2024 November

This is an exchange on Drug Watch International with questions from Roger Morgan and responses from Dr Stuart Reece (in bold italics)

Hi Stuart

In reflecting on the studies referred to by Peggy Mann from 40 or 50 years ago, combined with your recent research, I believe we need to do some more research.  I have the following questions:

  1. What is involved evaluating the chromosomes in cells of humans?  Do you take a chunk of flesh, or ???? No.  Would most universities have the capability to do this? No.

If you wanted to do this properly studies would involve the following.  I think they need to be detailed and extensive in view of the now massive populations risks which are presented.  You are actually talking about something which may be devastating – if 12% of Coloradan babies are impact PRIOR to legalization then “Houston, Houston we have a problem…  This is Apollo 13 calling.”

  1. Cell culture studies – many cells, neurons, sperm and eggs, gut cells skin cells
  2. Several species – white rabbit and hamsters model humans best.
  3. Human cell lines – many
  4. Human cells – skin cells, cheek cells, transformed white blood cells – lymphoblastoid cells – EBV infected lymphocytes taken from blood samples
  5. Human sperm
  1. A key change would be to apply next generation sequencing to these cells and tissues so:
    1. DNA
    2. RNA
    3. Proteins
    4. DNA methylation
    5. Histone changes – nuclear proteins looking for
    6. Epigenetic changes
    7. Epitranscriptomic changes
    8. Metabolome changes
    9. The interaction between the metabolome and the epigenome
    10. Profile the immune change including cytokines in detail – these are very important and far reaching and cause aging and germ cell damage – cytokines – TH17 cells etc…
    11. Compare the immune and growth factor changes seen in cannabis exposed patients with old folks and compare the way they reproduce clinical aging.
  1. Look at pregnancies prospectively.  Look at the sperm of males – sequence them do genetic and epigenetic studies.  Then study their babies and see if they carry the same abnormalities after birth…  See how the correlate with the various congenital anomalies.

2)  What are the implications if the cannabis consumers only have half of the 46 chromosomes that are normal in humans?  Not true.  Physical and mental abnormalities in offspring …. and future generations?..   Chromosomal anomalies will do this yes – and chromosomal shattering processes which cannabis can induce.  Cannabis changes cell division process causing chromosomal shattering and also epigenetic changes – changes in the signalling along the DNA on how the genes are used and expressed.

3)  Will the chromosome levels return to normal if a person quits consuming cannabis?   Short answer – not studied yet.

Long answer – yes I think there will be a degree of repair.  However I also think it is unlikely ever to return to normal. Especially after heavy use because some of the epigenetic imprinting is permanent – obviously from studies which have been done.

4)  Cannabis is known to cause mutations to sperm and ova which can affect a fetus even before pregnancy.  If they stop using, will everything return to normal?  Same as above. Serious concerns.  Depends on level of exposure.  Depends on time between cannabis and making babies…   I do not mean to imply that one or two joints as a young person and babies ten years later is bad.  Nothing suggests that.  But heavy cannabis use such as we are seeing more and more if – and Deborah Hasin from Mailman School of Public Health  in 2017 said USA has an extra 500,000 of in legal states – that is a big problem for later reproduction.

I think the evidence that young people of reproductive age should not go near cannabis for genotoxic reasons is now very strong indeed, and so too do all of my collaborators including my biostatistical friends.

Consider:

  1. 12.6% of Coloradan had major congenital anomalies in 2013 PRIOR to legalization
  2. The rate of cannabis use by people over 12 years in Colorado was 14% in 2013
  3. The rate of cannabis use by all pregnant women in California in 2015 was 8% on testing
  4. The rate of cannabis use by mothers less than 20 years in California was 24% in 2015.

So about as many babies are being born deformed AS ARE BEING EXPOSED TO CANNABIS.

So clearly a very high percentage of cannabis exposed babies are experiencing major congenital anomalies.

This should send shivers down our spine – not only that cannabis use is rolling out but that cannabis use is aimed primarily at young adults the very group who should be keeping well away from it.

We need to define these risks much better at the population level by careful studies.

Sperm would be easy to collect and study and define and then correlate with subsequent foetal outcomes.

Thanks and God bless – and spare us all,

Stuart.

Source: Email to Drug Watch International www.drugwatch.org April 2018

 – PERSPECTIVE

 CO-AUTHORS:

Albert Stuart Reece1,2 | Gary Kenneth Hulse1,2
1University of Western Australia, Crawley,
Western Australia, Australia

2School of Health Sciences, Edith Cowan
University, Joondalup, Western Australia,
Australia

Correspondence:
Albert Stuart Reece, University of Western
Australia, 35 Stirling Hwy, Crawley, WA 6009,
Australia.
Email: stuart.reece@uwa.edu.au

ABSTRACT:

Whilst mitochondrial inhibition and micronuclear fragmentation are well established
features of the cannabis literature mitochondrial stress and dysfunction has recently
been shown to be a powerful and direct driver of micronucleus formation and chromosomal
breakage by multiple mechanisms. In turn genotoxic damage can be
expected to be expressed as increased rates of cancer, congenital anomalies and
aging; pathologies which are increasingly observed in modern continent-wide studies.
Whilst cannabinoid genotoxicity has long been essentially overlooked it may in fact
be all around us through the rapid induction of aging of eggs, sperm, zygotes, foetus
and adult organisms with many lines of evidence demonstrating transgenerational
impacts. Indeed this multigenerational dimension of cannabinoid genotoxicity
reframes the discussion of cannabis legalization within the absolute imperative to
protect the genomic and epigenomic integrity of multiple generations to come.

KEYWORDS:   cannabis, chromothripsis, micronucleus


MAIN ARTICLE TEXT:

Recent papers in Science provide penetrating and far-reaching insights
into the mechanisms underlying micronuclear rupture a key genotoxic
engine identified in many highly malignant tumours.1,2 Reactive
oxygen species (ROS) generated either by damaged mitochondria or
the hypoxic tumour microenvironment were shown to damage micronuclear
envelopes, which made them more sensitive to membrane
rupture. Damage occurred by both increased susceptibility to membrane
rupture and impaired membrane repair. Micronuclear rupture is
known to be associated with downstream chromosomal shattering,
pan-genome genetic disruption by chromothripsis, widespread epigenetic
dysregulation and cellular ageing. Clinical expressions of genotoxicity
are expected to appear as cancer, birth defects and ageing.
CHMP7 (charge multivesicular body protein 7) oxidation caused
heterodimerization by disulphide crosslinking and aberrant crosslinking
with membrane bound LEMD2 (LEM-domain nuclear envelope
protein 2) inducing membrane deformation and collapse. ROS-CHMP7
directly induced chromosomal shattering. Oxidized CHMP7 bound
covalently to the membrane repair scaffolding protein ESCRT-III
(endosomal sorting complex required for transport–III). ROS triggered
homo-oligomerization of the autophagic receptor p62/sequestome
re-routing the CMPH7-ESCRT-III complex away from membrane
repair into macroautophagy via the autophagosome and microautophagy
via lysozomes.1–3 Expected downstream consequences of
micronuclear rupture including chromosomal fragmentation, chromothripsis
and cGAS-STING (cyclic adenosine-guanosine synthase–
stimulator of interferon signalling) activation were demonstrated.
Cancer-related innate inflammation is known to drive tumour progression
and distant metastasis. These principles were tested both in normal
and also numerous malignant (including head and neck squamous,
cervical, gastric, ovarian and colorectal cancers) cell lines.1,2 Similar
processes including DNA damage and epigenomic derangements have
also been identified in TH1-lymphocytes during fever indicating that
mitochondriopathic-genotoxic mechanisms may in fact be widespread
and fundamental.4


Received: 26 September 2024 Accepted: 26 September 2024
DOI: 10.1111/adb.70003
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.


 

Addiction Biology. 2024;29:e70003. wileyonlinelibrary.com/journal/adb
https://doi.org/10.1111/adb.70003


Cannabis has been known to be linked with both micronuclear
development and mitochondrial inhibition for many decades.5,6
All cannabinoids have been implicated in genotoxicity as the moiety
identified as damaging the genetic material is the central olivetol
nucleus on the C-ring itself.7 This finding implicates Δ8-, Δ9-, Δ10-,
Δ11-tetrahydrocannabinol, cannabigerol, cannabidiol and cannabinol
amongst all other cannabinoids.
Historically, the cancer-cannabis link has been controversial. Differing
results in published studies may be attributed to various factors
including multiple exposures (including tobacco), differences in
study design and the rapid rise of cannabis potency. One often quoted
study actually specifically excluded high level cannabis exposure, which
would now appear to have been a major methodological limitation.8 It
is widely documented that there has been a sharp increase in cannabis
concentration from the 1970s to the present day. THC concentrations
of 25%–30% are commonly noted in cannabis herb and flower sold
commercially, and 100% THC concentrations are well known for cannabinoid
based products such as dabs, waxes and ‘shatter’.
In this context, the recent appearance of a series of continentwide
epidemiological, space–time and causal inferential studies in
both Europe and North America is notable for many positive signals
for various cancers including breast, pancreas, liver, AML, thyroid, testis,
lymphoma, head and neck squamous cancer, total childhood cancer
and childhood ALL.9–15 The literature on cannabis and testicular
cancer is almost uniformly positive and has a relative risk of around
2.6-fold,16 this risk factor is now widely acknowledged17–19 and the
effect is quite fast since the median age of exposure may be about
20 years and the median age of testis cancer incidence is only
31 years. Testicular cancer is the adult cancer responsible for the most
years of life lost.17,18,20,21 The inclusion of several childhood cancers
in association with cannabis exposure obviously implicates transgenerational
transmission of malignant mutagenesis.
An intriguing finding in the case report literature is that in many
cases, cancers occur decades earlier and are very aggressive at diagnosis.
22 Mechanisms such as the synergistic mitochondriopathic–
micronuclear axis presently proposed in the recent Science papers1–4
may directly explain this very worrying observation.
Whilst cancer is thought to be a rare outcome amongst cannabis
exposed individuals, ageing effects are not. A dramatic acceleration
of cellular epigenetic age by 30% at just 30 years was recently
reported23 with indications this effect likely rises with age,24 and
the demonstration that cannabis exposed patients had adverse
outcomes across a wide range of physical and mental health outcomes
including myocardial infarction and emergency room presentations.
25 Importantly, the ageing process itself has been shown to
be due to redistribution of the epigenetic machinery in such a manner
as to produce dysregulation (and widespread reduction) of gene
expression and to be inducible by limited genetic damage resulting
from just a handful of DNA breaks.26 Extremely worryingly, agerelated
morphological changes have been described in both oocytes
and sperm.27,28
Epidemiological studies of European and American cannabiscancer
links are supported by epidemiological, space–time and causal
inferential studies of links between cannabis and congenital
anomalies.29–33 Reported congenital anomalies are clustered in the
cardiovascular, neurological, limb, chromosomal, urogenital and gastrointestinal
systems. The fact that all five chromosomal anomalies
studied here are represented in this list, notwithstanding their high
rate of known foetal loss, is strong evidence for chromosomal misegregation
during germ cell meiosis, which is the genetic precursor to
micronucleus development.34,35 The fact that almost identical results
were reported in both the United States and Europe provides strong
external validation to these findings.30
This is consistent with recent press reports of dramatic increases
in babies and calves born without limbs in both France and
Germany36,37 raising the public health spectre of downstream implications
of food chain contamination. Melbourne, Australia, is a multiethnic
city, which heads the global leaderboard for babies born with
the serious limb anomalies amelia and phocomelia.37–40 This pattern
of elevated rates of major birth defects is not seen in the host nations
from which these migrant populations are derived. Cannabis farms are
increasingly common around Melbourne, just as they are in the
French province of Ain, which has similar concerns.37,41–43
Major epigenetic changes have been found in human sperm,44
which have also been identified in exposed rodent offspring.44–46
Indeed, 21 of the 31 congenital anomalies described following prenatal
thalidomide exposure have also been observed epidemiologically
following prenatal cannabis exposure and 12 of 13 cellular pathways
by which thalidomide operates have been similarly identified in the
cannabis mechanistic literature.47 Both human and rodent epigenomic
studies44–46 and epidemiological studies show that adult cannabis
exposure is linked with the incidence of autism48–53 and cerebral processing
difficulties54–57 in children prenatally exposed. Together, this
data is clear and robust evidence for the transgenerational transmission
of major genotoxic outcomes.
Notwithstanding the well-known ambiguities in the epidemiological
literature for cannabis, it is clear from the above brief overview
that there is strong and compelling evidence that cannabis genotoxic
outcomes are well substantiated and form a remarkably congruent
skein of interrelated evidence across all three domains of genotoxic
pathology including cancer, congenital anomalies and ageing.
So too compelling epidemiological, morphological and epigenetic
evidence of transgenerational transmission of cannabinoid genotoxicity
to foetus, egg, sperm and offspring carries far reaching and
transformative implications and indeed reframes the discussion surrounding
cannabis legalization from merely personal-hedonistic to the
protection of the national genomic integrity for multiple subsequent
generations.
The present time therefore represents a watershed moment.
The new profoundly insightful studies from Science point the way and
provide the trigger. Clearly, there is a great need for a new
and updated cohort of epidemiological studies on these issues at the
population level in the modern context of the widespread availability
of much more potent cannabinoid preparations.
However, our first responsibility is to act on the evidence we do
have. Given the uniform picture painted by data from myriad directions.

It can be said that the evidence for cannabinoid genotoxicity
is at once so clinically significant, robust and compelling as to constitute
a resounding clarion call to action: The only outstanding
question is ‘Will we rise to the challenge?’


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CONFLICT OF INTEREST STATEMENT:
The authors declare no conflicts of interest.

ORCID:
Albert Stuart Reece https://orcid.org/0000-0002-3256-720X

REFERENCES

1. Di Bona M, Chen Y, Agustinus AS, et al. Micronuclear collapse from
oxidative damage. Science. 2024;385(6712):eadj8691. doi:10.1126/
science.adj8691
2. Martin S, Scorzoni S, Cordone S, et al. A p62-dependent rheostat
dictates micronuclei catastrophe and chromosome rearrangements.
Science. 2024;385(6712):eadj7446. doi:10.1126/science.adj7446
3. Maddaluno M, Settembre C. Micronuclear collapse mechanisms in
cancer. Science. 2024;385(6712):930-931. doi:10.1126/science.
adr7417
4. Heintzman DR, Sinard RC, Fisher EL, et al. Subset-specific mitochondrial
stress and DNA damage shape T cell responses to fever and
inflammation. Sci Immunol. 2024;9(99):eadp3475. doi:10.1126/
sciimmunol.adp3475
5. Sarafian TA, Kouyoumjian S, Khoshaghideh F, Tashkin DP, Roth MD.
Delta 9-tetrahydrocannabinol disrupts mitochondrial function and cell
energetics. Am J Physiol. 2003;284(2):L298-L306. doi:10.1152/
ajplung.00157.2002
6. Hall W, Degenhardt L. Adverse health effects of non-medical cannabis
use. Lancet. 2009;374(9698):1383-1391. doi:10.1016/S0140-
6736(09)61037-0
7. Nahas GG, Morishima A, Desoize B. Effects of cannabinoids on
macromolecular synthesis and replication of cultured lymphocytes.
Fed Proc. 1977;36(5):1748-1752.
8. Hashibe M, Morgenstern H, Cui Y, et al. Marijuana use and the risk of
lung and upper aerodigestive tract cancers: results of a populationbased
case-control study. Cancer Epidemiol Biomarkers Prev. 2006;
15(10):1829-1834. doi:10.1158/1055-9965.EPI-06-0330
9. Reece AS, Hulse GK. Geotemporospatial and causal inferential epidemiological
overview and survey of USA cannabis, Cannabidiol and
cannabinoid genotoxicity expressed in cancer incidence 2003–2017:
part 3—spatiotemporal, multivariable and causal inferential pathfinding
and exploratory analyses of prostate and ovarian cancers.
Arch Public Health. 2022;80(1):100-136. doi:10.1186/s13690-022-
00812-7
10. Reece AS, Bennett K, Hulse GK. Cannabis- and substance-related carcinogenesis
in Europe: a lagged causal inferential panel regression
study. J Xenobiotics. 2023;13:323-385. doi:10.3390/jox13030024
11. Reece AS, Hulse GK. In: BMartin CR, Preedy V, Patel V, eds.
Cannabis, Cannabinoids and Endocannabinoids. Vol 1. chap. 5. Elsevier;
2023:570.
12. Reece AS, Hulse GK. Geotemporospatial and causal inferential epidemiological
overview and survey of USA cannabis, cannabidiol and cannabinoid
genotoxicity expressed in cancer incidence 2003–2017: part
1—continuous bivariate analysis. Arch Public Health. 2022;80:99-133.
13. Reece AS, Hulse GK. Geotemporospatial and causal inferential epidemiological
overview and survey of USA cannabis, cannabidiol and
cannabinoid genotoxicity expressed in cancer incidence 2003–2017:
part 2—categorical bivariate analysis and attributable fractions. Arch
Public Health. 2022;80(1):100-135. doi:10.1186/s13690-022-
00812-7
14. Reece AS, Hulse GK. Cannabinoid exposure as a major driver of pediatric
acute lymphoid Leukaemia rates across the USA: combined
geospatial, multiple imputation and causal inference study. BMC Cancer.
2021;21(1):984-1017. doi:10.1186/s12885-021-08598-7
15. Baranger DAA, Paul SE, Colbert SMC, et al. Association of Mental
Health Burden With Prenatal Cannabis. Exposure from childhood to
early adolescence: longitudinal findings from the Adolescent Brain
Cognitive Development (ABCD) study. JAMA Pediatr. 2022;176(12):
1261-1265. doi:10.1001/jamapediatrics.2022.3191
16. Gurney J, Shaw C, Stanley J, Signal V, Sarfati D. Cannabis exposure
and risk of testicular cancer: a systematic review and meta-analysis.
BMC Cancer. 2015;15(1):897-906. doi:10.1186/s12885-015-1905-6
17. Ghasemiesfe M, Barrow B, Leonard S, Keyhani S, Korenstein D. Association
between marijuana use and risk of cancer: a systematic review
and meta-analysis. JAMA Netw Open. 2019;2(11):e1916318-
e1916332. doi:10.1001/jamanetworkopen.2019.16318
18. Hanna NH, Einhorn LH. Testicular cancer—discoveries and updates. N
Engl J Med. 2014;371(21):2005-2016. doi:10.1056/NEJMra1407550
19. McGlynn KA, Trabert B. Adolescent and adult risk factors for testicular
cancer. Nat Rev Urol. 2012;9(6):339-349. doi:10.1038/nrurol.
2012.61
20. Reece AS, Hulse GK. State trends of cannabis liberalization as a causal
driver of increasing testicular cancer rates across the USA. Int J Environ
Res Public Health. 2022;19(19):12759-12796. doi:10.3390/
ijerph191912759
21. Reece AS, Hulse GK. Causal inference multiple imputation investigation
of the impact of cannabinoids and other substances on ethnic
differentials in US testicular cancer incidence. BMC Pharmacol Toxicol.
2021;22(1):40-71. doi:10.1186/s40360-021-00505-x
22. Donald PJ. Marijuana smoking—possible cause of head and neck carcinoma
in young patients. Otolaryngol Head Neck Surg. 1986;94(4):
517-521. doi:10.1177/019459988609400420
23. Allen JP, Danoff JS, Costello MA, et al. Lifetime marijuana use and
epigenetic age acceleration: a 17-year prospective examination. Drug
Alcohol Depend. 2022;233:109363. doi:10.1016/j.drugalcdep.2022.
109363
24. Reece AS, Norman A, Hulse GK. Cannabis exposure as an interactive
cardiovascular risk factor and accelerant of organismal ageing: a longitudinal
study. BMJ Open. 2016;6(11):e011891-e011901. doi:10.
1136/bmjopen-2016-011891
25. Phillips KT, Pedula KL, Choi NG, et al. Chronic health conditions,
acute health events, and healthcare utilization among adults over
age 50 in Hawai’i who use cannabis: a matched cohort study. Drug
Alcohol Depend. 2022;234:109387. doi:10.1016/j.drugalcdep.2022.
109387
26. Yang JH, Hayano M, Griffin PT, et al. Loss of epigenetic information
as a cause of mammalian aging. Cell. 2023;186(2):305-326.e327. doi:
10.1016/j.cell.2022.12.027
27. Morishima A. Effects of cannabis and natural cannabinoids on chromosomes
and ova. NIDA Res Monogr. 1984;44:25-45.
28. Huang HFS, Nahas GG, Hembree WC. In: Nahas GG, Sutin KM,
Harvey DJ, Agurell S, eds. Marijuana in Medicine. Vol 1. chap. 28.
Human Press Totowa; 1999:359-366.
29. Reece AS, Hulse GK. Cannabinoid- and substance-relationships of
European congenital anomaly patterns: a space-time panel regression
and causal inferential study. Env Epigen. 2022;8(1):1-40. doi:10.1093/
eep/dvab015
30. Reece AS, Hulse GK. In: Martin CR, Preedy V, Patel V, eds.
Cannabis, Cannabinoids and Endocannabinoids. Vol 1. chap. 5. Elsevier;
2022:570.
31. Reece AS, Hulse GK. Effects of cannabis on congenital limb anomalies
in 14 European nations: a geospatiotemporal and causal inferential
study. Env Epigen. 2022;8(1):1-34. doi:10.1093/eep/dvac016
32. Reece AS, Hulse GK. Geotemporospatial and causal inference epidemiological
analysis of US survey and overview of cannabis,
REECE and HULSE 3 of 4
13691600, 2024, 11, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/adb.70003 by National Health And Medical Research Council, Wiley Online Library on [14/11/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
cannabidiol and cannabinoid genotoxicity in relation to congenital
anomalies 2001–2015. BMC Pediatr. 2022;22(1):47-124. doi:10.
1186/s12887-021-02996-3
33. Reece AS, Hulse GK. European epidemiological patterns of cannabisand
substance- related congenital cardiovascular anomalies: geospatiotemporal
and causal inferential study. Env Epigen. 2022;8(1):1-55.
doi:10.1093/eep/dvac015
34. Reece AS, Hulse GK. Epidemiological overview of multidimensional
chromosomal and genome toxicity of cannabis exposure in congenital
anomalies and cancer development. Sci Rep. 2021;11:13892-13912.
35. Reece AS, Hulse GK. Cannabis- and substance-related epidemiological
patterns of chromosomal congenital anomalies in Europe: geospatiotemporal
and causal inferential study. Int J Environ Res Public
Health. 2022;19(18):11208-11258. doi:10.3390/ijerph191811208
36. Robinson M., C. Health, Ed. (CNN News, 2019), vol. 2019. Agence
France-Presse in Paris, France to investigate cause of upper limb
defects in babies. The Guardian 2018.
37. Bermejo-Sánchez E, Cuevas L, Amar E, et al. Amelia: a multi-center
descriptive epidemiologic study in a large dataset from the International
Clearinghouse for Birth Defects Surveillance and Research, and
overview of the literature. Am J Med Genet C Semin Med Genet. 2011;
157C(4):288-304. doi:10.1002/ajmg.c.30319
38. Bermejo-Sánchez E, Cuevas L, Amar E, et al. Phocomelia: a worldwide
descriptive epidemiologic study in a large series of cases from the
International Clearinghouse for Birth Defects Surveillance and
Research, and overview of the literature. Am J Med Genet C Semin
Med Genet. 2011;157C:305-320.
39. Reece AS. Limblessness: cannabinoids inhibit key embryonic morphogens
both directly and Epigenomically. Br Med J. 2022;376:n3114.
40. Reece AS, Hulse GK. Epidemiological association of cannabinoid- and
drug- exposures and sociodemographic factors with limb reduction
defects across USA 1989–2016: a geotemporospatial study. Spat
Spatio-Temp Epidemiol. 2022;41:100480-100490. doi:10.1016/j.sste.
2022.100480
41. Connexion Journalist, Mayor wants to grow and sell cannabis in
French fields. 2018.
42. Willsher K., Baby arm defects prompt nationwide investigation in
France. Guardian 2018.
43. Le Figaro with AFP, Ain: seizure of 135kg of cannabis. Le Figaro 2018.
44. Schrott R, Murphy SK, Modliszewski JL, et al. Refraining from use
diminishes cannabis-associated epigenetic changes in human sperm.
Env Epigen. 2021;7(1):1-10. doi:10.1093/eep/dvab009
45. Schrott R, Greeson KW, King D, Symosko Crow KM, Easley CA IV,
Murphy SK. Cannabis alters DNA methylation at maternally imprinted
and autism candidate genes in spermatogenic cells. Syst Biol Reprod
Med. 2022;68(5-6):357-369. doi:10.1080/19396368.2022.2073292
46. Schrott R, Modliszewski JL, Hawkey AB, et al. Sperm DNA methylation
alterations from cannabis extract exposure are evident in offspring. Epigen
Chromatin. 2022;15(1):33. doi:10.1186/s13072-022-00466-3
47. Reece AS, Hulse GK. Chapter 3: geospatiotemporal and causal inferential
analysis of United States congenital anomalies as a function of
multiple cannabinoid- and substance- exposures: phenocopying thalidomide
and hundred megabase-scale genotoxicity. In: Reece AS,
Hulse GK, eds. Epidemiology of Cannabis: Genotoxicity and Neurotoxicity,
Epigenomics and Aging. Vol 1. Elsevier; 2025:1-570.
48. Reece AS, Hulse GK. Epidemiological associations of various substances
and multiple cannabinoids with autism in USA. Clin Pediatr:
Open Acc. 2019;4:1-20.
49. Reece AS, Hulse GK. Effect of cannabis legalization on US autism
incidence and medium term projections. Clin Pediatr: Open Acc. 2019;
4:1-17.
50. Reece AS, Hulse GK. Impact of converging sociocultural and
substance-related trends on US autism rates: combined geospatiotemporal
and causal inferential analysis. Eur Arch Psychiat Clin Neurosci.
2022;19:7726-7752.
51. Corsi DJ, Donelle J, Sucha E, et al. Maternal cannabis use in pregnancy
and child neurodevelopmental outcomes. Nat Med. 2020;
26(10):1536-1540. doi:10.1038/s41591-020-1002-5
52. Brents L. In: Preedy VR, ed. Handbook of Cannabis and Related Pathologies:
Biology, Pharmacology, Diagnosis and Treatment. Vol 1. chap. 17.
Academic Press; 2017:160-170.
53. Paul SE, Hatoum AS, Fine JD, et al. Associations between
prenatal cannabis exposure and childhood outcomes: results from the
ABCD study. JAMA Psychiat. 2021;78(1):64-76. doi:10.1001/
jamapsychiatry.2020.2902
54. Fried PA, Watkinson B, Gray R. Neurocognitive consequences of
marihuana—a comparison with pre-drug performance. Neurotoxicol
Teratol. 2005;27(2):231-239. doi:10.1016/j.ntt.2004.11.003
55. Smith AM, Fried PA, Hogan MJ, Cameron I. Effects of prenatal marijuana
on visuospatial working memory: an fMRI study in young
adults. Neurotoxicol Teratol. 2006;28(2):286-295. doi:10.1016/j.ntt.
2005.12.008
56. Smith AM, Longo CA, Fried PA, Hogan MJ, Cameron I. Effects of marijuana
on visuospatial working memory: an fMRI study in young
adults. Psychopharmacol (Berl). 2010;210(3):429-438. doi:10.1007/
s00213-010-1841-8
57. Smith AM, Mioduszewski O, Hatchard T, Byron-Alhassan A, Fall C,
Fried PA. Prenatal marijuana exposure impacts executive functioning
into young adulthood: an fMRI study. Neurotoxicol Teratol. 2016;58:
53-59. doi:10.1016/j.ntt.2016.05.010
How to cite this article: Reece AS, Hulse GK. Key insights into
cannabis-cancer pathobiology and genotoxicity. Addiction
Biology. 2024;29(11):e70003. doi:10.1111/adb.70003

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The martial language used by the government when presenting its plan to combat drug trafficking cannot mask the wide blind spots in its announcements, particularly in terms of health and social issues.

Published in Le Monde on November 9, 2024, at 12:46 pm (Paris), updated on November 9, 2024, at 2:14 pm 2 min read Lire en français

Gang warfare in a growing number of towns, repeated shootings punctuated by the deaths of ever-younger teenagers, drug traffickers with increased financial power and influence operating even from their prison cells… There can be little doubt that France, like other European countries, is grappling with the scourge of drugs on an unprecedented level. Criminal groups thrive on an illicit market estimated at over €3.5 billion, posing an ever-growing threat to the lives of entire neighborhoods, to public health and even to democracy.

Asymmetrical and unequal, the battle between drug traffickers prepared to do anything and a democracy based on the rule of law requires institutions and procedures to be strengthened and adapted. The announcements made in Marseille on Friday, November 8, by Interior Minister Bruno Retailleau and Justice Minister Didier Migaud are a step in this direction: The creation of a “national prosecutor” to combat organized crime, which would be subject to special criminal courts composed solely of magistrates to avoid pressure on juries. The system will also be improved for criminals who accept to collaborate with the justice system. Both of these procedures are among the logical proposals inspired by a Senate bill resulting from an inquiry commission report published in May, as well as by the former justice minister Eric Dupond-Moretti’s work.

There are, however, some grey areas surrounding this legislative measure, which is scheduled for parliamentary review in 2025, notably as regards the precise scope of the new prosecutor and the expansion of the current anti-drug office. As for the immediate measures announced on Friday, they remain imprecise, both in terms of the reinforcement of the Paris prosecutor’s office, to which a “coordination unit” would be attached, and the resources devoted to scrambling the telephone conversations of prisoners at the “top end” of the criminal spectrum, who would be assigned to specialized prison quarters.

Concrete action needed

But the martial language used by the two ministers to demonstrate their willingness to “join forces” over and above their political differences, cannot mask the blind spots in their announcements. Significantly, the health minister was not consulted. Information on addiction, risk reduction for drug users and providing care for people addicted to drugs are a few examples of these blind spots.

Cracking down on trafficking and putting pressure on the supply of illicit substances are essential, but they cannot be effective unless they are accompanied by strong action on demand and without a debate, informed by other countries, on the benefits and risks of partial decriminalization. At a time when consumption is becoming commonplace in many circles, from the most disadvantaged to the most privileged, public authorities should also strive to build and disseminate a counter-narrative to that of social ascent through trafficking.

A real “national cause,” the battle against drug trafficking requires France to build the conditions, if not for a consensus, at least for a political majority. This requires not only the addition of a strong preventive component but also that the government distances itself from the interior minister’s constant conflation of drugs and immigration.

Source: https://www.lemonde.fr/en/opinion/article/2024/11/09/france-s-drug-problem-both-repression-are-prevention-are-needed_6732224_23.html

 Supporters of psilocybin expressed dismay at the bans after thousands of people reported benefits from using the psychedelic drug

Oregon Capital Chronicle, November 7, 2024- by Ben Botkin and Lynne Terry.

                                 Image: PIXABAY

 Voters in more than a dozen Oregon cities, including in the Portland area, voted to ban the regulated sales and use of psilocybin mushrooms.

Anti-psilocybin measures were on the ballots in 16 cities and unincorporated Clackamas County, and are passing in coastal communities to urban Portland and central and southern Oregon by 55% to 70% of the vote.

Bans against psilocybin businesses are passing in  Brookings, Rogue River, Sutherlin, Redmond, Lebanon, Jefferson, Sheridan, Amity, Hubbard, Mount Angel, Estacada, Oregon City, Lake Oswego, Seaside and Warrenton. Redmond’s measure would enact a two-year moratorium on psilocybin businesses.

There was one notable outlier. The measure to ban psilocybin could fail in Nehalem, a small community in Tillamook County, according to initial returns. But it is failing by only three votes. The unofficial results on Wednesday were close: 80 voters oppose the ban and 77 voters support.

Comment was not immediately available from psilocybin opponents. Supporters of the drug expressed disappointment with the results Wednesday.

“I think it’s really unfortunate that local communities, often rural communities continue to prevent access to psilocybin services, especially given that we’ve seen over 7,000 people go through the Oregon program, and there’s been so many stories of healing and benefit for those who have done it,” said Sam Chapman, a longtime psilocybin advocate who is policy and development director for the Microdosing Collective, a nonprofit supporting use of the drug in small doses.

Chapman played a big role in getting Oregonians to approve licensed psilocybin treatment centers, facilitators and manufacturers with the passage of Measure 109 four years ago by 56% of the vote. The measure required the Oregon Health Authority to start a program to allow providers to administer psilocybin mushrooms and fungi products to people 21 or older.

To date, the health authority has licensed about 1,000 staff, including 350 facilitators who work directly with clinics while they’re on the hallucinogen. The agency has also licensed 30 psilocybin centers – from the Portland area to Eugene to Ashland and beyond – along with a dozen manufacturers and one lab.

Chapman said these centers give the state another “tool in the toolbox” to treat mental illness, especially depression, anxiety and PTSD, especially for veterans.

“We’re actually seeing the proof of concept for the people who are going through Oregon’s service centers now,” Chapman said. “I think the mental health crisis in rural communities is especially unique in that these rural communities are struggling not just for mental health but economically as well.”

The economy of the psilocybin industry has been soft, caused mainly by the cost of a single session, which can range from hundreds to several thousand dollars, with many customers flocking to Oregon from out of state.

Chapman said rejection of psilocybin is linked to a lack of education about the drug and how the industry works in Oregon. Consumers cannot buy the drug in stores, as they can for marijuana, and treatments are regulated.

They don’t understand psilocybin. They don’t understand the research and they don’t understand the Oregon program. And so in addition to the lack of that understanding, they make some assumptions. The biggest assumption is that this is just the same thing as cannabis. They assume this is for retail sales, which is not true,” Chapman said.

Healing Advocacy Fund, a nonprofit in Oregon and Colorado, will continue to push for the programs to grow, with state-regulated access to psychedelic healing. Heidi Pendergast, the group’s Oregon director, said the rollout in Oregon has been safe, with only four people needing emergency services out of thousands served.

“So while there may be some concerns, we haven’t seen that play out right now whatsoever in the program,” Pendergast said.

Oregon was the first state to decriminalize psilocybin in licensed settings and Colorado has followed suit. Massachusetts voters rejected a proposal to legalize the mushrooms and allow people to grow small quantities at their homes, National Public Radio reported.

Oregon Capital Chronicle is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. 

 

Source: The Lund Report – Latest Headlines | November 7, 2024

October 31, 2024

 

Scotland’s drug and alcohol deaths remain among Europe’s highest – despite an increase in spending and better national leadership.

The Scottish Government has made progress in increasing residential rehabilitation capacity and implementing treatment standards. However, it has been slow to progress key national strategies, such as a workforce plan and alcohol marketing reform. People in need still face many barriers to getting support. The workforce is under immense strain. And the increased focus on drug harm is shifting attention from tackling alcohol issues.

In 2023, there were 1,277 alcohol-specific deaths – the highest since 2008. And there were 1,172 drug misuse deaths, the second lowest number in the last six years. Scotland’s figures remain high compared to the rest of Europe despite alcohol and drug funding rising from £70.5 million in 2014/15 to £161.6 million in 2023/24.

Alcohol and drug services are co-ordinated by Alcohol and Drug Partnerships at a local level. But they have limited powers to influence change and direct funding, and their funding is falling in real terms due to inflation. Most alcohol and drug funding goes to NHS specialist services to treat people at crisis point. This means there is limited money to put into preventing people getting so ill in the first place.

Stephen Boyle, Auditor General for Scotland, said:

The Scottish Government needs to develop more preventative approaches to tackling Scotland’s harmful relationship with alcohol and drugs. That means helping people before they get to a crisis point.

Ministers also need to understand which alcohol and drug services are most cost-effective, and plan how they will be funded when the National Mission ends in 2026. That’s especially important at a time of increasing strain on the public finances.

With many alcohol and drug workers reporting feeling under-valued and at risk of burn-out, there is also an urgent need to put a timeline against plans to address the sector’s staffing challenges.

Christine Lester, a member of the Accounts Commission, said:

Alcohol and drug services are complex and delivered by a wide range of partners. But there needs to be more collective accountability across the system for how each body is helping people whose lives have been blighted by alcohol and drugs.

Better information is needed to inform service planning and where funding should be prioritised. There is also more to do to tailor services to individual needs, using the experience of service users. Right now, not everyone can access the services they need, and that experience is worse for people facing disadvantage.

Source: https://audit.scot/news/prevention-focus-needed-to-tackle-alcohol-and-drug-harm

Weekly / November 7, 2024 / 73(44);1010–1012

Alana M. Vivolo-Kantor, PhD1; Christine L. Mattson, PhD1; Maria Zlotorzynska, PhD1

What is already known about this topic?

Expanded availability of ketamine for management of treatment-resistant depression has resulted in increased use.

What is added by this report?

During July 2019–June 2023, ketamine was detected in <1% of overdose deaths and was the only drug involved in 24 deaths. During this period, the percentage of overdose deaths with ketamine detected in toxicology reports increased from 0.3% (47 deaths) to 0.5% (107 deaths). Approximately 82% of deaths with ketamine detected in toxicology reports involved other substances, including illegally manufactured fentanyls, methamphetamine, or cocaine.

What are the implications for public health practice?

Further investigation is needed to better understand the role of ketamine in drug overdoses, particularly when multiple substances are used before death.

Ketamine, a Schedule III controlled substance* that is Food and Drug Administration (FDA)–approved for general anesthesia, can produce mild hallucinogenic effects and cause respiratory, cardiovascular, and neuropsychiatric adverse events (1). In 2019, a form of ketamine (esketamine) was approved by FDA for use in treatment-resistant depression among adults (2). Ketamine use, poison center calls for ketamine exposure, and ketamine drug reports from law enforcement have increased through 2019 (3), but recent trends in ketamine involvement in fatal overdoses are unknown. Data from CDC’s State Unintentional Drug Overdose Reporting System (SUDORS) were analyzed to describe characteristics of and trends in overdose deaths with ketamine detected or involved during July 2019–June 2023.

Investigation and Findings

Data on drug overdose deaths with unintentional or undetermined intent come from SUDORS, which includes information from death certificates, medical examiner or coroner reports, and postmortem toxicology reports.§ Data are abstracted on all substances reported to cause death (i.e., involved) and substances detected through toxicology testing. Decedent demographics and other overdose characteristics were analyzed among 45 jurisdictions (44 states and the District of Columbia [DC]),** and trend analyses were conducted among 28 jurisdictions (27 states and DC).†† Analyses were restricted to deaths with toxicology reports or with ketamine listed as a cause of death on the death certificate. Ketamine detection included toxicology results for ketamine or its metabolites.§§ Among deaths with ketamine detected, drug involvement was analyzed to ascertain which drug or drugs caused death. This activity was reviewed by CDC, deemed not research, and was conducted consistent with applicable federal law and CDC policy.¶¶

During July 2019–June 2023, a total of 228,668 drug overdose deaths were identified in 45 jurisdictions. Ketamine was detected in 912 (0.4%) overdose deaths, listed as involved in 440 (0.2%) deaths, and was the only substance involved in 24 (0.01%) deaths (Table). A majority of deaths with ketamine detected involved illegally manufactured fentanyls (IMFs) (58.7%), followed by methamphetamine (28.8%) and cocaine (27.2%). Overall, 82.4% of deaths involved either IMFs, methamphetamine, or cocaine. Approximately one third (34.8%) of decedents in whom ketamine was detected were aged 25–34 years, and approximately three quarters were males (71.3%) and non-Hispanic White persons (73.7%).

Among 172,475 overdose deaths in 28 jurisdictions during July 2019–June 2023, <1% had ketamine detected (692 deaths; 0.4%) or were classified as ketamine-involved (348 deaths; 0.2%). The number and percentage of deaths with ketamine detected increased during July 2019–June 2023 from 47 (0.3%) to 107 (0.5%), with notable increases as early as July–December 2020

Conclusions and Actions

During July 2019–June 2023, although ketamine was detected or involved in <1% of all drug overdose deaths, overdose deaths with ketamine detected increased. Almost all overdose deaths with ketamine detected involved other substances, mostly IMFs or stimulants; however, the source of ketamine (e.g., illegally purchased or prescribed) is unknown. Because analyses included a subset of jurisdictions, findings might not be generalizable to the entire United States. In addition, the scope of postmortem toxicology testing varies within and across jurisdictions, and ketamine might not be included in testing panels or be tested for in all postmortem samples (4), which could lead to an underestimation of ketamine detection. Despite the lack of uniform testing, ketamine detection among overdose deaths has increased over time, yet both detection and involvement accounted for a small proportion of overdose deaths. As polysubstance use (5) and use of ketamine for treatment-resistant depression and in compounded formulations*** increase, continued monitoring is needed to identify potential changes in the detection and involvement of ketamine in overdose deaths and to better understand potential drug interactions or circumstances leading to death.

Source: https://www.cdc.gov/mmwr/volumes/73/wr/mm7344a4.htm?s_cid=mm7344a4_w

The drug and alcohol awareness event was held at Faizen-E-Madina Mosque on Gladstone Street

Published 

A drug and alcohol awareness event has taken place at a mosque to encourage Muslims and families struggling with addiction to seek help.

Dozens of people, including children, attended the workshop organised by Dr Azhar Chaudhry at Peterborough’s biggest Mosque, Faizan-E-Madina.

Dr Chaudhry said the issue of drug and alcohol dependency within the city’s Muslim community was “a huge problem”, but engaging with them had been a challenge due to cultural stigma.

Raja Alyas from Peterborough-based Aspire charity, which works with harder-to-reach communities, called it “a step in the right direction”.

Dr Azhar Chaudhry has been organising awareness workshops for the community as a volunteer over the years

‘Still work to be done’

Dr Chaudhry, who works at Thistlemoor Medical Centre, said the involvement of the mosque committee, who attended and helped organise it, was “encouraging”.

He said there was still work to be done on engaging with Mosques who can support initiatives like Aspire, but appreciated their efforts to work together.

He moved to the UK in 2001 from Pakistan and is part of the British Islamic Medical Association (BIMA).

He runs other workshops on CPR, diabetes and cancer screening to raise awareness within the community as a volunteer.

“I love what I do. I am passionate about saving lives”, he said.

“You will be shocked to see how prevalent the drug and alcohol issues are in the Muslim community. I see it as a GP who works in a diverse part of the city.

“But it is difficult to engage with them, they don’t want to seek help.

“It is a sensitive issue for the community. There is a lot of stigma, so it needs to be addressed cautiously but attitudes are improving, hopefully.”

Aspire said the mosque committee has offered to help organise more regular drug and alcohol awareness events

Aspire works with Peterborough City Council, GPs and the Probation Service.

It also operates a clinic regularly at Thistlemoor Medical Centre to give people facing stigma a “discreet option” to seek help.

Mr Alyas said: “The workshop was well attended and was very interactive and great to see young people asking questions about how they can safeguard themselves.

“The young generation is being empowered with knowledge on making their decisions,” he said.

“It was good to see the attendees acknowledging that there is an issue. Previously, when we tired to set up a workshop like this it was not as well received.

“But the mosque saying they look forward to more events including for women is a step in the right direction.”

The event was organised by Dr Azhar Chaudhry and the Aspire charity and was supported by Faizan-E-Madina Mosque

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Source: https://www.bbc.co.uk/news/articles/crr92nyl7k4o

By Gabrielle M. Etzel

November 6, 2024 10:45 am

Voters in the 2024 election dealt a rebuke to drug legalization efforts in four states, a major political development that will shape the future of both marijuana and psychedelic drug policy across the country:

  • Measures to legalize recreational marijuana failed in Florida, North Dakota, and South Dakota, despite record spending from the cannabis industry already operating in those jurisdictions.
  • Support for the Florida constitutional amendment, Amendment 3, to legalize recreational marijuana only received 55.9% of the vote as of 9:49 a.m. Wednesday, according to the Associated Press. A 60% supermajority threshold was necessary to amend the Florida constitution.
  • The “No” vote to the marijuana legalization efforts in both North Dakota and South Dakota received outright majorities.
  • North Dakota’s Measure 5 was voted down 52.5%-47.5% with 99% of the vote counted as of 4:08 a.m. Wednesday. The “No” vote for South Dakota’s Measure 29 received 56.3% of the vote compared to 43.7% in favor with 90.3% of the ballots counted, also as of Wednesday morning.
  • Massachusetts also heartily rejected an effort to legalize the medical and recreational use of psychedelic drugs, including psilocybin and psilocin.
  • According to the Associated Press, the ballot measure was voted down 56.9%-43.1% with 90.3% of the vote counted as of 9:28 a.m. Wednesday.

The legalization effort was dealt a decisive blow in mid-October by the Boston Globe, whose editorial board wrote that the measure “goes too far” despite the therapeutic promise of psychedelics for treating PTSD and other mental health conditions.

“Voters by wide margins rejected the legalization of drugs like marijuana and psychedelics from red Florida to blue Massachusetts,” Foundation for Drug Policy Solutions and Smart Approaches to Marijuana President Kevin Sabet said in a statement on the elections. “We expect this Administration to listen to this message loud and clear: More drugs are not good for any community.”

Nebraska medical marijuana is only victory

The two interrelated ballot initiatives for Nebraska were the only drug legalization amendments to pass on Tuesday night.

The Associated Press declared victory for the ballot measure to legalize medical marijuana, Initiative 437, 70.2%-29.3% with 99% of the votes counted as of 6:52 a.m.

The accompanying amendment, Initiative 438, which established the Nebraska Medical Cannabis Commission to regulate the medical marijuana program, passed with 67% of the vote, according to Ballotpedia. Results for Initiative 438 were not tracked by the Associated Press.

Nebraska is now one of 39 states that have legalized medical marijuana, which in the past has signaled that a recreational use policy will be introduced in the coming years.

Future of federal drug policy

Cannabis is still classified as a Schedule I drug under the Controlled Substances Act, along with heroin and ecstasy. Schedule I drugs are determined to have no accepted medical use and a high potential for abuse, and federal penalties for possession and intent to distribute can be severe.

President Joe Biden issued a directive to executive branch agencies in 2022 to begin a review of federal marijuana statutes. The Drug Enforcement Agency this spring started the process of reclassifying marijuana to a Schedule III substance, on par with ketamine and certain anabolic steroids.

Although it was not a major issue in the presidential campaigns, both Vice President Kamala Harris and President-Elect Donald Trump promised to continue with this spirit of drug reform at the federal level.

Trump, a resident of Florida, posted on Truth Social in September that he planned to vote in favor of Amendment 3 because he supported “smart regulations” for cannabis at the state level.

“As President, we will continue to focus on research to unlock the medical uses of marijuana to a Schedule 3 drug, and work with Congress to pass common sense laws, including safe banking for state authorized companies, and supporting states rights to pass marijuana laws, like in Florida, that work so well for their citizens,” Trump said in September.

Trump’s perspective on psychedelic drugs has not been as clear, but he has been a strong supporter of increasing access to clinical trials for experimental treatments for potentially fatal diseases.

Over the past two years, there has been strong bipartisan support in Congress for improving funding for the mental health benefits of psychedelic drug use for patients with severe PTSD, particularly combat veterans at risk of suicide.

Source: CLICK HERE TO READ MORE FROM THE WASHINGTON EXAMINER

Experts in Nigeria are increasingly concerned about the country’s rising drug abuse rates, urging the Federal Government to adopt a public health-centred approach. 

This proposed strategy prioritizes reducing drug use while establishing a supportive legal framework to empower health interventions.

With roughly 14.4 percent of the population or about 14.3 million Nigerians, affected by drug use, public health experts argued that a comprehensive legal structure is critical for the Federal Ministry of Health to address this crisis effectively.

At a one-day media sensitization workshop in Abuja, themed ‘Public Health Approach to Drug Control Response in Nigeria’ and organized by the Federal Ministry of Health and Social Welfare in partnership with Youth Rise Nigeria, experts advocated for treating drug dependency as a health issue rather than a criminal offence.

They stressed that many individuals struggling with drug dependency are dealing with health-related challenges.

The workshop highlighted the urgent need for a health-oriented approach to tackle what experts now view as a national drug dependency epidemic and the crucial role of the media in shaping public perception and reaction to drug abuse.

Chukwuma Anyaike, the Director of Public Health at the Federal Ministry of Health, argued that a public health approach is crucial for controlling drug issues in Nigeria.

He noted that existing supply-focused measures have limited access to treatment and prevention services, which has led to increased rates of HIV, tuberculosis, and hepatitis among people who inject drugs.

Anyaike called for a multidisciplinary approach integrating public health, legal, and social welfare frameworks and urged Nigeria to align with international standards such as the World Health Organization’s guidelines, the 2016 UN General Assembly Special Session on Drugs UNGASS), and the African Union (AU) Plan of Action to improve its response to drug abuse.

“This approach includes preventing drug use, providing treatment and care for individuals with substance use disorders, implementing harm reduction strategies, and ensuring access to controlled medications,” Anyaike explained.

Echoing these sentiments, Nonso Maduka, a Consultant with Youth Rise Nigeria, stressed the need for legislation that would facilitate a health-centered response to drug control.



Maduka argued that a supportive legal framework would help provide better resources and care for individuals, families, and communities affected by drug dependency, shifting away from the current punitive focus.

“Unfortunately, we have an unbalanced approach that targets mainly supply reduction, and the health sector lacks the legal authority to address demand, prevention, treatment, and harm reduction,” Maduka noted.

He highlighted that Nigeria’s current drug laws treat drug use as a criminal issue, which restricts health interventions and puts more strain on affected communities.

A public health perspective, he noted, could help curb drug dependency and reduce associated health risks like HIV and hepatitis.

Maduka also emphasized the importance of empowering local health initiatives and granting States authority to address drug challenges in their communities.

A health-focused legal framework, he noted, would allow targeted responses, including treatment, rehabilitation, and palliative care.

Such a framework, according to him, would create a balanced approach that not only reduces drug abuse but also mitigates its harmful effects, ultimately supporting a healthier future for the nation.

“If you want to solve it, it must be driven by evidence,” Maduka added, calling for an evidence-based approach that balances criminal justice with health-focused interventions, which includes drug demand reduction, harm reduction, and access to necessary medications.

“Understanding underlying causes, such as pain management needs and rural challenges, is essential for developing compassionate and comprehensive responses,” he added.

Oluwafisayo Alao, the Executive Director of Youth Rise Nigeria, underscored the crucial role of the media in changing public perceptions around drug dependency, saying, “The way we approach substance use in Nigeria impacts the lives of millions of people.

“This media partnership is a vital step toward a compassionate, health-focused response. By creating a framework that prioritizes health over punishment, we aim to protect individuals, families, and communities”.

Source: https://thenationonlineng.net/experts-propose-all-inclusive-approach-legal-framework-to-combat-drug-abuse/

United Nations  –  Office on Drugs and Crime

PRESS RELEASE  – Kabul / Vienna, 6 November 2024

Opium cultivation in Afghanistan in 2024 increased by an estimated 19 per cent year-on-year to cover 12,800 hectares, according to a new survey released by the UN Office on Drugs and Crime (UNODC) today.

The increase follows on a 95 per cent decrease in cultivation during the 2023 crop season, when the de-facto Authorities of Afghanistan enforced a ban that virtually eliminated poppy cultivation across much of the country. Despite the increase in 2024, opium poppy cultivation remains far below 2022, when an estimated 232,000 hectares were cultivated.

“With opium cultivation remaining at a low level in Afghanistan, we have the opportunity and responsibility to support Afghan farmers to develop sustainable sources of income free from illicit markets,” said Ghada Waly, Executive Director of UNODC. “The women and men of Afghanistan continue to face dire financial and humanitarian challenges, and alternative livelihoods are urgently needed.”

According to the survey findings, the geographic centre of opium cultivation has also shifted, from the south-western provinces – long the heart of Afghanistan’s opium cultivation up to and including 2023 – to the north-eastern provinces, where 59 per cent of cultivation occurred in 2024. This represents a sharp 381 per cent increase in these provinces over 2023.

Dry opium prices have stabilized to around US $730 per kilogram in the first half of 2024, up from a pre-ban average of US $100 per kilogram.

The high prices and dwindling opium stocks may encourage farmers to flout the ban, particularly in areas outside of traditional cultivation centers, including neighboring countries.

“This is important further evidence that opium cultivation has indeed been reduced, and this will be welcomed by Afghanistan’s neighbours, the region and the world,” said Roza Otunbayeva, Special Representative of the Secretary-General and head of the United Nations Assistance Mission in Afghanistan.

“But this also requires us to recognize that rural communities across Afghanistan have been deprived of a key income source in addition to the many other pressures they are facing, and they desperately need international support if we want this transition to be sustainable,” Otunbayeva said.

Read the Afghanistan Drug Insights Volume 1 here.

Note to Editors: The remaining reports in the Afghanistan Drug Insights series will cover a range of topics related to the drug situation in Afghanistan, including opium production and rural development; the socioeconomic situation of farmers after the drugs ban; drug trafficking and potential opium stocks; and treatment availability and drug use.

* *** *

For further information please contact:

Sonya Yee
Chief, UNODC Advocacy Section
Mobile: (+43-699) 1459-4990
Email: unodc-press[at]un.org

* *** *

Source: https://www.unodc.org/unodc/en/press/releases/2024/October/afghanistan_-opium-cultivation-increased-by-19-per-cent-in-second-year-of-drugs-ban–according-to-unodc.html

by Chloe Marklay, Katie Amrhein, WKRC

CINCINNATI (WKRC) – A local mother who lost her son to fentanyl has spearheaded an initiative to bring a powerful billboard to Cincinnati.

The billboard is located in the Northgate area. It includes pictures of 20 people who lost their lives to fentanyl, many of whom are local. The billboard reads: “Synthetic opioids kill over 150 people every day” and “fentanyl steals families.”

 

(WKRC)

Tamara Bohl lost her son Brian when he was 33 years old. Bohl wrote a book titled “My Child Died, Now What?” to help parents like her and to honor those who have lost their lives.

“These are real people, not just a statistic—real people that had lives, dreams, aspirations, families, friends, and kids,” said Bohl.

Bohl worked alongside Rachel’s Angels to create the sign and bring it to Cincinnati. The nonprofit is focused on providing drug education, prevention resources, and support to families affected by addiction.

The billboard dedication is set for Wednesday. The event will include speeches from city leaders, the Center for Addiction Treatment, and other parents like Bohl.

Bohl also featured the names of more than 900 people who lost their lives to fentanyl in her poetry book. One of them is Jason Durkin. At 21 years old, Durkin died from the drug in 2018. His mother Jennifer Bishop attended the billboard dedication.

“It’s gut-wrenching to see him up there, but I feel good that I’m putting him out there because he mattered,” said Bishop.

The event will also include the distribution of Narcan kits and educational resources on drug prevention and harm reduction.

Bohl also taped additional photos of fentanyl victims around the billboard pole. The billboard will stay up throughout November.

 

Source: https://local12.com/news/local/fentanyl-steals-families-new-cincinnati-billboard-spreads-awareness-opioid-epidemic-northgate-joseph-chevrolet-tamara-bohl-book-brian-drug-drugs-addiction-education-rachels-angels

Cultural, systemic and historical factors have converged to create the perfect storm when it comes to Black overdose deaths.

      By Liz Tung – June 14, 2024 Reporter at The Pulse

In this Jan. 23, 2018 photo, Leah Hill, a behavioral health fellow with the Baltimore City Health Department, displays a sample of Narcan nasal spray in Baltimore. The overdose-reversal drug is a critical tool to easing America’s coast-to-coast opioid epidemic. (AP Photo/Patrick Semansky)

From Philly and the Pa. suburbs to South Jersey and Delaware, what would you like WHYY News to cover? Let us know!

recent study from the Pennsylvania Department of Health has found that Black people who died from opioid overdoses were half as likely as white people to receive the life-saving drug naloxone, otherwise known as Narcan. The study also found that Black overdose deaths in Pennsylvania increased by more than 50% between 2019 and 2021, compared with no change in white overdose deaths.

In an email, a representative with the Department of Health said that similar rises in overdose deaths are being seen across the country, especially among Black, American Indian and Alaska Native populations. But researchers are still investigating what’s behind the spike.

“There does not appear to be a single reason why rates are increasing for Black populations and holding steady among white populations,” the statement reads. “The volatile and rapidly changing drug supply certainly has been a challenge as fentanyl is now found in every type of drug. Inequities in terms of treatment for substance use disorder may also play a factor as white people are more likely to have better access to the most evidence-based treatments and are more likely to stay in treatment.”

Fear of arrest

Abenaa Jones, an epidemiologist and assistant professor of human development and family studies at Penn State who was not involved in the study, has conducted similar research in Baltimore. She agreed that fentanyl-contaminated drugs — which are more common in lower-income neighborhoods — and less access to health care are likely factors in the growing number of overdose deaths among Black populations.

Jones said the criminal justice system, and its unequal treatment of Black people, also plays a role.

“We know that the intersection of criminal justice and substance use, and criminalization of drug use and how that disproportionately impacts minorities, can limit the accessibility of harm reduction services to racial-ethnic minorities for fear of harassment by police for drug paraphernalia,” Jones said, adding that even syringes obtained through needle-exchange programs can be considered illegal paraphernalia.

Fear of arrest, in turn, leads more people to using drugs in isolation.

“That may protect you from criminal legal involvement, but then in the event of an overdose, you may not have someone to help you,” Jones said. “So it could be that by the time the EMS come, it’s been too long for them to even consider administering naloxone.”

Contaminated drug supplies

An unexpected observation that Jones made in the course of her research could also be a factor in rising death rates — the fact that many of the Black people dying of opioid overdoses are older.

“For any other racial groups, overdose deaths peak around midlife — 35, 45,” she said. “For Black individuals, it’s more like 55, 64, and we were wondering what was going on with that.”

After investigating that question, Jones and her colleagues formulated a working theory.

“The running hypothesis for us is that this is a cohort effect,” she said. “Individuals who’ve been using drugs over time, particularly Black individuals back from the ‘80s and ‘90s with the cocaine epidemic, never stopped using.”

Those individuals may have remained relatively stable until fentanyl began to contaminate their drug supply without them knowing.

“So whatever harm reduction tools that you were using for so many years that’s been helping you, when fentanyl’s involved, it’s a different game,” Jones said. “You have to use less, but you have to also know that you have fentanyl in your drugs, right?

It’s a problem that Marcia Tucker, the program director of Pathways to Recovery — a partial hospitalization program focused on co-occurring substance use and mental health challenges — sees frequently among their mostly Black clients.

“If you come into treatment saying that I’m a cocaine user, or I’m a crack cocaine user, or I use marijuana, you’re not even thinking that an opioid overdose or fentanyl overdose could possibly happen to you,” Tucker said. “And it does happen.”

Fear, stigma and miseducation

In fact, Tucker said, she’s seen more of these kinds of overdoses over the past two years than in the three decades she’s spent working in addiction treatment. Despite that, there’s still a lack of education — and even stigma — surrounding both medication-assisted treatments (MATs) for opioid addiction, and the use of naloxone.

“I think sometimes culturally with the African American community, as far as MATs are concerned, there are some taboos about getting that extra help when they decide to come into treatment and get clean,” she said. “A lot of people feel like they want to do it from the muscle. They see it as another form of using.”

She said others may not know how to use naloxone, what kinds of effects it has or how to get it.

“I think a lot of folks don’t even know that they can walk into a pharmacy and get naloxone — you don’t have to have a prescription for that,” Tucker said. “And I think that information is just not always presented to communities, especially poor communities that don’t have a lot of resources.”

Other sources of hesitation are more immediate. Aaron Rice, a therapist at Pathways to Recovery, said that many of their clients fear naloxone because of its physical effects.

“I think they associate it with precipitated withdrawal at times,” Rice said, referring to the rapid-onset withdrawal that can cause symptoms including anxiety, pain, seating, nausea, vomiting and diarrhea.

“The only thing they’re thinking about is feeling better. And that feeling is going to supersede logic at that moment. It always does.”

Overcoming disparities in health care and mistrust of the system

The Department of Health acknowledged that the study only paints a partial picture, as it doesn’t include individuals whose overdoses were reversed by naloxone, and added that during the years of the study (2019–2021), naloxone was available by prescription only — a fact that likely played into the race-based disparity.

“There are recognized inequities in access to health care among persons of color, the concept of which likely extends to access to naloxone,” the Department of Health statement reads. “Historically, many public health materials and messaging more narrowly focused on persons using opioids. With people now taking two or more drugs together (whether intentionally or unintentionally), public health materials and messaging need to be more inclusive of all persons using drugs, regardless of the type.”

The study, researcher Abenaa Jones, Marcia Tucker and Aaron Rice all agreed on at least one intervention that could increase Black people’s access to naloxone — relying on trusted community leaders and institutions, like churches, to help educate residents and distribute the overdose-reversing drug.

“I just can’t stress enough how it’s a lifesaver — it’s the difference between life and death,” Tucker said. “I think people who aren’t medical professionals and find themselves in a situation where it might need to be used would probably be a little fearful — fearful about how to use it or how the person is going to react or whether it’s really going to work — just know that you’re better off with it and trying it. You don’t want to have to second guess yourself later and say, ‘I wish we had it. I wish we had gotten it,’ or, ‘I wish we had used it.’”

Source: https://whyy.org/articles/black-pennsylvanians-overdoses-naloxone-less-likely-to-receive/

From: thinkon908 via Drug Watch International
Subject: FROM DAVE EVANS WHAT TRUMP GOT WRONG PLEASE WRITE TO SENATOR VANCE ABOUT THIS

In a message dated 9/3/2024 6:52:58 AM Eastern Daylight Time:

President Trump and Senator Vance have recently come out in favor of marijuana legalization. This is a big mistake.

Here is what President Trump had to say

As everyone knows, I was, and will be again, the most respected LAW & ORDER President in U.S. History. We will take our streets back by being tough & smart on violent, & all other types, of Crime. In Florida, like so many other States that have already given their approval, personal amounts of marijuana will be legalized for adults with Amendment 3. Whether people like it or not, this will happen through the approval of the Voters, so it should be done correctly. We need the State Legislature to responsibly create laws that prohibit the use of it in public spaces, so we do not smell marijuana everywhere we go, like we do in many of the Democrat run Cities. At the same time, someone should not be a criminal in Florida, when this is legal in so many other States. We do not need to ruin lives & waste Taxpayer Dollars arresting adults with personal amounts of it on them, and no one should grieve a loved one because they died from fentanyl laced marijuana. We will make America SAFE again!

We will address these four statements made by President Trump.

1. As everyone knows, I was, and will be again, the most respected LAW & ORDER President in U.S. History.

If he supports legalization of marijuana he is not in favor of law and order. Marijuana use causes violence in general and violence against women and children. See the attached paper on marijuana and violence. Data also shows that marijuana use is the primary drug involved with child deaths by their caretakers. See the attached power point on child deaths.

2. We need the State Legislature to responsibly create laws that prohibit the use of it in public spaces, so we do not smell marijuana everywhere we go, like we do in many of the Democrat run Cities.

He got it right that marijuana smoking should be banned in public places including apartment buildings. Attached is the Cannabis Industry Victims Education Litigators paper “Marijuana Smoke Carries High Risks to the Health of Users or to the Health of Other Individuals or of the Community” that was sent to the DEA on the rescheduling issue. It covers the science on topics such as:

Relevant Facts about Marijuana Smoke – 9
Marijuana smoke has dangerous levels of particulate matter – 10
California Environmental Protection Agency Declares Marijuana Smoke a Carcinogen – 11
Marijuana Smoke is More dangerous than Tobacco Smoke – 12
Second Hand Marijuana Smoke Is Dangerous to Individuals and the Community – 13
Cannabis Smoke and Pollen Are Known Allergens – 18
Marijuana Is Addictive and Marijuana Smoke and Odor Can Trigger Relapse – 22
Marijuana Smoke May Trigger Relapse in Those Suffering from Cannabis Use Disorder – 24

3. We do not need to ruin lives & waste Taxpayer Dollars arresting adults with personal amounts of it on them.

 

President Trump got that wrong. I have been a criminal defense attorney since 1974. Attached is the AALM paper on social justice and marijuana arrests. It is a myth that there are many minorities in prison due to possession of small amount of marijuana. Most states treat this as a civil offense or a very minor offense and records can be expunged. An arrest can help get marijuana users evaluated and treated. See the attached paper on Compassionate Justice.

4. “no one should grieve a loved one because they died from fentanyl laced marijuana. We will make America SAFE again!

President Trump got that wrong

I was an EMT for 10 years and President of a rescue squad and also an EMT on a mountain fire company. Here is what first responders have to say about “fentanyl laced marijuana” in their Journal of Emergency Medical Services

Fentanyl-laced cannabis products are a malevolent myth that has appeared multiple times in law enforcement press releases and subsequent media reports. These rumors began as early as 2017 when a county coroner in Ohio erroneously stated that he had seen evidence of marijuana laced with fentanyl. It was later determined that his remarks were unsubstantiated and were based on third-hand hearsay. To-date, there are no scientifically verified reports fentanyl contamination of cannabis products. Writer and drug researcher Claire Zagorski notes that in addition to the paucity of evidence associated with the rumors, fentanyl is destroyed and rendered inert when it is burned. Meaning that even if it made its way onto cannabis flower, it would not have any effect on the individuals who inhaled it when smoking. Additionally, fentanyl is not well absorbed through the gastrointestinal tract, which is why there are no oral preparations of the medication which minimizes the risk of its impact if it were to end up in edible products. Finally, it is worth noting that it is possible that fentanyl could be vaporized (heated to its boiling point as opposed to burning). However, it requires much higher temperatures than are found in vaping devices that are used to consume tobacco and cannabis products.

There are, of course, a few different ways to consume cannabis. The method most of us probably think of is smoking. In the case of cannabis flower, smoking involves loading the material into a pipe or roll paper, lighting it on fire, and inhaling the smoke. Burning fentanyl with flame destroys it, so even if someone smoked cannabis contaminated with fentanyl, the fentanyl would not be active in the smoke. In fact, burning drugs in an incinerator is a common way to dispose of them, both for prescription medications and for illegal drugs seized by law enforcement.

David G. Evans, Esq.
www.ncagainstmarijuana.org

Source: www.drugwatch.org

10Sep2024

In this special episode of the Pathways 2 Podcast, recorded live at the National Prevention Network (NPN) Conference, we bring you two insightful conversations with leaders who are making a significant impact in the field of prevention.

First, we sit down with Ben Stevenson, who oversees prevention and harm reduction services for Montgomery County, Maryland, and also runs his own consulting firm, Bess Consulting LLC. Ben shares his innovative approach to integrating youth empowerment with harm reduction, his journey in building a successful Youth Ambassador Program, and the challenges of overcoming stigma and navigating county government to drive meaningful change.

Next, we hear from Steve Miller, a prevention champion, podcaster, and man in long-term recovery. Steve takes us through his personal and professional journey, highlighting the powerful role music has played in his recovery and prevention work. He discusses how music serves as a muse, guiding his work and helping others find their path in prevention.

Whether you’re a prevention professional, a community leader, or simply interested in stories of resilience and innovation, this episode is packed with practical insights, inspiration, and a deep dive into what it takes to make a lasting impact in our communities.

Key Takeaways:

  • The power of youth-led initiatives in prevention and harm reduction.
  • Strategies for overcoming stigma and building community buy-in.
  • How music can influence behavior and serve as a tool for prevention.

Transcript:

Welcome back to another episode of the Pathways to Prevention podcast, where we shine a light on the people stories and strategy’s making a difference in the field of prevention. I’m your host, Dave Closson and today I am excited to bring you to insightful conversations recorded live from the National Prevention Network Conference, where the theme was shining a light on prevention.

In this episode, you’ll hear from two exceptional leaders who are driving impactful change in their communities and beyond. First, we have Ben Stevenson from Maryland who oversees prevention and harm reduction services in Montgomery county. We’ll also running his own consulting firm. Ben shares his experiences, challenges and successes in empowering youth. And integrating prevention with harm reduction in innovative ways. Then. I had the opportunity to sit down with Steve Miller. A true prevention champion. Long-term recovery advocate and fellow podcaster. Steve takes us on a journey through his work in prevention. The powerful role that music has played in his life and in his recovery. And how it continues to inspire his mission to help others. These conversations are full of wisdom, practical insights, and inspiration for anyone involved in prevention work. So let’s dive in. And hear from these incredible prevention leaders.

The Vision, a world where all people live free of the burden of drug abuse. This is the Drug Free America Foundation’s Pathway to Prevention podcast, where we are committed to developing strategies that prevent drug use and promote sustained recovery. Thank you for not only tuning in, but your continued support and efforts to help make this world a better place.

We hope you enjoy this episode.

Alright, so, first off, coming to folks here from the National Prevention Network Conference, would love for you to just introduce yourself.

Okay. All right. So I’m Ben Stephenson from Maryland. So I work in, oversee, prevention of harm reduction services for Montgomery County, Maryland and then I also own a best consulting LLC. All right, rock. And so tell me a little bit about the work that you do, whether it be through your consulting company or the harm reduction work, what do you do?

Sure. So, on the prevention side, oversee, all of our prevention, education and awareness efforts. So that includes community awareness campaigns, efforts around drug take back. Also oversee a youth ambassador program. So, we have used, we pretty much empower young people to use their voice to educate about the dangerous substances, mental health, wellness, and in advocacy, we train them in advocacy.

And then on the harm reduction side, oversee our Narcan training and distribution efforts. A syringe services program as well as our efforts to distribute, fentanyl test strips, xylazine test strips, currently working on expanding harm reduction services into vending machines, and other avenues to try to, you know, meet people where they are and support people until they’re ready to pursue their treatment and recovery.

And then on the consulting side, I’m a SAPS trainer, so I was a part of the consultants that, update the SAPS curriculum. So, now it’s the SPF application for prevention success training versus the substance abuse prevention skills training. I also, also an ethics trainer, and then I also do, you know, conference presentations.

But this week, I decided I just want to be a participant. So, you know, participating in the NPN. Taking it all in. Yeah. All right. You got a lot of work. You’re doing. I can only imagine that through doing that work, getting it started, maintaining, sustaining, growing that work. You’ve encountered some, some challenges or barriers.

What are a couple that come to mind? Yeah, I think that the main challenges you can think of are related to maybe stigma, still stigma around substance use. So people not necessarily understanding, how prevention or how harm reduction works. How they can be married together in a sense to build a stronger system.

I think it’s been a lot of like education on my end and my team’s end to try to educate people on how this, how it could look, how it could work together versus, hey, you have this funding. They have that funding and then you don’t really, you know, communicate. Then of course, you know, me working in county government, sometimes you have some extra hoops and hurdles to work through.

To overcome. Which is of course, you know, a challenge within itself. But, you know, you just still, you get up every day. You fight the good fight and the, and the joy of prevention is that it’s always changing. It’s never the same. So you just adapt to the times and figure out how you can be innovative and help your community.

What are some of those successes that you’ve seen? I think for me as of late, so, we’re moving into our fourth year of having a youth ambassador program. in totality, I’ve been with the county for 10 years. It’s something I’d always wanted to do because I knew the power of the youth voice.

So giving them that space, I think has been very rewarding for me. You know, working with adults, you can kind of burn yourself out, but working with kids, they energize you, right? So I think this past couple of years, you know, the youth really were in tune with, You know, what we’ve been experiencing as a country around opioids and overdose deaths and wanted to do something.

So, you know, I worked with a group of young people who wanted to change policy within the within the school system so that you could carry Narcan within school. So you, you can carry Narcan in our school system without feeling as if they’re going to get punished. Right. Then also all of the schools have are equipped with Narcan all the way down to the elementary school.

Then this past year, youth wanted to actually train their peers on identifying the signs and symptoms of an overdose, how to respond, and how to administer Narcan. So, we trained 11 of our youth ambassadors to train other, their peers, and they trained about 300 youth last year and adults. So, I think, you know, that has been a, a major success because now the school system has seen it and they’re like, Hey, we want to make sure that you have youth ambassadors from every high school in the county where there’s 26 high schools and I’ve had representatives from maybe 11 of them.

So trying to get across the entire county and then build up the infrastructure to where you build a pipeline of those youth having that same message from the middle school level all the way to the high school. So once the high school situation gets solidified, we can filter it down to the middle school level.

I’ll call it a 10 year journey that you’ve been on and still are on to get the youth ambassador program to where it is today What might be some tips or some things you’ve learned that you can share with our listeners? Yeah, I think one challenge that I ran into initially was trying to establish smaller youth ambassador chapters at each school Which of course in those situations Me being in such a large jurisdiction Those situations is hard because you got to have a sponsor at the school to oversee that.

So that was a challenge within itself. So I realized, okay, maybe I need to just pull it back and just do something countywide. knowing that, okay, you got youth from all over the county. How do you want to make sure they have the ability to meet without having to drive somewhere? So, luckily zoom has been, you know, or, you know, I think Google meets all kinds of platforms we use initially.

Have been phenomenal because it helps to keep youth engaged. but then also giving them the power to control it to not just having the voice, but they it’s their baby and let them know that, hey, we’re only going to be successful based off of you. I’m just here to support you and to put some fiscal, you know, money or put something behind you to support the strategies and initiatives you want to do.

So, I think having that youth co-chair model, Having youth officers, them leading the meetings, them pretty much recruiting, doing all those different things has been, you know, phenomenal. I just, I just sit back and just kind of watching it manifest, you know? Yeah, yeah. Well, I heard what sounded like a pretty good piece of wisdom, but you kind of just rolled right off your tongue.

You had a vision, the local chapter’s vision, but then you realized that that wasn’t the right path forward and you, you adjusted course. All still within that grander big picture vision of the youth advisory that not afraid to pivot. Right. Of course. And I think I learned that, from, you know, experiences with like larger organizations like CADCA and then seeing other organizations within my state that were doing youth initiatives that were maybe that jurisdiction wasn’t at the size of mine, but saying, Hey, They can do it.

We can do it too. and then just getting, you know, upper leadership to believe that it could be done. And now that they’re seeing it, they’re like, wow, how can we be a part? What can we do to support? Like, what do you need and things like that? And so, I think that has, you know, being able to put prevention in a place of prominence is important.

because you know, we have the, what the Institute of Medicine’s continuum of care. But sometimes people still don’t understand prevention because it’s not providing those immediate results. Right. And so, if you can see, if you can show some, some of those mild substance moments, you know, from, you know, kids sharing their experiences in the program from them sharing what they learn, to, you know, county leadership, seeing them present and articulate themselves in a way that they’re just like, wow, these are some and even trying to get, you know, to the kids who might be on the fence of if I want to use or not, Hey, this seems pretty cool.

And I can get community service hours and, you know, writing recommendation letters for college. And we’ve gotten to a place of giving honor cords for graduating seniors that could wear graduation. So when other kids are seeing it, they’re like, Hey, I want to be a part of that. I think that kind of speaks to.

The importance of like, not only addressing risk factors in our community, but also addressing those protective factors. So that positive opportunity to belong is important because I, I mean, I can see it, you know, I can see the importance of it, right? Yes. So I’ve got, I’ll say I’ve got four questions left.

Okay. You touched on two things that I hear from folks in the prevention field all the time as far as barriers, challenges, or how the heck are we supposed to do that? Yeah. One getting upper leadership on board, but then also the, the buy in and the, the youth taking ownership. Yeah. What kind of insights or experience could you share there for our listeners?

Yeah. So, I learned a lot from, you know, just some time working with, with CADCA and a really good friend of mine oversaw like the youth leadership initiative and that mantra of youth, youth led, but adult guided. And I really believed in that because. I could see how like the, like the youth that were working with, with CACA in those spaces, they were, they were very bright, phenomenal, and they were leading educational sessions, things like that.

And I was like, I know I have kids in my, or youth in my, in my county that can do that same thing. I just have to find them. it’s, it’s initially it kind of happened organically, but then, you know you started reaching out, Hey, I’m doing this project on such and such. And it’s related to fentanyl or whatever.

And I’m like, well, why are you not in my program? Like, what have you been doing? And then they’ll sign on and they like, Hey, I don’t know why I haven’t been here, but I’m happy to be here now. Right. Yeah. So I think really just understanding that it’s not going to happen overnight. You got to just continue to just keep, keep fighting a good fight.

Eventually those things that you want to change and manifest in your community will happen. Like Rich Lucey from DEA says prevention is about the long game. Yes. 10 years running. Yeah. I’m curious if you have a, a good story that really shows the impact of your work with the youth and stigma, whatever it may be. Just a story that talks about the, the impact. Yeah. So I used to get requests to, do presentations at high schools, right? And you never really know, you never really know the impact of those presentations because you might be presenting to like a parent group or something like that.

Right. And so, we eventually got to a place of wanting to train all of our bus operators in the lock zone administration so that they can have Narcan on the bus and things like that. Just in case overdose happens on the bus. Well, not knowing that one of the administrators or one of the managers of supervisors over the transit system was in one of my presentations at the high school because their daughter was a student at the high school.

it was a full circle moment because he basically said to me, he was like, a lot of the things you share that night helped me and my wife because our daughter eventually dealt with substance use disorder. But we knew what to do to help support her and navigate her through that space.

So that really like it was a real like aha moment to me that, you know, what we’re doing is working. And yes, if someone does go down that path, you still want to make sure you give them those tools and maybe you can help bring them back in and keep them safe and keep them alive.

Right. So, I think that was just, I mean, there’s been a lot of moments, literally you thought it gave me goosebumps. I can feel that, one last question, one last, but I promise, I promise, you mentioned earlier, you said it so eloquently about putting prevention in a prominent place.

The theme of this conference is shining a light on prevention. So can you give us, you know, a description of what does that, what does that mean to you? Yeah. I, I really feel like there’s a lot of opportunities for prevention out here, whether it’s through not only, you know, pursuit of grant fund is, but I think that’s mobilizing to say, Hey, you know, block grant funds haven’t changed in the past 20 years.

What? Maybe we need to advocate, you know, to get that shift. But I think making sure that we’re at the tables. of those who are in control of funding, right? And so, I think for me, I’ve been fortunate enough to be at some of those tables where, you know, we are gaining access to some of the, like the opioid abatement funds to build up the infrastructure of prevention in the county and to build up harm reduction in the county and things like that, which, you know, you know, treatment services and crisis services and other service areas, they’ve always had money to do the things that they needed to do.

But prevention never really had that. So I think, you know, continuing to, you know, do the work, advocate, you know, show, you know, positive results and get to those tables is important to help us get to that prominent level that, hey, we’re part of the continuum or the spectrum of services as well. We need to be funded in a way so that we can prevent all those people from having to go to treatment to him and experience recovery.

Right. So I think Not only, you know, advocating for ourselves, but also building up those allies to help us advocate, to show the power of prevention because it’s definitely a place for us. and, you know, we’re all in the same business of trying to, you know, promote optimal wellbeing in our communities, right?

The themes that I heard were persistence, perseverance. together. Yeah. And, and I would say a twofold listening and learning. Yes, of course. Cause I mean, we might be the experts on the process, but of course we’ve got to connect with those and collaborate with those people in the community because they’re the experts on the, on the story of that community.

We can’t really, you know, talking to a lot of my colleagues, we, we talk about shifting from being implementers to coaches or mentors so that, you know, you can sustain some of the efforts and outcomes that are in the communities, you know, so, so that’s the hope and goal, right? Yeah. All right.

What would be one final takeaway call to action to leave our listeners with? Yeah. I’ll just say that, you know, my experience in this field is that It’s important to network because you can always learn from somebody else. Something innovative, something creative that somebody else has done in another part of the country that you could maybe implement in your, your area.

and then always just, just making sure you stay abreast and up on top of, you know, language and evidence based practices and all those different things. Because I’ve only been in the field for 18 years and it’s changed exponentially over the course of that time. So. Just saying, staying abreast of that and staying engaged, mentors, having a mentor, I have multiple.

And if you feel burnt out, make sure you take care of yourself. Mom’s always said, if you don’t take care of yourself, you can’t take care of somebody else. So All right. Folks. That was, was an enlightening conversation with Ben. Who’s truly leading the way. In integrating prevention and harm reduction in his community. And I just loved hearing about his work with youth and this commitment to breaking down barriers is, is inspiring and really does offer us some valuable lessons for, for everyone in the prevention field.

But now we’re shifting gears to another powerful voice in prevention. Steve Miller is not only a longterm recovery advocate, but also someone who’s found a unique way. To incorporate his passion for music into his prevention work. Steve’s insights on the role of music and shaping behavior. And his own journey through recovery are both thought provoking and motivating. So let’s dive into my conversation with Steve Miller.

All right, folks, bringing you another conversation from the NPN conference. Where the theme is shining a light on prevention, and I’m honored to be hanging out here with the one and only Steve Miller, who is a prevention champion, prevention podcaster, man in long term recovery and is sharing his voice, his story, his wisdom to help make positive change in this world.

So without further ado, Steve, great to be talking to you again. Hey, thanks, Dave. I’m glad to be here. Yeah. Oh, all right. So we’re jumping right in. We’re jumping right in. I don’t want to, to really tell your background and why you work in prevention now, but I’m hoping you might be able to, to give us, we’ll say a cliff notes version of highlights real of.

What led you to working in prevention? That’s always an interesting question, Dave. And one of the things that I’ve realized, and this has been in the last couple of years, that I would have said, oh, there’s just been so many random things that have happened in my life. And then when I sat down and kind of looked at them on a timeline, I realized it was actually a straight line.

And it wasn’t something that was so haphazard. It was actually what was intended all along for me to be doing. And, and part of that is, is the natural evolution. As you said, I am a person in, in long term recovery. And so I’ve been working in either the treatment field or some variation of prevention for three decades now.

And so that’s really been my life’s focus is my own recovery. And, and then what I’ve learned in that journey is how do I kind of. Find my work through who I, who I really am. And one of the common denominators through all of this, before I was in recovery, since I’ve been in recovery and now in the prevention field has been this.

I call it the muse leading me through song, if you will, and I had to learn the prevention field. I didn’t know it existed. I didn’t know there was a science. I just kind of fit the description of what they were looking for as a new staff member. And I thought, Oh, I could do that. And it didn’t take me long to figure out that.

My guiding force through prevention is believing that by finding, we find our work through ourselves and when we do that kind of strengthens our commitment to do this kind of work, but it also strengthens the workforce because just like you, you’ve kind of found a path that leads you in the work that you’re doing.

But you started in prevention and I found a path by starting in prevention, learning the science, learning how the strategic prevention framework operates, all that kind of stuff. Then I stood back and I thought, does music belong in? And lo and behold, that’s kind of the answer has been, Oh yeah, it does.

Because it’s been such a powerful force in my life. I thought it’s got to be added into what I’m doing in prevention, added into your story, because like you said, it, it’s been a muse behind that straight line to prevention. So let’s just talk about that. Let’s, let’s go right there and talk about. Music.

You say it’s been your muse. What do you mean by that? How has it been your muse? People ask me when I talk about it, they go, so what instrument do you play? And I’m like, I play the radio really well. And if I want to, I can put a record on the turntable, but I am not a musician. I have been someone who has been an avid consumer of music like a lot of people since I was an adolescent.

And I tell a whole story through a training that I do about how music shaped my life, but how it shapes our lives. And then I just overlay that in the, into the prevention field, because there’s a lot of research that shows how music influences our choices. And when we’re adolescents and we’re trying to figure out who we are and what we want out of life and where we’re going to go, we’re very susceptible to outside stimulus and peer pressure is really what that comes down to.

And music can be a part of that music. Plays a part in helping us form our identity because we have such this creative bond with music. Everybody can think for themselves, what was that song that was the soundtrack to your life as an adolescent? Did you dance to? Who’d you fall in love to? Who’d you hang out with your buddies?

You know, what was the, what was playing in the background? And we all kind of have that somewhere inside of us. My choices happen to be very detrimental and that was a part of my addiction. And then when I found myself in a recovery process, it was music again, that kind of just woke me up and made me realize there are messages in all of these songs that are beneficial to who I am at this particular point in my life.

So that we’re kind of a meditative process. But then when I got into prevention, I started thinking, how could, how could my experience And how could the research that supports my experience be beneficial to a message that would target an audience that’s either adolescents, or I talk about how music is a part of the workforce development in my life, music, really.

I start my day with it and I probably end with it, but I start most days with a song. And I mean, to prove that to you this morning, I woke up with a song in my head. And I sat down in the, before I even really get out of bed, I write kind of a journal entry about that song and what it means to me and how it kind of feels like it’s guiding me for the day, what that intention would happen to be.

And I’ve just followed it because it’s fun. I feel like I’m kind of the only one that does it. I’ve shared these ideas with other people, but been very insightful for me. And, and, I still provide training and technical assistance through prevention to lots of audiences, but there’s this little niche that I talk about where the music kind of fits right in there, I’d like to, to zoom in and.

Wanna really. Invite you to share a great example of, of how music played a part in your addiction. You said you kind of, it kind of kicked you off and had a prominent role there. Can you give us that, that kind of that, that clear example, like what happened? I mean, think, and I was trying to get, we were talking about this for the, for the audience to kind of.

I was how to Get this in their mindset as well. If you think about a song that you hear and when you hear it, you’re kind of transported to a time and place in your life. Now, I have a song that always takes me to exactly the same memory and it’s, it’s uncanny that I actually, it was, it’s, it’s a song by ACDC and it takes me to the lake outside of the town I grew up in.

And it’s not just the song and the, and, and the association of that time in my life. I actually, I’m telling you right now, it’s almost like I can feel the air around the lake on my skin. It, it’s like, It’s being transported to that memory and reliving it again. And that’s how powerful music is. So I ask people all the time, what is that song for you?

And why do you have such a strong association with it? Maybe it’s because you fell in love, you know, that kind of thing. Maybe it’s the first dance you ever had, because I have that story as well. But there was a time in my life when if you’d have said, Oh, Steve, you’ll smoke cigarettes, or you’ll drink alcohol, or you’ll use some kind of substance.

I would have thought you’re, you’re crazy. Cause I was like any other kid that I grew up with. I played sports, hung out with my friends. We rode our bikes everywhere. I grew up in the 1970s. Anybody that’s listening probably knows what that was like. And one day, I mean, I know that it was a Saturday. I know that it was eight minutes after nine o’clock in the morning and an older brother To one of my friends came into the room and put on a song and in that moment, everything about what I thought life was changed.

And the song to me was rock and roll. And I thought it was about something that I wanted to pursue. And it was really about. In that moment, to me, it was about using drugs and alcohol. Now, I had some experience with it before then, but after that moment, everything changed. I mean, it was like a slipper slide.

It went downhill quick. And then years later, when I got curious about this topic we’re talking about, I got to looking at that specific song. And I realized that song is not a pro drug use anthem that I thought it was. It’s actually a very thought provoking message to one of the singer’s bandmates because he was concerned about his own health and his own life because of his substance use.

And I, so I point out to the audience that as adolescents, we kind of make a lot of things up based upon what we want to hear, because we’re looking for that, that identity, who are we, where are we going? How do I feel those kinds of things? And a song can slip right in there. And I’m not unique in that fashion.

I have talked to several people in the last 10 plus years that have told me stories about how they heard a song and made a decision in the moment. And sometimes I’ve stood back and said, you did what, and then they explain it to me and it makes perfect sense because of the time of their life, what they were experiencing, those kinds of things.

And so that song really impacted my life. In a very detrimental way, some people, it impacts their lives in a very positive. And I’ve talked to some that it, a song shaped their life in a way. It is very financially rewarding. So I think it’s across the board. The question is, is do we ever, do we ever really listen to what that song is actually saying to us or how we feel about it or what it means to us?

And I think that’s the key is really being in the moment and aware enough to know that this song may say one thing, but I may take it another way. And then when we’re adolescents, it might behoove us to ask someone, an adult or someone we trust. This is what I hear this song saying, as opposed to this is what I think this song is saying.

So getting some of that feedback and checking that out before I make some sort of a critical life decision. And that’s basically, we talk in prevention about media literacy. So that could be printed or television ads or radio or social media, whatever that looks like. I just put it under the heading of it’s really about music literacy and understanding the impact it has in our lives.

You just made me kind of understand about myself. There’s a lot of songs that I love and they make me feel a way when I hear them and they take me back to those moments like you talked about, but I can’t say I know all the lyrics. I may only know just the chorus or one line, but I love these songs because of the memories I have, the feelings I have associated to them, like the, for my, my wedding.

I asked for a, I call it a secret first dance. I wanted to dance a specific song before we went into the actual like dinner afterwards. And so it was just my wife and I, and the photographer and that’s it. And I don’t know the lyrics to that song. I know the title of it and the artist, but that’s it.

But I love it whenever I hear it. Come on. It takes me right back to that moment. We’re having our moment. Yeah. Yeah. But I don’t know the lyrics. And what’s interesting is I watched it was. A reel on one of the social media channels just in the last couple of days. And it was something that said as a Gen Xer actually listens to the song and, and you can see ’em kind of keying into what the message is and being like, oh, I didn’t realize that’s what that song was saying.

Right? Mm-Hmm. . Mm-Hmm. . And, and that, that fits the bill. Some of us know that hook and some of us know just the, the feeling that we get. That’s associated with the song, but there’s a lot of research out there that says, even if we’re not consciously aware of the lyrics, some part of our brain is picking up on the messaging of that.

Now, whether that’s detrimental or whether that’s inspiring or whatever that looks like is different for the individual. No two songs are the same. But like I said, I hear a song and, and the song I heard this morning is one that I really only know the hook to, like you just said, so I Googled the whole lyrics and then I sat down and wrote a little passage about it, but I have had experiences where I woke up and I had that same thought, you know, some, some, some statements going through my head and I’m like, I don’t even know if that’s a song and then I’ll say, I’ll Google lyric and then whatever it is I’m thinking, and if it comes up as a song and I yeah.

I’m amazed. There’s been times when I’ve done that and I swear to you, I have no recollection of ever hearing that song in my life. Now, where did I pick it up? Why did it come to me in my sleep? I don’t know. But I am fascinated by the fact that when I’ve been led to understanding that there’s some something stuck in my subconscious, if you will, and it ekes out when I wake up in the morning and it’s a song that I picked up somewhere along the way, I just don’t know where or when or why, but that’s why the why is like, well, why is this showing up?

And then I try to kind of analyze it, kind of meditate on it, gives me a way to set my intention for the day. And sometimes I might share that with other people if I find it a profound insight in some way or another, I’m going to draw a connection that might not be there or not, but I’m reaching for it.

And I know and trust that you’ll be like, ah, Dave, there’s no connection there. But I talk a lot about the power of storytelling and prevention, treatment, and recovery, both for the, the listeners, but then also for the actual storyteller themselves, but songs. They have the story element, they have the story factor too.

So wouldn’t that be sort of one in the same? I think so. I’ve, I’ve heard people talk about that songwriting really is a gift because I’ve seen interviews with artists or authors that have written books and they’re like, they can tell a story in three and a half, four minutes that takes me a chapter or two to tell, but they can synthesize it down in a way.

And that’s the part like that led up to anything really being, you know, like understanding how music impacts me emotionally as an adolescent, because my parents played music when I was growing up, but the songs that stick with me to this day are the ones that tell a very vivid story. And so I’m kind of a storyteller of sorts myself, but I like a song that tells a really powerful story.

So as an example, The first song that I really can remember, I wanted that song so bad. And it was a, it’s a singer named Jim Croce. And the song is bad, bad Leroy Brown. And I was a nine year old boy. And I mean, bad, bad Leroy Brown was the baddest man in the whole damn town. Badder than old King Kong and meaner than a junkyard dog.

And to a nine year old boy, it’s like. I want to be, you know, like to me, it was like the he’s respected and, you know, he’s a tough guy and, you know, kind of things that as a nine year old boy, you’re playing G. I. Joe and playing army with your buddies. You know, you’re kind of wanting to be that masculine kind of identity.

And that was what bad, badly Roy Brown was. But it’s a very vivid story song. And a lot of Jim’s work is story songs. And so I’ve always sought those out. I like all kinds of music. I don’t pick a genre, but the ones that seem to rise to the top are the ones that tell me a story about something that I don’t understand.

And I’m, as I’m explaining this, I watched a documentary about a group and, and they had on there as a guest, he was a professor of music of some sort from a university. And he said, I had a student that did a, master’s thesis on this particular subject. And he spent all semester long or all year long, however long that takes and wrote this thesis.

And he said, this singer captured the same essence in three and a half minutes. That’s the power of a song. And if you can deliver that and people can really kind of onboard that, it can be powerful in a lot of ways, or it can be, like I said, it can be, it can be harmful in ways. So it just depends on the listener and how you.

How you perceive it, how you receive it and, and how you may or may not act on it. I want to ask about a powerful song that if I remember correctly, as part of your journey as to where you are today. So if I, if I throw out the Beatles song help, where does that take you to in your life? Well, that’s the turning point.

I’ve actually written a short story for a friend of ours that’s doing a collection of legacy stories. And I kind of tell the story through two things, the, the song that was kind of the gateway into substance misuse. And then it was the song by the Beatles help that was kind of the book into it. And it was the one that really kind of illustrated to me that songs spoke to people in very unique ways.

And it was a Catholic priest that was talking about the fact that, the lyrics of a popular song could be the catalyst to get someone’s attention about their addiction. And I remember thinking in that moment, wow, I wonder if that would happen for me. Now, when I look back, the surprise is it was happening to me, right?

But that’s the desperation of, of that point when you’re asking for help in recovery and the Beatles song help is, was the song he illustrated. And if you look at those lyrics. Makes perfect sense. When I was much younger, so much younger than today, I never needed anybody’s helping. Well, here I am in a institution asking for help and realizing that someone has captured that essence of what I’m going through and put it in a song and it kind of planted that seed like, well, what other songs are in my life that might be signposts and.

Those kinds of things. And, and I was a huge consumer still lamb, but I had more time on my hands when I was younger. I was a huge consumer of music and I worked in television at the time and the general manager’s assistant just one day casually said to me, Steve, how long has it been since you listened to any music?

And I said, it’s kind of a strange question. And she said, your personality is different when you don’t listen to music for a period of time. And that’s another point in my life when I was like. What, what is this all about, you know, and I started at that point, not just listening to like a popular song that I liked, I started like listening to entire albums, like what’s being portrayed here and I read an article and, and the author had said that if you really want to understand The author that writes popular novels or something like that, read everything that they’ve ever written, and you’ll have some understanding of who they are as a person.

And so I started that through the lens of music and started thinking about some of the artists that I was enamored with and started listening to their entire albums and their entire catalogs, just to kind of seek out, like, What has been the path for this person and, and lo and behold, after doing that for years on end, it found its way into the prevention work.

To me, it’s really about following the muse, if you will, or following your own life’s path. And in prevention, that’s kind of where I started in, in prevention. If you stick around here and you find some attraction to it. I think you have to put yourself into the work at some. It has to start becoming a reflection of who you are.

You have to be vulnerable enough to really say, this is this is kind of who I am. And this thing that I do kind of all merged together because for me, prevention and my recovery, but. Prevention is really about people. Somebody I know says prevention is better together, and together we are stronger. And that says everything about prevention.

Because it doesn’t happen in a vacuum. You can’t go in and change a community’s rate of underage alcohol consumption just by telling the chief of police or having an article in the newspaper. You have to get people together in a concerted effort. Effort to make a difference. And that’s why I do the work that I do.

And that’s why I’m passionate about bringing the music into it, because I think we all, whether we’re as active in their consumption of music as I am, I think we all have been touched by music or love music in some form or fashion. And if I can just help people to see that maybe those songs are speaking to them about something, then, then that’s, that’s kind of how it’s played out in my life.

I say that I practice a two way communication with music. I listened to the song and then I asked the song, what is it that you want me to hear from this? And then I try to write about it. So I know we could talk for hours. But we’ve got a conference to get back to, so I want to just throw one more thing your way before we wrap up this chat as a to be continued.

But I’m curious, what’s final takeaway if you’re going to leave with one thing, what’s it going to be or call to action for our listeners from around the globe? Well, I love the call to action and it is think about that song. What is that song that stops you in your tracks and takes you to that moment?

And why is it so? Unbelievably powerful in your life. And, and like I’ve already said, think about what it might be saying to you, because it’s unique. I heard Dave Grohl, he’s the lead singer for the band Foo Fighters, and others might know him as the drummer from Nirvana, but he said, the amazing thing is, is he said, I can stand on stage and I know that I am singing this song to 80, 000 people.

But the beauty of music is. 80, 000 people are singing back their own interpretation of that song. To me, that really personalizes all of this in that I think music is a very powerful presence in our lives and it must serve some greater purpose because a question I’ll often ask is. Music doesn’t have to exist, but it does.

Think for a moment that music no longer is a part of your life. And I’ve never met anybody say, well, I won’t miss it. Most people are like, wow, that means there’s, there’s no soundtrack at the movie, the commercials are just talking heads. You don’t even know that birds chirp because that’s music. If all of that was gone from our lives, what a different world it would be.

So I turn it around and say, this must mean that there’s something here. And I would always challenge people just to ask themselves, what is the value that music plays? And with that listeners do some thinking, do some listening and have a conversation with some songs. Steve, thanks for taking time to chat.

Always, always, always a pleasure. Thanks, Dave. Always glad to be here.

That concludes this episode. Thanks for tuning in. Be sure to hit the subscribe button and share this episode with a friend before you leave. And we look forward to seeing you on social media because prevention is better together. Together, we are stronger.

 

Source: Drug Free America Foundation

 

By  BRUCE SCHREINER

Kentucky Attorney General Russell Coleman unveiled plans Tuesday to create a statewide drug prevention program, saying the youth-focused initiative would fill a hole in the Bluegrass State’s fight against an addiction epidemic that has claimed thousands of lives.

Coleman presented the plan’s details to a state commission, which unanimously approved his request for a $3.6 million investment over two years to implement it.

“With over one million Kentuckians under the age of 18, we are going to put every single dollar to good use,” Coleman said. “Our parents and grandparents schooled us that an ounce of prevention is worth a pound of cure. I fully believe this initiative lives up to that age-old sentiment.”

Substance abuse is a deadly scourge in Kentucky though there are signs of progress in fighting back.

A total of 1,984 Kentuckians died last year from a drug overdose, down 9.8% from the previous year, Gov. Andy Beshear announced in June, citing an annual report. Fentanyl — a powerful synthetic opioid — remained the biggest culprit, accounting for 79% of overdose deaths in 2023, according to the report.

While conceding the fight against drug abuse is far from over, officials credited recent gains on expanded efforts to treat addiction, plus illegal drug seizures by law enforcement.

Source:  https://apnews.com/article/drug-abuse-kentucky-a23d7452851a18aa2420c93ff99cdf34

 

Published July 11, 2024

By Andrew Hutchinson

 

X is taking another step in combating the promotion of illegal substances in the app, by signing up to the Prevent Alliance, which aims to establish more definitive rules and approaches to combat synthetic drug promotion within social apps.

Synthetic drugs aim to replicate the effects of more commonly known illicit substances, like cocaine, marijuana and LSD. Arguably, the most notorious synthetic drug is fentanyl, though there are many other dangerous variations of synthetic substances that have now established a market among drug users around the world.

And they can cause serious harm. Research shows that the repeated use of synthetics can cause “long term or irreversible damage to dopaminergic, adrenergic and serotonergic pathways in the brain”.

The more potent mixes can also lead to more serious side effects and harms. As per the CDC, synthetic opioids are now the primary driver of overdose deaths in the United States.

As such, it’s important for X, and indeed all social platforms to crack down on the promotion of synthetics, and this new initiative will ideally help to establish more detection and prevention processes among social apps.

Though, at the same time, X owner Elon Musk himself takes ketamine, a synthetic substance, and his high profile endorsement of this, and other synthetics, could run counter to the aims of this project.

Probably best to view the two in isolation (and Musk, it’s worth noting, uses ketamine in a prescribed capacity), though with Elon’s celebrity, and his desire for attention, that’s increasingly difficult.

Source: www.socialmediatoday.com

Attorney General Russell Coleman proposed a statewide, youth-focused addiction prevention initiative before the Kentucky Opioid Abatement Advisory Commission Tuesday.

The Commission unanimously approved the two-year, $3.6 million proposal, which is centered around a research-backed youth education campaign.

This campaign, called “Better Without It,” will feature data-driven outreach to engage with young Kentuckians where they are, including on social media, streaming platforms, college campuses and through partnerships with influencers. The campaign will showcase positive, Kentucky-focused messages designed specifically to encourage young people to fulfill their potential.

The Commission and Attorney General’s Office will partner with prevention experts and creative marketing professionals to build the educational campaign that is compelling to young Kentuckians.

“Our kids are growing up with no margin of error. As little as one pill can – and is – killing our neighbors. Today, the Opioid Commission joined with our Office to build a prevention program that will give young people the encouragement that they are better without it,” said Attorney General Coleman “We will reach Kentucky’s young people where they are with a message that resonates. I’m grateful to the Commission for their strong support for this program that can truly save lives.”

In addition to the education campaign, the prevention program will also promote existing school-based programs and amplify the work of the Commission to support youth-focused prevention efforts.

To date, the Commission has distributed more than $55 million to combat the drug crisis, directly helping Kentuckians overcome addiction and promote long-term recovery.

Source: https://nkytribune.com/2024/09/attorney-general-coleman-announces-statewide-youth-drug-prevention-campaign/

Source: https://www.dea.gov/redribbon?

Students who feel a sense of belonging at their university are more likely to binge drink than those who do not feel the same connection, according to a new study by researchers at Penn State, the University of California, Santa Cruz and University of Oregon.

In the study, published in the Journal of Studies on Alcohol and Drugs, scientists -; including researchers in the Penn State College of Health and Human Development -; found that college students with “good” mental health who felt connected to their university were more likely to binge drink than those who did not feel as connected to their university.

Stephane Lanza, professor of biobehavioral health and Edna P. Bennett Faculty Fellow in Prevention Research, studied the topic with Danny Rahal and Kristin Perry when both were postdoctoral trainees in the Penn State Prevention and Methodology Training Program. The researchers examined the ways that both positive and negative aspects of mental health can contribute to the risk of binge drinking, cannabis use and nicotine use.

“In 2021, students at many universities were returning to campus after the COVID-19 shutdown -; and some students were attending in-person college classes for the first time,” said Rahal, lead author of this research and assistant professor of psychology at University of California Santa Cruz.

Data from that time indicated that many students felt disconnected from their school. Universities wanted to foster a sense of connectedness among their students for many good reasons, but we wanted to know if there was something positive -; specifically a sense of belonging -; that is related to substance use. Our study showed that feeling connected to one’s university is associated with higher rates of substance use.”

Danny Rahal, The Pennsylvania State University

The researchers examined data from 4,018 university students collected during the 2022-23 school year. Participants answered questions about substance use, their sense of belonging at their school and their mental health -; specifically about anxiety, depressive symptoms, perceived stress, flourishing in life and confidence in their academic success.

A statistical modeling technique called latent profile analysis allowed the researchers to simultaneously account for all these measures by combining them to identify five profiles of student mental health. In this study, a student was considered to have good mental health if they had lower levels of stress, depressive symptoms and anxiety, as well as higher flourishing and academic confidence than their peers.

 

The researchers said this does not mean that connectedness is bad for students to experience; rather, the results are nuanced.

“We want to cultivate connectedness among students,” said Perry, assistant professor of family and human services at University of Oregon. “Connectedness gets them involved. It can be a really powerful protective factor against negative mental health outcomes and can help keep students in school. But connectedness at school can go hand in hand with binge drinking if there is a culture of drinking at the school.”

Though the researchers said they expected these results about drinking, they were surprised to learn that students with poor mental health who felt connected to their university were more likely to use non-vaped tobacco products than students with poor mental health who did not feel connected to their university. The results around cannabis were less conclusive, but the researchers said the trend was clear.

“Generally, students who felt connected to their university were more likely to use substances than disconnected students with the same level of mental health,” Rahal said.

While a sense of belonging was related to substance use, it could also be part of the solution, according to the researchers.

“Cultivating belonging for all students is an important way that universities can embrace diversity and help all students thrive,” Lanza said.

Though drinking is common on university campuses, many students believe that it is far more common than it is, the researchers explained. In this dataset, slightly fewer than one-third of students reported binge drinking in the last month. Despite the fact that two-thirds of students had not engaged in binge drinking, the researchers also found that students believed a typical student consumed three to five drinks multiple times each week. The researchers said this disconnect between perception and reality points to an opportunity to change the culture -; by creating ample opportunities for all students to socially engage and participate in alcohol-free environments -; so that alcohol feels less central to student life.

Minoritized college students, in particular, often face messages that make them feel unwelcome based on their race, gender, socioeconomic status or other factors, according to the researchers.

“We cannot expect students to stay enrolled unless they are engaged with the campus community,” Lanza continued. “If universities lose students from a specific group, the campus becomes less diverse, and the entire university community becomes less rich. Additionally, when members of those groups leave school, they miss educational opportunities and the earning potential that comes with a college degree. By providing all students with diverse opportunities to build a real sense of belonging at their universities, we can improve campus life while putting people on the path to a healthier life.”

The National Institute on Drug Abuse and Penn State funded this research.

Posted 

October is National Bullying Prevention Month. Bullying prevention programs begin locally, with communities and the individuals within them creating safe and supportive schools, organizations, neighborhoods and family units.

While this campaign is not as recognized as much as the months dedicated to overdose awareness and suicide prevention, it is equally as crucial. Bullying is linked to drug addiction and suicide. Bullying prevention campaigns help save people from substance abuse and increase awareness in local communities.

According to the PACER’s National Bullying Prevention Center, one in five students report being bullied, but the actual number of bullying incidents can be far more significant. Roughly 41 percent of students who reported being bullied at school indicated that they think the bullying would happen again.

Anyone can be the victim of bullying. A poll conducted by the American Osteopathic Association found that 31 percent of Americans have been bullied as an adult.

The most common reasons for being bullied reported most often by students included physical appearance, race, ethnicity, gender, disability, religion and sexual orientation. The effects of bullying are serious because bullying increases the risk of depression, anxiety, substance use and even suicidal ideation.

According to the NYS Health Department, suicide is the second leading cause of injury-related deaths among New York State residents. National drug abuse statistics coming from the NCDAS show that 8.3 percent of 12- to 17-year-olds reported using drugs in the last month in New York State, and 18- to 25-year-olds are 8 percent more likely to use drugs than the average American. While there are countless reasons why someone would use drugs or alcohol or struggle with suicidal ideation, bullying is often an underlying factor.

National Bullying Prevention Month strives to prevent childhood bullying and promote kindness, acceptance and inclusion. However, anyone can prevent bullying and be part of the solution.

Start by knowing the signs of bullying. This makes it easier to intervene quickly. Generally, you could see shifts in behavior, such as a student becoming more withdrawn. The person could lose self-esteem, become ill, or change eating or sleeping habits. Students begin to lose interest in school and their grades are impacted.

Self-destructive behavior is also typical, such as using drugs or alcohol, or committing self-harm. Parents might see unexplained injuries, or lost or destroyed property as a result of physical bullying. You might also notice the person has become anxious, stressed and even depressed.

Knowing the warning signs is the first step, and the second is intervening. Kids or adults who are being bullied are not quick to talk about it. It’s a good idea to listen to them, assure them you want to help, and let them know it is not their fault this is happening.

Understand that it is painful for anyone to speak up about this, but begin discussing what can be done. Encourage them to speak to someone, such as a teacher, co-worker, friend, counselor or someone in a position of authority who could step in and end the bullying.

Moreover, work to remedy the situation, get people involved and follow up, as bullying does not stop immediately. The bully should also be informed that their behavior is wrong, harmful and, in some instances, illegal; make it known that it will not be tolerated.

Look at some local anti-bullying resources, such as the Advocates for Children of New York, New York State’s Dignity for All Schools Act, and the NYS Center for School Safety.

Early intervention is vital and even more critical if the individual being bullied is using drugs or alcohol to cope. In addition to this, anti-bullying programs are excellent resources for schools, communities and the workplace, and should be implemented. These programs save lives and encourage more people to become aware and help others.

Marie Garceau has been working in the field of substance use and addiction recovery for over a decade. She works at DRS and primarily focuses on reaching out to the community and spreading awareness.

Source: https://riverreporter.com/stories/preventing-bullying-can-prevent-substance-abuse,167846

Source: The Sunday Mail

Submission to the Joint Select Committee on Social Media and Australian Society

Executive Summary
Social media platforms have become a major part of young Australians’ lives. While these
platforms have many benefits, they also expose youth to content that promotes substance use,
including alcohol, tobacco, e-cigarettes, and illicit drugs. This is concerning because:
1. There are often no effective age restrictions on this content.
2. Substance-related posts are widely available and mostly show drug use in a positive
light.
3. Young people are seeing alcohol related advertisements on social media every few
minutes.
4. Exposure to this content can normalise substance use by young people and undermine
the perceived harms of substance use.

The Australian government and social media companies need to work together to protect
young people from this harmful content. This could include better age verification, stricter
content policies, and using technology to detect and remove posts promoting illegal
substances.

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

To access the full document:

  1. Click on the ‘Source’ link below.
  2. An image  – the front page of the full document will appear.
  3. Click on the image to open the full document.

 

Source: National Centre for Youth Substance Use Research

 

By Ian Webster  Oct 28, 2024

Ian W Webster AO is Emeritus Professor of Public Health and Community Medicine of the University of New South Wales. He has worked as a physician in public and regional hospitals in Australia and UK and in NGOs dealing with homelessness, alcohol and drug problems and mental illness.

Please review Ian Webster’s paper which clearly shows that we need to learn from our success in the past that Prevention is the best way forward.

The second New South Wales Drug Summit will be held in regional centres for two days in October and the final two days will be in Sydney on the 4th and 5th December to be co-chaired by Carmel Tebbutt and John Brogden – a balance of politics.

Do summits achieve worthwhile outcomes?

The first Drug Summit in 1985 was national. It worked. It established the enduring principle of harm minimisation. It brought police, health, and education together, canvassed all drugs – including alcohol and tobacco, and it started funding for practicable and policy-based research.

It worked because Prime Minister Hawke needed it to, for family reasons. It worked because the Health Minister, Neal Blewett, needed it to work as he had carriage of its outcomes and the national response to burgeoning HIV/AIDS epidemic.

The 1999 NSW Drug Summit was in response to the rising prevalence of heroin use and opiate deaths. It worked because there was a political will to succeed. It included measures to deal with blood borne infections of HIV, hepatitis B and C; it expanded the state’s opioid treatment programs; expanded needle-syringe programs; introduced the antidote naloxone; and three seminal firsts – the first medically supervised injecting centre, drug courts, and court referral into treatment.

It worked because the Premier Bob Carr wanted it to. Which meant that the summit’s recommendations were managed through the Cabinet Office, supported by a ministerial expert advisory group. The ‘piper called the tune’ for all the state government departments; and they were made to work together.

The Alcohol Summit of 2003 was not as effective. Politicians were too close to the alcohol problem and implementation was handed to the Department of Health which meant other departments washed their hands of involvement. Police, on the other hand, carried the day with counterattacks on alcohol violence and behaviours at liquor outlets.

Contemporary drug problems

Now other substances must be dealt with – amphetamine type stimulants, especially crystalline methamphetamine, cocaine, hallucinogens, MDMA, pharmaceutical stimulants, the potent drug fentanyl, the even more potent nitrazenes, ketamine and unsanctioned use of psychiatric/neurological drugs. Cocaine is flooding the drug markets.

Heroin and alcohol remain as major problems. The Pennington Institute estimated there were 2,356 overdose deaths in 2022, 80% of which were unintended. And alcohol, not only damages the drinker, and the bystander, but creates extensive social harms in the lives of others.

NSW Ice Inquiry

Four and half years ago Commissioner, Dan Howard, reported on his Inquiry into the Drug Ice; he had started the Inquiry six years previously. His recommendations provide a scaffold for the upcoming Summit. The earlier NSW Drug Summit (1999) was followed by a strong impetus to implement its recommendations, but the Government dropped the ball 20 years ago. The last formal drug and alcohol plan was 10 years before the Ice Inquiry.

Fundamental to drug law reform is the decriminalisation of personal use and possession of drugs. This recommendation stands above all others in Dan Howard’s Report.

The thrust of the Inquiry’s recommendations centre on harm minimisation:

  • drug problems are health problems,
  • government departments across the board have responsibilities,
  • treatment, diversion, workforce initiatives, education and prevention programs must be adequately resourced,
  • accessible and timely data are needed,
  • Aboriginal communities, and other vulnerable communities, those in contact with the criminal justice system, all disproportionally affected by alcohol and other drugs, must be high priority population groups.

The NSW Liberal Government pushed back against decriminalising low-level personal drug use, against medically supervised injecting centres, against pill testing, cessation of drug detection dogs at music festivals, and needle and syringe programmes in prisons. Later it gave in-principle support to 86 of the recommendations.

Will the Summit achieve?

The hopes of the drug and alcohol sector are for easy access to naloxone (antidote to opiates), supervised drug-taking services, accessible sites for drug-checking, early surveillance on trends, better access to now available effective treatments, for the treatment of prisoners to equal that for all citizens, and a more equitable distribution of treatment and rehabilitation services across the state, and to ‘at-risk’ population groups.

Success will depend on the practicality of the recommendations and the preparedness of government to act on them in good faith.

It is trite to say, but this depends on political will. The will was strong in the earlier national Drug Summit (1985) and NSW Drug Summit (1999). But so far, Government responses to the Ice Inquiry have been late and weak-willed which does not bode well for the delivery of needed reforms.

There is now a Labor Government, also tardy in its response. It remains to be seen whether NSW Labor has the stomach to overturn past prejudicial stances on drug use and addiction, and whether it will put sufficient funds to this under-funded and stigmatised social and health problem.

What will not be achieved

The Summit and its outcome cannot attack the real drivers of drug problems – the incessant search by humankind for mind altering substances, the mysteries of addiction, and the abysmal treatment of people in unremitting pain.

The root causes of drug problems are socially determined. Action at this level will require an unimaginable upheaval of society and government. In western countries drug overdoses (including alcohol overdoses), suicide, and alcoholic liver disease, are regarded as ‘diseases of despair’. The desperation and despair which pervades vulnerable, and not so vulnerable, population groups, is the underground of drug use problems here and in other countries. Commissioner Howard said, we [society] are given “tacit permission to turn a blind eye on the factors driving the most problematic drug use: trauma, childhood abuse, domestic violence, unemployment, homelessness, dispossession, entrenched social disadvantage, mental illness, loneliness, despair and many other marginalising circumstances that attend the human condition.”

Somehow a better balance must be struck for law enforcement between the war on traffickers and the human rights of users. It is for the rest of us to treat drug using people as our fellow citizens.

Kind Regards

Herschel Baker

 

Source: Drug Free Australia

By Brittany Vargas  /  September 30, 2024

The American Academy of Pediatrics (AAP) published its first clinical practical guidelines on opioid prescriptions for children with acute pain, outlining 12 evidence-based recommendations for safely and appropriately treating pain in young patients.

The guidelines have been published alongside a technical report in Pediatrics and presented at the group’s 2024 annual meeting.

While not the only set of guidelines of its kind, ”is the first set that is really for anyone who takes care of children, not just surgeons, anesthesiologists, and pain specialists,” said Rita Agarwal, MD, a pediatric anesthesiologist at Stanford University in Stanford, California, who helped write the recommendations.

The opioid guidelines were created to give clinicians a clearer, more objective framework for safe treatment of acute pain in the outpatient setting while mitigating the risk of addiction, overdose, or other harmful effects.

”Most of what we’ve been doing thus far as practitioners has been anecdotal, from experience, or from word of mouth,” said Adaora Gabriellene Madubuko, MBBS, MD, assistant professor of pediatrics at Rutgers New Jersey Medical School in Newark.

The AAP advises clinicians to start with the lowest possible dose based on age and weight, to use an immediate-release formula, and provide no more than a 5-day supply, unless trauma or surgery calls for longer-term pain management.

Clinicians should not use opioids as their only strategy for reducing pain in this population. Combining the drugs with other medications can enable prescription of lower doses of opioids and could decrease the side effects of other medications, according to the report. These might include acetaminophen and nonsteroidal anti-inflammatory drugs. Other strategies can include ice or heat, transcutaneous electrical nerve stimulation, age-appropriate relaxation or distraction strategies, and music therapy.

The report also recommends prescribing naloxone alongside each prescription and training caregivers to identify a potential overdose in their child. Clinicians should also provide tips to caregivers about safe storage and disposal of opioids.

The AAP also suggests restricting the use of codeine or tramadol among children under age 12; teens aged 12-18 with obesityobstructive sleep apnea, or severe lung disease; and patients under age 18 with postsurgical pain after tonsillectomy or adenoidectomy.

Other recommendations include:

  • Use caution in prescribing opioids for children or teens who already are taking sedating medications, such as benzodiazepines.
  • When treating acute, worsening pain in patients with preexisting chronic pain, clinicians should prescribe opioids when indicated and partner with any other opioid-prescribing clinicians involved in the patient’s care and with specialists in chronic pain and other opioid stewardship programs.
  • Do not prescribe codeine or tramadol to patients who are breastfeeding.

Each recommendation included a strength of evidence when available. When randomized controlled trials, diagnostic studies, or observational studies were not available, the AAP based recommendations on case reports or expert opinion.

”A lot of the guidelines are really common sense,” but methodically researched and well-defined recommendations were needed to reduce risks and guide clinicians who may be wary of prescribing the drugs in the wake of the opioid crisis, Agarwal said.

When awareness of the opioid epidemic first started, ”there was very little attention being paid to children,” Agarwal said. ”The thought was, ‘This doesn’t happen to our kids, this isn’t in my backyard.”’

Over time, evidence emerged that children and teens could misuse, abuse, and become addicted to opioids just like adults, said Agarwal. In response, rates of opiate prescriptions for kids dropped off.

”We’ve heard of the horror stories of high school kids sharing and distributing opioids to their friends,” Madubuko said. She has prescribed the drugs ”with great caution. I could count on my hands how many patients I’ve prescribed opioids to over the last couple of years.”

But a decline in opioid prescribing has led to some children lacking adequate pain management and lowering their quality of lifeaccording to the AAP practice guidelines. Underprescribing can particularly impact non-White patients and those in certain ethnic or socioeconomic groups, studies show.

The guidelines bring much-needed objectivity to the prescription process, potentially reducing some of these disparities, Agarwal said.

”By creating a standard that says, these are the things you should look for, these are the things you should treat, we leave less room for saying ‘I think this person is faking,’ or ‘I don’t think they’re having as much pain as they say they are.”’ Agarwal said. ”The guidelines emphasize the fact that if a patient says they’re having a lot of pain, you should believe them first.”

Madubuko is on AAP’s Patient and Family-Centered Care and Neonatal Care Task Forces but was not involved in the creation of the guidelines. 

Brittany Vargas is a medicine, mental health, and wellness journalist.

Source: Medscape Medical News

October 18, 2024

WASHINGTON – The U.S. Drug Enforcement Administration recognizes the Red Ribbon Campaign – the nation’s largest drug prevention effort – throughout the month of October by providing drug prevention, awareness, and education that encourages living healthy and drug-free.

DEA’s Red Ribbon Week is recognized October 23 through October 31 every year and honors the life of Special Agent Enrique “Kiki” Camarena who was tortured and brutally murdered by drug traffickers in Mexico in 1985.

“DEA honors Red Ribbon throughout the month of October to spread awareness and promote the importance of drug use prevention. We want to save lives by raising awareness about deadly drugs,” said DEA Administrator Anne Milgram. “The sacrifice DEA Special Agent ‘Kiki’ Camerena made motivates us to continue our important work to save American lives through our enforcement and outreach efforts. We know the work we do today will shape the future of our tomorrows.”

DEA’s Virtual National Red Ribbon Rally premiered on Tuesday, October 8, and is available for viewing throughout the month of October on www.DEA.gov/redribbon and www.getsmartaboutdrugs.com.

The National Red Ribbon Rally includes an opening video by DEA Administrator Anne Milgram; a musical performance by students from Volcano Vista High School in Albuquerque, New Mexico; the presentation of colors by the Greater Cleveland Color Guard in Cleveland, Ohio; the premiere of the “No Second Chance” fentanyl PSA from students in Tempe, Arizona; and the Red Ribbon Pledge led by students from the Richmond, California, Police Athletic and Activities League. The winners of DEA’s 2024 Community Drug Prevention Awards and Visual Arts Contest will be announced, and viewers will learn many ways community groups and families can get involved in this year’s Red Ribbon Campaign.

As part of the Red Ribbon Week campaign, DEA and the Substance Abuse and Mental Health Services Administration are sponsoring the 9th Annual Red Ribbon Campus Video PSA Contest. Last year’s winners and information on how campuses can submit a PSA can be found at www.campusdrugprevention.gov/psacontest. DEA is also a co-sponsor of the National Family Partnership’s annual Red Ribbon Week Photo Contest. More information is available at www.redribbon.org.

Red Ribbon Week began in 1985 in Kiki’s hometown of Calexico, California, and quickly gained momentum across the state and then across the rest of the country. The National Family Partnership turned Red Ribbon Week into a national drug awareness campaign, an eight-day event proclaimed by the U.S. Congress and chaired by then President and Mrs. Reagan.  Every year since, Red Ribbon Week has been celebrated in schools and throughout communities.

President Biden has designated October as National Youth Substance Use Prevention Month and the Red Ribbon Resolution for 2024 has been introduced in the U.S. Senate to support the goals and ideals of Red Ribbon Week.

Source: https://www.dea.gov/press-releases/2024/10/18/dea-supports-2024-red-ribbon-campaign-promote-healthy-drug-free

Even as officials hope tech can stem the tide of solitary drug fatalities, they know deploying these warning strategies could face obstacles.

By    and   

They die alone in bedrooms, bathroom stalls and cars. Each year in the United States, tens of thousands of fatal overdoses unfold as tragedies of solitude — with no one close enough to call 911 or deliver a lifesaving antidote.

Technology new and old might save some of those lives.

Motion detectors blare alarms when someone collapses inside a bathroom at a shelter or clinic. Biosensors detect slowed breathing triggered by an overdose and one day may be capable of automatically injecting overdose reversal medication. Simpler approaches — chat apps and hotlines — keep users connected to help if drugs prove too potent.

Source: https://www.washingtonpost.com/health/2024/10/19/fatal-drug-overdoses-alarms-sensors/

Counties will approach enforcement differently, providing yet another large-scale experiment in drug policy.

by Troy Brynelson|Oregon Public Broadcasting

October 17, 2024

Days after Oregon officially recriminalized drug possession, Douglas County Sheriff’s Deputy Ryan Gomez found himself helping with an arrest.

Officers in the town of Sutherlin stopped a car near a park, he recalled. They spotted fentanyl and methamphetamine inside. He and the officers arrested the man for misdemeanor drug possession.

Recriminalization went into effect Sept. 1. Before that date, drugs would have resulted in far less punishment. Officers would have ticketed the man.

“Now, there’s consequences to the actions,” Gomez said. “He has to face the judge and explain his actions.”

It may have been a different story for the man had he been stopped in a county deploying a new state program called “deflection.” It aims to get people criminally charged for possessing small amounts of drugs into treatment, in lieu of going to court.

Lawmakers over the summer offered counties state dollars in exchange for creating their own deflection programs. More than 20 counties applied, submitting plans that involved activities like establishing shelters and pairing police with substance use experts.

For example, a person in Multnomah County who has drugs, but no outstanding warrants, may be deflected away from the justice system. They go to treatment instead. A successful trip could result in the person never facing a criminal charge.

Other counties, like Douglas, didn’t apply at all.

What’s left is a patchwork of drug enforcement policies across the state. The contrasting approaches may look starkest at the border of Douglas and Lane counties. Both counties straddle Interstate 5 and are planning widely different approaches.

Lane County officials tell OPB they are planning a robust deflection program. Douglas County, on the other hand, plans to try policing illicit substances like the old days.

‘By golly, he‘s going to prosecute them’

In opting out of the state’s deflection program, Douglas County Sheriff John Hanlin is conscious that the county may look severe. He believes jail and the justice system can turn lives around.

To him, Measure 110, the voter-approved decriminalization of drugs in 2020, failed in its aim to improve drug users’ lives. He and his deputies had few means to get people into treatment without criminal charges looming over their heads.

“Don’t get me wrong; I believe treatment is an extremely important component to this drug problem that we’re dealing with,” Hanlin said. “Treatment works, but only if there are consequences that go along with that.”

While every deflection program will be different, criminal charges can still be leveled against a person if they don’t comply.

Hanlin noted that landing in jail for a drunken incident when he was a teenager proved a wakeup call. He also brought up his 31-year-old son’s ongoing addiction, which has led to a lengthy rap sheet of misdemeanors and felonies in Douglas County.

“If he got arrested and spent a day in jail and got out the next, that wasn’t even long enough for him to realize that he’d done anything wrong,” Hanlin said. Jail is “a necessity if you want to wake them up and get them to think, ‘You know what? I think this problem is getting out of hand.’”

Deputies made nine arrests in September under the new recriminalization statutes, according to a sheriff’s department spokesperson.

Overdose deaths have been rising. According to data from the Centers for Disease Control and Prevention, overdose deaths rose from 23 in 2020 to 43 in 2023. That’s less than 4 for every 10,000 people.

The sheriff, first elected in 2008, said it was a joint decision not to participate between himself, District Attorney Rick Wesenberg and the county’s Board of Commissioners. Wesenberg and the county commissioners did not respond to multiple requests for interviews.

Hanlin said he wanted to take a wait-and-see approach with deflection: Let other counties go first with their experiments. He added that the county worried about using one-time state grant dollars without assurances of ongoing funding.

He doubted empowering his deputies to enforce stricter penalties would lead to unintended consequences, such as crowding the jail.

“Most of these cases are going to be cite and release cases,” he said. “But the DA assures me that, by golly, he’s going to prosecute them.”

A drug user’s fate is then up to the courts, Hanlin said. Douglas County does offer diversion programs and a drug court that aim to soften punishment and help drug users get clean.

“I don’t think we can arrest our way out of the drug addiction problem,” Hanlin said. “But I know that, obviously, doing nothing isn’t going to cause the problem to go away either.”

‘A lot of folks just want to see people get help’

Crossing the county line north into Lane County, one will find a completely different approach. Officials there hope to get more people into treatment and keep them away from jail cells and courtrooms as much as possible.

Oregon gave Lane County $2.1 million to assist. That will help pay for housing, officials said, and for a team of substance use specialists, known as navigators, who work with police and decide if a person should be deflected.

Clint Riley, who is leading the program, said he has traveled to the county’s various police agencies to help train them on when to call a navigator.

“That’s a different training that most of us have never been to before,” Riley said. “Maybe five years ago, you would have taken this person to jail. Now, we’re using a different approach. So it’s crucial that the relationship between navigators and law enforcement is good.”

Law enforcement agencies seem to have bought in. Chris Parosa, the Lane County District Attorney, said officers are glad drug laws have more teeth yet they aren’t necessarily being asked to make many more arrests.

“That’s where the opportunity lies for them,” Parosa said. “Instead of having to – prior to ballot Measure 110 – have those people arrested, take them down to jail, fill out probable cause affidavits and immediately begin writing reports because that person is in custody, they can call out a person who is detached from the criminal justice system to take custody and control.”

Lane County is already home to one innovative first-responder program. CAHOOTS launched in the 1970s as one of the first-ever services dispatching mental health specialists through 9-1-1 to help people in crises.

Their deflection plans will effectively turn Riley and the navigator into case managers for low-level drug offenders. Parosa said the navigators will keep informing the county if people are actively pursuing treatment and not skirting responsibility.

“I’m not trained in the realm of substance abuse treatment,” Parosa said. “I’m a criminal attorney. It would be highly inappropriate for me as a criminal attorney to ultimately tell a substance abuse or behavioral health specialist how to do their job or what a person needs.”

Many of the navigators themselves will be ex-addicts, Riley said.

“Some law enforcement in our community might have arrested that navigator 15 years ago, when they were in that situation, and now they’ve completely changed their life,” he said. “They got help, got treatment, and now they’re working as a professional in our community with credentials.”

Lane County saw overdose deaths rise recently, too. From 2020 to 2023, deaths rose from 97 to 212, according to CDC figures. That’s about five-and-a-half deaths per 10,000 people.

The navigator program has not launched yet, according to Riley, but he envisions a system with wide latitude. A person facing criminal charges that aren’t inherently drug related – such as trespassing or theft, for example – may be able to get those charges deflected, too. The victim of a crime would have to agree, too.

“A lot of folks just want to see people get help, if they think it’s going to stop,” Riley said.

He doesn’t criticize counties like Douglas that are not participating in deflection. He acknowledged that many perceive Oregon’s drug decriminalization efforts to have failed. Another experiment can be daunting.

Riley formerly commanded the Lane County Sheriff’s Office jail. He said he saw firsthand that it was treatment, not jail in and of itself, that helped people. He said he helped launch new programs to get people medication and counseling.

“We started seeing people leave the jail in a better space, in a better place,” Riley said. “I’ve seen a lot of people spend a lot of time in jail and prison due to their addiction and, at some point, what stopped their addiction? For most people, they got treatment.”

Hanlin, the Douglas County Sheriff, said they are willing to learn from other counties if their programs succeed.

Source: This article was originally published by Oregon Public Broadcasting.

Washington, D.C. – Today, White House Office of National Drug Control Policy (ONDCP) Director Dr. Rahul Gupta released the following statement on the latest provisional data from the Centers for Disease Control and Prevention (CDC), showing drug overdose deaths decreased by 12.7% year-over-year (in the 12-months ending May 2024). This is the largest recorded reduction in overdose deaths, and the sixth consecutive month of reported decreases in predicted 12-month total numbers of drug overdose deaths.

“When President Biden and Vice President Harris took office, the number of drug overdose deaths was increasing 31% year-over-year. They immediately took action: making beating the overdose epidemic a key pillar of their Unity Agenda for the Nation and taking a comprehensive, evidence-based approach to strengthening public health and public safety. As an Administration, we have removed more barriers to treatment for substance use disorder than ever before and invested historic levels of funding to help crack down on illicit drug trafficking at the border. Life-saving opioid overdose reversal medications like naloxone are now available over-the-counter and at lower prices. We are at a critical inflection point. For the sixth month in a row, we are continuing to see a steady decline in drug overdose deaths nationwide. This new data shows there is hope, there is progress, and there is an urgent call to action for us all to continue working together across all of society to reduce drug overdose deaths and save even more lives.”

Source: https://www.whitehouse.gov/ondcp/briefing-room/2024/10/16/white-house-drug-policy-director-statement-on-latest-drug-overdose-death-data/

The recently released National Drug Control Strategy (2022) from the White House Office of National Drug Control Policy (ONDCP) lays out a comprehensive plan to, not only enhance access to treatment and increase harm reduction strategies, but also increase implementation of evidence-based prevention programming at the community level. Furthermore, the Strategy provides a framework for enhancing our national data systems to inform policy and to evaluate all components of the plan. However, not only are there several missing components to the Strategy that would assure its success, but there is a lack of structure to support a national comprehensive service delivery system that is informed by epidemiological data, and trains and credentials those delivering evidence-based prevention, treatment, and harm reduction/public health interventions within community settings. This paper provides recommendations for the establishment of such a structure with an emphasis on prevention. Systematically addressing conditions known to increase liability for behavioral problems among vulnerable populations and building supportive environments are strategies consistently found to avert trajectories away from substance use in general and substance use disorders (SUD) in particular. Investments in this approach are expected to result in significantly lower rates of SUD in current and subsequent generations of youth and, therefore, will reduce the burden on our communities in terms of lowered social and health systems involvement, treatment needs, and productivity. A national strategy, based on strong scientific evidence, is presented to implement public health policies and prevention services. These strategies work by improving child development, supporting families, enhancing school experiences, and cultivating positive environmental conditions.
Appeared originally in Clin Child Fam Psychol Rev 2023; 26:1–16
Source: https://psychiatryonline.org/doi/10.1176/appi.focus.24022020
The Narcotics Bureau (NB) and the Family Conflict and Sexual Violence Policy Unit of the Hong Kong Police Force have collaborated for the first time to stage a large-scale carnival, “Let’s T.A.L.K. LOL Party”, which will run for two consecutive days from today (November 16) at the West Kowloon Cultural District. The event will combine elements of sports, music and art to promote anti-drug and child protection messages to the public.


Officiating at the kick-off ceremony, the Commissioner of Police, Mr Siu Chak-yee, said that both anti-drug and child protection efforts have always been of paramount importance to the Police, and that the Force is committed to keeping children and young people away from drugs and violence, and to ensuring that they grow up in a safe and healthy environment. He also mentioned the importance of education as the first step in prevention. Enhancing the knowledge and awareness of children and young people about drug harm and violent behaviour is the key to effectively reducing drug abuse and child abuse incidents.

The Police emphasised that following the latest Policy Address, the listing of the emerging etomidate (i.e. “Space Oil”) as a dangerous drug is expected to take place in the first quarter of next year, and the implementation of the Mandatory Reporting of Child Abuse Ordinance is scheduled for January 2026. The Force will intensify its cross-territory enforcement efforts and multi-sector publicity campaigns, aiming to establish a stronger anti-drug cordon for children and young people.

In the first three quarters of this year, the number of young people committing drug-related offences recorded a year-on-year decline of 27 per cent, with about 100 arrestees aged under 21 for serious drug offences, while child abuse cases increased by 7 per cent year-on-year to 1 090, with the youngest victim of physical assault being under one year old. These demonstrate the effectiveness of anti-drug publicity and education initiatives, alongside heightened public awareness of child protection. Nevertheless, more significant outcomes require collective anti-drug and child protection efforts across all sectors to create a drug-free and violence-free community in Hong Kong filled with love.

The carnival’s kick-off highlight, “Love Our Children Yoga Challenge”, called for 640 participants performing partner yoga together, breaking the world record and bringing joyful moments to all involved. Other exciting activities include over 30 game booths set up by various departments, child welfare institutions, as well as 100 mentees from the Leadership Institute on Narcotics (L.I.O.N.); the “3D Post-Drug Simulation” on the anti-drug promotional truck; the child protection promotional truck, and sharing sessions by rehabilitating drug addicts, to convey the messages of love for life and “Drugs? Never ever!”.

Other officiating guests at the kick-off ceremony included the Director of Crime and Security of Police, Mr Yip Wan-lung; the Assistant Commissioner of Police (Crime), Ms Chung Wing-man; the Deputy Director of Public Prosecutions of the Department of Justice, Ms Catherine Ko; the Assistant Director (Family & Child Welfare) of the Social Welfare Department, Ms Wendy Chau; the Executive Chairman of the Hong Kong Youth Development Alliance, Ms Christine Lam; the Principal President of L.I.O.N., Mr Godfrey Ngai; Clinical Professor of the Department of Paediatrics and Adolescent Medicine of the University of Hong Kong, Dr Patrick Ip; Convenor of the Working Group on Child Protection of the Commission on Children, Ms Kathy Chung; and the Ambassadors of the Child Protection Campaign, Ms Linda Wong and Mr So Wa-wai.

This first collaborative anti-drug and child protection carnival by the Police carries triple significance: sustaining the efforts in the “Love Our Life – LOL Party” large-scale anti-drug exhibitions over the past two years to offer L.I.O.N. mentees a platform to showcase their learning outcomes; serving as the finale of NB’s Anti-Drug Campaign; and marking the launch of the “Let’s T.A.L.K. Child Protection Campaign 2024”.

Ends/Saturday, November 16, 2024
Issued at HKT 20:40
Source: https://www.info.gov.hk/gia/general/202411/16/P2024111600646.htm

14 November 2024 Law and Crime Prevention

Marking the inaugural International Day for the Prevention of and Fight against All Forms of Transnational Organised Crime on Friday, the UN Office on Drugs and Crime (UNODC) has called for unified global efforts to counter these pervasive threats.
Proclaimed by the General Assembly in March 2024, the observance honours victims of organised crime – including law enforcement and judicial personnel who have lost their lives in pursuit of justice.
The inaugural theme: Organised crime steals, corrupts and kills. It’s time we pull together to push back, underscores the urgency of collective action.
Speaking to UN News, Candice Welsch, UNODC Regional Representative for the Andean Region and southernmost areas of South America, emphasised the global nature of the threat: “Almost all organised crime is transnational, it does not take place within a single country, but often crosses borders within regions and even beyond.”
“Therefore, this UN observance aims at boosting action by governments, the private sector, civil society and the public,” she said.

Pillar of international cooperation
The UN Convention against Transnational Organized Crime adopted in 2000 and ratified by 192 States, serves as the cornerstone of UNODC’s efforts to combat and eventually eliminate the scourge of transnational organised crime.
“We are working hard to strengthen cooperation between countries so that they can share information and intelligence between police forces, or so that border agencies and prosecutors can conduct joint operations,” said Ms. Welsch.
UNODC’s efforts include bolstering local, national and international capacities to better understand and combat these challenges.

Cocaine, deforestation, community impact
In the Andean region, Colombia and Ecuador face significant challenges with transnational criminal groups. Colombia’s coca cultivation reached 253,000 hectares in 2023, yielding an estimated 2,664 metric tons of cocaine in 2022, according to UNODC data.
However, the issue is not confined to drug trafficking. Illegal mining, deforestation and wildlife trafficking – particularly in the Galapagos Islands – are also on the rise.
These activities disrupt security for communities, exacerbate gang violence and contribute to high homicide rates, impacting indigenous communities and young people who face recruitment risks. Migrant flows through the region also make vulnerable populations susceptible to human trafficking and other abuses.
To address these challenges, UNODC supports alternative development programmes for farmers reliant on coca cultivation. These initiatives promote legal crops such as coffee, cocoa, vanilla and sacha inchi, a nutrient-rich Amazonian plant.
“What we are trying to do with alternative development programmes is to offer these communities ways to move towards licit economies and a more secure future,” said Ms. Welsch.

Opium resurgence in Afghanistan
Despite a 2022 Taliban ban that initially reduced opium cultivation by 95 per cent, 2024 saw a 19 per cent resurgence driven by economic hardship and rising prices.
Since 2016, UNODC has aided over 85,000 households through alternative development initiatives, such as poultry farming projects that provide both food security and income generation for families affected by drugs.

Southeast Asia: The Golden Triangle’s drug economy
Myanmar has surpassed Afghanistan as the world’s leading opium producer, with production rising 36 per cent in 2023.
Collaborating on security issues can be challenging for states, but the UN plays a crucial role in fostering dialogue
– Jeremy Douglas, UNODC
The country also leads global methamphetamine production, which has become the dominant drug according to UNODC data, with seizures quadrupling between 2013 and 2022.
Furthermore, criminal groups in the Golden Triangle – Myanmar, Lao People’s Democratic Republic, and Thailand – have expanded into online scams, wildlife trafficking, money laundering and human trafficking.
In response, UNODC has promoted regional cooperation through the establishment of approximately 120 border liaison offices to facilitate intelligence sharing and coordinated action.
“Collaborating on security issues can be challenging for States, but the UN plays a crucial role in fostering dialogue,” said Jeremy Douglas, former UNODC Regional Representative for Southeast Asia and the Pacific and now Chief of Staff and Strategy Advisor to the Executive Director.

Global drug crisis
The impact of transnational crime extends far beyond producer countries.
New synthetic drugs are on the rise, particularly in North America, which faces a fentanyl crisis, as well as in areas of Asia and Africa.
Western and Central European countries, particularly those with a North Sea coastline, also face considerable challenges, with their ports becoming major entry points for cocaine.
In the Sahel, illicit gold and fuel trafficking undermine governance and security and complicates sustainable development, depriving the nation of critical income.

Wildlife crimes, gold smuggling, and organised fraud are just a few examples of how these crimes converge, exploiting fragile ecosystems and vulnerable communities worldwide.
Nevertheless, UNODC remains committed to supporting global efforts.

People-centred approach
“Despite these challenges, there is hope,” Ms. Welsch said.
She highlighted the importance of public awareness campaigns targeting youth and community programmes involving parents and teachers, as well as the need to ensure that everyone who requires treatment for drug abuse can access it.
“The only way to overcome global problems is to galvanise international action. That is why UNODC is joining forces with partners to help secure our common future,” she concluded.

Source: https://news.un.org/en/story/2024/11/1156981

Vienna, 14 November 2024 – “The drug landscape is evolving and growing more complex,” stated Ghada Waly, the Executive Director of the United Nations Office on Drugs and Crime (UNODC) in opening remarks at the 2024 thematic discussions of the Commission on Narcotic Drugs (CND), delivered on her behalf by John Brandolino, Director for Treaty Affairs at UNODC.

“New and deadlier combinations of synthetic drugs are proliferating and destroying livelihoods. Criminals are finding new ways of evading regulations to divert precursor chemicals and concoct new substances, while gaps in oversight are enabling the misuse of pharmaceuticals for non-medical purposes,” she continued. “At the same time, drug trafficking is increasingly overlapping with other forms of organized crime, from human trafficking and child exploitation to money laundering and crimes that affect the environment. As these trends intensify, they pose increasing risks to public health, safety and security.”

The CND, the United Nations’ central drug policy-making body, held its thematic discussions from 12-14 November this week. These discussions provided a platform for close to 600 participants from Member States, international organizations, academics and civil society to exchange good practices, identify challenges and share lessons learned in the implementation of international drug policy commitments.

Noting the cross-cutting nature of the challenges faced by Member States in addressing and countering the world drug problem, the Executive Director highlighted the need to enhance international collaboration harness technological innovation, continue collecting and analysing data and invest in capacity-building and resource mobilization. She also stressed the importance of embracing a paradigm shift focused on prevention, especially among youths.

Also speaking at the opening segment, the President of the International Narcotics Control Board urged delegates to “keep the safeguarding of health and well-being at the forefront” of their discussions.

Thematic areas

The thematic discussions in 2024 focused on several pressing issues:  the expanding range of drugs and diversifying markets; synthetic opioids and non-medical use of prescription drugs; challenges in illicit cultivation and production of narcotic drugs and psychotropic substances; illicit trafficking in substances and precursors, as well as domestic diversion of precursor chemicals; and legal, scientific and regulatory challenges in scheduling substances.

The Member States who had made a pledge under the Pledge4Action initiative, launched at the CND Midterm Review earlier this year, were also provided with an opportunity to provide updates on the status of their pledges towards addressing and countering the world drug problem.

In addition, Member States also raised other substantive topics for discussion, namely: challenges to the identification of new illicit drugs; harm reduction measures; social determinants, disproportionate impacts and barriers to service access in drug policy; the current status of the critical review of coca leaf; the relevance of scientific evidence in the work of UN bodies and agencies in the implementation of the Global Drug Policy; and challenges to the integrity of the international drug control system.

About the CND thematic discussions

At its 62nd session in March 2019, the Commission adopted by consensus the Ministerial Declaration entitled “Strengthening Our Actions at the National, Regional and International Levels to Accelerate the Implementation of our Joint Commitments to Address and Counter the World Drug Problem.”

Following up on this declaration, the Commission held the Midterm Review in March 2024, during which it adopted the High-level declaration by the Commission on Narcotic Drugs on the 2024 midterm review, following up to the Ministerial Declaration of 2019. This declaration continues the dialogue initiated in 2019 and outlines the path toward the final review of progress made in the implementation of all international drug policy commitments in 2029. To maintain momentum and focus, the Commission plans to hold annual thematic discussions from now until 2028 based on the High-level Declaration and the subsequently adopted workplan. The Chair’s summary and a procedural report of the thematic discussions will be published on the website of the CND thematic discussions once available.

Source: https://www.unodc.org/unodc/frontpage/2024/November/addressing-the-evolving-drug-landscape-at-the-2024-cnd-thematic-discussions.html

In the early 2000s, vaping emerged as a popular alternative to smoking tobacco. E-cigarettes, marketed as nicotine delivery systems without the harmful chemicals found in traditional cigarettes, quickly gained popularity. As vaping technology evolved, so did its applications. By the mid-2010s, the marijuana industry began to adopt vaping as a method for consuming marijuana.

This shift was possibly driven by the increase in legalization across states, the perception that vaping was safer than smoking, and the convenience of discrete portable vapes. However, as the popularity of marijuana vaping grows, so does the rise in its health effects.

By 2019, reports of lung injuries associated with vaping began to surface. Studies found that the combination of vaping marijuana, smoking tobacco and smoking marijuana was linked to younger individuals experiencing lung conditions in a short period. The Centers for Disease Control and Prevention (CDC) then identified a condition known as EVALI (e-cigarette or vaping product use-associated lung injury), which was linked to THC containing vape products. A chemical used to dilute THC and create low-cost products contributed to an outbreak of EVALI. CDC reported that as of late 2019, approximately 77% of vaping-related injury cases involved THC-containing products. By February 2020, this number increased to 80%, highlighting a significant association between marijuana vaping and respiratory complications.

The increased access to marijuana through online retailers and the rise in marijuana legalization across states has contributed to the increase in marijuana use by young adults posing new challenges. A 2024 meta-analysis found that the passing of recreational marijuana laws led to an increase in past-month marijuana use of 13% among youth and 22% among young adults. In addition to this analysis, the Monitoring the Future Survey revealed that marijuana and hallucinogen use among 19–30-year-olds remained elevated compared to previous years. When including vaping of either nicotine or marijuana, both trends showed a consistent increase over the past five years and are now at record levels. Specifically, the percentage of 19–30-year-olds who vaped marijuana in the past 12 months rose from 11.5% in 2017 to 22.2% in 2023, while vaping marijuana in the past 30 days increased from 5.9% to 14.4% over the same period. This aligns with the growing perception that vaping is a healthier alternative, leading more young people to experiment with these substances, potentially leading to a higher incidence of lung-related health issues.

The increase in demand for marijuana products has also driven the development of efficient delivery methods, such as online retail, introducing new challenges for regulation. A study highlighting the significant gaps in regulatory compliance among online retailers of flavored tobacco and marijuana vape products showed that, out of 156 purchase attempts, 67.3% were successfully delivered, including to areas with flavor restrictions. Worryingly, only 1% of buyers had their ID scanned successfully by delivery personnel, as required by law, with most deliveries not conducting ID check or interacting with purchaser. These findings underscore the need for better enforcement of age verification and shipping restrictions, especially as youth and young adult use of marijuana vape products increase.

The story of vaping’s evolution from tobacco to marijuana serves as a reminder of the complexities and unforeseen consequences that can arise with new technologies and changing substance use trends. As legalization and acceptance of marijuana continue to grow, so does the need for comprehensive research, clear regulations and widespread education to ensure public safety and prevent unintended consequences.

References:
• Ali, F. (2021). Combination of vaping, cannabis and smoking exposure: shorter time to bullous lung disease and pneumothorax. Journal of Lung Health and Diseases, 5(1), 8-10. doi.org/10.29245/2689-999x/2021/1.1169
• Bando, J. (2024). Impact of marijuana use on lung health. Seminars in Respiratory and Critical Care Medicine. doi.org/10.1055/s-0044-1785679
• Centers for Disease Control and Prevention. (2020). Outbreak of lung injury associated with the use of e-cigarette, or vaping, products. Centers for Disease Control and Prevention. https://archive.cdc.gov/www_cdc_gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.htm
• Dai, H. (2020). Self-reported marijuana use in electronic cigarettes among us youth, 2017 to 2018. Jama, 323(5), 473. https://doi.org/10.1001/jama.2019.19571
• Harati, R., Ellis, S.E., Satybaldiyeva N., Mejorado, T., Benitez, G., Henriksen, L., Leas, E. (2024). Online Retailer Nonadherence to Age Verification, Shipping, and Flavor Restrictions on E-Cigarettes. JAMA. doi:10.1001/jama.2024.21597
• Friedman, A. and Morean, M. (2021). State marijuana policies and vaping associated lung injuries in the us. Drug and Alcohol Dependence, 228, 109086. doi.org/10.1016/j.drugalcdep.2021.109086
• Malouff, J., Rooke, S., & Copeland, J. (2014). Experiences of marijuana-vaporizer users. Substance Abuse, 35(2), 127-128. doi.org/10.1080/08897077.2013.823902
• Navon, L., Ghinai, I., & Layden, J. (2020). Notes from the field: Characteristics of tetrahydrocannabinol–containing e-cigarette, or vaping, products used by adults — Illinois, September–October 2019. MMWR Morbidity and Mortality Weekly Report, 69(29), 973–975. doi.org/10.15585/mmwr.mm6929a5
• Pawar, A., Firmin, E., Wilens, T., Hammond, C. (2024). Systematic Review and Meta-Analysis: Medical and Recreational Cannabis Legalization and Cannabis Use Among Youth in the United States. Journal of the American Academy of Child & Adolescent Psychiatry, Volume 63, Issue 11, 1084 – 1113. DOI: 10.1016/j.jaac.2024.02.016
• Patrick, M. E., Miech, R. A., Johnston, L. D., & O’Malley, P. M. (2024). Monitoring the Future Panel Study annual report: National data on substance use among adults ages 19 to 65, 1976-2023. Monitoring the Future Monograph Series. Ann Arbor, MI: Institute for Social Research, University of Michigan. Available at: https://monitoringthefuture.org/results/annual-reports/

 

Source: Drug Free America Foundation | 333 3rd Ave N Suite 200 | St. Petersburg, FL 33701 US

The programs touch on various topics, including drug use and decision-making skills that could help youths avoid behaviors that put them at risk for substance use

NBC Universal, Inc.
Programs educating students about drug abuse and drug overdose prevention are now at San Diego schools, reports NBC 7’s Todd Strain.

Amid a rise in fatal fentanyl overdoses, a San Diego County task force convened to identify substance abuse prevention solutions for local youths. It released a report Monday outlining its recommendations for drug prevention programs at schools.

The report entitled “School-based Interventions for Substance Use and Overdose Prevention” was drafted by the San Diego County Substance Use and Overdose Prevention Taskforce, comprised of members of various entities including the San Diego County District Attorney’s Office, San Diego County Office of Education, California National Guard Counterdrug Task Force, Drug Enforcement Administration, and Center for Community Research.

With the goals in mind of preventing juvenile substance use and overdoses, the working group behind the report outlined five prevention programs identified for elementary, middle and high school populations: Positive Action, Project Towards No Drug Abuse, LifeSkills Training, DARE’s Keepin’ It Real, and Project Alert.

The programs touch on various topics, including drug use and decision-making skills that could help youths avoid behaviors that put them at risk for substance use.

Three other programs the report states may be instrumental to prevention efforts include:

  • Operation Prevention San Diego, a free DEA program with resources for educators that the report states “integrate seamlessly into classroom instruction.” The program addresses the impacts of drugs to the brain and body. The program is available to schools upon request or at operationprevention.com
  • I Choose My Future, a program offered by the San Diego County Office of Education that highlights substance abuse dangers and impacts at the individual, family, school, city, nation and global levels
  • A recommendation that all schools serving grades 6-12 have adequate supplies of naloxone, which the report states “has demonstrated effectiveness in reversing opioid overdoses and is recommended by the Centers for Disease Control and Prevention as a successful strategy for preventing an opioid overdose”

The task force says the recommendations have already been adopted by around two dozen San Diego County schools.

“It’s critical that we educate our youth through compelling and effective curriculum, giving them the tools they need to stay healthy and make decisions that can literally save their lives,” San Diego County District Attorney Summer Stephan said in a statement.

Source: https://www.nbcsandiego.com/news/local/san-diego-county-task-force-drug-prevention-programs-schools/3654778/

Source: https://static1.squarespace.com/static/599a426ee45a7ccab72c77d2/t/5f3ad99ce4a6280272c97cb6/1597692318766/Marijuana_%2BA%2Bman%2Bmade%2Bdisaster.pdf April 2018

     While schools nationwide emphasize the importance of drug prevention, students at Watson Elementary took the lesson beyond textbooks.
Published: Oct. 28, 2024 at 9:21 AM CDT

HASTINGS, Neb. (KSNB) – While schools nationwide emphasize the importance of drug prevention, students at Watson Elementary took the lesson beyond textbooks and into the realm of costumes.

“It’s such a prevalent thing especially now going even younger with the older kids in fourth and fifth grade,” said Chris Hollister, a teacher at Watson. “So bringing that awareness to the kids, knowing that they have the power and the will to say no so it’s just a fun, good way to learn about something important but also have fun doing it.”

The Red Ribbon campaign has provided drug prevention education for children since the 1980s, with one of its most popular events, Red Ribbon Week, celebrated annually. This year, Watson Elementary marked the occasion with themed dress-up days.

“You don’t have to wear normal clothes to school,” said Ruby, a student at Watson.

“I think it’s just fun seeing how everyone dresses up different and see what everyone’s favorite movie character is,” said Chloe, another student.

“Yeah it’s fun to ask people like ‘what are you?’ and the other days were really fun too, just getting to put on something wacky is fun,” said Elijah, who is also a student.

“With elementary kids they love to do these crazy wacky dress up days, and they’re all kids at heart even the teachers that are here we’re all still big kids at heart,” said Hollister. “I tell myself I’m still a kid, even though I’m 36 years old, so it’s just fun to let them express themselves.”

As much fun as it was for the kids to dress up, Hollister said the teachers enjoyed getting to see what they came dressed as.

“It’s interesting just to see what all they come up with because like today. I had a kid that dressed up like ‘The Fonz’ and he’s in the fifth grade and that show was prevalent in the 70s and 80s,” said Hollister. “We have Marty McFly, we have TV characters, we have movie characters, it’s just cool to see the ways they take it to make it a fun day.”

‘What’s Cool in Your School?’ is sponsored by Hastings College Watch it Sunday night and Monday morning on Local4. If you have something or someone ‘cool in your school’ you’d like us to highlight, let us know by clicking here.

Source: https://www.ksnblocal4.com/2024/10/28/watson-elementary-uses-red-ribbon-week-teach-about-drug-prevention-fun-way/?outputType=amp

At a glance

  • Cherokee Nation Action Network is using culture as prevention for youth substance use in Oklahoma.
  • The leading principle is “Walking in Balance,” which emphasizes balancing traditional Cherokee culture with modern contemporary culture in their everyday lives.

Cherokee Nation Community Action Network

The Cherokee Nation Community Action Network (CAN) coalition was originally developed in 2006 and became a Drug-Free Community coalition in 2018. The CAN uses culture as a strategy to prevent and reduce substance use in Cherokee communities. They partner with Sequoyah School, a tribal school in Tahlequah that young people can attend from anywhere within the reservation. The reservation includes some very rural and isolated communities with limited resources.

To increase community connectedness, the coalition teaches a National Association for Addiction Professionals-certified curriculum based on the book Walking in Balance by Abraham Bearpaw. Bearpaw was raised in one of the Cherokee Nation communities and, after coping with alcohol use for several years, decided it was time for a change. He reconnected with his culture by prioritizing mindfulness, health, and trust and has been in recovery for 12 years. He partners with different communities to teach his curriculum to young people in hopes of reducing the likelihood of them engaging in substance use. The curriculum includes 12 weekly lessons that teach students how to reconnect with culture, manage stress, and care for themselves. The leading principle is “Walking in Balance,” which emphasizes balancing traditional Cherokee culture with modern contemporary culture in their everyday lives.

The CAN coalition initially faced challenges with young people’s willingness to return to the ceremonial grounds. Due to some forbidden traditional practices, they felt they were too far removed. However, the coalition encouraged them to attend to learn and reconnect with their roots. Of the 100 young people living in the current town they serve, 75 showed up to participate in the curriculum. The day-to-day traditional and cultural activities include the making of clay beads, ribbon skirts, corn-bead necklaces, basket weaving, and stickball. The community activities are a source of Cherokee knowledge-building, sharing, and resiliency that helps build a culture of connectedness. The instructor teaches ceremonial values of youth and elder interaction, respect for ancestors, and the importance of taking care of the land. One community member said, “Our tribe has long known that building a sense of belonging, helping youth grow a connection to community, and cultural identity helps them grow into healthy adults.” The Cherokee Nation CAN will continue to foster safe and healthy environmental conditions, providing social support, encouraging school connectedness, and creating safe and caring communities on the reservation to improve the lives of those living there.

Source: https://www.cdc.gov/overdose-prevention/php/drug-free-communities/cherokee-nation.html

Manuel Balce Ceneta/Associated Press by CARMEN PAUN – 10/27/2024 04:00 PM EDT

 

Traffickers are to blame, the candidates say. Virtually no one’s talking about treatment.

The Harris and Trump campaigns said the presidential candidates are talking about drug treatment, albeit more quietly than they are border security. |

There’s a rare point of agreement among Republican and Democratic candidates this election year: America has a drug problem and it’s fentanyl traffickers’ fault.

Republicans, including former President Donald Trump, are hammering Democrats over border policies they say have allowed fentanyl to surge into the country. Democrats, including Vice President Kamala Harris, respond that they, too, have cracked down on traffickers and want stricter border enforcement.

The consensus reflects the resonance of border control among voters — most of the country’s fentanyl comes from Mexico — and a hardening of the nation’s attitude toward addiction. Troubled by drug use, homelessness and crime, voters even in the country’s most progressive states favor cracking down. Politicians from Trump and Harris on down the ballot say they will.

“It’s one of those things that people don’t want in their community,” said Rep. Jahana Hayes, a Democrat running for a fourth term representing a district including suburbs of Hartford, Connecticut, and rural areas to their west, of illicit drugs. “They want a tough-on-crime stance on it. They want it to go away. They’re afraid for their families, they’re afraid for their children.”

That view worries public health experts and treatment advocates, who see a backsliding toward the law enforcement focus that once looked futile in the face of Americans’ insatiable appetite for drugs. They fear it bodes ill for additional efforts from Washington to expand addiction care.

“There are a lot of things that both parties can point to, as far as progress that’s been made in addressing overdoses: We’ve seen bipartisan efforts to expand access to treatment, to expand access to health services for people who use drugs, and I wish they would talk about that more,” said Maritza Perez Medina, federal affairs director at Drug Policy Action, an advocacy group that opposes the law enforcement-first approach.

Six years ago, when a bipartisan majority in Congress passed the SUPPORT Act to inject billions of dollars into treatment and recovery services, and then-President Trump signed it, the vibes in Washington around drug use were more empathetic.

President Donald Trump declared the opioid crisis a nationwide public health emergency in October 2017. | Brendan Smialowski/AFP via Getty Images But after it passed, fatal drug overdoses driven by illicit fentanyl skyrocketed, hitting a record 111,451 in the 12 months ending in August 2023 before starting to recede. Homelessness, sometimes tied to drug addiction, also spiked.

When the SUPPORT Act came up for renewal last year, Congress wasn’t as motivated. The Democratic Senate hasn’t voted on a bill, while a House-passed measure from the chamber’s GOP majority offers few new initiatives and no new money.

Attitudes are similar in the states. Oregon, where voters legalized drugs for personal use in 2020, reimposed criminal penalties this year after its largest city, Portland, was overrun with homeless drug users. Polls indicate California voters, frustrated, too, by homelessness and crime, are likely to boost penalties for drug users by ballot initiative next month.

Candidates aim to prove they share voters’ frustration.

Republicans have spent more than $11 million on TV ads in the past month attacking Democratic opponents on fentanyl trafficking, according to a tally by tracking firm AdImpact. And Democrats have spent nearly $18 million defending themselves, mostly by highlighting their efforts or plans to provide more resources and personnel to combat trafficking.

“It’s an easy shortcut in a 30-second commercial to tie a broader issue to one that has an easy explanation,” said Erika Franklin Fowler, a professor of government at Wesleyan University who directs a project analyzing political advertising.

Trump’s not talking about the SUPPORT Act, one of his most consequential legislative successes. Vice President Kamala Harris is not touting the treatment policies of the president she serves, Joe Biden, who expanded access to medications that help people addicted to fentanyl, as well as to drugs that can reverse overdoses. Some public health specialists credit increased access to the drugs with reducing overdose death rates in the past 12 months after years of grim ascent.

Trump used his first anti-Harris ad this summer to blame her for the more than 250,000 deaths from fentanyl during the Biden-Harris administration.

Vice President Kamala Harris met state attorneys general in July 2023 to discuss possible actions against fentanyl. | Saul Loeb/AFP via Getty Images Harris responded by touting her prosecution of drug traffickers when she was California’s attorney general and a promise to strengthen the border.

“Here’s her plan,” a deep-voiced narrator intoned in Harris’ ad: “Hire thousands more border agents, enforce the law and step up technology — and stop fentanyl smuggling.”

‘A political cudgel’

Similar attacks and responses have played out in Senate and House races across the country.

In the tight Arizona race to replace Sen. Kirsten Synema (I-Ariz.), Republican Kari Lake has accused her opponent, Democratic Rep. Ruben Gallego, of empowering drug cartels to import fentanyl by supporting Biden-Harris administration border policies.

“We’re losing an entire generation of people, and you should know better, Ruben,” Lake told Gallego in a debate earlier this month, referencing the deaths of teens who took counterfeit pills laced with fentanyl.

Gallego, who was elected to Congress in 2014 as a progressive but has shied from that label in his Senate run, responded by touting bills he’s supported or introduced to fund more technology at the border and track fentanyl money flows across Mexico and China, where chemicals to make the drug are manufactured.

A mother visit her son’s grave, who died of a fentanyl overdose at 15. | Jae C. Hong/AP In Colorado’s hotly contested 8th congressional district, which encompasses Denver suburbs and rural areas to the north, Republican state Rep. Gabe Evans has blamed the incumbent, Democrat Yadira Caraveo, for the fentanyl crisis.

“This is our reality now: a 100 percent increase in fentanyl deaths because liberals open the border, legalize fentanyl and let criminals out of jail,” says a police officer in an ad for Evans. “And Yadira Caraveo voted for it all,” Evans adds.

Caraveo defended herself in a debate with Evans earlier this month, noting the bill he’s referring to was state legislation that “tried to balance the need to punish drug dealers and cartels but not incarcerate every single person that is addicted.”

In Connecticut, the National Republican Congressional Committee attacked Hayes for voting against a bill to permanently subject fentanyl to the strictest government regulation, reserved for those drugs with high likelihood of abuse and no medical uses.

Hayes said she opposed the bill because it included mandatory minimum prison sentences for people caught with drugs and no provisions supporting prevention, treatment or harm reduction.

“I hate that this is being used as a political cudgel because we’re missing out on an opportunity to say: ‘How do we address the root causes?’” Hayes said in an interview.

Hayes said she has responded to the attacks on the campaign trail and talked to constituents about the need for treatment, despite some advice to the contrary.

“Even amongst Democrats, there were people who were like: ‘You don’t want the headache, you don’t want people to think that you’re soft on crime or soft on drugs.’ And I was like: ‘This has to be about more than optics if we truly are trying to save people’s lives,’” Hayes said. ‘If we don’t keep the momentum going’

Oregon, where voters legalized drugs for personal use in 2020, reimposed criminal penalties this year after its largest city, Portland, was overrun with homeless drug users. | Patrick T. Fallon/AFP via Getty Images The lesson the Drug Policy Action’s Medina takes from the campaigns is that talking about drug treatment doesn’t sell in American politics.

“People are struggling. Social services aren’t where they need to be, health services aren’t where they need to be,” she said. “It’s easier to run a fear-based campaign rather than talking about really tough issues,” like breaking the cycle of addiction.

Ironically, the tough talk on the border comes as policymakers, for the first time in years, have evidence that the tide of fatal drug overdoses is receding.

The CDC estimates that overdose deaths, most caused by fentanyl, declined by nearly 13 percent between May 2023 and May 2024, to just under 100,000.

Harris’ running mate, Tim Walz, mentioned the dip during his debate with Trump’s vice-presidential pick, JD Vance, earlier this month.

The number is now about where it was when Biden took office, though still 50 percent higher than when Trump did in January 2017.

Expanding access to treatment, the Food and Drug Administration’s decision to make the opioid-overdose-reversal medication naloxone available over the counter last year, increased fentanyl seizures at the border, and the arrest and sanctioning of Mexican drug cartel leaders have contributed to the recent drop, Biden said last month.

Advocates for drug treatment say that’s all good cause for candidates to tout their access-to-treatment efforts and promise to expand them.

“The worst outcome for overdose prevention coming out of this election would be if we don’t keep the momentum going,” said Libby Jones, who leads the Overdose Prevention Initiative, an advocacy group.

But there’s not the groundswell of interest on Capitol Hill that there was in 2018, when Congress passed the SUPPORT Act.

Congress has continued to fund opioid treatment authorized in that law, but it mostly hasn’t taken the law’s 2023 expiration as an opportunity to increase funding or try big new ideas.

The Food and Drug Administration decision to make the opioid-overdose-reversal medication naloxone available over the counter last year has contributed to a drop in fatal overdoses over the past year, President Joe Biden said last month. | Diane Bondareff/AP The 2024 federal funding law Congress passed in March included some minor changes in the form of bipartisan legislation to require state Medicaid plans to cover medication-assisted treatment for substance use disorder. It also created a permanent state Medicaid option allowing treatment of substance use disorder at institutions that treat mental illness, in an effort to expand access to care.

But bipartisan legislation approved by the Senate committee responsible for health care to make it easier for others to gain access to methadone, a drug effective in helping fentanyl users, hasn’t gone to the floor and faces opposition from key Republicans in the House.

The Harris and Trump campaigns said the presidential candidates are talking about drug treatment, albeit more quietly than they are border security.

Vice President Harris’ campaign pointed to her web site, where she touts her prosecution of drug traffickers and the Biden-Harris administration’s investment in “lifesaving programs.”

Republican National Committee spokesperson Anna Kelly said “President Trump is uniquely able to connect with families combating addiction,” pointing to times when he’s talked about his brother’s struggles with alcohol use disorder and to his administration’s efforts to contain the opioid crisis.

But she added that the tough talk on the border is relevant: “Combating fentanyl is a public health issue and stopping it begins with securing the border.”

 

Source: https://www.politico.com/news/2024/10/27/fentanyl-drugs-elections-00185576

 

“Smart Choices, Safe Workplaces: Educate on Drug Risks”
National Drug Free Work Week 2024

 

 

This file was produced in relation to Join the National Drug Free Workplace Alliance (NDWA) in recognizing the Drug Free Work Week 2024 which ran from October 14th through 18th!

Check out these resources that provide essential information on the effects of various drugs and their potential impact on workplace dynamics and safety. Each resource breaks down the signs, symptoms, and behavioral changes associated with substance misuse, helping you recognize warning signs early. With this knowledge, you can better protect and support your employees, fostering a healthy work environment where risks are minimized, and everyone feels valued and safeguarded. These one-pagers are also a useful tool for reinforcing drug-free policies and engaging employees in health and wellness conversations. Resources can be found here.

 

NATIONAL DRUG-FREE WORKPLACE ALLIANCE

As the workplace division of Drug Free America Foundation, NDWA’s mission is to be a national leader in the drug-free workplace industry by directly assisting employers and stakeholders, providing drug-free workplace program resources and assistance, and supporting a national coalition of drug-free workplace service providers.

For more information and drug-free workplace resources, visit NDWA at www.ndwa.org.

Source: www.dfaf.org

MEDICINAL cannabis has been the hottest of hot-button issues in medicine for some years now. It’s one the few medications where media hype and patient demand seem to have moulded – some would say muddied – the regulatory framework in a way that has troubled many clinicians.

In Australia, there are now three different pathways to legally accessing medicinal cannabis. The Category A Special Access Scheme (SAS) allows the importation of unregistered products on compassionate grounds, but requires import licences and customs clearance, while Category B SAS gives access to locally stored medicinal cannabis, but requires TGA and state review and approval. Specialists can also obtain an Authorised Prescriber status to prescribe cannabis – these will usually be either oncologists for cancer-related pain, or paediatric neurologists for the control of severe epilepsy in children.

But what is the evidence for medicinal cannabis, and is it sufficient for clinicians to feel comfortable prescribing it? These issues are explored in two articles published in the MJAone a Perspective from the Royal Australasian College of Physicians (RACP) and the other a Narrative Review on the challenges of prescribing cannabis for paediatric epilepsy, authored by researchers from the Sydney Children’s Hospital.

The RACP comes down on the side of caution. It notes that Australia, along with the rest of the world, is “navigating unchartered waters with pharmaceutical grade cannabinoids”, and that more research is needed before we can say whether or not cannabis has a place in contemporary medical practice.

In paediatric epilepsy, some of that research seems to be coming into focus. Last May, a randomised, double-blind trial of cannabidiol, a cannabis derivative that does not contain the psychoactive ingredient tetrahydrocannabinol, provided hard data for the first time that the treatment may work in children with Dravet syndrome – a severe form of childhood epilepsy with often drug-resistant seizures. This was followed by another trial, published last month in the Lancet, that showed similar efficacy of cannabidiol in Lennox–Gastaut syndrome, another form of paediatric epilepsy characterised by multiple seizure types.

Laureate Professor Ingrid Scheffer, who is Chair of Paediatric Neurology Research at The University of Melbourne and co-author of the trial of cannabadiol in Dravet syndrome, says that although her study does provide solid evidence for the drug’s efficacy, it should in no way be considered a miracle cure.

“It’s been sold as a magic bullet by the media. And you have families who are on a terrible rollercoaster, they’re vulnerable and medicinal cannabis is being cast as this drug that may save their child. And the answer is that it often does not. It may help, and in our study cannabidiol had a 43% responder rate, defined as at least a 50% reduction in the seizure frequency. But that’s exactly the same as some of the other drugs we use.”

But she says that doesn’t mean it shouldn’t be prescribed.

“Dravet syndrome is usually drug-resistant and you don’t know which drugs will work, so it could be worth trying if others have failed. But the families should be aware of its chances of success and the fact that it can have side effects.”

She says the key is more research.

“What people are accessing is very variable. They’re importing it from all over the place, they may even be getting friends to grow it in their backyard, so we do not know what they’re giving their child. What we need to do is go forward with more trials in different populations and with different formulations. If we’re going to invest in this, we need to know it works and we’re not wasting our health dollar on it.”

Professor Scheffer says that another drug currently being trialled, fenfluramine, may end up the more successful treatment. Trial results have yet to be published, but interim findings suggest that fenfluramine may have a dramatically higher responder rate of up to 70%.

Dr John Lawson, a Sydney-based paediatric neurologist and co-author of the Narrative Review on cannabis and childhood epilepsy, agrees that cannabidiol, though worth trying in some children, is no wonder drug.

“I’m not hanging my hopes on cannabidiol,” he says in an exclusive podcast for MJA Insight.

“I came in as quite a sceptic, but my attitude has changed. I now believe that it is an antiepileptic, but I’m not sure what place it has. It’s the early stages of development, and there are other compounds that haven’t been looked at.”

Dr Lawson says that he wouldn’t suggest it to a family until many other antiepileptics had already failed, and the chances of the next drug working were already low.

“I’ve come around to bringing it up in conversation because everyone knows about it, and families know I’ve prescribed it. But the biggest reason to not prescribe is cost. For a small child, it will cost over $1000 every couple of weeks to give a Therapeutics Goods Administration-approved product. Almost the only people I have prescribed it for are those who have an absolute ‘bucketload’ of money. Or I form a contract with them, and I say look, this will cost you $3000, but all the trials say you will know very quickly if it’s working or not.”

He says that in the patients who are helped by cannabidiol, the effect is still relatively modest.

“Patients are very rarely seizure-free. It may have a role in the future, once the hype has died down, but it will be a very low [on a list of preferred antiepileptics].”

 

Source:  https://www.doctorportal.com.au/mjainsight/2018/6/medicinal-cannabis-miracle-cure-or-media-hype/

An overview of federal and state laws and legal issues impacting physicians, non-physician practitioners (NPPs), and health care facilities that treat patients with opioids for pain management and opioid use disorders (OUDs).

  • Federal and state governments impose restrictions on both physician and non-physician opioid prescribers
  • To dispense opioids, federal law requires licensed physicians to register with DEA, have an active license, and fulfill educational and training requirements
  • All states have licensing and registration requirements for providers who prescribe opioids

To help combat the ongoing opioid crisis, the federal government and many state governments have enacted statutes to help health care practitioners, including physicians, qualified NPPs, such as nurse practitioners and physician assistants (PAs), and health care facilities, respond to OUDs. These statutes establish protocols for handling pain management and OUDs, which address, among other things, treatment plans and the relationship between health care providers and patients.

This article highlights key federal and state legislation governing health care practitioners and facilities treating patients with opioids for pain management and OUDs, focusing on states with greater opioid misuse.

Source: https://www.reuters.com/practical-law-the-journal/legalindustry/opioid-crisis-issues-health-care-providers-2024-11-01/

Filed under: Health,Heroin/Methadone,USA :

“When President Biden and Vice President Harris took office, the number of drug overdose deaths was increasing 31% year-over-year. They immediately took action: making beating the overdose epidemic a key pillar of their Unity Agenda for the Nation and taking a comprehensive, evidence-based approach to strengthening public health and public safety. As an Administration, we have removed more barriers to treatment for substance use disorder than ever before and invested historic levels of funding to help crack down on illicit drug trafficking at the border. Life-saving opioid overdose reversal medications like naloxone are now available over-the-counter and at lower prices. We are at a critical inflection point. For the sixth month in a row, we are continuing to see a steady decline in drug overdose deaths nationwide. This new data shows there is hope, there is progress, and there is an urgent call to action for us all to continue working together across all of society to reduce drug overdose deaths and save even more lives.”

Abstract

In the 50 years since its establishment, the National Institute on Drug Abuse has made significant investment and strides toward improving individual and public health. Epidemiology serves as the foundation for understanding the how many, why, how, where, and who of drug use and its consequences, and effective epidemiology research and training are geared toward actionable findings that can inform real-world responses. Epidemiologic findings enhance clinicians’ ability to provide ongoing care by incorporating information about the patterns and outcomes of drug use that their patients may experience. The goal of this article is to provide a context for epidemiology of substance use as a foundation for prevention, with examples of how epidemiology can provide targets for prevention, and to set the stage for addressing the importance of prevention in clinical settings.
Source: https://psychiatryonline.org/doi/10.1176/appi.focus.20240018

This is the opening of a submission by Dr Stuart Reece to the FDA relating to the re-scheduling of cannabis:

 

“I am very concerned about the potential for increased cannabis availability in USA implied by full drug legalization; however, a comprehensive and authoritative submission of the evidence would take weeks and months to prepare. Knowing what we know now and indeed, what has been available in the scientific literature for a growing number of years concerning a myriad of harmful effects of marijuana, marijuana containing THC should not be reclassified. These effects that are now well documented in the scientific literature include, alarmingly, harm involving reproductive function and birth anomalies as a result of exposure to or use of marijuana with THC.

In addition to all of the usual concerns which you will have heard from many sources including the following I have further particular concerns:
1) Effect on developing brains
2) Effect on driving
3) Effect as a Gateway drug to other drug use including the opioid epidemic
4) Effect on developmental trajectory and failure to attain normal adult goals(stable relationship, work, education)
5) Effect on IQ and IQ regression
6) Effect to increase numerous psychiatric and psychological disorders
7) Effect on respiratory system
8) Effect on reproductive system
9) Effect in relation to immunity and immunosuppression
10) Effect of now very concentrated forms of cannabis, THC and CBD which are widely available
11) Outdated epidemiological studies which apply only to the era before cannabis became so potent and so concentrated 

These issues are all well covered by a rich recent literature including reviews from such major international authorities as Dr Nora Volkow Director of NIDA at NIH, Professor Wayne Hall and others “

 

The full text can be read here

Source: Letter from Dr Stuart Reece to FDA April 2018

In the 50 years since its establishment, the National Institute on Drug Abuse has made significant investment and strides toward improving individual and public health. Epidemiology serves as the foundation for understanding the how many, why, how, where, and who of drug use and its consequences, and effective epidemiology research and training are geared toward actionable findings that can inform real-world responses. Epidemiologic findings enhance clinicians’ ability to provide ongoing care by incorporating information about the patterns and outcomes of drug use that their patients may experience. The goal of this article is to provide a context for epidemiology of substance use as a foundation for prevention, with examples of how epidemiology can provide targets for prevention, and to set the stage for addressing the importance of prevention in clinical settings.
Source: https://psychiatryonline.org/doi/10.1176/appi.focus.20240018 

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