2025 February

Opinion – by Hannah E. Meyers, Published Feb. 16, 2025, 6:19 a.m. ET
Hannah E. Meyers is a fellow and the director of policing and public safety at the Manhattan Institute.

In November, Donald Trump made significant electoral gains in New York’s black and Latino neighborhoods, and in the city’s least affluent communities. Now he is poised to take an important step to improve public safety in these voters’ neighborhoods.

Rep. Nicole Malliotakis (R-SI) last week wrote to new Attorney General Pam Bondi, pleading for the administration to shut down the city’s two “safe injection sites.”

These facilities, located in East Harlem and Washington Heights, provide supervision to drug abusers as they consume harmful substances like fentanyl, meth, heroin and cocaine.

Yes, these are illegal drugs under federal law — and the aptly nicknamed federal “crack house statute” prevents individuals from retaining property for their consumption.

Indeed, Trump’s Justice Department successfully shuttered similar sites in the past – In 2019, his first administration sued to stop a Philadelphia injection center from opening, and in 2024 a US District Court judge in Pennsylvania finally agreed that the center was not exempt from federal drug laws.

Now Trump should listen to his NYC minority constituents and close the injection sites that are harming their neighborhoods.

New York’s two centers, both run by non-profit OnPoint, were the first in the nation, opening in 2021 under then-Mayor Bill de Blasio — who never met an injurious policy he wouldn’t support in the name of racial justice.

De Blasio gambled successfully that the Biden administration wouldn’t intervene.

OnPoint claims to have saved over 1,000 lives by preventing overdoses. But as my colleague Charles Fain Lehman has pointed out, the sites do not reduce addiction — so they are likely just delaying fatalities: More than 15% of those administered naloxone are dead within a year.

Indeed, data shows that NYC overdose rates have continued to rise since the centers opened.

That’s no surprise, since a rigorous look at the data from even the most touted injection sites in other countries provide no evidence of their effectiveness

But rigor has never been the calling card for politicians and advocates who happily sacrifice other people’s communities in the name of compassion.

State Sen. Gustavo Rivera (D-Bronx) has had the chutzpah to claim that “public drug use, syringe litter and drug-related crime goes down” around sites. In 2023, Rivera urged Gov. Hochul to expand supervised consumption sites statewide, and sponsored Senate legislation — still in committee — to do so.

In 2023, Mayor Eric Adams also proposed adding three more facilities to NYC — but he might be amenable to updating his views with some pressure from Washington.

And that pressure will come if Trump cares about the lives of local residents.

While major crimes fell 13% in northern Manhattan over the past two years, the predominantly black and Hispanic precinct around the East Harlem drug site has seen an almost 8% rise in major crime.

I’ve toured that location with the Greater Harlem Coalition. Members pointed out the large early-childhood education center directly across the street from the injection site, as parents hurried their tots into school in plain view of ongoing drug deals.

The perimeter of the block is dotted with addicts nodding off. Nearby restaurants have had to invest in private security to defend against the criminality the center attracts to the neighborhood.

What’s been keeping this site open despite four years in which the only evidenced change is neighborhood degradation?

Shameless advocacy by pompous, ideologically motivated and race-obsessed elites . . . whose kids don’t go to preschool in Harlem.

In August, Greater Harlem Coalition co-founder Shawn Hill was interviewed by one such far-left advocate: Ryan McNeil, director of harm reduction research at Yale’s School of Medicine.

McNeil was conducting funded “research” into safe injection sites — but a “hot mic” recording revealed his and his colleagues’ woke bias in favor of supporting safe injection sites (and drug decriminalization, more broadly).

With no sense of irony, McNeil — who is himself Caucasian — scorned Harlemites’ concerns over open drug abuse as nothing but “white discomfort,” and derided Hill for suggesting that the Yale researchers should walk around and speak with actual local residents.

But Trump has every reason to listen to these locals, three-quarters of whom are black or Latino.

And it would behove Adams, who faces a crowded primary race this summer, to reverse his past stance and voice support for a federal closure of the city’s two drug consumption sites.

In East Harlem, Trump won about 860 more votes last year than in 2020. Now these supporters, and their neighbors he has yet to persuade, are depending on his help.

 

Source: https://nypost.com/2025/02/16/opinion/inject-some-common-sense-shut-down-nycs-safe-drug-sites/

Filed under: Addiction,Crime/Violence/Prison,Culture,Drug use-various effects,Education,Health,HIV/Injecting-Drug-Users,Needle Exchange,Prevention and Intervention,Treatment and Addiction,USA :

by  Steven T. Bell,  Special Agent in Charge – Omaha Drug Enforcement Administration, and Emily Murray.
February 18, 2025


In an effort to build on drug education messaging to tribal communities, the Drug Enforcement Administration (DEA) Omaha Division worked with the Ponca Tribe of Nebraska and Mandaree High School of North Dakota to develop a poster that blends Native Indian imagery with wording emphasizing the importance of culture over drug use.

During visits to tribal communities, DEA’s community outreach specialist noticed posters sounding the alarm to human trafficking, domestic violence and missing  and murdered indigenous women at schools and buildings across Reservations. The common thread tying each poster together was an emphasis on native culture.

Looking to build on the Good Medicine Bundle

Culture-based prevention resources available through DEA’s Operation Prevention, conversation began on how best to help tribal communities relate to important messaging on drug use. Elders were consulted and the vision of a poster, reflecting youth, culture and the DEA mission, began to take shape.
With permission from the Ponca Tribe of Nebraska, photos reflecting tribal values were taken in Norfolk. Youth from the Ponca Tribe of Nebraska highlighted the significant role dance plays in Native Indian Culture. Dancing is used to tell stories, honor ancestors and celebrate important events. A photo of a drum from Mandaree High School places importance on the sacred instrument often used to symbolize the heartbeat of the earth. The wording at the top of the poster, “Drumming and Dance: The Heartbeat of our Culture, NOTDRUGS,” was written for tribal members to feel connected with the poster.
“It’s critical that we find ways to communicate with all members of our communities about the dangers of drug use,” DEA Omaha Division Special Agent in Charge Steven T. Bell said. “Our hope is that this poster resonates with tribal communities and sparks conversation about life choices and their ensuing consequences.”

Source: https://www.dea.gov/press-releases/2025/02/18/dea-works-tribal-communities-advance-drug-education

Filed under: Culture,Education,Prevention and Intervention,Uncategorized,USA,Youth :

Wall Street Journal      by Patricia Kowsmann, Dylan Tokar and Brian Spegele                      Feb. 18, 2025   

Chinese money brokers are teaming up with Mexican cartels, greasing the wheels of the fentanyl trade, U.S. officials say

On an October morning in 2022, an alleged drug trafficker drove a white pickup truck into the parking lot of a Global Fresh Market in San Gabriel, Calif., and stopped alongside a blue Maserati.

After a quick discussion with a woman in the Maserati, the man placed a large black bag in the sportscar’s back seat. Members of a U.S. government task force, who were watching, say it contained some $300,000 in cash.

The drop was part of what U.S. officials say is a new front in America’s war on drugs: an emerging partnership that has made China a crucial pit stop for dirty money flowing from the U.S.’s fentanyl crisis, according to law-enforcement officials and court documents.

Chinese money brokers, part of an underground banking system that has long served the country’s immigrant diaspora, have become go-to partners for fentanyl traffickers and other criminal groups needing to launder illicit drug profits, officials say.

Long operating in the shadows, the Chinese brokers use intermediaries, such as the woman in the Maserati, to collect drug profits from fentanyl dealers. Then, through a series of transactions, they sell those dollars to Chinese customers who want cash in the U.S. for purposes such as buying real estate or other investments, but can’t legally send money directly from China because of capital controls there.  The drug dealers end up with clean money in the process, law-enforcement officials say.

In the case involving the Maserati, dubbed “Operation Fortune Runner,” members of the Drug Enforcement Administration task force spent years investigating one such network, including thousands of hours of street-level surveillance. Traffic stops of suspects turned up cash stowed in a Fruity Pebbles cereal box and a gift bag with “Happy Birthday” printed on the side.

The investigation eventually led to indictments of 24 individuals last year, involving more than $50 million in drug proceeds prosecutors say Chinese brokers were laundering for associates of Mexico’s Sinaloa drug cartel.

Evidence of a deepening relationship between drug cartels and Chinese money brokers presents a challenge for President Trump, who has vowed to end the fentanyl crisis that causes the death of tens of thousands of Americans every year.

So far, his focus has been on cutting off the flow of fentanyl and the precursor ingredients that are used to make it into the U.S., imposing tariffs against producing countries, including a new 10% tariff on Chinese imports to the U.S. earlier this month.

But shutting down the sprawling network of money brokers, who U.S. officials think are critical to greasing the wheels of the trade, could also prove difficult.

In testimony to the House Select Committee on the Chinese Communist Party last year, a former DEA official estimated global drug sales reach $500 billion to $750 billion annually. The official said he believed Chinese networks were laundering a sizable chunk of it.

“The fentanyl crisis starts in China, and it ends in China,” Jarod Forget, DEA’s acting chief of operations, said in an interview.

China’s Foreign Ministry, in a written response to questions, didn’t directly address the role of Chinese nationals laundering drug proceeds. It said the root of the fentanyl crisis lies in the U.S. itself, and Trump’s tariffs ignored the results of U.S.-China cooperation, which has included cracking down on fentanyl production in China.

“Blaming others will not solve this problem,” the Foreign Ministry said. “Pressure and threats are not the right way to deal with China.”

While deaths from overdoses have fallen, fentanyl remains the U.S.’s deadliest drug. Last year, the amount of fentanyl the DEA seized—more than 55 million pills and nearly 8,000 pounds of powder—was estimated by the DEA to be enough to kill every American.

How the system works 

Drug cartels have always faced the problem of getting their profits from illegal sales in the U.S. converted into clean money and sent back home. Some have tapped middlemen who charge a high commission to help launder the money through a series of transactions that involve Colombian pesos, in what is known as the black-market peso exchange, according to U.S. officials.

Chinese money brokers came in with a much faster and cheaper service. They had a competitive edge because so many people in China want U.S. dollars, U.S. officials say.

The transaction begins in the U.S. Drug traffickers sell fentanyl or other narcotics to U.S. customers for cash. They then turn over that cash to a Chinese money broker.

The Chinese money broker now advertises the U.S. dollars on WeChat, a Chinese app. To buy them, a Chinese customer will transfer yuan, including a commission, into the broker’s bank account in China.

The Chinese broker then releases the U.S. dollars to Chinese customers who want to spend money in the U.S., acquiring real estate, paying college tuition, gambling, or making other investments.

Now the Chinese money broker needs to get the yuan to the drug traffickers in Mexico. One way to do that is for the broker to exchange the yuan for pesos in Mexico through a business that is looking to buy Chinese goods for export to Mexico.

The Chinese goods are exported to Mexico and sold. The Chinese broker now has Mexican pesos, which it can hand over to the Mexican cartel, minus a 1–2% commission.

Under China’s capital controls, meant to keep too much money from flowing out of the country, Chinese citizens are limited to buying only $50,000 worth of foreign currency each year. As China’s economy slows and its real-estate and stock markets languish, more Chinese want to move money overseas to protect their wealth. Tapping into underground banks connected to the fentanyl trade is a way to do that, U.S. officials say.

This is how it works: The Mexican cartels’ U.S. operatives provide the U.S. cash they received from selling fentanyl to a broker working for a Chinese money-laundering ring, all in the U.S. Through the Chinese messaging app WeChat, the brokers advertise the cash to people in China who could use the money on U.S. soil, according to current and former law-enforcement officials.

Once a Chinese buyer of the U.S. dollars is found, that person transfers the equivalent in Chinese yuan, plus a hefty commission, to a bank account in China belonging to the money launderers. The Chinese customer then receives access to the cash bought in the U.S.

The cartel’s money, now clean, is sitting in the Chinese money broker’s bank account in China. The money can then get back to the cartel in a couple of ways. It can be used to buy fentanyl precursors for the cartel, starting the cycle again.

Or, the yuan can be used to buy Chinese manufactured goods that are then shipped to Mexico and sold for pesos, which are then handed to the cartels.

Some Chinese nationals using the service might not know it involves drugs, U.S. officials say.

“This is now one of the most prominent, if not the most prominent way in the world that people launder money,” said Craig Timm, a former money-laundering official in the U.S. Department of Justice who is now at the Association of Certified Anti-Money Laundering Specialists.

Chinese money brokers have also differentiated themselves from competitors by taking on some of the risk associated with this multistep process. Instead of waiting until the process is complete to release pesos to Mexican cartels, they operate essentially on credit, transferring money to drug traffickers soon after receiving a cash delivery in the U.S., officials say.

The commission they charge drug traffickers is small, because they also make money from selling U.S. dollars to customers of their underground banking network.

“When the Colombians controlled it, it cost 7% to 10%. The Chinese were charging 1% to 2%. It was unheard of,” said Chris Urben, a former DEA agent who saw firsthand the emergence of Chinese money launderers in the New York area.

“All of a sudden, we were seeing Chinese money launderers picking up drug money all across the U.S.,” added Urben, now a managing director at private investigations firm Nardello & Co.

Many former law-enforcement officials say more cooperation with China is needed.

“A lot of the money under the scheme is flowing through banks in China where the Chinese have oversight,” said Anthony Ruggiero, a former senior U.S. Treasury official now at the Foundation for Defense of Democracies.

The DEA and other agencies have launched a spate of investigations in the U.S. In one case, two Chinese nationals were charged with laundering money for Mexican cartels after agents went undercover as money couriers. Both were later convicted, with one of the men receiving a 10-year sentence in December for taking part in efforts to launder $62 million.

The task force surveilling the cash drop in San Gabriel, Calif., in 2022 was part of a special DEA team that worked wiretaps on drug trafficking investigations. Their target was an alleged Chinese money-laundering ring run by a man named Sai Zhang who did business with alleged drug dealers, including the Sinaloa cartel, and cash runners such as the woman in the blue Maserati, who wasn’t identified in court records.

Officers spent several years following the suspects, watching them pick up and drop off bags throughout the Los Angeles area.

On the October morning in San Gabriel, officers said they were relying on a wiretapped phone conversation between two members of Zhang’s ring who were organizing the pick up of $300,000.

After the bag was handed off to the blue Maserati, agents followed the car to a residence, where the money was allegedly mixed with other drug proceeds and parceled out to underground banking customers, people familiar with the matter said. Later, police pulled over a driver who had left the residence and found $25,000, according to court documents.

Zhang was among the people charged with laundering money, running an unlicensed money transmitting business and facilitating drug trafficking. He has pleaded not guilty and is awaiting trial. A lawyer for Zhang didn’t respond to requests for comment.

Chinese authorities said in June they had arrested in the mainland one of the men indicted for allegedly working with the network.

Source: https://www.wsj.com/world/china/china-fentanyl-trade-network-9685fde2?mod=hp_lead_pos5

Filed under: Crime/Violence/Prison,Culture,Fentanyl,USA :
by James Cook, BBC Scotland editor and Anton Ferrie, BBC News contributor                                                               

James McMillan and Lisa McCuish grew up next to each other and now they lie side by side in Pennyfuir Cemetery

James McMillan grew up next door to Lisa McCuish in a neat cul-de-sac on a hillside above Oban Bay. Now they lie side by side in Pennyfuir Cemetery.

The newest headstones on the freshly-dug fringes of the graveyard tell an alarming story of a lost generation in this pretty tourist town on Scotland’s west coast.

Oban is home to just 8,000 people and at least eight recent confirmed or suspected victims of drug misuse were buried here. The youngest was 26, the oldest was 48.

The population of the town is about the same as the total number of overdose deaths recorded in Scotland in the past seven years – by far the worst rate in Europe.

The deaths have led to calls for urgent action to tackle addiction in rural Scotland with relatives citing problems accessing vital services.

Scotland’s Health Secretary Neil Gray has told BBC News that he accepts more needs to be done to tackle drug misuse in rural areas.

For James’ mother, Jayne Donn, the nightmare began before dawn on a freezing night in December 2022 when she was woken by the doorbell.

“At 10 to five in the morning, when it was snowing and my Christmas tree was up, the police came to my door,” she says.

The officers had come, as Jayne had long dreaded they would, to tell her that her 29-year-old son was dead of an overdose.

James was another victim of a crisis that has been raging across Scotland for almost a decade, claiming 1,172 lives in 2023.

“As a little boy he was blonde-haired, blue-eyed, full of mischief,” Jayne tells me in the living room of the family home.

The young James loved “fishing, music and his skateboard,” she says.

“As a man, there’s not so many good memories,” says Jayne.

“He was very mixed up. He was very angry. He was very lost.”

James McMillan, who died in December 2022, with his mother Jayne Donn
Jayne Donn

James’ father left the family home when he was seven.

He struggled at school with dyslexia and mental health challenges and later began to dabble with cannabis.

He started to get into trouble, first with teachers, then with the police.

As he grew into adulthood, James drifted away from Oban and from his family, losing a job as an apprentice bricklayer because of poor attendance and concentration, and disappearing to England.

Jayne says she knew little about what was happening there. In truth, her son’s life was unravelling.

He had been diagnosed with attention deficit hyperactivity disorder, bipolar disorder and drug-induced psychosis.

He was struggling with suicidal tendencies, taking more and harder drugs and increasingly turning to crime.

As a result he was in and out of custody for drug offences, breach of the peace, break-ins and theft, at one point serving a two-year prison sentence.

James died in Glasgow on 16 December 2022 – less than two days after he was released from custody following eight months on remand in Barlinnie prison.

James’ mother says she doesn’t know the details of the last charges he had faced or why he was released – but she believes more could have been done to support her son, as he had overdosed on release from custody on three previous occasions.

A Scottish Prison Service source pointed out that decisions taken at the end of a period of remand are a matter for the courts not the prison.

Jayne describes a web of organisations which dealt with her son: charities, local authorities, the NHS, addiction services, housing providers and more.

But she says: “He was released into a city he didn’t know with no jacket, no money and nobody aware.

“He lasted less than 36 hours.”

Lisa McCuish grew up in Oban.                                                                                                         MKC Photocreations 

Lisa McCuish grew up next to James in a street looking down on Oban Bay, where red and black Caledonian MacBrayne ferries bustle to and from the islands of the Hebrides.

Oban was recently named Scotland’s town of the year by an organisation which promotes smaller communities.

Today, Lisa’s sister Tanya is sitting in Jayne’s living room, tears in her eyes, recalling her sibling as “a larger than life character” with “a heart of gold”.

“Lisa was never into drugs, you know, that wasn’t her,” says Tanya.

Things began to go wrong only after Lisa was prescribed diazepam, which is typically used to treat anxiety, seizures or muscle spasms.

“She ended up buying it off the streets because she felt she needed more,” Tanya remembers.

“She kept on saying that she needed more help, more support.”

Then, she says, her sister started taking heroin.

Lisa had a cardiac arrest on 13 September 2022 and died four days later in hospital in Paisley. She was 42 years old.

She had prescription drugs in her system and also Etizolam, a benzodiazepine-type substance commonly known as street Valium because it is often sold illicitly.

Tanya and Jayne take us to the spot where they both mourn, pointing out other nearby graves where recent drug death victims are buried.

They include James’s best friend, who lies alongside him and Lisa. He was 30 when he died of a drug overdose.

“It’s just awful to think there’s at least 10 around here that we can think of,” says Jayne.

There is no official breakdown of how many lives have been claimed by drugs in small communities such as Oban.

We have been able to confirm that at least eight of the deaths occurred within just a year-and-a-half and were related to drugs, or are still under investigation.

This is the reality of Scotland’s drug deaths crisis in just one small community and both Tanya and Jayne say the Scottish government must do more to save lives.

“I personally believe that a lot of addiction is to do with mental health first,” says Tanya.

“There’s no continuity in support from addiction services or mental health services. There’s no link up.”

Jayne, who is a drugs support worker herself, says she spent years trying to bring James home to Oban where she felt he would have a better chance of recovery and survival.

A particular challenge, she says, was that Argyll and Bute Council offered James housing places in Dunoon and Helensburgh – both about two hours away – making it very difficult for his family to support him.

The local authority said it had offered “appropriate” services to James.

The council added that it had housing services throughout the area, but could not always satisfy “individual and sometimes changing criteria”.

Scotland’s Health Secretary Neil Gray says that both families have his deepest sympathies and he accepts that rural drug services could be improved.

“I think that the two cases that you’ve highlighted tell me that there’s more that can be done,” he said.

“I recognise that not everything is available in all parts of Scotland.”

Mr Gray added: “We support alcohol and drug partnerships across Scotland, whether they’re in rural areas or urban areas.

“I would obviously want us to be continuing to do more to make sure that there is access to facilities and services in rural and island areas.”

 

For Justina Murray, chief executive of the charity Scottish Families Affected by Alcohol and Drugs, the problems do not lie with strategy or funding but with culture and delivery, especially in NHS addiction services.

“People want services that are in their own community, they can access when they need them, they’re going to be met at the door by a friendly face,” she says.

“They’re going to be treated with dignity and respect.

“That’s not necessarily the experience you’re going to have engaging with an NHS or a statutory treatment service.”

According to the latest available figures, released in September 2024, there is capacity for 513 residential rehabilitation beds in Scotland, across 25 facilities.

Only 11 of those beds are available in what are considered by the Scottish government to be very remote rural areas, although the majority of facilities do accept referrals from any part of Scotland.

I ask Jayne and Tanya about the argument that individuals and their families, rather than the state, should take more responsibility for their own choices.

“Nobody sets out in life to be a drug addict,” replies Jayne.

“Nobody chooses it. The mental health issue was what led James to try and escape reality.

“He then no longer had capacity to make his choices. He wasn’t James any more.

“These are vulnerable adults who are unable to protect themselves from danger or harm,” adds Tanya.

“Why is more not being done?”

“Something’s got to change,” agrees Jayne.

“We’re losing far too many young people.”

Source: https://www.bbc.co.uk/news/articles/c20pwd04zy4o

Filed under: Addiction,Culture,Environment,UK,Youth :

Dangerous but common misconceptions can prevent crucial early addiction treatment.

Key points:

  • Misconceptions and the ignoring of research-based evidence prevent crucial early treatment of addiction.
  • Drugs of abuse cause health, life, and relationship problems with many long-lasting effects.
  • Teen and young adult drug prevention is necessary and needs funding.

Research published in high-quality peer-reviewed journals reveals key information on the realities of addiction, exposing pervasive myths and misconceptions, as in these examples.

False Belief 1: Drug experimentation is normal for teens and shouldn’t alarm parents.

Drug use and experimentation among teens often is ignored by many—even parents, who then may be unaware that any use places adolescent brains in jeopardy. For today’s teens, life often feels overwhelming, but avoiding alcohol, tobacco, marijuana, and other drugs is their one best choice to promote continued healthy physical and mental development. Preventing or delaying all teenage substance use not only reduces their current risks for depression, psychosis, and school/learning problems, but it also significantly decreases their probability of addiction as adults.

Harvard’s Sharon Levy, MD, MPH, and founding National Institute of Drug Abuse Director Robert DuPont, MD, strongly advocate a zero-tolerance approach to youth substance use. They emphasize that no amount of drug use is safe for young people. They promote the One Choice initiative encouraging adolescents to avoid substance use: alcohol, tobacco, marijuana, and other drugs.

It’s now known that THC in marijuana interferes with the developing brain circuits responsible for regulating behavior, leading to increased risk-taking and poor decision-making. Even infrequent teen use can impede judgment, increasing the probability of risky behaviors and accidents. Adolescents also are more likely than adults to develop cannabis use disorder (CUD) due to their heightened neuroplasticity during this developmental stage. The resulting impairment may lead to academic underperformance and problematic interpersonal relationships.

False Belief 2: Addiction is a personal weakness.

Addiction is not about people being weak-minded. It’s far more complicated. Becoming addicted depends on the drug used, dose, route, frequency, and risk factors like ages of users. Also, the same drug at the same dose affects people differently because of personal differences, as well as the presence/absence of traumatic past life experiences.

Yale’s Joel Gelernter identified genetic variants associated with vulnerability to addictions. However, genetic characteristics themselves interact with environmental factors in developing substance use disorders (SUDs). As Nora Volkow, director of NIDA, has said, “Addiction is a complex disease of a complex brain; ignoring this fact will only hamper our efforts to find effective solutions …”

False Belief 3: People must hit “rock bottom” to recover from addiction.

No, no, and no! Roadside alcohol testing has prevented thousands of deaths and helped many people with alcohol use disorders (AUD) obtain help, sometimes by coercion of courts. About 50 percent of those arrested for DUI have an AUD. Users often deny they have a problem with drugs or alcohol and believe they are truthful. But they are lying to themselves.

Addiction is a chronic, relapsing condition driven by changes in brain circuitry, particularly in areas controlling reward, stress, and decision-making. While some people seek help after suffering dire consequences, others are compelled into treatment by the courts, based on a past offense. Waiting to hit “rock bottom” increases major risks of harming the person’s relationships, job, and health—and strengthens the hold of the drug over the person.

False Belief 4: Addiction treatment never works.

Researchers from the University of British Columbia and Harvard Medical School recently analyzed survey data from nearly 57,000 participants in 21 countries over 19 years, providing clear data. They discovered that the number-one barrier to treatment was addicted people themselves: Most were in denial and did not recognize they needed treatment.

Alcoholics Anonymous is often successful, non-judgmentally providing new members a roadmap, role models, hope, and social connections. Successful people actively involved in AA complain that their friends kept asking them why they “weren’t cured yet” since they went to so many meetings. But going to meetings is what works.

Even among experts, there’s no consensus on what constitutes successful treatment. To some, success is that the person is still alive and hasn’t been rushed to the emergency room because of an overdose in the past 6 months or year. To others, it is taking treatment medications. And to still others, only abstinence and a full resumption of all family and work obligations counted as success.

Another issue is that most people with SUDs have multiple addictions. Even when they overdosed, most took multiple drugs. It’s also true that many people come to treatment also needing treatment for other medical, addiction, and psychiatric problems. Yet only rarely are patients evaluated and treated for all issues.

False Belief 5: Overdoses of drugs don’t cause brain damage.

Drugs of abuse can harm the brain. Overdose survivors may suffer from undetected brain damage and hypoxic brain injury caused by opioid-induced respiratory depression. As a society, we better understand hypoxia as associated with drowning or choking than its much more common occurrence in drug overdoses with loss of consciousness.

Recent studies estimate that at least half of people using opioids have illicitly experienced a non-fatal overdose or witnessed an overdose. People who regularly use drugs are at elevated risk of brain injury due to accidents, fights, and overdoses. A single fentanyl overdose could cause hypoxia, brain injury, and memory and concentration problems.

Overdoses with counterfeit pills, cocaine, methamphetamine, xylazine, or heroin usually also include fentanyl, making neurologically compromising overdoses more common.

Summary

Myths and misconceptions increase stigma and decrease the likelihood that someone with an addictive illness will receive prompt, effective treatment. We need early intervention and treatment during the preaddiction phase. Bottom line: Preventing teen and young adult use is crucial.

Mark Gold M.D.

Mark S. Gold, M.D., is a pioneering researcher, professor, and chairman of psychiatry at Yale, the University of Florida, and Washington University in St Louis. His theories have changed the field, stimulated additional research, and led to new understanding and treatments for opioid use disorders, cocaine use disorders, overeating, smoking, and depression.

Source: https://www.psychologytoday.com/intl/blog/addiction-outlook/202502/5-common-false-beliefs-about-drug-use-users-and-addiction
Filed under: Addiction,Brain and Behaviour,Crime/Violence/Prison,Culture,Economic,HIV/Injecting-Drug-Users,Marijuana and Medicine,Parents,Prevalence,Prevention and Intervention,Psychiatric drugs,Social Affairs (Papers),USA,Vaping :

by Dan Krauth WABC logo    Eyewitness News – Friday, February 14, 2025

Dan Krauth has more on the letter sent to the newly confirmed attorney general asking her to shut down safe injection sites in New York City.

NEW YORK (WABC) — There are places people can go take illegal drugs under the watchful eye of supervisors to ensure they don’t die.

They are called Overdose Prevention Centers, or also known as safe injection sites, and there are two of them in New York City — the first of its kind in the nation.

Now, after more than three years of operating, there’s a new effort under a new president to shut down the centers that are run by a non-profit organization.

It’s called OnPoint NYC and they have two locations in Washington Heights and East Harlem.

Drug users can take their drug of choice from heroin to cocaine inside the centers and supervisors intervene, most times with oxygen, if the user starts to overdose. They also provide test strips for drugs to ensure they don’t have fatal doses of fentanyl inside.

Since opening in 2021, the executive director said they’ve intervened in more than 1,700 overdoses. They also provide services like medical help, substance abuse treatment and housing assistance.

Opponents say the centers encourage people to do illegal drugs.

“They’re encouraging people to use by giving them a community center to go to and to use heroin, it’s something that’s encouraging addicts not helping them,” said Congresswoman Nicole Malliotakis.

She sent a letter to the newly confirmed attorney general, asking her to shut down both locations along with any others that have opened across the country.

“They don’t work, these heroin injection centers, in fact they attract crime to the neighborhood but also drug dealing, it just does not make sense and they should be shut down,” Malliotakis said.

In response, the executive director of OnPoint NYC sent Eyewitness News a statement:

“OPCs save lives. At OnPoint NYC, our staff has intervened in over 1,700 overdoses, providing life-saving care to mothers, fathers, and loved ones,” said OnPoint NYC Executive Director Sam Rivera. “Every single one of them deserves compassion and a chance at healing. I’m incredibly proud of our team and continually inspired by the dedication they show every day. They don’t just look at the overdose epidemic and wonder what can be done-they don’t have that luxury. They act, because they have lives to save. This work is not just vital; it’s transformational. Lives are being saved, hope is being restored, and healing is possible.”

 

Source:  https://abc7ny.com/post/president-trump-asked-shut-down-overdose-prevention-centers-have-operated-3-years-nyc/15907033/

Filed under: Addiction,Culture,Mental Health,Political Sector,Prevention and Intervention,Treatment and Addiction,USA :
COMMENTARY:  Public Health  – Feb 14, 2025

by Paul J. Larkin – Rumpel Senior Legal Research Fellow and Bertha K. Madras, PhD – Professor of psychobiology at Harvard Medical School, based at McLean Hospital and cross appointed at the Massachusetts General

Key Takeaways

Today, some members of America’s political class are desensitized to the drug crisis. They tolerate normalizing psychoactive substance use.

The relentless movement to legalize drug use has succeeded, largely by appealing to the goodwill and sympathies of the American public.

For supply reduction, the U.S. must send a clear message to the world that we are not an open market for drugs.

The federal government has long sought to prevent the horrors of drug addiction by interdicting the supply of dangerous psychoactive drugs—and reducing demand for them.

One step was the Anti-Drug Abuse Act of 1988. It established the Office of National Drug Control Policy (ONDCP) within the Executive Office of the President. Headed by a director colloquially known as “drug czar,” ONDCP had the task of developing a national drug-control strategy to reduce drug use. Its creation symbolized a strong bipartisan effort to prevent illicit drugs from destroying lives and weakening the nation.

Sadly, we have lost that shared mission. No president since George W. Bush has publicly demonstrated a deep and firm support for ONDCP and its mission.

The agency does not reside in the White House office building, let alone the West Wing. The federal government has largely been a bystander despite the unraveling of restrictive opioid prescribing, state implementation of medical/recreational marijuana programs in violation of federal laws, and the incipient movement by states to legalize psychedelics. Most presidents have largely ignored these trends.

The first Trump administration assembled a commission to combat drug addiction and the opioid crisis. The current one should support a comprehensive effort led by ONDCP to overhaul drug policies and strengthen America’s commitment to reducing and delegitimizing drug use. We need a revitalized ONDCP equipped with innovative goals and measurable outcomes to disrupt the pipeline to addiction and to cease preventable, premature deaths and mental health decline. A single centralized agency ensures coordination across federal agencies, state, and local levels to maximize efficiency and accountability.

Today, some members of America’s political class are desensitized to the drug crisis. They tolerate normalizing psychoactive substance use and the addiction, health crises, deaths, and collateral damage to families that follow.

Reformers advocate destigmatizing regular use of hazardous psychoactive drugs. “Harm reduction” practices, initially framed as temporary measures, now are uncritically promoted in some quarters without clear boundaries or outcome goals.

This “Meet drug users where they are” approach has regressed to a “Leave them where they are” one. The grim realities of “tranq”-induced catatonia on the streets of Philadelphia’s Kensington neighborhood, San Francisco’s Tenderloin district, Boston’s Mass and Cass intersection, and other drug-ridden homeless encampments lay bare the stark failure of America’s waning resolve to minimize drug use.

Among other nations, we are an outlier. America’s drug crisis has escalated dramatically since ONDCP was born. Overdose deaths surged from 3,907 (1.6 per 100,000) in 1987 to a record 107,543 (32.2 per 100,000) in 2023, with teen rates doubling recently. Among twelfth-graders, 13 percent use marijuana daily, despite heightened risks for addiction and psychosis. In 2023, daily use of marijuana and regular use of hallucinogens among 19- to 30-year-olds reached record levels, fueled by pervasive myths about “safety” or “medical” efficacy

Whether used for medical or recreational purposes, or both, 25 percent of cannabis users have a cannabis-use disorder; among twelve- to 24-year-olds, such a disorder is more prevalent than alcohol-use disorder. Over 90 percent of individuals with substance-use disorders (48.7 million people) neither recognize their need for help nor seek treatment.

Topping it off, seizures of fentanyl-laced pills exploded from 49,000 in 2017 to a staggering 115 million in 2023. Reversing this runaway train demands a transformative political and cultural shift led by the president, ONDCP, and Congress.

How?

Start by learning from past mistakes. The relentless movement to legalize drug use has succeeded, largely by appealing to the goodwill and sympathies of the American public. In 1996, activists persuaded California’s voters to adopt marijuana as a medicine by labelling it as “compassionate use” for end-stage cancer and HIV-AIDS wasting.

That success gave legalizers a foothold. Slowly, the movement persuaded other states to adopt medical-use marijuana for myriad purposes without a shred of evidence; this later morphed into recreational-use programs. Dual-purpose “dispensaries” now sell marijuana for any reason. Activists persuaded the medical profession that pain was the “fifth vital sign” and pressured caregivers to prescribe highly addictive opioids liberally for any type of pain. We know where that went.

Finally, recent campaigns to use political means to normalize hallucinogens for medical use bear a striking resemblance to the two campaigns noted above, including media hype and their tendency to lampoon cautious Cassandras. Compassion is a virtue, except when it leads to long-term harm.

Those who are driving the normalization of substance use as a chemical shortcut for pleasure or relief are willing to sacrifice long-term well-being for short-term escapism. Without prevention strategies to disrupt this pathway of use, addiction, and death, no amount of treatment or law enforcement will resolve the crisis.

We should oppose efforts to destigmatize drug use but support destigmatization of individuals with substance-use disorders to ease their entry into treatment and recovery. To end the frequently heard lament of parents—“If only I knew”—we need a national educational campaign that counters the myths promulgated by proponents.

We need more research to understand why substance-use disorders are resistant to treatment- and recovery. Harm-reduction strategies that don’t show objective reductions in disordered use should be challenged. And we must recognize that minorities are hurt, not helped, by liberalizing drug use because it can worsen the conditions in already suffering neighborhoods.

Finally, we should strengthen ONDCP by returning it to cabinet-level status and empowering it to adopt a results-driven business model. Steps would include, on the demand side, ensuring that federal funding is allocated to prevention and treatment programs that prioritize objective, evidence-based positive outcomes.

For supply reduction, the U.S. must send a clear message to the world that we are not an open market for drugs. This will involve stopping the smuggling of fentanyl, dismantling illegal markets, and seizing traffickers’ ill-gotten gains. Incentives and penalties can persuade nations that produce drugs and their precursor chemicals to curb their export of substances poisoning Americans.

President Trump has a unique opportunity to pivot and reform America’s recurring drug crises. A bold approach will signal America’s commitment to reversing our damaging trajectory.

This piece originally appeared in the National Review

Source:  https://www.heritage.org/public-health/commentary/the-drug-crisis-hasnt-gone-away-the-trump-administration-should-confront

Filed under: Culture,Drug Specifics,Drug use-various effects,Effects of Drugs,Mental Health,Political Sector,Prevalence,Prevention and Intervention,Treatment and Addiction,USA,Youth :

(1)    Use of Alternative Payment Models for Substance Use Disorder Prevention in the United States: Development of a Conceptual Framework

Journal: Substance Abuse Treatment, Prevention, and Policy, 2025, doi: 10.1186/ s13011-025-00635-z

Authors: Elian Rosenfeld, Sarah Potter, Jennifer Caputo, Sushmita Shoma Ghose, Nelia Nadal, Christopher M. Jones, … Michael T. French

Abstract:

Background: Alternative payment models (APMs) are methods through which insurers reimburse health care providers and are widely used to improve the quality and value of health care. While there is a growing movement to utilize APMs for substance use disorder (SUD) treatment services, they have rarely included SUD prevention strategies. Challenges to using APMs for SUD prevention include underdeveloped program outcome measures, inadequate SUD prevention funding, and lack of clarity regarding what prevention strategies might fit within the scope of APMs.

Methods: In November 2023, the Substance Abuse and Mental Health Services Administration (SAMHSA), through a contract with Westat, convened an expert panel to refine a preliminary conceptual framework developed for utilizing APMs for SUD prevention and to identify strategies to encourage their adoption.

Results: The conceptual framework agreed upon by the panel provides expert consensus on how APMs could finance a variety of prevention programs across diverse populations and settings. Additional efforts are needed to accelerate the support for and adoption of APMs for SUD prevention, and the principles of health equity and community engagement should underpin these efforts. Opportunities to increase the use of APMs for SUD prevention include educating key groups, expanding and promoting the SUD prevention workforce, establishing funding for pilot studies, identifying evidence-based core components of SUD prevention, analyzing the cost effectiveness of APMs for SUD prevention, and aligning funding across federal agencies.

Conclusion: Given that the use of APMs for SUD prevention is a new practice, additional research, education, and resources are needed. The conceptual framework and strategies generated by the expert panel offer a path for future research. SUD health care stakeholders should consider ways that SUD prevention can be effectively and equitably implemented within APMs.

To read the full text of the article, please visit the publisher’s website.

(2)     Quitline-Based Young Adult Vaping Cessation: A Randomized Clinical Trial Examining NRT and mHealth

Journal: American Journal of Preventive Medicine, 2025, doi: 10.1016/j.amepre.2024 .10.019

Authors: Katrina A. Vickerman, Kelly M. Carpenter, Kristina Mullis, Abigail B. Shoben, Julianna Nemeth, Elizabeth Mayers, & Elizabeth G. Klein

Abstract:

Introduction: Broad-reaching, effective e-cigarette cessation interventions are needed.

Study design: This remote, randomized clinical trial tested a mHealth program and nicotine replacement therapy (NRT) for young adult vaping cessation.

Setting/participants: Social media was used from 2021 to 2022 to recruit 508 young adults (aged 18-24 years) in the U.S. who exclusively and regularly (20+ days of last 30) used e-cigarettes and were interested in quitting.

Intervention: All were offered 2 coaching calls and needed to complete the first call for full study enrollment. Participants were randomized to one of 4 groups in the 2×2 design: mailed NRT (8 weeks versus none) and/or mHealth (yes versus no; stand-alone text program including links to videos and online content).

Main outcome measures: Self-reported 7-day point prevalence vaping abstinence at 3 months.

Results: A total of 981 participants were eligible and randomized; 508 (52%) fully enrolled by completing the first call. Enrolled participants were 71% female, 31% non-White, and 78% vaped daily. Overall, 74% completed the 3-month survey. Overall, 83% in the mailed NRT groups and 24% in the no-mailed NRT groups self-reported NRT use. Intent-to-treat 7-day point prevalence abstinence rates (missing assumed vaping) were 41% for calls only, 43% for Calls+mHealth, 48% for Calls+NRT, and 48% for Calls+NRT+mHealth. There were no statistically significant differences for mailed NRT (versus no-mailed NRT; OR=1.3; 95% CI=0.91, 1.84; p=0.14) or mHealth (versus no mHealth; OR=1.04; 95% CI=0.73, 1.47; p=0.84).

Conclusions: This quitline-delivered intervention was successful at helping young adults quit vaping, with almost half abstinent after 3 months. Higher than anticipated quit rates reduced power to identify significant group differences. Mailed NRT and mHealth did not significantly improve quit rates, in the context of an active control of a 2-call coaching program. Future research is needed to examine the independent effects of coaching calls, NRT, and mHealth in a fully-powered randomized control trial.

To read the full text of the article, please visit the publisher’s website.

(3)     The Alcohol Exposome

Journal: Alcohol, 2025, doi: 10.1016/j.alcohol.2024.12.003

Authors: Nousha H. Sabet, & Todd A. Wyatt

Abstract:
Science is now in a new era of exposome research that strives to build a more all-inclusive, panoramic view in the quest for answers; this is especially true in the field of toxicology. Alcohol exposure researchers have been examining the multivariate co-exposures that may either exacerbate or initiate alcohol-related tissue/organ injuries. This manuscript presents selected key variables that represent the Alcohol Exposome. The primary variables that make up the Alcohol Exposome can include comorbidities such as cigarettes, poor diet, occupational hazards, environmental hazards, infectious agents, and aging. In addition to representing multiple factors, the Alcohol Exposome examines the various types of intercellular communications that are carried from one organ system to another and may greatly impact the types of injuries and metabolites caused by alcohol exposure. The intent of defining the Alcohol Exposome is to bring the newly expanded definition of Exposomics, meaning the study of the exposome, to the field of alcohol research and to emphasize the need for examining research results in a non-isolated environment representing a more relevant manner in which all human physiology exists.

To read the full text of the article, please visit the publisher’s website.

(4)     Neural Variability and Cognitive Control in Individuals with Opioid Use Disorder

Journal: JAMA Network Open, 2025, doi: 10.1001/jamanetworkopen.2024.55165

Authors: Jean Ye, Saloni Mehta, Hannah Peterson, Ahmad Ibrahim, Gul Saeed, Sarah Linsky, … Dustin Scheinost

Abstract:

Importance: Opioid use disorder (OUD) impacts millions of people worldwide. Prior studies investigating its underpinning neural mechanisms have not often considered how brain signals evolve over time, so it remains unclear whether brain dynamics are altered in OUD and have subsequent behavioral implications.

Objective: To characterize brain dynamic alterations and their association with cognitive control in individuals with OUD.

Design, setting, and participants: This case-control study collected functional magnetic resonance imaging (fMRI) data from individuals with OUD and healthy control (HC) participants. The study was performed at an academic research center and an outpatient clinic from August 2019 to May 2024.

Exposure: Individuals with OUD were all recently stabilized on medications for OUD (<24 weeks). Main outcomes and measures: Recurring brain states supporting different cognitive processes were first identified in an independent sample with 390 participants. A multivariate computational framework extended these brain states to the current dataset to assess their moment-to-moment engagement within each individual. Resting-state and naturalistic fMRI investigated whether brain dynamic alterations were consistently observed in OUD. Using a drug cue paradigm in participants with OUD, the association between cognitive control and brain dynamics during exposure to opioid-related information was studied. Variations in continuous brain state engagement (ie, state engagement variability [SEV]) were extracted during resting-state, naturalistic, and drug-cue paradigms. Stroop assessed cognitive control.

Results: Overall, 99 HC participants (54 [54.5%] female; mean [SD] age, 31.71 [12.16] years) and 76 individuals with OUD (31 [40.8%] female; mean [SD] age, 39.37 [10.47] years) were included. Compared with HC participants, individuals with OUD demonstrated consistent SEV alterations during resting-state (99 HC participants; 71 individuals with OUD; F4,161 = 6.83; P < .001) and naturalistic (96 HC participants; 76 individuals with OUD; F4,163 = 9.93; P < .001) fMRI. Decreased cognitive control was associated with lower SEV during the rest period of a drug cue paradigm among 70 participants with OUD. For example, lower incongruent accuracy scores were associated with decreased transition SEV (ρ58 = 0.34; P = .008). Conclusions and relevance: In this case-control study of brain dynamics in OUD, individuals with OUD experienced greater difficulty in effectively engaging various brain states to meet changing demands. Decreased cognitive control during the rest period of a drug cue paradigm suggests that these individuals had an impaired ability to disengage from opioid-related information. The current study introduces novel information that may serve as groundwork to strengthen cognitive control and reduce opioid-related preoccupation in OUD.

To read the full text of the article, please visit the publisher’s website.

Source: https://drugfree.org/drug-and-alcohol-news/research-news-roundup-february-13-2025/

Filed under: Addiction,Brain and Behaviour,Culture,Health,Marijuana and Medicine,Mental Health,Treatment and Addiction,USA,Vaping,Youth :

by CNN Health (selected text) – February 12, 2025

A legal loophole is allowing children who access social media to see enticing advertisements for marijuana with potentially dangerous consequences, according to experts.

Under the Controlled Substances Act, it’s illegal to advertise the sale or use of marijuana using federal airwaves or across state lines. But that hasn’t stopped social media ads on cannabis websites from reaching youth of all ages who use screens, said Alisa Padon, research director for the Prevention Policy Group, a health equity and prevention association in Berkeley, California.

“Businesses are allowed to make their own pages and then post ads on their feed. Youth are bypassing age restrictions and seeing the ads for products they’re not legally allowed to buy. They can like, comment and share those posts with their friends,” Padon said.

“Research shows that type of engagement is related to an increased likelihood of wanting to use and using cannabis,” she added. “It’s a perfect storm, and regulators are doing nothing about it.”

According to a 2024 national survey, over 7% of eighth graders, nearly 16% of 10th graders and almost 26% of 12th graders said they have used cannabis in the past 12 months. When marijuana use occurs during the teen years, it’s more likely the individual will become addicted, according to the National Institute on Drug Abuse.

Cannabis use during adolescence can interfere with memory, cognition and brain growth at a critical time in a child’s natural development, said pediatrician Dr. Megan Moreno, a professor and academic chair of the Division of General Pediatrics and Adolescent Medicine at the University of Wisconsin School of Medicine and Public Health in Madison.

“There’s a dose response, so heavier users have longer-term effects, and there are concerns these developmental impacts may not reverse after abstinence,” Moreno said.

“It’s the wild west out there,” she added. “If you put an ad on your own little marijuana website, and it spreads virally through social media, there are no regulations against that.”

Effective advertising tactics

Marijuana stores and manufacturers are marketing their wares to youth using tested techniques popularized by the alcohol, tobacco and food industries, experts say.

“The marketing that we’re seeing in California for cannabis looks just like the marketing that is nationwide for alcohol and for e-cigarettes,” Padon said.

When it comes to social media advertising, however, the cannabis industry has excelled, said Moreno, who has studied the impact of marijuana ads on youth.

“The cannabis industry came into the market with traditional advertisements already illegal, so they became incredibly creative on social media,” she said. “The content is expertly crafted to appeal to youth.”

Moreno researched how marijuana sellers in four states where recreational marijuana is legal (Alaska, Colorado, Oregon and Washington) have advertised to underage adolescents.

A key method was the use of young-looking salespeople called “budtenders” who help clients in the store pick out their marijuana products.

“Budtender is a riff on bartender. Advertisers tend to photograph budtenders who look like they are 16,” Moreno said.

“Also, the crossover between food and tobacco industry advertising and cannabis marketing really stands out — both use enticing color schemes and flavors,” she said.

“And they are using the alcohol industry’s playbook to send messages hinting it’s sexy to use marijuana.”

Padon quizzed 409 California youth between the ages of 16 and 20 about their reaction to various online cannabis ads. The research was published in the March edition of the International Journal of Drug Policy.

Overall, illustrations and food and flavor references were extremely appealing to youth, Padon said. Depictions of heavy cannabis use and positive sensations from that use were also a hit with young audiences. Advertisements focusing on the health benefits of cannabis, however, fell flat.

An advertisement placing marijuana in the middle of a burst of red cherries and bright colors was the most appealing ad to kids in the study, Padon said. Another popular ad showed an attractive young man who appeared to be 14 to 15 years old displaying cannabis products in a store.

“Another theme we found in our past studies was tying cannabis to athletics and being active, which is appealing to youth,” Moreno said. “Teens are in that phase of identity development trying to figure out who they are. So if part of an adolescent’s identity is a sport or being outdoorsy, the cannabis product is tying into something that’s valuable to them.”

A problem that may only worsen

According to a 2024 report, daily or near daily marijuana use by California adults tripled and marijuana use during pregnancy nearly doubled in the past decade. This occurred despite warnings to expectant moms about the dangers of cannabis on an unborn fetus.

During a four-year period between 2015 and 2019, cannabis-related visits to emergency rooms increased by 70% in older adults, the report stated.

Nationally, the rate of use has been rising steadily, with 15% of all American adults saying they smoke marijuana, according to a Gallup poll. A 2022 study found people in states where recreational cannabis is legal use it 20% more frequently than those in states that have not passed legislation.

Increases in cannabis use can result in unforeseen dangers, Padon said: “Nationwide, there have been skyrocketing rates of accidental ingestion of gummies and chocolate edibles among very small kids because they look like candy.”

Calls to poison control centers about children age 5 and younger consuming edibles containing tetrahydrocannabinol, or THC, rose from 207 to 3,054 in four years — a 1,375% increase, according to a January 2023 study.

In fact, many edibles are packaged to look exactly like their candy and chip counterparts on store shelves. One bag of gummies looks virtually identical to the popular candy Gushers, said Danielle Ompad, a professor of epidemiology at NYU School of Global Public Health, in a prior interview.

“The Nerd Rope knockoffs I have personally seen looked just like the licensed product,” Ompad said.

However, small print included on the label of the Gushers knockoff said the bag contained 500 milligrams of THC, she said. A look-alike bag of Doritos contained 600 milligrams.

“The (knockoff) Doritos were shaped just like the real thing and had a crunch as well. If I ate that whole package, I would be miserable. People who are using edibles recreationally aren’t typically eating more than 10 milligrams,” Ompad said.

If a child ingests edibles, they can become “very sick,” according to the US Centers for Disease Control and Prevention. “They may have problems walking or sitting up or may have a hard time breathing.”

 

Source: https://www.cnn.com/2025/02/12/health/marijuana-ads-child-danger-wellness/index.html

Filed under: Culture,Marijuana and Medicine,Parents,Prevention and Intervention,USA,Youth :

by Brian Mann –  NPR’s first national addiction correspondent – published January 29, 2025 at 7:00 AM EST

When Robert F. Kennedy Jr. talks about the journey that led to his growing focus on health and wellness — and ultimately to his confirmation hearings this week for U.S. secretary of health and human services — it begins not with medical training or a background in research, but with his own addiction to heroin and other drugs.

“I became a drug addict when I was 15 years old,” Kennedy said last year during an interview with podcaster Lex Fridman. “I was addicted for 14 years. During that time, when you’re an addict, you’re living against conscience … and you kind of push God to the peripheries of your life.”

Kennedy now credits his faith; 12-step Alcoholics Anonymous-style programs, which also have a spiritual foundation; and the influence of a book by philosopher Carl Jung for helping him beat his own opioid addiction.

If confirmed as head of the Department of Health and Human Services after Senate hearings scheduled for Wednesday and Thursday, Kennedy would hold broad sway over many of the biggest federal programs in the U.S. tackling addiction: the Centers for Disease Control and Prevention, the National Institute on Drug Abuse and the Substance Abuse and Mental Health Services Administration.

While campaigning for the White House last year, Kennedy, now 71 years old, laid out a plan to tackle the United States’ devastating fentanyl and overdose crisis, proposing a sprawling new system of camps or farms where people experiencing addiction would be sent to recover.

“I’m going to bring a new industry to [rural] America, where addicts can help each other recover from their addictions,” Kennedy promised, during a film on addiction released by his presidential campaign. “We’re going to build hundreds of healing farms where American kids can reconnect with America’s soil.”

People without housing in San Francisco in May 2024. A film released by Robert F. Kennedy Jr.’s presidential campaign included a scene that 
appeared to blame methadone — a prescription medication used to treat opioid addiction — for some of the high-risk street-drug use visible
on the streets of San Francisco.

Some addiction activists — especially those loyal to the 12-step faith- and values-based recovery model — have praised Kennedy’s approach and are actively campaigning for his confirmation.

“RFK Jr is in recovery. He wants to expand the therapeutic community model for recovering addicts,” Tom Wolf, a San Francisco-based activist who is in recovery from fentanyl and opioid addiction, wrote on the social media site X. “I support him for HHS secretary.”

 

A focus on 12-step and spirituality, not medication and science-based treatment

 

But Kennedy’s approach to addiction care is controversial, described by many drug policy experts as risky, in part because it focuses on the moral dimension of recovery rather than modern, science-based medication and health care.

“He clearly cares about addicted people,” said Keith Humphreys, a leading national drug policy researcher at Stanford University. “But in terms of the plans he’s articulated, I have real doubts about them.”

According to Humphreys, Kennedy’s plan to build a network of farms or camps doesn’t appear to include facilities that offer proper medical treatments for seriously ill people facing severe addiction.

“That’s a risk to the well-being of patients, and I don’t see any merit in doing that,” Humphreys said.

“I think [Kennedy’s plan] would be an enormous step backward,” said Maia Szalavitz, an author and activist who used heroin and other drugs before entering recovery.

“We have spent the last 15, 20 years trying to move away from treating addiction as a sin rather than a medical disorder,” she said. “We’ve spent many years trying to get people to take up these medications that we know cut your death risk in half, and he seems to want to go backwards on all that.”

The vast majority of researchers, doctors and front-line addiction treatment workers agree that scientific data shows medications like buprenorphine, methadone and naloxone are game changers when it comes to treating the deadliest street drugs, including fentanyl and heroin.

The Biden administration moved aggressively to make medical treatments far more affordable and widely available. Many experts believe those programs are factors in the dramatic national drop in overdose deaths that began in 2023.

Kennedy, who studied law and political science, not health care, before becoming an activist on subjects ranging from pharmaceuticals and vaccines to the American diet, has remained largely silent on the subject of science-based medical treatments for opioid addiction.

His campaign film included a scene that appeared to blame methadone — a prescription medication that has been used to treat opioid addiction since the 1970s — for some of the high-risk street-drug use visible on the streets of San Francisco.

In public statements, Kennedy has also repeated the inaccurate claim that the addiction and overdose crisis isn’t improving. In fact, fatal overdoses have dropped nationally by more than 20% since June 2023, according to the Centers for Disease Control and Prevention, falling below 90,000 deaths in a 12-month period for the first time in half a decade.

“What we have mostly heard from Kennedy is a skepticism broadly of medications and a focus on the 12-step and faith-based therapy,” said Vanda Felbab-Brown, an expert on drug policy at the Brookings Institution, a Washington, D.C., think tank.

“That appeals to a lot of crucial groups that have supported President Trump in the election. But we know what is fundamental for recovery and stabilization of people’s lives and reducing overdose is access to medications,” Felbab-Brown said. “Unfortunately, many of the 12-step programs reject medications.”

She’s worried that under Kennedy’s leadership, the Department of Health and Human Services could shrink or eliminate funding for science-based medical treatment and instead focus on spirituality-based approaches that appear to help a relatively small percentage of people who experience addiction.

Kennedy’s views on other science-based treatments, including vaccines, have sparked widespread opposition among medical researchers and physicians.

 

Kennedy boosts an Italian model for addiction recovery that has faced controversy

 

Another concern about Kennedy’s addiction proposals focuses on his interest in a program for drug treatment created in Italy in the 1970s.

The San Patrignano community is a therapeutic rehabilitation community center in Italy for people with drug addictions. The center, which
was founded by Vincenzo Muccioli in 1978, received renewed media attention after a 2020 Netflix documentary described alleged abuses.
Robert F. Kennedy Jr. now describes the program as a model for recovery care in the United States.

“I’ve seen this beautiful model that they have in Italy called San Patrignano, where there are 2,000 kids who work on a large farm in a healing center, learning various trades … and that’s what we need to build here,” Kennedy said during a town hall-style appearance on the cable channel NewsNation last year.

According to Kennedy’s plan, outlined in interviews and social media posts, Americans experiencing addiction would go to San Patrignano-style camps voluntarily, or they could be pressured or coerced into accepting care, with a threat of incarceration for those who refuse care.

But the San Patrignano program has been controversial and was featured in a 2020 Netflix documentary that included images of people with addiction allegedly being held in shackles or confined in cages. The farm’s current leaders have described the documentary as biased and unfair.

Kennedy, meanwhile, has continued to use the program as a model for the camps he would like to build in the United States.

“I’m going to build these rehab centers all over the country, these healing camps where people can go, where our children can go and find themselves again,” he said.

Szalavitz, the author and activist who is herself in recovery, noted that the Italian program doesn’t include science-based medical care, including opioid treatment medications. She said Kennedy’s fascination with the model reflects a lack of medical and scientific expertise.

“It really is great to include people who have personal experience of something like, say, addiction in policymaking. But you don’t become an addiction expert simply because you’re someone who struggled with addiction,” Szalavitz said. “You have to engage with the research literature. You have to understand more beyond your own narrow anecdote. Otherwise you’re going to wind up doing harm to people.”

Copyright 2025 NPR

Source: https://www.ideastream.org/2025-01-29/rfk-jr-says-hell-fix-the-overdose-crisis-critics-say-his-plan-is-risky

Filed under: Addiction,Culture,Drug use-various effects,Political Sector,Prevention and Intervention,Social Affairs,USA,Youth :

 

Copied from DRB bulletin 03.02.2025:

Source: https://assets.publishing.service.gov.uk/media/679a44136907bee181d31480/240125+Annex+A+-+Response+to+the+ACMD+Fifth+addendum+to+Advisory+Council+on+the+Misuse+of+Drugs+_ACMD_+report+on+the+use+and+harms+of+2-benzyl+benzimidazole+_nit.pdf

 

Filed under: Opioids,Political Sector,Prevention and Intervention,Synthetics,UK :

by WRD News Team – January 14, 2025 

Forwarded by Shane Varcoe • 05.02.25

 

Breakthroughs in Addiction Science Over 50 Years

January 14, 2025 by WRD News Team

Addiction science has undergone tremendous progress over the past five decades, transforming our understanding of drugs and their impact on the brain and society. Recent advancements offer hope in addressing the escalating challenges of drug use, addiction, and overdose. However, the need for evidence-based prevention and treatment strategies remains crucial in combating this ongoing public health crisis.

Prioritising Drug Prevention

Prevention is one of the most effective ways to combat substance use disorders. Research consistently highlights how drug exposure can interfere with brain development from prenatal stages to young adulthood, setting the stage for lifelong challenges. Children and adolescents are particularly vulnerable, as early drug experimentation sharply increases the risk of addiction later in life.

Adverse childhood experiences—ranging from poverty to trauma—also contribute to substance use risks by disrupting brain development. Preventative measures can mitigate these risks and promote resilience. For example, school-based programmes and community initiatives have demonstrated significant success in reducing drug use among young people. Importantly, these interventions offer long-term benefits, improving mental health and reducing dependency rates across generations.

Scaling up these preventative approaches is vital. By investing in evidence-based prevention at schools, healthcare facilities, and community centres, society can safeguard future generations from the devastating impacts of drugs.

Challenges in Addressing Substance Use Disorders

One of the greatest hurdles today is the lack of access to effective addiction treatment. Millions of people struggle with substance use disorders, yet only a small percentage receive adequate care. This gap highlights the pressing need to expand addiction treatment services and eliminate barriers such as stigma and limited healthcare coverage.

Treatment options, including medication and behavioural therapies, have proven to be effective for many struggling with addiction. For instance, medications that address opioid dependency, combined with comprehensive care, can significantly improve recovery outcomes. However, these treatments remain inaccessible to many, especially in underserved communities.

Expanding treatment availability within prisons, rural areas, and low-income communities could swiftly reduce addiction rates and improve recovery success. Research also shows that offering treatment to individuals in justice systems can lower overdose risks after release and reduce reoffending, creating broader societal benefits.

The Role of Science in Combating Addiction

Scientific advancements are paving the way for more effective solutions to addiction. New innovations, such as brain stimulation therapies, target the neurological circuits disrupted by substance use, offering promising pathways for treatment. Additionally, cutting-edge pharmaceuticals like GLP-1 agonists, already used for managing diabetes, are showing potential in reducing cravings and dependency behaviours associated with addiction.

The use of artificial intelligence (AI) in addiction science is further revolutionising the field. AI tools can help detect overdose patterns, study drug impacts on mental health, and even guide personalised treatment interventions. Large-scale studies, such as those examining adolescent brain development, continue to shed light on how substance use affects young minds, offering invaluable insights for effective prevention.

Towards a Unified, Drug-Free Future

While remarkable progress has been made, the fight against addiction is far from over. Preventing drug use, providing accessible treatment, and investing in research remain paramount. By adopting a proactive, science-backed approach to addiction prevention, we can reduce the devastating effects of substance use disorders and create healthier, drug-free communities.

Addiction science offers the tools needed to address these challenges, but lasting change requires collective effort. Only through unified actions can we overcome this crisis and protect future generations from the harms of addiction.

Start prioritising prevention and treatment today to help build a safer, healthier world.

Source: https://wrdnews.org/breakthroughs-in-addiction-science-over-50-years/

Filed under: Addiction,Australia,Culture,Prevention and Intervention,Treatment and Addiction :
By: Jake Goldstein-Street – February 7, 2025 4:01 am

They’re not old enough yet to drink in bars, but a group of Washington students wants to make nightlife in the state safer.

A bill in the state Legislature requested by Lake Washington High School students aims to protect people from drink spiking.

The measure would require some establishments selling alcohol, including bars and nightclubs, to have testing kits on hand so patrons can see if their drinks have been drugged. Sponsors amended the bill this week in light of concerns of overreach lodged by a hospitality trade group.

Businesses covered by the proposal would also have to post a notice that test kits are available.

Bars would sell the test strips, stickers or straws to customers for a “reasonable amount based on the wholesale cost of the device.”

Usually, the tests look for drugs like Rohypnol, also known as “roofies.” When placed in alcoholic drinks, the drugs can incapacitate people unexpectedly so they can’t resist sexual assault, according to the federal Drug Enforcement Administration. The tests also detect ketamine and gamma hydroxybutyric acid.

“As a group of young women entering college, we are scared for our future,” Lake Washington senior Ava Brisimitzis told a Senate panel last week. “While nightlife is still years away, there are thousands of Washingtonians right now affected by this problem. No one should question whether or not they might return home safely.”

Senate Bill 5330 would take effect Jan. 1, 2026. It has a committee vote set for Friday.

The proposal is patterned after a similar law passed in California that went into effect last July. That law affected 2,400 establishments.

When a drink is spiked, “many times, it’s too late to prevent that person from falling victim to another crime, and that’s why prevention awareness is so important,” said Sen. Manka Dhingra, D-Redmond, the bill’s prime sponsor.

Critics said the original bill in Washington goes far beyond the California law. The initial version included taverns, nightclubs, theaters, hotels and more. The California legislation only applies to establishments like nightclubs that exclude minors and aren’t required to serve food.

Last week, Washington Hospitality Association lobbyist Julia Gorton said the bill “needs many more conversations.”

The hospitality association would support a version like California’s law, said Jeff Reading, a spokesperson for the trade group.

Now, a revised version of the bill looks to more closely align Washington’s proposal with California’s by focusing on establishments that don’t allow minors.

Washington’s unusual liquor licensing system has made drafting the bill difficult, Dhingra said. The state simply has too many types of licenses. She wants to “clean up” Washington’s liquor license statute.

“This is really not meant to be onerous, but really meant to be a partnership to make sure all the patrons are safe,” Dhingra told the Senate Labor & Commerce Committee last week.

California’s legislation also stated the signage must say “Don’t get roofied! Drink spiking drug test kits available here.” But Dhingra felt that language may be seen as blaming the victim, so the new version of the Washington bill doesn’t require specific verbiage in the sign.

A 2016 study published in the American Psychological Association’s journal Psychology of Violence found nearly 8% of 6,064 students surveyed at three universities believed they’d been drugged.

Source: https://washingtonstatestandard.com/briefs/washington-could-require-bars-to-carry-spiked-drink-drug-tests/

Filed under: Alcohol,Culture,Health,Mental Health,Sexual Behaviour,USA,Youth :

INTRODUCTORY NOTE BY NDPA:

THIS ARTICLE IS INCLUDED FOR ITS INTERESTING DESCRIPTION OF THE CONSUMPTION ROOM PHILOSOPHY AND PRACTICE. NDPA HAS SEVERAL SERIOUS CONCERNS ABOUT SO-CALLED ‘CONSUMPTION ROOMS’ AND WOULD TAKE ISSUE WITH SOME OF THE CLAIMS MADE IN THIS ARTICLE, NOT LEAST THE HEADLINE CLAIM THAT THIS IS A ‘SAFE’ SITE … (SEE OTHER ARTICLES ON THE NDPA SITE), NEVERTHELESS, IT IS WORTH READING, IN ORDER TO BETTER UNDERSTAND THE ATTITUDE BEHIND THE PROVENANCE OF SUCH FACILITIES.

by  Rebecca. L. Root – December 24, 2024 – SOURCE PRISM

At 8 a.m. on a Monday morning, most of the soft recliners in the waiting area of the three-story East Harlem overdose prevention center (OPC) are already occupied by those who have come to consume their first dose of the day. Whether it’s for fentanyl, heroin, or another drug, people of all ages trickle into the consumption room at OnPoint NYC, where mirrored cubicles line opposite sides of the room and a staff station sits in the middle with trays of needles, elastics, and wipes organized in rows.

A man, who looks to be in his late 30s, unwraps today’s first fix of what most likely is the opioid fentanyl, which staff say is the most common drug used here. He simultaneously chats with the staff who welcome each visitor with familiarity. The calm ambiance is occasionally punctuated with noise as the metal doors swing, allowing another person to enter.

OnPoint NYC, which opened in 2021 as the country’s first overdose prevention site, aims to be a judgment- and persecution-free space for drug users to safely consume. The idea of preventing people from dying of an overdose is a controversial one. Last year, former U.S. attorney for the southern district of New York Damian Williams told The New York Times that OnPoint’s methods were illegal and hinted at a shutdown, while New York Gov. Kathy Hochul is also opposed, having repeatedly said the centers violate federal and state laws, putting their future operations in the balance.

But amid the national opioid epidemic, drastic measures are needed. More than 100,000 people die each year from drug overdoses in the U.S., according to the National Center for Health Statistics. In November, President-elect Donald Trump announced plans to impose further tariffs on Chinese imports in an attempt to curb what he believes are fentanyl deliveries into the U.S. It follows calls in 2022 from President Joe Biden to increase funding in the budget to address the overdose epidemic, while in 2023 New York Times editors declared that the U.S. had lost the war on drugs.

“Every 90 minutes…four New Yorkers die [of an overdose],” said Sam Rivera, the executive director of OnPoint NYC.

Advocates for OPCs say having a sanitary and safe place to consume drugs diminishes the element of haste or need for discretion that might exist in a public place. This reduces the risk of an overdose, but should one occur, medically trained staff dressed in jeans and leather are ready to respond.

Tilting a chair back, a staffer explains the importance of getting the blood circulating and offering rescue breaths before administering naloxone, which can reverse the effects of opioids. Since 2021, OnPoint NYC has reversed 1,600 overdoses, cleaned up community parks, and opened a sister center in Washington Heights.

Despite the progress, the center, and the few others like it in the U.S., remain controversial. When a similar center was opened in San Francisco in 2022, a group of local mothers protested while others posited that creating safe spaces to consume drugs only increases drug use.

However, research found that following the opening of an OPC in San Francisco, there was no visible increase in drug use, and a Brown University study found no affiliation between the centers and increased crime.

Instead, Michel Kazatchkine, a commissioner of the Global Commission on Drug Policy (GCDP), which advocates for drug policies to be more humane and prioritize public and individual health, believes it is the current approach of criminalizing drug users that is the problem.

“The criminal justice approach has sent hundreds of thousands of people to prison with no benefit for these people and no benefit for the society and huge expenses involved,” said Kazatchkine, who is also the former executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, France.

Over 1.16 million people each year are incarcerated in the U.S. on drug offenses, while globally, governments spend $100 billion annually on punitive drug policies. In spite of such policies, global drug use has risen from about 180 million people in 2002 to 292 million in 2022, according to a report by the GCDP.

In states like New York, the response to tackle the drug problem has predominantly been to fund the distribution of naloxone and fentanyl test strips, which can detect the presence of fentanyl in other drugs, explained Toni Smith, the New York state director at Drug Policy Alliance. The group works with grassroots groups to advance public health solutions to drug use. While such resources are critical, Smith emphasized that the state must offer a full range of life-saving tools and services. More OPCs, Smith believes, could save more lives.

The harm reduction quandary

Historically, the U.S. has pushed back on any initiatives under the harm reduction umbrella, Kazatchkine said. Harm reduction, according to the World Health Organization (WHO), focuses on offering a suite of interventions designed to minimize the negative impacts related to drug use. That could include providing people with clean needles and syringes, with naloxone, with HIV testing, or with access to opioid substitution therapy programs. OPCs—often referred to as safe consumption sites in Europe, where they are widely used—are not on the WHO’s list of recommended harm reduction interventions but are a harm reduction approach.

 

“The concept of harm reduction is acknowledging that people use drugs and that these people have risks, but it is prioritizing health approaches over criminalization,” Kazatchkine said. “Acknowledging that people use drugs, you acknowledge something that is prohibited under the law and actually under criminal law, so a government or an international entity finds itself in a very uncomfortable situation.”

“Many people would come in and be shocked…They open the door and think everybody’s just using drugs. They don’t expect this kind of structure and loving environment,” he said. “We’ve invited the governor for three years. [She] hasn’t been here once. But you’re going to sit around and tell us the program doesn’t work.”

Beyond a safe space for consumption

More than just a consumption space, the center offers a health clinic and, up a narrow staircase to a second floor, therapy rooms host complimentary holistic treatments such as reiki, massage, and sound baths. Rivera himself occasionally hosts one. All services, including health care, are free.

On this day, a woman sleeps deeply in a reclining chair as soft music tinkles in the background and candles burn in the corner; two others lie on massage tables awaiting their treatments. Shower facilities are available in another corner of the center, and an on-site psychologist offers mental health services in a bid to help tackle the underlying trauma behind the addiction. It’s “multidimensional” support to treat a problem that surpasses simply addiction but intersects with issues around housing, access to care, criminalization, food and nutrition, sleep, as well as structural racism, Smith said. And the services aren’t just for drug users but all local community members.

“Creating this community and this space around a loving environment is so impactful, and it changes the experience for folks who come in,” Rivera said.

In New York City, Rivera believes there have also been economic benefits. OnPoint’s data suggests a reduction in visits to the emergency room for overdoses that has relieved the burden on the health system and, Rivera said, potentially saved two New York City neighborhoods $45 million in less than three years.

More OPCs could benefit the U.S. and reduce the impact the drug crisis is having, said Kazatchkine, but amid what Rivera believes is a game of politics, whether that will happen remains to be seen. In the meantime, elsewhere in the U.S., people will shoot up in alleyways and parks, at increased risk of unnecessarily overdosing. But the reality, Rivera said, is that with OPCs, there’s the potential for no one to have to die this way again.

Source: https://www.nationofchange.org/2024/12/24/inside-the-countrys-first-official-safe-drug-consumption-site/

Filed under: Crime/Violence/Prison,Culture,Drug use-various effects,Economic,Education,Heroin/Methadone,HIV/Injecting-Drug-Users,Mental Health,Needle Exchange,Opioids,Prevalence,Prevention and Intervention,Treatment and Addiction,USA :

INTRODUCTORY NOTE BY MAGGIE PETITO (OF DRUGWATCH INTERNATIONAL) WHO SUBMITTED THIS ARTICLE TO US:

“Albania, a nation of 11,000 square miles and population today of some 2.5 million, saw a recent exodus of half of its people, mostly claiming to be “refugees” – exiting to global outposts. Today’s Albania offers numerous benefits besides a lovely landscape. Resort and golf course maestros plan safe havens for Albanians and “friends” to relax, launder their dirty money, escape Interpol and wash with crypto-Bitcoin. This statement is not racist: it is a fact. NATO member Albania is half Sunni Muslim. Albania is still under a multi-year consideration to join the EU”. Maggie P.

                    

Opinion piece in Washington Post, by Samantha Schmidt,  Arturo Torres, and Anthony Faiola

December 28, 2024

 

A global boom in cocaine trafficking defies decades of anti-drug efforts

The cocaine trade is far bigger and more geographically diverse than at any point in history as Albanian traffickers expand the market in Europe for the drug.

Ecuadorian military officers seized what they said amounted to 22 tons of cocaine in January 2024 — one of the world’s largest single cocaine seizures on record.

In Guayaquil, Ecuador — Dritan Rexhepi, the drug lord, had already escaped the law in three countries, and he planned to do it again.

In less than a decade, Dritan Rexhepi had built a smuggling business that ran from the fields of Colombia to the ports of Ecuador and on to the streets of Europe, Italian and Latin American investigators said, rivaling the influence of Mexico’s powerful cartels. His brand, carved into cocaine packages, was “Bello” — beautiful.

The Albanian’s rise from gunman in his home country to transatlantic kingpin is part of a global explosion in the cocaine industry, a trade that is far bigger and more geographically diverse than at any point in history. South America now produces more than twice as much cocaine as it did a decade ago. Cultivation of coca crops in Colombia, the origin of most of the world’s cocaine, has tripled, according to U.S. figures, and the amount of land used to grow the drug’s base ingredient is more than five times what it was when the infamous drug lord Pablo Escobar was killed in 1993. And production keeps soaring. A record 2,757 tons of cocaine was produced worldwide in 2022, a 20 percent increase over 2021, according to the most recent global drug report from the U.N. Office on Drugs and Crime.

“It’s going up and up and up,” said Thomas Pietschmann, a research officer at the UNODC. “A few years ago, people were saying the future is synthetic drugs. … Right now, it’s still cocaine.”

For decades, cocaine consumers were primarily Americans, and interdiction was a U.S. government priority. But despite the tens of billions of dollars spent in the U.S. war on drugs in Latin America, the industry has not only grown, it has globalized, with new routes, new markets and new criminal enterprises.

Nearly every one of Latin America’s mainland nations has become a major producer or mover of the drug, with Ecuador now one of the most important cocaine transit points in the world. Demand is soaring in Europe, which rivals the United States as the world’s top cocaine destination. Cocaine seizures in E.U. countries grew fivefold between 2011 and 2021, and exceeded those in the United States in 2022. While the United States remains a huge market, cocaine use has declined by about 20 percent since 2006, according to UNODC.

Balkan, Italian, Turkish and Russian criminal groups have all swept into Latin America for a piece of the action. Few have managed to muscle their way into cocaine trafficking quite like Albanian criminal networks, investigators and analysts say.

“We know there’s not only one channel for cocaine,” said Marco Martino, a senior Italian police official in charge of coordinating counternarcotics operations. But “the Albanians,” he said, “are the best and the biggest.”

As cocaine production was exploding, investigators said, Albanian criminal networks rode the opportunity it presented. They were critical to getting the drug to Europe and fueling consumption across the continent.

Rexhepi, 44, built much of his empire from an Ecuadorian prison cell, fostering connections with Latin American gangs and turning his cellblock into an executive suite. A lawyer representing him in Albania declined to comment. Rexhepi, in a 2015 appeal, denied any involvement in drug trafficking, “either as a perpetrator, accomplice or accessory.” But in 2021, Italy sought his extradition, warning the authorities in Ecuador in a letter from its embassy in Quito that Rexhepi was the “undisputed leader” of an Albanian drug trafficking network with global reach and access to “infinite quantities of cocaine.”

Rexhepi’s emergence as a feared power broker within a federal prison in Cotopaxi province was symptomatic of the collapse of government control in Ecuador. But with the authorities in Rome seeking to imprison him for drug trafficking, he decided it was time to move again.

A local judge, citing a medical need, ordered him into home detention in an upscale neighborhood here in the port city of Guayaquil in August 2021, according to Ecuadorian officials. Then, predictably, Rexhepi vanished.

This investigation into the global expansion of the cocaine business and the rise of Albanian drug traffickers is based on interviews with more than two dozen current and former officials in Ecuador, Colombia, Europe and the United States, gang members in Ecuador, and thousands of pages of court documents from Ecuador, Albania and Italy. It reveals how criminal networks led by Albanians infiltrated Ecuador’s ports, judiciary, prison system and security forces to gain control of key parts of the cocaine supply chain and trigger a deluge of the drug in Europe — a more than $12 billion annual cocaine market, according to the E.U. Drugs Agency.

“With these profits, these organizations manage to permeate all public and private institutions, corrupting any structure,” said Ecuador’s former anti-narcotics director, Gen. Willian Villarroel, in an interview.

Drug trafficking entrepreneurs from Albania, a country of only about 2.8 million people, have begun to rival the world’s most powerful cartels by working with them, not against them, transforming how the trade is run. The new networks, investigators say, are often criminal coalitions of disparate and independent groups, rather than hierarchical, violently competitive cartels.

A boom in cocaine production and the expanding power of criminal organizations pose a growing threat in Latin America, the United States’ biggest trading partner. In a multipart series, The Washington Post is examining how organized crime groups have vastly expanded their influence, corroding the region’s democracies, strangling commerce and propelling thousands of people to the U.S. southern border.

Latin America is producing more than twice as much cocaine as it did a decade ago. Nearly every one of its mainland nations has become a major producer or mover of the drug, feeding booming markets in the United States, Europe and South America.

Organized crime groups have moved well beyond narcotics. They’ve created sprawling illicit industries in extortion, migrant smuggling and gold mining. Their power has become so great that they form a new kind of insurgency, infiltrating government operations.

Europol is aware of dozens of “Albanian-speaking” clans or organized criminal networks currently operating in Europe, Robert Fay, the head of Europol’s drug unit, said in an interview.

“It’s not about how many people you have,” said Fatjona Mejdini, an Albanian analyst with the Global Initiative Against Transnational Organized Crime. “It’s about the right alliances you can form.”

From his prison cell in Ecuador, Rexhepi paved the way. He befriended leaders of Ecuador’s most powerful gang, Los Choneros, who were already working for Mexico’s Sinaloa cartel, according to one of the gang’s founding members, who, like some others interviewed for this article, spoke on the condition of anonymity because of security concerns. That led to strategic partnerships with both South American traffickers and gang leaders across Europe. His goal was simple, investigators and analysts said: sell as much cocaine as possible with abundant profit for all parties to the deals. “Rexhepi is the pioneer,” Mejdini said.

Soaring cocaine production

The explosion in cocaine production can be traced back to the demobilization of Colombia’s largest leftist rebel group, the Revolutionary Armed Forces of Colombia (FARC). A historic peace deal with the country’s government in 2016 ended the longest-running civil conflict in the hemisphere, a conflict in which the United States played a critical role.

Since the start of the counternarcotics and security package known as Plan Colombia in 2000, the United States has sent about $14 billion in funding to Colombia, at least 60 percent of it for the military and police. The plan focused in large part on combating the country’s cocaine production and export, which the FARC controlled, using the proceeds to fund its insurgency and secure territory.

When the guerrillas laid down their weapons, a proliferation of smaller armed groups, driven by profit rather than ideology, swept into coca-producing areas.

These drug traffickers “no longer have political interests,” said Leonardo Correa, the head of the UNODC mission in Colombia. “What they want is to get the drug out as fast as possible, to make the most money possible.”

Source: https://www.washingtonpost.com/world/2024/12/28/cocaine-consumption-soars-europe-asia/

 

Filed under: Cocaine,Crime/Violence/Prison,Economic,Others (International News),USA :

by  David G. Evans, Esq., Senior Counsel, Cannabis Industry Victims Educating Litigators (CIVEL)

This item was collected by Dave Evans without any covering article.

To access the full array of documents:

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

 

  1. CDC.DELTA.8.DATED.9.14, 2021
  2. FDA.DELTA.8.WARNING
  3. FDA.HEMP.WARNING.LETTERS
  4. INTOXICATING HEMP PRODUCTS
  5. LETTER.HB.563.ROSSHEIM
  6. Rossheim – CV 6 7 24 pdf (1)
  7. Rossheim et al., 2022 Delta-8 THC Retail Availability, Price, and Minimum
  8. Rossheim et al., 2023 Delta-8, Delta-10, HHC, THC-O, THCP, and THCV What should we call these products_
  9. Rossheim et al., 2024 Derived psychoactive cannabis products and 4_20 specials An assessment of popular brands and retail price discounts in Fort Worth, Texas, 2023
  10. Rossheim et al., 2024 Types and Brands of Derived Psychoactive Cannabis Products an online retail assessment 2023

Source: David G. Evans, Esq., Senior Counsel, Cannabis Industry Victims Educating Litigators (CIVEL)

Filed under: Cannabis/Marijuana,Hemp,USA :

by David G. Evans, Esq., Senior Counsel, Cannabis Industry Victims Educating Litigators (CIVEL) –

Marijuana use makes autism scores worse. Autism Spectrum Disease (ASD) “is the commonest form of cannabis-associated clinical teratology.” (exhibits 1 and 2 ). A tetralogy is a collection of four things having something in common, such as a deformity with four features.

This is likely epidemiologically highly significant for the US, where autistic spectrum disorders have been shown to be growing exponentially. Cannabis use across the US was shown to be independently associated with autism rates across both time and space, to be dose-related, and, based on conservative projections, has been predicted to be at least 60% higher in cannabis-legal states than in states where cannabis was illegal by 2030. (exhibit 3)

Being particularly vulnerable to the pro-psychotic effects of cannabinoid exposure, autism spectrum individuals present with an increased risk of psychosis, which may be passed on to their own children. (exhibit 4)

Conclusion

Use of marijuana products can make autism scores worse in the user.

Exhibit 1.

Effect of Cannabis Legalization on US Autism Incidence and Medium-Term Projections. Reece AS and Hulse GK. Clinical Pediatrics. Vol 4, Iss 2, No:154

https://www.longdom.org/open-access/effect-of-cannabis-legalization-on-us-autism-incidence-and-medium-term-projections.pdf

Exhibit 2.

In a study, 3,080 young adult Australian twins were used to assess ADHD symptoms, autistic traits, substance use, and substance use disorders. Great ADHD symptoms and autistic traits scores were associated with elevated levels of cannabis use and cannabis use disorder. DeAkwis D, et al. ADHD Symptoms, Autistic Traits, and Substance Use and Misuse in Adult Australian Twins. Journal of Studies on Alcohol and Drugs, March 2014. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3965675/

Exhibit 3

Epidemiological Association of Various Substances and Multiple Cannabinoids with Autism in the USA. Reese SA and Hulse GK. Clinical Pediatrics., Vol 4, Issue2, No: 155.

Cannabinoids with Autism in USA. Accepted 22nd May 2019.  Clinical Pediatrics: Open Access. Published 31st May 2019.  https://www.longdom.org/open-access/epidemiological-associations-of-various-substances-and-multiple-cannabinoids-with-autism-in-usa.pdf

Exhibit 4.

Cannabis Use in Autism: Reasons for Concern about Risk for Psychosis
Riccardo Bortoletto 1,2, Marco Colizzi 2,3,*
Healthcare (Basel). 2022 Aug 16;10(8):1553. doi: 10.3390/healthcare10081553
PMCID: PMC9407973  PMID: 36011210
https://pmc.ncbi.nlm.nih.gov/articles/PMC9407973/

 

David G. Evans, Esq.

Senior Counsel

Cannabis Industry Victims Educating Litigators (CIVEL)

203 Main St. Suite 149

Flemington, NJ 08822

908-963-0254

www.civel.org

 

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Source: www.civel.org

Filed under: Cannabis/Marijuana,Drug use-various effects,Mental Health,USA :

Publication: American Journal of Psychiatry – 15 January 2024

Patricia Conrod, Ph.D. patricia.conrod@umontreal.ca, Sherry H. Stewart, Ph.D., Jean Seguin, Ph.D., Robert Pihl, Ph.D., Benoit Masse, Ph.D., Sean Spinney, M.Sc., and Samantha Lynch, Ph.D.

Abstract

Objective:

Rates of substance use disorders (SUDs) remain significantly above national targets for health promotion and disease prevention in Canada and the United States. This study investigated the 5-year SUD outcomes following a selective drug and alcohol prevention program targeting personality risk factors for adolescent substance misuse.

Methods:

The Co-Venture trial is a cluster randomized trial involving 31 high schools in the greater Montreal area that agreed to conduct annual health behavior surveys for 5 years on the entire 7th grade cohort of assenting students enrolled at the school in 2012 or 2013. Half of all schools were randomly assigned to be trained and assisted in the delivery of the personality-targeted PreVenture Program to all eligible 7th grade participants. The intervention consisted of a brief (two-session) group cognitive-behavioral intervention that is delivered in a personality-matched fashion to students who have elevated scores on one of four personality traits linked to early-onset substance misuse: impulsivity, sensation seeking, anxiety sensitivity, or hopelessness.

Results:

Mixed-effects multilevel Bayesian models were used to estimate the effect of the intervention on the year-by-year change in probability of SUD. When baseline differences were controlled for, a time-by-intervention interaction revealed positive growth in SUD rate for the control group (b=1.380, SE=0.143, odds ratio=3.97) and reduced growth for the intervention group (b=−0.423, SE=0.173, 95% CI=−0.771, −0.084, odds ratio=0.655), indicating a 35% reduction in the annual increase in SUD rate in the intervention condition relative to the control condition. Group differences in SUD rates were reliably nonzero (95% confidence) at the fourth and fifth year of assessment. Secondary analyses revealed no significant intervention effects on growth of anxiety, depression, or total mental health difficulties over the four follow-up periods.

Conclusions:

This study showed for the first time that personality-targeted interventions might protect against longer-term development of SUD.
Despite having made some strides with respect to reducing adolescent drinking rates, substance use disorder (SUD) rates are significantly above national targets for health promotion and disease prevention in Canada and the United States (1–5). These data suggest that there is a pressing need for more targeted intervention strategies designed to help those most at risk of transitioning to SUD. Recent national surveys suggest an alarmingly high prevalence of SUD in the general population (16.5%), with the highest rates reported among young adults, and approximately 9% of the adolescent population screened positive for past-year SUD (1–3). There is also an ongoing crisis of nonmedical prescription drug use in North America, as indicated by the dramatic increase in the prevalence of past-year prescription drug misuse and overdose deaths from 2003 to 2022 (1, 2) and the disproportionate growth of hospitalizations due to opioids among individuals 15–24 years of age (1–4). Furthermore, only ∼5% of respondents who report symptoms of SUD report having received any treatment for their SUD (1). As highlighted in numerous reports (5–9), including the U.S. Surgeon General’s 2016 report on addiction (2), evidence-based upstream solutions that prevent transition to SUD are desperately needed, considering the scale and severity of these public health concerns.
Most school-based prevention programs are universal and use some combination of alcohol and drug awareness, testimonials, flyers, brochures, peer education, and alcohol/drug-free activities. These have been shown to have weak positive or even negative effects (10, 11), but programs that promote general coping and drug-refusal skills are more promising (2, 10, 12, 13). One possible contributing factor to poor outcomes of many prevention programs is that they target generic factors implicated in normal drinking and drug experimentation and fail to target factors linked to risk for the development of more severe substance use problems (2, 10, 14–18), despite well-supported evidence for robust predictors of substance use and misuse across several sociodemographic contexts (2). New approaches to prevention are needed that translate research on addiction vulnerability to personalized prevention and early intervention (2).
Longitudinal and machine learning prediction strategies have highlighted the role of both externalizing and internalizing traits in future risk for substance misuse (19–23). A recent review suggests that distinct personality traits are related to risk for substance misuse through different motivational and cognitive risk profiles (23). Impulsivity and its cognitive correlate, poor response inhibition, appear to be specifically associated with conduct problems and misuse of stimulants (including prescription stimulant medications); sensation seeking and its neurocognitive correlate, reward sensitivity, are more associated with alcohol and cannabis misuse (2, 20–23). Anxiety sensitivity and hopelessness have been shown to be associated with risk for internalizing problems and preferential use/misuse of depressant drugs, such as alcohol, sedatives, and opioids (19, 20, 24–26).
The PreVenture Program is a brief (two group sessions) school-based cognitive-behavioral program focusing on building personality-specific skills and self-efficacy to reduce need on the part of a young person to use substances as a way to cope with interpersonal or intrapersonal challenges associated with each personality trait (27, 28). Given research indicating that different neurocognitive profiles mediate the relationship between specific personality factors and concurrent mental health conditions (22–26), the program focuses on promoting personality-specific cognitive-behavioral skills (e.g., skills relevant to the management of poor response inhibition for teens who report high levels of impulsivity vs. skills relevant to the management of global negative attributional styles for teens who report high levels of hopelessness). Numerous randomized trials have shown that the program is effective in reducing alcohol and drug use and mental health symptoms by a notable 30%–80% among secondary students (13–17, 21, 27, 28). However, this approach has yet to be shown to prevent transition to SUDs, which is critical when informing comprehensive drug prevention and health promotion strategies.
As a primary outcome, this longitudinal cluster-randomized controlled trial examined the impact of personality-targeted preventive interventions in reducing risk for SUD in adolescents over a 5-year period (18). It is becoming increasingly recognized that treatment outcome research should focus on pragmatic outcomes to facilitate the translation of research findings to policy and practice, and this was an important aim of the present study. Therefore, in consultation with local stakeholders, we selected a validated measure of SUD that is used to screen for SUD and to guide the delivery of SUD interventions in schools throughout the region in which the study was conducted. The primary research hypothesis was that relative to a control condition, the intervention would be associated with a reduced risk of transitioning to SUD by the end of high school among youths who report personality risk factors. Secondary outcomes examined the intervention effects on mental health outcomes in the 4 years after the intervention.

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Source: https://www.psychiatryonline.org/doi/10.1176/appi.ajp.20240042

Filed under: Education,Prevention and Intervention,USA,Youth :

 Vern Pierson – January 27, 2025

Vern Pierson is the district attorney of El Dorado County and was a co-sponsor of Proposition 36. He is a past president of the California District Attorneys Association.

A sign warning against selling fentanyl in Placer County hangs over Taylor Road in Loomis on July 24, 2023.
Photo by Miguel Gutierrez Jr., CalMatters

California’s drug crisis has only escalated, with so-called “compassionate solutions” like harm reduction and past policies that decriminalized hard drugs making things worse.  

Many drug addicts in the state have essentially faced two stark choices: homelessness or incarceration. This false dichotomy has normalized substance abuse, endangered public safety and failed to address the root causes of both homelessness and addiction.

In response, California voters last fall overwhelmingly passed Proposition 36, a third option that prioritizes rehabilitation over incarceration and offers a clear path to recovery, helping break the cycle of addiction and homelessness.

Programs like syringe exchanges, for example, have fallen short in addressing addiction itself. While well-intentioned, these programs have led to unintended consequences, including public spaces littered with used needles, increased health risks and the normalization of drug use. While syringe exchanges help reduce disease transmission, they don’t always guarantee that people enroll in treatment programs, and research shows they can even increase mortality rates.

The scale of this problem is stark. In 2021 alone, nearly 11,000 Californians died from drug overdoses, with over two-thirds involving opioids like fentanyl. Each of these lives lost represents a missed opportunity for intervention and recovery. Prop. 36 has given the state a framework to address this crisis by requiring treatment and rehabilitation for people struggling with addiction. This approach has the potential to reduce recidivism, save lives and help people reclaim their futures.

Source: https://calmatters.org/commentary/2025/01/addiction-homelessness-crisis-proposition-36/

Filed under: Addiction,Legal Sector,Social Affairs,USA :

by AFP Bureau report – January 28, 2025

PESHAWAR: Speakers at a seminar shared strategies for drug prevention and fostering resilience, said a press release issued here on Monday.

The Welfare and Peace Society, City University of Science and Information Technology (CUSIT) in collaboration with the Higher Education Regulatory Authority (HERA), Anti-Narcotic Force Pakistan and Anti-Drug Social Welfare Organization had hosted the seminar.

It was part of the efforts to promote peace through combating drug abuse in educational institutes. The activity was under the “Community Resilience Building for Countering Violent Extremism” project.

European Union funds the project. Collaboration is struck with the National Counter-Terrorism Authority and the UN Office on Drugs Crime Country. Key speakers of the seminar included Azazud Din, the HERA Advisor for Drug Use Prevention/Lead Policies, Umair, the Da Haq Awaz organization’s member, Fukhraz of Anti-Narcotic Force, Ikram of Khyber Pakhtunkhwa Centre of Countering Violence Extremism, and Ms Maria of the HERA.

Source: https://www.thenews.com.pk/print/1276828-strategies-shared-for-drug-prevention

Filed under: Education,Others (International News),Prevention and Intervention,Treatment and Addiction :

An update on the progress of national initiatives to address the opioid crisis.

by Mark S. Gold M.D. – Addiction Outlook

Updated January 31, 2025 | Reviewed by Jessica Schrader

  • Key points:
  • In 2016, drug experts mapped out solutions to the opioid epidemic.
  • Several major initiatives subsequently were proposed and implemented.
  • Many changes have had profound influences, reducing the impact of opioid use and saving lives.

In their 2016 New England Journal of Medicine article on opioids, Nora Volkow, M.D., director of the National Institute on Drug Abuse (NIDA) and A. Thomas McLellan, Ph.D., who served as deputy director of the White House Office of National Drug Control Policy during the Obama administration, reported on what was needed to combat the opioid epidemic.

They focused initially on opioid prescribing for pain. Pain experts resisted restrictions on opioids since they were the treatment of choice and addiction was only 3% to 8% for chronic pain and lower for acute pain. Pain patients develop a physical dependence on opioids, but few become addicts.

Volkow and McLellan were prescient in their statements/predictions nearly a decade ago. They acknowledged the need for opioids for managing chronic pain for some but pointed to overprescriptions in the 1990s and 2000s as a major driver of the opioid crisis. They discussed naloxone (Narcan) saving lives by reversing opioid overdoses. They advocated expanding access to medication-assisted treatment (methadone, buprenorphine) to treat opioid addiction, calling it an evidence-based strategy for reducing illicit drug use and deaths. They noted state prescription drug monitoring programs (PDMPs) could be enhanced to track prescribing patterns and minimize diversion.

Volkow and McLellan called for research to develop effective non-opioid pain treatments and reduce reliance on opioids. They also addressed stigma associated with pain management and addiction treatment, urging the medical community and policymakers to view these issues through an evidence-based lens rather than a cloud of blame/moral failure. Most of all, they called for integrating scientific advances into policy and practice and improving training for providers of pain management and addiction treatment.

Here’s my “report card” on how we’re doing, based on the major recommendations from these experts in 2016.

Balancing Pain Management and Developing New Pain Treatment with Addiction Prevention. Grade: C+

Real progress was made in preventing opioid addiction and overdose deaths. However, many chronic pain patients report inadequate relief now due to stricter prescribing practices, sometimes resulting in untreated/undertreated pain. This is a problem without easy answers. Dr. Volkow has emphasized an urgent need for non-opioid-based medications bypassing the brain’s reward pathways, reducing abuse potential. NIH’s Helping to End Addiction Long-term (HEAL) Initiative researched non-opioid pain medications and therapies. There are promising candidates, such as cebranopadol, suzetrigine (FDA approved 1/30/25), LEVI-04, and others in the pipeline. However, progress remains slow, and chronic pain patients face limited options.

Curbing Overprescription/Misuse. Grade: A-

Opioid prescribing rates nearly halved, from 81.3 prescriptions per 100 people in 2012 to 43.3 in 2023. Medical, pharmacy, and health professional education reversed years of over-prescription. All states have PDMPs to track opioid prescriptions, reducing over-prescription and diversion. Some overcorrections in prescribing (or rather, not prescribing) opioids led to some patients seeking illicit drugs (heroin or fentanyl), contributing to the overdose crisis.

Expanding Opioid Pain Prescription Guidelines. Grade: A-

The CDC says opioid prescriptions in the United States peaked in 2012, with a rate of 81.3 prescriptions per 100 persons. By 2023, this rate nearly halved to 43.3 prescriptions per 100. This major reduction reflects efforts to address the opioid epidemic through updated prescribing guidelines and increased awareness of opioid risks. The CDC Guidelines for Prescribing Opioids for Chronic Pain (2016) recommended limiting opioid prescriptions for chronic pain outside active cancer treatment, palliative care, and end-of-life care, emphasizing using the lowest effective dose of opioids and restricting opioid prescriptions for acute pain to three to seven days. However, some health care providers remain hesitant to prescribe any opioids, ever.

The SUPPORT Act (2018) required electronic prescribing for controlled substances under Medicare and imposed new requirements for education and monitoring. Medicare Part D Opioid Policies (2019) implemented stricter safety edits at the pharmacy level for high-dose opioid prescriptions and introduced limits on opioid-naive pain patients, such as a maximum of seven days for acute pain.

Naloxone and Medication-Assisted Treatment (MAT). Grade: B+

Naloxone (Narcan) is widely available now, and over-the-counter sales were approved, as has the longer-acting antagonist nalmefene. However, fentanyl, the predominant opioid abused today, is very strong and challenging naloxone reversal protocols. Nalmefene may help.

Access to MAT (buprenorphine, methadone) improved. Patients with OUDs can start on buprenorphine without having to see a physician in person. On the downside, existing treatments are old, and the best outcomes are with the oldest OUD treatment, methadone. Methadone should be available for prescription by office and clinic-based physicians. Without detox and residential care options, patients with polysubstance, alcohol, meth, or cocaine use disorders and psychiatric dual disorders have been difficult to treat .

Stigma. Grade: B

NIDA has led national efforts to destigmatize substance use disorders (SUDs), especially OUDs. Expanding federal and state reimbursement for buprenorphine and methadone, and expanding the number of OUD prescribers, have succeeded somewhat. Classification of addiction as a disease, working with ASAM, and supporting destigmatizing language have helped. However, stigma persists, discouraging patients from seeking care.

Chronic pain patients still report feeling judged. AA, NA, and other mutual help groups are ubiquitous and destigmatizing. Yet, social network fellowships have been underutilized. One 2016 national survey revealed three-quarters of primary care physicians were unwilling to have a person with opioid use disorder marry into their family, and two-thirds viewed people with OUD as dangerous. It is not clear this has changed.

Science-Driven Policy. Grade: A-

Federal and state policies increasingly rely on evidence-based recommendations, such as funding research in non-opioid treatments. This is a huge accomplishment.

Developing totally new approaches has lagged, but innovation and invention can be like that sometimes. Broadly and equitably supporting MATs has helped people with OUD access evidence-based treatments. In the absence of a cure, we have made limited progress in developing and implementing effective non-opioid therapies. However, the doctors’ original focus on leveraging science to guide policy, improve treatments, and address root causes of the opioid epidemic was spot on, saving lives.

Policy Initiatives Impacted Opioid Prescribing and Pain Management Shifts. Grade: B-

Balancing effective pain management with risks of opioid use remains challenging. Patients with pain are treated with a combination of alternative strategies and therapies, with mixed outcomes. In states where it is legal, cannabis is increasingly used as an alternative treatment for chronic pain—even though evidence of its efficacy is mixed and cannabis use disorders may emerge. Complementary and alternative treatments like acupuncture, chiropractic care, massage therapy, and yoga are gaining popularity. Alternative therapies can’t provide the same level of relief as opioids. Those with complex or severe pain feel marginalized by policies restricting opioids. Non-pharmacological therapies like physical therapy, acupuncture, or CBT may be expensive, time-intensive, or uncovered by insurance. Many patients report inadequate relief, difficulty accessing specialized therapies, and frustration with the healthcare system.

New Hope in the Lab

Yale researchers identified alternative compounds with therapeutic potential chemicals extracted from the cannabis plant. A recent study showed that certain cannabinoids reduced the activity of a protein central to pain signaling in the peripheral nervous system. The protein, Nav1.8, enables repetitive firing of those neurons, a key process in transmitting pain signals. Blocking Nav1.8, and muting its activity, has shown promise in reducing pain in clinical studies. Cannabigerol in particular has the potential to provide effective pain relief without opioid risks.

Summary

In the opioid death crisis, the first phase was dominated by prescription pain medication abuse. Volkow and McLellan outlined changes necessary to reverse the epidemic. While tremendous progress has been made in this decade, more needs to be done as users first switched from pain medications to heroin, then fentanyl, adding xylazine, and now speedballing or polydrug use. The investment in prevention efforts, such as the DEA’s “One Pill Can Kill”, should be expanded.

Source: https://www.psychologytoday.com/us/blog/addiction-outlook/202501/opioid-crisis-grading-the-progress-of-national-initiatives

Filed under: Addiction,Heroin/Methadone,Opioids,USA :

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