people

Because substance use and mental health are so intertwined, some programs can do prevention successfully with very little drug-focused content. In one of the PreVenture Program’s workshops for teens, only half a page in a 35-page workbook explicitly mentions substances.

“That’s what’s fascinating about the evidence base for PreVenture,” said clinical psychologist Patricia Conrod, PhD, a professor of psychiatry at the University of Montreal who developed the program. “You can have quite a dramatic effect on young people’s substance use without even talking about it.”

PreVenture offers a series of 90-minute workshops that apply cognitive behavioral insights upstream (addressing the root causes of a potential issue rather than waiting for symptoms to emerge) to help young people explore their personality traits and develop healthy coping strategies to achieve their long-term goals.

Adolescents high in impulsivity, hopelessness, thrill-seeking, or anxiety sensitivity face higher risks of mental health difficulties and substance use, so the personalized material helps them practice healthy coping based on their personality type. For example, the PreVenture workshop that targets anxiety sensitivity helps young people learn to challenge cognitive distortions that can cause stress, then ties that skill back to their own goals.

The intervention can be customized to the needs of a given community (in one trial, drag racing outstripped substance use as the most problematic thrill-seeking behavior). In several randomized controlled trials of PreVenture, adolescents who completed the program started using substances later than peers who did not receive the intervention and faced fewer alcohol-related harms (Newton, N. C., et al., JAMA Network Open, Vol. 5, No. 11, 2022). The program has also been shown to reduce the likelihood that adolescents will experiment with illicit substances, which relates to the current overdose crisis in North America, Conrod said (Archives of General Psychiatry, Vol. 67, No. 1, 2010).

“People shouldn’t shy away from a targeted approach like this,” Conrod said. “Young people report that having the words and skills to manage their traits is actually helpful, and the research shows that at behavioral level, it really does protect them.”

As young people leave secondary school and enter college or adult life, about 30% will binge drink, 8% will engage in heavy alcohol use, and 20% will use illicit drugs (Alcohol and Young Adults Ages 18 to 24, National Institute on Alcohol Abuse and Alcoholism, 2023; SAMHSA announces national survey on drug use and health (NSDUH) results detailing mental illness and substance use levels in 2021). But young people are very unlikely to seek help, even if those activities cause them distress, Murphy said. For that reason, brief interventions that leverage motivational interviewing and can be delivered in a school, work, or medical setting can make a big difference.

In an intervention Murphy and his colleagues are testing, young adults complete a questionnaire about how often they drink or use drugs, how much money they spend on substances, and negative things that have happened as a result of those choices (getting into an argument or having a hangover, for example).

In an hour-long counseling session, they then have a nonjudgmental conversation about their substance use, where the counselor gently amplifies any statements the young person makes about negative outcomes or a desire to change their behavior. Participants also see charts that quantify how much money and time they spend on substances, including recovering from being intoxicated, and how that stacks up against other things they value, such as exercise, family time, and hobbies.

“For many young people, when they look at what they allocate to drinking and drug use, relative to these other things that they view as much more important, it’s often very motivating,” Murphy said.

A meta-analysis of brief alcohol interventions shows that they can reduce the average amount participants drink for at least 6 months (Mun, E.Y., et al., Prevention Science, Vol. 24, No. 8, 2023). Even a small reduction in alcohol use can be life-altering, Murphy said. The fourth or fifth drink on a night out, for example, could be the one that leads to negative consequences—so reducing intake to just three drinks may make a big difference for young people.

Conrod and her colleagues have also adapted the PreVenture Program for university students; they are currently testing its efficacy in a randomized trial across multiple institutions.

Christie is also focused on the young adult population. As a policy intern with Students for Sensible Drug Policy, she created a handbook of evidence-based policies that college campuses can use to reduce harm among students but still remain compliant with federal law. For example, the Drug Free Schools and Communities Act mandates that higher education institutions formally state that illegal drug use is not allowed on campus but does not bar universities from taking an educational or harm reduction-based approach if students violate that policy.

“One low-hanging fruit is for universities to implement a Good Samaritan policy, where students can call for help during a medical emergency and won’t get in trouble, even if illegal substance use is underway,” she said.

Ultimately, taking a step back to keep the larger goals in focus—as well as staying dedicated to prevention and intervention approaches backed by science—is what will help keep young people healthy and safe, Weiner said.

“What everyone can agree on is that we want kids to have the best life they can,” he said. “If we can start there, what tools do we have available to help?”

 

Filed under: Drug use-various effects,Education Sector,Mental Health,Prevention (Papers),Prevention and Intervention,Social Affairs,USA :
Posted 
Nickolaus Hayes – Author and Parent

Being a father is not easy; it takes sacrifice, which means playing an essential role in a child’s life by being there for them and loving them unconditionally.

Every father knows they need to provide abundant love and support. A father is always there for their children, offering guidance, support, and education. The greatest joy, of course, for any father is seeing their children thrive, do well in life, and be healthy.

Yet things happen in life, and kids and teens experiment with risks while testing their limits and boundaries, such as trying drugs or alcohol. Fathers have a responsibility to speak to their kids about drugs and alcohol and help them understand the risks and consequences.

Fortunately, drug education and prevention campaigns have proven relatively effective in Illinois, but more should be done. According to drug abuse statistics, Teenagers in Illinois are 4.29% more likely to have used drugs in the last month than the average American teen. Roughly 8.69% of the 12 to 17-year-olds surveyed reported using drugs in the previous month, with marijuana being the most widely used substance.

Illegal drugs today are more readily available than ever before. According to the DEA, drug traffickers have turned smartphones into a one-stop shop to market, sell, buy, and deliver deadly fake prescription pills and other drugs. Amid this ever-changing age of social media influence, kids, teens, and young adults are easily influenced.

Drug traffickers advertise on social media platforms like Instagram, Snapchat, TikTok, Twitter, YouTube, and Facebook. The posts are promptly posted and removed with code words and emojis used to market and sell illicit drugs. Unfortunately, digital media provides an increased opportunity for both marketing and social transmission of risk products and behaviors.

Fathers are responsible for protecting and preparing our children for the world. Drug education is essential. Take the time to speak to your kids about the dangers of illicit substances, how to avoid and manage peer pressure, and what to look for. Be prepared to share personal experiences and help them understand that some choices have consequences.

Along with bearing this responsibility, fathers must not neglect their well-being and mental health. Raising children can be a lot; there are many challenges along the way, and the pressure of being a good influence can get the best of us. We may second guess our choices and decisions and stress over the small things.

All of this makes it vital not to ignore our mental health; children, especially younger kids, mimic what they see. How we cope with frustration, anger, sadness, or isolation impacts our children in several ways.

Our actions have consequences. Children see how we handle every situation, and while no father is perfect, we must be conscious of the fact they are impressionable when they are young. They look up to us, mimic our actions, and see when we are doing well in life mentally.

The key for fathers caring for children is to take the time to care for themselves. However, if you are struggling, contact 988 Suicide and Crisis Lifeline. Taking care of your mental health is the same as taking care of your physical health; it is an integral part of your well-being and contributes to you being the best father you can be.

Nickolaus Hayes is a healthcare professional in the field of substance use and addiction recovery and is part of the editorial team at DRS. His primary focus is spreading awareness by educating individuals on the topics surrounding substance use.

Source: https://rochellenews-leader.com/stories/every-father-should-speak-to-their-kids-about-drugs-and-alcohol,57623

Filed under: Drug use-various effects on foetus, babies, children and youth,Education,Education Sector,Mental Health,Parents,Prevention and Intervention,Social Affairs,USA :

Ty Roush

Forbes Staff

Teens who use cannabis have a significantly higher risk of developing a psychotic disorder compared to those who don’t, according to a study published in the journal Psychological Medicine Wednesday, the latest research linking the drug to mental health disorders among young adults.  Other research has linked the drug to mental health disorders in young adults.

KEY FACTS

Teens aged 12 to 19 who used cannabis had an 11 times higher risk of developing a psychotic disorder compared to teens not using cannabis, according to an analysis of health data for 11,000 teens and young adults aged 12 to 24.

The study did not find an association between cannabis use and psychotic disorders in people aged 20 to 33.
The data—pulled from the annual Canadian Community Health Survey from 2009 to 2012—looked into hospitalizations, emergency room visits and outpatient visits, and researchers followed up with the participants for additional visits to the doctor, the emergency room or other hospitalizations in the nine years after the survey.

Among the teens who visited the emergency room or were hospitalized for psychotic disorders, about 5 in 6 reported using cannabis previously, researchers said.

Teens who use cannabis might be at a higher risk of developing psychotic disorders because the drug disrupts the endocannabinoid system, which helps regulate bodily functions like sleep or mood, resulting in symptoms like hallucinations, according to the study.

Though there is a strong yet age-dependent association between cannabis use and psychotic disorders, researchers noted it’s hard to say whether there is a direct link, as it’s possible the teens were self-medicating with cannabis to treat symptoms of psychotic disorders before they were clinically diagnosed.

BIG NUMBER

29%. That’s the percentage of high school seniors in the U.S. who reported using cannabis over the previous year, according to the annual Monitoring the Future Survey in 2023, which reports drug and alcohol use among adolescent students.

KEY BACKGROUND

Other studies in recent years have linked psychotic disorders in young adults to cannabis. In a study published last year, researchers found young men who used cannabis have an increased risk of developing schizophrenia compared to young women. A year earlier, researchers found there was “considerable evidence” linking cannabis use and depression among adolescents. The study also suggested the link was caused by a disruption of the endocannabinoid system. In 2018, researchers called for additional drug prevention programs targeting cannabis use in teens, after data indicated cannabis use could result in increased anxiety.

TANGENT

Last week, the Justice Department moved to reclassify marijuana—listed as a Schedule I drug like heroin, LSD and ecstasy—as a Schedule III drug under the federal Controlled Substances Act. The designation, if approved, recognizes marijuana as having potential medical benefits, which could allow for future studies on the drug’s potential benefits. The proposal still requires approval from the Drug Enforcement Administration.

Source: https://www.forbes.com/sites/tylerroush/2024/05/22/teens-using-cannabis-are-at-higher-risk-of-psychosis-study-suggests/

Filed under: Cannabis/Marijuana,Mental Health,Prevention and Intervention,USA :

May 18, 2024

First, the good news: According to the U.S. Centers for Disease Control and Prevention, the number of fatal overdoses in the U.S. decreased last year — down 3% from 2022.

Now, the not so great news: That’s still 107,500 people who died at the hands of a decades-long substance abuse epidemic; and those same CDC researchers say the last time there was such a decrease, the number of fatal overdoses increased dramatically in the following year.

Further, Brandon Marshall, a Brown University researcher who studies overdose trends, offered some less-than-comforting reasons for the decrease that have little to do with winning the fight against this monster.

Shifts in the drug supply and use habits (smoking or mixing with other drugs rather than injecting, for example) could be one reason for the change. Another is simply that the epidemic has killed so many people already there are fewer to die.

That doesn’t mean prevention and recovery support efforts are not vital. And it does not mean there is any less need to support the families of those who have lost loved ones to this plague.

The Journal of the American Medical Association — Psychiatry, reported earlier this month that more than 321,000 U.S. children lost a parent to fatal drug overdose from 2011 to 2021.

“These children need support,” and are at a higher risk of mental health and drug use disorders themselves, said Dr. Nora Volkow, director of the National Institute on Drug Abuse. “It’s not just a loss of a person. It’s also the implications that loss has for the family left behind.”

Meanwhile, the fact that so many experts are reluctant to be optimistic about a small decrease could mean they understand something continues to fuel this epidemic. Yes, there is as much supply as demanded. That is one part of the problem. But the other is understanding what drives so many into the arms of this beast. How do we provide people the economic, mental health and social hope and support to break cycles? How do we encourage them to embrace a bright future, rather than being unable to see past a bleak present they can hardly bear?

“My hope is 2023 is the beginning of a turning point,” said Dr. Daniel Ciccarone of the University of California, San Francisco.

Imagine the possibilities if we all took a comprehensive, informed, compassionate approach to actually making that happen.

Source:  https://www.journal-news.net/journal-news/imagine-the-possibilities/article_330d84dc-7bbb-557f-ab5d-2eff8bd12fc5.html

Filed under: Mental Health,Prevention and Intervention,USA :

In Canada, cannabis poisonings rose sharply among people 65 and older after the country legalized the drug, a new study found.

By Matt Richtel

May 20, 2024

The News

As more places legalize marijuana, policymakers and health officials have worried about the health risks that the drug may pose to adolescents. But a new study suggests that an additional demographic is at risk: seniors.

The study, published Monday in JAMA Internal Medicine, found that after Canada legalized marijuana, the number of emergency room visits for cannabis poisoning rose sharply among people ages 65 and older. Poisonings doubled after Canada legalized sale of the cannabis flower, and then tripled just 15 months later, when Canada legalized the sale of edibles.

“It’s often a baked good, a chocolate or a gummy,” said Dr. Nathan Stall, a geriatrician at Mount Sinai Hospital and researcher at Women’s College Hospital in Toronto, and lead author on the study. Dr. Stall noted that researchers and emergency room doctors were finding that seniors used drugs intentionally but also sometimes by accident, when edibles were mistaken for regular food or snacks.

Symptoms of cannabis poisoning can include dizziness, confusion, nausea, loss of coordination and balance, drowsiness and hallucinations.

The findings were consistent with other research published in the United States, Dr. Stall said, and showed that more attention needed to be paid to drug use by seniors, and to the health effects.

“It’s somewhat in the shadows, and there is some ageism and bias in thinking that older adults aren’t using drugs,” Dr. Stall said.

Image

Edible marijuana samples at a cannabis testing laboratory in Santa Ana, Calif.Credit…Chris Carlson/Associated Press

The Study

The study looked at 2,322 emergency room visits for cannabis poisoning among people 65 and older in Ontario. The visits spanned 2015 through 2022, allowing researchers to see what happened before and after October 2018, when Canada legalized the sale of dried cannabis, and January 2020, when the sale of edibles was legalized.

In 2015, there were 55 emergency room visits caused by cannabis poisoning. That figure rose steadily to 462 by 2021, and then fell off slightly to 404 in 2022.

Dr. Stall said he was motivated to undertake the study after being called into the emergency room to consult on an octogenarian who was experiencing severe confusion. The patient was barely conscious and showed strokelike symptoms. Multiple tests revealed no clear cause, until Dr. Stall ordered a toxicology test and found cannabis in the patient’s urine.

When Dr. Stall disclosed the finding, he said, a family member of the patient who was present at the bedside “went beet red and realized that the older adult had got into their edible cannabis product and mistaken it for food.”

Dr. Stall said that the patient was hospitalized and given supportive care, and that there was not a specific treatment or antidote for such poisonings.

Why the Increase?

The study did not look at why seniors overdosed, but Dr. Stall said that he and other doctors were seeing poisonings caused by accidental ingestion as well as intentional use of edibles for recreation or medicinal reasons.

There are several reasons seniors might be prone to overdose, Dr. Stall said. Many cannabis strains are far more potent than in past decades, and seniors who used the drug earlier in life may underestimate the concentrations of THC they are inhaling or ingesting. Particularly with edibles, Dr. Stall said, the high can take about three hours to unfold, which might prompt users to ingest too much in the buildup.

Older adults also metabolize cannabis differently from younger people, Dr. Stall said, and their bodies eliminate the drug more slowly. Seniors also are more likely than younger people to take other medications, including psychoactive drugs for sleep, that can have problematic interactions with cannabis. And, Dr. Stall said, some seniors might already be prone to confusion or falling, which the use of cannabis could worsen.

“The question is What do we do about it?” Dr. Stall said.

What Can Be Done

Dr. Stall noted the importance of ensuring edibles were kept in locked locations and in clearly identified packaging, to prevent unintentional exposure.

Also, he said, policymakers should encourage senior-specific dosing information for cannabis, along with public-education campaigns about the kinds of conditions and circumstances that put older adults at risk when using the drug. He added that seniors who are experimenting with cannabis for the first time might want to draw from a mantra used in geriatric medicine: “Start low and go slow.”

“That would mean starting lower and going slower than a younger population who is trying cannabis for a first time,” Dr. Stall said.

Matt Richtel is a health and science reporter for The Times, based in Boulder, Colo. More about Matt Richtel

 

Source:  https://www.nytimes.com/2024/05/20/science/cannabis-seniors-poisoning.html?smid=nytcore-ios-share&referringSource=articleShare#site-content

Filed under: Canada,Cannabis/Marijuana :

Source: Email from Ed Moses to Drug Watch International drug-watch-international@googlegroups.com August 2017

Filed under: Brain and Behaviour,Cannabis/Marijuana,Drug use-various effects on foetus, babies, children and youth,Global Drug Legalisation Efforts :

Ernesto CabralErnesto CabralUpdated 
At least 1,089 people died from fentanyl poisoning in 2023, up 18.4% from the year before, preliminary data shows

The Trust Project

As many as 7 in 10 counterfeit pills tested in 2023 contained a potentially lethal dose of fentanyl, or roughly the amount that fits on the tips of a pencil, national DEA laboratory testing showed. (Photo courtesy of Rocky Mountain Field Division of the Drug Enforcement Administration)

Fentanyl-related overdose deaths hit a new high in 2023 as law enforcement seized record amounts of the synthetic opioid, official data shows.

At least 1,089 people died from fentanyl poisoning last year, up 18.4% from 920 the year before, according to preliminary data released by the Colorado Department of Public Health and Environment.

A surge that started five years ago has continued, with the number of fentanyl-related deaths increasing more than 900% from the 102 recorded in 2018, data from the health department’s Center for Health and Environmental Data shows.

Denver recorded more deaths in 2023 than any other county with 321, compared with Adams (136), Arapahoe (133), Jefferson (124) and El Paso (116).

The health department anticipates releasing final data in June.

So far this year, 141 fatalities have been reported to the CDPHE, however the data is typically lagging by at least three months. Denver again leads with 37 deaths from fentanyl.

The Centers for Disease Control and Prevention’s records tell a similar story about Colorado. In 2023, 1,187 fatalities were registered provisionally in the “other synthetic narcotics” category, which mainly comprises fentanyl. Unlike the state agency, the CDC said it does not have an exact number of fentanyl deaths.

The numbers for 2023 mark a 22.2% rise from the previous year and a 785% surge since 2018, according to the CDC database.

“We are facing more than just an opioid crisis in the U.S”, said Nora Volkow, director of the National Institute on Drug Abuse at the National Institutes of Health. “Stimulants like methamphetamine, which is more prevalent in use in the Western U.S., are now increasingly being contaminated or used together with fentanyl.”

News of the rising death toll comes days after the DEA announced a new strategy to combat fentanyl in the Rocky Mountain region. Earlier this month around 200 money service businesses and financial institutions that aid in sending money to people in other countries were asked to cooperate in an investigation into the cash flowing to support the illicit opioid market.

The probe, called Operation “Cash Out,” was launched in Colorado, Utah, Wyoming and Montana by the DEA, IRS and the Rocky Mountain High Intensity Drug Trafficking Area, the DEA said in a news release.

U.S. authorities say fentanyl constitutes a multi-billion-dollar enterprise for Mexican cartels such as Sinaloa and Jalisco, which operate near the U.S. border.

“The only thing they care about is their money. This interagency operation intends to target the networks and seize their assets through building stronger relationships with the private sector financial community,” said David Olesky, acting special agent in charge for DEA’s Rocky Mountain Field Division, in the release.

In recent years, new legislation, official investigations and initiatives from families and schools have emerged to prevent and combat the rising number of fentanyl-related deaths in Colorado, a bill signed into law on April 22 making it legal for students and staff at public and charter schools to carry and administer opioid overdose reversal drugs such as naloxone.

“The Colorado Department of Public Health and Environment is committed to doing all we can to prevent drug overdoses, and one of our current strategies is to increase access to naloxone,” said the state agency in a statement.

Filed under: Drug Specifics,Fentanyl,Social Affairs,USA :
·
For the first time in history, marijuana has surpassed alcohol in daily use amongst Americans, according to a new study

Research published earlier this week in the monthly peer-reviewed scientific journal “Addiction,” showed that more than 17.7 million Americans used marijuana daily or near-daily in 2022 as compared to 14.7 million who reported drinking alcohol at the same rate.

Far more people consume alcohol than cannabis, research showed, but “high-frequency” drinking is less common. In 2022, the “median drinker” reported drinking on 4 to 5 days in the past month, compared to 15 to 16 days in the past month for the median cannabis user.

Regular cannabis use still pales in comparison to daily use of cigarettes, researchers noted. More than 24.1 million people smoked cigarettes daily or near-daily compared to the 17.7 million Americans who used cannabis regularly.

The research also showed that older Americans are using more regularly than younger.

“In 2022, people 35 and older accounted for (slightly) more days of use than did those under the age of 35,” the study notes.

Researchers used data compiled over more than 40 years from the National Household Survey on Drug Abuse, which showed cannabis use began to rise at a corresponding rate to changes in cannabis policies.

As of 2024, 24 states and the District of Columbia have legalized recreational marijuana use, according to the Pew Research Center. Another 14 states allow for medical use only.

Last week, the U.S. Department of Justice proposed new regulations that would designate cannabis a Schedule III drug, rather than its current designation of a Schedule I drug. Cocaine, methamphetamine and fentanyl are among the drugs that have received the Schedule II designation.

Schedule I drugs are those with the highest potential to create dependency issues and are considered to have “no currently accepted medical use.” The DOJ decision cites the use of marijuana in the medical field as one of the reasons it warrants reclassification.

The recently published research concluded that long-term trends in cannabis use have paralleled cannabis policy changes, with declines during periods of “greater restriction and growth during periods of policy liberalization.”

But researchers stressed that changes in laws regarding cannabis can’t be definitely attributed to the rise in use.

“Both could have been manifestations of changes in underlying culture and attitudes. However, whichever way causal arrows point, cannabis use now appears to be on a fundamentally different scale than it was before legalization,” researchers wrote.

To read the full study and read more about the findings and methodology used, click here.

Copyright 2024 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

Source:https://www.yahoo.com/news/daily-cannabis-surpasses-daily-alcohol-211954850.html?

Filed under: Cannabis/Marijuana,Prevalence,Social Affairs,USA :

Revitalizing anti-corruption efforts

Supporting anti-corruption efforts in Hong Kong was a major focus during Ms. Waly’s mission. In a speech delivered at the 8th Symposium of the Independent Commission Against Corruption (ICAC) of Hong Kong on the occasion of the Commission’s 50th anniversary, Ms. Waly said that “In this era of uncertainty, as crises rage and threats simmer, we need to re-think and revitalize anti-corruption efforts,” adding that “corruption underpins many of the biggest challenges facing humanity today.”

In her remarks, Ms. Waly outlined four key priorities that UNODC considers essential to pave a new path for anti-corruption efforts, namely to 1) future-proof responses to corruption by leveraging the positive role of technology and unleashing the potential of youth; 2) unlock the full potential of international and regional anti-corruption frameworks, and to streamline cross border cooperation; 3) addressing gaps in capacities through partnerships; and 4) better understand corruption and its trends, through robust measurement, research, and analysis.

“Corruption is undermining everything we fight for, and empowering everything we fight against,” she said. “As we stand at this historic crossroads of challenges and opportunities, we need to seize every chance […] to innovate in the face of growing corruption challenges, together.”

On the sidelines of the Symposium, Ms. Waly signed a Memorandum of Understanding with ICAC Commissioner Woo Ying-ming to solidify their partnership and expand joint technical assistance to advance anti-corruption efforts in Asia.

Ms. Waly also met with the Chief Executive of Hong Kong, Mr. John KC Lee, to discuss the importance of coordinated regional action in the fight against organized crime.

Ms. Waly later visited the Hong Kong Jockey Club (HKJC) where she met its Executive Director of Racing and the Secretary General of the Asian Racing Federation (ARF).

Illegal betting in sports has become a global problem, helping to drive corruption and money-laundering in sports. By running the ARF and Anti-Illegal Betting and Related Financial Crime Council, HKJC is working to address issues like illegal betting and financial crimes that affect the integrity of sports and racing.

Ms. Waly invited the HKJC and ARF to support UNODC’s GlobE4Sport initiative, which will be launched this year. The initiative will create a global network which will support anti-corruption efforts in sport through the informal sharing of information between criminal justice authorities and sports organizations.

Ms. Waly also visited Hong Kong customs facilities, where she was briefed by Commissioner Louise Ho Pui-shan on the equipment and measures used by law enforcement to inspect cargo shipments and tackle trafficking in drugs and wildlife.

Supporting compassionate rehabilitation

With fewer than 20 per cent of people with drug use disorders in treatment globally, UNODC is committed to supporting non-stigmatizing and people-centred health and social services to people who use drugs, as reflected by Ms. Waly’s visit to the Association of Rehabilitation of Drug Abusers of Macau (ARTM).

ARTM is a civil society organization offering voluntary, evidence-based prevention, treatment and harm reduction services to affected communities in Macau, China. Civil society organizations (CSOs) play a vital role in tackling drug related issues, including by combating stigma and delivering essential services to affected communities.

During the visit, Ms. Waly met with people in rehabilitation for drug use and learned about the work of ARTM in providing new life skills, such as painting, baking and ceramics classes, as well as treatment for women and classes for children.

ARTM was itself founded by a former user of drugs, Augusto Nogueira, whose experience helps the organization provide compassionate and inclusive rehabilitation. Augusto says that his main struggle when he was using drugs was not being able to identify a solution for his problem.

“My addiction was stronger than my will to stop using,” he said.

After undergoing his own challenging rehabilitation process, Augusto had ideas on how to professionalize the existing prevention and treatment activities in Macau. With the goal of providing evidence-based, personalized approaches to drug treatment and rehabilitation services, he founded ARTM in 2000.

ARTM belongs to the Asia-Pacific Civil Society Working Group on Drugs, supported by UNODC. Convened by the Vienna NGO Committee on Drugs (VNGOC), the Working Group aims to strengthen civil society action on drug related matters and the implementation of joint international commitments in the Asia-Pacific region.

ARTM also works to bring the voices of civil society to the international stage, including by presenting civil society recommendations on how best to implement drug policies at the Commission on Narcotic Drugs.

During her visit, Ms. Waly acknowledged the call from grassroot civil society organizations like ARTM for greater investment in evidence-based prevention, including through the implementation of the CHAMPS initiative. Ms. Waly praised ARTM’s cooperation with UNODC, including by delivering a training workshop on UNODC’s family-based prevention programme, Strong Families.

Ms. Waly also met with the Secretary of Security of Macau to discuss how Macau’s experience can help inform regional responses in tackling organized crime, illegal online gambling, and drug trafficking.

Source: https://www.unodc.org/unodc/en/frontpage/2024/May/unodc-executive-director-highlights-anti-corruption–fight-against-organized-crime–and-drug-prevention-on-visit-to-hong-kong-and-macau–china.html

Filed under: Crime/Violence/Prison,Legal Sector,Others (International News),Political Sector,Prevention and Intervention,Social Affairs :

May 29, 2024  Contact: Kristen Govostes  Phone Number: (617) 557-2100

BOSTON – The U.S. Drug Enforcement Administration’s New England Field Division will team up with college esports teams from across New England to host the first of its kind, hybrid One Pill Can Kill Game Over Tournament. This event aims to meet a critical moment in time by using the esports platform to help educate young people about the dangers of fentanyl.

Twenty-two teenagers between the ages of 14 and 18 die every week from a drug poisoning or overdose death, according to a recent study by the New England Journal of Medicine.  To more effectively reach this important audience, DEA has teamed up with actress, founder of the Devon Michael Foundation, and influencer Ava Michelle and eight esports teams across the region to take an innovative new approach to fentanyl outreach and awareness.  With an overwhelming 97% of Americans between the ages of 12 and 17 engaged in video gaming, DEA is looking to reach young people where they often spend time – in the virtual world.

The One Pill Can Kill Game Over Tournament will be hosted by Clark University Esports on Thursday, June 6, 2024, from 7 to 9 p.m. ET on Twitch (twitch.tv/onepillcankill).  Access to view the tournament will also be available at DEA One Pill Can Kill Game Over Tournament | DEA.gov.  Joining Clark University for this Rocket League battle will be esports teams from Worcester Polytechnic Institute, University of Massachusetts Amherst, Boston University, Emerson College, Post University, University of New Hampshire, and the University of Southern Maine.

DEA will host an in-person pre-tournament program and live gameplay for invited guests at the state-of-the-art gaming center, All Systems Go, on Thursday, June 6, 2024, beginning at 4:30 p.m. Attendees will include high school aged students, community groups and dignitaries.  Media should plan to arrive around 5:45 p.m. for b-roll opportunities ahead of the press event, which will include remarks from DEA Associate Administrator Jon DeLena, Worcester County Sheriff Lew Evangelidis, Ava Michele and more. All Systems Go gaming center is located at 225 Shrewsbury Street, Worcester, Mass., 02604.

Fentanyl is a synthetic opioid, which is now involved in a majority of drug poisonings and overdose deaths.  Fentanyl is 50 times more potent than heroin, and just two milligrams – the amount that can fit on the tip of a pencil – can be deadly.  Often, people buy what they think is a legitimate prescription pill like Percocet or Xanax on social media, but it turns out, they’ve unknowingly purchased a fentanyl pill.  DEA laboratory testing indicates 7 out of 10 fentanyl pills seized contain a potentially deadly dose.  In 2023, DEA seized approximately 15.7 million potentially lethal doses of fentanyl in New England alone.

“I am thrilled we are able to team up with these amazing esports teams to host this One Pill Can Kill Game Over Tournament in New England and increase awareness about the dangers of fentanyl,” said DEA Associate Administrator Jon DeLena. “This event is extremely personal to me.  I know how much my own kids enjoy playing video games, so knowing they are also learning valuable, life-saving information while doing what they love is so important. I want to encourage any family with a gamer to join us – either virtually or in-person – watch the competition and then talk about what you’ve learned. It could be the most important talk you have as a family.”

“Connecting with people in an environment where they are having fun and are open to learning has been an incredible experience. Raising awareness and providing education about the fentanyl epidemic is absolutely crucial—I genuinely believe we are saving lives.” –  Ava Michelle Cota, Actress, and Founder, Devon Michael Foundation.

The One Pill Can Kill Game Over Tournament in New England will be the third tournament in this series.  The first tournament was held in the DEA’s New Orleans Field Division in January and reached more than 285,500 viewers. The second tournament was hosted by DEA Philadelphia in March and was viewed by more than 146,800. B-roll and soundbites from the previous events is available here. The New England event is the first to offer an in-person outreach event ahead of the tournament.

DEA would like to thank the participating teams, All Systems Go, The Rendon Group, and the esports community for their involvement and support of DEA’s One Pill Can Kill Game Over Tournaments.

 

Drug Enforcement Administration

Stephen Belleau, Acting Special Agent in Charge – New England

@DEANewEngland

Source: https://www.dea.gov/press-releases/2024/05/29/dea-brings-its-one-pill-can-kill-game-over-tournament-new-england-first

Filed under: Drug use-various effects,Mental Health,USA,Youth :

Associate Professor | Department Chair | Director, Forensic Science Research Center

Department of Criminal Justice, California State University

The opioid epidemic is a public health and safety emergency that is killing thousands and destroying the quality of life for hundreds of thousands of Americans and those who care about them. Fentanyl and other opioids affect all age ranges, ethnicities, and communities, including our most vulnerable population, children. Producing fentanyl is increasingly cheap, costing pennies for a fatal dose, with the opioid intentionally or unintentionally mixed with common illicit street drugs and pressed into counterfeit pills. Fentanyl is odorless and tasteless, making it nearly untraceable when mixed with other drugs. Extremely small doses of fentanyl, roughly equivalent to a few grains of salt, can be fatal, while carfentanil, a large animal tranquilizer, is 100 times more potent than fentanyl and fatal at an even smaller amount.

The Biden-Harris Administration should do even more to fund opioid-related prevention, treatment, eradication, and interdiction efforts to save lives in the United States. The 2022 Executive Order to Address the Opioid Epidemic and Support Recovery awarded $1.5 billion to states and territories to expand treatment access, enhance services in rural communities, and fund law enforcement efforts. In his 2023 State of the Union address, President Biden highlighted reducing opioid overdoses as part of his bipartisan Unity Agenda, pledging to disrupt trafficking and sales of fentanyl and focus on prevention and harm reduction. Despite extensive funding, opioid-related overdoses have not significantly decreased, showing that a different strategy is needed to save lives.

Opioid-related deaths have been estimated cost the U.S. nearly $4 trillion over the past seven years—not including the human aspect of the deaths. The cost of fatal overdoses was determined to be $550 billion in 2017. The cost of the opioid epidemic in 2020 alone was an estimated $1.5 trillion, up 37% from 2017. About two-thirds of the cost was due to the value of lives lost and opioid use disorder, with $35 billion spent on healthcare and opioid-related treatments and about $15 billion spent on criminal justice involvement. In 2017, per capita costs of opioid use disorder and opioid toxicity-related deaths were as high as $7247, with the cost per case of opioid use disorder over $221,000. With inflation in November 2023 at $1.26 compared to $1 in 2017, not including increases in healthcare costs and the significant increase in drug toxicity-related deaths, the total rate of $693 billion is likely significantly understated for fatal overdoses in 2023. Even with extensive funding, opioid-related deaths continue to rise.

With fatal opioid-related deaths being underreported, the Centers for Disease Control and Prevention (CDC) must take a primary role in real-time surveillance of opioid-related fatal and non-fatal overdoses by funding expanded toxicology testing, training first responder and medicolegal professionals, and ensuring compliance with data submission. The Department of Justice (DOJ) should support enforcement efforts to reduce drug toxicity-related morbidity and mortality, with the Department of Homeland Security (DHS) and the Department of the Treasury (TREAS) assisting with enforcement and sanctions, to prevent future overdoses. Key recommendations for reducing opioid-related morbidity and mortality include:

  • Funding research to determine the efficacy of current efforts in opioid misuse reduction and prevention.
  • Modernizing data systems and surveillance to provide real-time information.
  • Increasing overdose awareness, prevention education, and availability of naloxone.
  • Improve training of first responders and medicolegal death investigators.
  • Funding rapid and thorough toxicology testing in emergency departments and coroner/medical examiner agencies.
  • Enhancing prevention and enforcement efforts.

Challenge And Opportunity

Opioids are a class of drugs, including pain relievers that can be illegally prescribed and the illicit drug heroin. There are three defined waves of the opioid crisis, starting in the early 1990s as physicians increasingly prescribed opioids for pain control. The uptick in prescriptions stemmed from pharmaceutical companies promising physicians that these medications had low addiction rates and medical professionals adding pain levels being added to objective vital signs for treatment. From 1999 to 2010, prescription opioid sales quadrupled—and opioid-related deaths doubled. During this time frame when the relationship between drug abuse and misuse was linked to opioids, a significant push was made to limit physicians from prescribing opioids. This contributed to the second wave of the epidemic, when heroin abuse increased as former opioid patients sought relief. Heroin-related deaths increased 286% from 2002 to 2013, with about 80% of heroin users acknowledging that they misused prescription opioids before using heroin.  The third wave of the opioid crisis came in 2013 with an increase in illegally manufactured fentanyl, a synthetic opioid used to treat severe pain that is up to 100 times stronger than morphine, and carfentanil, which is 100 times more potent than fentanyl.

In 2022, nearly 110,000 people in the United States died from drug toxicity, with about 75% of the deaths involving opioids. In 2021, six times as many people died from drug overdoses as in 1999, with a 16% increase from 2020 to 2021 alone. While heroin-related deaths decreased by over 30% from 2020 to 2021, opioid-related deaths increased by 15%, with synthetic opioid-involved deaths like fentanyl increasing by over 22%. Over 700,000 people have died of opioid-related drug toxicity since 1999, and since 2021 45 people have died every day from a prescription opioid overdose. Opioid-related deaths have increased tenfold since 1999, with no signs of slowing down. The District of Columbia declared a public emergency in November 2023 to draw more attention to the opioid crisis.

In 2023, we are at the precipice of the fourth wave of the crisis, as synthetic opioids like fentanyl are combined with a stimulant, commonly methamphetamine. Speedballs have been common for decades, using stimulants to counterbalance the fatigue that occurs with opiates. The fatal combination of fentanyl and a stimulant was responsible for just 0.6% of overdose deaths in 2010 but 32.3% of opioid deaths in 2021, an over fifty-fold increase in 12 years. Fentanyl, originally used in end-of-life and cancer care, is commonly manufactured in Mexico with precursor chemicals from China. Fentanyl is also commonly added to pressed pills made to look like legitimate prescription medications. In the first nine months of 2023, the Drug Enforcement Agency (DEA) seized over 62 million counterfeit pills and nearly five tons of powdered fentanyl, which equates to over 287 million fatal doses. These staggering seizure numbers do not include local law enforcement efforts, with the New York City Police Department recovering 13 kilos of fentanyl in the Bronx, enough powder to kill 6.5 million people. 

The ease of creating and trafficking fentanyl and similar opioids has led to an epidemic in the United States. Currently, fentanyl can be made for pennies and sold for as little as 40 cents in Washington State. The ease of availability has led to deaths in our most vulnerable population—children. Between June and September 2023, there were three fatal overdoses of children five years and younger in Portland, OR. In a high-profile case in New York City, investigators found a kilogram of fentanyl powder in a day care facility after a 1-year-old died and three others became critically ill.

The Biden Administration has responding to the crisis in part by placing sanctions against and indicting executives in Chinese companies for manufacturing and distributing precursor chemicals, which are commonly sold to Mexican drug cartels to create fentanyl. The drug is then trafficked into the United States for sale and use. There are also concerns about fentanyl being used as a weapon of mass destruction, similar to the anthrax concerns in the early 2000s.

The daily concerns of opioid overdoses have plagued public health and law enforcement professionals for years. In Seattle, WA, alone, there are 15 non-fatal overdoses daily, straining the emergency medical systems. There were nearly 5,000 non-fatal overdoses in the first seven months of 2023 in King County, WA, an increase of 70% compared to 2022. In a landmark decision, in March 2023 the Food and Drug Administration (FDA) approved naloxone, a drug to reverse the effects of opioid overdoses, as an over-the-counter nasal spray in an attempt to reduce overdose deaths. Naloxone nasal spray was initially approved for prescription use only in 2015 , significantly limiting access to first responders and available to high-risk patients when prescribed opioids. In New York, physicians have been required to prescribe naloxone to patients at risk of overdose since 2022. Although naloxone is now available without a prescription, access is still limited by price, with one dose costing as much as $65, and some people requiring more than one dose to reverse the overdose. Citing budget concerns, Governor Newsom vetoed California’s proposed AB 1060, which would have limited the cost of naloxone to $10 per dose. Fentanyl testing strips that can be used to test substances for the presence of fentanyl before use show promise in preventing unwanted fentanyl-adulterated overdoses. The Expanding Nationwide Access to Test Strips Act, which was introduced to the Senate in July 2023, would decriminalize the testing strips as an inexpensive way to reduce overdose while following evidence-based harm-reduction theories.

Illicit drugs are also one of the top threats to national security. Law enforcement agencies are dealing with a triple epidemic of gun violence, the opioid crisis, and critical staffing levels. Crime prevention is tied directly to increased police staffing, with lower staffing limiting crime control tactics, such as using interagency task forces, to focus on a specific crime problem. Police are at the forefront of the opioid crisis, expected to provide an emergency response to potential overdoses and ensure public safety while disrupting and investigating drug-related crimes. Phoenix Police Department seized over 500,000 fentanyl pills in June 2023 as part of Operation Summer Shield, showing law enforcement’s central role in fighting the opioid crisis. DHS created a comprehensive interdiction plan to reduce the national and international supply of opioids, working with the private sector to decrease drugs brought into the United States and increasing task forces to focus on drug traffickers.

Prosecutors are starting to charge drug dealers and parents of children exposed to fentanyl in their residences in fatal overdose cases. In an unprecedented action, Attorney General Merrick Garland recently charged Mexican cartel members with trafficking fentanyl and indicting Chinese companies and their executives for creating and selling precursor chemicals. In November 2023, sanctions were placed against the Sinaloa cartel and four firms from Mexico suspected of drug trafficking to the United States, removing their ability to legally access the American banking system. Despite this work, criminal justice-related efforts alone are not reducing overdoses and deaths, showing a need for a multifaceted approach to save lives.

While these numbers of opioid overdoses are appalling, they are likely underreported. Accurate reporting of fatal overdoses varies dramatically across the country, with the lack of training of medicolegal death investigators to recognize potential drug toxicity-related deaths, coupled with the shortage of forensic pathologists and the high costs of toxicology testing, leading to inaccurate cause of death information. The data ecosystem is changing, with agencies and their valuable data remaining disjointed and unable to communicate across systems. A new model could be found in the CDC’s Data Modernization Initiative, which tracked millions of COVID-19 cases across all states and districts, including data from emergency departments and medicolegal offices. This robust initiative to modernize data transfer and accessibility could be transformative for public health. The electronic case reporting system and strong surveillance systems that are now in place can be used for other public health outbreaks, although they have not been institutionalized for the opioid epidemic.

Toxicology testing can take upwards of 8–10 weeks to receive, then weeks more for interpretation and final reporting of the cause of death. The CDC’s State Unintentional Drug Overdose Reporting System receives data from 47 states from death certificates and coroner/medical examiner reports. Even with the CDC’s extensive efforts, the data-sharing is voluntary, and submission is rarely timely enough for tracking real-time outbreaks of overdoses and newly emerging drugs. The increase of novel psychoactive substances, including the addition of the animal tranquilizer xylazineto other drugs, is commonly not included in toxicology panels, leaving early fatal drug interactions undetected and slowing notification of emerging drugs regionally. The data from medicolegal reports is extremely valuable for interdisciplinary overdose fatality review teams at the regional level that bring together healthcare, social services, criminal justice, and medicolegal personnel to review deaths and determine potential intervention points. Overdose fatality review teams can use the data to inform prevention efforts, as has been successful with infant sleeping position recommendations formed through infant mortality review teams.

Plan Of Action

Reducing opioid misuse and saving lives requires a multi-stage, multi-agency approach. This includes expanding real-time opioid surveillance efforts; funding for overdose awareness, prevention, and education; and improved training of first responders and medicolegal personnel on recognizing, responding to, and reporting overdoses. Nationwide, improved toxicology testing and reporting is essential for accurate reporting of overdose-involved drugs and determining the efficacy of efforts to combat the opioid epidemic.

Agency Role
Department of Education (ED) ED creates policies for educational institutions, administers educational programs, promotes equity, and improves the quality of education.

ED should increase resources for creating and implementing evidence-based preventative education for youth and provide resources for drug misuse with access to naloxone.
Department of Justice (DOJ) DOJ is responsible for keeping our country safe by upholding the law and protecting civil rights. The DOJ houses the Office of Justice Programs and the Drug Enforcement Agency (DEA), which are instrumental in the opioid crisis.

DOJ should be the principal enforcement agency, with the DEA leading drug-related enforcement actions. The Attorney General should continue to initiate new sanctions and a wider range of indictments to assist with interdiction and eradication efforts.
Department of Health and Human Services (HHS) HHS houses the Centers for Disease Control and Prevention (CDC), the nation’s health protection and preventative agency, and collects and analyzes vital data to save lives and protect people from health threats.

The CDC should be the primary agency to focus on robust real-time opioid-related overdose surveillance and fund local public health departments to collect and submit data. HHS should fund grants to enhance community efforts to reduce opioid-related overdoses and provide resources and outreach to increase awareness.
Department of Homeland Security (DHS) DHS focuses on crime prevention and safety at our borders, including interdiction and eradication efforts, while monitoring security threats and strengthening preparedness.

DHS should continue leading international investigations of fentanyl production and trafficking. Additional funding should be provided to allow DHS and its investigative agencies to focus more on producers of opioids, sales of precursors, and trafficking to assist with lessening the supply available in the United States.
Department of the Treasury (TREAS) TREAS is responsible for maintaining financial infrastructure systems, collecting revenue and dispersing payments, and creating international economic policies.

TREAS should continue efforts to sanction countries producing precursors to create opioids and trafficking drugs into the U.S. while prohibiting business ties with companies participating in drug trades. Additional funding should be available to support E.O. 14059 to counter transnational organized crime’s relation to illicit drugs.
Bureau of Prisons (BOP) The BOP provides protection for public safety by providing a safe and humane facility for federal offenders to serve their prescribed time while providing appropriate programming for reentry to ease a transition back to communities.

The BOP should provide treatment for opioid use disorders, including the option for medication-assisted treatment, to assist in reducing relapse and overdoses, coupled with intensive case management.
State Department (DOS) The DOS spearheads foreign policy by creating agreements, negotiating treaties, and advocating for the United States internationally.

The DOS should receive additional funding to continue to work with the United Nations to disrupt the trafficking of drugs and limit precursors used to make illicit opioids. The DOS also assists Mexico and other countries fight drug trafficking and production.

Recommendation 1. Fund research to determine the efficacy of current efforts in opioid misuse reduction and prevention.

DOJ should provide grant funding for researchers to outline all known current efforts of opioid misuse reduction and prevention by law enforcement, public health, community programs, and other agencies. The efforts, including the use of suboxone and methadone, should be evaluated to determine if they follow evidence-based practices, how the programs are funded, and their known effect on the community. The findings should be shared widely and without paywalls with practitioners, researchers, and government agencies to hone their future work to known successful efforts and to be used as a foundation for future evidence-based, innovative program implementation.

Recommendation 2. Modernize data systems and surveillance to provide real-time information.

City, county, regional, and state first responder agencies work across different platforms, as do social service agencies, hospitals, private physicians, clinics, and medicolegal offices. A single fatal drug toxicity-related death has associated reports from a law enforcement officer, fire department personnel, emergency medical services, an emergency department, and a medicolegal agency. Additional reports and information are sought from hospitals and clinics, prior treating clinicians, and social service agencies. Even if all of these reports can be obtained, data received and reviewed is not real-time and not accessible across all of the systems.

Medicolegal agencies are arguably the most underprepared for data and surveillance modernization. Only 43% of medicolegal agencies had a computerized case management system in 2018, which was an increase from 31% in 2004. Outside of county or state property, only 75% of medicolegal personnel had internet access from personal devices. The lack of computerized case management systems and limited access to the internet can greatly hinder case reporting and providing timely information to public health and other reporting agencies.

With the availability and use of naloxone by private persons, the Public Naloxone Administration Dashboard from the National EMS Information System (NEMSIS) should be supported and expanded to include community member administration of naloxone. The emergency medical services data can be aligned with the anonymous upload of when, where, and basic demographics for the recipient of naloxone, which can also be made accessible to emergency departments and medicolegal death investigation agencies. While the database likely will not be used for all naloxone administrations, it can provide hot spot information and notify social services of potential areas for intervention and assistance. The database should be tied to the first responder/hospital/medicolegal database to assist in robust surveillance of the opioid epidemic.

Recommendation 3. Increase overdose awareness, prevention education, and availability of naloxone.

Awareness of the likelihood of poisoning and potential death from the use of fentanyl or counterfeit pills is key in prevention. The DEA declared August 21 National Fentanyl Prevention and Awareness Day to increase knowledge of the dangers of fentanyl, with the Senate adopting a resolution to formally recognize the day in 2023. Many states have opioid and fentanyl prevention tactics on their public health websites, and the CDC has educational campaigns designed to reach young adults, though the education needs to be specifically sought out. Funding should be made available to community organizations and city/county governments to create public awareness campaigns about fentanyl and opioid usage, including billboards, television and streaming ads, and highly visible spaces like buses and grocery carts.

ED allows evidence-based prevention programs in school settings to assist in reducing risk factors associated with drug use and misuse. The San Diego Board of Supervisors approved a proposal to add education focused on fentanyl awareness after 12 juveniles died of fentanyl toxicity in 2021. The district attorney supported the education and sought funding to sponsor drug and alcohol training on school campuses. Schools in Arlington, VA, note the rise in overdoses but recognize that preventative education, when present, is insufficient. ED should create prevention programs at grade-appropriate levels that can be adapted for use in classrooms nationwide.

With the legalization of over-the-counter naloxone, funding is needed to provide subsidized or free access to this life-saving medication. Powerful fentanyl analogs require higher doses of naloxone to reverse the toxicity, commonly requiring multiple naloxone administrations, which may not be available to an intervening community member. The State of Washington’s Department of Public Health offers free naloxone kits by mail and at certain pharmacies and community organizations, while Santa Clara University in California has a vending machine that distributes naloxone for free. While naloxone reverses the effects of opioids for a short period, once it wears off, there is a risk of a secondary overdose from the initial ingestion of the opioid, which is why seeking medical attention after an overdose is paramount to survival. Increasing access to naloxone in highly accessible locations—and via mail for more rural locations—can save lives. Naloxone access and basic training on signs of an opioid overdose may increase recognition of opioid misuse and empower the community to provide immediate, lifesaving action.

However, there are concerns that naloxone may end up in a shortage. With its over-the-counter access, naloxone may still be unavailable for those who need it most due to cost (approximately $20 per dose) or access to pharmacies. There is a national push for increasing naloxone distribution, though there are concerns of precursor shortages that will limit or halt production of naloxone. Governmental support of naloxone manufacturing and distribution can assist with meeting demand and ensuring sustainability in the supply chain.

Recommendation 4. Improve training of first responders and medicolegal death investigators.

Most first responders receive training on recognizing signs and symptoms of a potential overdose, and emergency medical and firefighting personnel generally receive additional training for providing medical treatment for those who are under the influence. To avoid exposure to fentanyl, potentially causing a deadly situation for the first responder, additional training is needed about what to do during exposure and how to safely provide naloxone or other medical care. DEA’s safety guide for fentanyl specifically outlines a history of inconsistent and misinformation about fentanyl exposure and treatment. Creating an evidence-based training program that can be distributed virtually and allow first responders to earn continuing education credit can decrease exposure incidents and increase care and responsiveness for those who have overdosed.

While the focus is rightfully placed on first responders as the frontline of the opioid epidemic, medicolegal death investigators also serve a vital function at the intersection of public health and criminal justice. As the professionals who respond to scenes to investigate the circumstances (including cause and manner) surrounding death, medicolegal death investigators must be able to recognize signs of drug toxicity. Training is needed to provide foundational knowledge on deciphering evidence of potential overdose-related deaths, photographing scenes and evidence to share with forensic pathologists, and memorializing the findings to provide an accurate manner of death. Causes of death, as determined by forensic pathologists, need appropriate postmortem examinations and toxicology testing for accuracy, incorporated with standardized wording for death certificates to reflect the drugs contributing to the death. Statistics on drug-related deaths collected by the CDC and public health departments nationwide rely on accurate death certificates to determine trends.

The CDC created the Collaborating Office for Medical Examiners and Coroners (COMEC) in 2022 to provide public health support for medicolegal death investigation professionals. COMEC coordinates health surveillance efforts in the medicolegal community and champions quality investigations and accurate certification of death. The CDC offers free virtual, asynchronous training for investigating and certifying drug toxicity deaths, though the program is not well known or advertised, and there is no ability to ask questions of professionals to aid in understanding the content. Funding is needed to provide no-cost, live instruction, preferably in person, to medicolegal offices, as well as continuing education hours and thorough training on investigating potential drug toxicity-related deaths and accurately certifying death certificates.

Cumulatively, the roughly 2,000 medicolegal death investigation agencies nationwide investigated more than 600,000 deaths in 2018, running on an average budget of $470,000 per agency. Of these agencies, less than 45% had a computerized case management system, which can significantly delay data sharing with public health and allied agencies and reduce reporting accuracy, and only 75% had access to the internet outside of their personally owned devices. Funding is needed to modernize and extend the infrastructure for medicolegal agencies to allow basic functions such as computerized case management systems and internet access, similar to grant funding from the National Network of Public Health Institutes.

Recommendation 5. Fund rapid and thorough toxicology testing in emergency departments and coroner/medical examiner agencies.

Rapid, accurate toxicology testing in an emergency department setting can be the difference between life and death treatment for a patient. Urine toxicology testing is fast, economical, and can be done at the bedside, though it cannot quantify the amount of drug and is not inclusive for emerging drugs. Funding for enhanced accurate toxicology testing in hospitals with emergency departments, including for novel psychoactive substances and opioid analogs, is necessary to provide critical information to attending physicians in a timely manner to allow reversal agents or other vital medical care to be performed.

With the limited resources medicolegal death investigation agencies have nationally and the average cost of $3000 per autopsy performed, administrators need to triage which deaths receive toxicology testing and how in-depth the testing will be. Advanced panels, including ever-changing novel psychoactive substances, are costly and can result in inaccurate cause of death reporting if not performed routinely. Funding should be provided to medicolegal death investigating agencies to subsidize toxicology testing costs to provide the most accurate drugs involved in the death. Accurate cause of death reporting will allow for timely public health surveillance to determine trends and surges of specific drugs. Precise cause of death information and detailed death investigations can significantly contribute to regional multidisciplinary overdose fatality review task forces that can identify potential intervention points to strengthen services and create evidence to build future life-saving action plans.

Recommendation 6. Enhance prevention and enforcement efforts.

DOJ should fund municipal and state law enforcement grants to use evidence-based practices to prevent and enforce drug-related crimes. Grant applications should include a review of the National Institute of Justice’s CrimeSolutions.gov practices in determining potential effectiveness or using foundational knowledge to build innovative, region-specific efforts. The funding should be through competitive grants, requiring an analysis of local trends and efforts and a detailed evaluation and research dissemination plan. Competitive grant funding should also be available for community groups and programs focusing on prevention and access to naloxone.

An often overlooked area of prevention is for justice-involved individuals who enter jail or prison with substance use disorders. Approximately 65% of prisoners in the United States have a substance abuse order, and an additional 20% of prisoners were under the influence of drugs or alcohol when they committed their crime. About 15% of the incarcerated population was formally diagnosed with an opioid use disorder. Medications are available to assist with opioid use disorder treatments that can reduce relapses and post-incarceration toxicity-related deaths, though less than 15% of correctional systems offer medication-assisted opioid use treatments. Extensive case management coupled with trained professionals to prescribe medication-assisted treatment can help reduce opioid-related relapses and overdoses when justice-involved individuals are released to their communities, with the potential to reduce recidivism if treatment is maintained.

DEA should lead local and state law enforcement training on recognizing drug trends, creating regional taskforces for data-sharing and enforcement focus, and organizing drug takeback days. Removing unused prescription medications from homes can reduce overdoses and remove access to unauthorized users, including children and adolescents. Funding to increase collection sites, assist in the expensive process of properly destroying drugs, and advertising takeback days and locations can reduce the amount of available prescription medications that can result in an overdose.

DHS, TREAS, and DOS should expand their current efforts in international trafficking investigations, create additional sanctions against businesses and individuals illegally selling precursor chemicals, and collaborate with countries to universally reduce drug production.

Budget Proposal

A budget of $800 million is proposed to evaluate the current efficacy of drug prevention and enforcement efforts, fund prevention and enforcement efforts, improve training for first responders and medicolegal death investigators, increase rapid and accurate toxicology testing in emergency and medicolegal settings, and enhance collaboration between law enforcement agencies. The foundational research on the efficacy of current enforcement, preventative efforts, and surveillance should receive $25 million, with findings transparently available and shared with practitioners, lawmakers, and community members to hone current practices.

DOJ should receive $375 million to fund grants; collaborative enforcement efforts between local, state, and federal agencies; preventative strategies and programs; training for first responders; and safe drug disposal programs.

CDC should receive $250 million to fund the training of medicolegal death investigators to recognize and appropriately document potential drug toxicity-related deaths, modernize data and reporting systems to assist with accurate surveillance, and provide improved toxicology testing options to emergency departments and medicolegal offices to assist with appropriate diagnoses. Funding should also be used to enhance current data collection efforts with the Overdose to Action program34 by encouraging timely submissions, simplifying the submission process, and helping create or support overdose fatality review teams to determine potential intervention points.

ED should receive $75 million to develop curricula for K-12 and colleges to raise awareness of the dangers of opioids and prevent usage. The curriculum should be made publicly available for access by parents, community groups, and other organizations to increase its usage and reach as many people as possible.

BOP should receive $25 million to provide opioid use disorder medication-assisted treatments by trained clinicians and extensive case management to assist in reducing post-incarceration relapse and drug toxicity-related deaths. The policies, procedures, and steps to create medication-assisted programming should be shared with state corrections departments and county jails to build into their programming to expand use in carceral settings and assist in reducing drug toxicity-related deaths at all incarceration levels.

DOS, DHS, and TREAS should jointly receive $50 million to strengthen their current international investigations and collaborations to stop drug trafficking, the manufacture and sales of precursors, and combating organized crime’s association with the illegal drug markets.

Conclusion

Opioid-related overdoses and deaths continue to needlessly and negatively affect society, with parents burying children, sometimes infants, in an unnatural order. With the low cost of fentanyl production and the high return on investment, fentanyl is commonly added to illicit drugs and counterfeit, real-looking prescription pills. Opioid addiction and fatal overdoses affect all genders, races, ethnicities, and socioeconomic statuses, with no end to this deadly path in sight. Combining public health surveillance with enforcement actions, preventative education, and innovative programming is the most promising framework for saving lives nationally.

 

FEDERATION OF AMERICAN SCIENTISTS © 2024
Source: https://fas.org/publication/underscoring-opioid-epidemic/
Filed under: Drug Specifics,Drug use-various effects,Effects of Drugs,Fentanyl,Heroin/Methadone,USA :

The use of psychoactive substances among children and young people is one of today’s challenges. In order to solve this problem by acting in a coordinated manner, this academic year Vilnius city municipality, in cooperation with the Ministry of the Interior of the Republic of Lithuania, implemented a pilot model for the prevention of drug use and distribution by minors in schools. The project was implemented in three schools of the capital – Antakalnis, Vasilijaus Kačialovos and Vilnius Jesuit high schools.

“Initiating this project, we aimed to increase the safety of students in educational institutions and their entrances, to include in the project all persons participating in the student’s life and, most importantly, to respond to the needs of minors. The problem of psychoactive substance use among young people is not only in Vilnius, so we paid a lot of attention to the sharing of good practices between municipalities,” said Agneta Ladek, Deputy Minister of the Ministry of the Interior of the Republic of Lithuania.

In implementing the project, the Vilnius City Municipality relied on the international primary prevention model Planet Youth, based on scientific and practical evidence, which was implemented in the capital in 2020. One of the key aspects of the model is a community-based approach that fosters positive relationships between children and their families, peers, educators and other adults.

“Building a strong community—of children, parents, or teachers—is the healthiest and wisest way to promote children’s well-being and help them grow into mature individuals who make healthy choices.” It has been scientifically proven that children and teenagers who are surrounded by a positive environment, who have good relations with teachers and parents, use or consider using legal and illegal psychoactive substances much less often,” said Simona Bieliūnė, the vice-mayor of the city of Vilnius.

It is planned that the activities tested during the project will continue to be implemented in other schools of the capital. This will contribute to the consistent implementation of prevention of the use and distribution of psychoactive substances and will help to form healthy lifestyle habits.

Implementation of projects to strengthen school communities

The pilot model project was implemented in three schools of the capital – Antakalnis, Vasilijaus Kačialovos and Vilnius Jesuit high schools. Realizing the extent of the problem of the use and distribution of psychoactive substances among schoolchildren, the heads of educational institutions do not shy away from talking about it publicly and looking for solutions.

“Every year, students from about 30 different educational institutions come to the first classes of the high school, so it is natural that attitudes and attitudes differ. With the start of the new academic year, we face great challenges in order to familiarize students and their parents with the rules in force at our school, and their observance,” said Anželika Keršinskienė, director of Vilnius Antakalnis Gymnasium.

When planning the preventive measures for the implementation of the project, we were guided by the data of each school’s “Planet Youth” study on the extent of psychoactive substance use, children’s psychological resilience, trends in relations with parents, peers, teachers and other factors related to the use of psychoactive substances – common goals are achieved by adapting to unique school situations. After the initiation of the project, data-based individual prevention plans were created and the conditions for their implementation were created, as well as preventive activity planning, financing and implementation practices suitable for the entire municipality were tested.

All the schools that participated in the project note that the project allowed the school communities – administration, teachers, students and their parents – to focus, helped to become more active and strengthen mutual relations.

“During the project, the funds allocated by the municipality allowed our school to expand and renovate the student’s leisure spaces, install smoke detectors, partially covered the costs of fencing the school’s territory. We are happy that the students willingly got involved in the activities, initiated and created social advertisements themselves, but our most important achievement is that our school community started to speak “one language”, said Roza Dimentova, director of Vilnius V. Kačialovos Gymnasium.

“As part of the project, we established 6 student clubs according to their interests on the initiative of the students. Parents and teachers were involved in the activities. Such clubs, such as astronomy, politics or games, bring all participants together and encourage increased student engagement in extracurricular activities. We plan to continue these activities and expand them next year as well,” said Vilnius Jesuit High School director S. Edita Šicaite.

In the pilot model discussion – insights from the professionals

During the implementation of the pilot model for the prevention of underage drug use and distribution in schools, the Vilnius Public Health Office, police representatives, as well as experts from the Icelandic “Planet Youth” model joined the project activities together with the Vilnius City Municipality.

In the discussion of the pilot model, representatives of the municipality for the first time presented footage of the network of free services for the use of psychoactive substances in the city of Vilnius, which will be distributed to doctors and teachers. An informational publication has been created so far, which can be accessed at the address paslaugosjaunimui.lt.

The coordinator of the Vilnius Public Health Office presented the project activities implemented in pilot schools and the importance of student research results in planning targeted prevention measures at different levels of the community.

In the discussion of the pilot model, a tool for assessing the security of school infrastructure was also presented, as well as additional measures for the prevention of the use and distribution of psychoactive substances.

Source: https://madeinvilnius.lt/en/news/city/pilot-model-of-prevention-of-drug-use-and-distribution-by-minors-in-schools-was-implemented-in-Vilnius

Filed under: Drug use-various effects on foetus, babies, children and youth,Education Sector (Papers),Mental Health,Others (International News) :
PSYCHOPHARMACOLOGY

Medication for reversing overdose is life-saving—if used quickly and correctly.

 

Mark S. Gold M.D.
Addiction Outlook

Posted June 4, 2024

KEY POINTS

  • Fentanyl is a major threat causing overdose deaths in the United States.
  • Young people are unknowingly taking fentanyl and dying.
  • Fentanyl smoking is contributing to overdose and speedballing deaths.
  • Government and private agencies are cracking down on illegal fentanyl, but it’s an uphill fight.
Seized Fentanyl Pills
Source: National Institute on Drug Abuse

 “It is the deadliest drug threat our country has ever faced.” says Anne Milgram, Administrator, Drug Enforcement Administration (DEA), referring to the threat of fentanyl in the United States. She should know.

We still have record deaths, and that’s after the DEA seized more than 80 million fentanyl-laced fake pills and nearly 12,000 pounds of fentanyl powder so far in 2024 . The fentanyl seizures represent more than 157.6 million deadly doses; 70% of the counterfeit pills contain a lethal dose of fentanyl. Sometimes, the drug is smoked and as with intravenous injection, speeds access to the brain, further endangering users.

The best new prevention approach, the “One Pill Can Kill” initiative led by the DEA, is amplified by the Community Anti-Drug Coalitions of America (CADCA) and other volunteers educating the public and seeking to prevent flooding of the U.S. with fentanyl and fentanyl-laced fake pills resembling Xanax, Oxycontin, Adderall, Vicodin and other popular prescription medications—but with a deadly twist. The counterfeit pills, more often than not, contain a lethal dose of fentanyl.

“CADCA and its 7,000 coalition members across the nation have worked tirelessly to address the issue of fentanyl-laced fake pills that are poisoning our nation’s youth by planning and implementing comprehensive, data-driven strategies, with multiple public and private partners to address community conditions causing this problem,” said CADCA’s president and CEO, retired Army general Barrye L. Price.

Across the country, fentanyl has largely fueled a more than doubling of overdose deaths among children ages 12-17 since the start of the pandemic. The deaths were inadvertently hidden by “good news” reported by the CDC on May 15, 2024, announcing that there were an estimated 107,543 drug overdose deaths in the U.S. during 2023—a decrease of 3% from the 111,029 deaths estimated in 2022.

Fentanyl is killing adolescents and people of color, many with no idea they are taking fentanyl. The counterfeit drugs are easy to obtain from friends or buy through social media. Sold online for $2 to $10 apiece, their lethal potency caught policy leaders, emergency rooms, addiction experts, family health providers, and pediatricians nationwide by surprise.
 Such is the fentanyl crisis as of June 2024. As i will describe in this blog post, there are treatments of last resort and medications designed to reverse the effects of fentanyl when education, prevention, and treatment have failed. An estimated 80,000 deaths per year are attributed to opioid-induced respiratory depression (OIRD) caused by fentanyl alone. Wonder medicines that counter the effects include the widely-used naloxone (Narcan) and much-less-used (but also effective) opioid overdose reversal drug nalmefene (Opvee).

The Life-Saving Role of Naloxone

Naloxone has gained attention as a wonder drug capable of reviving a person who has overdosed, appeared to have died, or nearly died. I adminishtered, intravenously, my first dose of naloxone in 1975 while working in the Yale New Haven Hospital emergency room.. At the time, naloxone was most often given intravenously by anesthesiologists during surgery to reverse the sedative effects of opioids doctors had administered earlier. When naloxone was approved by the FDA in 1971, total drug overdose deaths in the U.S. were 6,771, rare enough that there was no national call to add it to emergency rooms to reverse overdoses. Since then, the number of overdoses has catastrophically escalated.

When Individuals Overdose on Opioids

What are signs of an opioid overdose? They include unconsciousness, very small eye pupils, slow or shallow breathing, vomiting, inability to speak, faint heartbeat, limp arms and legs, pale skin, and purple lips and fingernails. When a person overdoses on opioids, breathing slows or altogether stops. The overdosed person appears sleepy and is unresponsive.

Opioids

interfere with receptors in the brain, slowing breathing so that insufficient oxygen reaches the brain and other vital organs like the heart; the heart rate may slow or even stop. As breathing slows, oxygen levels fall, which may trigger abnormal heart rhythms. Blue lips and fingernails signal the lack of oxygen. Because insufficient oxygen reaches the brain and heart, the consequences are coma, brain damage, or death.

The antidote, naloxone, attaches to opioid receptors, reversing and blocking effects of opioids. Naloxone can quickly restore normal breathing. Naloxone is so safe we give it immediately to anyone with signs of opioid overdose or when an overdose is suspected. However, the drug has no effect on someone with no opioids in their system.

Reversing Respiratory Depression

The specific mechanism that drives opioid death by overdose is stimulation of one class of endogenous opioid receptors—mu-opioid receptors—in cells in the brainstem; it inhibits breathing. Respiratory depression, or decreased (or terminated) breathing, is a direct effect of opioid use, and, in the case of fentanyl, it appears extremely quickly.

Intravenous naloxone is not available in the community, where first responders depend on intranasal or intramuscular administration. Yet naloxone must be administered much sooner for fentanyl than for heroin because the window for saving the overdosed person is much shorter than with heroin. So, the right dose of naloxone must be given by a friend, loved one, or first responder almost immediately.

Other opioid antagonists, like nalmefene, may be expected to do a better job in fentanyl overdoses. After the person recovers, they should be offered long-term treatment resources, including the ability to initiate treatment for opioid use disorder in the emergency department, as Yale’s Brian Fuerhlein described in an earlier blog post.

Renarcotization

Researchers, addiction experts, and other healthcare providers have documented that when fentanyl is taken chronically, the drug may be absorbed into fat tissue and stay there, accumulating and forming a reservoir of fentanyl. Naloxone might reverse a “normal” fentanyl overdose, but due to the “depot effect,” after a person becomes conscious, they may lose consciousness again and stop breathing. This event is called re-narcotization.

If it is suspected that someone has overdosed on fentanyl and they are given naloxone, they may start breathing again and become conscious. With less potent opioids, naloxone can cover someone for 60 minutes. But someone with a supply of fentanyl in body fat depots can renarcotize several times. It is important to call 911. Additional doses of naloxone may be given as the patient is transported to the ER or hospital, where oxygen and other life support is available.

Narcan Nasal Spray

Naloxone can now be administered by non-health professionals via nasal spray to save lives. Intranasal naloxone works within two to three minutes. If the person has not responded after three minutes, another dose should be given. After administering naloxone, it’s very important to always call 911 because experts need to determine whether respiratory support, more naloxone, or other measures are necessary to reverse the overdose.

The FDA approved Narcan (naloxone) as a nasal spray for over-the-counter use because it is safe, easy to use, and saves lives. In 2021, the Food and Drug Administration approved an 8-mg intranasal naloxone product, twice the amount than the usual 4-mg dose. The FDA also granted a second over-the-counter naloxone agent in early 2024. This drug, RiVive, is a generic naloxone nasal spray available from Harm Reduction Therapeutics, a nonprofit pharmaceutical organization. Nasal naloxone is currently available in 3mg (Revive), 4mg (Narcan), and 8mg (Kloxxado) dosages.

Making naloxone available without a prescription expands its availability to people with an opioid-dependent loved one or who themselves have opioid use disorder (OUD). To save someone from an opioid overdose, you need naloxone or nalmefene. Steps for responding to an opioid overdose can be found here.

Another Opioid Overdose Reversal Drug: Nalmefene

Nalmefene has been saving lives from opioid overdoses since May 2023, when the FDA approved nalmefene hydrochloride nasal spray (Opvee). Nalmefene is a long-duration opioid antagonist first approved for injection in 1995. The original injectable nalmefene was removed from the market for commercial reasons in 2008. However, the dramatic rise in opioid overdose deaths and the emergence of powerful synthetic opioids catalyzed the development of an intranasal (IN) form of nalmefene for emergency treatment of opioid, and especially fentanyl, overdoses.

Nalmefene is an opioid receptor antagonist particularly well-suited for fentanyl overdoses. One reason is it has a longer half-life than naloxone, which means it stays in the body longer. This may protect against re-intoxication but may also make withdrawal symptoms last longer in those with opioid use disorders.

Synthetic opioids like fentanyl are now the most common drugs involved in drug overdose deaths in the U.S. Nalmefene is 10 times more potent than naloxone and has an 8- to 10-fold longer half-life (8 to 11 hours), reducing the likelihood of re-overdosing from long-acting opioids.

Xylazine and other adulterants illegally added to opioids in the U.S. have also received attention for generating zombie-like behavior in people. Such additives make overdose reversal more difficult. However, the key to harm reduction is reversing the effects of synthetic opioids on the heart, lungs, and brain.

The efficacy of frontline, community-based reversal of poisoning events with antidotes such as naloxone has been questioned due to the rise of highly potent synthetic opioids, primarily illicitly manufactured fentanyl (IMF), which causes 90% or more of opioid deaths in the U.S.

In many cases today, community-based first responders have improvised or evolved strategies to cope with fentanyl. Typically, multiple naloxone doses are given to individuals who overdosed on opioids. That was definitely not the case when I was giving naloxone to patients in the Yale emergency department in the 1970s or even back when the opioid crisis was primarily either a prescription-opioid or heroin crisis.

However, it’s unclear whether giving opioid overdose patients more doses sequentially is the optimal strategy in dealing with fentanyl. A very nice study by Strauss suggests it’s a good idea to have higher doses of intranasal naloxone available, as it appears that a large first dose at once is superior to the same dose given sequentially.

Some overdoses might be relatively naloxone-resistant and more easily respond to nalmefene. Additional research is needed to determine the optimal naloxone-dosing schedule for fentanyl overdose reversal. Multi-site studies directly comparing nalmefene to naloxone in the community setting are needed.

Conclusion

More than 1 in 8 Americans have had their lives disrupted by a drug overdose. Nearly 49 million Americans (more than 17%) age 12 and older have a substance use disorder. Among young adults aged 18-25, the share jumps to 28%. More than 6 million people had an opioid use disorder, and another 1.8 million had a methamphetamine use disorder in 2022.

The evolving opioid epidemic has morphed into a counterfeit-pill, multi-drug crisis centered on fentanyl, often paired—knowingly or unknowingly—with other illicit drugs. Smoking fentanyl is the newest opioid crisis or problem we have not prevented.

Overdose deaths are only one measure of the drug epidemic’s severity. An estimated 321,566 children lost a parent to drug overdose between 2011 and 2021.

Since 2000, more than 1.1 million overdose deaths have been reported in the U.S. Overdose reversal with intranasal anti-opioids like naloxone and nalmefene has made a big difference but should not be the centerpiece of opioid crisis strategy. Education and prevention are needed and, as we develop new and better treatments for OUDs, so are overdose reversal and relapse prevention. Some very effective means to reverse opioid overdoses are available today, and future research should provide further information on the best medication and dosages for fentanyl overdose situations.

References

Skolnick P. On the front lines of the opioid epidemic: Rescue by naloxone. Eur J Pharmacol. 2018 Sep 15;835:147-153. doi: 10.1016/j.ejphar.2018.08.004. Epub 2018 Aug 7. PMID: 30092179.

Ellison M, Hutton E, Webster L, Skolnick P. Reversal of Opioid-Induced Respiratory Depression in Healthy Volunteers: Comparison of Intranasal Nalmefene and Intranasal Naloxone. J Clin Pharmacol. 2024 Mar 4. doi: 10.1002/jcph.2421. Epub ahead of print. PMID: 38436495.

Crystal R, Ellison M, Purdon C, Skolnick P. Pharmacokinetic Properties of an FDA-approved Intranasal Nalmefene Formulation for the Treatment of Opioid Overdose. Clin Pharmacol Drug Dev. 2024 Jan;13(1):58-69. doi: 10.1002/cpdd.1312. Epub 2023 Jul 27. PMID: 37496452; PMCID: PMC1081801

Source:  https://www.psychologytoday.com/us/blog/addiction-outlook/202406/the-fentanyl-death-crisis-in-america

Filed under: Addiction,Drug Specifics,Health,USA :

As the workplace evolves, so do the challenges that organizations face in maintaining a safe and productive environment.

 

A Surge in Drug Test Tampering

 

According to Quest Diagnostics’ latest report, the percentage of employees in the general U.S. workforce showing signs of tampered drug tests increased dramatically in 2023. Instances of substituted urine specimens surged by over 600%, while invalid urine specimens rose by 45.2%. These unprecedented numbers indicate a significant increase in efforts to circumvent drug testing protocols.

 

Suhash Harwani, Ph.D., Senior Director of Science for Workforce Health Solutions at Quest Diagnostics, noted, “The increased rate of both substituted and invalid specimens indicates that some American workers are going to great lengths to attempt to subvert the drug testing process.” This trend underscores a growing issue where the normalization of drug use may be influencing employees to believe they can bypass drug tests without considering the consequences for workplace safety.

 

Historic Highs in Drug Positivity Rates

 

The overall drug positivity rate in the general U.S. workforce (those who do not work federally mandated, safety-sensitive positions) remained steady at 5.7% in 2023, maintaining historically high levels. The combined U.S. workforce (general workforce + federal mandated, safety-sensitive positions) also showed a persistent drug positivity rate of 4.6%, the highest in over two decades. Post-accident marijuana positivity has climbed sharply, with an increase of 114.3% between 2015 and 2023.

 

Marijuana Use and Legalization

 

Marijuana positivity tests continued to increase, particularly in states where recreational use is legal. In the general workforce, marijuana positivity increased by 4.7% in 2023, reaching a new peak. Over the past five years, this rate has risen by 45.2%. Despite the decrease in marijuana positivity among federally mandated, safety-sensitive workers, the data suggests that broader legalization might be contributing to increased usage and associated workplace risks.

 

Rising Drug Use in Office-Based Industries

 

Interestingly, the Quest Diagnostics report also highlights a rise in drug positivity rates within traditionally office-based industries. Real estate, lending, professional services, and education sectors all saw significant increases in drug positivity. This trend may reflect the broader impacts of the pandemic, such as increased stress and isolation from work-from-home policies, potentially leading to higher drug use.

 

Sam Sphar, Vice President and General Manager of Workforce Health Solutions at Quest Diagnostics, pointed out the importance of mental health support and drug education programs in these sectors: “The results underscore the growing need for mental health support and drug education programs to ensure employees are safe and productive, whether working at home or in the office.”

 

The Need for Comprehensive Drug Testing Programs

 

The findings from the Quest Diagnostics Drug Testing Index highlight the critical importance of effective drug testing programs. Such programs not only help maintain a safer work environment but also act as a deterrent against drug use. Dr. Harwani noted that the mere expectation of drug testing can dissuade individuals from using drugs or applying for positions where testing is standard practice.

 

In conclusion, as drug use continues to evolve and adapt to societal changes, organizations must remain vigilant. Implementing robust drug testing and support programs is essential to ensure a safe, healthy, and productive workplace.

 

Source: Workforce drug test cheating surged in 2023, finds Quest Diagnostics Drug Testing Index analysis of nearly 10 million drug tests. (2024, May 15). Quest Diagnostics Newsroom. https://newsroom.questdiagnostics.com/2024-05-15-Workforce-Drug-Test-Cheating-Surged-in-2023,-Finds-Quest-Diagnostics-Drug-Testing-Index-Analysis-of-Nearly-10-Million-Drug-Tests

Filed under: Drug use-various effects,Effects of Drugs,USA :

Australia won’t see any cannabis cafes selling brownies anytime soon, despite agreement that the use of marijuana should be prioritised as a health issue.

Eleanor Campbell  

https://www.dailytelegraph.com.au

 

A push to legalise the recreational use of cannabis on a national scale has been knocked back after experts expressed concerns it would lead to more use of the drug among young people.

A Senate committee rejected a bill introduced by Greens senator David Shoebridge on Friday, which calls to allow for cannabis possession for personal use in Australia, as well as the establishment of a national agency to regulate the growing of plants.

After receiving over 200 submissions the committee noted evidence from peak medical bodies including the Australian Medical Association (AMA) that warned wider access could exacerbate health risks, particularly for adolescents.

“Ultimately, the committee is concerned that the legalisation of cannabis for adult recreational use would create as many, if not more, problems than the bill is attempting to resolve,” the report said.

“While endeavouring to do so, the bill does not address several significant concerns, for example, ensuring that children and young people cannot access cannabis (particularly home-grow), managing risky cannabis use, and effective oversight of THC content.”

Multiple countries, including half of all US states have legalised recreational marijuana use. Picture: Ethan Miller/Getty Images/AFP

The committee report noted that the majority of submissions agreed that cannabis use “should be treated first and foremost as a health issue instead of a criminal issue.”

Cannabis remains the most commonly used illicit drug in Australia, according to the latest National Drug Strategy Household Survey, with more than 2.5 million people having used it recently.

In 2019, about 11.7 per cent of people aged 14 years reported having had used the drug at least once it in the past 12 months. The figure was higher for Aboriginal and Torres Strait Islander young people, at 16 per cent.

Under the Greens model, adults in Australia could legally grow six cannabis plants but it would remain a crime to sell the drug to anyone under the age of 18.

The bill also proposes the creation of licensed Amsterdam-style ‘cannabis cafes’ that sell marijuana products, such as edibles.

In his dissenting report, Senator Shoebridge argued the creation of a national cannabis market would generate thousands of jobs and remove “billions” from the black market.

“This inquiry shows clearly how evidence-based and human-centred reforms like this, we will need to break the stranglehold of politics as usual,” he said.

He said despite the committee’s findings the Greens plan to introduce the bill into parliament this year.

Senator Shoebridge claims up to 80,000 Australians could be flushed out of the criminal justice system if his Bill passed. Picture: NewsWire / Martin Ollman.

“The majority report in this inquiry reasonably fairly covers the evidence we had in the inquiry, although it does not detail the hundreds of individual submissions to the inquiry that, almost unanimously, asked us to vote this into law and to finally legalise cannabis,” he added.

Medical cannabis was legalised in Australia in 2016 and last year around 700,000 people reported having used cannabis for medical purposes.

Penalties for illicit use of marijuana, which remains illegal in all states and territories, vary based on jurisdiction.

In NSW, a first-time offender caught with a small amount of cannabis could be issued with a formal caution.

Offenders caught with up to 50 grams of cannabis in Queensland must be first offered a drug diversion program as an alternative to criminal prosecution.

In Western Australia, maximum fines can range from $2,000 to $20,000 and up to two years in prison.

 

Source: NCA NewsWire  June 3, 2024 – 5:10PM

 

Filed under: Australia,Cannabis/Marijuana,Legal Sector,Social Affairs :

The communication below was issued by John Coleman, Chairman of DrugWatch International, to summarise the position with CBD and its legal status, as reported on in May 2020.

The format, as an email, has been retained in this version.

 

From: drug-watch-international@googlegroups.com <drug-watch-international@googlegroups.com> On Behalf Of John J. Coleman, PhD
Sent: 21 May 2020 17:30
To: drug-watch-international@googlegroups.com
Subject: Is CBD a controlled substance? DEA: Yes- FDA: No

 

In April 2020, the FDA approved a labelling for Epidiolex that specifically stated (at sect. 9.1) “EPIDIOLEX is not a controlled substance.” (see attachment). The DEA’s list of controlled substances as of May 2020 shows “APPROVED CANNABIDIOL DRUGS, AS DEFINED IN 21 CFR 1308.15(f)” as Schedule V controlled substance. The Code of Federal Regulations section referred to defines this as: “(f) Approved cannabidiol drugs. (1) A drug product in finished dosage formulation that has been approved by the U.S. Food and Drug Administration that contains cannabidiol (2-[1R-3-methyl- 6R-(1-methylethenyl)-2-cyclohexen-1-yl]-5-pentyl-1,3- benzenediol) derived from cannabis and no more than 0.1 percent (w/w) residual tetrahydrocannabinols.” (See attachment)

 

It should be noted that the scheduling of Epidiolex and CBD was not done in the usual manner by both FDA and DEA performing medical and scientific evaluations and assessments of abuse potential but, instead, the placement of CBD in the Epidiolex formulation is Schedule V was done upon an Order by the Attorney General pursuant to notification by the Secretary of State that the drug is required to be controlled (i.e., scheduled) by virtue of its scheduling status in the 1961 Single Convention on Narcotic Drugs. The U.S. ratified this treaty and, as a result, the Constitution requires that treaty obligations be enforceable as domestic law. The Attorney General could undo the scheduling by simply rescinding his Order or issuing a replacement Order setting forth the removal of CBD and the approved formulation of Epidiolex from Schedule V.

 

I’ve checked the Federal Register and there is nothing indicating that the Attorney General has removed CBD or Epidiolex from Schedule V as of May 20, 2020. I will make additional inquiries to see what’s going on here. The FDA’s label (prescribing information) is a legal certification of an approved drug’s uses and indications – as is the Attorney General’s Order (delegated to DEA) of 9/28/2018, described in 83 FR 48953. (See attachment)

 

John Coleman

Source:  www.drugwatch.org

<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<DEA>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

Links to view the articles related to the above presentation:

First click on the link, then click on the image that appears:

Filed under: Cannabis/Marijuana,Drug Specifics,Legal Sector,USA :

 

 

 

 

April 24, 2024

 

Introductory remarks (shown in italic) added by NDPA (UK) on 19 May 2024:

 

The presentation below is from notable Australian specialists in the field of drug prevention, submitted to the Australian Government. The essence of the presentation is that: “The Australian community deserve a clear picture of all persons whose Mental Health has come to the attention of the police, hospitals and the community.”

 

Although this presentation is addressed to the Australian Government,  Drug Free Australia strongly feel that this information should inform and guide governments worldwide.

 

<<<<<<<<<<<<<<<<<<<<<DFA>>>>>>>>>>>>>>>>>>>>>>

 

When cannabis genotoxicity effects are added to cannabis neurotoxicity effects the argument against the widespread use of cannabis for everything becomes very robust indeed.

 

The drug prevention taskforce outlines below our real concerns regarding the Stabbing rampage at Sydney.  It does appear that here in Australia our State and Federal Medical Department has been testing toxic factors using blood and not using the much better hair test.

 

Most of the cannabis (80-90%) is excreted within 5 days as hydroxylated and carboxylated metabolites. See attached (Chemistry and Toxicology of cannabis).

 

Because 90% of THC is gone in 80 minutes from blood. Please demand hair testing of the subject for marijuana use (blood test may not be positive due to rapid clearance).  This is very indicative of cannabis induced psychosis most of the cannabis (80-90%) is excreted within 5 days as hydroxylated and carboxylated metabolites . There are eighteen acidic metabolites as per Goulle JP, Saussereau E, Lacroix C. [Delta-9-tetrahydrocannabinol pharmacokinetics]. Ann Pharm Fr 2008; 66: 232-244. Studies attached.

 

Drug Free Australia is seeking to bring urgent attention to Australian whether Federal or State, regarding extremely important research relating to Mental Health and cannabis use.  It appears that Australian public policies have moved from concern for the health and wellbeing of society – by improving and promoting good health – to pushing unnecessary drug use for profiteers while charging the tab to society-at-large.  DFA believes that it is time for governments worldwide to promote research and media publicity which avoids the cherry-picked faux studies used by those wanting to legalise cannabis.  Rather, the focus should be on its serious harms to mental and physical health particularly related to early use.

 

TOP 15 RISKS OF MARIJUANA ON HEALTH   https://iasic1.org. The Drug Free Australian paper (MENTAL HEALTH AND CANNABIS USE) see attached.  (A Panel Study of the Effect of Cannabis Use on Mental Health, Depression and Suicide in the 50 States)see attached.

 

EXCLUSIVE: Regular cannabis use in people’s mid-20s can cause permanent damage to the brain development and legalizing the drug has WRONGLY presented it as harmless, drug safety expert Dr Nora Volkow, director of the National Institute on Drug Abuse, warned cannabis use among young adults was a ‘concern’. She called for ‘urgent’ research into the potential health risks of the drug. Several papers have suggested regular use could be damaging mental development and affecting users’ social life

But these often also include people regularly using alcohol and tobacco, making it difficult to deduce whether cannabis is behind the changes. About 48million Americans use cannabis annually, a number that is rising. https://www.dailymail.co.uk/health/article-11138001/Taking-cannabis-mid-20s-damages-cognitive-development-NIH-expert-warns.html

 

1.Prohibition has worked globally for more than 100 years since the UN Drug Conventions began. These have kept illicit drug use down to 5% use worldwide, whereas legalised tobacco and alcohol have much higher rates.

 

  1. Legalising and decriminalizing substances inevitably gives a green light for use (as we have seen with increased use of cannabis in parts of the United States where it has been made legal.

 

  1. Global illicit drug industries are responsible for an enormous amount of environmental destruction

(Illegal Marijuana growers poison forests-these people fight back) https://www.nationalgeographic.com/environment/article/illegal-marijuana-growing-threatens-california-national-forests (Green But Not Green: How Pot Farms Trash the Environment) http://www.slate.com/articles/news_and_politics/uc_breakthroughs_2014/2014/04/green_but_not_green_how_pot_farms_trash_the_environment.html

 

 

RECOMMENDATIONS THAT CAN HELP PREVENT THE AUSTRALIAN “LOST GENERATION DYING”

 

All Australian Governments and community leaders need to take this evidence regarding Mental Health very seriously.  The issue of cannabis-caused violence needs to be addressed. For example, the Australian Government must consider organising several Mental Health teams working 24/7 to evaluate the mental health and wellbeing of those involved in animal cruelty, road rage, spousal abuse and child fatalities. These teams should have the authority to place these individuals into detox and rehabilitation centres for three to twelve months according to their progress. They will also need to be constantly reminded that they are very important to the Australian community’s future.  Here in Queensland, we have one centre available. .and a third that could be built. They could be equipped at minimum cost and run with existing staff for this mental health program.

 

The Australian National Drug Strategy 2017-2026 identifies cannabis as a priority substance for action, noting 20% of Australian drug and alcohol treatment services are provided to people identifying cannabis as their principal drug of concern. DFA believes that the number is higher for those under 25 years of age.

 

Herschel Baker

International Liaison Director,

Queensland Director

Drug Free Australia

M: 0412988835 

Prevent. Don’t Promote Drug Use

drugfreeaust@drugfree.org.au

drugfree@org.au

Joy Butler

President

WCTU

http://www.dfk.com.au/index.html

 

Links to view the articles related to the above presentation:

First click on the link, then click on the image that appears

 

Filed under: Mental Health,Prevention and Intervention :

There are several principal pathways to inheritable genotoxicity, mutagenicity and teratogenesis induced by cannabis which are known and well established at this time including the following. These three papers discuss different aspects of these effects.

1. Stops Brain Waves and Thinking
The brain has both stimulatory and inhibitory pathways.  GABA is the main brain inhibitory pathway. Brain centres talk to each other on gamma (about 40 cycles/sec) and theta frequencies (about 5 cycles/sec), where the theta waves are used as the carrier waves for the gamma wave which then interacts like harmonics in music.  The degree to which the waves are in and out of phase carries information which can be monitored externally.  GABA (γ-aminobutyric acid) inhibition is key to the generation of the synchronized firing which underpins these various brain oscillations. These GABA transmissions are controlled presynaptically by type 1 cannabinoid receptors (CB1R’s) and CB1R stimulation shuts them down. This is why cannabis users forget and fall asleep.

2. Blocks GABA Pathway and Brain Formation
GABA is also a key neurotransmitter in brain formation in that it guides and direct neural stem cell formation and transmission and development and growth of the cerebral cortex and other major brain areas. Gamma and theta brain waves also direct neural stem cell formation, sculpting and connectivity. Derangements then of GABA physiology imply that the brain will not form properly.  Thin frontal cortical plate measurements have been shown in humans prenatally exposed to cannabis by fMRI. This implies that their brains can never be structurally normal which then explains the long lasting and persistent defects identified into adulthood.

3. Epigenetic Damage
DNA not only carries the genetic hardware of our genetic code but it also carries the software of the code which works like traffic lights along the sequence of DNA bases to direct when to switch the genes on and off. This is known as the “epigenetic code”. Fetal alcohol syndrome is
believed to be due to damage to the software epigenetic code. The long lasting intellectual, mood regulation, attention and concentration defects which have been described after in utero cannabis exposure in the primary, middle and high schools and as college age young adults
are likely due to these defects. Epigenetics “sets in stone” the errors of brain structure made in (2) above.

4. Arterial Damage
Cannabis has a well described effect to damage arteries through (CB1R’s) (American Heart Association 2007) which they carry in high concentration (Nature Reviews Cardiology 2018). In adults this causes heart attack (500% elevation in the first hour after smoking), stroke,
severe cardiac arrhythmias including sudden cardiac death; but in developing babies CB1R’s acting on the developing heart tissues can lead to at least six major cardiac defects (Atrial- ventricular- and mixed atrioventricular and septal defects, Tetralogy of Fallot, Epstein’s deformity amongst others), whilst constriction of various babies’ arteries can lead to serious side effects such as gastroschisis (bowels hanging out) and possibly absent limbs (in at least one series).

5. Disruption of Mitotic Spindle
When cells divide the separating chromosomes actually slide along “train tracks” which are long chains made of tubulin. The tubulin chains are called “microtubules” and the whole football-shaped structure is called a “mitotic spindle”. Cannabis inhibits tubulin formation,
disrupting microtubules and the mitotic spindle causing the separating chromosomes to become cut off in tiny micronuclei, where they eventually become smashed up and pulverized into “genetic junk”, which leads to foetal malformations, cancer and cell death. High rates of
Down’s syndrome, chromosomal anomalies and cancers in cannabis exposed babies provide clinical evidence of this.

6. Defective Energy Generation & Downstream DNA Damage
DNA is the crown jewel of the cell and its most complex molecule. Maintaining it in good repair is a very energy intensive process. Without energy DNA cannot be properly maintained. Cannabis has been known to reduce cellular energy production by the cell’s power plants,
mitochondria, for many decades now. This has now been firmly linked with increased DNA damage, cancer formation and aging of the cells and indeed the whole organism. As it is known to occur in eggs and sperm, this will also damage the quality of the germ cells which go into forming the baby and lead directly to damaged babies and babies lost and wasted through spontaneous miscarriage and therapeutic termination for severe deformities.

7. Cancer induction
Cannabis causes 12 cancers and has been identified as a carcinogen by the California Environmental Protection agency (2009). This makes it also a mutagen. 4 of these cancers are inheritable to children; i.e. inheritable carcinogenicity and mutagenicity. All four studies in
testicular cancer are strongly positive (elevation by three fold). Carcinogen = mutagen = teratogen.

8. Colorado’s Teratology Profile
From the above described teratological profile we would expect exactly the profile of congenital defects which have been identified in Colorado(higher total defects and heart defects, and chromosomal defects) and Ottawa in Canada (long lasting and persistent brain
damage seen on both functional testing and fMRI brain scans in children exposed in utero) where cannabis use has become common. Gastroschisis was shown to be higher in all seven studies looking at this; and including in Canada, carefully controlled studies. Moreover in
Australia, Canada, North Carolina, Colorado, Mexico and New Zealand, gastroschisis and sometimes other major congenital defects cluster where cannabis use is highest. Colorado 2000-2013 has experienced an extra 20,152 severely abnormal births above the rates prior to
cannabis liberalization which if applied to the whole USA would equate to more than 83,000 abnormal babies live born annually (and probably about that number again therapeutically aborted); actually much more since both the number of users and concentration of cannabis have risen sharply since 2013, and cannabis has been well proven to be much more severely genotoxic at higher doses.

9. Cannabidiol is also Genotoxic
Cannabidiol tests positive in many genotoxicity assays, just as tetrahydrocannabinol does.

10. Births defects registry data needs to be open and transparent and public.
At present it is not. This looks too much like a cover up.

 

Source:  By Professor Dr. A. S Reece
(Edith Cowan University & University of Western Australia) 2019

 

 

Filed under: Drug use-various effects,Genes,Health :

Back to top of page

Powered by WordPress