Drug Specifics

“I don’t think we’ve had truly robust public policy actions in the U.S. that we can point to that would have resulted in such a sudden and profound downturn in mortality,” says U. of I. health and kinesiology professor Rachel Hoopsick about the recent decline in drug-overdose deaths. “Although fentanyl-only deaths have declined, we’re seeing increases in deaths that co-involve fentanyl and stimulants, like methamphetamine. There have also been increases in nonopioid sedative adulterants, like xylazine.”

  • Editor’s notes:
    Hoopsick is lead author of the paper “Methamphetamine-related mortality in the United States: Co-involvement of heroin and fentanyl, 1999-2021.” The study is available online.

    DOI: 10.2105/AJPH.2022.307212

    To contact Rachel Hoopsick, email hoopsick@illinois.edu.

    Source: https://news.illinois.edu/view/6367/2075718277

Emphatic Rejection by DrugWatch International

COMMENT BY JOHN J. COLEMAN Ph.D, PRESIDENT, DRUGWATCH INTERNATIONAL – 01 December 2024 

From: drug-watch-international@googlegroups.com

The proposal from the Secretary of HHS and the Attorney General to reschedule marijuana from Schedule I to Schedule III – responding to President Biden’s request to take a second look at marijuana scheduling – is probably DOA at this point. The hearing at DEA tomorrow is closed except to media and designated participants (apparently, though, it will be online for the public). They may go through some of the motions because that’s what they are supposed to do, but the usual time of several months to go from hearing to Final Order or Final Rule will place the resolution of this matter well into the next administration. When there’s a change of parties, as in this case, the new administration is not eager to adopt or implement the changes or proposals of the old one.

The current move to reschedule marijuana amount to a political hoax because Congress is not about to add the number of federal employees that would be needed to enforce a Schedule III status for marijuana. Every “dispensary” in all the states (est. 38 of 50, plus D,C.) would immediately or within a time set by a Final Rule must register with DEA, pay a registration fee, meet certain requirements, before being able to fill and dispense valid prescriptions for marijuana. The Controlled Substances Act imposes strict controls on imports and exports of controlled substances, as well as its packaging, labeling, distribution, and storage.

The federal government that in 1993 abdicated its responsibility for controlling marijuana (per the infamous Cole Memorandum) has neither the resources nor the desire to enforce new marijuana provisions of the CSA because it no longer enforces even a modicum of the old ones. This is nothing but a cruel joke perpetrated by insincere leaders contemptuous of those who disagree with them. The DEA administrator refused to sign the Notice of Proposed Rulemaking leaving the Attorney General to regain his authority and issue the NPRM in the form of an Attorney General’s Order. That, alone, disqualifies this rescheduling exercise, assuming, that is, that this lunacy ever reaches a judicial review.

As for tomorrow’s meeting at DEA’s administrative law court, I think it will be perfunctory and simply set the agenda for the following two or three months when there may be a hearing. I say “may” because the incoming AG and DEA administrator could very well put the kibosh on this nutty move by the Biden administration. As our late friend and colleague Otto Moulton used to say, “read what the other side is saying!” According to Cannabis.net, a pro-marijuana website, the headline of their alarming article says it all: “Trump’s Not So Cannabis Friendly Cabinet Picks – His VP, AG, Head of the CDC and FDA Nominees all Hate Legal Weed: The cannabis scorecard for Trump’s new cabinet is not shaping up well for legalization fans!”

That pretty much says it all.

John Coleman

************************

Submission by Maggie Petito to DrugWatch International –  mlp3@starpower.net
Sent: Sunday, December 1, 2024 7:21 AM
To: drug-watch-international@googlegroups.com
Subject: Chronister12-1-24

From The Washington Post: “ Chronister would enter an agency that has been roiled by the convictions of several former agents in corruption cases and scrutiny of Milgram’s hiring practices.

The incoming DEA administrator will also helm the agency as it handles a Biden Justice Department proposal to loosen restrictions on marijuana — a measure supported by Trump despite objections from other GOP leaders…

The Justice Department has proposed to reclassify marijuana from a tier reserved for substances such as heroin and LSD. The move to reclassify marijuana would not legalize the drug but would move it to Schedule III, a category that includes prescription drugs such as ketamine, anabolic steroids and testosterone. The proposal met pushback internally at the DEA, which questioned whether reclassification violated international treaty obligations regarding drug control and if a federal health agency used the wrong legal standard in making its determination, according to a Justice Department legal opinion that sided with the Department of Health and Human Services. When officials submitted the proposed rule to reclassify marijuana in April, the paperwork was signed by Attorney General Merrick Garland, not Milgram.

The marijuana proposal will be considered in DEA administrative court; a preliminary hearing is scheduled for Monday, 2nd December 2024.  The proposal, if it goes through, would not be finalized until after Trump becomes president.”

************************

Washington Post     David Ovalle and Anumita Kaur    November 30, 2024                    Hillsborough Sheriff Chad Chronister picked to lead DEA under Trump – The Washington Post

President-elect Donald Trump on Saturday tapped Hillsborough County Sheriff Chad Chronister to lead the Drug Enforcement Administration, replacing Anne Milgram.

The incoming DEA administrator will also helm the agency as it handles a Biden Justice Department proposal to loosen restrictions on marijuana — a measure supported by Trump despite objections from other GOP leaders.

The Justice Department has proposed to reclassify marijuana from a tier reserved for substances such as heroin and LSD. The move to reclassify marijuana would not legalize the drug but would move it to Schedule III, a category that includes prescription drugs such as ketamine, anabolic steroids and testosterone.

The proposal met pushback internally at the DEA, which questioned whether reclassification violated international treaty obligations regarding drug control and if a federal health agency used the wrong legal standard in making its determination, according to a Justice Department legal opinion that sided with the Department of Health and Human Services. When officials submitted the proposed rule to reclassify marijuana in April, the paperwork was signed by Attorney General Merrick Garland, not Milgram.

The marijuana proposal will be considered in DEA administrative court; a preliminary hearing is scheduled for Monday. The proposal, if it goes through, would not be finalized until after Trump becomes president.

Source: COMMENT BY JOHN J. COLEMAN Ph.D, PRESIDENT, DRUGWATCH INTERNATIONAL

MEDIA ADVISORY

WASHINGTON – Formal hearing proceedings regarding the proposed rescheduling of marijuana will begin on December 2, 2024 at 9:30 A.M. ET in the North Courtroom at DEA Headquarters located at 700 Army Navy Drive, Arlington, VA. This preliminary hearing will serve as a procedural day to address legal and logistical issues and discuss future dates for the evidentiary hearing on the merits.  No witness testimony will be offered or received at this time.

In-person attendance is limited to designated participants and credentialed members of the media who have received confirmation of their in-person attendance.

WHAT:    Commencement of formal hearing proceedings regarding the proposed rescheduling of Marijuana

WHO:    Open to designated participants and designated credentialed members of the media.

WHEN:        December 2, 2024 | 9:30 a.m. to 5 p.m.

WHERE:     DEA Headquarters | 700 Army Navy Drive, Arlington, Va. 22202 | North Courtroom

FOR MEMBERS OF THE PUBLIC: Members of the public will have access to the court sessions virtually at www.DEA.gov/live.

FOR NEWS MEDIA: News media wishing to attend in person must RSVP to DEAPress@dea.gov by 10 a.m. on November 29, 2024.  Due to limited capacity, RSVPs will be accepted on a first come, first served basis.

Designated members of the media should arrive no later than 9:00 a.m. on December 2 and follow all security screening procedures. Media credentials are required to be visible while inside DEA Headquarters. Video and audio recordings are not permitted at any time inside the courtroom.

Background:
On May 21, 2024, the Department of Justice proposed to transfer marijuana from schedule I of the Controlled Substances Act to schedule III of the CSA, consistent with the view of the Department of Health and Human Services that marijuana has a currently accepted medical use as well as HHS’s views about marijuana’s abuse potential and level of physical or psychological dependence. The CSA requires that such actions be made through formal rulemaking on the record after opportunity for a hearing. If the transfer to schedule III is finalized, the regulatory controls applicable to schedule III controlled substances would apply, as appropriate, along with existing marijuana-specific requirements and any additional controls that might be implemented, including those that might be implemented to meet U.S. treaty obligations. If marijuana is transferred into schedule III, the manufacture, distribution, dispensing, and possession of marijuana would remain subject to the applicable criminal prohibitions of the CSA. Any drugs containing a substance within the CSA’s definition of “marijuana” would also remain subject to the applicable prohibitions in the Federal Food, Drug, and Cosmetic Act. For more information, visit www.DEA.gov.

Source: https://www.dea.gov/stories/2024/2024-11/2024-11-26/dea-hold-hearing-rescheduling-marijuana

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

Cryptocurrency Tether enables a parallel economy that operates beyond the reach of U.S. law enforcement

Wall Street Journal     Angus Berwick  and Ben Foldy       Sept. 10, 2024

A giant unregulated currency is undermining America’s fight against arms dealers, sanctions busters and scammers. Almost as much money flowed through its network last year as through Visa cards. And it has recently minted more profit than BlackRock, with a tiny fraction of the workforce. Its name: tether. The cryptocurrency has grown into an important cog in the global financial system, with as much as $190 billion changing hands daily.

In essence, tether is a digital U.S. dollar—though one privately controlled in the British Virgin Islands by a secretive crew of owners, with its activities largely hidden from governments.

Known as a stablecoin for its 1:1 peg to the dollar, tether gained early use among crypto aficionados. But it has spread deep into the financial underworld, enabling a parallel economy that operates beyond the reach of U.S. law enforcement.

Wherever the U.S. government has restricted access to the dollar financial system—Iran, Venezuela, Russia—tether thrives as a sort of incognito dollar used to move money across borders.

Russian oligarchs and weapons dealers shuttle tether abroad to buy property and pay suppliers for sanctioned goods. Venezuela’s sanctioned state oil firm takes payment in tether for cargoes. Drug cartels, fraud rings and terrorist groups such as Hamas use it to launder income.

Yet in dysfunctional economies such as Argentina and Turkey, beset by hyperinflation and a shortage of hard currency, tether is also a lifeline for people who use it for quotidian payments and as a way to protect their savings.

Tether is arguably the first successful real-world product to emerge from the cryptocurrency revolution that began over a decade ago. It has made its owners immensely rich. Tether has $120 billion in assets, mostly risk-free U.S. Treasury bills, along with positions in bitcoin and gold. Last year it generated $6.2 billion in profit, outearning BlackRock, the world’s largest asset manager, by $700 million.

Tether’s CEO, Paolo Ardoino, boasted earlier this year that, with under 100 employees, it earned more profit per person than any company ever.

Tether wants “to build a fairer, more connected, and accessible global financial system,” Ardoino said in a May press release. He claims over 300 million people are using the currency.

With sanctions, Washington can cut adversaries off from the dollar and thus much of the global trading system, since all dollar transactions involve U.S. regulated banks. Tether’s popularity subverts those powers.

“We need a regulatory framework that doesn’t allow offshore dollar-backed stablecoin providers to play by a different set of rules,” Deputy Treasury Secretary Wally Adeyemo told The Wall Street Journal. Adeyemo singled out tether in April testimony before Congress.

For this article, the Journal spoke with tether users, researchers and officials, and reviewed messages exchanged between intermediaries, court and corporate records, and blockchain data.

Tether didn’t respond to requests for comment. The company said in May it collaborates with law enforcement and was upgrading its capacity to monitor transactions for sanctions evasion. Tether voluntarily freezes digital wallets used to transfer its tokens that were connected with sanctioned entities, it says. Ardoino said Tether has a “proactive approach to safeguarding our ecosystem against illicit activities.”

How Tether works: The company behind tether, Tether Holdings, issues the virtual coins to a select group of direct customers, mostly trading firms, who wire real-world dollars in exchange. Tether uses those dollars to purchase assets, mostly U.S. Treasurys, that back the coin’s value.

Once in the wider market, tether can be traded for other tokens or traditional currencies through exchanges and local brokerages. In Iran, for example, a crypto exchange called TetherLand allows Iranians to swap rials into tether.

Tether vets the identities of its direct customers, but much of its vast secondary market goes unpoliced. The tokens can be pinged near-instantaneously along chains of digital wallets to obfuscate the source. A United Nations report this January said tether was “a preferred choice” for Southeast Asian money launderers.  The company says it can track every transaction on public blockchain ledgers and can seize and destroy tether held in any wallet.

But freezing wallets is a game of Whac-A-Mole. Between 2018 and this June, Tether blacklisted 2,713 wallets on its two most popular blockchains that had received a total of about $153 billion, according to crypto data provider ChainArgos. Of that massive sum, Tether could only freeze $1.4 billion because the rest of the funds had already been sent on.

Tether’s founders—a group that included a former plastic surgeon called Giancarlo Devasini—created the currency back in 2014. Uptake for a stable token was initially slim. The prospect of profiting from billions of accumulated dollars was a “fantasy,” said William Quigley, an investor who was part of the founding team.

He and other co-founders sold their stakes soon after to Devasini, who has run Tether ever since, according to people familiar with the company. The reclusive billionaire lives at a modernist villa in the French Riviera enclave of Roquebrune-Cap-Martin, corporate records show. Ardoino, a fellow Italian, has become Tether’s public face.

Tether’s entry into the crypto mainstream came during the market’s 2020-2021 bull run, as traders used tether to buy and sell out of risky bets. Its market capitalization exploded from $4 billion to almost $80 billion.

The dollar for all: In Venezuela, financially isolated by sanctions and economic mismanagement, Tether found a ready user base.

President Nicolás Maduro’s government was under siege in 2020 from U.S. measures that targeted state oil firm Petróleos de Venezuela, or PdVSA. That October, Maduro’s parliament passed an “Anti-Blockade Law” that authorized the government to use crypto to protect its transactions.

PdVSA began demanding payment for oil shipments in tether, according to people familiar with its activities and transaction records. Purchase orders authorized by PdVSA often instructed buyers to transfer tether to a certain wallet address. Another method was for intermediaries to swap deliveries of cash for tether and load the tokens onto prepaid travel cards, which enabled holders to use crypto for purchases. Venezuelan President Nicolás Maduro’s parliament passed a law allowing the government to use crypto to protect its transactions. The company’s adoption of tether was so pervasive it had another effect: instead of sending oil revenues back to the government, the middlemen that PdVSA used for the sales diverted funds for themselves, leading to a scandal that toppled the oil minister.

“This cryptocurrency’s use only has served to perpetuate gigantic levels of corruption,” Rafael Ramírez, a former oil minister under Maduro, said in an interview.

Venezuela’s government didn’t respond to requests for comment. The country’s attorney general said in April that middlemen’s use of crypto made the stolen funds “undetectable” for authorities.

For regular Venezuelans, tether became a lifeline, too. Inflation that reached 2 million percent wiped out savings held in bolivars. Currency controls made bank transfers abroad impractical.

Guillermo Goncalvez, a 30-year-old Caracas graduate, runs a platform called El Dorado that offers Venezuelans peer-to-peer tether trading, which links buyers and sellers directly.  El Dorado has over 150,000 users, who pay fees that are a fraction of what traditional money remitters charge: local stores converting daily revenues into tether, Venezuelan migrants sending money back to families, and freelancers receiving salaries in USDT, as tether is also known. “USDT is the digital dollar for all Venezuelans,” Goncalvez said.

Enough money to fill a plane: In Russia, tether is a vital payment channel, the Journal has previously reported.

A confidential report drawn up this year by a government-backed Russian research center identified tether as one of the most popular ways for importers to convert rubles into foreign currencies. Major institutions are involved, too: Rosbank, a Russian lender, arranges tether transfers for clients to pay suppliers abroad, according to a company presentation circulated in June. Rosbank spokespeople didn’t respond to requests for comment.

It is also the go-to currency for Russia’s elite.

A glamorous fixer called Ekaterina Zhdanova told associates in Telegram messages in 2022 and 2023 that she was arranging huge ruble-for-tether deals for clients. Digital wallets she shared had transferred over $350 million in tether, according to blockchain data.

Born in a Siberian village, Zhdanova, 38 years old, ran a concierge service to help wealthy Russians get foreign visas, and a travel agency that organized luxury cruises. Her ex-husband was a top lieutenant for a billionaire Russian real-estate developer.

Russia’s invasion of Ukraine and the subsequent sanctions amplified demand for her services.

Two months into the war, Zhdanova relayed a request from a client to a group of large Russian crypto traders, according to chats on Telegram. The client, who she said had their own bank, wanted to buy about $10 million of tether each month, needing $300 million’s worth in total, in exchange for cash that would be handed over in the United Arab Emirates or Turkey.

After finding a trader willing to accept the deal, Zhdanova told the group she could coordinate the cash’s collection. “They will use planes to pick up the cash,” she said.

Treasury sanctioned Zhdanova late last year, accusing her of transferring crypto on behalf of unnamed oligarchs. Police in France detained her around that time at an airport there as part of a separate French money laundering investigation, people familiar with her arrest said. She remains in custody. A lawyer for Zhdanova declined to comment.

‘Everything. Everywhere.’: Tether is now investing in startups that use tether for everyday payments. The more Tether can encourage its usage, the more tokens it needs to issue, and so the more dollars it will have to put to work.

In Tbilisi, Georgia, a popular landing spot for Russian émigrés, the token’s symbol—an encircled green “T”—glimmers outside money-change shops with blacked-out windows. Cash machines advertise that users can deposit bills for the stablecoin.

Ardoino, the Tether CEO, visited Georgia last year and approached government officials with an offer to help expand the local crypto economy. They signed a cooperation deal that Ardoino said would make the former Soviet republic a flourishing payments hub. Tether invested $25 million in local startups, according to Georgia’s innovation agency.

The main recipient of Tether’s financing, CityPay.io, has rolled out tether-payment systems for thousands of Georgian businesses. Hotels including Tbilisi’s downtown Radisson Blu Iveria have CityPay point-of-sale terminals, and it has joined with a property venture there to sell premium apartments in tether.

CityPay also facilitates international payments in tether for companies, totaling as much as $50 million a month, according to Eralp Hatipoglu, its Turkish CEO. He said the pressure the U.S. applied on the global banking system created these opportunities. Companies exporting from Turkey to Georgia get hammered with questions from correspondent banks, he said, and wire transfers take days. CityPay’s website advertises “100% anonymous transactions,” though Hatipoglu said they check clients’ identities against sanctions lists and don’t accept Russian businesses.

Tether has said it aims for CityPay to expand into other emerging markets. At a crypto conference in a Tbilisi skyscraper this June, sponsored by Tether and attended by its head of expansion, banners promoted the currency’s use for daily payments on CityPay. Guests queued to buy coffee in tether. “Pay with USDT,” read one sign. “Everything. Everywhere.”

 

Source: Tether: The Cryptocurrency Fueling the Financial Underworld – WSJ

BY LAUREN IRWIN – 06/01/24 1:10 PM ET

 

Containers depicting OxyContin prescription pill bottles rest on the ground amid a protest over over-prescription of opioids, Friday, April 5, 2019, in front of the Department of Health and Human Services’ headquarters in Washington, D.C. (AP Photo/Patrick Semansky)

Roughly one in every three Americans have reported knowing someone who has died of a drug overdose, a new survey found.

The poll, conducted by researchers at Johns Hopkins Bloomberg School of Public Health, found that 32 percent of people have known someone who has died of a drug overdose. Those who reported knowing someone who has passed away from drug use were also more likely to support policy aimed at curbing addition, per the poll.

The survey results, published Friday in JAMA Network, suggest that an avenue for enacting greater policy change for addiction may be by mobilizing those who lost someone due to drug addiction, researchers wrote.

Experts also noted that opioids — often prescribed by doctors for pain management — especially with the proliferation of powerful synthetic drugs like fentanyl and polysubstance, have accelerated the rising rate of overdose deaths in recent years.

Since 1999, more than 1 million people have died of a drug overdose in the United States and while studies are still being conducted on the reasoning, researchers noted that there’s not much known about the impacts on the family or friends of the deceased.

The survey also found that personal overdose loss was more prevalent among groups with lower incomes but did not differ much across political parties.

Nearly 30 percent of Democrats said they lost someone to overdose, while 33 percent of Republicans and 34 percent of independents said the same.

“This cross-sectional study found that 32% of US adults reporting knowing someone who died of a drug overdose and that personal overdose loss was associated with greater odds of endorsing addiction as an important policy issue,” the researchers wrote. “The findings suggest that mobilization of this group may be an avenue to facilitate greater policy change.”

similar study examined overdose deaths from 2011 to 2021 and estimates that more than 321,000 children in the U.S. have lost a parent to drug overdose.

According to the Centers for Disease Control and Prevention (CDC), U.S. drug overdose deaths dropped slightly in 2023, the first annual decrease in overdose deaths since 2018. Still, the overall number of deaths is extremely high, with more than 107,000 people dying in 2023 due to the overuse of drugs.

 

Source: https://thehill.com/tag/overdose-deaths/

By Carole Tanzer Miller HealthDay Reporter

MONDAY, June 10, 2024 (HealthDay News) — Though overdose deaths continue to surge, there is no approved medication to treat methamphetamine use disorder.

Now, an experimental two-drug therapy has yielded promising results, UCLA researchers report.

“These findings have important implications for pharmacological treatment for methamphetamine use disorder,” said researcher Dr. Michael Li, an assistant professor-in-residence of family medicine at the David Geffen School of Medicine at UCLA, adding that methamphetamine-involved overdoses have surged.

His team published its findings June 10 in the journal Addiction.

In urine tests for methamphetamine, drug-free results rose 27% among participants who received a combination of injectable naltrexone plus extended-release oral buproprion. Negative tests rose only 11%, meanwhile, in a control group.

Methamphetamine abuse is a growing problem around the world, with an estimated 34 million users in 2020 compared to 33 million 10 years earlier. In the United States alone, overdose deaths rose fivefold between 2012 and 2018.

The National Institute on Drug Abuse Clinical Trials Network has supported various trials, including this one, to evaluate different treatments for methamphetamine use disorder.

This trial, known as ADAPT-2, ran from May 2017 to July 2019 at eight sites. More than 400 participants were included, including 109 who received the experimental drug therapy in the first phase. That demonstrated that the combo worked at six weeks.

The new findings are from the trial’s second phase, which looked at a longer period. Partipants were drug-tested at weeks seven and 12 and again, after treatment, at 13 and 16 weeks.

While their results were encouraging, researchers said further study is needed to find out if the treatment lasts longer than 12 weeks and leads to further reductions in drug use.

“Prior stimulant use disorder treatment trials suggest that change in use is gradual [consistent with our findings], unlikely to result in sustained abstinence in a typical 12-week trial, and dependent on treatment duration,” the researchers said in a UCLA news release. “This warrants future clinical trials to quantify changes in [methamphetamine] use beyond 12 weeks and to identify the optimal duration of treatment with this medication.”

Source: https://www.medicinenet.com/two_drug_treatment_could_curb_meth_addiction/news.htm

 

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

By Liz Tung – June 14, 2024

Reporter at The Pulse

WHYY (PBS) 14th June 2024

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

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

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

Fear of arrest

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

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

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

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

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

Contaminated drug supplies

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

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

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

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

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

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

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

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

Fear, stigma and miseducation

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

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

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

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

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

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

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

Overcoming disparities in health care and mistrust of the system

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

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

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

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

 

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

Israel, now the largest per capita consumer of opioids, faces a rising crisis. Learn about the challenges, responses from health authorities, and the need for improved treatment and prevention.

When in 2021, the US Centers for Disease Control and Prevention counted the deaths of over a million Americans from overdosing with opioids – synthetic, painkilling prescription drugs including fentanyl (100 times more powerful than morphine), oxycodone, hydrocodone and many others – Israel’s Health Ministry was asked whether it could happen here. No, its spokesperson said, even though nearly every negative and positive phenomenon in North America inevitably arrives here within a couple of years.

The epidemic began about 25 years ago when drug and healthcare companies began to enthusiastically promote these very-addictive chemicals, claiming they were effective in relieving suffering and did not cause dependency.

A study published this past May by researchers at the Johns Hopkins Bloomberg School of Public Health found that one out of every three Americans have lost someone – a relative or a friend – to an opioid or other drug overdose. The US National Institute on Drug Abuse found that more than 320,000 American children have lost parents from overdoses in the past decade, and the annual financial costs to the US of the opioid crisis is $1 trillion.

Largest consumers of opioids per capita

Incredibly, Israelis today are the largest consumers per capita in the world of opioids, and an untold number of them are addicted or have already died. No one knows the fatality figures here, as the causes of death are described as organ failures, seizures, heart attack or stroke – not listed by what really caused them.

Is this another example of a “misconception” – wishful thinking on the scale of the belief by the government, the IDF, and the security forces that Hamas would “behave” if regularly paid off with suitcases full of cash? Is Israel headed to where the US already is? Perhaps. What is clear is that our various health authorities now have to somehow clean up the opioid mess.

The scandal has been indirectly embarrassing for Israel because among the most notorious companies involved in the opioid disaster is the Sackler family, who own the Purdue Pharma company that manufactured and promoted the powerful and addictive opioid OxyContin and who are now drowning in huge lawsuits. Tel Aviv University’s Medical Faculty that was for decades known as the Sackler Faculty has deleted it from its name.

Last year, the Knesset Health Committee met to discuss the rise in opioid consumption here, with testimony from Ben-Gurion University of the Negev School of Public Health dean and leading epidemiologist Prof. Nadav Davidovitch, who is also the principal researcher and chairman of the Taub Center Health Policy Program. He stressed that inappropriate use of strong pain medications leads to addiction and other severe negative consequences and noted that while most of the rise in consumption is among patients of lower socioeconomic status, the well-off are also hooked. Davidovitch called for the launching of serious programs to treat addicted Israelis based on the experiences of other countries with the crisis.

Opioids attach themselves to opioid-receptor proteins on nerve cells in the brain, gut, spinal cord, and other parts of the body. This obstructs pain messages sent from the body through the spinal cord to the brain. While they can effectively relieve pain, they can be very addictive, especially when they are consumed for more than a few months to ease acute pain, out of habit, or from the patients’ feeling of pleasure (they make some users feel “high”). Patients who suddenly stop taking them can sometimes suffer from insomnia or jittery nerves, so it’s important to taper off before ultimately stopping to take them.

The Health Ministry was forced in 2022 to alter the labels on packaging of opioid drugs to warn about the danger of addiction after the High Court of Justice heard a petition by the Physicians for Human Rights-Israel and the patients’ rights organization Le’altar that claimed the ministry came under pressure from the pharmaceutical companies to oppose this. After ministry documents that showed doctors knew little about the addictions caused by opioids were made public by the petitioners, psychiatrist Dr. Paola Rosca – head of the ministry’s addictions department – told the court that the synthetic painkillers cause addiction. She has not denied the claim that the ministry was squeezed by the drug companies to oppose label changes.

No special prescription, no time limit, no supervision

In an interview with The Jerusalem Post, Prof. Pinhas Dannon – chief psychiatrist of the Herzog Medical Center in Jerusalem and a leading expert on opioid addiction – noted that anyone with a medical degree can prescribe synthetic painkillers to patients. “There is no special prescription, no time limit, no supervision,” he said.

“A person who undergoes surgery who might suffer from serious pain is often automatically given prescriptions for opioids – not just one but several,” Dannon revealed. “Nobody checks afterwards whether the patient took them, handed them over to others (for money or not), whether they took several kinds at once, or whether they stopped taking them. They are also prescribed by family physicians, orthopedists treating chronic back pain, urologists, and other doctors, not only by surgeons.”

Dannon, who runs a hospital clinic that tries to cure opioid addiction, said there are only about three psychiatric hospitals around the country that have small in-house departments to treat severely addicted patients. “Not all those addicted need inpatient treatment, but when we build our new psychiatry center, we would be able to provide such a service.”

Since opioids are relatively cheap and included in the basket of health services, the four public health funds that pay for and supply them have not paid much attention. Once a drug is in the basket, it isn’t removed or questioned. Only now, when threatened by lawsuits over dependency, have the health funds begun to take notice and try to promote reductions in use.

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Dannon declared that the health funds, hospitals, and pharmacies must seriously supervise opioid use by tracking and be required by the ministry to report who is taking them, how much, what ages, and for how long. Opioids are meant for acute pain, not for a long period. “The Health Ministry puts out fires but is faulty in prevention and supervision,” he said.

A Canadian research team has just conducted a study at seven hospital emergency departments in Quebec and Ontario to determine the ideal quantity of prescription opioids to control pain in discharged patients and reduce unused opioids available for misuse.

They recommended that doctors could adapt prescribing quantity to the specific condition causing pain, based on estimates to alleviate pain in 80% of patients for two weeks, with the smallest quantity for kidney or abdominal pain (eight tablets) and the highest for back pain (21 tablets) or fractures (24 tablets), and add an expiry date for them. Since half of participants consumed even smaller quantities, pharmacists could provide half this quantity to further reduce unused opioids available for misuse.

No medical instruction on the issue

Rosca, who was born in Italy where she studied medicine and came on aliyah in 1983, has worked in the ministry since 2000; in 2006, she became head of the addictions department.

“In Italy, every psychiatrist must learn about alcohol and other drug addictions including opioids,” she said. “Here, there is no mandatory course in any medical school on the subject. We tried to persuade the Israel Medical Association and its Scientific Council, which decides on curricula and specializations, but we didn’t succeed. Maybe now, in the face of the crisis, it will change its mind. We run optional courses as continuing medical education for physicians who are interested.”

Her department wanted pharmacists to provide electronic monitoring of opioid purchases, but “the Justice Ministry opposed it on the grounds that it would violate privacy. I wasn’t asked for my opinion.”

She concedes that the ministry lacks statistics on the number of addicted people, and Arabs have been excluded from estimates until now. “We’re doing a study with Jerusalem’s Myers-JDC-Brookdale Institute to find out how many. Some say one percent, some say five percent. We hope that by December, we will get more accurate figures. Before the COVID-19 pandemic, the ministry set up a committee on what to do about opioids, but its recommendations were never published, and there was no campaign,” Rosca recalled.

In 1988, the government established the statutory Anti-Drug Authority that was located in Jerusalem’s Givat Shaul neighborhood. It was active in fighting abuse and shared research with foreign experts, but seven years ago, its name was changed to the National Authority for Community Safety and became part of the Ministry for National Security, losing much of its budgets – and, according to observers, its effectiveness as well.

The Health Ministry used to be responsible for setting up and operating clinics for drug rehabilitation, but it handed this over in 1997 to a non-profit organization called the Israel Public Health Association, which employs numerous former ministry professionals. Its director-general, lawyer Yasmin Nachum, told the Post in an interview that the IPHA is very active in fighting drug addiction.

“Israel can’t deny anymore that we are in a worrisome opioid epidemic like that in the US: We are there,” he said. “We see patients every day. Some used to take heroin and other street drugs, but with the easy access and low price, they have switched to opioids. If they are hospitalized for an operation and don’t use all the prescriptions they are given, they sell them to others. We want to have representation in every hospital to warn doctors and patients.”

Of a staff of 1,100, the IPHA has 170 professionals – narcotics experts, social workers, occupational therapists, and others working with 3,000 addicted patients every day. Its other activities include mental health, ensuring safety of food and water, and rehabilitation.

Stopping after six months

“We work in full cooperation with the ministry,” Nachum said. “Our approach is that when opioids are taken for pain for as long as six months, it’s the time to stop taking them. The doctors provide addicted patients with a drug called buprenorphine, sold under the brand name Subutex, which is used to treat opioid-use disorder, acute pain, and chronic pain.”

Buprenorphine is a mixed opioid agonist and antagonist. That means it has some of the effects of opioids but also blocks some of their effects. Before the patient can take it under direct observation, he must have moderate opioid-withdrawal symptoms. The drug relieves withdrawal symptoms from other opioids and induces some euphoria, but it also blocks the efficacy of many other opioids including heroin, to create an effect.

Buprenorphine levels in the blood stay consistent throughout the month. Nachum said the replacement drug is relatively safe, with some side effects, but fortunately, there is no danger of an overdose.

NARCAN (NALOXDONE) is another prescription drug used by some professionals to fight addiction. Not in Israel’s basket of health services, it blocks the effects of opioids by temporarily reversing them, helping the patient to breathe again and wake up from an overdose. While it has saved countless lives, new and more powerful opioids keep appearing, and first responders are finding it increasingly difficult to revive people with it.

Now, US researchers have found an approach that could extend naloxone’s lifesaving power, even in the face of continually more dangerous opioids by using potential drugs that make naloxone more potent and longer lasting. Naloxone is a lifesaver, but it’s not a miracle drug; it has limitations, the team said.

After the Nova massacre on October 7, when significant numbers of participants who were murdered were high on drugs, the IPHA received a huge number of calls. In December, Nachum decided to open a hotline run by professionals about addiction that has been called monthly by some 300 people. “We also hold lectures for pain doctors, family physicians, and others who are interested, because there has been so little awareness.”

All agree that the opioid crisis has been seriously neglected here and that if it is not dealt with seriously and in joint efforts headed by healthcare authorities, it will snowball and add to Israel’s current physical and psychological damage.

Source: https://www.jpost.com/health-and-wellness/article-811126

May 09, 2024

WASHINGTON – Today, DEA Administrator Anne Milgram announced the release of the 2024 National Drug Threat Assessment (NDTA), DEA’s comprehensive strategic assessment of illicit drug threats and trafficking trends endangering the United States.

 

For more than a decade, DEA’s NDTA has been a trusted resource for law enforcement agencies, policy makers, and prevention and treatment specialists and has been integral in informing policies and laws. It also serves as a critical tool to inform and educate the public.

 

DEA’s top priority is reducing the supply of deadly drugs in our country and defeating the two cartels responsible for the vast majority of drug trafficking in the United States. The drug poisoning crisis remains a public safety, public health, and national security issue, which requires a new approach.

 

“The shift from plant-based drugs, like heroin and cocaine, to synthetic, chemical-based drugs, like fentanyl and methamphetamine, has resulted in the most dangerous and deadly drug crisis the United States has ever faced,” said DEA Administrator Anne Milgram. “At the heart of the synthetic drug crisis are the Sinaloa and Jalisco cartels and their associates, who DEA is tracking world-wide. The suppliers, manufacturers, distributors, and money launderers all play a role in the web of deliberate and calculated treachery orchestrated by these cartels. DEA will continue to use all available resources to target these networks and save American lives.”

Drug-related deaths claimed 107,941 American lives in 2022, according to the Centers for Disease Control and Prevention (CDC). Fentanyl and other synthetic opioids are responsible for approximately 70% of lives lost, while methamphetamine and other synthetic stimulants are responsible for approximately 30% of deaths.

 

Fentanyl is the nation’s greatest and most urgent drug threat. Two milligrams (mg) of fentanyl is considered a potentially fatal dose. Pills tested in DEA laboratories average 2.4 mg of fentanyl, but have ranged from 0.2 mg to as high as 9 mg. The advent of fentanyl mixtures to include other synthetic opioids, such as nitazenes, or the veterinary sedative xylazine have increased the harms associated with fentanyl.

Seizures of fentanyl, in both powder and pill form, are at record levels. Over the past two years seizures of fentanyl powder nearly doubled. DEA seized 13,176 kilograms (29,048 pounds) in 2023. Meanwhile, the more than 79 million fentanyl pills seized by DEA in 2023 is almost triple what was seized in 2021. Last year, 30% of the fentanyl powder seized by DEA contained xylazine. That is up from 25% in 2022.

 

Social media platforms and encrypted apps extend the cartels’ reach into every community in the United States and across nearly 50 countries worldwide. Drug traffickers and their associates use technology to advertise and sell their products, collect payment, recruit and train couriers, and deliver drugs to customers without having to meet face-to-face. This new age of digital drug dealing has pushed the peddling of drugs off the streets of America and into our pockets and purses.

 

The cartels have built mutually profitable partnerships with China-based precursor chemical companies to obtain the necessary ingredients to manufacturer synthetic drugs. They also work in partnership with Chinese money laundering organizations to launder drug proceeds and are increasingly using cryptocurrency.

 

Nearly all the methamphetamines sold in the United States today is manufactured in Mexico, and it is purer and more potent than in years past. The shift to Mexican-manufactured methamphetamine is evidenced by the dramatic decline in domestic clandestine lab seizures. In 2023, DEA’s El Paso Intelligence Center (EPIC) documented 60 domestic methamphetamine clandestine lab seizures, which is a stark comparison to 2004 when 23,700 clandestine methamphetamine labs were seized in the United States.

 

DEA’s NDTA gathers information from many data sources, such as drug investigations and seizures, drug purity, laboratory analysis, and information on transnational and domestic criminal groups.

Click here to read the DEA’s Threat Assessment report

Source: https://www.dea.gov/press-releases/2024/05/09/dea-releases-2024-national-drug-threat-assessment

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

They found:

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

Medical vs non-medical CBD

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

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

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

Chronic pain

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

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

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

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

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

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

 

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

Barry Ewing JUNE 23RD, 2024

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

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

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

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

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

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

Barry Ewing – Lethbridge Herald

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

 

Ernesto CabralUpdated 
At least 1,089 people died from fentanyl poisoning in 2023, up 18.4% from the year before, preliminary data shows
As many as 7 in 10 counterfeit pills tested in 2023 contained a potentially lethal dose of fentanyl, or roughly the amount that fits on the tips of a pencil, national DEA laboratory testing showed. (Photo courtesy of Rocky Mountain Field Division of the Drug Enforcement Administration)

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

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

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

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

The health department anticipates releasing final data in June.

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

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

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

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

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

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

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

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

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

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

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

Department of Criminal Justice, California State University

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

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

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

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

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

Challenge And Opportunity

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

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

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

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

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

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

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

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

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

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

Plan Of Action

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

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

ED should increase resources for creating and implementing evidence-based preventative education for youth and provide resources for drug misuse with access to naloxone.

Department of Justice (DOJ) DOJ is responsible for keeping our country safe by upholding the law and protecting civil rights. The DOJ houses the Office of Justice Programs and the Drug Enforcement Agency (DEA), which are instrumental in the opioid crisis.

DOJ should be the principal enforcement agency, with the DEA leading drug-related enforcement actions. The Attorney General should continue to initiate new sanctions and a wider range of indictments to assist with interdiction and eradication efforts.

Department of Health and Human Services (HHS) HHS houses the Centers for Disease Control and Prevention (CDC), the nation’s health protection and preventative agency, and collects and analyzes vital data to save lives and protect people from health threats.

The CDC should be the primary agency to focus on robust real-time opioid-related overdose surveillance and fund local public health departments to collect and submit data. HHS should fund grants to enhance community efforts to reduce opioid-related overdoses and provide resources and outreach to increase awareness.

Department of Homeland Security (DHS) DHS focuses on crime prevention and safety at our borders, including interdiction and eradication efforts, while monitoring security threats and strengthening preparedness.

DHS should continue leading international investigations of fentanyl production and trafficking. Additional funding should be provided to allow DHS and its investigative agencies to focus more on producers of opioids, sales of precursors, and trafficking to assist with lessening the supply available in the United States.

Department of the Treasury (TREAS) TREAS is responsible for maintaining financial infrastructure systems, collecting revenue and dispersing payments, and creating international economic policies.

TREAS should continue efforts to sanction countries producing precursors to create opioids and trafficking drugs into the U.S. while prohibiting business ties with companies participating in drug trades. Additional funding should be available to support E.O. 14059 to counter transnational organized crime’s relation to illicit drugs.

Bureau of Prisons (BOP) The BOP provides protection for public safety by providing a safe and humane facility for federal offenders to serve their prescribed time while providing appropriate programming for reentry to ease a transition back to communities.

The BOP should provide treatment for opioid use disorders, including the option for medication-assisted treatment, to assist in reducing relapse and overdoses, coupled with intensive case management.

State Department (DOS) The DOS spearheads foreign policy by creating agreements, negotiating treaties, and advocating for the United States internationally.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Recommendation 6. Enhance prevention and enforcement efforts.

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

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

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

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

Budget Proposal

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

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

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

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

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

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

Conclusion

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

 

PSYCHOPHARMACOLOGY

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

 

KEY POINTS

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

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

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

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

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

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

Fentanyl is killing adolescents and people of color, many with no idea they are taking fentanyl. The counterfeit drugs are easy to obtain from friends or buy through social media. Sold online for $2 to $10 apiece, their lethal potency caught policy leaders, emergency rooms, addiction experts, family health providers, and pediatricians nationwide by surprise.

 Such is the fentanyl crisis as of June 2024. As i will describe in this blog post, there are treatments of last resort and medications designed to reverse the effects of fentanyl when education, prevention, and treatment have failed. An estimated 80,000 deaths per year are attributed to opioid-induced respiratory depression (OIRD) caused by fentanyl alone. Wonder medicines that counter the effects include the widely-used naloxone (Narcan) and much-less-used (but also effective) opioid overdose reversal drug nalmefene (Opvee).

The Life-Saving Role of Naloxone

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

When Individuals Overdose on Opioids

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

Opioids

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

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

Reversing Respiratory Depression

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

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

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

Renarcotization

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

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

Narcan Nasal Spray

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

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

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

Another Opioid Overdose Reversal Drug: Nalmefene

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

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

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

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

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

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

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

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

Conclusion

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

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

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

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

References

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

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

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

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

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

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

 

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

 

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

 

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

 

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

 

John Coleman

Source:  www.drugwatch.org

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

Links to view the articles related to the above presentation:

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

The International Narcotics Control Board (INCB) study recommends responding with the same methods, running counter-narcotics campaigns offering advice that can be trusted on popular online platforms.

“We can see that drug trafficking is not just carried out on the dark web. Legitimate e-commerce platforms are being exploited by criminals too,” said Jallal Toufiq, INCB President.

Criminal gangs take advantage of the chance to reach large global audiences on social media channels by turning them into marketplaces and posting inappropriate, misleading and algorithm-targeted content that is widely accessible to children and adolescents, the board noted.

Poppy cull

The authors of the report observed a significant decline in opium poppy cultivation and heroin production in Afghanistan following the Taliban’s ban on drugs. But, South Asia’s methamphetamine trafficking boomis linked to its manufacture in Afghanistan with outlets in Europe and Oceania.

In Colombia and Peru, there has been a notable increase in illicit coca bush cultivation, rising by 13 per cent and 18 per cent respectively in 2022.

Cocaine seizures also reached a record level in 2021 in West and Central Africa, a major transit region.

And Pacific island States have transitioned from being solely transit sites along drug trafficking routes to becoming destination markets for synthetic drugs.

In North America, the opioid crisis persists, with the number of deaths involving synthetic opioids other than methadone surpassing 70,000 in 2021. In Europe, several countries are pursuing a regulated market for cannabis for non-medical purposes, which, the INCB experts believe, may be inconsistent with drug control.

Soundcloud

Real-world dangers online

Other trends linked to drug dealing today include the use of encryption methods in communications and transactions, anonymous browsing on the darknet and payments in hard-to trace cryptocurrencies, which increase challenges for prosecutors.

The INCB report also highlighted how criminals relocate their operations to regions with less stringent law enforcement or lighter sanctions, often choosing countries where extradition can be evaded.

The latest data also emphasizes the heightened risk of deadly overdoses linked to the online availability of fentanyl – many times more potent than heroin – and other synthetic opioids.

Another area of concern is telemedicine and online pharmacies. While such services have the potential to enhance healthcare access and simplify the prescription and delivery of lifesaving medicines, illegal internet outlets that sell drugs without a prescription directly to consumers are a very real health risk.

The global trade in illicit pharmaceuticals is estimated at $4.4 billion.

In many cases, it is impossible for consumers to know whether the drugs or medicines they are buying are counterfeit, banned or illegal.

To combat the online threat, the report’s authors insist that internet platforms should be used to raise awareness about drug misuse and support public health campaigns, especially targeting young people.

Given the global nature of the challenge, countries should cooperate to identify and respond to new threats, said INCB, whose 13 members are elected by the UN’s Economic and Social Council (ECOSOC).

Source: https://news.un.org/en/story/2024/03/1147252

The United States is knee-deep in what some experts call the opioid epidemic’s “fourth wave,” which is not only placing drug users at greater risk but is also complicating efforts to address the nation’s drug problem.

These waves, according to a report from Millennium Health, began with the crisis in prescription opioid use, followed by a significant jump in heroin use, then an increase in the use of synthetic opioids like fentanyl.

The latest wave involves using multiple substances at the same time, combining fentanyl mainly with either methamphetamine or cocaine, the report found.

“And I’ve yet to see a peak,” said one of the co-authors, Eric Dawson, vice president of clinical affairs at Millennium Health, a specialty laboratory that provides drug testing services to monitor use of prescription medications and illicit drugs.

The report, which takes a deep dive into the nation’s drug trends and breaks usage patterns down by region, is based on 4.1 million urine samples collected from January 2013 to December 2023 from people receiving some kind of drug addiction care.

Its findings offer staggering statistics and insights. Its major finding: How common polysubstance use has become. According to the report, an overwhelming majority of fentanyl-positive urine samples — nearly 93% — contained additional substances.

“And that is huge,” said Nora Volkow, director of the National Institute on Drug Abuse at the National Institutes of Health.

The most concerning, she and other addiction experts said, is the dramatic increase in the combination of meth and fentanyl use. Methamphetamine, a highly addictive drug often in powder form that poses several serious cardiovascular and psychiatric risks, was found in 60% of fentanyl-positive tests last year. That is an 875% increase since 2015.

“I never, ever would have thought this,” Volkow said.

Among the report’s other key findings:

  • The nationwide spike in methamphetamine use alongside fentanyl marks a change in drug use patterns.
  • Polydrug use trends complicate overdose treatments. For instance, though naloxone, an opioid-overdose reversal medication, is widely available, there isn’t an FDA-approved medication for stimulant overdose.
  • Both heroin and prescribed opioid use alongside fentanyl have dipped. Heroin detected in fentanyl-positive tests dropped by 75% since peaking in 2016. Prescription opioids were found at historic low rates in fentanyl-positive tests in 2023, down 89% since 2013.

But Jarratt Pytell, an addiction medicine specialist and assistant professor at the University of Colorado’s School of Medicine, warned these declines shouldn’t be interpreted as a silver lining.

A lower level of heroin use “just says that fentanyl is everywhere,” Pytell said, “and that we have officially been pushed by our drug supply to the most dangerous opioids that we have available right now.”

“Whenever a drug network is destabilizing and the product changes, it puts the people who use the drugs at the greatest risk,” he said. “That same bag or pill that they have been buying for the last several months now is coming from a different place, a different supplier, and is possibly a different potency.”

In the illicit drug industry, suppliers are the controllers. It may not be that people are seeking out methamphetamine and fentanyl but rather that they’re what drug suppliers have found to be the easiest and most lucrative product to sell.

“I think drug cartels are kind of realizing that it’s a lot easier to have a 500-square-foot lab than it is to have 500 acres of whatever it takes to grow cocaine,” Pytell said.

Dawson said the report’s drug use data, unlike that of some other studies, is based on sample analysis with a quick turnaround — a day or two.

Sometimes researchers face a months-long wait to receive death reports from coroners. Under those circumstances, you are often “staring at today but relying on data sources that are a year or more in the past,” said Dawson.

Self-reported surveys of drug users, another method often used to track drug use, also have long lag times and “often miss people who are active for substance use disorders,” said Jonathan Caulkins, a professor at Carnegie Mellon University’s Heinz College. Urine tests “are based on a biology standard” and are good at detecting when someone has been using two or more drugs, he said.

But using data from urine samples also comes with limitations.

For starters, the tests don’t reveal users’ intent.

“You don’t know whether or not there was one bag of powder that had both fentanyl and meth in it, or whether there were two bags of powder, one with fentanyl in it and one with meth and they took both,” Caulkins said. It can also be unclear, he said, if people intentionally combined the two drugs for an extra high or if they thought they were using only one, not knowing it contained the other.

Volkow said she is interested in learning more about the demographics of polysubstance drug users: “Is this pattern the same for men and women, and is this pattern the same for middle-age or younger people? Because again, having a better understanding of the characteristics allows you to tailor and personalize interventions.”

All the while, the nation’s crisis continues. According to the Centers for Disease Control and Prevention, more than 107,000 people died in the U.S. in 2021 from drug overdoses, most because of fentanyl.

Caulkins said he’s hesitant to view drug use patterns as waves because that would imply people are transitioning from one to the next.

“Are we looking at people whose first substance use disorder was an opioid use disorder, who have now gotten to the point where they’re polydrug users?” he said. Or, are people now starting substance use disorders with methamphetamine and fentanyl, he asked.

One point was clear, Dawson said: “We’re just losing too many lives.”

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

Source:  https://dailymontanan.com/2024/03/17/fourth-wave-of-opioid-epidemic-crashes-ashore-propelled-by-fentanyl-and-meth/

Nearly 108,000 Americans died of drug overdoses in 2022, according to final federal figures released Thursday by the Centers for Disease Control and Prevention.Over the last two decades, the number of U.S. overdose deaths has risen almost every year and continued to break annual records — making it the worst overdose epidemic in American history.The official number for 2022 was 107,941, the CDC said, which is about 1% higher than the nearly 107,000 overdose deaths in 2021.

Between 2021 and 2022, data shows the fatal overdose rate for synthetic opioids other than methadone — which the CDC defines as fentanyl, fentanyl analogs and tramadol — increased 4.1%. Rates for cocaine and psychostimulants with abuse potential — which includes drugs such as methamphetamineamphetamine and methylphenidate — also increased.

There were also some declines seen in certain drugs, with lower rates reported for heroin, natural and semisynthetic opioids, and methadone.

The overdose death rate for females declined for the first time in five years, according to the report. But the male overdose death rate continued to inch up, the report said, accounting for about 70% of U.S. overdose deaths.

There were also shifts among age groups from 2021 to 2022, with a decreased rate of drug overdose deaths among those aged 15 to 24, and 25 to 34.

Rates increased, however, among adults aged 35 and older, with the highest rates for adults aged 35 to 44.

While adults aged 65 and older had the lowest rates in both 2021 and 2022, they also experienced the largest percent increase at 10.0% (from 12.0 per 100,000 in 2021 to 13.2 per 100,000 in 2022).

The overall drug overdose death rate rose from 2021 to 2022, but the increase was so small it was not considered statistically significant.

Earlier provisional data estimated more than 109,000 overdose deaths in 2022, but provisional data includes all overdose deaths, while the final numbers are limited to U.S. residents.

The CDC has not yet reported overdose numbers for 2023, although provisional data through the first 10 months of the year suggest overdose deaths continued to be stable last year.

In an effort to prevent drug overdoses and deaths in young people, the American Medical Association has called for school staff to “put naloxone in schools so it can save lives.” The association also issued a statement in conjunction with other organizations encouraging states, schools and local communities to allow students to carry naloxone in schools of all grade levels.

State and federal legislators have introduced legislation to require schools carry naloxone, and the Biden administration encouraged schools at the end of last year to keep the medication on-hand and teach staff how to use it.

 

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

Filed under: Drug Specifics,USA :

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Source: https://www.wpsdlocal6.com/news/dead-people-don-t-recover-msu-panel-discusses-drug-epidemic-solutions-in-america/article_aa168e78-ebcf-11ee-9f07-0385030995de.html

Police forces in the province collected 795 blood samples from motorists suspected of driving while under the influence.

One year after the legalization of recreational use of cannabis in Canada, the black market for the drug — as well as its use behind the wheel — continues to keep Quebec police forces busy.

In 2018, police collected 795 blood samples from motorists suspected of driving while under the influence, and sent them to Quebec’s medical legal centre for processing. That’s 254 more than in the previous year.

The presence of cannabis was detected in 46 per cent of those cases.

The Sûreté du Québec says cannabis is the most commonly detected drug in its traffic stops.

The provincial force said that since legalization, cannabis was detected in the systems of 113 persons pulled over for impaired driving, compared with 73 cases a year earlier — an increase of 54 per cent.

More than 670 officers trained in drug use evaluation have been deployed across the province.

In a statement issued Thursday detailing its operations over the past year, the SQ said it had opened 1,409 investigations into the illegal production, supply and distribution of cannabis, which led to 1,458 warrants being executed and charges filed against 1,403 individuals.

Meanwhile, raids on illegal outdoor cannabis fields were carried out in August and September, and saw 37,000 plants seized.

Over the past year, the SQ seized 71,500 cannabis plants, 161 kilograms of cannabis, 15.8 kilograms of cannabis oil and resin, 23,460 units of edible cannabis and $180,000 in cash.

Source:  https://montrealgazette.com/news/local-news/quebec-pot-arrests-behind-the-wheel-up-54-since-legalization October 2019

30 July 2019

I had forgotten how much I disliked cannabis until I found myself under its influence, in the rain, trying and failing to find Toronto’s Union Train Station so I could get to the airport and go home. The plan had been to enhance my mood for a long journey, floating back to the UK in a higher state of consciousness. In practice, I just got confused, wet and was lucky to make my flight.

I had intended to purchase the kind of low-THC, high-CBD weed that disappeared from Britain’s black market when skunk took over in the 1990s. Put simply, THC is the psychoactive component that gets you high but is associated with psychosis, while CBD is the antipsychotic component that gave cannabis its natural balance before it was bred out of the plant by drug dealers. Alas, laziness prevailed and I settled for a ready-rolled joint which my vendor candidly admitted was made up of scrapings from whatever they’d been chopping up that day.

In truth, the spliff had been bought on the ‘when in Rome’ principle. Recreational cannabis has been legal in Canada since last October and I was on a fact-finding trip with a BBC film crew and a cross-party group of MPs, including Norman Lamb, David Lammy and Jonathan Djanogly. In a few months time, Illinois will become the eleventh US state to legalise recreational marijuana. With the dominos falling, it is only a matter of time before a European country, possibly Britain, follows suit. We were there to see how it works.

Only two of us sampled the product. Norman Lamb received a knighthood for his work on mental health while we were there and marked the occasion by becoming the first British politician to be filmed buying and taking cannabis. I wish I could claim that it was a wild party, but the truth is more mundane. Struggling with jet lag and keen to get a decent night’s sleep, he tried a little cannabis oil. I am told the results were satisfactory.

Being male, middle-aged and more or less law-abiding, Sir Norman and I are demographically just the kind of chaps to dabble in the legal marijuana market. More people are consuming cannabis in Canada since it was legalised, with prevalence rising from 14 per cent to 18 per cent in the last year. In the first quarter of 2019, 646,000 people, most of them men and half of them aged over 45, tried cannabis for the first time. The most common reason given by these debutants for buying cannabis on the legal market is ‘quality and safety’. It is not so much that the law was an effective deterrent – everybody knew the police barely enforced it – rather that would-be consumers were put off by the idea of buying an unregulated product from a criminal supply chain.

The problem is that there are more than four million Canadians who are used to buying on the black market and have been given little incentive to stop. An illicit cannabis market that was worth $1,289 million in the last full quarter before legalisation was still worth $1,014 million in the first quarter of this year. The legal, recreational market was worth a mere £377 million. The illicit trade is proving hard to shake off.

Everyone I spoke to in Ontario was eager to point out that these are early days. Canada is only the second country to legalise cannabis (after Uruguay) and there were bound to be teething problems. There is a temporary shortage of both cannabis and shops from which to buy it. Toronto, a city of three million souls, has just four recreational cannabis shops. Nevertheless, the primary goal of legalisation was to take out the criminal element and so it is concerning that most of the country’s weed continues to be sourced on the black market.

Things are unlikely to improve until prices fall. The average gram of cannabis on the street costs $6.37. The average gram in a shop costs $9.99. Casual smokers might be prepared to pay ten bucks for government-approved cannabis, but the costs of switching to the legal market start to add up if you’re one of the two million Canadians who consume the drug at least once a week.

Marijuana is being produced on a truly industrial scale in Canada. Factories are turning seeds into six foot plants in a matter of weeks. The legal product could easily be sold cheaper than its illicit competitors, but over-regulation, taxation and a lack of competition have got in the way. Politicians hoped to smash the black market while regulating the product in such a way that it would not attract new punters. These two goals were never easy to reconcile, and neither has been achieved. High prices, plain packaging and restrictive licensing conditions have deterred long-term users from switching to the legal market while new customers have given it a try anyway.

Everything about Toronto’s cannabis shops feels regulated to the last inch. Browsing their shelves gave me a fresh appreciation for the subtle nudges of consumer capitalism. With logos and colours stripped from the packaging, there is nothing to signal quality, economy or potency; nothing to remember. The windows are blacked out. Edible and vaped cannabis cannot be sold. Small quantities of marijuana are held in over-sized plastic tubs, apparently to provide enough room for large yellow warning labels. The only concession to branding is that some of the tubs are white and some are black.

It all amounts to a concerted effort to suck the fun out of cannabis shopping, which makes sense if your aim is to deter people from buying the stuff, but not if your aim is to switch people from street cannabis to high street cannabis.

On an Indian reservation outside Toronto things could not be more different. Here, in a settlement of 4,100 people, there are no fewer than nineteen cannabis shops. Although it is illegal for visitors to take their shopping off-site, the authorities turn a blind eye to it as part of their efforts to atone for historic wrongs done to the indigenous population. As far as the proprietors are concerned, the unique selling point is their organic, homegrown product which they have reverse-engineered into the Indian way of life, but the real difference between these shops and their state-sanctioned counterparts is variety, low prices and an unabashed pride in selling something that is pleasurable.

All the weed sold here is unlicensed and therefore technically illicit, but when we visited, eight months after federal legalisation, it was doing good business. Until the Canadian government loosens up and allows a little more consumerism into its noble experiment, neither they nor the rest of the unlicensed sector have much to fear.

Source: Christopher Snowdon Spectator Magazine July 2019

Abstract

The recent demonstration that massive scale chromosomal shattering or pulverization can occur abruptly due to errors induced by interference with the microtubule machinery of the mitotic spindle followed by haphazard chromosomal annealing, together with sophisticated insights from epigenetics, provide profound mechanistic insights into some of the most perplexing classical observations of addiction medicine, including cancerogenesis, the younger and aggressive onset of addiction-related carcinogenesis, the heritability of addictive neurocircuitry and cancers, and foetal malformations. Tetrahydrocannabinol (THC) and other addictive agents have been shown to inhibit tubulin polymerization which perturbs the formation and function of the microtubules of the mitotic spindle. This disruption of the mitotic machinery perturbs proper chromosomal segregation during anaphase and causes micronucleus formation which is the primary locus and cause of the chromosomal pulverization of chromothripsis and downstream genotoxic events including oncogene induction and tumour suppressor silencing. Moreover the complementation of multiple positive cannabis-cancer epidemiological studies, and replicated dose-response relationships with established mechanisms fulfils causal criteria. This information is also consistent with data showing acceleration of the aging process by drugs of addiction including alcohol, tobacco, cannabis, stimulants and opioids. THC shows a non-linear sigmoidal dose-response relationship in multiple pertinent in vitro and preclinical genotoxicity assays, and in this respect is similar to the serious major human mutagen thalidomide. Rising community exposure, tissue storage of cannabinoids, and increasingly potent phytocannabinoid sources, suggests that the threshold mutagenic dose for cancerogenesis will increasingly be crossed beyond the developing world, and raise transgenerational transmission of teratogenicity as an increasing concern.

Keywords: Cannabis; Chromothripsis; Dose-response relationship; Epigenetics; Foetal malformations; Heritable; Interdisciplinary; Microtubules; Oncogenesis; Population effects; Threshold dose; Transgenerational; Tubulin.

Source:  Drugwatch International 2018

|Assemblyman Jim Wood (D-Healdsburg), who has crafted cannabis regulations, said the licensing system had not yet lived up to its promise.

The state licensing process this past year has been a painful one,” said Wood, adding that the complex rules are particularly difficult for small businesses. “I recognize that this has been a significant undertaking for the state, and you combine that with the cannabis industry learning how to navigate the process — it’s been difficult for them both.”

The legalization of recreational pot has also created tension in areas of the state where cannabis growers are operating close to residents.

Jesse Jones said he moved his family to Petaluma from Marin County six months ago so his three children could enjoy more open space, but he is now fighting a proposal for a cannabis farm to operate a few hundred feet from his home, in part because of safety issues.

“You are going to have what is still a [Schedule 1] narcotic being produced in line of sight of my kids’ trampoline, on a shared road that was never intended for this type of commercial operation,” said Jones, an energy industry executive.

Sanjay Bagai, a former investment banker who lives with his family next door to a new cannabis farm in Sonoma County, is a leader of a residents group called Save Our Sonoma Neighborhoods, which has obtained a preliminary court ruling against one cannabis-growing operation.

Bagai said his group was “not anti-cannabis” but added that pot cultivation “is not something that fits into our neighborhood here.”

“The smell is horrific,” he said of the marijuana plants. “It’s like rotting flesh. And the traffic is insane.”

Quality-of-life complaints have also surfaced in neighborhoods where cannabis sellers have set up shop.

Van Nuys Neighborhood Council President George Thomas said he had received about a dozen complaints in the last year from residents living near pot stores who were concerned about loitering, the smell of marijuana smoke and other issues. Thomas, who is the publisher of the Van Nuys News Press and is an LAPD volunteer, passes complaints on to police officers.

“If they are not in compliance,” Thomas said, “if they are within a thousand feet of a school or church, we are totally against them and we are happy to work with the neighborhood prosecutor in the city attorney’s office to shut them down.”

By Kurtis Lee  Dec 19, 2018

 

Source:  http://www.latimes.com/politics/la-pol-ca-marijuana-year-anniversary-review-20181227-story.html

 

At the same time, he said, the neighborhood council has worked with licensed cannabis stores to get them involved in improving the community and has asked the Los Angeles City Council to devote some of the tax revenue from Van Nuys shops to solving local problems, including homelessness and crime.

Meanwhile, despite concerns from law enforcement, the state is finalizing a proposal to allow deliveries throughout California — including in cities that ban retail stores. The new rule by Lori Ajax, chief of the state Bureau of Cannabis Control, is expected to be implemented in January.

Ajax says she believes that as the system is refined and is shown to operate successfully in some cities, other local governments will allow retail pot sales. But opponents of pot legalization, including Kevin Sabet, president of Smart Approaches to Marijuana, are happy that most cities are saying “no” to selling the drug.

“The residents of Compton and these other cities have seen the ills that come with allowing marijuana in the door,” Sabet said, “including skyrocketing drugged driving; the promise, then failure of social justice; and the targeting of children through the use of colorful and deceptive candies, gummies and sodas.”

Even in cities that allow cannabis sales, businesses face big hurdles.

The various taxes and fees could drive up the cost of legal cannabis in parts of California by 45%, according to the global credit ratings firm Fitch Ratings.

There is less of a tax burden in Oregon, where voters legalized recreational pot in 2014, and state and local taxes are capped at 20%. With nearly a tenth of the population of California, that state has more licensed cannabis shops — 601. On a per capita basis, Alaska has also approved more pot shop licenses than California, — 94 so far. The state imposes a tax on cultivation, but there is no retail excise tax on pot.

Assemblyman Rob Bonta (D-Alameda) tried and failed this year to push for a temporary reduction in California’s pot taxes to help the industry get on its feet.

“It’s a work in progress,” Bonta said of the current regulatory system. “We knew we weren’t going to get it exactly right on Day 1, and so we’re always looking for ways to achieve the original intentions and goal.”

Bonta said he may revisit the taxation issue in 2019 and is exploring the idea of having the state do more to get cities to approve businesses, possibly by providing advisory guidelines for local legalization that address cities’ concerns.

California cannabis businesses, like their counterparts in Colorado and Oregon, also face costs to test marijuana for harmful chemicals.

“The testing costs are excessive — $500 to $1,000 per batch, and most crops involve multiple batches,” said Gieringer, the director of California NORML. “No other agricultural product is required to undergo such costly or sensitive tests.”

Another problem hampering the legal market is a lack of banking for cannabis businesses. Federally regulated banks are reluctant to handle cash from pot, which remains an illegal drug under federal law.

“Banking continues to be an issue in terms of creating a real public safety problem with significant amounts of cash being moved for transactions,” said Bonta, who co-wrote a bill this year that would have created a state-sanctioned bank to handle money from pot sellers. It failed to pass after legislative analysts said the proposal faced “significant obstacles,” including no protection from federal law enforcement.

Industry leaders and activists said they knew it would be a slow process to establish a strong legal market, noting other states with legal pot, including Colorado, Washington and Oregon, also faced growing pains and problems along the way.

But Ajax, the state pot czar, says her agency has had a productive first year, issuing initial licenses, refining the rules and stepping up action against unlicensed operations, including partnering with the Los Angeles Police Department to seize $2 million worth of marijuana products from an unlicensed shop in Sylmar in October.

“I am optimistic about the coming year, where our focus will be primarily on getting more businesses licensed and increasing enforcement efforts on the illegal market,” Ajax said.

By Kurtis Lee   Oct 15, 2018

Source:  http://www.latimes.com/politics/la-pol-ca-marijuana-year-anniversary-review-20181227-story.html

Abstract
Background—As an increasing number of states liberalize cannabis use and develop laws and local policies, it is essential to better understand the impacts of neighborhood ecology and marijuana dispensary density on marijuana use, abuse, and dependence. We investigated associations between marijuana abuse/dependence hospitalizations and community demographic and environmental conditions from 2001–2012 in California, as well as cross-sectional associations between local and adjacent marijuana dispensary densities and marijuana hospitalizations.

Source: Drug Alcohol Depend. 2015 September 1; 154: 111–116. doi:10.1016/j.drugalcdep.

 

Outbreak Alert Update: Potential Life-Threatening Vitamin K-Dependent Antagonist Coagulopathy Associated With Synthetic Cannabinoids Use

Summary

 

Since the index case was identified on March 8, 2018 in Illinois, at least 160 people have presented to Healthcare facilities with serious unexplained bleeding. The preponderant number of patient presentations were in Illinois with other cases being reported from Florida, Indiana, Kentucky, Maryland, Missouri, Pennsylvania, Virginia, and Wisconsin. Laboratory investigation confirms brodifacoum exposure in at least 60 patients. There are at least 3 fatalities. At least 7 synthetic cannabinoids product samples related to this outbreak have tested positive for brodifacoum. At least one synthetic cannabinoids product has tested positive for both synthetic cannabinoid AB-FUBINACA and brodifacoum.

 

Lessons Learned:

Patients with a history of synthetic cannabinoids (e.g., K2, Spice, and AK47) use may:

  • Present with complaints unrelated to bleeding (e.g., appendicitis) and have numerical coagulopathy.
  • Be asymptomatic and ignorant of their numerical coagulopathy.

The issue with vitamin K treatment is cost, not availability. The cost of oral vitamin K for two weeks treatment can be $8,000 and treatment may be for months. Options are being explored to address these issues.

What are the Clinical Signs of Coagulopathy?

 

Clinical signs of coagulopathy include bruising, nosebleeds, bleeding gums, bleeding disproportionate to injury, vomiting blood, coughing up blood, blood in urine or stool, excessively heavy menstrual bleeding, back or flank pain, altered mental status, feeling faint or fainting, loss of consciousness, and collapse.

 

 

What Do Health Care Providers Need To Do?

 

Healthcare providers should maintain a high index of suspicion for vitamin K-dependent antagonist coagulopathy in patients with a history of synthetic cannabinoids (e.g., K2, Spice, and AK47) use:

 

  • Presenting with clinical signs of coagulopathy, bleeding unrelated to an injury, or bleeding without another explanation; some patients may not divulge use of synthetic cannabinoids.
  • Presenting with complaints unrelated to bleeding (e.g., appendicitis).

 

Healthcare providers should be aware that patients with vitamin K-dependent antagonist coagulopathy associated with synthetic cannabinoids use may have friends or associates who have used the same synthetic cannabinoids product but are asymptomatic and ignorant of their numerical coagulopathy.

 

All patients should be asked about history of illicit drug use. All “high-risk” patients (e.g., synthetic cannabinoids users), regardless of their presentation, should be screened for vitamin K-dependent antagonist coagulopathy by checking their coagulation profile (e.g., international normalized ratio (INR) and prothrombin time (PT)).

 

  • Proceduralists (e.g., trauma/general/orthopedic/oral/OB-GYN/cosmetic surgeons, dentists, interventional cardiologists/radiologists, and nephrologists) should be aware that patients with a history of synthetic cannabinoids (e.g., K2, Spice, and AK47) use may be anti-coagulated without clinical signs of coagulopathy. These patients should be screened for vitamin K-dependent anti-coagulant coagulopathy prior to their procedure.

 

  • Contact your local Poison Information Center (1-800-222-1222) for questions on diagnostic testing and management of these patients.
  • Promptly report suspected cases to your local health department or your state health department, if your local health department is unavailable. In addition, report any similar cases encountered since 01 February 2018 to your local health department.

 

In an effort to better understand the scope of this outbreak, ask your Medical Examiners’ office to report suspected cases, especially those without an alternative diagnosis. If individuals are identified after death or at autopsy showing signs of suspicious bleeding as described above, coroners are encouraged to report the cases to their local health department.

 

For updated information about the Illinois outbreak—connect with the Illinois Department of Health http://www.dph.illinois.gov/topics-services/prevention-wellness/medical-cannabis/synthetic-cannabinoids

 

 

Source:  Coca @ CDC

 

 

 

 

 

 

There exists sufficient empirical data from cellular to epidemiological studies to warrant caution in the use cannabinoids including cannabidiol as recreational and therapeutic agents.

Cannabinoids bind to CB1R receptors on neuronal mitochondrial membranes where they can directly disrupt key functions including cellular energy generation, DNA maintenance and repair, memory and learning.

Empirical literature associates cannabinoid use with CB1R-mediated vasospastic and vasothrombotic strokes, myocardial infarcts and arrhythmias.  Cannabis has been associated with increased cardiovascular stiffness and vascular aging, a major surrogate for organismal aging.  In the pediatric-congenital context CB1R-mediated cannabis vasculopathy forms a major pathway to teratogenesis including VSD, ASD, endocardial cushion defects, several other cardiovascular anomalies  and, via the omphalo-vitelline arterial CB1R’s, gastroschisis.  Cannabis has been linked with several other malformations including hydrocephaly.  Cannabinoids also induce epigenetic perturbations; and, like thalidomide, interfere with tubulin polymerization and the stability of the mitotic spindle providing further major pathways to genotoxicity.

Assuming validity of the above data, increased levels of both adult and neonatal morbidity should accompany increased cannabis use. The “Colorado Responds to Children with Special Needs” program tracked congenital anomalies 2000-2013.  Importantly this data monitors the teratological history of Colorado since 2001 when the state was first advised that intrastate cannabis would not be prosecuted by the Federal Government.

Over the period 2000-2013 Colorado almost doubled its already high congenital anomaly rate rising from 4,830 anomalies / 65,429 births (7.4%) to 8,165 / 65,004 (12.6%); the US mean is 3.1%.  Major cardiovascular defects rose 61% (number and rate); microcephaly rose 96% (from 30 to 60 cases peaking at 72 in 2009); and chromosomal anomalies rose 28% (from 175 to 225, peaking at 264 in 2010).  Over the whole period this totals to 87,772 major congenital anomalies from 949,317 live births (9.25%).

The use of cannabis in Colorado can be determined from the SAMHSA National Survey on Drug Use and Health.  A close correlation is noted between major congenital anomaly rates and rates of cannabis use in Coloradans >12 years (R=0.8825; P=0.000029; Figure 1).  Although data is not strictly comparable across U.S. registries, the Colorado registry is a passive rather than active case-finding registry and so might be expected to underestimate anomaly rates.  Given the Colorado birth rate remained almost constant over the period 2000-2013, rising only 3.6%, a simple way to quantitate historical trends is to simply project forwards the historical anomaly rate and compare it to the rise in birth numbers.  However rather than remaining relatively stable in line with population births, selected defects have risen several times more than the birth rate.

Colorado had an average of 67,808 births over the period 2000-2013 and experienced a total of 87,772 birth defects, 20,152 more than would have been predicted using 2000 rates.  Given the association between cannabis use and birth defects and the plausible biological mechanisms, cannabis may be a major factor contributing to birth congenital morbidity in Colorado. If we accept this and apply the “Colorado effect” to the over 3,945,875 births in USA in 2016 we calculate an excess of 83,762 major congenital anomalies annually nationwide if cannabis use rises in the US to the level that it was in Colorado in 2013.

In reality both cannabis use and cannabis concentration is rising across USA following legalization which further implies that the above calculations represent significant underestimations.  This data series terminates in 2013 prior to full legalization in 2014.  Moreover parents of children harbouring severe anomalies may frequently elect for termination, which will again underestimate numbers of abnormal live births.

In California 7% of all pregnant mothers were recently shown to test positive for cannabis exposure, including almost 25% of teenage mothers in 2015  so cannabinoids clearly constitute a significant population-wide teratological exposure.  This is particularly relevant to cannabis genotoxicity as many studies show a dramatic up-tick in genotoxic effect in the dose-response curve for both tetrahydrocannabinol and cannabidiol above a certain threshold dose as higher, sedating levels are reached.  Cannabis is usually used amongst humans for its sedative effects.

Other examples of high congenital anomaly rates accompanying increased cannabis use include North Carolina, Mexico, Northern Canada, New Zealand and the Nimbin area in Australia.

The above data leave open the distinct possibility that the rate of congenital anomalies from significant prenatal paternal or maternal cannabis exposure may become substantial.

With over 1,000 trials listed on clincaltrials.gov the chance of a type I experimental error for cannabinoid therapeutics and a falsely positive trial finding is at least 25/1,000 trials at the 5% level.

The major anomaly rate is just the “tip of the iceberg” of the often subtle neurobehavioral teratology of Foetal Cannabinoid Syndrome (FCS) following antenatal cannabinoid exposure characterized by attention, learning, behavioral and social deficits which in the longer term impose significant educational, other addiction and welfare costs – and is clearly more common .  Foetal Alcohol Syndrome (FAS) is known to be epigenetically mediated and foetal alcohol is known to act via CB1R’s.  Cannabis has significant and heritable epigenetic imprints in neural, immune and germ cell (sperm) tissues, and epigenomic disruption has been implicated in FCS.  CB1R-mediated disruption by disinhibition of the normal gamma and theta oscillatory rhythms of the forebrain which underpin thinking, learning and sanity have been implicated both in adult psychiatric disease and the neurodevelopmental aspects of FCS.

All of this implies that in addition to usually short-term therapy-oriented clinical trials, longer term studies and careful twenty-first century next generation studies will be required to carefully review inter-related genotoxic, teratologic, epigenetic, transcriptomic, metabolomic, epitranscriptomic and long term cardiovascular outcomes which appears to have been largely overlooked in extant studies – effects which would appear rather to have taken Coloradans by surprise.  Congenital registry data also needs to be open and transparent which it presently is not.  We note that cannabidiol is now solidly implicated in genotoxicity.  Governments are duty-bound to carefully weigh and balance the implications of their social policies; lest like Colorado, we too unwittingly create a “Children with Special Needs Program”.

Source :

Albert Stuart Reece

39 Gladstone Rd.,                                                                                               

Highgate Hill,

Brisbane, Queensland, Australia.   

Human sperm stained for semen quality testing in the clinical laboratory.
Credit: Bobjgalindo/Wikipedia

 

As legal access to marijuana continues expanding across the U.S., more scientists are studying the effects of its active ingredient, tetrahydrocannabinol (THC), in teens, adults and pregnant women.

New research from Duke Health suggests men in their child-bearing years should also consider how THC could impact their  and possibly the children they conceive during periods when they’ve been using the drug.

Much like previous research that has shown , pesticides, flame retardants and even obesity can alter sperm, the Duke research shows THC also affects epigenetics, triggering structural and regulatory changes in the DNA of users’ sperm.

Experiments in rats and a study with 24 men found that THC appears to target genes in two major cellular pathways and alters DNA methylation, a process essential to normal development.

The researchers do not yet know whether DNA changes triggered by THC are passed to users’ children and what effects that could have. Their findings will be published online Dec. 19 in the journal Epigenetics.

“What we have found is that the effects of cannabis use on males and their  are not completely null, in that there’s something about cannabis use that affects the genetic profile in sperm,” said Scott Kollins, Ph.D., professor in psychiatry and  at Duke and senior author of the study.

“We don’t yet know what that means, but the fact that more and more young males of child-bearing age have legal access to cannabis is something we should be thinking about,” Kollins said.

National research has shown a steady decline in the perceived risk of regular marijuana use. This, combined with the demand and wide availability of marijuana bred specifically to yield higher THC content, make this research especially timely, Kollins said.

The study defined regular users as those who smoked marijuana at least weekly for the previous six months. Their sperm were compared to those who had not used marijuana in the past six months and not more than 10 times in their lifetimes.

The higher the concentration of THC in the men’s urine, the more pronounced the genetic changes to their sperm were, the authors found.

THC appeared to impact hundreds of different genes in rats and humans, but many of the genes did have something in common—they were associated with two of the same major cellular pathways, said lead author Susan K. Murphy, Ph.D., associate professor and chief of the Division of Reproductive Sciences in obstetrics and gynecology at Duke.

One of the pathways is involved in helping bodily organs reach their full size; the other involves a large number of genes that regulate growth during development. Both pathways can become dysregulated in some cancers.

“In terms of what it means for the developing child, we just don’t know,” Murphy said. It’s unknown whether sperm affected by THC could be healthy enough to even fertilize an egg and continue its development into an embryo, she said.

The study was a starting point on the epigenetic effects of THC on sperm and is limited by the relatively small number of men involved in the trial, Murphy said. The findings in men also could be confounded by other factors affecting their health, such as their nutrition, sleep, alcohol use and other lifestyle habits.

The Duke team plans to continue its research with larger groups. They intend to study whether changes in sperm are reversed when men stop using marijuana. They also hope to test the umbilical cord blood of babies born to fathers with THC-altered sperm to determine what, if any epigenetic changes, are carried forward to the child.

“We know that there are effects of cannabis use on the regulatory mechanisms in sperm DNA, but we don’t know whether they can be transmitted to the next generation,” Murphy said.

“In the absence of a larger, definitive study, the best advice would be to assume these changes are going to be there,” Murphy said. “We don’t know whether they are going to be permanent. I would say, as a precaution, stop using cannabis for at least six months before trying to conceive.”

 

Source: https://medicalxpress.com/news/2018-12-exposure-cannabis-genetic-profile-sperm.html

DECEMBER 19, 2018

 

The deaths of two men have been linked to a bad batch of drugs, with police warning people not to take it.

 

Officers believe the two deaths and the serious illness of a third man could be linked to a bad batch of ‘monkey dust’ being sold in the Telford area.

It is not known whether any of the men had taken monkey dust, but police are concerned that their deaths and illness are connected to the drug.

The third man remains in a serious condition in hospital, West Mercia Police said, as they confirmed that the three incidents all happened separately.

Officers have now urged anyone who falls ill after taking the drug to seek medical help immediately.

Detective Inspector Lee Holehouse, from Telford CID, said: “Our inquiries are very much in the initial stages and it may be that these deaths are not connected but we want people to be aware there may be a bad batch of monkey dust circulating.

“If anyone has taken the drug and falls ill then they should seek medical attention immediately.

“The dangers of taking drugs are well known and all drugs pose a risk to those who take them but I would like to reiterate this additional danger.”

One of the men found dead was in his late 30s and was found in a house in Madeley, the other was a man in his late 40s and found at a house in Merseyside. The man in hospital is in his 30s.

Symptoms include intoxication, blood shot eyes, hallucinations, suicidal thoughts, violence, slurred speech and smelling like prawns or vinegar.

What is monkey dust?

Monkey dust is another name for MDPV, or methylenedioxypyrovalerone.

It is an addictive Class B drug usually sold in powder form or swallowed.

Its appearance is similar to cocaine – a white or brownish powder – although it is far cheaper.  Also known as dust or bath salts, the drug’s effects are similar to ecstasy or mephedrone and last for up to five or six hours.

It is a stimulant which can cause feelings of euphoria and increased alertness but also lead to heart damage, depression and paranoia.

According to drugs information website Why Not Find Out, monkey dust can make people who take it smell of urine and it can also lead to skin rashes, insomnia, vomiting and headaches.

Source:  https://www.expressandstar.com/news/health/2018/07/20/monkey-dust-warning-as-deaths-linked-to-bad-batch-of-drug/   July 20th 2018

Filed under: Drug Specifics :

Sir, Your leading article on cannabis harms (Dangerous Skunk Jan 8th) is timely, as more countries drift casually towards legalisation.  I hope the UK will not be so careless.  As appalling as the cannabis mental health data is, it is but a very small part of its public health risks, which now obviously include damage to both the genes and the complex system that regulates and controls genes. Cannabis genotoxicity is expressed clinically as elevated rates of many cancers (testicular, breast, pancreas, thyroid and liver cancers), dozens of birth defects (thalidomide-like affecting the cardiovascular, nervous, chromosomal, digestive and kidney systems) and accelerated ageing of human cells and organisms. All of this accelerates exponentially at the higher doses which inevitably accompany cannabis legalisation. Our findings have been confirmed in Colorado, Canada, Australia, Hawaii, and The US and most recently in Europe and can be found via Google Scholar. There is much more to come.

Professor Stuart Reece

University of Western Australia


A response by David Raynes to the above letter from Professor Reece

Sent: 10 January 2022
To: letters@thetimes.co.uk
Subject: Dangers of formal Cannabis decriminalisation

Sir

We have been here before.  Police Commander Brian Paddick (now  LibDem Lord Paddick) led the discredited “Lambeth Experiment” a few years ago, announcing no action against Cannabis.

It was a similar formal and public relaxation of Policing which was much opposed by those who understood the dangers.

After that, in 2012 there was an Institute of Fiscal Studies  review, (Kelly& Rasul 2012),  of drug related hospitalizations (ER Room visits), not just for Cannabis, in Lambeth and adjoining areas.

They summarised their findings thus:

“We find the depenalization of cannabis had significant longer term impacts on hospital admissions related to the use of hard drugs. Among Lambeth residents, the impacts are concentrated among men, and are proportionately larger in younger cohorts, and among those with prior histories of hospitalization related to drug or alcohol use. The magnitudes of the impacts are large, corresponding to between 33% and 64% of baseline admission rates across age cohorts. The dynamic impacts across cohorts vary in profile with some cohorts experiencing hospitalization rates remaining above pre-intervention levels six years after the depenalization of cannabis was first introduced. We find evidence of positive spill over effects in hospitalization rates related to hard drugs among those resident in boroughs neighbouring Lambeth, and these are concentrated among cohorts without prior histories of hospitalizations related to the use of illicit drugs or alcohol. Finally, the severity of hospital admissions, as measured by the length of hospital stays, significantly increases for admissions related to the use of hard drugs and cannabis. Overall, our results suggest policing strategies related to the cannabis market have significant, nuanced and lasting impacts on public health”.

This finding was based on hard incontrovertible data.

National or local politicians should surely take note?

 

David Raynes, Executive Councillor

National Drug Prevention Alliance

 

 

As recreational marijuana dispensaries prepare to open in Massachusetts, you may be wondering whether it’s safe to indulge. Is pot good or bad for your health?

As recreational marijuana dispensaries prepare to open in Massachusetts, you may be wondering whether it’s safe to indulge. Is pot good or bad for your health?

You’ll find no shortage of anecdotes and opinions in answer to that question.

But if you want the verdict of hard science, you’re pretty much out of luck.

Although marijuana has been studied in many ways over many years, the studies vary in quality and often reach conflicting conclusions, according to experts on the issue.

Forget yesterday’s news. Get what you need today in this early-morning email.

“We’re in a situation where policy is running ahead of the science,” said Neal Shifman, chief executive of Advocates for Human Potential, a consulting group that organizes national conferences to discuss cannabis policy and science. “There’s a hunger in the marketplace for real information.”

The federal Drug Enforcement Administration classifies marijuana as among the most dangerous drugs, making it very difficult for researchers to obtain the plant for study. Nearly all the research to date involves either purified ingredients from the cannabis plant or smoked marijuana.

But marijuana has dramatically increased in potency in recent years. And today, people can rub marijuana oils on the skin, inhale highly concentrated cannabis vapors, or munch on pot-infused candies and cookies. The effects of the drug consumed in these ways have not been studied.

Amid the uncertainty, discussions tend toward pro-or-con polarization, said Dr. Kevin P. Hill, director of addiction psychiatry at Beth Israel Deaconess Medical Center.

“There are still many, many people who spend a lot of energy trying to make cannabis a simple topic — ‘the greatest medication ever’ or ‘if you use it you’re doomed,’ ” Hill said. “Neither of those is true.”

So what is true?

“If you use cannabis today, we’re pretty sure about what it can do to you,” Hill said, ticking off impairment of judgment, learning, memory, attention, and physical performance, and raising your heart rate. These reactions wear off within a day or so, he said.

But when it comes to long-term effects, the answers get murky.

A couple of years ago, the National Academies of Sciences, Engineering, and Medicine reviewed 10,000 studies of marijuana’s health effects. The result: Conclusive or substantial evidence could be found for only a handful of findings, meaning that several good studies support the finding and few refute it.

These are the beneficial effects that the National Academies concluded are supported by strong evidence:

■ Cannabis helps relieve chronic pain.

■ A cannabis ingredient (cannabidiol) taken orally reduces vomiting from chemotherapy and eases painful muscle spasms in people with multiple sclerosis.

The academies also found strong evidence that these negative effects occur more frequently among people who use marijuana:

■ the development of schizophrenia or other psychoses in adolescents;

■ an increased risk of motor vehicle crashes;

■ lower birth weight when the mother smokes during pregnancy;

■ worse respiratory symptoms and more frequent bronchitis in long-term users.

Many experts also agree that adolescents and adults younger than 25 should avoid marijuana because it can alter their developing brains.

One other effect is known for sure about marijuana, added Susan Weiss, director of the Division of Extramural Research at the National Institute on Drug Abuse: It can be addictive. About 9 percent of regular users develop cannabis use disorder; that goes up to 17 percent among people who start when they’re young.

Research limitations

Marijuana contains hundreds of chemical compounds, the most powerful of which are delta-9-tetrahydrocannabinol, or THC, and cannabidiol, or CBD.

THC produces the psychoactive effects — the marijuana high. CBD has a role in pain control and also moderates the effect of THC. But many strains of marijuana in use today have high concentrations of THC and little CBD to balance it. The long-term effects of this shift are unknown.

Last month, the Food and Drug Administration approved a purified form of CBD as a treatment for two rare forms of severe epilepsy in children, the first time it approved a marijuana ingredient as a therapeutic drug.

(Two synthetic forms of THC, dronabinol and nabilone, are approved for treating nausea and vomiting from chemotherapy.)

Because of the federal restrictions, researchers’ only legal source for study is a Mississippi farm. But the marijuana plants there are not necessarily identical to those that people get at the dispensary or on the street.

Research typically consists of comparing marijuana users with those who abstain. But the most that such studies can show is a correlation with certain outcomes, not a causal connection.

For example, some studies indicate that people who started heavy cannabis use as teens have lower educational and employment achievement and lower income than those who avoided the drug.

That doesn’t necessarily mean that marijuana directly causes those impairments, though it might have a role. The lower performance might also result from other factors in the lives of people who happen to smoke marijuana — and the marijuana smoking may even be a result of those factors rather than their cause.

The better-designed studies control for confounding factors, such as excluding people who use other drugs or have mental health issues. But even those studies still only show elevated risk — not destiny for everyone who smokes pot.

With such obstacles and ambiguities, the research yields a host of suggestive findings and unanswered questions. Among them:

Brain development

Staci Gruber, director of McLean Hospital’s Marijuana Investigations for Neuroscientific Discovery project, said her work and that of others suggests that heavy marijuana use starting before age 16 may result in difficulty with abstract reasoning, impulsivity, and problem-solving. Imaging tests show the brain structure changes, resulting in “a different pattern of cognitive performance,” she said.

But it appears these effects can be mitigated by stopping or reducing consumption, and the same effects are not seen in people who start later in life or who consume moderate amounts.

And not every pot-smoking teenager is severely damaged. “Most of these kids are doing just fine,” Gruber added.

In older patients who use marijuana for medical reasons, Gruber has observed the opposite — an improvement in cognitive functioning within three months of starting cannabis use. Perhaps people’s minds clear up when freed of pain or anxiety, or when they stop taking opioids or tranquilizers. But cannabis might also directly improve mental functioning in older people.

Pregnancy

Studies show a clear link between smoking marijuana while pregnant and lower birth weight. Otherwise, the National Academies deemed it “unclear” whether smoking marijuana affects the pregnancy or the child after birth.

But Weiss, of the National Institute on Drug Abuse, is worried about indications that children whose mothers used cannabis while pregnant have alterations in brain structure and exhibit behavioral problems as they enter school.

Mental health

Substantial evidence shows that smoking marijuana as a teen increases the risk of psychosis, particularly for those with a family history of schizophrenia or other psychotic illnesses. Otherwise, the studies are inconclusive to the point of being confusing.

People with psychotic disorders who use cannabis seem to do better on learning and memory tasks. But they also may hallucinate more.

Many people with anxiety or mood disorders use cannabis, but any relationship is murky. People may smoke marijuana to treat the symptoms of a mental disorder, or other factors may lead to both marijuana use and mental illness.

Still, some evidence suggests that regular cannabis use might increase the risk for developing an anxiety disorder, and it might also worsen the symptoms of bipolar disorder and increase thoughts of suicide.

The lungs

Regular smoking is associated with chronic cough and phlegm production. Quitting seems to resolve those problems. The National Academies couldn’t find clear evidence on its effect on other lung diseases.

But Suzaynn Schick, who studies the chemistry and toxicity of smoke at the University of California San Francisco, believes the same health effects seen with tobacco, including the hazards of secondhand smoke, will eventually come to light.

“It doesn’t matter whether you’re burning tobacco, wood, diesel, or marijuana. When you burn things, you create toxins,” she said. “Cannabis can be a medicine, but smoking it is a really stupid way to get your medicine.”

Source:  https://www.bostonglobe.com/opinion/2018/07/24/the-dangers-pot July 2018

 

Abstract

Cannabidiol (CBD) and cannabidivarin (CBDV) are natural cannabinoids which are consumed in increasing amounts worldwide in cannabis extracts, as they prevent epilepsy, anxiety, and seizures. It was claimed that they may be useful in cancer therapy and have anti-inflammatory properties. Adverse long-term effects of these drugs (induction of cancer and infertility) which are related to damage of the genetic material have not been investigated. Therefore, we studied their DNA-damaging properties in human-derived cell lines under conditions which reflect the exposure of consumers. Both compounds induced DNA damage in single cell gel electrophoresis (SCGE) experiments in a human liver cell line (HepG2) and in buccal-derived cells (TR146) at low levels (≥ 0.2 µM). Results of micronucleus (MN) cytome assays showed that the damage leads to formation of MNi which reflect chromosomal aberrations and leads to nuclear buds and bridges which are a consequence of gene amplifications and dicentric chromosomes. Additional experiments indicate that these effects are caused by oxidative base damage and that liver enzymes (S9) increase the genotoxic activity of both compounds. Our findings show that low concentrations of CBD and CBDV cause damage of the genetic material in human-derived cells. Furthermore, earlier studies showed that they cause chromosomal aberrations and MN in bone marrow of mice. Fixation of damage of the DNA in the form of chromosomal damage is generally considered to be essential in the multistep process of malignancy, therefore the currently available data are indicative for potential carcinogenic properties of the cannabinoids.

Filed under: Drug Specifics,Health :

The legalization of recreational marijuana is associated with an increase in its abuse, injury due to overdoses and car accidents, according to a study of 28million hospital records by University of California San Francisco.

 

The legalization of recreational marijuana is associated with an increase in its abuse, injury due to overdoses, and car accidents, but does not significantly change health care use overall, according to a study by researchers at UC San Francisco.

In a review of more than 28 million hospital records from the two years before and after cannabis was legalized in Colorado, UCSF researchers found that Colorado hospital admissions for cannabis abuse increased after legalization, in comparison to other states. But taking the totality of all hospital admissions and time spent in hospitals into account, there was not an appreciable increase after recreational cannabis was legalized.

The study, appearing online May 15, 2019, in BMJ Open, also found fewer diagnoses of chronic pain after legalization, consistent with a 2017 National Academy of Sciences report that concluded substantial evidence exists that cannabis can reduce chronic pain.

“We need to think carefully about the potential health effects of substantially enhancing the accessibility of cannabis, as has been done now in the majority of states,” said senior author Gregory Marcus, MD, MAS, a UCSF Health cardiologist and associate chief of cardiology for research in the UCSF Division of Cardiology.

“This unique transition to legalization provides an extraordinary opportunity to investigate hospitalizations among millions of individuals in the presence of enhanced access,” Marcus continued. “Our findings demonstrate several potential harmful effects that are relevant for physicians and policymakers, as well as for individuals considering cannabis use.”

According to the 2014 National Survey on Drug Use and Health, more than 117 million Americans, or 44.2 percent of all Americans, have used cannabis in their lifetime, and more than 22 million Americans report having used it within the past 30 days. While its use is a federal crime as a controlled substance, 28 states and the District of Columbia now allow it for treating medical conditions. Nine of those states have legalized it for recreational use.

To understand the potential shifts in health care use resulting from widespread policy changes, Marcus and his colleagues reviewed the records of more than 28 million individuals in Colorado, New York and Oklahoma from the 2010-2014 Healthcare Cost and Utilization Project, which included 16 million hospitalizations. They compared the rates of health care utilization and diagnoses in Colorado two years before and two years after recreational marijuana was legalized in December 2012 to New York, as a geographically distant and urban state, and to Oklahoma, as a geographically close and mainly rural state.

The researchers found that after legalization, Colorado experienced a 10 percent increase in motor vehicle accidents, as well as a 5 percent increase in alcohol abuse and overdoses that resulted in injury or death. At the same time, the state saw a 5 percent decrease in hospital admissions for chronic pain, Marcus said.

“There has been a dearth of rigorous research regarding the actual health effects of cannabis consumption, particularly on the level of public health,” said Marcus, holder of the Endowed Professorship of Atrial Fibrillation Research in the UCSF School of Medicine. “These data demonstrate the need to caution strongly against driving while under the influence of any mind-altering substance, such as cannabis, and may suggest that efforts to combat addiction and abuse of other recreational drugs become even more important once cannabis has been legalized.”

The study findings may be beneficial in guiding future decisions regarding cannabis policy, the researchers said.

“While it’s convenient and often most compelling to simplistically conclude a particular public policy is ‘good’ or ‘bad,’ an honest assessment of actual effects is much more complex,” Marcus said. “Those effects are very likely variable, depending on each individual’s idiosyncratic needs, propensities and circumstances. Using the revenues from recreational cannabis to support this sort of research likely would be a wise investment, both financially and for overall public health.”

The researchers could not explain why overall health care utilization remained essentially neutral, but said the harmful effects simply may have been diluted among the much larger number of total hospitalizations. They said it also may be that some beneficial effects, either at the individual or societal level, such as violent crime, counterbalanced the negatives.

Source:  https://www.eurekalert.org/pub_releases/2019-05/uoc–lmr051319.php

Here’s what we know

As recreational marijuana dispensaries prepare to open in Massachusetts, you may be wondering whether it’s safe to indulge. Is pot good or bad for your health?

As recreational marijuana dispensaries prepare to open in Massachusetts, you may be wondering whether it’s safe to indulge. Is pot good or bad for your health?

You’ll find no shortage of anecdotes and opinions in answer to that question.

But if you want the verdict of hard science, you’re pretty much out of luck.

Although marijuana has been studied in many ways over many years, the studies vary in quality and often reach conflicting conclusions, according to experts on the issue.

Forget yesterday’s news. Get what you need today in this early-morning email.

“We’re in a situation where policy is running ahead of the science,” said Neal Shifman, chief executive of Advocates for Human Potential, a consulting group that organizes national conferences to discuss cannabis policy and science. “There’s a hunger in the marketplace for real information.”

The federal Drug Enforcement Administration classifies marijuana as among the most dangerous drugs, making it very difficult for researchers to obtain the plant for study. Nearly all the research to date involves either purified ingredients from the cannabis plant or smoked marijuana.

But marijuana has dramatically increased in potency in recent years. And today, people can rub marijuana oils on the skin, inhale highly concentrated cannabis vapors, or munch on pot-infused candies and cookies. The effects of the drug consumed in these ways have not been studied.

Amid the uncertainty, discussions tend toward pro-or-con polarization, said Dr. Kevin P. Hill, director of addiction psychiatry at Beth Israel Deaconess Medical Center.

“There are still many, many people who spend a lot of energy trying to make cannabis a simple topic — ‘the greatest medication ever’ or ‘if you use it you’re doomed,’ ” Hill said. “Neither of those is true.”

So what is true?

“If you use cannabis today, we’re pretty sure about what it can do to you,” Hill said, ticking off impairment of judgment, learning, memory, attention, and physical performance, and raising your heart rate. These reactions wear off within a day or so, he said.

But when it comes to long-term effects, the answers get murky.

A couple of years ago, the National Academies of Sciences, Engineering, and Medicine reviewed 10,000 studies of marijuana’s health effects. The result: Conclusive or substantial evidence could be found for only a handful of findings, meaning that several good studies support the finding and few refute it.

These are the beneficial effects that the National Academies concluded are supported by strong evidence:

■ Cannabis helps relieve chronic pain.

■ A cannabis ingredient (cannabidiol) taken orally reduces vomiting from chemotherapy and eases painful muscle spasms in people with multiple sclerosis.

The academies also found strong evidence that these negative effects occur more frequently among people who use marijuana:

■ the development of schizophrenia or other psychoses in adolescents;

■ an increased risk of motor vehicle crashes;

■ lower birth weight when the mother smokes during pregnancy;

■ worse respiratory symptoms and more frequent bronchitis in long-term users.

Many experts also agree that adolescents and adults younger than 25 should avoid marijuana because it can alter their developing brains.

One other effect is known for sure about marijuana, added Susan Weiss, director of the Division of Extramural Research at the National Institute on Drug Abuse: It can be addictive. About 9 percent of regular users develop cannabis use disorder; that goes up to 17 percent among people who start when they’re young.

Research limitations

Marijuana contains hundreds of chemical compounds, the most powerful of which are delta-9-tetrahydrocannabinol, or THC, and cannabidiol, or CBD.

THC produces the psychoactive effects — the marijuana high. CBD has a role in pain control and also moderates the effect of THC. But many strains of marijuana in use today have high concentrations of THC and little CBD to balance it. The long-term effects of this shift are unknown.

Last month, the Food and Drug Administration approved a purified form of CBD as a treatment for two rare forms of severe epilepsy in children, the first time it approved a marijuana ingredient as a therapeutic drug.

(Two synthetic forms of THC, dronabinol and nabilone, are approved for treating nausea and vomiting from chemotherapy.)

Because of the federal restrictions, researchers’ only legal source for study is a Mississippi farm. But the marijuana plants there are not necessarily identical to those that people get at the dispensary or on the street.

Research typically consists of comparing marijuana users with those who abstain. But the most that such studies can show is a correlation with certain outcomes, not a causal connection.

For example, some studies indicate that people who started heavy cannabis use as teens have lower educational and employment achievement and lower income than those who avoided the drug.

That doesn’t necessarily mean that marijuana directly causes those impairments, though it might have a role. The lower performance might also result from other factors in the lives of people who happen to smoke marijuana — and the marijuana smoking may even be a result of those factors rather than their cause.

The better-designed studies control for confounding factors, such as excluding people who use other drugs or have mental health issues. But even those studies still only show elevated risk — not destiny for everyone who smokes pot.

With such obstacles and ambiguities, the research yields a host of suggestive findings and unanswered questions. Among them:

Brain development

Staci Gruber, director of McLean Hospital’s Marijuana Investigations for Neuroscientific Discovery project, said her work and that of others suggests that heavy marijuana use starting before age 16 may result in difficulty with abstract reasoning, impulsivity, and problem-solving. Imaging tests show the brain structure changes, resulting in “a different pattern of cognitive performance,” she said.

But it appears these effects can be mitigated by stopping or reducing consumption, and the same effects are not seen in people who start later in life or who consume moderate amounts.

And not every pot-smoking teenager is severely damaged. “Most of these kids are doing just fine,” Gruber added.

In older patients who use marijuana for medical reasons, Gruber has observed the opposite — an improvement in cognitive functioning within three months of starting cannabis use. Perhaps people’s minds clear up when freed of pain or anxiety, or when they stop taking opioids or tranquilizers. But cannabis might also directly improve mental functioning in older people.

Pregnancy

Studies show a clear link between smoking marijuana while pregnant and lower birth weight. Otherwise, the National Academies deemed it “unclear” whether smoking marijuana affects the pregnancy or the child after birth.

But Weiss, of the National Institute on Drug Abuse, is worried about indications that children whose mothers used cannabis while pregnant have alterations in brain structure and exhibit behavioral problems as they enter school.

Mental health

Substantial evidence shows that smoking marijuana as a teen increases the risk of psychosis, particularly for those with a family history of schizophrenia or other psychotic illnesses. Otherwise, the studies are inconclusive to the point of being confusing.

People with psychotic disorders who use cannabis seem to do better on learning and memory tasks. But they also may hallucinate more.

Many people with anxiety or mood disorders use cannabis, but any relationship is murky. People may smoke marijuana to treat the symptoms of a mental disorder, or other factors may lead to both marijuana use and mental illness.

Still, some evidence suggests that regular cannabis use might increase the risk for developing an anxiety disorder, and it might also worsen the symptoms of bipolar disorder and increase thoughts of suicide.

The lungs

Regular smoking is associated with chronic cough and phlegm production. Quitting seems to resolve those problems. The National Academies couldn’t find clear evidence on its effect on other lung diseases.

But Suzaynn Schick, who studies the chemistry and toxicity of smoke at the University of California San Francisco, believes the same health effects seen with tobacco, including the hazards of secondhand smoke, will eventually come to light.

“It doesn’t matter whether you’re burning tobacco, wood, diesel, or marijuana. When you burn things, you create toxins,” she said. “Cannabis can be a medicine, but smoking it is a really stupid way to get your medicine.”

Source:  https://www.bostonglobe.com/opinion/2018/07/24/the-dangers-pot July 2018

 

Filed under: Drug Specifics :

 

Fentanyl overdoses share many characteristics with heroin overdoses – with some important differences, according to an addiction specialist at Boston Medical Center’s Grayken Center for Addiction.

“Fentanyl is faster acting and more potent than heroin, so overdoses evolve in seconds to minutes, instead of minutes to hours, as we see with heroin overdoses,” says Alexander Walley, M.D., Director of the Boston University Addiction Medicine Fellowship Program and the Inpatient Addiction Medicine Consult Service at Boston Medical Center. “The window during which a bystander can respond shrinks substantially with fentanyl,” said Dr. Walley, who spoke about fentanyl overdoses at the recent annual meeting of the College on Problems of Drug Dependence. He noted that people may not know they are using fentanyl. In addition to being mixed into heroin, fentanyl can be sold as cocaine or counterfeit prescription opioids.

Dr. Walley was the principal investigator of a study published last year by the Centers for Disease Control and Prevention that included interviews with 64 people who survived or witnessed an opioid overdose, as well as a review of medical examiner records of 196 people who died of an opioid overdose.

He found 75 percent of people who witnessed a suspected fentanyl overdose described symptoms as occurring within seconds to minutes. Among people who witnessed the opioid overdose antidote naloxone being administered, 83 percent said that two or more naloxone doses were used before the person responded.

When Dr. Walley and colleagues analyzed death records for people who died of an opioid overdose, they found 76 percent tested positive for fentanyl in March 2015 – up from 44 percent in October 2014. They found 36 percent of fentanyl deaths had evidence of an overdose occurring within seconds to minutes after drug use, and 90 percent of people who died from a fentanyl overdose had no pulse by the time emergency medical services arrived.

Only 6 percent of fentanyl overdose deaths had evidence of lay bystander-administered naloxone. “Although bystanders were frequently present in the general location of overdose death, timely bystander naloxone administration did not occur because bystanders did not have naloxone, were spatially separated or impaired by substance use, or failed to recognize overdose symptoms,” the researchers concluded. “Findings indicate that persons using fentanyl have an increased chance of surviving an overdose if directly observed by someone trained and equipped with sufficient doses of naloxone.”

Dealing With the Fentanyl Crisis

The approach to fentanyl overdoses should be similar to heroin overdoses – except that time is especially of the essence, Dr. Walley noted. “The best way to reduce overdose risk is to not use opioids in the first place,” he said. “But if a person is using opioids, he or she should make sure someone else is observing and is prepared to use naloxone quickly.”

He stressed that for people who use fentanyl or heroin and stop because of treatment or incarceration, and then start taking the drug again upon release, the risk of an overdose is especially high because their tolerance for the drug has decreased.

Early treatment for addiction is especially important in the age of fentanyl, Dr. Walley said. “We need to make a better effort to reach people sooner,” he said. “Fentanyl is so deadly we can’t afford to wait.”

As with other types of opioid use disorders, the recommended treatment for fentanyl addiction is medication – methadone, buprenorphine (Suboxone) or naltrexone (Vivitrol).

“We need to figure out ways to make effective treatments work for patients, rather than make the patients work for the treatment,” Dr. Walley said. “That means making treatment more convenient and patient-centered. We also need to start treatment in in-patient detox programs. We know these people are more vulnerable to overdose when they are discharged, so we should start treatment before then. We also need to engage people who seek help in the emergency room in overdose prevention, harm reduction and treatment.”

 

Source:  https://drugfree.org/drug-and-alcohol-news/featured-news-rapid-response-fentanyl-overdose-critical/?utm_source=pns&utm_medium=email&utm_campaign=featured-news-rapid-response-fentanyl-overdose-critical

America’s opioid crisis was caused by rapacious pharma companies, politicians who colluded with them and regulators who approved one opioid pill after another.

Of all the people Donald Trump could blame for the opioid epidemic, he chose the victims. After his own commission on the opioid crisis issued an interim report this week, Trump said young people should be told drugs are “No good, really bad for you in every way.”

The president’s exhortation to follow Nancy Reagan’s miserably inadequate advice and Just Say No to drugs is far from useful. The then first lady made not a jot of difference to the crack epidemic in the 1980s. But Trump’s characterisation of the source of the opioid crisis was more disturbing. “The best way to prevent drug addiction and overdose is to prevent people from abusing drugs in the first place,” he said.

That is straight out of the opioid manufacturers’ playbook. Facing a raft of lawsuits and a threat to their profits, pharmaceutical companies are pushing the line that the epidemic stems not from the wholesale prescribing of powerful painkillers – essentially heroin in pill form – but their misuse by some of those who then become addicted.

In court filings, drug companies are smearing the estimated two million people hooked on their products as criminals to blame for their own addiction. Some of those in its grip break the law by buying drugs on the black market or switch to heroin. But too often that addiction began by following the advice of a doctor who, in turn, was following the drug manufacturers instructions.

Trump made no mention of this or reining in the mass prescribing underpinning the epidemic. Instead he played to the abuse narrative when he painted the crisis as a law and order issue, and criticised Barack Obama for scaling back drug prosecutions and lowering sentences.

But as the president’s own commission noted, this is not an epidemic caused by those caught in its grasp. “We have an enormous problem that is often not beginning on street corners; it is starting in doctor’s offices and hospitals in every state in our nation,” it said.

heroin
 ‘This is an almost uniquely American crisis.’ Photograph: Spencer Platt/Getty Images

Opioids killed more than 33,000 Americans in 2015 and the toll was almost certainly higher last year. About half of deaths involved prescription painkillers. Most of those who overdose on heroin or a synthetic opiate, such as fentanyl, first become hooked on legal pills.

This is an almost uniquely American crisis driven in good part by particular American issues from the influence of drug companies over medical policy to a “pill for every ill” culture. Trump’s commission, which called the opioid epidemic “unparalleled”, said the grim reality is that “the amount of opioids prescribed in the US was enough for every American to be medicated around the clock for three weeks”.

The US consumes more than 80% of the global opioid pill production even though it has less than 5% of the world’s population. Over the past 20 years, one federal institution after another lined up behind the drug manufacturers’ false claims of an epidemic of untreated pain in the US. They seem not to have asked why no other country was apparently suffering from such an epidemic or plying opioids to its patients at every opportunity.

With the pharmaceutical lobby’s money keeping Congress on its side, regulations were rewritten to permit physicians to prescribe as many pills as they wanted without censure. Indeed, doctors sometimes found themselves hauled before ethics boards for not supplying enough.

Unlike most other countries, the US health system is run as an industry not a service. That gives considerable power to drug manufacturers, medical providers and health insurance companies to influence policy and practices.

Too often, their bottom line is profits not health. Opioid pills are far cheaper and easier than providing other forms of treatment for pain, like physical therapy or psychiatry. As Senator Joe Manchin of West Virginia told the Guardian last year: “It’s an epidemic because we have a business model for it. Follow the money. Look at the amount of pills they shipped in to certain parts of our state. It was a business model.”

But the system also gives a lot of power to patients. People coughing up large amounts of money in insurance premiums and co-pays expect results. They are, after all, more customer than patient. Doctors complain of patients who arrive expecting a pill to resolve medical conditions without taking responsibility for their own health by eating better or exercising more.

In particular, the idea has taken hold, pushed by the pharmaceutical industry, that there is a right to be pain free. Other countries pursue strategies to reduce and manage pain, not raise expectations that it can simply be made to disappear. In all of this, regulators became facilitators. The Food and Drug Administration approved one opioid pill after another.

As late as 2013, by which time the scale of the epidemic was clear, the FDA permitted a powerful opiate, Zohydro, onto the market over the near unanimous objection of its own review committee. It was clear from the hearing that doctors understood the dangers, but the agency appeared to have put commercial considerations first.

US states long ago woke up to the crisis as morgues filled, social services struggled to cope with children orphaned or taken into care, and the epidemic took an economic toll. Police chiefs and local politicians said it was a social crisis not a law and order problem.

Some state legislatures began to curb mass prescribing. All the while they looked to Washington for leadership. They did not get much from Obama or Congress, although legislation approving $1bn on addiction treatment did pass last year. Instead, it was up to pockets of sanity to push back.

Last year, the then director of the Centers for Disease Control, Tom Frieden, made his mark with guidelines urging doctors not to prescribe opioids as a first step for chronic or routine pain, although even that got political pushback in Congress where the power of the pharmaceutical lobby is not greatly diminished.

There are also signs of a shift in the FDA after it pressured a manufacturer into withdrawing an opioid drug, Opanathat should never have been on sale in the first place. It was initially withdrawn in the 1970s, but the FDA permitted it back on to the market in 2006 after the rules for testing drugs were changed. At the time, many accused the pharmaceutical companies of paying to have them rewritten.

Trump’s opioid commission offered hope that the epidemic would finally get the attention it needs. It made a series of sensible if limited recommendations: more mental health treatment people with a substance abuse disorder and more effective forms of rehab.

Trump finally got around to saying that the epidemic is a national emergency on Thursday after he was criticised for ignoring his own commission’s recommendation to do so. But he reinforced the idea that the victims are to blame with an offhand reference to LSD.

Real leadership is still absent – and that won’t displease the pharmaceutical companies at all.

Source: https://www.theguardian.com/commentisfree/2017/aug/13/dont-blame-addicts-for-americas-opioid-crisis-real-culprits August 2017

Source:Drug Use in Colorado 2000 – 2013 SAMHSA NSDUH data

 

TO ALL OUR READERS: THE NDPA WOULD URGE YOU TO READ THE REPORT MENTIONED IN THE ARTICLE BELOW, (Tracking the Money That’s Legalizing Marijuana and Why It Matters), WHICH GIVES A DETAILED DESCRIPTION OF HOW MARIJUANA BECAME THE NUMBER ONE DRUG OF CHOICE FOR MILLIONS OF PEOPLE WORLDWIDE, HOW IT BECAME ‘BIG BUSINESS’ IN THE USA AND WHY WE NEED TO DISSEMINATE THIS INFORMATION WIDELY.

Report by National Families in Action Rips the Veil Off the Medical Marijuana Industry
Research Traces the Money Trail and Reveals the Motivation Behind Marijuana as Medicine

Tracking the Money That’s Legalizing Marijuana and Why It Matters documents state-by-state financial data, exposing the groups and the amount of money used either to fund or oppose ballot initiatives legalizing medical or recreational marijuana in 16 U.S. states.

• NFIA report reveals three billionaires — George Soros, Peter Lewis and John Sperling — who contributed 80 percent of the money to medicalize marijuana through state ballot initiatives during a 13-year period, with the strategy to use medical marijuana as a runway to legalized recreational pot.
• Report shows how billionaires and marijuana legalizers manipulated the ballot initiative process, outspent the people who opposed marijuana and convinced voters that marijuana is medicine, even while most of the scientific and medical communities say marijuana is not medicine and should not be legal.

• Children in Colorado treated with unregulated cannabis oil have had severe dystonic reactions, other movement disorders, developmental regression, intractable vomiting and worsening seizures.

• A medical marijuana industry has emerged to join the billionaires in financing initiatives to legalize recreational pot.

ATLANTA, March 14, 2017 (GLOBE NEWSWIRE) — A new report by National Families in Action (NFIA) uncovers and documents how three billionaires, who favor legal recreational marijuana, manipulated the ballot initiative process in 16 U.S. states for more than a decade, convincing voters to legalize medical marijuana. NFIA is an Atlanta-based non-profit organization, founded in 1977, that has been helping parents prevent children from using alcohol, tobacco, and other drugs. NFIA researched and issued the paper to mark its 40th anniversary.

The NFIA study, Tracking the Money That’s Legalizing Marijuana and Why It Matters, exposes, for the first time, the money trail behind the marijuana legalization effort during a 13-year period. The report lays bare the strategy to use medical marijuana as a runway to legalized recreational pot, describing how financier George Soros, insurance magnate Peter Lewis, and for-profit education baron John Sperling (and groups they and their families fund) systematically chipped away at resistance to marijuana while denying that full legalization was their goal.

The report documents state-by-state financial data, identifying the groups and the amount of money used either to fund or oppose ballot initiatives legalizing medical or recreational marijuana in 16 states. The paper unearths how legalizers fleeced voters and outspent — sometimes by hundreds of times — the people who opposed marijuana.

Tracking the Money That’s Legalizing Marijuana and Why It Matters illustrates that legalizers lied about the health benefits of marijuana, preyed on the hopes of sick people, flouted scientific evidence and advice from the medical community and gutted consumer protections against unsafe, ineffective drugs. And, it proves that once the billionaires achieved their goal of legalizing recreational marijuana (in Colorado and Washington in 2012), they virtually stopped financing medical pot ballot initiatives and switched to financing recreational pot. In 2014 and 2016, they donated $44 million to legalize recreational pot in Alaska, Oregon, California, Arizona, Nevada, Massachusetts and Maine. Only Arizona defeated the onslaught (for recreational marijuana).

Unravelling the Legalization Strategy: Behind the Curtain

In 1992, financier George Soros contributed an estimated $15 million to several groups he advised to stop advocating for outright legalization and start working toward what he called more winnable issues such as medical marijuana. At a press conference in 1993, Richard Cowen, then-director of the National Organization for the Reform of Marijuana Laws, said, “The key to it [full legalization] is medical access. Because, once you have hundreds of thousands of people using marijuana medically, under medical supervision, the whole scam is going to be blown. The consensus here is that medical marijuana is our strongest suit. It is our point of leverage which will move us toward the legalization of marijuana for personal use.”

Between 1996 and 2009, Soros, Lewis and Sperling contributed 80 percent of the money to medicalize marijuana through state ballot initiatives. Their financial contributions, exceeding $15.7 million (of the $19.5 million total funding), enabled their groups to lie to voters in advertising campaigns, cover up marijuana’s harmful effects, and portray pot as medicine — leading people to believe that the drug is safe and should be legal for any use.
Today, polls show how successful the billionaires and their money have been. In 28 U.S. states and the District of Columbia, voters and, later, legislators have shown they believe marijuana is medicine, even though most of the scientific and medical communities say marijuana is not medicine and should not be legal. While the most recent report, issued by the National Academies of Sciences (NAS), finds that marijuana may alleviate certain kinds of pain, it also finds there is no rigorous, medically acceptable documentation that marijuana is effective in treating any other illness. At the same time, science offers irrefutable evidence that marijuana is addictive, harmful and can hinder brain development in adolescents. At the distribution level, there are no controls on the people who sell to consumers. Budtenders (marijuana bartenders) have no medical or pharmaceutical training or qualifications.

One tactic used by legalizers was taking advantage of voter empathy for sick people, along with the confusion about science and how the FDA approves drugs. A positive finding in a test tube or petri dish is merely a first step in a long, rigorous process leading to scientific consensus about the efficacy of a drug. Scientific proof comes after randomized, controlled clinical trials, and many drugs with promising early stage results never make it through the complex sets of hurdles that prove efficacy and safety. But marijuana legalizers use early promise and thin science to persuade and manipulate empathetic legislators and voters into buying the spin that marijuana is a cure-all.

People who are sick already have access to two FDA-approved drugs, dronabinol and nabilone, that are not marijuana, but contain identical copies of some of the components of marijuana. These drugs, available as pills, effectively treat chemotherapy-induced nausea and vomiting and AIDS wasting. The NAS reviewed 10,700 abstracts of marijuana studies conducted since 1999, finding that these two oral drugs are effective in adults for the conditions described above. An extract containing two marijuana chemicals that is approved in other countries, reduces spasticity caused by multiple sclerosis. But there is no evidence that marijuana treats other diseases, including epilepsy and most of the other medical conditions the states have legalized marijuana to treat. These conditions range from Amyotrophic lateral sclerosis (ALS) and Crohn’s disease to Hepatitis-C, post-traumatic stress disorder (PTSD) and even sickle cell disease.

Not So Fast — What about the Regulations?
Legalizers also have convinced Americans that unregulated cannabidiol, a marijuana component branded as cannabis oil, CBD, or Charlotte’s Web, cures intractable seizures in children with epilepsy, and polls show some 90 percent of Americans want medical marijuana legalized, particularly for these sick children. In Colorado, the American Epilepsy Society reports that children with epilepsy are receiving unregulated, highly variable artisanal preparations of cannabis oil recommended, in most cases, by doctors with no training in paediatrics, neurology or epilepsy. Young patients have had severe dystonic reactions and other movement disorders, developmental regression, intractable vomiting and worsening seizures that can be so severe that their physicians have to put the child into a coma to get the seizures to stop. Because of these dangerous side effects, not one paediatric neurologist in Colorado, where unregulated cannabidiol is legal, recommends it for these children.

Dr. Sanjay Gupta further clouded the issue when he produced Weed in 2013, a three-part documentary series for CNN on marijuana as medicine. In all three programs, Dr. Gupta promoted CBD oil, the kind the American Epilepsy Society calls artisanal. This is because not one CBD product sold in legal states has been purified to Food and Drug Administration (FDA) standards, tested, or proven safe and effective. The U.S. Congress and the FDA developed rigid processes to review drugs and prevent medical tragedies such as birth defects caused by thalidomide. These processes have facilitated the greatest advances in medicine in history.

“By end-running the FDA, three billionaires have been willing to wreck the drug approval process that has protected Americans from unsafe, ineffective drugs for more than a century,” said Sue Rusche, president and CEO of National Families in Action and author of the report. “Unsubstantiated claims for the curative powers of marijuana abound.” No one can be sure of the purity, content, side effects or potential of medical marijuana to cause cancer or any other disease. When people get sick from medical marijuana, there are no uniform mechanisms to recall products causing the harm. Some pot medicines contain no active ingredients. Others contain contaminants. “Sick people, especially children, suffer while marijuana medicine men make money at their expense,” added Ms. Rusche.

Marijuana Industry — Taking a Page from the Tobacco Industry
The paper draws a parallel between the marijuana and tobacco industries, both built with the knowledge that a certain percentage of users will become addicted and guaranteed lifetime customers. Like tobacco, legalized marijuana will produce an unprecedented array of new health, safety and financial consequences to Americans and their children.

“Americans learned the hard way about the tragic effects of tobacco and the deceptive practices of the tobacco industry. Making another addictive drug legal unleashes a commercial business that is unable to resist the opportunity to make billions of dollars on the back of human suffering, unattained life goals, disease, and death,” said Ms. Rusche. “If people genuinely understood that marijuana can cause cognitive, safety and mental health problems, is addictive, and that addiction rates may be three times higher than reported, neither voters nor legislators would legalize pot.”
The paper and the supporting data are available at www.nationalfamilies.org.
About National Families in Action

National Families in Action is a 501 (c) (3) nonprofit organization that was founded in Atlanta, Georgia in 1977. The organization helped lead a national parent movement credited with reducing drug use among U.S. adolescents and young adults by two-thirds between 1979 and 1992. For forty years, it has provided complex scientific information in understandable language to help parents and others protect children’s health. It tracks marijuana science and the marijuana legalization movement on its Marijuana Report website and its weekly e-newsletter of the same name.

Source: https://globenewswire.com/news-release/2017/03/14/936283/0/en/New-Report-by-National-Families-in-Action-Rips-the-Veil-Off-the-Medical-Marijuana-Industry.html

The Centers for Disease Control and Prevention (CDC) stated that 33,091 people died from opioid overdoses in 2015, which accounts for 63 percent of all drug overdose deaths in the same year. A recent report from the CDC found that drug deaths from fentanyl and other synthetic opioids, other than methadone, rose 72 percent in just one year, from 2014 to 2015. Last year, the death of music icon Prince was linked to fentanyl and the prescription drug has become a source of concern for government agencies and law enforcement officials alike, as death rates from fentanyl-related overdoses and seizures have risen across the country.

What exactly is fentanyl?

According to the National Institute on Drug Abuse, fentanyl is a powerful synthetic opioid analgesic that is similar to morphine – but is 50 to 100 times more potent. It is a schedule II prescription drug, and it is typically used to treat patients with severe pain or to manage pain after surgery. It is also sometimes used to treat patients with chronic pain who are physically tolerant to other opioids. In its prescription form, fentanyl is known by such names as Actiq®, Duragesic® and Sublimaze®. Like heroin, morphine and other opioid drugs, fentanyl works by binding to the body’s opioid receptors, which are found in areas of the brain that control pain and emotions.

When opioid drugs bind to these receptors, they can drive up dopamine levels in the brain’s reward areas, producing a state of euphoria and relaxation. But fentanyl’s effects resemble those of heroin and include drowsiness, nausea, confusion, constipation, sedation, tolerance, addiction, respiratory depression and arrest, unconsciousness, coma and death.

So why is abuse and misuse of fentanyl so dangerous?

When prescribed by a physician, fentanyl is often administered via injection, transdermal patch or in lozenges. However, the fentanyl and fentanyl analogs associated with recent overdoses are produced in clandestine laboratories.

This non-pharmaceutical fentanyl is sold in the following forms: as a powder; spiked on blotter paper; mixed with or substituted for heroin; or as tablets that mimic other, less potent opioids. Fentanyl sold on the street can be mixed with heroin or cocaine, which markedly amplifies its potency and potential dangers.

Users of this form of fentanyl can swallow, snort or inject it, or they can put blotter paper in their mouths so that the synthetic opioid is absorbed through the mucous membrane. Street names for fentanyl or for fentanyl-laced heroin include Apache, China Girl, China White, Dance Fever, Friend, Goodfella, Jackpot, Murder 8, TNT, and Tango and Cash.

Can misuse of fentanyl lead to death?

Opioid receptors are also found in the areas of the brain that control breathing rate. High doses of opioids, especially potent opioids such as fentanyl, can cause breathing to stop completely, which can lead to death. The high potency of fentanyl greatly increases risk of overdose, especially if a person who uses drugs is unaware that a powder or pill contains fentanyl.

The United States Drug Enforcement Administration issued a nationwide alert in 2015 about the dangers of fentanyl and fentanyl analogues/compounds. Fentanyl-laced heroin is causing significant problems across the country, particularly as heroin use has increased in recent years.

Source: http://drugfree.org/newsroom/news-item/overdose-deaths-fentanyl-rise-know/   Jan 18th 2017

A GP behind a ground-breaking, multi-award winning alcohol treatment service has said he almost feels like quitting after the scheme was decommissioned in an NHS cost-cutting drive, warning the decision suggests there is ‘no point innovating’.

NHS commissioners in Cambridgeshire have said they will no longer fund the innovative Gainsborough Foundation alcohol treatment service despite claims it reduces hospital admissions and saves the health service six-figure sums each year.

The service, which covers 26 GP practices in Huntingdon and treats 200 new patients a year, will close in April after the local CCG withdrew funding.

A letter from Cambridgeshire and Peterborough CCG said that it could no longer afford to support the community recovery and detox service because it is not a statutory requirement. The CCG has previously acknowledged that the Gainsborough service had reduced emergency hospital admissions and reduced NHS costs.

GP alcohol service

Dr Arun Aggarwal, the GP who founded the service at his practice with a recovered alcoholic in 2000, said that while neighbouring areas had seen alcohol-related admissions grow by 6% a year, admissions in Huntingdon were falling. The £200,000-a-year programme was saving £670,000 on hospital billed activity every year, he told GPonline. In just three months of 2015, CCG documents show, the service saved almost £100,000 on emergency admissions alone.

But in a letter to Dr Aggarwal, Cambridgeshire and Peterborough CCG chief officer Tracy Dowling said there was no evidence the alcohol service had reduced admissions.  The CCG continued to support the service after responsibility for alcohol treatment passed to local authorities under the 2013 NHS shakeup. Now commissioning bosses, who reported an £11.5m deficit last year and are planning cuts of £44m, have said they will no longer support the service.

From April practices will have to refer patients with alcohol dependency to the existing local authority-commissioned service. But Dr Aggarwal said his programme is more successful.

Detox treatment The Gainsborough Foundation, which was awarded the 2014 GP Enterprise Award, as well as a BMJ and an east of England innovation award, uses non clinically qualified recovered alcoholics to provide recovery and detox treatment in patients’ homes. The service has, said Dr Aggarwal, a 60% success rate breathalysed dry at two months, while patients are seen much quicker than in traditional services.  A survey of local GPs showed 73% believe the Gainsborough service is ‘invaluable’ while 83% rate is as more effective than the local authority service.

‘There have been no arguments about its efficacy or safety or outcomes,’ said Dr Aggarwal. ‘They have all been ignored.’

The GP said the CCG’s decision was short-sighted and would do little to help resolve the local NHS’s finance problems which were the consequence of unfair funding.

‘I think they have had management teams coming in saying the only way to solve your funding formula problem is to cut everything you are not statutorily responsible for’, he said.

GP innovation

Dr Aggarwal said the decision was ‘totally demotivating for GPs trying to be innovative’.

‘The combination of … this cut in the alcohol service and other hassles …  is almost enough to make me hand in the keys,’ he said. ‘In this current era there is no point innovating.’

In a statement on its website Cambridgeshire and Peterborough CCG chief officer Tracy Dowling said: ‘The CCG has taken the decision to serve notice on the alcohol support service provided by the Gainsborough Foundation for patients in the Huntingdon area.

‘Although the CCG has previously funded alcohol support services from Gainsborough Foundation Trust in the Huntingdon locality, the funding and Responsible Commissioner duties for Drug and Alcohol Services transferred to Cambridgeshire County Council Public Health commissioners in 2013. Inclusion is the organisation commissioned by CCC to provide these services across all of Cambridgeshire.

‘The CCG receives a fixed budget to buy and provide health services for the entire local population. Like all CCGs up and down the country, there is greater demand on our budget than we have the budget to spend. We need to look at all our services, and can only commission those we have the funding and responsibility for.

‘Our priority is to ensure that patients can continue access to support services when they need and will work with our partners and service users to ensure this happens.’

Source:  http://www.gponline.com/gps-award-winning-alcohol-service-scrapped-despite-saving-nhs-500000-year/article/1424309   Feb.2017

Two thirds of drug-misuse patients in the health service in Northern Ireland last year had taken cannabis, new figures show.

From a total of a total of 2,229 people presenting to health services here with problem drug misuse, almost 66% were cannabis users.

The figures are contained in the Department of Health’s Northern Ireland drug misuse database.   Cannabis was by far the most commonly-used substance amongst problem drug-misuse patients here, according to the database.

Benzodiazepines, a class of drug with a host of medical uses that is commonly prescribed to patients suffering from anxiety, was the next most commonly used drug with just over 37% reporting having taken benzodiazepines.

The next on the list is cocaine with more than a third of those in the database (almost 35%) having taken it.  That represents a significant increase in the number of people who said they took cocaine. Last year it was 25%.

The use of ecstasy dropped substantially, from 26% last year to 10% this year, while heroin use has also fallen, from 13% to 10%.

One-in-20 said they had injected themselves with drugs.

The database also shows that most (60%) of those presenting for treatment took more than one drug. A fifth (23%) took two drugs, while another fifth (19%) said they took at least four different drugs.

Almost half (46%) said they took stimulants; this type of drug includes cocaine and amphetamines.  Just over a quarter (26%) said they used at least one opioid analgesic drug – a class of drugs used in medicine to relieve pain, that also includes the illegal drug heroin.  A fifth (20%) of all those who said they used these type of drugs also said it was their “main drug”.   The figures also showed a clear gender divide with males making up 79% of patients.

The Department of Health say they hold “information relating to 2,340 individuals that presented to drug misuse treatment services in 2015/16”.  The figures quoted in this article are based on 2,229 of those individuals who agreed to be included in the database.

Tobacco and alcohol misuse is excluded.

Source:  http://www.newsletter.co.uk/news/crime/two-thirds-of-mental-health-drug-patients-used-cannabis-   23rd December 2016

A synthetic opioid known as “pink” is legal in most states, even though it is almost eight times stronger than morphine, CNN reports.

The drug, also known as U-47700, is responsible for dozens of deaths nationwide, the article notes. Adam Kline, Police Chief of White Lake, Michigan, told CNN the drug can be legally purchased on the “dark web” in the form of a powder, pill or nasal spray. Last month, the Drug Enforcement Administration told NBC News it is aware of confirmed deaths associated with the drug in New Hampshire, North Carolina, Ohio, Texas and Wisconsin. The drug, along with other synthetic opioids, is being shipped into the United States from China and other countries.

Source:  thepartnership@drugfree.org  2nd Nov.  2016

New psychoactive substances (NPS) are synthesized compounds that are not usually covered by European and/or international laws. With a slight alteration in the chemical structure of existing illegal substances registered in the European Union (EU), these NPS circumvent existing controls and are thus referred to as “legal highs”. They are becoming increasingly available and can easily be purchased through both the internet and other means (smart shops). Thus, it is essential that the identification of NPS keeps up with this rapidly evolving market.

In this case study, the Belgian Customs authorities apprehended a parcel, originating from China, containing two samples, declared as being “white pigments”. For routine identification, the Belgian Customs Laboratory first analysed both samples by gas-chromatography mass-spectrometry and Fourier-Transform Infrared spectroscopy. The information obtained by these techniques is essential and can give an indication of the chemical structure of an unknown substance but not the complete identification of its structure. To bridge this gap, scientific and technical support is ensured by the Joint Research Centre (JRC) to the European Commission Directorate General for Taxation and Customs Unions (DG TAXUD) and the Customs Laboratory European Network (CLEN) through an Administrative Arrangement for fast recognition of NPS and identification of unknown chemicals. The samples were sent to the JRC for a complete characterization using advanced techniques and chemoinformatic tools.

The aim of this study was also to encourage the development of a science-based policy driven approach on NPS.

These samples were fully characterized and identified as 5F-AMB and PX-3 using1H and 13C nuclear magnetic resonance (NMR), high-resolution tandem mass-spectrometry (HR-MS/MS) and Raman spectroscopy. A chemo-informatic platform was used to manage, unify analytical data from multiple techniques and instruments, and combine it with chemical and structural information.

Source:    http://www.fsijournal.org/   August 2016   Volume 265, Pages 107–115

DOI: http://dx.doi.org/10.1016/j.forsciint.2016.01.024

In recent years, the use of cannabis in medical treatment has sparked a heated debate between state and federal governments. Although the federal government has banned marijuana — it is classified as a Schedule I Drug and a license is needed to possess it — some individual states have decriminalized it for medical use. A Schedule I Drug is defined as one with no currently accepted medical use and a high potential for abuse. As of July 2014, 23 states and Washington, D.C., have legalized medical marijuana and have set laws, fees and possession limits. 

What if there were an alternative?  In time, there could be. 

Researchers such as Aron Lichtman, Ph.D., professor of pharmacology and toxicology in the Virginia Commonwealth University School of Medicine, are studying cannabis-like chemicals called endogenous cannabinoids that are made by the human body and brain.

For more than 25 years, Lichtman has studied the effects of marijuana and THC on the brain, and the long-term consequences of exposure.

Below, Lichtman discusses misconceptions about marijuana, defines cannabinoids and delves into his field of research. Ultimately, he hopes his work will lead to the development of a medication that shares the medical benefits of cannabis, but has been scientifically proven to be safe and effective to reduce pain and suffering in patients.

One of the main reasons patients may obtain a prescription for medicinal cannabis is to manage pain due to headaches or diseases such as cancer or chronic conditions such as nerve pain. What are the issues with medical marijuana as it stands now? 

The problem with cannabis is that where it has been made legal, state medical dispensaries can prescribe it for any medical condition. Unfortunately, there are few studies that prove that cannabis is actually effective at treating a particular medical issue, although there are many claims about it.

Further, cannabis is not regulated by the Food and Drug Administration, or any other federal agency. There are no standardized guidelines in place for its use, and there is a lack of scientific evidence to support its use and long-term effects.

The science that we have about marijuana should help guide those who are experts in public health policy. Delivering medication as a raw material that has to be smoked and contains a lot of toxins is not safe.

Health care professionals do not give patients opium to smoke — there are better ways of administering it. As scientists, we know its active ingredients, we’re working on codeine and we have other opiates that chemists have synthesized.  I believe we can do the same thing for cannabis. We can do far better than cannabis.

What is the public perception of marijuana? 

Many in the general public believe that marijuana is safe — and that’s a problem. Cannabis is a drug, it contains THC, and yes, THC does have beneficial medical effects. But there is little known about the implications of long-term use of cannabis, and we’re just starting to investigate this. It could produce problems in terms of learning and memory. We do not know how it effects the brains and bodies of juveniles.

While it is helpful for some people, there are others who can get into trouble with it in terms of dependency. A small percentage of people can have acute panic attacks with it — have a psychotic episode. This can land people in the ER/hospital.

What are cannabinoids? 

Cannabinoids represent a class of drugs that are different in structure, but are most often thought about as being present in cannabis or marijuana.

There are three groups of cannabinoids: phytocannabinoids, synthetic or man-made cannabinoids and endogenous cannabinoids.

The most well-known cannabinoid is delta-9-tetrahydrocannabinol, or THC, which is the main constituent of cannabis responsible for most of the effects associated with marijuana. In addition to THC, there are more than 100 similarly structured chemicals. Some of them have THC effects, and some have effects of their own. These are called phytocannabinoids, which are plant-derived cannabis-like chemicals.

How did synthetic/man-made cannabinoids come to be? How potent are they? 

Through the years, chemists have been involved with this research and once the structures of these naturally-occurring plant materials were elucidated, the chemists made modifications to these structures so they could add different chemical constituents to THC or change it around – and these are considered synthetic or man-made cannabinoids.

There are thousands of synthetic cannabinoids that have been developed. Some of these are equally as potent as THC, others are inactive. But there are some that are up to 100 times more potent than THC. Potency refers to the dose that delivers a given effect. When there is an increase in potency of these chemicals, there can be a lot of side effects.

THC is approved by the FDA in a capsule to be taken orally to treat nausea and vomiting associated with cancer chemotherapy and to stimulate appetite in AIDS patients. The dose range is between 5 and 90 milligrams. A synthetic cannabinoid in pill form called cesamet is also approved by the FDA which delivers a similar effect as marinol, but at a fraction of that dose. It can be done at 2-4 milligrams per day.

Your main area of research focus is the third type of cannabinoid — endocannabinoids. What is known about this group?

Endogenous cannabinoids are chemicals that naturally occur in our bodies and brains. They are lipids, so they are greasy and stick to cell membranes very well. When compared with THC and synthetic cannabinoids, endogenous cannabinoids differ in chemical structure – but they produce very similar effects. Much in the way endorphins (which occur in the body) mimic morphine and heroine, which are both opiates derived from plant matter, the endocannabinoids mimic THC.

Anandamide and 2-arachidonoylglycerol, or 2-AG, are examples of endocannabinoids. 2-AG can be found in the central nervous system at a high concentration. These endocannabinoids work dramatically differently to the chemicals in marijuana. The body produces enzymes that very quickly break down these endocannabinoids. We and others have developed drugs that inhibit these enzymes, which when administered in preclinical models result in elevated levels of endocannabinoids and reductions in pain and anxiety, but without THC-like effects. Our bodies also have marijuana-like receptors called cannabinoid receptors. We have studied these, too.

Through your research, what are you hoping to learn? How could this research one day impact patients? 

Our goal is to see if we can produce a medication that is targeted toward this naturally occurring marijuana-like system. To get there, we need to understand how the endogenous cannabinoid system works on the basic science level.

From there, we can eventually develop a medication that has decreased dependence liability and decreased addiction liability (so people are not going to crave it and become dependent on it), but it would reduce pain and make people more functional.

This work could possibly impact treatment for different disease states — from post-traumatic stress disorder to neurodegenerative diseases such as Alzheimer’s disease and Parkinson’s disease. The medications that may be developed could help reduce some of the symptoms of disease and improve a patient’s quality of life.

There’s not going to be a cure-all, but I think the potential is there to help with public health by understanding how the system works and developing target drugs and therapies. This is not developing another anti-inflammatory drug that works like all the rest but in a new flavor. This is searching out brand new targets, finding different enzymes that regulate endocannabinoids that can produce a wide range of effects.

Source:  http://www.healthcanal.com/   8th Sept 2014 

Do manualized psychosocial interventions help reduce relapse among alcohol-dependent adults treated with naltrexone or placebo? A meta-analysis.

Agosti V., Nunes E.V., O’Shea D. et al.

Unable to obtain a copy by clicking title? Try asking the author for a reprint by adapting this prepared e-mail or by writing to Dr Agosti at agostiv@pi.cpmc.columbia.edu.

Supplementing the medication naltrexone with psychosocial relapse-prevention therapies has not helped prevent relapse among alcohol-dependent patients. However, these therapies have elevated outcomes among placebo patients to the level of those prescribed naltrexone.

SUMMARY Medications such as naltrexone and acamprosate are used in the treatment of alcohol dependence to combat frequent relapse to heavy drinking, but their impact has overall been modest, and many patients leave treatment early or do not take medication as intended. Researchers have tried to address these shortcomings by supplementing medication with psychosocial interventions. The featured review assessed whether these attempts have been successful by conducting a meta-analytic synthesis of results from studies which used psychosocial relapse-prevention interventions (typically cognitive-behavioural in approach) to support adult, alcohol-dependent patients who had achieved abstinence, and then randomly been allocated either to naltrexone or a placebo. Relapse was defined as a return to drinking at least 70g alcohol a day for men or 56g for women.

Key points

The review synthesised results from relevant studies to test whether supplementing the medication naltrexone with psychosocial relapse-prevention therapies helps prevent relapse among adult, alcohol-dependent patients.

It concluded this was not the case, though one finding suggested that psychosocial therapies can elevate outcomes for patients prescribed a placebo to the level of those prescribed naltrexone.

The implications of this and of other studies are that naltrexone can be a valuable supplement to medical counselling of dependent drinkers, especially when specialist therapies such as cognitive-behavioural therapy are refused or unavailable.

In some situations these therapies also work better when naltrexone is added. But if the core treatment is naltrexone, good quality medical care or counselling will on average be as effective as specialist structured psychosocial therapies.

Four of the 18 studies which met these criteria had also randomly allocated patients to cognitive-behavioural therapies versus a different approach – specifically either medical management or supportive psychotherapy. These direct tests of the impact of a cognitive-behavioural approach were analysed separately from the remaining 20 studies, in which all the patients were offered the same psychosocial therapies, either cognitive-behavioural or one typical of that type of service.

All 18 studies had recruited nearly 2,600 patients on average about 42 years old. Where this was known, three-quarters were men, 71% were employed, and about half were married.

Main findings

Within each of the four studies which had randomly allocated patients to these therapies, generally the proportions who relapsed when supported by cognitive-behavioural therapies were about the same as those who relapsed when supported in other ways. This was the case both among patients given naltrexone and those allocated to a placebo. When results from these studies were pooled, relapse rates among patients allocated to naltrexone or placebo were virtually the same regardless of the type of psychosocial support.

Among the remaining studies which each allocated all their patients to the same form of psychosocial support, results were available from seven in which this was a structured, manualised programme, usually cognitive-behavioural in nature. Across these studies, virtually the same proportion of patients (about half) relapsed whether prescribed naltrexone or placebo. In contrast, when support took a typical, less structured form such as counselling, fewer naltrexone patients relapsed (33%) than did patients prescribed a placebo (43%). This contrast was statistically significant, and was largely due to results from older studies published between 1992 and 1997. Another unexpected finding was that whether prescribed naltrexone or a placebo, fewer patients relapsed when the treatment was a typical approach than when it was a structured psychosocial therapy.

The authors’ conclusions

Results show that relative to other approaches, cognitive-behavioural therapy did not significantly decrease the likelihood of relapse to heavy drinking among patients prescribed naltrexone or among those prescribed a placebo, and did not augment the impacts of naltrexone relative to an inactive placebo. In the four studies which made direct comparisons, supportive psychotherapy and medical management interventions worked as well. Among the remaining studies, overall those which used a manualised programme such as cognitive-behavioural therapy actually recorded higher rates of relapse than studies which used a more typical, less structured approach.

These results should be viewed in the light of several major limitations. No adjustments could be made for important factors related to the chance of successful treatment such as severity of dependence, and relapse to heavy drinking was the only drinking outcome sufficiently commonly reported to be amalgamated across the studies. Also, the results derived from studies that required initial abstinence and excluded patients with major comorbid disorders, diminishing their applicability to routine practice.

Source: American Journal on Addictions: 2012, 21(6), p. 501–507. April 2015

COMMENTARY The weight of the evidence in respect of treating alcohol or drug dependence is that despite the prominence of cognitive-behavioural therapies, their theoretical pedigree, and an extensive research effort which has distilled them in to expert manuals (for example, 1 2), overall the advantage they confer over alternatives is minor, and especially so when added to a drug-based treatment. In respect of alcohol problems, an analysis has concluded that any variation in outcomes across different psychosocial therapies is likely to have been due to chance or to the allegiance of the researchers.

However, the large US COMBINE trial did find that supplementing inactive placebo pills with psychological therapy incorporating cognitive-behavioural elements raised outcomes to the level of patients prescribed naltrexone. A similar message emerged from another US study which found that as long as naltrexone was prescribed, primary care-style consultations were as effective as specialist cognitive-behavioural therapy in initiating and sustaining recovery from alcohol dependence. Without the medication, cognitive-behavioural therapy was the more effective option. A similar result emerged from the featured review’s analysis of studies which offered the same psychosocial support to all patients; when this was a structured therapy (generally cognitive-behavioural), it helped raise outcomes for placebo patients to the level of those prescribed naltrexone.

All these results suggest that structured therapies can elevate the outcomes of patients not prescribed an active medication to the level of those prescribed naltrexone – that either medication or structured therapy help relative no medication plus typical care. Combining the two does not augment the drug’s impacts – a surprise, since relapse-prevention therapies would be expected to have their own impacts and to give medication greater leverage by persuading more patients to complete treatment and take the pills as intended.

Even if adding structured cognitive-behavioural therapy to naltrexone does not help, the reverse may still be the case – that supplementing cognitive-behavioural therapy with naltrexone makes a more effective package. In several studies (described in these notes) this has indeed been the case. The findings are in line with guidance from the UK’s National Institute for Health and Clinical Excellence (NICE) that in addition to evidence-based psychological interventions, patients whose alcohol dependence is moderate or severe should also be able to access relapse prevention medication, including naltrexone.

Practice implications seem to be that naltrexone can be a valuable supplement to the medical counselling (by GPs or nurses) of dependent drinkers of the kind who might be treated in primary care, especially when specialist therapies such as cognitive-behavioural therapy are refused or unavailable. In some situations these therapies also work better when naltrexone is added. But if the core treatment is naltrexone, a good quality medical care approach or counselling will on average be as effective as specialist structured psychosocial therapies.

Last revised 17 April 2015. First uploaded 10 April 2015

Teen Marijuana Use And The Risks Of Psychosis

Doctors in Germany have noted an alarming rise in psychotic episodes linked to excessive marijuana use among young people, which follows other studies around the world raising alarms.

BERLIN — Miklos has survived the worst of it. He doesn’t hear voices anymore. And if he did, he’d know it’s just an hallucination. “This isn’t real,” he would tell himself.

The 21-year-old can also interact with people again — even look them in the eye. As soon as his therapist enters the room he starts smiling. This would have seemed impossible just a few weeks ago. Miklos was admitted a while back to the psychiatric ward of the Hamburg University Hospital, which diagnosed him as having suffered from an “extreme psychotic episode after abuse of cannabis.”

Initially the help he received there seemed to have little effect. He suffered from paranoia, and even broke out of the hospital and caused a major traffic accident while on the run. He had frequent violent outbursts, refused to speak to anyone, and was fixated on just one thought: “I want to leave, just leave, leave, leave.” But he eventually came to embrace his treatment.

Miklos had slid into addiction three years earlier. Nothing in his life seemed to be working at the time. A girl he liked laughed in his face when he confessed his love for her. His math teacher let it be known she thought he was a failure. He was in constant conflict with his parents. “Every time things went wrong, I would hide in my room and smoke weed,” he recalls.

Miklos smoked with a bong, or water pipe, so the relaxing effect of marijuana would kick in faster. He’d take his first puffs as soon as he woke up in the morning. Smoking pot became his full-time job.

Miklos stopped going to school and ended up failing his final exams. He became indifferent, avoided his friends and ultimately had virtually no social connections. And then the voices appeared. “Oh good God, you are such a loser, you never do anything right,” they would say. Finally, he turned to his parents for help and was admitted to the university hospital.

Playing with fire

The number of patients admitted with psychotic episodes after having consumed cannabis has more than tripled in Germany over the last 15 years, from 3,392 in 2000 to 11,708 in 2013. More than half of the patients are younger than 25.

Andreas Bechdolf is the chief of medicine for psychiatry and psychotherapy at the Berlin Urban Hospital and heads a two-year-old facility called the Center for Early Intervention and Therapy, or FRITZ, which focuses specifically on adolescents. It is the country’s only such project to date. “All major psychological disorders usually begin in adulthood,”
Bechdolf says. “But until now the welfare system has paid very little attention to young adults.”

FRITZ employs psychologists, psychiatrists, care providers and social workers as well as young people who cannot, at first glance, be distinguished from patients. They don’t wear white clothing. Some have nose piercings or large rings inserted in their earlobes. And they are purposely informal in how they relate with the patients. Bechdolf calls this a “subcultural” strategy.

“The truly awful thing is that it often takes years before young adults with psychoses receive treatment, and many feel stigmatized,” Bechdolf says. “It often takes another year from the point they start hearing voices before they finally take the step to open up to a doctor.” This is something FRITZ aims to change.

The program works with several hundred patients between the ages of 18 to 25. Some spend several weeks in the hospital ward. Others are outpatients, and some are treated at home. The vast majority (between 80% and 90%) were smoking marijuana on a regular basis before their treatment began. “Not all of them are addicted, but many of them are,” Bechdolf says.

Those who start smoking marijuana on a regular basis before the age of 15 are six times more likely to suffer from psychosis in later years. Adolescent cannabis consumers suffer from more anxiety and depression than their non-consuming counterparts. Cognitive performance is diminished and the loss of concentration is a common side effect. Quite often, these adolescents are unable to recall the content of a text they read only a few days before.

British scientists have established that people who smoked cannabis on a regular basis when young ended up, 10 years later, in a lower social standing, had worse academic results and a lower income than people who didn’t smoke.

“Dramatic effects”

The active ingredient is cannabis is Tetrahydrocannabinol (THC), which has been shown to inhibit brain maturation. The connecting of nervous cells in the brain takes place until about 25 years of age. THC impedes certain connections and certain areas remain underdeveloped while others connections are made by mistake.

A University of Melbourne study has even shown that the amygdala area of the brain, responsible for regulating the feelings of anxiety and depression, shrinks with regular cannabis abuse.

The abuse of marijuana also causes an unusually large amount of the neurotransmitter dopamine to be distributed throughout the brain. This in turn causes the feeling of relaxation but can, if abused over a long period of time, lead to hallucinations. The THC content in artificially cultivated cannabis, the most common form of cannabis production nowadays, is often quite high, up to 20%.

“This cannot be compared to the joints that were smoked in the 1960s and 1970s,” Bechdolf says. “The THC content of cannabis back then may have been only as high as 5%. But the cultivation of cannabis has become an industry that strives for optimization.”

High TCH levels are less of a problem for older people. “Those who are in their late 40s and smoke the occasional joint on the weekends don’t need to fear any repercussions,” the FRITZ head explains. “But the regular consumption of cannabis can have very dramatic effects on a 14- or 15-year-old.”

Bechdolf believes that nearly 20% of people who suffer from psychoses — extreme psychological disorders and loss of the concept of reality — could be healthy had they not smoked cannabis.

Trying to refocus

Psychoses often develop over several years. At first people have difficult concentrating and putting thoughts together. Things that used to be second nature become increasingly difficult. People are unable to understand the meaning of once-familiar words. Perceptions begin to change. Colors become more intense. A car that is 10 meters away might seem to be right in front of you.

“Those are the early symptoms,” Bechdolf explains. “This stage develops at a very slow pace over three or four years.” Then, when the psychosis manifests itself perceptively, acoustic hallucinations are added to the mix. Often the voices divulge secrets or utter a running commentary on the person’s shortcomings. People also feel they are being constantly followed or spied on.

The prognosis with a so-called substance-induced psychosis is usually relatively good. “Those who stop smoking pot have a very good chance of being healed,” Bechdolf says. Continued outpatient therapy after being released from the hospital is part of this healing process. Instead of going back to thinking, “If I have a joint, everything will be fine,” patients need to find a different approach to tackling their issues. “It is a huge challenge for those affected to re-learn how to deal with problems,” he says.

For Miklos, that’s meant nurturing a passion for longboarding. “It doesn’t give you the same kick as smoking pot, but it’s still pretty cool,” he says.

If his condition continues to be stable for the next two weeks, he will be discharged from the clinic and will have sessions with his therapist twice weekly. Miklos will not be moving back in with his parents when he’s discharged. Instead, he’ll be going to a supervised communal residence.

He even wants to try to repeat his final exams during the summer. Miklos says he’s also now able to appreciate the help he’s getting from the hospital’s doctors and social workers. “I know that I never would have been able to get better without them.”


Source: worldcrunch.com 3rd May 2015

flakka-surge-in-florida

Law enforcement officials in Florida say use of the synthetic drug known as “flakka” is surging there, ABC News reports.

The drug, also called gravel, is available for $5 a vial or less, the article notes. Officials say people are ordering small quantities of flakka through the mail. Its main ingredient is a chemical compound called alpha-PVP.

According to the National Institute on Drug Abuse (NIDA), alpha-PVP is chemically similar to other drugs known as “bath salts,” and takes the form of a white or pink crystal that can be eaten, snorted, injected, or vaporized in an e-cigarette or similar device.

Vaporizing, which sends the drug very quickly into the bloodstream, may make it particularly easy to overdose, NIDA notes. Alpha-PVP can cause a condition called “excited delirium” that involves extreme stimulation, paranoia, and hallucinations that can lead to violent aggression and self-injury. “The drug has been linked to deaths by suicide as well as heart attack. It can also dangerously raise body temperature and lead to kidney damage or kidney failure,” NIDA explains on its website.

The laboratory of the Broward Sheriff’s Office in Fort Lauderdale reports 275 flakka submissions already in the first three months of 2015, compared with fewer than 200 in all of last year.

Flakka makers are continually changing the chemical makeup of the drug, and often mix it with other substances such as crack cocaine or heroin, according to Don Maines, a drug treatment counselor with the Broward Sheriff’s Office. In as little as three days of use, a person’s behavior can undergo striking changes, he said.

“It actually starts to rewire the brain chemistry. They have no control over their thoughts. They can’t control their actions,” Maines said. “It seems to be universal that they think someone is chasing them. It’s just a dangerous, dangerous drug.”

Source: drugfree.org 5th May 2015

Scientific studies increasingly suggest marijuana may not be the risk-free high that teens — and sometimes their parents — think it is, researchers say. Yet pot is still widely perceived by young smokers as relatively harmless, said Dr. Romina Mizrahi, director of the Focus on Youth Psychosis Prevention clinic and research program at the Centre for Addiction and Mental Health.

She cites a growing body of research that warns of significantly higher incidence of hallucinations, paranoia and the triggering of psychotic illness in adolescent users who are most predisposed.

“When you look at the studies in general, you can safely say that in those that are vulnerable, it doubles the risk.”  Such fallout is increasingly evident in the 19-bed crisis monitoring unit at the Children’s Hospital of Eastern Ontario in Ottawa.

“I see more and more cases of substance-induced psychosis,” said Dr. Sinthu Suntharalingam, a child and adolescent psychiatrist. “The most common substance that’s abused is cannabis.” One or two cases a week are now arriving on average. “They will present with active hallucinations,” Suntharalingam said. “Parents will be very scared. They don’t know what’s going on. They’ll be seeing things, hearing things, sometimes they will try to self-harm or go after other people.”

She and Mizrahi, an associate professor in psychiatry at University of Toronto, are among other front-line professionals who say more must be done to help kids understand potential effects.

“They know the hard drugs, what they can do,” Suntharalingam said. “Acid, they’ll tell us it can cause all these things so they stay away from it. But marijuana? They’ll be: ‘Oh, everybody does it.”‘  Mizrahi said the message isn’t getting through.

“Teenagers think that cannabis is harmless. It is not. And for some people, it’s particularly dangerous.” She stressed that risk depends on many factors. “Not every 14-year-old who smokes marijuana will have schizophrenia,” she said in an interview. Genetics, social issues, marijuana strength and frequency of use are among complex variables along with how young a person starts using the drug. “We are starting to see this as a very important issue,” Mizrahi said. “I think we have to start to talk about this.”

Brain development in childhood continues through teenage years and into the early 20s, she explained. Cannabis affects how the brain’s regulator — called the endocannabinoid system — controls things like mood and memory, she said. “You’re kind of tampering with or altering the system that’s there to regulate other things.”

Mizrahi said she typically gets feedback when she discusses this topic from people who say they’ve used marijuana for decades with no psychotic effect. There are also those who point out myriad medical benefits. But psychotic episodes, when they occur, could be short-lived or trigger a longer-term illness.

The Centre for Addiction and Mental Health says marijuana use in Canada is most common among teens and young adults. It estimates past-year use in Ontario at 23 per cent for students in Grade 7 to 12, and 40 per cent for those aged 18 to 29.

Amir Englund of King’s College London specializes in the effects of cannabis on the brain and behaviour. Pot with higher THC or tetrahydrocannabinol content, the ingredient that induces most psychological effects, can pack the punch of three shots of scotch versus a pint of beer, he said.  Studies of frequent adolescent users suggest those who start smoking earlier have a higher tendency to develop psychotic illnesses, he said in an interview. “People who get an illness much earlier, their likelihood of having a bad prognosis is higher.”

In Canada, pot is often more accessible to under-agers than alcohol but with no content controls. The Centre for Addiction and Mental Health, the country’s largest teaching hospital of its kind, called last fall for legalization with strict regulation to reduce harm.

Mizrahi advises all young people to avoid pot until they’re at least in their early 20s. “Certainly don’t do it when your brain is developing,” she said. “Don’t put yourself at risk.”

Source:  http://www.ctvnews.ca/health    5th May 2015

The following short  video from SAM deserves a viewing:

https://youtube/cKiZ2RmcZLs

Filed under: Drug Specifics :

Summary

The 2012/13 New Zealand Health Survey (NZHS) provides valuable information about cannabis use by adults aged 15 years and over. It builds upon and adds value to the findings of the 2007/08 New Zealand Alcohol and Drug Use Survey report on cannabis.

This report presents information on cannabis use in New Zealand, including patterns of use, drug-driving, harms from use (productivity and learning, and mental health), legal problems, and cutting down and seeking help. Information on the medicinal use of cannabis is also presented.

Patterns of cannabis use

Eleven percent of adults aged 15 years and over reported using cannabis in the last 12 months (defined here as cannabis users). Cannabis was used by 15% of men and 8.0% of women. Māori adults and adults living in the most deprived areas were more likely to report using cannabis in the last 12 months. Thirty-four percent of cannabis users reported using cannabis at least weekly in the last 12 months. Male cannabis users were more likely to report using cannabis at least weekly in the last 12 months.

Cannabis and driving

Thirty-six percent of cannabis users who drove in the past year reported driving under the influence of cannabis in the last 12 months. Men were more likely to have done so.

Cannabis-related learning and productivity harms

Six percent of cannabis users reported harmful effects on work, studies or employment opportunities, 4.9% reported difficulty learning, and 1.7% reported absence from work or school in the last 12 months due to cannabis use.

Cannabis and mental health harms

Eight percent of cannabis users reported a time in the last 12 months that cannabis use had a harmful effect on their mental health. Younger cannabis users (aged 25–34 years) were most affected, with reported harm to mental health decreasing markedly by age 55+ years.

Cannabis and legal problems

Two percent (2.1%) of cannabis users reported experiencing legal problems because of their use in the last 12 months.

Cutting down and help to reduce cannabis use

Most cannabis users (87%) did not report any concerns from others about their use. Seven percent of cannabis users reported that others had expressed concern about their drug use or had suggested cutting down drug use within the last 12 months. Of cannabis users, 1.2% had received help to reduce their level of drug use in the last 12 months. Few cannabis users who wanted help did not get it (3.6%).

Cannabis use for medicinal purposes

Forty-two percent of cannabis users reported medicinal use (ie, to treat pain or another medical condition) in the last 12 months. Rates were similar for men and women. Older cannabis users (aged 55+ years) reported higher rates of medicinal use.

An  infographic (PDF, 174 KB)  provides a short overview of these findings.

The methodology report for the 2012/13 New Zealand Health Survey is also available on this website.

If you have any queries please email hdi@moh.govt.nz

Downloads

Source:  Ministry of Health. 2015. Cannabis Use 2012/13: New Zealand Health Survey. Wellington: Ministry of Health. Published online:  28 May 2015

http://www.health.govt.nz/publication/cannabis-use-2012-13-new-zealand-health-survey

Ingenious pill formulations and the latest manufacturing technologies are helping to stem the tide of painkiller addiction.

Mary Marcuccio’s life was turned upside down by drug misuse and addiction. Her son, now 26, started with alcohol and marijuana. Then came cocaine and hallucinogens. By 14, he was stealing prescription painkillers from friends’ medicine cabinets, crushing and snorting the pills to achieve a quick and euphoric high. Within one year, he had graduated to injecting heroin.

This progression is “so stereotypical”, says Marcuccio, founder of My Bottom Line, a Florida-based consulting business for families dealing with substance misuse. According to US survey data, 77% of heroin users say that, like Marcuccio’s son (who remains addicted to heroin), they misused prescription opioids — derivatives of natural or synthetic forms of opium or morphine — before trying heroin.

“It behooves us to make a greater effort at creating unabusable formularies.”

But substance-misuse specialists think that this chain of addiction might be broken with the aid of the latest manufacturing processes to make powerful opioid pain medication more resistant to various forms of tampering. Such drug preparations could also save lives. The death toll from misusing prescription opioids has skyrocketed around the world in the past 20 years, with opioid-linked overdoses exceeding fatalities from road accidents or deaths from heroin and cocaine in countries including the United Kingdom, the United States and Australia. “It behooves us to make a greater effort at creating unabusable formularies,” Marcuccio says.

Fortunately, the science and manufacturing of misuse-deterrence are advancing rapidly — and so is the political climate. In the United States — a country that consumes more than 80% of the global opioid supply — politicians are beginning to craft bills to incentivize the development of misuse-resistant formulations. “The idea is to transition the market,” says Dan Cohen, chair of the Abuse Deterrent Coalition, a network of advocacy organizations, technology manufacturers and drug companies based in Washington DC. “There are now so many different abuse-deterrent formulations that are either in products or in development that there’s enough variety out there for any product to be able to put abuse-deterrence in it.”

The new guard

Some of the latest tablet formulations are so hard that even a hammer-blow cannot pulverize them. Many pills form a gelatinous goo when dissolved that renders them difficult to inject. Others contain reversal agents that negate the high when the tablets are messed with. The idea is to create pain-relief medicines that are less prone to misuse yet work when taken as directed.

The technologies in place today are not ironclad, though. A quick perusal of online message boards and videos reveals numerous tips on how to circumvent the defences of even the most reinforced tablets. What is more, not all prescription opioids on the market are misuse-resistant. “We’re still in abuse-deterrent formulations 1.0,” says Richard Dart, director of the Rocky Mountain Poison and Drug Center in Denver, Colorado. But, he adds with a touch of hyperbole, “there are a zillion abuse-deterrent formulations coming”.

Manufacturers have been worried about prescription-drug misuse for decades. When the first controlled-release formulation of the opioid oxycodone hit the US market 20 years ago, the drug’s manufacturer, Purdue Pharma of Stamford, Connecticut, touted the twice-a-day medicine as a less-addictive alternative to the faster-acting painkillers that provide a big opioid hit all at once. In reality, however, Purdue’s longer-lasting pill, sold under the trade name OxyContin, had the opposite effect.

Drug users easily defeated OxyContin’s time-release mechanism by crushing or chewing it. Just one OxyContin could contain more oxycodone than a dozen instant-release pills but no extra ingredients such as paracetamol that make people sick if taken at high doses. OxyContin quickly became the number one addiction problem in many parts of the world, particularly in the United States and Australia. The drug was so popular among the rural poor of Appalachia in West Virginia and Kentucky that it earned the street name ‘hillbilly heroin’.

Purdue set to work to guard against some of the worst forms of misuse. In 2010, the company introduced a misuse-averting version of OxyContin that contains a polymer made of long-chain molecules. This makes the new tablet more difficult to crush — although it is not rock hard. “It behaves more like plastic,” explains Richard Mannion, executive director of pharmaceutics and analytical development at Purdue. “So, it will deform if subjected to force, but it doesn’t break into a powder easily.” The revised formulation is thus much harder to snort. Plus, Mannion says, when combined with water, the polymer forms a gummy substance that makes it very difficult to draw into a syringe (although misuse is still possible).

The new version of OxyContin has proved to reduce the incidence of therapeutic misuse. A study1 of more than 140,000 people treated at rehabilitation centres across the United States found that misuse by injection, snorting or smoking declined by two-thirds in the two years after the reformulation. In light of these results, in 2013, Purdue won the right from the US Food and Drug Administration (FDA) to describe the misuse-deterrent benefits of OxyContin on the drug’s label and to make marketing claims accordingly. The FDA said at the time that any future generic versions of OxyContin would have to incorporate equivalent misuse-deterrent protection. (In April 2015, the FDA released a guidance document outlining the types of study needed to establish misuse-deterrence, but the report stopped short of addressing generic opioid products.)

Other painkillers that now have FDA-approved misuse-deterrent labelling include Embeda, an extended-release morphine from New York-based pharmaceutical firm Pfizer, and Targiniq, another long-acting preparation of oxycodone from Purdue. Both contain antagonist agents — offsetting ingredients that remain largely inactive when the drugs are taken as directed, but that will annul the opioid’s effects if the drugs are snorted or injected.

“These new technologies are showing some positive results,” notes Robert Jamison, a pain psychologist at the Brigham and Women’s Hospital Pain Management Center in Chestnut Hill, Massachusetts. In Australia, for example, OxyContin users accounted for more than 60% of the visits to the Medically Supervised Injecting Centre in Sydney. After the tamper-resistant version of OxyContin hit the Australian market in April 2014, a team led by Louisa Degenhardt, a drug-addiction researcher at the University of New South Wales in Sydney, found2 that the number dropped to 5%. In the United States, levels of opioid misuse have decreased from their peak in 2010, when the new formulation of OxyContin arrived on the market. Rates of opioid dispensing and overdoses have dropped appreciably, too.

These public-health benefits come with an economic bonus. According to calculations from Noam Kirson and his colleagues at Analysis Group, a consulting firm in Boston, Massachusetts, the reformulated OxyContin has reduced misuse-related medical expenses and indirect societal costs by more than US$1 billion per year in the United States3. “These are substantial savings,” Kirson says.

 

Old habits die hard

Despite the gains, the misuse-deterrence field still has a long way to go. Drug users who have been thwarted by one technology can switch to another prescription medicine that lacks anti-tampering defences. That is what happened in rural Appalachia following the introduction of reformulated OxyContin. Opioid misusers simply started snorting and injecting the less potent immediate-release preparations of oxycodone, most of which lack misuse-deterrence characteristics. “It’s kind of a whack-a-mole situation,” says Jennifer Havens, an epidemiologist at the University of Kentucky Center for Drug and Alcohol Research in Lexington.

Plus, even with the latest physical defences it is still possible to get high by swallowing lots of OxyContin or Embeda pills at once. Preventing oral misuse requires a different approach — which a company called Signature Therapeutics, based in Palo Alto, California, is pursuing.

Signature Therapeutics’ technology uses prodrugs, which are inactive until they undergo the appropriate chemical conversion in the body. When these pills are taken by mouth as directed, a digestive enzyme in the gut called trypsin releases part of the prodrug, initiating the process of opioid drug release. But because trypsin is not found elsewhere in the body, the prodrug remains inert when injected, snorted or smoked. Signature Therapeutics has already tested its painkilling hydromorphone prodrug in a phase I trial of healthy volunteers; the company plans to begin evaluating its oxycodone prodrug in human studies later this year.

Prodrugs alone do not prevent excessive pill-popping, but scientists at Signature Therapeutics have another trick up their sleeves. If the prodrugs look promising in the clinic, the company will add a second compound that blocks trypsin activity. This might seem counterintuitive, but it is all about threshold levels. The amount of trypsin inhibitor found in one or two pills will not interfere with the prodrug modification, but a handful of pills collectively contain enough inhibitor to shut down the conversion process. With this approach, Signature Therapeutics can create either extended-release or immediate-release opioids. Bill Schmidt, chief medical officer at the company, says that the potential of these drugs is “maximum therapeutic benefit with very low abuse liability”.

New formulations such as these could ultimately prove to be almost addiction-proof, but they are not cheap. And their benefits might not be fully realized unless authorities require drug companies to include them. “The problem with abuse-deterrence right now is the lack of incentives,” Cohen says.

Lawmakers in the US House of Representatives previously proposed legislation that would have barred the approval of any new pharmaceuticals that did not use formulas resistant to tampering. That bill died in committee, but, according to Cohen, revised legislation should be introduced again “soon”. Individual US states have also begun to pass laws that compel pharmacists exclusively to dispense, and insurers to cover, misuse-deterrent versions of opioids unless instructed otherwise by a physician.

Ultimately, the success of long-term efforts to rein in opioid addiction could depend on the regulations surrounding generic painkillers. In December 2014, Australia allowed the sale of a generic long-acting oxycodone without misuse-deterrence characteristics. Degenhardt, who is monitoring the drug-misuse data, worries that many of the gains of OxyContin’s reformulation will now be lost. By contrast, US authorities have already said that they will not approve such a product.

All of these efforts should help to bring down the number of overdose deaths and also prevent experimentation with prescription pills. In her study population in rural Appalachia, Havens has met so many young people like Marcuccio’s son — for whom easily misused opioids were the gateway to addiction — that she has reached a simple, but absolute, conclusion: “The only way that abuse-deterrent formulations are going to work is if they’re all abuse-deterring,” she says. “It can’t just be piecemeal. It’s got to be all or nothing.”

Source:   Nature  522, S60–S61 doi:10.1038/522S60a  (25 June 2015)

The young woman was shocked when the addiction-treatment clinic’s drug test showed extraordinary levels of THC in her system. She knew she had a drug problem. But she wasn’t like those acquaintances who sat around smoking pipes, bongs and joints all day.

“We asked how she could have had such an extremely high level of THC in her system,” explained Joanie Lewis, founder of Insight Services, an outpatient addictions treatment facility in Colorado Springs. “We learned her parents were preparing almost all of their food in a marijuana butter. You got the feeling they didn’t really consider it drug abuse. But her level of intoxication was much higher than if she had been a traditional user who sat down and smoked pot several times a day. The impairment crept up on her slowly but profoundly. This kind of thing may be why we’re seeing more impairment, more addiction and more serious withdrawals.”

The proliferation of foods infused or coated with THC has become a growing concern, even among some marijuana advocates. Several high-profile marijuana crimes and deaths involve consumption of edible THC products.

“When THC is available in food, it’s even harder for people to see it as a drug,” Lewis said. “But it is a drug. It is a depressant, a hallucinogen and an addictive substance that changes chemistry in the brain. Research shows all of the above.”

Given the United States’ hard-fought and continuing battles against tobacco and illness caused by its use, Americans would rebuff sales of lemon drops, cookies and soda pops infused with nicotine. Yet, the marijuana industry — quickly emerging as Big Tobacco 2.0 — infuses child-friendly snacks and drinks with doses of mind-
altering and brain-damaging THC up to 50 times stronger than 1960s-era pot.

“Practically nobody had even heard of THC concentrates until after Colorado voted to legalize marijuana, and, honestly, this state had no idea what it was unleashing before it made that decision,” said Dr. Ken Finn, a Colorado Springs physician who is board certified in pain medicine. “Even today, a lot of people don’t seem to understand how potent and addictive this drug is or how easily it is concealed.”

When voters enacted Amendment 64, which sanctioned marijuana for recreational use, many did not envision a cookie more potent than dozens of Woodstock joints. Concealed in Amendment 64’s definitions of “marijuana” and “marihuana” is the phrase “marihuana concentrate.” It means the law allows sale, transport, possession and use of up to one1 ounce of leafy marijuana. It also means one 1 ounce of any form of THC concentrate, which can compare to 50 ounces or more of traditional pot that is smoked.

“I would appreciate it very much if people would send me links to news stories or government-sponsored communications explaining the THC levels that were established by Amendment 64,” Dr. Christian Thurstone, an associate professor of psychiatry at the University of Colorado who treats adolescent addiction and serves on the board of Safe Approaches to Marijuana, wrote on his website in February 2013. “I am unaware of any attempt of this nature to educate the public before Election Day, Nov. 6, 2012.”

Now the threats THC concentrates pose to public health and safety loom large. A new study from researchers at Ohio’s Nationwide Children’s Hospital finds more American children are exposed to marijuana before reaching their fifth birthday. The report, published in the peer-reviewed journal Clinical Pediatrics, found that between 2006 and 2013, the marijuana exposure rate rose 147.5 percent among children age 5 and under. In that same period, the rate rose nearly 610 percent in states that sanctioned medical marijuana before 2000, the year Colorado followed suit.

While consequences of most exposures reportedly were minor, the study’s researchers found 17 marijuana-exposed children fell comatose and 10 had seizures.

In Colorado, the number of exposures to THC-infused edibles in young children increased fourfold in one year, from 19 cases in 2013 to 95 in 2014, according to the Rocky Mountain Poison and Drug Center.

Experts overwhelmingly attribute spikes in marijuana exposure among children to THC-infused “edibles.” The drug-laced food is the most promising aspect of Big Marijuana’s economic future. Edibles make up about 45 percent of Colorado’s marijuana sales, based on state figures, and are projected to quickly surpass the sale of THC products that are smoked.

Advocates for edibles say the products provide a healthy alternative to inhaling smoke. Others go further, marketing drug-infused foods and drinks as health food.

“Here comes the Whole Foods-
ification of Marijuana,” states the headline for a story published by Fast Company, a news organization founded by former editors of Harvard Business Review, touting its focus on “ethical economics.” . The report describes the author’s experience with ordering front-door delivery of a jar of “organic, sun-grown marijuana from farmers Casey and Amber in Mendocino, Calif.”

“There’s a whole industry being built around the upscale branding of weed,” author Ariel Schwartz explains. “Marijuana is now something that should be organic, grown by friendly farmers…”

For marijuana sellers, edibles mean a potentially boundless market share. “Edibles are the future of the industry due to their familiarity,” explains an article on a website that markets “The Stoner’s Cookbook.” “Non-smokers are not inclined to medicate with a joint, but an infused cookie is something familiar that they’re comfortable ingesting.”

Indeed, THC-infused foods and drinks — all fashioned from marijuana the state doesn’t yet test for contaminants — are sold in hundreds of store-front establishments throughout the state. They are shared and traded on the campuses of middle schools and high schools, where young users with developing brains are especially susceptible to addiction. They are stowed in lunch boxes in the workplace.

Employers, law enforcement officials, educators and addiction treatment providers say Colorado has cooked up a poorly regulated THC-food fiasco that crisscrosses the country with the ease of exporting gummy bears in glove compartments, pockets and handbags. For taxpayers, the growing edibles market means an array of social costs — including hospitalizations, traffic accidents, school dropouts and lost work productivity — that state and federal officials haven’t fully investigated, estimated and made public.

Known as hash oil, wax, dabs, and shatter, concentrates deliver a high so fast and intense many users refer to them as “green crack.” One ounce of the highest potency THC concentrate can yield 560 average tokes on an electronic cigarette. In edibles, Colorado law defines an average serving of THC as 10 milligrams.

“That average serving size? That’s a political number, not anything rooted in real, reputable science,” said Kevin Sabet, a former senior White House drug policy advisoer and co-founder of Smart Approaches to Marijuana, an organization opposed to marijuana legalization and supported by several of the country’s top addiction treatment experts.

The 10-milligram serving size established by Colorado lawmakers means one1 ounce of high-potency THC oil — the amount one adult is allowed to buy or possess at any given time — also can equal 2,800 average servings. That’s a well-stocked bakery.

“I don’t need scientific evidence to show me that students are completely zoned out and that more stoned kids are showing up for class,” said Kelly Landen, a high school teacher in Denver. “If they’ve smoked marijuana, you smell it on them. But students also show up with candy and cookies and whatever … and there’s no way to know for certain what’s in that food. They could be eating (THC) right in front of me.”

Unregulated by the U.S. Food and Drug Administration, concentrated THC is practically undetectable. There is no pill. Unlike alcohol and cigarettes, there is no smell. Users can get high on food and beverages while hiding in plain sight in almost any location.

“There is great danger in how easy these food products are to conceal,” said Frank Szachta, director of The Cornerstone Program, an adolescent addiction treatment center in Centennial. “Someone could do this drug in front of you, or in front of a teacher, in front of the boss. … No one would have to know.”

Colorado legislators have grappled with the problem of people — particularly children and adolescents — consuming marijuana in common snacks that land them in emergency rooms with panic attacks and hallucinations. Authorities have linked at least three deaths in Colorado, including a murder, to excessive consumption of THC-laced foods.

When ingested through the stomach, the user may not experience effects for an hour or more. The delayed effect is blamed in part for new users becoming impatient and eating too much.

“Like a bottle of vodka, you can’t just drink the entire bottle. You have to take it slow and understand what you’re doing,” said Julie Berliner in a YouTube video. She’s the founder of Sweet Grass Kitchen, an edibles manufacturing company in Denver.

But edibles are not like a bottle of vodka in important ways. The vodka’s contents are exactly known, and drinks can be measured precisely. The label on a THC-infused brownie or candy bar might state “servings per package: 10,” but the maker can’t say whether the consumer will ingest all of those servings in one small bite. The folly is akin to cutting a cupcake into tenths and presuming each piece contains exactly one serving of vanilla extract.

Making matters worse, said Lewis of Insight Services, is that many people are not inclined to follow recommended serving sizes.

“The state says a serving size is 10 milligrams, so that’s how much THC you might find in one small piece of candy,” she said. “But very few people sit down with a bag of candy and eat only one piece.”

State lawmakers’ efforts to regulate edibles and their packaging have done little to stop accidental overdoses and deter underage use — in part because they haven’t applied to homemade goods infused with THC, health professionals say. State law also is undermined when someone removes the contents of a package and stores the THC-infused food in a bowl, jar or other container.

A law enacted in 2014 instructs the Colorado Department of Public Health and the Environment to devise standards and procedures that will make unpackaged, commercial food products easily stand out if they contain THC. It’s a tall order when dealing with small pieces of food — such as crumbs of granola — and the agency continues to grasping for a solution.

Since legalization and the mass marketing of highly potent, THC foods began, Colorado addiction treatment providers have reported increasing levels of toxicity among clients, more severe addiction and poorer prognoses for recovery from substance use disorders.

For example, the average level of THC found in the urine of about 5,000 adolescents ages 13-19 by researchers at the University of Colorado jumped from 358 nanograms per milliliter in 2007 through 2009 — just before the state’s boom in medical marijuana dispensaries — to 536 milliliters from 2010 through 2013.

The rapidly widening scope of THC-infused food is shaping up to be a recipe for great losses for individuals, families and the entire state, Lewis said.

“People are coming to us later in the addiction cycle than they used to,” she said. “When people get high on food, there is the perception that they’re not really using a drug. It seems less harmful than taking pills or smoking. By the time they realize there’s a problem, some of them are quite a ways further into the addiction than if they had been smoking it.”

Source: http://m.gazette.com/clearing-the-haze-thc-extracts-concentrate-problems/article/1554097   June 2015

SUSAN SCHENK AND DAVID HARPER

REUTERS

Ecstasy deserves to remain an illegal drug, as there is substantial evidence of it causing harm.

A dangerous case is being made in New Zealand for the legalisation of MDMA, the primary active ingredient of the street drug, Ecstasy.

Ecstasy rose in popularity among the rave party scene in the early 1980s. Use has since spread to more mainstream groups. New Zealanders are some of the heaviest users of ecstasy worldwide, with an estimated 13 per cent of Kiwi respondents to the Global Drug Survey having used ecstasy in the past year.  Supporters of the move to legalise claim the drug is safe, and recent comments made by Wellington Hospital emergency department specialist, Dr Paul Quigley, would seem to support this position.  Quigley has reported few emergency admissions related to ecstasy use, and from this he has incorrectly assumed this means that MDMA use poses minimal harm.

Emergency room admissions are a flawed benchmark for determining the safety of a drug, such as MDMA, as the major harm associated with MDMA is the death of brain cells, and associated behaviour changes.   These effects are generally not life-threatening and would therefore not lead users to seek emergency care.

This does not, however, indicate that MDMA is safe.

Rather, considerable published evidence has demonstrated that memory loss and attention issues are common in MDMA users and there is compelling evidence for the loss of the brain chemical, serotonin, which leads to further problems associated with sleep patterns and emotional wellbeing.

These effects can seriously impact the individual’s ability to lead a productive life, and it is common for users to experience negative emotional after-effects of ecstasy. Importantly, there are no quick fixes for the many detrimental effects of ecstasy and these effects may persist for years.

It has also been suggested that MDMA dependence is not a likely consequence of use, providing proponents of legalisation another indication that MDMA use poses minimal harm.   This too is unsupported in the scientific literature.

* John Key unconvinced by emergency doctor’s call to legalise MDMA

* Don’t freak out over changing drug laws

For most drugs of abuse, including cocaine and methamphetamine (P), about 10-15 per cent of users become dependent on the drug. The same is true of ecstasy users.

Studies have suggested that a subset of ecstasy users progress to misuse and consume the drug frequently and in high dosages.  In New Zealand, the Illicit Drug Monitoring System provides a snapshot of heavy drug users over time.

According to this authoritative survey, ecstasy use among heavy drug users is substantial, and 15 per cent use ecstasy weekly.  An online survey in Britain suggests MDMA users were more likely to report dependence symptoms than users of cocaine.

Another assumption is that by regulating the supply of MDMA, both producers and users will engage in safe drug production and use.  While it is true that most users don’t know what else they are actually taking when taking an ecstasy pill – it is frequently mixed with any range of other substances, some harmful, some not – that doesn’t mean that pure MDMA is actually safe.

Perhaps ‘safer’, but not ‘safe’.

New Zealand has toyed with legalisation of psychoactive substances for many years. First there were the BZP-TFMPP “legal highs” that were subsequently banned as they were shown to be dangerous after all.  The same was true of synthetic cannabis products that have also recently been banned because they were shown to pose more than an acceptable risk of harm.

Despite what has recently been suggested in the media, there is substantial evidence of harm and risk arising from the use of MDMA.  We have been studying the effects of MDMA on brain and behaviour for about 10 years, and the negative effects of ecstasy have been well-documented by us and many other researchers.

Knowing what we know about ecstasy use, and the well-documented negative consequences of its use, the potential for misuse and the persistent and prolific adverse consequences of MDMA use, it is clear that unrestricted use of MDMA poses a great risk of harm, and that it would be irresponsible to provide MDMA for legal sale in New Zealand.

Professor Susan Schenk is from Victoria University’s school of psychology, and Professor David Harper is the dean of science.

Source:  stuff.co.nz  29th June 2015

Officials in cities across the United States are reporting a rise in overdoses related to synthetic marijuana, CNN reports. Police chiefs meeting in Washington this week said they need field tests to help them quickly determine whether suspects have taken the drug.

Synthetic marijuana, sold under names such as “K2,” “Spice” and “Scooby Snax,” is very different from marijuana, according to the American Association of Poison Control Centers. It is made with dried herbs and spices that are sprayed with chemicals that induce a marijuana-type high when smoked. The drug is not tested for safety, so there is no way for a person to know what chemicals they are using.

Health effects can include severe agitation and anxiety; fast, racing heartbeat and high blood pressure; nausea and vomiting; muscle spasms, seizures, and tremors; intense hallucinations and psychotic episodes; and suicidal and other harmful thoughts and/or actions.  From January 1 to August 2, 2015, poison control centers received calls about 5,008 exposures to synthetic marijuana, compared with 3,682 in all of last year.

According to a survey of 35 major city police departments, 30 percent have attributed some violent crimes to synthetic marijuana, the article notes. Overdoses in some cities are clustered in homeless populations.

On Tuesday, New York Police Commissioner William Bratton called the drug “weaponized marijuana,” and called it “a great and growing concern.”

The products are widely available, despite laws prohibiting them. With the passing of each regulation to control synthetic marijuana, drug manufacturers and suppliers are quickly changing the ingredients to new, non-controlled variations.

Source:  http://www.drugfree.org/join-together/   5th August 2015

Abstract

INTRODUCTION AND AIMS:

This study aims to evaluate the feasibility and effects of a group cessation program for cannabis and tobacco co-smokers.

DESIGN AND METHODS:

Using a repeated-measures design with pre-, post- and six months follow-up assessments, feasibility (intervention utilisation, safety and acceptability) and changes in substance use behaviour and mental health were evaluated. The intervention consisted of five to six group sessions and was based on current treatment techniques (e.g. motivational interviewing, cognitive-behavioural therapy, and self-control training). In total, 77 adults who used cannabis at least once weekly and cigarettes or similar products at least once daily participated in the study.

RESULTS:

Within nine months, the target sample size was reached. Treatment retention was 62.3%, and only three participants discontinued treatment due to severe problems (concentration problems, sleeping problems, depressive symptoms, and/or distorted perceptions). In total, 41.5% and 23.4% reported abstinence from cigarettes, cannabis or both at the end of treatment and the follow-up, respectively. The individual abstinence rates for cigarettes and cannabis were 32.5% and 23.4% (end of treatment) and 10.4% and 19.5% (follow-up), and 13% (end of treatment) and 5.2% (follow-up) achieved dual abstinence validated for tobacco abstinence. Over the study period, significant decreases in tobacco and cannabis use frequencies and significant improvements in additional outcomes (drinking problems, symptoms of cannabis use disorder, nicotine dependence, depression and anxiety) were achieved.

DISCUSSION AND CONCLUSIONS:

The evaluated intervention for co-smokers is feasible regarding recruitment, intervention retention and safety. The promising results regarding substance use and mental health support a randomised controlled trial to evaluate effectiveness.

Source:  Drug Alcohol Rev. 2015 Jul;34(4):418-26. doi: 10.1111/dar.12244. Epub 2015 Feb 11.

This new street drug is 10,000 times more potent than morphine, and now it’s showing up in Canada and the U.S.

It was first developed in a Canadian lab more than three decades ago, promising and potent — and intended to relieve pain in a less addictive way. Labeled W-18, the synthetic opioid was the most powerful in a series of about 30 compounds concocted at the University of Alberta and patented in the U.S. and Canada in 1984.

But no pharmaceutical company would pick it up, so on a shelf the recipe sat, the research chronicled in medical journals but never put to use. The compound was largely forgotten.  Then a Chinese chemist found it, and in labs halfway around the world started developing the drug for consumers in search of a cheap and legal high — one experts say is 100 times more potent than fentanyl and 10,000 stronger than morphine. [Deaths from opioid overdoses set a record in 2014]

And now it has come to North America. The substance first surfaced in Canada last fall, when Calgary police seized pills containing traces of the drug,according to the Calgary Herald. Then more than 2.5 pounds of W-18 was discovered in the home of a Florida man, who was sentenced to 10 years in federal prison after he pleaded guilty to smuggling fentanyl from China,reported the Sun Sentinel. He faced no charges for possessing the W-18, however, because it’s not yet illegal in the U.S.

And just last week, Health Canada’s Drug Analysis Service confirmed that four kilograms of a chemical powder seized in a fentanyl investigation in December 2015 was indeed the dangerous W-18 drug. Health officials are concerned for many reasons. There are currently no tests to detect the drug in a person’s blood or urine, according to reports, making it difficult for doctors to help someone who might be overdosing, a risk outlined in the drug’s 1984 patent.  Its effect on humans is largely unknown because W-18 was only ever tested on lab mice.

“Whenever this drug starts circulating on the streets you’re going to have deaths,” Sacramento-based forensic chemist Brian Escamilla told the Calgary Sun. Health Canada is working to have W-18 added to its Controlled Drugs and Substances Act.

The Drug Enforcement Administration has not made a formal statement warning of the hazards of W-18, but a spokesman for the department did tell the Calgary Sun that its unclear how far the drug has infiltrated the U.S. and alluded to reports suggesting W-18 is being cut with heroin and cocaine in Philadelphia.  If that’s true, the new drug could exacerbate the growing heroin epidemic.

The debut of W-18 also draws attention to the growing influence Chinese chemists have on the kinds of drugs entering the U.S. Last fall, China banned 116 different synthetic drugs, according to reports, including fentanyl and the deadly flakka, a drug that put south Florida in crisis mode. Since then, flakka has all but disappeared.

In its absence, however, Chinese drug manufacturers began producing alternatives to sell, including W-18, a DEA spokesman told the Calgary Sun.

“Instead of selling heroin in quarter-ounce, half-ounce quantities, you’re talking about micrograms of these substances that are 100 times more potent than fentanyl,” Baer said.

Source:  https://www.washingtonpost.com/news/morning-mix/wp/2016/04/27

Filed under: Drug Specifics :

This wonderful book tells much of the story about cannabis that we are not allowed to hear.

I strongly commend it to you all. It does the neuroscience very well, and reviews much of the brain and neuroscience nicely and in a sensible and balanced way, and also indicates how the crazy side skews their presentation of evidence to aid and abet their grossly dishonest agenda. It actually gives a list of 21 social harms directly related to drug addiction – and then says that there are several dozen more which have not been mentioned!!!!

It is written by a senior practising psychiatrist majoring in addiction medicine, who was also a cannabis addict from 17-19 years of age. So he has known both sides of the fence.

Source: Book reviewed by Stuart Reece sreece@bigpond.net.au  Sept 2015

https://books.google.co.uk/

On the heels of the Federal Drug Administration’s (FDA) second public workshop to explore the public health considerations associated with e-cigarettes, nonprofit research organization RTI International released a new research paper “Exhaled Electronic Cigarette Emissions: What’s Your Secondhand Exposure?,” which explores the composition of e-cigarette vapor and the potential health impacts of secondhand exposure.

“As proliferation of e-cigarettes surges, understanding the health effects of e-cigarette use and exposure to vapors is essential,” said Jonathan Thornburg, Ph.D., author of the study published by RTI Press, and director of Exposure and Aerosol Technology at RTI. “We need to be aggressively investing in and conducting research that answers lingering questions about the potential health impacts of secondhand exposure to e-cigarettes, while taking the necessary action to protect public health now.”

The study finds e-cigarette emissions contain enough nicotine, and numerous other chemicals to cause concern. A non-user may be exposed to secondhand aerosol particles similar in size to tobacco smoke and diesel engine smoke. Meanwhile, e-cigarettes are a rapidly growing business with annual sales doubling yearly to $1 billion in 2013, and a current lack of regulation that has allowed for a surge in marketing.

Because e-cigarette products are not yet regulated, the chemicals and devices involved vary widely, as may the potential health impacts. Many factors — including the specific device used — influence the chemical makeup and toxicity of e-cigarette emissions. The full scope of health impacts of e-cigarette smoke, as well as secondhand exposure’s impacts on children, is still unknown.

“Secondhand exposure to e-cigarettes is just one aspect of the research that must be considered as we make decisions about appropriate use of these products,” said Annice Kim, Ph.D., senior social scientist at RTI. “It is critical that we explore the role of e-cigarette marketing — especially to children and youth — so that we can better understand motivators for use and put public health safeguards in place.”

RTI hosted a press briefing today to answer questions about public health concerns associated with secondhand exposure to e-cigarette emissions and product marketing.

The briefing featured RTI experts Thornburg and Kim as well as Stanton Glantz, Ph.D., professor of medicine, University of California, San Francisco (UCSF) and director, UCSF Center for Tobacco Control Research and Education.  E-cigarettes are nicotine-delivering consumer products designed to closely mimic the experience of smoking conventional cigarettes. The courts have already determined e-cigarettes to be tobacco products, and the FDA has proposed following the same classification.

According to the Centers for Disease Control and Prevention, secondhand smoke from traditional cigarettes has killed 2.5 million adults who were non-smokers, in the past 50 years. Secondhand smoke from traditional cigarettes is associated with the top four causes of death in America.

To read the study “Exhaled Electronic Cigarette Emissions: What’s Your Secondhand Exposure?,” which is the 100th publication of RTI Press, and to access more research about e-cigarettes, visit http://www.rti.org/e-cigarettes and follow RTI on Twitter @RTI_Intl.

Source: RTI Press, March 2015  http://www.newswise.com/articles/view/631070/?sc=dwtn   12th March 2015

Sanjay Gupta, MD, has gone off the rails and taken CNN with him. To promote his third documentary on the subject, Weed 3, he wrote an article titled “Dr. Sanjay Gupta: It’s time for a medical marijuana revolution” on CNN’s website datelined April 20. Yes, that 4/20, the day marijuana smokers nationwide gather outside to flout federal and state law by openly smoking pot. (Even the four states and DC that have legalized recreational marijuana prohibit smoking in public.)

In his call for a medical marijuana revolution, he morphs from less-than-objective reporter to shameless huckster, concluding, “We should legalize medical marijuana. We should do it nationally. And, we should do it now.”

As CNN’s chief medical correspondent, a practicing neurosurgeon, assistant professor of neurosurgery at Emory University School of Medicine, and associate chief of the neurosurgery service at Atlanta’s Grady Memorial Hospital, he understands how medicine works.

In covering the admission of the nation’s first Ebola patient, American Dr. Kent Brantley who fell ill while caring for Liberians stricken with the disease and was flown to Emory University Hospital for treatment, Dr. Gupta noted how unusual it would be to administer an experimental drug that hadn’t gone through the rigorous FDA process, even to patients with an incurable disease.

But his infatuation with marijuana somehow enables him to suspend the tools of modern medicine that protect people from unsafe, ineffective drugs. Anderson Cooper interviewed Dr. Gupta to promote Weed 2 shortly before it aired last year.

“It’s really fascinating, Anderson,” Dr. Gupta said, “because we’re used to an FDA process where you have the trials that take place and then you’re given a certain dosage and all that stuff. That hasn’t happened with cannabis. What happens is you have these different strains [of marijuana] and they [the producers] will create these hybrids . . . and then, you know, the people who are the dispensers will often times be talking to the patients who come in, finding out what works for them . . . . But, you know, the trial and error of this just feels so nascent and new in what they’re trying to do and really something like this hasn’t been done before, at least not for a long time, in this country.”

Dr. Gupta fails to mention that the dispensers, called “budtenders” – the marijuana equivalent of bartenders – have no medical training whatsoever. Welcome to the brave new world of word-of-mouth medicine: tell me which marijuana strain relieves your (name any of the 50 illnesses legislators have approved marijuana to treat despite lack of FDA approval) and I’ll pass it on to the next person with a similar complaint.

It is the responsibility of all medicine makers, whether pharmaceutical companies or “medical” marijuana growers, to submit their medicines to FDA for approval before marketing them to the public. What Dr. Gupta fails to see is that if a government legalizes “medical” pot, marijuana growers are free to promote and sell their “medicines” without bothering to prove they are safe or effective. But then, when you are so enamored with “medical” weed that you call for it to be legalized, you can forget that love is blind.

Source: The MarijuanaReport.org 22nd April 2015

On the street, it’s also called “gravel” for its white, crystal chunks. In the lab, it’s known as a stimulant, part of a chemical class called cathinones, with the amphetamine-like effects of Molly and Ecstasy. In the media it’s been dubbed “the insanity drug.”

Indeed, flakka has fuelled a recent, bizarre a spate of public behavior, all occurring in Fort Lauderdale, Florida. On April 4, a man who had smoked flakka ran naked in the streets, claiming people had stolen his clothes. In March, a man on flakka impaled himself on a spiked fence outside the police station. He survived. In February, a man on flakka tried to kick in the police station door, claiming cars were chasing him.

“This is bad stuff,” said epidemiologist James N. Hall, co-director of the Center for the Study and Prevention of Substance Abuse at Nova Southeastern University in Florida.

“The biggest danger is these are guinea pig drugs and the users are like lab rats.”

Flakka simulates the effects of the khat plant, which grows in Somalia and in the Middle East. Experts say that in high doses, it can cause an “excited delirium,” during which a user’s body temperature can rise to as high as 105 degrees. It can also create heart problems like tachycardia and life-threatening kidney failure.

“Some get high and some get very sick and may become addicted,” Hall said. “Some go crazy and even a few die. But they don’t know what they are taking or what’s going to happen to them.” In 2013 alone, cathinones, created in China and sold over the Internet, caused 123 deaths in Florida, according to the United Way of Broward County Commission on Substance Abuse.

Flakka, which can be crushed and snorted, swallowed or injected, is peddled under many brand names, including the less-potent cathinone, “Molly.” Flakka is often mixed with other drugs like methamphetamine.

Ecstasy or MDMA is a different class of chemical altogether, but Molly, though often touted as “pure” MDMA, is a first-generation cathinone. Because flakka is sold under so many different brand names, including “Molly,” users can be fooled, not knowing the potency of this new synthetic drug.

Flakka is “very dose specific,” said Hall. “Just a little (of it) delivers the high effect. It produces energy to dance and euphoria. But just a little more — and you can’t tell by looking at the capsule or baggie. Its name comes from the Spanish word “flaco” for thin. Latinos also use “la flaca” as a clubbing term for a pretty, skinny girl.

Spelled “flakka,” it’s “an eloquent collegial term — a beautiful, skinny woman who charms all she meets,” said Hall. “They give [synthetic drugs] names that are hip and cool and making it great for sales.”

Flakka emerged in South Florida last year, and has been seen in parts of Texas and Ohio, but is still not illegal in many states, according to Hall.

The abuse of synthetic drugs is a well-worn story in the United States — the largest consumer market of illicit drugs, according to Dr. Guohua Li, an epidemiologist and founding director of the Center for Injury Epidemiology and Prevention at Columbia University.

“Each generation is exposed to different drugs of choice,” Li said. “The signature substances and their particular effects become a unique feature of the birth cohort.”

“Designer drugs must stay ahead of the authorities and medical communities to keep their illegal business afloat,” Li added.

In the 1940s, a Swiss chemist synthesized a drug from the ergot fungus and discovered the psychedelic properties of lysergic acid diethylamide or LSD. But in 1966, after Timothy Leary urged a generation to, “turn on, tune in, drop out,” the drug was made illegal.

In the 1980s, the all-night rave scene gave birth to the synthetic drug MDMA or ecstasy, giving users the euphoric high of amphetamines and the psychedelic effects of hallucinogens.

By the 1990s, the scourge of lab-produced meth appeared on the West Coast and increased in popularity throughout a decade.

Synthetic marijuana dubbed K2 or Spice, emerged in 2006, and was eventually banned in 2011.

At the same time, MDMA, which is a phenethylamine, saw a resurgence, but by 2010, synthetic cathinones — “bath salts” and the drug Molly — arrived on the club scene.

But now, use of MDMA has tapered off, due to the growing popularity of flakka, which costs only about $5 a dose.

“It’s emerging as the crack cocaine of 2015 with its severe effects high addiction rate for a low cost,” said Hall. “People are terrified of the drug. It’s because the consequences are so devastating.”

Source: http://www.nbcnews.com/health/health-news/flakka-attack-new-synthetic-drug April 15th 2015

Filed under: Drug Specifics,Synthetics :

These remarkable scans clearly reveal how smoking during pregnancy harms an unborn baby’s development.

New ultrasound images show how babies of mothers who smoke during pregnancy touch their mouths and faces much more than babies of non-smoking mothers.

Foetuses normally touch their mouths and faces much less the older and more developed they are. Experts said the scans show how smoking during pregnancy can mean the development of the baby’s central nervous system is delayed. Doctors have long urged pregnant women to give up cigarettes because they heighten the risk of premature birth, respiratory problems and even cot death.

Now researchers believe they can show the effects of smoking on babies in the womb – and use the images to encourage mothers who are struggling to give up.

Image shows the 4-D ultrasound scan of two foetuses at 32 weeks gestation, one whose mother was a smoker (top) and the other carried by a non-smoker (bottom). The foetus carried by the smoker touches its face and mouth much more, indicating its development is delayed

As part of the study, Dr Nadja Reissland, of Durham University, used 4-D ultrasound scan images to record thousands of tiny movements in the womb.

She monitored 20 mothers attending the James Cook University Hospital in Middlesbrough, four of whom smoked an average of 14 cigarettes a day.

After studying their scans at 24, 28, 32 and 36 weeks, she detected that foetuses whose mothers smoked continued to show significantly higher rates of mouth movement and self-touching than those carried by non-smokers. Foetuses usually move their mouths and touch themselves less as they gain more control the closer they get to birth, she explained.

The pilot study, which Dr Reissland hopes to expand with a bigger sample, found babies carried by smoking mothers may have delayed development of the central nervous system. Dr Reissland said: ‘A larger study is needed to confirm these results and to investigate specific effects, including the interaction of maternal stress and smoking.’

She believed that videos of the difference in pre-birth development could help mothers give up smoking.

But she was against demonising mothers and called for more support for them to give up. Currently, 12 per cent of pregnant women in the UK smoke but the rate is over 20 per cent in certain areas in the North East. All the babies in her study were born healthy, and were of normal size and weight.

Dr Reissland, who has an expertise in studying foetal development, thanked the mothers who took part in her study, especially those who smoked. ‘I’m really grateful, they did a good thing,’ she said. ‘These are special people and they overcame the stigma to help others.’

Co-author Professor Brian Francis, of Lancaster University, added: ‘Technology means we can now see what was previously hidden, revealing how smoking affects the development of the foetus in ways we did not realise.

‘This is yet further evidence of the negative effects of smoking in pregnancy.’ The research was published in the journal Acta Paediatrica. 


Read more: http://www.dailymail.co.uk  23 March 2015

DENVER, CO – MARCH, 4: Lights hang above cannabis plants in a “flower room” inside a medical cannabis cultivation facility in Denver, Colorado, U.S., on Monday, March 4, 2013. (Photo by Matthew Staver/For The Washington Post)

Across the country, there’s a growing trend toward the legalization of marijuana. Four states— Oregon, Washington, Colorado, Alaska —have voted to allow people to possess limited amounts of marijuana for personal use and also to let producers apply for licenses to produce and sell it. D.C. also just voted to allow personal possession. All of this is on top of the 23 states that allow it for medical reasons.

In some states, where businesses are also now legally cultivating and producing marijuana, a mainstream industry is emerging. Marijuana sales totalled $700 million in Colorado last year, for instance. But there’s a surprising catch. It turns out that indoor marijuana growth in particular — a cultivation method often favoured in the industry for many reasons — uses a surprising amount of energy.

Indeed, the level of power use appears to be so significant that one scholar is now suggesting that as the industry grows, states and localities should take advantage of marijuana licensing procedures to also regulate the industry’s energy use and greenhouse gas emissions.

“Given that this is a new ‘industry’ that is going to be pretty highly regulated, I felt like the state and local policymakers have a unique opportunity to incorporate energy usage and climate assessments into their state marijuana licensing fees,” says Gina Warren, a professor at the Texas A&M University School of Law whose paper, titled “Regulating Pot to Save the Polar Bear: Energy and Climate Impacts of the Marijuana Industry,”will soon appear in the Columbia Journal of Environmental Law.

The published statistics on energy use from indoor marijuana production will blow your mind (whether or not you use the stuff). In a 2012 study of the “carbon footprint of indoor cannabis production” published in the journal Energy Policy, researcher Evan Mills noted that “on occasion, previously unrecognized spheres of energy use come to light,” and marijuana is a textbook example.

The study estimated that indoor cannabis (both illegal and legal) uses $6 billion worth of electricity every year, amounting to 1 percent ofoverall U.S. electricity. And in some production-intensive states like California, it was much higher — 3 percent, Mills found.

“One average kilogram of final product is associated with 4,600 kg of carbon dioxide emissions to the atmosphere, or that of 3 million average U.S. cars when aggregated across all national production,” wrote Mills.

The reason is simply the technology required. “Specific energy uses include high-intensity lighting, dehumidification to remove water vapour and avoid mould formation, space heating or cooling during non-illuminated periods and drying, pre-heating of irrigation water, generation of carbon dioxide by burning fossil fuel, and ventilation and air-conditioning to remove waste heat,” writes Mills.

Outdoor production also has environmental consequences —it has been charged with deforestation and high levels of water and pesticide use.But as pot becomes more legal and mainstream, notes Warren, outdoor producers will have to abide by pre-existing environmental laws, just like everyone else.

In effect, that makes indoor production the chief climate change and energy concern. According to Warren’s article, while underground indoor marijuana production already consumed plenty of energy, legalization will increase energy use even farther. “As theindustry grows, so will its negative externalities,” she writes.

Which is why she’s proposing that states that legalize marijuana use should also require the growing industry to power itself cleanly. And it’s not without precedent: Starting in October of this year, Boulder County in Colorado will require many marijuana facilities to “directly offset 100% of electricity, propane, and natural [gas] consumption” through renewables or other means.

Warren says she’s not “picking on the marijuana industry” with her proposals — it’s just that, well, we don’t often have new industries appear that use a lot of energy and are likely to be highly regulated as they become legal.

“I think it could actually be a marketing tool for the industry,” says Warren, “because if you have people who are purchasing the product who are the type of individual who cares about the environment, then they would gravitate towards the green marijuana production.”

Source:http://www.washingtonpost.com/

President Obama this week told an audience in Jamaica that U.S. efforts against illegal drugs were “counterproductive” because they relied too much on incarceration—particularly for “young people who did not engage in violence.”

In what the president termed “an experiment … to legalize marijuana” in Colorado and Washington state, he said he believed they must “show that they are not suddenly a magnet for additional crime, that they have a strong enough public health infrastructure to push against the potential of increased addiction.”

In regard to Jamaica and the entire Caribbean and Central American region, he said, “a lot of folks think … if we just legalize marijuana, then it’ll reduce the money flowing into the transnational drug trade, there are more revenues and jobs created.”

To some of us, Jamaica hardly seems an auspicious location for encouraging “experimentation” with drugs, in particular because of the challenges already faced by their deficient institutions of public health and criminal justice. The U.S. Department of State 2015 International Narcotics Control Strategy Report(INCSR) states:

Jamaica remains the largest Caribbean supplier of marijuana to the United States and local Caribbean islands. Although cocaine and synthetic drugs are not produced locally, Jamaica is a transit point for drugs trafficked from South America to North America and other international markets. In 2014, drug production and trafficking were enabled and accompanied by organized crime, domestic and international gang activity, and police and government corruption. Illicit drugs are also a means of exchange for illegally-trafficked firearms entering the country, exacerbating Jamaica’s security situation.

Drugs flow from and through Jamaica by maritime conveyance, air freight, human couriers, and to a limited degree by private aircraft. Marijuana and cocaine are trafficked from and through Jamaica into the United States, Canada, the United Kingdom, Belgium, Germany, the Netherlands, and other Caribbean nations. Jamaica is emerging as a transit point for cocaine leaving Central America and destined for the United States, and some drug trafficking organizations exchange Jamaican marijuana for cocaine. . . .

The conviction rate for murder was approximately five percent, and the courts continued to be plagued with a culture of trial postponements and delay. This lack of efficacy within the criminal courts contributed to impunity for many of the worst criminal offenders and gangs, an abnormally high rate of violent crimes, lack of cooperation by witnesses and potential jurors, frustration among police officers and the public, a significant social cost and drain on the economy, and a disincentive for tourism and international investment.

This does not seem like a place where “legal” marijuana would contribute to “reduced money flow” to the transnational drug trade, or “create jobs.”  The president apparently thinks Jamaica should consider allowing more drugs, based on a faulty understanding of what is actually happening in Jamaica and in the U.S.

His charge of high incarceration rates for non-violent offenders is not factual. For instance, data show that only a fraction of one percent of state prison inmates are low-level marijuana possession offenders, while arrests for marijuana and cocaine/heroin possession and use were no more than 7 percent of all arrests,nationwide, in 2013.

Though critics of drug laws claim that hundreds or even thousands of prisoners are low-level non-violent offenders unjustly sentenced, the reality was shown recently by the President’s inability to find more than a  of incarcerated drug offenders who would be eligible for  of their sentence because they fit the mythological portrait of excessive or unjust drug sentences.

Further, since 2007, the US is currently experiencing a surge in daily marijuana use, an epidemic of heroin overdose deaths (with minorities hardest hit), while the southwest border is flooded with heroin and methamphetamine flow, as shown by skyrocketing border seizures.

Importantly, Colorado, following marijuana “legalization,” has become a black-market magnet, and is currently supplying marijuana, including ultra-high-potency “shatter” to the rest of the U.S., leading to law suits by adjacent states. Legalization 

As for Central America, Obama’s policies have shown stunning neglect. Actual aid for counter-drug activities, and for resources for interdicting smugglers have all diminished, while the countries of Central America have become battlegrounds for Mexican cartels, with meth precursors piling up at the docks, the cocaine transiting Venezuela to Honduras is surging, and violence is at an all-time high, with families fleeing north in unprecedented numbers. The Caribbean/Central American region has become deeply threatened, as noted by the State Department report above—torn apart by drug crime.

In this context the president encourages governments in the region to make drugs more acceptable and more accessible in their communities, and with even greater legal impunity?

Moreover, these developments have been accompanied by a steady drumbeat of medical science  increasingly showing the serious dangers of marijuana use, especially for youth.   Yet President Obama speaks in a manner increasingly disconnected from the domestic and international reality of the drug problem.

Source:  David W. Murray and John P. Walters  WEEKLY STANDARD  April 11, 2015

CLEARING THE HAZE

….The ugly truth is that Colorado was suckered. It was promised regulation and has been met by an industry that fights tooth and nail any restrictions that limit its profitability.”  Ben Cort, Director of Professional Relations for the Center for Additction Recovery and rehabilitation at the University Of Colorado Hospital

Source:   http://gazette.com/clearingthehaze

 

REGULATION STILL INEFFECTIVE

But how it would work was described only in general terms and sound bites before voters headed to the polls to make a decision Gov. John Hickenlooper later would call “reckless” and “a bad idea” and new Colorado Attorney General Cynthia Coffman declared “not worth it” to dozens of state attorneys general last month.

Source:http://www.washingtonexaminer.com/regulation-still-ineffective/article/2562323?custom_click=rss

 

NO APPROVED MEDICINE IN MARIJUANA

Dr. Stuart Gitlow, a physician serving as president of the American Society of Addiction Medicine, does not mince words: “There is no such thing at this point as medical marijuana,” he said. It’s a point he has made routinely for the past decade, as advocates for marijuana legalization have claimed the drug treats an array of serious illnesses, or the symptoms of illnesses, including cancer, depression, epilepsy, glaucoma and HIV, the virus that causes AIDS.

Source:http://www.washingtonexaminer.com/no-approved-medicine-in-marijuana/article/2562336

 

LEGALIZATION DIDN’T UNCLOG PRISONS

Of all the misunderstandings about marijuana’s impact on the country, perhaps none is greater than the belief that America’s courts, prisons and jails are clogged with people whose only offense was marijuana use. This is the perception, but statistics show few inmates are behind bars strictly for marijuana-related offenses, and legalization of the drug will do little to affect America’s growing incarceration numbers.

Source:http://www.washingtonexaminer.com/legalization-didnt-unclog-prisons/article/2562326

 

DRUG USE A PROBLEM FOR EMPLOYERS

“This is a very troublesome issue for our industry, but I do not see us bending or lowering our hiring standards,” Johnson said. “Our workplaces are too dangerous and too dynamic to tolerate drug use. And marijuana? In many ways, this is worse than alcohol. I’m still in shock at how we (Colorado) voted. Everyone was asleep at the wheel.”

Source:http://www.washingtonexaminer.com/drug-use-a-problem-for-employers/article/2562334

 

MEDICAL MARIJUANA INDUSTRY STILL GROWING

And amid all the hoopla around legalized recreational pot, its older cousin, the medical marijuana (MMJ) industry — with 505 stores throughout Colorado — quietly continued to grow, adding patients by the thousands who seemingly had no problem finding physicians willing to diagnose what critics say are often phantom medical conditions. Statewide, the number of people on the Medical Marijuana Registry grew 4 percent in 2014 — the first year of legal recreational sales — from 111,030 to 115,467 by year’s end.

Source:http://www.washingtonexaminer.com/medical-marijuana-industry-still-growing-in-colorado/article/2562335

The most obvious characteristic of marijuana-legalisation campaigners – apart from billionaire interests on the scale of Big Tobacco – is that their lobbying and promises are based on theories not facts.

Legalisers regularly use the words “science” and “evidence base” but rarely cite research references. Never has this chasm between theory and fact been so powerfully and conspicuously exposed as in the March analysis by local media in Clearing the Haze of events a year after marijuana was legalised for recreational use in Colorado.

Here in the UK, a decade-long follow up by researchers into Britain’s disastrous 2004 ‘Lambeth experiment’ of depenalisation proved that it led to more crime and hospitalisations not less. The Colorado aftermath of legalisation is on a vaster scale.

CLAIM:“We view our top priority as creating an environment where negative impacts on children from marijuana legalisation are avoided completely,” Colorado’s governor promised.

FACT:There are growing concerns over exposure, potency and availability of marijuana to children. Even before legalisation, Governor John Hickenlooper predicted the need for “a project to analyse the correlation between marijuana use during pregnancy and birth defects” (FYI, here’sa listand one on perils tochildren). Colorado hospitals have admitted more children for marijuana harms. A June 2014 survey of 100 Colorado school officers found that 89 per cent witnessed a rise in marijuana-related incidents since legalisation.

CLAIM:Legalisation will fund prevention, education.

FACT:Colorado budgeted only about $34,000 for its Office of Behavioral Health’s prevention work in the 2014-2105 fiscal year; nothingwas received. Its Department of Public Health and EnvironmentGood to Knowcampaign, crafted with marijuana business owners, tells children how to use pot. “It’s like inviting a tobacco company to help us learn how to use tobacco and develop our next anti-smoking campaign.”

CLAIM:Regulation works.

FACT:How regulation would work was described only in soundbites before voting. Hickenlooper later admitted it was “reckless” and “a bad idea”. This February, Colorado Attorney General Cynthia Coffman declared it “not worth it”. Ben Cort at the University of Colorado Hospital disclosed that “Colorado has been met by an industry that fights tooth and nail any restrictions that limit profitability. Like Big Tobacco, the marijuana industry derives profits from addiction and its survival depends on turning a percentage of kids into lifelong customers.”

CLAIM:Legalisation of marijuana will unclog prisons.

FACT:There aren’t enough offenders in prison for simple possession of pot to unclog the system if they were freed: only 103. In 2011, the federal government convicted only 48 marijuana offenders with under 5,000 grams of marijuana: almost 12,000 joints.

CLAIM:Legalisation will produce new revenue for the general fund.

FACT:Tax revenues failed to meet projections – taxpayers could even get two refunds. The Governor’s Office of Marijuana Coordination director said the first priority for tax revenue is to cover regulatory costs. Moreover, Colorado isn’t equipped to gather cost-benefit analysis to quantify costs linked with cannabis abuse. This is alongside lawsuits against the state, manufacturing hazards, pressured resources for the homeless, concerns over children’s welfare and more: “Voters didn’t understand how difficult, resource-intensive and costly the enforcement of even just marijuana driving laws would be”.

CLAIM:Legalisation of marijuana will hobble drug cartels.

FACT:Cheaper marijuana prices mean cartels turn to ‘harder’ drugs including ‘black tar’ heroin and methamphetamine, as well as cybercrime and continued people-trafficking.

CLAIM:By regulating sales of marijuana, Colorado will make money otherwise locked into the black market.

FACT:Black-market sales are booming so much that they are blamed for cannabis tax revenues falling short of claims. “Don’t buy the argument that regulating sales will eliminate the black market, reduce associated criminal activity and free up law enforcement agencies’ resources,” Coffman urged in February. Worse is that “Colorado is the black market for the rest of the US”: neighbouring Denver suffered an almost 1,000 per cent spike in marijuana seizures.

CLAIM:Legalisation and regulation will see people using lower strengths of drugs.

FACT:Colorado permits one ounce of tetrahydrocannabinol (THC), the active ingredient giving a euphoric high. Many people envision an ounce of dried marijuana plant, about 40 standard cigarettes. But one ounce of concentrated THC equals over 2,800 average-size brownies or candy; an ounce of hash oil is roughly 560 standard ‘vaping’ hits.

CLAIM:Medical marijuana works, only legalisation allows research.

FACT:Treating marijuana – sold in dispensaries without FDA approval and shown to be more carcinogenic than tobacco when combusted – as if exempt from the approval process others drugs must undergo for public safety, is seen as derailing legitimate research on specific parts of the marijuana plant for new clinically-proven medicines without addiction risks. As the prevention charity, Cannabis Skunk Sense, puts it: “it’s like getting penicillin by eating mouldy bread”. Non-legalisation has not stopped 70+ scientific studies on cannabinoids elsewhere, and the National Institutes of Health awarded over $14million for such research.

CLAIM:Marijuana is safer than alcohol.

FACT:“Not when it comes to driving – and officers are seeing people using both substances, which is worse,” revealed one police chief.In the first six months of 2014, 77 per centDUIDs (driving under influence of drugs) involved marijuana. Accident risk doubles with any measurable amount of THC in the bloodstream, rising when alcohol is added.

The tragic fact above all else is that these downsides were predicted by authoritative individuals and organisations – and ignored. The good of many people was sacrificed for the greed of a few: be it for money, power or a drugged delusion. Deirdre Boyd

Source: www.conservativewoman.co.uk 1st April 2015

A new political party is planning to field as many as 100 candidates at the general election to force the issue of cannabis legalisation centre stage.

Cista – Cannabis is Safer than Alcohol – is inspired by legalisation of the drug in some US states. The party’s election candidates will include Paul Birch, who co-founded Bebo before it was sold to AOL for $850m (£548m) in 2008 and says he is investing up to £100,000 in the venture.

Other candidates around the UK are soon to be named; this week the party said Shane O’Donnell, a former Conservative party activist, would stand against Labour’s Keir Starmer and the Green party leader, Natalie Bennett, in the London constituency of Holborn and St Pancras.

According to YouGov polling commissioned by Cista and provided to the Guardian, 44% of voters support the legalisation of cannabis against 42% who don’t (with 14% undecided).

The two mainstream parties with the most to lose from some voters being tempted to opt for Cista in marginal constituencies are the Greens, which supports decriminalisation, and the Liberal Democrats, which has been looking at the decriminalisation of all drugs for personal use and allowing cannabis to be sold on the open market.

However, Birch’s party has made a policy decision not to run in Brighton, where the sole Green MP Caroline Lucas is defending her seat, and in constituencies with incumbent Lib Dem MPs. The decision was taken after Lib Dem MP Julian Huppert, one of parliament’s most visible advocates of the decriminalisation of drugs, raised the issue of a candidate from Cista standing against him.

Birch said that in the main the other parties were keen not to talk about the issue of legalisation because they were embarrassed by it. “In the absence of this party forming I doubt that it would be an election issue. The Greens are the most explicit but even they don’t make it a prominent issue,” he added.

“With what has been happening in US states though, it now feels like it’s within touching distance. It’s like this is the final push and the time is right.”

Birch suggested that parallels with the road to legalisation in US states were forming on the basis of another of his party’s YouGov poll findings, which was that 18% of people believed that cannabis was safer than alcohol, while more than half thought that they were the same in safety terms.

He said: “In Colorado [one of the first US states to legalise the recreational use and sale of marijuana] the basis of their campaign was to juxtapose cannabis and alcohol. They knew that once they moved people to understand that it was safer then people would be happy to legalise it.”

Principally, Birch has faith that the public will come around to the idea in greater numbers as a result of becoming ever more informed. Of a recent experiment where the Channel 4 News anchor Jon Snow took large amounts of skunk-type cannabis, resulting in him feeling “as if his soul had been wrenched from his body”, Birch said that this was akin to forcing a teetotaller to down a bottle of illegally distilled moonshine. In a regulated industry, he argued, the risk to consumers could be considerably reduced.

Cista’s candidates will campaign for a royal commission to review the UK’s drug laws relating to cannabis – a relatively modest initial aim calibrated to maximise its appeal. They will also push the economic argument for legalisation, which the party argues could net the exchequer as much as £900m if cannabis were legalised and properly controlled.

The party, which is keen to establish itself as a professional outfit in contrast to previous electoral attempts at highlighting the decriminalisation cause, is signing up members and candidates using online forms. It is eager to push back against stereotypes and, in particular, encourage women to become involved.

Five candidates, including Birch, are signed up to stand for election on 7 May, while he and his team will this week begin travelling around the UK in search of other candidates who they expect will include academics, existing campaigners, students and people who work or have experience of working in the criminal justice system.

Source:  http://www.theguardian.com/society/2015/feb/25

To go or not to go? That is the question when invited to take part in supposedly objective drugs conferences and television investigations, behind which  looms the constant presence of one Sir Richard Branson. Two seemingly flattering invitations to drugs policy events came my way this month.

The first was to be invited to a Home Affairs Select Committee event at the University of Cambridge’s Homerton College on March 12th.  At first sight, it felt a welcome recognition of my longstanding work in the field of drug addiction, and of my new recovery solutions service (DB Recovery Resources). Moreover, it seemed like an opportunity to guide and inform public opinion – even as far as the United Nations. But I was torn for days on whether to accept or not. Finally, I regretfully declined.

Why? The Home Affairs Select Committee’s invitation was entitled “The International Conference on Drugs Policy” and its findings at the end of the day were to be fed into the influential UNGASS, the United Nations General Assembly’s Special Session on world drug problems in 2016. Tempting. But a closer look raised concerns. What exactly was a Parliamentary select committee doing hosting a drugs policy conference? Why had they chosen deputy prime minister Nick Clegg who, at the time of my invitation, was scheduled to chair it? He is a recognised proponent of drugs legalisation, going so far as to include it in his election pledge.

So I was aware of the agenda and bias of the conference before I was invited.  The list of speakers spoke for itself. Every single speaker bar one  – Sarah Graham, an addiction therapist – turned out to be  a high-profile legalisation campaigner, several from organisations funded by the convicted insider trader and fomenter  George Soros. Only after I had publicised the biased agenda on my daily newsletter did HASC kindly invited me to attend. They also at the same time added a second ‘non-legalisation’ speaker to their invite list: Professor Neil McKeganey. But I could see it was still skewed. We would be the minority underdog against high-profile and well-funded legalisation campaigners, like Dr Julian Huppert MP, Baroness Molly Meacher, Roberto Dondisch from Mexico, Danny Kushlick of Transform, Professor David Nutt, who famously said taking ecstasy was less risky than horse riding, former policeman and cannabis activist Tom Lloyd, and last but not least Mike Trace, who was forced to resign his UN role when the Daily Mail revealed him to be the driving force behind an effort to disband the world’s anti-drug laws by stealth.

What chance would I have to support my colleagues? Would this be like National Treatment Agency meetings I had attended too many times in the past (before it was abolished)  where vested-interest findings and recommendations were written before the meeting and then presented as an impartial consensus of all those present – and absent?

Would it be like the self-styled United Kingdom Drug Policy Commission meetings (before it closed) which exploited the names of attendees as supporting its predetermined ‘consensus agreement’, when in reality there was a dearth of support? Was I confident that any anti-legalisation points would be included in the final report to UNGASS? That I sadly declined the invitation gives you the answer.

No. The worry is now that UNGASS may believe this Home Affairs Select Committee report, that UK taxpayers are unwittingly funding, to be impartial.  Better to blog, I thought, and hopefully open their eyes to the truth.

The second ‘flattering’  invitation was to appear on Channel 4’s Cannabis Live programme on 3 March. Although warned in advance about its inherent bias – it was funded by both C4 and Soros-supported organisations, and known legalisation proponents were booked as its speakers – I decided to accept in the hope I would be able to capture some airtime for anti-legalisation views.

(Declaration: my view is informed by the basic laws of supply and demand: increased availability leads to increased consumption. In addition there is, to my very real knowledge, so much disinformation about pot in the public domain that few people can make an informed choice). It was the right decision; although it was questionable whether there was a need for a programme experimenting ‘live’ with substances that are already known to have significant and very negative side effects. It was also worrying that Professor Nutt was  an “independent” scientific expert on it, given his obsession with cannabis legalisation and his well known insistence that it is less harmful than alcohol.

A plus turned out to be Jon Snow’s and Andrew Marr’s very negative experiences when skunk was tested on them. Perhaps that’s why presenter Snow carefully inched my neighbour off his seat to interview me, allowing time for me to make some pivotal points.  These were particularly in response to Branson’s call for regulation [legalisation] of cannabis as a solution to the world’s drug problems. I pointed out  that tobacco is regulated yet kills  more people than any other drug in the world;   that alcohol, benzos and methadone are all regulated but follow tobacco in killing more people each than illicit drugs.

I also pointed out that the first paper linking cannabis and psychosis was published 170 years ago –  in 1845  – so this is not new. All my points were transmitted unedited. A number of ‘silent’ audience members in Narcotics Anonymous introduced themselves and thanked me as we were leaving the studio.  It reminded  me of  US drug czar Michael Botticelli’s recent comment: “I do wish the recovery community was much more involved in anti-legalisation efforts.

However the trouble with Cannabis Live – posing as science when it was exhibitionist entertainment, as one distinguished former Professor of pharmacology commented to me afterwards  – is that it provided a launchpad for the differences between “beneficent” hash and “nightmarish” skunk to be exploited by the legalisation lobbyists. Their hidden agenda. It was worrying that the programme ignored the harms from hash (as opposed to skunk):  yet these include the risk of psychosis, behavioural changes, lack of motivation, lowering of IQ, lung cancer, mouth cancer, motor crashes, lowering of fertility (a mixed blessing) – and the fact that pregnant women using hash can give birth to addicted babies with a range of mental-health problems and medical problems, including leukaemia.

At a press conference the next day, billionaire legalisation campaigner Branson was still calling for regulation (legalisation of cannabis) as a solution despite all the downsides he’d witnessed at Cannabis Live. Of course he did not mention that tobacco is regulated and it kills more people than any other drug in the world, for the simple reason that it is the most widely used drug in the world.

In his cloud cuckoo land, the 80 per cent of cannabis users who use skunk would downgrade to the milder version if they were both legal. I don’t think so. It’s against human nature. Finally, it was left to David Nutt to round up the programme – with his extraordinary recommendation that skunk should remain low in the index of drug harms, in cannabis’s current place, while hash should plummet to the lowest ranking. Maybe he was too close to the skunk factory set up beside his artificial brain in the studio. Had anyone in the audience changed their mind about being pro- or anti-legalisation, asked Snow at the end of the programme? Not one hand went up. I leave you to decide whether this infotainment fulfilled Channel 4’s mission to “keep public service values to the fore”.

Source:   www.the Conservative Woman.co.uk    7th March 2015

To go or not to go? That is the question when invited to take part in supposedly objective drugs conferences and television investigations, behind which  looms the constant presence of one Sir Richard Branson.

Two seemingly flattering invitations to drugs policy events came my way this month. The first was to be invited to a Home Affairs Select Committee event at the University of Cambridge’s Homerton College on March 12th.  At first sight, it felt a welcome recognition of my longstanding work in the field of drug addiction, and of my new recovery solutions service (DB Recovery Resources). Moreover, it seemed like an opportunity to guide and inform public opinion – even as far as the United Nations.

But I was torn for days on whether to accept or not. Finally, I regretfully declined. Why?

The Home Affairs Select Committee’s invitation was entitled “The International Conference on Drugs Policy” and its findings at the end of the day were to be fed into the influential UNGASS, the United Nations General Assembly’s Special Session on world drug problems in 2016. Tempting. But a closer look raised concerns.

What exactly was a Parliamentary select committee doing hosting a drugs policy conference? Why had they chosen deputy prime minister Nick Clegg who, at the time of my invitation, was scheduled to chair it? He is a recognised proponent of drugs legalisation, going so far as to include it in his election pledge.  So I was aware of the agenda and bias of the conference before I was invited.  The list of speakers spoke for itself. Every single speaker bar one  – Sarah Graham, an addiction therapist – turned out to be  a high-profile legalisation campaigner, several from organisations funded by the convicted insider trader and fomenter  George Soros.

Only after I had publicised the biased agenda on my daily newsletter did HASC kindly invited me to attend. They also at the same time added a second ‘non-legalisation’ speaker to their invite list: Professor Neil McKeganey. But I could see it was still skewed. We would be the minority underdog against high-profile and well-funded legalisation campaigners, like Dr Julian Huppert MP, Baroness Molly Meacher, Roberto Dondisch from Mexico, Danny Kushlick of Transform, Professor David Nutt, who famously said taking ecstasy was less risky than horse riding, former policeman and cannabis activist Tom Lloyd, and last but not least Mike Trace, who was forced to resign his UN role when the Daily Mail revealed him to be the driving force behind an effort to disband the world’s anti-drug laws by stealth.

What chance would I have to support my colleagues?

Would this be like National Treatment Agency meetings I had attended too many times in the past (before it was abolished)  where vested-interest findings and recommendations were written before the meeting and then presented as an impartial consensus of all those present – and absent? Would it be like the self-styled United Kingdom Drug Policy Commission meetings (before it closed) which exploited the names of attendees as supporting its predetermined ‘consensus agreement’, when in reality there was a dearth of support?

Was I confident that any anti-legalisation points would be included in the final report to UNGASS? That I sadly declined the invitation gives you the answer.   No.

The worry is now that UNGASS may believe this Home Affairs Select Committee report, that UK taxpayers are unwittingly funding, to be impartial.  Better to blog, I thought, and hopefully open their eyes to the truth.

The second ‘flattering’  invitation was to appear on Channel 4’s Cannabis Live programme on 3 March. Although warned in advance about its inherent bias – it was funded by both C4 and Soros-supported organisations, and known legalisation proponents were booked as its speakers – I decided to accept in the hope I would be able to capture some airtime for anti-legalisation views. (Declaration: my view is informed by the basic laws of supply and demand: increased availability leads to increased consumption. In addition there is, to my very real knowledge, so much disinformation about pot in the public domain that few people can make an informed choice).

It was the right decision; although it was questionable whether there was a need for a programme experimenting ‘live’ with substances that are already known to have significant and very negative side effects. It was also worrying that Professor Nutt was  an “independent” scientific expert on it, given his obsession with cannabis legalisation and his well known insistence that it is less harmful than alcohol.

A plus turned out to be Jon Snow’s and Andrew Marr’s very negative experiences when skunk was tested on them. Perhaps that’s why presenter Snow carefully inched my neighbour off his seat to interview me, allowing time for me to make some pivotal points.  These were particularly in response to Branson’s call for regulation [legalisation] of cannabis as a solution to the world’s drug problems. I pointed out  that tobacco is regulated yet kills  more people than any other drug in the world;   that alcohol, benzos and methadone are all regulated but follow tobacco in killing more people each than illicit drugs.

I also pointed out that the first paper linking cannabis and psychosis was published 170 years ago –  in 1845  – so this is not new. All my points were transmitted unedited.

A number of ‘silent’ audience members in Narcotics Anonymous introduced themselves and thanked me as we were leaving the studio.  It reminded  me of  US drug czar Michael Botticelli’s recent comment: “I do wish the recovery community was much more involved in anti-legalisation efforts.

However the trouble with Cannabis Live – posing as science when it was exhibitionist entertainment, as one distinguished former Professor of pharmacology commented to me afterwards  – is that it provided a launchpad for the differences between “beneficent” hash and “nightmarish” skunk to be exploited by the legalisation lobbyists. Their hidden agenda.

It was worrying that the programme ignored the harms from hash (as opposed to skunk) : yet these include the risk of psychosis, behavioural changes, lack of motivation, lowering of IQ, lung cancer, mouth cancer, motor crashes, lowering of fertility (a mixed blessing) – and the fact that pregnant women using hash can give birth to addicted babies with a range of mental-health problems and medical problems, including leukaemia.

At a press conference the next day, billionaire legalisation campaigner Branson was still calling for regulation (legalisation of cannabis) as a solution despite all the downsides he’d witnessed at Cannabis Live. Of course he did not mention that tobacco is regulated and it kills more people than any other drug in the world, for the simple reason that it is the most widely used drug in the world.

In his cloud cuckoo land, the 80 per cent of cannabis users who use skunk would downgrade to the milder version if they were both legal. I don’t think so. It’s against human nature.

Finally, it was left to David Nutt to round up the programme – with his extraordinary recommendation that skunk should remain low in the index of drug harms, in cannabis’s current place, while hash should plummet to the lowest ranking. Maybe he was too close to the skunk factory set up beside his artificial brain in the studio.

Had anyone in the audience changed their mind about being pro- or anti-legalisation, asked Snow at the end of the programme? Not one hand went up. I leave you to decide whether this infotainment fulfilled Channel 4’s mission to “keep public service values to the fore”.

Source:   www.the Conservative Woman.co.uk    7th March 2015

“The toxic properties of chemical molecules and their cellular damage are not matters of opinion or debate.

They are not determined by adolescent servicemen, or by scientifically uneducated lawyers, legislators, judges, or ‘doctors’ without the facts. Certainly they are not determined  by Ted Koppel, Abbie Hoffman, Benjamin Spock, William Buckley, Geraldo Rivera, Oprah Winfrey, Dan Rather, or the mayors of our beleaguered cities.

We cannot vote for or against the ‘toxicity’ of a drug. How much a drug impairs cell structure or chemical function is neither subject to nor governed by congressional committee, public referendum, or the federal constitution.

We cannot govern the electromagnetic behavior of chemical molecules by popular vote, judicial proclamation, personal opinion or individual desire.

Everyone is entitled to his own ‘opinion.’ He is not entitled to his own ‘facts.’

Chemically, marijuana is far more dangerous drug than most scientifically ignorant media and American consumers have been duped into believing.”

Robert C. Gilkeson, M.D.,

Child and Adolescent Neuro-psychiatrist

 

D.A.R.E. America joins every major public health association, including the American Medical Association, the American Psychiatric Association, the American Society of Addiction Medicine, and other groups in opposing the legalization of marijuana. Simply put, legalization would drastically increase marijuana use and use disorder rates, as well as hamper public safety and health at a cost of billions to society in lost productivity, impaired driving, health care, and other costs. 

Of particular concern to D.A.R.E. is the relaxed attitude regarding the use of marijuana, which will lead to increased accessibility and reduced perception of harm. This will undoubtedly contribute to greater youth use and abuse of the drug.

Legalized marijuana means ushering in the next “Big Tobacco.” Already, private holding groups and financiers have raised millions of start-up dollars to promote businesses that will sell marijuana and marijuana-related merchandise.  The former head of Strategy for Microsoft has even said he wants to “mint more millionaires than Microsoft” with marijuana and that he wants to create the “Starbucks of marijuana.” A massive industry has exploded in the legal marijuana states of Washington and Colorado.

Colorado’s experience is already going poorly. Colorado is the first jurisdiction to fully legalize marijuana and sell marijuana in state-licensed stores. And already in its first year, the experience is a disaster. Calls to poison centers have skyrocketed, incidents involving kids coming to school with marijuana candy and vaporizers have soared, and explosions involving butane hash oil extraction have increased. Employers are reporting more workplace incidents involving marijuana use, and deaths have been attributed to ingesting marijuana “edibles.” Open Colorado newspapers and magazines on your web browser (or look at the real thing) on any given day and you will find pages of marijuana advertisements, coupons, and cartoons. Remember Joe Camel and candy cigarettes? The marijuana industry offers a myriad of marijuana-related products such as candies, sodas, ice cream, and cartoon-themed paraphernalia and vaporizers, which are undoubtedly attractive to children and teens.i  As Al Bronstein, medical director of the Rocky Mountain Poison and Drug Center recently told the Denver Post, “We’re seeing hallucinations, they become sick to their stomachs, they throw up, they become dizzy and very anxious.” Bronstein reported that in 2013 there were 126 calls concerning adverse reactions to marijuana. From January to April 2014 alone the center receive 65 calls.ii Dr. Lavonas, also from the Rocky Mountain Poison and Drug Center, said in 2014 that emergency rooms have seen a spike in psychotic reactions from people not accustomed to high potency marijuana sold legally, severe vomiting that some users experience, and children and adults having problems with edibles. iii 

No advocate for marijuana legalization will openly promote making marijuana available to minors. However, it would be unwise to believe that relaxed attitudes about the drug, reduced perceptions of harm and increased availability will not result in increased youth use and abuse of marijuana. Children are the marijuana marketer’s future customers. Just as alcohol and tobacco companies have been charged with promoting their goods to children, so has the Colorado marijuana industry. In March 2014, the Colorado legislature was forced to enact legislation to prohibit edible marijuana products from being package to appeal to children. “Keeping marijuana out of the hands of kids should be a priority for all of us,” said Governor Hickenlooper, before signing the bill.iv But that was not enough.  

As discussed above, Dr. George Sam Wan of the Rocky Mountain Poison and Drug Center and his colleagues compared the proportion of marijuana ingestions by young children who were brought to an emergency room before and after October 2009, when Colorado drug enforcement laws regarding medical marijuana use were relaxed. The researchers found no record of children brought into the ER in a large Colorado children’s hospital for marijuana-related poisonings between January 2005 and September 30, 2009 — a span of 57 months. It is a different story following legalization.v Dr. Bronstein reported twenty-six people have reported poisonings from marijuana edibles this year, when the center started tracking such exposures. Six were children who swallowed innocent-looking edibles, most of which were in plain sight. Five of those kids were sent to emergency rooms, and two to hospitals for intensive care.vi

The scientific verdict is in: marijuana can be addictive and dangerous. Despite denials by legalization advocates, marijuana’s addictiveness is not debatable: 1 in 6 kids who ever try marijuana, according to the National Institutes of Health, will become addicted to the drug. Today’s marijuana is not your “Woodstock weed” – it can be 5-10 times stronger than marijuana of the past.vii More than 400,000 incidents of emergency room admissions related to marijuana occur every year, and heavy marijuana use in adolescence is connected to an 8-point reduction of IQ later in life, irrespective of alcohol use.

Marijuana legalization would cost society in real dollars, and further inequality in America. Alcohol and tobacco today give us $1 for every $10 that we as society have to pay in lost social costs, from accidents to health damage.viii The Lottery and other forms of gambling have not solved our budget problems, either. We also know these industries target the poor and disenchantedix – and we can expect the marijuana industry to do the same in order to increase profits. 

IF THEY SAY…

YOU SAY…

Marijuana is not addictive.

Science has proven – and all major scientific and medical organizations agree – that marijuana is both addictive and harmful to the human brain, especially when used as an adolescent. One in every six 16 year-olds (and one in every eleven adults) who try marijuana will become addicted to it.x

Marijuana MIGHT be psychologically addictive, but its addiction doesn’t produce physical symptoms.

Just as with alcohol and tobacco, most chronic marijuana users who attempt to stop “cold turkey” will experience an array of withdrawal symptoms such as irritability, restlessness, anxiety, depression, insomnia, and/or cravings.xi

Lots of smart, successful people have smoked marijuana. It doesn’t make you dumb.

Just because some smart people have done some dumb things, it doesn’t mean that everyone gets away with it. In fact, research shows that adolescents who smoke marijuana once a week over a two-year period are almost six times more likely than nonsmokers to drop out of school and over three times less likely to enter college.xii In a study of over 1,000 people in 2012, scientists found that using marijuana regularly before the age of 18 resulted in an average IQ of six to eight fewer points at age 38 versus to those who did not use the drug before 18.xiii These results still held for those who used regularly as teens, but stopped after 18. Researchers controlled for alcohol and other drug use as well in this study. So yes, some people may get away with using it, but not everyone.

No one goes to treatment for marijuana addiction.

More young people are in treatment for marijuana abuse or dependence than for the use of alcohol and all other drugs.xiv

Marijuana can’t hurt you.

Emergency room mentions for marijuana use now exceed those for heroin and are continuing to rise.xv

 

IF THEY SAY…

YOU SAY…

I smoked marijuana and I am fine, why should I worry about today’s kids using it?

Today’s marijuana is not your Woodstock Weed. The psychoactive ingredient in marijuana—THC—has increased almost six-fold in average potency during the past thirty years.xvi

Marijuana doesn’t cause lung cancer.

The evidence on lung cancer and marijuana is mixed – just like it was 100 years ago for smoking – but marijuana contains 50% more carcinogens than tobacco smokexvii and marijuana smokers report serious symptoms of chronic bronchitis and other respiratory illnesses.xviii

Marijuana is not a “gateway” drug.

We know that most people who use pot WON’T go onto other drugs; but 99% of people who are addicted to other drugs STARTED with alcohol and marijuana. So, indeed, marijuana use makes addiction to other drugs more likely.xix

Marijuana does not cause mental illness.

Actually, beginning in the 1980s, scientists have uncovered a direct link between marijuana use and mental illness. According to a study published in the British Medical Journal, daily use among adolescent girls is associated with a fivefold increase in the risk of depression and anxiety.xx  Youth who begin smoking marijuana at an earlier age are more likely to have an impaired ability to experience normal emotional responses.xxi

 

The link between marijuana use and mental health extends beyond anxiety and depression. Marijuana users have a six times higher risk of schizophreniaxxii, are significantly more likely to development other psychotic illnesses.

Marijuana makes you a better driver, especially when compared to alcohol.

Just because you may go 35 MPH in a 65 MPH zone versus 85 MPH if you are drunk, it does not mean you are driving safely! In fact, marijuana intoxication doubles your risk of a car crash according to the most exhaustive research reviews ever conducted on the subject.xxiii

 

IF THEY SAY…

YOU SAY…

Marijuana does not affect the workplace.

Marijuana use impairs the ability to function effectively and safely on the job and increases work-related absences, tardiness, accidents, compensation claims, and job turnover.xxiv

Marijuana simply makes you happier over the long term.

Regular marijuana use is associated with lower satisfaction with intimate romantic relationships, work, family, friends, leisure pursuits, and life in general.xxv

Marijuana users are clogging our prisons.

A survey by the Bureau of Justice Statistics showed that 0.7% of all state inmates were behind bars for marijuana possession only (with many of them pleading down from more serious crimes). In total, one tenth of one percent (0.1 percent) of all state prisoners was marijuana-possession offenders with no prior sentences. Other independent research has shown that the risk of arrest for each “joint,” or marijuana cigarette, smoked is about 1 arrest for every 12,000 joints.xxvi

Marijuana is medicine.

 

 

Marijuana may contain medical components, like opium does. But we don’t smoke opium to get the effects of Morphine. Similarly we don’t need to smoke marijuana to get its potential medical benefit.xxvii

The sick and dying need medical marijuana programs to stay alive.

 

Research shows that very few of those seeking a recommendation for medical marijuana have cancer, HIV/AIDS, glaucoma, or multiple sclerosis;xxviii and im most states that permits the use of medical marijuana, less than 2-3% of users report having cancer, HIV/AIDS, glaucoma, MS, or other life-threatening diseases.xxix

Marijuana should be rescheduled to facilitate its medical and legitimate use.

 

Rescheduling is a source of major confusion. Marijuana meets the technical definition of Schedule I because it is not an individual product with a defined dose. You can’t dose anything that is smoked or used in a crude form. However, components of marijuana can be scheduled for medical use, and that research is fully legitimate. That is very different than saying a joint is medicine and should be rescheduled.xxx

 

IF THEY SAY…

YOU SAY…

Smoking or vaporizing is the only way to get the medical benefits of marijuana.

 

No modern medicine is smoked. And we already have a pill on the market available to people with the active ingredient of marijuana (THC) in it – Marinol. That is available at pharmacies today. Other drugs are also in development, including Sativex (for MS and cancer pain) and Epidiolex (for epilepsy). Both of these drugs are available today through research programs.xxxi

Medical marijuana has not increased marijuana use in the general population.

Studies are mixed on this, but it appears that if a state has medical “dispensaries” (stores) and home cultivation, then the potency of marijuana and the use and problems among youth are higher than in states without such programs. This confirms research in 2012 from five epidemiological researchers at Columbia University. Using results from several large national surveys, they concluded, “residents of states with medical marijuana laws had higher odds of marijuana use and marijuana abuse/dependence than residents of states without such laws.xxxii

Legalization is inevitable – the vast majority of the country wants it, and states keep legalizing in succession.

The increase in support for legalization reflects the tens of millions of dollars poured into the legalization movement over the past 30 years. Legalization is not inevitable and there is evidence to show that support has stalled since 2013.

Alcohol is legal, why shouldn’t marijuana also be legal?

Our currently legal drugs – alcohol and tobacco – provide a good example, since both youth and adults use them far more frequently than illegal drugs. According to recent surveys, alcohol use is used by 52% of Americans and tobacco is used by 27% of Americans, but marijuana is used by only 8% of Americans.xxxiii

 

IF THEY SAY…

YOU SAY…

Colorado has been a good experiment in legalization.

 

 

 

Colorado has already seen problems with this policy. For example, according to the Associated Press: “Two Denver Deaths Linked to Recreational Marijuana Use”. One includes the under-aged college student who jumped to his death after ingesting marijuana cookie.

 

The number of parents calling the poison-control hotline to report their kids had consumed marijuana has risen significantly in Colorado.

Marijuana edibles and marijuana vaporizers have been found in middle and high schools.xxxiv

We can get tax revenue if we legalize marijuana.

With increased use, public health costs will also rise, likely outweighing any tax revenues from legal marijuana. For every dollar gained in alcohol and tobacco taxes, ten dollars are lost in legal, health, social, and regulatory costs.xxxv And so far in Colorado, tax revenue has fallen short of expectations.

I just want to get high. The government shouldn’t be able to tell me that I can’t.

 

Legalization is not about just “getting high.” By legalizing marijuana, the United States would be ushering in a new, for-profit industry – not different from Big Tobacco. Already, private holding groups and financiers have raised millions of start-up dollars to promote businesses that will sell marijuana and marijuana-related merchandise. Cannabis food and candy is being marketed to children and are already responsible for a growing number of marijuana-related ER visits.xxxvi

 

Edibles with names such as “Ring Pots” and “Pot Tarts” are inspired by common children candy and dessert products such as “Ring Pops” and “Pop Tarts.” Moreover, a large vaporization industry is now emerging and targeting youth, allowing young people and minors to use marijuana more easily in public places without being detected.xxxvii

 

IF THEY SAY…

YOU SAY…

Legalization would remove the black market and stop enriching gangs.

Criminal enterprises do not receive the majority of their funding from marijuana. Furthermore, with legal marijuana taxed and only available to adults, a black market will continue to thrive. The black market and illegal drug dealers will continue to function – and even flourishxxxviii – under legalization, as people seek cheaper, untaxed marijuana.

 

A poll reported in the Washington Post on September 23 offers positive news for those troubled by the movement to legalize marijuana. It also does not auger well for those pushing more states to follow Colorado and Washington, where legalization is already underway.

In a national poll, support for legal marijuana fell seven percentage points in a single year, from 51 percent in 2013 to 44 percent in 2014. The results are well outside the poll’s margin of sampling error, and though only a single result, represent the first sign that the public may be reconsidering what had been climbing enthusiasm.

Of course, public support for issues in the abstract (such as nationalized health care, or ending involvement in Middle Eastern wars) can change when actual events begin to shape perceptions. It is possible that deteriorating public health and public safety conditions in places like Colorado are giving pause.

The public has to be made aware of the actual damage, however, which is no easy task given the widespread presence of media bias on behalf of legal marijuana, both explicitly (the New York Times’s editorial support for legalization) or more implicitly through a steadfast neglect of bad news in reportage (the Washington Post on any given day).   Yet word has gotten out, and credit is due the various groups and individuals (educators, physicians, and family advocates, as well as a small core of policy analysts) who have created a growing source of data and genuine analysis.

But the uphill struggle is not over. For instance, though the Post did cover the poll results, their story contained this striking effort at spin: the results “could mean that Americans generally don’t like the news coming out of Colorado and Washington—even if that news has been largely positive.”

Really? The referenced “news”—a Brookings study, the headline of which is, “Colorado’s Rollout of Legal Marijuana is Succeeding”—can only be regarded, charitably, as a weak reed. Sure enough, media coverage followed suit (“Colorado Legalization is Working, says Brookings Institute,” San Francisco Gate, July 31, 2014). Does that mean things are going fine?

Not exactly. What the Brookings report actually argues is that the state has met “the most basic standard of success” because it has “created regulatory and administrative apparatuses that facilitate the legal retail marijuana market.” Is the mere fact that Colorado now has businesses selling marijuana a serious standard of success?

It is revealing that in order to reference the positive Brookings report, the Post had to climb over a mound of data about the actual impact on the ground in Colorado. A High Intensity Drug Trafficking Area (HIDTA) report in August detailed a parade of damage across the spectrum. And last week’s Quest Workplace Drug Testing national results showed for the first time in a decade an increase in marijuana positives nationally—5 percent overall in a single year—compared with Colorado’s 20 percent increase over that same period. That can’t be a success for businesses, can it?

Showing even more evasion, the Post did decide to report on the impact of legalized marijuana—in Alaska, based on a ruling from 39 years ago—“Alaska Legalized Weed 39 Years Ago. Wait, What?” (September 25, 2014).

The piece attempts to draw implications for the current Colorado “experiment.” In Alaska, we are told, the lesson is, “the sky hasn’t fallen.” Never mind the striking differences between the two states. Alaska “legalized” marijuana in 1975, but not through a voter referendum. Rather, a court ruling held that a provision of the state’s constitution concerning privacy extended to personal possession of marijuana. Voters explicitly overturned this result in 1991, but a successful ACLU suit kept the judges’ ruling largely intact, though a legalization measure on the ballet in 2000 was beaten by 60 percent of the vote.

In reality, not only is the judge’s ruling against federal Controlled Substance law, it is also a continued violation of state law (a felony punishable by up to 5 years in prison and a fine of $50,000) to have more than 25 marijuana plants or more than 4 ounces of pot. And in Alaska it has never been permissible to have commercial growing, sales, or even a commercial building providing pot; homegrown personal amounts only.

To argue that the Alaska scheme is remotely similar to Colorado’s commercial run-away—and that we should evaluate Alaska’s drug use rates or social conditions as though they contained a lesson for Colorado—is to mislead. Colorado is awash in for-profit enterprises enlisting advertising gurus and marketing their products to youth and adults alike. Alaska, thankfully, did not and does not face these conditions—though we are told at the piece’s conclusion that Alaskans “use marijuana twice as much as Americans elsewhere.”

Nonetheless, the Post’s takeaway is that there is clearly no truth to the view that “the slightest departure from full prohibition would inevitably lead to a stoner dystopia, with a nation of drug-addled high school dropouts.”

To make this non-serious point, it is worth noting that the Post also had to “forget” the report in the British journal Lancet (September 9, 2014), showing that youth who were daily smokers of marijuana had a 60 percent greater likelihood of dropping out of high school. Just as they neglected to even mention the results of the 2013 National Household Survey on Drug Use and Health (September 2014) showing that rates of near-daily use of marijuana have risen some 80 percent since 2007.

Lastly, one more point about Alaska. The total state population (700,000) is roughly a fifth of the Denver metropolitan area (3.3 million). This fact makes national household surveys of drug use in that state less than reliable. In fact, for the use of some drugs, such as methamphetamine and heroin, the numbers are so small in Alaska that extrapolating to the wider population is precarious, and in some cases, difficult to disaggregate from the larger sample of marijuana users.

The Post sees in this data gap an opportunity to speculate. Perhaps, we are told, “Alaskans are substituting marijuana for more habit-forming drugs, such as heroin or methamphetamine.” Well, yes, perhaps; maybe in Alaska marijuana serves as a kind of “reverse gateway,” helping people stay away from the use of other drugs. There are not sufficient data to contradict this conjecture, so why not float it?

Except, the same Lancet study (“Young Adult Sequelae of Adolescent Cannabis Use: An Integrative Analysis”) also provided strong support for the actual “gateway” hypothesis. The study’s authors found that youth who were daily users of marijuana also had an 8 times greater risk to use other drugs, such as heroin and methamphetamine, than youth who did not use. There is further the important 2012 finding in the Proceedings of the National Academy of Sciences that heavy marijuana users in youth lost, over time, fully eight IQ points, enough to diminish many aspirations.

It is impossible to miss the fact that those trying to educate the public about the dangers of the course we are on must overcome a tendentious, even agenda-driven, media “narrative” in support of greater drug access.

The positive news is that the resistance may have begun to check the momentum of the marijuana movement for the 2014 and 2016 electoral cycles, when legalization advocates are planning their big breakout. That there has been some headway in public opinion is no small feat.   There is now an unexpected opportunity to change direction and avert the problems that have been of our own making—or at least the making of the Department of Justice which, following the policy of the then Attorney General, transformed the fundamental guardian against an American drug debacle into a facilitator of legalization nationwide.

It was the explicit guidance of AG Eric Holder that not only would the DOJ decline to defend its Constitutional authority, upheld by the Supreme Court, establishing the pre-eminence of federal law concerning drugs, he further opened the door to Colorado and Washington state by declining to prosecute clear violations of federal law. His departure presents an opening for a return to lawfulness—and protecting many, many young lives now at risk.

Drug policy should at a minimum be a hard question posed for the next AG nominee, appearing before the Senate. And we should hope the reporters covering these confirmation hearings are not blinded by their preference for legal dope. Their readers, it would appear, are rethinking that choice.

John P. Walters and David W. Murray, of Hudson Institute, direct its Center for Substance Abuse Policy Research. They both served in the Office of National Drug Control Policy.

Source: http://www.weeklystandard.com/blogs/does-eric-holder-s-successor-face-momentum-shift-dope_808439.html       1st October 2014

 The Center for Disease Control and Prevention recently reported that excessive alcohol drinking accounts for one in 10 deaths among working-age adults in the U.S.

This is a horrible waste of lives and the CDC is working with partners to support the implementation of strategies for preventing excessive alcohol use as recommended by the Community Preventive Services Task Force.

The CDC says excessive drinking includes binge drinking (four or more drinks on an occasion for women, five or more drinks on an occasion for men); heavy drinking (eight or more drinks a week for women, 15 or more drinks a week for men); and drinking while underage or pregnant.

 Annually from 2006 to 2010, excessive alcohol use led to an average of 87,798 deaths and 2.5 million years of potential life lost. Excessive drinking shortened the lives of those who died by about 30 years.

 Most of the deaths (69 percent) involved adults 20 to 64 years old. About 5 percent of the deaths involved people younger than 21.

These deaths were due to health effects from drinking too much over time, such as breast cancer, liver disease and heart disease, as well as health effects from drinking too much in a short period, such as violence, alcohol poisoning and motor vehicle crashes.

The findings were based on an analysis of data from the Alcohol-Related Disease Impact application for 2006-2010.

 The ARDI provides national and state-specific estimates of alcohol-attributable deaths and years of potential life lost. It currently includes 54 causes of death for which estimates of alcohol involvement were either directly available or could be calculated on the basis of existing scientific information.

The national annual average death rate due to excessive alcohol use was 28 deaths per 100,000. State-specific estimates of deaths and years of potential life lost because of excessive drinking by condition are available at apps.nccd.cdc.gov/DACH_ARDI/default/default.aspx

 Unfortunately, the estimates for 2006 through 2010 are similar to the 2001 estimates, which emphasize the substantial and ongoing public health impact of excessive drinking.

According to the CDC, excessive drinking cost the U.S. about $224 billion, or $1.90 per drink, in 2006. Most of these costs were due to lost productivity, including reduced earnings among excessive drinkers as well as deaths due to excessive drinking among working-age adults.

 The real question is how to manage this problem. Prohibition has already been tried and was a dismal failure. Laws are already on the books to regulate the sale and use of alcohol. Yet it continues to injure and/or kill too many of those who use it.

Now, many states have chosen to disregard the lessons offered by alcohol and are choosing to allow recreational marijuana use in addition to alcohol, in spite of the fact that there is nothing in place to reliably measure the level of intoxication from marijuana.

In a few years, I hope that we are not going to look back on the injury and fatality statistics for marijuana and wonder why we let yet another dangerous drug out into our world, and especially the world of our children. Dr. Terry Gaff is a physician in northeast Indiana

 Source: kpcnews.com 2nd August 2014

Colorado’s tax collections from recreational marijuana sales in the past fiscal year came in more than 60 percent below early predictions, and now a state lawmaker says it may be time to reconsider the tax formula.
State Rep. Dan Pabon, who is leading a special legislative committee on marijuana revenue, said the medical-marijuana system also may come under scrutiny.
“There’s some real impact that the medical marijuana market is having on the recreational marijuana market,” said Pabon, D-Denver. “I think it’s worth looking at the taxation on the recreational side but also looking at the rules and regulations on the medical side.” Tuesday marked the first meeting of the committee, which is studying how Colorado spends its marijuana tax money.

The first item of business: Why is there so much less of it than predicted?

When Colorado voters approved special taxes on recreational marijuana in November, the official fiscal analysis estimated the taxes would bring in a combined $33.5 million through that fiscal year, which ended this summer. Budgeters for Gov. John Hickenlooper had similarly optimistic projections.  But the actual number came in at just more than $12 million.  A market study for the Colorado Department of Revenue says the lower-taxed medical-marijuana market, which continues to outpace the recreational market in sales, is to blame.  Rather than pulling consumers out of the medical-marijuana market, the recreational market largely has feasted on tourists and people who previously bought pot on the black market.  “I think our original assumption about the cannibalization was wrong,” Colorado Legislative Council economist Larson Silbaugh said at Tuesday’s committee meeting.  The result, suggested David Blake of the Colorado attorney general’s office, is that the resilience of the medical-marijuana market “is being driven by avoidance of that tax.”

Dorinda Floyd, the chief financial officer for the Department of Revenue, said recreational sales continue to rise and eventually are expected to surpass medical sales “in the out years.” Meanwhile, state economists have adjusted their predictions. A forecast in June significantly dialed back expectations for the current fiscal year — $30.6 million in special recreational marijuana taxes, compared with the roughly $100 million that Hickenlooper’s office had predicted this year. A new forecast is due in September.  “While I think our forecasts are getting better,” Silbaugh said, “they’re still based on just six months of data.”

Source: denverpost.com 12th August 2014

UK’s youth ‘legal high’ use is the highest in Europe. The drugs were linked to 97 deaths in 2012 – and could top 400 in 2016 Think tank urges punishment for high street shops selling   dangerous drugs.

Deaths linked to ‘legal highs’ could overtake those linked to heroin by 2016, according to experts on addiction. 

The Centre for Social Justice (CSJ) claims hospital admissions are soaring and forecasts that deaths linked to the drugs, sold with names such as Clockwork Orange’, ‘Bliss’ and ‘Mary Jane’, could be higher than heroin in just two years.  The CSJ says many legal highs are sold in ‘head shops’, of which there are close to 250 in the UK.

It wants to see the introduction of a scheme similar to one in Ireland which made it easier for police and courts to close down head shops that were thought to be selling NPS. This resulted in the number of the shops dropping from more than 100 to less than 10.

Despite small reductions in the number of people using heroin and those drinking every week, the think-tank says the costs of addiction are rising, with alcohol-related admissions to hospital doubling in a decade.

The rise of ‘legal highs’ – or new psychoactive substances (NPS) – were linked to 97 deaths in 2012.

Hospital admissions due to legal highs rose by 56 per cent between 2009-12, according to new CSJ data. The think-tank forecasts that on current trends deaths related to the drugs could be higher than heroin by 2016 – at around 400 deaths per year.  The report also calls for greater investment in the clampdown of online ‘legal high’ sales. 

The problem was highlighted in August last year when Adam Hunt, 18, died after taking the psychoactive substance AMT at his home in Southampton, Hampshire, after purchasing it from a website.

An inquest heard how the keen football fan had told a friend he planned to take the drug, which he believed had the same effects as ecstasy, but died four days later.

A ‘treatment tax’ should be added to the cost of alcohol in shops to fund a new generation of rehabilitation centres and stem the tide of Britain’s addiction problem, the report recommends.

Image

The CSJ says many legal highs are sold in ‘head shops’, of which there are close to 250 in the UK. File picture of a head shop in Dublin 

It is also highly critical of the Government’s flagship drug and alcohol prevention programme, FRANK, which it describes as ‘shamefully inadequate’, noting that a recent survey found that only one in ten children would call the ‘FRANK’ helpline to talk about drugs.

The CSJ also says the NHS, Public Health England and local authorities risk ‘giving up’ on many addicts.   ‘Addiction rips into families, makes communities less safe and entrenches poverty,’ said CSJ Director Christian Guy.

‘For years full recovery has been the preserve of the wealthy – closed off to the poorest people and to those with problems who need to rely on a public system. We want to break this injustice wide open.’

The report says 300,000 people in England are addicted to opiates and/or crack, 1.6 million are dependent on alcohol and one in seven children under the age of one live with a substance-abusing parent.

Every year drugs cost society around £15 billion and alcohol £21 billion.

Researchers say residential treatment – the most effective form of abstinence-based treatment – has been continually cut and are calling for this to be reversed.  A ‘treatment tax’ should be added to off-licence alcohol sales to fund rehab for people with alcohol and drug addictions, the CSJ said.

Under the scheme, a levy of a penny per unit would be added by the end of the next Parliament to fund recovery services to the tune of £1.1billion over the five years.  It would be spent solely on setting up a network of abstinence-based rehabilitation centres and funding sessions within them.

Last month ministers called the rise in the use of legal highs a ‘national emergency’.

MPs spoke out after several leading UK festivals, including Glastonbury and Bestival, banned the sale of the drugs, and called for more action to be taken against a problem blighting communities around the country.

Democratic Unionist Jim Shannon described the festivals’ involvement as proof that there is concern ‘at every level’ about the consequences of new manufactured chemical highs that have not been banned.

He told a Westminster Hall debate: ‘There is concern at every level about what legal highs do. It’s fantastic to see such influential festivals getting involved in the campaign to rid our country of these potentially fatal substances, but more is required.’

Meanwhile, Labour frontbencher Toby Perkins described how legal highs had made a part of his Chesterfield constituency town centre a ‘no-go area’ as they fuel anti-social behaviour among teenagers who use the drugs.  Mr Perkins claimed that head shops are ‘mocking the law’ and called for councils to be given more power to deal with problems in their areas.

He described the problem as a ‘national emergency’, saying: ‘The truth is that some retailers are mocking the law, laughing at powerless regulators, while visiting misery and mayhem on our communities.’

Source:   http://www.dailymail.co.uk/news/article-2727072/Legal-highs-kill-people-heroin-two-years-drugs-experts-warn.html#ixzz3AfTr6YYW   17th August 2014

It was reported today that Ian Duncan Smith is threatening to stop heroin addicts from being able to claim incapacity benefits.  About a hundred of my patients are heroin users and they are all signed off work. IDS pointed out that it was unfair that hardworking tax payers were paying for the addictions of others. This may well be true but is an attempt to force heroin users in to gainful employment really a viable option?

We recently advertised for an admin assistant at our surgery. It is a low paid, unskilled, part time position that required no previous experience and no great physical exertion. Such is the nature of the times; we had over 60 applicants, most of whom were greatly over qualified for the post. None of the applicants were intravenous heroin users, but if they were we wouldn’t have short listed them. If we wouldn’t consider employing a heroin user, who does Mr. Smith think will? With the exception of the odd ailing rock star, I am yet to hear of a gainfully employed injecting heroin addict.

Heroin is an awful all-consuming drug that destroys the personality of the person behind the habit. The next fix becomes more important to the user than food, shelter and most sadly the people who care about them most. It is not a lifestyle that can easily coexist with a 9-5 job. IDS is very welcome to switch all of my heroin addicts from incapacity benefit to job seekers allowance, but it would simply be an expensive and time consuming PR exercise that led people from one handout to another.

If he chose to take it one step further and remove all their benefits, the result would be an almighty Hurrah from some, but would simply mean a large number of the most vulnerable members of our society being made homeless and being pushed further in to crime, prostitution and begging as they looked for alternative ways to feed their habits. The extra burden placed on to the criminal justice system would almost certainly end up costing far more than the relatively meager handouts that heroin users currently receive in the form of incapacity benefits.

Our local drug and rehab services are quite good but although most of my patients who use heroin are actively enrolled within substance misuse services, very few will successfully turn their lives around. Treating heroin addicts punitively with prison sentences doesn’t seem to work either, so it would appear to me better to try and work out why people fall in to heroin addiction in the first place. Most of us experiment with drugs to some level or another in our youth, but even during my own sustained and enthusiastic period of adolescent experimentation, I never got anywhere near a place where injecting a syringe full of heroin in to my arm jumped out as being a good idea.

Most, although by no means all of my patients who use heroin seem to take those extra few steps in to harder drugs and full scale addiction after fairly miserable starts in life. Heroin is often an escape from the grim realities of life and amongst my patients, child abuse and growing up in care seem to pop up time and time again as the most damaging experiences addicts are trying to escape from.

As a doctor I try not to get carried away with the emotion and morality of what I see as it interferes with the practical aspect of the job. Many of my patients have self inflicted injuries and illnesses and whether they are due to heroin, alcohol, smoking, or falling off horses, me offering extra indignation benefits no one. In my eyes politicians have no option but to take the same approach. I am dealing with addiction on an individual basis whilst they have to consider it on a more national scale, but ultimately the realities are the same.

Heroin dependence exists and is hugely detrimental to everyone. Vitriolic sound bites about the cost to taxpayers might make favorable headlines in the right wing media, but it doesn’t make the problem go away. There will always be victims who fall prey to heroin, but how about trying to prevent young vulnerable people from plunging in to addiction, rather than simply vilifying them once they have.

Source: www.blogs.independent.co.uk   23rd May 2012

Filed under: Drug Specifics :

Prisoners increasingly using ‘spice’, which is undetectable but has put growing numbers of users in hospital Spice: the drug ‘more devilish than weed’ sweeping British prisons Link to video: Spice: the drug ‘more devilish than weed’ sweeping British prisons

Synthetic cannabis known as “spice” or “black mamba” is a growing problem in UK prisons with serious physical and mental health consequences, the chief inspector of prisons, Nick Hardwick has said.

Its popularity with inmates has surged because the psychoactive designer drug can be passed off as a tobacco roll-up, has no distinctive smell and it evades current drug testing capabilities in prisons.

In a Guardian Films investigation, we spoke to several prisoners, former prisoners and officials and analysed Her Majesty of Prisons Inspectorate (HMIP) reports that revealed it had become a problem in at least 28 prisons in England.

Several former prisoners said the drug was rife inside, having been thrown over the walls or otherwise smuggled in, and one said its lack of smell meant it could be smoked in front of the guards. Another, a remand prisoner currently at HMP Forest Bank near Manchester, said in a telephone interview that some of those using it were “going down like flies”. He said it had led to multiple calls to the emergency services.

“I’ve never seen anything like it in prison. Guys are taking it and having psychotic episodes all over the place. Ambulances are coming in and out of the place more frequently than the escort vans,” he said. It is not clear how many of these incidents involved other drugs in combination. The recent annual Global Drug Survey (GDS), which surveys thousands of drug users on their experiences, indicated that users of synthetic cannabis were seven times more likely to need hospital treatment than users of the natural form of the drug. Several deaths in the US have been blamed on spice, which is made from dried plants sprayed with engineered chemicals.

“What we can say for definitive is that spice is a significant problem in a number of prisons and it is rising,” Hardwick told the Guardian.

“As opiate-based drugs become less popular, spice has become a more favoured option. We’ve seen examples where its affected people’s heart and so have had to have emergency treatment. It has affected people’s mental health and what it it seems to do is exacerbate people’s existing conditions”.

There was currently no effective test for the drug, he said.

The HMIP reports describe prisoners who have taken the drug experiencing seizures, psychosis, loss of motor control and an irregular heartbeat. At HM Prison Ford in West Sussex, the prison’s drugs and alcohol recovery team said 85% of its prisoners were using or supplying spice.

A government ban on spice-like drugs in place since 2009 does not cover many newer and often more potent versions as the chemicals used to synthesise them are different. .

Spice-like drugs can still be bought on the high street and online on the basis that they are not for human consumption.

At HMP Wealstun in West Yorkshire, a notice issued to practitioners and visitors to the prison and made available to the Guardian reveals that in a two-week period in March, 13 prisoners required medical attention after using synthetic cannabis, and five cases were so severe that they were rushed to hospital.

Glyn White, 35, who has served time in more than 15 prisons including Norwich, Leicester, Weyland and Ranby, said he first noticed synthetic cannabis in 2006. He first smoked it in 2012, and said he witnessed grown men experiencing breakdowns. “I saw people pass out. I saw people cut themselves. I took it and had to go to my cell for a couple hours because that buzz is intense when you ain’t had no weed,” he said.

“I went to Weyland. It just exploded there. It was selling for £100 a gram. That is better than selling the buds [natural cannabis]. It don’t smell and is easier to conceal. When I got out of prison I started smoking a bit of it, but I reckon its worse than weed.”

Dr John Ramsey, a toxicologist based at St Georges University London, told the Guardian that testing for drugs such as spice was difficult because manufacturers change their composition changes so often. “The number of chemicals you can think of that would mimic cannabis is a very, very large number. Whatever you do, you can probably tinker with the molecule and find a way around it because they are a very diverse group of compounds.”

The list of drugs prisoners are tested for has not been updated for five years and does not include synthetic agents, but a Ministry of Justice spokesman said it had commissioned scientists to devise a test for new psychoactive substances.

The government has also introduced an amendment to the criminal justice and courts bill to expand prisons’ power to test for non-controlled drugs.

The spokesperson told the Guardian: “Prison staff take the use of any illicit substances in prison extremely seriously and use a range of robust measures to find them, including interrogation, intelligence, searches, specially trained dogs and random drug tests. Anyone caught with them will be dealt with severely and may be referred to the police for prosecution.

“The misuse of new psychoactive substances is an issue affecting many parts of society, including prisons.”

The psychoactive chemicals tend to be imported from pharmaceutical companies abroad, most notably in China, and then blended in the UK.

The terms spice initially referred one brand of synthetic cannabis, but now all forms of the drug. Other names also include K2 and clockwork orange.

Source:   www.theguardian.com  15th  May 2014

SCOTS are some of the biggest users of drugs in Europe, a new study has shown.

The annual report by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), has shown that 11 per cent of Scottish adults used cannabis last year – second only to Italy – compared with an European average of 6.8 per cent, and a UK rate of 8.4 per cent.

The report also showed Scotland has the highest usage of cocaine (3.8 per cent), amphetamines (2.2 per cent) and LSD (0.6 per cent), while ecstasy use came in at 3.2 per cent, second to the Czech Republic, which has a rate of 3.5 per cent.

The figures follow controversy over cannabis classification following UK government drug adviser Professor David Nutt’s sacking last week.

He had spoken out against the decision to reclassify cannabis from a Class C drug to the more dangerous category B.

The EMCDDA’s figures, which are based on the most up-to-date regional cannabis-use statistics, revealed that the Dutch were among the lowest users, with just 5.4 per cent using the drug.

Scottish Drugs Forum director David Liddle said the figures pointed to wider issues about approaches to tackling drug use.

“They raise the question of what is the best route, through education and giving young people information about drug use, or through the legal route,” he said. “The bigger issue is the one of early use, which leads young people on to particular cultures and problematic use of illegal substances, but early drunkenness and smoking are also linked to this.”

A spokesman for the Scottish Government said: “This report highlights why Scotland’s drugs problem cannot be tackled overnight.

“We need long-term cultural change, which is why we launched ‘Road to Recovery’, Scotland’s national drugs strategy.”

Scottish Conservative justice spokesman Bill Aitken said the figures reflected the need for a rethink on drugs policy.

Mr Aitken said: “These are clearly very concerning figures, and the cannabis statistics in particular result from the lack of a firm message from the UK government on cannabis classification.”

Source:  http://thescotsman.scotsman.com/scotland   7th Nov. 2009

WASHINGTON — The Obama administration recently sounded the alarm over rising marijuana use among the nation’s youth, saying softening attitudes about the perceived risk of the drug are responsible for the increase.  Sixty percent of 12th-graders do not view regular marijuana use as harmful, and more than 12 percent of eighth-graders said they’d used the drug in the past year, according to a survey released by the National Institute on Drug Abuse.

“Making matters worse, more teens are now smoking marijuana than smoke cigarettes,” said Gil Kerlikowske, President Barack Obama’s drug czar. “Well, this isn’t a recipe for raising a healthy generation of young people who are prepared to meet America’s challenges.”  He criticized the legalization of marijuana in Washington state and Colorado, calling the plans “a very large social experiment.” And he delivered a shot aimed at pro-legalization advocates who argue marijuana is safer than alcohol, saying: “For some to say that it is less dangerous than other substances is a ridiculous statement.”

The survey found 23 percent of high school seniors used marijuana in the past month, compared with 16 percent who smoked cigarettes.  Among 12th-graders, 6.5 percent said they smoked pot every day, and more than 36 percent said they had smoked it in the past year. Among 10th-graders, 4 percent said they used marijuana daily, with 18 percent reporting past month use, and 29.8 percent said they had used it in the previous year.

“These are very high numbers, considering that these are kids at school,” said Nora Volkow, director of the National Institute on Drug Abuse, which conducts the study as part of a project with the University of Michigan.  Volkow said this year’s survey carried some bright spots: Alcohol and tobacco use declined, and fewer students said they were using synthetic marijuana.

But the survey cited the misuse of prescription stimulants as another “cause for concern.” The percentage of 12th-graders who said they used amphetamines for non-medical reasons in the past year rose from 6.8 percent in 2008 to 8.7 percent in 2013, and officials said many of them said they were using them not for fun but before exams hoping to boost their performance.

Kerlikowske, a former Seattle police chief who now serves as the director of the Office of National Drug Control Policy for the White House, called the marijuana results both “a serious setback” and a disappointment.   He said schools have done a poor job on dealing with drug education, eliminating it or making it an inconsistent part of their health curriculum.

And he predicted that Washington state and Colorado, the two states that last year voted to legalize the recreational use of marijuana, will face “a very difficult time” as they move forward with their plans to sell the drug in retail stores beginning in 2014.   “It’s an important issue and … clearly these two states are engaging in a very large social experiment,” Kerlikowske said.

He said kids who live in states with medical marijuana laws already are finding it easier to obtain the drug, proving that state-regulated systems are having trouble confining the marijuana to adults. Kerlikowske said the survey found that 34 percent of high school seniors who live in states with medical marijuana laws say that one of the ways they’ve obtained the drug is from others who have gotten prescriptions to buy the drug.

Volkow said marijuana use among school-age children could hinder their brain development and put them at increased risk of addiction in later years.  “We should be extremely concerned that 12 percent of 13- to 14-year-olds are using marijuana,” Volkow said. “The children whose experimentation leads to regular use are setting themselves up for declines in IQ and diminished ability for success in life.”

Source: http://www.sunherald.com   2014/01/04

Filed under: Drug Specifics,USA :

A doctor who runs a drug treatment clinic for youth in Colorado says legalizing marijuana has led to many problems in his state and also carried over into Iowa. Dr. Christian Thurstone recently met with drug prevention groups in Iowa. “We’ve seen referrals to substance treatment, to adolescent substance treatment skyrocket — they’ve quadrupled in the last couple of years. We’ve seen used rates, prevalence of use among teenagers — go up significantly, pre-post,” Thurstone says.

He says there are other problems created by marijuana. “We’ve seen a doubling in traffic fatalities, with a driver who is positive for marijuana, double since 2006. We’ve seen school expulsions go up 40-percent pre-post 2010 when we had our defacto legalization of marijuana,” according to Thurstone.

Thurstone says three peer-reviewed medical articles have documented widespread abuse of medical marijuana. “We’ve documented that teenagers who use medical marijuana have more severe addiction than those who don’t use medical marijuana, just because of the potency of medical marijuana products that they’re using,” Thurstone says. He says the legalization has led to some ironic circumstances for the kids he sees in his Denver practice. “Sometimes people will be in treatment for marijuana addiction, yet they will also have a medical marijuana card,” Thurstone says.

He says Iowa has also been impacted. “In terms of the internet advertising of marijuana products, and the specific marijuana products which have tripled the number interdictions of marijuana coming from Colorado to Iowa the last few years. So, there are people who are really trying to change the current patterns of marijuana use in Iowa,” according the Thurstone.

Thurstone made a couple of appearances in Iowa last week. One was in his role as board member of the group “Smart Approaches to Marijuana” or SAM.

Source: www.radioiowa.com   18th Nov.2013 

A highly concentrated form of marijuana challenges the drug’s benign reputation.

The organizers of this summer’s Hempfest in Seattle had to ban something that you might not expect to be a common item at a marijuana-themed festival: blowtorches. And despite that effort, people still showed up with them. Blowtorches are used for dabbing, which is a newish way of getting high that’s becoming increasingly popular, especially in states with some degree of marijuana legalization. It has some parents and doctors concerned, and it puts advocates of legal marijuana in a rather uncomfortable position. That’s because it gets you really high really fast, and sometimes people doing it blow up their houses.

If you’re not from Colorado, Washington, California, or Oregon, odds are you’re not familiar with dabbing. That’s because it’s most popular in the states with the loosest marijuana laws. Producing dabs — the technical term is “butane hash oil” — is a fairly complex process. The short version is that you extract resins from marijuana with liquid butane, then evaporate the butane to leave behind a highly concentrated form of THC. The residue usually weighs 10 to 20 percent of what the original marijuana did.  You consume the resultant product, called dabs or BHO, by using a blowtorch and what’s called an oil rig to heat the concentrate until it smokes. Then you breathe the smoke in and get extremely high.

“Isaac,” a black-market dealer based in a Denver suburb, tells NATIONAL REVIEW ONLINE that people should use extreme caution when first dabbing: “Most people I know who try it for the first time don’t say much for about an hour and a half, two hours,” he says. “They just sit there — ‘Oh sh*t.’”   He adds that he’s seen people throw up and pass out when trying it, and that dabbing once is like smoking an entire eighth (1/8 ounce, or 3.5 grams) of marijuana. In general, he’s not a huge fan of the process. “It’s less of a social thing,” he says. “It’s like you’re chewing on coca leaves or you’re doing cocaine. It’s kind of the same. You’re smoking a joint and you’re passing it around to your friends and having a good time, or you’re sitting in the corner with a torch.”

But from the perspective of those in the cannabis industry, the increasing popularity of dabbing is good news. If you’re in the black market, it’s a boon because BHO is much more compact, and thus easier to transport, than marijuana flowers (the usual form in which the drug is consumed). Isaac says he can mail the BHO derived from a quarter pound of marijuana — worth up to $1,500 — for about five bucks. Flowers are much

more fragrant and take up more space, which makes them a lot more likely than concentrate to be noticed by postal workers. And if you get pulled over with ten grams or so in your car, Isaac says, you can just eat it without getting especially high. Problem solved!

Dabbing is also making a splash in the legal marijuana industry. Kayvan Khalatbari, who works as a consultant for marijuana businesses and owns a dispensary in Denver, tells NATIONAL REVIEW ONLINE that concentrates are becoming a much bigger part of his market share than they were a few years ago: “It’s definitely a huge part of where this industry’s headed.”

And it’s lucrative. Producing the concentrates isn’t very expensive, and as demand has gone up, so have prices. Khalatbari says concentrates were selling for $5 to $15 a gram wholesale six months ago but now go for about $30. Retail prices of concentrates have gotten as high as $90 in the state. And naturally, it’s even pricier in places like Atlanta that are far outside the perimeter of states with lax marijuana laws. So a mail-order dabbing business can be very profitable. Isaac thinks that in ten years, half the marijuana consumed in this country will be through dabbing.

From a PR perspective, though, dabbing isn’t great for advocates of looser cannabis laws. For starters, some of the implements you can use to dab look a lot like crack pipes. There’s also the risk that you’ll inhale butane, which isn’t fantastic for your lungs. On top of that, there can be flashy accidents when the steps involved in producing and consuming dabs aren’t followed properly (houses blow up, people get third-degree burns all over their bodies, etc.).. An organization called notMYkid has issued a “Parent Alert” on the subject, and news stories detailing doctors’ concerns are starting to crop up.

Source:  WWW.NATIONALREVIEW.COM         DECEMBER 6, 2013 4:20 PM 

Hospital emergency department visits related to the dangerous hallucinogenic drug Ecstasy, sometimes known as “Molly,” increased 128 percent between 2005 and 2011 (from 4,460 visits in 2005 to 10,176 visits in 2011) for visits among patients younger than 21 years old, according to a new report from the Substance Abuse and Mental Health Services Administration (SAMHSA).  Overall in 2011, there were approximately 1.25 million emergency department visits related to the use of illicit drugs.  Ecstasy (3,4-methylenedioxy-methamphetamine) has both stimulant and hallucinogenic properties, and produces feelings of increased energy and euphoria among users. Abuse of Ecstasy can produce a variety of undesirable health effects such as anxiety and confusion, which can last one week or longer after using the drug. Other serious health risks associated with the use of Ecstasy include becoming dangerously overheated, high blood pressure, and kidney and heart failure.  Recently there have been several deaths associated with Molly, a variant of Ecstasy, among young people taking it at concerts and raves.  Another key finding shows that a substantial proportion of hospital emergency departments visits associated with Ecstasy during the six year period also involved underage drinking. In each year from 2005 to 2011, an average of 33 percent of emergency department visits among those younger than age 21 involved Ecstasy and involved alcohol. This unsafe combination causes a longer-lasting euphoria than Ecstasy or alcohol use alone and may increase the risk for potential abuse.  “These findings raise concerns about the increase in popularity of this potentially harmful drug, especially in young people,” said Dr. Peter Delany, Director of SAMHSA’s Center for Behavioral Health Statistics and Quality. “Ecstasy is a street drug that can include other substances that can render it even more potentially harmful. We need to increase awareness about this drug’s dangers and take other measures to help prevent its use.”  The report, titled Ecstasy-Related Emergency Department Visits by Young People Increased between 2005 and 2011; Alcohol Involvement Remains a Concern, is based on 2005 to 2011 findings from the Drug Abuse Warning Network (DAWN). DAWN is a public health surveillance system that monitors drug-related hospital emergency department visits and drug-related deaths to track the impact of drug use, misuse and abuse in the United States. The complete survey findings are available on the SAMHSA website at: http://www.samhsa.gov/data/spotlight/spot127-youth-ecstasy-2013.pdf.

Source:  www.cadca.org  5.12.13

October 30, 2013  On October 7-9, the city of Seoul, Korea served as host for the third Global Alcohol Policy Conference.  At the conference, more than 850 participants from 45 countries discussed the current state of science-based alcohol policies, recent successes in the alcohol policy field, the prospects for improvement, and the challenges facing alcohol policy advocates.

One important theme running through the conference was the role of the global alcohol industry in maintaining and intensifying alcohol-related harm through its tactics and practices.

Dr. Thomas Babor of the University of Connecticut, for example,  stressed reasons to doubt the sincerity of the global alcohol industry in its insistence to be part of the solution to alcohol problems.  This is particularly true, given that the strategy of the multi-national alcohol producers and their industry associations and social aspects organizations is clearly to increase overall consumption – a strategy which is inimical to public health and public safety.  Additionally, the industry clings to “self-regulation” – a strategy Babor described as “spectacularly ineffective” in actually preventing industry misconduct or associated alcohol-related harms.

Other plenary speakers and workshop presenters illustrated specific cases of alcohol industry efforts either to prevent evidence-based policies from taking effect or to render such policies ineffective.  Dr. Ronald Laranjeira (Professor of the Federal University of São Paulo [UNIFESP], Brazil; Director of Alcohol and Drug Research Unit of UNIAD) described the almost total lack of functional alcohol policies in much of Latin America.  He called attention to the suspension of a national ban on the sales of alcohol beverages in soccer stadia during the forthcoming 2014 World Soccer Cup in Brazil.  The removal of the ban was forced by the Fédération Internacionale de Football Association (FIFA), linked to that organization’s multimillion-dollar contract with Anheuser-Busch InBev’s Budweiser brand.  Similarly, Dr. Evelyn Gillan,  Chief Executive of Alcohol Focus Scotland (AFS), Scotland’s national alcohol charity, addressed the tactics of the Scotch Whiskey Association to work to prevent or delay implementation of the Scottish Government’s Minimum Unit Pricing policy.

In South Africa – and the rest of that continent – multinational brewer SABMiller has made clear its intention to “grow per capita beer consumption.” Dr. Charles Parry, Director of the South African Medical Research Council’s Alcohol & Drug Abuse Research Unit (ADARU), described the efforts of SABMiller and other alcohol operators to resist a proposed total ban on alcohol advertising.  Specifically, he listed the various arguments marshaled by industry groups and related associations and media outlets – all of which should be familiar to public health advocates vying with health-harming industries:

ŸCasting doubt on the underlying science (the “scientific evidence is not uniform”) * Attacking public health advocates (the Minister of Health is a “Nanny from Hell,” and his allies are akin to the Nazi and Apartheid regimes)

* ŸWarning of the “unintended consequences” of regulating industries, including dire economic consequences

* Claiming that the measures would be disproportionately burdensome to small businesses (“hurt the little guy”).  (Dr. Parry noted that this claim begs the

question:  if this measure is so beneficial to big business, why would SABMiller raise such vigorous opposition?)

Finally, one of the workshops at GAPC 2013 specifically addressed alcohol industry influences in the alcohol policy process.  During that session, Professor Jeff Collin (Director of the Global Public Health Unit at the University of Edinburgh) called out the disconnect between the British government’s ostensible embrace of a multi-sectoral approach to global health in its “Health is Global” framework – and the reality of its trade policy, including the active promotion of hard liquor as a key export.  Sven-Olov Carlsson, International President of IOGT International, compared the tactics of Big Alcohol to those of Big Tobacco and found many parallels, including the creation of front groups to “fill the policy space.”

Sri Lanka’s Shakyra Nanayakkara detailed the various legal maneuvers utilized by alcohol industry interests to undermine that nation’s National Authority on Tobacco and Alcohol (NATA) Act – which prohibits the sale of alcohol and tobacco to person under the age of twenty-one.  These maneuvers include legal challenges and infiltrating the NATA training panel with industry-funded lawyers.

A key takeaway of the conference is that understanding the current gap between alcohol policy science and alcohol policy practice is impossible without taking into consideration the machinations of an industry which profits handsomely from underage and excessive adult alcohol consumption.

Thus, reducing the global burden of alcohol-related harm will require advocates to effectively counter that industry influence – through reliance on the best science, savvy media advocacy, and robust grassroots organization.

Source: www.corporationsandhealth.org  30th October 2013

Filed under: Drug Specifics :

Ten years ago this week, Insite, North America’s first supervised drug injection site, opened at 139 East Hastings in Vancouver’s Downtown Eastside, thanks mainly to two men, Dr. Julio Montaner and Thomas Kerr of the British Columbia Centre for Excellence in HIV/AIDS.

It’s an amazing story. Since 2003, folks in Canada’s most drug-infested neighbourhood have been buying heroin, cocaine and crystal meth on the street, strolling into InSite and shooting-up under the watchful eye of government nurses. All in the name of harm reduction, a philosophy of addiction treatment through enablement. How’d they do it? Early last decade, Montaner and Kerr lobbied for an injection site. In 2003, the Chretien Liberals acquiesced, gave the greenlight to B.C.’s Ministry of Health, which, through Vancouver Coastal Health, gave nearly $1.5 million to the BC Centre (that’s Montaner and Kerr, you remember them) to evaluate a three-year injection site trial in Vancouver. Voila! InSite was born. If the three-year trial was successful, or in other words, if InSite’s chief lobbyists, who received $1.5 million from taxpayers to study its pros and cons, concluded that InSite was a good fit for Vancouver, the provincial government would consider funding it in perpetuity. Amazing. Through Freedom of Information legislation, I obtained a copy of the $1.5 million contract, which tasked the BC Centre to “evaluate the process, impacts and economic elements” of InSite and note “any adverse events that may occur.” Yet every study produced by the BC Centre since 2003 has cast InSite in a positive light. Every study. And the BC Centre is very protective of its conclusions. For example. In 2009, the BC Centre released a report summarizing 33 InSite studies, all co-authored by Thomas Kerr, all singing InSite’s praises. At that time, I interviewed Kerr who bristled at my questions, claiming that his researchers “passed the test of independent scientific peer review and got our work published in the best medical journals in the world, so we don’t feel like we need to be tried in the popular media.” I asked him about the potential conflict of interest (lobbyists conducting research) and he ended the interview with a warning. “If you took that one step further you’d be accusing me of scientific misconduct, which I would take great offense to. And any allegation of that has been generally met with a letter from my lawyer.” Was I being unfair? InSite is a radical experiment, new to North America and paid for by taxpayers. Kerr and company are obligated to explain their methods and defend their philosophy without issuing veiled threats of legal action.

In the media, Kerr frequently mentions the “peer review” status of his studies, implying that studies published in medical journals are unassailable. Rubbish. Journals often publish controversial studies to attract readers — publication does not necessarily equal endorsement. The InSite study published in the New England Journal of Medicine, a favourite reference of InSite champions, appeared as a “letter to the editor” sandwiched between a letter about “crush injuries” in earthquakes and another on celiac disease. Yet Kerr thunders away like Moses. Where did he obtain this astonishing sense of entitlement? Two words: the media. The reportage on InSite by Vancouver’s print and broadcast media does not meet, by any definition, basic standards of professional journalism. It’s been shameful. When the BC Centre stages a press conference, it’s always the same formula. A handful of Kerr-authored studies and an obligatory recovering addict who owes his life to InSite. The reporters in attendance nod along and write or broadcast the same story with the same quotes and BC Centre statistics.  If a story involves an InSite skeptic such as Dr. Don Hedges, an addictions expert from New Westminster or David Berner, a drug treatment counsellor with more than 40 years of experience, it almost always includes a familiar narrative propagated by the BC Centre. InSite opponents are blinded by ideology; conservative moralists who care little about the poor and addicted. InSite proponents, on the other hand, are pure and unburdened, following the facts and relying on science. Really? What kind of “science” produces dozens of studies, within the realm of public health, a notoriously volatile research field, with positive outcomes 100 per cent of the time? Those results should raise the eyebrows of any first-year stats student. And who’s more likely to be swayed by personal bias? InSite opponents, questioning government-sanctioned hard drug abuse?  Or Montaner, Kerr and their handful of acolytes who’ve staked their careers on InSite’s survival?  From 2003 to 2011, the BC Centre received $2,610,000 from B.C. taxpayers to “study” InSite.  How much money have InSite critics received? There has never been an independent analysis of InSite, yet, if you base your knowledge on Vancouver media reports, the case is closed. InSite is a success and should be copied nationwide for the benefit of humanity. Tangential links to declining overdose rates are swallowed whole. Kerr’s claims of reduced “public disorder” in the neighbourhood go unchallenged, despite other mitigating factors such as police activity and community initiative. Journalists note Onsite, the so-called “treatment program” above the injection site, ignoring Onsite’s reputation among neighbourhood residents as a spit-shined flophouse of momentary sobriety. Where’s the curiosity? Where did these reporters learn their craft? The BC Centre won’t answer your questions? Then ask the politicians who, unlike Montaner and Kerr, operate inside the bounds of democratic accountability. If InSite works in the Downtown Eastside, Mayor Robertson, why not Dunbar, Mount Pleasant or West Point Grey? If, God forbid, you had a child who became addicted to drugs, Minister Lake, would you refer him to InSite? Premier Clark, your government funds InSite yet shuns many abstinence-based treatment programs. Why? And so on. For the record, my opposition to InSite is based on the countless conversations I’ve had

with Downtown Eastside residents over the past decade, as a journalist, volunteer and friend. In my judgement, public money is better spent on treatment and recovery facilities outside the neighbourhood, which is where the vast majority of addicts settle when they finally decide to quit using drugs. Ten years later, despite any lofty claims, for most addicts, InSite’s just another place to get high.

Source: www.drugpreventionnetworkofcanada.ca    19th Sept 2013

Filed under: Canada,Drug Specifics :

The number of people suspected of being sickened by synthetic marijuana in Colorado has risen to 150, NPR reports. Last week, the Colorado Department of Public Health and the Centers for Disease Control (CDC) said they were investigating three deaths and 75 hospitalizations potentially caused by the drug.

Synthetic marijuana, commonly known as K2 or Spice, is a mixture of herbs, spices or shredded plant material that is typically sprayed with a synthetic compound chemically similar to THC, the psychoactive ingredient in marijuana. K2 is typically sold in small, silvery plastic bags of dried leaves and marketed as incense that can be smoked.

Short-term effects of using synthetic marijuana include loss of control, lack of pain response, increased agitation, pale skin, seizures, vomiting, profuse sweating, uncontrolled/spastic body movements, elevated blood pressure, heart rate and palpitations.

According to Colorado’s Acting Chief Medical Officer, Dr. Tista Ghosh, hospital emergency rooms across the state are reporting people coming in with agitation, delirium and confusion, as well as unresponsiveness, extreme sleepiness and seizures. About one-fifth of the hospitalized patients appear to be teenagers, the article notes. “We’re not exactly sure what molecule or chemical we’re looking for,” Dr. Ghosh said. “It’s pretty rare to be able to do this kind of testing. There’s not that many labs in the country that can do this.” Last year, the CDC found Spice caused kidney failure in three young people, and vomiting and back pain in a dozen others in Wyoming. “In [the Wyoming] investigation, they did find a novel compound that was being put into the synthetic marijuana,” Dr. Ghosh said. “That makes this kind of investigation more challenging, because they are constantly changing the chemical compositions that are in synthetic marijuana.”

Source:  http://www.drugfree.org/join-together/prescription-drugs   Sept 20th 2013

The first study of the global dependence upon illicit drugs has revealed dependence on opiods, such as heroin, causes the greatest health burden of all the illict drugs.

The results come from new analysis of the Global Burden of Disease Study 2010.

A team of Australian and US researchers, led by Professor Louisa Degenhardt from UNSW’s National Drug and Alcohol Research Centre, performed a comprehensive search of available data on the prevalence and effects of amphetamines, cannabis, cocaine, and opioids. Other drugs, including MDMA (ecstasy) and hallucinogens such as LSD, were not included in the analysis due to a lack of high quality data on their prevalence and health effects.

The results, published today in The Lancet, show that the burden in the worst affected countries, including Australia, was 20 times greater than in the least affected countries. Other largely high-income nations such as the US and UK had similar poor outcomes.

The researchers also found that disability and illness caused by the four drugs studied has increased by over half in the 20 years between 1990 and 2010. Although some of this increase is due to increasing population size, over a fifth (22%) of the increase is thought to be due to increasing prevalence of drug use disorders, particularly for opioid dependence. Of the around 78,000 deaths in 2010 attributed to drug disorders, more than half (55%) were thought to be due to opioid dependence.

Regional breakdown of the results shows that the highest prevalence of cocaine dependence was in North America and Latin America, and among the highest levels of opioid dependence were in Australasia and Western Europe. The UK, US, South Africa, and Australia all had notably high overall burdens of death and illness due to illicit drugs.

“Our results clearly show that illicit drug use is an important contributor to the global disease burden, and we now have the first global picture of this cause of health loss,” says Professor Degenhardt.

“Young men aged 20-29 are disproportionately affected at a crucial time in their lives.

“Although we have fewer means of responding to some causes of burden, such as cocaine and amphetamine dependence, well-evaluated and effective interventions can substantially reduce two major causes of burden – opioid dependence and injecting drug use. The challenge will be to deliver these efficiently and on a scale needed to have an effect on a population level,” she says.

Effective strategies to reduce the burden of opioid dependence and injecting drug use include opioid substitution treatment.

Source:  www.healthcanal.com  30.08.2023

Campaigners have urged the Government to rethink drug laws in light of a widely respected independent body likening cannabis use to “moderately risky” gambling or junk food.

The publication of a six-year study from the UK Drug Policy Commission (UKDPC) today reveals that the £3bn spent annually tackling drugs is not evidence-based and calls for a “wholesale review” of existing laws.   The body, part-funded by the Home Office, was launched in April 2007 to provide objective analysis of drug policy, independent of government interference and special interest groups.

Its report, “A Fresh Approach to Drugs”, examined the effects of drug policy and makes recommendations ahead of the UKDPC being wound up this autumn. The report recommended re-categorising the possession of small amounts of drugs for personal use as a civil and not criminal offence.

It said there was an argument for amending the laws relating to growing cannabis for personal use which might “go some way to undermining the commercialisation of production”.   In England and Wales 160,000 people are given cannabis warnings each year. The National Treatment Agency for Substance Abuse says 2.8 million people in England use drugs, but only 300,000 use heroin and crack cocaine which “cause the most problems”.

The UKDPC report said there are “some moderately selfish or risky behaviours that free societies accept will occur” and seek to limit but not prevent entirely, such as “gambling or eating junk food”.   Politicians must heed its findings and begin this review as a matter of urgency” said Danny Kushlick, of the Transform Drug Policy Foundation.

Source: www.independent.co.uk   15. Oct.2012

Filed under: Drug Specifics :

The Dutch government said Friday it would move to classify high-potency marijuana alongside hard drugs such as cocaine and ecstasy, the latest step in the country’s ongoing reversal of its famed tolerance policies.

The decision means most of the cannabis now sold in the Netherlands’ weed cafes would have to be replaced by milder variants. But skeptics said the move would be difficult to enforce, and that it could simply lead many users to smoke more of the less potent weed.  Possession of marijuana is technically illegal in the Netherlands, but police do not prosecute people for possession of small amounts, and it is sold openly in designated cafes. Growers are routinely prosecuted if caught.

Economic Affairs Minister Maxime Verhagen said weed containing more than 15 percent of its main active chemical, THC, is so much stronger than what was common a generation ago that it should be considered a different drug entirely.

The high potency weed has “played a role in increasing public health damage,” he said at a press conference in The Hague .  The Cabinet has not said when it will begin enforcing the rule. Jeffrey Parsons, a psychologist at Hunter College in New York who studies addiction, said the policy may not have the benefits the government is hoping for.  “If it encourages smoking an increased amount of low-concentration THC weed, it is likely to actually cause more harm than good,” he said, citing the potential lung damage and cancer-causing effects of extra inhalation.

The Dutch Justice Ministry said Friday it was up to cafes to regulate their own products and police will seize random samples for testing.   But Gerrit-Jan ten Bloomendal, spokesman for the Platform of Cannabis Businesses in the Netherlands, said implementing the plan would be difficult “if not impossible.”   “How are we going to know whether a given batch exceeds 15 percent THC? For that matter, how would health inspectors know?” he said. He predicted a black market will develop for highly potent weed.

The ongoing Dutch crackdown on marijuana is part of a decade-long rethink of liberalism in general that has seen a third of the windows in Amsterdam’s famed prostitution district shuttered and led the Netherlands to adopt some of the toughest immigration rules in Europe.

The number of licensed marijuana cafes has been reduced, and earlier this year the government announced plans to ban tourists from buying weed. That has been resisted by the city of Amsterdam, where the marijuana cafes known euphemistically as “coffee shops” are a major tourist draw. Marjan Heuving of the Netherlands’ Trimbos Institute, which studies mental health and addiction, said there is a growing body of evidence that THC causes mental illnesses.   She said it stands to reason “the more THC the body takes in, the more the impact.” But it has not been demonstrated scientifically that high THC weed is worse for mental health, she said.

Parsons of Hunter College said it remains difficult to be sure whether marijuana causes mental problems or whether people predisposed to, say, depression seek it out as a form of self-medication.

The Trimbos Institute says the average amount of THC in Dutch marijuana is currently around 17.8 percent. It has been declining since 2004 after increasing steadily from 4 percent or so in the 1970s.By comparison, in the United States the average level of THC in marijuana is around 10 percent and rising, according to the last measure released by the Office of National Drug Control Policy in 2009.

Heuving agreed with Ten Bloomendal that determining THC levels outside of a laboratory setting would prove difficult, as exact content varies widely from batch to batch and even within a single plant.   “I don’t know of any home test,” she said. “How this is going to work in practical terms, I have no idea.”

Source:   www.independent .co.uk    Oct. 2011

Do you know how “industrial hemp”** is being used to promote the legalization of marijuana? Jeanette McDougal, Drugwatch International

 

If you don’t know the facts you may be deceived into promoting a dangerous psychoactive and addictive drug! Nobody likes to be tricked . . Nobody likes to be used…………..

 

Matthew Cheng and Alex Shum, importers of hemp fabric, “feel that the way to legalize marijuana is to sell marijuana legally.  When you can buy marijuana in your neighborhood shopping mall, IT’S LEGAL!  So, they are going to produce every conceivable thing out of hemp . . .”                                as reported High Times, “Hemp Clothing Is Here!”, March 1990

 

“Legal Hemp is Here!  Hemp clothing is now available!  The Hemp Tour.  Stoned Wear.  HEMP FOR VICTORY!”

Cover of High Times, March 1990

 

“The issue of legalizing marijuana needs to be publicized and not just worn on clothes to look cool.  NORML is trying to educate people on the usefulness of hemp, the plant that produces marijuana.

as reported in Minnesota Daily — University of Minnesota — 12-4-93

 

” ‘It’s the leaky bucket strategy,’ says Eric E. Sterling.’Legalize it in one area, and sooner or later it will trickle down into the others.’ ”

as reported in Mademoiselle Magazine, 1993

 

 

“The issue of legalizing marijuana needs to be publicized and not just worn on clothes to look cool.  NORML is trying to educate people on the usefulness of hemp, the plant that produces marijuana.

as reported in Minnesota Daily — University of Minnesota — 12-4-93

 

 

“After the Freedom Fighter Convention in April 1994, “Thus began the first national letter-writing campaign in the movement.  Members wrote letters about hemp to elected officials and requested a reply.”     as reported in High Times, p. 46 May 1994

 

 

“Over 1500 protesters attended the [Hash] Bash, 10 times the number of the previous year.  The HIGH TIMES hemp movement had officially begun.”

as reported in High Times, p. 45, May 1994

 

“In 1989 . . . We put Jerry Garcia on the cover of the issue, employing Masel’s strategy of promoting hemp through the Deadhead underground.”

as reported in High Times, p. 45, May 1994

 

“Unexpectedly, an ad for Stoned Wear, the first hemp clothing line, suddenly appeared in HIGH TIMES. . . The hemp industry in America had officially begun.”

as reported in High Times, p.46, May 1994)

 

“HIGH TIMES had been instrumental in getting the hemp movement off the ground.  Now it was time for us to step back and let the movement run itself.”

as reported in High Times, p. 47, May 1994

 

“[Colorado] Sen. Lloyd Casey had planned on introducing legislation to legalize marijuana this session, but he’s been persuaded to wait until 1995.” “He said the government should treat marijuana like tobacco and alcohol.” “For the last few months, pro-hemp activists have staged smoke-ins on the steps of the [Colorado] Capitol to call attention to the importance of legalizing marijuana.”

as reported in The Capitol Reporter, Colorado, January 19, 1994

 

One problem for farmers has been keeping pot smokers away.  Cannabis fields have been raided by people used to growing individual cannabis plants on high-rise balconies or deserted rail sidings.”

as reported in “British farmers experiment with hemp,” Sarnia Observer,

Sarnia, Ontario,Canada, Oct. 4/94

 

“All activist groups, including the National Organization for the Reform of Marijuana Laws (NORML), were severely hampered by lack of support and funding.  Could

hemp be the issue capable of drawing the smokers [marijuana users] out of their closets?”

as reported in High Times, p. 45,  May 1994

 

“Don’t forget that the joints you smoke and the fiber you make into clothes are the same plant.”

as reported in High Times, “Desert Showdown”, p. 52, April 1995

 

A trio of “twenty something” Americans — Dunn, Mignola and Markgraff — own a hemp and marijuana seed emporium in Amsterdam.  “He [Markgraff] and his partners fervently believe that once the rest of the world accepts the practical uses of the cannabis plant, it’s only a matter of time before they warm to the beneficent uses of smoking it as well.”

 

as reported in Details Magazine, “Weed the World”, p. 70, May 4/95

 

“The prosecutor in the Swiss canton of Thurgau seized hemp plants in October after forensic tests showed that the THC contents of the hemp was 4 – 5.5%, instead of 0.5%.)

Hassela Nordic Network press release, 12/6/95

People who take “Molly,” the powder or crystal form of MDMA, the chemical used in Ecstasy, don’t know what they are actually ingesting, experts say. They warn many powders sold as Molly do not contain any MDMA.

“Anyone can call something Molly to try to make it sound less harmful,” Rusty Payne, an agent at the Drug Enforcement Administration’s (DEA) national office, told The New York Times. “But it can be anything.” The DEA considers MDMA to be a Schedule I controlled substance, which means it has a high potential for abuse, and no accepted use in medical treatment.

Dr. John Halpern, a psychiatrist at Harvard who has conducted several MDMA studies, said some powders sold as Molly are synthetic versions that are designed to imitate the drug’s effects. The drug is now thought to be as adulterated as Ecstasy once was, he noted, adding, “You’re fooling yourself if you think it’s somehow safer because it’s sold in powdered form.” Molly has been a popular drug at music festivals. It has also been popularized by rappers. The drug costs between $20 and $50 a dose.

Dr. Robert Glatter, an emergency room physician at Lenox Hill Hospital in New York, says he now sees about four patients a month who come in with common side effects of Molly, including teeth grinding, dehydration, anxiety, insomnia, loss of appetite and

fever. More serious side effects can include uncontrollable seizures, high blood pressure, elevated body temperature and depression, the article notes.

“Typically in the past we’d see rave kids, but now we’re seeing more people into their 30s and 40s experimenting with it,” he told the newspaper. “MDMA use has increased dramatically. It’s really a global phenomenon now.” According to the national Drug Abuse Warning Network, MDMA-related emergency department visits increased from 10,227 in 2004 to 22,498 in 2011.

Source:  By Join Together Staff | www.drugfree.org    June 24, 2013

JONESBORO — Several Jonesboro health professionals said the risks associated with the proposed medical marijuana issue on the state ballot far outweigh potential benefits. They acknowledge marijuana may have some positive effects — like easing pain, increasing appetite and decreasing pain — but that legalization for medicinal purposes is unnecessary because a similar drug already exists in pill form. And, the act of smoking generally is considered harmful.

“As a physician, we do not encourage people to smoke — anything,” Craighead County health director Dr. Joe Stallings said. “Cigarettes, pipes, cigars, marijuana. Just because it’s marijuana doesn’t mean it doesn’t cause lung damage and difficulty breathing. Physicians should not recommend or accept smoking for health purposes of any drug.”

Dr. Shane Speights, a hospitalist at St. Bernards Medical Center, said his biggest reason for opposing the measure is that a pill form already exists. “Nobody has said that,” he said. “If it’s this life-saving drug, it’s already available. It’s already been tested, it’s already been approved. And so all this is, is an attempt for people to have recreational marijuana that they can grow in their back yard and smoke. No credible medical professional organization says that smoking marijuana should be something that you can do.”

Speights said there is evidence of pain control when the cannabinoid hits the receptors in the brain, but smoking marijuana reduces that benefit. “Because now you’re taking in all those carcinogens and all those toxins that are just going to make things worse,” he said.

One of the most common pill-form drugs comparable to marijuana is Marinol. Dr. Tom Frank, a clinical pharmacist with the University of Arkansas for Medical Sciences (UAMS) Area Health Education Center (AHEC), said although Marinol is readily available, it’s not widely used. He suggested that might speak to the true effectiveness of it compared to other medications used, for example, to combat nausea. Stallings said few patients request drugs like Marinol.

“Doctors can prescribe it, but people do not want it,” he said. “Apparently a lot of people would like to have marijuana in a smokeable form because they have a lot of problems, and the way that the issue is worded on the ballot it is so vague it could be any vague medical problem that patients might want to be prescribed medical marijuana. I don’t think it’s wise to smoke, and I don’t think we’re going to offer anything by legalizing marijuana that we don’t already have.”

To the argument that a natural, plant-based drug is better than some of the man-made chemicals, which often carry nasty side effects, Frank rebutted: “Strychnine and arsenic are natural, too.”

Speights said other illegal drugs such as cocaine may have the potential to kill pain, but that does not justify legalizing them for such uses. And while marijuana may be less addictive than other substances, the argument that it is not addictive is a myth, Speights said.

“Is it as addictive as cocaine? No,” he said. “Is it as addictive as nicotine? No. But it is addictive.”

Frank said he has philosophical objections to the way the proposed act handles a scientific matter. “We’re in an evidence-based era of health care where we try to take randomized controlled trials of groups to compare treatment or no treatment, or treatment A against treatment B, and be able to make an informed estimate as to whether a particular therapeutic intervention is going to be something that’s beneficial for the patient or not,” he said. “The way this act is written, I’m concerned that these people are basically going to be an individualized clinical trial every time they engage in this therapy.”

He added there would be no safety net of a trial review committee. Frank noted supporters rely heavily on anecdotal information. “Lots and lots of folks have stories to tell — and some of them are very compelling stories — but they don’t include data. They just include stories,” Frank said.

The answer to solving the apparent divide is more and better trials to try to meet any unmet health-care needs, he said. He also thinks the measure is written too broadly, and said the projected outcomes of the marijuana use should be better defined.

“From my perspective, professionally, it’s just a blank space,” he said. “What we need is the kind of information we would have in the package insert of a drug, where if you take X dose you get Y serum level, and you can expect in a 200 pound patient that you’re going to get these kinds of results.”

Yet another concern is how the dispensaries would operate.

“We already have places that you go to have drugs dispensed. They’re called pharmacies,” Frank said. “And you have professional people that are there” to help guide each patient’s use of the drug.

Also needed is more study of marijuana’s interactions with other drugs. “We don’t know what the implication is, if someone’s smoking marijuana on the other drugs that they’re taking,” he said. “Might it speed their seizure drugs to faster metabolism, or might it slow down an antidepressant that they’re taking? We just don’t know.”

Speights said another major concern was provisions for children under 18 to obtain medical marijuana. “That was a problem for me because there’s no pediatric data at all,” he said. Source: jonesborosun.com November 9, 2012

Source: jonesborosun.com November 9, 2012

Filed under: Drug Specifics :


Now 14, this girl from Maidenhead began using mephedrone at the age of 12. She is currently getting help at Turning Point

I was the “it” girl at school and had a lot of friends. I have an older sister who is two years older than me and was also known as the “it” girl. She went to parties with her friends and I knew that she got drunk and used drugs like weed. Her use of drugs scared me a bit because I knew so little about drugs and alcohol, but I just got with it hiding it from my mum because I didn’t want her to get into trouble.

I remember one day in particular when my sister came home and told me that she had been to a party and tried this thing called “mephedrone”. She told me she snorted it and that really scared me. Being so young I thought she was going to die, but time went on and she kept doing it and I got used to her doing it and it started not to bother me that much. In my world everything was still fine.

I remember that day. It was boiling hot and I was on my way to the river to meet my friends when I got a phone call from my sister. I answered it and I could tell she was high; she invited me to go to her friend’s house. As I got there I could see that they were all on something, but it didn’t bother me, I was used to seeing it and they all seemed so happy. I got to known to everyone that day as “the little one” by all of my sister’s friends. They had set tents up in the back garden and listening to music and dancing. I remember one of my sisters friends called me over to the tent; I remember so clearly the words she used: “Hey lil sis, wanna try a bit?” I had never done drugs before and I remember the adrenalin running through my body. My heart started racing with excitement and nerves, and I remember looking over to my sis to make sure she was OK with it. Because she was high she didn’t mind and gave me a wink. I took the tooter to my nose and sniffed hard. That was possibly the worst mistake I ever made. I fainted and remember my sister holding me up with the sun blasting on my face. A few seconds later I got up and felt amazing. Because I was gymnastic I started doing flips everywhere and was having the time of my life. The day went on and I done more and more, so I can’t remember the rest until I got home and felt like death had just stabbed me in the back. My sister and her friends hadn’t warned me about the comedown and I was crying my eyes out feeling like I wanted to die. It was so horrible and because I didn’t even smoke weed or cigarettes I couldn’t do anything to calm me down. I was young and panicking. I was 12. For about a month afterwards I remember that every time I heard a particular song that we had listened to that day I started feeling down.

On another day it was snowing, my friends and I decided to go to a local venue in town where we met another girl I suggested we should try mephedrone. She had never sniffed anything before. We loved it so much we done it the week after, and the week after and the week after that. For about four or five months we were on it every weekend and became very close with this boy who was 18 at the time and he done it with us. Every weekend I would buy at least 3-4 grams (£20 a gram). It got so bad we started stealing money from our parents and one time my friend even stole £100 from her dad’s bank account. We were hurting everyone around us, but we couldn’t care less as long as we were having a good time. I was so unhealthy; being awake from Friday morning till Sunday night was not good for a small 13-year-old girl’s body. My face was grey and I had constant bags under my eyes. I would chew my lips so much from gurning it would bleed.

Over these few months I lost most of my friends and I became known as one of the druggies which didn’t bother me so much. I found hanging out with my old friends was boring, I mean, why would you want to hang out with a bunch of 13-year-olds when you could be hanging our with 16-to-20-year-olds? In between doing all this drone, I had tried coke, speed, MDMA, mushrooms, ketamine and some prescription drugs. By this time I had travelled down a long dark road, always isolated or excluded from smoking, swearing, arguing, fighting etc. I was the definition of a rebel, and it made me stand out in school. I was the class clown and all my classmates used to tell me how funny and brave I was to get into massive arguments with teachers. I blamed it on partly entertaining myself and partly on the drugs always making me hot headed. I wasn’t just getting into trouble in school, I was arguing at home too. I didn’t care what anyone thought, and I didn’t listen to anyone. We bunked a lot, and walked out almost every day. I remember on my 14th birthday we walked out of school and went and bought a gram of drone and did a half-gram line. We did the same the week after because it was my friend’s birthday.

I looked back at the last year and half of my life, most of it I couldn’t remember but the bits I could, I had nothing to show for it. I started becoming depressed and was like this for a few months. I didn’t see the light at the end of the tunnel. A big argument with my best friend gave me some space away from each other which is what I really needed. I met up with the few friends that had stuck by me even though I totally ditched them for a few months. When I caught up with them I found out how much they had all changed. Even though I had seen them for the little time I was actually in school, when I went out with them I could see how much they had grown up. Months passed and life was getting easier, but I remember when I saw someone sniffing drone I would still get butterflies and think of a way I could have a sneaky line. Sometimes I gave in, other times I didn’t but as time went on it was getting harder to say no.

I started year 10 and wanted it to become a clean slate. I stopped smoking weed before school so I could concentrate and I slowly decreased the number of days I went out in the week. I met with “T2”; a local charity which works with young people who have substance misuse problems through my school. My key worker helped me clear things in my head. I started to finally see what was good for me, what was right and wrong, because up to now all the drugs had mushed my brains and changed my perceptions of life. T2 got me back on track, heading up the right path. This had felt like I had broken through my first barrier. I was starting to become a normal teen again and I loved it.

I have reached a crossroads in my life. I could carry on the way I was and achieve nothing in my life or I could stop all of it and be somebody. Obviously I don’t want to waste my life away and I wanted to stop and become someone. I find it hard for a 14-year-old girl to choose between partying, having fun and staying in revising to become successful. I know what I want in life and I am not going to let alcohol, drugs or wrong crowds stop me. I’m not “innocent yet” so to speak but I ‘m a lot further along this road than I was a year ago. Whoever is reading this, and might be in a situation like I was/am, it so hard to snap yourself out of that lifestyle – believe me, I’m two years down the line and still travelling but it gets easier and you HAVE to keep going if you want to make something of yourself in life.

Source: The Guardian 16th September 2012

Filed under: Drug Specifics,Parents :

November 23, 2011

Medical Marijuana: The Government’s View

To the Editor:

In his Nov. 7 Op-Ed article, “Reefer Madness,” Ethan Nadelmann criticized the Obama administration’s position on medical marijuana and described the debate as “essentially a cultural and political struggle.”

The issue of medical marijuana is not about culture and counterculture. It is not a struggle; it is not a war. It simply comes down to how we approve medications as safe and effective for use in theUnited States. To date, the Food and Drug Administration has not found smoked marijuana to be either safe or effective medicine for any condition.

No national medical association has come out in favour of smoked marijuana for widespread medical use. Further, many public health organizations, including the American Cancer Society, American Glaucoma Foundation, National Pain Foundation and National Multiple Sclerosis Society, do not support smoked “medical” marijuana.

The administration’s position is clear: the medication approval process should remain above the political fray. Smoked marijuana does not meet scientific standards for safe and effective medicine, and marijuana use and distribution remain illegal under federal law for any purpose.

Like our National Drug Control Strategy, it is a position driven by evidence, not ideology. When it comes to protecting public health and public safety, the American people deserve no less.

RAFAEL LEMAITRE
Associate Director for Public Affairs
Office of National Drug Control Policy
Washington, Nov. 14, 2011

Filed under: Drug Specifics,USA :

Next November, Californians will ballot on allowing people 21 years and older to possess, cultivate and transport cannabis for personal use, as well as enable its commercial production and sale. Professor Keith Humphreys of Stanford University School of Medicine’s psychiatry and behavioural sciences departments, discusses the potential consequences.

He recently returned to Stanford after a one-year stint in the White House as a senior adviser on national drug control policy – and was a key speaker at the UK/European Symposium on Addictive Disorders inLondon last May.

Click here for related facts, also CannabisSkunk Support

Q: There are estimates that, with legalisation, marijuana use could rise 50-100 percent%. Are those projections reasonable?

Humphreys: We know very well from other commodities that if you make something illegal, the price of it goes up. And when you make it legal, it becomes much cheaper. So the findings are credible. Why they’re scary is that big drops in price tend to affect mainly people with less disposable income…teenagers, the unemployed, other people who have just a small amount of extra money. This will drop marijuana to something they could easily afford to do on a daily basis.

It is not just legalising consumption; it is legalising production. That means you’re going to have an industry, like the tobacco industry, that will have lobbyists and marketers and lots of money. In fact, I wonder if tobacco companies might go into this business. They are well-positioned. They have the outlets and the pricing power. It will become a mass-produced, very cheap product.

Q: But the proposition also allows people to grow their own marijuana…

Humphreys: For the vast majority of people, if there’s a refined product in a nice package down at the store that costs 1/10th as much, and you don’t have to water or worry about sunlight, then they will buy it.

Q: What about the argument that taxing marijuana will provide much-needed revenue?

Humphreys: We should be legalising child pornography and human trafficking? There’s lots of awful things that raise money, and that doesn’t make them right. The second point is that taxes never recoup the harm from substances. If you look at all estimates of alcohol and tobacco taxation, it never even touched a fifth of the amount of health damage. So you get a little money in the short term, but in the long term, someone’s got to pay for car accidents and kids flunking out of school and things like that.

Q: What about the notion that by legalising it you take it out of clandestine operations?

Humphreys: You will probably get rid of some gun violence, for example. But look at the example of a tobacco company. You could have substantially more death. There’s lots of ways to do violence in this world. You can weaken government regulations in a way that results in thousands of people dying.

In terms of its medical use, I have compassion for patients; I was a hospice worker for many years. But I don’t feel that’s the typical person getting medical marijuana. A paper in the Harm Reduction Journal that profiled about 4,000 such people said the prototypical patient was a 30-year-old male who had been smoking pot for about 15 years and wasn’t seriously ill – that group is riding on our compassion for the people who have Aids, MS or cancer.

To me, it’s a pretty big jump to go from saying that this plant has some medical value, to saying that its consumption — and also its production and advertising — should be legalised.

Source:    Addiction Today   August 6th2010

Position Statement – December 2011

The flawed proposition of drug legalisation

Various well funded pressure groups have mounted campaigns to overturn the United Nations Conventions on drugs. These groups claim that society should accept the fact of drugs as a problem that will remain and, therefore, should be managed in a way that would enable millions of people to take advantage of an alleged ‘legal right’ to use drugs of their choice.

It is important to note that international law makes a distinction between “hard law” and “soft law.” Hard law is legally binding upon the States. Soft law is not binding. UN Conventions, such as the Conventions on Drugs, are considered hard law and must be upheld by the countries that have ratified the UN Drug Conventions.

International narcotics legislation is mainly made up of the three UN Conventions from 1961 (Single Convention on Narcotic Drugs), 1971 (Convention on Psychotropic Substances), and 1988 (Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances):

• The 1961 Convention sets out that “the possession, use, trade in, distribution,import, export, manufacture and the production of drugs is exclusively limited to medical and scientific purposes”. Penal cooperation is to be established so as to ensure that drugs are only used licitly (for prescribed medical purposes).

• The 1971 Convention resembles closely the 1961 Convention, whilst
establishing an international control system for Psychotropic Substances.

• The 1988 Convention reflects the response of the international community to increasing illicit cultivation, production, manufacture, and trafficking activities. International narcotics legislation draws a line between licit (medical) and illicit (non-medical) use, and sets out measures for prevention of illicit use, including penal measures. The preamble to the 1961 Convention states that the parties to the Convention are “Recognizing that addiction to narcotic drugs constitutes a serious evil for the individual and is fraught with social and economic danger to mankind”. The Conventions are reviewed every ten years and have consistently been upheld.

The UN system of drug control includes the Office of Drugs and Crime, the International Narcotics Control Board, and the Commission on Narcotic Drugs. The works of these bodies are positive and essential in international drug demand and supply reduction. They are also attacked by those seeking to legalise drugs.

It is frequently and falsely asserted that the so-called “War on Drugs” is inappropriate and has become a very costly and demonstrable failure. It is declared by some that vast resources have been poured into the prevention of drug use and the suppression of illicit manufacturing, trafficking, and supply. It is further claimed that what is essentially a chronic medical problem has been turned into a criminal justice issue with inappropriate remedies that make “innocent” people criminals. In short, the flawed argument is that “prohibition” monies have been wasted and the immeasurable financial resources applied to this activity would be better spent for the general benefit of the community.

The groups supporting legalisation are: people who use drugs, those who believe that the present system of control does more harm than good, and those who are keen to make significant profits from marketing newly authorised addictive substances. In addition to pernicious distribution of drugs, dealers circulate specious and misleading information. They foster the erroneous belief that drugs are harmless, thus adding to even more confused thinking.

Superficially crafted, yet pseudo-persuasive arguments are put forward that can be accepted by many concerned, well intentioned people who have neither the time nor the knowledge to research the matter thoroughly, but accept them in good faith. Frequently high profile people claim that legalisation is the best way of addressing a major social problem without cogent supporting evidence. This too influences others, especially the ill informed who accept statements as being accurate and well informed. Through this ill-informed propaganda, people are asked to believe that such action would defeat the traffickers, take the profit out of the drug trade and solve the drug problem completely.

The total case for legalisation seems to be based on the assertion that the government assault on alleged civil liberties has been disastrously and expensively ineffective and counter-productive. In short, it is alleged, in contradiction to evidence, that prohibition has produced more costs than benefits and, therefore, the use of drugs on a personal basis should be permitted. Advocates claim that legalisation would eliminate the massive expenditure incurred by prohibition and would take the profit out of crime for suppliers and dealers. They further claim that it would decriminalise what they consider “understandable” human behaviour and thus prevent the overburdening of the criminal justice system that is manifestly failing to cope. It is further argued irrationally that police time would not be wasted on minor drug offences, the courts would be freed from the backlog of trivial cases and the prisons would not be used as warehouses for those who choose to use drugs, and the saved resources could be used more effectively.

Types of drug legalisation

The term “legalisation” can have any one of the following meanings:

1. Total Legalisation – All illicit drugs such as heroin, cocaine, methamphetamine, and marijuana would be legal and treated as commercial products. No government regulation would be required to oversee production, marketing, or distribution.

2. Regulated Legalisation – The production and distribution of drugs would be regulated by the government with limits on amounts that can be purchased and the age of purchasers. There would be no criminal or civil sanctions for possessing, manufacturing, or distributing drugs unless these actions violated the regulatory system. Drug sales could be taxed.

3. Decriminalisation – Decriminalisation eliminates criminal sanctions for drug use and provides civil sanctions for possession of drugs. To achieve the agenda of drug legalisation, advocates argue for:

• legalising drugs by lowering or ending penalties for drug possession and use – particularly marijuana;

• legalising marijuana and other illicit drugs as a so-called medicine;
• harm reduction programmes such as needle exchange programmes, drug injection sites, heroin distribution to addicts, and facilitation of so-called safe use of drugs that normalize drug use, create the illusion that drugs can be used safely if one just knows how, and eliminates a goal of abstinence from drugs;

• legalised growing of industrial hemp;
• an inclusion of drug users as equal partners in establishing and enforcing drug policy; and

• protection for drug users at the expense and to the detriment of non-users under the pretence of “human rights.”

The problem is with the drugs and not the drug policies

Legalisation of current illicit drugs, including marijuana, is not a viable solution to the global drug problem and would actually exacerbate the problem. The UN Drug Conventions were adopted because of the recognition by the international community that drugs are an enormous social problem and that the trade adversely affects the global economy and the viability of some countries that have become transit routes.

The huge sums of illegal money generated by the drug trade encourage money laundering and have become inextricably linked with other international organised criminal activities such as terrorism, human trafficking, prostitution and the arms trade. Drug Lords have subverted the democratic governments of some countries to the great detriment of law abiding citizens.

Drug abuse has had a major adverse effect on global health and the spread of communicable diseases such as AIDS/HIV. Control is vitally important for the protection of communities against these problems. There is international agreement in the UN Conventions that drugs should be produced legally under strict supervision to ensure adequate supplies only for medical and research purposes. The cumulative effects of prohibition and interdiction combined with education and treatment during 100 years of international drug control have had a significant impact in stemming the drug problem. Control is working and one can only imagine how much worse the problem would have become without it. For instance:

• In 2007, drug control had reduced the global opium supply to one-third the level in 1907 and even though current reports indicate recent increased cultivation in Afghanistan and production in Southeast Asia, overall production has not increased.

• During the last decade, world output of cocaine and amphetamines has stabilized; cannabis output has declined since 2004; and opium production has declined since 2008. We, therefore, strongly urge nations to uphold and enhance current efforts to prevent the use, cultivation, production, traffic, and sale of illegal drugs. We further urge our leaders to reject the legalisation of currently illicit drugs as an acceptable solution to the world’s drug problem because of the following reasons:

• Only 6.1% of people globally between the ages of 15 and 64 use drugs (World Drug Report 2011 UNODC) and there is little public support for the legalisation of highly dangerous substances. Prohibition has ensured that the total number of users is low because legal sanctions do influence people’s behaviour.

• There is a specific obligation to protect children from the harms of drugs, as is
evidenced through the ratification by the majority of United Nations Member States of the UN Convention on the Rights of the Child (CRC). Article 33 states that Member States “shall take all appropriate measures, including legislative, administrative, social and educational measures, to protect children from the illicit use of narcotic drugs and psychotropic substances as defined in the relevant international treaties, and to prevent the use of children in the illicit production and trafficking of such substances”.

• Legalisation sends the dangerous tacit message of approval, that drug use is
acceptable and cannot be very harmful.

• Permissibility, availability and accessibility of dangerous drugs will result in
increased consumption by many who otherwise would not consider using them.

• Enforcement of laws creates risks that discourage drug use. Laws clearly define what is legal and illegal and emphasise the boundaries.

• Legalisation would increase the risks to individuals, families, communities and world regions without any compensating benefits.

• Legalisation would remove the social sanctions normally supported by a legal system and expose people to additional risk, especially the young and vulnerable.

• The legalisation of drugs would lead inevitably to a greater number of dependencies and addictions likely to match the levels of licit addictive substances. In turn, this would lead to increasing related morbidity and mortality, the spread of communicable diseases such as AIDS/HIV and the other blood borne viruses exacerbated by the sharing of needles and drugs paraphernalia, and an increased burden on the health and social services.

• There would be no diminution in criminal justice costs as, contrary to the view held by those who support legalisation, crime would not be eliminated or reduced. Dependency often brings with it dysfunctional families together with increased domestic child abuse.

• There will be increases in drugged driving and industrial accidents.

• Drug Control is a safeguard protecting millions from the effects of drug abuse and addiction particularly, but not exclusively, in developing countries.

• Statements about taxation offsetting any additional costs are demonstrably flawed and this has been shown in the case of alcohol and tobacco taxes. Short of governments distributing free drugs, those who commit crime now to obtain them would continue to do so if they became legal.

• Legalisation would not take the profit out of the drug trade as criminals will always find ways of countering legislation. They would continue their dangerous activities including cutting drugs with harmful substances to maximise sales and profits. Aggressive marketing techniques, designed to promote increased sales and use, would be applied rigorously to devastating effect.

• Other ‘legal’ drugs – alcohol and tobacco, are regularly traded on the black market and are an international smuggling problem; an estimated 600 billion cigarettes are smuggled annually (World Drug report 2009). Taxation monies raised from these products go nowhere near addressing consequential costs.

• Many prisons have become incubators for infection and the spread of drug related diseases at great risk to individual prisoners, prison staff and the general public. Failure to eliminate drug use in these institutions exacerbates the problem.

• The prisons are not full of people who have been convicted for mere possession of drugs for personal use. This sanction is usually reserved for dealers and those who commit crime in the furtherance of their possession.

• The claim that alcohol and tobacco may cause more harm than some drugs is not a pharmacokinetics of psychotropic substances suggest that more, not less, control of their access is warranted.

• Research regularly and increasingly demonstrates the harms associated with drug use and misuse. There is uncertainty, yet growing evidence, about the long-term detrimental effects of drug use on the physical, psychological and emotional health of substance users.

• It is inaccurate to suggest that the personal use of drugs has no consequential and damaging effects. Apart from the harm to the individual users, drugs affect others by addiction, violence, criminal behaviour and road accidents. Some drugs remain in the body for long periods and adversely affect performance and behaviour beyond the time of so-called ‘private’ use. Legalisation would not diminish the adverse effects associated with drug misuse such as criminal, irrational and violent behaviour and the mental and physical harm that occurs in many users.

• All drugs can be dangerous including prescription and over the counter medicines if they are taken without attention to medical guidance. Recent research has confirmed just how harmful drug use can be and there is now overwhelming evidence (certainly in the case of cannabis) to make consideration of legalisation irresponsible.

• The toxicity of drugs is not a matter for debate or a vote. People are entitled to their own opinions but not their own facts. Those who advocate freedom of choice cannot create freedom from adverse consequences.

• Drug production causes huge ecological damage and crop erosion in drug producing areas.

• Nearly every nation has signed the UN Conventions on drug control. Any government of signatory countries contemplating legalisation would be in breach of agreements under the UN Conventions which recognise that unity is the best approach to combating the global drug problem. The administrative burden associated with legalisation would become enormous and probably unaffordable to most governments. Legalisation would require a massive government commitment to production, supply, security and a bureaucracy that would necessarily increase the need for the employment at great and unaffordable cost for all of the staff necessary to facilitate that development.

• Any government policy must be motivated by the consideration that it must first do no harm. There is an obligation to protect citizens and the compassionate and sensible method must be to do everything possible to reduce drug dependency and misuse, not to encourage or facilitate it. Any failures in a common approach to a problem would result in a complete breakdown in effectiveness. Differing and fragmented responses to a common predicament are unacceptable for the wellbeing of the international community. It is incumbent on national governments to cooperate in securing the greatest good for the greatest number.

ISSUED this 21st day of December, 2011 by the following groups:
Drug Prevention Network of the Americas (DPNA)
Institute on Global Drug Policy
International Scientific and Medical Forum on Drug Abuse
International Task Force on Strategic Drug Policy
People Against Drug Dependence & Ignorance (PADDI), Nigeria
Europe Against Drugs (EURAD)
World Federation Against Drugs (WFAD)
Peoples Recovery, Empowerment and Development Assistance (PREDA)
Drug Free Scotland

Illegal drugs not only harm a user’s mind and body, they devastate families, communities, and neighborhoods. They jeopardize public safety, prevent too many Americans from reaching their full potential, and place obstacles in the way of raising a healthy generation of young people.

To address these challenges, today we are releasing the 2012 National Drug Control Strategy — the Obama Administration’s primary policy blueprint for reducing drug use and its consequences in America. The President’s inaugural National Drug Control Strategy, published in 2010, charted a new direction in our approach to drug policy. Today’s strategy builds upon that approach, which is based on science, evidence, and research. Most important, it is based on the premise that drug addiction is a chronic disease of the brain that can be prevented and treated. Simply put, we are not powerless against the challenge of substance abuse — people can recover, and millions are in recovery. These individuals are our neighbors, friends and family members. They contribute to our communities, our workforce, our economy, and help make America stronger.

Our emphasis on addressing the drug problem through a public health approach is grounded in decades of research and scientific study. There is overwhelming evidence that drug prevention and treatment programs achieve meaningful results with significant long-term cost savings. In fact, recent research has shown that each dollar invested in an evidence-based prevention program can reduce costs related to substance use disorders by an average of $18.

But reducing the burden of our nation’s drug problem stretches beyond prevention and treatment. We need an all of the above approach. To address this problem in a comprehensive way, the President’s new strategy also applies the principles of public health to reforming the criminal justice system, which continues to play a vital role in drug policy. It outlines ways to break the cycle of drug use, crime, incarceration, and arrest by diverting non-violent drug offenders into treatment, bolstering support for reentry programs that help offenders rejoin their communities, and advancing support for innovative enforcement programs proven to improve public health while protecting public safety.

Together, we have achieved significant reform in the way we address substance abuse. And the Affordable Care Act will — for the first time — require insurers to cover treatment for drug addiction the same way they would other chronic diseases. This is a revolutionary shift in how we address drug policy in America.
Over the past three decades, we have reduced illegal drug use in America. Over the long term, rates of drug use among young people today are far lower than they were 30 years ago. More recently cocaine use has dropped nearly 40 percent and meth use has dropped by half. And we can do more. As President Obama has noted, we have successfully changed attitudes regarding rates of smoking and drunk driving, and with your help we can do the same with our illegal drug problem.

Source: R. Gil Kerlikowske
Director, White House Office of National Drug Control Policy 18th April 2012

The fashionable party drug mephedrone has been linked to up to 98 recent deaths in Britain, the Government’s advisers warned last night, as they called for tougher action to combat the proliferation of legal highs.

The Advisory Council on the Misuse of Drugs (ACMD) said unscrupulous manufacturers made a mockery of the law by falsely advertising addictive substances as “plant food” or “bath salts”. Its chairman, Professor Les Iverson, warned young users of “designer drugs” were playing “Russian roulette” with their lives – and said the effects were already being seen in hospitals. He said: “We are not seeing just a nice party drug but something that can kill.”

Prof Iverson released figures showing that in the past two years mephedrone had been confirmed as a factor in 42 deaths and had not been ruled out as contributing to another 56.
Users of designer drugs – created in labs to mimic the make-up of banned substances such as ecstasy and amphetamines – suffered such extreme side-effects that they had to be sedated. They had also been treated for paranoia, psychosis, high heart rates and raised blood pressure, he said. He added: “Users are playing Russian roulette. They are buying substances marked as research chemicals. The implication is that you should do the research on yourself to find out whether they’re safe or not. This is a totally uncontrolled, unregulated market.”

The first large quantities of legal highs, or psychoactive drugs – many made in China – appeared in Britain two years ago. They can be easily bought online or from shops selling drug paraphernalia and herbal goods. Some undergraduates also sell them to fellow students. The ACMD said: “Many people importing these new substances appear to have had no previous involvement in the illicit drug trade and are just in it to make a quick buck. They have included students who have set up websites to supply nationally and who also supply the local student population.”

Ministers have outlawed several such substances, but the ACMD warned that producers were sidestepping the bans by tweaking the composition of drugs. It backed creating a new system of broader bans in which all substances chemically similar to controlled drugs were automatically made illegal. The ACMD also called for suppliers to have to demonstrate that legal highs were not being produced for human consumption and for a fresh drive to alert the public to their dangers.

Roger Howard, chief executive of the UK Drug Policy Commission, backed the proposals. He said: “We have rapidly growing numbers of psychoactive drugs on the market and it’s increasingly difficult for police to identify the different drugs they are finding.”

The Home Office said it was considering the recommendations and added: “The Government is leading the way in cracking down on legal highs by outlawing not just individual drugs but whole families of related substances.”

By numbers…
2009 The year police made first seizure of mephedrone. It was banned in 2010.
£15 Approximate price of a gram before it was classified.
98 The number of deaths recently linked to mephedrone.

Source: The Independent 26th October

Dutch coffee shop owners went to court Wednesday in a last ditch bid to block a government plan to stop foreigners from buying marijuana in the Netherlands.
Lawyers representing the coffee shops oppose what would be the most significant change in decades to the country’s famed soft drug tolerance: turning marijuana cafes into “members only” clubs open solely to Dutch residents. Members would only be able to get into the coffee shops by registering for a “weed pass” and the shops would only be allowed a maximum of 2,000 members.
The move comes into force in the south of the country May 1 and is scheduled to roll out nationwide on Jan. 1, 2013. Whether it will be enforced in Amsterdam, whose coffee shops are a major tourist draw card, remains to be seen.
The city has strongly opposed the pass idea and mayor Eberhard van der Laan says he wants to negotiate a workable compromise with the country’s Justice Minister Ivo Opstelten.  Lawyers for the cafe owners told a judge at The Hague District Court that the move — aimed at reining in problems caused by foreign “drug tourists” who buy marijuana in the Netherlands and resell it in neighboring countries — is “clearly discriminatory.”
Lawyer Ilonka Kamans argued that Dutch drugs policy gives citizens “the fundamental right to the stimulant of their choosing” and should not deprive visiting foreigners of the same right.
Another of the coffee shop lawyers, Maurice Veldman, told The Associated Press outside the court that the problem of drug tourism is confined to southern provinces close to the Dutch border with Germany and Belgium and should be tackled with local measures, not nationwide legislation.
But government lawyer Eric Daalder defended the measures.
“Fighting criminality and drug tourism is a reasonable justification” for the crackdown, Daalder told the court. He said the government wants to bring coffee shops back to what they were originally intended to be: “small local stores selling to local people.”
Marc Josemans of the Easy Going coffee shop in Maastricht said he expects the government will lose because it hasn’t thought through consequences or tried other ways of achieving its aims.
“We understand that this topic is something that’s of interest to tourists, but it’s equally important to our Dutch customers, which is most of them,” he told the AP ahead of Wednesday’s hearing.
“The limits on membership are going to lead to immediate problems in cities that don’t have enough coffee shops.”
Josemans said that if the court’s April 27 ruling goes against them, the Maastricht coffee shops plan to disregard the ruling, forcing the government to prosecute one of them in a test case.
Though the weed pass policy was designed to resolve traffic problems facing southern cities, later studies have predicted that the result of the system would be a return to street dealing and an increase in petty crime — which was the reason for the tolerance policy came into being in the 1970s in the first place.
The cities of Tilburg, Breda and Maastricht have now said they oppose the pass system, though Eindhoven plans to move ahead with it and the eastern city of Dordrecht wants to adopt it in anticipation of an influx of foreign buyers — even though it is not yet required to do so.
Marijuana cafes are a major tourist draw for Amsterdam, with some estimates saying a third of visitors try the drug, perhaps in between visiting the Van Gogh Museum and other major attractions.
Mayor Van der Laan says the Dutch capital doesn’t suffer major problems from pot smokers, and it doesn’t make sense to apply the same policy developed for the border cities here.  According to U.N. data, the use of marijuana by Dutch nationals is in the mid-range of norms for developed countries — higher than in Sweden or Japan but lower than in Britain, France or the United States.
In the face of growing evidence linking marijuana smoking with mental illness, the Dutch government has been placing new restrictions on coffee shops for a decade. It has set limits on the amount of active chemicals that can be contained in weed and hash; refused to renew licenses for shops that cause problems or are located too close to schools; and banned tobacco smoking at coffee shops in 2008.
Source:http://www.sfgate.com/cgi-bin/article.cgi?f=/n/a/2012/04/18/international/i063025D58.DTL
April 18th 2012

A pill that makes alcoholics want to drink less has been developed by scientists for the first time, a conference has been told.

The drug is thought to work by blocking mechanisms in the brain that give alcoholics enjoyment from drink and so helps them fight the urge to drink too much. It only needed to be taken when people were going out where they might be tempted to drink alcohol. Alcoholics taking the drug and having counselling more than halved the amount of alcohol they drank per day and binged on fewer days. The findings were presented at the European Psychiatric Association (EPA) congress in Prague.

The drug, developed by Lundbeck pharmaceutical company, called nalmefene is not licensed yet and is currently going through clinical trials. There are other drugs on the market that make addicts ill if they drink any alcohol at all but this is thought to be the first aimed at reducing the amount of alcohol consumed. Side effects included dizziness, nausea, fatigue, sleep disorder or insomnia, vomiting, cold-like symptoms or excessive sweating.

Dr David Collier, of Barts and The London School of Medicine, Queen Mary University of London and an investigator in a nalmefene study, said: “The people volunteering for these trials had real problems with alcohol dependence, most had never sought help before, and others had tried and failed with abstinence strategies – stopping drinking for good.”

“Abstinence is the right option for many people, but not everyone wants to do that, and in those that do try, it helps only about half of them. From our experience in these trials, reducing alcohol consumption to safer levels can be a realistic and practical treatment goal for people who are dependent on alcohol, that can bring many short- and longer-term benefits to health.”

“These trial results suggest that the combination of medication and counselling could offer a new option for people in the UK not currently treated for their alcohol dependence.” There are thought to be 1.6m people addicted to alcohol who are not currently being treated.

Andrew Langford, Chief Executive of The British Liver Trust said: “We are genuinely worried about the increasing numbers of people from all walks of life with alcohol problems who are functioning seemingly well with their lives yet have built up a need for alcohol. Many feel that they need to drink just to feel normal, increasing potential negative effects on their physical and emotional health, including liver disease such as cirrhosis and liver cancer.”

In the study, nalmefene was used as needed by the patients, who took one tablet only when they perceived that there was a risk of drinking alcohol. Both the nalmefene and placebo groups of the study received counselling to maximise their motivation to reduce their alcohol intake, and ensure they continued to take the medicine.

Over six months in the trial the average amount of alcohol consumed per day reduced from 84g per day – the equivalent to a bottle of wine – to 30g per day or a large glass of wine. The number of days they drank heavily reduced from 19 to seven in those taking the drug alongside counselling.

The large study was conducted with 604 patients in Austria, Finland, Germany and Sweden.

Source: www. WiredIn.org.uk 6th March 2012

Filed under: Drug Specifics,Europe :

 

“The longer he is in Downing Street, the more aware the prime minister is becoming of the forces that can thwart progress… every attempt at reform has to fight its way past vested interests and the forces of bureaucratic inertia,” James Forsyth of The Spectator and Daily Mail recently noted. This coalition government’s humane goal of getting addicts off drugs in its first Drug Strategy is no exception.

On Friday, the National Treatment Agency for Substance Abuse sent a press release to treatment commissioners, saying how much they will get in 2011-12 from a £570million budget for community and prison drug treatment services – but throughout the press release  and accompanying three-page letter from NTA CEO Paul Hayes, there was not one recommendation that they use the funds for the coalition government’s reasonable goal of getting addicts drug-free.

There is mention of “recovery”, but the NTA does not define recovery, leaving it meaningless for those commissioners spending the pot of money.

It does mention people leaving treatment successfully – but how is that defined? Does it mean those classified this way in NTA annual reports who actually died? Does it mean patients who have been years on methadone must vomit blood, break their clavicles and limbs or have a stroke before they “successfully exit” their substitute drugs and are sent to rehab?

“I believe the sum is sufficient to enable the field to deliver the transformative change set out in the Drug Strategy and ensure that 2011-12 is the year of transition to a recovery-focused treatment system.” said Hayes. We agree that the sum is sufficient – but again note no mention of the government’s goal.

“”The fact that the prime minister has to devote such attention to checking his instructions are followed acrossWhitehalldoes suggest that parts of the Civil Service are forgetting that its role is to implement government policy,” Forsyth concludes. 

Source:  Addiction Today  Feb. 14th 2011

 

 

 

Filed under: Drug Specifics :

The attraction that the medical profession has for medical marihuana continues to mystify me. Many of the same physicians who will exercise exemplary caution in caring for their patients, will throw caution aside when it comes to pot. I know internists in private practice who refuse to accept new patients if they smoke tobacco. I often wonder if they would have the same reaction if the patients smoke pot! Yesterday, I entered an online discussion by a medical group on this subject and I’ve pasted my comment below.


The medical profession needs to apologize for letting the public down on this one – once again. In the early 1900s, although medical organizations like the AMA were against patent medicines and refused to post ads in JAMA that did not list the ingredients of the products being promoted, there were quite a few doctors who nonetheless sold and promoted the use of patent medicines, most of which were worthless elixirs of cocaine or morphine or heroin or cannabis or combinations thereof, laced with copious amounts of alcohol, coloring agents and flavorings. They were promoted as curing everything from the common cold to cancer. Although the docs knew better, they argued that they were giving their patients what they wanted and if they didn’t, the patients would buy them on the street from sidewalk vendors who were not trained healthcare professionals. Ethical?


As best we know, any “positive” effects of these nostrums came in the form of intoxication, a normal reaction to psychotropic substances, including alcohol. Therapeutic they were not. Even during alcohol prohibition (1919-1933), the federal government issued special prescriptions to physicians –only– that allowed them to prescribe “medicinal alcohol” in the form of wine, whiskey, and beer. Overnight, pharmacies became liquor stores. And doctors did, indeed, prescribe alcohol for medicinal purposes and plenty of it during Prohibition. Ethical?


Fast-forward to the 1980s and 1990s and along comes the return of “medical marihuana.” This time, however, it’s not in the form of a tincture but, instead, promoted for use in its crude form as smoked marihuana. Not surprisingly, smoked pot today is touted as a cure-all for anything that ails one, from stress, to headache, to multiple sclerosis, to cancer pain and even cancer itself. How could a drug that’s so great be overlooked for so long by so many? Moreover, as in the case of alcohol prohibition, only doctors in certain states can prescribe (or recommend) it for medicinal purposes only. Ethical?


What these brief histories have in common is the promotion and use of intoxicants for therapeutic purposes. In all three cases, doctors promoted the use of these substances knowing that the anecdotal evidence of efficacy was weak at best, unsupported by unbiased clinical trial data, and not likely to improve the patient’s condition but only mask symptoms temporarily through intoxication. Incidentally, we could add tobacco to this list, too. A favorite ad of mine comes from a 1950s magazine that shows a photo of a physician holding a cigarette with a caption proclaiming that in a national survey of physicians, more preferred Camels over any other brand of cigarette. Ethical?


Wake up, America, and realize that whatever therapeutic molecules we might be able to squeeze out of the pot plant must be synthesized, purified, and manufactured to measured standards and dosing units before being used in medical treatment. Consider morphine and codeine. We don’t recommend that people grow opium poppies, harvest them, extract and chew the gum to get pain relief. Instead, we have synthesized and standardized pharmaceutically pure opiate medicines. Current pot research is underway to isolate and restructure the genetic pathways that provide pot’s psychic effect. This, scientists say, will be accomplished without interfering or reducing in any way the therapeutic properties of the beneficial cannabinoids in the plant. The final product will be safe and effective – far more effective as a medicine than smoking pot because dosing will be concentrated and stronger – and not controlled because there will be no psychotropic response.

In effect, if pot truly has medicinal benefits independent of its intoxicating effects, they should be more readily available and useful in a finished pharmaceutical form. Also, users will be spared the toxic effects of inhaling smoke. Smoking anything — paper, tobacco, dry leaves, or pot — is not good for lung tissue of any living organism. Finally, the new pot without its psychic effect can be compared to decaffeinated coffee. It will have many of the same properties of the real thing except the kick. And, let’s face it, a good cup of Starbuck’s decaf can’t be distinguished from the regular stuff.
When all this happens in a few years, pot heads now desperately trying to promote pot for everything and anything will be left with nothing but the fact that their story of pot’s medicinal history will join the other historical artifacts described above. Someday, their kids and grand-kids will look back and say the same thing that we say now when we look at those old cigarette ads from the 1950s: What were you thinking?

Source: John Coleman Drug-Watch International Feb.2010

Filed under: Drug Specifics :

Jay’s story has a familiar ring. The pre-teen experimentation with cannabis after his father walked out on the family, followed by flirtation with ecstasy and cocaine. He had smoked his first wrap of heroin before he was old enough to buy a pint of beer. But it was only when he was off the street, safely incarcerated in a young offender institution, that methadone was added to Jay’s palate. As the gaunt teenager with grey skin shuffled from foot to foot in the West London drizzle, uncaringly dressed in a hooded tracksuit, his pin-pricked pupils scanned the streets.


“I was running wild with a raging [heroin] habit when they got me,” he said. “They tried to detox me inside but as soon as I complained they put my dose of methadone up again. I came out needing drugs as much as when I went in.”


His six-month stretch inside passed in a methadone-induced daze with, according to Jay, little attempt by prison staff to offer him a pathway to drug-free recovery. When he was released two years ago, Jay, whose only family contact is an elder brother he occasionally stays with, swiftly returned to the messy chaos of an opiate-obsessed existence. He thinks that he will be back in prison within weeks. “Most junkies I know want to be clean but if you can’t do it when you’re inside, when can you?” he says.


Methadone, a heroin substitute that is more addictive than heroin itself, has assumed a dominant position in the State’s drug-control armoury. It is given to half the country’s estimated 300,000 heroin addicts while parliamentary answers have revealed that 65,000 prisoners were prescribed it in the past year, including nearly 20,000 on a maintenance programme which can last years — an annual rise of 57 per cent. In some patches of “broken Britain” it is responsible for more fatal overdoses than any other substance.


Supporters say it stabilises addicts and protects society by removing the need for drug-financing crime sprees. Opponents argue that the State is happy to “park” people on methadone for years, giving up hope that addicts will ever lead a productive, drug-free life.


One aspect most agree on is that drug addiction is a lucrative business. Professor Neil McKeganey, a leading opponent of mass methadone medicating, said: “There’s considerable financial incentive that drug users remain drug dependent.” Drug companies make millions from producing methadone, GPs in many parts of the country get paid in the region of £220 per methadone patient per year, pharmacists can get £200 administration fees plus about £1.50 per administered dose, while more than 150,000 people are employed in drug-action teams funded largely from the public purse.
Mark Johnson, a former drug user who founded the charity Uservoice, said that although prisons are the ideal location for rehabilitation because they are “the only place that removes some people from dysfunction and gives them a respite”, the authorities are increasingly opting for the methadone route. “All we’re doing is containing the problem, not solving it,” he said.


Several studies have shown that a residential-based abstinence programme lasting at least a month has a roughly one in four success rate, while a recent study on addicts in society showed that after three years on methadone only 3 per cent are drug-free.


Despite this, however, the Government, backed by a cadre of policy experts and health professionals, is increasing its multi-million annual spend on methadone maintenance programmes. At the same time, at least 20 residential rehabilitation centres have closed in the past two years because primary care trusts have stopped referring clients. Last month Middlegate Lodge, the only residential rehab centre specifically for teenagers, closed.


Just 850 prisoners were put on the relatively succesful 12-step abstinence programme last year. No figures are available for how many young offenders are prescribed methadone.
Inspectors’ reports into young offenders’ institutions record that while alcohol and cannabis are the biggest substance problems, the use of methadone is being encouraged and is increasing.
Kathy Gyngell, a drugs policy analyst for the Centre for Policy Studies, said that prescribing methadone to young offenders had become routine. She added: “It might appear the easier option but it leads to longer term problems. Individuals who historically used their short sentences to gain clean time now feel the necessity to carry on using methadone, as it takes no effort other than presenting themselves at the healthcare door to get it.”


David Burrowes, a Tory justice spokesman, said that drug treatment was “characterised by methadone” and that a variety of treatment options needed to be available.


Katherine, a former addict, whose descent into heroin addiction began after she was raped as a teenager, said that after a decade ricocheting between methadone in prison and heroin outside, she had finally kicked her habit after becoming one of the few prisoners to be offered a place on a RAPt (Rehabilitation for Addicted Prisoners Trust) abstinence programme.


“Methadone is not a solution,” said Katherine, who left prison drug-free in 2008. “The message it gives is, ‘You come in with a habit and we’ll keep the habit and let you back out into society with no changes whatsoever.” She said that even in prison, addicts are able to exploit the system by using cotton wool to absorb the sickly-sweet green methadone linctus, before selling it on to other inmates and buying heroin with the proceeds.


Rosie, who started taking heroin at the age of 14, was prescribed methadone after leaving a young offenders’ institution and said that she had never seen a succesful methadone-led withdrawal from drug use. “It’s almost more of a poison than heroin, there doesn’t ever seem to be an end to it,” she said. She became drug-free after attending an abstinence-based treatment centre provided by the Nelson Trust.


To its advocates, though, methadone is a useful tool. At best, it stabilises addicts before they are weaned off; at worst, it can be used to maintain addicts long term, minimising the need for them to commit crime to pay for street heroin. Overall, drug-related crime is estimated to cost the country more than £13 billion a year.


There are also risks associated with forcing prisoners to go cold turkey. Cynics suggest the prison authorities’ increasing enthusiasm for methadone may have something to do with the £750,000 it was forced to pay out in 2006 after almost 200 drug-addicted prisoners sued the Government, claiming that their rights were infringed when they were forced to withdraw suddenly.


Even for those who claim to have benefited from it, methadone is at best a stopgap. James, 30, from Renfrewshire, had been a heroin user for nine years when he was given methadone in Barlinnie Prison, Glasgow. “Everything in prison was all about drugs,” he said. “Sometimes you couldn’t get any heroin and you couldn’t eat your dinner, you were in bed with all your clothes on, teeth rattling. They put me on 30ml of methadone, a low dose, and it settled me. I was a lot calmer; it was like a safety net.”


Roger Howard, the chief executive of the UK Drug Policy Commission, an advocate for methadone, admits that it could not alone cure drug addicts. “What everyone wants is to reduce deaths from dangerous street heroin and to reduce criminality,” he said. “Methadone is not the problem. These people come with a bucketful of problems: abuse, unemployment, homelessness, family.”


Professor McKeganey, who works at the Centre for Drug Misuse at the University of Glasgow, warned that Britain was sleepwalking into a situation similar to that in the Netherlands, where the Government provided places at old people’s homes for those with long-term methadone habits: the so-called “geriaddicts”. Mr Howard agreed: “There is a cohort who are probably so damaged and with such profound health problems that they will never get a job and will for ever rely on the State.”


As he prepared to pad the darkened streets of West London in shoes as punctured as his bony, needle-marked forearm in an all-consuming search for his next hit, Jay pondered a parting question: if you could survive in prison on methadone alone, why not, when outside, give your daily, drug-free urine sample, take the supervised dose of methadone and shun street drugs?


“But where would it get me? All right, the craving for smack’s not there but you soon get the craving for the meth. Nobody I know on a heroin ’script is getting any better. They’re just surviving.”

Source: Times Online 17th March 2010

The cost of a quick fix
2.4m Methadone prescriptions written in 2007, a rise of 60 per cent since 2003
£1.2bn Amount spent annually by government (central and local) tackling drug use in England in 2009-10
£15.3bn The cost per year to society of problem drug use
£13.9bn The estimated cost of drug-related offending in 2003, made up of a £9.9 billion cost to victims of crime and £4 billion costs incurred by the criminal justice system
330,000 Estimated number of problem drug users in England, of whom 166,000 are in some form of treatment programme

Sources: NAO, Drugscope, Home Office

Whichever way you look at it, the Government’s increasing reliance on methadone to treat heroin addicts involves moral issues. Predominant among these is that the State is in effect cast in the role of drug dealer — conceivably for as long as the addicts live.


The uneasy relationship becomes especially problematic when users die of overdoses, having supplemented methadone with other street drugs.


Never forget how dangerous this is. When official figures show that in some areas a third of the people who die from drug-related causes have methadone in their bodies, put there by the taxpayer, and that this proportion doubled from 2006-08, we are on dodgy ethical ground.


Increasingly, it means the substance that is supposed to be a primary solution appears to be an intrinsic part of the problem. What methadone also represents is the transfer of personal responsibility for addiction away from the drug user. In this sense, the heroin substitute symbolises the cultural shift in modern drug policy: the addict is a victim who needs support and maintenance, rather than someone who should change their behaviour.


This official non-judgmentalism is interesting, especially when there is public debate about the resources devoted to the consequences of smoking, alcohol and overeating — which are not illegal. The merits of a humane approach to drug addiction are apparent. No one argues that methadone is not a useful part of the weaponry. It’s relatively cheap; it can stabilise the lives of addicts who shoplift or supply heroin to others; and of course, rather importantly, it allows the Government to say that it is doing something.


But what worries critics of methadone is not only its excessive use, but the lack of an exit strategy. In parts of the country there are addicts who have been taking it for decades. Even advocates concede that people are being kept on the drug for too long without any target to get them off.
All of which makes it troubling to hear that young offenders are being prescribed it, if only because, without any commitment to get them off drugs, they may end up “parked” for many years of dependency.


Professor Neil McKeganey, in his latest book, laments the lack of consensus about the goals of treatment, pointing out that although the majority of addicts want to be free of drugs, this is not facilitated by government policy. He wants to see a target limiting use to two years.


Methadone is a smokescreen for the absence of alternatives when it comes to problem use. There appears to be no new thinking, no initiatives, few open minds; and indeed little political will.
In a sense, the ubiquity of the heroin substitute is an admission that not only have social policies failed, but that we have no solutions for the consequences.

Source: Times Online 17th March 2010

Filed under: Drug Specifics :

The California Medical Association (CMA) took a major leap lacking science and common sense. With the issuance of a White Paper calling for the legalization of marijuana for medical and non-medial purposes, they have transitioned from a medical group into a lapdog of the drug legalization lobby.
“I am thoroughly appalled by the CMA’s decision to release this policy in an attempt to legalize a drug that we know causes so much harm to individuals and families,” said Eric Voth, M.D., F.A.C.P. and Chair of the Institute on Global Drug Policy. “The CMA has managed to single-handedly make a mockery of modern medicine and the ethical practices of physicians. There is nothing scientific about this White Paper – it is total politics.”

The White Paper just released contains a number of incorrect statements. Contrary to what the paper states:
• According to the National Household Survey on Drug Abuse, the rate of current, past 30-day use of marijuana by Americans aged 12 and older in 1979 was 13.2%. In 2008 that figure stood at 6.1%. This 54% reduction over that 29-year period is a major public health triumph, not a failure! Now, we must not only push back against the drugs but, the advocates who seek to normalize and legalize them.
• The Netherlands reclassified high potency marijuana as a “hard drug” because of the harms that have occurred from the drug and moved to shut down hundreds of “coffee shops” that serve marijuana. Their lenient policy caught up with them and they are moving back to more conservative actions.
• Portugal’s policy that decriminalized consumption and possession of illicit drugs in 2001 was a dismal failure. The 2007 national drug survey showed an increase in life-time prevalence of drug use in the general population, especially regarding cannabis use and use of cocaine has nearly doubled. Cocaine seizures increased seven-fold between 2001and 2006 and murders increased 40%.

 

“The CMA is dead wrong in asserting that the marijuana legalization movement is driven by the public. Instead it is driven by a group of well-financed legalization advocates. The ballot initiative to legalize pot was defeated in California and no other state has approved such an ill-advised policy, despite millions of dollars poured into this effort by ivory-tower elitists unaffected by the impact of drug use, like the rest of us. Even the issue of marijuana as medicine was rejected by two-thirds of the country,” stated Calvina Fay, Executive Director of Drug Free America Foundation.

“It is laudable that CMA supports more research and more education efforts to reduce marijuana use among children, adolescents, and young adults (although we believe it should include all adults). Ongoing research into potential medicines and cures is an important endeavor but, the solution should be to require marijuana to meet the standards of modern medicine, not by ballot initiatives or legislation and certainly not by legalizing it for recreational use” Fay concluded.
Drug Free America Foundation, Inc. is dedicated to fighting drug use, drug addiction and drug trafficking and to promoting effective sound drug policies, education and prevention.

Source: www.dfaf.org October 17, 2011

Filed under: Drug Specifics,USA :

Irish research shows addicts on methadone programme still abusing crack cocaine and other substances. The Irish Government drugs policy needs to change
There has been an apparent levelling off of the need for opiate centred drug treatment. However the researchers believe their findings show that this is misleading. Their evidence suggests that multiple drug use is the norm among many addicts.

Realities of Drug Misuse Investigated

The study was led by Dr A. Jamie Saris (Principal Investigator) and Fiona O’Reilly (Primary Field Researcher), Dept of Anthropology at NUI Maynooth and is the result of a long-term study which closely examined the realities of drug misuse in three adjacent neighbourhoods.
Of 92 abusers surveyed, 98% were on a methadone drugs treatment programme yet almost two thirds claimed to have used heroin within the past 3 months. Whilst over half were on prescription tranquilisers almost as many had used illegally obtained tranquilisers. Nearly one third had used crack cocaine and more than one in five powder cocaine. “Multiple drug use is the reality for nearly all users, and official policy needs to have this understanding at its centre”, claims Dr Saris.

Stigma Against Heroin Among the Young

A surprising finding was that there is a stigma against heroin among many of the younger users (aged 16 to 25). But these individuals still abuse what the study team describe as a “dizzying array” of other substances. The established approach to treatment, being so heavily focused on heroin, means that the issues faced by such people are not being addressed.
Another problem with the focus on crack and heroin is that it sets the users of those drugs apart from society when, in fact, such people are rarely defined solely by their addiction. A lot of local community activities aimed at assisting users recognise that they often lead lives that are not so very different from everyone else.
Drug Treatment Services Should Focus on Individuals
However it is often difficult to justify such activities to official funders under the rubric of ‘treatment’, as currently understood. Dr Saris believes that it is important to understand who users are, what they are taking and why, so that the authorities can assign the appropriate resources, treatments or management systems.
Tony MacCarrthaigh chairs the Local Drugs Task Force that covers the area of the study and he agrees with Dr Saris. “Individuals and not chemicals, need to become the focal point of treatment, and that treatment needs to assist individuals in developing another orientation not just to drugs, but to life,” he said. (A Dizzying Array of Substances; An Ethnographic Study of Drug Use in the Canal Communities, Department of Anthropology, NUI Maynooth, 2010.)

Source: Apparent Success of Drug Treatment Aimed at Heroin is Misleading

http://news.suite101.com/article.cfm/apparent-success-of-drug-treatment-aimed-at-heroin-is-misleading-a259572#ixzz0tO3OAGXw

On Tuesday, July 20th 2010, internationally recognized anti-drug experts from every region of the world united to oppose a set of dangerous unproven global strategies recommended in the Vienna Declaration. The declaration is based on three false premises: 1) that the criminalization of illegal drug use fuels the HIV/AIDS epidemic, 2) that criminal justice and health promotion are conflicting approaches to drug policy, and 3) that the major costs of illegal drug use are those generated by the criminal justice system.
This document was released in anticipation of the 18th International AIDS Conference and has been under scrutiny by several non-governmental organizations. Calvina Fay, Executive Director of Drug Free America Foundation says, “There is no ‘reasonable evidence’ that supports the strategies outlined in the Vienna Declaration. Further, we should reject ineffective harm reduction tactics that are not based on scientific evidence while accepting drug use and creating an illusion that drugs can be used safely or responsibly. Such ill-conceived schemes foster the misunderstanding that drug use itself is not harmful and increases addiction.”
Many of the experts who opposed the Vienna Declaration know from research and practical experience that the optimal way to truly beat addiction, prevent the spread of AIDS and other sexually transmitted diseases, and prevent drug-related harm are effective strategies that target drug use and include prevention, education, treatment and law enforcement efforts and do not trade one for the other.
“The best foundation for prevention is policy. We know from experience that a balanced and restrictive drug policy is effective in keeping drug use at low levels. Since drug utilization in itself is an important risk factor for being infected by HIV, it is good AIDS-prevention to preclude illicit drug use. We must always strive to protect young people from getting involved with illegal drugs,” says Sven-Olov Carlsson, International President, World Federation Against Drugs.

To view the full joint statement issued opposing the Vienna Declaration, please visit www.wfad.se. If you would like to conduct an interview with Ms. Fay, Mr. Carlsson and/or other drug policy and prevention experts on this statement, please contact Lana Beck, Director of Communications with Drug Free America Foundation, Inc. at 727-828-0211 or 727-403-7571.

The World Federation Against Drugs (www.wfad.se) is a multilateral community of non-governmental organizations and individuals. Founded in 2009, the aim of WFAD is to work for a drug-free world. Drug Free America Foundation (www.dfaf.org) is a national and international nonprofit organization dedicated to fighting drug use, drug addiction and drug trafficking and to promoting effective sound drug policies, education and prevention. Drug Free America Foundation is a Non-Governmental Organization (NGO) in Special Consultative Status with the Economic and Social Council of the United Nations.

For More Info Contact Lana Beck 727-828-0211 or 727-403-7571 after hours

Source: Joint Press Release from www.wfad.se and www.wfad.se July 2010

RESPONSE TO THE NTA BUSINESS PLAN 2010/2011

Deirdre Boyd, CEO of the Addiction Recovery Foundation
Kathy Gyngell, chair of the Centre for Policy Studies’ Addictions working group

With the threat of abolition hanging over its head, the National Treatment Agency has cleverly extended its longevity by promising to mend its ways. It will, it announced on Friday, use the final two years of its now-extended life to change the policy it has promulgated over the past nine years.
“We’ve got to get rid of the centralised bureaucracy that wasteS money and undermines morale,” prime minister David Cameron stated in July. But the NTA would seem to have got the last laugh, with over £42.8million of taxpayer‘s money now allocated to it for two more years to change the disastrous system it created and has so steadfastly defended even in face of the indefensible.
The NTA will, it promises, help people get off the methadone dependency, tier 2/3 organisation dependency and state dependency which it created via its performance-managed targets. Its new Business Plan 2010/11, in a truly Orwellian “four legs bad, two legs good” style, now seemingly advocates the very abstinence approach its spokespeople have repeatedly declared to be unviable.
It will even consult rehabs, the NTA graciously announced – those very rehabs it has ignored for almost a decade and of whose success in getting addicts into drug-free and rewarding recovery Paul Hayes (yes, still the NTA’s CEO) has publicly belittled, scorned or downright denied. Could it be less than two years ago that the NTA’s ‘first point-of-contact’ told BBC Home Affairs editor Mark Easton that “rehab doesn’t work”? (see Comment 5th from bottom here for more derogatory comments from NTA senior managers).
But maybe this was not such a hard promise for the NTA top brass to make, as they look forward to their ‘brobdingnagian’ pension pots in two years’ time. After all, there are fewer rehabs to consult… For under the NTA regime, only 2-4% of addicts seeking help to quit drugs were actually referred to them. The result? Financial hardship, redundancies, the closure of over 20 specialist rehabs, more wing and bed closures and a loss of the real expertise required to rehabilitate addicts. And with their own personal futures well secured, would success of change be in their interest?
There isn’t any evidence for abstinence or for rehab, they have repeated declared. This is despite two national treatment outcomes surveys – Ntors and Doris – which indicate strongly to the contrary. It is also in face of experience. As Sir Ian Gilmore said yesterday, the “absence of evidence” about school milk for under fives is only that; it does not mean that it is not a good thing and has not helped children’s health. All experience suggests it certainly has, he insisted. Similarly with rehab: a joint report in 2008 by the Commission for Social Care Inspectorate with the NTA itself that “residential rehabs outstrip other sectors in every outcome group we measure”.
The NTA seems to have bamboozled the Department of Health and a too readily believing government. For who have they tasked to change their policy and now shift people into ‘recovery’? Brazenly, it has appointed as one of the duo the addiction psychiatrist most closely associated with the failed medico-clinical treatment approach of the past 20 years years, one of the the proponents and instigators of the last government’s failed treating-drugs-with-drugs approach so loved by the NTA, key lobbyist for counterintuitive, expensive and ethically questionable prescribing programmes: John Strang of the National Addiction Centre.
In his capacity as a director of the UKDPC – recipient of millions of charitable funds to, among other briefs, redefine for the nation the notion of (addiction) recovery – Strang chose to use this remit to ensure that any new official definition of recovery excluded full abstinence, ignoring all expert advice to the contrary.
Nor did he stop there. His UKDPC’s plan was to use this new definition of “recovery” to replace real total drug-free outcomes as the measure for the NTA’s Treatment Outomes Profile forms, meaning that their targets could be easily be hit. Very convenient. For, in one Orwellian sleight of hand, the NTA could claim a recovery outcome when no such thing had been achieved. A reduction in injection frequency would suffice. This would be the basis of NTA’s (aspirationless) claims of treatment success. In face of the derision this deserved, the NTA has gone on record saying it does not define recovery at all now – despite the fact that “recovery” is the raison d’etre of its Janus-faced Business Plan 2010/2011. That all the goals and actions therein are meaningless can thus be taken as read.
For example, there is apparently no plan to replace the discredited and bureaucratically heavy Top form. It will be forced on ever more people. The NTA states, too, that it has looked at the ASAM patient placement criteria. Yet instead of contacting the creators of this highly-researched method, it plans to reinvent the wheel and spend taxpayer money developing a version for its own purposes. It also plans to spend more taxpayer money on a mutual aid directory. Yet this is already provided free by Addiction Today. Under Championing abstinence-focussed treatment in the business plan… well, for further help interpreting the Business Plan’s double speak, read our glossary.
It is, however, commendable that Dr David Best, who has wriiten so cogently and expertly on abstinence-based recovery in the pages of Addiction Today and other professional journals, has been appointed as the other half of the recovery duo. We wish him the very best of luck in counterbalancing his former mentors, and getting them on the true road to recovery with a Damascene conversion. They should heed him, for he is the only person giving this exercise any credibility.
As David Cameron said in June,“There is a problem in our national health service, in that we spend too much time treating the symptoms rather than necessarily dealing with the causes… All addictions need proper attention, and proper treatment and therapy, to rid people of their addictions”.
We really would love to believe, as he and many in government must wish to believe, that we will witness the NTA’s respecting the trust that has been placed in it and seeking the rehab expertise that actually helps people to get off life-destroying drugs and rebuild their lives and their families’ lives. But the serious worry is that this initiative for change get will be lost in adherence to disinformation and blowback, and submerged in intransigent ideology about the non-recoverability from addiction. Of even more concern, will its lack of understanding continue to marginalise the expertise necessary to help the 330,000 or so addicts desperate for the sobriety which is the basis for them to get back, or get for the first time, their self esteem and their lives?
We will be happy to be proved wrong. But we are not holding our breath.

Source: www.addictiontoday.org. 10th August 2010

Filed under: Drug Specifics :

CALLS have been made for a rethink on the use of methadone in Scotland after official figures revealed the number of deaths in which it was implicated reached a ten-year high last year.
Amid a general fall in people being killed by drugs, fatalities in which the heroin substitute was cited as a contributory factor rose to 173 in 2009, up from 169 in 2008 and a surge of 51 per cent since 2007 when it was associated with 114 deaths. The controversial drug treatment was found to be at least partly responsible for more than a third (32 per cent) of all of the 545 drug-related fatalities in Scotland last year, and was associated with the second-highest number of drug-addict deaths after heroin or morphine, which contributed to 322 losses of life – 59 per cent of the total.

The 2009 methadone figure also equates to roughly one death every 48 hours.

The rising number of deaths linked to methadone led to calls for the policy of wide prescription of the treatment to addicts to be reviewed, with one drug-misuse expert describing the current situation as being of “enormous concern”.

Professor Neil McKeganey, the director of the Centre for Drug Misuse Research at Glasgow University, said: “The situation in relation to methadone – where it appears we have around a third of addict deaths associated with the drug we are prescribing most widely to treat drug addiction – is of enormous concern. We really ought to be looking again at this policy of widespread methadone prescribing. The statistics are inescapable – we ought to be looking at why we are doing it and whether all of those to whom it is being prescribed are deriving benefit from it.”

Peter McCann, the chairman of the Castle Craig Hospital for alcoholism and drug addiction, lent his weight to the calls, adding: “Today’s drug-death figures would have been described as totally catastrophic just a few years ago. There must now be a total rethink in Scotland along the lines of the National Treatment Agency in England which totally reversed its policy earlier this month. “They will be limiting the use of methadone with strict multi-disciplinary assessments at regular intervals. The policies prescribing methadone in Scotland have obviously failed and must be revised.”

Murdo Fraser, Scottish Conservative health spokesman, said the focus of the Scottish drugs strategy should be on recovery and abstinence. He said: “The attempts of the last decade to merely manage the problem, based on harm reduction and an over-reliance on methadone, just have not worked. The challenge now is to expand the range of rehabilitation services on offer and move to abstinence and recovery.”

But the treatment was defended by Biba Brand of the Scottish Drugs Forum: “We know from research that staying on methadone tends to prolong their life by about 13 per cent. “We also know that of those deaths that are occurring (overall], two-thirds are outwith treatment, so being in treatment – and generally that involves methadone – is helping people stay alive. Methadone can help save lives, but we need to help people progress through treatment.”

A Scottish Government spokesman added: “We do not favour one form of treatment over any other. Decisions on the most appropriate treatment to prescribe an individual are for clinicians, in discussion with their patients and in line with national guidelines.”

Overall, the number of people killed by drugs in Scotland fell by 5 per cent since 2008, but the 545 drug-related deaths during 2009 equated to the second-highest total ever recorded; an increase of 20 per cent since 2007 and a rise of 87 per cent since 1999.

A wider analysis, using figures recorded by the Office for National Statistics, showed the number of deaths related to drugs in Scotland last year was 716, down from 737 in 2008, but a rise from the 2007 total of 630.

This figure included people killed by solvent abuse, legal highs and through overdoses of prescription medication. It also included people dying with mental-health problems linked to drug abuse, as well as those killed by the health complications allied to contaminated drugs. More than a third of all deaths in Scotland, some 200, were in the Greater Glasgow and Clyde NHS board area, and this represented the highest total on record. Deaths in Lothian dropped, by 13 to 81, as did fatalities in Fife (37 to 32) and Forth Valley (23 to 14).

There was also a rise in the number of older people dying from drugs, with deaths among those aged 35 and over rising from 271 in 2008 to 296 in 2009, while at the same time deaths among users under 35 dropped from 303 to 249.

Source: News.Scotsman.com 18th Augutst 2010

 

Filed under: Drug Specifics :

 The Planning Commission will consider on Wednesday asking the City Council to revise the city charter to permanently bar medical marijuana dispensaries from operating in Downey.
Citing federal law that still makes it a crime to grow, use or possess marijuana, city administrators recommend the charter be amended to prohibit the dispensaries.

The City Council last year enacted a moratorium on medical marijuana clinics that is scheduled to expire Nov. 10.

In a report prepared by community development director Brian Saeki and senior planner David Blumenthal, city officials also cited reports of violent crime — specifically robberies and homicides — at dispensaries in neighboring cities.

“Besides crimes against persons and property, the operation of medical marijuana dispensaries has been linked to organized criminal activity, money laundering and firearm violations,” the report states.

California voters approved the use of marijuana for medicinal purposes in 1996. The state created a voluntary medical marijuana identification card program in 2003 to protect residents from state marijuana laws. The San Diego Union-Tribune reported in June that of California’s 481 incorporated cities, 132 have banned medical marijuana dispensaries. Another 101 have enacted temporary moratoriums.

Best, Best & Krieger, before they were fired as the city’s law firm, wrote a whitepaper suggesting Downey had the discretion to either regulate or prohibit medical marijuana clinics. The law firm also warned the city against “adverse secondary impacts” dispensaries could pose. “On balance, any utility to medical marijuana patients in care giving and convenience that marijuana dispensaries may appear to have on the surface is enormously outweighed by a much darker reality that is punctuated by the many adverse secondary effects created by their presence in communities,” Best, Best & Krieger wrote. “These drug distribution centers have even proven to be unsafe for their own proprietors.”

The city of Los Angeles recently approved a restrictive ordinance aimed at corralling the city’s estimated 400 medical marijuana dispensaries. Attorneys representing marijuana dispensaries given shut-down notices have said they will sue Los Angeles to remain open.

Only one medical marijuana dispensary has operated legally in Downey. It closed after the city’s moratorium went into effect late last year.  by Eric Pierce 

Source:www.thedowneypatriot.com 31st Aug.2010

Filed under: Drug Specifics,USA :

 

The impact medical marijuana has had on our adolescent substance-abuse treatment program in Denver is profound.

The 2009 boom in marijuana distribution coincides with a tripling of teens referred to our program. Currently, 51 percent of our patients report getting their marijuana from someone with a medical marijuana license.

Not surprisingly, patient attitudes about marijuana are changing – and in ways that make it much more difficult for us to help them stop using the drug. Recently, a teenage boy said he couldn’t stop smoking marijuana because “it is my medicine for anger.”

Even worse, a few young adult patients in treatment for marijuana addiction have marijuana licenses. These patients struggle with conflicting messages from one physician who recommends smoking marijuana and another who recommends stopping.

In Denver, marijuana is advertised on billboards and in magazines and newspapers using themes that appeal to young people. Because youth are highly vulnerable to both the effects of advertising and the addictive potential of marijuana, it is not surprising that 60 percent of the state’s medical marijuana users are under 44 years old.

We must act swiftly to prevent situations such as this from getting worse.
Christian Thurstone, M.D. is the Medical Director of Adolescent Substance Treatment, Education and Prevention at Denver Health and Hospital Authority and Assistant Professor, Department of Psychiatry, University of Colorado Denver.

Source: http://ofsubstance.gov/cs/blogs Wednesday, October 13, 2010

Filed under: Drug Specifics,USA :

 

The extension of “payment by results” to the treatment of drug addicts will test the method’s limits

AT PHOENIX FUTURES in Birmingham, Karen is six weeks into a programme of group therapy sessions, life-skills training and one-on-one meetings with her keyworker, Dean. Things are looking pretty good. A former heroin user, she was on methadone for years before going into residential rehab last October. Karen now takes a relatively low dose of Subutex, a weaker heroin substitute, which she intends to come off altogether over the next six weeks. She credits her treatment with giving her the stability to have her three-year-old son to stay with her at weekends, and hopes to take a course or get a job—and eventually to work with drug users—once she is fully abstinent.
There are many Karens in Britain, though most are not doing as well as she is. Around 320,000 people are thought to be on heroin or crack cocaine or both in England alone. Many more use cannabis (the most popular drug), powder cocaine or a constantly changing clutch of designer drugs and legal highs: in all, almost 3m in England and Wales used some sort of illegal drug in 2009-10. A big push by the previous Labour government lifted the numbers in treatment (see chart), and drug use seems to be falling a bit now. But it remains high by European standards. Some argue that too many users have been “parked” on methadone rather than encouraged to kick chemical dependence altogether.
Intent on remedying what the Conservatives see as the persistent ills of “broken Britain”, the Tory-led coalition government has big ambitions in drugs policy. It wants to get more people through treatment and functioning again—free of drugs if possible, but also employed, housed and law-abiding. There is a moral dimension to its emphasis on recovery rather than harm reduction, but also an economic one. Use of heroin or crack cocaine is linked to between a third and a half of all acquisitive crimes; an estimated 400,000 benefit claimants who are dependent on drugs or drink cost the Treasury £1.6 billion a year; and demands on the health service and criminal-justice system are great. The coalition’s commitment is real: at a time of screaming budget cuts, central-government funds for drug treatment in communities and prisons have barely been hit.
A key plank of the strategy is “payment by results”. This approach to delivering public services—rewarding charities, community groups or private firms not for what they do but for how well they do it—has been seized on gratefully by a cash-strapped government. Versions are being tried to get welfare recipients into work and discourage criminal reoffending. Now eight drug-treatment pilots are to be launched. This breaks new ground internationally, says Martin Barnes, the head of DrugScope, a drug-information charity.
No magic wand
The theoretical argument for payment by results is that, by rewarding only success, it drives up standards while reducing costs. “It will make organisations focus on delivering quality services because they won’t survive if they don’t,” says David Biddle, deputy chief executive of CRI, a charity whose drug and alcohol services have grown rapidly. Kent is one area chosen for a payment-by results pilot. “Commissioners will now have the opportunity to reward those who innovate, and deliver efficient and effective services,” says Amanda Honey of Kent County Council.
Not everyone is sure that payment by results will work in drug treatment, however. Outcomes are hard to measure. In welfare-to-work schemes, a claimant either gets and holds a job or he doesn’t. A prisoner is convicted of reoffending or he isn’t. With drugs, progress often consists of baby steps on various fronts, which is why the government proposes to pay for a range of positive outcomes including jobs, housing and so forth. Coming up with precise measures is proving hard.
Setting tariffs is difficult, too. Payment by results works only if risk is transferred to the provider. But drug users are prone to relapses, and recovery can take years. Most not-for-profits in drug treatment are small; they need payment along the way to cover their costs. If instead they become subcontractors to larger outfits, a one-size-fits-all approach could replace the tailored solutions seen by many as a key to success. Whoever is contracted, “if the basic tariff isn’t enough, it will wipe out the chances of the provider doing anything good. If it’s too much, then there is no risk transfer. If it’s the wrong mix [of incentives], then it encourages gaming,” says Lord Adebowale, the chief executive of Turning Point, a health and social-care organisation.
Despite the challenges, Turning Point and CRI are both interested in the trials. For its part, smaller Phoenix Futures has started offering a payment-by-results option off its own bat. “I wanted us to be ready,” says Karen Biggs, its chief executive.
But other uncertainties loom, as more administrative power is pushed down from Whitehall. From 2013 the funds earmarked by central government for drug treatment in the community (currently about £500m) will be handed over by Public Health England, a new bit of the NHS, to local authorities; drug and alcohol funding will merge, and perhaps disappear into the overall public-health pot. New elected police and crime commissioners will have a say in this area, as might local GPs newly charged with commissioning health care.
Anne Milton, the minister for public health, is determined that money will not leak away from drug treatment, counting on a national “outcomes framework” to make sure that needs which are not regarded as a priority locally continue to be met. Payment by results in this complicated and difficult area might prove transformative in all the right ways—or it might turn out an unholy mess. If it does work, says one sceptical charity, “they can use payment by results to deliver absolutely anything.”

Source: www.economist.com 14th April 2011

Filed under: Drug Specifics :

 

 

Harm Reduction: More than just side effects!

 The recent stance from the managing editor of the South African Medical Journal in favor of the extremely controversial practice of decriminalizing drugs of abuse (Harm Reduction) is both surprising and disconcerting. It shows a mixture of “arm chair medicine”, selective quoting of studies and conventions, and some really flawed reasoning.

 One wonders when last he has sat in front of a drug addict who’s lost their family, through being consumed by an overriding passion for drugs, or lost their job due to multiple accidents in the workplace related to the abuse of cannabis, heroin or other drugs. Or when last has he treated a marijuana smoker who has developed schizophrenia as a result of his marijuana smoking, a complication which has become increasingly well established in medical publications over the last 4 years?

 Medical Science is exploding with new research on virtually a weekly basis, that proves the harmful effects of marijuana use including:

  •  Causing psychosis in healthy people.[1]
  • Harming the brains of teenagers.[2]
  • Increasing the risk of testicular cancer.[3]
  • Poor foetal growth.[4]
  • Suppression of the immune system. [5]

 I suppose he has also not had to treat wash-out drug addicts from Switzerland like some of us have had to, where they have tried to regulate substance abuse through the medical provision of clean needles, syringes and drugs.

 The archaic argument that we cannot root out drug abuse by keeping it a crime is also a strange way of thinking to Doctors for Life. Since time began we have not managed to root out one single crime, but we are far from considering decriminalizing murder, rape, theft and fraud, to name but a few. Really, to use the example of Jackie Selebi’s corruption as a argument to legalize drugs is an illogical and distorted way of reasoning.

 Even though the article has quite a few references and appears very scientific, one is kind of left wondering what has happened to common sense. Dr van Niekerk keeps on quoting the fact that more harm is caused by legal drugs such as tobacco and alcohol (90% of all drug related deaths in theUK!) than illegal drugs, and somehow seems to miss the obvious point that having legalized them did not reduce the harm done by them. On the contrary, it appears to have increased the harm they cause. The implications of legalizing the use of drugs of abuse for the benefit of the economy of the country are vast. To mention just a few:

 Politoxemia, the simultaneous addiction to different drugs.

  • The financial implication of increased accidents in the workplace.
  • An increase in hours off work.
  • Medical expenses for treating the complications of substance abuse.

 It also includes the expense of establishing an infrastructure of medical personal to oversee the handing out of these drugs (and that in a country where our health system is already overloaded). DFL finds the reasoning justifying decriminalization immature.

 Dr. van Niekerk also quotes the UN Single Convention on Narcotic Drugs of 1961, but does not mention the UNODC’s 52nd session of the Annual Commission on Narcotic Drugs March 2009, to whichSouth Africa is a co-signatory. When some parties tried to slip in a Harm Reduction policy (such as Dr. van Niekerk is supporting),Sweden,Russia,Japan,USA,Colombia,Sri Lanka andCuba refused to sign the document unless the reference to harm reduction was removed.

 Experiences of a few countries that have moved in the direction of decriminalisation should also be taken note of:

 The Alaska Supreme Court ruled in 1975 that the state could not interfere with an adult’s possession of marijuana for personal consumption in the home. Although the ruling was limited to persons 19 and over, a 1988 University of Alaskastudy, the state’s 12 to 17-year-olds used marijuana at more than twice the national average for their age group.Alaska’s residents voted in 1990 to re-criminalize the possession of marijuana, demonstrating their belief that increased use was too high a price to pay

 In Holland the Dutch government started closing down a third of their coffee shops because they found that many of the coffee shops had become a legal outlet for the illegal drug trade and after 15 years of legalised marijuana use, they were unable to separate the illegal and crime related activities from the legal trade. With the South African Police Force struggling to effectively police crime in the country, how do we think we ever are going to better the Dutch!

 The U.K.first reclassified marijuana as a less harmful Class C drug, but in January 2009 moved it back to a more dangerous Class B drug.

 Doctors For Life International is all in favour of doing more regarding the rehabilitation of drug addicts. But we do feel that having a prison sentence as an alternative to being sent for rehabilitation is a powerful incentive for many substance abusers to try and get help. To this end we would argue for more government funding to established rehabilitation units, and for NGO’s, who to a large extent have taken over the responsibility of the government in this regard.

 Doctors for Life International, represents more than 1800 medical doctors and specialists, three-quarters of whom practice in South Africa. Since 1991 DFL has been actively promoting sound science in the medical profession and health care that is safe and efficient for all South Africans. For more information visit: http://www.doctorsforlife.co.za

 References:

 [1] Causing psychosis in healthy people:                 

Dr Theresa Moore, Theresa HM Moore MSc, Dr Stanley Zammit PhD, Anne Lingford-Hughes PhD, Thomas RE Barnes DSc, Peter B Jones PhD, Margaret Burke MSc, Glyn Lewis PhD

Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review.UniversityofBristol, InstituteofPsychiatryinCardiffUniversity, Wales.

The Lancet, Volume 370, Issue 9584, Pages 319 – 328, 28 July 2007

 [2] Harming the brains of teenagers:                     

Manzar Ashtari, Ph.D: Children’sHospitalofPhiladelphia

Staci A. Gruber:HarvardMedical School

http://news.harvard.edu/gazette/story/2010/11/marijuana-study/

 [3] Increased risk of testicular cancer:                            

FredHutchinsonCancerResearchCenter: Stephen Schwartz

Association of Marijuana Use and the Incidence of Testicular Germ Cell Tumours

http://www.fhcrc.org/about/ne/news/2009/02/09/marijuana.html

Kristen Woodward, 206-667-5095 or kwoodwar@fhcrc.org

 [4] Poor foetal growth:                                            

Hanan El Marroun, Henning Tiemeier, Eric A.P. Steegers, Vincent W.V. Jaddoe, Albert Hofman, Frank C. Verhulst, Wim van den Brink, Anja C. Huizink.
Intrauterine Cannabis Exposure Affects Fetal Growth Trajectories: The Generation R Study
Journal of the American Academy of Child & Adolescent Psychiatry
December 2009 (Vol. 48, Issue 12, Pages 1173-1181)

 [5] Suppression of the immune system:                     

Venkatesh L. Hegde, Mitzi Nagarkatti and Prakash S. Nagarkatti.

Cannabinoid receptor activation leads to massive mobilization of myeloid-derived suppressor cells with potent immunosuppressive properties.

European Journal of Immunology, 2010; 40 (12): 3358-3371 DOI: 10.1002/eji.201040667

 Source:  Doctors for Life International, Dr.Thomas Gray 032 4815550  Jan 2011

David Raynes. Executive Councillor UK National Drug Prevention Alliance wrote to the BBC following the Any Questions programme on BBC Radio 4 with the following response.  Subsequently David appeared on the follow up programme.

 ANY QUESTIONS BBC Radio 4. The drugs policy debate

Date: Sat, 4 Jun 2011

 Dear Sir

Since our organisation, the NDPA, was mentioned several times in the programme please allow me to respond.

 Nadine Dorries was correct that much modern cannabis is stronger than years ago but we do not agree with her figures. Typically modern cannabis is three to four times stronger in THC (the psychoactive ingredient) than the /strongest/ cannabis of the 60s & 70s.

 This has been achieved by selective breeding and in response to consumer demand. But the picture is more complex than /just/ THC strength, the presence (or rather absence in modern forms) of another chemical, CBD, appears to have aggravated the ever present brain damaging potential of cannabis.

 Use has also changed, age of first use & regular use, is earlier than in the 60s and that is another damaging factor. The evidence caused theUKgovernment, with cross-party agreement, to reclassify cannabis upwards, two years ago.

 With Prime Minister David Cameron saying, (SKY NEWS SUNDAY APRIL 6TH APRIL 2008) that a parliamentary committee of which he had been a member, had been wrong about lowering the classification of cannabis.

 Lessons have been learned and are unlikely to be overturned.  We say that cannabis contributes substantially to academic  under achievement and very poor mental health, regardless of other effects.

 On the wider question of decriminalisation and even legalisation of all drugs, the NDPA says that a monstrous, well financed and very slick fraud is being perpetrated internationally and that this fraud has fooled some of the “great & good” who have signed up as supporters.

 There is no evidence at all that either measure could reduce the  total harm from drugs. The reverse is very much the case, with academic opinion saying that either measure would inevitably normalise and increase, use. The manifest harm from the legal drugs and the legislation on alcohol & tobacco, as variously applied around the world, confirms that.

 Comment from the panel on the good effects from decriminalisation was profoundly incorrect and just reflects implanted manipulative messages.

 For years we have been bombarded with theNetherlands as THE example of sound drug policy, this despite the fact that the country, through it’s policies, created the largest base for drugs related criminality inEuropewith supply, warehousing, distribution and manufacture at astonishing levels. At one stage the Netherlandshad more drug related murder than anywhere else inEurope. The Netherlandsis changing, it spends proportionally more than the UK on enforcement and is currently more effective and better organised.

 Portugaland decriminalisation appears now to be “the new orthodoxy” for those with a certain direction of travel and for those “user advocates” who want more freedom to use, regardless of the wider social effects.

ButPortugalis being misrepresented:

 1.       The number of new cases of HIV and Hepatitis C inPortugalis eight times the average in other EU countries

 2       Portugal has the most cases of injected drug related AIDS with 85 new cases per one million citizens. Other EU countries averaging 5 per million.

 3.       Since decriminalisation, drug related homicides have increased 40%.

 4.       Drug overdoses have increased substantially, over 30% in 2005

 5.       There has been an increase of 45% in post mortems testing positive for illegal drugs

 6.       Amphetamine & cocaine consumption has doubled inPortugalwith cocaine seizures increasing sevenfold between 2001 and 2006.

 Finally the suggestion that legalisation would somehow remove criminality from drug supply is ridiculous. Criminality loves use-reinforcing substances and behaviours. More than 20% of the UK tobacco market is smuggled, counterfeit, or both. In some other countries it is much worse.

 Legalisation or decriminalisation, of substances unfit for human consumption, should only occur if a demonstrable “public good” can be evidenced.

 The problem for the legalisation lobby is that it cannot.

 David Raynes. Executive Councillor UK National Drug PreventionAlliance

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Filed under: Drug Specifics :

Should drugs be legalized? Some people think so, like a recent article written by Ethan Nadelmann in Foreign Policy magazine. The Executive Director of UNODC, Antonio Maria Costa, put forward his views on the topic to a meeting in New Orleans hosted by the Drug Policy Alliance. Here is a full text of the speech:

Ladies and Gentlemen,

From both sides of the aisle, there have been noises about my presence here. Is it right to invite this fellow, the so-called drug czar of the United Nations, to our annual conference?  Indeed, in some of the pro-legalization literature I am depicted as a die-hard prohibitionist, a drug control Taleban, a naive proponent of a drug free world, even a general in the war on drugs.

I have heard similar complaints from the opposite front: what is the point of the UNODC Executive Director joining the caucus of those who ask for the end of drug control, mixing with drug legalizers, the radical fringe of the pro-drug lobby, pressing for a world of free drugs that will never come?

I am glad that eventually we all decided that this exchange of views could be constructive, and help public opinion understand better a century-old drama: drug abuse, and the damage that it causes.

Is there some common ground between those who insist on a world free of drugs, and those who propose a world of free drugs? By the time this session is over, I hope we will all be able to answer in the affirmative. Here are a few pointers:

  • First, health and security have to be protected when we talk about society, including when we talk about how society deals with drugs.
  • Second, as a corollary, we can all agree on the need to reduce the harm caused by drugs — by preventing their use, by treating those who abuse them, and by limiting the damage they cause to the individual and society.
  • Third, I hope we also agree on the need to ensure that drug policy is evidence-based, not the result of political considerations or ideological preferences.
  • Fourth, I submit that the dichotomy prohibition vs legalization is a misnomer. Such a confrontation is too simplistic for scientific deliberations, nor does it help those whom we all wish to assist: our brothers and sisters, the drug addicts.
  • Fifth, and finally, I hope you also agree that it is more accurate to refer to our divergence as a difference about the degree to which addictive substances (drugs, alcohol and tobacco) should be regulated.

If these points are accepted, the discussion is to be centred on  where the bar is set , how to define the degrees of regulation. In other words, instead of accentuating our differences, I hope we build on the ground we share.

Let me begin with the world drug situation: where do we stand?

The world drug situation

In a recent article Ethan Nadelmann wrote: “it is dangerous when rhetoric drives policy”. I agree.  Res, not verba, [actions, not words] my ancestors the Romans, would have said. So let’s begin with the facts.

A growing body of evidence, including recent UNODC World Drug Reports, shows that the drug market has stabilized over time and space. [Opium in Afghanistan is mostly an insurgency issue (4/5 of the cultivation takes place in the areas controlled by the Taliban).]

On the basis of this evidence, I can state that, since a few years, for all drugs there are signs of world market stability (for opiates, cocaine, cannabis, and ATS). What I mean is that in every component of the drug business (cultivation, production, consumption), aggregate totals have lost the upward momentum they had in the 1980s and ’90s. Of course, world aggregates hide improvements in some countries and for some drugs, offset by deterioration elsewhere. Yet, the global totals are stable. This is what I like to call containment.

This finding refers to the past few years. Hopefully, in the period ahead evidence to support this claim – over the long term – will become statistically and logically incontrovertible.

Next question: how did this market change come about? Is this the result of the UNGASS process? I see correlations over time and space, but evidence of causality is hard to come by (social sciences are generally poor in proving cause/effect relations). Drug trends respond to a wide range of factors, especially changes in society’s revealed preferences. Yet for me, the result is what counts. If you have evidence to refute our data, I would like to see it.

Despite evidence of containment the world still has an enormous drug problem. There are some 25 million problem drug users. But let’s keep this in perspective – that’s less than 0.6% of the world’s population. Even if you take into account the number of people who take drugs at least once a year (approximately 200 million people), this is still below 5% of everyone on the planet.

By comparison, 50% of the world’s population uses alcohol, and 30% smoke. Alcohol, we know, kills 2.5 million people a year. More than half of all homicides and road-accidents, and most domestic violence, is alcohol-related. Tobacco kills 5 million people a year, because of cardio-vascular diseases and cancer — two of the greatest killers of our time.

What is my conclusion? There is growing public and medical pressure to tighten controls on the consumption of alcohol and cigarettes. That’s right. So why increase the public health damage caused by drugs by making them more freely available: drugs whose damage — thanks to the controls — is limited to 1/10th the casualties caused by tobacco? Why ignore the knowledge that we have gained from our experience with other addictive substances?

If dreams come true…..

In order to show where I like to set the drug control bar, let me begin with the slogan so many of you have ridiculed:  a drug free world. Wait, wait: hold on to the tomatoes — I am not the author of this slogan. While in my life time I would certainly like to see a world without drugs, I have never used this slogan. Actually, you will not find it in any of my speeches, nor in any of the official United Nations documents, starting from the most relevant of them: the conventions (of 1961, 1971, and 1988) that created the UN drug control regime, and the General Assembly resolution about drugs (most notably from the UNGASS, 1998).

Yes, of course, several years ago (ie BC, before Costa) my Office put out posters with that slogan screaming across the page. While I never used this concept, personally I see nothing wrong with it. Is a drugs free world attainable? Probably not. Is it desirable? Most certainly, yes. Therefore I see this slogan as an aspirational goal, and not as an operational target – in the same way that we all aspire to eliminate poverty, hunger, illiteracy, diseases, even wars.

So let’s move on. I start with a series of (hypothetical) situations that I deem useful to set priorities in drug policy. I present them to you as dreams.

First, I invite you all to imagine that this year, all drugs produced and trafficked around the world, were seized: the dream of law enforcement agencies. Well, when we wake up having had this dream, we would realize that the same amount of drugs – hundreds of tons of heroin, cocaine and cannabis – would be produced again next year. In other words, this first dream shows that, while law enforcement is necessary for drug control, it is not sufficient. New supply would keep coming on stream, year after year.

So let’s dream a second time. Let’s dream that, by some miracle, we can convince farmers around the world to eradicate the thousands of hectares of drug crops, replaced by the fruits of development assistance (in Afghanistan, Colombia, Morocco, and Myanmar). A great dream of course, but yet again one that would not on its own solve the world drug problem. Why? Because when we wake up after this second dream we would realize that other sources of supply would inevitably open up somewhere else on the planet, to satisfy the craving of millions of drug users around the world.

So we come to a third dream which is the real challenge of drug policy: to reduce the demand for drugs. Prevention, treatment and reintegration, combined in a single health based programme, must be our priority. Of course the world’s supply of drugs needs to be reduced, but lower demand for drugs is the required condition to make drug policy realistic and pragmatic.

I hope you agree on this sequence, to separate the three elements of the drug chain, and their primary agents:  supply, by farmers in need of assistance;  trafficking, by criminals deserving retribution; and demand, by addicts in need of health care. At the UN, governments have captured this concept nicely in the expression shared responsibility.

Our Office focuses on the first and third part of this trilogy, namely the farmers and the drug users. Going after the traffickers is the role of law enforcement agencies. We help indirectly in this endeavour by promoting criminal justice and counter-narcotics cooperation. I take this opportunity to salute the work of counter-narcotics officials around the world whose important work is often carried out at the cost of their lives: please recognize that they deal with loathsome predators who exploit human vulnerability for the purposes of profit.

Health and Security  

With two building blocks of my argumentation in place (namely, stability of the world drug market and the priority of reducing drug demand), let me now turn to the issues of health and security.

Some people say that drug use is a personal and private choice – and nobody else’s business.

I have a few problems with this argument. First, there is a health issue. A growing body of scientific evidence shows that drug abuse is a disease affecting the brain, as much as any other neurological or psychiatric disorder. It is both triggered by vulnerability, and, in turn, deepens vulnerability. This has consequences both for the drug user and society as a whole.

Second, if people don’t care about the dangers to themselves, what about the dangers that drugs cause to others: like road accidents or crimes committed by people under the influence of psycho-active substances, or the spread of blood borne diseases to others? The pharmacological effects of drugs are independent of their legal status. Drugs are not dangerous because they are illegal. They are illegal because they are dangerous. No wonder that public outcry against the collateral damage of drug use is building, just like successful campaigns against passive smoking or drunk driving.

Third, drugs threaten security – not only public safety in inner-cities, but the security of states — think of Central America, the Caribbean and West Africa, caught in the cross-fire of drug trafficking.

I know your argument on this last point. Prohibition causes violence and crime by creating a lucrative black market for drugs: so, legalize drugs to defeat organized crime. Thus far, as an economist, I agree with you. But this is not only an economic argument. Legalization may reduce the profits to organized crime, but it will also increase the damage done to the health of individuals and society. Evidence shows a strong correlation between drug availability and drug abuse. Let us therefore reduce the availability of drugs – through tackling supply and demand – and thereby reduce the risks to health and security.

In short, drug policy does not have to choose between either (i) protecting health, through drug control, or (ii) ensuring law-and-order, by liberalizing drugs. Democratic governments can and must protect both health and safety.

Besides, just because something is hard to control doesn’t mean that its legalization will solve the problem. For example, it is hard to stop human trafficking – a modern form of slavery. This is a multi-billion dollar business. Because the problem is out of control, would you equally propose that we accept it?

Let’s Not Condemn People to a Life of Addiction  

In order not to condemn people to a life of addiction, my Office is putting a strong emphasis on drug prevention and treatment. This goes back to the roots of drug control. The 1961 Convention on Narcotic Drugs is based on the premise that health is the first principle of drug control. This becomes more relevant every day as a growing body of medical and scientific evidence shows that drug addiction is an illness. So let’s treat it that way. There are no ideological debates about curing cancer or diabetes. So why have them about drug addiction? People to the left or right of the political spectrum are not divided on the need for preventing or treating tuberculosis and HIV/AIDS. So why with drugs?

Scientific evidence has proven that drug dependence is a health and social issue, the result of nature and nurture. People are vulnerable to addiction because of a mix of genetic, personal and social factors: gene variants , namely genetic predisposition to addiction, childhood, pre-natal stress and inadequate parental care, neglect, abuse, low school engagement, lack of bonding, and social conditions , marginalization, exclusion, poverty, latent or overt psychiatric disorders as well as popular culture and peer pressure.

There is a double jeopardy at play here: not only are such people more vulnerable to addiction, but addiction deepens their vulnerability. As a result, the disadvantaged are pushed even further away from society.

If drugs were legalized, these people would be condemned to a life of dependence. The privileged can afford expensive treatment for their drug habits, or those of their kids. But what about the less fortunate who lack the same means and opportunities?

Now extrapolate the problem onto a global scale. Imagine the impact of unregulated drug use in developing countries where no prevention or treatment are available. This would unleash an epidemic of drug addiction and all the social and health consequences that go with it.

Instead of reducing harm, there would be increased damage to individuals and communities because of drugs. Will you share the responsibility for the overdoses, HIV, and broken lives?

Beyond 2008 

Ladies and gentlemen, if you really want to rethink drug policy, then help rebalance global drug control in favour of prevention and treatment. You are an outspoken Alliance. Be more radical. Go beyond handing out condoms, clean needles or a bowl of soup. Offer all drug addicts a comprehensive package that includes prevention, treatment and reintegration, not only harm reduction gadgets. Join me as an “extremist of the centre”. We have been hearing about a balanced approach for a quarter century. It’s time to turn it into reality.

If you want to shake things up, if you want to break the vicious circle of dependence and disadvantage, then:

Do not only:

– prevent the spread of diseases that precede and accompany drug use, like HIV and hepatitis.

This is a noble aim that we all share. But let us go further and:

– devote more attention to prevention and early detection of drug vulnerability;

– reach out to people who need treatment, on a non-discriminatory basis;

– support the mainstreaming of drug therapy into high-quality and accessible public health and social services.

Let us also:

– promote alternative measures to prison for drug addicts, offering them rehabilitation programmes;

– treat all forms of addiction. There is no consolation for stabilizing drug trends if people turn instead to other substances;

– finally, and most importantly, make drug control a society-wide issue.

Drug policies are too important to be left to drug experts like you and me, and to governments alone. It is a society-wide responsibility that requires society-wide engagement. This means working with children, starting from parents and teachers, to ensure that they develop self-esteem. Support family-based programmes, because prevention begins at home.

Schools teach life-skills. They should also teach the dangers of drugs. Help young people engage in healthy activities, like sports and culture, to prevent social isolation that leads to drugs and crime. Invest in better understanding, preventing and treating the illness of addiction.   People can be steered away from drugs. And those that do suffer the misery of addiction can be brought back into society. This is the true meaning of harm reduction which goes far beyond its usual narrow definition. My Office promotes this approach, together with the World Health Organization.

Ladies and Gentlemen,

The strength of the international drug control system is its universality, with all governments solidly behind the United Nations drug conventions and strongly supportive of my Office. I hope I have won you over as well. If not, any change you would like to make to the existing drug control regime must be done by governments. You can influence the process. The review of UNGASS is a golden opportunity. We all want to help the poor farmers – to switch from crops to sustainable livelihoods. We all want to help the drug addicts – to save them from a life of misery. We all want to reduce the violence and crime associated with the drug economy.

So let’s build on this common ground to make a safer and healthier world.  Thank you for your attention.

Source:  Antonio Maria Costa. United Nations Office Drug Control. Dec. 7th, 2007

It is a cocktail of heroin and cold medicine that can kill your child – and it goes by the name ‘Cheese’. Police in New York are on alert for a wave of deaths as young children get hooked on the latest fad drug to sweep the city.
Coined ‘Cheese’ by the schoolchildren who are addicted to it, the brown powder gives a high for just $2 that can easily be sniffed between lessons.
Victims: Oscar Gutierrez, 15, and Nick Cannata, 16, both died after becoming addicted to ‘Cheese’. Dealers are increasingly the drug, known as ‘starter heroin’, at children to get them addicted young
Dealers have been stamping packets with child-friendly brands like Lady Gaga, Mickey Mouse, the Looney Tunes logo and characters from the Lion King in order to lure in ever younger customers. But once children are hooked they find it incredibly hard to quit – withdrawal symptoms start within six hours meaning addicts have to dose themselves up to 15 times per day.
The dark twist is that ‘Cheese’ also contains a potentially fatal amount of acetaminophen, a common ingredient in cold medicines like Tylenol, giving rise to its other name – ‘Tylenol With Smack’.
The drug has been linked to a string of fatalities in Texas and now police in New York fear it is heading their way too ‘It can ruin lives,’ said an NYPD commander who recently taught patrol officers how to spot it.
Lethal: Cheese is a combination of heroin and cold medicine which is highly addictive and is said to be behind at least 20 deaths in the U.S.
‘Cheese’ has been on the radar of drugs officials since 2005 since when it has been blamed for more than 20 deaths in Dallas alone. Although just 2.6 per cent of high school students have tried heroin, dealers are using ‘Cheese’ to get them hooked at a lower cost. The drug is made by mixing the heroin powder with cough medicine, possibly with the addition of water or other ingredients, and then usually snorted.It has a heroin purity of up to 8 per cent, well below the level of intravenously injected drugs, but enough to make it addictive.
Police have found that children as young as 12 have become hopelessly addicted to the drug and only escaped its clutches with the constant help of their families.
Among those who lost their child to ‘Cheese’ is Dave Cannata from Dallas, who now travels the U.S. warning other parents about the drugs. Mr Cannata found son Nick dead in his bedroom five years ago after he overdosed on the cocktail. The 16-year-old had only been out of rehab for six months when he came home and apparently went straight to bed. He was found dead the next morning.
‘Parents need to be scared of this stuff,’ Mr Cannata said. ‘Every day I look at his picture and I wish that I spent the 40 grand a month to send him away to get some help. ‘You have to jump on the problem right away. This drug is so highly addictive.’
The Drug Enforcement Agency refers to ‘Cheese’ as ‘starter heroin’ because of the low amount of the drug in it. Over time users build up their tolerance level so they need increasingly large amounts to get high – before moving on to the real thing.

Source: – http://www.dailymail.co.uk 14th Oct 2010

Dr. Dewey, a Physiatrist and Scientist has studied for over 20 years the brains of people using all kinds of drugs.

At a forum in Ronkonkoma,he presented information about a recent study with teenagers who smoke marijuana. He asked for subjects only using marijuana. He needed 400 teenagers just using pot. He received 7000 responses.

He selected 400 teenagers and tested them. In 72% of the marijuana use Methamphetamine was found. Every subject indicated that they were not using Methamphetamine.

Dr. Dewey stated that the pot is laced with Methamphetamine. This is very alarming said
Ginger Katz CEO of The Courage to Speak Foundation.

Source: Ginger Katz Founder & CEO of The Courage to Speak Foundation Oct 2010

Filed under: Drug Specifics :


Methadone for drug addicts costs the taxpayer £105m in four years
METHADONE for drug addicts has cost the Scottish government more than £105million in just over four years, it was revealed yesterday.
An average of £67,838 was spent every day buying and dispensing the heroin substitute since March 2006 – despite experts claiming it does not work.
More than 100 people have died of methadone overdoses in that time.
And there are fears that addicts are being “parked” on the substance as Scotland’s drug problems spiral out of control. Rehabilitation workers have joined politicians in calling for a radical overhaul of treatments.
Professor Neil McKeganey, of the Centre for Drug Misuse Research in Glasgow, described the bill as “staggering”. He said: “Scotland needs to address its reliance on methadone, which has become our main drug treatment – but it is costly and delivering dubious results. It is becoming difficult to persuade the Scottish government to look at alternatives. The solution is to get people off drugs and into drug treatment services. But that can’t be done by putting people on methadone indefinitely.”
Mark Hepburn, clinical director of the Alexander Rehabilitation Clinic at Oldmeldrum in Aberdeenshire, said: “My criteria for recovery is not for a drug-maintained life, but a drug-free one. But we are just parking people on it.”
Former Aberdeen heroin addict Barry Glaze, 29, was on methadone for five years and now believes it made coming off drugs harder. He said: “I started taking heroin when I was 16 and was first prescribed methadone when I was 19. It wasn’t until I was 25 that I came off it and that was after I asked my GP. If I hadn’t, I would probably still be on it.”
Labour justice spokesman Richard Baker said: “There have been too many cuts in services that work with addicts, and unless we see support for these services then these figures will not go down”.
The government spent £20.5million prescribing the drug in 2006-07, £24.7million in 2007-08, £27.5million in 2008-09 and £27.9million in 2009-10.
A government spokesman said: “We know that the annual cost of drug misuse in the wider context of total economic and social costs is estimated at £3.5billion.
“That’s over £60,000 per problem drug user – a cost for the whole community. However, these costs typically decrease by tens of thousands of pounds once an individual engages in treatment to support their recovery.
“That’s why we are providing a record £28.6million investment in frontline drug treatment services in 2010-11 and our view is that the overarching aim of all drug treatment services should be recovery and this is at the core of our drugs strategy.”

Source: http://www.dailyrecord.co.uk/news 30.09.10

Filed under: Drug Specifics :


The journalist who chose the headline would have known that ‘Cold Turkey’ implies a harsh treatment. Using residential rehabs to help those addicted to recover may be tough but it is not inhumane – and far better than allowing drug dependents to languish for years in addiction to methadone….. The great sadness is the number of residential rehabs which were forced to close when the NTA preferred methadone maintenance to treatment towards abstinence. NDPA

David Cameron is to push ahead with radical “abstinence” plans for the most serious drug addicts.

There are estimated to be 200,000 seriously-addicted users of heroin, crack and cocaine Photo: ALAMY

The Coalition is working on proposals to stop the widespread prescription of methadone for heroin users and instead increase the use of “cold turkey” residential treatment programmes.

Drug services are expected to be paid by results if they manage to get addicts off heroin and cocaine. It also emerged last week that ministers are considering withholding benefits from those refusing treatment.

Theresa May, the Home Secretary, has been charged with drawing up the new strategy despite pressure from the Department of Work and Pensions to take the lead in tackling addiction.

There are estimated to be 200,000 seriously-addicted users of heroin, crack and cocaine and many existing programmes have focused on keeping them away from crime rather than treating their addiction.

James Brokenshire, the Drugs Minister, said: “We are looking to have greater emphasis on recovery rather than simply on treatment itself. The aim is to get people clear of addiction.”

Mr Brokenshire said that there should only be a limited role for methadone in treatment. “[Methadone] should be seen as part of a pathway taking people to a position where they are clear of addiction,” he said.

Source: Telegraph 23rd August 2010

Filed under: Drug Specifics :

Over the past ten days, 40 reports were received by the National Poisons Information Centre regarding persons suffering severe adverse reactions attributed to using a new head shop substance “WHACK”.
The majority of these individuals are young males in their twenties. They live in different parts of Ireland with 20 presenting in the mid-Western region. They have suffered a range of symptoms including increased heart and breathing rates and raised blood pressure. Emergency Physicians and GPs have described that the majority suffered from differing levels of anxiety with at least 7 cases experiencing psychotic episodes. This psychosis is severe and is proving difficult to treat.

The National Poisons Information Centre, the Forensic Science Laboratory, the Irish Medicines Board and others are monitoring closely the emergence of any new psychoactive substances.

On the 11th May 2010, the Government brought in new legislation. This legislation has brought under control approximately 200 individual substances and covers the vast majority of products of public health concern, which were on sale in head shops.

In addition to the recent controls on legal highs introduced by the Minister for Health and Children, the Minister for Justice and Law Reform is bringing forward the Criminal Justice (Psychoactive Substances) Bill 2010 which aims to ensure that the sale or supply of substances which may not be specifically proscribed under the Misuse of Drugs Act, but which have psychoactive effects, will be a criminal offence.

The advice from the HSE is not to try this dangerous drug or other similar substances as the effect on an individual can impact significantly on one’s health.

Source: HSE Press & Media, Dr Steevens’ Hospital, Dublin 8, 09/06/2010

Filed under: Drug Specifics :

The Government’s official drug advisers will recommend later this month that the “legal high” mephedrone should be banned because of the potential serious risks to public health.  But the drug – a legal stimulant sold as plant food and known as miaow-miaow – will not be formally banned until at least the summer as further consultation is needed on whether it should be a Class A, B or C drug.

Pressure on the Government to outlaw mephedrone intensified yesterday when a post-mortem examination on John Sterling Smith, 46, of Hove, East Sussex, showed he died from mephedrone poisoning. His family said they were stunned and called for a ban. Results of toxicology tests released last night blamed mephedrone for his fatal cardiac arrest.  A Sussex Police spokeswoman said that Mr Smith collapsed at a party in Hove in the early hours of February 7. “Two men, aged 35 and 40, both from Brighton, were arrested on suspicion of supplying Class A drugs and released on police bail until May 5 pending further inquiries,” she said.

Headteachers called yesterday for action on the drug, which has been linked with at least five deaths.  Louis Wainwright, 18, and Nicholas Smith, 19, from Scunthorpe, died after taking mephedrone, which can be bought for £4 and is also known as “M-cat”. Both teenagers had been drinking alcohol and police said last night that they may have taken the heroin substitute methadone too.  There have been two other deaths in Britain linked to mephedrone, which is illegal in countries including Norway, Germany and Finland.

The Advisory Council on the Misuse of Drugs at present lacks sufficient members to make a formal recommendation, but the appointments process is being brought forward to next week to get over the legal problem. A spokesman said: “The council has been looking at the dangers of mephedrone and related cathinone compounds, as a priority. The ACMD held an evidence-gathering meeting on February 22 and continues to carefully work on considerations with a view to providing advice to ministers on March 29.”

Alan Campbell, a junior Home Office minister, said: “We are determined to act swiftly but it is important we consider independent expert advice to stop organised criminals exploiting loopholes by simply switching to a different but similar compound.”  The Home Office denied that the sacking of Professor David Nutt, former chairman of the council, and subsequent resignations of key members of the organisation had led to “inordinate” delays in considering a ban.

Professor Nutt warned yesterday against a hasty reaction, saying a ban had to be based on “sound science”.

Tim Hollis, the Association of Police Chief Constables’ spokesman on drugs, said a ban would enable police to act against those possessing and supplying the drug. He spoke as Mike Stewart, head of Westlands School in Torquay, Devon, said teachers were in the absurd position of having to hand back packages of the drug seized in lessons.  Side-effects of mephadrone include high blood pressure, a burning throat, nose bleeds and purple joints.

Source:   Times online 18th March 2010

Filed under: Drug Specifics :

An angry row has blown up over proposals to upgrade cannabis to a class B drug, with leading experts from the Advisory Council on the Misuse of Drugs (ACMD) accusing the Government of a “deliberate leak” of its plans.
Ignoring a directive not to speak to journalists about reports that the Government has already made its mind up, ACMD member Professor Les Iversen, a pharmacologist at Oxford University, said: “I was not pleased to read what appears to be a deliberate leak about the government’s alleged intention to reclassify, regardless of advice received.
“If ACMD were to recommend no change and this were to happen, I believe it would be the first time that any Home Secretary acted against the recommendations offered and it would call into question the whole function and future of this group.”
The outburst followed claims that Gordon Brown and the Home Secretary, Jacqui Smith, were determined to reverse the decision to downgrade the drug to class C when the ACMD completes its report in the next few months. Although its recommendations are not yet known, ministers are already making clear that Ms Smith is prepared to overrule the expert body.
But one former member of the influential council last night claimed the ACMD was totally opposed to the Government’s stance. “There is no way that the ACMD would support any reclassification of cannabis, unless there were some political shenanigans going on,” said the Reverend Martin Blakeborough.
Rev Blakeborough, who runs the Kaleidoscope drug abuse charity, said: “There is no significantly new evidence to suggest that cannabis is any more harmful than in the last review we did 18 months ago.”
“The only reason that the ACMD is being forced to discuss this matter is because every new Home Secretary seems to want to show how tough they are,” he added.
Professor David Nutt, chair of the ACMD’s technical committee, which will start taking evidence on classification at a public meeting next month, said: “In the end, as with all laws, it’s a political decision – the ACMD only advises.”
But David Raynes, of the National Drug Prevention Alliance, criticised the ACMD’s stance and said that it was dominated by people who advocate “harm reduction” and whose sympathies lie with pro-legalisation campaigners: “I actually think that the harm reduction/liberalisation/legalisation lobby is too strong in there (and in the Home Office). Some ACMD members are genuine but misguided, some are just the great and good with little understanding of the legalisation game that is being played by others.”
The controversy comes days after new figures revealed that almost 500 people are being treated by the NHS every week for cannabis-related mental health problems. Since the Government downgraded it from a class B to a class C drug in 2004, the number of adults being treated for its effects has risen from 11,057 in 2004-05 to 16,685 in 2006-07. Also, the number of children needing medical attention because of cannabis use has increased to more than 9,200 – up from 8,014 in 2005-06.
Fears over the hidden health risks of the drug, particularly on the mental health of young people, have prompted the calls for a review of cannabis. More than 2.5 million 16-24 year-olds have used the drug. The ACMD is expected to make its own recommendations known in April.
In a statement, a Home Office spokesman reiterated that the ACMD’s role is confined to providing “advice on classification”.

Source: The Independent on Sunday. 20th January 2008

Filed under: Drug Specifics :

This month, the National Treatment Agency published the staggering figure of nearly 25,000 young people under 18 getting “treatment” for their drugs and alcohol problems.[1] 10 years ago, the thought of so many young teenagers using drugs to this degree was unimaginable, writes Kathy Gyngell, chair of the Prisons and Addiction forum at the Centre for Policy Studies.
The sad fact is that, despite 10 years of a drug strategy purportedly designed to reduce use by young people, there are thousands of children beginning their lives so damaged by drugs that they need treatment. This is major social problem that can neither be denied nor brushed under the carpet. What teenagers do today determines the scale of the drugs problem tomorrow.
National school-age statistics show that a staggering 25% of UK children (aged 11–15) have tried drugs and that 10% of them use drugs regularly.[3] This is way higher than the European average. It is also likely that levels of teenage cannabis use are higher than the published statistics, as the Advisory Council on the Misuse of Drugs recently acknowledged.
Hospital admissions reflect the rising strength of cannabis and that children are moving earlier to Class A drugs. With the UK cannabis market dominated by high-THC skunk – which, according to a former head of the Dutch Police Narcotics Division, should now count as a ‘hard drug’ – what we are witnessing is an earlier and disturbing shift to hard drug use.
When drugs services and drugs advisors have no more urgent need than to highlight “the problems faced by young people when they reach 18 and are no longer eligible for specialist services” and “to ease their transition to adult services”, the outlook is dire indeed.
The NTA’s tables reveal that 1,600 teenagers are receiving “treatment” for heroin, cocaine and crack addiction. They reveal that 29%, some 6,000 in all of those in treatment, receive‘harm reduction’ interventions – usually understood to be a euphemism for prescribing an opiate substitute like methadone. As Professor Neil McKeganey, a leading expert in drugs misuse, said: “The idea of starting someone under 18 on a methadone prescription with an implicit expectation that they may be on that drug for the next 10 or more years is appalling. We need services to think beyond the chemical”.[6]
ONLY ONE REHAB FOR CHILDREN IN THE UK
The desperate fact though, is that there is still only one small dedicated residential rehabilitation centre [Middlegate Lodge] with statutory funding for no more than 12 children/teenagers at a time in the country.
Last year, Mike Trace, Chief Executive of the Rehabilitation of Addicted Prisoners trust, spoke of the urgent need for residential treatment for young, under 18, addicts.[7] Young addicts, he said, were unlikely to get better within the environment they had grown up and that had fed their problems.
How much of the National Treatment Agency’s dedicated funding of £25 million is spent on this?
How many teenagers are emerging drug free from their encounters with services?
It is simply not enough for the NTA to tell us that the proportion of young people who “complete an intervention according to the goals set out in their care plans’ is 57%. Unless we know what the goals of their care plans are in the first place and what the aspirations are for the young people in question, it is a meaningless statement. As we already know from adult services, “completing treatment” can be a measure of virtually nothing.

Source: Addiction Today Jan.2009

Hospitals and prisons will be supplied with syringes, swabs, citric acid and even spoons. The Government says the aim is to cut the numbers of addicts getting hepatitis C through sharing needles. But drug expert Professor Neil McKeganey said they should concentrate on getting addicts OFF drugs, rather than help to feed their habits.
Prof McKeganey, of Glasgow University’s Centre for Drug Misuse, said: “I think that the Scottish Government are labouring under the mis-apprehension that if they provide drug users with the means of using illegal drugs that they will effectively reduce some of the harm. “Yet we have in Scotland record levels of drug related death, record levels of hepatitis C infections these are indications of failure to prevent harm. I think that such a sum of money would be much more usefully spent on funding abstinence based programmes.”
He added: “Our government is so wedded to the principle of harm reduction that they are giving inadequate resources to those places which are about abstinence That is what we have been doing of the last 15 years and failing.
“If we continue doing that then we will continue to fail.”
The Scottish Government is inviting bids from firms to supply the gear.
A spokesman said: “Scotland is in the middle of a hepatitis C epidemic and it would be irresponsible to ignore that. To tackle this effectively we must reduce, as much as possible, the frequency of intravenous drug users sharing injecting equipment.”

Source: The Scottish Sun Tues.19th Jan 2010

Filed under: Drug Specifics :


Mephedrone — a stimulant that is currently legal in both the U.K. and the U.S. — has gained recent and surprising popularity among club-goers in the U.K., according to Britain’s National Addiction Center.
The BBC reported Jan. 14 that the drug, also known as meph, 4-MMC, MCAT, Drone, Meow or Bubbles, was the fourth-most popular drug cited by readers of Mixmag, a popular British dance magazine.
“It’s come from nowhere to become very popular,” said researcher Adam Winstock. “For a drug that’s been around for a relatively short amount of time, mephedrone has certainly made a big impact on the dance drug scene.”
Users describe the drug’s high as falling somewhere between that of ecstasy and cocaine. The drug is sold legally in the U.K. as a plant food; it is a powder that can be taken in pill form, snorted, mixed with liquid or even injected.
Side effects include headaches, heart palpitations, and nausea.
Source: BBC 14th Jan 2010

Filed under: Drug Specifics :

 Jul 10, 2008

A Review of What Works

Introduction
Alcoholism affects millions of people in the United States alone. According to the National Institute of Alcohol Abuse (NIAA), a division of the National Institutes of Health in Bethesda, Maryland USA, at least 700,000 Americans receive treatment for this disease every day. Some kinds of treatment, such as Alcoholics Anonymous (AA) have been around for many years while others are relatively new. Clinical research to determine the effectiveness of these various treatments has resulted in some important findings.
In October 2000 the NIAA released a summary of its conclusions based on fifteen years of research on alcohol treatments. According to the NIAA, self-help programs such as AA, psychotherapy and pharmacotherapy, either alone or in combination, are in fact effective and do reduce the use of alcohol.
Alcoholics Anonymous
Of all the treatments for alcohol misuse, Alcoholics Anonymous (AA) is probably the most well known. In AA, a form of “self-help” treatment, participants take part in a series of mental, written and verbal activities that can lead to recovery and abstinence. In one study, alcoholic patients who received inpatient and outpatient psychotherapy, as well as AA, had better outcomes than those patients who attended only one kind of treatment.
It is thought that AA helps people because it provides a new social network that replaces the alcohol abuser’s usual group of friends who drink with him or her, and provides a fellowship that inspires motivation and lends support toward the goal of reaching and maintaining abstinence. AA also teaches a set of coping skills so that, when stressed, the alcohol abuser has more constructive ways of coping, and does not need to turn to alcohol to escape his or her problems.
Another study, conducted at a Department of Veteran Affairs hospital, indicated that those alcoholic patients who underwent either cognitive-behavioral therapy (CBT) or a 12-step program in combination with CBT did better, over the long run, than those who participated in the 12-step program alone. (CBT entails learning coping skills, new ways of interpreting and reacting to stressful situations, and changing one’s destructive or maladaptive behavior patterns.) The patients who received the combination treatment stayed sober longer and were able to hold down a job for longer periods than those patients who received only CBT.
Both of these studies seem to show that a combination of some kind of psychotherapy and a 12-step program such as AA produces the most beneficial results for patients who use alcohol in excess.
Other beneficial treatments
Other promising treatments of alcohol abuse that are being studied include Motivational Enhancement Therapy (MET); couples therapy; Brief Intervention Therapy; dual-addiction treatment; and pharmacotherapy.
Motivational Enhancement Therapy: The key component of MET is an interviewing technique conducted by a trained psycho-therapist. The goal of this method is to increase an individual’s degree of motivation to stop drinking and to maintain abstinence. This is accomplished by the therapist gauging the individual’s readiness to change and then adjusting feedback accordingly. An intensive, individualized interviewing strategy, MET was demonstrated to overcome many patients’ disinclination to address their alcohol problem in treatment and increase their willingness to change.
Couples Therapy: Patients who include their non-alcohol abusing partners in their psychotherapy are more apt to attend therapy, and more likely to alter their unhealthy drinking habits. In one model of couples therapy known as Behavioral-Marital Therapy (BMT), communication and conflict-resolution skills are taught. When a relapse-prevention plan was added to this model, alcohol abstinence rates were even higher.
Brief Intervention Therapy: This treatment method usually takes place when alcohol users visit their primary care physicians. It typically entails the imparting of information about the negative consequences of drinking to excess, as well as supportive programs in the community. Two studies, carried out in the United States and Canada, showed that patients did reduce their alcohol consumption as a result of these interventions. This treatment seems to work best with those individuals who are at-risk for alcohol abuse. Those who are already dependent are better off being referred to specialized treatment programs.
Dual-addiction treatment: This method attempts to target both cigarette (nicotine) and alcohol dependencies at once. The use of one of these substances seems to make an individual more susceptible to dependence on the other. The rationale behind dual-addiction treatment is that reducing dependence on one may help a person reduce his or her reliance on the other. Although this is a newer approach to treatment, a recent study seems to suggest that this is indeed the case.
Pharmacotherapy: Finally, if taken on a regular basis, the drug naltrexone, approved by the U.S. Food and Drug Administration in 1995, can be a valuable aid in preventing relapse among recovering alcoholics receiving psychotherapy. Another medication, acamprosate, proved helpful in several European trials. (Editor’s note: It is now undergoing clinical trials in the United States.) Zofran, a medication usually used to prevent nausea during chemotherapy for cancer, was beneficial in the treatment of early-onset (i.e. those who started drinking heavily before age 25) alcoholism. Sertraline (Zoloft), an anti-depressant, was found to be helpful in reducing drinking in those with late-onset alcoholism.
Summary
Using proven methods of evaluating medical therapies, recent research reveals that many effective treatments exist to help people to stop drinking and maintain abstinence. These treatments include self-help groups such as AA, psychosocial approaches and medications.
Continued research in the field of alcoholism is likely to produce highly specific medications that will reduce the craving for alcohol. It will also yield an even broader range of therapies, including those mentioned here, that will improve the alcohol abusing person’s chance for recovery.
Over time, those who suffer from alcohol abuse and/or dependence will have even more and possibly better options for successful treatment. In the meantime, effective treatments already being offered by mental health professionals and community groups have been demonstrated to reduce alcohol use and promise a better life for people who make use of them.

Filed under: Drug Specifics :

In May 2008 the current Home Secretary Jacqui Smith announced that she would reverse the 2004 decision and put cannabis back into category B.
The move went against the ACMD’s latest recommendations, but was, she said, necessary because of research linking heavy use of the drug with schizophrenia and other mental illnesses.

Ms Smith said she was particularly concerned over the rise in consumption of super-strength strains of cannabis, such as “skunk”.
The Home Office say such strains account for 80% of all cannabis seizures in the UK.

Read the article
http://news.bbc.co.uk/go/pr/fr/-/2/hi/uk_news/7845023.stm

*** THE NEW APPROACH

Class A: Ecstasy, LSD, heroin, cocaine, crack, magic mushrooms,
amphetamines (if prepared for injection).
Possession: Up to seven years in prison or an unlimited fine or both.
Dealing: Up to life in prison or an unlimited fine or both.

Class B: Cannabis, amphetamines, Methylphenidate (Ritalin), Pholcodine.
Possession: Up to five years in prison or an unlimited fine or both.
Dealing: Up to 14 years in prison or an unlimited fine or both.

Class C: Tranquilisers, some painkillers, Gamma hydroxybutyrate (GHB),
Ketamine.
Possession: Up to two years in prison or an unlimited fine or both.
Dealing: Up to 14 years in prison or an unlimited fine or both

Source: ECAD Newsletter 25th Jan. 2009

Filed under: Drug Specifics :
The annual United Nations World Drug Report published yesterday confirmed my analysis of the available data which shows the UK to have the worst drugs problem in Europe. Yet a month ago when the The Phoney War on Drugs was published by the CPS Jacqui Smith and the Home Office went into denial mode.
While repeating Labour’s worn out justification that “overall drug use is lower than when Labour took office”, and that this is “a clear sign that our strategy is working” – exactly the myth that my paper debunked – she resolutely turned her back on the facts of rising drug deaths, rising ‘problem’ drug use (now put by the UN at 400,000, some 70,000 higher than 2006 measures) rising prescribed methadone dependency and the doubling of cocaine consumption.
Even before the latest UN report figures were released new data in the last month on drugs related damage and a new analyses of seizure data confirmed my thesis. The Independent on Sunday revealed a 67% increase in the number of babies born suffering from drug withdrawal symptoms in the past 10 years even though these statistics (of opiate addicted babies) exclude those newborns with problems due to their mother’s exposure to cocaine, amphetamines and cannabis.
Yesterday’s UN Report repeated my comparative data analysis which showed that the UK is the largest market for cocaine and that consumption has more than doubled in recent years and is higher than anywhere else in Europe.
Martin Blakebrough, the CEO of the drug charity Kaleidoscope said in response that, “The numbers exploded probably around five years ago and they’ve continued to rise because it’s become more mainstream .. it has a kudos or glamour not associated with other substances”. Meanwhile drugs counsellors confirm that teenagers are moving from cannabis to cocaine as young as 14 and that use by children as young as 11 is rising. It is something that the government’s preferred treatment intervention, methadone prescribing, can do nothing about.
SOCA’s claim that this consumption rise is despite cocaine prices reaching record levels due to their interdiction must however be treated with extreme scepticism. These are not street prices and reflect currency exchange rate changes as I pointed out a few weeks ago.
The truth is that the explosion in cocaine use mirrors a period in which UK cocaine quantity seizures have dropped, as have prices, while the market has expanded. The hard evidence I detailed in my paper points to failing enforcement competence and commitment on the part of the government and SOCA. Furthermore publication this month of an analysis of Scottish heroin seizures by Professor Neil McKeagney confirmed that these are at record lows.
So, surely now the Government and its various drugs satellites and quangos must face the truth of the uniquely appalling social problem we face in Britain and the extent to which their misguided policy has contributed to it. They must finally give up trying to justify themselves by one selective measure of drugs use prevalence picked from the British Crime Survey and the English Schools survey and accept the fact that this does not even begin to measure the extent of drugs related harm. Even less does it measure policy efficacy.
Nowhere is this claim less credible than in their resort to these ‘official’ measures of declining cannabis use to ‘prove’ that adolescent drug use and addiction are under control. Neither of these surveys reach the part of the population that drugs reach most. Fewer schools sampled each year chose to cooperate. The number of truanting, absentee and excluded children continues to rise. The Government apparently remains convinced that if schoolchildren’s cannabis use is dropping that this is sufficient unto the day. The ‘if’ remains quite big.
The reality on the streets however is one of a youth alcohol and drugs crisis that Ray Lewis illustrated powerfully in response to my paper. The number in need of drugs treatment continues to rise (alongside hospital admissions); demand outpaces provision while the ‘treatment’ on offer is totally inadequate.
One thin and poorly nourished boy I met last week told me that on his estate he knew no one, neither adolescent nor adult, who did not use drugs. And just a few weeks ago when I asked a health visitor working in inner London how many of the 400 families on her books had a drug problem, she countered defensively, “don’t ask, it is a fact of life, we have to accept it.” That is the trouble. This is the official attitude to drug use and everything that goes with it is: ‘There is nothing you can do’.
But it is the Government’s performance-driven, methadone ‘treatment’ drugs policy that is maintaining these lifestyles rather than changing them. All the kids do, one adolescent addiction counsellor told me, is use ‘community treatment’ on offer as part of this lifestyle. They are offered nothing to make them change or to enable such a change. Treatment ‘in the community’ leaves them with the same older adults still in their lives and subject to the same environment. They may go through several methadone ‘detoxes’ with the aim of ‘bringing down’ their illicit drug use, but this is often even without a plan to reduce the methadone use. There is no other ambition. “You can get up to 40mls of methadone a day if you are under 16”, one girl confidently told me. “All it does”, she said, “is to keep everything going – to maintain everything else”.
She was one of the handful of lucky ones. Two three month sessions at Middlegate, the only dedicated residential adolescent addiction centre in the country, had changed her life. A heroin addict at 14, moved from one inadequate foster home to another, finding herself on the street and in dealers flats, missing out on years of her education, she had, thanks to one enlightened and persistent social worker who forced the local authority to stump up the cash, been sent to Middlegate. This summer she has been sitting four academic AS levels.
The staff at Middlegate despair at the years of wasted public money pumped into ‘community treatment’ when they know what they can achieve with the most desperate of cases. What the kids need, they say, is rescuing and lifting out of their environments – not a sequence of social workers and drug workers operating with their government defined agendas to ‘rebuild families’ at whatever the cost yet incapable of providing the long term commitment required.
Yet the National Treatment Agency, wedded to this ‘treatment in the community’ agenda for all adolescents, refuses to ring fence any funds for Middlegate to ensure this life changing programme can continue, let alone be replicated anywhere else.
Responding to The Phoney War on Drugs one highly respected addiction psychiatrist commented that I had not emphasised sufficiently “the huge waste of resource brought about by the NTA’s enthusiasm to allow managerialism to take over the field.” He is right. The NTA’s approach to treatment is now so entrenched in a complex, resource hungry but inflexible bureaucracy that it is standing in the way of the revolution in rehabilitation that is required. Nothing less than a major diversion of resources in the direction of rehabilitation and away from people processing plus a clearly conditional and contractual approach to drug treatment will work.
The government would do well now, before inflicting more damage on our society, to face the facts and acknowledge that their approach to ‘treatment’ and their drugs policy has failed abysmally.
Source: http://www.cps.org.uk 25.06.2009

 

Filed under: Drug Specifics :

UK Advocates threatens legal action against health authorities providing drug-based treatments over rehabilitation. Alcohol dependency affects 1.1 million people
NHS authorities that offer alcoholics controlled drinking treatments relying on medication rather than total abstinence could face legal action from a patients’ organisation. UK Advocates, a pressure group campaigning for the wider availability of rehabilitation courses for addicts, is preparing to file claims against the Department of Health and local health services.
The charity maintains it has found evidence of thousands of patients with severe alcohol problems being given “psycho-active drugs” while they are still drinking. The combination, it is alleged, can be “potentially lethal” and is at odds with the manufacturer’s prescription advice and guidelines. “In many cases,” UK Advocates claims, “drugs and controlled drinking programmes are administered to sufferers without the doctor or clinicians involved having performed effective liver function tests to establish the extent of liver damage from excessive drinking.
“Treating alcoholics with drugs and on a basis of ‘moderation’ is similar to advising someone with lung cancer to cut down their smoking,” says Bob Beckett, founder of UK Advocates. “Controlled drinking programmes … hark back to the 1960s and 70s when we believed pharmaceuticals would cure everything, including addiction to alcohol. They simply have not worked.
“There are nearly one million people with alcohol problems taking up NHS beds. If we are serious about dealing with alcohol addiction then we have to look at cessation programmes, not drug-based detox, not hypnotherapy, but properly defined, intensive abstinence treatment.”
UK Advocates says its insistence on abstinence programmes follows guidelines adopted by the World Health Organisation (WHO). The organisation is now assessing whether programmes offered by primary care trusts (PCTs) meet “these statutory requirements as adopted by the European Union in accordance with WHO recommendations”. It says it will take “legal action against those it believes have been negligent by failing to offer day and residential abstinence treatments where clearly required”.
In May, the all-party parliamentary group on alcohol criticised “a general lack of capacity and variety in alcohol treatment services, due to poor levels of funding and, in some cases, a harm reduction agenda driven largely by crime and disorder rather than health considerations”. The committee found that although as many as 1.1 million people are classified as alcohol dependent nationally, only 1 in 18 enter any sort of specialist treatment each year. Spending on drug addiction outweighs that on alcohol dependency. UK Advocates says that it will issue proceedings in the administrative division of the high court “against PCTs and clinicians who may be proven to have acted negligently”.
Tom Gard, a spokesman for the group, said: “We have heard of someone who has been drinking two bottles of wine a day and has [only] been told to cut down to one and a half.” The charity claims that an audit of PCTs across the East Midlands and Yorkshire has revealed a picture, reflected nationwide, of many trusts offering no residential or intensive day abstinence treatment at all.
“In many areas those suffering from alcohol dependence are instead offered only ‘controlled drinking’ programmes, often without appropriate prior tests to establish whether or not the person needs to stop drinking completely to avoid developing serious physical and mental health problems.”
A Department of Health spokesperson said: “We have a comprehensive strategy to tackle health-related alcohol harm. The number of structured alcohol treatment places is increasing. Around 104,000 people were recorded as receiving treatment in 2007-08, against an estimated number of 63,000 in 2004.
“We have launched the alcohol improvement programme which assists PCTs in understanding local need and planning commissioning decisions. Most specialist alcohol services aim to help people reduce the harm associated with drinking. For those with moderate and severe dependence, this will usually involve advice and support to become abstinent, whether in the community or in-patient settings.
“Where a clinician considers medication would be the most appropriate treatment it is normal practice to discuss the effects and potential side-effects of the medication with the patient.”
Source: guardian.co.uk, Monday 3 August 2009

Professor Susan GreenfieldIt is folly to legalise a drug that is known to leave users with permanent damage to their ability to reason, argues Susan Greenfield, the distinguished expert on brain processes (Sunday August 18 2002, The Observer) now that those anxious to look cool can puff cannabis freely in without fear of arrest, perhaps those of us who have argued that relaxing the laws on cannabis is Irresponsible and dangerous should retreat gracefully behind our chintz curtains. Yet the downgrading of
the classification of cannabis perpetuates the same tired old myths and the same serious problems.

Take the myth that cannabis is ‘just the same as’ alcohol. A glib yet logical riposte might be that if the drugs are truly identical why not just stick with the booze? What is the distinct appeal of cannabis that can be ignored in equating the two drugs? Such sophistry is inappropriate because alcohol and cannabis work on the brain and body in very different ways. Alcohol has a range of non-specific actions that affect the tiny electrical signals between one brain cell and another; cannabis has its own specialised chemical targets, so far less has a more potent effect.

Moreover, although drinking in excess can lead to terrible consequences, there are guidelines for the amount of alcohol that constitutes a ‘safe’ intake. Such a calculation is possible because we know alcohol is eliminated relatively quickly from the body.

With cannabis, it is a different story. The drug will accumulate in your body for days, if not weeks, so, as you roll your next spliff, you never know how much is already working away inside you. I challenge any advocate of cannabis to state what a ‘safe’ dose is. Until they do, surely it is irresponsible to send out positive signals, however muted? Another notion is that cannabis is less harmful than cigarettes. I’m not sure how this idea came about, certainly not as the results of any scientific papers.

We do know cannabis smoke contains the same constituents as that of tobacco: however, it is now thought that three to four cannabis cigarettes a day are equivalent to 20 or more tobacco cigarettes, regarding damage to the lining of the bronchus, while the concentration of carcinogens
in cannabis smoke is actually higher than in cigarettes. And if cannabis were ‘just the same’ as alcohol and cigarettes, why are people not taking those already legal drugs for the much-lauded
pain-relief effects? After all, another case for the relaxation of the laws on cannabis is the ‘medical’ one that it is an effective analgesic. But there is a world of difference between medication prescribed in a hospital, where the cost-benefit balance tips in favour of pain relief, compared to a healthy person endangering their brain and body needlessly. Even the most loony of liberals has not suggested tolerance for morphine or heroin abuse, because they are prescribed clinically as potent painkillers.

And think about it: if cannabis brings effective relief from pain, then how does it do so? Clearly by a large-scale action on the central nervous system. Further wishful thinking is that, because cannabis doesn’t actually kill you, it is OK to send out less negative legal signals, even though the Home Secretary admits that the drug is dangerous. Leaving aside the issue that cannabis could indeed be lethal, in that
the impaired driving it can trigger could well kill, there is more to life than death. It is widely accepted that there is a link between cannabis and schizophrenia: as many as 50 per cent of young people
attending psychiatric clinics may be regular or occasional cannabis users. The drug can also precipitate psychotic attacks, even in those with no previous psychiatric history. Moreover, there appears to be a
severe impairment in attention span and cognitive performance in regular cannabis users, even after the habit has been relinquished.
All these observations testify to a strong, long-lasting action on the brain. Some attempts have been made in laboratories to work out what cannabis could actually be doing to brain cells. So far, some data have suggested that there can be damage to neurons, and at doses comparable to those taken on the street.

None the less, others argue that the experimental scenario of isolated neurons growing in a lab dish are hardly a natural situation, and that such data have to be interpreted with caution. But absence of evidence is not evidence of absence. The effects on the brain in real life are most probably subtle and therefore hard to monitor: it’s not so much that cannabis will create great holes in your brain, or deplete you wholesale of all your best neurons. Instead, by acting on its own special little chemical targets (and because it will therefore work as an impostor to a naturally occurring transmitter), the drug is likely to modify the configuration of the networks of brain cell connections. These configurations of connections make you the unique person you are, since they usually reflect your particular experiences. So a change
will be hard to register from one person to another, and certainly from one slice of rat brain to another: but still, it will make you see the world in a different way – characteristically one depleted of
motivation.

It is hard for me, as a neuroscientist, to accept that a drug that has the biochemical actions that it does, that hangs around in the brain and body, and that has dramatic effects on brain function and dysfunction, could not be leaving its mark, literally, on how our neurons are wired up and work together. It is argued that we will never stamp out cannabis use, and therefore we should
give up trying. But we will not stamp out murder or house break-ins or mugging, yet I’ve never heard an argument for freeing up police time by liberalising the law on these acts. Laws, it is said, are
only enforceable when the majority wants them enforced, yet the arguments used for easing up on cannabis apply equally to promoting ecstasy or other mind-bending substances.
Do we really want a drug-culture lifestyle in the UK? Cynically, one could argue that it is politically expedient to court the youth vote, to open up the inevitable prospect of revenue from a new source of taxes and to help the ailing tobacco industry prosper from a great new product of readymade packets of spliffs. The condoning of chemical consolation also distracts from other problems. We have failed our young people in providing homes and jobs and, by giving them an easy route into a chilled-out oblivion, have turned our backs on the far more challenging prospect of initiating policies to help them realise their potential and live better and more fulfilling lives. They are paying a high price for cool.

Source: www.guardian.co.uk/science Aug.2002

 

Despite this government spending £10billion – £1.5billion a year – on its drugs policy, the numbers emerging from government treatment programmes are the same as if there had been no treatment at all, revealed Kathy Gyngell in a recent document from the apolitical Centre for Policy Studies. We share its seminal factsThis summer saw the release of The Phoney War on Drugs by researcher Kathy Gyngell, chair of the Centre for Policy Studies’ Prisons and Addictions forum and editor of the 400-page Addictions section of Breakthrough Britain. It is a devastating critique of the failure of the UK’s drugs policy, the waste of valuable resources and lives.

Many experts implementing good practice will have witnessed the reality of the conclusions Gyngell arrives at, but perhaps not known the exact statistics. Truth gives power. Not only might counterproductive policies and practices be reduced, but Gyngell offers some tried-and-tested solutions. The UK is compared with Sweden and the Netherlands throughout The Phoney War. Both countries were chosen because they have adopted drug policies which are markedly different to
those of the UK and their drug use is lower. It is noteworthy that, despite the perception that the Netherlands has a liberal drugs policy, 76% of Dutch municipalities now operate local zero tolerance drug policies. Coffee shops are now increasingly tightly regulated and policed. A third have been closed in recent years. Sweden and the Netherlands also have more effective prevention strategies.

BLIGHTING THE NEXT GENERATION.

“Trae-blue Lane had just turned three when she died from an overdose of methadone, the heroin substitute supplied to her mother,” reported the Sunday Telegraph in January 2009. A Channel 4 Freedom of Information request found that between 2005-2006 police caught over 6,000 children selling drugs from class-A substances to cannabis, and caught a further 53,497 children in possession of drugs.

The deaths of infants are small windows on the UK’s worsening and chaotic drugs culture which Labour’s drug policy has, inadvertently, promoted. Consider these trends:

Filed under: Drug Specifics :

By Joey Thompson, The Province

If you’re ticked at the fact Vancouver’s supervised injection site has done little to convince addicts to kick the habit you won’t like what I have to say about the city’s so-called drug treatment court.

The program on West Pender Street in downtown Vancouver is almost halfway through a four-year, $3.6-million drive to help junkies get clean so they aren’t compelled to nick grandma’s jewelry or your sound system, and yet home and business break-ins as well as auto-theft rates are as high, if not higher, around here than they’ve ever been.

That could explain why no one from government has been trumpeting the project’s successes despite the offer to addicts of free counselling, out-patient therapy, training and education, courtesy of taxpayers and a parade of well-meaning defence lawyers, prosecutors, probation officers, court liaison workers and addiction counsellors.

So why don’t do-good programs work here?

The recovering addicts who replied to last week’s column know only too well. Barry Joneson, a member of the drug court’s community consultation board, says his life as a Burnaby businessman is a far cry from his earlier world on the dank, greasy concrete behind a dumpster in the Downtown Eastside. It was the will to change, not access to handouts, that turned him around.

And that’s the problem. There’s no incentive for junkies to straighten out. The few who are arrested on our streets rarely see the inside of a cell. As Cordova Street dweller John Parsons put it, “judges don’t lock up here.”

Indeed, why get clean when life is cushy and you have liberal use of free medical and social services as well as drugs?

Addicts here have it too good, these two say, unlike the dire straits many in the U.S. find themselves in. They face serious time there if convicted. With fewer options, U.S. drug users are apt to take an offer of help more seriously.

“But in Canada, down and out means you see a doctor and go on disability [hep C, HIV, bad back, sore toe, etc.] and then get on the methadone maintenance program,” Joneson said. “It’s a junkie’s dream come true; someone pays your way in life and gives you drugs as well.

“It has nothing to do with compassion and everything to do with the birth of an industry that caters to addicts through the various services available to them. There are billions upon billions of dollars to be made and that’s why it is such a powerful pro drug/less consequence lobby.”

But Joneson warns we are enabling addicts to live a life that is arguably worse than death.

” I know. I lived that life for over 20 years,” he told me. “And I’m sure glad there were no government shooting galleries or free heroin when I was using, as I probably would not have hit the bottom that was necessary for me to instil the desire to seek recovery.”

Source: The Vancouver Province (British Columbia) E-mail: jthompson@png.canwest.com September 24, 2004 Friday

By Peter Stoker for HNN News

For some time now the organisations and individuals advocating preventive drug strategies have been watching in horror as the UK Government appeared to be selling prevention down the river, by downgrading cannabis to a lower category of perceived harmfulness. Currently Class B, its new classification of Class C would rate it lower than speed and codeine. But more than this, it would have given exactly the opposite effect to that sought in the UK strategy, which aimed (and still aims) to reduce use of all drugs of abuse.
But then, little obstacles like a national strategy – or UN Conventions – are of scant importance to the pro-drug lobbies, who are used to getting a good hearing in the UK corridors of power, thanks to their large resources and sympathetic contacts.
As reported elsewhere in HNN News, UK Home Secretary David Blunkett had been subjected to a barrage of pro-cannabis rhetoric over the months before the 2001 General Election which gave him a chance to replace Jack Straw as Home Secretary. The ink on his letter of appointment had scarcely dried before he uttered the fateful words, that he ‘was minded’ to reclassify cannabis; the location he chose was the opening session of the Home Affairs Select Committee (HASC), newly populated in consequence of the general election.  HASC had expressed its intention of reviewing UK’s whole drug strategy, including – of course – what to do about the most-used illegal drug which is cannabis. Mr Blunkett’s remarks inevitably added blinkers to this significant segment of their vision.

Buttressing his position, Mr Blunkett said he would take advice from a specialist committee. That committee was the Advisory Council on the Misuse of Drugs (ACMD). Seasoned observers could scarcely conceal their scepticism at this; the ACMD has very few scientists in its 35-strong line up, but does have a large contingent of people associated with liberalising lobbies. It has consistently leaned towards a more relaxed drug strategy, and had recommended downgrading cannabis as long ago as 1979. It was therefore no surprise when in March 2002 ACMD duly announced itself persuaded by the Home Secretary’s thinking. (Nevertheless, their report made a number of important concessions about the harmfulness of cannabis, and to this extent it is required reading).

HASC were not to be upstaged; in May 2002 they revealed their worst-kept secret; that they too had agreed with the Home Secretary’s notion. It must have seemed to the members of the inaccurately-titled Police Foundation (a small, self-elected liberalising lobby, not associated with any police authority) that the legalisation snowball they started rolling back under the chairmanship of Lady Runciman in 1999 was at last within sight of its destination. Cheering the snowball on would also have been Rosie Boycott, who as the then Editor of the Sunday Independent, in 1994, launched the first major UK media campaign for legalisation of cannabis.

This then is the environment in which prevention associations struggle to make themselves heard – no easy matter when you are short of breath through being denied the oxygen of funding.

In the summer of 2002, in the aftermath of HASC’s final report, prevention lobbies contemplated what to do next. It was clear that several aspects of the harms from cannabis had been lightly dismissed – or not even considered. The so-called ‘Lambeth experiment’ in which a senior police officer, Commander Brian Paddick, had recently jumped the gun by instructing his officers in the London Borough of Lambeth not to arrest for cannabis possession, overnight making him the darling of all apologists for cannabis. The combined efforts of Home Office, HASC and ACMD generated the image of a large, well-oiled steamroller, being given a helpful shove by liberalising lobbies like DrugScope and the Police Foundation. Flattened, figuratively and literally by this steamroller, the resistance took a while to pick itself up, dust itself off, and start all over again. But start again they did.

Internal seminars led to the first major public meeting, held in the Moses Room at the House of Lords, in November 2002, under the sponsorship of the Noble Lords Alton, Mackenzie, and Hylton; the Bishop of Wakefield, and MPs Alistair Burt and Gerald Howarth. The meeting was open to all MPs and Lords, and they would have struggled to get into a room packed to capacity.

Twenty one speakers included leading professors specialising in the subject, teachers, medical practitioners, police officers, prevention specialists and representatives from Holland and Sweden all presented. Ex users and parents gave testimony on how cannabis has damaged them or others around the users. Social, emotional and spiritual damage, as well as medical damage, came in for highlighting. Young people testified to the poor quality of drug education and the negative influences they experience in a drug-oriented society.

This initiative generated many useful waves; meetings and representations with parliament, the civil service, the media and within the drugs profession followed. From ‘friends in high places’ it was learnt that there was a far from united attitude to the reclassification idea – another encouragement to go that extra mile …

That ‘extra mile’ came in the form of another public meeting, on 21st October, this time in the plush new parliamentary offices of Portcullis House, across the road from Big Ben.

The proceedings were opened by a cross-party group of sponsors, Lady Ann Winterton (Conservative), Kate Hoey (Labour) and Bob Russell (Liberal Democrats) – an important display of non-partisan unity. All three spoke with evident knowledge on the subject, no mere figureheads. Ann Winterton had been a ‘front bench’ spokesperson on drugs, Kate Hoey represents Lambeth, so often a centre for drug policy confrontations – including the infamous Paddick ‘experiment’, and Bob Russell is a member of HASC, and one of the few dissenting with its more extreme liberalising recommendations.

The first speaker was Professor Robin Murray from the Institute of Psychiatry. Leaving no doubt as to his focus, Professor Murray entitled his talk ‘Marijuana and Madness’. Recent research has confirmed suspicions long held in the field, that cannabis can cause psychoses. The correlation of psychosis with cannabis users is at least twice that for non-users. Whilst correlations are not of themselves proof of causality, there are now studies to show causality; in the case of a study of 4,000 people in Holland, heavy users of cannabis were seen to be seven times more likely to suffer psychosis. Similar studies in New Zealand and Sweden supported this finding. Professor Murray ended by considering why this should be so; psychotic symptoms such as schizophrenia are mediated by dopamine, and recent evidence demonstrates that THC increases the release of dopamine within the brain, increasing the level of cerebral dopamine.

Next up was Professor John Henry of Imperial College, London and a professor of Accident and Emergency Medicine at the prestigious St Mary’s Hospital in Paddington, London, which has long specialised in treatment of drug users. With a career in this specialism spanning decades, and including a long period as one of the leaders of the National Poisons Unit, John was able to enunciate from firsthand observation the real damage cannabis causes, from both short term and long term use. He concluded with a comparison between cannabis and tobacco. Quoting the highly-regarded New England Journal of Medicine, he said ‘Prevention and cessation are the two principal strategies in the battle against tobacco. However there is no such battle against cannabis. The lesson should be learnt from tobacco, and we should be prepared to do likewise with cannabis’.

Hamish Turner is a Past President of the Coroner’s Society of England and Wales. The title of his paper – ‘The view from the mortuary slab’ gives a fair indication of his topic. He was unequivocal on the progression or ‘gateway’ syndrome whereby a significant proportion of those who use cannabis move on to other drugs. Jan Berry, Chairman of the Police Federation of England and Wales described the frustrations of police officers at street level in wrestling with the aftermath of the Home Secretary’s flirtation with cannabis liberalism, and the Reverend Chris Andre-Watson, based in Lambeth, was able to give a particularly vivid picture of how this had affected his area – and how Commander Paddick’s autonomous initiative had made things even worse. Chris also made the point that – contrary to stereotypes – it was the black community who were more opposed to cannabis law relaxation then anyone else.

Mary Brett, a qualified biologist and Head of Health Education at one of England’s top secondary schools, spoke on the mess that is drug education in the UK. Too often in the hands of doctrinaire zealots, the education rarely seeks to dissuade pupils from drug use, but instead pre-supposes that they will use and tells them ways to do so – in the forlorn hope that they will be persuaded to do something irresponsible in a responsible manner. Some purveyors of ‘soft porn’ drug education material have been exposed, but they are still operating. Peter Stoker, Director of the National Drug Prevention Alliance, described Britain’s drug education process as ‘…not just neutral, but neutered’. The proponents of drug lifestyles, having emasculated drug education, have moved on to prevention, asserting without evidence that it is ineffective, using a process which he described as ‘a lie told ten times becomes the truth’. (It has subsequently been found that Goebbels said something rather similar). Peter closed by referring to the powerful outcome of the Rome conference last month, convened by the Global Drug Prevention Network, and uniting 84 countries in taking a preventive approach to drug policy.

Three young people from the NDPA’s ‘Teenex’ programme – Darren West, Beth Fairweather and Anthony Hassan – then made emphatic statements. Angry at the assumption that ‘all youth are doing drugs’ they made it clear that the opposite is true, especially when discounting the number that have one or two tries before rejecting the practice. Blaming the government and other authorities for inducing more use by their limp approach, Beth, Darren and Anthony told how Teenex had made them confident enough to not only avoid drugs themselves but also help others to do the same. They found the knowledge and the lifeskills in this low-budget enterprise to promote health instead of leaving the arena to the drug promoters.

Two medical practitioners concluded the proceedings. Dr Ivan van Damme from Belgium described the evaluations of random drug testing in several schools in a number of countries; provided that testing is used as a means of helping rather than an excuse to expel unwanted pupils, it has been found to have tangible benefits. Dr Hans-Christian Raabe summed up the mood of the seminar, saying that the next action would be to engage once more with Mr Blunkett, giving him the large amount of evidence that fully justified him thinking again about reclassification.

Subsequent to the Portcullis seminar, appeals for a meeting with the Home Secretary have been vigorously prosecuted by the Coalition on Cannabis. The stakes were raised a few days ago when it was learnt that there would be a debate this week (Wednesday 29th October) on reclassification, suddenly inserted in between Prime Minister’s Questions and another debate, on the problems of Northern Ireland – if nothing else this juxtapositioning should increase the number attending this particular drugs debate from the usual near-invisible level on such occasions. The Coalition is working on several fronts this week, and if nothing else the disciples of dope will not find an empty goal facing them. “These are exciting times …”

Filed under: Drug Specifics :


The Times of London. Wednesday’s newspaper – January 07, 2004

By Steve Boggan

ONE of Britain’s foremost authorities on psychosis has said that cannabis use is now the leading problem facing the country’s mental health services — just three weeks before the Government downgrades the drug to Class C. Robin Murray, head of psychiatry at the Institute of Psychiatry, told The Times that inner-city psychiatric services were nearing a crisis point, with up to 80 per cent of all new psychotic cases reporting a history of cannabis use.
David Blunkett, the Home Secretary, announced in 2002 that he intended to re-classify the drug after a lengthy examination of drugs policy by the Commons Select Committee on Home Affairs. However, Professor Murray said that new evidence had since come to light proving that people who used cannabis in their teens were up to seven times more likely to develop psychosis, delusional episodes or manic depression.
“Unfortunately, there were no experts in psychosis on the committees that advised the Government,” he said. “That’s not a criticism; at the time, no one thought there should have been. Since then, there have been at least four studies that show the use of cannabis, particularly in young people, can significantly increase the likelihood of the onset of psychosis.
“There is a terrible drain on resources. The drug also drastically reduces recovery — people who improve go out on the street, meet their dealer, use the drug again and relapse.”
It will still be an offence, from January 29, to possess, cultivate or supply cannabis but the maximum sentence for possession will fall from five years to two.
The Home Office said it was aware of the new research but felt it was important to differentiate between cannabis and more serious drugs such as crack, heroin and Ecstasy.

Filed under: Drug Specifics :

Almost a year ago, in September 2003, the French-speaking Swiss Committee Against the Revision of the Narcotics Act distributed 8,000 copies of a booklet entitled Echec au lobby de la drogue (The drug lobby in check) and participated in the drafting of a German booklet entitled Stopp der Drogenlobby (Stop the drug lobby). Today, the lobby for the liberalisation of all drugs has been checkmated.

Highly toxic product

On 14 June, the National Council (Lower House of the Swiss Parliament) by 102 votes to 92 and with 2 abstentions, indeed reduced to smithereens the Dreifuss-Couchepin Bill which aimed not only to depenalise the consumption of and petty trafficking in cannabis, but also to tolerate the production and wholesale trading in this drug, to limit the obligation to prosecute the consumption of all other narcotics, to delete heroin from the list of prohibited substances and to make the prescription of this opiate a recognised therapy and thus refundable by health insurance, to make “survival assistance” a legal practice and thus to impose injection premises for the consumption of illicit narcotics on those cantons which do not want them, along with a considerable reinforcement of the driving role of the Confederation in the drug policy. At the first reading on 25 September 2003, the Lower House had already refused to examine the villainous Bill by 96 votes to 89.

Federal lies

“According to the Government, the revision suggested is compatible with the International Conventions on narcotics”, Christiane Imsand, a Parliamentary correspondent still insisted, in seven French-Swiss daily newspapers on 14 June. Pow! The Liberal National Counsellor, Claude Ruey, in the plenary, provided the proof that Mr. Couchepin had hidden the truth from the Swiss people. He read out a letter addressed to the Federal Council on 16 June 2003 by the Chairman of the custodian institution of the International Conventions: “If the bill were to be adopted in its current form, the situation in Switzerland would be such that the International Narcotics Control Board (INCB) would have no choice but to envisage taking measures against this country as provided for in article 14 of the Single Convention on Narcotic Drugs of 1961, which considers the adoption of retaliatory measures. Just for good measure, the Liberal National Counsellor quotes an interview by the educationalist Pierre Rey accusing Mrs. Dreifuss of also having lied when she stated that cannabis was no more dangerous than alcohol and cigarettes: “Mrs. Dreifuss is quite simply lying, because she knows perfectly well that other experts, just as respectable as hers, say the opposite. She should at least have the objectivity to recognise that she is quoting only one point of view”. That is precisely what occurred in the Health Commission on 1st April last.

When invited to comment on his own defeat in the NZZ am Sonntag, Dr. Thomas Zeltner, Director of the Federal Office of Public Health and holder of a prize from an American foundation seeking the legalisation of all drugs, explained that the wind began to turn last Autumn, when “certain circles started featuring new studies all of which stressed the danger of cannabis, thus causing quite a media stir and starting to make many Members of Parliament feel unsure of themselves”.

Rewarded efforts

The fact of the matter is that, as of last September, the French-speaking Swiss Committee against the revision of the Narcotics Act, in which the Centre Patronal (employers’ organization in Paudex/Lausanne) is deeply involved, stepped up its working sessions, publications, Press conferences, contacts with Members of Parliament and even with Mr. Couchepin, to present facts, facts, and still more facts in relation to the latest scientific and epidemiological developments concerning drugs and cannabis in particular. These efforts, combined with those of its German-speaking wing, helped turn the tide.

The historical decision of the National Council does not create any gap in the law. It opens the way to a more strict application of the laws in effect, to the cantonal and federal plans, and to measures aimed at supplementing them if necessary, in particular with respect to prevention and the care of drug addicts. (JPC)

Source:Jean-Philippe Chenaux, Centre Patronal, Paudex/Lausanne


Filed under: Drug Specifics :

As was to be expected, the New Libertine Party (aka the Conservatives) is now no longer supporting the re-reclassification of cannabis back up to a category B drug. The Times reports that the Tories volte-face takes the heat off the Home Secretary:

Pressure on Charles Clarke to change cannabis back to a Class B drug eased significantly yesterday when the Conservatives abandoned their campaign for reclassification. The Home Secretary was also urged by experts to stick with the new Class C status to avoid further confusion. David Cameron, the new Tory leader, made it clear yesterday that he would not put Mr Clarke under any pressure to reclassify the drug. At the general election, the Tories said they would reverse Labours decision on cannabis and change it back to class B.

David Davis, the Shadow Home Secretary, also called for reclassification during the Conservative leadership campaign, but he issued a statement yesterday welcoming Mr Clarkes decision to voice concern over the impact of the drug on mental health and looked forward to further debate. “We welcome the Home Secretary’s recognition that there is new evidence about the dangers of cannabis, particularly with regard to mental health”, Mr Davis said. “We look forward to the publication of the advisory councils report and appropriate action from the Government, in particular to protect young
people”.

My interpretation of this situation is different from that of the Times.

The Tories shift on drugs was written the day David Cameron was elected leader. As I have written before (see October 17 post) Cameron has shown that he has uncritically swallowed all the garbage produced by the legalisation lobby.

In a diary for the Guardian Unlimited website in 2001, he wrote:

“I am an instinctive libertarian who abhors state prohibitions and tends to be sceptical of most government action, whether targeted against drug use or anything else…Hounding hundreds of thousands – indeed millions – of young people with harsh criminal penalties is no longer practicable or desirable.”

It remains to be seen whether the Home Secretary actually has the bottle to go against the received wisdom in the drug culture-addled Home Office (not forgetting the same lunacy within the higher echelons of the police) and restore some belated sanity to the law on cannabis. Of course this would be embarrassing as is any U-turn. But there is also surely an opportunity here for some canny cross-positioning. With the ‘Cameroons’ now pitching for the über-left vote and with millions of socially responsible voters therefore left totally disenfranchised, the obvious ploy for Tony Blair would be to
pitch the message to those abandoned souls that only Labour stands for social responsibility against the anarchic irresponsibility of social libertinism. Cannabis re-reclassification would be an excellent place to start.

Clarke should sack the ACMD and reclassify cannabis  to class A, where this most dangerous drug properly belongs.

Source: By Melanie Phillips. January 06, 2006
Filed under: Drug Specifics :

European Union Group Urges Censorship of Pro-Cannabis Web Sites, Activists Plot Counter-attack

A European Union (EU) working group on drug policy has issued a draft resolution identifying marijuana as European drug problem number one and recommending, among other things, that governments move to censor or criminalize Internet sites that provide information on cannabis cultivation or promote its use. The European Coalition for Just and Effective Drug Policies (http://www.encod.org), an umbrella organization of drug reform groups that seeks to influence EU drug policy, was working this week to formulate a response.

Meeting on July 6, the EU’s Horizontal Drug Group approved the Draft Council Resolution on Cannabis. It will now be presented to the European Council for approval as the EU works toward completing its continental drug strategy. Noting its concern about the rising popularity of cannabis (marijuana), the high potency of some marijuana, possible ill health effects, and the role of organized crime in the cannabis trade, the drug group called for more international law enforcement cooperation against trafficking, “alternative development” for cannabis producing regions, demand reduction at home, no marijuana in prison, and more research.

But it was the drug group draft’s 21st paragraph that was the attention-getter. It encouraged “Member States in accordance with national legislation to consider taking measures against Internet sites providing information on cultivation and promoting the use of cannabis.”

“This is nothing less then a direct attack against many organizations, groups of people, and individuals, who are active on the Internet giving information on cannabis cultivation and use,” said Joep Oomen, ENCOD coordinator. “If member states really adopt these measures, they could even address them to all sites that have a cannabis leaf on it,” he said. “If Western authorities start to limit the freedom of expression of their own citizens — and we are talking about 25-40 million cannabis consumers in the EU — we can be sure that something is really going wrong.”

“It is also a silly measure,” he told DRCNet. “Local and national authorities are well aware that allowing consumers to cultivate cannabis is not leading to massive health problems. On the contrary, if you persecute them, conditions for obtaining cannabis become harder, and all kinds of problems start to arise which had disappeared with depenalization,” he argued. “Cultivation of cannabis for own one’s consumption is depenalized in several EU countries, such as the Netherlands, Belgium and Spain, and in practice in all the EU — no one will get into trouble for cultivating some plants. So allowing them to cultivate but forcing them and others to keep their mouth shut about it is a ridiculous policy.”

ENCOD, which includes more than 75 different European drug reform organizations in its membership, is plotting a response, said Oomen. “After the European Union drug summit in Dublin in May (http://stopthedrugwar.org/chronicle/338/dublin.shtml), we have a foot inside the door for the debate on the new EU drug strategy,” he said. “We were already preparing a proposal to organize a dialogue between civil society and policymakers on the new strategy, and we may use this issue as a good example to explain our main criticism to policymakers, namely that they are completely out of sync with reality. We will offer them our help to design and implement reality-based drug policies.”

Still, said Oomen, there may be less here than meets the eye. “It is a nonbinding resolution and is really meant as a symbolic measure, with which the national and supranational policymakers hope to strengthen the repressive trend in recent European drug policies,” he explained. “It comes just before the start of the discussion on a new EU Drug Strategy, and is meant to push this discussion in a certain direction.”

The resolution was the work of the governments of Sweden, probably Europe’s leading prohibitionist government, and Spain, but the conservative Spanish government of Prime Minister Felipe Aznar has since been replaced by the more reform-friendly Socialists. “It was presented in March by Sweden and Spain in an even more repressive form, but afterwards a lot of member states presented objections, but chose to agree on the final version as they did not want this discussion to be mixed up with the debate on the new EU Drug strategy that starts in September,” Oomen reported.

Support for the resolution is not strong, Oomen said. According to one government official who spoke to Oomen, “everybody, including the governments that presented it, prefers now to forget this resolution, and go on to the discussion on the EU Drug Strategy.” This official advised laying low, saying, “Don’t paint the devil on the wall — then it will appear in person.”

But ENCOD’s membership appears disinclined to simply watch and wait. “Perhaps everyone has forgotten about this already, but the main trend behind this resolution will not go away if we just sit and pray, so we definitely plan actions,” said Oomen. “First we want to see how far they allow us to go with the dialogue process, and if that is unsatisfactory, we have other ways to put pressure on them.”

Read the EU Horizontal Drug Group’s Draft Council Resolution on Cannabis online at: http://register.consilium.eu.int/pdf/en/04/st11/st11267.en04.pdf

Source:forwarded by email from Drug Watch International 2006
Filed under: Drug Specifics,Europe :

17TH January 2006-01-17

As Parliament, and certain sections of the public wait for Mr.Blair (or his Home Secretary Charles Clarke) to issue a pronouncement on the classification of cannabis, the situation becomes daily almost as blurred as the outlook of a heavy user.

In parliamentary updates covering just a few days in early January there were no less than 14 bulletins.

Conservative MP Nigel Evans updated his Early Day Motion highlighting links between cannabis and psychosis. (speaking on drug use generally, not just cannabis, MP John Mann elicited an answer from the Minister for Employment, Margaret Hodge, giving another facet to the costs borne by society in consequence of disabilities arising from drug abuse. Mrs. Hodge revealed that as at May 2005, there were 48,300 Incapacity Benefit and Severe Disability Allowance claimants whose primary diagnosis was recorded as ‘drug abuse’.

Shadow Home Secretary David Davis welcomed Charles Clarke’s expression of concern about links between cannabis and mental illness, but – significantly – he no longer pressed for cannabis to be re-classified to Class B. (In the past he had several times made this an unequivocal commitment on his part, but with the arrival of David Cameron as the new leader, this commitment was shelved. Cameron had been a member of the Home Affairs Select Committee , in which he was minuted as supporting the downgrading of cannabis, and also of Ecstasy, as well as suggesting that the UN Conventions were due for reappraisal).

Lib-Dem MP Mark Oaten said “the government should base its drug classification on the facts and not tabloid pressure”. (said tabloid pressure has in the past been kind to Mr. Oaten when he has suggested the liberalisation of drug laws).

One unexpected knock-back for prevention workers came when the mental health charity Rethink said that they were “against reinstating cannabis as a Class B drug”. Rethink CEO Cliff Prior said “such a move would unnecessarily waste resources, which could be better invested in education”. Prior called for public education and cessation programmes, however he believed that “the legal status doesn’t seem to make any difference at all to the level of use”. (it is not known how Mr. Prior reached this conclusion, when comparing it with evidence worldwide). Rethink are said to be in discussion with the Dept. of Health in the context of public health education.

Other comments were more predictable. Labour MP Paul Flynn (a long term advocate of liberalisation) said it would be a mistake to re-classify back to Class B. The Release charity said it should remain a class C drug. Drugscope nailed its colours firmly to the fence by saying that the government “would have to have very compelling reasons to reverse the re-classification of cannabis from Class B to Class C if an Advisory Council recommended maintaining the status quo”. At the same time Drugscope CEO Martin Barnes warned that “ cannabis may be more dangerous than many people believe”. He said that he believed that cannabis carried many health risks.

The University of London introduced a sober note in reporting on links between cannabis and mental illness. Professor Colin Drummond said the Home Secretary is right to consider raising the classification of cannabis due to the mental health risks. He felt that the downgrading of cannabis to Class C had led people to wrongly believe that it was ‘safe’. He stressed ‘it would send a better message if cannabis was re-classified and there was more consideration given to public information about the risks of cannabis. The professor also said that, whilst he supported the freedom of people to make personal choices the ‘vulnerable group in the population of adolescents’ could not be expected to make an informed choice without improvement to drugs education.

A former companion of Professor Drummond on the rostrum, arguing for greater concerns about cannabis, was Professor Robin Murray from the Institute of Psychiatry. He argued that even though the government “wrongly introduced downgrading” the impact of greater knowledge amongst the populace had actually yielded s small decrease in the use of the drug. Revealingly, Professor Drummond said “the government had a hole dug for it by the Advisory Council on the Misuse of Drugs. They got a very false account from that Council in 2002 which essentially said that cannabis was relatively safe and there was not a link between cannabis and psychosis.” However, he went on to say that he did not think the exact classification to be that important. For him “the crucial thing is education”.

Prevention-oriented advisory NGO’s such as the National Drug Prevention Alliance have continued to advocate upgrading cannabis to Class B, and this has been endorsed by media commentators who could be classified as ‘conservative with a small c’. A surprising ally in criticising the downgrading was Deputy Asst Commissioner for Met. Police Brian Paddick who, when a Commander of the police division encompassing Lambeth, unilaterally decriminalised cannabis on the eve of the pro-cannabis lobby march through the division. D.A.C Paddick says that he had “always opposed downgrading the drug”. He said he had always believed the move was unnecessary and would cause more damage than good. In an interesting aside he suggested that the Home Office decision may have dissuaded officers from concentrating on tackling crack cocaine and heroin suppliers; this is because “cannabis warnings now count the same as a conviction for rape or murder under figures for the number of offences brought to justice” he said. “Effectively, it means that a cannabis warning on the street is one of the quickest and easiest ways of achieving targets that police forces are under increasing pressure to meet”.

Home Secretary Charles Clarke will be drawing his conclusions against the background of his own statement to the public that “the public were misled about cannabis”. Mr. Clarke has been known in the past to be a supporter of preventive policies. The move to downgrade cannabis by his predecessor, David Blunkett, has clearly left him uncomfortable; in recent days Mr. Blunkett has seen fit to press Mr. Clarke (and Mr. Blair) to keep the classification where he, Mr. Blunkett, put it. It remains to be seen whether this will be seen as advice or provocation.

 

* * * * * * * * * * * * * * * *


NDPA COMMENT:

IN WRITING THIS WEEKEND (16TH JANUARY) TO BOTH MR. BLAIR AND MR. CLARKE, THE NDPA DID WHAT IT COULD TO STRENGTHEN THE RESOLVE TO UPGRADE CANNABIS WHICH HAS BEEN PERCEIVED IN THE RECENT STATEMENTS BY THESE TWO. IN THE LETTER, NDPA SAYS:

“WE ENCOURAGE YOUR GOVERNMENT TO BE BOLD AND TO RE-CLASSIFY CANNABIS. WE BELIEVE CANNABIS WAS PROPERLY CLASSIFIED WHEN IN CLASS B.”

OUR ANALYSIS OF THE CURRENT UK DRUGS MARKET SUGGESTS TO US THAT THERE IS NO SINGLE ACT THE BRITISH GOVERNMENT COULD TAKE THAT WOULD MAKE THE BRITISH PEOPLE, AND INDEED THE WORLD, MORE AWARE OF THE DANGERS OF CANNABIS THAN BY PUTTING IT BACK WHERE IT WAS, IN CLASS B.

SUCH A DECISION WOULD REVERBERATE THROUGHOUT THE WORLDWIDE MEDIA AND WOULD SECURE WORLDWIDE ATTENTION. SUCH A DECISION WOULD LEAD ANY WORLDWIDE POLICY REVIEW.


Filed under: Drug Specifics :

Health campaigners have accused the Government of creating “dangerous confusion” over the mental health risks of smoking cannabis after it scrapped a multi-million pound publicity campaign.

The Home Office announced in January that the publicity drive would launch in the spring but, six months later, it has been quietly pushed to one side. .

The scheme was recommended by the Advisory Council on the Misuse of Drugs, a Home Office committee made up of scientists, medical experts, drugs charity workers and police. It said that a major campaign was required to let people know about the mental health risks and to combat confusion about the drug brought about by the change in its classification, from class B to class C. .

Days later, Charles Clarke, the home secretary at the time, told the Commons: “The illegal status of the drug is not enough. We need a massive programme of public education to convey the danger of cannabis use.” .

Paul Goggins, then a Home Office minister, subsequently said the campaign would be launched “in the spring” and would cost “many millions of pounds”..

The decision to scrap the campaign has brought an angry response. One member of the advisory panel, who asked not to be named, said: “We decided a campaign about the risks associated with mental health was needed. If charities and members of the public are saying they have not seen any sign of this campaign, then that speaks for itself.” .

Prof Robin Murray, from the Institute of Psychiatry, said: “This has caused a dangerous confusion about cannabis among young people. We are seeing more people with cannabis-related mental health issues.” .

David Davis, the shadow home secretary, said: “This Government’s confused policy has sent out the message that it is okay to take drugs. They have compounded this error by failing to warn people of the very harmful consequences of taking cannabis.” .

Mr Clarke declined to comment on the scrapping of the publicity campaign. .

A Home Office spokesman said that information about drug use was provided on the website talktofrank.com and that the Department for Education and Skills was running a campaign for 11-to-14 year olds giving information about drugs. .

Source: Telegraph.co.uk July 30 2006
Filed under: Drug Specifics :

White House drug czar John Walters said high-potency marijuana coming from Canada is causing an increase in marijuana-related emergency-room cases in the U.S., “Canada is exporting to us the crack of marijuana and it is a dangerous problem,” Walters said. “We need to have political leadership in Canada that recognizes the problem. Addiction is going to spread in Canada dramatically. It has in many places.”

Walters blamed Canada’s more relaxed attitude towards marijuana and an increase in hydroponically-grown marijuana, which is grown in nutrient-rich solutions rather than soil, for the growing number of ER cases. Walters said such marijuana contains 20 to 30 percent of psychoactive Delta-9-Tetrahydrocannabinol (THC), compared with 1 percent THC of marijuana from the 1960s and 1970s.

“It is extremely dangerous. It is one of the reasons why we believe we have seen a doubling of emergency-room cases involving marijuana in the last several years from 60,000 to 120,000,” Walters said.

Despite U.S. criticism, Canadian Prime Minister Paul Martin said he plans to proceed with his strategy to decriminalize possession of small amounts of marijuana.

Source: Source:Reuters report April 14. 2004

The Ministry of Health is warning users of illegal drugs about the added danger they may be exposing themselves to after Dutch authorities found strychnine in a sample of MDMA (Ecstasy} in Holland. The New Zealand Customs Service advise that most of the Ecstasy smuggled into New Zealand comes from Western Europe, particularly Holland. Strychnine, which is now only used as a rat poison, is deadly in quite small doses. Two tablets, each containing the amount reported from the Dutch sample, could be fatal. Substances including and ketamine, anaesthetic medicine also used as an animal tranquilliser, have been found. “This issue highlights the danger with illegal drugs. The consumer has no idea what he/she is buying and they should realise that they could be putting themselves at serious risk of injury or death”, said Dr Bob Boyd, Chief Advisor.

Source: www.moh.govt.nz/media.html Feb 2000

An increasing number of American youths who use the club drug Ecstasy are mixing it with the anti-impotence drug Viagra, leading drug-abuse specialists to warn about the health risks of a combination that users say fuels all-night dancing and marathon sex.
The combined drugs known in the club scene as ‘sextasy’ began as a fad among youths in England and Australia. About a year ago, officials of the U.S. Drug  Enforcement Administration began hearing reports that the mixture had become popular in the country’s gay party culture.

Source: Published in USA today.com, Sept 2002.

Calling medical marijuana the “Trojan horse of the new millennium,” Andrea Grubb Barthwell, deputy director for demand reduction for the White House Office of National Drug Control Policy, criticized the use of medical pot and said the drug is a public-health threat. Barthwell made her comments in San Francisco, California during a 25-city nationwide tour to discuss drug-fighting efforts with local officials. Barthwell criticized medical-marijuana advocates, saying they are using the drug as a pawn in their agenda to legalize all dangerous drugs.  “Marijuana is a wedge issue to create a change in drug policy, with the intent to legalize drugs without limits,” Barthwell said. “Today, marijuana is strong enough to change the trajectory of a kid’s life.”

In response, marijuana advocates said the Bush administration is ignoring research showing the positive medical applications for marijuana. Advocates also cited studies that showed that since voters approved Proposition 36 three years ago, 35,000 Californians arrested for possessing marijuana and other drugs have opted for treatment instead of criminal penalties. “The bottom line is, her administration is still spending 70 percent to 80 percent of its money on interdiction instead of treatment,” said Daniel .Abrahamson, director of legal affairs for the Drug Policy Alliance. “She can play politics and stand on the bandwagon, but things are passing her by.” Barthwell acknowledged that Proposition 36 is valuable in getting drug users into treatment. But she said the federal government needs to strongly re establish “a culture of disapproval” while increases access to treatment. Barthwell also argued that no significant studies have found marijuana use beneficial.

Source: Reported in Contra Costa Times Oct 15, 2003
Filed under: Drug Specifics :

A new health education campaign launching in the Phoenix area seeks to respond to data from the Partnership for a Drug-Free America (PDFA) that finds usage rates of methamphetamine and Ecstasy among Phoenix-area teens are above national averages. The campaign unveiled today by the Partnership – with support from the Partnership for a Drug-Free Arizona, the Arizona Chapter of the American Academy of Pediatrics (AzAAP) and Consumer Healthcare Products Association (CHPA) – is dedicated to reducing methamphetamine and Ecstasy use among teens in the Phoenix area. The campaign consists of a pediatrician-driven media outreach effort designed to educate parents and teens about the dangerous health consequences of these drugs, and includes an intensive public service advertising campaign in the Phoenix market. Phoenix is one of two U.S. cities where the campaign is being introduced.

“The disturbing number of teens in the Phoenix area who already are experimenting with these drugs makes this a health problem that must be addressed,’ said Dr. Peggy Stemmler, president of the AzAAP, a key partner in the new health education campaign. “Paediatricians are in a unique position to help close the gap between perception and reality about the real consequences of these drugs.”

In the Phoenix area, 14 paediatricians will serve as primary spokespeople for the media communications effort. Campaign coordinators believe the voice of the medical community will resonate with parents in particular in order to motivate them to take an active role in persuading their teens not to use these drugs. HMA Public Relations, a local public relations agency, will coordinate media efforts for paediatricians participating locally.

“More than one of every three teens in the Phoenix area has been offered Ecstasy or ‘meth,’ and teen use of both drugs is above national averages,” said Steve Pasierb, president and CEO of the Partnership, the national non profit organization best known for its media-based drug education campaigns. “Phoenix needs the facts about the real risks of using these drugs if we’re going to turn those numbers around.” The Partnership is providing the local effort with hard-hitting public service ads for television, radio, print and Internet, as well as with research to measure the impact of the effort.

Top-line findings of the Partnership for a Drug-Free America’s study include:

* 13 percent of Phoenix-area teenagers report having used methamphetamine (meth), compared to nine percent of all teens nationwide; 13 percent report having used Ecstasy, compared to 11 percent of all teens nationwide;
* 33 percent of teens report having been offered methamphetamine, and 35 percent report being offered Ecstasy;
* 61 percent of teens report knowing someone who uses Ecstasy, and half (50 percent) report knowing someone who uses methamphetamine; and
* Just one to two percent of Phoenix-area parents surveyed (one percent for Ecstasy, two percent for meth) agree that it’s possible their kids may have tried these drugs.

“Survey data also show parents and teens underestimate the specific health risks of these drugs,’ said Pasierb. “Risk-related attitudes correlate strongly with trends in drug use; for example, when teenagers see greater risks associated with a particular drug, use of that drug declines, Unfortunately, the opposite holds true as well, so the time is right for a concerted intervention to reverse the trends were seeing in Phoenix.”

Methamphetamine is an addictive stimulant. Often called ‘speed’ or ‘crystal’, meth is a crystal-like, powdered substance that sometimes comes in large rock-like chunks. Meth is usually white or slightly yellow, depending on the purity. The drug can be taken orally, injected, snorted or smoked. Once a threat largely in the American southwest, production and use of the drug, which is cheaper and longer lasting than cocaine, has moved steadily eastward in recent years, finding willing users in a generation unlikely to remember the phrase, ‘speed kills’. Long-term use and/or high doses of methamphetamine can bring on full-blown toxic psychosis, often exhibited as violent, aggressive behaviour. Ecstasy–chemically known as 3-4 methylenedioxymethamphetamine, or MDMA – is a psychoactive drug with amphetamine-like and hallucinogenic properties. It can be extremely dangerous, especially in high doses. Usually taken orally in pill form, the drug accelerates the release of serotonin in the brain and provides users with an intense high, characterized by feelings of love and acceptance, as well as a general sense of well being, decreased anxiety and enhanced sensitivity to touch. Ecstasy can cause dramatic increases in body temperature, muscle breakdown, and kidney and cardiovascular system failure, as reported in some fatalities.
Source: Press release, Partnership For Drug Free America June 200

A smoking ban was today introduced on long-distance commuter services between Waterloo, Hampshire and borset following a “serious safety
incident’ involving a discarded cigarette.The ban, however, while popular with the majority of commuters will infuriate others, many of whom have pledged defiance and say they will continue to light up.
Stagecoach-owned SWT, one of the busiest commuter operators, is among the few remaining which permit smoking on trains. It is only allowed on
certain long-distance routes.

Source: Evening Standard, 1 December 2003

Ben Mitchell argues that drugs should not be legalised.

In the UK, the social and economic costs of drug misuse account for between £10 billion and £18 billion a year. Around 250000 problematic drug users’ contribute to 99% of these costs.1 These addicts spend around £16,500 a year each to feed their habits, with most of this coming from the proceeds of crime2. Hard drug users, who indulge in heroin, crack cocaine and powder cocaine, are responsible for 50% of all crimes3.

On the one side, them are proponents of ‘harm reduction’. In the case of heroin, they want to see persistent users prescribed heroin under the NHS.

Opponents compare the Dutch and Swedish approach to drugs over the last 25 years, and point out that drug use in the Netherlands, which has adopted a policy of ‘harm reduction, has seen use of cannabis amongst the young more than double, with use of ecstasy and cocaine by l5 year olds rising significantly.

By contrast, in Sweden, the goal has been to create a ‘drugs free society,’ with everyone from the police to schools working towards such a strategy. As a result, overall lifetime prevalence of drug abuse, amongst 15-16 year-olds. is 8% in Sweden, compared to 29% in the Netherlands. In 1998, only 496kg of cannabis were seized in Sweden, compared to 118 in the Netherlands, now described as the drugs capital of Western Europe5 . This is because in Sweden drug use is seen as inimical to a civilised, tolerant society, whereas in the Netherlands drugs have been accepted as a ‘way of life’ and have contributed hugely to crime.

The UK’s approach to drugs is deeply flawed. with the government sending out confusing and misleading messages. Cannabis has been downgraded from a class B to class C drug; yet many people widely believe that cannabis has been decriminalised.

The ‘Lambeth Experiment’, which led the way to reclassification, caused an explosion in the number of drug dealers preying upon the area6. The experiment has to all intents and purposes ‘allowed’ people to smoke cannabis publicly. But, the moral and ethical question still remains: is it acceptable to tolerate something which is proven to damage both the health and judgement of individuals, and can also affect relationships with families, friends and the wider society?

There are now several experiments being conducted across Europe in an effort to contain heroin addiction. In Switzerland, since 1994, 1,000 of the country’s 33 heroin addicts have been prescribed pure heroin. The aim is to stabilise the health of addicts and prevent them from using heroin in public, thus taking their habit away from the black market.

Swiss officials claim that the experiment is working because crime is down, However, addicts are now becoming dependent on prescription heroin and hopes of weaning them off the substance have quickly faded.

The Police Federation disputes that legalisation would cut crime. This assumes that the powerful international drug cartels would simply fade away into the night. More likely scenarios are that they would fight to maintain their lucrative street trading.

Notes
1. The Government Reply to the Third Report from the Home Affairs Committee Session 2001-02: The Government Drug Policy: Is it working?, p.5
2. Home Affairs Third Report: The Government Drug Policy. Is it working?, Illegal Drugs, Drugs-related property crime. no.36 3.The Government Reply to the Third Report from the Home Affairs Committee session 2001-02: The Government Drug Policy. Is it working?, p.5
4 .Home Affairs Select Committee Report: The Government Drug Policy. Is it Working? Memoranda of Evidence – no.16 (submitted by the Criminal Justice Association)
5. Risk of Legalising Cannabis Underestimated: A Comparison of Dutch and Swedish Drug Policy. Criminal Justice Association, February 2002
6. The Dealers Think They’re Untouchable Now’, The Observer, 24 February 2002 and ‘London’s Drug Crime Hotspots Revealed. Evening Standard. 28 May 2003
7. Better Ways’. The Economist, 26 July 2001
8. Quoted in Home Affairs Select Committee Third Report: The Government ‘s Drugs Policy. Is Working’., no.60

Source: CIVITAS; Institute for the Study of Civil Society
The Mezzanine, Elizabeth House, 39 York Road, London SEI 7NQ
Phone; +44 (0)20 7401 5470 Fax: +44(0)201401 5471
Email; info@civitas.org.uk

The federal government recently announced that the growing potency of America’s most popular illegal drug, marijuana, and the number of kids seeking help to get off the drug (one in five users) worried them so much that they were soliciting new marijuana-research proposals and urging local law enforcement to crack down on those who sell the drug.

The pro-marijuana lobby was furious and immediately charged the feds with fear-mongering and clamoring to protect their (not so glamorous, actually) jobs in Washington. Their cries rested on claims that more potent marijuana is not tantamount to more dangerous marijuana and that the rise in the number of treatment beds for marijuana users is due to criminal justice referrals, not the drug’s harmfulness.

But the evidence shows the government may indeed have it right. The pro-drug movement, fuelled with the motivation to legalize harmful substances and angry at the attack on its values of “drug use for all,” is putting kids at risk by downplaying the known dangers of marijuana.

Although not as destructive as shooting heroin or smoking crack, marijuana use is unquestionably damaging. Today’s more powerful marijuana probably leads to greater health consequences than the marijuana of the 1960s: Astonishingly, pot admissions to emergency rooms now exceed those of heroin. Visits to hospital emergency departments because of marijuana use have risen steadily, from an estimated 16,251 in 1991 to more than 119,472 in 2002. That has accompanied a rise in potency from 3.26 percent to 7.19 percent, according to the Potency Monitoring Project at the University of Mississippi.

More potent marijuana is also seen as more lucrative on the market. Customs reports claim that a dealer coming north with a pound of cocaine can make an even trade with a dealer traveling south with a pound of high-potency marijuana. It makes sense that people pay more for stronger pot because the high is better.

A flurry of very recent research studies – concerning withdrawal, schizophrenia and lung obstruction, for example – have also shown marijuana’s unfortunate consequences. These conclusions were not being reached in the ’70s and ’80s (legalizers often point to the Nixon-commissioned Shafer report, which said nice things about the drug as evidence of marijuana’s harmlessness), because marijuana from that era was weaker and less dangerous than today’s drug. The May 5 issue of the Journal of the American Medical Association reported that the number of marijuana users over the past 10 years stayed the same while the number dependent on the drug rose 20 percent – from 2.2 million to 3 million.

And although a majority of kids in treatment for marijuana are referred there by the criminal justice system, it still remains only a slight majority – about 54 percent. The rest is self-, school or doctor referral.To paint the picture that the reason marijuana dependence looks higher is because of the criminal justice system is disingenuous (especially because most people who use only marijuana never interact with law enforcement as a result of that use).

Some still argue that it’s wrong to arrest kids and force them into treatment. It seems like the government can never win: If it arrests and locks people up, legalizers kick and scream that we’re not giving users “alternatives to incarceration.” If it arrest kids as a way to get them help, and not as a punishment mechanism, all of a sudden the government is giving in to George Orwell.

It’s too bad that pot apologists don’t see what most parents do see: Marijuana is a harmful drug with serious consequences, and mechanisms – even a brush with the law to help a user realize that what he’s doing is harmful – to help stop the progression of use should be seen as a good thing. That’s not government propaganda. That’s common sense.And it may save a few lives.

Source: Kevin A. Sabet recently stepped down as senior speechwriter to America’s drug czar, John P. Walters. A Marshall Scholar, he is writing a book on drug policy and is also a Ph.D. candidate at Oxford University.

Recently, the British Prime Minister Mr. Tony Blair gave an interview to the News of the World newspaper. In a paper more noted for salacious stories it was a sober affair. Reflecting on 6 years in power , he said “I’ve had lumps kicked out of me ….but I’m tougher than ever”. In the wide ranging interview, Mr. Blair introduced his newest plan -random drug testing in schools.

Mr. Blair’s government does not seem to know what to do about the drugs problem. They ignore evidence from other countries on what works to lower the incidence of drug use and rely instead upon advice from so-called experts – many of whom have been advocating the relaxation of drug laws for years.

Re-classifying Cannabis has sent out totally the wrong message to our youth who mostly now believe that cannabis is (a) legal and (b) harmless. The government rushes in to Spend £1 million on a campaign to tell people that cannabis is (a) not legal and (b) harmful.

More money is being spent on treatment – and with this we have no argument. People who have problems from drug use need all the help and treatment they can get to become drug free and contributory members of society again. Treatment is always expensive – and there is the ‘revolving door’ syndrome where users enter treatment for a few weeks or months, return to society and often begin using again – once the use results in a more chaotic lifestyle again the user returns to treatment. Relapse is common and costs money.

Mr. Blair’s new idea – random drug testing – has resulted in the inevitable dichotomy between those who approve of the plan and those who regard it as a great infringement of personal liberty. Some organizations who want drug laws relaxed are scaremongering by suggesting that pupils know that cannabis stays in the body for longer than many other drugs and so would stop using cannabis and instead turn to Ecstasy or Heroin. This is very unlikely since the majority of young people who do use cannabis whilst at school do so because they believe it is harmless – they do not use so-called ‘hard’ drugs because they know they are harmful. Understandably the teaching profession have expressed great concern about the time, costs and legal ramifications of testing. A large majority of parents think it is an excellent idea – and, surprisingly to some, most young people agree with it.

The NDPA have seen evidence of the success of drug testing in America and Australia and work closely with a Belgian colleage who has made a study of drug testing. One of our colleagues has also worked in Restorative Justice and this could be tied in with drug testing. Many companies in the USA and the UK have introduced random drug tests amongst their work force and this has cut down accident and absence rates and staff turnover . Therefore, our belief is that there is mileage in using random drug tests in schools – provided they are handled sensitively. It would need all schools and colleges to ‘opt in’ to be a total success – and schools would need financial help to cover the inevitable costs. And schools need to consider that random drug testing should not belinked to punishing or excluding pupils who test positive.

Today, the Florida Department of Law Enforcement (FDLE) released the Florida Medical Examiners Commission’s Report on Drugs Identified in Deceased Persons. The report contains information compiled from autopsies performed by medical examiners across the state in 2003. During that period there were approximately 170,000 deaths. According to the report, 6,767 individuals examined had drugs in the system.

Medical Examiners collected information on the following drugs: Ethyl Alcohol, Amphetamines, Methamphetamines, MDMA (Ecstasy), MDA, MDEA, Alprazolam, Diazepam, Flunitrazepam (Rohypnol), other Benzodiazepines, Cannabinoids, Carisoprodol/Meprobamate, Cocaine, GHB, Inhalants, Ketamine, Fentanyl, Heroin, Hydrocodone, Hydromorphone, Meperidine, Methadone, Morphine, Oxycodone, Propoxyphene, Tramadol, and Phencyclidine (PCP).

The report reveals a decrease in the incidences of Heroin in 2003 when compared with 2002. This decrease includes cases in which the drug levels found during the exams were both lethal and non-lethal. In addition, the report indicates the three most frequently occurring drugs found in decedents were Ethyl Alcohol (3,467), all Benzodiazepines (1,794), and Cocaine (1,614). The drugs that caused the most deaths were Cocaine, all Benzodiazepines, Methadone, Oxycodone, Ethyl Alcohol, Heroin, Alprazolam, and Morphine.

The three drugs that were the most lethal, meaning more than 50 percent of the deaths were caused by the drug when the drug was found, were Heroin (88 percent), Fentanyl (63 percent), and Methadone (60 percent). The report also reveals that excluding newly tracked prescription drugs, prescription drugs of Benzodiazepines, Hydrocodone, Methadone, and Oxycodone continued to be found more often than illicit drugs in both lethal (60 percent) and non-lethal (55 percent) levels during 2003.

“This report shows that with few exceptions, both illicit and prescription drugs persist in being a continuing and increasing danger to the citizens of the State of Florida,” said FDLE Commissioner Guy Tunnell. “While heroin deaths have decreased over the past year, most of the other illicit and prescription drug deaths remain at an alarming level for the year, although decreases are noted during the second half of the year.”

“The results from this report are evidence of the immense danger associated with drug abuse and more specifically prescription drug abuse,” said Jim McDonough, Director of the Florida Office of Drug Control. “Far too many Floridians are dying from prescription drugs. To address this problem Florida will continue to strengthen its efforts in the areas of prevention, treatment, and law enforcement in order to reduce the unacceptable amount of deaths that result from the abuse of prescription drugs.”

Source: http://www.fdle.state.fl.us/publications/examiner_drug_report_2003.pdf ;May 26, 2004

In 2004, the 28 High Intensity Drug Trafficking Areas (HIDTA) implemented a Performance Management Process (PMP) to measure their performance, identify the outcomes of their efforts, and improve the efficiency and effectiveness of their initiatives. The National High Intensity Drug Trafficking Area Program 2004 Annual Report highlights the initial results of the PMP, including two of sixteen performance measures developed—the number of Drug Trafficking Organizations (DTOs) disrupted or dismantled and the return on investment (ROI).

In 2004, the HIDTA Program received a law enforcement budget of $176,835,426. In that same year, HIDTA initiatives disrupted.or dismantled 3,538 DTOs and seized more than $10.5 billion in drugs and nearly $500 million in assets from DTOs.

Thus, every $1 invested in the HIDTA program yielded an estimated $63 in drugs and assets removed from the market.
SOURCE: Adapted by CESAR from National HIDTA Directors Association, National High Intensity Drug Trafficking Area Program 2004 Annual Report, 2006.
For more information, contact Erin Artigiani at CESAR aterin@cesar.umd.edu

The use of Ecstasy in combination with other drugs is an increasing diagnostic and treatment problem for A&E staff, a study has revealed. The records of all patients tending A&E at St Thomas’ Hospital London were studied over a 15 month period. The notes of those who were suspected of having used Ecstasy, or methylenedioxymethamphetarnine, were systematically reviewed. They found 48 cases all in the 15-30 age group. Most presented in the early hours at weekends, The average number of tablets taken was two, and 40% of the patients had taken drugs before. However, half of them had taken another substance at the same time, usually amphetamines or cocaine. A wide range of clinical features were noted. The most common are detailed below. The most serious complications were in patients who had taken more than one drug. The authors say the problems caused in A&E by dance drugs are increased by multiple drug ingestion.

Symptoms of Ecstasy use alone or in combination. Most common symptoms with Ecstasy use alone:

Strange/unwell/dizzy/weak 44 %
Palpitations 37 %
Nausea or vomiting 31 %
Panic/anxiety/restlessness 31 %
Hot/cold 25 %
Abdominal pain 15 %
Most common symptoms with Ecstasy and other drugs/alcohol:
Collapsed/Loss of consciousness 31 %
Strange/unwell/dizzy/weak 25 %
Nausea or vomiting 19 %
Palpitations 19 %
Panic/anxiety/restlessness 12 %
Headache 12 %
Shaking 12 %
Source: Williams H., Drareau L, Taylor L., et al. (1998)
“Saturday night fever” Ecstasy related problems in a London accident and emergency department journal of Accident and Emergency Medicine 15: 5. 322-325

Recreational use of 3,4 methylenedioxyethylamphetamine (MDMA), more commonly known as “ecstasy” (and a variety of other names including “XTC”, “Adam” or “E”), is now well established. In Britain upwards of 500,000 people are said to use the drug each week (Harris Poll (1992) for “Reportage”, BBC2, 22 Jan 1993).

MDMA is a ring-substituted amphetamine with psychoactive properties. First synthesised in 1914 from methylenedioxyamphetamine (MDA), itself a drug of misuse (known as the “love drug”), it has been used in psychotherapy and was originally used as an appetite suppressant. The drug has ceased to be used medicinally and is now an established part of the illegal drug scene. It is banned in most countries. In the UK it is a class A drug as defined in Schedule 2 of the Misuse of Drugs Act 1971. It has no medicinal use in the UK and cannot be prescribed.

As well as MDA and MDMA, another variant, methylenedioxyethylamphetamine (MDEA, known as “eve”), which is similarly proscribed, is commonly encountered. All have similar pharmacological effects.
In the UK, MDMA is often taken by young people at discos and rave parties. Both involve dancing, but especially at the latter there is vigorous repetitive dancing in crowded rooms with a hot and humid atmosphere. The dangers of this activity are recognised to a certain extent as rooms to “chill out” are often available for people to rest in after periods of exertion. Toxic effects and the occasional death following ring substituted amphetamine misuse have been reported but postmortem data are lacking. In this paper we report on deaths associated with ring substituted amphetamine misuse and detail the postmortem findings.

Seven deaths have been investigated by the University of Sheffield Department of Forensic Pathology in the past three years, which were associated with ring substituted amphetamine misuse. All of the subjects were white men, between 20 and 25 years of age. Three of the victims collapsed at a rave or disco, two were found in bed, one in a collapsed state and one dead, one collapsed in the street, and one was admitted to hospital with progressive jaundice.

Abstract
Aims – To study the postmortem pathology associated with ring substituted amphetamine (amphetamine derivatives) misuse.

Methods
The postmortem findings in deaths associated with the ring substituted amphetamines 3,4-methylenedioxymethyl-amphetamine (MDMA, ecstasy) and 3,4-methylenedioxyethylamphetamine (MDEA, eve) were studied in seven young white men aged between 20 and 25 years.

Results
Striking changes were identified in the liver, which varied from foci of individual cell necrosis to centrilobular necrosis. In one case there was massive hepatic necrosis. Changes consistent with catecholamine induced myocardial damage were seen in five cases. In the brain perivascular haemorrhagic and hypoxic changes were identified in four cases. Overall, the changes in four cases were the same as those reported in heat stroke, although only two cases had a documented history of hyperthermia. Of these four cases, all had changes in their liver, three had changes in their brains, and three in their heart. Of the other three cases, one man died of fulminant liver failure, one of water intoxication and one probably from a cardiac arrhythmia associated with myocardial fibrosis.

Conclusions
These data suggest that there is more than one mechanism of damage in ring substituted amphetamine misuse, injury being caused by hyperthermia in some cases, but with ring substituted amphetamines also possibly having a toxic effect on the liver and other organs in the absence of hyperthermia.

C M Milroy J C Clark A R W Forrest Department of Clinical Chemistry, Royal Hallamshire Hospital, Sheffield – Department of Forensic Pathology, University of Sheffield
Source: (J Clin Pathol 1996;49:149-.153)

This study examines the extent to which alcohol and drug use is related to violent and nonviolent criminal activity among adolescent males. Based on data collected from 312 youthful offenders at a public juvenile facility, the findings reveal that in comparison to marijuana and heroin, alcohol use is more strongly and consistently associated with both violent and nonviolent offenses. When other factors are introduced into the analysis, the results show that while an adolescent’s criminal history and racial identity are relatively more important in predicting criminal activity overall, the effect of substance use (especially alcohol and marijuana) continues to be present.

Source: Dawkins, M. Adolescence 32(126):395-405, 1997
Availability: Marvin P Dawkins, Department of Sociology Coral Gables FL 33124

Imaging studies in humans suggest that the amygdala plays an important role in craving elicited by cocaine and cocaine-conditioned environmental stimuli. The research examined the relationship between neurochemical changes in the amygdala and cocaine-seeking behavior following exposure to a cocaine-paired environment or a cocaine priming injection. It measured cocaine-seeking behavior by assessing the persistence of lever-pressing in the absence of cocaine reinforcement in animals previously trained to press a lever for cocaine infusions. Lever-pressing under these conditions is thought to reflect the incentive motivational properties of cocaine and cocaine-associated stimuli. It first investigated whether the pattern of changes in cocaine-seeking behavior corresponded with changes in concentrations of dopamine in dialysates obtained from the amygdala during the course of cocaine withdrawal.

There were concomitant changes in cocaine-seeking behavior and dialysate dopamine following the cocaine priming injection, but not following exposure alone to the cocaine self-administration environment. It next investigated changes in Fos protein expression as a general marker for neuronal activation. Exposure to the cocaine self-administration environment, but not the cocaine priming injection, elicited Fos expression in the basolateral nucleus of the amygdala, nucleus accumbens shell, and cingulate cortex. In contrast, the cocaine priming injection, but not the environmental stimuli, elicited Fos expression in the central nucleus of the amygdala and dorsolateral caudate-putamen.

The findings suggest that different neural mechanisms mediate cocaine-seeking behavior elicited by cocaine conditioned environmental stimuli and those elicited by a priming injection of cocaine. Increases in extracellular dopamine may be critical for the induction of cocaine-seeking behavior elicited by cocaine but may not be elicited by cocaine-conditioned environmental stimuli.

Source: Janet Neisewander, Ph.D., Arizona State University

This edition of Prevention Works lists some studies, which look at the gateway/addiction theory of progressive drug misuse. The implications for prevention are clear – Early use of nicotine, alcohol and marijuana is a predictor of later use of cocaine (etc. …)

Predicting continued use of marijuana among adolescents: the relative influence of drug-specific and social context factors.

Bailey SL. Flewelling RL. Rachal JV Journal of Health and Social Behavior1992:33:51-66

Compared with people who used only one gateway drug (tobacco, alcohol and marijuana), children who used all three are 77 times more likely to use cocaine.
Children who smoke daily are 13 times more likely to use heroin than children who smoke less often.

Compton DR. Dewey WL. Martin BR. Advances in Alcohol and Substance Abuse. 199O:9:129-147. [Cannabis dependence and tolerance production]

Children who use marijuana are 85 times more likely to use cocaine than non-marijuana users. 90% of children who used marijuana, smoked or drank first. Children who drink are 50 times more likely to use cocaine than non drinkers.

Children who use gateway drugs – tobacco, alcohol and marijuana are up to 266 times more likely to use cocaine than those who don’t use any gateway drugs.
Study concludes nearly 90% of cocaine users smoked, drank and used marijuana

Center on Addiction and Substance Abuse at Columbia University (CASA), Oct. 27, 1994.

A 12- year-old who smokes is 30 times more likely to have used illicit drugs than a child of the same age who doesn’t smoke. This analysis proves that, for too many children cigarettes are a drug of entry into the world of illicit drugs

Center on Addiction and Substance Abuse at Columbia University (CASA), March 10, 1994.

Marijuana’s role as a gateway drug to serious drug use appears to have increased.

Golub A. Johnson BD. The Shifting Importance of Alcohol and Marijuana as Gateway Substances among Serious Drug Abusers. J. Stud Alcohol 1994:55:607-614.

Very few try illicit drugs other than marijuana without prior use of marijuana.

Kandel DB. Yamaguchi K. Chen K. Stages of Progression in Drug Involvement from Adolescence to Adulthood: Further Evidence for the Gateway Theory, J Stud. Alcohol; 1992:447-457.

Study describes cannabis dependence. Impaired cognitive skills and functioning were documented in chronic cannabis users.

Lundqvist. Life Science, Vol. 56 pp 2145 -2155.

Brain event-related measures normalize during acute marijuana intoxication. suggesting a basis for the physical dependence component of marijuana use.

Solowij et at. Life Sciences, Vol. 56 pp 2127-2134. 1995.

The chronic use of cocaine. particularly when used with marijuana, sets up craving behavior by depleting brain dopamine and norepinephrine.

Mirochnik, et at. Pediatrics 99:555-559,1997.

A 12-step treatment approach for marijuana (cannabis) dependence.

Miller NS, Gold MS. Pottash AC. Journal of Substance Abuse Treatment. 1989; 6:24 1-250.

Results of tests for drug use in 21 big cities in the US are found in the ADAM Report. The conclusion says that: By any measure, the level of recent drug use among 1997 ADAM arrestees is significant. Every site reported that a majority of its male adult arrestees tested positive for at least one drug. The same is true for female adult arrestees in 19 out of 21 sites where data was collected. There are differences in trends for specific drugs and segments of persons arrested.
The 1996 national Survey of Inmates in Local Jails in the U.S. showed that
A. 82% of all jail inmates in 1996 said they had ever used an illegal drug, up from 78% in 1989.
B. The percentage ever using drugs regularly went from 58% in 1989 to 64% in 1996.
C. 55% used drugs in the month before the offense, vs. only 44% in 1989.
D. 36% were using drugs at the time of the offense, up from 27%.
E. 16% said they committed the crime for drug money, up a little from the 13% in 1989.

Arrestee Drug Abuse Monitoring Program

Much of the push toward drug testing has come from the federal government. In 1982, the Navy began the first broad-scale random drug testing after an aircraft accident aboard the USS Nimitz uncovered widespread drug use about the ship. The practice soon spread to other branches of the military. Then drug testing was introduced in safety-sensitive government agencies such as the Nuclear Regulatory Commission, and mandated for government contractors with contracts worth more than $25,OOO.

Several horrific accidents spurred drug testing in the transportation industry. In 1987, two trains collided in Chase, Md., causing 16 deaths, and it was later revealed that one of the trains engineers had been smoking marijuana before the collision. And in 1991, eight people were killed in a New York subway train crash; the train’s driver later tested positive for alcohol.

These incidents led to the passage of the Omnibus Transportation Employee Testing Act of 1991 which required the Department of Transportation to mandate drug and alcohol  testing of employees in safety-sensitive transportation positions in private companies.

A snapshot of how drug testing works comes from Tom Warner, president of three D.C-based plumbing, heating and air conditioning companies that together employ 92 workers.  He wasn’t pushed to his drug-testing policy because of any big disaster. Instead, it was little things such as recurring minor accidents and foolish mistakes.  He remembers one experienced technician, for example, who had used his bare hands on a sewer-contaminated piece of machinery, rather than use his gloves. “It wasn’t something a rational person would do” he recalled thinking at the time.

Warner decided to introduce drug testing, and the first results startled him.  About half of a group of new trainees failed. as did the worker who had failed to use his safety gloves. Some drug users quit rather than be tested. Warner decided to clean out the problem workers by simply firing people who tested positive for drug use.  They are invited to reapply after one year and will be rehired if they pledge to remain drug-free.  Few drug users either apply or reapply now, Warner said. “It’s known we’re a drug-free company,”  he said. “People who do drugs want to do drugs — and want to be in a place where they can.” The percentage of major firms requiring employee drug tests has escalated in the past decade, … and the percentage of employees who test positive has declined significantly.

Construction workers are among the category of employees reporting the highest usage rate of Illegal drugs. Percentage of employees, 18-49, reporting use of illicit drugs in the past month :-
 

Construction  15.6%
Sales  11.4%
Wait staff. bartenders  11.2%
Handlers, laborers  10.6%
Machine operators 10.5%
Precision production  8.6%
Administrative support  5.9%
Other service  5.6%
Executive, managerial  5.5%
Technicians, related support  5.5%
By Kirstin Downey Grimsley Washington Post Staff  Writer Sunday, May 10, 1998

The Swedish epidemic of intravenous amphetamine injection, which started in 1945, was surveyed annually in Stockholm from 1965 to 1987. During that period, approximately 250.000 arrestees were examined for needle marks from intravenous drug injections that they presented in their cubital regions. The progression or regression of the epidemic was gauged by calculating the percentage of addicts (marked with needle scars) among the population arrested for any kind of criminal or civil offense. This epidemiological study using an objective marker demonstrated that a permissive drug policy leads to a rapid spread of drug use. A restrictive policy not only checks the spread of addiction but brings about a considerable reduction in the rate of current consumption. The restrictive policy is based on a general consensus of social refusal of illicit drug use, and strict law enforcement. All countries which have adopted this model such as China, Japan, Korea, Singapore and Taiwan have succeeded in controlling epidemics of amphetamine or heroin addiction. By contrast, Western industrialized nations which have accepted permissive policies have seen their epidemics of drug addiction grow steadily since World II War and erode their democratic institutions. The author concludes that such a trend may only be reversed by adopting a restrictive model validated by epidemiological and historical facts.

Professor Nils Bejerot
The Swedish Carnegie Institute, Stockholm
Presented at an International Colloquium held in Paris at the French Senate in March 1998

United States of America
At the turn of the century cocaine, heroin and marijuana were in use legally and widely promoted. Between 1907 and 1917 thc murder rate rose by 300% Cocaine and opium addiction rates in these early years rivaled those of today and the effects led to pub1ic outcry.
In 1914 these drugs were made illegal and by 1940 the number of addicts had dropped from 250,000 to 50,000. Between 1923 and 1939 the rate of opium addiction fell 90%, apparently simply as a result of a strict drug policy which dramatically reduced exposure factors.

The US experimented briefly with decriminalisation of marijuana in the period 1975 to 1978. This resulted in a statistically significant increase in the reported number of marijuana-related visits to hospital emergency departments compared to metropolitan areas where decriminalisation had not been implemented.

By 1979 use of all drugs in the US was very high but between then and 1991, largely due to the efforts of parents, the number of users dropped from 23 million to 14 million, a 60% reduction sustained over a 12-year period. Use of cannabis halved, daily use fell by 75% and the use of cocaine fell by 50%. A wide-ranging and successful collaboration between Customs & Excise. Police. educationists, social workers and parents and the young people themselves reinforced the idea that the use of drugs is not normal and is socially unacceptable However, since 1991 a relaxation of this strategy has seen an increase in the problem.

In the state of Arizona Proposition 200 authorised doctors to issue prescriptions for drugs such as marijuana, heroin, LSD and PCP. It encouraged the immediate release of 1032 prison inmates sentenced for drugs offences and prohibited prison sentences for drug offences until the third conviction. A poll carried out between January 27th and 31st  1997 by Dr. Bruce Merrill (Prof. Of Mass Communications and Director of the Walter Cronkite School. Arizona State University) overwhelmingly supports the conclusion that Arizona residents believe the enactment of Proposition 200 has led to dangerous unintended consequences 85% of registered voters in Arizona believe that Proposition 200 needs to be changed.  60% of registered voters believe it should be repealed.

References
1. Musto, David F. “The American Disease – Origins of Narcotic Contr6l’. OUP New York 1987 especially pp 70-73
2. US Bureau of the Census. Historical Statistics of the United States Colonial Times to 1970. Part One. Washington DC. 1975
3. See ref 1: especially pp 91. 115. Also Wall St Journal June 11th  1986. p30: Parade July 31st  1988
4. See ref 1. Also Wilson. James Q. “Against the Legalisation of Drugs”, Commentary February 1990, pp 21-28
5. Bejerot. N. ‘Drogue et Societe. Masson Paris 1990 ‘Cannabis: Physiopathology. Epidemiology, Detection.’ Nahas G & Latour C (eds). CRC Press. 1993.
6. Model. KE. The Effect of Marijuana Decriminalisation on Hospital Emergency Room Episodes 1975-1978. Journal of the American &Statistical Association. 88: 737-747. 1993
7. Rosenthal. MS. Report from North America. In “Cannabis: Physiopathology, Epidemiology. Detection.’ Nahas G & Latour C (eds). CRC Press~ 1993
8. News Release from the Office of Maricopa County Attorney, 301 West Jefferson, Phoenix, Arizona 85003

Filed under: Drug Specifics,USA :

By JAMES SLACK

Drug addicts have been given £2.5million of heroin and nursing care in NHS “shooting galleries” while law-abiding patients are denied life-prolonging treatment.

The addicts are allowed to inject themselves with a pure form of the class A drug in private rooms, under the supervision of round-the-clock nursing staff.

Despite free access to the drug – which costs £15,000 a year, including nursing care – many are still committing crimes.

But leaders of the joint Home Office and Department of Health project, which began quietly two years ago, say initial results are encouraging.

The pilot, limited to London, Brighton and Darlington, could eventually be rolled out nationwide.

Trial leader Professor John Strang, of the National Addiction Centre, based at London’s Institute of Psychiatry, said about 40 per cent of users in London had “quit their involvement with the street scene completely”. “Of those who have continued, which obviously is a disappointment, it goes down from every day to about four days per month,” he added.

“Their crimes, for example, have gone from 40 a month to perhaps four crimes per month. The reduction in crime is not perfect but is a great deal better for them and crucially a great deal better for society.”

The cost of the treatment, including providing heroin, is between £9,000 and £15,000 per patient – three times as much as a year’s course of methadone. It is restricted to hardcore addicts, who experts say cannot be helped in other ways. But critics questioned the decision to plough so much money into treating drug addicts when law-abiding citizens were being denied much-needed drugs.

Despite a huge public backlash, Alzheimer’s patients newly diagnosed with mild symptoms no longer qualify for medication – despite a cost of only £2.50 each day.

Drugs for some types of cancer, arthritis, bone disease and the prevention of blindness in older people are also being restricted, leading to claims of postcode prescribing and bitter court challenges.

Matthew Elliott, chief executive of the Taxpayers’ Alliance, said: “It shows a pretty warped sense of priorities to give criminals free drugs on the NHS whilst denying life-saving treatments to law-abiding citizens.

“Free healthcare shouldn’t be about getting high at the taxpayer’s expense. Drug users should be given help to give up their habits and to lead an honest life. We shouldn’t be aiding and abetting their personal failings.”

Shadow home secretary David Davis said: “This is a white flag approach. The Government are effectively conceding that the war on drugs is not winnable and instead spending millions of pounds trying to ‘manage’ addiction.

“We believe the Government should not focus spending on trying to manage drug addiction but should spend the drugs budget on ending addiction.

“We would do this by expanding the use of abstinence-based drug rehabilitation programs which have proved far more successful at getting people off drugs than the Government’s approach.

“By simply giving addicts drugs, the Government is betraying the people in our society who so desperately need our help, to a life of addiction.”

A spokesman for the Victims of Crime Trust said: “We should not be giving free Class-A drugs to addicts – many of whom will be prolific criminals – at a time when law-abiding members of the public are being forced to go to the High Court to get life-saving treatment.

“We need to get criminals off drugs and stop them re-offending, but it should not be at the expense of people whose only crime is to be gravely ill. We are allowing Class-A drug addicts to hold us to ransom.”

Dr Nicola Metrebian, who manages the clinical trials, acknowledged that supplying the addicts with the specially imported heroin is a heavy financial investment but she added: “It is more expensive than standard treatment, but what we do know is that standard treatment – although it is cheaper – is not effective for this group of people.”

Source: Daily Mail 19th Nov. 2007

Filed under: Drug Specifics :

The government was at loggerheads with its own advisers last night over its new drugs policy.

An influential Home Office-backed committee raised serious doubts about the consultation process behind the 10-year strategy which will be unveiled in April. The Advisory Council on the Misuse of Drugs (ACMD) described the process as ‘self-congratulatory and generally disappointing’ and questioned the credibility of much of the evidence presented to government.  

A spokesman for the Home Office said last month that the consultation process, which is being conducted by the polling agency Mori, had been ‘open’ and had included a wide range of views.

But the council said: ‘We consider that an opportunity has been missed to address the public health problem relating to drug misuse and the balance with law enforcement and the Criminal Justice System…The consultation would benefit from extending further to the wider social harm of drug misuse.’ 

It also said: ‘It is of concern that the evidence presented, and the interpretation given, are not based on rigorous scrutiny. It is not acknowledged that in many cases the information is uncertain and sometimes of poor quality.’ 

Last night politicians said the council’s response raised questions about whether the government was more interested in spinning its record than tackling the war on drugs. ‘The failures of the government’s drugs policy are laid bare for all to see when their own advisory committee condemns the Home Office as being misleading and self-congratulatory,’ said Liberal Democrat leadership contender Nick Clegg. ‘When will the government wake up and acknowledge something many members of the public know: we are losing the war on drugs?’ Clegg said  

Steve Rolles of think tank Transform, which advises the UN on drugs policy, said: ‘The consultation process behind the new strategy has been woeful.’ Last month Transform branded the consultation process a ‘sham’, saying the government had already made up its mind to continue with its current strategy. 

Concerns about the direction of the government’s next drugs strategy come as senior police officers warn that cannabis now presents a greater ‘long-term’ threat to Britain than cocaine. The increasing strength of high-grade ‘skunk’ combined with growing evidence of major criminal involvement in its production was fast becoming an issue of mounting concern. Hospitals recently revealed that the number of mental health admissions as a result of cannabis use had risen by 73 per cent.

 Source: The Observer December 2, 2007

Filed under: Drug Specifics :

Overdoses have claimed more than 30 lives in Glasgow this year

Councillors and drug groups in Glasgow and Lanarkshire are to pilot use of the anti-opiate revival drug Naloxone.

They believe heroin overdose deaths could be halved if addicts’ families are issued with the treatment to inject into overdose victims.

The Conservatives have criticised the £20,000 project as sending out a message that drug misuse is acceptable.

It is estimated that most drug overdoses are witnessed by members of family or friends of addicts.

Police have warned that purer heroin on the streets is contributing to a rise in overdose deaths.

Chaotic lives

In Glasgow alone there were 35 fatalities in the first four months of this year.

Glasgow City Council and the Lanarkshire Drug Action Team have now agreed on pilot projects to provide addicts’ families with Naloxone, which reverses opiate harm.

Neil Hunter, general manager of Glasgow Addiction Services, said: “We have to accept that there are some individuals in the city who are unable, at the moment, to benefit from rehabilitation or treatment.

“They are still leading fairly chaotic and high-risk lives and we have to do something to intervene to try to avoid any harmful consequences.”

However, Scottish Conservative health spokesman David Davidson said: “It’s as if the agencies have given up all hope of getting people away from drugs and getting people back into society.”

Source: BBC News 11th June 2006

Filed under: Drug Specifics :

DRUG USERS IGNORE NEEDLE BINS AS HUNDEREDS THROWN AWAY IN STREETS SURROUNDING CITY CBD;
By Sonia Campbell

CITY Place has been revealed as Cairns’s biggest drug shooting gallery with 1000 syringes discarded since January in toilets and streets surrounding the inner city mall. Addicts are also dumping hundreds of used syringes at many of the city’s other popular public places, including the Esplanade near Muddy’s playground and the city library.

The figures were released this week by Cairns City Council after an audit of its sharps disposal bin program. From January to October the highest number of needles placed in sharps containers in public toilets in Cairns and south of the city were – City Place (700), McKenzie St (188), Lennon Park in West Cairns (129), and Greenpatch at Gordonvale (100).

While the council says the figures confirm the sharps disposal program is working, alarmingly hundreds more used syringes are being discarded carelessly on the ground and in gardens in various public places.

Most of them were found at City Place (300), the Esplanade from Muddy’s to the pirate ship (100), City library (100), and old library site on Lake St (100). “These figures that we’ve got are basically for the southern and city areas and we’re waiting on the northern areas,” Cr Margaret Cochrane said yesterday.

Cr Cochrane said while the City Place figure of 300 syringes found improperly discarded was of particular concern, it wasn’t “disturbing”. “It’s only one improperly discarded needle a day. Which shows that the (sharps) receptacles are being utilised to their intent and the current program is working where the receptacles are,” she said. However, she said in light of the figures, the council would monitor the area more closely. “There would be an opportunity to view the footage on the (security) cameras … and our staff just need to be a little bit more aware of what’s going on.”

Dianne Forsyth from the Cairns Addiction Help Agency said while any used syringe found in a public place was a concern, the numbers being found were quite low, given that about 500,000 needles were issued to the city’s IV drug users in the needle exchange program each year.

“If you look at the number of (discarded) needles that we’re actually collecting, I’m assuming that most are disposing of them safely somewhere else,” Ms Forsyth said. She said more education material supplied to those accessing the city’s needle program, could be one solution.

Cairns Mayor Kevin Byrne said the results of the audit would be used to determine other areas where sharps disposal bins were needed.

Source: The Cairns Post/The Cairns Sun (Australia) December 3, 2005 Saturday

Filed under: Drug Specifics :

Editorial Comment on British government’s New Media strategy for drugs. May 2003

NEW BRITISH MEDIA DRUG CAMPAIGN HAS SCHIZOID TENDENCIES

Late May saw the public launch, on satellite and terrestrial channels, of the British Government’s latest strategy concerning drug misuse. The strategy includes an array of TV and radio announcements, a new web page (www.talktofrank.com), a new telephone help line (to replace the National Drugs Helpline), an email help line, and a collection of CD Rom or print based materials, which local agencies are encouraged to use to promote the campaign and to generate activities with the public. The budget for this campaign is set at £3 million a year for the next three years. The strategy has been given the brand name of ‘Frank’ – this was chosen after much internal contemplation and focus group dialogue. The organizers perceive this brand name to convey an image which is non-judgmental, honest, down-to-earth, entertaining and always there for you – maybe something like an older uncle … that kind of relative whom young people would feel more comfortable speaking with than they would with their own parents. 

The most usual dictionary definition of the word ‘FRANK’ is “open, honest and direct, especially when dealing with unpalatable matters ” … but another definition – intriguingly – is the “stamping of an official mark on a communication”. Moreover, the original Franks were a people that controlled much of Western Europe for several centuries … the choice of name for this campaign might therefore achieve a certain resonance in Downing Street (as an ‘aspirational target’, anyway).

It would be quite wrong to be unremittingly carping about Frank; there are aspects which deserve commendation and encouragement. Paul Betts, father of the late Leah Betts, whose death from ecstasy sparked off a major media campaign, expressed himself encouraged by some of the content, and by the principle of ‘talking with’ rather than ‘talking at’ the young (not a new practice, but certainly a good one). At the same time any campaign which sets itself up as being ‘open, honest and direct’ must expect commentary upon it to be likewise. An overview, therefore, would conclude that there is a mix of the good and the bad; a mix of the sophisticated and the naive – and, above all, Frank seems to be suffering from schizophrenia when he contemplates his goals.

This last point is most evident when