INTERNATIONAL NEWS

Two major public health issues are colliding,’ CDC official warns

Public health officials grappling with record-high syphilis rates around the nation have pinpointed what appears to be a major risk factor: drug use.

“Two major public health issues are colliding,” said Dr. Sarah Kidd, a medical officer at the Centers for Disease Control and Prevention and lead author of a new report issued Thursday on the link between drugs and syphilis.
The report shows a large intersection between drug use and syphilis among women and heterosexual men. In those groups, reported use of methamphetamine, heroin and other injection drugs more than doubled from 2013 to 2017.
The data did not reveal the same increases in drug use among gay men with syphilis, the group with the highest rates of the disease.

Researchers said the results suggest that drug use — and the risky sexual behaviors associated with it — may be driving some of the increase in syphilis transmission among heterosexuals.
People who use drugs are more likely to engage in unsafe sexual behaviors, which put them at higher risk for sexually transmitted diseases, experts said. The CDC also saw increases in syphilis among heterosexuals during the crack cocaine epidemic of the 1980s and 1990s, and use of the drug was associated with higher syphilis transmission.
“The addiction takes over,” said Patricia Kissinger, an epidemiology professor at Tulane University School of Public Health and Tropical Medicine.

For example, people using drugs may avoid condoms, have multiple sex partners or exchange sex for drugs or money — all significant risk factors for sexually transmitted diseases, said Dr. Sara Kennedy, medical director of Planned Parenthood Northern California.
“I think it’s impossible to eradicate syphilis and congenital syphilis unless we are simultaneously addressing the meth-use and IV-use epidemic,” Kennedy said.
Syphilis rates are setting records nationally. They jumped by 73 percent overall and 156 percent for women from 2013 to 2017. The highest rates were reported in Nevada, California and Louisiana.
Syphilis — which had been nearly eradicated before its resurgence in recent years — is treatable with antibiotics, but if left untreated it can lead to organ damage and even death. Congenital syphilis, which occurs when a mother passes the disease to her unborn baby, can lead to premature birth and newborn deaths.

The study’s authors analyzed syphilis cases from 2013 to 2017 and determined which patients had also reported using drugs. They discovered methamphetamine was the biggest problem: More than one-third of women and one-quarter of heterosexual men with syphilis reported using methamphetamine within the previous year.
Substance use among both populations was highest in 13 Western states and lowest in the Northeast. In California, methamphetamine use by people with syphilis nearly doubled for women and heterosexual men from 2013 to 2017, according to the California Department of Public Health.

‘OPPORTUNITY LOST’

The intersecting epidemics of sexually transmitted infections and substance abuse make it harder to identify and treat people with syphilis because drug use makes people less likely to go to the doctor and to report their sexual partners, Kidd said.
Pregnant women also may be reluctant to seek prenatal care and get syphilis testing and treatment because of concerns their doctor will report the drug use.
To stem the transmission of syphilis, the CDC urges more collaboration between programs that address STDs and programs that treat substances abuse.

Drug use is an “incredibly huge contributing factor” to somebody getting an STD and transmitting it, said Jennifer Howell, sexual health program coordinator for the health district in Washoe County, Nev.
“Everybody needs to see that we are dealing with a lot of the same clients,” she said.
Fresno County has the highest rate of congenital syphilis in California. Its health department analyzed 25 cases of congenital syphilis in 2017 and determined that more than two-thirds of the mothers were using drugs, said Joe Prado, the county’s community health division manager.
The county has started offering STD testing for people entering inpatient drug treatment facilities, Prado said. “That’s our opportunity to get them screened,” he said.
Those who return for the results are offered incentives such as gift cards. The county also gives people in drug treatment a care package that contains condoms and education materials about sexually transmitted infections, Prado said.

The city of Long Beach sends a mobile clinic to drug treatment facilities, where it provides HIV testing, said Dr. Anissa Davis, the city’s health officer. She said Long Beach hopes to expand services to include screening for other sexually transmitted infections.
Although increased collaboration between drug treatment providers and STD clinics is essential, it’s not always easy because they traditionally have not worked together, said Kissinger of Tulane.
“The STI people are hyper-focused on STIs and the substance abuse people are focused on substance abuse,” she said. It is an “opportunity lost” if people in drug treatment aren’t screened for syphilis and other sexually transmitted infections, she added.

Fighting the rising rates of syphilis will also require more resources, said Dr. Jeffrey Klausner, a professor of medicine and public health at UCLA.
“The STD workforce has almost entirely disappeared,” he said. “While policies could be put in place that require syphilis testing, those policies also have to come with resources.”

SOURCE: ANNA GORMAN, KAISER HEALTH NEWS 15TH FEB2019

If you’re a gun-owning Pennsylvania resident, the Pennsylvania State Police are urging you to turn in your firearms if you are seeking medical marijuana cards.

Sorry, what?

statement from the Pennsylvania State Police’s website is receiving a lot of local attention over what appears to be an erroneous statement concerning state and federal law.

The statement reads:

“It is unlawful for you to keep possession of any firearms which you owned or had in your possession prior to obtaining a medical marijuana card, and you should consult an attorney about the best way to dispose of your firearms.”

According to the Pittsburgh Post-Gazette, state police spokesman Ryan Tarkowski suggested seeking legal counsel if a citizen possesses firearms before seeking and receiving medical marijuana.

“It’s unlawful to keep possession of firearms obtained prior to registering,” Tarkowski said.

“The Pennsylvania State Police is not in the business of offering legal advice, but it might be a good idea to contact an attorney about how best to dispose of their firearms,” Tarkowski suggested.

Criminal defense attorney Patrick Nightingale told KDKA-TV on Monday that the suggestions being pushed by the state police disturb him.

“It disturbs me greatly to see the Pennsylvania State Police put on their website references to federal law while ignoring the fact that it is legal under Pennsylvania law,” Nightingale said.

“Firearms are woven into the fabric of our country,” Nightingale added. “It’s the second most important right in the Bill of Rights.”

Here’s the catch

According to Pennsylvania state law, the use of medical marijuana is legal, and not a hindrance to owning a firearm. However, according to the state police website, Pennsylvania’s legalization of medical marijuana is not federally recognized.

According to 18 U.S.C. § 922(g)(3) and 27 C.F.R. § 478.32(a)(3), possession of a medical marijuana card and the use of medical marijuana determines that a citizen is an “unlawful user of or addicted to any controlled substance.”

Federal law prohibits an “unlawful user of or addicted to any controlled substance” from purchasing, acquiring, or possessing a firearm.

In short, federal law says it is illegal for a citizen to attempt the purchase of a firearm if they are a medical marijuana cardholder.

This isn’t new information: the Bureau of Alcohol, Tobacco, Firearms, and Explosives (ATF) has held the position since 2011 that no one in possession of a medical marijuana card may also legally own a firearm.

Generally speaking, state police cannot enforce federal law unless a statute gives them express permission to do so. Pennsylvania law is somewhat ambiguous on this point, allowing the PSP make arrests “for all violations of the law,” without specifying whether this includes federal law.

If marijuana is considered a controlled substance — much like opioids — then one might wonder why are opioid users permitted to own firearms.

Attorney Andrew Sacks, co-chair of the Pennsylvania Bar Association’s Medical Marijuana and Hemp Law Committee, told the Pittsburgh Post-Gazette the same thing.

“It’s hypocritical,” Sacks said. “You can be an opioid addict, or buy a bottle of rum, drink it and go to a store and buy one. But a person who is registered as a medical marijuana patient in Pennsylvania, and has a very small dosage of THC, can’t own a gun to protect themselves or hunt.”

What is synthetic cannabis?

Synthetic cannabis is a new psychoactive substance that was originally designed to mimic or produce similar effects to cannabis and has been sold online since 2004. However, some of the newer substances claiming to be synthetic cannabis do not actually mimic the effects of THC (delta-9 tetrahydrocannabinol, the active ingredient in cannabis).

Reports suggest it also produces additional negative effects. These powdered chemicals are mixed with solvents and added to herbs and sold in colourful, branded packets. The chemicals usually vary from batch to batch as manufacturers try to stay ahead of the law, so different packets can produce different effects even if the name and branding on the package looks the same.

Other names

Synthetic cannabis is marketed under different brand names.

Spice was the earliest in a series of synthetic cannabis products sold in many European countries. Since then a number of similar products have been developed, such as Kronic, Northern Lights, Mojo, Lightning Gold, Blue Lotus and Godfather.

Synthetic cannabis is also marketed as aphrodisiac tea, herbal incense and potpourri.

How is it used?

It’s most commonly smoked and is sometimes drunk as a tea.

Effects of synthetic cannabis

There is no safe level of drug use. Use of any drug always carries some risk. It’s important to be careful when taking any type of drug.

Synthetic cannabis affects everyone differently, based on:

  • Size, weight and health
  • Whether the person is used to taking it
  • Whether other drugs are taken around the same time
  • The amount taken
  • The chemical that is used and its strength (varies from batch to batch)

Synthetic cannabis is relatively new, so there is limited information available about its short- and long-term effects, including how safe or unsafe it is to use. However, it has been reported to have similar effects to cannabis along with some additional negative and potentially more harmful ones including:

  • Fast and irregular heartbeat
  • Racing thoughts
  • Agitation, anxiety and paranoia
  • Psychosis
  • Aggressive and violent behaviour
  • Chest pain
  • Vomiting
  • Acute kidney injury
  • Seizures
  • Stroke
  • Death

Long-term effects

There has been limited research into synthetic cannabis dependence. However, anecdotal evidence suggests that long term, regular use can cause tolerance and dependence.

Withdrawal

Giving up synthetic cannabis after using it for a long time is challenging because the body has to get used to functioning without it.

It has been reported that some people who use synthetic cannabis heavily on a regular basis may experience withdrawal symptoms when they try to stop, including:

  • Insomnia
  • Paranoia
  • Panic attacks
  • Agitation and irritability
  • Anxiety
  • Mood swings
  • Rapid heartbeat

The risk of tolerance and dependence on synthetic cannabis and their associated effects may be reduced by taking regular breaks from smoking the drug and avoiding using a lot of it at once.

Health and safety

There is no safe way to use synthetic cannabis. If you do decide to use the drug, it’s important to consider the following

Regulating intake

  • It is difficult to predict the strength and effects of synthetic cannabis (even if it has been taken before) as its strength varies from batch to batch.
  • Trying a very small dose first (less than the size of a match head) could help gauge the strength and possible effects. Dose size should only be increased slowly – time should be given for the previous dose to wear off.
  • Taking synthetic cannabis on its own without a ‘mixer’ such as tobacco or dried parsley should always be avoided. Similarly, inhaling the drug via bongs or pipes can increase the risk of an overdose or bad reaction.

Misleading packaging

  • The packaging of synthetic cannabis can be misleading. Although contents may be described as ‘herbal’, the actual psychoactive material is synthetic.
  • Not all ingredients or their correct amounts might be listed, which can increase the risk of overdose.
  • Chemicals usually vary from batch to batch, so different packets can produce different effects, even if the packaging looks the same.

Mental health risks

  • People with mental health conditions or a family history of these conditions should avoid using synthetic cannabis. The drug can intensify the symptoms of anxiety and paranoia.
  • Taking synthetic cannabis in a familiar environment in the company of people who are known and trusted may alleviate any unpleasant emotional effects. Anxiety can be counteracted by taking deep, regular breaths while sitting down.

When it absolutely shouldn’t be used

Use of synthetic cannabis is likely to be more dangerous when:

  • Taken in combination with alcohol or other drugs, particularly stimulants such as crystal methamphetamine (‘ice’) or ecstasy
  • Driving or operating heavy machinery
  • Judgment or motor coordination is required
  • Alone (in case medical assistance is required)
  • The person has a mental health problem
  • The person has an existing heart problem

In an emergency

There have been a number of deaths caused by synthetic cannabis. Call triple zero (000) immediately if someone is experiencing negative effects such as:

  • Fast/irregular heart rate
  • Chest pain
  • Breathing difficulties
  • Delusional behaviour

Ambulance officers don’t have to involve the police.

Synthetic cannabis statistics

National

  • 2.8% of Australians aged 14 years and over have used synthetic cannabis at some stage in their lives.
  • 0.3% of Australians aged 14 years and over have used synthetic cannabis in the previous 12 months.

According to Australian data from the Global Drug Survey, synthetic cannabis was the 33rd most commonly used drug – 1.1% of respondents had used this type of drug in the last 12 months

Synthetic cannabis and the law

The laws surrounding NPS are complex, constantly changing and differ between states/territories, but in general they are increasingly becoming stronger.

In Queensland, New South Wales, South Australia and Victoria there is now a ‘blanket ban’ on possessing or selling any substance that has a psychoactive effect other than alcohol, tobacco and food.
In other states and territories in Australia specific NPS substances are banned and new ones are regularly added to the list. This means that a drug that was legal to sell or possess today, may be illegal tomorrow. The substances banned differ between these states/territories.

Source: https://adf.org.au/drug-facts/synthetic-cannabis/ May 2019

From afar, America’s opioid epidemic may seem like just another sensationalised scare story in a country constantly at war with drugs. But this is not a fad, nor an overblown segment on morning television. It is real, it is decimating entire counties, and it represents the summation of the country’s failures towards its own citizens over decades.

Twenty million Americans have some form of opioid addiction, and those addictions kill almost 150 people every day.

The CDC estimates that 64,000 Americans died of drug overdoses last year

Twenty million is a shocking number of people for whom the ordinary act of living is crushing. An opioid addiction is fundamentally an instinct to numb, to sleep, to exist unencumbered. It is made possible by over-prescription from doctors and aggressive lobbying from pharmaceutical companies, but it reflects the deeper malaise of places and people whose lives have few prospects for dramatic improvement.

As we saw last November, that malaise has become desperation, and that desperation now covers a vast swathe of the electorate.

America was never a feudal society, and so our national mythology does not include a character who exemplifies the nobility of poverty; in a country of pilgrims and pioneers, driven by Calvinist mores, being poor suggests that you’re just not working hard enough.

Faced with a society where poverty is considered a deficiency of both morals and material wealth, and where it has become more difficult to outdo your parents, it is easy to see how a life enslaved to the brief release of opioids seems preferable to one spent in the ugly realities of hardship.

The death toll has been staggering. The Centers for Disease Control estimates that 64,000 Americans died of drug overdoses last year – the whole 20 years of the Vietnam War, by contrast, cost 58,000 American lives.

Between 1999 and 2015, drugs killed 560,000 Americans; over the next decade, they are expected to take another half million lives. These are the kind of numbers that make you sit up and wonder how there aren’t daily protests outside the Food and Drug Administration’s headquarters – until you realise that many of those affected by this crisis gave up on the idea of change, or even hope, a long time ago.

If you believe, as so many Americans do, that everything from voting to the economic system itself is rigged, why would you bother trying to change things?

In the wake of the financial crisis, when a generation (my generation) was told that the white-collar jobs for which they’d spent 20 years and a small fortune preparing were no longer available, many dissembled entirely. In previous generations, being a middle-class white kid in America guaranteed a life devoid of difficult decisions; suddenly, the system (and the social contract which came with it) collapsed.

President Donald Trump announced in August that he would declare opioid abuse a national emergency

With the purposeful numbness of the corporate world out of reach, many chose a different sort of numbing agent. And so what began as “hillbilly heroin” went mainstream, snaking its way through leafy suburbs up and down the East Coast.

Nevertheless, the reinvention of heroin and opioids as scourges of “nice” families means that drug reform and rehabilitation are stamped in bold type on to the conservative political agenda.

Nearly every GOP candidate in the crowded 2016 primary spent time stomping around New England and the Rust Belt, partaking in the grief of families who had lost children or spouses to this epidemic, and offering aggressive plans for reform.

President Donald Trump announced in August thathe would declare opioid abuse a national emergency, a mechanism ordinarily deployed after natural disasters. It appears that this declaration could be coming early next week, although its parameters, and thus its efficacy in addressing a problem as systemic as opioid abuse, remain unclear.

It is difficult to imagine any successful intervention in this crisis which stops at methadone clinics, naloxone for overdoses and needle exchanges. Addiction perpetuates the cycles of poverty, but it is also a symptom of that poverty and the despair that accompanies it.

Creating hope in communities where the lights went out years ago is key to preventing the creation of future addicts, and to convincing current addicts that society can offer them something better than a few hours of escape.

It is time for this administration to move past flashy announcements, and to settle into the grunt work of crafting policy that tackles the effects, but also the root causes, of opioid addiction.

Molly Kiniry is a researcher at the Legatum Institute

Source: https://www.telegraph.co.uk/news/2017/10/21/opioid-epidemic-crushing-americas-middle-class-need-action-not/ October 2017

Donald Trump’s choice of his VP running mate, Indiana Gov. Mike Pence, worries the marijuana lobby. They question Pence’s belief that marijuana is a gateway drug and its abuse is a crime, deserving penalty. While the marijuana lobby claims “Marijuana is a happy, healthy, wonderful plant and everybody should have the right to grow it, just as they grow dandelions,” the National Insitute of Drugs (NIDA) findings support Pence’s objection to the legalization of marijuana.  According to NIDA’s latest available data, “illicit drug use in the U.S. is on the rise, and “More than half of new illicit drug users begin with marijuana.” Yet, marijuana legalization has become an issue in the U.S. presidential elections.

How did we get here?

The impresario who staged and pushed to legally dope of the American people is the billionaire financier George Soros. He found a kindred spirit in President Obama who got this dog and pony show on the road. The chosen vehicle was Obama-Care. And the first indication for this came on August 5, 2009, with the National Institute on Drug Abuse (NIDA)’s little noticed tender for the production and distribution of large quantities of marijuana cigarettes, for purposes other than for research, clocked under the DEA control and supposedly in compliance  with FDA regulations

According to pro-legalization activist Sean Williams, “President Obama has suggested that the best way to get the attention of Congress is to legalize marijuana in as many states as possible at the state level. If a majority of states approve marijuana measures, and public opinion continues to swell in favor of cannabis, Congress may have no choice but to consider decriminalization — or legalize the substance.” Not surprisingly, recently  there have been widely-reported leaks from the DEA  that the agency anticipates making “medical” marijuana” legal in all 50 states, even though this requires FDA approval.

Until the early 1990s, the voices to legalize drugs in the United States were not in sync. This changed with Soros’ first foray into U.S. domestic politics in 1992-1993. Soros, who made his fortune by bidding on instability, is known to say, “If I spend enough, I make it right.” While other billionaires give to the arts, higher education and medicine to better the quality of the lives of their fellow men, Soros chose to “right” illegal drug use, under the guise of a social reformer. “The war on drugs is doing more harm to our society than drug abuse itself.” Due to the widespread social and political opposition to illegal drug use, he chose to begin his efforts to “right” the situation, with a popular getaway drug, marijuana – a brain and mind altering drug that creates life-long dependency. To make his decision more palatable, the ultimate opportunistic Soros, declared marijuana is a “compassionate drug,” and for more than two decades poured tens of millions of dollars into campaigns to first legalize the use of “medical marijuana,” and more recently to decriminalize the use of “recreational” marijuana. 

Pretending to support an “open society,” Soros,  uses his philanthropy to “change” or more accurately deconstruct the moral values and attitudes of the Western world, and particularly of the American people. He claims to support humanitarianism, equality and individual and political freedom, what Karl Pooper, the Austrian-born British philosopher argued were necessary for what he considered an “open society.”nominal contact with Popper while studying at the London School of Economics. Although Popper met with Soros once or twice while Soros was a student at the London School of Economics, Soros failed to make much of an impression on the old philosopher. According to Michael T. Kaufman’s 2003 unauthorized biography of the billionaire, when Soros contacted Popper in 1982 to let him know about how he’d been naming funds, foundations, and various other entities after the concepts enshrined in the The Open Society, Popper wrote back: “Let me first thank you for not having forgotten me. I am afraid I forgot you completely; even your name created at first only the most minute resonance. But I made some effort, and now, I think, I just remember you, though I do not think I should recognize you.”

Not surprisingly, Soros’ “open society” Institute and foundations are not about promoting any of Popper’s ideas. Certainly not freedom.  Instead, by working diligently to legalize drugs, Soros advances the greatest slavery ever–drug addiction. This sits well with his rejection of the notion of ordered liberty, in favor of a progressive ideology of rights and entitlements.

On February 7, 1996, I opined in The Wall Street Journal that Soros’s “sponsorship unified the movement to legalize drugs and gave it the respectability and credibility it lacked.” I suggested “unchallenged, Soros would change the political landscape of America.” It took two decades and lots of money to achieve what he set out to get. For him, legalizing marijuana was a necessary stepping-stone to advancing drug policies in the U.S. and elsewhere toward legalizing the use of all drugs.

Money is but one of the many possible speculations on Soros’s motivation to legalize drugs. If asked, he’ll respond with gibberish that makes no sense.  However, the revenues from the illegal drug trade are enormous. There are no other commodities on the market that yield such high and fast a return. Since 2014, legally listed marijuana producing and distributing companies will be generating huge revenues. Soros seems to believe that state-controlled drug distribution will best serve to increase dependency on the state.

The overwhelming evidence on the short and long term harm caused by marijuana to the user and to society should have stopped any attempt to legalize the drug. However, the vast amounts of money spent on influencing the public and the politicians generated the desired social acceptance of the “compassionate drug,” marijuana. 

In November 1996, Soros’ efforts succeeded in California, making it the first state to legalize “medical marijuana.”

Recreational use of marijuana has nothing to do with medical marijuana. As with other drugs, the development of marijuana/cannabis as medicine has to follow modern medical rules – advancing with clinical trials with specific compounds, looking for side effects and interactions with other drugs, etc.

But when last November, the DEA Acting Administrator Chuck Rosenberg said, “We can have an intellectually honest debate about whether or not we want to legalize something that is bad and dangerous, but don’t call it medicine. That’s a joke.” Rosenberg opined there was a need for “legitimate research into the efficacy of marijuana for its constituent parts as a medicine. But I think the notion that state legislatures just decree it so is ludicrous.” The pro-drug lobby called for his dismissal. 

Among the ill-effects of marijuana use (whether obtained legally or not) is memory loss, as proven by researchers at Northwestern University. The study also found “evidence of brain alterations … significant deterioration in the thalamus, a key structure for learning, memory, and communications between brain regions.”  If this were not enough, the study concluded, “chronic marijuana use could “memory-related structure [to] shrivel and collapse.s..[and] boosts the underlying process driving schizophrenia.”

This study as many others documented the devastating long-term harm caused by marijuana use. Another National Institute on Drug Abuse (NIDA) study found that “marijuana smoke contains 50% to 70% more carcinogenic hydrocarbons than does tobacco smoke … which further increases the lungs’ exposure to carcinogenic smoke.” Moreover, “marijuana users have a 4.8-fold increase in the risk of heart attack in the first hour after smoking the drug. … This risk may be greater in aging populations or those with cardiac vulnerabilities.”

Other studies documented “distorted perceptions, impaired coordination, difficulty in thinking and problem-solving, and problems with learning and memory.”  As a result, someone who smokes marijuana every day may be functioning at a suboptimal intellectual level all of the time.” In conclusion: “Research clearly demonstrates that marijuana has the potential to cause problems in daily life or make a person’s existing problems worse. In fact, heavy marijuana users generally report lower life satisfaction, poorer mental and physical health, relationship problems, and less academic and career success compared to their peers who came from similar backgrounds. For example, marijuana use is associated with a higher likelihood of dropping out from school. Several studies also associate workers’ marijuana smoking with increased absences, tardiness, accidents, workers’ compensation claims, and job turnover.” NIDA’s latest survey from 2013, show that drug users are exacting more than $700 billion annually in costs related to crime, lost work productivity and health care. Add yo this the cost of newly hooked Americans on social welfare, including food stamps, Obamacare, public housing, free cell phones, and other entitlements.

Moving to relax Federal oversight on marijuana use, a Department of Justice memo on August 29, 2013, clarified the government’s prosecutorial priorities and stated that the federal government would rely on state and local law enforcement to “address marijuana activity through enforcement of their own narcotics laws.”

When Colorado legalized the use of “recreational” use of marijuana, on January 1, 2014, the TSA announced it stopped deploying detection dogs in the state’s airports, even though these dogs are trained to also detect other illegal drugs, explosives, blood, contraband electronics, stashed currency, and more. Similar measures will take place once marijuana is legalized, exposing American airport to terrorist attacks.

The Obama’s endorsed and Soros’ funded Democratic presidential candidate Hillary Clinton, has promised to “defend and build on the progress…made under President Obama,” including his and the billionaire’s efforts to legalize marijuana. American voters should keep this in mind when voting for their next President.

Source: http://acdemocracy.org/the-obama-soro-legacy/ July 2016

This week, the Rocky Mountain High Intensity Drug Trafficking Area released its fifth annual report titled The Legalization of Marijuana in Colorado: The Impact, Volume 5. We devote today’s issue of The Marijuana Report newsletter to highlighting a few of many significant findings the report contains.

National Families in Action has remade some of the graphs and charts in the report to emphasize key findings. This one shows how many of Colorado’s students were expelled, referred to law enforcement, or suspended in the 2015-2016 school year. This is the first year the Colorado Department of Education differentiated marijuana violations from all drug violations, and this year’s report will serve as a baseline to determine whether marijuana violations increase, decrease, or stay fundamentally the same.

Read The Legalization of Marijuana in Colorado: The Impact, Volume 5 here. This information appears on page 41 (PDF page 49).
The new report explains that although Colorado created its own Healthy Kids Survey, the combination of a poor response rate and the fact that several major counties with large populations had low or no participation rendered the 2015 survey’s results invalid. For a discussion of this see page 33 (PDF page 41). Volume 5 relies on the National Survey on Drug Use and Health to compare Colorado marijuana use with the national average for ages 12-17, 18-25, and 26 & older over a ten year period (2005-2006 to 2014-2015).

See data for these graphs on the following pages:

  • Ages 12-17, page 36 (PDF page 44)
  • Ages 18-25, page 56 (PDF page 64)
  • Ages 26 & Older, page 60 (PDF page 68)

Read The Legalization of Marijuana in Colorado: The Impact, Volume 5 here.
The report notes that data from the National Highway Traffic Safety Administration, 2006-2011 Fatality Analysis Reporting System (FARS), and 2012-2016 Colorado Department of Transportation show that drivers testing positive for marijuana who were killed in traffic crashes rose from 6 percent of all traffic deaths in 2006 to 20 percent eleven years later. Marijuana-related traffic deaths jumped from 9 percent to 14 percent once the state commercialized marijuana for medical use and from 11 percent to 20 percent after legalizing the drug for recreational use.

Read more about marijuana-related driving in Colorado here starting on page 13 (PDF page 21).
In 2016, more than one-third of Colorado drivers who tested positive for marijuana had marijuana only in their systems. Another 36 percent had marijuana and alcohol. Slightly over one-fifth tested positive for marijuana and other drugs but no alcohol, while 7 percent had marijuana, alcohol, and other drugs on board.

See page 18 (PDF page 26) in The Legalization of Marijuana in Colorado: The Impact, Volume 5 here.
The Marijuana Report is a weekly e-newsletter published by National Families in Action in partnership with SAM (Smart Approaches to Marijuana).

Visit National Families in Action’s website, The Marijuana Report.Org, to learn more about the marijuana story unfolding across the nation.

Our mission is to protect children from addictive drugs
by shining light on the science that underlies their effects.

Addictive drugs harm children, families, and communities.
Legalizing them creates commercial industries that make drugs more available,
increase use, and expand harms.

Science shows that addiction begins in childhood.
It is a pediatric disease that is preventable.

We work to prevent the emergence of commercial
addictive drug industries that will target children.

We support FDA approved medicines.

We support the assessment, treatment, and/or social and educational services
for users and low-level dealers as alternatives to incarceration.

About SAM (Smart Approaches to Marijuana)

SAM is a nonpartisan alliance of lawmakers, scientists and other concerned citizens who want to move beyond simplistic discussions of “incarceration versus legalization” when discussing marijuana use and instead focus on practical changes in marijuana policy that neither demonizes users nor legalizes the drug. SAM supports a treatment, health-first marijuana policy.  SAM has four main goals:

  • To inform public policy with the science of today’s marijuana.
  • To reduce the unintended consequences of current marijuana policies, such as lifelong stigma due to arrest.
  • To prevent the establishment of “Big Marijuana” – and a 21st-Century tobacco industry that would market marijuana to children.
  • To promote research of marijuana’s medical properties and produce, non-smoked, non-psychoactive pharmacy-attainable medications.

Source: Email from National Families in Action http://nationalfamilies.org October 2017 

For those who are still concerned about ‘evidence based science’ and ‘best medical and pharmaceutical practice’…the following ‘open letter’ with attachments was sent to all Federal Senators, NSW and Victorian Premiers last week. 

Dear Senator,
 
In the coming weeks/months, you will no doubt be presented with a Bill to consider changing both law and process to permit a new version of ‘medical marijuana’. On behalf of our Institute and a concerned public I would like you to carefully consider the following.

Firstly I write with some concerns about the consultation conducted on behalf of Victorian State government by the VLRC in Melbourne on May 6th this year and the now subsequent recommendations that have emerged from this very small Melbourne meeting (Less than 60 people in attendance! – This issue was directly raised with Victorian Health Minister earlier this year).

Whilst we gleaned from radio interviews with VLRC representatives prior to the consultation that the public discussions on the potential introduction of a new form ‘medical marijuana’ (different to existing medicinal forms of cannabis derived pharmaceuticals already in the Australian market) were not for changing laws to suit a particular agenda. It was instead implied that the purpose was to look at potential redundancies that might hinder best practice.  It was to be, for all intents and purposes an unbiased mechanism to: glean evidence, perspectives, opinions and ideas from the general public for consideration in the higher and more important discussion of wise, evidence based, best healthcare practice before making any move on the release of another version of therapeutic cannabis.

Conversely, our affiliate/colleagues experience of the very small Melbourne consultation did not reflect any of the above expectation. Rather those of our affiliates who attended observed the following:

  1. A seemingly deliberately emotively charged atmosphere, in favour of getting cannabis legalised for medical purposes. The tone seemed to be set to that end from the outset.
  2. The meeting was facilitated by representatives of the VLRC who appeared to have a bias toward the legalisation of ‘medical marijuana’ in manner that suited the self-medicating option, regardless of evidence based science.
  3. When attempts were made to present evidence contrary to the seemingly predetermined agenda of these facilitators, they were either quickly shut down (if they dared to speak in the first place) or continually ignored; apparently, dissenting opinions were not welcome. Whilst at the same time, proponents for ‘self-medication’ use of cannabis were given complete and unfettered access to the floor, producing statements such as:“Many, many people have been cured – from just about anything and everything.”
    “What would you rather have – infertility or 35 seizures a day?”
    “Random workplace drug testing is wrong.”Not only are these statements (now on record) outrageous, they are also utterly unsubstantiated by any legitimate clinical trial. This very small contingent of pro-cannabis lobbyists were permitted to simply spruik anecdotes with no evidence based presentation yet also had their evidenced-deprived opinions affirmed and validated by the facilitators.
  4. The facilitators appeared to infer that the Government (of Victoria, at least) already has legislation in place with this current ‘consultation’ process simply in play to validate those changes and therefore it is in essence a forgone conclusion. There was also a strong indication that either the A.M.A. or T.G.A. recommendations or processes would be ignored and negated wherever possible by simple legal changes.

Senator, it is a concern that if this particular experience of ours was repeated in other consultations with the same consensus manufacturing agenda, then this consultative process is a travesty.

If a government negates not only good evidence based science, but also established protective, best practice medical processes to enable a legal rite of passage for self-medication, it is placing itself at an extremely high risk of litigation. Future law-suits are likely, from the ‘victims’ of self-medicating regimes who will cite the changes in law that were NOT based on proper clinical trial or TGA and AMA recommendations and protocols.  When emotionally charged vitriol combines with vote chasing and misguided sympathies, it is the recipients of these untested substances that will be the final casualties – especially children! Compassion and wisdom dictate that all fair and democratic processes be engaged to maximise help and minimise harm, especially to children who will be the ones at greatest risk of an ill-advised self-medicating regime.

Senator, for purposes of clarification about the possible national legalisation of ‘another’ route/process/protocol for medicines are you able to confirm or deny that:

  1. The representations by the facilitators at the Melbourne consultation are in fact reflective of the pre-ordained intent of the public consultation documented above in not only Victoria, but other States and Territories?
  2. If not, will a review of the practice/method/behaviours be made into this particular process and subsequently the clearly questionable recommendations that have emerged from such narrow, non-evidence based and seemingly biased processes?
  3. A fair and proper representation of all views on this matter be gleaned from these meetings/consultations and interpreted and represented fairly without prejudice?
  4. A.M.A. and T.G.A. processes and protocols for best practice on medicines will be upheld and engaged, or simply ignored and by-passed?

Finally Senator, it is of grave concern that a pattern seems to be emerging from this ‘populist’ process, that best practice, evidence based protocols may simply be ignored and by passed.  If this is indeed the plan and the use of VLRC type agencies is the vehicle to do so, then the following must be raised.

The Dalgarno Institute ask:

  • Do you want your government and your ministerial role to be linked with a poorly considered and non-evidenced based process that enables a self-medicating policy – particularly for the ones the State has greatest responsibility to protect – the children?
  • Will your government and ministerial role be the ones who in so ignoring proper clinical processes facilitate a quasi-health regime that will precipitate immediate and long term unwanted side effects that can then be later subject to litigation and class-actions?
  • If an unqualified and unproven self-medicating mechanism is sanctioned and approved by government, and the inevitable damage (particularly to children) emerges, will the taxpayers of Australia have to fund the damages of an ill-conceived and non-TGA/AMA approved medical practice? Or will there be iron-clad caveats in place that ensure those who chose to use their own version of ‘medicine’ be the only ones liable for the outcomes of it, and not place further healthcare and monetary burden on the vast majority of tax-payers who have sought to follow best evidence-based and prescriptive practices?
  • If proper clinical trials and T.G.A and A.M.A. processes and protocols are negated or circumvented and a ‘new’ or ‘alternative’ process for registering, manufacturing, prescribing and dispensing marijuana as medicine be put in place, then how will you/your government  address the following important questions.
    • Who will be ‘growing’ and preparing this ‘medicine’?
    • Who will monitor content and quality of ‘medicine’?
    • Who will determine dosage rates and quantities?
    • What mechanisms will be in place to ensure quality control is followed?
    • What mechanisms will be in place to ensure, movement, dispensing and use of this ‘medicine’ is done without risk to non-patients?
    • Who will be able to prescribe this ‘medicine’ – Doctors, pharmacists, naturopaths, nurses, and counsellors? Who will monitor this process and ensure total safety?
    • What community safe-guards will be in place to ensure this new ‘medicine’ will not be misused?
    • Will the ‘medicine’ come in edible or smoked form and what safeguards will be in play around such a ‘medicine delivery’ system?
    • Will there be advertising and public promotion of this new form of ‘medicine’? Will that be strictly monitored to ensure no misinformation will mislead the public?
    • Which government department will oversee this process and how many more new protocols, processes, staff and finance will be required to set up this new vehicle for ‘medicine’ identification and management?
    • Who will be paying for this new and added cost?

We at Dalgarno Institute and its growing coalition remain very concerned for the overwhelming majority of Australians who are being kept in the dark about this new and illegitimate push to change evidence based processes and the laws that ensure those processes are protected. We are looking to you, in your role, to ensure that there is a genuine and robust pursuit of best medical and health practice outcomes for all Australians, particularly the most vulnerable – the young, very sick and disadvantaged – and that any mechanism that seeks to undermine that platform not be permitted to emerge under any circumstance.  Science and best health practice, NOT lawyers should determine pharmaceutical best practice.

I have also attached just a very small sample of the volumes of evidence-based data currently in the scientific space that raise clear warnings about a ‘new’ and untested version of cannabis as medicine. Please avail yourself of them and consult the people who do know better, compassion and good government demands it.
We look forward to receiving your response.

Sincerely Yours, 

Shane Varcoe
Executive Director
Dalgarno Institute

You can read our compassionate policy stance on M.M titled ‘CANNABIS AS MEDICINE? CAUTION NEEDED’!

https://dalgarnoinstitute.org.au/index.php/advocacy/dalgarno-aod-policy/86-open-letter-to-all-australian-politicians-regarding-new-version-of-medicinal-cannabis

Source: Email from Dalgarno Institute

September 2017

OCTOBER 25, 2018 BY PARTNERSHIP NEWS SERVICE STAFF

A new study finds traffic accidents are increasing in states that have legalized recreational marijuana, Bloomberg reports.

Crashes have risen by as much as 6 percent in Colorado, Nevada, Oregon and Washington, compared with neighboring states that haven’t legalized marijuana for recreational use, according to research from the Insurance Institute for Highway Safety (IIHS) and Highway Loss Data Institute (HLDI).

“The new IIHS-HLDI research on marijuana and crashes indicates that legalizing marijuana for all uses is having a negative impact on the safety of our roads,” IIHS-HLDI President David Harkey said in a news release. “States exploring legalizing marijuana should consider this effect on highway safety.”

In a separate study, IIHS examined police-reported crashes before and after retail marijuana sales began in Colorado, Oregon and

Washington. The study found the three states combined saw a 5.2 percent increase in the rate of crashes per million vehicle registrations, compared with neighboring states that did not legalize marijuana.

Source: https://drugfree.org/learn/drug-and-alcohol-news/traffic-accidents-rising-in-states-with-legalized-recreational-marijuana Oct. 2018

Sydney Parliament House, 09.07.2018

Cannabis has been greatly oversold by a left leaning press controlled by globalist and centralist forces while its real and known dangers have not been given appropriate weight in the popular press. In particular its genotoxic and teratogenic potential on an unborn generation for the next hundred years has not been aired or properly weighed in popular forums.

These weighty considerations clearly take cannabis out of the realm of personal choice or individual freedoms and place it squarely in the realm of the public good and a matter with which the whole community is rightly concerned and properly involved.

Cannabinoids are a group of 400 substances which occur only in the leaves of the Cannabis sativa plant where they are used by the plants as toxins and poisons in natural defence against other plants and against herbivores.

Major leading world experts such as Dr Nora Volkow, Director of the National Institute of Drug Abuse at NIH 1, Professor Wayne Hall, Previous Director of the Sydney Based National Drug and Alcohol Research Centre at UNSW 2, and Health Canada 3 – amongst many others – are agreed that cannabis is linked with the following impressive lists of toxicities:

1) Cannabis is addictive, particularly when used by teenagers

2) Cannabis affects brain development

3) Cannabis is a gateway to other harder drug use

4) Cannabis is linked with many mental health disorders including anxiety, depression,

psychosis, schizophrenia and bipolar disorder

5) Cannabis alters and greatly impairs the normal developmental trajectory – getting a

job, finishing a course and forming a long term stable relationship 4-11

6) Cannabis impairs driving ability 12

7) Cannabis damages the lungs

8) Cannabis is immunosuppressive

9) Cannabis is linked with heart attack, stroke and cardiovascular disease

10) Cannabis is commonly more potent in recent years, with forms up to 30% being widely available in many parts of USA, and oils up to 100% THC also widely available.

Serious questions have also been raised about its involvement in 12 different cancers, increased Emergency Room presentations and exposures of developing babies during pregnancy. It is with this latter group that the present address is mainly concerned.

Basic Physiology and Embryology Cells make energy in dedicated organelles called mitochondria. Mitochondrial energy, in the form of ATP, is known to be involved in both DNA protection and control of the immune system. This means that when the cell’s ATP is high DNA maintenance is good and the genome is intact. When cellular ATP drops DNA maintenance is impaired, DNA breaks remain unsealed, and cancers can form. Also immunity is triggered by low ATP.

As organisms age ATP falls by half each 20 years after the age of 20. Mitochondria signal and shuttle to the cell nucleus via several pathways. Not only do cells carry cannabinoid receptors on their surface, but they also exist, along with their signalling machinery, at high density on mitochondria themselves 13-19. Cannabis, and indeed all addictive drugs, are known to impair this cellular energy generation and thus promote the biochemical aging process 14-16,19,20. Most addictions are associated with increased cancers, increased infections and increased clinical signs of ageing 21-34.

The foetal heart forms very early inside the mother with a heartbeat present from day 21 of human gestation. The heart forms by complicated pathways, and arises from more than six groups of cells inside the embryo 35,36. First two arteries come together, they fold, then flex and twist to give the final shape of the adult heart. Structures in the centre of the heart mass called endocardial cushions grow out to form the heart valves between the atria and ventricles and parts of the septum which grows between the two atria and ventricles. These cardiac cushions, and their associated conoventricular ridges which grow into and divide the cardiac outflow tract into left and right halves, all carry high density cannabinoid type 1 receptors (CB1R’s) and cannabis is known to be able to interfere with their growth and development.CB1R’s appear on foetal arteries from week nine of human gestation 37.

The developing brain grows out in a complex way in the head section 35,36. Newborn brain cells are born centrally in the area adjacent to the central ventricles of the brain and then migrate along pathways into the remainder of the brain, and grow to populate the cortex, parietal lobes, olfactory lobes, limbic system, hypothalamus and hippocampus which is an important area deep in the centre of the temporal lobes where memories first form.

Developing bipolar neuroblasts migrate along pathways and then climb out along 200 million guide cells, called radial glia cells, to the cortex of the brain where they sprout dendrites and a major central axon which are then wired in to the electrical network in a “use it or lose it”, “cells that fire together wire together” manner.

The brain continues to grow and mature into the 20’s as new neurons are born and surplus dendrites are pruned by the immune system. Cannabinoids interfere with cellular migration, cellular division, the generation of newborn neurons and all the classes of glia, axonal pathfinding, dendrite sprouting, myelin formation around axons and axon tracts and the firing of both inhibitory and stimulatory synapses 14-16,19,20,38-40. Cannabinoids interfere with gene expression directly, via numerous epigenetic means, and via immune perturbation.

Cannabinoids also disrupt the mechanics of cell division by disrupting the mitotic spindle on which chromosomal separation occurs, causing severe genetic damage and frank chromosomal mis-segregation, disruption, rupture and pulverization 41-43.

Cannabis was found to be a human carcinogen by the California Environmental Protection agency in 2009 44. This makes it a likely human teratogen (deforms babies). Importantly, while discussion continues over some cancers, it bears repeating that a positive association between cannabis and testicular cancer was found in all four studies which investigated this question 45-49.

Cannabis Teratogenesis

The best animal models for human malformations are hamsters and rabbits. In rabbits cannabis exhibits a severe spectrum of foetal abnormalities when applied at high dose including shortened limbs, bowels hanging out, spina bifida and exencephaly (brain hanging out). There is also impaired foetal growth and increased foetal loss and resorption 50,51.

Many of these features have been noted in human studies 52. In 2014 Centres for Disease Control Atlanta Georgia reported increased rates of anencephaly (no brain, usually rapid death) gastroschisis (bowels hanging out), diaphragmatic hernia, and oesophageal narrowing 53,54. The American Heart Association and the American Academy of Pediatrics reported in 2007 an increased rate of ventricular septal defect and an abnormality of the tricuspid valve (Ebstein’s anomaly) 55. Strikingly, a number of studies have shown that cannabis exposure of the father is worse than that of the mother 56. In Colorado atrial septal defect is noted to have risen by over 260% from 2000-2013 (see Figure 1; note close correlation (correlation coefficient R = 0.95, P value = 0.000066) between teenage cannabis use and rising rate of major congenital anomalies in Colorado to 12.7%, or 1 in 8 live births, a rate four times higher than the USA national average !) 57.

And three longitudinal studies following children exposed to cannabis in utero have consistently noted abnormalities of brain growth with smaller brains and heads – persisting into adult life – and deficits of cortical and executive functioning persistent throughout primary, middle and high schools and into young adult life in the early 20’s 58-63. An Australian MRI neuroimaging study noted 88% disconnection of cortical wiring from the splenium to precuneus which are key integrating and computing centres in the cerebral cortex 38,39,64. Chromosomal defects were also found to be elevated in Colorado (rose 30%) 57, in Hawaii 52 in our recent analysis of cannabis use and congenital anomalies across USA, and in infants presenting from Northern New South Wales to Queensland hospitals 65. And gastroschisis shows a uniform pattern of elevation in all recent studies which have examined it (our univariate meta-analysis) 52,54,66-71.

Interestingly the gastroschisis rate doubled in North Carolina in just three years 1997-2001 72, but rose 24 times in Mexico 73 which for a long time formed a principal supply source for Southern USA 74. Within North Carolina gastroschisis and congenital heart defects closely followed cannabis distribution routes 74-76. In Canada a remarkable geographical analysis by the Canadian Government has shown repeatedly that the highest incidence of all anomalies – including chromosomal anomalies – occurs in those northern parts where most cannabis is smoked 77,78.

Congenital anomalies forms the largest cause of death of babies in the first year of life. The biggest group of them is cardiovascular defects. Since cannabis affects several major classes
of congenital defects it is obviously a major human teratogen. Its heavy epigenetic footprint,
by which it controls gene expression by controlling DNA methylation and histone modifications 79-81, imply that its effects will be felt for the next three to four generations – that is the next 100 years 82,83. Equally obviously it is presently being marketed globally as a major commodity apparently for commercial – or ideological – reasons. Since cannabis is clearly contraindicated in several groups of people including:

1) Babies

2) Children

3) Adolescents

4) Car drivers

5) Commercial Drivers – Taxis, Buses, Trains,

6) Pilots of Aeroplanes

7) Workers – Manual Tools, Construction, Concentration Jobs

8) Children

9) Adolescents

10) Males of Reproductive age

11) Females of Reproductive age

12) Pregnancy

13) Lactation

14) Workers

15) Older People – Mental Illness

16) Immunosuppressed

17) Asthmatics – 80% Population after severe chest infection

18) People with Personal History of Cancer

19) People with Family History of Cancer

20) People with Personal History of Mental Illness

21) People with Family History of Mental Illness

22) Anyone or any population concerned about ageing effects 34

… cannabis legalization is not likely to be in the best interests of public health.

Concluding Remarks

In 1854 Dr John Snow achieved lasting public health fame by taking the handle off the Broad Street pump and saving east London from its cholera epidemic, based upon the maps he drew of where the cholera cases were occurring – in the local vicinity of the Broad Street pump.

Looking across the broad spectrum of the above evidence one notices a trulyremarkable concordance of the evidence between:

1) Preclinical studies in

i) Rabbits and

ii) Hamsters

2) Cellular and biological mechanisms, particularly relating to:

i) Brain development

ii) Heart development

iii) Blood vessel development

iv) Genetic development

v) Abnormalities of chromosomal segregation

i. Downs syndrome

ii. Turners syndrome

iii. Trisomy 18

iv. Trisomy 13

vi) Cell division / mitotic poison / micronucleus formation

vii) Epigenetic change

viii) Growth inhibition

3) 84Cross-sectional Epidemiological studies, especially from:

i) Canada 77,85

ii) USA 86,87

iii) Northern New South Wales 65,88 4) Longitudinal studies from 58:

i) Ottawa 59-63

ii) Pittsburgh

iii) Netherlands

Our studies of congenital defects in USA have also shown a close concordance of congenital anomaly rates for 23 defects with the cannabis use rate indexed for the rising cannabis concentration in USA, and mostly in the three major classes of brain defects, cardiovascular defects and chromosomal defects, just as found by previous investigators in Hawaii 52.

Of no other toxin to our knowledge can it be said that it interferes with brain growth and development to the point where the brain is permanently shrunken in size or does not form at all. The demonstration by CDC twice that the incidence of anencephaly (no brain) is doubled by cannabis 53,54 implies that anencephaly is the most severe end of the neurobehavioural teratogenicity of cannabis and forms one end of a continuum with all the other impairments which are implied by the above commentary.

(Actually when blighted ova, foetal resorptions and spontaneous abortion are included in the teratological profile anencephaly is not the most severe end of the teratological spectrum – that is foetal death). It is our view that with the recent advent of high dose potent forms of cannabis reaching the foetus through both maternal and paternal lines major and clinically significant neurobehavioural teratological presentations will become commonplace, and might well become all but universal in infants experiencing significant gestational exposure.

One can only wonder if the community has been prepared for such a holocaust and tsunami amongst its children?

It is the view of myself and my collaborators that these matters are significant and salient and should be achieving greater airplay in the public discussion proceeding around the world at this time on this subject.

Whilst cannabis legalization may line the pockets of the few it will clearly not be in the public interest in any sense; and indeed the public will be picking up the bill for this unpremeditated move for generations to come. Oddly – financial gain seems to be one of the primary drivers of the present transnational push. When the above described public health message gets out amongst ambitious legal fraternities, financial gain and the threat of major medico-legal settlements for congenital defects – will quickly become be the worst reason for cannabis legalization.

Indeed it can be argued that the legalization lobby is well aware of all of the above concerns – and their controlled media pretend debate does not allow such issues to air in the public forum. The awareness of these concerns is then the likely direct reason that cannabis requires its own legislation. As noted in the patient information leaflet for the recently approved Epidiolex (cannabidiol oil for paediatric fits) the US Food and Drug Administration (FDA) is well aware of the genotoxicity of cannabinoids.

The only possible conclusion therefore is that the public is deliberately being duped. To which our only defence will be to publicize the truth.

Source: Summary of Address to Sydney Parliament House, 09.07.2018 by Professor Dr. Stuart Reece, Clinical Associate Professor, UWA Medical School. University of Western Australia

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SUMMARY

Background

Interest in the use of cannabis and cannabinoids to treat chronic non-cancer pain is increasing, because of their potential to reduce opioid dose requirements. We aimed to investigate cannabis use in people living with chronic non-cancer pain who had been prescribed opioids, including their reasons for use and perceived effectiveness of cannabis; associations between amount of cannabis use and pain, mental health, and opioid use; the effect of cannabis use on pain severity and interference over time; and potential opioid-sparing effects of cannabis.

Methods

The Pain and Opioids IN Treatment study is a prospective, national, observational cohort of people with chronic non-cancer pain prescribed opioids. Participants were recruited through community pharmacies across Australia, completed baseline interviews, and were followed up with phone interviews or self-complete questionnaires yearly for 4 years.

Recruitment took place from August 13, 2012, to April 8, 2014. Participants were asked about lifetime and past year chronic pain conditions, duration of chronic non-cancer pain, pain self-efficacy, whether pain was neuropathic, lifetime and past 12-month cannabis use, number of days cannabis was used in the past month, and current depression and generalised anxiety disorder. We also estimated daily oral morphine equivalent doses of opioids.

We used logistic regression to investigate cross-sectional associations with frequency of cannabis use, and lagged mixed-effects models to examine temporal associations between cannabis use and outcomes.

Findings

1514 participants completed the baseline interview and were included in the study from Aug 20, 2012, to April 14, 2014. Cannabis use was common, and by 4-year follow-up, 295 (24%) participants had used cannabis for pain. Interest in using cannabis for pain increased from 364 (33%) participants (at baseline) to 723 (60%) participants (at 4 years). At 4-year follow-up, compared with people with no cannabis use, we found that participants who used cannabis had a greater pain severity score (risk ratio 1·14, 95% CI 1·01–1·29, for less frequent cannabis use; and 1·17, 1·03–1·32, for daily or near-daily cannabis use), greater pain interference score (1·21, 1·09–1·35; and 1·14, 1·03–1·26), lower pain self-efficacy scores (0·97, 0·96–1·00; and 0·98, 0·96–1·00), and greater generalised anxiety disorder severity scores (1·07, 1·03–1·12; and 1·10, 1·06–1·15).

We found no evidence of a temporal relationship between cannabis use and pain severity or pain interference, and no evidence that cannabis use reduced prescribed opioid use or increased rates of opioid discontinuation.

Interpretation

Cannabis use was common in people with chronic non-cancer pain who had been prescribed opioids, but we found no evidence that cannabis use improved patient outcomes. People who used cannabis had greater pain and lower self-efficacy in managing pain, and there was no evidence that cannabis use reduced pain severity or interference or exerted an opioid-sparing effect. As cannabis use for medicinal purposes increases globally, it is important that large well designed clinical trials, which include people with complex comorbidities, are conducted to determine the efficacy of cannabis for chronic non-cancer pain. Funding National Health and Medical Research Council and the Australian Government.

Source:https://www.thelancet.com/pdfs/journals/lanpub/PIIS2468-2667(18)30110-5.pdf July 2018

RESEARCH UPDATE

Co-prescription of opioids and selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs) was common in the US from 2013 to 2014, according to a recent study.1 In March 2016 the FDA issued a safety warning about the risk of serotonin syndrome with combined use of opioids and triptans, or SSRIs/SNRIs.2 Whether the FDA warning has resulted in changes in prescribing practices is unknown, though it may be too early to know.

However, what’s clear is that the opioid problem in the US is not going away quickly. Despite recommendations against opioids for acute migraine from the American Academy of Family Physicians (AAFP) and the American Headache Society (AHS) and despite CDC guidelines3 against opioids for chronic non-cancer pain, prescription of opioids in the US tripled between 1999 and 2015.

Serotonin syndrome is a very rare but serious adverse effect of serotonergic antidepressants, caused by excess serotonergic agonism. Symptoms range from mild (diarrhea, shivering) to severe and potentially life-threatening (muscle rigidity, fever, seizures). The opioids most commonly linked to serotonin syndrome include fentanyl, methadone, andoxycodone. Meperidine, methadone and tramadol carry label warnings about the risk of serotonin syndrome.

To provide better epidemiological data about the nationwide prevalence of co-prescription of these medications in the period before the FDA warning, researchers lead by David A. Sclar, PhD, of the Midwestern University College of Pharmacy in Glendale, Arizona, used data from the National Ambulatory Medical Care Survey (NAMCS) database for 2013 to 2014. NAMCS is a cross-sectional nationally representative survey of office-based physician visits run annually by the National Center for Health Statistics (NCHS). The analysis included data from 903.6 million outpatient visits.

Key results

• 2% of visits (17.7 million) involved co-prescription of opioids with a triptan or SSRI/SNRI

-Opioid–SSRI/SNRI: 16,044,721 visits

-Opioid–triptan: 1,622,827 visits

• 20% of opioid co-prescribing involved higher-risk opioids with a label warning about serotonin syndrome

-Tramadol most common: 18.6% of opioid–SSRI/SNRI and 21.8% of opioid–triptan co-prescriptions

• 16.3% of visits for migraine involved opioid prescribing

-3.8% of these involved opioid-SSRIs/SNRIs co-prescriptions

-2.0% of these involved opioid-triptan co-prescriptions

The authors emphasized that the prevalence of opioid prescriptions for migraine has changed little over the past decade. A complicating factor is that patients with migraine commonly suffer from depression, making them at increased risk of co-prescription for serotonergic antidepressants and opioids. While acknowledging the importance of effective pain control in migraine, they warned that these results should not discourage undertreatment of depression.

“[T]reatment with serotonergic antidepressants in patients with migraine and comorbid depression must not be unnecessarily discouraged, given the importance of treatment with appropriate pharmacotherapy and evidence that depression is highly prevalent and may be undertreated in this patient population,” they wrote.

They noted that the study precedes the FDA warning by about 2 years, and most of the study occurred before the 2014 DEA re-classification of tramadol as a schedule-IV controlled substance and hydrocodone as a schedule-II controlled substance. Further study is needed to evaluate how these changes may have affected prescribing practices.

Take home points

• Between 2013 to 2014, 2% of outpatient visits surveyed by NAMCS involved co-prescription of opioids with a triptan or SSRI/SNRI

• 20% of these involved higher-risk opioids with a label warning about serotonin syndrome

• 16.3% of visits for migraine involved opioid prescribing

• Further study is needed to evaluate how a 2016 FDA warning about co-prescription of opioids and SSRIs/SNRIS or triptans may have affected prescribing practices.

Source: http://www.neurologytimes.com/high-co-prescription-opioid-ssri-snris-despite-risks?rememberme=1&elq_mid=2125&elq_cid=1748615&GUID=8CCBBF2C-6541-4A09-A30A-3E72BFE8C975 June 27th 2018

More Than Three Quarters of African-American and Latino Respondents Did Not Support Marijuana Legalization

Today, Smart Approaches to Marijuana (SAM) and its New York Affiliate, SAM-NY, released the results of a new Emerson College poll finding that the majority of New Yorkers do not support the legalization of marijuana. A plurality support either decriminalization or the current policy. 

The poll, conducted by Emerson College — the same college that recently conducted a poll for pro-marijuana groups Marijuana Policy Project (MPP) and the Drug Policy Alliance (DPA) — found that 56% of respondents favored either keeping the current policy in New York, repealing decriminalization, were unsure, or were in favor or reinstating full criminalization. 

A previous New York poll commissioned by pro-marijuana legalization groups pushed the false dichotomy of there only being two options in marijuana policy — full legalization or full prohibition. When respondents are informed of current marijuana laws (legal for medical use and decriminalized) support for legalization drops 27% from those polls. 

The poll also found that 76% of New Yorkers did not support marijuana advertising, 73% did not support public use of marijuana, 58% did not support marijuana stores in their neighborhoods, and half of New Yorkers were against marijuana candies, gummies, cookies, and other edibles.  

Finally, the poll found that minority communities overwhelmingly opposed the full legalization of marijuana. Only 22% and 24% of Latinos and African Americans, respectively, supported legalization. 

“New Yorkers do not support pot legalization. This poll shows us that elected officials need to slow down,” said Dr. Kevin Sabet, founder and president of SAM Action. “This poll shows similar results to our poll of New York voters in December–legalization is far from a slam dunk. One of the crucial takeaways from this is that minority communities are firmly opposed to legalization. And they should be — pot arrests for African American and Latino youth have gone up since legalization in Colorado. Pot Shops are always predominately in lower income neighborhoods.” 

###

About SAM New York 

SAM-NY, a project of SAM Action, is a nonpartisan alliance of lawmakers, scientists and other concerned citizens of New York dedicated to responsible marijuana policy that does not include the legalization of addictive substances. Learn more and join us at www.sam-ny.org.

Source: Email from SAM Action <reply@learnaboutsam.org>, June 2018

In 2016, Gov. Greg Abbott announced a $9.75 million grant to McKesson Corporation. Now, Texas is among the states investigating the giant drug distributor’s role in a growing opioid crisis

In the early months of 2016, as U.S. overdose deaths were on track to break records and the number of Texas infants born addicted to opioid painkillers climbed steadily higher, Gov. Greg Abbott was courting a massive pharmaceutical company, McKesson, with a multimillion-dollar offer.

At the time, the two stories — Texas public health officials grappling with an overdose epidemic while the governor’s office worked on economic development — seemed unrelated. When Abbott announced he would give McKesson a $9.75 million grant from the state’s Enterprise Fund to woo the pharmaceutical distributor into expanding its operations in North Texas, he mostly received favorable news coverage for promising nearly 1,000 jobs to the local Irving economy.

But as the state and nation’s focus on the opioid crisis has sharpened in recent months, McKesson and other drug companies have come under legal scrutiny and the deal has put Abbott in an uncomfortable position.

Texas has since joined a multistate investigation into pharmaceutical companies, including McKesson, over whether they are responsible for feeding the nation’s opioid crisis and whether they broke any laws in the process. Several Texas counties have moved to sue McKesson and other companies for economic damages, alleging that manufacturers downplayed addiction risks and their distributors failed to track suspicious orders that flooded communities with pills.

The state grant to McKesson, worth about $10,000 for each job it brought to North Texas, is the largest Abbott has doled out from the Enterprise Fund, the controversial deal-closing incentives program created in 2004 under former Gov. Rick Perry. No U.S. state or local government has publicly given McKesson a more generous grant since 2000, according to data compiled by Good Jobs First, a Washington D.C.-based group that tracks government subsidies and other economic incentives.

In statements at the time, Abbott said the company’s expansion would “serve as an invaluable contribution to the Texas economy.”

But if Texas decides to sue McKesson, as several of its counties have, lawyers for the state will likely argue the opposite has happened — at least in the context of the company’s distribution of opioids. Across the country, local and state governments have begun to argue they are bearing the financial burden associated with opioid addiction.

One state lawmaker suggested Abbott’s office should have more closely scrutinized McKesson’s record before issuing the grant — even though the grant happened more than a year before Attorney General Ken Paxton announced Texas was joining the multistate investigation.

“There needs to be better oversight here,” said state Rep. Joe Moody, an El Paso Democrat and member of the new House panel examining the opioid crisis. “You’re in the middle of the opioid crisis, and we’re issuing an enormous grant that comprises a significant amount of grants this company is getting across the country.” 

Abbott’s office did not respond to repeated requests for comment.

Faced with the lawsuits and investigations, McKesson — headquartered in San Francisco but with a sizable Texas footprint — has denied any wrongdoing and insisted it is trying to work toward halting the opioid crisis, not fuel it.

“Our partnership with the state remains strong,” said Kristin Chasen, a company spokeswoman. “We certainly agree that the opioid epidemic is a national public health crisis, and we’re cooperatively having lots of conversations with AG Paxton and the others involved in the multistate investigation.”

A nationwide emergency

Opioids are a family of drugs that include prescription painkillers like hydrocodone as well as illicit drugs like heroin. Last Thursday, President Donald Trump declared a nationwide emergency to address the surging human and financial toll of opioid addiction.

U.S. drug overdose deaths in 2015 far outnumbered deaths from auto accidents or guns, and opioids account for more than 60 percent of overdose deaths — nearly 100 each day, according to the U.S. Centers for Disease Control. That death toll has quadrupled over the past two decades. 

“Beyond the shocking death toll, the terrible measure of the opioid crisis includes the families ripped apart and, for many communities, a generation of lost potential and opportunity,” Trump said Thursday

In Texas, opioids have claimed proportionately fewer lives than in other states, and the growth of opioid-related deaths has been slower, according to U.S. mortality data. Still, the casualties in Texas — 1,107 accidental opioid poisoning deaths in 2016 — have seized the attention of state policymakers.

Last week, Texas House Speaker Joe Straus ordered lawmakers to form a select committee on opioids and substance abuse to examine an issue that he said has had a “devastating impact on many lives.” The announcement came after Paxton joined a 41-state investigation into whether a slew of drug manufacturers and distributors broke any laws in allegedly fueling the crisis.

“This is a public safety and public health issue. Opioid painkiller abuse and related overdoses are devastating families here in Texas and throughout the country,” Paxton said when he announced the probe in June.

Some Texas counties have already taken the drug companies to court.

In late September, Upshur County, population about 40,000, sued a slew of painkiller manufacturers and distributors — including McKesson. Seeking to recoup an unspecified amount in financial damages, the East Texas county argues the drug companies broadly “ignored science and consumer health for profits,” meaning the county “continues to spend large sums combatting the public health crisis created by [a] negligent and fraudulent marketing campaign.”

More specifically, the suit argues McKesson and other distributors “did nothing” to address the “alarming and suspicious” overprescription of drugs.

Bowie County, a rural slice of East Texas nudging Arkansas, has since joined the lawsuit, with other East Texas counties expected to follow. El Paso County isalso mulling legal action, and Bexar County, home to San Antonio, has announced plans to sue.

In an interview last week, Bexar County Judge Nelson Wolff said he couldn’t immediately offer a complete list of companies his county would target, but “I’m sure McKesson is one of them.”

Wolff chuckled when asked about the company’s grant from the state. “That’d give us $10 million more that we could get out of their hides in our lawsuit, if you look at it that way.”

In teaming up to probe drug companies, some experts suggest governments are following a playbook similar to one used during the 1990s to sue tobacco companies for their role in fueling a costly health crisis — an effort that resulted in a settlement yielding more than $15 billion for Texas alone.

“It’s like a polluter externalizing all his risk,” said Mike Papantonio, a Florida-based lawyer with experience in tobacco litigation. 

“He makes a lot of money because he pours the poison right into the river,” said Papantonio, who now organizes a legal conference for groups interested in suing pharmaceutical companies. “The shareholders love it, but then the taxpayers have to come back and fix it.”

“McKesson is a great company”

At the April grand opening of the new McKesson campus in Las Colinas, near Irving, local leaders gathered alongside Abbott and company executives for a ribbon-cutting at the $157 million, 525,000-square foot campus.

“McKesson is a great company,” Abbott said on the stage of a large meeting room at the newly renovated headquarters. 

“I am proud of the work McKesson is doing,” he went on, “and make a commitment of my own to continue to ensure Texas attracts further business and expanding enterprise.”

Beth Van Duyne, then the mayor of Irving, now a U.S. Housing and Urban Development administrator under Trump, defended the city’s decision to give the pharmaceutical company a more than $2 million incentives package on top of the state’s Enterprise Fund gift.

“Having to offer incentives is always a difficult decision to make, but as long as the return on that investment is strong, we can support it,” Van Duyne said in a video recorded from the grand opening.

Even though the promise of taxpayer funds came before Paxton launched his investigation, Moody, the Democratic lawmaker, said Abbott’s office should more carefully vet companies before granting them taxpayer money, and in McKesson’s case, it should have considered the drug company’s alleged role in the opioid crisis.

“We know there’s a problem with drug distribution. These drugs being taken out of the regular route, finding their way into other people’s hands — leading to deaths, leading to overdoses,” he said, later adding, “I don’t think it’s unrealistic to ask that to be part of the evaluation at all. Part of the conversation of growing the economy is what types of companies, businesses do you want?” 

State Rep. Kevin Roberts, a Houston Republican and fellow member of the House panel studying opioids, said he did not know what went into Abbott’s decision making, so he couldn’t comment on the wisdom of the grant. But he agreed that the state should also consider wider issues when deciding which businesses are awarded grants from the enterprise fund.

“I do believe that there is some ethical responsibility in that process as well,” he said. “Just because things look profitable doesn’t mean you do them.”

The fact that McKesson got the state grant doesn’t shield it from liability if Texas ultimately files an opioid lawsuit, Roberts added. “If General Paxton goes forward, the fact that they got a TEF grant does not excuse them.”

Pressure to act

McKesson is also facing legal challenges outside of Texas.

In a recent report to the U.S. Securities and Exchange Commission, the company noted an opioid-related lawsuit brought by the State of West Virginia and nine similar complaints filed in state and federal courts in West Virginia against McKesson and other large distributors. McKesson also listed a federal lawsuit in which the Cherokee Nation alleges the company oversupplied drugs to its population.

In January, McKesson agreed to pay $150 million and revamp its compliance procedures to settle a lawsuit brought by the U.S. Department of Justice after prosecutors alleged the company failed to detect and report “suspicious orders” of opioids.

The company paid $13.25 million to settle a similar Justice Department suit in 2008. McKesson did not admit wrongdoing in either case.

Chasen, the spokeswoman, said McKesson is “really proud of our controlled substances monitoring program today,” and the recent scrutiny addresses conduct “that was really far in the past at this point.”

Chasen added that the company reports all orders “in real time” to the U.S. Drug Enforcement Agency, flagging suspicious ones. 

Mark Kinzly, a co-founder of the Texas Overdose Naloxone Initiative, which educates police officers and the public on overdose prevention, has been critical of the state’s mixed response to the opioid epidemic. In 2015, for example, Abbott drew the ire of Kinzly and other advocates when he vetoed a “Good Samaritan” bill that would have protected someone from prosecution, even if they possessed a small amount of drugs, when they called 911 to help a friend in the throes of overdose.

Abbott said at the time that the bill had an admirable goal but did not include “adequate protections to prevent its misuse by habitual drug abusers and drug dealers.”

Kinzly said Trump’s declaration of a national opioid emergency may lead more politicians to demonstrate support for expanding drug treatment programs. “That will put some pressure on Republican governors, I would imagine,” he said.

Trump, for his part, suggested Thursday that pharmaceutical companies remained in the federal government’s crosshairs.

“What they have and what they’re doing to our people is unheard of,” he said. “We will be bringing some very major lawsuits against people and against companies that are hurting our people.” 

Source: https://www.texastribune.org/2017/10/31/during-opioid-crisis-texas-subsidized-drug-company-its-now-investigati/

October 2017

There was big news in Congress today that I wanted you to know about. A proposed government spending bill released today eliminated a provision that has protected the marijuana industry from federal prosecution for violating the Controlled Substances Act.

The Rohrabacher-Farr language was eliminated from the Commerce, Justice, Science bill that funds the Department of Justice, even though the language had previously been included in the 2017 base text. In addition, the Financial Services bill retained language preventing Washington, DC from implementing full retail sales and commercialization of recreational marijuana.

Smart Approaches to Marijuana (SAM) submitted testimony to the Appropriations Committee to push back against this provision, which has allowed unsafe and untested products to masquerade as medicine. Rather than submit their products to the FDA for approval as safe and effective medicines, the marijuana industry has instead been using medical marijuana laws as a guise to increase demand for marijuana consumption and service the black market with large amounts of high-potency marijuana.

“If I were an investor, I would sell my marijuana stocks short,” said Kevin Sabet, President of SAM. “The marijuana industry has lost in every state in which they were pushing legislation in 2017, the industry’s largest lobbying group is losing its bank account , and now they are losing protection that has helped them thrive despite marijuana’s illegal status. Although the debate over Rohrbacher-Farr is far from over, the bad news just keeps coming for the pot industry. But it’s great news for parents, prevention groups, law enforcement, medical professionals, victims’ rights advocates and everyone who cares about putting public health before profits.”

Evidence demonstrates that marijuana – which has skyrocketed in average potency over the past decade – is addictive and harmful to the human brain, especially when used by adolescents. Moreover, in states that have already legalized the drug, there has been an increase in drugged driving crashes and youth marijuana use. States that have legalized marijuana have also failed to shore up state budget shortfalls with marijuana taxes, continue to see a thriving black market, and are experiencing a continued rise in alcohol sales.

Thank you for the work that you are doing to help with these big wins for public health and safety!  

Source: Email from Smart Approaches to Marijuana (SAM) June 2017

There was big news in Congress yesterday that I wanted you to know about. We are pleased to report that the House has not included any pro-pot riders in its spending bills this year! Thank you for all of your efforts, including calls and emails. Congress has heard your voice and acted to preserve the public health and safety of our kids and communities.

Pro-pot advocates filed more than ten amendments to protect the marijuana industry and increase marijuana investment opportunities, but none of the amendments were allowed to proceed. The lessons of legalization are getting out, and it’s clear the experiment has failed, as our recent Cole Memo Report has shown. The black market is thriving, kids are ending up in emergency rooms, and drugged driving fatalities are soaring .

The fight isn’t over, though. Even though the House bill is clear, the Senate version of the spending bill still contains key marijuana industry protections. Those differences will be resolved in the coming months. We will continue to send out alerts to let you know when it’s time to come together and act.

Thank you again for all your work over the past years. You’ve made a difference, and we are grateful for your partnership. Please consider a donation to help with our efforts as we continue this battle in the coming months.

Source: Email SAM Action <info@samaction.net> from Kevin Sabet September 2017

The opioid crisis is unlike any drug epidemic America has ever known. It’s claiming lives at an almost unimaginable rate.

But to get an idea of why these drugs are taking such a toll, you have to look at the people who are dying.

This is not just the curse of the stereotypical addict.

Many of those admitted to the country’s fast swelling mortuaries were middle class professionals whose first fix was dealt to them by a doctor.

Back in the 90s and early 2000s, pharmaceutical firms began a major lobbying exercise, persuading doctors to prescribe their synthetic forms of heroin for pain relief.

Soon GPs across the country were handing out powerful prescriptions for relatively minor ailments.

The drugs worked, but they proved highly addictive and when patients’ prescriptions ran out, many took to the streets to feed what had fast become a habit.

That’s where the problem really starts. In pill form, this medication could be controlled, but by going to “street chemists” for their fix, people were taking a huge risk.

They’d buy the drugs, illegally imported from China, ready mixed with harmless powders. Just a few grains of opioid in each capsule, which they’d either snort, smoke or inject.

Most of the powders are phenomenally potent. One, Carfentanil, is said to be 10,000 times stronger than heroin.

Originally created as an elephant tranquiliser, a couple of grains could be enough to kill.

Others are less powerful but still deadly, and here’s the real issue – most addicts have no idea which kind of opioid they’re taking.

Yet across America people are seeking out dealers and buying this stuff for as little as two dollars per fix.

Some have reached a truly hopeless stage.

Ian Blackburn, a long-time addict, told me he’s never known anything like it. He’s felt in control of his drug habit in the past. Not any more.

“Three hits, that’s all it takes”, he told me: “You take this stuff three times and it’s forever”.

He explained how he doesn’t get a buzz from the drug any more, he simply takes it to feel normal, to take the pain of withdrawal away. Without it, his legs start to cramp, his stomach wrenches and he loses control of his functions.

“Every couple of hours you need a hit”, he says “no ifs ands or buts, you’re going to find it and you’re going to get money to get it, no matter what”.

Source: http://www.itv.com/news/2017-06-27/opioid-crisis-claiming-record-number-of-addicts-lives-in-the-us/

September 2017

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

A team of researchers from the UF Drug Policy Institute, Harvard University, and other institutions authored a lengthy response to a recent monograph written by the George Soros-funded ICSDP claiming that cannabis health claims have been overblown.

The team, led by former American Society of Addiction Medicine President Stu Gitlow, and other researchers with leadership ties to groups like the American Academy of Pediatrics, Boston Children’s Hospital, the University of Texas, the University of Pennsylvania, and other institutions found that the ICSDP report is an example of deceptive and biased research and that it contains abundant factual errors and logical flaws.

The report’s introduction reads: “The ICSDP conveniently cites evidence that supports its own predetermined narrative, concluding that only the pro-marijuana lobby has any substantive evidence in its favor-and ignores evidence to the contrary. Its main strategy is to attribute overblown “straw man” arguments to established marijuana researchers, misstating their positions and then claiming to “rebut” these positions with research.

“This response/critique reveals the lack of objectivity present in the report and, point-by-point, shows how the interests of the nascent Big Marijuana industry, private equity firms, and lobbyists lining up to capitalize on a new marijuana industry, are served.”

About the UF Drug Policy Institute

The UF Drug Policy Institute (DPI) serves the state of Florida, the Nation, and the global community in delivering evidence-based, policy-relevant, information to policymakers, practitioners, scholars, and the community to make educated decisions about issues of policy significance in the field of substance use, abuse, and addiction.

Read about our Distinguished Fellows Here

Filed under: Cannabis/Marijuana,USA :

The following letter was submitted to the US government Food and Drug Adminstration by Australian Professor Dr. Stuart Reece as evidence against the suggested re-scheduling of cannabinoids in the USA. This item can be found online where a full list of carefully researched references is included. Professor Reece has produced an extraordinary article which should be widely read.

We cannot recommend this article highly enough.

NDPA April 2018

http://GordonDrugAbusePrevention.com

This website has been created as a public service to help address the problem of the use of marijuana and other mood- and mind-altering substances in the United States and around the world. A purpose is help inform the public, the media, and those in positions of public responsibility of the challenges facing the nation as a result of the widespread use of psychoactive and mood-altering substances, particularly marijuana and designer drugs. The harmful effects of these substances have not been well understood. In fact, there is great ignorance of the harmful effects of marijuana and other drugs that are being used for experimental or recreational purposes. The implications that the harmful effects that these drugs have for the health and wellbeing of individuals, families, and society are legion. * * * * * * *

Federal Register Submission
Food and Drug Administration,
10903 New Hampshire Ave.,
Silver Spring,
MD, 20993-0002, USA.

Re: Re-Scheduling of Cannabinoids in USA – Tetrahydrocannabinol and Cannabidiol Related Arteriopathy, Genotoxicity and Teratogenesis

I am very concerned about the potential for increased cannabis availability in USA implied by full drug legalization; however, a comprehensive and authoritative submission of the evidence would take weeks and months to prepare. Knowing what we know now and indeed, what has been available in the scientific literature for a growing number of years concerning a myriad of harmful effects of marijuana, marijuana containing THC should not be reclassified.

These effects that are now well documented in the scientific literature include, alarmingly, harm involving reproductive function and birth anomalies as a result of exposure to or use of marijuana with THC. In addition to all of the usual concerns which you will have heard from many sources including the following I have further particular concerns:

1) Effect on developing brains

2) Effect on driving

3) Effect as a Gateway drug to other drug use including the opioid epidemic

4) Effect on developmental trajectory and failure to attain normal adult goals(stable relationship, work, education)

5) Effect on IQ and IQ regression

6) Effect to increase numerous psychiatric and psychological disorders

7) Effect on respiratory system

8) Effect on reproductive system

9) Effect in relation to immunity and immunosuppression

10) Effect of now very concentrated forms of cannabis, THC and CBD which are widely available

11) Outdated epidemiological studies which apply only to the era before cannabis became so potent and so concentrated

12) Cannabis is now known to have an important arteriopathic effect and cardiovascular toxic effect .

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

Cannabinoid Therapeutics

In my view the therapeutic effects of cannabinoids have been wildly inflated by the press. Moreover, with over 1,000 studies listed for cannabinoids on clinicaltrials.gov, the chance of a type I experimental error, or studies being falsely reported to be positive when in fact they are not, is at last 25/1,000 at the 0.05 level.

THC as dronabinol is actually a failed drug from USA which has such a high incidence of side effects that it was rarely used as superior agents are readily available for virtually all of its touted and alleged therapeutic applications. My American liaisons advise that dronabinol sales have climbed in recent times as patients use it as a ruse to avoid detection of cannabinoid use at work in states where it is not yet legal. So when I call it a failed therapeutic I mean in a traditional sense, not in the novel way it is now applied for flagrantly flouting the law.

In considering the alleged benefits of cannabis one has to be particularly mindful of cannabis addiction in which cannabinoids will alleviate the effect of drug withdrawal as they do in any other addiction. Moreover, the fact that cannabis itself is known to cause both pain and nausea, greatly complicates the interpretation of many studies.

I also have the following concerns which relate in sum to the arteriopathy and vasculopathy and the genotoxicity of cannabis, tetrahydrocannabinol and likely including cannabidiol and various other cannabinoids:

Cannabinoid Arteriopathy

Particularly noteworthy amongst these various reports are two reports by Dr Nora Volkow in 2014, the Director of the National Institute of Drug Abuse at NIH to the New England Journal of Medicine which together document the adverse cardiovascular and cerebrovascular effects of cannabis at the epidemiological level ; a report from our own increase cardiovascular aging to BMJ Open ; a series of reports showing a fivefold

increase in the rate of heart attack within one hour after cannabis smoking ; several reports of cannabis related arteritis ; other reports of the cerebrovascular actions of cannabis ; documentation that cannabis exposure increases arterial stiffness and cardiovascular and organismal aging ; and a recent report showing that human endothelial vascular function – vasodilation – is substantially inhibited within just one minute of cannabis exposure .

It is also relevant that a synthetic cannabinoid was recently shown to directly induce both thromboxane synthase and lipoxygenase, and so be directly vasoconstrictive, prothrombotic and proinflammatory .

Vascular aging, including both macrovascular and microvascular aging is a major pathological feature not only because most adults in western nations die from myocardial infarction or cerebrovascular accidents, but also because local blood flow and microvascular function is a key determinant of stem cell niche activity in many stem cell beds. This has given rise to the vascular theory of aging which has been produced by some of the leading researchers at the National Health Lung and Blood Institute at NIH, amongst many others .

It can thus be said not only that “You are as old as your (macrovascular) arteries”, but also that “you are as old as your (microvascular) stem cells.” Hence the now compelling evidence for the little known arteriopathic complications of cannabis and cannabinoids, carry very far reaching implications indeed. This was confirmed directly in the clinical study of arterial stiffness from my clinic mentioned above .

Whilst aging, myocardial infarction and cerebrovascular accidents are all highly significant outcomes and major public health endpoints, these effects assume added significance in the context of congenital anomalies. Some congenital defects, such as gastroschisis, are thought to be due to a failure of vascular supply of part of the anterior abdominal wall . Hence in one recent study the unadjusted odds ratio of having a gastroschisis pregnancy amongst cannabis users (O.R.=8.03, 95%C.I. 5.63-11.46) was almost as high as that for heroin, cocaine and amphetamine users (O.R.= 9.35, 95%C.I.
6.64-13.15), and the adjusted odds ratio for any illicit drug use (of which was 84% cannabis) was O.R.=3.54 (95%C.I. 2.22-5.63) and for cannabis alone was said by these Canadian authors to be O.R.=3.0. Hence cannabis related vasculopathy – arteriopathy beyond its very serious implications in adults also carries implications for paediatric and congenital disorders and may also constitute a major teratogenic mechanism.

Cannabinoid Genotoxicity and Teratogenesis

Cannabis is associated with 11 cancers (lung, throat, bladder, airways, testes, prostate,

cervix, larynx) including;

Four congenital and thus inherited cancers (rhabdomyosarcoma, neuroblastoma,ALL,

AML and AMML);

Sativex product insert in many nations carries standard warning against its use by

males or females who might be having a baby.

Cannabis – and likely also CBD – is known to be associated with epigenetic changes

some of which are believed to be inheritable for at least four generations.

Cannabis is known to interfere with tubulin synthesis and binding and it also

acts via Stathmin so that microtubule function is impeded . This leads directly to

micronucleus formation. Cannabis has been known to test positive in the

micronucleus assay for over fifty years. This is a major and standard test for

genotoxicity. Micronucleus formation is known to lead directly to major chromosomal toxicity including chromosomal shattering – so-called chromothripsis –and is known to be associated with cell death, cancerogenesis and major foetal abnormalities.

Cannabis has also been linked definitively with congenital heart disease is a statement

by the American Heart Association and the American Academy of Pediatrics in 2007, on the basis of just three epidemiological studies, all done in the days before cannabis became so concentrated. Congenital heart defects have also been linked with

the father’s cannabis use . Indeed, one study showed that paternal cannabis use was

the strongest risk factor of all for preventable congenital cardiac defects.

Cannabis has also been linked with gastroschisis in at least seven cohort and case

control studies some of which are summarized in a Canadian Government

Report 200. In that report the geographic incidence of most major congenital anomalies

closely paralleled the use of cannabis as described in other major Canadian reports.

The overall adjusted odds ratio for cannabis induction of gastroschisis was

quoted by these authors as 3.0. Moreover, outbreaks of both congenital heart disease and gastroschisis in North Carolina also paralleled the local use of cannabis in that state as described by Department of Justice Reports . The incidence of gastroschisis was noted to double in North Carolina 1999-2001 in the same period the cannabis trade there was rising.

Figures of cannabis use in pregnant women in California by age were also

recently reported to JAMA 229, age group trend lines by age group which closely

approximate those reported by CDC for the age incidence of gastroschisis in the USA

Importantly much of the cannabis coming into both North Carolina and Florida is said to originate in Mexico. An eight-fold rise in the rate of gastroschisis has been reported from Mexico . Gastroschisis has also risen in Washington state. Cannabis has also been associated with 17 other major congenital defects by major Hawaiian epidemiological study reported by Forrester in 2007 when it was used alone

When considered in association with other drug use – which in many cases cannabis leads to – cannabis use was associated with a further 19 major congenital defects. In addition to the effect of cannabinoids on the epigenome and microtubules, cannabinoids have been firmly linked to a reduction of the ability of the cell to produce energy from their mitochondria. An extensive and robust evidence base now links cellular energy generation to the maintenance and care of cellular DNA .

Moreover, as the cellular energy charge falls so too DNA maintenance collapses, and indeed, the cell can spiral where its remaining energy resources, particularly as NAD+, are routed into failing and futile DNA repair, the cell slips into pseudohypoxic metabolism like the Warburg effect well known in cancerogenesis , NAD+ falls below the level required for further energy generation and cellular metabolism collapses. Hence this well-established collapse of the mitochondrial energy charge and transmembrane potential forms a potent engine of continuing and accelerating genotoxicity .

Moreover, the well documented decline in mitochondrial respiration induced by cannabinoids, including tetrahydrocannabinol, cannabidiol and anandamide achieves particular significance in the light of the robustly documented decline in cellular energetics including NAD+ which not only occurs with age but indeed, has now been shown to be one of the primary drivers of cellular and whole organismal aging. It follows therefore that cannabinoid administration (including THC andCBD) necessarily phenocopies cellular aging. This implies of course that cannabinoid dependent patients are old at the cellular level. Indeed, normal human aging is phenocopied in the clinical syndrome of cannabinoid dependence which includes:

1) Neurological deficits in:

i) attention,

ii) learning and

iii) memory;

iv) social withdrawal and disengagement and

v) academic and

vi) occupational underachievement

2) Psychiatric disorders including

i) Anxiety,

ii) Depression,

iii) Mixed Psychosis

iv) Bipolar Affective disorder and

v) Schizophrenia,

3) Respiratory disorders including:

i) Asthma

ii) Chronic Bronchitis (increased sputum production)

iii) Emphysema (Increased residual volume)

iv) Probably increased carcinomas of the aerodigestive tract

4) Immune suppression which generally implies

i) segmental immunostimulation in some parts of the immune system since the innate and adaptive immune systems exert profound homeostatic mechanisms in response to suppression of one of its parts. A Substantial literature on immunostimulation

5) Reproductive effects generally characterized by reduced

i) Male and

ii) Female fertility

6) Cardiovascular toxicity with elevated rates of

i) Myocardial infarction

ii) Cerebrovascular accident

iii) Arteritis

iv) Vascular age – vascular stiffness

7) Genotoxicity in

i) Respiratory epithelium and

ii) Gonadal tissues.

8) Osteoporosis

9) Cancers of the

i) Head and neck

ii) Larynx

iii) Lung

iv) Leukaemia

v) Prostate

vi) Cervix

vii) Testes

viii) Bladder

ix) Childhood neuroblastoma

x) Childhood acute lymphoblastic leukaemia

xi) Childhood Acuter Myeloid and myelomonocytic leukaemia

xii) Childhood rhabdomyosarcoma 201,202.

The issue here of course is that cannabinoid dependence therefore copies without exception all of the major disorders of old age, each of which is also faithfully phenocopied by cannabis dependence.

The most prominent disorders of older age include:

1) Alzheimer’s disease

2) Cardiovascular and cerebrovascular disease

3) Osteoporosis

4) Systemic inflammatory syndrome

5) Changes in lung volume and the mechanics of breathing

6) Cancers

Hence this provides one powerful pathway by which cannabinoid exposure can replicate and phenocopy the disorders of old age. This is not of course to suggest that this is the only such pathway. Obviously changes of the general level of immune activity, or alterations of the level of DNA repair occurring directly or indirectly associated with cannabis use can form similar such pathways: both are well documented in cannabis use and also in the aging literature as major pathways implicated in systemic aging.

Nevertheless, the decline in mitochondrial energetics together with its inherent genotoxic implications does seem to be a particularly well substantiated and robustly demonstrated pathway which must give serious pause to cannabinoid advocates if the sustainability of the health and welfare systems is to be factored in together with any consideration of individual patient, advocate and industrial-complex rights.

The genotoxicity of THC, CBD and CBN has been noted against sperm since at least 1999 (Zimmerman and Zimmerman in Nahas “Marijuana and Medicine” 1999, Springer). This is clearly highly significant as sperm go directly into the formation of the zygote and the new human individual. CB1R receptors are known to exist intracellularly on both the membranes of endoplasmic reticulum and mitochondria. In both locations they can induce organellar stress and major cell toxicity including disruption of DNA maintenance. Interestingly mitochondrial outer membrane CB1R’s signal via a complex signalling chain involving the G-protein transduction machinery, protein kinase A and cyclic-AMP across the intermembrane space to the inner membrane and cristae, in a fashion replicating much of the G-protein signalling occurring at the cell membrane. This machinery is also implicated in mitonuclear signalling, and the mitonuclear DNA balance between mitochondrial DNA and nuclear DNA transcriptional control, which has long been implicated in inducing the mitochondrial unfolded protein cellular stress response cell aging, stem cell behaviour and DNA genotoxic mechanisms.

You are no doubt aware that human sperm are structured like express outboard motors behind DNA packets with layers of mitochondria densely coiled around the rotating flagellum which powers their progress in the female reproductive tract. These mitochondria also carry CB1R’s and are significantly inhibited even at 100 nanomolar THC. The acrosome reaction is also inhibited .

Cannabidiol is known to act via the PPARγ system 101,302-308. PPARγ is known to have a major effect on gene expression, reproductive and embryonic and zygote function during development 309-332 so that significant genotoxic and / or teratogenic effects seem inevitable via this route. Drugs which act in this class, known as the thiazolidinediones, are classed as category B3 in pregnancy and caution is indicated in their use in pregnancy and lactation.

The Report of the Reproductive and Cancer Hazard Assessment Branch of the Office of Environmental Health Hazard Assessment of the Health Department of California was mentioned above in connection with the carcinogenicity of marijuana smoke . Since virtually all mutagens are also teratogens it follows therefore from the basic tenets of mutagenesis that if cannabis is unsafe as a known carcinogen it must also be at the very least a putative teratogen.

CBD has also been noted to be a genotoxic in other studies . All of which points to major teratogenic activity for both THC and CBD. Some of the quotations from Professor James Graham’s classical book on the effects of THC in hamsters and white rabbits, the best animal models for human genotoxicity, bear repeating:

a) “The concentration of THC was relatively low and the malignancy severe.”

b) “40-100μg resin/ml there occurred marked inhibition of cell division.

c) “large total dose, Hamsters, 25-300mg/kg …“oedema,phocomelia,omphalocoele, spina bifida, exencephaly, multiple malformations and myelocoele. This is a formidable list.”

d) “It is to this anti-mitotic action that the authors attribute the embryotoxic action of cannabis.”

e) “By such criteria resin or extract of cannabis would be forbidden to women

during the first three months of pregnancy.”

Indeed, even from the other side of the world I have heard many exceedingly adverse reports from US states in which cannabis has been legalized including Colorado, Washington, Oregon, Florida and California. Taken together the above evidence suggests that these negative reports stem directly from the now known actions of cannabis and cannabinoids, and are by no means incidental epiphenomena somehow related to social constructs surrounding cannabis use or the product forms, dosages, or routes of administration involved.

Cannabis that contains increasingly high levels of THC is now widely available, particularly in the jurisdictions where the use of cannabis has been legalized. This means that another major genotoxin, akin to Thalidomide, is being unleashed on the USA and the world. This is clearly a very grave, and. indeed, an entirely preventable occurrence.

Dr Frances Kelsey of FDA is said to have the public servant based at FDA who saved American from the thalidomide scandal which devastated so many other English-speaking nations including my own . This occurred because the genotoxicity section of the file application with FDA was blank. It was blank because thalidomide tested positive in various white rabbit and guinea pig assays. It is these same tests which cannabis is known to have failed. Dr Kelsey’s photograph has been published in the medical press with President Kennedy for her service to the nation. The challenge to FDA at this time seems whether Science can triumph over agenda driven populism, its primary vehicle, the mass media, and its primary proximate driver the burgeoning cannabis industry. Since FDA is the Federal agency par excellence where Health Science is weighed, commissioned and thoughtfully considered the challenge in our time would appear to be no less.

Evidence to date does not suggest that major congenital malformations are as common after prenatal cannabis exposure as they are after prenatal thalidomide exposure. Nevertheless the qualitative similarities remain and indeed are prominent. It is yet to be seen whether the rate of congenital anomalies after cannabis are quantitatively as common: epidemiological studies in a high potency era have not been undertaken; and even the birth defects rates from most birth defects registers in western nations including that held by CDC, Atlanta appear to be seriously out of date at the time of writing. Moreover the non-linear dose response curve in many cannabis genotoxicity studies which includes a sharp knee bend upwards beyond a certain threshold level which suggests that we could well be in for a very unpleasant quantitative surprise. At the time of writing this remains to be formally determined.

Dr Bertha Madras, Professor of Addiction Psychiatry at Harvard Medical School has recently argued against re-scheduling of cannabis. Her comments include the following:

“Why do nations schedule drugs? …… Nations schedule psychoactive drugs because we revere this three-pound organ (of our brain) differently than any other part of our body. It is the repository of our humanity. It is the place that enables us to write poetry and to do theater, to conjure up calculus and send rockets to Pluto three billion miles away, and to create I Phones and 3 D computer printing. And that is the magnificence of the human brain. Drugs can influence (the brain) adversely. So, this is not a war on drugs. This is a defense of our brains, the ultimate source of our humanity” .

I look forward to seeing the comments that you post concerning the reasons why the classification for marijuana should not be changed and that, indeed, the public should be alerted to the very harmful effects of marijuana with THC, especially in light of the wide range of marijuana’s harmful effects and the high potency of THC in today’s marijuana and in light of the idiosyncratic effects of marijuana of even low doses of THC and owing to the certain risk of harm to progeny and babies born to users of marijuana.

Please feel free to call on me if you would like further information concerning the research to which I have referred herein.

Yours sincerely,

Professor Dr. Stuart Reece, MBBS (Hons.), FRCS(Ed.), FRCS(Glas.), FRACGP, MD(UNSW). School of Psychiatry and Clinical Neurosciences Edith Cowan University and University of Western Australia, Perth, WA stuart.reece@uwa.edu.au

Source: http://GordonDrugAbusePrevention.com.

July 2017 Revised January 2018

Injury Prevention Centre: Who we are

The Injury Prevention Centre (IPC) is a provincial organization that focuses on reducing catastrophic injury and death in Alberta. We act as a catalyst for action by supporting communities and decision-makers with knowledge and tools. We raise awareness about preventable injuries as an important component of lifelong health and wellness. We are funded by an operating grant from Alberta Health and we are housed at the School of Public Health, University of Alberta.

Injury in Alberta

Injuries are the leading cause of death for Albertans aged 1 to 44 years. In 2014, injuries resulted in 2,118 deaths, 63,913 hospital admissions and 572,653 emergency department visits. Of all age groups, young adults, 20 to 24 years old had the highest percentage of injury deaths with 84.9%. Youth, 15 to 19 years of age had the second highest percentage of injury deaths with 76.4%.

1. Alberta is spending an estimated $4 billion annually on injury – that amounts to $1,083.00 for every Albertan.

2. Potential impact of cannabis legalization on injury in Alberta In 2018, the Government of Canada will legalize the use of cannabis for recreational purposes. In the United States, some jurisdictions have similarly legalized cannabis for recreational use and have collected data on the changes in injuries due to cannabis use. Jurisdictions that have legalized the use of recreational as well as medical cannabis have experienced increases in injuries due to burns (100%), pediatric ingestion of cannabis (48%), drivers testing positive for cannabis and/or alcohol and drugs (9%), drivers testing positive for THC (6%) and drivers testing positive for the metabolite caboxy-THC (12%) when comparing pre- and post-legalization numbers.

3. (pg. 149) Of greatest concern are the traffic outcomes. “Fatalities substantially increased after legislation in Colorado and Washington, from 49 (in 2010) to 94 (in 2015) in Colorado, and from 40 to 85 in Washington. These outcomes suggest that after legislation, more people are driving while impaired by cannabis.”

4. (pg.155) Alberta can expect to see similar changes in injuries when the new laws take effect. The objective of this document is to recommend policies for inclusion in the Alberta Cannabis Framework that will minimize negative impacts of cannabis legalization on injuries to Albertans. Our focus is on:

* Preventing Cannabis-Impaired Driving

* Preventing Poisoning of Children by Cannabis

* Preventing Burns due to Combustible Solvent Hash Oil Extraction

* Preventing Other Injuries due to Cannabis Impairment

* Developing Surveillance to Identify Trends in Cannabis-Related injury

* Implementing a Comprehensive Public Education Plan

Injuries due to cannabis impairment in Alberta can be expected to rise following the legalization of recreational cannabis use. To mitigate the negative effects of legalization on injuries in Alberta, the Injury Prevention Centre recommends the Government of Alberta take the following actions for:

Preventing Cannabis-Impaired Driving

Impose administrative sanctions at a lower limit than Criminal Code impairment

Mandate a lower per se levels for THC/alcohol co-use

Increase sanctions for co-use of alcohol and cannabis

Separate cannabis and alcohol outlets by the creation of a public retail system for the distribution of cannabis products

Support Research to Improve Enforcement Tools

Apply sufficient resources to training and enforcement

Conduct public education regarding cannabis-impaired driving .

Preventing Poisoning of Children by Cannabis

Uphold federal legislation regarding packaging

Support public education on cannabis poisoning’

Preventing Burns due to Combustible Solvent Hash Oil Extraction

Prohibit the production of cannabis products using combustible solvents if it fails to appear in federal Bill C45.

Implement public education regarding the dangers of producing cannabis products using combustible solvents

Preventing Other Injuries due to Cannabis-Impairment

Inform the public about the risks of other activities when impaired

Develop Surveillance to Identify Trends in Cannabis-Related injury

Collect and analyze emergency department, hospital admission and death data for injuries involving cannabis impairment

Develop and implement a comprehensive public education campaign about the safe use of cannabis

Source: https://injurypreventioncentre.ca/downloads/positions/IPC%20-%20Cannabis%20Legalization Jan. 2018

A growing number of drug overdose deaths are due to cocaine laced with fentanyl, NPR reports. Fentanyl is 50 to 100 times more potent than heroin. The image above shows two potentially fatal dosages of fentanyl and heroin

According to the Drug Enforcement Administration (DEA), 7 percent of cocaine seized in New England in 2017 included fentanyl, up from 4 percent the previous year. In Connecticut, the number of deaths involving fentanyl-laced cocaine has increased 420 percent in the last three years. Massachusetts officials say an increasing amount of fentanyl-laced cocaine is changing hands on the streets. The DEA, in its National Drug Threat Assessment, says people typically add fentanyl to cocaine for the purpose of “speedballing,” which combines the rush of cocaine with a drug that depresses the nervous system, such as heroin. Some experts told NPR fentanyl may be mixed with cocaine accidentally during packaging. Others say drug cartels are adding fentanyl to cocaine to expand the market of people who are addicted to opioids.

How Can I Protect My Child from Fentanyl? 5 Things Parents Need to Know

Deaths from fentanyl and other synthetic opioids (not including methadone), rose a staggering 72 percent in just one year, from 2014 to 2015. Government agencies and officials of all types are rightly concerned by what some are describing as the third wave of our ongoing opioid epidemic.

As a concerned parent, whose top priority is keeping your child safe — and alive — the following are the most important things to understand about fentanyl.

1. Fentanyl is 50 to 100 times more potent than heroin or morphine. It is a schedule II prescription drug 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®.

2. It is relatively cheap to produce, increasing its presence in illicit street drugs. Dealers use it to improve their bottom line. According to a report from the Office of National Drug Control Policy, evidence suggests that fentanyl is being pressed into pills that resemble OxyContin, Xanax, hydrocodone and other sought-after drugs, as well as being cut into heroin and other street drugs. A loved one buying illicit drugs may think they know what they’re getting, but there’s a real risk of it containing fentanyl, which can prove deadly.

3. Naloxone (Narcan) will work in case of overdose, but extra doses may be needed. Because fentanyl is far more powerful than other opioids, the standard 1-2 doses of naloxone may not be enough. Calling 911 is the first step in responding to any overdose, but in the case of a fentanyl-related overdose the help of emergency responders, who will have more naloxone, is critical. Learn more about naloxone and responding to opioid overdose >>

4. Even if someone could tell a product had been laced with fentanyl, it may not prevent their use. Some individuals claim they can tell the difference between product that has been laced with fentanyl and that which hasn’t, but overdose statistics would say otherwise. Some harm reduction programs are offering test strips to determine whether heroin has been cut with fentanyl, but that knowledge may not be much of a deterrent to a loved one who just spent their last dollar to get high.

5. Getting a loved one into treatment is more critical than ever. If you need help in determining a course of action, please reach out to one of our parent counselors on our free Parent Helpline. Learn more about all the ways you can connect with our free and confidential services and begin getting one-on-one help.

Source: https://drugfree.org/parent-blog April 2017

While writing, I wondered what kind of details I should publish about the previous lives of people in the marijuana industry. Virgil Grant, one of the article’s subjects, told me stories about how he would sell marijuana from his family grocery store in Compton in the 1980s and 1990s by putting the weed in empty boxes of Lucky Charms. He mentioned, without much elaboration, that would-be competitors in Compton regretted going up against him.

It’s an awkward and confusing transition period in the marijuana industry. What was illegal yesterday in California may be legal today, but that’s of course not the way the federal government sees it. Mr. Grant has spent time in both federal and state prisons.

Since legalization of recreational sales came into effect in California in January, there have been stories about cities and counties that banned marijuana. But I had never seen reporting on the bigger picture. So I reached out to a company called Weedmaps, a website that hosts online reviews of cannabis businesses. When they added it up, the data surprised me: Only 14 percent of California’s cities and towns authorize the sale of recreational marijuana. By contrast, Proposition 64, the ballot measure that allowed marijuana legalization, passed with 57 percent voter approval in 2016, a seemingly solid majority.

The low acceptance of marijuana businesses strikes me as part of the liberal, not-in-my-backyard paradox in California. Yes, Californians want shelters for the homeless, but just not across the street. Yes, Californians want more housing built, but not if it changes the character of the neighborhood. A marijuana dispensary? Sure, preferably in the next town.

A New York Times reporter wanted to find out why California cities are taking such different approaches to legal pot. Previously, he covered a story about why California growers are so reluctant to leave the black market and seek a state license to become legitimate. He found that only about 10 percent have done so. The other 90 percent remain in black market. California is the nation’s biggest producer and consumer of marijuana. One estimate projects the state produces seven times the amount of pot it consumes and exports the surplus to non-legal states. Pursuing this story took the reporter to Compton, in Los Angeles County, where residents voted in January to ban marijuana businesses by a 3-to-1 margin. He compared this to Oakland, near San Francisco, which has embraced the marijuana industry. It’s as if the two cities had been asked the same question and come up with completely different answers, he opined. To get a bigger picture, he consulted Weedmaps to find out how common industry bans are. He was surprised to find that only 14 percent of California’s cities and towns authorize marijuana sales, even though legalization passed in 2016 with 57 percent voter approval.

It’s still early days — it’s been less than three months since legal sales started — but for now the trend is that larger cities like Oakland, San Francisco, Los Angeles, Sacramento and San Diego are the hubs of the marijuana industry, while smaller cities and towns are ambivalent or outright hostile to the idea of opening marijuana dispensaries. Orange County, in Southern California, is a recreational marijuana desert, with only a handful of dispensaries allowed.

California has a reputation for very tolerant attitudes toward pot, and it’s the biggest consumer and producer of the drug in the United States by a wide margin. It is also the nation’s premier exporter to other states: By one estimate, the state produces seven times more than it consumes.

But the visit to Compton helped peel back another, more conservative set of attitudes toward marijuana.

At the Compton airport, Shawn Wildgoose, a former enlisted Marine who lives in Compton and works in the construction industry, told me he wanted to see the city focusing on its homeless problem and reducing crime, which is sharply down from previous decades.

Legal marijuana?

“Compton has other issues,” Mr. Wildgoose said. “We don’t need that distraction.”

Source: National Families in Action’s The Marijuana Report nfia@nationalfamilies.org 21st March 2018

Hamilton County Coroner Dr. Lakshmi Kode Sammarco released 2017 drug statistics Tuesday.

Last fall, the coroner said overdoses in Hamilton County had surpassed the total of last year, with 427 suspected deaths – and three months remaining in 2017, making the toll the worst since the heroin epidemic began. in the Tri-State.

Most overdose deaths have been due to fentanyl or chemically similar drugs, Sammarco said.

The county reported 403 overdose deaths in 2016 – up 30 percent, overdose deaths were totalled at 529 for 2017.

Sammarco described the increasing number of cases as “scary.” She said drug prevention efforts can only do so much without the help of the public.

“We can’t do this alone. Everybody here is busting their butt to try to get a handle on not just the supply, but to get help for the addicts and families. But we need the communities to step up, we need every neighborhood to keep an eye on their neighborhood. To try and help us get the dealers off the street, to try and get help to the addicts. You see something, say something.”

Sammarco noted the death toll was reduced by Narcan.

“The number of lives being saved is huge,” she said. “There’s no doubt they would’ve been double or triple what they were without Narcan.”

The coroner said 30,000 items were turned into the office’s drug section in 2017. Hfour drug analysts each processed well over 7,000 items, which 2.5 times higher than any other lab in Ohio.

Prevention First, a local non-profit aimed at reducing substance abuse released their findings from this year’s student drug-use survey.

They said of the more than 30,000 students grades 7 through 12 surveyed, nearly 14 percent have admitted to using alcohol in the past 30 days.

Tobacco use was only reported in five percent of students. Marijuana usage was slightly higher at more than eight percent.

Prescription drug abuse was reported in only 2.4 percent of students.

Commissioners said aside from marijuana use, the statistics have been trending downward since 2000.

“Hats off to Prevention First for leading the charge on that and for providing all of this really important information when it comes to prevention and what young people are doing in this community because this is the tip of the spear,” Commissioner Denise Driehaus said.

The survey, which is given every two years by Prevention First, was distributed to 80 public and private schools in six southwest Ohio counties.

To try to top overdoses before they happen, the Hamilton County Heroin Coalition is launching a Quick Response Teams early next month, on April 3.

The coalition is uniting with fire departments, law enforcement and social workers to create a team that follows up with overdose victims and offers them same-day addiction treatment. according to a prepared statement.

Modelled on an effort in Colerain Twp., the team will try to find overdose survivors using a database maintained by the Greater Cincinnati Fusion Center, a public safety data collecting agency.

Heroin Coalition commander and Norwood Police Lt. Tom Fallon told Hamilton County commissioners Monday the database would help locate overdose survivors who are otherwise hard to find.

The team will also use “predictive analysis” to track drug activity to target potential overdoses in with the help of University of Cincinnati’s Institute of Crime Science.

The effort is funded by a $400,000 grant from the U.S. Department of Justice funded through the Comprehensive Addiction and Recovery Act.

Source: http://www.fox19.com/story/37764381/hamilton-county-coroner

Filed under: Cannabis/Marijuana,Health,USA :

SIXTY people have died in the UK in the past eight months, in circumstances believed to be linked to a drug more potent than heroin, it has been revealed.

The National Crime Agency (NCA), which is investigating the use of the potentially deadly fentanyl and its variants, warned the toll could rise as they await further toxicology results.

Tests on heroin seized by police since November found traces of the synthetic drug, with more than 70 further deaths pending toxicology reports, the NCA.

The toxic synthetic opioid is being mixed with heroin and in some cases proving fatal, the agency said, as it accused dealers of playing “Russian roulette” with users’ lives.

The NCA’s deputy director Ian Crouton said recent investigations have uncovered that fentanyl and its chemical derivatives are being both supplied in and exported from the UK.

He said: ”We believe the illicit supply from Chinese manufacturers and distributors constitutes a prime source for both synthetic opioids and the pre-cursor chemicals used to manufacture them.”

Fentanyl, which can be legally prescribed as a painkiller sometimes in the form of a patch or nasal spray, is around 50 times more potent than heroin, according to America’s Drug Enforcement Agency (DEA).

A variant known as carfentanyl – which is often used to anaesthetise large animals like elephants – can be up to 10,000 times stronger than street heroin.

The potency means investigating officers often have to wear protective clothing to handle the substance.

Health officials and police have warned drug users to be “extra careful” as heroin and other class A drugs were being laced with synthetic drugs like fentanyl.

The 60 victims, whose post mortem examination results indicated their drug-related deaths were known to be linked to fentanyl or one of its chemical variants, were predominantly men and a range of ages, although no person was younger than 18.

Detective Superintendent Pat Twiggs, of West Yorkshire Police, said: “People are playing Russian roulette with their lives by taking this stuff, that’s why we would strongly recommend to the drug-using community to stay away from it.

“The business is not done under lab conditions, it’s not done by scientists, it’s done in a very uncontrolled way by people seeking out profit – this is why we’re concerned when you’re dealing with such toxic chemicals.”

Following links between fentanyl and deaths this year in the north of England, Public Health England (PHE) said it began an urgent investigation.

Pete Burkinshaw, the organisation’s alcohol and drug treatment and recovery lead, said the “sharp increase” in overdoses that had been feared did not appear to have materialised.

He said: “We have been working with drug testing labs and local drug services to get more information on confirmed and suspected cases.

“We do not have a full picture, but the deaths in Yorkshire do appear to have peaked earlier in the year and fallen since our national alert and, encouragingly, our investigations in other parts of the country suggest we are not seeing the feared sharp increase in overdoses.

“Investigations are ongoing and plans are in place for a scaled-up response if necessary.”

PHE is working with the Local Government Association to increase the availability of naloxone, an overdose antidote, to drug users and at hostels and outreach centres.

A raid at a drug-mixing facility in Morley, Leeds, in April resulted in three people being charged with conspiracy to supply and export class A drugs.

The NCA said it had identified 443 customers of that “criminal enterprise” – 271 overseas, and 172 within the UK.

A fourth man was charged on Monday night, following a separate investigation in May, after police said they identified him using the so-called dark web to buy fentanyl or synthetic opioids.

Kyle Enos, of Maindee Parade in Gwent, is accused of importing, supplying and exporting class A drugs.

The 25-year-old, who is in custody, is due at Cardiff Crown Court for a hearing on August 29.

The death of US pop star Prince was linked to an overdose of fentanyl in 2016.

The opioid was first made in 1960 by Belgian doctor Paul Janssen and introduced in hospitals as an intravenous anaesthetic.

Last November, 18-year-old Briton Robert Fraser died after unintentionally overdosing on the drug.

Robert’s mother Michelle said: “It shouldn’t be on the streets, this sort of stuff.

“These days there is too much and its too easily accessible for teenagers especially as we have mobile phones and the internet.

“It’s kids giving it to kids a lot of the time – they don’t know what they are giving.”

Source:

https://www.express.co.uk/news/uk/835794/Fentanyl-heroin-painkiller-overdose-60-dead-NCA-PHE-carfentanyl

Filed under: Europe,Heroin/Methadone :

I was recently moderating several nights of focus groups in Denver when the subject of marijuana suddenly and unexpectedly broke into the conversation.

At the beginning of each group I asked respondents to introduce themselves, stating their favorite hobbies or leisure time interests, and one thing they would change about Colorado. I’ve been doing this for decades and am used to hearing “the usual suspects” when it comes to what respondents want to change. Fix the traffic. Improve the schools. Stop the influx of new residents, particularly those from California and Texas. I even got a few mentions of the oddly standard, “I wish we had an ocean and a beach.”

But this time, in every group, someone mentioned he or she would go back on the state’s wholesale legalization of marijuana. I probed Coloradans some on the topic this trip, and the buyers’ remorse is palpable. People didn’t really know what they were getting into.I wrote about the possibility of second thoughts on marijuana previously, in early April; ordinarily I wouldn’t circle back so quickly, but I am seeing too much evidence to ignore the growing backlash.

It’s not just ordinary voters who now are second-guessing the move. Leaders are wondering aloud whether they should have done more to fight against approval of the referendum. Colorado’s mainstream civic elite, which ordinarily and routinely organizes large coalitions to fight ballot measures it deems bad for the state, generally chose to stand aside during the two referenda — one on medical marijuana and the other on leisure use — leaving the opposition to movement to conservative groups alone.

The problem with new policies enacted through the referendum process is that there are always unintended consequences. I spotted one on this last trip to Mile High country. Some voters now think that the marijuana trade, and the associated tax revenue, is such a financial bonanza that it should pay for most everything. It’s going to be a lot harder to pass any increases in general sales or property taxes because voters will instead want pot tax dollars to carry the burden.

It may be only a statistical margin of error quirk, but looking at the latest CBS News polling on marijuana legalization, I am wondering if there is a larger doubting of the wisdom of legalization.

For the first time in any time series I’ve monitored, support for legalization actually declined in mid-May’s CBS poll.

CBS found that just 48 percent of Americans believe marijuana should be legal, down from 51 percent in two earlier polls taken by CBS in January and February. Given that each study interviewed samples of approximately 1,000 adults, for a 3 percent margin of error, a 4-point drop in legalization support is just outside the margin — and more importantly, it’s a rare drop of any magnitude in momentum for legalization. For more than a decade, every successive poll saw rising support for marijuana. The latest CBS numbers are a throwback to a poll the organization took in 2012. That’s a serious regression for marijuana advocates.

Pot’s regress since January in the CBS polling is most noteworthy among the middle-aged (45-64) population (-13 percentage points in support for legalization) and by liberals (-9 points in support). Frankly, I am not at all surprised by the latter. Overall, support by liberals still stands at a stout 63 percent, but if I had deeper crosstabs, I’d expect that some green liberals with children under the age of 18 are starting to have some reservations about pot, just as many do about tobacco.

Pollsters will be keeping a close watch on these numbers. Is the trend in rising support for marijuana reaching a ceiling? Could there even be a growing pushback? Could the backlash be more about health and air quality than about conservative ideology? 

Hill is a pollster who has worked for Republican campaigns and causes since 1984.

Source:

http://thehill.com/opinion/david-hill/207342-david-hill-buyers-remorse-on-marijuana

By HAEYOUN PARK and MATTHEW BLOCH JAN. 19, 2016

Deaths from drug overdoses have jumped in nearly every county across the United States, driven largely by an explosion in addiction to prescription painkillers and heroin.

Some of the largest concentrations of overdose deaths were in Appalachia and the Southwest, according to new county-level estimates released by the Centers for Disease Control and Prevention.

The number of these deaths reached a new peak in 2014: 47,055 people, or the equivalent of about 125 Americans every day.

Deaths from overdoses are reaching levels similar to the H.I.V. epidemic at its peak.

The death rate from drug overdoses is climbing at a much faster pace than other causes of death, jumping to an average of 15 per 100,000 in 2014 from nine per 100,000 in 2003.

The trend is now similar to that of the human immunodeficiency virus, or H.I.V., epidemic in the late 1980s and early 1990s, said Robert Anderson, the C.D.C.’s chief of mortality statistics.

H.I.V. deaths rose in a shorter time frame, but their peak in 1995 is similar to the high point of deaths from drug overdoses reached in 2014, Mr. Anderson said. H.I.V., however, was mainly an urban problem. Drug overdoses cut across rural-urban boundaries.

In fact, death rates from overdoses in rural areas now outpace the rate in large metropolitan areas, which historically had higher rates.

Heroin abuse in states like New Hampshire make it a top campaign issue.

Drugs deaths have skyrocketed in New Hampshire. In 2014, 326 people died from an overdose of an opioid, a class of drugs that includes heroin and fentanyl, a painkiller 100 times as powerful as morphine.

Nationally, opioids were involved in more than 61 percent of deaths from overdoses in 2014. Deaths from heroin overdoses have more than tripled since 2010 and are double the rate of deaths from cocaine.

In New Hampshire, which holds this year’s first presidential primary, residents have repeatedly raised the issue of heroin addiction with visiting candidates.

“No group is immune to it — it is happening in our inner cities, rural and affluent communities,” said Timothy R. Rourke, the chairman of the New Hampshire Governor’s Commission on Alcohol and Drug Abuse.

Most of the deaths from overdose in the state are related to a version of fentanyl. “Dealers will lace heroin with it or sell pure fentanyl with the guise of being heroin,” Mr. Rourke said.  But fentanyl can be deadlier than heroin. It takes much more naloxone, a drug that reverses the effects of an opioid overdose, to revive someone who has overdosed on fentanyl.

Mr. Rourke said that high death rates in New Hampshire were symptomatic of a larger problem: The state is second to last, ahead of only Texas, in access to treatment programs. New Hampshire spends $8 per capita on treatment for substance abuse. Connecticut, for example, spends twice that amount.

Appalachia has been stricken with overdose deaths for more than a decade, in many ways because of prescription drug addiction among its workers.  West Virginia and neighboring states have many blue-collar workers, and “in that group, there’s just a lot of injuries,” said Dr. Carl R. Sullivan III, the director of addiction services at the West Virginia University School of Medicine.

“In the mid-1990s, there was a social movement that said it was unacceptable for patients to have chronic pain, and the pharmaceutical industry pushed the notion that opioids were safe,” he said.

A few years ago, as laws were passed to address the misuse of prescription painkillers, addicts began turning to heroin instead, he said. Because of a lack of workers needed to treat addicts, overdose deaths have continued to afflict states like West Virginia, which has the highest overdose death rate in the nation.

“Chances of getting treatment in West Virginia is ridiculously small,” Dr. Sullivan said. “We’ve had this uptick in overdose deaths despite enormous public interest in this whole issue.”

While New Mexico has avoided the national spotlight in the current wave of opioid addiction, it has had high death rates from heroin overdoses since the early 1990s.

Heroin addiction has been “passed down from generation to generation in small cities around New Mexico,” said Jennifer Weiss-Burke, executive director of Healing Addiction in Our Community, a non-profit group formed to curb heroin addiction. “I’ve heard stories of grandparents who have been heroin users for years, and it is passed down to younger generations; it’s almost like a way of life.”

Dr. Michael Landen, the state epidemiologist, said the state recently began grappling with prescription opioids. Addictions have shifted to younger people and to more affluent communities.

Ms. Weiss-Burke, whose son died from a heroin overdose in 2011, said it was much harder to treat young people. “Some young people are still having fun and they don’t have the desire to get sober, so they end up cycling through treatment or end up in jail,” she said.

Her center recently treated a 20-year-old man who was sober for five months before relapsing, then relapsed several more times after that.  “When you go right back to the same environment, it’s hard to stay clean,” she said. “Heroin craving continues to haunt a person for years.”

Source : https://www.nytimes.com/interactive/2016/01/07/us/drug-overdose-deaths-in-the-us.html

 

It’s a question often raised in today’s heated discussion about the efficacy of drug policy in America: Do regulations outlawing certain drugs actually work?

Let’s go to the data. Here’s what the Nation’s largest, longest-running, and most comprehensive source on the state of drug use in America shows:

As you can see, the use of legal drugs like alcohol and tobacco far outpaces the use of illegal drugs. It is clear, then, that laws discouraging drug use do have an effect in keeping rates relatively low compared to rates for other drugs that are legal and therefore more available.  Even beyond this one-year snapshot, we know that significant progress has been made in the long term.  Since 1979, there has been a roughly 30 percent decline in the overall use of illicit drugs in America.

So our challenge is not that we’re powerless against the problem of substance use in America. The challenge is that rates of drug use – a behavior that harms too many of our fellow citizens — are still too high. That’s why the President’s National Drug Control Strategy supports innovative and proven programs that aim to reduce drug use and its consequences through a combination of public health and public safety interventions.

It boils down to simple arithmetic: The more Americans use drugs, the higher the health, safety, productivity, and criminal justice costs we all have to bear. And if sensible drug laws (in combination with a wide array of prevention, treatment, and other health interventions, of course) help keep those numbers down, then the answer is yes, they are working.

Source: www.whitehouse.gov   2013 ONDCP                                                                                                  

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For decades, attorney Richard Blau focused his legal savvy on the high-stakes business of booze. Alcohol-industry law was an attorney’s dream, full of unresolved questions and deep-pocketed players clawing their way to the top.

So when Florida’s talk turned to marijuana, another storied pastime with its own dubious history, Blau’s titan of a law firm, GrayRobinson, jumped at the opportunity. Blau now leads a special practice for clients wanting to capitalize on medical cannabis — and bend the laws to their advantage.

“The playbook is to get in and lend a hand in crafting those rules, so they read the way our clients want them to read,” Blau said. “The powerful people are the ones to get in on the ground floor.”

Months before the state’s November vote to legalize medical marijuana, some of Florida’s biggest law firms are already staking their claims to the lucrative legal minefield of the budding weed industry.

Orlando-based GrayRobinson, which employs 101 attorneys in Tampa Bay and nearly 300 across the state, will devote a core of its “regulated products” group to the nuances of marijuana law.

Attorneys with Holland & Knight, a prominent firm in Tampa with more than 1,000 lawyers across the world, last week released an alert for clients on the “legal landscape (and) complex marketplace for marijuana-related businesses.”

And Akerman, the Miami-based corporate-law giant and largest law firm in the state, recently launched a “regulated substances task force” with nearly two dozen senior attorneys and public-policy professionals ready to advise, among others, cultivators, private-equity groups and dispensaries.

“The shifting interplay between state and federal laws presents new challenges and unprecedented opportunities for Akerman clients,” managing partner Richard Spees said in a statement, “and we are positioned to help them capitalize.”

Groups with ostensible legal ties have filed for Florida business licenses with names like Medical Marijuana Business Lawyers and the Cannabis Law Group, joining a wave of “ganjapreneurs” grabbing for a piece of industry profits.

But the introduction of these powerhouse firms ups the ante, helping squash the images of two-bit, Breaking Bad-style “Better Call Saul” legal operations and legitimizing what could be a landslide of million-dollar corporate disputes.

“We’re not the ‘pot lawyers.’ This is not ‘reefer madness.’ It’s 100 percent professional, 100 percent legitimate . . . and we take it 100 percent seriously,” said Troy Kishbaugh, a health care specialist serving on GrayRobinson’s regulated-products group. “We have a large health care base . . . and they want their patients to get the best care possible. And if medical marijuana happens to be part of that medical regimen, they want to make sure they’re doing it right.”

The state’s biggest firms bolstered their practices this spring after Florida lawmakers passed a “Charlotte’s Web” bill legalizing a non-high-producing cannabis strain used to treat cancer and epilepsy.

An even bigger fight comes in November, when voters could pass Amendment 2 and legalize weed for a much broader slate of medical uses. Its prospects seem increasingly upbeat: A Quinnipiac University poll last week found 88 percent of Florida voters support adult medical-cannabis use.

If the vote passes, Florida could follow California in becoming America’s second-biggest medical-weed state, with around 400,000 patients spending an average of $3,000 a year, estimates from state regulators and a national cannabis-industry trade group show.

State regulators have several months to decide on the law’s little details, leaving a huge window for “cannabusiness” interests pushing to find an unserved niche. The state Department of Health’s Office of Compassionate Use, which is drafting the rules, discussed at a public hearing Friday a range of potential enterprises, from medical-cannabis testing to home delivery.

Lawyers wise to food and alcohol regulation are shoo-ins for the firms’ legal-weed practices: Many of the rules facing Big Pot, attorneys argue, could look a lot like those governing Big Tobacco, Big Food and Big Booze.
Joining them are lawyers with a vast range of expertise:

• Health care experts to address hospital and physician groups on how to protect themselves while administering, storing and suggesting the use of a drug still illegal under federal law.
• Banking and financial gurus to advise on securing investment, handling money and saving on taxes in what has long been an all-cash business.
• Land use attorneys who can help resolve zoning and landlord disputes over where growers and distributors can operate from seed to sale.
• Even intellectual-property specialists with knowledge on how to protect and preserve cannabis companies’ strains, brands and reputations, in much the same way consultants have long advised Budweiser or Marlboro.

For precedent, attorneys here are analyzing the legal laboratories of the 23 states, plus Washington D.C., that have legalized medical cannabis, and the two states, Washington and Colorado, that have okayed weed for personal use.

They also are following in the footsteps of nationwide firms versed in guiding the emerging trade. Seattle’s Canna Law Group, launched by international law firm Harris Moure in 2011, proved “profitable almost instantly,” partner Dan Harris told the Puget Sound Business Journal last year, adding, “We were shocked at the demand.” One of the group’s attorneys, a young University of Miami graduate, was voted “Marijuana Industry Attorney of the Year” in 2013 by Dope Magazine.

For the finer details, attorneys said, firms are following their clients’ requests to lobby their way into influence. Litigation seems likely: A proposed rule limiting Florida’s medical weed to five nurseries, chosen by lottery, has already stirred up legal wrath.
Attorneys have likened their legal timing to representing alcohol outfits near the sunset of prohibition, a potentially historical chance to mold law and make nice with the grateful captains of a new industry.

But GrayRobinson’s Blau, whose practice group is taking on three new clients a week, stops short of supporting the “green rush” of small-time entrepreneurs. He compares the early days of legal Florida weed to that of the American gold rush, in which organized business interests, not excited ground troops, ended up with the most to gain.

“All those individual wannabe miners thought (they’d strike it rich) when they pushed forward to mine the Klondike … but very few emerged out of that with anything,” Blau said. “In reality, it was the established gold-mining companies who took the ground, and made it their own.”

Source: www.tampabay.com 1st August 2014

Source:   ZOHYDRO Backlash,  ACCBO newsletter, April-June 2014

A pair of new studies has revealed that marijuana use could lead to abuse of other drugs and alcohol. Experts said that these risks need to be considered not only by doctors and patients but by policy makers as well particularly in states where marijuana is legalized for recreational or medical use.

For the first study, which was published in the journal Drug and Alcohol Dependence, the results showed that adults who smoke marijuana have five times increased odds of developing alcohol use disorder (AUD) compared with their counterparts who do not smoke.

By looking at the data of more than 27,000 adults, researchers found that the participants who did not have AUD but reported using cannabis during the first survey were 5.4 times more likely to have an AUD three years later.  The participants who already battle with an alcohol use disorder and were using marijuana were also found to aggravate their dependence on alcohol.

“Among adults with no history of AUD, cannabis use at Wave 1 was associated with increased incidence of an AUD three years later relative to no cannabis use,” study researcher Renee Goodwin, from Columbia University, and colleagues wrote. “Among adults with a history of AUD, cannabis use at Wave 1 was associated with increased likelihood of AUD persistence three years later relative to no cannabis use.”

The second study, which was published in JAMA Psychiatry and involved more than 34,000 subjects, revealed that participants who used cannabis during the first survey were about six times as likely to suffer from substance use disorder after three years.

Researchers also found an increased risk for drug use disorders and nicotine dependence among pot smokers.   Although the study authors said that their findings do not establish a cause and effect relationship between pot use and substance abuse, they noted that there may be an overlap in brain circuitry that influence drug use and dependence.

“Our study indicates that cannabis use is associated with increased prevalence and incidence of substance use disorders,” Carlos Blanco, from the National Institute on Drug Abuse, and colleagues wrote. “These adverse psychiatric outcomes should be taken under careful consideration in clinical care and policy planning.”

 Source:  http://www.techtimes.com/articles/135554/20160222   22nd Feb 2016

The Rocky Mountain High Intensity Drug Trafficking Area released its third annual report this week. The organization has been tracking the impact of marijuana legalization in Colorado since the state first legalized the drug for medical use in 2000, passed legislation to allow dispensaries beginning in 2009–which spawned a commercial marijuana industry–and legalized pot for recreational use in 2012. The 2015 report shows that by 2013, Colorado marijuana use was nearly double the national usage rate. The state ranked 3rd in the nation for youth use in 2013, up from 14th in 2006; 2nd in the nation for young adult use in 2013, up from 8th in 2006; and 5th in the nation for adults, up from 8th in 2006.

Drug-related school expulsions, most of which are marijuana-related, far exceed school expulsions for alcohol use. Note the sudden jump in drug expulsions that began in 2009 when Colorado allowed a commercial marijuana industry to emerge. Total school suspensions and expulsions rose from 3,736 by the end of the 2008-2009 school year to 5,249 by the end of the 2013-2014 school year.

Marijuana-related traffic fatalities in Colorado also began rising with the introduction and growth of the commercial marijuana industry in 2009. While total State wide fatalities decreased between 2006 and 2014, marijuana-related fatalities increased over that time.

Colorado marijuana-related emergency room visits increased to 18,255 in in 2014.

Marijuana-related hospitalizations have nearly quintupled since Colorado first legalized marijuana for medical use. Again, note the surge starting in 2009 when growers, processors, and dispensaries were first authorized, and a commercial industry began developing extensive marijuana products such as edibles, vape pens, and butane hash oils (BHO) to attract new customers. BHO has elevated THC levels to the highest seen in the nation; some contain 75 percent to 100 percent THC.

Although there is no data to document whether the increase in homelessness in Denver and other Colorado cities is marijuana-related, those who provide services to the homeless report that many say they relocated to Colorado because of marijuana’s legality.

In Colorado, marijuana is not available in about three-fourths of the state. Of a total 321 local jurisdictions, 228 (71 percent) ban all forms of marijuana businesses; 67 (21 percent) allow both medical and recreational marijuana businesses; and 26 (8 percent) allow only medical or recreational marijuana businesses.

Read report here.
Source: www.themarijuanareport.org  16th September 2015

WASHINGTON — A new report out from the Governors Highway Safety Association finds that driving while on drugs, even marijuana, poses a significant safety risk on our roadways, on par with drunken driving.

Researchers found that the percentage of drivers killed who tested positive for drugs is almost the same as those who tested positive for any alcohol — 40 percent.  More than 5,000 drivers killed each year have drugs in their system at the time of the crash.

“The proportion with drugs in their system has increased over the past several years and now the level is about the same with alcohol in their systems,” says Dr. Jim Hedlund, author of the report.

The report puts a special emphasis on marijuana use and its impact on driving because lawmakers across the country are debating whether to legalize the drug.

“The evidence is very clear that marijuana affects decision times, reaction times and so forth.  If you are using marijuana, you are at an increased risk of being in a crash,” says Hedlund.

He is particularly concerned that lawmakers are not considering the impact of marijuana on deadly crashes when talking about legalizing the drug.  Hedlund also says the laws on the books for drug-impaired driving need to be clearer and more in line with drunken driving laws.

“Every state must take steps to reduce drug-impaired driving, regardless of the legal status of marijuana,” says Jonathan Adkins, executive director of GHSA.

“This is the first report to provide states and other stakeholders with the information that they need.  And we encourage [the National Highway Traffic Safety Administration] to issue guidance on best practices to prevent marijuana-impaired driving.  We look to the federal government to take a leadership role in this issue similar to that of drunk driving and seat belt use,” he adds.

The report calls on states to take several measures to address the issue head-on.  It urges states to assess the data in their region, examine and update drug-impaired driving laws, test all drivers who are killed in a crash for drugs and separate statistics between drunken driving from driving while on drugs.

Source:    Governors Highway Safety Association  Sept.2015

Haven Dubois, 14, died in accidental drowning on May 20, 2015, coroner says

Family members hold a picture of Haven Dubois, 14, who was found in cardiac arrest in a Regina creek on May 20, 2015. (CBC)

Richelle Dubois, the mother of 14-year-old Haven Dubois, says she is determined to learn more about the circumstances surrounding her son’s death. “I’m not done with this until I’m satisfied that they’ve looked into everything,” Dubois said Wednesday following the release of a coroner’s report that looked into the May 20, 2015 death of Haven. “I need to make sure that they’ve done their job properly.”
According to the report, the Regina boy was found drowned. The report said boys who were with Haven on that day told the coroner that he suffered a bad reaction to marijuana.
The boy’s mother Dubois has expressed concerns the death might have been connected to gangs. Police said foul play had been ruled out. Richelle Dubois said last fall she had waited a long time for the coroner to complete her report on her son Haven’s death. (CBC)
Coroner Maureen Stinnen interviewed a number of boys who were with Dubois, who said he was at school in the morning before getting into a car with friends.
“They apparently smoked some marijuana and they indicated that Haven began ‘freaking out,'” Stinnen’s report said. One of the youths Stinnen interviewed said it was Dubois’s first time smoking drugs. After getting out of the car, Dubois continued suffering ill effects and started walking away from the school, F. W. Johnson Collegiate.

Left alone on a bench

“Witnesses indicate he was ‘spinning in circles’ with his arms crossed at his chest,” the report said. One witness said he sat for a while with Dubois on a bench in a park, but left him alone so he could go get a skateboard and backpack. When the boy returned, Dubois wasn’t at the bench.
A friend said he last saw Dubois walking north by the creek in the area where his mother had discovered the body. Over the noon hour, Dubois was found face down in about a metre of water. Efforts to resuscitate him failed.
Dubois had no history or depression or suicidal tendencies, the coroner said. However, a toxicology report indicated he had the active component of cannabis in his blood.

Reactions to marijuana vary, coroner says

“The effect of marijuana on individuals varies considerably, from minor effects such as general feeling of well-being, to agitation and paranoia,” the report said. “These effects are subject to dose, age and experience of the user. Even in low doses, marijuana can precipitate a panic reaction and irrational behaviour.”
Stinnen said the case was thoroughly investigated by the Regina police and while “questions remain,” there were no indications of foul play. She concluded that Dubois’s death was an accidental drowning with drug use a “significant contributing factor.”

Mother seeks more information

Richelle Dubois said Wednesday she feels she did not get enough information from police about their investigation. “It’s so easy for them to brush it aside. It’s just another dead Indian to them,” Dubois said. “That’s how I feel; that we’re just another Indian family.”
According to a spokesperson from the police, officers met with Dubois three times. Dubois said the findings of the coroner, noting how marijuana can lead some people to panic and act irrationally, provide a possible explanation for her son’s death, but she still has questions.
“l know this isn’t the end of it,” she said. “This little two and a quarter page [report] isn’t the end of it.” Dubois added she has made a formal request to view police reports on the case.

Source: http://www.cbc.ca/news/canada/saskatchewan/marijuana-significant-factor-in-haven-dubois-death-1.3392179

Proponents raised $7.6 million to opponents’ $169,000 to legalize marijuana for recreational use, a ratio of 45 to 1. Opponents in Alaska and Oregon could not afford to present other viewpoints in TV commercials. Meanwhile, after just ten months of legal marijuana, five Colorado cities passed amendments to ban the sale of recreational marijuana within their borders. The Republican gubernatorial challenger ran on a platform calling for the repeal of legalization. As citizens’ anger mounts over outsiders sweeping in, getting what they want, and leaving behind a mess for taxpayers to clean up, we are likely to see more of that.

Alaska Legalizes Recreational Marijuana–You might think the 23 states that have legalized marijuana were responding to citizen demand. You would be wrong. The Drug Policy Alliance and the Marijauna Policy Project, their funders George Soros and the late Peter Lewis, a by-now burgeoning marijuana industry, and an estimated $200 million are behind the drive to legalize marijuana. Imagine a Congress where all 435 Representatives and 100 Senators belong to just one party, and you can begin to understand how one-sided marijuana initiatives have been.

Source:  TheMarijuanaReport.org  Nov. 2014

 

Big Business made a lot of money out of selling tobacco products  –  and it took many years before the link between smoking and  cancer were accepted.   Big Pharma make a lot of money from selling pharmaceutical drugs.  Big Business Mark II intends to make a lot of money out of selling marijuana (cannabis) products – regardless of the research that now shows this substance is not harmless.

The graphics above show just how much money was spent by the proponents of drug legalisation compared to the amounts that those who oppose legalisation were able to muster from grass roots supporters.   It is not surprising that so many of the American public were hoodwinked into voting for easier access to drugs – beginning with marijuana but eventually all currently illegal substances.

There was much misinformation, errors of omission and emphasis on ‘ individual freedoms’ – and no information about scientific research showing the dangers – particularly to young people – of using marijuana.

Already there are signs of discontent in many places with legalised marijuana – more driving accidents,  more instances of children being made ill from consuming what appeared to be sweets but was in reality marijuana packaged as a candy or chocolate bar …..how long will it be before the

Pandora’s Box can be tightly closed ?

National Drug Prevention Alliance   November 2014

Xcel Energy utility officials say lighting companies working with cannabis growers are testing LED lamps that require less electricity

DENVER, CO – DECEMBER 02: Denver Fire Department Lieutenant, Tom Pastorius, does an inspection of a Denver marijuana grow operation, December 02, 2014. Local government officials from Denver to smaller cities and rural hamlets say the pivotal first-year rollout went smoothly in most cases. (Photo by RJ Sangosti/The Denver Post)

GOLDEN — Surging electricity consumption by Colorado’s booming marijuana industry is sabotaging Denver’s push to use less energy — just as the White House perfects a Clean Power Plan to cut carbon pollution.

Citywide electricity use has been rising at the rate of 1.2 percent a year, and 45 percent of that increase comes from marijuana-growing facilities, Denver officials said Wednesday.

Denver has a goal of capping energy use at 2012 levels. Electricity is a big part of that.

The latest Xcel Energy data show cannabis grow facilities statewide, the bulk of which are in Denver, used as much as 200 million kilowatt hours of electricity in 2014, utility officials said. City officials said 354 grow facilities in Denver used about 121 million kwh in 2013, up from 86 million kwh at 351 facilities in 2012.

“Of course we want to grow economically. But as we do that, we’d like to save energy,” city sustainability strategist Sonrisa Lucero said.

She and other Denver officials joined 30 business energy services and efficiency leaders seeking U.S. Department of Energy guidance Wednesday at a forum in Golden. Energy Undersecretary Franklin Orr said feds will promote best practices and provide technical help through an Office of Technology Transitions.

“It’s a big issue for us,” Lucero told Orr. “We really do need some assistance in finding some good technology.”

Orr said he tried to figure out “how we would address that to Congress.”

When the EPA later this summer unveils the Clean Power Plan for state-by-state carbon cuts and installation of energy-saving technology, utilities are expected to accelerate a shift away from coal-generated electricity toward cleaner sources, such as natural gas, wind and solar.

Until they can replace more coal-fired plants, the nation’s utilities increasingly are trying to manage demand by, for example, offering rebates to customers who conserve electricity.

Colorado for years has been encouraging cuts in carbon emissions by requiring utilities to rely more on renewable sources.

Yet electricity use statewide has been increasing by 1 percent to 2 percent a year, due in part to population growth, said Jeffrey Ackermann, director of the Colorado Energy Office.

The rising electricity demand means more opportunities to save money by using energy more efficiently , Ackermann said. “We’re not going to compel people to reduce their usage. … But we’re going to try to bring efficiency into the conversation.”

Colorado’s marijuana sector, in particular, is growing rapidly, relying on electricity to run lights that stimulate plant growth, as well as air-conditioning and dehumidifiers. The lights emit heat, raising demand for air conditioning, which requires more electricity.

“How do you capture their attention long enough to say: Hey, if you make this investment now, it could pay back in the future,” Ackermann said, referring to possibilities for better lights.

Southwest Energy Efficiency Project director Howard Geller said new adjustable light-emitting diode, or LED, lights have emerged that don’t give off heat. Companies installing these wouldn’t require so much air-cooling and could cut electricity use, Geller said.

Lighting companies are working with pot companies to test the potential for LED lamps to reduce electricity use without hurting plants, Xcel spokesman Mark Stutz said. Xcel is advising companies on how much electricity different lights use, he said.

Denver officials currently aren’t considering energy-efficiency rules for the industry, said Elizabeth Babcock, manager of air, water and climate for the city. Marijuana-growing facilities in 2013 used 1.85 percent of total electricity consumed in Denver.

“We see many opportunities in all sectors,” Babcock said. “Energy efficiency lowers the cost of doing business, and there are lots of opportunities to cut energy waste in buildings, transportation and industry.”

Source:    www.denverpost.com   7th January 2015

By Fabrizio Schifano Chair in Clinical Pharmacology and Therapeutics at University of Hertfordshire

Fabrizio is a member of the UK advisory council on the misuse of drugs. He has also received EC funding in relation to researching the effects of novel psychoactive substances. These views are his own and in no way represent either the council or the EC.

In one respect, the world’s drug problem is not getting much worse. The UN believes that the use of drugs such as cocaine and heroin has stabilised, for example. In fact, the ground in the drugs battle has just shifted. The focus is now increasingly on legal highs.

People might be aware that altered versions of ecstasy or cannabis are available nowadays, but the true range of what we in the trade call novel psychoactive drugs is far more varied. There are derivatives of everything from ketamine to cocaine, from opiates to psychotropics. Their use is rising, and so is the number of fatalities. Some people fear that the figures are only going in one direction.

Enforcers vs chemists

Why has this happened? In recent years there was a worldwide decrease in the purity of drugs like amphetamine and cocaine and the MDMA content of ecstasy. This decrease helped fuel demand for alternatives (though admittedly there are signs that this purity decrease is now reversing). The internet has also made possible the sort of sharing of information that makes it much easier to sell these substances nowadays. And as has been well documented, banning these drugs is difficult because the manufacturers can constantly bring out new varieties with slight alterations to the chemistry.

It has turned into a battle between the drug enforcers and the drug chemists, who are typically based in the Far East, for example in China and Hong Kong. There are many databases online with information on the molecular structures of existing drugs. This makes it easier for these people to modify them to create a new product.

The market is very strong in the UK. You might think it is because the information online is often written in English. This would explain why Ireland has a big problem too, but then again the US does not. And other problem countries includeLatvia, Hungary, Estonia and Russia.

The big worries

Certain categories particularly worry us. One is the ecstasy derivatives known as phenethylamines. One of the well-known ones in the UK is PMA, which has been nicknamed “Dr Death” because of the number of fatalities. Another is known as “blue mystique”. These have been made illegal in a number of European countries, but many more keep appearing. A related group is known as NBOMe, which are very powerful and therefore also a great concern.

Then there are cannabimimetics, which are sometimes known as the “spice drugs”. There are a few hundred known variations, many of which are very powerful, sometimes thousands of times more than cannabis. They were behind the “spiceophrenia” epidemic in Russia, but are prevalent closer to home too. Last week a new HM Prisons report mentioned them among a number of legal-high concerns in British prisons. To make matters worse, they are very easy to modify and have the big selling point that they can’t always be traced in urine.

Sometimes legal highs are marketed as a solution to a problem that an illegal drug might cause. For example ketamine (“special K”) is known to damage the intestine and bladder, so a new drug reached the market called methoxetamine, or “special M,” which claimed to be bladder-friendly. But in fact it is still toxic for the bladder and also the kidney and central nervous system. And after it was made illegal, a number of other derivatives appeared such as diphenidine. The health risks associated with this class makes the new versions particularly scary.

The unwinnable battle?

We often don’t know how these drugs affect people. Researchers like myself are working on this, but the number of new substances is increasing too quickly for us to keep up. By the time we publish papers focusing on more popular versions, the market has changed. When something goes wrong, doctors don’t know how to treat the effects – in many cases they can’t even ascertain the exact drug.

We have reached the point where I am now more worried about legal highs than illegal drugs. Whenever I see a heroin client in my clinic, I know exactly what to do. That is often not the case with legal highs. And as a psychiatrist I know that they potentially have far more psychiatric consequences than heroin. Whenever you tamper with very sensitive mechanisms in your brain, it’s difficult to know what will happen.

One argument is that we should keep these drugs legal since we are facing an unwinnable battle. But the big drawback with this is that it makes adolescents and other susceptible people think that the drug must be safe. New Zealand tried this approach by permitting drugs to remain in circulation if the producers could demonstrate they were low risk, but this year the government U-turned after there were a number of adverse incidents. Now its approach is similar to the UK with its expanding prohibition schedule.

The problem with the New Zealand low-risk policy is that establishing the safety of a drug is a very slow process if you are going to do it properly. Proving through clinical trials that a drug works, is safe and is not toxic takes upwards of 10 years. Anything less would be cutting corners. If a manufacturer were to go through that process and prove that a drug was low risk, that might be a different discussion, but it’s not going to help with today’s problem.

Similarly there has been some debate about permitting the supply of legal highs but keeping it tightly restricted – perhaps allowing one distributor per town, for example. But this both ignores the reality of the internet and offers no answer to the safety problem.

Another possibility is to legalise the illegal drugs that we know much more about, so that people are encouraged to take them instead. But even if this was politically possible, it doesn’t sound like the right course of action either. I see disasters from drug-taking on a daily basis. And it wouldn’t necessarily stop people from taking legal highs anyway.

The answer to what we actually should do is complex. The answer probably lies in prevention: we need dedicated resources and funding, we need new ideas to try and convince youngsters that these drugs are not safe just because they are legal. This requires a big change in how we see these substances. These are not just some marginal concern. This is the new drug battle for the decades ahead.

Source:  http://theconversation.com/legal-highs-regulation-wont-work  29th October 2014

There has been a lot of talk recently about marijuana legalization — increasing tax revenue for states, getting nonviolent offenders out of the prison system, protecting personal liberty, possible health benefits for those with severe illnesses. These are good and important conversations to have, and smart people from across the ideological spectrum are sharing their perspectives.

But one key dimension of the issue has been left out of the discussion until now: the marketing machine that will spring up to support these now-legal businesses, and the detrimental effect this will have on our kids.

Curious how this might work? Look no further than Big Tobacco. In 1999, the year after a massive legal settlement that restricted certain forms of advertising, the major cigarette companies spent a record $8.4 billion on marketing. In 2011, that number reached $8.8 billion, according to the Campaign for Tobacco-Free Kids. To put it into context, the auto industry spent less than half of that on advertising in 2011, and car ads are everywhere.

At the same time, despite advertising bans, these notoriously sneaky tobacco companies continue to find creative ways to target kids. Data from the 2011 National Survey on Drug Use and Health found that the most heavily marketed brands of cigarettes were also the most popular among people under 18.

This is not a coincidence, and gets to the very core of Big Tobacco’s approach: Hook them young, and they have a customer for life. Why do we think the legal marijuana industry will behave differently from Big Tobacco? When the goal is addiction, all bets are off.

In Colorado, where there are new rules governing how legal marijuana is advertised in traditional media, there are still many opportunities to market online and at concerts, festivals and other venues where kids will be present. Joe Camel might be retired, but he’s been replaced by other gimmicks to get kids hooked — like snus and flavored cigarettes. The marijuana industry is following suit by manufacturing THC candies, cookies, lollipops and other edibles that look harmless but aren’t. Making marijuana mainstream will also make it more available, more acceptable and more dangerous to our kids.

Addiction is big business, and with legal marijuana it’s only getting bigger.

Not surprisingly, Big Tobacco is also getting on the marijuana bandwagon. Manufacturers Altria and Brown & Williamson have registered domain names that include the words “marijuana” and “cannabis.” Imagine how much they will spend peddling their new brand of addiction to our kids. We cannot sit by while these companies open a new front in their battle against our children’s health.

Why is this an issue? There is a mistaken assumption that marijuana is harmless. It is not. Marijuana use is linked with mental illness, depression, anxiety and psychosis. It affects parts of the brain responsible for memory, learning, attention and reaction time. Developing brains are especially susceptible to all of the negative effects of marijuana and other drug use. In fact, poison control centers in Colorado and Washington state have seen an increase in the number of calls regarding marijuana poisoning. This isn’t a surprise — with legal marijuana comes a host of unintended consequences.

I’ve spent the past several years after leaving Congress advocating for a health care system that treats the brain like it does any other organ in the body. Effective mental health care, especially when it comes to children, is critically important.

Knowing what we now know about the effects of marijuana on the brain, can we really afford to ignore its consequences in the name of legalization? Our No. 1 priority needs to be protecting our kids from this emerging public health crisis. The rights of pot smokers and the marijuana industry end where our children’s health begins.

I’m not alone in my concerns about this trend toward legalization. Even Colorado Gov. John Hickenlooper has said that marijuana legalization in his state was “reckless” and reaffirmed his opposition to it during his campaign for re-election. He also said he will “regulate the heck” out of it. For that, I applaud his leadership and courage.

Alaska, Oregon and the District of Columbia have legalization ballot measures up for a vote this fall. I hope common sense will prevail, and they choose a better path than making addiction the law of the land.

At the end of the day, legalizing and marketing marijuana is making drug use acceptable and mainstream. Just as Big Tobacco lied to Americans for decades about the deadly consequences of smoking, we can’t let “big marijuana” follow in its footsteps, target our kids and profit from addiction.

Patrick J. Kennedy is a former United States representative from the state of Rhode Island.

Source: http://www.npr.org/2014/10/30/360217001/kennedy-are-we-ready-for-big-tobacco-style-marketing-for-marijuana

 

National Families in Action (NFIA) was founded in Atlanta in 1977, to protect children from drugs.   It led a national effort to help parents  prevent the marketing of drugs and drug use to children and helped them form parent groups to protect children’s health.

Today NFIA publishes the weekly Marijuana Report, an update on major news affecting marijuana across the US.  NFIA has worked continuously for many years.    Tobacco and alcohol cause enough problems in the US and it’s unwise to add a third addictive drug.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Source: http://www.poppot.org/2015/05/22/national-families-of-action-states-marijuana-policy />

 

 

 

PHOENIX (December 18) — New state data from the U.S. Substance Abuse and Mental Health Services Administration shows that Colorado now leads the nation in marijuana use across all age levels and, most disturbingly, in the 12-17 and 18-25 age categories. Marijuana legalization advocates have persistently claimed that marijuana use will not rise with legalization, and that legalization will have little bearing on under-age use. This latest data from the U.S. Department of Health and Human Services proves otherwise.

“Sadly for Colorado’s youth, the data now substantiates the theory that increased availability leads to increased use — despite being assured the contrary by legalization advocates. Arizonans should pay close attention,” said Seth Leibsohn, chair of Arizonans for Responsible Drug Policy. “In Colorado, teen marijuana use has not only increased since legalization, it is now the highest in the nation — more than 73 percent higher than the national average. For those who recommended a ‘wait-and-see’ approach based on Colorado’s experience, the results are in and they are not good. It should be crystal clear, in Arizona and any other state considering legalizing marijuana, that going down the same path would be devastating to our youth and our communities.”

“According to this data, Colorado is not only number one for marijuana use but also ranks near the top in the nation in its use of other illicit drugs,” said Sheila Polk, vice chair of Arizonans for Responsible Drug Policy. “Serious peer-reviewed science warns us that marijuana does significant harm to the developing adolescent brain, causes impaired memory and judgment, lowers IQ and increases school drop-out rates. It is unconscionable to unleash this harmful drug on Arizona’s youth.”

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About Arizonans for Responsible Drug Policy

The Arizonans for Responsible Drug Policy PAC was formed to actively oppose any initiative that would legalize the recreational use of the drug marijuana in the state of Arizona. Visit www.arizonansforresponsibledrugpolicy.org for more information.

Source:  Press Release 18th Dec 2015  melissa@axiompublicaffairs.com

Drug law enforcement is not just unnecessarily punitive but discriminately so. We’d all be better without it.  No that’s not what I think.  It’s the received wisdom of drug legalisation campaigners that George Soros has been putting his billions behind.  Law enforcement is more harmful by far than the effects of the noxious drugs its purpose is to control, they claim.

In any debate on drugs policy I take part in, figures are routinely flung at me of the number of people unjustly incarcerated in the United States or unjustly convicted in the UK.  Suddenly I find democracy US/UK style is racist and as evil as ISIL.

Typically, I am told that half of all federal prisoners in the US are in for drug offences and that this “…punishment falls disproportionately on people of colour”. “Blacks make up 50 percent of the state and local prisoners incarcerated for drug crimes” is typically claimed and rarely challenged.

As for our punitive drugs laws on this side of the pond, I am also routinely informed that  “…roughly 87,000 people are being wrongly convicted every year” some 70 per cent of which are for that delightful social drug cannabis, strangely about the same number as the total number of prison places in the UK.

Fact and fiction could not be more different.  A recently published written answer shows that in any of the last 5 years, the number of people sentenced to more than a year in prison in the UK for  a Class A drugs offence can be counted on two hands ; a sentence of over 6 months for class B drugs (which include cannabis)  can be counted on one hand.

Though  cautions, discharges and rehabilitation orders far exceed all other sentencing (which includes fines and community orders) outraged liberals like Sam Bowman of the Adam Smith Institute irresponsibly persist in  their hyperbole that, “prohibition means putting thousands of people in jail, giving criminal records to hundreds of thousands of others”.

The law is unjust they insist, despite the absence of any evidence for this, that  ‘possession’ arrests damage lives, fill prisons and waste police resources.

The latest to get behind the gross social injustice banner is Bill de Blasio, the Democrat Mayor of New York City  (the first Democrat since 1993).  Under this banner and persuaded that the enforcement of federal marijuana laws doesn’t so much protect minority communities as harm them, he’s instructed the New York Police Department not to enforce them.

The reality is otherwise, however, as John Walters and David W Murray explain  here. As here in the UK the actual risk of arrest while using marijuana in the States is stunningly low – about one arrest for marijuana possession for every 34,000 joints smoked.

Drug arrests are far from being a significant portion of law-enforcement activity.  Possession arrests for marijuana do not fill US prisons – fewer than 0.3 per cent of the total of those incarcerated in state prisons (which is where most US inmates are incarcerated) in fact.  And many of these have “pled down” from more serious offences.

Nor, as we are supposed to uncritically believe,  are African-Americans the directly targeted victims of the drug laws; race is not the driver of “disparate impact”.

Walters and Murray will not make themselves popular for explaining why there are more black drug arrests. The simple facts are that: African Americans are more engaged in drug trafficking; their drug use “often occurs in areas with intensive policing, such as urban street corners” which means, yes,  that the risk of arrest for African-Americans is indeed higher than for whites, whose use of drugs is typically less conspicuous.

Nor is it just drug-related crime where there are racial disproportions in arrests and incarcerations. As they point out, the same is true for almost all crimes.  This difficult fact leaves the outraged liberal in the ‘logical’ but untenable position of having to believe that  virtually all efforts to combat crime must be “wars on communities of colour”.

The trouble is with this specious racial discrimination position is that the only solution would be to decriminalise all crime.  Where that leaves minority communities is far from protected.

Mayor de Blasio only has to look at recent crime rises California to understand this.

There, the recent passing of Proposition 47 has reduced or eliminated prison time for certain drug and stolen property crimes,  the most visible impact of which is its effect on drug possession cases; making California the first state to make drug possession crimes misdemeanours instead of felonies.

The impact has been immediate. It appears to be responsible for an increase in crime figures.

In certain areas, aggravated assault is up 9.9 per cent since the law came into effect and burglary by a whopping 30.7 per cent in the same period.

Myths about the harm of punitive enforcement are myths.  The price of no enforcement is severe – much more crime which threatens all our well being, whatever our colour.

By Kathy Gyngell 

Source: conservativewoman.co.uk   19th Dec.2014

Theresa May has walked into the sunshine again after a few awful days. Such is the magic of politics.

Just a few days ago, much of her shine as a tough and competent Home Secretary had worn off.  Her child abuse inquiry appeared doomed before it had begun. With the prospect of an expensive and endless white elephant ahead (what the experience of both the Saville and Chilcot probes portend) as she apologised to the victims, she must have been ruing the day she ever gave into their demands.

Yes, it was just a few days ago that she could please no one. Her insistence on opting back into the European Arrest Warrant infuriated her backbenchers and left the Eurosceptic public astonished. Could she really be giving carte blanche for us to be picked off our own streets and dumped in a Latvian, Czech or Bulgarian gaol where due process, habeas corpus and so forth are, despite their EU member status, still  pretty much conspicuous for their absence?

Then at the nadir of her fortunes up she comes smiling.  All thanks to the Daily Mail – and very grateful she should be to them too – she was handed Norman Baker’s scalp on a plate.  Overnight she became the new scourge of the Lib Dems, to the joy of her party and her admirers.

Nick Clegg, the Mail discovered, had encouraged the BBC to give airtime to the drug-legalising organisations (Transform and Release) to promote the controversial and highly (Lib Dem) spun Home Office report pushed by his Home Office placeman, one Norman Baker.

This report was already proving a severe embarrassment to her, adding to her woe.

Opening up the drug debate to ‘legalising liberals’ had never been of her choosing.  She was bounced into it.  At the time of the Home Affairs Select Committee report and Nick Clegg’s demand for a Royal Commission on Drugs Policy (a couple of years ago now), giving permission to her then (Lib Dem) Minister, Jeremy Browne, to go on a jaunt (sorry, I meant an international drugs policy fact-finding mission) must have seemed infinitely preferable.

But instead of subsequently chucking into the bin the contents of this ‘jolly’ (to the drug-loving countries of Uruguay, Colorado, the Czech Republic and Portugal, to name but a few of those selected)  – which she should and could have done on the basis of its questionable content – she sat on it.

At that moment she made herself a hostage to fortune. Specifically, she made herself a hostage to Norman Baker, the conspiracy theorist, ageing hippy and would-be rock star that Clegg had chosen to replace the more cogent and intelligent Mr Browne.

But for the Daily Mail scoop, but for their forensic research, which exposed the report’s dodgy facts, but for their pinning the whole thing on Calamity Clegg and Barmy Baker, Theresa would today still be doing daily battle with an unbearably smug Norm and seeming rather less than in charge.

Indeed, she still might be blissfully unaware of the civil servant porkies they so glibly presented in her name as ‘evidence-based’ policy  – of the false facts it took the Mail to expose.

“It is clear that there has not been a lasting and significant increase in drug use in Portugal since 2001”, the civil servants, who drafted the report with Baker’s blessing, asserted.     Except there has been.

In the decade following decriminalisation, school-age drug use, as the Mail correctly pointed out, rose from 12 per cent to 19 per cent of the age group. Back in 1995 (before decriminalisation) only 8 per cent of this group had tried drugs.

Either the researchers were not going  to let an inconvenient fact get in the way of good story or they just didn’t bother to do their homework. That’s why anyone interested in reading through the entire report is advised to put down the rose-tinted spectacles accompanying it.

It skates through medical marijuana in the United States, legalisation of cannabis in Colorado and Uruguay, drug consumption rooms, ‘assisted heroin injecting’ and other liberal ‘harm reduction’ but ethically dubious policies in other countries. It ignores swathes of criticism of these back door to legalisation policies and lacks the rigour and detail to provide a credible basis for discussion.

Predictably, it treats Portugal’s ‘dissuasion commissions’ on a par with the USA’s longstanding, 2,500-strong federal wide and much respected drug court network – of which independent evaluations have demonstrated positive outcomes and over whose time span  cocaine use has dropped by 75 per cent.

Frankly, Mrs May is lucky to no longer have this dodgy dossier still hanging round her neck.  With all the plaudits that have been raining down on her – from the Mail to the Telegraph – for being the longest-serving Home Secretary since Rab Butler, for surviving one of the most difficult senior roles in Cabinet, for regaining the top spot in the battle for the Tory succession in the regular poll of activists by Conservative Home and accompanying fulsome praise –  she’d do well to reflect how lucky she has been.

She might think it is time to sharpen up those micro-management skills that The Times’s Francis Elliott rather kindly supposes to have kept her on top.  The Daily Mail scoop and the Lib-Dems’ shenanigans and spin surrounding the publication of a report that she herself signed off show these much-hyped qualities have not been much in evidence.

A bit more micro-management and she’d have sent her civil servants back to the drawing board and queried their ‘facts’, instead of letting Norman’s day arrive and allowing the report’s publication on the very same day as ‘loopy’ Caroline Lucas’s much heralded and Russell Brand-supported parliamentary drugs debate.

For all her apparent skills this is far from her first mistake. She made a far worse one on her first day in office when she signed off Harriet Harman’s horrendous and costly Equalities Act without any further discussion or reflection.  She didn’t stop there but published her own ‘right on’ Contract for Equalities.  There is nothing that ‘We’re all in this together’ does not cover.

I guess we just have to be thankful she didn’t then, this last week, under Lib Dem pressure for ‘evidence-based policy’,  action equal access to illicit drug use by decriminalising it.  Her featherbrained new feminist minister Lynne “gay marriage” Featherstone (responsible for crime prevention) is bound to suggest it. Be warned.

Source: By Kathy Gyngell conservativewoman.co.uk    6th November 2014

A lack of guidance from the U.S. Environmental Protection Agency frustrated Colorado’s efforts to decide how to handle pesticides and pot.

State regulators have known since 2012 that marijuana was grown with potentially dangerous pesticides, but pressure from the industry and lack of guidance from federal authorities delayed their efforts to enact regulations, and they ultimately landed on a less restrictive approach than originally envisioned.

Three years of e-mails and records obtained by The Denver Post and dozens of interviews show state regulators struggled with the issue while the cannabis industry protested that proposed limits on pesticides would leave their valuable crops vulnerable to devastating disease.

Last year, as the state was preparing a list of allowable substances that would have restricted pesticides on marijuana to the least toxic chemicals, Colorado Department of Agriculture officials stopped the process under pressure from the industry, The Post found.

DENVER, CO – AUGUST 19: Lucas Targos the head grower at L’Eagle sprays the marijuana plants in their cultivation room on Wednesday August 19, 2015. They spray with neem oil which helps combat the spider mites and mildew. He sprays the plants every 7-10 days. This was the last spraying before they go into the flowering stage. Targos was an organic food farmer before working with marijuana. (Photo by Cyrus McCrimmon/The Denver Post )

“This list has been circulated among marijuana producers and has been met with considerable opposition because of its restrictive nature,” wrote Mitch Yergert, the CDA’s plant industry director, shortly after the April 2014 decision. “There is an inherent conflict with the marijuana growers’ desire to use pesticides other than those” that are least restrictive.

Another year passed before regulators publicly released a draft list of pesticides allowed on marijuana plants — a broader, less restrictive list than initially proposed. That only occurred after the city of Denver began quarantining plants over concerns that pesticides posed a health hazard.

The marijuana industry “was the biggest obstacle we had” in devising any effective pesticide regulation, said former Colorado agriculture commissioner John Salazar.

“We were caught between a rock and a hard spot,” he said. “Anything we wanted to allow simply was not enough for that industry.”

The U.S. Environmental Protection Agency, which regulates pesticides, offered the state little advice about what to do because marijuana is an illegal crop under federal law.

“We tried to work with the EPA, to figure out what to do, but we got nothing,” Salazar said.

With little federal guidance and no science to know which pesticides might be safe for consumers, the department made pesticide inspections a low priority, records show.

“Our current policy is to investigate complaints related to MJ (marijuana), otherwise focus on higher priorities,” Laura Quakenbush, the CDA’s pesticide registration coordinator, wrote to a colleague in a December 2012 e-mail.

Critics say the state bowed to industry’s influence.

“Colorado has given the marijuana industry way too much power, way too much control over the political process,” said Kevin Sabet, co-founder of Smart Approaches to Marijuana, a group that opposed legalizing marijuana.

“Regulators are trusting the industry and saying, ‘Show us how to regulate you.’ They’re putting their trust in the industry,” said Samantha Walsh, a lobbyist who has represented marijuana-testing labs and the unions representing workers at cannabis cultivation facilities.

“There’s been foot-dragging in much of the industry,” she said. “It’s a failure of the government to step in and institute these practices.”

State officials say it was important to take into account industry concerns.

“CDA felt there was a need to further explore all possibilities of how best to regulate and identify what pesticides could be legally used on marijuana. During this process, we believe we have identified a better way forward than what we originally proposed in April of 2014,” Yergert told The Post.

The agency is just now preparing for regular inspections of marijuana growers using pesticides, Yergert said, something it already does for other commercial users such as crop-dusting businesses. In July, the CDA began visiting marijuana businesses for “compliance assistance” that focuses on education and training.

And last week, Yergert said, the agency began a new rule-making process to formalize the list of pesticides growers can use.

Heavy-hitting pesticides

Marijuana and pesticides hit CDA’s radar in 2012 when a former employee of the Kine Mine, then a medical marijuana dispensary in Idaho Springs, complained to the state of not being given protective clothing to spray growing plants.

CDA inspectors found two heavy-hitting pesticides — Floramite and Avid — were used on dozens of cannabis plants.

The CDA cited the business with violating a pesticide’s label restrictions. The state was unable to do more because it had not yet determined which pesticides could and could not be used on cannabis in Colorado.

As commercial grow operations spread after recreational pot sale became legal in 2014, complaints continued to flow. Sales of recreational and medical marijuana reached nearly $700 million last year and topped $540 million through July. There are 600 pot-growing licenses in Denver alone.

“I think everyone thought marijuana growers were a bunch of organic growers who would never use pesticides on pot, but that’s definitely not the case,” said Mowgli Holmes, a molecular geneticist at Phylos Bioscience and board member of the Cannabis Safety Institute in Oregon. “A lot of this pesticide use is new and driven by commercial pressures.”

When large numbers of cannabis plants are grown indoors and in close proximity, they are vulnerable to mites and powdery mildews, which can destroy a crop quickly.

To date, there have been 24 inquiries into pesticide complaints involving marijuana businesses, CDA officials said.

Another early complaint came in 2012 when a consumer said a popular cannabis leaf wash for killing bugs claimed to be “99.9999%” water that worked because of an ionic charge.

A state lab found it actually contained high levels of “pyrethrin, a plant-based insecticide that requires EPA registration,” wrote Quakenbush, the CDA’s pesticide registration coordinator.

Officials determined that because the product label did not say that it contained a pesticide, they lacked authority over its use, according to e-mails. The state referred the mislabelling problem to the EPA for investigation, and the state did not look further into the issue.

But the case led state inspectors to send several e-mails to the EPA seeking guidance on how to handle the emerging pesticide problem. Officials also asked whether pesticides allowed on tobacco would suffice. The state received no response, according to e-mails the state provided.

The federal agency responded in an e-mail to The Post that “over the past several years, the U.S. EPA has had interactions with representatives from the Colorado Department of Agriculture on this issue” but provided no details.

Health impact

Colorado initially wanted to do as New Hampshire did, allowing only the least harmful pesticides to be used in marijuana cultivation.

Those included neem, cinnamon and peppermint oils — products so nontoxic that federal registration is not required and no tolerance level is necessary for their residues.

By restricting cannabis growers to those products, Colorado could adapt its rules over time as more information became known about the health impact of chemical residues from pesticides.

Before the sale of recreational pot became legal in 2014, “a majority in the industry’s underground didn’t have very sophisticated practices and were using lots of toxic things they shouldn’t have on a regular basis,” said Devin Liles, who runs The Farm cultivation facility in Boulder.

In April 2014, the CDA laid out the issue: “For food crops, a tolerance (of pesticide residues) must be established. No tolerances have been established for marijuana because they are not recognized as a legal ‘agricultural crop.’ “

Put simply, many pesticides that the marijuana industry was already using — some of them allowed by the EPA on food crops — were to be off the table.

Small, informal working group meetings were held in March and April. Liles said other members of a group on which he participated immediately were worried.

“Some operations were really concerned because what they were using was now on the chopping block,” he said, “and they didn’t know if it would become more restrictive later.”

The proposed rule was published, and a meeting during which stakeholders could speak was scheduled for that May.

“The Colorado Department of Agriculture does not recommend the use of any pesticide not specifically tested, labeled and assigned a set tolerance for use on marijuana because the health effects on consumers are unknown,” the proposed rule said.

Then in late April 2014, soon after CDA issued the proposed rule — and following two meetings where officials heard the industry’s reaction — the agency pulled the plug on its rule-making process.

“The termination will allow the agency more time to meet with the representative group of stakeholders and further review the impacts of the proposed rule,” according to the portion of the Colorado secretary of state’s website where the hearings are tracked.

“We continued to have conversations without having any resolution,” Ron Carle ton, CDA’s former deputy commissioner, said in an interview. “The industry was of the opinion they needed the same kind of access to pesticides that other growers were using, that this low-level stuff wouldn’t do it.”

CDA and the marijuana industry continued to wrangle. That June, CDA shared copies of an early, broadened draft list of approved pesticides with at least one industry group.

“The list never meant much because it was always in draft form, never formalized or finalized, and rule-making never occurred,” Michael Elliott, executive director of the Marijuana Industry Group, told The Post in an e-mail.

At a CDA meeting with businesses in December, Elliott said growers were frustrated because they did not believe the state was giving them the tools necessary to fight the problems they faced.

“We need clean product, and we have a huge list of things to test for and failure could literally shut down a business,” he said.

Meanwhile, CDA continued its policy of not checking to see what pesticides marijuana growers were using unless someone complained.

“To date, CDA has not actively sought to inspect and enforce the provisions of the (Colorado) Pesticide Applicator’s Act on marijuana producers,” Yergert, CDA’s plant industry director, wrote in a memo for a meeting in December. The Pesticide Applicator’s Act is the state’s authority to enforce EPA pesticide laws.

The delays had Yergert worried that CDA’s inaction could be problematic.

“The last thing that I want is somebody to get sick and they say it was due to pesticide use” and that the state knew about it, he said at the December meeting with industry representatives. “None of us wants to be in front of that train.”

Turning up the heat

While state regulators and the industry debated how pesticides should be regulated, Denver was about to turn up the heat.

Denver firefighters conducting routine safety inspections of marijuana growhouses in early 2014 discovered some growers were burning sulphur as a fumigant to kill mites. Firefighters say that’s a fire hazard.

Once stopped from using the dangerous substance, the growers turned to pesticides, and firefighters noticed cabinets full of odd-sounding chemicals.

“They will do something to protect these million-dollars worth of plants,” said Lt. Tom Pastorius. “We stopped one issue with the sulphur. But that just led to a whole different issue.”

The city’s environmental health department responded by quarantining about 100,000 plants in March after application logs showed pesticides they knew little about. City health officials met with CDA and learned of the agency’s draft list of pesticides it said were OK to use.

The meeting prompted the state to release the list publicly. It was the first time growers say they were fully aware of what they could and could not use.

“At that time, we didn’t want to put the list out,” said John Scott, CDA’s pesticide program manager. “We were still working on the rule itself.”

But once Denver had quarantined the plants, “we felt like it couldn’t wait,” Scott said.

Pesticides on the list have labels so broadly written that the state determined their use on marijuana is permissible. However, CDA also says it does not recommend their use because no one knows whether the pesticides are safe when used on marijuana.

Three of the growers whose plants were quarantined fought back in court, suing the city for allegedly overextending its authority. Pesticides, the businesses argued, were the purview of CDA, not the city.

The industry also turned to the Colorado legislature and had a last-minute amendment designed to stop Denver’s enforcement added to a bill about marijuana tax revenues, according to documents and interviews.

It’s not the only example of marijuana growers looking toward the Capitol for help. Also during the last session, several legislators tried but failed to pass a law that would have removed pesticides entirely from the list of ingredients on marijuana product packages.

The enforcement amendment, which ensured that pesticide oversight of marijuana growers would stay with the state, was tacked on from the Senate floor on the day before it adjourned.

“The worry was that communities could basically ban the use of some pesticides based on emotional responses rather than factual ones,” said Sen. Jerry Sonnenberg, R-Sterling, the amendment’s sponsor. “It was to codify that the state was in charge, not Denver, not any city.”

The impetus for his amendment, Sonnenberg said, came primarily from conversations with three lobbyists who records show are with the Marijuana Industry Group.

Sonnenberg’s re-election committee had accepted about $1,000 in contributions from the three since 2010, according to state campaign finance records. In that time, he’s accepted about $1,800 from all marijuana-related contributors, records show. All contributions Sonnenberg received since 2010 totaled $49,900, according to state filings.

More broadly, the industry has spent at least $421,000 on lobbying on various cannabis-related issues this year, state reports show. In contrast, utility giant Xcel Energy has spent $230,640, according to the company. The city eventually won in court, but the amendment passed as well. Subsequent enforcement actions by Denver occurred at the retail level, far from where plants are actually covered in pesticides and where CDA’s pesticide authority extended.

The city declined to comment on the legislature’s action.

“What was most frustrating about what happened in Denver is that the city went from not participating in the statewide conversation and doing absolutely nothing to placing holds on businesses,” Elliott at MIG said in an interview. “We would have appreciated having them involved in the state process and perhaps having worked out more local solutions instead of coming down quickly with holds.”

Elliott paused, then offered: “That said, I understand why they reacted the way they did. They identified a safety issue and took action. Very little has been going on on this issue on a statewide level.”

Source: The Denver Post   4th Oct. 2015

John Hickenlooper, D-Colo., and Sen. Cory Gardner, R-Colo., don’t seem to care much about the toll recreational marijuana imposes on Colorado. Each reacted with righteous indignation to the Trump administration’s decision to rescind the Obama administration’s lax pot policies.

“It’s not a black market anymore. It’s not a criminal activity, and we would hate for the state to go backwards,” Hickenlooper said Thursday, expressing concern about the potential for more federal enforcement against our state’s illegal marijuana industry.

Gardner asserted his duty Thursday to protect the state’s “right” to sanction, host, and profit from an industry that flagrantly violates federal law to the detriment of traffic safety, federal lands, children, and neighboring states that are burdened by Colorado pot. Never mind that even the Obama policy emphasized a need for federal enforcement against drugged driving, damage to kids and neighboring states, and the presence of cartels and pot on federal land. Somehow, Colorado has a right to avoid these federal enforcement measures even the Obama administration wanted.

Colorado politicians need to stop pandering and start leading, which means telling the truth about the severely negative consequences of big commercial pot.

Hickenlooper, Gardner, and other politicians tell us everything is rosy, but that’s not what we hear from educators, cops, social workers, doctors, drug counselors, parents, and others in the trenches of the world’s first anything goes marijuana free-for-all. It is not what we see in the streets.

If Hickenlooper and Gardner cared to lead on this issue, they would tell the world about the rate of pot-involved traffic fatalities that began soaring in their state in direct correlation with the emergence of legal recreational pot and Big Marijuana. They would talk about Colorado’s status as a national leader in the growth of homelessness, which all major homeless shelter operators attribute to commercialized, recreational pot.

They would talk about the difficulty in keeping marijuana from crossing borders into states that don’t allow it. They would spread the words of classroom educators and resource officers who say pot consumption among teens is out of control.

Honest leaders would talk about illegal grow operations invading neighborhoods and public lands. They would stop selling false, positive impressions about a failed policy for the sake of “respecting the will of voters” who made a mistake. They would not follow public perception but would lead it in a truthful direction.

Hickenlooper says legalization has eliminated illegal pot in Colorado, which is laughable to men and women who enforce the law and talk to us.

El Paso County Sheriff Bill Elder speaks of more than 550 illegal rural home-grow operations in El Paso County alone.

Mayor John Suthers — Colorado’s former U.S. attorney, attorney general, district prosecutor and state director of corrections — speaks of hundreds of illegal pot operations in Colorado Springs he hopes to raid. We could go on with countless accounts of leading law enforcers who describe illegal pot activity that exceeds limits of departmental budgets and personnel.

That’s the small stuff, relative to the massive black market Colorado’s legalization attracts to federal property.

Dave Condit, deputy forest and grassland supervisor for the Pike-San Isabel and Cimarron-Comanche National Grasslands, recently accompanied Forest Service officers on the raid of a Mexican cartel’s major grow operation west of Colorado Springs. It was among at least 17 busts of cartel operations in the past 18 months. He describes the type of operation mostly based in Mexico, before legalization made Colorado more attractive. Condit said the agency lacks resources to make a dent in the additional cartel activity in the region’s two national forests.

“It was eye opening to put on the camouflage and sneak through the woods at 4 in the morning,” Condit told The Gazette’s editorial board Friday. “I had no idea the scope of these plantations. These are huge farms hidden in the national forests. The cartels de-limb the trees, so there is some green left on them. Other trees are cut down. They fertilize the plants extensively, and not all these fertilizers and chemicals are legal in this area.

“This is different than anything we have experienced in the past. These massive plantations are not the work of someone moving in from out of state who’s going to grow a few plants or even try to grow a bunch of plants and sell them. These are massive supported plantations, with massive amounts of irrigation. The cartels create their own little reservoirs for water. These operations are guarded with armed processors. They have little buildings on site. The suspects we have captured on these grows have all been Mexican nationals.”

Condit said the black market invading Colorado’s national forests has grown so large the entire budget for the Pike and San Isabel forests would not cover the costs of removing and remediating cartel grows in the forests he helps supervise.

“There’s a massive amount of resource damage that has to be mitigated,” Condit said. “You’ve got facilities and structures that have to be deconstructed. We would need to bring in air support to get materials out of there. There are tens of thousands of plants that have to be destroyed.”

Condit hopes the Colorado Legislature will channel a portion of marijuana proceeds to the Forest Service to help pay for closure and reclamation of cartel operations.

“For every plantation we find, there are many more,” Condit said.

Authorities captured only two cartel suspects in the raid Condit witnessed, and others escaped by foot into the woods.

“This operation had a huge stockpile of food. Hundreds and hundreds of giant cans (of food), and stacks of tortillas two or three people could not consume in months,” Condit said. “So it appeared they were planning to bring in a large crew for the harvest. I wouldn’t have thought you could hide something like that in our woods, but you can.”

Officers seized a marijuana stash and plants worth an estimated $35 million that morning. Merely destroying the plants presented a significant expense.

“Whether you’re a recreational shooter, a weekend camper, or you’re going to walk your dog in the woods, you should be concerned,” Condit said. “Some of these people have guns. If you stumble into $35 million worth of illegal plants, I’d be concerned. We are concerned for our own personnel.”

That’s not the view of either Colorado senator, other pandering politicians or the state’s top executive. From their offices Washington and Denver, they see things quite differently.

“Now the people who cultivate marijuana, the people who process marijuana, the people who sell marijuana are not criminals,” Hickenlooper said Thursday. “They’re not committing any crimes.”

No black market? No crimes? Tell the cartels. They come to Marijuana Land in the wake of Amendment 64, wisely betting state leaders will defend their risky and unprecedented law no matter what. They count on politicians to look the other way, so they can tell the world their new system works.

The Colorado Springs Gazette is a sister newspaper to the Washington Examiner. This editorial originally ran there.

Source: Colorado Springs Gazette Editorial Board | Jan 10, 2018, 9:23 AM

WASHINGTON – China’s Ministry of Public Security last week announced scheduling controls on two fentanyl precursor chemicals – NPP and 4ANPP, substances that can be used to make illicit drugs. The scheduling controls will take effect on February 1, 2018 and is the result of the ongoing collaboration between the Drug Enforcement Administration and the Government of China and their shared commitment to countering illicit fentanyl-class substances.

“Fentanyl compounds significantly contribute to the current opioid crisis in the United States. By stemming the chemicals used to make these substances, this latest Chinese scheduling action will help save lives,” said DEA Acting Administrator Robert W. Patterson. “This scheduling action is an important step and a testament to the progress our countries are making together in addressing this epidemic.”

DEA and Chinese officials maintain frequent contact to collaborate and share data on the threat from fentanyl-class substances and their impact on the United States. Information-sharing includes scientific data, trafficking trends, and sample exchanges. This dialogue has resulted in improved methods for identifying and submitting deadly substances for government control.

The Chinese Government previously controlled four fentanyl-class substances – carfentanil, furanyl fentanyl, valeryl fentanyl, and acryl fentanyl – which took effect on March 1, 2017, and another four new psychoactive substances/fentanyl-class substances – U-47700, MT-45, PMMA, and 4,4’ DMAR – which took effect on July 1, 2017. Source: U.S. Drug Enforcement Administration dea@public.govdelivery.com 5th Jan 2018

America’s worsening opioid crisis has caused life expectancy to fall for the second year running for the first time in more than half a century.

The average life expectancy in the US is now 78.6 years – down by 0.1 years, figures from the National Center for Health Statistics (NCHS) found.

It is the first consecutive drop in life expectancy since 1962-63 and surpasses the previous one-year dip in 1993 at the height of the Aids epidemic.

America’s opioid addiction crisis – caused by the over-prescription of opioid based painkillers – has been blamed for the trend.

The addiction sees patients turning to heroin and other substances when their doctors stops issuing prescription medication.

Synthetic opioids such as fentanyl, which has flooded the US drugs market and is 100 times more powerful than heroin, are thought to be behind the dramatic increase in overdoses among heroin users.

“The key factor in all this is the increase in drug overdose deaths,” said Robert Anderson, from the NCHS, who said the two-year drop was “shocking”.

US president Donald Trump has called the crisis a “public health emergency” and pledged to tackle illegal drug trades.

He said: “Nobody has seen anything like what is going on now.

“As Americans, we cannot allow this to continue. It is time to liberate our communities from this scourge of drug addiction.”

Official figures show the number of people who died from a drug overdose in 2016 was 63,000 – 21 per cent higher than the previous year and three times the rate in 1999.

Opioid-related overdoses increased by 28 per cent, causing 42,249 deaths, mostly in the 25-to-54 age group.

Average male life expectancy has fallen 0.2 years – average female life expectancy is unchanged at 81.1 years.

A continued decline in life expectancy in 2017 would represent the first three-year fall in the US since the outbreak of Spanish flu 100 years ago.

Death rates fell for seven leading causes of death, including heart disease, cancer, stroke and diabetes, however an ageing population meant Alzheimer’s related deaths increased by 3.1 per cent and suicide rates increased by 1.5 per cent.

Source: http://www.telegraph.co.uk/news/2017/12/22/americas-opioid-crisis Dec.22.2017

The truth is it can indeed mean trouble, especially for young people.

These days, it’s become fairly square to criticize marijuana and its rush toward legalization. Twenty-three states have condoned the drug in some form, with four permitting recreational use, and Massachusetts is set to vote on permitting it next year. The proposed federal CARERS Act of 2015 would let states legalize medical marijuana without federal interference and demote pot from a Schedule I drug — one with high abuse potential — to Schedule II. The path toward nationwide decriminalization is looking unobstructed.

But underscoring the incredible momentum to legalize marijuana is the misconception that the drug can’t hurt anybody. It can, especially young people.

The myth that marijuana is not habit-forming is constantly challenged by physicians. “There’s no question at all that marijuana is addictive,” Dr. Sharon Levy tells me. She is the director of the Adolescent Substance Abuse Program at Boston Children’s Hospital, one of a few programs designed to pre-emptively identify substance use problems in teens. At least 1 in 11 young adults who begin smoking will develop an addiction to marijuana, even more among those who use the more potent products that are entering the market.

Levy speaks of an 18-year-old patient who had started smoking marijuana several times a day in 10th grade, dropped out of high school, and been stealing money from her parents. “She and her family were at their wits’ end trying to find appropriate treatment in a health care system that doesn’t consider addiction to marijuana a serious problem,” Levy says. “We are simply not prepared for the fallout of marijuana legalization.”

Such perspectives have been obfuscated by those who might gain from legalization. “People strongly defend marijuana because they don’t want legalization to be derailed,” says Jodi Gilman, an assistant professor at Harvard Medical School with the Center for Addiction Medicine.

An insistence on the banality of the drug is especially dangerous among younger smokers, a population with an epidemic level of pot use. According to the most recent National Survey on Drug Use and Health, the use of tobacco and alcohol among 12-to-17-year-olds has fallen in the past year, but habitual use of marijuana among those 12 and up is increasing.   “If you go into a high school and ask the classroom, ‘Are cigarettes harmful? Is alcohol harmful?’ every kid raises their hands,” Gilman says. “But if I ask, ‘Is marijuana harmful?’ not a hand goes up.”

To bring balance to a narrative driven by pro-legalization campaigns, Gilman and others are interested in leveraging data to show pot’s real effects. Last year, Gilman published research on 18-to-25-year-olds that showed differences in the brain’s reward system between users and non-users. (“I got a lot of hate mail after that,” Gilman says.) And data supporting the hazards keep accumulating. Recently Gilman found that in a group of college students, smokers had impaired working memory even when not acutely high.

Physician concern for marijuana’s acceptance isn’t because doctors are a stodgy bunch — their scepticism is rooted in science and in history. In the 1950s, nearly half of Americans smoked tobacco, a level of adoption that rendered its health hazards invisible. Meanwhile, the corporate forces that drove cigarette smoking to its ascendancy actively subverted those that governed public health.

While marijuana has not been definitively shown to cause cancer or heart disease, its harmful cognitive and psychological effects will take time to capture in studies. The underlying biochemistry at work suggests deeply pathologic consequences. Tetrahydrocannabinol (THC) in marijuana attaches to receptors in the brain that subtly modulate systems ordinarily involved in healthy behaviors like eating, learning, and forming relationships. But THC — which has been increasing in potency in legal products being sold in places like Colorado — throws the finely tuned system off balance.

“Smoking pot turns the volume on this system way, way up,” says Jonathan Long, a research fellow at the Dana-Farber Cancer Institute.

Each hit of THC rewires the function of this critical cognitive system: Early evidence in mice has shown that repeated exposure to THC causes these receptors to disappear altogether, blunting the natural response to positive behaviors and requiring higher doses to achieve the same effect. Marijuana exploits essential pathways we’ve evolved to retrieve a memory, to delicately regulate our metabolism, and to derive happiness from everyday life.

Medical science at its best operates independently of forces that drive the market and its associated politics. It was science that eventually curtailed the power of Big Tobacco and prevented nearly 800,000 cancer deaths in the United States between 1975 and 2000. As marijuana marches toward the same legal status as cigarettes, its potential hazards will require equal attention by science.    The argument here isn’t whether marijuana should be legal. There are champions on either side of that debate. Instead, should the drug become widely available, it’s to our detriment to blindly consider marijuana’s legalization a victory worthy of celebration. We must be cautious when societal shifts can affect health, especially among our most vulnerable populations.

Source: http://www.bostonglobe.com/magazine/2015/10/08/can-please-stop-pretending-marijuana-harmless/MneQebFPWg79ifTAXc1PkM/story.html

 

Erie police and local hospitals are dealing with a rash of overdoses involving the synthetic marijuana known as K2, which police said is highly addictive and is sold in packages such as this packet, which was recently seized in a drug investigation. The packets typically sell for $20 to $30, according to police.

A form of synthetic marijuana is filling local emergency rooms. Authorities said seven teenagers ended up in hospitals after attending a party Thursday night in Erie that involved the drug, known as K2. At least some of the teens were later transferred to a Pittsburgh hospital for follow-up care.

Shortly before 1 p.m. Friday, Erie police and EmergyCare were sent to the 400 block of East 15th Street on a report of a K2 overdose. The call was separate from the call about the party, whose location police are still investigating. The incidents were among the latest in what Erie police and hospital officials are calling a recent spike in overdoses involving K2, a form of synthetic marijuana also known by such names as Spice and Potpourri.  Officials said they have no reports of fatal K2 overdoses in Erie, but that the overdoses trigger erratic and dangerous behavior. The emergency room at UPMC Hamot had handled more than 20 K2 overdose cases in the past week as of Friday morning, said Ferdinando Mirarchi, D.O., the hospital’s medical director of emergency medicine.

“It’s kind of like marijuana on steroids,” he said. Saint Vincent Hospital has also treated K2 overdose cases, including some of the teenage victims from the Thursday night party, said James Amsterdam, M.D., the hospital’s chief medical officer.  Erie police and the Erie County District Attorney’s Drug Task Force are investigating.

 K2 is a mixture of spices or plant material that is typically sprayed with a synthetic compound that is chemically similar to THC, the psychoactive ingredient in marijuana. K2 is typically sold in small bags and marketed as incense that can be smoked, according to information on the Partnership for Drug-Free Kids website and is treated with chemicals that come from overseas, said Mike Nolan, of the Erie Bureau of Police Drug & Vice Unit.

The K2 that is winding up in Erie is made in clandestine labs in the West and is treated with chemicals that come from overseas, said Lt. Mike Nolan, of the Erie Bureau of Police Drug & Vice Unit.

“The thing is, you don’t know what (the chemical) is,” he said.  The packets of K2, under various names, are typically sold out of stores illegally, police said. They cost $20 to $30 for a 3-to-5-gram packet, city drug investigators said.

Investigators are learning from users that K2 is highly addictive, Nolan said. One person in a recent investigation told detectives that the only thing more addictive than K2 is heroin, he said. Unlike marijuana, which typically has a calming effect, K2 can produce hyper-excitability in those who smoke it, Hamot’s Mirarchi said. Users can get very agitated or very depressed, and then can develop seizures and respiratory problems, he said.

The more typical symptom of K2 overdose patients who come into the ER is excitability to the point of acting psychotic, Saint Vincent’s Amsterdam said. Users can be extremely violent, resulting in injury to themselves as well as to hospital staff, he said.  “It might take actual sedation and muscle paralysis to control the patient, in which case they need to be put on a ventilator,” Amsterdam said. “Some patients can present, after the excited state, more of an exhausted state. They could be hard to arouse, and could need airway protection.” Amsterdam said there is no antidote, and the length of time it takes for the drug to wear off typically results in a two- to three-day hospital stay. “The frustrating thing is, these places don’t stop selling it,” Nolan said.

An amendment to Pennsylvania’s Controlled Substances, Drugs, Device and Cosmetic Act in 2013 included synthetic cannabinoids, which makes them illegal, and provided a list of specific chemicals, said former Erie County Assistant District Attorney Roger Bauer, who was recently hired as a deputy attorney general in Erie for the state Attorney General’s Office Drug Strike Force Section. Bauer prosecuted K2 cases for the District Attorney’s Office.

“Everyone knows what marijuana does to the body. These chemicals are clandestine manufactured. No one really knows what goes into them until after the fact. That’s why you have cases of people dying or getting high and acting in a different manner,” Bauer said.  Erie Police Deputy Chief Donald Dacus said his department is still actively investigating and serving search warrants on local businesses suspected of selling K2. Anyone who knows of anyone actively selling it is asked to call the bureau’s Drug & Vice Unit at 870-1199.

Source: Erie Times-News, Erie, Pa., Oct. 17, 2015.  

Filed under: Synthetics,USA :

The only thing green about that bud is its chlorophyll.

—By Josh HarkinsonBrett Brownell, and Julia Lurie

March/April 2014 Issue of Mother Jones

You thought your pot came from environmentally conscious hippies? Think again. The way marijuana is grown in America, it turns out, is anything but sustainable and organic. Check out these mind-blowing stats, and while you’re at it, read Josh Harkinson’s feature story, “The Landscape-Scarring, Energy-Sucking, Wildlife-Killing Reality of Pot Farming.”

 

Sources: Jon Gettman (2006), US Forest Service (California outdoor grow stats include small portions of Oregon and Nevada), Office of National Drug Control Policy, SF Public Utilities Commission, Evan Mills (2012).

UPDATE: Beau Kilmer of the RAND Drug Policy Research Center argues that the government estimates of domestic marijuana production used in this piece and many others are in fact too high. Kilmer’s research, published last week, suggests that total US marijuana consumption in 2010 (including pot from Mexico) was somewhere between 9.2 and 18.5 million pounds.

Source:  https://www.motherjones.com/environment/2014/03/marijuana-pot-weed-statistics-climate-change/

For more than four decades, marijuana has been synonymous with Jamaica. It was traditionally associated with the Rastafarian community in Jamaica and is regarded as a herb of religious significance by the Rastafarians and is widely used as a sacrament in their religious ceremonies.

However, the use of marijuana has transcended its traditional use from that of a sacrament for Rastafarians and it is now being used as a recreational drug in mainstream society. It has assumed both cultural and religious significance and is regarded as a harmless “holy herb” that bestows wisdom on its users.

Marijuana has permeated the society to such an extent that the taboo once associated with its use has her diminished, and this has led to it being more available. As a result of such availability, the “weed” is easily accessible and can be found in the palms of many of the countries’ youth (12 to 19 years old), especially those in the lower socioeconomic communities.

With the amendments to the Dangerous Drugs Act decriminalising the use and possession of small quantities of marijuana, it is projected that more youth will be using the drug.

Given Jamaica’s history with marijuana use and it’s so, called powers of wisdom, persons are unwilling to accept the fact that this herb can have any ill affect on one’s mental health, and persons who admit to suffering ill effects from its use are seen as weak.

This policy seeks to address the effect marijuana usage has on the mental health of adolescents and outlines options for preventing marijuana usage and reducing ganja- related harms.

THE PROBLEM FACING JAMAICA

1) Smoking marijuana increases the risk of mental disorders such as depression and schizophrenia in adolescents.

2) The decriminalising of small quantities of marijuana will only serve to increase the availability and usage of marijuana among the nation’s youth, resulting in increased ganja-related mental illnesses.

3) The focus on marijuana is largely on the criminal justice perspective. However, there is insufficient attention being placed on the issue of health, especially the mental health of young persons who consume the drug.

4) Marijuana is the most commonly used drug in Jamaica. Some of the active ingredients in marijuana have been shown to be harmful to the user. they can induce hallucinations, change thinking, and cause delusions.

5) The United Nations Office on Drugs and Crime (UNDOC) reports that the majority of marijuana users in Jamaica are between the ages of 13-25 years, implying that marijuana use is occurring in the most productive years of individuals’ lives.

6) The World Health Organisation (WHO) and (others) have reported that the most prevalent disorder in Jamaica is schizophrenia, which has been increasing yearly between 2009 and 2013. These studies have also highlighted the connection with early usage of marijuana and the increase in mental illness.

7) The National Secondary Schools Survey (2013) conducted islandwide from a sample of 3,365 grades 8, 10, 11, and 12 students, revealed the following:

a) 43.2% reported that marijuana was the easiest illicit drug to access.

b) One in five students who were current marijuana users were at high risk for marijuana misuse

c) Age of first use of marijuana was 12.9 years

d) 30.8% reported that drugs(including marijuana) were available at their school

e) 50.4% believed that drugs, including marijuana were available near school. Students who believed that drugs were available reported significantly higher use than those who did not believe drugs were available in and around school.

The American Psychiatric Association (APA) is opposed to the use of marijuana. Its position is based the following on:

i. There is no current scientific evidence that marijuana is in any way beneficial for the treatment of any psychiatric disorder. In contrast, current evidence supports, at minimum, a strong association of cannabis use with the onset of psychiatric disorders. Adolescents are particularly vulnerable to harm, given the effects of cannabis on neurological development.

ii. The use of marijuana/ganja in young people has been examined in many major studies worldwide. Results on the findings of these studies have differed. Some have found little or no association between marijuana use and mental disorders. Others have found deleterious effects of marijuana usage on mental health.

iii. Longitudinal studies conducted in New Zealand and Denmark suggest that the effects on the brain caused by marijuana probably explains higher rates of psychose.

The findings highlighted above suggest that the effects on the brain caused by marijuana usage can lead to mental disorders.

OPTIONS

a) A public education/media campaign (digital, print, radio, and TV) to develop and disseminate effective drug information for youth, parents, and caregivers. At the core of the strategy is essential information about the harmful effects of marijuana use.

i. To bring awareness to the fact that the teen brain continues to develop to age 25, therefore, it is vitally important that teens refrain from marijuana use as this use will affect brain development.

ii. Once youth perceive that marijuana use is harmful and risky, marijuana use dramatically declines.

iii. The longer a child delays drug use, addiction and substance abuse disorders are significantly reduced.

b) Teach life skills and drug-refusal skills focusing on critical thinking, communication, and social competency. This strategy will take on the following options:

i. Engaging families to strengthen these skills by setting rules, clarifying expectations, monitoring behaviour, communicating regularly, providing social support, and modelling positive behaviours.

ii. Encouraging social bonding and caring relationships, with people holding strong standards against substance abuse in families, schools, peer groups, mentoring programmes, religious and spiritual contexts, and structured recreational activities.

The campaign will have an enhanced focus on marijuana use and abuse. In addition to new national-level prevention and demand reduction messaging, the education-media campaign will work directly with communities to amplify the effects of the campaign and to encourage youth participation in the initiative through the help of on-the-ground partner organisations such as uniform groups, youth clubs, and national non-profit organisation devoted solely to the education and development of young people through policy and programme creation.

Since marijuana use has become ingrained in Jamaica’s social and cultural psyche, then any policy directed at marijuana reduction must be geared at behaviour modification.

Public education campaigns, whether they are used as a drug-prevention or health-promotion tool, tend to be based on their ability to affect behavioural change.

They have been successfully applied to the reduction of tobacco use and the promotion of road safety and have shown moderately positive results in a number of areas, including the promotion of healthier nutrition, physical activity, participation in screening for breast and cervical cancer, disease prevention, and other health related concerns.

EXPECTED OUTCOMES

i. First 12 months – 42 per cent improvement in perception of risks of marijuana use by both youth and adults; 50 per cent improvement in the disapproval rates of marijuana use by 12 to 19 year-olds;

ii.Year 3-4 – 70 per cent decrease in marijuana use by youth ages 12 to 19 years; 30 per cent decline in ganja-related mental illnesses.

iii. Year 5-7 – 91 per cent reduction in marijuana use by youth ages 12-19 years old; 75 per cent decline in ganja-related mental illnesses.

Despite the best efforts, some teens will use drugs invariably. Legislative and law enforcement methods offer an alternative to prevent and/or reduce adolescent marijuana usage. At the core of this option are the following strategies:

i. Mandatory counselling and treatment for adolescent found using marijuana.

ii. Mandated community service if adolescent continues to offend.

iii. Mandated prison sentence after the offender has done community service on two previous occasions.

Marijuana is the most widely consumed illicit (pre-decriminalisation in some nation states) drug. It is targeted in one way or another by most prevention interventions. However, few interventions have targeted marijuana specifically. Prevention is typically delivered in the context of wider informational activities and shares a platform with prevention for other substances such as other illicit drugs, alcohol, and tobacco. This policy will be geared specifically at marijuana.

The recommended option of a public education campaign marijuana prevention and reduction programme offers the best alternatives for achieving the stated objectives of the policy.

– This is a heavily edited presentation by Sophia Simpson-Wickham who recently completed an MSc in International Public and Development Management in the Department of Government, UWI, Mona. Feedback: mozzass@hotmail.com or editorial

Source: http://jamaica-gleaner.com/article/news/20171210/target-ganja-babies-urgent-focu

Millions of people use cannabis as a medicine. That’s not based on clinical evidence, nor do we know which of the hundreds of compounds in the plant is responsible for its supposed effects. Elizabeth Finkel reports.

LAST YEAR DEDI MEIRI, A CANNABIS RESEARCHER AT THE TECHNION, ISRAEL’S OLDEST UNIVERSITY, RECEIVED A “BEFORE AND AFTER” VIDEO OF AN AUTISTIC BOY.

The before showed the boy helmeted, hands tied behind his back, butting his head against a wall. The after showed him calmly sitting at a table, sketching. The difference: two drops of cannabis oil administered below the tongue. The video had been sent to Meiri by Abigail Dar, an Israeli champion for the use of cannabis in children with autism.

Early this year it was a different story. Over the course of a day, Meiri’s lab received a stream of phone calls from Dar: a few autistic children had gone berserk after receiving their two drops of oil.

Meiri, who is primarily a cancer researcher, received the video and the calls because he has, reluctantly, become one of Israel’s cannabis experts. “Even now I am reluctant to tell people I work on medical cannabis,” he says. “I am not pro-cannabis; I think 90% is placebo.”

But Israel is in the grip of a vast medical experiment. Cannabis has taken hold here to treat a startling range of medical conditions. Not just familiar things like anorexia and pain in cancer patients but autism, Crohn’s disease, Tourette’s syndrome, epileptic seizures, multiple sclerosis, arthritis, diabetes and more. With close to 30,000 users in a population of eight million, Meiri says “everyone knows someone who is being treated with cannabis”. While there is a semblance of orderly medicine, with doctors prescribing cannabis oil from eight registered growers, no one can say just what, exactly, is responsible for the apparent responses.

A cannabis plant is a pot-pourri of more than 500 chemicals whose abundance varies greatly across different genetic strains and according to growth conditions – they’re not cultivars so much as chemovars. The medicinal effect may depend on tetrahydrocannabinol (THC), the chemical that gives you the high, or cannabidiol (CBD), which is thought to reduce inflammation and pain, or a hundred other “cannabinoids” unique to the plant with their own medicinal profile.

Bottom line: with dozens of varieties grown under different conditions, Israeli patients are receiving quite different medicinal concoctions.

Israel’s predicament is tame by comparison to the United States. Here it is the Wild West. Federal sheriffs outlaw medical research on the plant while cannabis cowboys peddle chemovars (varying in their content of THC and CBD) for cures and profit. In the 29 US states that have legalised medical cannabis, dispensaries that resemble something out of a Harry Potter tale sell candies, cookies, oils, ointments and joints to an estimated 2.3 million Americans. As to their exact medical benefits and risks, no one knows. This is medieval medicine – akin to boiling willow bark to treat headache. It is also great business – the North American market for legal cannabis products grew 30% in 2016, with sales topping $US6.7 billion.

Israel’s medical cannabis mess is a lot easier to deal with. To help address it, Meiri’s laboratory of Cancer Biology and Cannabinoid Research is conducting a reverse clinical trial. While patients using medical cannabis fill in a monthly questionnaire, the ranks of analytical machines bursting out of Meiri’s lab create chemical fingerprints of the cannabis extracts patients are using. The idea is to try to link individual cannabis compounds to the patient response.

It is an approach that’s “two or three rungs down” from the ideal of randomised placebo-controlled clinical trials (RCTs), says Donald Abrams, an oncologist at the University of California, San Francisco, who prescribes cannabis as a palliative for patients with cancer. “But, if well done and there’s a strong effect, observational studies like these are invaluable.”

Israel is also one of the few places in the world pushing forward with gold-standard RCTs. But given that dozens of cannabis strains are already being used for a ballooning number of conditions, RCTs seem like a finger in the dyke.

Countries like Australia, where the federal government legalised medical cannabis in October 2016, are entering this brave new world with trepidation. “Because there has been no proper research, we’re now at a difficult crossroads,” says University of Melbourne pharmacologist James Angus, who chairs the federal government’s advisory council on the medical use of cannabis. “Our health workforce has no guidelines or experience in prescribing, and patients are demanding it. We’ve run out of time.”

The Promised Land may well be the world’s best bet for deliverance from the medical cannabis mess.

Anecdotes on the medical use of cannabis go back to mythical Chinese emperor Shen Neng in 2700 BCE. More piquant references can be found in ancient Roman, Greek and Indian texts. Or just google.

Thousands of years on from Shen Neng, it seems we still don’t have a great deal more than anecdotes to go on. As a report from the US National Academies of Science in January 2017 states: “Despite increased cannabis use and a changing state-level policy landscape, conclusive evidence regarding the short- and long-term health effects – both harms and benefits – of cannabis use remains elusive.”

While the medical uses of the opium poppy, a vastly more dangerous plant, are well understood, cannabis has remained stuck in a no man’s land. It had been part of the US pharmacopeia till the 1930s, as an alcohol-based tincture, until the federal government effectively outlawed its possession and sale through the Marijuana Tax Act. More draconian penalties followed. It is still demonised by federal law as a ‘Schedule 1’ drug with no medical use, lumped in the same category as heroin, LSD and ecstasy. Yet as a quick online search will show, the plant is lauded for a seemingly inexhaustible list of curative properties.

In the past two decades the disparity between evidence and anecdotes has grown extreme. Despite a majority of states (beginning with California in 1996) having legalised cannabis to treat medical conditions, federal restrictions on research remained ironclad. So researchers have great difficulty studying whether such medical uses have any basis in science. “What we have is a perfect storm,” says Daniele Piomelli, a neurobiologist at the University of California, Irvine.

Piomelli has been researching cannabis as best as he can. To comply with the mandates of the federal Drug Enforcement Agency (DEA), his precious store of 50 milligrams of THC must be kept in a locked safe, in a locked cool room, in a locked lab. “Any person on the street can go to a dispensary and for $10 obtain cannabis,” he says. “But if we bring it into the university we risk being raided by the FBI and DEA. We live in a schizophrenic state.”

Even when researchers have gained permission to do research, the cannabis can only be supplied by one authorised lab, at the University of Mississippi. The lab has been growing the same variety for decades, one that bears little resemblance to the chemovars now available through dispensaries.

In San Francisco, Abrams tried valiantly in the 1990s to set up a clinical trial to test the claims of dying AIDS patients that smoking weed outperformed their anti-nausea drugs. After more than a year trying to get permission from the National Institute on Drug Abuse, the penny finally dropped; the agency, as he often tells journalists, sees itself as the National Institute “on” Drug Abuse, not “for” Drug Abuse. So the January report of the National Academies of Science was hardly a surprise. The document, based on reviewing 10,000 publications, found “modest” evidence for the effectiveness of cannabis to treat nausea and vomiting in adults undergoing chemotherapy, for chronic pain, and to alleviate spasms in multiple sclerosis. It did not, however, deliver a verdict for a long list of illnesses including epilepsy, inflammatory bowel disease, Parkinson’s Disease, post-traumatic stress, anxiety, insomnia and cancer. “For these conditions, the report states, “there is inadequate information to assess their effects.”

But bits of information are trickling through. In May, a report in the New England Journal of Medicine offered evidence that an oily, strawberry-flavoured formulation of pure cannabidiol (made by British company GW Pharmaceuticals) could reduce the severity of seizures in children with a rare form of epilepsy known as Dravet’s syndrome. Of the 120 youngsters recruited, 60 received cannabidiol and 60 received only a strawberry-flavoured oil, the placebo. Three of the treated group achieved complete remission from their seizures while in 40% of those treated, the frequency of seizures was reduced by half. But 27% of the placebo group also saw a halving in their seizure rate and there were significant side effects amongst the treated group. “It’s not a magical drug”, explains Ingrid Scheffer, a paediatric neurologist at the University of Melbourne and co-author of the study. But she points out the sometimes exasperated parents of her patients have a different view. “The attitude is, ‘it’s obvious you fuddy duddy, just give it to us’.”

Most of the 400 pages in the hefty NAS tome report on the adverse effects of cannabis, like a raised risk of schizophrenia or road accidents or chronic cough. This, says Piomelli, reflects what researchers obtained funding for: “There is a bias towards the null hypothesis – that cannabis causes harm.” Those harms exist, he agrees. “But society is asking for answers about its benefits, and that’s not a question that researchers have been able to answer.”

Israel staked its claim in the field of cannabis research back in the 1960s. It was the beginning of the pot-smoking hippy revolution. But no one actually knew what the psychoactive ingredient of pot was.

Raphael Mechoulam, a chemist at the Hebrew University of Jerusalem, saw an opportunity. In 1964 he was the first to link pot’s mind-altering effects to THC. His research flourished in a regulated but permissive environment: his chief source of cannabis was the local police station. His group also isolated the natural equivalents of cannabis made by the brain, using pigs (with great difficulty, given the researchers were in Jerusalem). In 1992 they identified anandamide, the so-called bliss molecule, and in 1995 its more prosaically named partner, 2-arachidonoyl glycerol or 2 AG. These brain-made counterparts of THC are known as endocannabinoids.

Meanwhile the Israeli public began to clamour for medical cannabis. Just as in San Francisco, the AIDS epidemic had put medical cannabis on the radar. Mirroring the experience of Donald Abrams, immunologist Zvi Bentwich also witnessed the anti-nausea and pain-relieving effects that smoking cannabis had on his AIDS patients. While anti-retroviral drugs would mercifully bring the raging AIDS epidemic in both countries under control, the clamour for the palliative use of cannabis by cancer patients grew, aided by the internet.

Israel’s government obliged but with strict regulation. Patients, supported by a letter from a physician, could obtain a medical cannabis permit from the ministry of health. Growers needed a licence. One of the first companies to gain one, in 2007, was Tikun Olam. As patient numbers grew, it began to collect information about their responses. In 2015 Bentwich, who also heads the Centre for Emerging Tropical Diseases and AIDS at Ben Gurion University, joined Tikun Olam to lead a formal clinical trials program. “If the medical community is to accept cannabis, that depends on carrying out large reliable clinical trials,” he says. “In the US, as well as in most European countries, that is still extremely difficult.”

So far Israel is leading the pack. It is the only country, for instance, to have published the results of a randomised double blind study on the use of cannabis by Crohn’s disease patients. Timna Naftali, a gastroenterologist at Meir Medical Centre, carried out the trial after discovering several patients were self-medicating with cannabis. “They had reduced their medication and not suffered flare ups,” she says. “It was very intriguing.”

In her trial, 21 patients were assigned randomly to a group that smoked THC-rich cannabis cigarettes twice a day for eight weeks or to a group that smoked cannabis free of THC and other cannabinoids. The results, published in Clinical Gastroenterology and Hepatology, showed that in 10 of 11 patients with Crohn’s disease who smoked the THC-rich cigarettes, there were “significant clinical benefits”. One criticism was that perhaps patients merely felt better due to the euphoric effects of cannabis, so Naftali is repeating the trial, leaving it to an endoscopist to decide. This time 50 patients are receiving an oil, containing a 4:1 ratio of cannabidiol to THC. “As a doctor, I’m not happy about telling patients to smoke,” Naftali says. Another trial that tested a pure extract of cannabidiol was ineffective. “Perhaps it was the low dose,” Naftali muses. “There’s also a claim you have to have it in combination.” Perhaps it is a case of what Mechoulam has dubbed the “entourage effect” – the consequence of a mysterious biological synergy between cannabis compounds.

Another world-first trial under way in Israel is testing the effects of cannabis on youngsters with autism. Given cannabis can trigger psychotic behaviour, it is surprising to think it would be a candidate for a condition where psychotic behaviour is often part of the problem. But a third of autistic children also suffer from seizures.

When paediatric neurologist Adi Aran, at Jerusalem’s Shaare Zedek Medical Centre, prescribed cannabis for the seizures of autistic children, their parents reported dramatic results. Children who never spoke began speaking, and writing for the first time. To verify these anecdotal results, he is running a trial on 120 youngsters, aged 5 to 21 years. Some receive whole cannabis oil containing, amongst other things, a 20:1 ratio of cannabidiol to THC; others receive a purified extract containing only cannabidiol and THC; a final group receive a placebo, an identically flavoured oil. All will undergo a ‘washout’ period, where they are gradually weaned off their oil.

In principle, most doctors would like to see the results of numerous such trials before prescribing cannabis. However, parents like Abigail Dar disagree with this approach. “A parent like me with a complicated child doesn’t have the luxury of principles,” she says. Her son, Yuval, now in his early twenties, is severely autistic, and was once so prone to violent outbreaks she could not be alone with him. “Yuval tried over a dozen anti-psychotic medications since he was 12 years old to treat symptoms

like endless anxiety, restlessness, violent outbreaks or, as we call it, ‘life in the shadow of hell’. They only made him more agitated and aggressive.”

Dar managed to get a medical cannabis prescription for Yuval in 2015. Though autism did not count as one of Israel’s qualifying conditions, the health ministry finally granted permission as a ‘mercy treatment’. “It was a life-changer from the very first day,” according to Dar. “He hasn’t exhibited a single self-injurious behaviour or outburst in the last 14 months. He is calmer, more attentive and communicative. He smiles more.”

Dar has carried out her own careful experimentation for what works for her son, using chemovars that vary in their CBD-to-THC ratio. As far as she is concerned, placing Yuval in a randomised, placebo-controlled, washout trial would be immoral. “With suffering kids you don’t take it away,” she says. “I tell parents to stay away; it’s not in favour of kids.”

Instead, through a collaboration with Meiri’s lab, she is pushing to gather the data already being generated. “We have 200 kids and adults with severe autism we are guiding through strains and dosages to find out what works. We track them with questionnaires: we look at things like violent outbreaks, sleep and appetite. The idea eventually is to go global. It will give us some small amount of knowledge on how to treat autism.”

It’s not just desperate cases like Dar that make cannabis a poor fit for the box of a RCT. Abrams sees no need for more trials when it comes to treating pain or nausea in patients with cancer. Nor is he alarmed by the range of products sold in dispensaries. “I don’t consider it to be that dangerous, compared to the pharmaceutical agents we already prescribe,” he says. “I have many patients that were weaned off opiates thanks to cannabis.” He points out that in the US, 90 people die each day from overdoses of opiates, in many cases prescribed to treat chronic pain [LINK: https://www.cdc.gov/drugoverdose/epidemic/index.html].

Mieri never imagined his CV would one day include heading a laboratory for cannabis research. In early 2015, after four years at the Ontario Cancer Institute, he was all set to return to cancer research.

Then he noticed a curious publication from a Japanese research group that reported a cannabis extract blocked the ability of human breast cancer cells to spread in a culture dish. What pricked Meiri’s interest was that the extracts appeared to be scrambling the cell’s internal scaffolding – his particular area of expertise.

Meiri repeated the experiment on different types of cancer cells. He found the cannabis extract was just as potent as some chemotherapy drugs. But it was another finding that really captured his interest: the effectiveness of the extract depended on the cannabis variety and the grower.

As the son of a strawberry farmer, he understood exactly what he was seeing. “Strawberries taste different in the morning and afternoon,” he explains. He was seeing the effects of a cocktail of different chemicals.

Which of these chemicals were responsible for the anti-cancer effect? To find out, Meiri bought a machine for high-performance liquid chromatography, a technique to separate and identify parts of a mixture. Soon he was a de facto guru. A grant from a philanthropist in 2016 marked a point of no return.

‘The plural of anecdote is not data’ is an oft-quoted medical aphorism. But anecdotes can’t be ignored either. Meiri is acquiring quite a collection. On one occasion, he was contacted by the father of a seven-year-old whose seizures had returned after being free of them for nearly a year. The father, wanting to know why the oil had stopped working, sent samples to Meiri. When the scientist analysed them, he found they were just olive oil. “It was a data point,” he says, “showing that the effects of cannabis extract were real.”

Then there was the disastrous day he learned that several autistic kids taking cannabis oil had gone berserk. “Tali, we have a situation,” he recalls telling the head of the project. All the extracts the children were taking had the same 20:1 ratio of CBD to THC. But looking at the chemical profiles, it was clear the offending medication carried at least five different compounds. “It doesn’t provide the answers,” he says. “It shows where to begin searching.”

There is no simple way out of the cannabis mess. With much of the world clamouring to use cannabis as a cure for all manner of ailments, and an exploding cannabis industry that is happy to push that demand along, it is crucial to establish just how real its clinical benefits and harms are – especially for children.

The medical establishment ideally needs randomised clinical trials, such as those Israel is admirably pushing ahead with. “I would say the Israelis have taken the lead,” Abrams says.

But 30,000 users in Israel and millions in the US aren’t waiting for such results. Some, like Abigail Dar, are too desperate. Others are wedded to their own trial-and-error experiments with different chemovars.

Another complicating factor is that the diabolically complex chemistry of the cannabis plant is too overwhelming to sort out through individual RCTs. Researchers are still scratching at the surface of a potential treasure trove of medicines that appear to act synergistically. The list of conditions to try them against appears never-ending. The number of trials needed to test each combination against each condition seems mindboggling.

The database collated by Meiri and his clinical collaborators is now being prepared for publication. It should help link the pot-pourri of chemicals inside cannabis to its clinical effects. It may be second-tier science, but it appears to be one of the best strategies for navigating a path out of the haze that still envelops medical cannabis.

Conflict of interest statement. Elizabeth Finkel is a member of the scientific advisory board of AUSiMED, which raises funds to support scientific collaborations between Australia and Israel.

Source: Cosmos 76 – Spring 2017

MEDS Act promotes FDA-compliant medical research of marijuana

 (Alexandria, VA)– Smart Approaches to Marijuana (SAM) applauds U.S. Senators Brian Schatz (D-HI), Orrin Hatch (R-UT), Thom Tillis (R-NC), and Chris Coons (D-DE) for introducing the Marijuana Effective Drug Studies (MEDS) Act of 2016. Once passed, it would make it easier for researchers to perform legitimate research on the medical effectiveness and safety of marijuana’s components.

Rather than rescheduling marijuana, the MEDS Act comprehensively identifies barriers to legitimate research and offers comprehensive, responsible solutions instead of “medicine by ballot initiative.” More specifically, the bill:

  • Enables more research on marijuana by creating a faster, more streamlined process for obtaining approval from the Drug Enforcement Agency (DEA) to conduct research, including the ability to amend and supplement research proposals without reapplying.  Currently, researchers who want to conduct research on marijuana must interface with several federal agencies and engage in a complex application process that can take a year or longer must start from scratch if they make any changes to their research proposal;
  • Eliminates the burdensome requirement of some DEA field offices that marijuana be kept in bolted safes – a requirement not possible in many research and clinical settings – and codifies current DEA regulations that allow marijuana to be stored in securely locked, substantially constructed cabinets; and
  • Requires the licensing of marijuana manufacturers for the purpose of valid scientific and clinical research and drug development and establishes manufacturing licenses for the commercial production of FDA-approved medical marijuana products.

“These steps are important because despite state laws, raw marijuana (smoked or ingested) is not medicine, and has never passed through the rigorous FDA approval process to ensure the health and safety of patients,” said Dr. Kevin Sabet, President of SAM.  “The plant’s components should be studied so those in need can access any therapeutic benefits while knowing dosage, side effects, and contraindications.  And more broadly speaking, the MEDS Act upholds the important, basic principle that all medications-including marijuana-based drugs-should go through the scientific process and accessed through legitimate doctors.”

SAM is proud to join the American Medical Association, American Academy of Pediatrics, American Cancer Society Cancer Action Network, American Society of Addiction Medicine, American Preventive Medical Association, American Pain Society, American Society of Anesthesiologists, and the American Academy of Pain Medicine in support of the MEDS Act.

Source:  https://learnaboutsam.org/sam-applauds-bi-partisan-legislation-legitimate-medical-marijuana-research/   

20th June 2016

Washington’s pot is a bit more potent than the national average. And the state’s teens are more likely to smoke marijuana than young people nationwide.

Although we have the same problems with marijuana as we do with liquor abuse, no blockbuster conclusions came from a recent report on Washington’s marijuana universe.

But a couple of somewhat unexpected environmental wrinkles from Washington’s marijuana industry — both legal and illegal — also emerge in the second annual look at the state’s experience since passage of a 2012 initiative allowing recreational pot sales.

Marijuana growers and processors use 1.63 percent of the state’s electricity, which is a lot, according to the report by the Northwest High Intensity Drug Trafficking Area — a combined effort by several federal, state and local government agencies. By way of comparison, all forms of lighting — in homes, commercial buildings and manufacturing — account for just 7 to 11 percent of electrical consumption nationally. Or, as the report puts it, the power is enough for 2 million homes.

The high power consumption stems from the heat lamps and the accompanying air conditioning for indoor marijuana growing operations. “They are exceedingly energy-consumptive,” said Steven Freng, manager for prevention and treatment for the High Intensity Drug Trafficking Area.

The carbon footprint, according to the report, equals that of about 3 million cars.

And illegal pot growers siphoned off 43.2 million gallons of water from streams and aquifers during the 2016 growing season — water that tribes, farmers and cities would otherwise use as carefully as possible, in part to protect salmon.

Sixty percent of Washington’s illegal pot was grown on state-owned land in 2016. That’s because black-market growers tend to worry about gun-toting owners on private lands, according to Freng and Luci McKean, the organization’s deputy director. The black-market operations use the water during a roughly 120-day growing season.

Marijuana purchases have boomed in Washington. Legal marijuana sales were almost $1 billion in fiscal year 2016 and were on track to be about $1.5 billion in fiscal 2017, which ended June 30. As of February, the state had 1,121 licensed producers, 1,106 licensed processors and 470 licensed retailers.

What Washington’s marijuana users are getting is above average in potency. According to the report, nationwide marijuana products average a THC percentage of 13.2 percent, while Washington state’s THC average percentage was 21.6 percent.

Teen use of marijuana has grown slightly. Depending on how the numbers are crunched, marijuana use among Washington’s young adults and teens ranges from 2 to 5 percent above the national average. Five percent of Washingtonians age 18-to-25 use pot daily, slightly above the national average, the report said.

According to a survey cited in the report, 17 percent of high school seniors and 9 percent of high school sophomores have driven within three hours after smoking pot.

Adult use before driving is still a fuzzy picture. A third of Washingtonians arrested for driving under the influence had THC, the active ingredient in marijuana, in their bloodstreams. One study found an increase in dead drivers with THC above the legal limit in their blood from 7.8 percent in 2013 to 12.8 percent in 2014.

“Adults still don’t understand the effects of impairment behind the wheel of a car,” Freng said.

McKean said that one major unknown is marijuana-laced edibles, which authorities believe have become a significant factor in THC-impaired drivers, but has not been studied enough to provide solid numbers.

Another major unknown, McKean and Freng said, is how marijuana consumption contributes to emergency room and hospital cases because the state hospitals have not agreed to release that data to government officials.

Source: http://crosscut.com/2017/10/washingtons-pot-industry-not-environmentally-friendly-marijuana/

Legalising marijuana can lead to increased use of the drug, according to a French study that looked at consumption levels in two US states and Uruguay in the midst of a debate over France’s narcotics laws.

The study conducted by France’s National Institute of Higher Security and Justice Studies and the French Observatory for Drugs and Drug Addiction examined data from Washington and Colorado, which in 2012 became the first two US states to legalise marijuana for recreational use.

Like several US studies on the subject it noted that legalisation in the states had not increased marijuana use among teenagers, “which nonetheless remains at a high level.”

Among adults, however, marijuana use had increased, particularly among over-25s, the French researchers found.

But in Uruguay, which in July became the first country to legalise marijuana nationwide, “all the indicators of use have risen”, including among teens, the study showed.

In the two American states, the legalisation had led to a “significant” increase in the number of people admitted to hospital with suspected cannabis poisoning, particularly tourists, it added.

On the economic front, it found that sales of recreational marijuana in Colorado and Washington had steadily increased, reaching $1 billion a year in each case.

State tax receipts from the sales had surpassed taxes on cigarettes, the report said, while noting that legalisation had not stamped out marijuana trafficking.

In Uruguay, trafficking was driven by the huge gap between demand and legal production, which accounted for just 10 to 20 percent of marijuana use.

In the American states, by contrast, the black market was being fuelled by the higher cost of over-the-counter marijuana, the report concluded.

The researchers acknowledged, however, that legalisation of marijuana had eased the caseload of the police and judiciary.

In France, marijuana use is a crime punishable by up to a year in prison and a fine of 3,750 euros ($4,400). President Emmanuel Macron has proposed easing the penalty to an on-the-spot fine.

Source: https://medicalxpress.com/news/2017-10-legalising-marijuana-french.html

The Liberal government, thanks to Justin Trudeau’s mindless statements during the federal election of 2015, became committed to legalizing the recreational use of marijuana. The purpose of this initiative was to encourage millennials to vote for the Liberal Party.

Like many of its other policies, the Liberal government was clueless about the unintended consequences of this promise. For example, it has yet to solve the problem that has arisen because Canada ratified UN drug treaties that prohibit the use of marijuana. Further, S. 33 of the UN Convention on the Rights of the Child (CRC) specifically states that it is the responsibility of governments to protect children from the use and trafficking of drugs:

33. Parties 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 their illicit production and trafficking of such substances.

The CRC defines “child” as anyone under 18 years of age. However, once marijuana is legalized, it becomes normalized and becomes acceptable. As a result, adolescents under the age of 18 years will have access to it, as they have easy access, today, to cigarettes.

The Liberals are merrily proceeding with their legalization of marijuana, ignoring their treaty obligations as well as many other serious problems inherent with the legalization.

Unfortunately, the government thinks it cannot back down from its proposal on marijuana as its credibility is already seriously on the line with its accumulating failures on other policies. These include the defeat of electoral reform; the enormous, accumulating national debt, far in excess of what had been promised; the incompetence of the Murdered and Missing Indigenous Women Inquiry; failure to provide transparency and honesty, insisting on continuing with its pay-for-access scheme for corporate high rollers; the flaunting of regulations by Trudeau to vacation with billionaire, the Imam Aga Khan, in the latter’s private island, and the $10.5 million award to terrorist Omar Khadr, who killed an American soldier and blinded another in Afghanistan. Under all these circumstances, it is not unreasonable to describe the Trudeau government as dumb and dumber, as the Liberal blunders are piling up.

Despite this, on April 13, 2017, the Liberal government tabled legislation on marijuana. It provides only a vague and little considered framework for the sale, distribution and possession of it. This framework is based on the federal government’s use of its criminal law provisions to supposedly provide “protection of public health”. This is why Trudeau has been going across the country loudly proclaiming that the objective of his marijuana legislation is “to reduce harm to Canadians” and to “decrease the black market of marijuana”. These comments are nothing more than mindless prattle.

The government is ignoring the reality of recreational marijuana use which occurred in Colorado when it legalized recreational marijuana in 2013. Since that time, Colorado has experienced:

· Marijuana use by Colorado youth between the ages of 12 and 17 years old increased by 20%; this was 74% higher than the national average of that age group;

· Marijuana use of university age youths increased by 17%;

· Marijuana use by adults age 26+ years old increased 63% in comparison to an increase nationally of 21%;

· In 2014 when retail marijuana businesses began operating in Colorado, there was a 32% increase in marijuana related traffic deaths. During the same period of time, alltraffic deaths increased by only 8%. Marijuana related traffic deaths were approximately 20% of all traffic deaths;

· There was a 29% increase in the number of marijuana related emergency room visits in 2014 and a 38% increase in the number of marijuana related hospitalizations;

· During the years 2013-2014, the average number of children exposed to marijuana was 31 per year. This was an increase of 138%;

· According to the Colorado Attorney General, legalization of marijuana did not reduce black market marijuana activity “the criminals are still selling on the black market…. We have plenty of cartel activity and plenty of illegal activity that has not decreased at all”; and

· Homelessness in Colorado surged by 50% with 20 to 30% of newcomers living in shelters, having moved to Colorado to have easy access to marijuana.

Trudeau and his government apparently haven’t even read their own Health Canada Website, which lists the risks of marijuana to include:

· Risks to health, some of which may not be known or fully understood. Studies supporting the safety and efficacy of cannabis for therapeutic purposes are limited and do not meet the standard required by the Food and Drug Regulations for marketed drugs in Canada.

· Smoking cannabis is not recommended. Do not smoke or vapourize cannabis in the presence of children.

· Using cannabis or any cannabis product can impair concentration, ability to think and make decisions, reaction time and coordination. This can affect your motor skills, including ability to drive. It can also increase anxiety and cause panic attacks, and in some cases cause paranoia and hallucinations.

· Cognitive impairment may be greatly increased when cannabis is consumed along with alcohol or other drugs which affect the activity of the nervous system (e.g. opioids, sleeping pills, other psychoactive drugs)

The warning goes on to list specifically when cannabis should never be used by anyone:

· under the age of 25

· who has serious liver, kidney, heart or lung disease

· who has a personal or family history of serious mental disorder such as schizophrenia, psychosis, depression, or bipolar disorder

· who is pregnant, is planning to get pregnant, or is breast-feeding

· who is a man who wishes to start a family

· who has a history of alcohol or drug abuse or substance dependence

In June 2016, ignoring this crucial information, Trudeau established a Task Force to make recommendations on marijuana use. The Committee was headed by former Liberal Justice Minister Anne McLellan. The bad news was that the nine-member Committee included the controversial Dr. Perry Kendall, who, both as Ontario Medical Officer of Health and BC Provincial Health Officer, has advocated for legalization of drugs. In June, 2010, Dr. Kendall claimed that the use of the drug ecstasy can be “safe” when consumed “responsibly”. In 2016, Dr. Kendall called for the decriminalization of personal drug use and possession.

The Committee’s Report, released in December, 2016, could have been written by the marijuana industry. It is void of concerns for public safety and, if implemented, will cause damage to generations of Canadians to the benefit of the marijuana industry.

The Committee recommended that the age of majority, that is 18, be set for the use of marijuana (nineteen years for those in provinces where that is the age of majority).

On May 29th, 2017 an alarmed Canadian Medical Association (CMA), in an editorial in its Journal, stated that current research shows the brain doesn’t reach maturity until around age 25. The CMA editorial referred to the fact that the 9% risk of developing dependence over a lifetime rises to 17% if marijuana use is started in the teen years.

The CMA recommends that the government raise the legal age for buying marijuana to 21, and that it restrict the quantity and potency of the marijuana available to those under 25 years of age.

The Canadian Paediatric Society position paper on the effects of cannabis on children and youth cites serious potential effects, such as: increased presence of mental illness, including depression, anxiety and psychosis; diminished school performance and lifetime achievement; increased risk of tobacco smoking; impaired neurological development and cognitive decline; and a risk of addiction.

In 2010, Canadian youth were ranked No. 1 for cannabis use among 43 countries in Europe and North America. Are we trying to maintain this record?

The federal Task Force also recommended that individuals be allowed to possess 30 grams of marijuana and be permitted to cultivate marijuana for non-medical purposes providing it is limited to four plants per residence, and has the maximum height limit of 100 centimetres. No doubt the police will be knocking on doors with their measuring sticks to ensure that the width and height of the marijuana plants conform to the law.

Just like the Big Tobacco Industry before it, the Big Marijuana Industry is pumping up its corporate growers, in anticipation of grabbing billions of dollars in the growing, distribution and selling of pot across the country. Tobacco smoking is the second biggest risk factor for early death and disability after high blood pressure. Fortunately, because of intense advertising against tobacco smoking, its prevalence has dropped from 35% to 25% among men and from 8% to 5% among women. What on earth then, are we doing by reversing ourselves and adding dangerous marijuana smoke to the deadly mix?

Provinces Concerned About the Marijuana Proposal

Each of the provinces will be required to implement its own rules and restrictions in respect of the distribution and sale of marijuana. This means the provinces will have the last say on the method of sale and point-of-sale restrictions, having regard to the key objective of the federal legislation – supposedly, to prevent or reduce harm to Canadians. In deciding their own rules, Houdini wouldn’t be able to accomplish this. Neither are the provinces likely to reap the supposed vast profits from the sale of marijuana. The provinces are rightly skeptical about any such windfall since taxes on pot are expected to stay low to ensure the regulated market elbows out illegal dealers.

It is significant that on November 1, 2016, the Parliamentary Budget Officer (PBO), Jean-Denis Frechette, released a 77 page study entitled, “Legalized Cannabis: Fiscal Considerations”, which states that the federal government may have little fiscal space to heavily tax cannabis the way it does tobacco, without pushing the legal price well beyond that of currently illicit pot. Price legal pot too high and the black market will continue to flourish; too low and governments could be seen to be encouraging its use.

The PBO projects that sales tax revenue in 2018 could be as low as $356 million and as high as $959 million, with a likely take of about $618 million based on legalized retail cannabis selling for $9 per gram – in line with current street prices.

In addition, health care costs are expected to soar with the legalized use of recreational marijuana. As an example, a new study presented to the Pediatric Academic Societies in 2016, found that one in six toddlers admitted to a Colorado hospital with coughing, wheezing and other symptoms of bronchiolitis tested positive for marijuana exposure.

The Liberal government hopes to have this marijuana muddle all sorted out by July 1, 2018, disregarding the harm to society caused by this legislation. What seems to matter to this government, only, is that millennials vote for the party in the 2019 federal election – even if they are all spaced-out from the use of marijuana!

The Liberal government is reckless and utterly irresponsible in bringing this marijuana legislation forward.

Reality Volume XXXVI Issue No. 10 October 2017 Source: http://www.realwomenofcanada.ca/big-bad-liberal-marijuana-muddle/

US life expectancy fell because of the opioid crisis. (Reuters/Adrees Latif)

September 28, 2017 The opioid crisis in the United States is killing nearly one hundred people per day. Some areas are particularly hard hit, leaving officials to deal with constantly multiplying bodies of those claimed by overdose. In Ohio, morgues keep running out of space, forcing authorities to use temporary cold-storage trailers instead. In New Hampshire, medical examiners can’t handle the influx of bodies, making them unable to perform routine autopsies.

Add to that a new, terribly sad number: in West Virginia, officials had to spend nearly $1 million on the transportation of corpses in the fiscal year that ended June 30. Authorities told the Charleston-Gazette Mail that the number of body transports nearly doubled from 2015 to 2017, with a record 880 people dying in the state of overdose last year—the highest rate in the US. One embalmer had to come out of retirement three years ago to help deal with the amount of bodies.

Each death requires at least two trips—to the morgue and to the funeral home. With only two state-run morgues, long trips become costly. West Virginia lawmakers had to approve an additional $500,000 in funding to transport the dead this year. With body transport becoming such a big business—$881,620 paid to private contractors in fiscal year 2017—some improprieties emerged as well. A company that at one point controlled 94% of the state’s business has recently been suspended for a potential and alleged breach of confidentiality, the Charleston Gazette-Mail reported.

The opioid crisis has reached such dire proportions in the US that a recent analysis published in the Journal of the American Medical Association said it cut the life expectancy in the US by 2.5 months. The total estimates of the epidemic’s cost to the economy vary, from $25 billion to even $150 billion a year, when you consider the cost of a lost life (paywall).

The Trump administration promised to take on the issue, with the president himself saying it was a “national emergency,” but no concrete steps have been made yet—including a formal declaration that the epidemic is a national emergency, which would unlock resources that could help.

Source: Reuters . September 28, 2017

Objective:

The authors sought to determine whether cannabis use is associated with a change in the risk of incident nonmedical prescription opioid use and opioid use disorder at 3-year follow-up.

Method:

The authors used logistic regression models to assess prospective associations between cannabis use at wave 1 (2001–2002) and nonmedical prescription opioid use and prescription opioid use disorder at wave 2 (2004–2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Corresponding analyses were performed among adults with moderate or more severe pain and with nonmedical opioid use at wave 1. Cannabis and prescription opioid use were measured with a structured interview (the Alcohol Use Disorder and Associated Disabilities Interview Schedule–DSM-IV version). Other covariates included age, sex, race/ethnicity, anxiety or mood disorders, family history of drug, alcohol, and behavioral problems, and, in opioid use disorder analyses, nonmedical opioid use.

Results:

In logistic regression models, cannabis use at wave 1 was associated with increased incident nonmedical prescription opioid use (odds ratio=5.78, 95% CI=4.23–7.90) and opioid use disorder (odds ratio=7.76, 95% CI=4.95–12.16) at wave 2. These associations remained significant after adjustment for background characteristics (nonmedical opioid use: adjusted odds ratio=2.62, 95% CI=1.86–3.69; opioid use disorder: adjusted odds ratio=2.18, 95% CI=1.14–4.14). Among adults with pain at wave 1, cannabis use was also associated with increased incident nonmedical opioid use (adjusted odds ratio=2.99, 95% CI=1.63–5.47) at wave 2; it was also associated with increased incident prescription opioid use disorder, although the association fell short of significance (adjusted odds ratio=2.14, 95% CI=0.95–4.83). Among adults with nonmedical opioid use at wave 1, cannabis use was also associated with an increase in nonmedical opioid use (adjusted odds ratio=3.13, 95% CI=1.19–8.23).

Conclusions:

Cannabis use appears to increase rather than decrease the risk of developing nonmedical prescription opioid use and opioid use disorder.

Source: http://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2017.17040413

NEW 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, Ga. (March 14, 2017)—A new report by National Families in Action (NFIA) uncovers and documents how three billionaires, who favour 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 nonprofit 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.” NDPA recommends readers to read the whole report Tracking the Money That’s Legalizing Marijuana and Why It Matters

Source: www.nationalfamilies.org. 2017

· Trials on mice found THC – which causes the ‘high’ in weed, can induce seizures

· The same was shown for JWH-018 – the main part of the synthetic cannabis spice

· Japanese researchers have described their findings are being ‘quite important’

· Skunk, made mostly of THC, dominates the illegal British market of marijuana

Smoking super-strength cannabis or spice may trigger life-threatening seizures, researchers have warned.

Trials on mice showed seizures can be induced by both THC – which causes the ‘high’ in marijuana, and JWH-018 – the main component of spice. The rodents also suffered from a shortness of breath and impaired walking after being given both compounds, the scientists discovered.

Japanese researchers warned the results should act as a wake-up call, given how widely high-potency and synthetic weed is used.

The findings contradicts pro-cannabis campaigners who have long argued that cannabis can help to tackle seizures and highlighted research which shows weed can prevent and control seizures in epileptic patients.

However, lead researcher Dr Olga Malyshevskaya, based at the University of Tsukuba, said the latest findings show cannabis is not a soft drug and warned of its dangers.

She said: ‘Our study is quite important. Unaware of the particularly severe effect by those cannabinoids, people see marijuana as a soft drug, without dangerous health effects.’

She added: ‘It is critically important for health-care professionals and policy makers to be aware of the serious adverse effects, as shown in this report. Clinicians in the emergency departments should always suspect seizure activity in patients who have a history of cannabinoid intoxication.

WHAT IS THC?

THC is found in all forms of cannabis, but is abundant in skunk – a super-strength form of the drug that dominates Britain’s illegal market.

Some 80 per cent of what is available on the streets is believed to be skunk, which is created by growers aiming to make the most potent strain of the drug possible in order to maximise their profits.

They remove high amounts of CBD from the plant, allowing the modified herb to contain only THC. It is unsure how much THC was in the strain of cannabis used in the new study.

Over the years, a host of previous research has pointed to a link between the popular recreational drug and mental health conditions. Last October, University College London researchers found that skunk may be twice as addictive as normal strains of cannabis.

Similar health concerns have been raised about synthetic cannabis spice, which can slump users and turn them into ‘zombies’.

It was previously known as a legal high before it was banned last year following a surge in its use. Now it has reached epidemic levels in prison.

‘The number of clinical cases involving marijuana intoxication has been steadily increasing due to increase in cannabis potency over the last two decades.’

What do other experts think?

Ian Hamilton, a cannabis researcher at York University, cautioned the results, which are published in Scientific Reports.

He told MailOnline: ‘We don’t know if people who use cannabis are using something as potent as this.’ For the study, researchers measured the brain activity of the mice after giving them both compounds and recorded them.

Research that claims to show cannabis can control seizures

The findings contradict a body of research which shows weed can prevent and control seizures in epileptic patients. Campaigners have long argued that cannabis has the opposite effect to the new findings and can help to tackle seizures.

Researchers have previously suggested that CBD – the other compound in cannabis which produces no ‘high’, binds to a receptor in the brain that calms down the electrical activity in the brain which causes a seizure.

First Briton to be prescribed liquid cannabis oil on the NHS

Their case was strengthened when an 11-year-old on the brink of death from a severe form of epilepsy made an ‘incredible’ recovery from taking marijuana.

Billy Caldwell, from Castlederg, Northern Ireland, made headlines in April when he became the first Briton to be prescribed such a drug on the NHS.

And 10 months since he was first given the liquid cannabis oil, he hasn’t had any seizures. He used to suffer up to 100 a day.

THE MAN WHO SUFFERS SEIZURES FROM SYNTHETIC CANNABIS

The news comes just a week after DailyMail.com reported on a disturbing video which shows a man from Des Moines, Iowa, having a seizure as an effect of years smoking synthetic marijuana.

Coby O’Brien-Emerick, 27, has experienced chronic seizures every three months for the past five years, putting him in the hospital for weeks on end.

In the video uploaded in December, Coby is seen on the floor convulsing for about nine minutes while paramedics are being called.

The father-of-two told Dailymail.com he asked for his seizure to be recorded in order to understand the severity of it.

The video was posted to YouTube by his mother-in-law to warn others about the dangerous effects of smoking synthetic marijuana .

Source: http://www.dailymail.co.uk/health/article-4917100/Smoking-super-strength-cannabis-trigger-seizures.html 26 Sept. 2017

Draft rules are unlikely to contain an exemption to state law barring smoking in public places, so pot would have to be consumed through edibles or tincture.

Maine may be the first state in the country to license marijuana social clubs, but the pot could not be smoked in the clubs and would have to be consumed in another manner.

The legislation to regulate adult-use marijuana under consideration in Augusta now would push club licensing off until at least June 2019, about a year after Maine’s first retail stores are likely to open. Although not thrilled with the delay, most legalization advocates say they are just happy that club licensing was not stripped out of the bill, which is a legislative rewrite of last November’s successful citizen initiative.

The bill does not expressly prohibit smoking in the clubs, but it also doesn’t carve out an exemption to the state’s no-smoking law, which bans smoking of any kind, including vaping, in public places such as bars and restaurants. That means the clubs would be limited to the sale of pot edibles or tinctures that patrons would have to use on site, said state Sen. Roger Katz, R-Augusta, co-chairman of the Legislature’s Committee on Marijuana Legalization Implementation.

“The committee was divided on this issue,” Katz said. “Some of us, including myself, did not want to be the first state to experiment with social clubs because of the public safety concerns. Others said it was going to happen anyway, better we recognize it and appropriately license and regulate them, which is what voters wanted. But we had consensus on keeping our smoking ban intact.”

NO POT SMOKING-LAW EXEMPTION

Maine law currently allows smoking in cigar bars, but Katz said a majority of committee members didn’t want to add a smoking law exemption for marijuana. The bill is still in draft form, however, so it could undergo many changes before it is sent to the full Legislature for a vote next month. A public hearing on the bill is scheduled to begin at 9 a.m. Tuesday at the State House in Augusta.

Advocates in Maine are pleased that the bill would allow club patrons to buy and use marijuana in the same location, but they argue that the 2019 licensing date is too late. They want cannabis social clubs to have the same rights as alcohol and tobacco clubs. A city like Portland should be able to license a marijuana club with a rooftop patio that would allow outdoor smoking, said advocate David Boyer.

“We have social clubs for alcohol, and they are called bars,” said Boyer, director of the Maine chapter of the Marijuana Policy Project, one of the groups that helped pass the Marijuana Legalization Act last fall. “Bars can have outside smoking patios. And cigar clubs, they certainly allow smoking. Marijuana is safer than either of those substances.”

Boyer’s organization is considering a petition drive in Portland to establish local licensing rules for social clubs that would be ready to implement in order to speed up the process once the clubs are approved. That might not be necessary, however, because city officials are thinking along the same lines and are already planning a fact-finding trip to Denver.

But legalization opponents say social clubs are just one of the reasons they lobbied against the ballot question last year. The leader of Mainers Protecting Our Youth and Communities, Scott Gagnon, has said social clubs would put more impaired drivers on

Maine roads. Since no state has yet licensed social clubs, there are no data available on whether they would lead to more traffic accidents or fatalities.

IMPACT ON ROAD SAFETY UNCLEAR

Data on the impact of legalization on traffic safety are mixed.

Like many other states, Maine has had its share of underground marijuana-friendly clubs, and certain parks and beaches are popular spots to use marijuana with different degrees of discretion. The adult-use law adopted last fall allows adults to grow six plants on their own property or someone else’s, with permission, and have up to 2½ ounces of marijuana in their possession for personal use.

Current law bans public cultivation or consumption, which doesn’t give the 36 million people who visit Maine each year a place to use any pot that they might buy when here, because most hotels ban smoking inside rooms. Club advocates have said pot lounges would give tourists a legal place to use the pot they buy here and keep them out of the parks and off the beaches.

But a review of other states’ marijuana laws and regulations reveals that marijuana clubs remain uncharted territory in the national landscape. Even in Colorado, which was the first state in the nation to legalize recreational marijuana, government officials have been reluctant to license pot clubs, worried that it would invite federal authorities to crack down on a drug that is still illegal under federal law.

Oregon does not allow pot social clubs. Alaska and California are considering whether to license them. California, Nevada and Colorado laws do not prohibit clubs, so local governments could agree to grant licenses. So far, only Colorado City has any licensed social clubs, where consumers can use pot they bring with them – but even those are under order to shut down by 2023.

Denver adopted a pot social club pilot program and announced it was ready to begin accepting applications last month, but so far no one has applied. Would-be club operators say the rules are too restrictive, partly because they ban consumption at places that sell marijuana, essentially making clubs a bring-your-own venue, and require clubs to be twice as far away from schools or playgrounds as bars.

Massachusetts law allows social clubs in local municipalities, but the newly appointed Cannabis Control Commission will likely take up that issue while it writes state regulations. A Denver-based party bus service, Loopr, which bills itself as a mobile cannabis lounge, is targeting Boston for expansion into New England next year, as well as having franchises in California and Nevada.

ADVICE: DON’T BE THE GUINEA PIG

“I always advise clients you don’t want to be the first at something,” said Andrew Freedman, former director of marijuana coordination for Colorado who now works as a marijuana consultant. “It’s better to see what other states have done to see what works, and what doesn’t, with marijuana. There’s a lot of public health and safety on the line, and the federal authorities are always watching. Freedman’s firm is now taking on state clients to advise them on how to set up their adult-use markets, and would like to find work in Maine.

Source: http://www.pressherald.com/2017/09/25/maines-marijuana-social-clubs-likely-to-be-no-smoking-venues/

Consumption of alcohol, tobacco and illegal psychoactive substances, mainly cannabis, have increased in the last five years in Portugal, according to a study by the Intervention Service for Addictive Behaviours and Dependencies (SICAD).

“We have seen a rise in the prevalence of alcohol and tobacco consumption and of every illicit psychoactive substance (essentially affected by the weight of cannabis use in the population aged 15-74) between 2012 and 2016/17, according to the 4thNational Survey on the Use of Psychoactive Substances in the General Population, Portugal 2016/17.

The study focused on the use of legal psychoactive substance (alcohol, tobacco, sedatives, tranquilizers and/or hypnotics, and anabolic steroids), and illegal drugs (cannabis, ecstasy, amphetamines, cocaine, heroin, LSD, magic mushrooms and of new psychoactive substances), as well as gambling practices.

According to the study, alcohol consumption shows increases in lifetime prevalence, both among the total population (15-74 years) and among the young adult population (15-34 years), and among both men and women.

Tobacco consumption shows a slight rise in lifetime prevalence, which, according to the report, “is mainly due to increased consumption among women.”

The study also saw an increase from 8.3% in 2012, to 10.2% in 2016/17, in the prevalence of illegal psychoactive substance use. There were increases in both genders when considering the total population, a decrease among men and a rise among young adult women.

“These are the trends found for cannabis,” the most popular illegal substance, according to the provisional results of the study.

Compared to 2012, there is a later average onset age of consumption for alcohol, tobacco, drugs, amphetamines, heroin, LSD and hallucinogenic mushrooms.

Source: http://theportugalnews.com/news/alcohol-tobacco-and-drug-consumption-rise-over-last-five-years/43214 20th Sept.2017

2015 will be remembered as the year legalization hit bumps most supporters never anticipated.

For pro-health advocates that oppose marijuana legalization, it was a year of fantastic victories! Here are the top 10:

10. Big Marijuana is Real — and People are Writing About It.

When we started talking about Big Marijuana in 2013, many people laughed. Could marijuana even be compared with Big Tobacco in any credible way? But now, that’s ancient history. Several articles – even in legalization-friendly blogs like this one – mention the term. And the term is not just rhetoric — the most senior federal legalization lobbyist in the country resigned in protest because, in his words, “industry was taking over the legalization movement.” Not only was that heroic of him, it was historic for us.

9. Continuing Positive Press Coverage of Groups Opposing Legalization. 

With the exception of some very pro-pot columnists, this year represented one in which our side was represented just a little bit better than in the past. A profile of SAM was featured in the International Business Times, and other articles continued to broadcast our message to new audiences.

With the hiring of a new Communications Director in 2016, you can bet we won’t let up on this next year.

8. Several States Resisted Full-Blown Legalization. 

We entered 2014 after setbacks in Alaska and Oregon; but we stuck to winning messages and formed coalitions in a bloc of New England states that were all under attack in the early part of 2015. From Maine to Massachusetts to New Hampshire to Rhode Island, our partners and affiliates fought back —- and not one state legalized via legislature as the legalizers had promised. We’ll be taking this momentum into 2016.

7. Lawyering Up.

 Many of our friends made strong statements in court — “Colorado and other states cannot legalize in the face of federal law,” they argue. Of course we know they are right, and we know that regardless of legal outcomes the statement they sent was loud and clear. (We’re also happy that the Justice Department, in its opposition to the suit, solely argued against it on procedural grounds — they did not substantively come out in favor of legalization to the Solicitor General). The plaintiff’s bar should take notice—just like Big Tobacco became a big target for lawsuits, Big Marijuana and those who sell the drug will, too.

6. Marijuana Stores Banned in California, Washington, Colorado, Oregon, Michigan, and Elsewhere. 

Despite legalization in some states, we know that local ordinances are one of the key strategies to keeping marijuana out of communities. The majority of towns in most weed-friendly states have indeed banned stores altogether. Even in Detroit, up to half of Detroit’s roughly 150 medical marijuana dispensaries could close following a Detroit City Council vote to approve a restrictive zoning ordinance. We will keep pushing hard for more bans in 2016.

5. Legalizers Made No Gains in Congress This Year
.

 For the past decade, it seemed that every year we lost a little more in Congress. Not in 2015. Despite the most aggressive lobbying effort yet by pro-marijuana folks, they made no progress on key provisions:

· They wanted to give tax breaks to pot shops—just like Big Tobacco lobbies to lower taxes on cigarettes.

  • They wanted to allow pot businesses to leverage Wall Street money through the banking system.
  • They wanted to stop the Justice Department from enforcing the law in states with legalized recreational marijuana.
  • They wanted to give pot to our most vulnerable citizens to “treat” PTSD — even though science says marijuana makes PTSD, as well as other mental illness, worse.
  • They wanted Washington, DC, to become a mecca for Big Marijuana.

And we won – on every issue.

4. Continued Support from ONDCP, DEA, and NIDA.

2015 was a transitional year for key federal drug policy agencies. A new ONDCP Director was appointed — and even though we are still waiting for the Obama Administration to enforce federal law, it is clear where Director Botticelli’s heart is. Right after getting into office, the Director sat down with me for a one-to-one on-the-record interview where he blasted legal pot. And only a few weeks ago, he was featured on 60 Minutes talking about the harms of marijuana and the harms of the industry.

Additionally, we saw the appointment of a new DEA Administrator — this time from the FBI. Administrator Rosenberg has been an excellent leader by moving to support legitimate medical research over faux claims of “medical” marijuana.

And we continue to receive support from NIDA Director Nora Volkow, who headlined SAM’s summit last year, for her unwavering support of public health above profits. 

3. Real Progress on Researching the Medical Components of Marijuana.

 I’m proud that SAM took a bold stand this year to defend the legitimate research of medical components of marijuana. And our ground-breaking report paid off. The federal government has already adopted two of the report’s provisions — eliminating the Public Health Service review and getting rid of onerous CBD handling requirements. We will continue to fight for legitimate marijuana research, and to separate it from faux medicine-by-ballot-initiative. 

2. No States Legalized “Medical” Marijuana in 2015.

This is a big one, given where the country is on the “medical” marijuana issue. No state legalized the drug for medical purposes this year, despite several tries in key states. Even in Georgia, where legalizers have been emboldened by a few pot-friendly legislators, a government-convened panel voted to follow science and impose sensible restrictions on the drug. 

1. Ohio! 

Of course, the victory in Ohio tops the field. Despite being outspent 12-to-1, our affiliates and partners brought us a huge victory in November. We plan to build on this for 2016, but we need your help.

Despite the nonstop talking point of “inevitability,” we know that the 8% of Americans who use pot don’t speak for 92% of Americans that don’t want to see Big Tobacco 2.0, don’t want to worry about another drug impairing drivers on the road, and don’t want to think about keeping things like innocuous-looking “pot gummy bears” away from their kids. We know that the pot lobby will work hard for things like not only full-blown legalization in several more states next year, but also things like on-site pot smoking “bars” (they are really proposing these in Alaska and Colorado as we speak) and an expansion of pot edibles.

In 2016, let’s nip Big Marijuana in the bud.

Source: https://www.huffingtonpost.com/kevin-a-sabet-phd/top-10-antimarijuana-lega_b_8879338.html

Legalizing opioids may give Americans greater freedom over their decision-making, but at what cost? One painful aspect of the public debates over the opioid-addiction crisis is how much they mirror the arguments that arise from personal addiction crises.

If you’ve ever had a loved one struggle with drugs — in my case, my late brother, Josh — the national exercise in guilt-driven blame-shifting and finger-pointing, combined with flights of sanctimony and ideological righteousness, has a familiar echo. The difference between the public arguing and the personal agonizing is that, at the national level, we can afford our abstractions.

When you have skin in the game, none of the easy answers seem all that easy. For instance, “tough love” sounds great until you contemplate the possible real-world consequences. My father summarized the dilemma well. “Tough love” — i.e., cutting off all support for my brother so he could hit rock bottom and then start over — had the best chance of success. It also had the best chance for failure — i.e., death. There’s also a lot of truth to “just say no,” but once someone has already said “yes,” it’s tantamount to preaching “keep your horses in the barn” long after they’ve left.

But if there’s one seemingly simple answer that has been fully discredited by the opioid crisis, it’s that the solution lies in wholesale drug legalization. In Libertarianism: A Primer, David Boaz argues that “if drugs were produced by reputable firms, and sold in liquor stores, fewer people would die from overdoses and tainted drugs, and fewer people would be the victims of prohibition-related robberies, muggings and drive-by-shootings.”

Maybe. But you know what else would happen if we legalized heroin and opioids? More people would use heroin and opioids. And the more people who use such addictive drugs, the more addicts you get. Think of the opioid crisis as the fruit of partial legalization. In the 1990s, for good reasons and bad, the medical profession, policymakers, and the pharmaceutical industry made it much easier to obtain opioids in order to confront an alleged pain epidemic. Doctors prescribed more opioids, and government subsidies made them more affordable. Because they were prescribed by doctors and came in pill form, the stigma reserved for heroin didn’t exist. When you increase supply, lower costs, and reduce stigma, you increase use.

And guess what? Increased use equals more addicts. A survey by the Washington Post and the Kaiser Family Foundation found that one-third of the people who were prescribed opioids for more than two months became addicted. A Centers for Disease Control study found that a very small number of people exposed to opioids are likely to become addicted after a single use. The overdose crisis is largely driven by the fact that once addicted to legal opioids, people seek out illegal ones — heroin, for example — to fend off the agony of withdrawal once they can’t get, or afford, any more pills. Last year, 64,000 Americans died from overdoses. Some 58,000 Americans died in the Vietnam War.

Experts rightly point out that a large share of opioid addiction stems not from prescribed use but from people selling the drugs secondhand on the black market, or from teenagers stealing them from their parents. That’s important, but it doesn’t help the argument for legalization. Because the point remains: When these drugs become more widely available, more people avail themselves of them. How would stacking heroin or OxyContin next to the Jim Beam lower the availability? Liquor companies advertise — a lot. Would we let, say, Pfizer run ads for their brand of heroin? At least it might cut down on the Viagra commercials. I think it’s probably true that legalization would reduce crime, insofar as some violent illegal drug dealers would be driven out of the business.

I’m less sure that legalization would curtail crimes committed by addicts in order to feed their habits. As a rule, addiction is not conducive to sustained gainful employment, and addicts are just as capable of stealing and prostitution to pay for legal drugs as illegal ones. The fundamental assumption behind legalization is that people are rational actors and can make their own decisions. As a general proposition, I believe that. But what people forget is that drug addiction makes people irrational. If you think more addicts are worth it in the name of freedom, fine. Just be prepared to accept that the costs of such freedom are felt very close to home.

Source: http://www.nationalreview.com/article/453304/opioid-crisis-legalization-not-solution

 

Legalisation of cannabis is likely to lack priority for this new government.

There is one benefit to MMP, it is that the whackier campaign ideas tend to perish in the coalition negotiation process.

That hasn’t entirely been the case this time, the worst example being the Green Party’s promise to initiate a referendum on the subject of legalising cannabis (by 2020).

This would seem to be a case of a party formulating policy in the hope that it will garner votes as opposed to genuinely believing it will be beneficial. That view is reinforced by Green leader James Shaw’s assurance last week that he had never smoked cannabis, adding the illuminating comment, “It isn’t good for you, is it?”

“We know that cannabis is a carcinogenic, as is tobacco. Unlike tobacco, however, it is also linked, beyond dispute, with mental illness and poor academic achievement.”

Too right it isn’t. There is enough evidence to support that to stupefy an entire nation, which makes it all the more extraordinary that he would not only propose a referendum in the first place, but would stick to his guns when it came to striking a deal with Labour.

All the more extraordinary because Mr Shaw’s party is one of the leading lights in the drive to make New Zealand tobacco-free by 2025. (Presumably the term smoke-free is now redundant).

If all goes according to his plan, a substance that harms the physical health of the user will disappear just in time to be replaced by another substance that does even more damage, physically, emotionally and intellectually, than tobacco ever has.

We know that cannabis is a carcinogenic, as is tobacco. Unlike tobacco, however, it is also linked, beyond dispute, with mental illness and poor academic achievement. From there it can be held accountable for reducing the user’s ability to find employment, and everything that goes with that, including poverty, for themselves and their dependents.

The drive for legalisation has taken a turn (for the worse) this time around because of strident appeals to recognise its medicinal benefits. It might well dull pain – it certainly dulls most of the user’s senses – but there is a undoubtedly deliberate blurring of the lines by the drug’s supporters between medicinal cannabis, which does not include its mind-altering properties, and the ‘benefits’ to be gained by allowing its cultivation/possession and consumption in the traditional manner.

People have long waxed eloquent about cannabis as a pain killer, usually from the dock as they are in the process of being sentenced for growing the stuff. If personal experience of that is anything to go by, its fans tend to show all the signs of long-term use, which might make them happy but has reduced their role in society to that of passengers.

It might well be true that cannabis does not represent any great threat to the physical or mental health of a middle-aged dope smoker who indulges on an occasional basis. The same cannot be said for those who start young, and there, Mr Shaw, lies the rub.

We have been told for years, most often by the National Organisation for the Reform of Marijuana Laws (Norml – there’s an oxymoron for you) that legalisation would of course need to be accompanied by strict controls that would keep it out of the hands of young people.

That assurance has been given to the writer on numerous occasions, but no one has ever been able to explain how any such measures would stand any chance of success, given our experience with tobacco and alcohol.

Neither of those substances may be legally purchased or used by minors, but both are. No one in this country has yet been able to devise controls that prevent that, and the same, inevitably, will apply to cannabis. Prove to us that you have cracked that, Mr Shaw, and people might start listening to you.

The best reason for not legalising cannabis was offered to this newspaper some years ago by a teacher at Kaitaia College. He said the college was home to any number of bright, determined, ambitious young people who knew what they wanted to do with their lives, and had mapped out exactly how they were going to achieve their ambitions.

They knew that even a minor cannabis conviction would nobble those ambitions, and for that reason alone wouldn’t touch the stuff with a barge pole.

No one the writer knows has ever come up with a better reason for not legalising it. And no one will. If it is legalised future generations of bright, ambitious young people will assuredly dabble in it, to their (and our) cost.

Even if they don’t succumb to regular use it will rob them, to some degree, of their potential, to a far greater degree than flirting with alcohol or tobacco ever would.

We don’t hear Mr Shaw, or anyone else, suggesting that our children should have greater access than they already do to alcohol and tobacco, for good reason. How they can be prepared to countenance access to cannabis defies explanation.

Perhaps Mr Shaw’s political interest in this issue outweighs any concern he might have for future generations. Perhaps the legalising of cannabis has such appeal to his voter base that he can accept the inevitable collateral damage. Hopefully he is in a very small minority, and will remain so.

And don’t buy the hoary old story that our prisons are full of people who wouldn’t be there if cannabis was legal. Those who insist that this is true have either been doing too much personal research into the ‘benefits’ of sucking on cannabis cigarette all day or are deliberately trying to deceive.

No one is in jail in this country today purely because they have been caught using cannabis. One or two might be there because they were caught growing or dealing it on a substantial scale, but possession of cannabis, whatever the law might say, is no longer an imprisonable offence in this country, and hasn’t been for a very long time.

There will be some who are in jail on convictions that include possession of cannabis, but it won’t have been the drug that put them behind bars. They will have offended in other ways. To say that people are in jail because of personal possession is a blatant lie.

Some elements of the current debate are certainly worth pursuing, including that drug addiction in general should be regarded as a health issue rather than a criminal matter. And there is no doubt that drug treatment facilities are woefully inadequate. But again, this is where the pro-cannabis logic collapses.

We know the harm cannabis does; we know it leads to dependence on much harsher chemical substances; we know that people who become addicted, to whatever substance, are unlikely to get the help they need to get off it. And we know that the damage done, by cannabis and other drugs, is permanent. Dead brain cells don’t grow back.

Yet here we are talking about legalising it. It makes no sense whatsoever to even consider it. A handful of people might genuinely believe that it will ease their pain, or, in medical form, will reduce the severity of some far from common conditions (again, the use of medical marijuana is a separate issue), but legalising cannabis for all and sundry will not benefit society in any imaginable way.

There can be absolutely no question that legalising cannabis will, in fact, do enormous harm, and any politician who is unaware of that, or is prepared to trade that harm for electoral success, has no place in Parliament.

Source:http://www2.nzherald.co.nz/northland-age/opinion/news/article.cfm?c_id=1503399&objectid=11938825-

by  Elizabeth Stuyt, MD

For the past 27 years, working as an addiction psychiatrist, I have struggled with big industries that push their products more for their financial gain rather than the best interests of the clients they serve. The most disconcerting piece occurs when physicians or other treatment providers or governmental entities appear to be influenced by big industry, touting the party line and minimizing any downsides to the product. I have experienced this with the tobacco industry, the pharmaceutical industry and now with the marijuana industry.

It is clear to me that wherever it happens, the push to legalize medical marijuana is simply a back-door effort, by industry, to legalize retail marijuana. However, the lack of any regulations on the potency of THC in marijuana or marijuana products in Colorado has allowed the cannabis industry to increase the potency of THC to astronomical proportions, resulting in a burgeoning public health crisis.

The potency of THC in currently available marijuana has quadrupled since the mid-1990s. The marijuana of the 1980s had <2% THC, 4.5% in 1997, 8.5% in 2006 and by 2015 the average potency of THC in the flower was 17%, with concentrated products averaging 62% THC.

Sadly, the cannabidiol (CBD) concentrations in currently available marijuana have remained the same or decreased. CBD is the component of marijuana that appears to block or ameliorate the effects of THC. Plants that are bred to produce high concentrations of THC cannot simultaneously produce high CBD. Higher-potency THC has been achieved by genetically engineering plants to product more THC and then preventing pollination so that the plant puts more energy into producing cannabinoids rather than seeds. This type of cannabis is referred to as sinsemilla (Spanish for without seed). (It has also been referred to as “skunk” due to its strong smell.)

In my view, this is no different than when the tobacco industry increased the potency of nicotine by genetically engineering tobacco plants to produce more nicotine and then used additives like ammonia to increase the absorption of nicotine. Industry’s efforts to increase the potency of an addictive substance seem to be done purely with the idea of addicting as many people as possible to guarantee continued customers. This certainly worked for the tobacco industry. And we have increasing evidence that high potency THC cannabis use is associated with an increased severity of cannabis dependence, especially in young people.12

Although marijuana has been used for thousands of years for various medical conditions, we have no idea if the benefit comes from the THC or CBD or one of the other multiple cannabinoids present in marijuana, or a combination. And we have no idea how much is needed or how often. Most of the research indicates that it is likely the CBD that is more helpful but we obviously need research on this. There is no evidence that increasing the potency of THC has any medical benefits. In fact, a study on the benefits of smoked cannabis on pain actually demonstrated that too high a dose of THC can cause hyperalgesia – similar to what is seen with high dose opiates – meaning that the person becomes more sensitive to pain with continued use. They found that 2% THC had no effect on pain, 4% THC had some beneficial effects on chronic pain and 8% resulted in hyperalgesia.3

The discovery of the “active component” in marijuana that makes it so desirable is a fairly recent phenomenon. THC and CBD were first discovered in 1963 in Israel.4

Because cannabis was made a DEA schedule I drug in 1970, very little research has been done on cannabis in the United States and most of the indications for medical marijuana have very little good research backing up the use. The chemical that is made by the body and fits the receptor which accommodates THC was discovered in 1992.5

The researcher named the chemical anandamide which means “supreme joy” in Sanskrit.  However, it turns out that the endocannabinoid system plays a very significant role in brain development that occurs during childhood and adolescence. It controls glutamate and GABA homeostasis and plays a role in strengthening and pruning synaptic connections in the prefrontal motor cortex. The consequences of using the high potency THC products during this period, especially without the protective benefits of CBD, are multifaceted and include disturbance of the endocannabinoid system, which can result in impaired cognitive development, lower IQ and increased risk of psychosis.

There is also evidence that marijuana use contributes to anxiety and depression. A very large prospective study out of Australia tracked 1600 girls for 7 years and found that those who used marijuana every day were 5 times more likely to suffer from depression and anxiety than non-users.6

Teenage girls who used the drug a least once a week were twice as likely to develop depression as those who did not use. In this study, cannabis use prior to age 15 also increased the risk of developing schizophrenia symptoms.

While there definitely are people who can use marijuana responsibly without any untoward effects, similar to how some people can drink alcohol responsibly and not have any problems, there are people who are very sensitive to the effects of THC, and its use can precipitate psychosis. The higher the potency of THC the more likely this may happen and we have no idea how to predict who will be affected. In one of the first double blind randomized placebo controlled trials on smoked cannabis (maximum of 8% THC) for the treatment of pain, a cannabis naïve participant had a psychotic reaction to the marijuana in the study and this then required that all future study participants have some experience with smoking marijuana.7

This kind of makes it difficult to have “blind” unbiased participants.

A 2015 study out of London analyzed 780 people ages 18-65, 410 with first episode psychosis and 370 healthy controls, and found that users of high potency (“skunk-like”) cannabis (THC > 15%) are three times as likely to have a psychotic episode as people who never use cannabis, and the risk is fivefold in people who smoke this form of the drug every day.89 There was no association of psychosis with THC levels < 5%. Most of the marijuana in the U.S. is of the high-THC variety. Many retailers in Colorado sell strains of weed that contain 25 percent THC or more.

Sadly, Colorado has now joined several other states in approving PTSD as an indication for the use of medical marijuana. Marijuana does not “treat” PTSD any more than benzodiazepines or opiates “treat” PTSD. All these addictive drugs do is mask the symptoms, allowing the person to continue life unaffected by the memory of the trauma. However, the psychological trauma is never resolved and the individual has to continue to use the substance in order to cope. This sets the individual up for the development of addiction to the substance or the use of other addictive substances. There is absolutely no good research to support the use of marijuana for PTSD, and there is observational data that this would be a bad idea unless this use was supported by a lot more (and better-designed) longitudinal research.

In an excellent longitudinal, observational study from 1992 to 2011, 2,276 Veterans admitted to specialized VA treatment programs for PTSD had their symptoms evaluated at intake and four months after discharge.10

They found that those who never used marijuana or quit using while in treatment had the lowest levels of PTSD symptoms, while those who continued to use or started using marijuana after treatment had worse symptoms of PTSD. Those who started using the drug during treatment had higher levels of violent behavior too.

Those of us working in the trenches in Colorado are seeing the downsides of what our governor has called “one of the great social experiments of the 21st century.” Emergency room physicians are seeing a significant increase in people experiencing consequences from marijuana use since it was legalized. One such physician wrote a very poignant piece about his experience returning to his home town of Pueblo, Colorado where he is now practicing.11

His experiences are totally supported by the Rocky Mountain High Intensity Drug Trafficking Report, volume 4 from September 2016 which documents significant increases in marijuana related emergency department visits (49%) and hospitalizations related to marijuana (32%) compared to rates prior to retail legalization. This report also documents significant increases in the use of marijuana by youth, with Colorado youth “past month marijuana use” for 2013/2014 being 74% higher than the national average, compared with 39% higher in 2011/2012.

 

In Pueblo, Colorado, where I practice, it has developed into a perfect storm. According to the Healthy Kids Colorado Survey in 2015, we have the highest incidence of youth marijuana use in the state, with 30.1% reporting using marijuana in the last 30 days. The legalization of retail marijuana seems to be reflected in the increased abuse of opiates and heroin too. In addition to the highest rates of marijuana use by youth, Pueblo has the highest rates of heroin-related deaths in the state.

 

This is a very disturbing correlation that needs attention. I have definitely seen in my practice that marijuana acts as a gateway drug to opiates, and to relapse to opiates after treatment if the person goes back to using marijuana. The Smart Approaches to Marijuana status report, which assesses state compliance with federal marijuana enforcement policy, following what is known as the Cole memo, documents that Colorado, four years after legalization, has failed to meet the specific DOJ requirements on controlling recreational marijuana production, distribution and use. This report documents a significant increase in drugged driving crashes, youth marijuana use, a thriving illegal black market and unabated sales of alcohol, which supports the idea that people are not using marijuana instead of alcohol but rather in addition to alcohol.

In spite of all this information, powerful people in the government of Colorado have publicly minimized the consequences. Larry Wolk, MD, the Chief Medical Officer for the Colorado Department of Public Health and Environment, has reported that he has “not seen any significant problems” with the legalization of marijuana.

Governor Hickenlooper’s response to Attorney General Sessions recent questions about compliance with the Cole Memo minimized the adolescent use of marijuana by saying that youth marijuana use in Colorado has “remained stable since legalization.” This is not true for Pueblo, but in any event, any use of marijuana by youth in Colorado should not be minimized and should be a major concern for future generations.

While there are people who believe we need to enforce federal law and go back to making marijuana illegal, I am afraid the horse is already out of the barn and cannot be put back in as we already have several states with “legal” retail marijuana and multiple more with “medical marijuana.” I cannot conceive of any way this could be reversed at this point, when the majority of society supports the legalization of marijuana.

Solutions to our marijuana problems have to be realistic to our current situation/environment. The number one solution is more education. Many people seem to lack a true understanding of the drug and all the potential negative consequences of the higher-potency THC. This is why education is so important. Adults should have the right to make their own decisions but they need informed consent, just like with any drug.

The biggest concern is with adolescent use and the developing brain. This requires a lot more education and increased efforts at prevention, early intervention and treatment. I believe society would be truly served by a federal ban on all advertising of addicting drugs including alcohol, tobacco and marijuana, as well as all pharmaceutical drugs. The decision to use a pharmaceutical medication should be between the patient and the medical professional, not influenced by big industry. We clearly have the big industries— alcohol, tobacco and marijuana—doing everything they can to influence the public and convince them to use their product.

Since we only have anecdotal evidence at this point that marijuana can aid any medical condition, I recommend eliminating “medical marijuana” and just have retail marijuana with limits on THC and regulations similar to alcohol and tobacco. This could help take away the perception, which adolescents and others have, that because is it “medical” it must be “safe.” In order to be able to say it is medical, it should go through the same standards for testing the safety and efficacy of any prescription drug.

In this vein, I believe we do need more research and that marijuana should be reclassified as a schedule II drug so this can occur. Since marijuana has been used medicinally for thousands of years, I believe that the plant deserves some true research to determine if and what parts of the plant are helpful medicinally. The reports that marijuana use resulted in less than 10% becoming addicted to it were done back in the 1990s when THC levels were <5%. Since we are seeing significant increases in people developing marijuana use disorder with the higher doses of THC, perhaps the limits on THC should be <5%. Editor’s note: for more information, see the pdf of the author’s talk on this topic.     Show 11 footnotes

Source:  https://www.madinamerica.com/2017/09/unintended-consequences-colorado-social-experiment/  11th September 2017

Mathias B. Forrester and Ruth D. Merz

Hawaii Birth Defects Program, Honolulu, Hawaii, USA

Extracts from Study 

The literature on the association between prenatal illicit drug use and birth defects is inconsistent. The objective of this study was to determine the risk of a variety of birth defects with prenatal illicit drug use.

Data were derived from an active, population based adverse pregnancy outcome registry. Cases were all infants and foetuses with any of 54 selected birth defects delivered during 1986–2002.

The prenatal methamphetamine, cocaine, or marijuana use rates were calculated for each birth defect and compared to the prenatal use rates among all deliveries.

Among all deliveries, the prenatal use rate was 0.52% for methamphetamine,0.18% for cocaine, and 0.26% for marijuana.

Methamphetamine rates were significantly higher than expected for 14 (26%) of the birth defects.

Cocaine rates were significantly higher than expected for 13 (24%) of the birth defects.

Marijuana rates were significantly higher than expected for 21 (39%) of the birth defects. Increased risk for the three drugs occurred predominantly among birth defects associated with the central nervous system, cardiovascular system, oral clefts, and limbs. There was also increased risk of marijuana use among a variety of birth defects associated with the gastrointestinal system. Prenatal uses of methamphetamine, cocaine, and marijuana are all associated with increased risk of a variety of birth defects.

The affected birth defects are primarily associated with particular organ systems.

DISCUSSION

Using data from a Statewide, population-based registry that covered over 300,000 births and a 17-yr period, this investigation examined the association between over 50 selected birth defects and maternal use of methamphetamine, cocaine, or marijuana during pregnancy. Much of the literature on prenatal illicit drug use and birth defects involved case reports, involved a small number of cases, were not population-based, or focused on only one or a few particular birth defects.

There are various limitations to this investigation. The number of cases for many of the birth defects categories was relatively small, limiting the ability to identify statistically significant differences and resulting in large confidence intervals.

In spite of this, a number of statistically significant analyses were identified. Some statistically significant results might be expected to occur by chance. If 1 in every 20 analyses is expected to result in statistically significant differences solely by chance, then among the 162 analyses performed in this study, 8 would be expected to be statistically significant by chance. However, 48 statistically significant differences were identified. Thus, not all of the statistically significant results are likely to be due to chance.

This study included all pregnancies where methamphetamine, cocaine, or marijuana use was identified through either report in the medical record or positive toxicology test. This was done because neither self-report nor toxicology testing is likely to identify all instances of prenatal illicit drug use (Christmas et al., 1992).

In spite of using both methods for determining prenatal illicit drug use, all pregnancies involving methamphetamine, cocaine, or marijuana were not likely to have been identified. The degree of under ascertainment is unknown. A previous study examined the maternal drug use rate around the time of delivery in Hawaii during 1999 (Derauf et al., 2003). This study found 1.4% of the pregnancies involved methamphetamine use and 0.2% involved marijuana use. Among 1999 deliveries, the HBDP identified a prenatal methamphetamine use rate of 0.7% and a marijuana use rate of 0.4%. However, comparisons between the 2 studies should be made with caution because the previous study collected data from a single hospital during only a 2-mo period.

Another limitation is that the present study did not control for potential confounding factors such as maternal demographic characteristics, health behaviors, and prenatal care. Increased risk of birth defects has been associated with inadequate prenatal care (Carmichael et al., 2002), maternal smoking (Honein et al., 2001), and maternal alcohol use (Martinez-Frias et al., 2004).

These factors are also found with maternal illicit drug use (Cosden et al., 1997; Hutchins, 1997; Norton-Hawk, 1997). Thus the increased risk of selected birth defects with illicit drug use in this study might actually be due to one of these other underlying factors. Unfortunately, informationon some of the potential confounding factors such as socioeconomic status are not collected by the HBDP. Information collected on some other factors such as smoking and alcohol use is suspect because of negative attitudes toward their use during pregnancy. Moreover, the small number of cases among many of the birth defects groups would make controlling for these factors difficult.

Finally, this investigation included use of the illicit drugs at any time during the pregnancy. Most birth defects are believed to occur at 3–8 wk after conception (Makri et al., 2004; Sadler, 2000). In a portion of the cases, the drug use might have occurred at a time when it could not have caused the birth defect. Furthermore, this study does not include information on dose; however, teratogenicity of a substance may depend on its dose (Werler et al., 1990). In spite of the various potential concerns of the present study, data may suggest future areas of investigation where the limitations inherent in the present one are excluded.

This investigation found significantly higher than expected rates for prenatal use of methamphetamine, cocaine, and marijuana among a number of specific birth defects. Although not identical, there were general similarities between the three illicit drugs and the birth defects with which they were associated. Increased rates for methamphetamine, cocaine, and marijuana occurred predominantly among birth defects affecting the central nervous system, cardiovascular system, oral clefts, and limbs. There were also increased rates of marijuana use with a variety of birth defects associated with the gastrointestinal  system. With the exception of marijuana and encephalocele, none of illicit drugs were associated with neural-tube defects (anencephaly, spina bifida, encephalocele). The rates of use for the three illicit drugs were not significantly elevated with eye defects other than anophthalmia/microphthalmia, genitourinary defects, and musculoskeletal defects aside from limb defects.

In the majority of instances, the associations between particular illicit drugs and birth defects were found whether or not those cases involving use of multiple types of drugs were included.

Of the 14 significant associations between methamphetamine and specific birth defects, 10 (71.4%) remained once multiple drug cases were excluded. Corresponding rates were 61.5% (8 of 13) for cocaine and 81.0% (17 of 21) for marijuana.

The similarities in the patterns of birth defects with which methamphetamine, cocaine, and marijuana are associated might suggest that the three drugs exert similar effects on embryonic and foetal development. This might not be expected, considering that the three illicit drugs differ in their mechanisms of action and clinical effects (Leiken & Paloucek, 1998).

Some of the associations between methamphetamine, cocaine, and marijuana observed in the present investigation were previously reported. Other studies observed similar associations, or lack thereof, of methamphetamine or amphetamine with neural-tube defects (Shaw et al., 1996) and cardiovascular and musculoskeletal defects (McElhatton et al., 2000); cocaine with neural-tube defects (Shaw et al., 1996), cardiovascular defects (Lipshultz et al., 1991), ventricular septal defect and atrial septal defect (Ferencz et al., 1997c; Martin & Edmonds, 1991), tricuspid atresia (Ferencz et al., 1997d), craniosynostosis (Gardner et al., 1998), and situs inversus (Kuehl & Loffredo, 2002); and marijuana with neural-tube defects (Shaw et al., 1996), single ventricle (Steinberger et al., 2002), ventricular septal defect (Williams et al., 2004), tricuspid atresia (Ferencz et al., 1997d), and gastroschisis (Torfs et al., 1994).

In contrast, this study differed from other research with respect to their findings regarding methamphetamine or amphetamine and gastroschisis (Torfs et al., 1994); cocaine and microcephaly (Martin & Edmonds, 1991), conotruncal defects (Adams et al., 1989), endocardial cushion defect (Ferencz et al., 1997b), situs inversus (Ferencz et al., 1997a), oral clefts (Beatyet al., 2001), and genitourinary defects (Abe et al., 2003; Battin et al., 1995; Martin & Edmonds, 1991); and marijuana and conotruncal defects (Adams et al., 1989), Ebstein anomaly (Ferencz et al., 1997e; Correa-Villasenor et al., 1994), and oral clefts (Beaty et al., 2001).

The inconsistent findings between this and the other studies could be due to differences in study methodology, case classification, or number of cases. The mechanisms by which methamphetamine, cocaine, and marijuana might contribute to the rates for birth defects is currently unknown. Any potential explanation would have to take into account the observation that each of the illicit drugs was associated with a variety of specific birth defects affecting different organ systems. This might suggest that these three drugs would need to influence a basic, common factor involved in embryonic development.

Folic acid is involved in nucleic acid synthesis and cellular division (Scholl & Johnson, 2000) and thus would play an important role in the early growth and cellular proliferation of the embryo. Folic acid has been found to prevent a variety of birth defects (Forrester & Merz, 2005). Thus, anything that interferes with the activity of folic acid might be expected to increase the risk for these birth defects. Many of these birth defects were associated with methamphetamine, cocaine, and/or marijuana in the present study.

However, two of the birth defects most closely affected by folic acid—anencephaly and spina bifida—were not associated with any of the three illicit drugs. Vascular disruption has been suggested as a potential cause for a variety of different birth defects such as intestinal atresia/stenosis, limb reduction defects, and gastroschisis.

Since cocaine is a vasoconstrictor, it has been hypothesized that cocaine use could increase the risk of these vascular disruption defects (Hume et al., 1997; Martin et al., 1992; Hoyme et al., 1983; de Vries, 1980). Although this investigation found an association between cocaine and limb reduction deformities, no association was found with intestinal atresia/stenosis or gastroschisis.

In conclusion, this study found that prenatal use of methamphetamine, cocaine, or marijuana were associated with increased risk of a variety of birth defects. The affected birth defects were primarily associated with particular organ systems. Because of various limitations of the study, further research is recommended.

Source:  Journal of Toxicology and Environmental Health, Part A, 70: 7–18, 2007

St. Petersburg, FL – Thursday, August 31, 2017 – Drug Free America Foundation today introduced a first-of-its-kind Opioid Tool Kit in an effort to help address the opioid epidemic gripping the United States.

The Opioid Tool Kit was unveiled in conjunction with International Overdose Awareness Day, a global event held on August 31st each year that aims to raise the awareness of the problem of drug overdose-related deaths.

“With more than 142 people dying each day, drug overdoses are now the leading cause of death for Americans under the age of 50,” according to Calvina Fay, Executive Director of Drug Free America Foundation. “Moreover, deaths from drug overdose are an equal opportunity killer, with no regard to race, religion or economic class,” she said.

“While alcohol and marijuana still remain the most common drugs of abuse, the nonmedical use of prescription painkillers and other opioids has resulted in a crisis-level spike in drug overdose deaths,” said Fay.

The Opioid Tool Kit has been designed to educate people about the opioid epidemic and offer strategies that can be used to address this crisis. “The Tool Kit is also intended to encourage collaboration with different community sectors and stakeholders to make successful and lasting change,” Fay continued.

The Opioid Tool Kit is a comprehensive guide that defines what an opioid is, examines the scope of the problem, and addresses why opioids are a continuing health problem.  The Tool Kit also provides strategies for the prevention of prescription drug misuse and overdose deaths and includes a community advocacy and action plan, as well as additional resources.

Fay emphasized that the best way to prevent opioid and other drug addiction is not to abuse drugs in the first place.  “The chilling reality is that the long-term use and abuse of opioids and other addictive drugs rewire the brain, making recovery a difficult and often a life-long struggle,” she concluded. The Opioid Tool Kit can be found on Drug Free America Foundation’s website at https://dfaf.org/Opioid%20Toolkit.pdf.

Source:   https://dfaf.org/Opioid%20Toolkit.pdf..  August 2017

Background

On August 29, 2013, the U.S. Department of Justice (DOJ) issued guidelines to Federal prosecutors and law enforcement officials regarding where to focus their drug enforcement efforts in states that have passed laws legalizing the retail sales of marijuana. The so-called “Cole Memo” directs enforcement officials to focus resources, including prosecutions, “on persons and organizations whose conduct interferes with any one or more of [eight] priorities, regardless of state law.”

Per the memorandum, the eight DOJ priorities are:

● Preventing distribution of marijuana to minors

● Preventing marijuana revenue from funding criminal enterprises, gangs or cartels

● Preventing marijuana from moving out of states where it is legal

● Preventing use of state-legal marijuana sales as a cover for illegal activity

● Preventing violence and use of firearms in growing or distributing marijuana

● Preventing drugged driving or exacerbation of other adverse public health consequences associated with marijuana use

● Preventing growing marijuana on public lands

● Preventing marijuana possession or use on federal property

According to the Department of Justice, the Federal “hands-off” approach to marijuana enforcement enumerated in the Cole Memo is contingent on its expectation that “states and local governments that have enacted laws authorizing marijuana-related conduct will implement strong and effective regulatory and enforcement systems that will address the threat those state laws could pose to public safety, public health, and other law enforcement interests.

A system adequate to that task must not only contain robust controls and procedures on paper, it must also be effective in practice.”

Unfortunately, since Colorado and Washington became the first states to legalize the recreational sale of marijuana in 2012, evidence has emerged that regulations intended to control the sale and use of marijuana have failed to meet the promises made by advocates for legalization.

For example, states with legal marijuana are seeing an increase in drugged driving crashes and youth marijuana use. States that have legalized marijuana are also failing to shore up state budget shortfalls with marijuana taxes, continuing to see a thriving illegal black market, and are experiencing an unabated sales of alcohol, despite campaign promises from advocates promising that marijuana would be used as a “safer” alternative instead.

Moreover, state regulatory frameworks established post-legalization have failed to meet each of the specific DOJ requirements on controlling recreational marijuana production, distribution, and use.

While long-term studies and research on the public health and safety impacts of marijuana legalization are ongoing, this report provides a partial census of readily available information that demonstrates how Colorado, Oregon, and Washington State –

the jurisdictions with the most mature regulatory markets and schemes – have not fulfilled the requirements of the Cole Memo.

DOJ Guideline 1: “Preventing distribution of marijuana to minors”

● According to the nation’s largest and most comprehensive survey of drug use trends in the nation, past-month use of marijuana among 12 to 17-year-olds in Colorado increased significantly – from 9.82% to 12.56% after marijuana retail sales began (Colorado legalized marijuana in 2012 and implemented legal marijuana stores in 2014).

The same study notes that teens and adults in Colorado now use marijuana at a higher rate than the rest of the country. No other representative sample of drug users in Colorado has contradicted this sample.

● A 2017 study from the University of Colorado found that marijuana-related emergency room visits and visits to its satellite urgent care centers by teens in Colorado more than quadrupled after the state legalized marijuana.

● In Colorado, a new report from the state’s public safety agency reveals that after the state legalized the drug, marijuana-related arrests for black and Hispanic youth rose by 58% and 29% respectively, while arrest rates for white kids dropped by eight percent. School Resource Officers in Colorado have reported a substantial increase in marijuana-related offenses in Colorado schools after the state commercialized the drug.

● According to data from the State of Washington, there have been over 240 violations of legal marijuana sales to minors and of minors frequenting restricted marijuana sales areas as of July 2017. ● Youth use – among 8th and 10th graders at least – is increasing in Washington State. According to a special analysis of teenage drug use published in the peer-reviewed, highly regarded Journal of American Medical Association Pediatrics, the perceived  harmfulness of marijuana in Washington declined 14.2% and 16.1% among eighth and 10th graders, respectively, while marijuana use increased 2.0% and 4.1% from 2010-2012 to 2013-2015.

● According to the Washington State Office of the Superintendent of Public Instruction during 2013-2014, 48 percent of statewide student expulsions were for marijuana in comparison to alcohol, tobacco, and other illicit drugs. During the 2014-2015 school year, statewide student expulsions for marijuana increased to 60 percent. Marijuana related suspensions for the 2013-2014 school year reported 42 percent and for the 2014-2015 school year, suspensions increased to 49 percent.

● In Washington State, youth (12-17) accounted for 64.9% of all state marijuana seizures in 2015 as compared to 29.9% in 2010, according to data from the National Incident Based Reporting System (NIBRS).

● From 2012 to 2016, reported exposure calls for marijuana increased 105 percent in Washington. According to the 2016 Annual Cannabis Toxic Trends Report, of exposures related to children under the age of five, 73 percent occurred in those one to three years of age. The counties with the highest reported exposures for both 2015 and 2016 were: King, Spokane, Snohomish, and Pierce.

DOJ Guideline 2: “Preventing revenue of the sale of marijuana from going to criminal enterprises, gangs, and cartels”

● In June 2017, Colorado Attorney General Cynthia Coffman announced a takedown of a massive illegal marijuana trafficking ring in Colorado. The bust is the largest since legalization and indicted 62 individuals and 12 businesses in Colorado. The operation stretched into other states including Kansas, Texas, Nebraska, Ohio and Oklahoma.

● In March 2017, a leaked report from the Oregon State Police uncovered evidence from state officials that the black market for marijuana continues to thrive in the state. The 39-page report noted that, “The illicit exportation of cannabis must be stemmed as it undermines the spirit of the law and the integrity of the legal market…it steals economic power from the market, the government, and the citizens of Oregon, and furnishes it to criminals, thereby tarnishing state compliance efforts.”

Washington State Office of the Superintendent of Instruction. (2016, Jan. 26). Behavior Report. http://www.k12.wa.us/SafetyCenter/Behavior/default.aspx

Washington State Poison Center – Toxic Trends Report: 2016 Annual Cannabis Report

● In 2016, Seattle Police spokesman Sean Whitcomb noted that “large-scale illegal grow operations… are still prevalent in Seattle, and we do come across those with a degree of frequency.” DOJ Guideline 3: “Preventing the diversion of marijuana from states where it is legal under state law in some form to other states”

● In 2014, two states – Nebraska and Oklahoma – sued their neighbor state of Colorado by citing evidence of increased marijuana flowing into those states. Law enforcement officials have reported a substantial increase in marijuana flow across state borders into neighboring states.

● In 2016, there were multiple raids conducted by state law enforcement in Colorado, leading authorities to seize more than 22,0000 pounds of marijuana intended for sales outside of Colorado.

● According to the Oregon State Police, the state has an “expansive geographic footprint” on marijuana exports across the U.S. Several counties in Oregon including Jackson, Multnomah, Josephine, Lane, Deschutes and Washington “lead the way” in supplying marijuana to states where it is not legal.

● According to the Rocky Mountain High Intensity Drug Trafficking Area task force, “there were 360 seizures of marijuana in Colorado destined for other states. This is nearly a 600% increase in the number of individual stops in a decade, seizing about 3,671 pounds in 2014. Of the 360 seizures reported in 2014, 36 different states were identified as destinations, the most common being Kansas, Missouri, Illinois, Oklahoma and Florida.”

● Law enforcement officials report that since legalization in 2012, Washington State marijuana has been found to be destined for 38 different states throughout the United States. Between 2012 and 2017, 8,242.39 kilograms (18,171.35 pounds) have been seized in 733 individual seizure events across 38 states. From 2012 to 2016, 470 pounds of marijuana have been seized on Washington State highways and interstates. Since 2012, 320 pounds of Washington State-origin marijuana have been seized during attempted parcel diversions. DOJ Guideline 4: “Preventing state-authorized marijuana activity from being used as a cover or pretext for the trafficking of other illegal drugs or other illegal activity”

● According to Jorge Duque from the Colorado Department of Law, cartels operating in Colorado are now “trading drugs like heroin for marijuana,” and the trade has since opened the door to drug and human trafficking. Duque also explains that money 5 laundering is a growing problem as “cartels are often disguising their money through legally purchasing marijuana or buying houses and growing marijuana in it.”

● In June 2017, a former Colorado marijuana enforcement officer and a Denver-based marijuana entrepreneur were indicted for running a statewide marijuana trafficking ring that illegally produced and sold “millions of dollars worth of marijuana across state lines.” This trafficking organization obtained 14 marijuana licenses in order to present their activities as protected business endeavors, despite “never ma[king] a single legal sale of cannabis in their two years of operation.”

● In Oregon, State Police officials report that criminals are exploiting Oregon’s legal marijuana industry for financial crimes and fraud. In one example, according to the Oregon State Police report, “Tisha Silver of Cannacea Medical Marijuana Dispensary falsified licensing to solicit investors and worked with Green Rush Consulting to locate unwitting investors. Silver exploited the burgeoning cannabis industry in the state to entice investors to back an illegitimate company, securing a quarter of a million dollars in fraudulent gains. According to some analysts, cannabis investors fell prey to ‘pump and dump’ schemes and lost up to $23.3 billion in 2014 alone.”

● Officials in Oregon note that the U.S. Postal Service is being exploited to ship marijuana products and revenue. According to former Attorney General Eric Holder, “The Postal Service is being used to facilitate drug dealing,” a clear violation of federal law and a violation of the sanctity of the U.S. mailing system.

DOJ Guideline 5: “Preventing violence and the use of firearms in the cultivation and distribution of marijuana”

● While crime rates dropped or remained stable in many of the nation’s largest cities, Colorado’s crime rate increased. There has been an increase in rape, murder, robbery and auto thefts. While it is not possible to link legalization to a direct change in crime rates, officials in Colorado cited marijuana legalization as one of the reasons behind the rise.

● In Colorado, prosecutors are reporting an increase in marijuana-related homicides since the state legalized the drug.  This situation is detailed here: http://www.oregonlive.com/marijuana/index.ssf/2016/07/state_slaps_portland_dispensar.h tml.

Other instances of fraud have been discussed here: Sapient Investigations Newsletters (2015, Feb. 10) “High Times for Fraud,” available online at https://sapientinvestigations.com/spi-news/high-times-for-fraud/

● In Oregon, state police report that, “Cannabis is a lucrative target for robbery. As recently as December 2016, a state-licensed cannabis producer was targeted for a violent armed robbery. In the aforementioned case, a well-known cannabis grower in Jackson County was assaulted, bound, and his harvest was taken by armed assailants.”

● In Prince George’s County Maryland, Police Chief Henry Stawinski noted a significant rise in marijuana-related homicides since neighboring D.C. legalized the drug. Stawinski said 19 homicides in 2016 were related to marijuana.

DOJ Guideline 6:  “Preventing drugged driving and the exacerbation of other public health consequences associated with marijuana use”

● Drugged driving has increased in states with legal marijuana sales. According to a study published by the American Automobile Association, fatal drugged driving crashes doubled in Washington State after the state legalized marijuana. The Governors Highway Safety Association also notes a disturbing rise in drugged driving crashes even as alcohol-related crashes are declining.

● A Denver Post analysis found the number of marijuana-impaired drivers involved in fatal crashes in Colorado more than doubled since 2013, the year after the state voted to legalize recreational marijuana use. Colorado saw a 145 percent increase in the number of marijuana-impaired drivers involved in fatal crashes between 2013 and 2016. Marijuana is also figuring into more of Colorado’s fatal crashes overall: in 2013, marijuana-impaired drivers accounted for 10 percent of all fatal crashes, but by 2016 it reached 20 percent.

● According to a study published in the Annals of Emergency Medicine, poison control calls for children more than tripled after marijuana legalization. Much of this is linked to a boom in the sale of marijuana “edibles.” THC concentrate is mixed into almost any type of food or drink, including gummy candy, soda, and lollipops. Today, these edibles comprise at least half of Colorado’s marijuana market.

● In Washington State, the number of marijuana-involved DUIs are increasing with 38 percent of total cases submitted in 2016 testing above the five nanogram per milliliter of blood legal limit for those over the age of twenty-one. In addition, 10 percent of drivers involved in a fatal accident from 2010 to 2014 were THC-positive.

● A study by the Highway Loss Data Institute reveals that Colorado, Oregon, and Washington have experienced three percent more collision claims overall than would ( NWHIDTA Drug Threat Assessment For Program Year 2018)  have been expected without legalization.

Colorado witnessed the largest jump in claims. The state experienced a rate 14 percent higher than neighboring states.

● In Washington State, from 2012 to 2016, calls to poison control centers increased by 79.48%. Exposures increased 19.65% from the time of marijuana commercialization in 2014 to 2016. Of the marijuana calls answered by the Poison Center in 2016, youth under the age of 20 accounted for almost 40% of all calls.

According to the 2016 Annual Cannabis Toxic Trends Report, 42% of the calls reported were for persons aged 13 to 29. Additionally, among exposures related to children under the age of five, 73% involved children one to three years of age. The counties with the highest reported number of exposures for 2015 remained in the top four for 2016: King, Spokane, Snohomish, and Pierce.

DOJ Guideline 7: “Preventing the growing of marijuana on public lands and the attendant public safety and environmental dangers posed by marijuana on public lands”

● In Washington State, 373,778 marijuana plants were found growing illegally on public and private lands between 2012 and 2016. Of the illegal marijuana plants eradicated in 2016, 60% were being cultivated on state land, and the 58,604 illegal marijuana plants eradicated in 2016 consumed an estimated 43.2 million gallons of water over a full growing season (120-day cycle).

More than 400 pounds of fertilizers, chemicals, and pesticides were removed from illegal marijuana growing operations in 2016, and Furadan, a neurotoxin that is extremely dangerous to humans, was found in an illegal marijuana growing operation the same year.

● In June 2017, Colorado officials found more than 7,000 illegal plants on federal land in the state’s San Isabel National Forest. This was the fifth illegal grow found in that area alone since the year marijuana legalization passed, demonstrating legalization has not curbed the problem of grows exploiting public lands.

● In Oregon, the legalization of marijuana in the state has failed to eliminate illegal growing operations and public lands continue to be exploited despite a legal market. According to a report from state officials, “To date in Oregon, cannabis legalization has not had a noticeable influence on Mexican National [Drug Trafficking Organizations] illicit cannabis cultivation operations on public lands… leaving a lasting scar on Oregon’s unique ecosystems.

Illicit cannabis grows employ excessive amounts of pesticides, rodenticides, and herbicides, thereby threatening local wildlife habitats. Additionally, many illicit grow sites clear-cut timber, furthering soil erosion and water contamination. Research on the environmental impact of illicit cannabis grows indicates that grows tend to be bunched near water sources, resulting in disproportionate impacts on ecologically important areas…

Oregon is robbed of roughly 122 Olympic swimming pools 8 worth of water annually, or roughly 442,200 gallons of water daily during the growth season.”

DOJ Guideline 8: “Preventing marijuana possession or use on federal property”

● Advocates for legal marijuana frequently flout federal laws by possessing and using marijuana on federal properties purportedly in acts of civil disobedience. In January 2017, one group gave away free marijuana in Washington, D.C. to smoke on the National Mall during the inauguration of President Trump. On April 24, 2017, four activists were arrested after purposely flouting federal law and publicly using marijuana on U.S. Capitol grounds.

Conclusion and Key Recommendations

Federal resources should target the big players in the marijuana industry. Individual marijuana users should not be targeted or arrested, but large-scale marijuana businesses, several of which now boast of having raised over $100 million in capital, and their financial backers, should be a priority. These large businesses are pocketing millions by flouting federal law, deceiving Americans about the risks of their products, and targeting the most vulnerable.

They should not have access to banks, where their financial prowess would be expanded significantly, nor should they be able to advertise or commercialize marijuana.

These businesses target many of the marijuana products they sell toward kids, such as pot candies, cookies, and ice cream. And despite state regulations, these products continue to have problems with contamination. Recently, one of the largest, most sophisticated manufacturers of these pot “edibles” was forced to recall a number of products because they contained non-food-grade ingredients.

Additionally, the black market continues unabated in legalized states. A leaked report from Oregon police showed that at least 70 percent of that state’s marijuana market is illegal, despite legalization. In June 2017, Colorado Attorney General Cynthia Coffman said, “The black market for marijuana has not gone away since recreational marijuana was legalized in our state, and in fact continues to flourish.”

Further, state-legal businesses have acted as top cover for these illegal operations, as recent large-scale arrests in Colorado have shown. These large marijuana operations, which combine the tactics of Big Tobacco with black marketeering, should form the focus of federal law enforcement, not individual users.  Recalls are becoming more commonplace because of pesticides, moulds, and other issues.

See The Denver Post for news stories related to these recalls in legalized states: http://www.thecannabist.co/tag/marijuana-recall/

At the same time, the federal government along with non-government partners should implement a strong, evidence-based marijuana information campaign, similar to the truth ® campaign for tobacco, which alerts all Americans about the harms of marijuana and the deceitful practices of the marijuana industry.

Arrests are up. We still have a black market. And people are in danger.

Last week, Senator Cory Booker introduced the Marijuana Justice Act in an effort to legalize marijuana across the nation and penalize local communities that want nothing to do with this dangerous drug. This is the furthest reaching marijuana legalization effort to date and marks another sad moment in our nation’s embrace of a drug that will have generational consequences.

Our country is facing a drug epidemic. Legalizing recreational marijuana will do nothing that Senator Booker expects. We heard many of these same promises in 2012 when Colorado legalized recreational marijuana.

In the years since, Colorado has seen an increase in marijuana related traffic deaths, poison control calls, and emergency room visits. The marijuana black market has increased in Colorado, not decreased. And, numerous Colorado marijuana regulators have been indicted for corruption.

In 2012, we were promised funds from marijuana taxes would benefit our communities, particularly schools. Dr. Harry Bull, the Superintendent of Cherry Creek Schools, one of the largest school districts in the state, said, “So far, the only thing that the legalization of marijuana has brought to our schools has been marijuana.”

In fiscal year 2016, marijuana tax revenue resulted in $156,701,018. The total tax revenue for Colorado was $13,327,123,798, making marijuana only 1.18% of the state’s total tax revenue. The cost of marijuana legalization in public awareness campaigns, law enforcement, healthcare treatment, addiction recovery, and preventative work is an unknown cost to date.

Senator Booker stated his reasons for legalizing marijuana is to reduce “marijuana arrests happening so much in our country, targeting certain communities – poor communities, minority communities.” It’s a noble cause to seek to reduce incarceration rates among these communities but legalizing marijuana has had the opposite effect.

According to the Colorado Department of Public Safety, arrests in Colorado of black and Latino youth for marijuana possession have increased 58% and 29% respectively after legalization. This means that Black and Latino youth are being arrested more for marijuana possession after it became legal.

Furthermore, a vast majority of Colorado’s marijuana businesses are concentrated in neighborhoods of color. Leaders from these communities, many of whom initially voted to legalize recreational marijuana, often speak out about the negative impacts of these businesses.

Senator Booker released his bill just a few days after the Washington Post reported on a study by the Review of Economic Studies that found “college students with access to recreational cannabis on average earn worse grades and fail classes at a higher rate.” Getting off marijuana especially helped lower performing students who were at risk of dropping out.

Since legalizing marijuana, Colorado’s youth marijuana use rate is the highest in the nation, 74% higher than the national average, according to the Rocky Mountain High Intensity Drug Trafficking Area Report. This is having terribly negative effects on the education of our youth.

If Senator Booker is interested in serving poor and minority communities, legalizing marijuana is one of the worst decisions. There is much work to be done to reduce incarceration and recidivism, but flooding communities with drugs will do nothing but exacerbate the problems.

The true impact of marijuana on our communities is just starting to be learned. The negative consequences of legalizing recreational marijuana will be felt for generations. I encourage Senator Booker to spend time with parents, educators, law enforcement, counsellors, community leaders, pastors, and legislators before rushing to legalize marijuana nationally. We’ve seen the effects in our neighborhoods in Colorado, and this is nothing we wish upon the nation.

Jeff Hunt is the Vice President of Public Policy at Colorado Christian University. Follow him on Twitter: @jeffhunt.

Source:  https://www.usatoday.com/story/opinion/2017/08/07/marijuana 

The Advocates for Substance Abuse Prevention (ASAP) coalition serves the top two counties of the northern panhandle of West Virginia. The coalition got creative and utilized trending youth activities to draw youth to prevention work.

The coalition is located only a half hour from Pittsburgh, PA, and roughly three hours from Columbus, Ohio.  Based on a 2015 United States Census, the total population served is 53,165 combined for Brooke and Hancock counties.  One of the largest cities, Weirton, resides in both counties and has always had a proud tradition of steel making and industrial employment.  Unfortunately, this tradition has seen many declines in recent years and the increase in unemployment has hit the area hard, causing many families and young adults to move or have long commutes to find decent work.

Hancock County borders a major interstate where drug trafficking occurs easily between three states.  The local news reports multiple drug arrests in the Ohio Valley almost daily with incidents involving drug trafficking, abuse, and death, as is illustrated by the story of four heroin overdoses in Weirton in one weekend.  The ASAP coalition started as a small committee who met to discuss the drug problems in the area in 1996 and grew to where they are today.  The coalition’s main focus remains towards community youth with the mission of “working together to reduce substance abuse in the Brooke and Hancock communities, focusing on youth and families, by means of prevention efforts in community education, mobilization, and the change of values and beliefs.”

In 2014, ASAP found a group of youth to form a new committee called the Youth Council.  Thanks to these youth, they have gained new insight about how they should be hosting and promoting alternate activities to community youth, and actually get them to participate.  They have seen a vast increase in participation at events targeted towards youth. One such activity, that has become an instant hit, is the ASAP Youth Council Video Game Tournament.

Youth focused activities are hard for any group, but thanks to the ASAP Youth Council, the coalition has been having success getting youth involved.

“Their input is invaluable, and when you have youth telling you “don’t advertise you are doing drug prevention to kids or they won’t come,” you listen,” said Mary Ball, ASAP Coordinator. “Their ideas were simple, focus on what kids like to do, then use that as a way into their world.  So, we did.  The first event we held was a video game tournament that we used for multiple purposes.  First, it was a great fundraiser for the kids.  Second, it was the perfect draw to get youth to show up.  Third, it was fun!  We chose a game everyone, young and old could play (Smash Bros.) and changed how we promoted the event to word-of-mouth, flyers where kids hang out, and utilized social media promotions.  The response was amazing.  But nothing in the advertising said anything about substance abuse prevention.  We had over 50 attendees at our first event, which was a small miracle compared to the 10-12 we normally got, if we were lucky.“

To incorporate the message of prevention, displays were placed at the event and announcements dispersed, reminding attendees about the dangers of sharing prescriptions; where to dispose of prescriptions; and pointing out how much fun they were having at an alcohol-free event.

The event not only drew youth, but the parents, friends, grandparents of the youth who participated, did not leave.  They stayed for the entire thing to cheer those competing in the tournament on, expanding the audience from the target of just youth, to all ages.  The success of this program led the coalition to try other things, such as taking advantage of the Pokémon Go game to bring people to ASAP by hosting a “Lure Party.”  The coalition got creative and added a cosplay contest to the video game tournament and increased participation by almost 10 percent. The coalition even designed pop culture prevention buttons that kids snag off the prevention tables because they want to wear that message.

“Listen to your youth members.  They are smart, they know what other kids want to see and will participate in,” advises Ball. “Do not be closed off to stepping out of your adult-zone and entering their world.  If we want kids to listen to our messages, we need to go to them and not expect them to come to us.”

Source: http://www.cadca.org/resources/coalitions-action-asap-coalition-uses-smash-creativity-engage-youth   8th Aug.2017

Kevin Sabet, the president and CEO of Virginia-based Smart Approaches to Marijuana, has become arguably the most influential critic of marijuana legalization in the United States. But in an extended interview on view below, he fights against the perception that he’s a one-dimensional prohibitionist along the lines of U.S. Attorney General Jeff Sessions.

Sabet stresses that he and his organization, shorthanded as SAM, take what he sees as a sensible approach to cannabis by arguing in favor of treatment rather than jail time for users in trouble and advocating for greater study of the substance to determine the best ways to utilize it medically.

We first spoke to Sabet in January 2013, just prior to SAM’s launch in Denver, when he appeared alongside co-founder Patrick Kennedy, a former congressman from Rhode Island and a member of the Kennedy political dynasty. Sabet’s background is similarly stocked with connections to heavyweights. The author of Reefer Sanity: Seven Great Myths About Marijuana, he served stints in the Clinton and Bush administrations and spent two years as senior adviser to President Barack Obama’s drug-control director before taking on the SAM cause.

In the more than four years since then, he’s made countless media appearances while lobbying behind the scenes to try and stop the momentum generated by the pot legalization bandwagon.

Sabet, who says SAM’s funding mainly comes from small donors and grants as opposed to hard-core drug-war groups or Big Pharma, doesn’t think it’s too late to accomplish this goal, in part because only a relatively small percentage of the populace actually uses marijuana. Moreover, he feels that plenty of those who abstain will more actively fight against pot’s normalization if public use (and its attendant smoke and scent) becomes more prevalent in cities such as Denver, which he sees as having been demonstrably harmed by legalization. He blames cannabis for turning the 16th Street Mall into a homeless haven that visitors actively avoid and suspects that in his heart of hearts, Governor John Hicklenlooper knows legalization was a terrible mistake but can’t admit it publicly because the right to toke is enshrined in the state constitution.

Likewise, Sabet considers it inarguable that the marijuana industry is targeting young people with colorfully packaged pot edibles and argues that simply keeping cannabis away from kids isn’t enough. He cites studies showing that the brains of 25-30 year olds are still developing — and can still be harmed by weed.

Continue to learn more about Sabet’s cause and the arguments he makes to support it.

Westword: SAM recently put out a release about the amount of tax revenue Colorado has collected as a result of the marijuana industry [in reference to a VS Strategies report estimating that the state has generated more than $500 million in cannabis revenue since legalization]. In it, you talk about how drug use and its consequences cost taxpayers $193 billion per year, with Colorado’s annual share being approximately $3.3 billion. But that’s for all drugs, correct?

Kevin Sabet: Oh, yeah, absolutely. But you need to look at the fact that marijuana is used far more than any of the other drugs, and look at the costs associated with driving, crashing, mental illness — and long-term costs we’re not able to account for. Marijuana isn’t correlated with mental illness overnight. If often takes time. And so the cost of that can’t be calculated in any way. There was a study done a few weeks ago by the Canadian Centre on Substance Abuse and Addiction finding that just in

Canada alone, a much smaller country than the U.S. in population, marijuana-related car crashes cost a billion dollars. That’s just the car crashes, and those were directly related to marijuana. And the report came from a government think tank, not any kind of anti-drug group.

I honestly think it isn’t surprising coming from this group [VS Strategies]. It’s an industry group that wants to basically make money from marijuana — much more money than the State of Colorado will make after you account for costs. When you look at the actual number and context of just education alone, the marijuana revenue is barely newsworthy. The Department of Education in Colorado says they need $18 billion in capital construction funds alone. The reality is, the Colorado budget deficit is actually rising, not falling. This isn’t plugging a hole in the deficit. It’s actually costing money. There’s one area where I’d agree with [former Colorado Director of Marijuana Coordination] Andrew Freedman: You don’t do this for the money. But it’s a great talking point, and it polls well, just like the talking point of it being safer than alcohol polls well. This polls well, too, so you’re going to have an industry group that thrives off commercialization touting the numbers. That’s not surprising at all.

SAM is usually described as an anti-marijuana organization. Is that an accurate description from your viewpoint? Or is it pejorative in some way?

I wouldn’t necessarily say it’s pejorative, but I think it’s overly simplistic. It’s true that we don’t want to see the legalization of another illegal substance. We think that our experience with pharmaceuticals, which are, of course, legal, as well as alcohol and tobacco, has been an utter disaster from a public cost and public-policy point of view. We’ve never regulated those drugs in a responsible way. Lobbyists and special interests own the rule-making when it comes to these drugs. And what we’re saying is, do we really want to repeat history once again? It just happens to be marijuana. It really could have been any substance. And we will be talking about the legalization of other drugs if marijuana goes through. Because it doesn’t stop with marijuana in terms of the policy goals of many of these organizations. So I think it is overly simplistic. And we’re very concerned about commercialization.

Also, we don’t want to see a return to an enforcement-heavy policy that throws everybody behind bars or saddles young people, especially, with criminal records that prevent them from getting a job or being able to access public benefits or being able to go to school. We want to see people given another chance. But we also want to see this treated as a health issue, and you don’t treat marijuana as a health issue by ignoring it or facilitating its use. You do brief interventions if they’re needed, treatment if it’s needed. I don’t think everyone who uses marijuana needs treatment, just like everyone who drinks or uses other drugs doesn’t need treatment. But some people are using it in a way that is problematic, and they need an early intervention, perhaps, to prevent them from moving on to a substance-use disorder — or they need more intense treatment. It really just depends.

We also want to see research into components of marijuana that may have therapeutic value. We don’t want to see people needlessly suffering. But if Perdue Pharma or Pfizer said tomorrow that they have a new blockbuster drug but they don’t want it to go through the FDA and instead want to put it up to a vote, we’d be up in arms. And rightfully so. Everybody would be up in arms. And we don’t think marijuana should get a free pass because there are stories of it helping people. I don’t doubt that it helps some people — things like cannabidiol oil, etc., or even smoking marijuana to relieve pain. I don’t doubt that it helps some people. But we don’t want to turn back the clock to pre-FDA days, where we had snake-oil salesmen and wild claims about drugs. We want to put it through the same system, and if that system is problematic and difficult, then let’s look at what those barriers are and resolve them.

So I think we are a sensible organization that takes our cues from science. That’s why, on our board, you don’t see people benefiting from the policy position that we take. If anything, people like the doctors from Boston Children’s Hospital who are on our advisory board, or Harvard professors, they’re going to have more business if marijuana is legal, because they’re going to have people with more problems. We’re working counter to their self-benefit, if you think about it. That’s why we’re led by the science. And the reason we started this…. I left the White House and saw there was a huge disconnect between the public’s understanding of marijuana and what was being told to them by various sources, and we’re trying to bridge that gap. Many of the things you just touched upon are on the four items in the “What We Do” section of your website. But some things, such as “To promote research on marijuana in order to obtain FDA-approved, pharmacy-based cannabis medications,” we don’t hear your organization talking about very often. Is that the fault of the media, because they’re only focusing on the legalization-is-bad angle? Are you giving equal weight to some of these other goals?

I think that’s just people looking through the glasses they want to look through. I think the legalization groups are threatened by a sensible organization led by Harvard doctors that doesn’t want to put people in prison, so they want to paint us as the most irrational dinosaurs from the Stone Age on these issues. The reality is, we spend a lot of our time on all of these issues. In fact, we have released the most comprehensive document that any policy organization has released, I think, on the hurdles of medical marijuana research. That’s right on our website — the six-point plan. And we’ve also done a CBD guide — everything you need to know about CBD. After the guide to everything you need to know about CBD, we did a report on research barriers, and we got a lot of people from both extremes that didn’t like it. John Walters, my former boss, wrote a scathing editorial, saying we were off the mark in calling for more research. When we get criticized from multiple angles, I think people can decide for themselves whether that’s credible or not….

It’s just not sexy, though. I can’t remember the last time that someone from USA Today or Huffington Post said, “Oh, we want to cover the fact that you released a wonky policy document aimed at FDA senior scientists with ten letters after their name.” They’re not banging on the door to get that story. Instead, they’re banging on the door to say, “The governor of Nevada has just declared a state of emergency on pot. What do you think?”

I’m not going to say it’s the fault of the media. I think that’s overused these days. But we’re doing our best, and whether it’s noticed by USA Today or the Huffington Post or the Washington Post or not, that doesn’t matter as much. We’re getting it out there, and I know that hundreds of lawmakers have read it. In fact, three out of our six recommendations have been adopted since we released that report. I don’t think we’re the only reason they’ve been adopted, but I think us pushing and prodding and putting it down on paper gave some political cover to some people who may not have supported it in the past, and I’m very proud of that. I know it doesn’t satisfy Medical Marijuana Inc. or these hundreds of CBD manufacturers who are selling God knows what because they don’t get it looked at by the FDA; they’re not going to be happy about that. But I think the science speaks for itself, and scientists and others have noticed. That’s why they’ve asked to join my advisory board — top researchers who want to be part of this team not because we’re zealots, but because we look at the science and are able to get it out there….

Another of the talking points on your website says, “Alcohol is legal. Why shouldn’t marijuana be legal?” How do you answer that question?

To me, saying, “Alcohol is bad and it’s legal, so why shouldn’t marijuana be legal?” is like saying, “My headlights are broken, so why don’t we break the taillights, too?” It doesn’t make much sense. First of all, alcohol and marijuana are apples and oranges in many ways. They’re different just because of their biology and their pharmacology, but they’re also different in their cultural acceptance and prevalence in Western society. Alcohol has been a fixed part in Western civilization since before the Old Testament. The reason alcohol prohibition didn’t work — and that’s debatable….

What’s the debate?

If you look at scholars who studied Prohibition much more than I have, there is a vigorous debate. Alcohol use fell during Prohibition, harm fell as well. Cirrhosis of the liver, which is a top-ten killer of white men, wasn’t a top-ten killer. Organized crime had been in place, and obviously it was strengthened from Prohibition, although it isn’t like it caused it, and it certainly didn’t go away when Prohibition ended…. But it’s very difficult to prohibit something that 60 to 70 percent of the population are doing on a regular basis. Marijuana is still used by fewer than 10 percent of the population monthly, and so the idea that it’s the same in terms of acceptance is wrong. Right now, those 10 percent of users have convinced 55 percent of Americans that this is a good idea.  HOW

That also points to the fact that I think support for marijuana is very soft. I think the industry has overplayed its hand about things like public nuisance, public use, secondhand smoke, car crashes. Once these things become greater in prevalence, which they inevitably will if more states legalize and commercialize, then I think you’re going to have the backlash I think will come, and it will come because of the increased problems….

Alcohol is such an accepted part of society. We accept the negative consequences. Alcohol is not legal because it’s safe. Alcohol isn’t legal because it’s so good for you. Alcohol is legal because it’s been a fixed part of Western civilization for millennia. Marijuana has not been. Of course it was used thousands of years ago. Was it used by certain cultures? Absolutely. But there’s no comparison, complete apples and oranges, when it comes to alcohol’s culture acceptability. So that’s why alcohol is legal — not because we love the effects it has on society. No parent, no teacher, no police officer, says, “I’d be better if I was drinking all the time.” No police officer says, “Man, I wish more people drank.” No parent says, “I wish my kid drank more.” That’s not why it’s legal, because it’s so great.

And alcohol has done very little for our tax base. One of the reasons Prohibition was repealed was because the industrialists were convinced that it would help eliminate or mitigate the corporate tax or even the personal income tax. That’s laughable today. It doesn’t do that at all. Instead it costs us way more money than any revenue we bring in. I think marijuana would be the same story. It affects our bodies differently.

Alcohol affects the liver, marijuana affects the lungs. Alcohol is in and out of your system quite rapidly, but marijuana lingers in the system longer, and according to studies, the effects also linger for longer. They affect different parts of the brain. So they’re different in many ways, but in some respects, they’re the same. They’re both intoxicants, and unlike tobacco, they specifically cause changes in behavior. And that’s a difference with tobacco, another legal drug. Tobacco isn’t correlated with paranoia or obsessiveness or mental illness and car crashes, and obviously, marijuana is.

In some ways, legal drugs offer an interesting example. I think they offer an example of the sort of social and financial consequences that would come with legalizing other drugs.

Source:  http://www.westword.com  14th August 2017

Just a few miles from where President Trump will address his blue-collar base here Tuesday night, exactly the kind of middle-class factory jobs he has vowed to bring back from overseas are going begging.

It’s not that local workers lack the skills for these positions, many of which do not even require a high school diploma but pay $15 to $25 an hour and offer full benefits. Rather, the problem is that too many applicants — nearly half, in some cases — fail a drug test.

The fallout is not limited to the workers or their immediate families. Each quarter, Columbiana Boiler, a local company, forgoes roughly $200,000 worth of orders for its galvanized containers and kettles because of the manpower shortage, it says, with foreign rivals picking up the slack.

“Our main competitor in Germany can get things done more quickly because they have a better labor pool,” said Michael J. Sherwin, chief executive of the 123-year-old manufacturer. “We are always looking for people and have standard ads at all times, but at least 25 percent fail the drug tests.”

Source:   https://mobile.nytimes.com/2017/07/24/business/economy/drug-test-labor-hiring.html

Filed under: Addiction,Economic,USA :

A string of recent deaths in New Zealand is being attributed to the rise of so-called synthetic cannabis is made to look like normal cannabis

A man in his 20s died on Tuesday night, bringing the number of fatalities this month linked to the illegal substance to eight.  The drug consists of dried plants sprayed with synthetic drugs – it triggers effects similar to cannabis but is more powerful and dangerous.  Synthetic cannabis has already caused huge concerns in the US and Europe.

In each of the eight deaths this month, the victim was thought to have used the drug before dying or was found with the drug on them.  The actual substance in the drug responsible for the deaths is not yet known.

All eight deaths have occurred in Auckland and authorities say there is a much higher number of non-fatal cases where people had to be taken to hospital.

Earlier this month, the Auckland City District Police issued a warning on Facebook over the drug use and the apparent link to the rising number of victims.

“This is not an issue unique to Auckland,” the statement warned. “Police are also concerned at the impact of synthetic cannabis in other communities in New Zealand.”

Auckland police also took the rare step of releasing CCTV footage of a man violently ill and barely able to stand after smoking synthetic cannabis.

“We have grave concerns as users don’t know what poisonous chemicals they are potentially putting into their bodies when they’re smoking this drug,” Det Insp Lendrum said.

 

What is synthetic cannabis?

§ Actual cannabis contains an active ingredient which interacts with certain receptors in the brain.

§ Synthetic cannabis is dried plant matter sprayed with chemicals that interact with the same receptors.

§ Produced and sold illegally, the chemicals used vary a lot. That means the effect of the drug is a lot less predictable, so a lot more dangerous.

§ Effects can be extreme, including increased heart rates, seizures, psychosis, kidney failure and strokes.

Cannabis-simulating substances – or synthetic cannabinoids – were developed more than 20 years ago in the US for testing on animals as part of a brain research programme.  But in the last decade or so they’ve become widely available to the public.

In the UK, synthetic cannabis was also temporarily legal, being sold under a variety of names most prominently Spice and Black Mamba.  The drugs were banned in 2016 but continue to cause widespread problems in the country.

Synthetic cannabis has also been banned in the US but continues to be widely available as an illegal drug.

Source:   http://www.bbc.co.uk/news/world-asia-40724390      26 July 2017

Legalizing marijuana not only harms public health and safety, it places a significant strain on local economies and weakens the ability of the American workforce to compete in an increasingly global marketplace.

Today, a growing class of well-heeled lobbyists intent on commercializing marijuana are doing everything they can to sell legal weed as a panacea for every contemporary challenge we face in America. Over the past several years we’ve been barraged by claims that legal pot can cure the opioid crisis, cure cancer, eliminate international drug cartels, and even solve climate change.

One seemingly compelling case made by special interest groups is that legal marijuana can boost our economy too: after all, marijuana businesses create jobs and bring in millions of dollars in much-needed tax revenue.

Yet, a closer look at the facts reveals a starkly different reality. The truth is, a commercial market for marijuana not only harms public health and safety, it also places a significant strain on local economies and weakens the ability of the American workforce to compete in an increasingly global marketplace.

We already know that drug use costs our economy hundreds of millions of dollars a year in public health and safety costs. The last comprehensive study to look at costs of drugs in society found that drug use cost taxpayers more than $193 billion – due to lost work productivity, health care costs, and higher crime. A new study out of Canada found that marijuana-impaired driving alone costs more than $1 billion. Laws commercializing marijuana only make this problem worse and hamper local communities’ ability to deal with the health and safety fallout of increased drug use.

“So far in Colorado, marijuana taxes have failed to shore up state budget shortfalls. The budget deficit there doubled in the last few years, despite claims that pot taxes could turn deficit into surplus.”

This isn’t just a theory – it’s already happening. As marijuana use has increased in states that have legalized it, so has use by employees, both on and off the job. Large businesses in Colorado now state that after legalization they have had to hire out-of-state residents in order to find employees that can pass a pre-employment drug screen, particularly for safety-sensitive jobs like bus drivers, train operators, and pilots.

And now drug using employees – supported by special interest groups – are organizing to make drug use a “right” despite the negative impacts we know it will have on employers and the companies that hire them.

And what about that promised tax revenue? So far in Colorado, marijuana taxes have failed to shore up state budget shortfalls. The budget deficit there doubled in the last few years, despite claims that pot taxes could turn deficit into surplus.

Collected pot taxes only comprise a tiny fraction of the Colorado state budget— less than one percent. After costs of enforcement and regulation are subtracted, the remaining revenue used for public good is very limited.

Even viewed solely in the context of Colorado’s educational needs, pot revenue is not newsworthy. The Colorado Department of Education indicates their schools require about $18 billion in capital construction funds alone. Marijuana taxes do not even make a dent in this gap.

In Washington State, half of the $42 million of marijuana tax money legalization advocates promised would reach prevention programs and schools by 2016 never materialized. We’ve seen this movie before: witness our experience with gambling, the lottery, and other vices.

We should also care about the human fallout of increased marijuana acceptance. Recent evidence demonstrates that today’s marijuana isn’t the weed of the 1960s. It is addictive and harmful to the human brain, especially when used by adolescents.

Moreover, in states that have already legalized the drug, there has been an increase in drugged driving crashes and youth marijuana use. States that have legalized marijuana also continue to see a thriving black market, and are experiencing a continued rise in alcohol sales despite arguing users will switch to a “safer” drug.

Over the past several months, the Trump Administration has signaled it is considering a crackdown on marijuana in states where it is legal. We don’t yet know what this policy change may look like, but one thing we know for sure is that incarcerating low-level, nonviolent offenders in federal prisons is not the answer. Individual users need incentives to encourage them to make healthy decisions, not handcuffs.

But we do need to enforce federal law. Indeed, by reasserting federal control over the exploding marijuana industry, we know we can make a positive difference in preventing the commercialization of a drug that will put profits over public health and fight every regulation proposed to control its sale and use. Marijuana addiction is real, and simply ignoring this health condition will only cost us down the road. We should assess marijuana users for drug use disorders as well as mental health problems, and assist those into recovery. This can’t happen in a climate that promotes use.

Source:  http://www.cnbc.com/2017/07/27/trump-should-crackdown-on-legal-weed-commentary.html

Introduction  

On 31 July 2017 a court case commences in the Pretoria High Court about the constitutional legality of South Africa’s dagga legislation. The media is calling it the “Trial of the Plant”.

What is the “Trial of the Plant” about?

It is about the dagga plant and its prohibition in our society. Scientists have long since proven that the dagga plant is highly complex and dangerous and must be prohibited, but some believe it is not dangerous and even medicinal.

What does the law in SA say about dagga?

Except for medical and research exemptions, the possession, use, cultivation, transportation and distribution of dagga is criminalised in terms of the Drugs and drug trafficking act as well as the Medicines and related substances act.

Was the law not settled by the Constitutional court in 2002?

In 2002 a Rastafarian brought a case to the Constitutional Court about Dagga where he complained that the law prevented him smoking dagga as a religious observance and this violated his rights to religious freedom.

The court accepted that a Rastafarian’s religious rights were violated but dismissed the case as there is no objective way for law enforcement officials to distinguish between the possession or use of cannabis for religious or for recreational purposes.

The trial of the plant will in all likelihood be the final decider.

Why is that?

Because the Trial of the Plant will be the first and only case where there will be oral evidence given and tested, in the witness stand.

These other cases were fought and decided on affidavit evidence in a day or two.

The trial of the plant is very different and will take many days in court starting on 31 July and continuing through the month of August.

There are three legal teams comprising 6 attorneys, 11 advocates, 16 expert witnesses and as many as 12 other witnesses.  The trial will probably be recorded by the media and will also probably go all the way to the Constitutional Court to be finally decided.

DFL’s lead counsel is Adv Reg Willis instructed by the University of Pretoria Law Clinic.

How did this case start?

In 2010 a couple were arrested with approximately R500 000.00 worth of dagga in their home. They became known as the dagga couple.

To avoid prosecution they obtained an interdict in the Pretoria High Court against their prosecution, pending the outcome of a case to declare that all the SA dagga legislation is unconstitutional.

The case is against various government departments and against Doctors for Life International.

DFL joined this case to be of assistance to the State.

So for example DFL will lead the evidence of Harvard Professor Bertha Madras who is one of the foremost authorities on cannabis in the world. She contends that the legalisation of cannabis has to be resisted in the interests of the human brain.

Who is Doctors for Life and what does it do?

DFL is a non-profit relief and civil society organisation of doctors who care and give voluntarily of their own time and money to the many needs of the poor.

DFL serve the needs of the underprivileged communities they serve in South Africa and Southern Africa.  DFL also has an extensive track record of being involved in public interest cases predominantly as a friend of the court, especially to assist with scientific and similar evidence.

So then how is the dagga couple funding their case?

The dagga couple dragged the case out for some years, while they raised money.  They started an organisation called “Fields of Green for All” “FOGFA” which now has over 45000 supporters who are funding the case.

How important is this case for South Africa?

Given the role of dagga in crime, women and child abuse and the future of our youth, this trial is one of the most important to ever reach our courts.  If the dagga couple win their case as they want to, there will be no restriction on the possession, consumption, cultivation, transportation and distribution of cannabis.  A free for all.

Read our dagga court case press releases and more info on cannabis Media Release: High Court Blunders into Dagga Minefield

Source:  Letter from Johan Claassen  www.doctorsforlife.co.za) sent to Drugwatch International  27th July 2017

A new study provides credible evidence that marijuana legalization will lead to decreased academic success. (Elaine Thompson/AP)

The most rigorous study yet of the effects of marijuana legalization has identified a disturbing result: College students with access to recreational cannabis on average earn worse grades and fail classes at a higher rate. Economists Olivier Marie and Ulf Zölitz took advantage of a decision by Maastricht, a city in the Netherlands, to change the rules for “cannabis cafes,” which legally sell recreational marijuana. Because Maastricht is very close to the border of multiple European countries (Belgium, France and Germany), drug tourism was posing difficulties for the city. Hoping to address this, the city barred noncitizens of the Netherlands from buying from the cafes.

This policy change created an intriguing natural experiment at Maastricht University, because students there from neighboring countries suddenly were unable to access legal pot, while students from the Netherlands continued.

The research on more than 4,000 students, published in the Review of Economic Studies, found that those who lost access to legal marijuana showed substantial improvement in their grades. Specifically, those banned from cannabis cafes had a more than 5 percent increase in their odds of passing their courses. Low performing students benefited even more, which the researchers noted is particularly important because these students are at high-risk of dropping out. The researchers attribute their results to the students who were denied legal access to marijuana being less likely to use it and to suffer cognitive impairments (e.g., in concentration and memory) as a result.

Other studies have tried to estimate the impact of marijuana legalization by studying those U.S. states that legalized medicinal or recreational marijuana. But marijuana policy researcher Rosalie Pacula of RAND Corporation noted that the Maastricht study provide evidence that “is much better than anything done so far in the United States.”

States differ in countless ways that are hard for researchers to adjust for in their data analysis, but the Maastricht study examined similar people in the same location — some of them even side by side in the same classrooms — making it easier to isolate the effect of marijuana legalization. Also, Pacula pointed out that since voters in U.S. states are the ones who approve marijuana legalization, it creates a chicken and egg problem for researchers (i.e. does legalization make people smoke more pot, or do pot smokers tend to vote for legalization?). This methodological problem was resolved in the Maastricht study because the marijuana policy change was imposed without input from those whom it affected.

Although this is the strongest study to date on how people are affected by marijuana legalization, no research can ultimately tell us whether legalization is a good or bad decision: That’s a political question and not a scientific one. But what the Maastricht study can do is provides highly credible evidence that marijuana legalization will lead to decreased academic success — perhaps particularly so for struggling students — and that is a concern that both proponents and opponents of legalization should keep in mind.

Source:https://www.washingtonpost.com/news/wonk/wp/2017/07/25/these-       college-students-lost-access-to-legal-pot-and-started-getting-better-grades/?   

As the U.S. is facing its most challenging drug epidemic in history, the need to prevent adolescence drug misuse is imperative. For the past two years, Mentor Foundation USA and George Washington University have piloted an innovative drug prevention peer-to-peer initiative at three high schools in Columbia County, NY. The program, which engages youth through social media is showing some promising results in terms of shifts in attitudes towards drugs and intent to use.

The interactive “multi-media” initiative is called Living the Example (LTE), a program that incorporates messages for prevention specifically designed to counteract the misinformation adolescents have about drugs and alcohol.  Messages are framed to promote the benefits of prevention behaviors. “This approach to branding, an alternative, healthy behavior, or ‘counter-marketing’ as it has been termed in tobacco control, has been highly effective and is recognized as one of the main elements in successful prevention programs, such as in tobacco control,” says Principal Investigator, Dr. Doug Evans, a pioneer in the use of this strategy. Dr. Evans is a Professor of Prevention and Community Health & Global Health, with Milken Institute School of Public Health at George Washington University.

Youth Ambassadors are trained to create LTE branded prevention messages, disseminate them via social media platforms, and engage peers in their preferred social networks, with the intention of increasing peer interaction around the brand’s core messaging.  Positive receptivity to LTE messages was associated with some evidence of reduced self-reported drug use intentions, specifically for marijuana use, and reports of intent to use any drug. Among youth who reported exposure and receptivity to LTE, they reported a significant decrease in marijuana use intentions. The most common overall reason for drug use among all respondents was family stress (81.3%), boredom (40%) and academic stress (40%).

“Findings from the study suggest that peer-to-peer substance use prevention via social media is a promising strategy, especially given the low cost and low burden as an intervention channel, which schools, communities, and prevention programs can use as an approach, even in low resource settings,” says Michaela Pratt, President of Mentor Foundation USA. “Through our international network, Mentor Foundation shares over 20 years of global experience in best prevention practices, and Mentor Foundation USA has always been a pioneer in empowering young people to become their own advocates for drug prevention.”

This program was generously supported by The Conrad N. Hilton Foundation, Rip Van Winkle Foundation, among local foundations in Columbia County. Mentor Foundation USA is a member affiliate of Mentor International, which was founded in 1994 by Her Majesty Queen Silvia of Sweden and the World Health Organization and is the largest network of its kind for evidence based programs that prevent drug abuse among youth. Collectively, Mentor has implemented projects in over 80 countries impacting more than 6 million youth.  Mentor Foundation USA is a Delaware registered 501(c)3 non-profit organization.

SOURCE http://www.prnewswire.com/news-releases/200-dc-high-school-students-shatter-the-myths-around-substance-abuse-in-an-innovative-proven

Blue Cross Blue Shield issued a report on the opioid crisis with their data from all members in their commercial plans.  Early in the document, they report a pair of striking numbers.

First, that 21% of members filled a prescription for an opioid in 2015. I’ve heard these kinds of numbers before, but I never get numb. That’s 1 in 5 members, despite growing attention to excessive prescribing of opioids.

Second, a 493% increase in diagnosis of opioid use disorders over 7 years. My reaction is that this has to reflect changes in coding or diagnostic practices rather than the population. It’s implausible that there was an increase this large in the number of people with an opioid use disorder.

The document then devotes a great deal of attention to opioid prescribing.

Toward the end, there are a couple of graphics that caught my attention.

First, a map showing rates of opioid use disorders.

 

Then, this:

Though critical to treating opioid use disorder, the use of medication-assisted treatments (e.g., methadone) does not always track with rates of opioid use disorder (compare Exhibits 10 and 11). For example, New England leads the nation in use of medication-assisted treatments but it has lower levels of opioid use disorder than other parts of the country

 

So . . . they note that New England has average rates of opioid use disorders, yet they have high rates of utilization of medication-assisted treatment. This caught my attention because New England has higher rates of overdose, as depicted in the CDC graphics below.

Number and age-adjusted rates of drug overdose deaths by state, US 2015

 

Statistically significant drug overdose death rate increase from 2014 to 2015, US states

(It’s worth noting that BCBS is not among the top 3 insurers in Maine or New Hampshire, but they are the biggest in Massachusetts and Vermont.)

It begs questions about what the story is, doesn’t it?

I don’t presume to know the answers.

§ What was the sequence of events for the high OD rates and the utilization of MAT? And, what impact, if any, has the expansion of MAT had on overdose rates?

§ Is the BCBS data representative? (This brand new SAMHSA report suggest that the data about use is representative.)

§ We know that opioid maintenance meds reduce risk of OD, but we also know that people stop taking these meds at high rates. Does this imply that, in the real world, these meds end up providing less OD protection than hoped?

§ What are the policies and practices of the other insurers in the state?  (For example, we know that Anthem [the largest insurer in Maine and Vermont] recently ended prior authorization requirements for MAT. It’s not clear how restrictive they had been. They also are attempting to institute reformsto address the fact that, “only about 16 to 19 percent of the members taking the medications for opioid use disorder also were getting the recommended in-person counseling.”)

§ Are there regional differences in drug potency that explain this?

Let’s hope that more insurers follow suit and share their data.

Source:   https://addictionandrecoverynews.wordpress.com/2017/07/16/blue-cross-blue-shield-publishes-major-opioid-report/

A study by researchers from the Murdoch Children’s Research Institute (MCRI) that followed a sample of almost 2000 Victorian school children from the age of 14 until the age of 35 found that social disadvantage, anxiety, and licit and illicit substance use (in particular cannabis), were all more common in participants who had reported self-harm during adolescence.

The longitudinal study, the Victorian Adolescent Health Cohort Study, was the first in the world to document health-related outcomes in people in their 30s who had self-harmed during their adolescence. Until now, very little has been known about the longer-term health and social outcomes of adolescents who self-harm.

Published in the new Lancet Child and Adolescent Health journal, the study found the following common elements:

· People who self-harmed as teenagers were more than twice as likely to be weekly cannabis users at age 35

· Anxiety, drug use, and social disadvantage were more common at age 35 among participants who had self-harmed during their teenage years. While most of these associations can be explained by things like mental health problems during adolescence and substance use during adolescence, adolescent self-harm was strongly and independently associated with using cannabis on a weekly basis at age 35 years

· Self-harm during the adolescent years is a marker for distress and not just a ‘passing phase’

The findings suggest that adolescents who self-harm are more likely to experience a wide range of psychosocial problems later in life, said the study’s lead author, Dr Rohan Borschmann from MCRI. “Adolescent self-harm should be viewed as a conspicuous marker of emotional and behavioural problems that are associated with poor life outcomes,” Dr Borschmann said.

The study found that anxiety, drug use, and social disadvantage were more common at age 35 among participants who had self-harmed during their teenage years. “While most of this can be explained partly by things like mental healthduring adolescence and substance use during adolescence, adolescent self-harm was strongly and independently associated with using cannabis on a weekly basis at age 35 years,” Dr Borschmann said.

Interventions during adolescence which address multiple risk-taking behaviours are likely to be more successful in helping this vulnerable group adjust to adult life.

More information: Rohan Borschmann et al. 20-year outcomes in adolescents who self-harm: a population-based cohort study, The Lancet Child & Adolescent Health (2017). DOI: 10.1016/S2352-4642(17)30007-X

Source:  https://medicalxpress.com/news/2017-07-twenty-year-outcomes-adolescents-self-harm-substance.htm

Canada’s Liberal government has stated that marijuana will be decriminalized by July 2018. This means the removal, or at the least, a lessening of laws and restrictions related to marijuana use and associated pot services.

While people on both sides of the debate have strongly held and differing opinions, the protection of youth is an area of agreement.

Marijuana, also known as cannabis, has been illegal in Canada for close to 100 years. Marijuana can’t be produced, sold or even possessed. If caught, one faces fines, jail time or both.

Despite this, Canada has one of the highest rates of cannabis use in the world. Over 40 per cent of Canadians have used cannabis during their lifetime. Furthermore, studies conducted by Health Canada indicate that between 10.2 and 12.2 per cent of Canadians use cannabis at least once a year.

As changes in cannabis regulation occur, new research has been conducted. The findings are, in a word, alarming. According to published research, someone who uses marijuana regularly has, on average, less grey matter in the orbital frontal cortex of the brain. Other research has found increasing evidence of a link between pot and schizophrenia symptoms.

A major factor is the potency of cannabis, which has gone through the roof for the last two decades. In the 1960s, THC levels were reported to have been in the one-to-four-per-cent range. Research reported in the science journal, Live Science, in 21014 indicates that marijuana’s main psychoactive ingredient, THC, in random marijuana samples, rose from about four per cent in 1995 to about 12 per cent in 2014. In a more-recent article, the leader of the American Chemical Society stated: “We’ve seen potency values close to 30-per-cent THC, which is huge.”

Despite these clear and increasing dangers, the Government of Canada’s stated objective is to “legalize, strictly regulate and restrict access to cannabis for non-medical purposes.” Unfortunately, the government’s approach has serious flaws.  Most importantly, their approach lacks protections for youth, despite this being another specifically stated objective of the Canadian government’s new law.

While supporters of cannabis often compare it with alcohol, a legal, but carefully controlled substance in Canada, there is an important difference. Cannabis is commonly consumed by smoking, which leads to significant, second-hand affects and, as a result, second-hand structural changes in the brain.

In my neighbourhood, cannabis-users in one house, taking advantage of the decreasing legal response to cannabis in B.C. these days, happily smoke the substance on their back deck, only to have the blue smoke waft across to the trampoline next door, where my younger brother and his friends often play.

The government’s proposed new policy actually encourages youth exposure by making it legal for citizens to grow cannabis in their homes. There is no mention of the protection of children living in those residences, where cannabis is grown, consumed and potentially sold.

The Canadian Association of Chiefs of Police makes this point well. They warn that allowing home-grown cultivation will fuel the cannabis black market and that the four-plant limit proposed under the legislation is impossible to enforce. The chiefs further note that home cultivation is a direct contradiction to the government’s promise to create a highly regulated environment that minimizes youth access to the drug.

The biggest concern that the youth of Canada should have about the government’s approach to decriminalization is, however, drug quality — potentially with deadly results. The opportunity for tampering is obvious. A high school friend and classmate of mine casually uses cannabis and landed in the hospital for a few weeks. She believes that some of the cannabis she used was laced with another substance. I often wonder how close my friend came to dying like another of our fellow students at New Westminster Secondary School.

Canada isn’t ready for the decriminalization of cannabis. The Canadian government, and our health-care and legal systems, aren’t fully prepared for the problems and long-term effects that’ll have serious consequences for our youth. Important issues, including second-hand effects and basic safety, not to mention enforcement and legal implications, have yet to be fully defined and planned for. The federal government’s plan to decriminalize pot, as it stands now, doesn’t provide enough protection for Canada’s young people.

Mitchell Moir is a Grade 12 student at New Westminster Secondary.

Source:  http://vancouversun.com/opinion/op-ed/opinion-proposed-cannabis-policy-doesnt-do-enough-to-protect-youth   23rd June 2017

 

In the first 5 months of this year,  nine children had been treated at the Colorado Children’s Hospital in Aurora for ingesting marijuana.  Seven of these children were in intensive care.    By August, at least 3 more children had been in emergency treatment for marijuana at the same hospital.

The first stores for recreational marijuana opened in January, 2014.  Marijuana overdoses in children began October, 2009, when medical marijuana suddenly exploded in Colorado.  There were no such incidences recorded between 2005 and 2009, according to Dr.George Wang, head of emergency services at Colorado Children’s Hospital.  He explained the problem in a Colorado Public Radio interview last year.   Colorado’s medical marijuana was approved by voters in 2000, but the expansion of medical marijuana in 2009 caused the new problem.  The pace doubled this year, as a commercialized marijuana industry started selling new products.  “Legalizing creates greater promotion…. and also legitimizes the drug,” according to Bob Doyle, who was featured in a video we shared.

In response to two deaths from edible marijuana, the governor signed legislation to regulate marijuana in May.  The laws will go into effect in 2016.  Edible pot will require child-proofing, as is required for pharmaceutical and over-the-the-counter medicine.

Despite labels, many of the children who have been hospitalized were too young to read.

A TV investigation showed that most children can’t tell the difference between the “adult candies” and those that are only for children.  Previously, we published pictures of commercial pot candies available in Colorado, and in California.  Here’s an additional sampling.

Even when parents try to keep it away from them, children go for sweets.  Cartoon-like characters and bright colors will always attract children.   It’s logical that school-age children could be so attracted to the packaging that they would not bother to read.

Both the manufacturing of marijuana sweets and the packaging make them so appealing.  Edible pot processors make products that closely imitate familiar products, like Cap’N Crunch cereal and Pop Tarts. One company’s Pot-tarts are hard to distinguish from Kellogg’s Pop-tarts.

The Hershey Co. has filed a trademark infringement lawsuit against Tincture Belle, a Colorado marijuana edibles company, claiming it makes four pot-infused candies that too closely resemble iconic products of the chocolate maker.

The specific products which mimic the look of Hershey’s candies are: Ganja Joy, like Almond Joy; Hasheath, which looks like Heath Bars; Hashees which resemble Reese’s peanut cups, and Dabby Patty, made to look like York peppermint patties.  The company’s website says its products “diabetic safe and delicious” and helpful with a variety of issues, including pain, headaches and insomnia.

Hershey says the products are packaged in a way that will confuse consumers, including children. The lawsuit alleges that Tincture Belle “creates a genuine safety risk with regard to consumers” who may inadvertently eat them thinking they are ordinary chocolate candy.   Other pot candies that look like Kit Kats, Milky Ways, Nestle’s Crunch and Butterfingers.  Will other candy companies like Nestles or Mars file a lawsuits, also?

Source:  http://www.poppot.org/2014/08/24/new-marijuana-candy-tricks-kids/

Today’s Reality

Even if you smoked pot 20+ years ago without harm, today’s situation is different.  We want our children to avoid marijuana because they care about the risks in marijuana itself.

Here’s the facts for raising your children today:

* Marijuana has been modified since 1994. The THC, which gives the high, is 3-10x stronger in the plants of today.  If a child begins using today’s pot , it’s like to learning to drink with grain alcohol, instead of beer or wine.  Also, youth today frequently use the potent “dabs” “wax” and “budder.”  These are extractions can have 40-80% THC.

* Marijuana is addictive, contrary to a popular myth, particularly with today’s stronger strains of pot.

* In states with medical marijuana, teen usage is much higher than in other states, and many teens who use pot get it from some marijuana cardholders.

* Those who begin in adolescence or their teens, have an addiction rate of 17 percent, as opposed to 9 percent for those who begin using marijuana as an adult. *Emergency Department hospitalizations from marijuana rose from 281,000 to 455,000 between 2004 and 2011, making it 2nd amongst the illegal drugs causing ER treatment.

* Individuals responses to marijuana can be vary greatly, and the potential for paranoia and psychotic reactions are real side effects, omitted in the pot propaganda.

* Marijuana is fat soluble and stays in the body for weeks, which is why some people have flashbacks.

* The  brain, which is 1/3 fat, isn’t fully developed until age 25 or later, and until it is, marijuana can cause irreversible damage.

* Marijuana is not as widely used as alcohol,  6-7% of the adult population, vs.  66% who drink, one reason the comparison doesn’t work. * Marijuana usage causes traffic deaths and it is not safe to combine with driving.

* More teens seek substance abuse treatment for pot than any other legal or illegal substance. * Marijuana is a gateway drug,  because nearly every young person who develops a drug addiction begins with marijuana.  Early pot users such as Robert Downey, Jr. (age 9), and Cameron Douglas  (age 13), prove that the stranglehold of drug addiction lasts for years.

* A multi-year study out of New Zealand, tracking marijuana users and through their mid-30s showed IQs decrease an 6-8 percentage points over time.  Again, we point to the medical studies summarized on this webpage.

* In a recent study, schizophrenics who have used marijuana had an onset of the disease 2-1/2 years earlier than those who did not use marijuana. * Marijuana can trigger psychotic symptoms and/or mental illness, and cognitive decline in youth, more quickly than alcohol, while tobacco does not.

* Since marijuana usage increases the odds of developing a mental illness, expansion of pot will expand mental health treatment needs.

* Efforts to legalize for age 21+  hide the motivation to attract young users and build big profits.  Legal pot mean more young users.

* Marijuana usage is associated with greater risk for testicular cancer in males.

* With universal health care, all of us will pay for the increase in medical care for those needing help from pot abuse.

* The number of pot-related hospitalizations in Colorado accelerated in 2009 and went out of control in the first half of 2014.

* Existing mental health issues, such as ADHD, anxiety and depression, greatly increase the use of drugs for self-medication.

Mental Health, Physical Health Alike

“We cannot promote a comprehensive system of mental health treatment and marijuana legalization, which increases permissiveness for a drug that directly contributes to mental illness,”  states former Congressman Patrick Kennedy, who fought tirelessly on behalf of parity for mental health treatment. Kennedy and policy expert Kevin Sabet promote  Smart Approaches to Marijuana.

* The National Alliance for Mental Illness lists four illegal drugs which cause psychosis: cannabis, LSD, methamphetamine and heroin and two classes of legal drugs, amphetamines and steroids. Pharmaceutical drugs are sold with warnings, while marijuana isn’t.

Sharon Levy, Chairwoman of the American Academy of Paediatrics committee on substance abuse, said “We’re losing the public health battle” and policy is being made by legalization advocates who might be misinformed about marijuana’s dangers.”

Source:  http://www.poppot.org/2016/08/08/latest-child-dangers-marijuana-edibles/

Mass Illness from Marijuana Edibles in San Francisco There’s more potential for overdose from edibles than smoked marijuana, although the teen in Seattle who jumped to his death last December did it after smoking pot for the first time.  Two shocking incidents in California suggest that overdose emergencies will increase if that states vote to legalize marijuana in November.  Here’s a summary of recent cases of toxicity from edibles:

· 19 people were hospitalized in San Francisco on August 7 from THC, after attending a quinceañera party.  The source is believed be marijuana-infused candies, perhaps gummy bears. Several children were among those poisoned, one as young as six.  A 9-year-old had severe difficulty breathing.

· Pot brownies sent a bachelorette party to the emergency room in South Lake Tahoe over the weekend of July 30-31. Eight of the 10 women were admitted to the hospital according to the City of South Lake Tahoe’s website.

· A JAMA Paediatrics article explains the dramatic rise in children’s hospitalizations related to marijuana in Colorado since legalization.  In 10 cases, the product was not in a child-resistant container; in 40 scenarios (34%) there was poor child supervision or product storage.  Edible products were responsible for 51 (52% ) of exposures.  The report claimed that child-resistant packaging has not been as effective in reducing kids’ unintended exposure to pot as hoped.

· The report mentions the death of one child, an 11-month-old baby.  Nine of the children had symptoms so serious that they ended up in the intensive care unit of Colorado Children’s Hospital.  Two children needed breathing tubes.

· The state of Washington has a similar problem with edibles, as reported on the King County Health Department’s website.  From 2013 to May 2015, there were 46 cases of children’s intoxications related to marijuana edibles reported in Washington.  However, reporting is voluntary and the state estimates that number could be much higher.

·  In May, a father plead guilty to deliberately giving his 4-year-old daughter marijuana-laced cake in Vancouver, Washington.  He was sentenced to two years in prison.

Intoxication from marijuana edibles has risen steadily since legalization. Source: King County Department of Health. Top photo: AP

· In Hingham, MA, there was a 911 related to teen girl who ingested marijuana edibles.  The candies were in a package labelled Conscious Creations, which didn’t disclose ingredients.   Massachusetts has a medical marijuana program, but it is not clear how or to whom they were sold or dispensed.

 

· July, 2016: Two California teens were hospitalized after eating a marijuana-laced cookie. The teens reported purchasing the cookie from a third teenager who was subsequently arrested.

· July, 2016: A California man was arrested for giving candy laced with marijuana to a 6-year-old boy and an 8-year-old boy; the 6-year-old was hospitalized for marijuana poisoning.

· July, 2016: Police in Arizona arrested a mother for allegedly giving her 11- and 12-year-old children gummy candy infused with marijuana. Police say the marijuana-infused candy was originally purchased by an Arizona medical marijuana user, but was illegally transferred to the mother in question.  (State medical marijuana programs have poor track records of assuring the “medicine” goes to whom it is intended.)

· On April 27, a Georgia woman was arrested after a 5- year-old said he ate a marijuana cake for breakfast.  The child was taken to the hospital for treatment following the incident; according to officials, his pulse was measured at over 200 beats per minute.

· Last year there were more than 4,000 treatments at hospitals and poison center treatments in the US related to marijuana toxicity in children and teens.

Growth of marijuana edibles intoxication by age. Source: King County, Washington

Edible marijuana poses a “unique problem,” because “no other drug is infused into a palatable and appetizing form” – such as cookies, brownies and candy.    Many household items cause poisonings, but marijuana edibles are different because they’re made to look appealing and they appeal to children.

 

Source:  http://www.poppot.org/2016/08/08/latest-child-dangers-marijuana-e

A volunteer non-partisan coalition of people from across the US and Canada who have come to understand the negative local-to-global public health and safety implications of an organized, legal, freely-traded, commercialized and industrialized marijuana market. Here’s What’s Coming to Your Back Yard — A tour of a Colorado Commercial Marijuana Operation

Our colleague,  Jo McGuire, in Denver was recently asked to accompany a group of delegates from other states investigating commercial marijuana legalization on a tour of the Colorado marijuana industry. Here’s her account of what they observed:

A delegation from out of state came to Denver in late April to see how the Colorado marijuana industry is working. I was asked to help guide the tour and ask questions of the industry leaders.

This was an all-day experience, so I will give you the highlights that stand out to me.

After the delegation heard a bit about my experience and area of expertise in safe & drug free workplaces, we were given a presentation by two officers of the Marijuana Enforcement Division (MED) in Colorado.

They started off the presentation by repeating how utterly impossible it is to regulate marijuana and keep all the rules and know all the enforcement measures they are supposed to follow (these are the people overseeing enforcement for the whole state.) They bragged that they now have 98 people in their office overseeing regulation but later in the day admitted that only 25% of those do on-site inspections statewide (3,000 facilities), the rest are trying to keep up with paperwork.

They cannot get to every site in the state for inspections (again – impossible) so they respond to complaints, spot-check and rely on other community entities to report anything they may find or see. The largest amount of complainants come from other MJ facilities trying to get their competition shut-down.

The greatest violations are: 1. Using pesticides banned in the U.S. 2. Not using the proper inventory tracking system 3. Waste disposal violations 4. Circumventing the required video-monitoring system

They were asked how potency of marijuana is determined and they said, “It is impossible to determine potency.” When challenged – they were adamant that it is not possible.

When asked how their office is paid for (marijuana money? state coffers?) they did not know. (It’s state coffers – I was on the committee.)

After their presentation, we headed to a marijuana grow facility in downtown Denver. You could smell it from a block away. They grow over 600,000 plants at this one location.

Guards with guns let us into the gate and gave us security badges, telling us that no photos were allowed and we would be on-camera at all times, escorted out if we broke any rules.

First we were shown a tray of baby plants with no tags. There is supposed to be a seed-to-sale tracking system. They said, “Well you can’t track every single one, so we track them in batch numbers when they are less than 8 inches high and then they get individual tags after that.” (More on that later).

This facility does not use “seeds” anyway. They clone their grows from mother plants – so their system is completely different.

They ship dirt over from Sri Lanka because the coconut shells are natural fertilizer for marijuana. So they have a huge room that smells like elephant poo with pallets of dirt “squares” stacked 20 feet high. What else is in it? Is it subject to inspection? No one knew. We were told, “If there were harmful bugs, we would find out eventually.”

Into the first state-of-the-art grow room. There were plants labelled “REC” and “MED”. When asked the difference between recreational and medical marijuana the grower said, “The tags and the tax rates.”

There was an environmental researcher on the tour who asked if the …. 6 gallons of water per plant per day …. is being recycled. The grower said they could not possibly store the massive thousands of gallons it would take to recycle the water. The researcher asked if Denver has any plan in place to test the water for contaminants because many contaminants have been found at both legal and illegal grow sites in northern California and the Enforcement Officers said, “We hadn’t really thought about that.”

When asked if they recycle the dirt, the grower said, “No way. My quality of production ensures every plant has fresh dirt.”

(A side note – the researcher told us later that he expects the contaminants from marijuana will impact our communities for generations on a level similar to DDT exposure.) His research is another story for another day.

Next we passed through the processing area where the trimmers, dryers and baggers were working. Employees are mostly young or people who can’t find jobs elsewhere. They used to have to pass a federal background check (no felonies allowed) but the enforcement guys said, “That was too hard, so we don’t have that requirement anymore.”

An employee perk is “highly discounted product“. They make minimum wage with no benefits, but “everyone is happy”. They discourage Work Comp claims (trimmers get carpal tunnel) because “they would melt the drug cup.” He said they have very high employee turn-over. Some were wearing hazard gear and some were not. Some were wearing protective gear and some were not. This owner also keeps his 11 locations under 11 separate LLC’s so that he can maintain “Eleven separate small businesses” so that he is not to subject to requirements that large employers must meet for employee volume.

I saw rolls of un-printed bags and asked how they determine the potency of their weed. This owner voluntarily sends random samples (of each strain) to a 3rd party lab twice a year. When the lab tells him the approximate potency – correct within 4 nanograms – they print their labels according to that potency until the next random sample is sent in.

GET THIS: He has had product labelled at 18% but the next batch came back at 30%. He said that people know it’s a guessing game and you don’t expect accuracy in

the labelling – just that it’s labelled and it may or may not be close. Also – the product in the package doesn’t necessarily have to be what is printed on the label, as long as he is volunteering for the lab spot checks.

Not all facilities submit to the spot checks that regularly. Remember – we are at this particular place because this business owner is cream-of-the-crop. And by the way, ALL products in the state to include edibles are only subject to random spot checks for quality and potency. That having been said, each brand begins with a lab analysis in order to create the initial labels – but once the creation has been approved – they move full steam ahead with mass production, inspection free (unless it’s voluntary quality checks or complaints are filed).

Also – the labs are not state-owned or run. They are independently owned and operated by “other marijuana industry investors” and they just choose who is cheapest and fastest. For quality checks.

Next we went into the drying room and I asked about how he prevents mould. He doesn’t. It happens. They remove it by hand when they find it. (Pesticides to remove it are illegal and lights are ineffective). At one point he took a few of us down a row to see the dried buds in hundreds of rows of trays … where the labels went from individual plants back to mass batches. Why is this important? Voters believe in “seed-to-sale” tracking but no one knows how much one plant will produce. Will it produce 10 buds or 50 buds? 50 buds cannot have “one” label so this goes in batches. How do you know if buds come up missing from the tracking system? You don’t.

As we were asking these questions and I was curious about some of his branding – he speaks in a very low voice to us while we were rows away from the enforcement team. “Listen, you’re safe in my facility because I am the one that follows the rules – thus why you are here, right? But if you go to any other place, don’t touch anything, don’t go near any equipment and be careful of anything that could contaminate you“. This business is filthy, dirty, scummy, underhanded and full of cheaters, liars and the majority of this industry is shady as hell. Just be careful.”

On to the BIG grow room ….

I thought I had seen and heard everything up to this point.

We walked into one of the rooms where mature “plants” (TREES) are growing and I saw buds that were the length of my entire forearm. He said, “That’s nothing, I’ve got some as big as your whole arm!” And these trees have so many of these HUGE, heavy buds, they are drooping down and propped-up with dozens of bamboo sticks. One bud by itself can bring in hundreds of dollars … and the seed-to-sale tracking system has loopholes bigger than the buds.

One of the enforcement officers shared, “Now these are labelled with THC-A … which is not impairing and has no euphoric effect unless and until it’s smoked.” (I am not sure what comment to place here … but imagine every policy maker outside of our state getting this “sell”.)

I asked a lot of questions to make sure that what I say in my presentations are accurate – I had heard natural marijuana could not grow over 22% – he said he regularly grows it at 33% with no additives. I have been told that I was lying when I said “it is impossible to test every single product that is sold” and this young man laughed and said, “Here is my card, I will go with you and tell them you are right and back you up all the way. If you want them to hear it straight from my mouth – call me.”

Onto the retail store where two ATM’s sit side-by-side in the lobby. This is a cash only business and banking is not allowed, no credit-cards or checks, etc. So the “work-around” is that the Marijuana Facilities take the cash they get from customers and load-up their own ATM’s so electronic transactions go to their separate non-marijuana LLC

and they can deal through the banking system that way. In law enforcement circles this is called money laundering.

The store products ranged from stash devices to pipes and rigs, to intimacy “helpers”, candies, gums, mints and apparel, to a filled syringe and a 90% THC wax product, etc. There are pictures on my FB page … you should check them out.

The store staff are extremely friendly, proud of their work, answer all questions without hesitation and often let slip very damning information without even realizing it’s coming out of their mouth. So interesting.

When we returned to the van, there were people who were stunned to near tears because they truly didn’t believe what they had heard – how it really doesn’t and cannot work successfully, but we are simply doing the best we can at lightning speed. The shock was palpable. Some were extremely angry.

Another interesting tidbit: Colorado just outlawed gummy bears because they are too attractive to children. So we asked what the new rule means for the production of gummy candies. “That’s easy – you can’t use shapes of people, animals or fruit – but vegetables are o.k. because kids hate those and geometric designs are o.k. You know, like Lucky Charms!” They have a year to “sell” all of the candies “attractive to children” before they have to get them off the shelves.

As an aside, I discovered later that evening that I had broken out in hives wherever my skin was exposed and itched terribly for days after this trip.

I know that many other states are “new” to legal pot and if any of your states delegations here for this same tour – PLEASE – make sure I am notified and either I, or one of my colleagues, accompany them. Jo McGuire jo@jomcguire.org

Source:  http://marijuana-policy.org/heres-whats-coming-back-yard-tour-colorado-commercial-marijuana-operation/   2nd July 2017

La Porte, Ind. – Authorities with the La Porte County Sheriff’s Office say 11 teens from Fishers were hospitalized after eating gummy bears laced with THC, an active ingredient found in marijuana.

Police began investigating the incident just before midnight on Thursday after they were dispatched on a medical call to the 5200 N block of CR 325 W.

A 19-year-old male at the scene told a deputy that he became ill after ingesting drugs, and he needed to go to the hospital. He said he was in the area camping with friends, and they also ingested the drugs.

Several more sheriff’s deputies arrived and found 10 other teens that all said they were suffering from a rapid heart rate, pain in their legs, blurred vision, and hallucinations.

According to the sheriff’s office, a deputy determined that they each ate one half of a gummy bear that supposedly contained THC.

Three ambulances arrived at the scene to transport all 11 teens to two local hospitals.

All of the teens were from Fishers, and they are believed to have been staying at a relative’s home. Nine of the teens are 18-years-old and two were 19-years-old; six were males and five were females. Two of the patients were tested and were found to have high levels of THC in their system.

Police are still trying to determine where the teens got the drugs.

Source: http://fox59.com/2017/07/07/police-11-fishers-teens-hospitalized-after-eating-thc-laced-gummy-bears/

Filed under: Social Affairs,USA :

Drinking alcohol during pregnancy could harm not just a woman’s unborn child, but her grandchildren and beyond.

Researchers in the US have found brain abnormalities linked to foetal alcohol spectrum disorder (FASD), at least in mice, can be passed down through the generations.

“Traditionally, prenatal ethanol exposure from maternal consumption of alcohol was thought to solely impact directly exposed offspring, the embryo or foetus in the womb,” says Kelly Huffman from the University of California.

“However, we now have evidence that the effects of prenatal alcohol exposure could persist transgenerationally and negatively impact the next-generations of offspring who were never exposed to alcohol.”

In the experiment, Prof Huffman’s team found the children of mice with FASD also had reduced body weight and brain size, and were more likely to show signs of anxiety and depression. The defects were present in further generations.

“By demonstrating the strong transgenerational effects of prenatal ethanol exposure in a mouse model of FASD, we suggest that FASD may be a heritable condition in humans,” says Prof Huffman.

Babies born with FASD often have intellectual and physical disabilities, behavioural problems and distinct facial features. It is irreversible. A study in 2015 found almost third of Kiwi women continue to drink alcohol during their first trimester, and 11 percent right up until birth. · Concerns over number of women drinking while pregnant

The Ministry of Health says there is no known safe level of drinking, and recommends women abstain from alcohol from the time they decide to have a baby, through conception and the entire pregnancy.

The discovery that FASD affects children who were never exposed to alcohol is a clue to future potential therapies and perhaps even prevention, the researchers say.

The research was published in journal Cerebral Cortex.

Source:  http://www.newshub.co.nz/home/health/2017/07/drinking-alcohol-while-pregnant-harms-kids-for-generations-study.html

Cannabis has recently been legalised in many US states

Cannabis itself is harmful to cardiovascular health and increases the chance of early death regardless of related factors such as smoking tobacco, new research reveals.

Data taken from more than 1,000 US hospitals found that people who used the drug had a 26 per cent higher chance of suffering a stroke than those who did not, and a 10 per cent higher chance of having a heart attack.

The findings held true after taking into account unhealthy factors known to affect many cannabis smokers, such as obesity, alcohol misuse and smoking.

‘This leads us to believe that there is something else going on besides just obesity or diet-related cardiovascular side effects’ Dr Aditi Kalla, Einstein Medical Center, Philadelphia

They indicate there is something intrinsic about cannabis which can damage the proper functioning of the human heart.

“Even when we corrected for known risk factors, we still found a higher rate of both stroke and heart failure in these patients, so that leads us to believe that there is something else going on besides just obesity or diet-related cardiovascular side effects,” said Dr Aditi Kalla, Cardiology Fellow at the Einstein Medical Center in Philadelphia and the study’s lead author.

“It’s important for physicians to know these effects so we can better educate patients.”

Previous research in cell cultures has shown that heart muscle cells have cannabis receptors relevant to contractility, or squeezing ability, suggesting that those receptors might be one mechanism through which marijuana use could affect the cardiovascular system.

The research team analysed more than 20 million records of young and middle-aged patients aged between 18 and 55 who were discharged from 1,000 hospitals in 2009 and 2010, when marijuana use was illegal in most states.

It identified 316,000 patients – 1.5 per cent – where marijuana use was diagnosed in the notes.  Their cardiovascular disease rates were compared to those who shunned the drug.

The research was published yesterday at a meeting of the American College of Cardiology in Washington DC.

Source:  http://www.telegraph.co.uk/science/2017/03/09/cannabis-boosts-risk-stroke-heart-attack-independent-tobacco/  

ABSTRACT

PURPOSE:

Nationwide data have been lacking on drug abuse (DA)-associated mortality. We do not know the degree to which this excess mortality results from the characteristics of drug-abusing individuals or from the effects of DA itself.

METHOD:

DA was assessed from medical, criminal, and prescribed drug registries. Relative pairs discordant for DA were obtained from the Multi-Generation and Twin Registers. Mortality was obtained from the Swedish Mortality registry.

RESULTS:

We examined all individuals born in Sweden 1955-1980 (n = 2,696,253), 75,061 of whom developed DA. The mortality hazard ratio (mHR) (95% CIs) for DA was 11.36 (95% CIs, 11.07-11.66), substantially higher in non-medical (18.15, 17.51-18.82) than medical causes (8.05, 7.77-8.35) and stronger in women (12.13, 11.52-12.77) than in men (11.14, 10.82-11.47). Comorbid smoking and alcohol use disorder explained only a small proportion of the excess DA-associated mortality.

Co-relative analyses demonstrated substantial familial confounding in the DA-mortality association with the strongest direct effects seen in middle and late-middle ages. The mHR was highest for opiate abusers (24.57, 23.46-25.73), followed by sedatives (14.19, 13.11-15.36), cocaine/stimulants (12.01, 11.36-12.69), and cannabis (10.93, 9.94-12.03).

CONCLUSION:

The association between registry-ascertained DA and premature mortality is very strong and results from both non-medical and medical causes. This excess mortality arises both indirectly-from characteristics of drug-abusing persons-and directly from the effects of DA. Excess mortality of opiate abuse was substantially higher than that observed for all other drug classes. These results have implications for interventions seeking to reduce the large burden of DA-associated premature mortality.

Source:  https://www.ncbi.nlm.nih.gov/pubmed/28550519   May 2017

It comes as no surprise that the prevalence of marijuana use has significantly increased over the last decade. With marijuana legal for recreational use in four states and the District of Columbia and for medical use in an additional 31 states, the public perception about marijuana has shifted, with more people reporting that they support legalization. However, there is little public awareness, and close to zero media attention, to the near-doubling of past year marijuana use nationally among adults age 18 and older and the corresponding increase in problems related to its use. Because the addiction rate for marijuana remains stable—with about one in three past year marijuana users experiencing a marijuana use disorder—the total number of Americans with marijuana use disorders also has significantly increased. It is particularly disturbing that the public is unaware of the fact that of all Americans with substance use disorders due to drugs other than alcohol; nearly 60 percent are due to marijuana. That means that more Americans are addicted to marijuana than any other drug, including heroin, cocaine, methamphetamine, and the nonmedical use of prescription drugs.

Stores in Colorado and Washington with commercialized marijuana sell innovative marijuana products offering users record-high levels of THC potency. Enticing forms of marijuana, including hash oil used in discreet vaporizer pens and edibles like cookies, candy and soda are attractive to users of all ages, particularly those underage. The legal marijuana producers are creatively and avidly embracing these new trends in marijuana product development, all of which encourage not only more users but also more intense marijuana use.

Yet despite the expansion of state legal marijuana markets, the illegal market for marijuana remains robust, leaving state regulators two uncomfortable choices: either a ban can be placed on the highest potency—and most enticing—marijuana products which will push the legal market back to products with more moderate levels of THC, or the current evolution to ever-more potent and more attractive products can be considered acceptable despite its considerable negative health and safety consequences. If tighter regulations are the chosen option, the illegal market will continue to exploit the desire of marijuana users to consume more potent and attractive products. If state governments let the market have its way, there will be no limit to the potency of legally marketed addicting marijuana products.

The illegal marijuana market thrives in competition with the legal market by offering products at considerably lower prices because it neither complies with regulations on growth and sale, nor pays taxes on sales or their profits. Unsurprisingly, much of the illegal marijuana in the states with legalized marijuana is diverted from the local legal marijuana supply. It is troubling that in response to the decline in demand for Mexican marijuana, Mexican cartels are increasing the production of heroin, a more lucrative drug.

When alcohol prohibition ended in 1933, bootlegged alcohol gradually and almost completely disappeared. Those who favour drug legalization are confident that the same will occur in the market for drugs; they argue that legalizing drugs will eliminate the illegal market with all its negative characteristics including violence and corruption. The initial experience with marijuana legalization shows that this is dangerous, wishful thinking. Why doesn’t legalization now work for marijuana as it did for alcohol 80 years ago? One obvious reason is that there is little similarity between the bootleg industry of alcohol production that existed during prohibition and contemporary drug trafficking organizations. Today’s illegal drug production and distribution system is deeply entrenched, highly sophisticated, and powerfully globalized. Traffickers are resourceful and able to rapidly to adjust to changes in the market, including competing with legal drugs.

The legalization of marijuana or any other drug is making a bargain with the devil. All drugs of abuse, legal and illegal, including marijuana, produce intense brain reward that users value highly—so highly that they are willing to pay high prices and suffer serious negative consequences for their use. Marijuana users’ brains do not know the difference between legal and illegal marijuana, but, as with other drugs, the brain prefers higher potency products. Drug suppliers, legal and illegal, are eager to provide the drugs that users prefer.

The challenge of drug policy today is to find better ways to reduce drug use by using strategies that are cost-effective and compatible with modern values. Legalization fails this test because it encourages drug use. Most of the costs of drug use are the result of the drug use itself and not from efforts to curb that use. It is hard to imagine a drug user who would be better off with having more drugs available at cheaper prices. Supply matters. More supply means more use. Drug legalization enhances drug supply and reduces social disapproval of drugs.

Our nation must prepare itself for the serious negative consequences both to public health and safety from the growth of marijuana use fuelled by both the legal and the illegal marijuana markets.

Source: http://www.rivermendhealth.com/resources/marijuana-legalization-led-use-addiction-illegal-market-continues-thrive/    June 2017  Author: Robert L. DuPont, M.D.

Cannabis Use, Gender and the Brain

Cannabis is the most widely used illicit drug in the U.S. and, as a result of legalization efforts for both medical remedy and for recreational use, is now the second leading reason (behind alcohol) for admission to addiction treatment in the U.S. The health consequences, cognitive changes, academic performance and numerous neuroadaptations have been debated ad nauseam. Like other drugs and medications, effects are different if exposure occurs in the young vs. the old or in males vs. females. Exposure in utero, early childhood, adolescence-young adult, adult and elderly may have different effects on the brain and outcomes. Yet the best available independent research shows that marijuana use is associated with consistent regionally specific alterations to important brain circuitry in the striatum and pre-frontal and post orbital regions. In this study, Chye and colleagues have investigated the association between marijuana use and the size of specific brain regions that are vitally important in goal-directed behavior, focus and learning within in the orbitol frontal cortex (OFC) and caudate. This investigation suggests that marijuana dependence and recreational use have distinct and region-specific effects.

Why Does This Matter?

This is an important finding, but distinction between cannabis use, abuse and dependence is not always clear, objective, linear or well understood. However, dependence-related medial OFC volume reduction was robust and highly significant. Lateral OFC volume reduction was associated with monthly marijuana use. Greater reductions in brain volume of specific regions were stronger among females who were marijuana dependent. This finding correlates with previous evidence of gender-dependent differences towards the various physiological, behavioral and the reinforcing effect of marijuana for both recreational use and addiction.

The results highlight important neurological distinctions between occasional cannabis use and addiction. Specifically, Chye and colleagues found that smaller medial OFC volume may be driven by marijuana addiction-related mechanisms, while smaller lateral OFC volume may be due to ongoing exposure to cannabinoids. The results highlight a distinction between cannabis use and dependence and warrant future examination of gender-specific effects in studies of marijuana use and dependence.

Source: http://www.rivermendhealth.com/resources/cannabis-use-gender-brain/   June 2017  Author: Mark Gold, MD

Author: Mark Gold, MD

Mortality resulting from opioid use (over 33,000 in 2015) is now epidemic in the U.S., exceeding drug-related deaths from all other intoxicants. Dr. Ted Cicero of Washington University, Dr. William Jacobs, Medical Director of Bluff Plantation, and I discussed the opioid over-prescribing and switch to heroin at DEA Headquarters on November 17, 2015. Things have gone from bad to worse. In a recent JAMA article (March 2017), Dr. Bertha Madras, Professor in the Department of Psychiatry at Harvard Medical School, offers compelling analysis and recommendations to rein in this crisis.

Physicians have increasingly prescribed opioids for pain since the AMA added pain as the “fifth vital sign,” which, like blood pressure, mandated assessment during each patient encounter. As a result of this and acceptance of low-quality evidence touting opioids as a relatively benign remedy for managing both acute and chronic pain, prescriptions for opioids have risen threefold over the past two decades.

Addiction, overdose and mortality resulting directly from opioid misuse increased rapidly. In addition, the influx of cheap heroin, often combined with homemade fentanyl analogues, became increasingly popular as prescription opioids became harder to attain and cost prohibitive on the streets. Consequently, a proportion of prescription opioid misusers transitioned to cheaper, stronger and more dangerous illicit opioids.

Opioid Mortality

The breakdown in mortality was confirmed by surveys (2015) revealing a disproportionate rise in deaths specifically attributable to: fentanyl/analogs (72.2%) and heroin (20.6%) compared with only prescription opioids, at less than eight percent. The unprecedented rise in overdose deaths and association with the heroin trade catalyzed the formation of federal and state policies to reduce supply and increase the availability of treatment and of a life saving opioid antagonist overdose medication Naloxone, a short-acting, mu 1, opioid receptor antagonist. Naloxone quickly reverses the effect of opioids and acute respiratory failure provoked by overdose.

Yet, according to Dr. Madras, the current federal and state response is woefully inadequate. She writes: “Of more than 14,000 drug treatment programs in the United States, some funded by federal block grants to states, many are not staffed with licensed medical practitioners. An integrated medical and behavioral treatment system, under the supervision of a physician and substance abuse specialist, would foster comprehensive services, provide expedient access to prescription medicines, and bring care into alignment with current medical standards of care.”

Why Does This Matter?

As baby boomers age and live longer, chronic non-cancer pain is highly prevalent. Opioids for legitimate non-cancer pain are not misused or abused by most patients under proper medical supervision. Yet there is no effective, practical means in this managed care climate whereby Primary Care Physicians (PCPs) can determine who is at risk for abuse and addiction and who is not. And frankly, addicts lie to their doctors to get opioids. Without proper training, physicians, who genuinely want to help their patients, get in over their heads and don’t know how to respond.

Further complicating the issue is that many of the affordable treatment programs do not employ medical providers who are trained and Board Certified in Addiction and Pain

Medicine, not to mention addiction psychiatry, or addiction medicine physicians. Thus the outcomes are dismal, which fosters doubt and mistrust of treatment.

Lastly, the lack of well-trained providers is due, in part, to the lack of training for medical doctors in addiction and behavioral medicine. At the University of Florida, we developed a mandatory rotation for all medical students in “the Division of Addiction Medicine.” We also started Addiction as a sub-specialty within psychiatry, where residents and post-doctoral fellows were immersed in both classroom and clinical training.

Since 1990, many other similar fellowship programs have started, yet few are training all medical students in the hands-on, two-week clerkship experience in Addiction Medicine like they have in obstetrics. We took this a step further when we developed a jointly run Pain and Addiction Medicine evaluation and treatment program which focused on prevention and non-opioid treatments. Many more are needed, as well as increased CME in addictive disease for physicians in any specialty.

Source:   http://www.rivermendhealth.com/resources/chronic-pain-opioid-use-consequences   June 2017

Today, Dr. Kevin Sabet, president of Smart Approaches to Marijuana (SAM), a national group promoting evidence-based marijuana laws, issued the following statement regarding medical marijuana legislation introduced by Senators Booker (D-NJ) and Gillibrand (D-NY) and Rep. Steve Cohen (D-TN):

“No one wants to deprive chronically ill patients of medication that could be helpful for them, but that’s not what the legislation being introduced today is about. We wouldn’t allow Pfizer to bypass the FDA – why would we let the marijuana industry? This bill would completely undermine the FDA approval process, and encourage the use of marijuana and marijuana products that have not been proven either safe or effective. The FDA approval process should set the standard for smart, safe, and sound healthcare in our country, so we can be sure that patients are receiving the best treatments that do more help than harm,” said SAM President and former senior White House drug policy advisor Kevin Sabet.

“Raw marijuana is not medicine, so marijuana in crude form should not be legal, but the medicinal components properly researched, purified, and dosed should be made available through compassionate research programs, as outlined in SAM’s six-point plan entitled “Researching Marijuana’s Medical Potential Responsibly.” We understand the FDA process can seem cumbersome to those suffering from intractable diseases, but early access programs to drugs in development are already available.

“Also, while FDA approval is the long-term goal, seizure patients shouldn’t have to go to the unregulated market to get products full of contaminants. Responsible legislation that fast-tracks these medications for those truly in need should be supported, rather than diverting patients to an unregulated CBD market proven to be hawking contaminated or mislabeled products as medicine, as this bill would endorse. In 2015 and 2016 the FDA sent multiple warning letters to numerous CBD manufacturers, outlining these concerns. We support the development of FDA-approved CBD medications, like Epidolex, which is in the final stages of approval.”

News media requesting a one-one-one interview with a representative from SAM can contact anisha@learnaboutsam.org.

 About SAM

Smart Approaches to Marijuana (SAM) is a nonpartisan, non-profit alliance of physicians, policy makers, prevention workers, treatment and recovery professionals, scientists, and other concerned citizens opposed to marijuana legalization who want health and scientific evidence to guide marijuana policies. SAM has affiliates in more than 30 states. For more information about marijuana use and its effects, visit http://www.learnaboutsam.org.

Highlights

· •Cannabidiol appears often in Norwegian THC-positive blood samples.

· •Cannabidiol does not appear to protect against THC-induced impairment.

· •Cannabidiol may be detected in blood for more than 2 h after cannabis intake.

· •Hashish has revealed far lower THC/cannabidiol ratios than marijuana in Norway.

Abstract

Background and aims

Several publications have suggested increasing cannabis potency over the last decade, which, together with lower amounts of cannabidiol (CBD), could contribute to an increase in adverse effects after cannabis smoking. Naturalistic studies on tetrahydrocannabinol (THC) and CBD in blood samples are, however, missing. This study aimed to investigate the relationship between THC- and CBD concentrations in blood samples among cannabis users, and to compare cannabinoid concentrations with the outcome of a clinical test of impairment (CTI) and between traffic accidents and non-accident driving under the influence of drugs (DUID)-cases. Assessment of THC- and CBD contents in cannabis seizures was also included.

Methods

THC- and CBD concentrations in blood samples from subjects apprehended in Norway from April 2013–April 2015 were included (n = 6134). A CTI result was compared with analytical findings in cases where only THC and/or CBD were detected (n = 705). THC- and CBD content was measured in 41 cannabis seizures.

Results

Among THC-positive blood samples, 76% also tested positive for CBD. There was a strong correlation between THC- and CBD concentrations in blood samples (Pearson’s r = 0.714, p < 0.0005). Subjects judged as impaired by a CTI had significantly higher THC- (p < 0.001) and CBD (p = 0.008) concentrations compared with not impaired subjects, but after multivariate analyses, impairment could only be related to THC concentration (p = 0.004). Analyzing seizures revealed THC/CBD ratios of 2:1 for hashish and 200:1 for marijuana.

Conclusions

More than ¾ of the blood samples testing positive for THC, among subjects apprehended in Norway, also tested positive for CBD, suggesting frequent consumption of high CBD cannabis products. The simultaneous presence of CBD in blood does, however, not appear to affect THC-induced impairment on a CTI. Seizure sample analysis did not reveal high potency cannabis products, and while CBD content appeared high in hashish, it was almost absent in marijuana.

Source:  http://www.fsijournal.org/article/  July 2017 Volume 276, Pages 12–17

DATE: June 1, 2017

DISTRIBUTION: All First Responders

ANALYST: Ralph Little/904-256-5940

SUBJECT: Grey Death compound in Jacksonville & Florida

NARRATIVE:  The compound opioid known as Grey Death has been detected for the first time in North Florida. Although Purchased in March in St. Augustine, the basic drugs were from Jacksonville and may have been purchased pre-mixed.  Other  samples have occurred from March through May. Delays are due to testing requirements.  Grey Death has been detected in Florida since November 2016 in four counties south of NFHIDTA. Palm Beach reported a related death on May 19th.  Grey Death has been reported in the Southeast, with overdoses and at least  two deaths in Alabama and Georgia. It has  also been found in Ohio, Pennsylvania and Indiana. The compound is  a mixture of U-47700, heroin and fentanyl. Overall, different fentanyls, including carfentanil, have been detected and the amount of each ingredient varies.  The substance’s appearance is similar to concrete mixing powder with a varied texture from fine powder to rock-like. While grey is most common and is the color seen in St. Augustine, pictures indicate tan as well. The potency is much higher than heroin and can be administered via injection, ingestion, insufflation and smoking.

DANGER: Grey Death ingredients and their concentrations are unknown to users, making it particularly lethal. Because these strong drugs can be absorbed through the skin, touching or the accidental inhalation of these drugs  can result in absorption. Adverse effects, such as disorientation, sedation, coughing, respiratory distress or cardiac  arrest can occur very rapidly, potentially within minutes of exposure. Any concoction containing U-47700 may not respond to Narcan, depending on its relative strength in the mix.   Light grey powder in a test tube.

CONCLUSION: Responders are advised to employ protective gear to prevent skin absorption or inhalation. Miniscule (grains) of this substance are dangerous. Treat any particles in the vicinity of scene or potentially adhering to your or victim outer clothing or equipment as hazardous.

Source:  HIDTA Intelligence brief.   1st June 2017

Sirs,

I believe that a state’s Attorney General and Secretary of State have the obligation to reject any petition that is obviously in violation of any law.

Whether a ballot initiative is properly worded or not, if it proposes, facilitates or allows the violation of any law – it is illegal.

EXCERPT:  “In an opinion dated Tuesday and released Wednesday, Rutledge said the ballot title of the proposal is ambiguous and “that a number of additions or changes” are needed “to more fully and correctly summarize” the proposal.

“The proposal [to legalize recreational marijuana use in the state] by Larry Morris of West Fork would allow for the cultivation, production, distribution, sale and possession of marijuana for recreational use in Arkansas.”:

As you can readily see, Mr. Morris’ proposal would violate federal law and place persons who engage in any of those activities at risk of federal prosecution or other liability.

I draw to your attention a  LEGAL PRIMER(BELOW) ON: ENFORCING THE CONTROLLED SUBSTANCE ACT IN STATES THAT HAVE COMMERCIALIZED MARIJUANA by Mr. David Evans, Esq. in which he concludes that: “Anyone who participates in the growing, possession, manufacturing, distribution, or sales of marijuana under state law or aids or facilitates or finances such actions is at risk of federal prosecution or other liability.”

I ask that you continue to reject these illegal proposals to legalize marijuana in any form in our state of Arkansas.

I reiterate, it is your job to UPHOLD the LAW, not facilitate LAWBREAKING.

Jeanette McDougal

Board Member, Drug Watch, Intl.

Director, NAHAS – National Alliance of Health and Safety dems8692@aol.com

HUNTINGTON, W.Va. — Officer Sean Brinegar arrived at the house first — “People are coming here and dying,” the 911 caller had said — and found a man and a woman panicking. Two people were dead inside, they told him.

Brinegar, 25, has been on the force in this Appalachian city for less than three years, but as heroin use has surged, he has seen more than his fair share of overdoses. So last Monday, he grabbed a double pack of naloxone from his gear bag and headed inside.

A man was on the dining room floor, his thin body bluish-purple and skin abscesses betraying a history of drug use. He was dead, Brinegar thought, so the officer turned his attention to the woman on a bed. He could see her chest rising but didn’t get a response when he dug his knuckle into her sternum.

Brinegar gave the woman a dose of injected naloxone, the antidote that can jumpstart the breathing of someone who has overdosed on opioids, and returned to the man. The man sat up in response to Brinegar’s knuckle in his sternum — he was alive after all — but started to pass out again. Brinegar gave him the second dose of naloxone.

Maybe on an average day, when this Ohio River city of about 50,000 people sees two or three overdoses, that would have been it. But on this day, the calls kept coming.

Two more heroin overdoses at that house, three people found in surrounding yards. Three overdoses at the nearby public housing complex, another two up the hill from the complex.

From about 3:30 p.m. to 7 p.m., 26 people overdosed in Huntington, half of them in and around the Marcum Terrace apartment complex. The barrage occupied all the ambulances in the city and more than a shift’s worth of police officers.

By the end of it, though, all 26 people were alive. Authorities attributed that success to the cooperation among local agencies and the sad reality that they are well-practiced at responding to overdoses. Many officials did not seem surprised by the concentrated spike.

“It was kind of like any other day, just more of it,” said Dr. Clay Young, an emergency medicine doctor at Cabell Huntington Hospital.

But tragic news was coming. Around 8 p.m., paramedics responded to a report of cardiac arrest. The man later died at the hospital, and only then were officials told he had overdosed. On Wednesday, authorities found a person dead of an overdose elsewhere in Cabell County and think the death could have happened Monday. They are investigating whether those overdoses are tied to the others, potentially making them Nos. 27 and 28.

It’s possible that the rash of overdoses was caused by a particularly powerful batch of heroin or that a dearth of the drug in the days beforehand weakened people’s tolerance. But police suspect the heroin here was mixed with fentanyl, a synthetic opioid that is many times more potent than heroin. A wave of fatal overdoses signaled fentanyl’s arrival in Huntington in early 2015, and now some stashes aren’t heroin laced with fentanyl, but “fentanyl laced with heroin,” said Police Chief Joe Ciccarelli. Another possibility is carfentanil, another synthetic opioid, this one used to sedate elephants. Police didn’t recover drugs from any of the overdoses, but toxicology tests from the deaths could provide answers.

A battle-scarred city

In some ways, what happened in Huntington was as unremarkable as the spurts in overdoses that have occurred in other cities. This year, fentanyl or carfentanil killed a dozen people in Sacramento, nine people in Florida, and 23 people in about a month in Akron, Ohio. The list of cities goes on: New Haven, Conn.; Columbus, Ohio; Barre, Vt.

But what happened in Huntington stands out in other ways. It underlines the potential of a mysterious substance to unleash wide-scale trauma and overwhelm a city’s emergency response. And it suggests that a community that is doing all the right things to combat a worsening scourge can still get knocked back by it.

“From a policy perspective, we’re throwing everything we know at the problem,” said Dr. James Becker, the vice dean for governmental affairs and health care policy at the medical school at Marshall University here. “And yet the problem is one of those that takes a long time to change, and probably isn’t going to change for quite a while.”

Surrounded by rolling hills packed with lush trees, Huntington is one of the many fronts in the fight against an opioid epidemic that is killing almost 30,000 Americans a year. But this city, state, and region are among the most battle-scarred. West Virginia has the highest rate of fatal drug overdoses of any state and the highest rate of babies born dependent on opioids among the 28 states that report data. But even compared with other communities in West Virginia, Huntington sees above-average rates of heroin use, overdose deaths, and drug-dependent newborns. Local officials estimate up to 10 percent of residents use opioids improperly.

The heroin problem emerged about five years ago when authorities around the country cracked down on “pill mills” that sent pain medications into communities; officials here specifically point to a 2011 Florida law that arrested the flow of pills into the Huntington area.

As the pills became harder to obtain and harder to abuse, people turned to heroin. It has devoured many communities in Appalachia and beyond.

In Huntington, law enforcement initially took the lead, with police arresting hundreds of people. They seized thousands of grams of heroin. But it wasn’t making a dent. So in November 2014, local leaders established an office of drug control policy.

“As far as numbers of arrests and seizures, we were ahead of the game, but our problem was getting worse,” said Jim Johnson, director of the office and a former Huntington police officer. “It became very obvious that if we did not work on the demand side just as hard as the supply side, we were never going to see any success.”

The office brought together law enforcement, health officials, community and faith leaders, and experts from Marshall to try to tackle the problem together.

Changes in state law have opened naloxone dissemination to the public and protected people who report overdoses. But the city and its partners have gone further, rolling out programs through the municipal court system to encourage people to seek treatment. One program is designed to help women who work as prostitutes to feed their addiction. Huntington has eight of the state’s 28 medically assisted detox beds, and they’re always full.

Also, in 2014, a center called Lily’s Place opened in Huntington to wean babies from drugs. Last year, the local health department launched this conservative state’s first syringe exchange. The county, health officials know, is at risk for outbreaks of HIV and hepatitis C because of shared needles, so they are trying to get ahead of crises seen in other communities afflicted by addiction.

“Huntington just happens to have taken ownership of the problem, and very courageously started some programs … that have been models for the rest of the state,” said Kenneth Burner, the West Virginia coordinator for the Appalachia High Intensity Drug Trafficking Areas program.

‘A revolving door’

While paramedics in the area have carried naloxone for years, it was this spring that Huntington police officers were equipped with it. Just a few officers have administered it, but Monday was Brinegar’s third time reviving overdose victims with naloxone.

Paramedics, who first try reviving victims by pumping air with a bag through a mask, had to administer another 10 doses of naloxone Monday. Three doses went to one person, said Gordon Merry, the director of Cabell County Emergency Services. During the response, ambulances from stations outside Huntington were called into the city to assist the eight or so response teams already deployed.

Merry was clearly proud of the response, but also frustrated. He was tired, he said, of people whom emergency crews revived going back to drugs. Because of the power of their disease, saving their lives didn’t get at the root of their addiction.

“It’s a revolving door. We’re not solving the problem past reviving them,” he said. “We gave 26 people another chance on life, and hopefully one of those 26 will seek help.”

In the part of town where half the overdoses happened, some homes are well-kept, with gardens, bird feeders, and American flags billowing. “Home Sweet Home,” read an engraved piece of wood above one front door; in another front yard, a wooden sculpture presented a bear holding a fish with “WELCOME” written across its body.

But many structures are decrepit and have their windows blacked out with cardboard and sheets. At one boarded-up house, the metal slats that once made up an overhang for the front porch split apart and warped as they collapsed, like gnarled teeth. On the plywood that covered a window frame was a message spelled out in green dots: GIRL SCOUTS RULE.

In and around the public housing complex, which is made up of squat two-story brick buildings sloping up a hill, people either said they did not know what had happened Monday, or that “lowlifes” in another part of the complex sparked the problem. Even as paramedics were responding to the overdoses, police started raiding residences as part of their investigation, including apartments at the complex, the chief said.

Just up the hill, a man named Bill was sitting on a recliner on his front porch with his cat. He said he saw the police out in the area Monday, but doesn’t pay much attention to overdoses anymore. They are so frequent.

Bill, who is retired, asked to be identified only by his first name because he said he has a son in law enforcement. He has lived in that house for five decades and started locking his door only in recent years. His neighbors’ house had been broken into, and he had seen people using drugs in cars across the street from his house. He called the police sometimes, he said, but the users were always gone by the time the police arrived.

“I hate to say this, but you know, I’d let them die,” Bill said. “If they knew that no one was going to revive them, maybe they wouldn’t overdose.”

Even here, where addiction had touched so many lives, it’s not an uncommon sentiment. Addiction is still viewed by some as a bad personal choice made by bad people.

“Some folks in the community just didn’t care” that 26 of their fellow residents almost died, said Matt Boggs, the executive director of Recovery Point.  Recovery Point is a long-term recovery program that teaches “clients” to live a life without drugs or alcohol. Boggs himself is a graduate of the program, funded by the state and donations and grants.

The clients live in bunk rooms at the facility for an average of more than seven months before graduating. The program says that about two-thirds of graduates stay sober in the first year after graduation, and about 85 percent of those people are sober after two years.

Local officials praise Recovery Point, but like many other recovery programs, it is limited in what it can do. It has 100 beds for men at its location in Huntington, and is expanding at other sites in the state, but Boggs said there’s a waiting list of a couple hundred people.

Mike Thomas, 30, graduated from the main part of the program a month ago and is working as a peer mentor there as he transitions out of the facility. Thomas has been clean since Oct. 15, 2015, but has dreams about getting high or catches himself thinking he could spare $100 from his bank account for drugs.

Thomas hopes to find a full-time job helping addicts. His own recovery will be a lifelong process, one that can be torn apart by a single bad decision, he said. He will always be in recovery, never recovered.    “I’m not cured,” he said.

 

A killer that doesn’t discriminate

As heroin has bled into communities across the country, it has spread beyond the regular drug hotbeds in cities. On a 2004 map of drug use in Huntington — back then, mostly crack cocaine — a few blocks of the city glow red. Almost the entire city glows in yellows and reds on the 2014 map.

In 2015, there were more than 700 drug overdose calls in Huntington, ranging from kids in their early teens to seniors in their late 70s. In 2014, it was 272 calls; in 2012, 146. One bright spot: fatal overdoses, which stood at 58 in 2015, have ticked down so far this year.

“I used to be able to say, ‘We need to focus here,’” said Scott Lemley, a criminal intelligence analyst at the police department. “I can’t do that anymore.”

Heroin hasn’t just dismantled geographic barriers. It has infiltrated every demographic “It doesn’t discriminate.   Prominent businessmen, their child. Police officers, their child. Doctors, their child,” Merry said. “The businessman and police officer do not have their child anymore.”

The businessman is Teddy Johnson. His son, Adam, died in 2007 when he was 22, one of a dozen people who died in a five-month period because of an influx of black-tar heroin. The drug hadn’t made its full resurgence into the region yet, but now, Johnson sees the drug that killed his son everywhere.

 

Teddy Johnson lost his son, Adam, in 2007 to a heroin overdose. He has several tattoos dedicated to Adam’s memory.  He runs a plumbing, heating, and kitchen fixture and remodelling business. From his storefront, he has witnessed deals across the street.

Adam, who was a student at Marshall, was a musician and artist who hosted radio shows. He was the life of any party, his dad said.

Johnson was describing Adam as he sat at the marble countertop of a model kitchen in his business last week. With the photos of his kids on the counter, it felt like a family’s home. Johnson explained how he still kept Adam’s bed made, how he kept his son’s room the same, and then he began to cry.

“The biggest star in the sky we say is Adam’s star,” he said. “When we’re in the car — and it can’t be this way — but it always seems to be in front of us, guiding us.”

Adam’s grave is at the top of a hill near the memorial to the 75 people — Marshall football players, staff, and fans — who died in a 1970 plane crash. It’s a beautiful spot that Johnson visits a few times each week, bringing flowers and cutting the grass around his son’s grave himself. Recently a note was left there from a couple Johnson knows who

just lost their son to an overdose; they were asking Adam to look out for their son in heaven.

But even here, at what should be a respite, Johnson can’t escape what took his son. He said he has seen deals happen in the cemetery, and he recently found a burnt spoon not more than 20 feet from his son’s grave.

Johnson keeps fresh flowers on his son’s grave and cuts the grass around the grave himself.

“I’ve just seen too much of it,” he said.

If Huntington doesn’t have a handle on heroin, at least the initiatives are helping officials understand the scale of the problem. More than 1,700 people have come through the syringe exchange since it opened, where they receive a medical assessment and learn about recovery options. The exchange is open one day a week, and in less than a year, it has distributed 150,000 clean syringes and received 125,000 used syringes.

But to grow and sustain its programs, Huntington needs money, officials say. The community has received federal grants, and state officials know they have a problem. But economic losses and the collapse of the coal industry that fueled the drug epidemic have also depleted state coffers.

“We have programs ready to launch, and we have no resources to launch them with,” said Dr. Michael Kilkenny, the physician director of the Cabell-Huntington Health Department. “We’re launching them without resources, because our people are dying, and we can’t tolerate that.”

In some ways, Huntington is fortunate. It has a university with medical and pharmacy schools enlisted to help, and a mayor’s office and police department collaborating with public health officials. But what does that herald then for other communities?

“If I feel anxious about what happens in Huntington and in Cabell County, I cannot imagine what it must be like to live in one of these other at-risk counties in the United States, where they don’t have all those resources, they don’t have people thinking about it,” said Dr. Kevin Yingling, the dean of the Marshall University School of Pharmacy.

Yingling, Kilkenny, and others were gathered on Friday afternoon to talk about the situation in Huntington, including the rash of overdoses. But by then, there was already a different incident to discuss.

A car had crashed into a tree earlier that afternoon in Huntington. A man in the driver seat and a woman in the passenger seat had both overdosed and needed naloxone to be revived. A preschool-age girl was in the back seat.

Source:    https://www.statnews.com/2016/08/22/heroin-huntington-west-virginia-overdoses/ 22.08.16

Drug trade’s efforts to launder profits by creating agricultural land results in loss of millions of acres, researchers say.

A hillside in Jocotán, eastern Guatemala, damaged by deforestation. Photograph: Marvin Recinos/AFP/Getty Images

Cocaine traffickers attempting to launder their profits are responsible for the disappearance of millions of acres of tropical forest across large swaths of Central America, according to a report. The study, published on Tuesday in the journal Environmental Research Letters, found that drug trafficking was responsible for up to 30% of annual deforestation in Nicaragua, Honduras and Guatemala, turning biodiverse forest into agricultural land.

The study’s lead author, Dr Steven Sesnie from the US Fish and Wildlife Service, said: “Most of the ‘narco-driven’ deforestation we identified happened in biodiverse moist forest areas, and around 30-60% of the annual loss happened within established protected areas, threatening conservation efforts to maintain forest carbon sinks, ecological services, and rural and indigenous livelihoods.”

The research, which used annual deforestation estimates from 2001 to 2014, focuses on six Central American countries – Guatemala, El Salvador, Honduras, Nicaragua, Costa Rica and Panama. It estimates the role of drug trafficking, as opposed to drug cultivation, in deforestation for the first time.

“As the drugs move north their value increases and the traffickers and cartels are looking for ways to move this money into the legal economy. Purchasing forest and turning it into agricultural land is one of the main ways they do that,” said Sesnie. He said the US-led crackdown on drug cartels in Mexico and the Caribbean in the early 2000s concentrated cocaine trafficking activities through the Central American corridor.

“Now roughly 86% of the cocaine trafficked globally moves through Central America on its way to North American consumers, leaving an estimated $6bn US dollars in illegal profits in the region annually.”

This had led to the loss of millions of acres of tropical forest over a decade as drugs cartels laundered their profits, Sesnie said.

“Our results highlight the key threats to remaining moist tropical forest and protected areas in Central America,” he said, adding that remote forest areas with “low socioeconomic development” were particularly at risk.

The report calls for drugs and environment policy – nationally and internationally – to be integrated “to ensure that deforestation pressures on globally significant biodiversity sites are not intensified by … supply-side drug policies in the region”.

Source:  https://www.theguardian.com/environment/2017/may/16/drug-money-traffickers-destroying-swaths-forest-central-america    

 

Addiction Advocacy Needs A Bill Gates, David Geffen, Warren Buffett, Or Tom Steyer

Addiction doesn’t need someone to put their name on a building, or name a research institute. Addiction desperately needs bold philanthropists who want to leverage the people power of the grassroots. Addiction and drug overdoses claim one life every four minutes in America. In the time it takes to order a latte, someone dies—from an illness that is highly treatable. The addiction crisis is the result of social prejudice; criminal justice policies that incarcerate people with addiction instead of giving them treatment; health care policies that make it difficult or impossible to get medical help for substance use disorders; ignorance; and “abstinence-only” drug policies that are ineffective and backwards.

The fact is, people who struggle with substance use disorder are treated like second-class citizens. Admitting there’s a problem can mean losing your job, home, and custody of your children. That makes addiction a civil rights issue. And, thanks to the work of advocates across the nation, it’s finally being recognized as a moral issue, as well. Thought leaders like Tom Steyer are helping to drive this message home. I first met Tom during the Democratic National Convention. I had just shared my experience with addiction and recovery when Tom approached me. I was taken aback by the story he shared. He, too, lost someone very dear to him due to addiction: his best friend, who struggled with addiction for decades. His friend contracted HIV and Hepatitis C through drug use, and died of medical complications due to his illnesses. A few months later, Tom joined me at the Facing Addiction in America summit in Los Angeles, where we invited him to share his story on stage with the U.S. Surgeon General. As Tom talked, tears filled my eyes. He said, “We must embrace our shared humanity and recognize that addiction is a deadly, chronic illness, not a personal failing.” I’d lost friends, too. I was at risk, too. It was time to bridge the gap between policies and public awareness.

People like Tom Steyer and other pioneering philanthropists, who give tens of millions to progressive causes such as medical research, environmental causes, and water quality, must also step up to end the addiction crisis in America. Our fight is America’s fight. The sooner they do, the quicker we can heal this nation from our generation’s most urgent public health crisis.

Working alongside lobbyists, nonprofit groups, social organizers, and peer recovery groups, they can help fill the gaps left by policies and laws that omit or punish people with substance use disorder. As the current administration takes steps toward a health care bill that will leave people suffering from addiction without medical care, these philanthropic giants are in a unique position to help. Why? Because their involvement would not be tied to political party or personal gain. Rather, they would focus on the solution, plain and simple.

Addiction should be one of the issues on the list of social problems we urgently address, next to finding a cure for cancer and ending childhood hunger. Addiction permeates the social fabric of America. Nobody is exempt. As many people suffer from addiction as diabetes; more people use pain medications than tobacco products. For every person who’s developed full blown substance use disorder, another dozen are on the road to addiction. Substance use disorder affects every corner of society, including our collective health, family unity, the economy, workplace productivity, and our reliance on social programs. It also keeps jails full of people who may struggle to find jobs to support their families once they’re released, and will never be able to vote again.

The recovery advocacy movement has been built slowly, through the efforts of individuals and highly fragmented groups. We have an incredible grassroots movement that addresses an issue that directly impacts one in every three families in America, and indirectly touches all of us. But fundraising for recovery advocacy has been largely through family and friend donations—which, although heartfelt, aren’t sufficient to fund serious research, create desperately needed social infrastructure, or provide education about the true nature of addiction. While organizations dedicated to battling cancer, heart disease, and diabetes raise hundreds of millions of dollars annually, the “addiction field,” such as it is, raises perhaps $25 million from private sources. This is unconscionable.

Gates, Geffen, Buffett, Steyer, and other philanthropic giants have the potential to be visionaries in this space. They could quickly stem the addiction epidemic without waiting for policy makers to hammer out yet another law that places people’s recovery at risk. They could find the solution that keeps families intact. With their help, nobody will lose another friend to this disease or the health problems that come with it. Bob and Suzanne Wright demonstrated the power and possibility of this kind of giving when they funded Autism Speaks. Their philanthropy helped move autism front and center: why not do the same for addiction?

What will our society, our culture, be like when we finally take addiction out of the equation? For many people, and their families, the answer is coming much too slowly.

It’s time to apply our knowledge, build a coalition, and offer the solutions our country so desperately needs. It’s time to change the framework of this crisis and confront our deepest values. Instead of punishment, we need to help the people who are sick—dying from this illness. It’s time to work together and end America’s addiction crisis for good.

What we need now is for America’s philanthropic visionaries to step up to help us dramatically accelerate the pace of progress in this urgent effort. Addiction doesn’t need someone to put their name on a building, or name a research institute. Addiction desperately needs bold philanthropists who want to leverage the people power of the grassroots. Ryan Hampton is an outreach lead and recovery advocate at Facing Addiction, a leading nonprofit dedicated to ending the addiction crisis in the United States.

Source:  http://www.huffingtonpost.com/entry/addiction-advocacy-needs-a-bill-gates-david-geffen_us_592ddfaae4b075342b52c0f5   30th May 20127

As Cpl. Kevin Phillips pulled up to investigate a suspected opioid overdose, paramedics were already at the Maryland home giving a man a life-saving dose of the overdose reversal drug Narcan.

Drugs were easy to find:  a package of heroin on the railing leading to a basement; another batch on a shelf above a nightstand.

The deputy already had put on gloves and grabbed evidence baggies, his usual routine for canvassing a house.  He swept the first package from the railing into a bag and sealed it; then a torn Crayola crayon box went from the nightstand into a bag of its own.  Inside that basement nightstand:  even more bags, but nothing that looked like drugs.

Then—moments after the man being treated by paramedics come to—the overdose hit.

“My face felt like it was burning.  I felt extremely lightheaded.  I felt like I was getting dizzy,” he said.  “I stood there for two seconds and thought, ‘Oh my God, I didn’t just get exposed to something.’ I just kept thinking about the carfentanil.”

Carfentanil came to mind because just hours earlier, Phillips’ boss, Harford County Sheriff Jeffrey Gahler, sent an e-mail to deputies saying the synthetic opioid so powerful that it’s used to tranquilize elephants had, for the first time ever, showed up in a toxicology report from a fatal overdose in the county.  The sheriff had urged everyone to use extra caution when responding to drug scenes.

Carfentanil and fentanyl are driving forces in the most deadly drug epidemic the United States has ever seen.  Because of their potency, it’s not just addicts who are increasingly at risk—it’s those tasked with saving lives and investigating the illegal trade.  Police departments across the U.S. are arming officers with the opioid antidote Narcan.  Now, some first responders have had to use it on colleagues, or themselves.

The paramedic who administered Phillips’ Narcan on May 19 started feeling sick herself soon after;  she didn’t need Narcan but was treated for exposure to the drugs.

Earlier this month, an Ohio officer overdosed in a police station after bushing off with a bare hand a trace of white powder left from a drug scene.  Like Phillips, he was revived after several doses of Narcan.  Last fall, SWAT officers in Hartford, Connecticut, were sickened after a flash-bang grenade sent particles of heroin and fentanyl airborne.

Phillips’ overdose was eye-opening for his department, Gahler said.  Before then, deputies didn’t have a protocol for overdose scenes; many showed up without any protective gear.

Gahler has since spent $5,000 for 100 kits that include a protective suit, booties, gloves, and face masks.  Carfentanil can be absorbed through the skin and easily inhaled. and a single particle is so powerful that simply touching it can cause an overdose, Gahler said.  Additional gear will be distributed to investigators tasked with cataloguing overdose scenes—heavy-duty gloves and more robust suits.

Gahler said 37 people have died so far this year from overdoses in his county, which is between Baltimore and Philadelphia.  The county has received toxicology reports on 19 of those cases, and each showed signs of synthetic opioids.

“This is all a game-changer for us in law enforcement,” Gahler said.  “We are going to have to re-evaluate daily what we’re doing.  We are feeling our way through this every single day . . . we’re dealing with something that’s out of our realm.  I don’t want to lose a deputy ever, but especially not to something the size of a grain of salt.”

Source:  – Erie Times-News, Erie, Pa. – May 28, 2017 – www.goerie.com  The Associated Press

Ohio had the most overdose fatalities in the United States in 2014 and 2015.

A newspaper’s survey of county coroners has painted a grim picture of fatal overdoses in Ohio: more than 4,000 people died from drug overdoses in 2016 in the state badly hit by a heroin and opioid epidemic.

At least 4,149 died from unintentional overdoses last year, a 36 percent climb from the previous year, or a time when Ohio had the most overdose fatalities in the United States so far.

“They died in restaurants, theaters, libraries, convenience stores, parks, cars, on the streets and at home,” wrote The Columbus Dispatch in its report revealing the findings.

Survey Findings

It’s likely getting worse, too, as coroners warned that overdose deaths this year are fast outpacing these figures brought on by overdoses from heroin, synthetic opioids fentanyl and carfentanil, and other drugs.

The Dispatch obtained the number by getting in touch with coroners’ offices in all 88 Ohio counties. Coroners in six smaller counties, according to the paper, did not provide the requested figures.

Leading the counties in rapid drug overdose rises are counties such as Cuyahoga, where there were 666 deaths in 2016, as well as Franklin, Hamilton, Lucas, Montgomery, and Summit.

The devastation, added the survey, did not discriminate against big or small cities and towns, urban or rural areas, and rich and poor enclaves.

“It’s a growing, breathing animal, this epidemic,” said Medina County coroner and ER physician Dr. Lisa Deranek, who has sometimes revived the same overdose patients a few times each week.

Fentanyl Overdoses

Cuyahoga County, which covers Cleveland, had its death toll largely blamed on fentanyl use. Heroin remains a leading killer, but the autopsy reports reflected the major role of fentanyl, a synthetic opiate 50 times stronger than morphine, and animal tranquilizer carfentanil.

“We’ve done so much, but the numbers are going the other way. I don’t see the improvement,” said William Denihan, outgoing CEO of Cuyahoga County Alcohol, Drug Addiction and Mental Health Services Board.

Cuyahoga County had 400 fentanyl-linked deaths from Nov. 21 in 2015 to Dec. 31 last year, more than double related deaths of all previous years in combination. The opioid crisis, too, no longer just affected mostly white drug users, but also minority communities.

Dr. Thomas Gilson, medical examiner of Cuyahoga County, warned that cocaine is now getting mixed into the fentanyl distribution and fentanyl analogs in order to bring the drugs closer to the African-American groups.

Plans And Prospects

The state’s Department of Mental Health and Addiction Services stated that the overdose death toll back in 2015 would have been higher if not for the role of naloxone, an antidote use for opioid overdose cases. It has been administered by family members, other drug users, and friends to revive dying individuals.

State legislature moved to make naloxone accessible in pharmacies without a prescription. Ohio topped the nation’s drug overdose death numbers in 2014 and 2015. In the latter year, it was followed by New York, according to an analysis by the Kaiser Family Foundation using statistics from the U.S. Centers for Disease Control and Prevention.

Experts are pushing for expanding drug prevention as well as education initiatives from schoolkids to young and middle-aged adults, which also make up the bulk of dying people.

And while the state pioneered in crushing “pill mills” that issue prescription painkillers, health officials warned that this sent addicts to heroin and other stronger substances.

Naloxone, too, is merely an overdose treatment and not a cure for the growing addiction. Last May 22 in Pennsylvania, two drug counselors working to help others battle their drug addiction were found dead from opioid overdose at the addiction facility in West Brandywine, Chester County.

Source:  http://www.techtimes.com/articles/208540/20170529/ohio-leads-in-nations-fatal-drug-overdoses-with-4-000-dead-in-2016-survey.htm  29.05.17

During the 2015 election, the Liberals campaigned on a plan to greenlight marijuana for recreational use to keep it out of the hands of children and the profits out of the hands of criminals.

The party’s election platform said Canada’s current approach — criminalizing people for possession and use — traps too many Canadians in the justice system for minor offences.

Last month, the government spelled out its plans in legislation, setting sweeping policy changes in motion.  The new law proposes setting the national minimum age to legally buy cannabis at 18 years old. It will be up to the provinces should they want to restrict it further.

Is it true, as Wilson-Raybould and the Liberals suggest, that legalization will in fact keep cannabis out of the hands of kids?

Spoiler alert: The Canadian Press Baloney Meter is a dispassionate examination of political statements culminating in a ranking of accuracy on a scale of “no baloney” to “full of baloney” (complete methodology below)

This one earns a lot of baloney — the statement is mostly inaccurate but contains elements of truth. Here’s why:

THE FACTS

There is no doubt cannabis is in the hands of young people today.

In fact, Canada has one of the highest rates of teenage and early-age adulthood use of marijuana, says Dr. Mark Ware, the vice-chair of the federally-appointed task force on cannabis and a medicinal marijuana researcher at McGill University.

“We don’t anticipate that this is going to eliminate it; but the public health approach is to make it less easy for young adolescents, young kids, to access cannabis than it is at the moment,” he said.

Bonnie Leadbeater, a psychology professor at the University of Victoria who specializes in adolescent behaviour, said as many as 60 per cent of 18-year-olds have used marijuana at some point in their lives.

The aim of a regulated, controlled system of legalized cannabis is to make it more difficult for kids to access pot, Ware said, noting the principle goal is to delay the onset of use.

So will a recreational market for adults coupled with a regulatory regime really keep pot out of the hands of kids?

THE EXPERTS

Public health experts — including proponents of legalization — say that probably won’t happen.

“I don’t exactly know what they are planning to do to keep it out of the hands of young people and I think some elaboration of that might be helpful,” Leadbeater said. “It is unlikely that it will change … it has been very, very accessible to young people.”

Benedikt Fischer, a University of Toronto psychiatry professor and senior scientist with the Centre for Addiction and Mental Health, agrees the expectation that legalization will suddenly reduce or eliminate use among young people is counter-intuitive and unrealistic to a large extent.

“The only thing we could hope for is that maybe because it is legal, all of a sudden it is so much more boring for young people that they’re not interested in it anymore,” he said.

Increasing penalties for people who facilitate access to kids will help discourage law-abiding Canadians from doing so, says Steven Hoffman, director of a global strategy lab at the University of Ottawa Centre for health law, policy and ethics.

“That being said, when there’s a drug, there’s no foolproof way of keeping it out of the hands of all children,” Hoffman said. “For sure, there will still be children who are still consuming cannabis.”

Cannabis will not be legal for people of all ages under the legislation, he added, noting this means there may still be a market for criminal activity for cannabis in the form of selling it to children.

In Colorado, officials thought there would be an increase in use as a result of legalization, according to Dr. Larry Wolk, chief medical officer at the Department of Public Health and Environment, but he said there’s been no increase among either youth or adults.    Nor has there been a noticeable decrease.

“What it looks like is folks who may have been using illicitly before are using legally now and teens or youth that were using illicitly before, it’s still the same rate of illicit use,” he said.

THE VERDICT

Donald MacPherson, executive director of the Canadian Drug Policy Coalition, said the Liberal government could provide a more nuanced, realistic message about its plans to legalize marijuana.

“To suddenly go over to the rhetoric … that strict regulation is going to keep it out of the hands of young people doesn’t work,” he said.

“There’s a better chance of reducing the harm to young people through a … public health, regulatory approach. That’s ideally what they should be saying.”

Careful messaging around legalized marijuana — like the approach taken by the Netherlands — could make cannabis less of a tempting forbidden fruit for young people, said Mark Haden, an adjunct professor at the University of British Columbia.

“What we know is that prohibition maximizes the engagement of youth, so if we did it well and skillfully and ended prohibition with a wise approach and made cannabis boring, it would keep it out of the hands of kids,” he said.

“It isn’t completely baloney, it just hasn’t gone far enough in terms of a rich, real discussion. It is just political soundbites.”

For this reason, Wilson-Raybould’s statement contains “a lot of baloney.”

METHODOLOGY

The Baloney Meter is a project of The Canadian Press that examines the level of accuracy in statements made by politicians. Each claim is researched and assigned a rating based on the following scale:

· No baloney – the statement is completely accurate

· A little baloney – the statement is mostly accurate but more information is required

· Some baloney – the statement is partly accurate but important details are missing

· A lot of baloney – the statement is mostly inaccurate but contains elements of truth

· Full of baloney – the statement is completely inaccurate

Source:   http://www.ctvnews.ca/politics/fact-check-will-legalizing-pot-keep-it-out-of-the-hands-of-kids-1.3397542   4th May 2017

The first to die was the family’s pet duck, killed in an attempt to rid the house of evil.

By then, Raina Thaiday had already been on a cleaning frenzy for a week, scrubbing the ceilings of her Cairns home and tossing possessions out into the yard in a bid to “cleanse” the house.  But it was when she heard a dove’s call, which she interpreted as a sign from God, that she decided she must “kill her children in order to save them”.

The Mental Health Court of Queensland last month ruled, in a decision not made public until Thursday, that Raina Mersane Ina Thaiday was of unsound mind when she stabbed to death seven of her children and a niece in her home on December 19, 2014.

In 2009, Raina Thaiday was interviewed thanking paramedics for safely delivering her child in the back of an ambulance. Photo: Nine News

“To her way of thinking at the time, what she was doing was the best thing she could do for her children. She was trying to save them,” Justice Jean Dalton said, exempting the mother from trial and confining her to mental health treatment.

Along the way the court heard details of the 40-year-old’s descent into “schizophrenia at its very depths”, likely exacerbated by years of heavy cannabis use, and culminating in her being in a psychotic state when she killed eight children under the age of 15.

A week before the killing, her then-20-year-old son, Lewis Warria found Mrs Thaiday stressed and serious, spending large amounts of time lecturing him about God, the court heard.  She went on a mission to “cleanse” her house, which Justice Dalton noted went far beyond a “normal spring clean”.

“All the furniture from the house was taken outside and put in the yard,” she said.”Inside the house was cleaned, in a most unusual way, including scrubbing the ceilings and the walls and a lot of Mrs Thaiday’s possessions were thrown away.  “And a lot of them were quite valuable.”

Things deteriorated still further the night of December 18. Her eldest daughter, niece and godchild had gone out shopping and did not return at 10pm as she had requested. Mrs Thaiday walked up and down the street, “preaching” to neighbours about their use of drugs and alcohol.  Agitated, she slept outside on a mattress dragged out in the cleaning.

Justice Dalton said with the benefit of hindsight, the things neighbours heard as Mrs Thaiday walked up and down the street, talking to herself or on the phone, were “clearly psychotic”.  “She was saying things like ‘I am the chosen one’,” the judge said.

“‘I have the power to kill people and to curse people. You hurt my kids, I hurt them first. You stab my kids, I stab them first. If you kill them, I’ll kill them’.”

At 11.40am on December 19, Mr Warria arrived home to find his mother slumped on the front verandah, covered in approximately 35 self-inflicted stab wounds that included a punctured lung. His siblings and cousin were dead inside.

Nearly two-and-a-half years later Mr Warria was in the courtroom inside Brisbane’s Queen Elizabeth II Courts of Law as a judge heard the opinions of six psychiatrists who had painstakingly analysed his mother’s mental state.

The court heard when police and paramedics arrived Mrs Thaiday immediately admitted she had killed the children inside. “Papa God” had been speaking to her, she told

psychiatrists, describing herself as the “anointed one” at risk from demons, who had to rid her Cairns home of an evil presence.

Psychiatrist Dr Angela Voita treated Mrs Thaiday from the day she came into The Park, one of Australia’s largest mental health facilities, on Christmas Eve 2014, five days after the mass killing.  She assessed her more than 50 times and, along with three other psychiatrists who gave evidence to the hearing, unanimously agreed she was mentally ill at the time of the offences.

After examining reams of evidence and interviews, Dr Voita said her patient was not capable of telling right from wrong or being able to control her actions at the time of the killings.  Assisting psychiatrist Dr Frank Varghese described the “unique” crime as “a horrendous case, the likes of which I have never seen before, and hopefully will never see (again).”   This is not ordinary schizophrenia,” he advised the judge.

“This is schizophrenia at its very depths and at its worst in terms of the terror for the patient as well as for the consequences for the individuals killed as a result of psychotic delusions.”

Mrs Thaiday had no psychiatric history or previous contact with mental health services outside of counselling at a local indigenous health service.  Independent psychiatrist Dr Pamela van de Hoef said there was some evidence that in 2007 she was also very disturbed.

“She had cut all her own hair off and threatened to kill one of the children with an axe.”

In 2011, she had ideas to drown herself and similar thoughts two weeks out from the 2014 killing, the psychiatrist said. The court heard cannabis was commonly linked to the onset of schizophrenia in those already vulnerable to the illness.

Ms Thaiday kicked a 10-20 cone a day habit in the months before the slaughter, leading psychiatrists to question whether her “psychosis” was a form of withdrawal, before mostly rejecting the notion.

Instead, Dr Jane Phillips and Dr Donald Grant agreed it was more likely the illness began to affect her while she was still using cannabis, causing to her to develop “religious delusions” that “forced her to live a clean life”.

“Altogether it amounts to a very convincing body of evidence that Mrs Thaiday was psychotic at the time of the killing,” Justice Dalton said.

She ruled Mrs Thaiday had the defence of unsoundness of mind available to her and issued a forensic order for ongoing mental health treatment.

Source: http://www.brisbanetimes.com.au/queensland/schizophrenia-at-its-very-depths-drove-mother-to-kill-eight-children-20170503-gvyf42.html   4th May 2017

SAN FRANCISCO – Visits by teens to a Colorado children’s hospital emergency department and its satellite urgent care centers increased rapidly after legalization of marijuana for commercialized medical and recreational use, according to new research being presented at the 2017 Paediatric Academic Societies Meeting in San Francisco.

The study abstract, “Impact of Marijuana Legalization in Colorado on Adolescent Emergency Visits” on Monday, May 8 at the Moscone West Convention Center in San Francisco.

Colorado legalized the commercialization of medical marijuana in 2010 and recreational marijuana use in 2014. For the study, researchers reviewed the hospital system’s emergency department and urgent care records for 13- to 21-year-olds seen between January 2005 and June 2015.

They found that the annual number of visits with a cannabis related diagnostic code or positive for marijuana from a urine drug screen more than quadrupled during the decade, from 146 in 2005 to 639 in 2014.

Adolescents with symptoms of mental illness accounted for a large proportion (66%) of the 3,443 marijuana-related visits during the study period, said lead author George Sam Wang, M.D., FAAP, with psychiatry consultations increasing from 65 to 442. More than half also had positive urine drug screen tests for other drugs. Ethanol, amphetamines, benzodiazepines, opiates and cocaine were the most commonly detected.

Dr. Wang, an assistant professor of paediatrics at the University of Colorado Anschutz Medical Campus, said national data on teen marijuana use suggest rates remained roughly the same (about 7%) in 2015 as they’d been for a decade prior, with many concluding no significant impact from legalization. Based on the findings of his study, however, he said he suspects these national surveys do not entirely reflect the effect legalization may be having on teen usage.

“The state-level effect of marijuana legalization on adolescent use has only begun to be evaluated,” he said. “As our results suggest, targeted marijuana education and prevention strategies are necessary to reduce the significant public health impact of the drug can have on adolescent populations, particularly on mental health.”

Dr. Wang will present the abstract, “Impact of Marijuana Legalization in Colorado on Adolescent Emergency Department (ED) Visits,” from 8 a.m. to 10 a.m. Numbers in this news release reflect updated information provided by the researchers. The abstract is available at https://registration.pas-meeting.org/2017/reports/rptPAS17_abstract.asp?abstract_final_id=3160.11.

The Paediatric Academic Societies (PAS) Meeting brings together thousands of individuals united by a common mission: to improve child health and well-being worldwide. This international gathering includes paediatric researchers, leaders in academic paediatrics, experts in child health, and practitioners. The PAS Meeting is produced through a partnership of four organizations leading the advancement of paediatric research and child advocacy: Academic Paediatric Association, American Academy of Paediatrics, American Paediatric Society, and Society for Paediatric Research. For more information, visit the PAS Meeting online at www.pas-meeting.org, follow us on Twitter @PASMeeting and #pasm17, or like us on Facebook. For additional AAP News coverage, visit http://www.aappublications.org/collection/pas-meeting-updates.

Source:   http://www.aappublications.org/news/2017/05/04/PASMarijuana050417

 A New Agenda to  Turn Back the Drug Epidemic

Robert L. DuPont, MD, President , Institute for Behavior and Health, Inc.

A. Thomas McLellan, PhD, Senior Strategy Advisor , Institute for Behavior and Health, Inc.  May 2017

Institute for Behavior and Health, Inc. , 6191 Executive Blvd , Rockville, MD 20852 , www.IBHinc.org 1

Background 

The Institute for Behavior and Health, Inc. (IBH) is a 501(c)3 non-profit substance use policy and research organization that was founded in 1978. Non-partisan and non-political, IBH develops new ideas and serves as a force for change.

Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs and Health was published in November 2016. Four months later, in March 2017, IBH held a meeting of 25 leaders in addiction treatment, health care, insurance, government and research to discuss the scope and implications of this historic document. The US Surgeon General, VADM Vivek H. Murthy, MD, was an active participant in the meeting. The significance of this new Surgeon General’s Report is analogous to the historic 1964 Surgeon General’s report, Smoking and Health, a document that inspired an extraordinarily successful public health response in the United States that has reduced the rates of cigarette smoking by over 64% and continues its impact even today, more than 50 years following its release.

The following is a summary of the discussion at the March 2017 meeting and the conclusions and recommendations that were developed.

Introduction: The 2016 Surgeon General’s Report 

The two primary objectives of the US Surgeon General’s Report of 2016 are first to provide scientific evidence that shows that in addition to nicotine, other substance misuse and addiction issues (e.g., alcohol, opioids, marijuana, etc.) also are best understood and addressed as public health problems; and second to encourage the inclusion of addiction – its prevention, early recognition and intervention, treatment and active long-term recovery management – into the mainstream of American health care. At present these elements are not integrated either as a stand-alone continuum or within the general medical system. As is true for other widespread illnesses, addiction to nicotine, alcohol, marijuana, opioids, cocaine and other substances is a serious chronic illness. This perspective is contrary to the common perception that addiction reflects a moral failing, a personal weakness or poor parenting. Such opinions have stigmatized individuals who are suffering from these often deadly substance use disorders and have led to expensive and ineffective public policies that segregate prevention and treatment outside of mainstream medical care. A better public health approach encourages afflicted individuals and their family members to seek and receive help within the current health care system for these serious health problems.

An informed public health approach to reducing the prevalence and the harms associated with substance use disorders requires more than the brief treatment of serious cases. Particularly important are substance use prevention programs in schools, healthcare and in all other parts of the community to protect adolescents (ages 12 – 21), the group most at risk for the initiation of substance-related harms and substance use disorders.  Importantly, abundant tragic experience and accumulating science show that substance use disorders are not effectively treated with only short-term care. Because substance use disorders produce 2 significant long-lasting changes in the brain circuits responsible for memory, motivation, inhibition, reward sensitivity and stress tolerance, addicted individuals remain vulnerable to relapse years following specialized treatment.1, 2, 3 Thus, as is true for all other chronic illnesses, long periods of personalized treatment and monitoring are necessary to assure compliance with care, continued sobriety, and improved health and social function. In combination, science-based prevention, early intervention, continuing care and monitoring comprise a modern continuum of public health care. The overall goals of this continuum comport well with those of other chronic illnesses:

1 US Department of Health and Human Services (HHS), Office of the Surgeon General. (2016). Chapter 2. The Neurobiology of Substance Use, Misuse, and Addiction. In: Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Washington, DC: HHS. Available: https://addiction.surgeongeneral.gov/

2 US Department of Health and Human Services (HHS), Office of the Surgeon General. (2016). Chapter 5. Recovery: The Many Paths to Wellness. In: Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Washington, DC: HHS. Available: https://addiction.surgeongeneral.gov/

3 Betty Ford Institute Consensus Panel. (2007). What is recovery? A working definition from the Betty Ford Institute. Journal of Substance Abuse Treatment, 33(3), 221-228.

4 White, W. L. (2012). Recovery/remission from substance use disorders: An analysis of reported outcomes in 415 scientific reports, 1868-2011. Philadelphia, PA: Philadelphia Department of Behavioral Health and Intellectual Disability Services.

· sustained reduction of the cardinal symptom of the illness, i.e., substance use;

· improved general health and function; and,

· education and training of the patient and the family to self-manage the illness and avoid relapses.

In the addiction field achieving these goals is called “recovery.” This word is used to describe abstention from the use of alcohol, marijuana and other non-prescribed drugs as well as improved personal health and social responsibility.3,4 Over 25 million formerly addicted Americans are in stable, long-term recovery of a year or longer.4 Understanding how to consistently accomplish the life-saving goal of recovery must inform health care decisions.

The 2016 Surgeon General’s Report offers a science-informed vision and path to recovery in response to the nation’s serious addiction problem, including specifically the opioid overdose epidemic. Research shows that it is possible to prevent or delay most cases of substance misuse; and to effectively treat even the most serious substance use disorders with recovery as an expectable result of comprehensive, continuous care and sustained monitoring. To do this, substance use disorders must be recognized as serious, chronic health conditions that are both preventable and treatable. The nation must integrate the short-term siloed episodes of specialty treatment that now are isolated from mainstream healthcare into a fully integrated continuum of care comparable to that currently available to those with other chronic illnesses such as diabetes, hypertension, asthma and chronic pain.

Meeting Discussion and Conclusions 

The Surgeon General’s Report and the meeting convened by the Institute for Behavior and Health, Inc. (IBH) to promote its recommendations are significant responses to the expanding epidemic of opioid 3 and other substance use disorders, an epidemic that struck nearly 21 million Americans aged 12 and older in 2015 alone.5 That year saw more than 52,000 overdose deaths.6 This drug epidemic has devastated countless families and communities throughout the US. Unlike earlier and smaller drug epidemics, the current opioid epidemic is not limited to a few regions or communities or a narrow range of ethnicities or incomes in the United States. Instead it afflicts all communities and all socioeconomic groups; its impacts include smaller communities and rural areas as well as suburban areas and inner cities. Fuelled by the suffering of countless grieving families, the nation is in the early stages of confronting the new epidemic. A growing national determination to turn back this deadly epidemic has opened the door to innovation that is sustained by strong bipartisan political support for new and improved efforts in both prevention and treatment of substance use disorders.

5 Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50). Available: http://www.samhsa.gov/data/

6 Rudd, R. A., Seth, P., David, F., & Scholl, L. (2016, December 30). Increases in drug and opioid-involved overdose deaths – United States. Morbidity and Mortality Weekly Report, 65(50-51), 1445-1452. Available: https://www.cdc.gov/mmwr/volumes/65/wr/mm655051e1.htm

7 Levy, S. J., Williams, J. F., & AAP Committee on Substance Use and Prevention. (2016). Substance use screening, brief intervention, and referral to treatment. Pediatrics, 138(1), e20161211. Available: http://pediatrics.aappublications.org/content/138/1/e20161211

8 US Department of Health and Human Services (HHS), Office of the Surgeon General. (2016). Chapter 3. Prevention Programs and Policies. In: Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Washington, DC: HHS. Available: https://addiction.surgeongeneral.gov/

Abstinence is an Achievable Goal, both for Prevention and for Treatment 

Embracing and synthesizing the 30 years of science supporting the findings of the 2016 Surgeon General’s Report, the group discussed a single goal for the prevention of addiction: no use of alcohol, nicotine, marijuana or other non-prescribed drugs by youth for reasons of health. This goal should be the core prevention message to all children from a very young age. Health care professionals, educators and parents should understand the importance of this simple, clear health message. They should continue to reinforce this message of no-use for health as children grow to adulthood. Even when prevention fails, it is possible for parents, other family members, friends, primary care clinicians, educators and others to identify and to intervene quickly to stop youth substance use from becoming addiction.7

The science behind this ambitious but attainable prevention goal is clear. Alcohol, nicotine products, marijuana and other non-prescribed drug use is uniquely harmful to the still-developing brains of adolescents. Thus any substance “use” among youth must be considered “misuse” – use that may harm self or others. The goal of no substance use is not just for the purpose of preventing addiction, though that is one clear and important by product of successful prevention. Addiction is a biological process that can take years to develop. In contrast, even a single episode of high-dose use of alcohol or other substance could immediately produce an injury, accident or even death. While it is true that most episodes of substance misuse among adults do not produce serious problems, it is also true that substance misuse is associated with 70% or more of the injuries, disabilities and deaths of young people.8 These figures are even higher for minority youth. Many adolescent deaths are preventable 4 because most are related to substance use – including substance-related motor vehicle crashes and overdose.9

9 Subramaniam, G. A., & Volkow, N. D. (2014). Substance misuse among adolescents. To screen or not to screen? JAMA Pediatrics, 168(9), 798-799. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4827336/

10 Data analyzed by the Center for Behavioral Health Statistics and Quality. CBHS. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15- 4927, NSDUH Series H-50).

11 2014 data obtained by IBH from the Monitoring the Future study. For discussion of data through 2013 see DuPont, R. L. (2015, July 1). It’s time to re-think prevention; increasing percentages of adolescents understand they should not use any addicting substances. Rockville, MD: Institute for Behavior and Health, Inc. Available: https://www.ibhinc.org/s/IBH_Commentary_Adolescents_No_Use_of_Substances_7-1-15.pdf

Youth who use any one of the three most common “gateway” substances, i.e., alcohol, nicotine and marijuana, are many times more likely than those who do not use that single drug to use the other two substances as well as other illegal drugs.10 The use of any drug opens the door to an endless series of highly risky decisions about which drugs to use, how much to use, and when to use them. This perspective validates the public health goal for youth of no use of any drug.

Complete abstinence from the use of alcohol or any other drug among adolescents is not simply an idealistic goal – it is a goal that can be achieved. Data were presented at the meeting from the nationally representative Monitoring the Future study showing that 26% of American high school seniors in 2014 reported no use of alcohol, cigarettes, marijuana or other non-prescribed drugs in their lifetimes. 11 This is a remarkable increase from only 3% reported by American high school seniors in 1983. Moreover, in the same survey, 50% of high school seniors had not used any alcohol, cigarettes, marijuana or other non-prescribed substance in the past 30 days, up from 16% in 1982. These largely overlooked and important findings show that youth abstinence from any substance use is already widespread and steadily increasing.

In parallel with the goal of abstinence for prevention, the recommended goal for the treatment of those who are addicted is sustained abstinence from the use of alcohol and other drugs, with the caveat, explicitly acknowledged by the group, that individuals who are taking medications as-prescribed in the treatment of substance use disorders (e.g., buprenorphine, methadone and naltrexone) and who do not use alcohol or other non-prescribed addictive substances – are considered to be abstinent and ”in recovery.” Abstinence from all non-prescribed substance use is the scientifically-informed goal for individuals in addiction treatment. This treatment goal is widely accepted in the large national recovery community. The long-lasting effects of addiction to drugs are easily seen among cigarette smokers: smoking only a single cigarette is a serious threat to the former smoker, even decades after smoking the last cigarette. There is incontrovertible evidence from brain and genetic research showing the long-term effects of substance misuse on critical brain regions.2 It is unknown when or if these brain changes will return to being entirely normal following cessation of substance use; however, it is known that the recovering brain is particularly vulnerable to the effects of return to any substance use, often leading to overdose or rapid re-addiction. 5

Participants in the IBH meeting supported the idea that abstinence is the high-value outcome in addiction treatment; and that while any duration of abstinence is valuable, longer-term, stable abstinence of 5 years is analogous to the widely-used standard in cancer treatment of 5-year survival. The scientific basis for the value of sustained recovery is validated by the experience of the estimated 25 million Americans now in recovery. This increasingly visible recovery community is a remarkable and very positive new force in the country.

Measuring and Attaining these Goals 

The mantra from the IBH meeting was, if you don’t measure it, it won’t happen. The group of leaders recognized the paucity of current models for systematic integration of addiction treatment and general healthcare. The group encouraged the identification of promising models and the promotion of innovation to achieve the goal of sustained recovery. Even programs that include fully integrated care of other diseases, managed care and other comprehensive health programs do not reliably achieve the goal of sustained or even temporary recovery for substance use disorders. The meeting participants noted the absence of long-term outcome studies of the treatment of substance use disorders and encouraged all treatment programs not only to extend the care of discharged patients but also to systematically study the trajectories of discharged patients to improve their long-term treatment outcomes. The increasing range of recovery support services after treatment is an important and promising new trend that is now actively promoting sustained recovery.

Meeting participants noted one particularly promising model of public health goal measurement and attainment – the 90-90-90 goals for the treatment of HIV/AIDS: 90% of people with HIV will be screened to know their infection status; 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy; and 90% of all patients receiving antiretroviral therapy will have viral suppression (i.e., zero viral load).12 These measurable goals provide an operational definition of public health success for the country, states and individual healthcare organizations.

12 UNAIDS. (2014). 90-90-90: An Ambitious Treatment Target to Help End the AIDS epidemic. Geneva, Switzerland: Joint United Nations Programme on HIV/AIDS. Available: http://www.unaids.org/sites/default/files/media_asset/90-90-90_en_0.pdf

With this model as background, the IBH group concluded that a similar public health approach and similarly specific numeric goals should be established for preventing and treating substance use disorders. Examples of parallel national prevention goals could include 90% rates of screening for substance misuse among adolescents; 90% provision of interventions and follow-up for those screening positive; and 90% total abstinence rates among youth aged 12-21. While these are admittedly ambitious prevention goals, adoption of them could incentivize families, schools and communities to increase the percentage of youth who do not use any alcohol, nicotine, marijuana or other drugs every year.

A similar approach was adopted by the IBH group to improve the impact of addiction treatment. Again, there would be significant public health value if the US adopted the following goals: 90% of individuals aged 12 or older receive annual screening for substance misuse and substance use disorders; 90% of those who receive a diagnosis of a substance use disorder are referred and meaningfully engaged (at 6 least three sessions) in some form of addiction treatment; and 90% of those engaged in treatment achieve sustained abstinence as measured by drug testing, during and for six months following treatment.

Source:  IBH-Report-A-New-Agenda-to-Turn-Back-the-Drug-Epidemic  May 2017

In Southern Ohio, the number of drug-exposed babies in child protection custody has jumped over 200%.  The problem is so dire that workers agreed to break protocol to invite a reporter to hear their stories.  Foster care placements are at record levels, and the number of drug-exposed newborns in their custody has jumped over 200% in the past decade

Inside the Clinton County child protection office, the week has been tougher than most.

Caseworkers in this thinly populated region of southern Ohio, east of Cincinnati, have grown battle-weary from an opioid epidemic that’s leaving behind a generation of traumatized children. Drugs now account for nearly 80% of their cases. Foster-care placements are at record levels, and the number of drug-exposed newborns in their custody has jumped over 200% in the past decade. Funding, meanwhile, hasn’t budged in years.

“Many of our children have experienced such high levels of trauma that they can’t go into traditional foster homes,” said Kathi Spirk, director of Clinton County job and family services. “They need more specialized care, which is very expensive.”

The problem is so dire that workers agreed to break protocol and invite a reporter to camp out in a conference room and hear their stories. For three days, they relived their worst cases and unloaded their frustrations, in scenes that played out like marathon group therapy, for which they have no time. Many agreed that talking about it only made them feel worse, yet still they continued, one after another.

Hence the bad week.

Given the small size of their community, they asked that their names be changed out of concern for their own safety and the privacy of the children.

The caseworkers, like most, are seasoned in despair. Many worked in the 1990s when crack cocaine first arrived, followed by crystal meth in the early 2000s. In 2008, after the shipping giant DHL shuttered its domestic hub here in Wilmington and shed more than 7,000 jobs, prescription pill mills flourished while the economy staggered. Back then, a typical month saw 30 open cases, only a few of them drug-related. But the flood of cheap heroin and fentanyl, now at its highest point yet, has changed everything. A typical month now brings four times as many cases, while institutional knowledge has been flipped on its head.

“At least with meth and cocaine, there was a fight,” said Laura, a supervisor with over 20 years of experience. “Parents used to challenge you to not take their kids. And now you have them say: ‘Here’s their stuff. Here’s their formula and clothes.’ They’re just done. They’re not going to fight you any more.”

Heroin has changed how they approach every step of their jobs, they said, from the first intake calls to that painstaking decision to place a child into temporary foster care or permanent custody. Intake workers now fear what used to be routine.

“Occasionally, we’d get thrown a dirty house, something easy to close and with little trauma to the child,” said Leslie, another worker. “We’re not getting those any more.

Now they’re all serious, and most of them have a drug component. So you may get a dirty house, but it’s never just a dirty house.”

‘I had a four-year old whose mom had died in front of her and she described it like it was nothing’ Children come into the system in two ways. The first is through a court order after caseworkers deem their environment unsafe, and if no friends or family can be found.

Because of the added trauma, removing a child is always the last option, caseworkers said. But in a county with only 42,000 people spread out over 400 square miles, the magnitude of the epidemic has compromised an already delicate safety net. Relatives are overwhelmed financially. Multiple generations are now addicted, along with cousins, uncles, and neighbors. In many cases, a safe house with a grandparent or other relative will eventually attract drug activity.

Law enforcement will also bring children in, usually after parents overdose. These cases often reveal the most horrendous neglect: a three-year old who needed every tooth pulled because he’d never been made to brush them, or kids found sleeping on bug-infested mattresses, going to the toilet in buckets because the water had been shut off. Children are coming in more hardened, they said, older than their years.

“I had a four-year-old whose mom had died in front of her and she described it like it was nothing,” said Bridgette, another caseworker. “She knew how to roll up a dollar bill and snort white powder off the counter. That’s what she thought dollar bills were for.” She added that many of the children could detail how to cook heroin. One foster family had a five-year-old boy who put his medicine dropper in his shoe. “Because that’s where daddy hid his needles,” she said.

“The kids are used to surviving in that mess,” added Carole, another veteran. “Now all the sudden the system is going in and saying it’s not safe. All their survival instincts are taken away and they go ballistic. They don’t know what to do.”

During the first weeks of foster care, meltdowns, tantrums, and violence are common as children navigate new landscapes and begin to process what they’ve experienced.

One afternoon, the caseworkers brought in a foster couple who’d taken in two sisters, an infant born drug-exposed, and her four-year old sister. The baby had to be weaned off opioids and now suffered chronic respiratory problems. Part of her withdrawal had included non-stop hiccups. The older girl had lived with her parents in a drug house and displayed clear signs of post-traumatic stress. Once, a family friend sitting next to her in a car had overdosed and turned purple. She’d witnessed domestic abuse, and one day a neighbor shot and killed her dog while she watched (she’d let the dog out). After a meltdown at a classmate’s pool party, over a year after entering foster care, she revealed having seen a toddler drown in a pond while adults got high. Through therapy, she’d also revealed sexual assault. The foster mother described how the girl suffered flashbacks, triggered by stress and certain anniversaries, like the day of her removal, and other seemingly random events. When this happened, she slipped into catatonic seizures.

“Her eyes are closed and you can’t wake her,” she said. “It’s like narcolepsy, a deep, unconscious sleep. We later discovered it was a coping mechanism she’d developed in order to survive.”

Despite what they’ve endured, most children wish desperately to return to their parents. Many come to see themselves as their parents’ caretakers and feel guilty for being taken away, especially if they were the ones to report an overdose, as in the case of a four-year-old girl who climbed out of a window to alert a neighbor. “She asked me: if I took her away, who was going to take care of mommy?” Bridgette remembered.

For caseworkers, reunification is the endgame. After children enter temporary foster care, the agency spends up to two years working closely with the family while the parents try to stay sober. The only contact with their children comes in the form of twice-weekly visits held in designated rooms here at the office. Each contains a tattered sofa and some second-hand toys. Currently, the agency runs about 200 visits each week. The encounters are monitored through closed-circuit cameras. For everyone involved, it can be the most trying period.

Many parents use the time to build trust and re-establish bonds. “During those first four years, a child gets such good stuff from their parents,” said Sherry, the caseworker who monitors the visits. “The kids are just trying to get that back.” Some parents bring doughnuts and pictures, while others need more guidance. Caseworkers hold parenting classes. Some moms lost newborns at the hospital after they tested positive for drugs; workers teach them how to feed and hold the child, and encourage them to bring outfits to dress their babies.

For other children, the visits trigger a storm of emotion that churns up the trauma of removal. “We had one girl who’d scream and wail at the end of every visit,” Laura, the supervisor, remembered. “Each time she thought she’d never see her mother again. We’d have to pry her out of mom’s arms and carry her down the hallway.”

“We’d sit in our offices and just sob,” added another worker. “But that girl’s cries weren’t enough to keep Mom off heroin.”

The number of available foster families is dwindling, while the cost of supporting them has never been higher

Perhaps the greatest difference with heroin and opioids, caseworkers said, is their iron grasp. Staying sober is a herculean task, especially in this rural community short on resources, where the nearest treatment facilities are over 30 miles away in Dayton, Cincinnati, or Columbus. At some point, nearly every parent falls off the wagon. They disappear and miss visits, leaving children to wait. One of the hardest parts of the job is telling a child that mom or dad isn’t coming, or that they can’t even be found.

“You see the hurt in their eyes,” Sherry said. “It’s a look of defeat, and it just breaks your heart.” She remembered a mother who’d failed to show up for months, then made it for her twin boys’ birthday. “The next day she overdosed and died.”

A tally sheet is used to track how many times prospective clients waiting to enter the program call a detox center, in Huntington, West Virginia. Photograph: Brendan Smialowski/AFP/Getty Images

When parents fail drug screenings during the 18-month period, caseworkers use discretion. Parents might be doing better in other areas like landing a job, or finding secure housing, so workers help them to get back on the wagon. “It’s all about showing progress,” Laura said. Some parents make it 16, 17 months sober and fully engaged. “And they’re the toughest cases, because we’ve been rooting for them this whole time and helping them. We’re giving kids pep talks, saying: ‘Mom’s doing great, she’s getting it together!’ They’re so happy to be going home. And then it all falls apart.”

With heroin, defeat is something the workers have learned to reckon with. Lately they’ve started snapping photos of parents and children during their first visit together, getting medical histories and other vital information – something they used to do much later. “Because we know the parents probably aren’t going to make it,” Laura admitted. “And if we never see them again, this is the info we need.” When asked how many opioid cases had ended in reunification, only two workers raised their hands.

The repeated disappointments come as resources and morale have reached their tipping point. The number of available foster families is dwindling, they said, while the cost of supporting them – over $1.5m a year – has never been higher.

Spirk, the agency’s director, said that all the agency’s budget was paid for with federal dollars and a county tax levy, although they’ve been flat-funded for nearly 10 years. The state contributes just 10%. When it comes to investing in child protection, Ohio ranks last in the country – despite having spent nearly $1bn fighting its opioid problem in 2016 alone.

The Ohio house of representatives recently passed a new state budget with an additional $15m for child protective services, but the state senate has yet to pass its own version. The only bit of hope came in March, when the Ohio attorney general’s office announced a pilot program that will give Clinton County, along with others, additional resources to help treat children for trauma, and to assist with drug treatment. It starts in October.

The epidemic’s unrelenting barrage has also taken a toll on mental health. “Our caseworkers are experiencing secondary trauma and frustration at not being able to reunify children with their parents because of relapses,” Spirk said.

Almost every caseworker said they had experienced depression or some form of PTSD, although no one had sought professional help. The privacy of their cases also means that few can speak openly with friends or family members. Some chose to drink, while others leaned on their faiths. But most said coping mechanisms they once relied on had failed.

“I used to have a routine on my drive home,” Laura said. “I’d stop in front of a church, roll down my window, and throw out all the day’s problems. The next morning I’d pick them back up. These days, I can’t do that anymore.”

“There’s no more outlet,” added Shelly, another supervisor. “You think you’re able to separate but you can’t let it go anymore. You try to eat healthy, do yoga, whatever they tell you to do. But it’s just so horrific now, and it keeps getting worse.”

At some point, the inevitable happens. When a parent can’t stay sober, or stops showing progress, the decision is made to place the child into permanent custody and put them up for adoption. For everyone, including caseworkers, it’s the most wrenching day.

The final act of every case is the “goodbye visit”, held in one of the nicer conference rooms. It’s a chance for parents to let their children know they love them and will miss them, and that it’s time to move on. Adoptive parents can choose to stay in contact, but it isn’t mandatory.

To make the time less stressful, Sherry, the worker who monitors the visits, has them draw pictures together, which she scans and gives to them as mementoes. She also tapes the meetings for them to keep. Watching from her tiny room full of TV screens, she can’t help but cry. “What people don’t realize is that when a baby comes into our custody, they’re still in a carrier seat. By the time the case is over, we’ve helped to potty train them. Two years is a very long time with a child. So in a way, it’s like my goodbye visit, too.”

Caseworkers have started making “life books” for kids once they come into the system. It’s where they put the photos they’ve taken, plus any pictures of birth parents or relatives they can find, report cards, ribbons and medals – the souvenirs of any childhood.  “It’s their history,” Sherry said, “so that one day they can make sense of their lives.”   She noted that one kid, after turning 18, tore his to pieces, taking with him only the good memories.

Source:  https://www.theguardian.com/us-news/2017/may/17/ohio-drugs-child-protection-workers

Addiction is treatable. So why aren’t more people receiving quality care?

The crisis is well documented and reported: More people are dying of drug overdose than any other non-natural cause—more than from guns, suicide, and car accidents. Politicians have held press conferences, formed commissions and task forces, and convened town-hall meetings. Vivek Murthy, the Surgeon General under President Obama (fired by Donald Trump), issued an historic report on America’s drug-use and addiction crises. Pharmaceutical companies have been blamed. Drug cartels. Physicians who hand out pain pills like Skittles.

In the meantime, the problem worsens. In 2015, 52,000 people died because of overdose, including 33,000 on OxyContin, heroin, and other opioids. Almost three times that number died of causes related to the most-used mood-altering addictive drug, alcohol. The 2016 and 2017 overdose numbers are predicted to be higher. Currently, fentanyl deaths are skyrocketing. If not politicians, to whom can we turn to address the crisis? Since addiction is a health problem, the logical answer would be the addiction-treatment system, but it’s in disarray.

Currently most people who enter treatment are subjected to archaic care, some of which does more harm than good. Only about 10 percent of people who need treatment for drug-use disorders get any whatsoever. Of those who do, a majority enter programs with practices that would be considered barbaric if they were common in treatment systems for other diseases.

Many programs reject science and employ one-size-fits-all-addicts treatment. Patients are often subjected to a slipshod patchwork of unproven therapies. They pass talking sticks and bat horses with Nerf noodles. In some programs, patients are subjected to confrontational therapies, which may include the badgering of those who resist engaging in 12-Step programs, participation in which is required in almost every program. These support groups help some people, but alienate others. When compulsory, they can be detrimental.

Patients are routinely kicked out of programs for exhibiting symptoms of their disease (relapse or breaking rules), which is unconscionable. They are denied life-saving medications by practitioners who don’t believe in them—as Richard Rawson, PhD, research professor, UVM Center for Behavior and Health, says, “this is tantamount to a doctor not believing in Coumadin to prevent heart attacks or insulin for diabetes.”

Patients are put in programs for arbitrary periods of time. Three or five days of detox isn’t treatment. Many residential programs last for twenty-eight days, but research has shown that a month is rarely long enough to treat this disease. Some of those who enter residential treatment do get sober, but they relapse soon after they’re discharged, with, as addiction researcher Thomas McLellan, PhD, sums, “a hearty handshake and instructions to go off to a church basement someplace.” As he says, “It just won’t work.” Finally, people afflicted with this disease are almost never assessed and treated for co-occurring psychiatric disorders, in spite of the fact they almost always accompany and underlie life-threatening drug use. If both illnesses aren’t addressed, relapse is likely.

The disastrous state of the system suggests that addiction-medicine specialists don’t know how to treat substance-use disorders (or even if they can be treated). It’s not the case. The National Institute on Drug Abuse (NIDA) and organizations of addiction-care professionals like the American Society of Addiction Medicine (ASAM) and American Association of Addiction Psychiatry (AAAP) have identified effective treatments. There’s no easy cure for many complex diseases, including addiction. However, cognitive-behavior therapy, motivational interviewing, and addiction medications, often used in concert with one another and in concert with assessment and treatment dual diagnoses, are among many proven treatments. However, most patients are never offered these treatments because of a fatal chasm between addiction science and practitioners and programs.

Fixing the system requires modeling it on the one in place for other serious illnesses. Most people enter the medical system in their primary-care doctors’ offices, health clinics, or emergency rooms. Currently, most doctors in these settings have had little or no education about addiction. A recent ASAM survey of two thirds of U.S. medical schools found that they require an average of less than an hour of training in addiction treatment.

Doctors must be taught to recognize substance-use disorders and treat them immediately—the archaic “let them hit bottom” paradigm has been discredited. They should offer or refer for brief interventions. A program called SBIRT (Screening, Brief Intervention and Referral to Treatment), which seeks to identify risky substance use and includes as few as three counselling sessions, has proven effective in many cases, and may be implemented in general healthcare settings.

Primary-care doctors should be trained and certified to prescribe buprenorphine, a medication that decreases craving and prevents overdose on opioids. Currently, there are limitations on the number of patients doctors can treat. Still, in Vermont, for example, almost 50 percent of opioid users in treatment receive care in their doctors’ offices- they don’t have to go to addiction specialists or intensive treatment programs to receive care.

When a patient requires a higher level of care, doctors must refer them to addiction specialists, which excludes many current practitioners whose only qualification to treat addiction is their own experience in recovery. Instead, patients must be seen by psychiatrists and psychologists trained to diagnose and treat the wide range of substance use disorders. There’s a shortage of these doctors; there needs to be a concerted effort to fill the void.

According to Larissa Mooney, MD, director of the UCLA Addiction Medicine Clinic, “Individuals entering treatment should be presented with an informed discussion about treatment options that include effective, research-based interventions.  In our current system, treatment recommendations vary widely and may come with bias; medication treatments are either not offered or may be presented as a less desirable option in the path to recovery. Treatment should be individualized, and if the same form of treatment has been repeated over and over with poor results (i.e. relapse), an alternative or more comprehensive approach should be suggested.”

When determining if a patient should be treated in physicians’ offices, intensive-outpatient, or residential setting, doctors should rely on ASAM guidelines, not guesses. The length of treatment must be determined by necessity, not insurance. If a patient relapses, is recalcitrant, or breaks rules, treatment should be re-evaluated. They may need a higher level of care, but sick people should never be put out on the street. In addition, all practitioners must reject the archaic proscriptions against medication-assisted treatment; Rawson says that failing to prescribe addiction medications in the case of opioid addiction “should be considered malpractice.”

Programs must also address the fact that a majority of people with substance-use disorders have interrelated psychiatric illnesses. Patients should undergo clinical evaluation, which may include psychological testing. Those with dual diagnoses must be treated for their co-occurring disorders. Finally, initial treatments must be followed by aftercare that’s monitored by an addiction psychiatrist, psychologist, or physician. In short, the field must adopt gold-standard, research-based best practices.

People blame politicians, drug dealers, and pharmaceutical companies for the overdose crisis. However, that won’t help the millions of addicted Americans who need treatment now. Even the most devoted and skilled addiction professionals must acknowledge that they’re part of a broken system that’s killing people. No one can repair it but them.

Source:https://www.psychologytoday.com/blog/overcoming-addiction/201705/sobering-truth-about-addiction-treatment-in-america  May 2017

COLUMBUS, Ohio — It’s being called “gray death” — a new and dangerous opioid combo that underscores the ever-changing nature of the U.S. addiction crisis.

Investigators who nicknamed the mixture have detected it or recorded overdoses blamed on it in Alabama, Georgia and Ohio. The drug looks like concrete mix and varies in consistency from a hard, chunky material to a fine powder.

The substance is a combination of several opioids blamed for thousands of fatal overdoses nationally, including heroin, fentanyl, carfentanil – sometimes used to tranquilize large animals like elephants – and a synthetic opioid called U-47700.

“Gray death is one of the scariest combinations that I have ever seen in nearly 20 years of forensic chemistry drug analysis,” Deneen Kilcrease, manager of the chemistry section at the Georgia Bureau of Investigation, said.  Gray death ingredients and their concentrations are unknown to users, making it particularly lethal, Kilcrease said. In addition, because these strong drugs can be absorbed through the skin, simply touching the powder puts users at risk, she said.

Last year, the U.S. Drug Enforcement Administration listed U-47700 in the category of the most dangerous drugs it regulates, saying it was associated with dozens of fatalities, mostly in New York and North Carolina. Some of the pills taken from Prince’s estate after the musician’s overdose death last year contained U-47700.

Gray death has a much higher potency than heroin, according to a bulletin issued by the Gulf Coast High Intensity Drug Trafficking Area. Users inject, swallow, smoke or snort it.

Georgia’s investigation bureau has received 50 overdose cases in the past three months involving gray death, most from the Atlanta area, said spokeswoman Nelly Miles.

In Ohio, the coroner’s office serving the Cincinnati area says a similar compound has been coming in for months. The Ohio attorney general ‘s office has analyzed eight samples matching the gray death mixture from around the state.

The combo is just the latest in the trend of heroin mixed with other opioids, such as fentanyl, that has been around for a few years.  Fentanyl-related deaths spiked so high in Ohio in 2015 that state health officials asked the federal Centers for Disease Control and Prevention to send scientists to help address the problem.

The mixing poses a deadly risk to users and also challenges investigators trying to figure out what they’re dealing with this time around, said Ohio Attorney General Mike DeWine, a Republican.

“Normally, we would be able to walk by one of our scientists, and say ‘What are you testing?’ and they’ll tell you heroin or ‘We’re testing fentanyl,’” DeWine said. “Now, sometimes they’re looking at it, at least initially, and say, ‘Well, we don’t know.’”

Some communities also are seeing fentanyl mixed with non-opioids, such as cocaine. In Rhode Island, the state has recommended that individuals with a history of cocaine use receive supplies of the anti-overdose drug naloxone.

These deadly combinations are becoming a hallmark of the heroin and opioid epidemic, which the government says resulted in 33,000 fatal overdoses nationally in 2015. In Ohio, a record 3,050 people died of drug overdoses last year, most the result of opioid painkillers or their relative, heroin.

Most people with addictions buy heroin in the belief that’s exactly what they’re getting, overdose survivor Richie Webber said.  But that’s often not the case, as he found out in 2014 when he overdosed on fentanyl-laced heroin. It took two doses of naloxone to revive him. He’s now sober and runs a treatment organization, Fight for Recovery, in Clyde, about 45 miles (72 kilometers) southeast of Toledo.

A typical new combination he’s seeing is heroin combined with 3-methylfentanyl, a more powerful version of fentanyl, said Webber, 25. It’s one of the reasons he tells users never to take drugs alone.

“You don’t know what you’re getting with these things,” Webber said. “Every time you shoot up you’re literally playing Russian roulette with your life.”

Source:  https://www.statnews.com/2017/05/04/opioid-gray-death-overdoses/  4th May 2017

The opioid epidemic has led to the deadliest drug crisis in US history – even deadlier than the crack epidemic of the 1980s and 1990s.

Drug overdoses now cause more deaths than gun violence and car crashes. They even caused more deaths in 2015 than HIV/AIDS did at the height of the epidemic in 1995.

A new study suggests that we may be underestimating the death toll of the opioid epidemic and current drug crisis. The study, conducted by researchers at the Centers for Disease Control and Prevention (CDC), looked at 1,676 deaths in Minnesota’s Unexplained Death surveillance system (UNEX) from 2006 – 2015. The system is meant to refer cases with no clear cause of death to further testing and analysis. In total, 59 of the UNEX deaths, or about 3.5 percent, were linked to opioids. But more than half of these opioid-linked deaths didn’t show up in Minnesota’s official total for opioid related deaths.

It is unclear how widespread of a problem this is in other death surveillance systems and other states, but the study’s findings suggest that the numbers we have so far for opioid deaths are at best a minimum. Typically, deaths are marked by local coroners or medical examiners through a system; if the medical examiner marks a death as immediately caused by an opioid overdose, the death is eventually added to the US’s total for opioid overdose deaths. But there is no national standard for what counts as an opioid overdose, so it’s left to local medical officials to decide whether a death was caused by an overdose or not. This can get surprisingly tricky – particularly in cases involving multiple conditions or for cases in which someone’s death seemed to be immediately caused by one condition, but that condition had a separate underlying medical issue behind it.

For example, opioids are believed to increase the risk of pneumonia. But if a medical examiner sees that a person died of pneumonia, they might mark the death as caused by pneumonia, even if the opioids were the underlying cause for the death. “In early spring, the Minnesota Department of Health was notified of an unexplained death: a middle-aged man who died suddenly at home. He was on long-term opioid therapy for some back pain, and his family was a little bit concerned that he was abusing his medication,” said Victoria Hall, one of the study’s authors.

“After the autopsy, the medical examiner was quite concerned about pneumonia in this case, and that’s how the case was referred to the Minnesota Department of Health unexplained deaths program. Further testing diagnosed an influenza pneumonia, but also detected a toxic level of opioids in his system. However, on the death certificate, it only listed the pneumonia and made no mention of opioids.”

Since this is just one study of one surveillance system in one state, it’s unclear just how widespread this kind of underreporting is in the United States. But the data suggests that there is at least some undercounting going on – which is especially worrying, as this is already the deadliest drug overdose crisis in US history. “It does seem like it is almost an iceberg of an epidemic,” said Hall. “We already know that it’s bad. And while my research can’t speak to what percent we’re underestimating, we know we are missing some cases.” In 2015, more Americans died of drug overdoses than any other year on record – more than 52,000 deaths in just one year. That’s higher than the more than

38,000 who died in car crashes, the more than 36,000 who died from gun violence, and the more than 43,000 who died due to HIV/AIDS during that epidemic’s peak in 1995.

See more: • The Changing Face of Heroin Use in the US study • Today’s Heroin Epidemic – CDC

Source:  Prevention Weekly. news@cadca.org  May 2017

Challenges Top Marijuana Lobbyist to Answer Four Questions

[Alexandria, VA, May 2, 2017] – Today, Smart Approaches to Marijuana (SAM), a national organization committed to promoting evidence-based marijuana laws at the Federal, state, and local levels, released the following statement in reaction to the admission by Rob Kampia, the Executive Director of the Marijuana Policy Project, that the special interest group is actively soliciting financial contributions from the tobacco industry in exchange for shaping their marijuana legalization initiatives. MPP is the lead lobbying group responsible for funding and organizing every state-based marijuana commercialization campaign in the U.S.

“Rob Kampia’s shameless solicitation for contributions from the tobacco industry is quid pro quo special interest politics at its worst,” said Dr. Kevin Sabet, President and CEO of SAM. “Marijuana laws in our country should be informed by science and evidence, not the financial interests of the tobacco industry or a growing for-profit marijuana industry.  When the head of the lobbying group responsible for every single marijuana legalization initiative in America asks tobacco companies, ‘what do you want?’ it should send chills down the spine of every public health and safety official in America.

This is an outrage and we challenge the Marijuana Policy Project to immediately disclose any and all ties to the tobacco industry so that communities in Michigan and across the country considering changes to marijuana laws can see through the haze of what’s really driving pro-marijuana legalization campaigns in America.”

Kampia’s admission was published last week in the Marijuana Business Daily in a story entitled, “MPP Chief Ready to Barter For Marijuana Campaign Donations.” According to the Daily:

The executive director of Marijuana Policy Project, Kampia called Marijuana Business Daily on Thursday after reading an MJBizDaily story about negotiations in Michigan over a likely ballot measure to legalize recreational cannabis in the state.

He solicited tobacco business interests in Michigan in search of campaign donations to run what will likely be a multimillion-dollar, 19-month endeavor, but he said he was largely unsuccessful.

“It’s the kind of thing where I actually go out and I try to court well-funded constituencies and philanthropists, and say, ‘What do you want, what do you hate, what’s going to turn you off so I can’t actually ask you for money later,’ and sometimes you get so far as to say … ‘Is there something that we put something in here that would cause you to immediately escalate your commitment?'” Kampia explained…

In response to Kampia’s latest comments, SAM also challenged MPP to answer four questions regarding MPP’s ties to the tobacco industry:

1. How much total money has MPP taken from the tobacco industry since the organization was established in 1995?

2. Which state-based marijuana ballot initiatives led by MPP have been influenced by input from the tobacco industry?

3. What specific changes to marijuana legislation or ballot initiatives has the tobacco industry proposed in exchange for financial contributions to MPP?

4. Has MPP disclosed its ties to the tobacco industry with Members of Congress it is currently lobbying in support of Federal legislation that would incentivize the commercialization of marijuana in the United States?

Evidence demonstrates that marijuana – which has skyrocketed in average potency over the past decades – is addictive and harmful to the human brain, especially when used by adolescents. Moreover, in states that have already legalized the drug, there has been an increase in drugged driving crashes and youth marijuana use. States that have legalized marijuana have also failed to shore up state budget shortfalls with marijuana taxes, continue to see a thriving black market, and are experiencing a continued rise in alcohol sales.

Source:  learnaboutsam.org.  2nd May 2017

Fifty years on, I still wince in recalling those two frightened high school kids I saw hauled into an Oshawa courtroom and handed stiff jail terms, two years less a day, for possessing miniscule amounts of marijuana.

They weren’t dealers. They were just teens dabbling in the latest thing, but they had the misfortune of being the first “drug arrests” in a tough, beer-swilling automotive city that was close to hysteria over the arrival of dirty, long-haired hippies and their damn weed.

Those kids would be senior citizens now, but I still wonder what became of them. Were their lives ruined by that jail time and the criminal records that followed them everywhere? Or did they move on and become brain surgeons and bank presidents?

I get the argument behind decriminalizing marijuana consumption. Nobody should do jail time for simply consuming a product less damaging, at least to the liver, than alcohol. If deterrence was the intent of those harsh marijuana sentences, they utterly failed. By the early 1970s, it was all but impossible to attend a social gathering without being handed a joint and expected to partake, at least a polite puff or two, or be labelled a pariah.

But the pendulum has swung. The anti-weed hysteria of the late ’60s has become raging 21st-century fury that anyone would dare voice concerns about the fallout of Justinian Canada becoming only the second nation to give marijuana its full blessing.

Mayor Drew Dilkens ran afoul of the pot crusaders and their missionary zeal three weeks ago when he described, in this space, how a trip to Denver, Colo., where marijuana was legalized four years ago, left him worried about the possible impact on a border city like Windsor. On the 16th Street pedestrian mall, he had encountered throngs of aggressive “riff-raff and undesirables.” Denver’s mayor has gone even further, decrying the area’s “scourge of hoodlums.”

Enraged readers dumped on Dilkens. They ripped him for being out-of-touch with the times and failing to recognize a potential tourism bonanza for our downtown. They mocked him for being concerned for his safety in Denver and wailed that he was trying to deny them their precious medicinal marijuana.

Never mind that Dilkens never mentioned medical marijuana and didn’t say whether he’s for or against legalization. Facts don’t matter. All that matters is that he wasn’t out front leading the marijuana welcoming parade, pompoms in hand, and that merited condemnation.

The most interesting message Dilkens received after the column appeared came from someone who actually knows what he’s talking about.

“As a Colorado sheriff who’s had to deal with the impacts of commercialized marijuana, I will tell you that your concerns are warranted,” wrote Justin Smith, the outspoken sheriff of Larimer County, population 334,000, an hour’s drive north of Denver.

“Since we approved commercial marijuana production and sales, we’ve been overrun by transients and transient-related crime. In the last three years my jail population has soared by more than 25 per cent. Six years ago, transients accounted for one-in-eight inmates in my jail. Today, they account for one-in-three inmates and many have multiple pending cases. Our county prosecutor predicts a 90 per cent increase in felony crime prosecutions over the last three years.

“Decriminalized marijuana has proven to be anything but safe and well-regulated in my state,” the sheriff warned. “If I could give your country any words of wisdom, they would be, don’t sell the future of your country to the pot industry.”

Too late, sheriff. The industry, now in the clutches of powerful corporations and feverish investors, is slathering over the immense profits to be made now that our flower child PM has given them the all clear.

Late-night host Jimmy Kimmel joked a few nights ago that Canada is becoming “the stoner in America’s attic.”

Funny, yes.   But insightful as well.  Next summer, when the stoners and those who feed off them occupy our downtown, which will be enveloped in the acrid stench of burning weed, we’ll see who’s laughing.

Source:http://www.theprovince.com/opinion/columnists/henderson+laughing+when+recreational+legalized/13316471/story.html

A new study released today by JAMA Psychiatry found that rates of marijuana use and marijuana addiction increased significantly more in states that passed medical marijuana laws as compared to states that have not. Examining data from 1992 to 2013, researchers concluded that medical marijuana laws likely contributed to an increased prevalence of marijuana and marijuana-addicted users.

“Politicians and pro-pot special interests are quick to tout the benefits of medical marijuana legalization, but it’s time to see through the haze —     medical marijuana has gone completely unregulated,” said SAM President Kevin Sabet. “More people in these states are suffering from an addiction to marijuana that harms their lives and relationships, while simultaneously more have begun using marijuana. No one wants to see patients denied something that might help them, but this study underscores the fact that “medical” and “recreational” legalization are blurred lines. Smoked marijuana is not medicine, and has not been proven safe and effective as other FDA-approved medications have.”

The study’s researchers wrote that increases in marijuana use in states with medical marijuana laws “may have resulted from increasing availability, potency, perceived safety, [or] generally permissive attitudes.” They conclude that “changing state laws (medical or recreational) may also have adverse public health consequences.”  Evidence demonstrates that marijuana —     which has skyrocketed in average potency over the past decades —     is addictive and harmful to the human brain, especially when used by adolescents. Moreover, in states that have already legalized the drug, there has been an increase in drugged driving crashes and youth marijuana use. States that have legalized marijuana have also failed to shore up state budget shortfalls with marijuana taxes, continue to see a thriving black market, and are experiencing a continued rise in alcohol sales.

Source:  http://www.learnaboutsam.org.  Alexandria, VA, April 26, 2017

About SAM

Smart Approaches to Marijuana (SAM) is a nonpartisan, non-profit alliance of physicians, policy makers, prevention workers, treatment and recovery professionals,  scientists, and other concerned citizens opposed to marijuana legalization who want health and scientific evidence to guide marijuana policies. SAM has affiliates in more than 30 states. For more information about marijuana use and its effects, visit http://www.learnaboutsam.org.

Alzheimer’s and Marijuana ?

An estimated 200,000 people in the United States under age 65 are living with younger-onset Alzheimer’s disease. And hundreds of thousands more are coping with mild cognitive impairment, a precursor to Alzheimer’s and other dementias.

“It’s beyond epidemic proportions. There truly is a tidal wave of Alzheimer’s disease,” said Dr. Vincent Fortanasce, a clinical professor of neurology in Southern California who is also a renowned Catholic bioethicist, author and radio host.

Fortanasce, a member of Legatus’ San Juan Capistrano Chapter, for several years has studied Alzheimer’s disease, its underlying causes and treatments. Through his research, he believes there may be a link between chronic use of marijuana — especially when started at a young age — and Alzheimer’s.

Finding the link

Fortanasce notes that medical research shows chronic users of marijuana, in particular the kind with high quantities of THC, have reduced volume in the hippocampus, the region of the brain responsible for memory and learning. In Alzheimer’s disease, Fortanasce said, medical researchers have also noticed reduced hippocampus volume with increased B-amyloid plaques and neurofibrillary tangles.

Taking into account other factors, such as skyrocketing obesity rates and lack of exercise, Fortanasce argues that chronically smoking marijuana and consuming products laced with cannabis are harming the long-term mental health of millions of young Americans. He is trying to convince the American Academy of Neurology to conduct a major survey to see if people diagnosed with dementia have also smoked marijuana.

Source: :  http://legatus.org/kicking-pot-curb/  April 9th 2017

In 2014, recreational cannabis use was legalized in Colorado, and seven other states have since followed suit. With an ever-expanding part of the population using marijuana to cure a number of ailments, researchers at Colorado State University have investigated its effects on mood. The researchers – led by Lucy Troup, assistant professor in the university’s Department of Psychology – publish their findings in the journal PeerJ.

They note that the “relationship between cannabis use and symptomatology of mood and anxiety disorders is complex,” adding that although “a great deal of research exists and continues to grow, the evidence remains contradictory.” Troup and colleagues point to a large international survey published in 2013, in which 5.2 percent of respondents reported that they used cannabis to alleviate depressive symptoms. Meanwhile, a survey of medical marijuana users in California revealed that 26.1 percent of participants reported therapeutic benefits for depression, and 37.8 percent reported benefits for anxiety.

“This trend of self-medication for conditions other than the one prescribed is too large to ignore when investigating the associations between cannabis use and mood disorders,” write the Colorado State University researchers.

They add that this increases “the need to include recreational users for research, especially when the casual user group are most likely recreational users and seem to sustain the greatest deficits in mood.”

Is cannabis used correctly for self-medication? For their study, Troup and colleagues wanted to focus on Colorado, which was the first state to legalize recreational marijuana.

As such, they conducted an in-depth, questionnaire-based study of 178 legal cannabis users who were aged 18-22.

They divided their participants into three groups based on self-reported use: a control group who never used cannabis, a casual user group, and a group of chronic users.

Interestingly, the participants who were categorized with subclinical depression, and who also used cannabis to treat their depressive symptoms, scored lower on anxiety symptoms than on their depressive symptoms. In short, they were more depressed than anxious.

The researchers also say that the self-reported anxiety sufferers were found to be more anxious than depressed.

Study co-author Jacob Braunwalder, a researcher in Troup’s laboratory, says that “if they were using cannabis for self-medication, it wasn’t doing what they thought it was doing.”

The questionnaire used in the study was developed by co-author Jeremy Andrzejewski. Called the Recreational Cannabis Use Evaluation, the questionnaire delved into users’ habits, including whether they smoked cannabis or used stronger products such as hash oils or edibles.

The researchers say that inconsistencies in previous studies are better understood when considering how cannabis use is reported. “Phytocannabinoid type and strength is not consistent between studies,” they say, “and there have been significant changes in the strength of these products post-legalization.”

‘Infrequent users have stronger relationship with negative mood’

Troup and colleagues say that it is important to point out that they looked at the residual effects of cannabis use, not administration of specific doses.

However, they do note that their results “suggested that cannabis use had an effect on measurements of mood disorder symptomatology. In particular, those who used cannabis less frequently, the casual user group, had the strongest correlations with overall score and negative effect on the CES-D [Center for Epidemiological Studies depression scale].”

Interestingly, the researchers did not observe a relationship with pre-anxiety symptoms in the cannabis user groups, compared with controls.

The researchers emphasize that their study does not conclude that cannabis causes depression or anxiety. It also does not show that cannabis cures these conditions. However, they add that their analysis displays a need for further study regarding how cannabis affects the brain.

Andrzejewski adds that “there is a common perception that cannabis relieves anxiety,” but this has not been fully backed by research.

“It is important not to demonize cannabis, but also not to glorify it,” adds Troup. “What we want to do is study it, and understand what it does. That’s what drives us.”

Concluding their study, the researchers write:

“Our data indicate that infrequent users have a stronger relationship with negative mood. Our data suggested that those that use cannabis casually scored higher on the CES-D scale for depression, and consequently could be at greater risk for developing pre-depression symptomology compared to both chronic users and controls.”

It is important to note that the study has limitations, including:

  •  Sample size
  •  Control for phytocannabinoids in terms of strength and type
  •  Confounding variables such as multiple drug use and alcohol consumption
  •  The self-report design
  • A limited interpretation of depression due to lack of clinical evaluation.

Still, the researchers say that their study “provides a starting point from which to design controlled experiments to further investigate the relationship between mood and cannabis use in a unique population.”

Source:  http://www.medicalnewstoday.com/articles/314823.php   Dec. 2014

A disturbing majority of businesses in the U.S. are being negatively impacted by prescription painkiller abuse and addiction among employees.

A survey recently released by the National Safety Council reveals more than 70 percent of workplaces are feeling the negative effects of opioid abuse. Nearly 40 percent of employers said employees are missing work do to painkiller abuse, with roughly the same percent reporting employees abusing the drugs on the job. Despite the prevalence of addiction in offices across the country, employers are doing little to mitigate risk. Record pill abuse in workplaces is coming at a time when Americans are taking more opioids than ever before, reports The Washington Post.

A recent survey from Truven Health Analytics and NPR reveals more than half of the U.S. population reports receiving a prescription for opioids at least once from their doctor, a 7 percent increase since 2011. Data released by the Centers for Disease Control and Prevention (CDC) Friday reveals that almost half of non-cancer patients prescribed opioids for a month or more are still dependent on the pills a year later.

Experts say that current opioid and heroin abuse is driven in large part by the over-prescribing of pain pills from doctors. Despite the problems opioid abuse is causing in the workplace, many employee drug tests do not look for the substance. Fifty-seven percent of businesses test for drugs, but 41 percent of those businesses do not test for opioids.

“Employers must understand that the most dangerously misused drug today may be sitting in employees’ medicine cabinets,” Deborah Hersman, president and CEO of the National Safety Council, said in a statement. “Even when they are taken as prescribed, prescription drugs and opioids can impair workers and create hazards on the job.”

Among people not currently taking opioids, nearly half view addiction as the biggest threat from using painkillers. Among current patients on opioids, fears over unwanted side effects still dwarf fears about long-term dependence and addiction. Medical professionals say doctors need to start by prescribing the least potent and least addictive pain treatment option, and then cautiously go from there.

Experts also say the patient must take greater responsibility when they visit their doctor and always ask “why” before accepting a prescription.

Addicts may begin with a dependence on opioid pills before transitioning to heroin after building up a tolerance that makes pills too expensive. States hit particularly hard by heroin abuse are beginning to crackdown on doctors liberally doling out painkillers.

“When four out of five new heroin users are getting their start by abusing prescription drugs, you have to attack the problem at ground zero – in irresponsibly run doctors’ offices,” New Jersey Attorney General Porrino said in a statement March 1. “Physicians who grant easy access to the drugs that are turning New Jersey residents into addicts can be every bit as dangerous as street-corner dealers. Purging the medical community of over-prescribers is as important to our cause as busting heroin rings and locking up drug kingpins.”

A record 33,000 Americans died from opioid related overdoses in 2015, according to the CDC. Opioid deaths contributed to the first drop in U.S. life expectancy since 1993 and eclipsed deaths from motor vehicle accidents in 2015. Combined, heroin, fentanyl and other opiate-based painkillers account for roughly 63 percent of drug fatalities, which claimed 52,404 lives in the U.S. in 2015.

Source:  http://dailycaller.com/2017/03/19/opioid-addiction-is-infiltrating-a-majority-of-us-workplaces/

“We should all be dead,” said Jonathan Goyer one bright morning in January as he looked across a room filled with dozens of his co-workers and clients. The Anchor Recovery Community Center, which Goyer helps run, occupies the shell of an office building in Pawtucket, Rhode Island. Founded seven years ago, Anchor specializes in “peer-to-peer” counselling for drug addicts. With state help and private grants, Anchor throws everything but the kitchen sink at addiction. It hosts Narcotics Anonymous meetings, cognitive behavioral therapy sessions, art workshops, and personal counselling. It runs a telephone hotline and a hospital outreach program. It has an employment center for connecting newly drug-free people to sympathetic hirers, and banks of computers for those who lack them. And all the people who work here have been in the very pit of addiction—shoplifting to pay for a morning dose, selling their bodies, or dragging out their adult lives in prison. Some have been taken to emergency rooms and “hit” with powerful anti-overdose drugs to bring them back from respiratory failure.

That is how it was with Goyer. His father died of an overdose at forty-one, in 2004. His twenty-nine-year-old brother OD’d and died in 2009. When he was shooting heroin he slept on the floor of a public garage. He would pick up used hypodermic needles if they were new enough that the volume gauges inked on the outside hadn’t been rubbed off with use. He OD’d several times before getting clean in 2013. Now he visits people after overdoses and tells them, “I was right where you’re at.”

There have always been drug addicts in need of help, but the scale of the present wave of heroin and opioid abuse is unprecedented. Fifty-two thousand Americans died of overdoses in 2015—about four times as many as died from gun homicides and half again as many as died in car accidents. Pawtucket is a small place, and yet 5,400 addicts are members at Anchor. Six hundred visit every day. Rhode Island is a small place, too. It has just over a million people. One Brown University epidemiologist estimates that 20,000 of them are opioid addicts—2 percent of the population.

Salisbury, Massachusetts (pop. 8,000), was founded in 1638, and the opium crisis is the worst thing that has ever happened to it. The town lost one young person in the decade-long Vietnam War. It has lost fifteen to heroin in the last two years. Last summer, Huntington, West Virginia (pop. 49,000), saw twenty-eight overdoses in four hours. Episodes like these played a role in the decline in U.S. life expectancy in 2015. The death toll far eclipses those of all previous drug crises.

And yet, after five decades of alarm over threats that were small by comparison, politicians and the media have offered only a muted response. A willingness at least to talk about opioid deaths (among other taboo subjects) surely helped Donald Trump win last November’s election. In his inaugural address, President Trump referred to the drug epidemic (among other problems) as “carnage.” Those who call the word an irresponsible exaggeration are wrong.

Jazz musicians knew what heroin was in the 1950s. Other Americans needed to have it explained to them. Even in the 1960s and 1970s, with bourgeois norms and drug enforcement weakening, heroin lost none of its terrifying underworld associations. People weren’t shooting it at Woodstock. Today, with much of the discourse on drug addiction controlled by medical bureaucrats, it is common to speak of addiction as an “equal-opportunity disease” that can “strike anyone.” While this may be true on the pharmacological level, it was until quite recently a sociological falsehood. In fact, most of the country had powerful moral, social, cultural, and legal immunities against heroin

and opiate addiction. For 99 percent of the population, it was an adventure that had to be sought out. That has now changed.

America had built up these immunities through hard experience. At the turn of the nineteenth century, scientists isolated morphine, the active ingredient in opium, and in the 1850s the hypodermic needle was invented. They seemed a godsend in Civil War field hospitals, but many soldiers came home addicted. Zealous doctors prescribed opiates to upper-middle-class women for everything from menstrual cramps to “hysteria.” The “acetylization” of morphine led to the development of heroin. Bayer began marketing it as a cough suppressant in 1898, which made matters worse. The tally of wrecked middle-class families and lives was already high by the time Congress passed the Harrison Narcotics Tax Act in 1914, threatening jail for doctors who prescribed opiates to addicts. Americans had had it with heroin. It took almost a century before drug companies could talk them back into using drugs like it.

If you take too much heroin, your breathing slows until you die. Unfortunately, the drug sets an addictive trap that is sinister and subtle. It provides a euphoria—a feeling of contentment, simplification, and release—which users swear has no equal. Users quickly develop a tolerance, requiring higher and higher amounts to get the same effect. The dosage required to attain the feeling the user originally experienced rises until it is higher than the dosage that will kill him. An addict can get more or less “straight,” but approaching the euphoria he longs for requires walking up to the gates of death. If a heroin addict sees on the news that a user or two has died from an overly strong batch of heroin in some housing project somewhere, his first thought is, “Where is that? That’s the stuff I want.”

Tolerance ebbs as fast as it rises. The most dangerous day for a junkie is not the day he gets arrested, although the withdrawal symptoms—should he not receive medical treatment—are painful and embarrassing, and no picnic for his cellmate, either. But withdrawals are not generally life-threatening, as they are for a hardened alcoholic. The dangerous day comes when the addict is released, for the dosage he had taken comfortably until his arrest two weeks ago may now be enough to kill him.

The best way for a society to avoid the dangers of addictive and dangerous drugs is to severely restrict access to them. That is why, in the twentieth century, powerful opiates and opioids (an opioid is a synthetic drug that mimics opium) were largely taboo—confined to patients with serious cancers, and often to end-of-life care. But two decades ago, a combination of libertarian attitudes about drugs and a massive corporate marketing effort combined to instruct millions of vulnerable people about the blessed relief opioids could bring, if only mulish oldsters in the medical profession could get over their hang-ups and be convinced to prescribe them. One of the rhetorical tactics is now familiar from debates about Islam and terrorism: Industry advocates accused doctors reluctant to prescribe addictive medicines of suffering from “opiophobia.”

In 1996, Purdue Pharmaceuticals brought to market OxyContin, an “extended release” version of the opioid oxycodone. (The “-contin” suffix comes from “continuous.”) The time-release formula meant companies could pack lots of oxycodone into one pill, with less risk of abuse, or so scientists claimed. Purdue did not reckon with the ingenuity of addicts, who by smashing or chewing or dissolving the pills could release the whole narcotic load at once. That is the charitable account of what happened. In 2007, three of Purdue’s executives pled guilty to felony misbranding at the time of the release of OxyContin, and the company paid $600 million in fines. In 2010, Purdue brought out a reformulated OxyContin that was harder to tamper with. Most of Purdue’s revenues still come from OxyContin. In 2015, the Sackler family, the company’s sole owners,

suddenly appeared at number sixteen on Forbes magazine’s list of America’s richest families.

Today’s opioid epidemic is, in part, an unintended consequence of the Reagan era. America in the 1980s and 1990s was guided by a coalition of profit-seeking corporations and concerned traditional communities, both of which had felt oppressed by a high-handed government. But whereas Reaganism gave real power to corporations, it gave only rhetorical power to communities. Eventually, when the interests of corporations and communities clashed, the former were in a position to wipe the latter out. The politics of the 1980s wound up enlisting the American middle class in the project of its own dispossession.

OxyContin was only the most commercially successful of many new opioids. At the time, the whole pharmaceutical industry was engaged in a lobbying and public relations effort to restore opioids to the average middle-class family’s pharmacopeia, where they had not been found since before World War I. The American Pain Foundation, which presented itself as an advocate for patients suffering chronic conditions, was revealed by the Washington Post in 2011 to have received 90 percent of its funding from medical companies.

“Pain centers” were endowed. “Chronic pain” became a condition, not just a symptom. The American Pain Society led an advertising campaign calling pain the “fifth vital sign” (after pulse, respiration, blood pressure, and temperature). Certain doctors, notoriously the anaesthesiologist Russell Portenoy of the Beth Israel Medical Center, called for more aggressive pain treatment. “We had to destigmatize these drugs,” he later told the Wall Street Journal. A whole generation of doctors was schooled in the new understanding of pain. Patients threatened malpractice suits against doctors who did not prescribe pain medications liberally, and gave them bad marks on the “patient satisfaction” surveys that, in some insurance programs, determine doctor compensation. Today, more than a third of Americans are prescribed painkillers every year.

Very few of them go on to a full-blown addiction. The calamity of the 1990s opioid revolution is not so much that it turned real pain patients into junkies—although that did happen. The calamity is that a broad regulatory and cultural shift released a massive quantity of addictive drugs into the public at large. Once widely available, the supply “found” people susceptible to addiction. A suburban teenager with a lot of curiosity might discover that Grandpa, who just had his knee replaced, kept a bottle of hydrocodone on the bedside table. A construction boss might hand out Vicodin at the beginning of the workday, whether as a remedy for back pain or a perquisite of the job. Pills are doseable—and they don’t require you to use needles and run the risk of getting AIDS. So a person who would never have become a heroin addict in the old days of the opioid taboo could now become the equivalent of one, in a more antiseptic way.

But a shocking number of people wound up with a classic heroin problem anyway. Relaxed taboos and ready supply created a much wider appetite for opioids. Once that happened, heroin turned out to be very competitively priced. Not only that, it is harder to crack down on heavily armed drug gangs that sell it than on the unscrupulous doctors who turned their practices into “pill mills.” Addicts in Maine complain about the rising price of black-market pharmaceutical pills: They have risen far above the dollar-a-milligram that used to constitute a kind of “par” in the drug market. An Oxy 30 will now run you forty-five bucks. But you can shoot heroin when the pills run out, and it will save you money. A lot of money. Heroin started pouring into the eastern United States a decade ago, even before the price of pills began to climb. Since then, its price

has fallen further, its purity has risen—and, lately, the number of heroin deaths is rising sharply everywhere. That is because, when we say heroin, we increasingly mean fentanyl.

Fentanyl is an opioid invented in 1959. Its primary use is in transdermal patches given to people for end-of-life care. If you steal a bunch of these, you can make good money with them on the street. Addicts like to suck on them—an extremely dangerous way to get a high. Fentanyl in its usual form is about fifty times as strong as street heroin. But there are many different kinds of fentanyl, so the wallop it packs is not just strong but unpredictable. There is butyrfentanyl, which is about a quarter the strength of ordinary fentanyl. There is acetylfentanyl, which is also somewhat weaker. There is carfentanil, which is 10,000 times as strong as morphine. It is usually used as an animal tranquilizer, although Russian soldiers used an aerosol version to knock out Chechen hostage-takers before their raid on a Moscow theater in 2002. A Chinese laboratory makes its own fentanyl-based animal tranquilizer, W-18, which finds its way into Maine through Canada.

China manufactures a good deal of the fentanyl that comes to the U.S., one of those unanticipated consequences of globalization. The dealers responsible for cutting it by a factor of fifty are unlikely to be trained pharmacists. The cutting lab may consist of one teenager flown up from the Dominican Republic alone in a room with a Cuisinart and a box of starch or paracetamol. It takes considerable skill to distribute the chemicals evenly throughout a package of drugs. Since a shot of heroin involves only the tiniest little pinch of the substance, you might tap into a part of the baggie that is all cutting agent, no drug—in which case you won’t get high. On the other hand, you could get a fentanyl-intensive pinch—in which case you will be found dead soon thereafter with the needle still sticking out of your arm. This is why fentanyl-linked deaths are, in some states, multiplying year on year. The federal CDC has lagged in reporting in recent years, but we can get a hint of the nationwide toll by looking at fentanyl deaths state by state. In Maryland, the first six months of 2015 saw 121 fentanyl deaths. In the first six months of 2016, the figure rose to 446.

Sometimes arrested or hospitalized users are surprised to find that what they thought was heroin was actually fentanyl. But there are addicts who swear they can tell what’s in the barrel of their needles. One in Rhode Island, whom we’ll call Gilberto, says heroin has a pleasant caramel brown tint, like the last sip of Coca-Cola in a glass. Fentanyl is clear. And many addicts claim they can recognize the high. “Fentanyl just hits you. Hard,” Gilberto says. “But it’s got no legs on it. It lasts about two hours. Heroin will hold you.” This makes fentanyl a distinctly inconvenient drug, but many addicts prefer it. All dealers, at least around Rhode Island, describe their heroin as “the fire,” in the same way all chefs describe their ribs as so tender they just fall off the bone.

“I knew we were screwed, as a state and as a country,” Jonathan Goyer says, “when I had a conversation with a kid who was going through withdrawals.” Although he had enough money to get safer drugs, the kid was going to wait through the sweats and the diarrhea and the nausea until his dealer came in at 5 p.m. That would allow him to risk his life on fentanyl.

Those in heroin’s grip often say: “There are only two kinds of people—the ones I get money from and the ones I give money to.” A man who is dead to his wife and his children may be desperate to make a connection with his dealer. They don’t buy much besides heroin—perhaps a plastic cup of someone else’s drug-free urine on a day when they need to take a drug test for a hospital or employer. This will set them back twenty or thirty dollars. In addiction, as in more mainstream endeavors, the lords of hedonism

are the slaves of money. Gilberto in Rhode Island claims to have put a million dollars into each of his needle-pocked arms, at the rate of three fifty-bag “bricks” of heroin a day.

Dealers are businessmen and behave like businessmen, albeit heavily armed ones. They may “throw something” to a particularly reliable customer—that is, give him enough heroin from time to time to allow him to deal a bit on his own account and stay solvent. An addict who discovers that the 10mg pills he is paying $18 each for in Maine are available for $10 in Boston, a three-hour drive away, may be tempted to sell them to support his own habit. The line between users and pushers blurs, rendering impractical the policy that most people prefer—be merciful to drug users, but come down hard on dealers.

Addicts wake up “sick,” which is the word they use for the tremulous, damp, and terrifying experience of withdrawal. They need to “make money,” which is their expression for doing something illegal. Some neighborhood bodegas—the addicts know which ones—will pay 50 cents on the dollar for anything stolen from CVS. That is why razor blades, printer cartridges, and other expensive portable items are now kept under lock and key where you shop. Addicts shoplift from Home Depot and drag things from the loading docks. They pull off scams. They will scavenge for thrown-out receipts in trash cans outside an appliance store, enter the store, find the receipted item, and try to return it for cash. On the edge of the White Mountains in Maine, word spread that the policy at Hannaford, the dominant supermarket chain, was not to dispute returns of under $25. For a while, there was a run on the big cans of extra virgin olive oil that sold for $24.99, which were brought to the cash registers every day by a succession of men and women who did not, at first sight, look like connoisseurs of Mediterranean cuisine. Women prostitute themselves on Internet sites. Others go into hospital emergency rooms, claiming a desperately painful toothache that can be fixed only with some opioid. (Because if pain is a “fifth vital sign,” it is the only one that requires a patient’s own testimony to measure.) This is generally repeated until the pain-sufferer grows familiar enough to the triage nurses to get “red-flagged.”

The population of addicts is like the population of deer. It is highest in rustic places with access to urban supplies. Missouri’s heroin problem is worst in the rural counties near St. Louis. New Hampshire’s is worst in the small cities and towns an hour or so away from the drug markets of Massachusetts: Lawrence, Lowell, and Boston. But the opioid epidemic of the past decade is unusually diverse. Anchor’s emergency room clients are 82 percent white, 9 percent Hispanic, and 6 percent black. The state of Rhode Island is 85 percent white, 9 percent Hispanic, and 5 percent black. “I try to target outreach,” Goyer says, “but the demographics are too random for that.”

Drug addiction used to be a ghetto thing. Now Oxycodone has joined shuttered factories and Donald Trump as a symbol of white working-class desperation and fecklessness. The reaction has been unsympathetic. Writes Nadja Popovich in The Guardian: “Some point to this change in racial and economic demographics as one reason many politicians have re-evaluated the tough ‘war on drugs’ rhetoric of the past 30 years.”

The implicit accusation is that only now that whites are involved have racist authorities been roused to act. This is false in two ways. First, authorities have not been roused to act. Second, when they do, they will have epidemiological, and not just tribal, grounds for doing so. A plague afflicting an entire country, across ethnic groups, is by definition more devastating than a plague afflicting only part of it. A heroin scourge in America’s housing projects coincided with a wave of heroin-addicted soldiers brought back from Vietnam, with a cost peaking between 1973 and 1975 at 1.5 overdose deaths per 100,000. The Nixon White House panicked. Curtis Mayfield wrote his soul ballad

“Freddie’s Dead.” The crack epidemic of the mid- to late 1980s was worse, with a death rate reaching almost two per 100,000. George H. W. Bush declared war on drugs. The present opioid epidemic is killing 10.3 people per 100,000, and that is without the fentanyl-impacted statistics from 2016. In some states it is far worse: over thirty per 100,000 in New Hampshire and over forty in West Virginia.

In 2015, the Princeton economists Angus Deaton and Anne Case released a paper showing that the life expectancy of middle-aged white people was falling. Prominent among the causes cited were “the increased availability of opioid prescriptions for pain” and the falling price and rising potency of heroin. Census figures show that Case and Deaton had put the case mildly: Life expectancy was falling for all whites. Although they are the only racial group to have experienced a decline in longevity—other races enjoyed steep increases—there are still enough whites in the United States that this meant longevity fell for the country as a whole.

Bill Clinton alluded to the Case-Deaton study often during his wife’s presidential campaign. He would say that poor white people are “dying of a broken heart.” Heroin has become a symbol of both working-class depravity and ruling-class neglect—an explosive combination in today’s political climate.

Maine’s politicians have taken the opioid epidemic as seriously as any in the country. Various new laws have capped the maximum daily strength of prescribed opioids and limited prescriptions to seven days. The levels are so low that they have led some doctors to warn that patients will go onto the street to get their dosages topped off. “We were sad,” State Representative Phyllis Ginzler said in January, “to have to come between doctor and patient.” She felt the deadly stakes of Maine’s problem gave her little alternative.

Paul LePage, the state’s garrulous governor, has been even more direct. Speaking of drug dealers at a town hall in rural Bridgton in early 2016, he said: “These are guys with the name D-Money, Smoothie, Shifty, these types of guys. They come from Connecticut and New York, they come up here, they sell their heroin, they go back home. Incidentally, half the time they impregnate a young white girl before they leave.” This is what the politics of heroin threatens to become nationwide: To break the bureaucratic inertia, one side will go to any rhetorical length, even invoking race. To protect governing norms, the other side will invoke decency, even as the damage mounts. It is what the politics of everything is becoming nationwide. From town to town across the country, the correlation of drug overdoses and the Trump vote is high.

The drug problem is already political. It is being reframed by establishment voices as a problem of minority rights and stigmatization. A documentary called The Anonymous People casts the country’s 20 million addicts as a subculture or “community” who have been denied resources and self-respect. In it, Patrick Kennedy, who was Rhode Island’s congressman until 2011 and who was treated for OxyContin addiction in 2006, says: “If we can ever tap those 20 million people in long-term recovery, you’ve changed this overnight.” What’s needed is empowerment. Another interviewee says, “I refuse to be ashamed of what I am.”

This marks a big change in attitudes. Difficult though recovery from addiction has always been, it has always had this on its side: It is a rigorously truth-focused and euphemism-free endeavor, something increasingly rare in our era of weasel words. The face of addiction a generation ago was that of the working-class or upper-middle-class man, probably long and intimately known to his neighbors, who stood up at an AA meeting in a church basement and bluntly said, “Hi, I’m X, and I’m an alcoholic.”

The culture of addiction treatment that prevails today is losing touch with such candour. It is marked by an extraordinary level of political correctness. Several of the addiction professionals interviewed for this article sent lists of the proper terminology to use when writing about opioid addiction, and instructions on how to write about it in a caring way. These people are mostly generous, hard-working, and devoted. But their codes are neither scientific nor explanatory; they are political.

The director of a Midwestern state’s mental health programs emailed a chart called “‘Watch What You Call Me’: The Changing Language of Addiction and Mental Illness,” compiled by the Boston University doctor Richard Saltz. It is a document so Orwellian that one’s first reaction is to suspect it is a parody, or some kind of “fake news” dreamed up on a cynical website. We are not supposed to say “drug abuse”; use “substance use disorder” instead. To say that an addict’s urine sample is “clean” is to use “words that wound”; better to say he had a “negative drug test.” “Binge drinking” is out—“heavy alcohol use” is what you should say. Bizarrely, “attempted suicide” is deemed unacceptable; we need to call it an “unsuccessful suicide.” These terms are periphrastic and antiscientific. Imprecision is their goal. Some of them (like the concept of a “successful suicide”) are downright insane. This habit of euphemism and propaganda is not merely widespread. It is official. In January 2017, less than two weeks before the end of the last presidential administration, drug office head Michael Botticelli issued a memo called “Changing the Language of Addiction,” a similarly fussy list of officially approved euphemisms.

Residents of the upper-middle-class town of Marblehead, Massachusetts, were shocked in January when a beautiful twenty-four-year-old woman who had excelled at the local high school gave an interview to the New York Times in which she described her heroin addiction. They were perhaps more shocked by her description of the things she had done to get drugs. A week later, the police chief announced that the town had had twenty-six overdoses and four deaths in the past year. One of these, the son of a fireman, died over Labor Day. At the burial, a friend of the dead man overdosed and was rushed to the hospital. One fireman there said to a mourner that this was not uncommon: Sometimes, at the scene of an overdose, they will find a healthy- and alert-looking companion and bring him along to the hospital too, assuming he might be standing up only because the drug hasn’t hit him yet. In communities like this, concerns about “hurtful” words and stigma can seem beside the point.

Former Bush administration drug czar John Walters and two other scholars wrote last fall, “There is another type of ‘stigma’ afflicting drug users—that their crisis is somehow undeserving of the full resources necessary for their rescue.” Walters is talking largely about law enforcement. As he said more recently: “If someone were getting food poisoning from cans of tuna, the whole way we’re doing this would be more aggressive.”

Which is not the direction we’re going. In state after state, voters have chosen to liberalize drug laws regarding marijuana. If you want an example of mass media–induced groupthink, Google the phrase “We cannot arrest our way out of the drug problem” and count the number of politicians who parrot it. It is true that we cannot arrest our way out of a drug problem. But we cannot medicate and counsel our way out of it, either, and that is what we have been trying to do for almost a decade.

Calling addiction a disease usefully describes certain measurable aspects of the problem—particularly tolerance and withdrawal. It fails to capture what is special and dangerous about the way drugs bind with people’s minds. Almost every known disease is something people wish to be rid of. Addiction is different. Addicts resist known cures—even to the point of death. If you do not reckon with why addicts go to such

lengths to continue suffering, you are unlikely to figure out how to treat them. This turns out to be an intensely personal matter.

Medical treatment plays an obvious role in addressing the heroin epidemic, especially in the efforts to save those who have overdosed or helping addicts manage their addictions. But as an overall approach, it partakes of some of the same fallacies as its supposed opposite, “heartless” incarceration. Both leave out the addict and his drama. Medicalizing the heroin crisis may not stigmatize him, but it belittles him. Moral condemnation is an incomplete response to the addict. But it has its place, because it does the addict the compliment of assuming he has a conscience, a set of thought processes. Those thought processes are what led him into his artificial hell. They are his best shot at finding a way out.

In 1993, Francis F. Seeburger, a professor of philosophy at the University of Denver, wrote a profound book on the thought processes of addicts called Addiction and Responsibility. We tend to focus on the damage addiction does. A cliché among empathetic therapists, eager to describe addiction as a standard-issue disease, is that “no one ever decides to become an addict.” But that is not exactly true, Seeburger shows. “Something like an addiction to addiction plays a role in all addiction,” he writes. “Addiction itself . . . is tempting; it has many attractive features.” In an empty world, people have a need to need. Addiction supplies it. “Addiction involves the addict. It does not present itself as some externally imposed condition. Instead, it comes toward the addict as the addict’s very self.” Addiction plays on our strengths, not just our failings. It simplifies things. It relieves us of certain responsibilities. It gives life a meaning. It is a “perversely clever copy of that transcendent peace of God.”

The founders of Alcoholics Anonymous thought there was something satanic about addiction. The mightiest sentence in the book of Alcoholics Anonymous is this: “Remember that we deal with alcohol—cunning, baffling, powerful!” The addict is, in his own, life-damaged way, rational. He’s too rational. He is a dedicated person—an oblate of sorts, as Seeburger puts it. He has commitments in another, nether world.

That makes addiction a special problem. The addict is unlikely ever to take seriously the counsel of someone who has not heard the call of that netherworld. Why should he? The counsel of such a person will be, measured against what the addict knows about pleasure and pain, uninformed. That is why Twelve Step programs and peer-to-peer counselling, of the sort offered by Goyer and his colleagues, have been an indispensable element in dragging people out of addiction. They have authority. They are, to use the street expression, legit.

The deeper problem, however, is at once metaphysical and practical, and we’re going to have a very hard time confronting it. We in the sober world have, for about half a century, been renouncing our allegiance to anything that forbids or commands. Perhaps this is why, as this drug epidemic has spread, our efforts have been so unavailing and we have struggled even to describe it. Addicts, in their own short-circuited, reductive, and destructive way, are armed with a sense of purpose. We aren’t. It is not a coincidence that the claims of political correctness have found their way into the culture of addiction treatment just now. This sometimes appears to be the only grounds for compulsion that the non-addicted part of our culture has left.

Christopher Caldwell is a senior editor at the Weekly Standard.

Source:  https://www.firstthings.com/article/2017/04/american-carnage

Substance use disorders affect businesses in surprising ways. Although there are obvious signs that an employee is struggling with a substance use disorder, there are other factors affecting their workplace performance that may be less obvious. Unfortunately, a survey from the National Safety Council found that employers underestimate how prescription drug abuse affects their businesses. Employers may not realize some of the facts illuminated in the study, such as:

• Employees with substance use disorders miss nearly 50 percent more days than their peers and up to six weeks of work annually.

• Healthcare costs for employees who misuse or abuse prescription drugs are three times the costs for an average employee.

• Getting an employee into treatment can save an employer up to $2,607 per worker annually.

The survey serves as a reminder that although some employees need support, they may not ask for it. “Businesses that do not address the prescription drug crisis are like ostriches sticking their head in the sand,” said Deborah A.P. Hersman, president and CEO of the National Safety Council. “The problem exists and doing nothing will harm your employees and your business.”

The National Safety Council alongside NORC at the University of Chicago and Shatterproof created a tool to show how the substance use disorder crisis can affect your workplace.

The Substance Use Cost Calculator is a quick and easy way to track the potential cost of substance use disorders. Employers input basic statistics about their workforce, such as industry, location, and number of employees. The tool then calculates the estimated prevalence of substance use disorders among employees and dependents. Once you have all that information on hand, you can figure out a way to prioritize helping those who are struggling with a substance use disorder. If you are worried about addressing such a difficult problem, remember that leaders ask how they can help others and utilize subject-matter resources.

Source:  https://images.magnetmail.net/images/clients/CADCA/attach/SubstanceUseCosts.pdf April 2017

Filed under: Economic,Social Affairs,USA :

[Alexandria, VA, April 20, 2017]

Today, a group of national drug policy leaders, elected officials, and public health experts convened in Atlanta to coordinate the opposition to marijuana legalization in the U.S. and advance evidence-based marijuana laws. Held in conjunction with the National Rx Drug Abuse & Heroin Summit, the 4th Annual Smart Approaches to Marijuana (SAM) Summit featured keynote speakers including Former Clinton Drug Czar Barry McCaffrey and Arizona Governor Doug Ducey. The day-long program highlighted concerns about the special interest marijuana lobby and empowered concerned citizens with grassroots advocacy strategies to protect public health and safety in their local communities.

“So far, 2017 has been a bad year for the pro-marijuana special interests looking to profit off the next big addictive industry,” said SAM President and CEO Kevin A. Sabet. “More states are realizing that marijuana legalization produces more costs than benefits, so this momentum gives our summit new significance as we look to energize our base and move the needle toward evidence-based marijuana policy that puts people over profit.”

“Smart drug policy starts with science and research, not ideology or profit,” said SAM Honorary Advisor and Former Drug Czar General Barry McCaffrey. “SAM embodies this belief by advocating for common-sense laws that protect American families and communities from the social and health consequences of marijuana legalization. I continue to be concerned about the serious problems around drug abuse and its effects on our country, so I’m proud to stand up for SAM’s health first agenda today.”

“Last year, Arizonans went to the ballot and soundly rejected the misguided and harmful proposal to legalize marijuana,” said Arizona Governor Doug Ducey. “This vote shows that Arizonans don’t want the harmful consequences of legalizing this drug that have been seen in other states, like drugged driving incidents and more kids using marijuana. I am honored to stand with SAM today in support of the message that the health and safety of our communities must come first.”

Evidence shows that marijuana – which has skyrocketed in average potency over the past decades – is addictive and harmful to the human brain, especially when used by adolescents. Moreover, in states that have already legalized the drug, there has been an increase in drugged driving crashes and youth marijuana use. States that have legalized marijuana have also failed to shore up state budget shortfalls with marijuana taxes, continue to see a thriving black market, and are experiencing a continued rise in alcohol sales.

Source:  anisha@learnaboutsam.org   20th April 2017 About SAM Smart Approaches to Marijuana (SAM) is a nonpartisan, non-profit alliance of physicians, policy makers, prevention workers, treatment and recovery professionals, scientists, and other concerned citizens opposed to marijuana legalization who want health and scientific evidence to guide marijuana policies. SAM has affiliates in more than 30 states. For more information about marijuana use and its effects, visit http://www.learnaboutsam.org.

Formerly inconceivable ideas—like providing drug users a safe place to inject—are gaining traction.

America’s opioid problem has turned into a full-blown emergency now that illicit fentanyl and related synthetic drugs are turning up regularly on our streets. This fentanyl, made in China and trafficked through Mexico, is 25 to 50 times as potent as heroin. One derivation, Carfentanil, is a tranquilizer for large animals that’s a staggering 1,000 to 5,000 times as powerful.

Adding synthetic opioids to heroin is a cheap way to make it stronger—and more deadly. A user can die with the needle still in his arm, the syringe partly full. Traffickers also press these drugs into pills that they sell as OxyContin and Xanax. Most victims of synthetic opioids don’t even realize what they are taking. But they are driving the soaring rate of overdose—a total of 33,091 deaths in 2015, according to the Centers for Disease Control and Prevention.

Hence the ascendance of a philosophy known as “harm reduction,” which puts first the goal of reducing opioid-related death and disease. Cutting drug use can come second, but only if the user desires it. As an addiction psychiatrist, I believe that harm reduction and outreach to addicts have a necessary place in addressing the opioid crisis. But as such policies proliferate—including some that used to be inconceivable, such as providing facilities where drug users can safely inject—Americans shouldn’t lose sight of the virtues of coerced treatment and accountability.

What does harm reduction look like? One example is Maryland’s Overdose Survivor Outreach Program. After an overdose survivor arrives in the emergency room, he is paired with a “recovery coach,” a specially trained former addict. Coaches try to link patients to treatment centers. Generally this means counseling along with one of three options: methadone; another opioid replacement called buprenorphine, which is less dangerous if taken in excess; or an opioid blocker called naltrexone. Overdose survivors who don’t want treatment are given naloxone, a fast-acting opioid antidote. Coaches also stay in touch after patients leave the ER, helping with court obligations and social services.

Similar programs operate across the country. In Chillicothe, Ohio, police try to connect addicts to treatment by visiting the home of each person in the county who overdoses. In Gloucester, Mass., heroin users can walk into the police station, hand over their drugs, and walk into treatment within hours, without arrest or charges. It’s called the Angel Program. Macomb County, Mich., has something similar called Hope Not Handcuffs.

Another idea gaining traction is to provide “safe consumption sites,” hygienic booths where people can inject their own drugs in the presence of nurses who can administer oxygen and naloxone if needed. No one who goes to a safe consumption site is forced into treatment to quit using, since the priority is reducing risk.

In Canada, staffers at Vancouver’s consumption site urge patrons to go into treatment, but they also distribute clean needles to reduce the spread of viruses such as HIV and hepatitis C. Naloxone kits are on hand in case of overdose. One study found that opening the site has reduced overdose deaths in the area, and more than one analysis showed reduced injection in places like public bathrooms, where someone can overdose undiscovered and die.

There are no consumption sites in the U.S., but in January the board of health in King County, Wash., endorsed the creation of two in the Seattle area. A bill in the California

Assembly would allow cities to establish safe consumption sites. Politicians, physicians and public-health officials have called for them in Baltimore; Boston; Burlington, Vt.; Ithaca, N.Y.; New York City; Philadelphia and San Francisco. Drug-war-weary police officers and harm reductionists would rather see addicts opt for treatment and lasting recovery, but they’ll settle for fewer deaths.

When all else fails, handcuffs can help, too. A problem with treatment is that addicts often stay with the program only for brief periods. Dropout rates within 24 weeks of admission can run above 50%, according to the National Institute on Drug Abuse. Courts can provide unique leverage. Many drug users are involved in addiction-related crime such as shoplifting, prescription forgery and burglary. Shielding them from the criminal-justice system often is not in society’s best interests—or theirs.

Drug courts, for example, keep offender-patients in treatment through immediately delivered sanctions (e.g., a night in jail) and incentives (e.g., looser supervision). Upon successful completion of a 12- to 18-month program, many courts erase the criminal record. This seems to work. The National Association of Drug Court Professionals reports that 75% of drug court graduates nationwide “remain arrest-free at least two years after leaving the program.”

What’s more, if the carrot-and-stick method used by drug courts is scrupulously applied, treatment may not always be necessary. This approach, called “swift, certain and fair,” has been successful with methamphetamine addicts in Hawaii and alcoholics in South Dakota. Some courts in Massachusetts and New Hampshire have now adopted it with opioid addicts. I predict that the combination of anti-addiction medication plus “swift, certain, and fair” will be especially effective.

With synthetic drugs similar to fentanyl turbocharging the opioid problem, the immediate focus should be on keeping people safe and alive. But for those revived by antidotes and still in a spiral of self-destruction, the criminal-justice system may be the ultimate therapeutic safety net.

Source:  https://www.wsj.com/articles/saving-lives-is-the-first-imperative-in-the-opioid-epidemic-1491768767  April 9, 2017

Marijuana Legalization Proposals Die in Committee

[Alexandria, VA, April 12, 2017] –  Yesterday, an alliance of concerned citizens, public health experts, and safety officials soundly defeated two marijuana legalization bills in Maryland. The bills, which would have permitted commercial pot shops in communities throughout the state, died without a vote in the Maryland Senate last night. SAM Executive Vice President Jeff Zinsmeister and Maryland-based neuroscientist and SAM Science Advisor Dr.Christine Miller testified in Annapolis last month, urging the legislature to reject marijuana legalization and commercialization. AAA Mid-Atlantic also testified against the bills, citing traffic safety concerns due to drugged driving increases in states that have legalized marijuana.

“This is a major victory in the effort to put public health and common sense before special interests,” said SAM Executive Vice President Jeff Zinsmeister. “The costs of legalization, including more stoned drivers on the roads causing fatalities, more people being driven into treatment for addiction, and higher regulatory costs far outweighed any benefit Maryland would see. The Big Marijuana lobbyists came into Maryland touting the notion that marijuana legalization would fix our criminal justice system and rake in millions – but Maryland smartly concluded that legalization actually exacerbates these issues. All they had to do was look to Colorado, where more minority youth are being arrested for marijuana and the state deficit is growing.”

“We believe that science and research, not profit, should drive what marijuana laws look like in our state,” said Dr. Christine Miller, a Maryland neuroscientist and member of SAM’s Science Advisory Board.  “The pro-marijuana lobby was looking to profit by selling a harmful, addictive substance that would harm our communities and endanger public safety. I’m proud that evidence-based policy putting health first prevailed in Maryland yesterday.”

Evidence demonstrates that marijuana – which has skyrocketed in average potency over the past decades – is addictive and harmful to the human brain, especially when used by adolescents. Moreover, in states that have already legalized the drug, there has been an increase in drugged driving crashes and youth marijuana use. States that have legalized marijuana have also failed to shore up state budget shortfalls with marijuana taxes, continue to see a thriving black market, and are experiencing a continued rise in alcohol sales.

Source: info@learnaboutsam.org  April 2017

Highlights

* Cannabis collisions resulted in 75 deaths and 4407 injuries in 2012.

* There were up to 24,879 victims of property damage only cannabis collisions in 2012.

* Cannabis collisions costs ranged from $1.09 to $1.28 billion CAD in 2012.

* Cannabis collision harms were particularly high amongst those ages 16–34 years old.

Abstract

Introduction

In 2012, 10% of Canadians used cannabis and just under half of those who use cannabis were estimated to have driven under the influence of cannabis. Substantial evidence has accumulated to indicate that driving after cannabis use increases collision risk significantly; however, little is known about the extent and costs associated with cannabis-related traffic collisions. This study quantifies the costs of cannabis-related traffic collisions in the Canadian provinces.

Methods

Province and age specific cannabis-attributable fractions (CAFs) were calculated for traffic collisions of varying severity. The CAFs were applied to traffic collision data in order to estimate the total number of persons involved in cannabis-attributable fatal, injury and property damage only collisions. Social cost values, based on willingness-to-pay and direct costs, were applied to estimate the costs associated with cannabis-related traffic collisions. The 95% confidence intervals were calculated using Monte Carlo methodology.

Results

Cannabis-attributable traffic collisions were estimated to have caused 75 deaths (95% CI: 0–213), 4407 injuries (95% CI: 20–11,549) and 7794 people (95% CI: 3107–13,086) were involved in property damage only collisions in Canada in 2012, totalling $1,094,972,062 (95% CI: 37,069,392–2,934,108,175) with costs being highest among younger people.

Discussion

The cannabis-attributable driving harms and costs are substantial. The harm and cost of cannabis-related collisions is an important factor to consider as Canada looks to legalize and regulate the sale of cannabis. This analysis provides evidence to help inform Canadian policy to reduce the human and economic costs of drug-impaired driving.

Source:  Estimating the harms and costs of cannabis-attributable collisions in the Canadian provinces     Drug & Alcohol Dependence , Volume 173 , 185 – 190

Abstract

Cannabis use remains a critical issue in the United States.  In 2014, an estimated 22 million US residents used cannabis,1 double the number from 10 years age.

As of December 2016, 28 states and the District of Columbia have implemented or have voted to authorize medical cannabis programs, and 8 states and the District of Columbia have legalized recreational cannabis.

Health care professionals often are concerned about whether cannabis use will lead to psychiatric illnesses such as substance use disorders, anxiety disorders, or mood disorders among their patients. Many stakeholders are concerned that an association between cannabis use and psychiatric illnesses will lead to a steady increase in these illnesses as more states implement medical or recreational cannabis legalization policies. Given these trends and concerns, it has become increasingly important to obtain longitudinal data to clarify the relationship between cannabis use and subsequent psychiatric disorders.

Source:  JAMA. 2017;317(10):1070-1071. doi:10.1001/jama.2016.19706

The Director of the NDPA, Peter Stoker, visited Vancouver East Side in 1999.  It was tragic to see drug dependent men and women living rough on the streets – in the alleys behind the main road – injecting in public.  A team of police officers called The Odd Squad worked the area and did everything they could to help these people – producing a great video called ‘Through the Blue Lens’ – we took this video into schools and it was the most powerful drug prevention message we had ever used.  We would urgently ask you to see this video on You Tube – https://www.youtube.com/watch?v=gwFRsfATaag

The article below is covering the same story – 19 years later.  Isn’t it about time that Canada began to promote good drug prevention instead of relaxing their drug laws? 

As overdose deaths spike, provincial health officials say more overdose prevention sites will soon open across the province.

The number of overdose deaths related to illicit drugs in British Columbia leapt to 755 by the end of November, a more than 70-per-cent jump over the number of fatalities recorded during the same time period last year.

In August, 50 people died of drug overdoses in British Columbia.  In September, 57 died. In October, the number jumped to 67 — an increase that worried health officials, who had thought that increasing the supply and training for administering the overdose reversal drug naloxone was making a difference.

In November, drug overdoses caused 128 deaths — 61 more than the previous month, and nearly double the October total. That spike has brought the total number of deaths between January and November to 755, the highest number ever recorded by the BC Coroner and a 70 per cent increase over this time last year

“We’re quite fearful that the drug supply is increasingly toxic, it’s increasingly unpredictable, and it’s very, very difficult to manage,” said Lisa Lapointe, B.C.’s chief coroner, referring to the increasing prevalence of the synthetic opioid fentanyl being added to many illicit drugs.  “Those who…attempt to use drugs safely, it’s almost impossible.”

With advance notice from the coroner that November numbers would be much higher, provincial health officials announced three weeks ago that several overdose prevention sites would open in Vancouver, Surrey and Victoria. People can go inside the sites to inject drugs, and are given first aid if they overdose.

An unofficial safe consumption site located in the alley behind the Downtown Eastside Market off East Hastings Street.

Health officials have insisted the sites are temporary and are not supervised injection sites, which are currently difficult to open because of a strict Conservative-era law that current federal health minister Jane Philpott has promised to change.

If there is any good news to be found within the grim statistics, it is that no deaths have occurred at any of those overdose prevention sites. And no one has died at a volunteer-run tent that has been operating since September, without official permission or government funding, out of an alley in the heart of the Downtown Eastside. People can smoke or snort drugs at that site, not just inject.

“We’re pretty steady, we get about 100 people a day,” said Sarah Blyth, the Downtown Eastside market coordinator and one of the organizers of the tent. “We’re coming up to welfare (day)…it’s happening this Wednesday, so I imagine up until Christmas it’s going to be pretty busy.”

A sign on the front door of VANDU’s storefront at 380 E. Hastings advertises that the location is an overdose prevention site, with volunteers trained in first aid

“A lot of people use during Christmas,” Blyth added. “Not everybody’s Christmas is as happy as others.”  At the Vancouver Area Network of Drug Users storefront further down East Hastings Street, Linda Bird confirmed the overdose prevention site located there has been busy, with around 60 people a day passing through. Volunteers, who are paid a small stipend by Vancouver Coastal Health, work two to four hour shifts. Overdoses are common, small stipend by Vancouver Coastal Health, work two to four hour shifts. Overdoses are a small stipend by Vancouver Coastal Health, work two to four hour shifts. Overdoses are common, Bird said.

“A lot of them are taking this very, very seriously,” Bird said of the volunteers. “It’s a crisis and a lot of them have seen their friends dropping.”

Vancouver Coastal Health has announced a fourth overdose prevention site in Vancouver, while Fraser Health has added more sites in Langley, Abbotsford and Maple Ridge.

Overdose deaths in November were nearly double the number seen in October

Health authorities in the Interior, Vancouver Island and the north are also planning to open sites in the future, said Perry Kendall, B.C.’s health officer.  “We’re still struggling in many communities with the idea of having these (overdose prevention) sites open,” Kendall said. “That doesn’t help.”

He urged the federal government to introduce the new legislation as soon as possible.

“You must use (drugs) in the presence of somebody who can help you,” Lapointe emphasized. “We are seeing people die with a naloxone kit open beside them, but they haven’t even had time to use it. We are seeing people die with a needle in their arm or a tablet nearby…You must go somewhere where someone is able to give you immediate medical assistance.”

Source:  http://www.metronews.ca/news/vancouver/2016/12/19/bc-drug-deaths

I was just a year old when I had my first experience with opioids. I was born with a hiatal hernia, which constricted my esophagus and caused me to reflux like crazy. I couldn’t keep breast milk down and I became malnourished, tiny and weak. One night, my parents, Gayle and Morty Gebien, rushed me to the hospital. I was dehydrated and spitting up everything they tried to get me to eat or drink. The doctors told my parents to prepare themselves for the possibility that I wouldn’t live through the night. They brought me into surgery and gave me morphine for the pain. Maybe that’s where it all began.

I’ve always had a difficult time coping with stress. I sucked my thumb until I was eight years old. I started smoking at age 14 and never stopped. In high school, I was a pothead, and so were most of my friends. I dropped acid and did ecstasy a handful of times. Academically, I was apathetic, skipping class often and bringing home terrible report cards. One day, when I was 17, I went golfing with friends. When I got home, my back began to ache, a dull pain like a hand wrapping around my spine and squeezing it tight. I didn’t know it then, but I had a herniated disc. I lay down on the floor of my bedroom, and it felt like my vertebrae were shifting beneath me. Eventually, the sensation passed, and I got up.

The next year, I started volunteering at a hospital in Richmond Hill, folding blankets, mopping floors and stocking shelves. That’s when I first considered becoming a doctor. I studied science at the University of Toronto Scarborough, but my grades weren’t strong enough to get me into medical school, so I moved to Montreal and did a master’s in molecular biology at McGill. After that, I went to med school at the University of Queensland in Australia and did my residency in emergency medicine in Michigan.

In 2007, I visited my parents on vacation in Florida. I slept on the couch and, during the night, I displaced the disc in my back. The pain was much stronger than what I’d experienced in high school. My mother, who had prescriptions for her own back issues—she’d slipped on wet stairs a few years before I was born—gave me a powerful opioid called Dilaudid to soothe it. I knew I liked it too much. The back pain melted away, but so did everything else. It was like taking a happy pill. I immediately felt calm, relaxed, brighter and more wakeful than usual. Later that month, I sprained my thumb playing hockey. I went to the hospital, where the doctor asked me if I wanted codeine-based Tylenol 3s or oxycodone-based Percocet. I chose the latter. I knew Percs were the stronger of the two and I wanted to know just how strong. The feeling was great—similar to how I’d felt on Dilaudid that morning in Florida. My first bottle of Percocets—30 tiny white pills—lasted about a year.

In 2008, following stints as a cruise-ship doctor and an air-ambulance physician, I landed an ER job in Saint John, New Brunswick. At the bar one night, I met a blond girl named Katie, a personal support worker at a pain clinic. I was taken by her eyes, a light bluish-grey I’d never seen before. It took me a couple of tries, but, eventually, she agreed to go out with me. In February 2009, I moved back to Toronto to take a job as an ER doctor at the York Central Hospital, and Katie and her two-year-old daughter soon followed. They rented an apartment at Bathurst and Steeles, and began settling into a routine.

I found a new doctor in Toronto who prescribed me another 30 Percocets for my back, and I started taking them more often. After a few weeks, the pain subsided, and I stopped using them, but I stashed the extras, maybe half the bottle, in my medicine cabinet. One Friday night, some buddies came over for a few beers and some PlayStation golf, and I popped a few Percocets. It wasn’t some big decision, but, in hindsight, I realize that was the moment I crossed the line. It was the first time I took them purely recreationally. They gave me a fuzzy, happy feeling I couldn’t access any other way. Soon, I was dipping into my bottle once every few weeks—if Katie and I were going camping with friends or if I needed a boost of energy to play with Katie’s daughter after a long shift. She couldn’t tell when I was high and, at first, neither could Katie. The following year, in early 2011, we learned that Katie was pregnant with a boy and we bought a five-bedroom stone house at Bathurst and Sheppard.

My parents lived a short drive away and were proud grandparents. They were over at least once a week, but my mom and Katie didn’t get along. Katie felt they were too involved in her daughter’s life—they weren’t biologically related, after all. My mom would get upset if Katie’s daughter didn’t call her on her birthday. A series of slights, real and imagined, between my mother and Katie culminated in an exchange of profanity-laden emails. I became the rope in a vicious tug-of-war. My mother would tell me to assert myself and “be a man.” Katie would say I wasn’t standing up for her. Eventually, Katie asked me to choose between her and my parents. I was dedicated to making my life with Katie work, so I told my parents that they weren’t welcome at the house anymore. Shortly after that, Katie and I flew to Las Vegas to get married. A little more than a year later, she gave birth to our second child together, a girl. My parents weren’t there for the birth, which broke my heart.

Over time, I began to rely on the pills not just to help my back pain but also to cope emotionally. Initially, I went to my doctor every couple of months, then once a month and then every couple of weeks. He recommended that I exercise, lose weight and see a physiotherapist, but he always filled my prescription. He never told me it was too much.

In August 2012, I got a job as an emergency room doctor at the Royal Victoria Regional Health Centre in Barrie. Katie and I bought a spectacular five-bedroom house on the waterfront, at the end of a cul-de-sac. We had a dock and a boat. I was making roughly $300,000 a year. I bought Katie a Lexus SUV, which we eventually traded in for an Audi Q7. But our marriage was deteriorating. We were arguing all the time—about my family, about my parenting. I’d reprimand her daughter for misbehaving, and Katie would undermine me, saying, “Daddy’s just had a bad day.” Katie had also noticed my drug use, which had gone from two pills a day to as many as eight. We fought about it at least once a week.

She wanted me to get help, but I always refused. Seeking help would have meant two things: one, admitting that I had a problem; and two, admitting that I was no longer in control. The pills helped me get through my days, and I wasn’t ready to let that go. Sometimes I slept in my car to avoid another fight.

The first time it occurred to me that I might have a drug problem, I was standing next to a lumber pile in Rona, waiting for my contractor to pick out aluminum framing for our basement renovation. I felt irritation wash over me, totally unprovoked. I couldn’t figure out what was wrong, but I popped a Percocet and immediately felt relieved. I wondered if I had been experiencing withdrawal symptoms, but I felt ashamed even considering it. I dealt with patients every day and didn’t see myself as one. Throughout my career as a doctor, I was trained to believe I was infallible. As far back as medical school, we were told that, no matter what, you don’t call in sick; you show up. So, even though I knew I was in trouble, I didn’t ask for help.

As the months went on, I continued using. That May, I was visiting my folks when I started having withdrawal symptoms. I asked my mom for a few fentanyl patches and she obliged, thinking that I just needed relief for my back pain. She had a prescription for the opioid, which is up to a hundred times more powerful than morphine. The intensely potent drug is usually doled out in surgery or given to patients with chronic pain who have built up a tolerance to other opioids. The transparent squares, which at the time looked a little like clear Band-Aids, contained two layers: one with the slow-release drug and one that’s skin adhesive. I slapped one on my back and stashed the others for later.

About a week later, I got home after a long shift and typed, “How to smoke fentanyl” into Google. My kids were with their nanny at the park near our house. I went to the garage and cut a patch into one-centimetre squares. I lined each piece up on a larger square of tin foil, then I held the lighter under the first piece, watched the puff of smoke come up and inhaled. The sweet smell of burnt plastic filled my nose and travelled deep into my lungs. It was as if I were being pushed by a powerful but gentle wave. Calm washed over me. My anxiety and fear were gone. I slowly lowered myself backward into a chair. I was higher than I’d ever been. Imagine a surge of confidence kicking in, a worldly reassurance that all of your problems will just dissolve. A soft happiness sets in, then a creativity spike. You feel totally alert, more awake and sharper than ever. Everything around you feels warmer. Now, imagine those sensations happening within a few milliseconds of each other. And that’s what it’s like to smoke fentanyl. I sat there, eyes glazed, staring out at the street for 20 minutes. I was in heaven.

Gayle Gebien, above, gave her son a few fentanyl patches for his back pain. He took them home and Googled “How to smoke fentanyl”

A drug like fentanyl doesn’t inject your body with new feelings; it borrows from the ones you already have. When the high starts to wear off, the positive sensations retreat and the negative ones become amplified. And addicts have no shortage of negative emotions. A dark cloud descends upon your brain. You become scared, anxious, agitated. The warmth rolls away and leaves you in cold sweats, shivering. Self-loathing kicks in, followed by guilt, fear, sadness, paranoia. Coming down off that first rush, my body began to ache. All I could focus on was escaping those feelings as quickly as possible, and the only solution was to smoke again. And again—each iteration sinking me deeper into dependency. From that day on, I smoked fentanyl at least six times a day and sometimes as many as 15 times.

The scariest part was that, as a doctor, I knew exactly what I was getting into, and I didn’t care. Fentanyl is one of the most dangerous opioids on the market. It can be smoked, injected or dissolved under your tongue. The federal health minister, Jane Philpott, has called Canada’s opioid problem a national public health crisis. In Ontario, 162 people died of fentanyl overdoses in 2015. In B.C., 332 people died in the first nine months of 2016.

Doctors are part of the problem. One of the most common complaints we get from patients is that we under-treat chronic pain. And, because pain is subjective and difficult to diagnose, we tend to take patients’ word for it when they say they’re in pain. Late last year, the College of Physicians and Surgeons announced it was investigating 86 doctors for prescribing daily opioid dosages that wildly exceeded national guidelines. One patient was prescribed the equivalent of 150 Tylenol 3s per day. Some of those cases occur because patients undergoing cancer treatment or living with multiple sclerosis may need very high dosages. But, in other cases, like mine, there’s rampant abuse of the system.

When I think about it now, I’m disgusted that I kept drugs in the same house as my children. At first, I locked up my patches in my toolbox in the garage. Later, I would smoke in the shower stall in our basement and hide my fentanyl under the sink behind the pipes. I convinced myself that, by taking those precautions, I was being a responsible father. I was high-functioning, but, still, my kids were getting a stoned daddy, even if they were too young to realize it. I wanted to believe that I was like any other doting dad—I took my kids to the beach in the summer, dunking the little ones in the water and wading hand in hand with the eldest. I took them apple-picking in the fall and tobogganing in the winter. The only difference was that, 15 times a day, I’d head to the basement to smoke up. That I was high around my kids is one of the hardest things for me to forgive of myself.

That summer, my cravings were ruthless, and I had no legitimate access to patches. I knew I couldn’t write prescriptions in my own name, so I came up with a plan: I began to write prescriptions for Katie, then I’d go to the pharmacy to pick them up. But I didn’t want pharmacists getting suspicious of Katie, so I began to recruit other pretend patients. I had become friendly with one of the contractors renovating our basement. At one point, I asked him: “Can you do me a favour?” I explained that I needed someone to pick up my fentanyl and that I could supply him with Percocet if he agreed, which he did. I’d write two prescriptions in his name: one for fentanyl and one for Percocet. He’d get them both filled and keep the Percs. One night, my supply was dry and I was going through withdrawal. Katie and I were arguing, and I left the house. I got in a taxi and went into town. I was so desperate that I began going from taxi to taxi, knocking on windows and asking strangers, “Are you interested in doing a swap? I can get you Percocet, but I need you to pick up some fentanyl for me.” The first three weren’t interested. The fourth was.

From August to October, I also cajoled two assistants and a nurse into giving me painkillers from the hospital. I never offered to pay them; I just told them I was in a lot of pain and couldn’t write prescriptions in my own name. I put them in a terrible position and I minimized the stakes. “Oh, it’s not a big deal,” I said. They saw I was hurting and agreed. (They were later fired for it.) Over 16 months, I acquired 445 patches of fentanyl with fraudulent prescriptions, smoking about a patch a day.

At home, my relationship with Katie was in tatters. Instead of offering support, Katie would yell at me, and I would yell back or retreat in silence. “You’re smoking again,” she would shout when she caught me going downstairs. She threatened to leave. She called me a junkie.

I never smoked before work. But I did wear a patch to stave off withdrawal symptoms. Twice I had to leave work because my cravings were too intense to keep going. I lost more than 30 pounds, my cheeks were sunken and I became irritable and jittery. Once, a colleague asked me if I was okay. I told her there were problems at home and left it at that. She didn’t ask again.

My mom had noticed my ragged state and, unbeknownst to me, called and told the hospital I might have a drug problem. My supervisor and the hospital’s chief of staff called me into a meeting and asked me if I had any problems they should be aware of. I lied. I said that things were rocky with Katie but, otherwise, no. They gave me pamphlets on addiction and mental health, and I went back to work.

I decided to change tactics. For the next four months, I forged prescriptions from other doctors in my own name. I’d go to the pharmacy and sweet-talk the staff—it was usually the same guy—into not faxing my prescription over to the hospital. Pharmacists hate to bother busy doctors, and I played on that. Every time I went to get one filled, I threatened everything: my job, my family, my freedom. I didn’t care.

One Sunday in November 2014, the pharmacist was too busy administering flu shots to speak to me and faxed the prescription. I could have tried harder to intervene, but, for some reason, I didn’t. My endless scheming had worn me down. The doctor who happened to pick it up in the ER was the same doctor whose signature I’d forged on the script, which requested a dozen patches. I didn’t know it then, but the doctor reported me to my supervisor. After 20 minutes of nervously waiting, I was waved over by the pharmacist. “We’ve run out of supplies, actually,” she said. She gave me what she claimed were her last few patches, and I went home none the wiser. Two days later, the chief of emergency and the chief of staff greeted me in the doctors’ change room. They told me that they knew about the false prescriptions, that the pharmacy had called the police and that I couldn’t work—I’d be going on unofficial leave without pay, and my medical licence would be suspended. I was scared shitless. The shame of being caught in a tangle of lies was overwhelming. I was afraid for my family, afraid I’d lose my job, afraid of what other people would say. I should have felt lucky to be alive—at that point I was a bag of skin and bones—but I just felt dizzying fear for the future. And yet, on top of all that was an unexpected wave of relief. My life had just come crashing down; at least I couldn’t deny it anymore.

I was arrested at home. Police charged me with three counts of forgery and gave me a notice to appear in court. Three days later, I went to Homewood Health Centre in Guelph, a facility recommended to me by a psychiatrist at my hospital, for five weeks. My parents covered the $10,000 bill. There, the doctors decided I should go into a rapid wean, a process intended to produce intense withdrawal and, with it, a deterrent to using drugs again. First, doctors gave me Suboxone, a pill used to get addicts off opiates. The drug satisfies some of the body’s narcotic cravings but doesn’t get you high. Coming off the Suboxone was vicious, as my endorphin levels plummeted and my brain began to rewire itself. I thought I was going to die. When I tried to walk, my body curled inward, neck down, arms tight to my chest, in a position known in rehab as the Suboxone shuffle. My ears were ringing. My body temperature began to swing like crazy: one moment I’d soothe my chills in a hot shower and the next I’d be running aimlessly outside, rubbing snow on my face. I remember telling the doctor that I couldn’t handle the pain. He agreed to give me another two milligrams of Suboxone to stave off my withdrawal. I knew that would only delay the inevitable, but, at that point, I didn’t care—I was so desperate I considered throwing myself in front of a bus. My body felt like it was disintegrating. Lifting a spoon to my mouth was tiring; walking up a ramp left me winded. The next day, I thought I was progressing, but, 32 hours later, I was still in the throes of withdrawal. I lay down on the hospital bed in my room to take a nap. When I woke up four hours later, the weakness was gone, my limbs had uncurled and my gait returned to normal. The week from hell was over.

On my 14th day in rehab, Katie brought the kids to visit. She told them that I was sick, and they assumed Homewood was a regular hospital. I’ll never forget my son asking why I wasn’t coming home with them that day.

My return from rehab was strange. Katie was exhausted from caring for the kids by herself for five weeks, and we were soon back to our bickering. I was sleeping on the couch and I was still on leave from my job, so my days were empty.

There’s a grieving process that comes with addiction, and I was grieving the loss of my drug of choice. The cycles of shame, self-loathing, rationalization and apathy returned. So I did what I always did to cope: I wrote a prescription for fentanyl using one of my old prescription pads. I didn’t realize the police were monitoring me.

Within a week, I was back to getting high 15 times a day. On the morning of January 4, I lost track of how much I’d smoked. I overdosed and collapsed in my basement shower stall. My face was a putrid shade of green, drool was dribbling down my chin and my dry tongue was hanging from my open mouth. I was barely breathing when Katie walked in. She had seen me high many times before, and she could spot the telltale bursts of energy, hoarse voice and constricted pupils, but that day was different. I’d been downstairs for longer than usual, and she hadn’t seen my face like that before. I remember her screams tearing through the fog in my head. “I’m calling an ambulance,” she cried. I jolted awake, flailing my arms as my paraphernalia went flying. I gasped for breath a few times, head lolling, then lunged for the toilet and vomited. “I thought you were dead,” she said. I told her I didn’t need an ambulance and, eventually, she stopped insisting, worn down from so many arguments. A few hours later, I was back in the stall lighting up another patch.

At 7 a.m. on January 19, 2015, 10 officers from the Barrie drug crimes unit showed up at my front door. If I have a rock bottom, I hit it that day. I woke to my three dogs barking and peered out the window to see the cops on the front steps. I opened the door in my underwear. “Sorry to do this, but your life is never going to be the same,” one of them said to me. I asked for a minute to put the dogs out in the backyard, and the officer

agreed. Another went upstairs to tell Katie she would be arrested, too, wrongly thinking she was involved. They let me put my clothes on and have a cigarette in the garage. They handcuffed me as we were walking outside, so that my kids wouldn’t see if they came downstairs. I was taken to the police station and charged with 72 counts of trafficking—for compelling the pharmacist to supply drugs under false pretences—plus six counts of forging prescriptions.

From January 19 to February 5, I was in jail at the North Correctional Centre in Penetanguishene awaiting my bail hearing. I was despondent. There was a stairwell on the second storey that overlooked the unit’s concrete floor, and I figured that if I jumped headfirst I would die. I told one guy I’d made friends with about my plan, and he pulled me aside. “Wait a second, motherfucker,” he said. “You’ve got your wife, your kids. That’s the most selfish thing you could do.” I went back to my cell. I hadn’t been using long enough after my first stint in rehab to go through acute withdrawal again, but I had the munchies like crazy, a sign of early recovery. I had an appetite so ferocious I’d chug the syrup that came with our French toast in the morning. My cellmate let me eat some of his snacks, too—Rice Krispies Treats, ketchup chips, Twix bars.

With the help of my parents, I made the $80,000 bail, but one of the conditions was that I live with my mom and dad at their Yonge and Sheppard condo. I went home briefly to collect my things. Katie wanted a stable environment for the kids, so she moved them back to New Brunswick 10 days later. I was devastated but didn’t have a choice. In April, I enrolled in Renascent, a clinic at Spadina and Bloor, for my second stint in rehab. I stayed for four weeks. During my daily walks in the neighbourhood, every time I saw a homeless person, I’d think to myself that I was closer to becoming one of them than I was prepared to admit. I was nearly out of money, my marriage was probably over and my network of friends had dwindled. I was initially represented by Marie Henein and Danielle Robitaille, the lawyers who represented former attorney general Michael Bryant and CBC host Jian Ghomeshi. I put the first payment of $35,000 on a line of credit but changed lawyers shortly after. I was still paying the mortgage on our home in Barrie and couldn’t keep up with their retainer.

In August, I walked into the Vitanova Foundation recovery centre in Woodbridge, another government-funded facility, not knowing how long I would be there. The centre offered a free rehab program and dorm-style residence, and, as the weeks passed, I felt my strength and clarity returning.

Three months later, on November 2, 2015, my 45th birthday, I got a call from my dad telling me that my mom had died. He’d found her in bed, non-responsive, wearing three 50-milligram fentanyl patches that we think she applied by accident. Her usual dose was a 25-milligram patch. It was the worst day of my life. I redoubled my efforts to stay clean. I checked out of Vitanova and moved back into my father’s condo. I slept on the couch and have continued to for the past two years. I FaceTime with my kids every couple of days, but it feels like no way to be a father. I’m on social assistance and help my dad with rent when I can—his pension isn’t enough to support both of us. Our Barrie home sold shortly after my mom’s death, and I gave most of the money to Katie, knowing that I might not be working much in the next few years. I run a flooring company with an old friend to make extra cash. And I’m still drug-free.

But my body hasn’t fully recovered: my short-term memory is spotty, I have hearing loss in my right ear and, for the first time in my life, I suffer from panic attacks. I apologized to the City of Barrie for betraying the trust of its residents. And I’ve done some outreach work, speaking to officials at the Ontario Ministry of Health and Toronto Public Health about how to tackle the opioid epidemic.

In April 2016, I filed for bankruptcy. Katie sent divorce papers a few months later. I had been hoping we’d find a way to make it as a couple, but I understood. In February, my biological kids came to stay with me for a week. I got to see my son—now five years old—skate for the first time; my little girl, who’s four, was so excited with the Hatchimal we picked out at Toys’R’Us that she carried the box around with her everywhere and showered me with hugs. I didn’t explain what was going on—I just said I’d talk to them soon. They’re too young to understand what happened. I worry about what they’ll think of me when they do find out. I hope they can be proud of my recovery, but that day is a long way away.

In December 2016, I pleaded guilty, and, as part of the deal, Katie’s charges were finally dropped. I’m awaiting my sentence. The Crown wants me locked up for eight years; my lawyer is arguing for house arrest. Most likely, the judge will settle on a multi-year prison term. My dad has early-stage Alzheimer’s, and I’m concerned about how he’ll cope while I’m gone. I worry constantly about Katie and our kids, too. I’m embarrassed that my life has become a cautionary tale, but I’m thankful that I got caught. Had I not been arrested, I’m certain I’d be dead right now.

When I get out, I will have to face the College of Physicians and Surgeons’ discipline committee, as is standard in cases like mine. My medical licence is currently suspended, and they’ll probably revoke it entirely. If they don’t, I plan to practise again, ideally in the area of addiction. I became a doctor so that I could help people. I messed up my life, but I can still help others avoid the same fate.

Correction  March 30, 2017

An earlier version of this story indicated that Darryl Gebien’s stay at Renascent was covered by OHIP, when in fact the fees there are covered by the Ministry of Health, as well as the centre’s foundation.

Source:  http://torontolife.com/city/crime/doctor-perfect-life-got-hooked-fentanyl/

The surrender of more than 2,000 minors involved in drugs in Cebu shows the need to step up efforts to educate the youth on the ill effects of illegal drugs. The Cebu Provincial Anti-Drug Abuse Office has produced a module on this for integration in Grades 7 to 9 classes starting this school year.

Jane Gurrea, Education Supervisor I of the Department of Education’s Division of Cebu Province, says anti-drug activities in schools have been strengthened by a memorandum issued by the department mandating the establishment of Barkada Kontra Droga chapters in schools.

Barkada Kontra Droga is a preventive education and information program to counter the dangers of drug abuse. HALF of the 2,203 minors rounded up under Project Tokhang were out-of-school youth, according to data collected by the Police Regional Office 7 from July 1, 2016 to Feb. 2, 2017.

Tokhang is the Philippine National Police’s program to knock on the doors of homes to persuade those suspected of involvement in illegal drugs to surrender. Some 2,166 of the minors in Cebu were drug users, 28 were sellers, while nine were mules. Could the rampant involvement of out-of-school youth in drugs have been prevented if Section 46 of the Comprehensive Dangerous Drugs Act of 2002 had been implemented?

Section 46 requires the establishment of a Special Drug Education Center (SDEC) for out-of-school youth and street children in every province to implement drug abuse prevention programs and activities. The SDEC should be led by the Provincial Social Welfare Officer. “Cebu Province still has to establish one,” however, said Grace Yana, social welfare officer  in charge of social technology unit of the Department of Social Welfare and Development (DSWD) . But areas in Cebu with active Pag-Asa Youth Association of the Philippines (PYAP) chapters, like Talisay, Naga, Danao and Mandaue cities, already have SDECs, she said. PYAP is the organization of out-of-school youth organized by the local government units.

“When the local government units hear the word center, they think they will need a building, and it needs a budget. So we tell them, even if it’s just a corner,” Yana said of the challenges of setting up the SDEC. Cebu Province may not have an SDEC, but the Cebu Provincial Anti-Drug Abuse Office (Cpadao) unveiled last November Project YMAD (Youth Making a Difference) that aims to provide out-of-school youth with socio-economic, physical, psychological, cultural and spiritual support through the PYAP.

Barkada Kontra Droga For in-school youth, the Cpadao is facilitating the implementation of the Barkada Kontra Droga drug prevention program, said Cpadao executive director Carmen Remedios Durano-Meca. Dangerous Drugs Board (DDB) Regulation 5, Series of 2007 calls for the institutionalization of the Barkada Kontra Droga (BKD), a preventive education and information program to counter the dangers and disastrous effects of drug abuse. It empowers the individual to be the catalyst in his peer groups in advocating healthy and drug-free lifestyles, the regulation says. “Cpadao is the one facilitating that this be implemented in every school,” Meca said. “We tap the Supreme Student Government officers. We have a Student Assistance Program (SAP) designed to help children who get into trouble with drugs in the school setting.”

SAP includes an intervention program to reduce substance abuse and behavioral problems by having the parent-teacher association take up school and home concerns. Under SAP, which will be established through the guidance office, the school will establish drug policies and regulations.

In addition, Cpadao made a module, which it has given to the Department of Education (DepEd) to distribute to schools. “It’s been agreed to be integrated in the Grades 7, 8 and 9 classes starting school year 2017. It will be one hour a week from MAPEH (Music, Arts, Physical Education and Health) for the whole school year. Later, we plan to teach it to the younger children, like Grade 4,” she said. “We’ve had a review of the module,” Jane Gurrea, Education Supervisor I of DepEd’s Division of Cebu Province, said last month. “If we receive that module, this will be integrated initially for public schools as additional reference materials.”

The DepEd Division of Cebu Province covers the 44 towns in Cebu. This month, the division will have a training of teachers for the integration of drug abuse prevention education, which will include a discussion of the Cpadao module. But even now, under the present K to 12 curriculum, basic concepts on illegal drugs can already be tackled as early as in Grade 4, as teachers could integrate these concepts in subjects like Health, when the subject of medicine use and abuse is discussed, she said. Gurrea, who is also the National Drug Education Program coordinator in the Division, said drug prevention education can be taught in subjects dealing with values education, social studies or MAPEH. “For music, students can write a poem or song on drug use prevention. They can have role playing. In art, they can do drawing (on drugs).”

Additionally, under Section 42 of the Dangerous Drugs Act, all student councils and campus organizations in elementary and secondary schools should include in their activities “a program for the prevention of and deterrence in the use of dangerous drugs, and referral for treatment and rehabilitation of students for drug dependence.” It is unclear how actively these student groups have campaigned against illegal drugs, but Gurrea said that every third week of November, students join the celebration of Drug Abuse Prevention and Control Week under the Supreme Student Government.

“The officers have to campaign room to room to talk about issues related to prevention of drug use. In the public schools in rural areas, you can see signs on fences or pergolas saying, ‘Get high on grades, not on drugs.’ They invite speakers for drug symposiums, like the police,” she said. The Supreme Student Government is for high school, while the Supreme Pupil Government is for elementary school. “In every town, we have a federated Supreme Student Government (SSG) and Supreme Pupil Government (SPG), and also a Division Federation of SSG and SPG. One of the programs is drug education,” Gurrea said. The Department of Education mandates all schools to have a student council organization strengthened. Gurrea said the anti-drug activities in schools were already there, but the term Barkada Kontra Droga was not used then. It was only when the DepEd coordinated with Cpadao that the term BKD was used. With the assistance of Cpadao that spent for resource speakers and meals of the students last year, BKD was institutionalized. BKD was strengthened further by DepEd Memorandum 200, Series of 2016 issued on Nov. 23, 2016 mandating the establishment of BKD chapters in schools, Gurrea said. “With this institutionalization, on the part of the budget for activities, students now have access through the Municipal Anti-Drug Abuse Councils (Madac).

So instead of spending their SSG funds for their activities, they can present their planned activities to the Madac, from which they can seek financial or other assistance (like for speakers),” she said. With the memo, the SSG has been recognized as an entity, enabling it to connect with the community, such as with agencies and non-government organizations for anti-drug activities, she said. “We have continuous advocacy and awareness programs. Some schools have a walk for a cause or caravan,” Gurrea said. The public schools in the division also have their student handbook. “One thing stipulated there is that no student is allowed to be involved in illegal drugs. There are schools that let students sign that piece of paper containing the rules and regulations, for their commitment to follow the rules in that handbook,” she said.

So if awareness of the dangers of illegal drugs is not the problem, what accounts for the high number of minors involved in drugs? “We are looking at peer pressure or circumstances in the family,” Gurrea said.

Source:  http://www.sunstar.com.ph/cebu/local-news/2017/03/04/who-watching-children-529169

Ontario opted not to follow B.C.’s lead on harm reduction, rejecting the idea of creating safe injection sites similar to the one in Vancouver. Postmedia News files

In December, the Liberal government introduced Bill C-37 in response to an epidemic of illicit drug use. The bill facilitates the creation of additional supervised injection sites by reducing previously established restrictions.

The decision to promote supervised injection sites is in line with the latest philosophy guiding addiction management — that of harm reduction. Proponents claim harm-reduction institutions will save lives while averting hundreds of thousands in medical and criminal-legal expenses.

Much in the harm-reduction philosophy is laudable — the desire to destigmatize and protect those with severe illnesses for one — but the field is slipping into dangerous, almost Brave-New-World territory.

In Toronto and Ottawa, supposedly inveterate alcoholics receive calculated amounts of alcohol hourly throughout the day at designated wet shelters and managed alcohol programs. Residents line up on the hour to receive just enough house-made wine to keep withdrawal symptoms at bay. Some drink almost three bottles of wine daily with little to do in between scheduled drinks.

Vancouver, which was Canada’s first city to establish a safe injection site in 2003, has now progressed to experimenting with “heroin-assisted treatment” as a means of further protecting addicts from the harms of tainted street drugs. Participants receive pharmaceutical-grade heroin injections two to three times daily. Recently, in place of heroin, the more innocuous-sounding but no less potent opiate, hydromorphone, is being administered instead.

Is their drug use no longer a problem because they’re off the street? And where exactly do the patients go from here?

Most lay supporters of harm-reduction policy assume a gradual attempt is made to wean the addict off the substance of abuse. Proponents claim that harm reduction isn’t about “giving up” on the addict but is actually a temporary stepping stone towards the ultimate goal of recovery.

But the reality is different.

Dr. Jeffrey Turnbull, who established Ottawa’s managed alcohol program, offers a more sober portrayal of the goals of harm reduction. In a Fifth Estate documentary, he compares his program for those with chronic and severe addictions to palliative care. He agrees his facility is a place for alcoholics to “die with dignity” as opposed to dying on the streets. One resident featured in the episode had been using the program’s services for four years; he was only 24 when he first entered the managed alcohol program.

No doubt, the medical community is frustrated by the high failure rates associated with abstinence-based treatment programs but the criteria for determining when an addict now warrants a harm-reduction approach is unclear. Addiction does not follow a linear natural history akin to metastatic cancer; rather, there exists a variable trajectory and the possibility for recovery is always there.

However, Turnbull’s admission points to an uncomfortable belief underlying the harm-reduction philosophy — the view that some addicts are without hope of ever leading a full, productive life free of drug use.

It may be true that, for some, the best we can do is safe, controlled sedation. But the medical community and society should not be so quick to condemn many others to the compromised mental prison that is the life of the addict.

Proponents argue that harm reduction and abstinence are not mutually exclusive, and some even suggest that harm-reduction institutions actually improve recovery rates. But this is a fiction and is without evidence.

Harm-reduction researchers have conveniently neglected to investigate any potentially negative findings of their policies. Their studies focus exclusively on the obvious benefits such as decreased overdose deaths, cost savings, and so-called “treatment retention.” That addicts will remain “in treatment” longer when freely administered their drug of choice is not surprising, but that this is in their best interests is highly questionable.

Politicians insist supervised injection sites and managed substance programs are effective “evidence-based” interventions, but these assertions are problematic when the evidence only tells half the story.

Canada is quickly moving towards an addiction defeatist infrastructure. Toronto, Montreal, Ottawa and Victoria are all following Vancouver’s lead in constructing further supervised injection sites. Widespread creation of managed substance programs is the next logical step of the harm-reduction approach. Unless vigilance is exercised, we risk relegating addicts to a half-conscious state whereby life is maintained but not really lived.

It is both tragic and ironic that the activist responsible for implementing widespread harm reduction policies in Toronto, Raffi Balian, recently died from an accidental overdose while attending a harm-reduction conference in Vancouver. His death highlights the inadequacy of half measures when dealing with the insidious and powerful disease that is addiction.

Jeremy Devine is a medical student at the University of Toronto’s Faculty of Medicine and a CREMS research scholar in the medical humanities and social sciences

Source: http://www.nationalpost.com/m/search/blog.     2nd March 2017

Highlights

* •The THC content in French cannabis resin has risen continuously for the last 25 years.

* •The emergence of a new high potency cannabis resin in France is shown by the monitoring of THC content and THC/CBD ratio.

* •The THC content in French herbal cannabis has known three stages of growth for the last 25 years.

* •The rise of potency and freshness of French herbal cannabis may be correlated to the increase of domestic production.

Abstract

Cannabis contains a unique class of compounds known as the cannabinoids. Pharmacologically, the principal psychoactive constituent is Δ9-tetrahydrocannabinol (THC). The amount of THC in conjunction with selected additional cannabinoid compounds (cannabidiol/CBD, cannabinol/CBN), determines the strength or potency of the cannabis product. Recently, reports have speculated over the change in the quality of cannabis products, from nearly a decade, specifically concerning the increase in cannabinoid content. This article exploits the analytical data of cannabis samples analyzed in the five French forensic police laboratories over 25 years. The increase potency of both herbal and resin cannabis in France is proved through the monitoring of THC content.

For cannabis resin, it has slowly risen from 1992 to 2009, before a considerable increase in the last four years (mean THC content in mid-2016 is 23% compared to 10% in 2009). For herbal cannabis, it has known three main stages of growth (mean THC content is 13% in 2015 and mid-2016 compared to 7% in 2009 and 2% in 1995). The calculation of THC/CBD ratios in both herbal and resin samples confirms the recent change in chemotypes in favor of high potency categories. Finally, the CBN/THC ratios in marijuana samples were measured in order to evaluate the freshness of French seized hemp.

Source: source: http://dx.doi.org/10.1016/j.forsciint.2017.01.007 March 2017Volume 272, Pages 72–80 

Filed under: Cannabis/Marijuana,Europe :

HARRISBURG, Pa. (AP) – They’re the tiniest and most innocent victims of the heroin addiction crisis but it doesn’t spare them their suffering.

They cry relentlessly at a disturbing pitch and can’t sleep. Their muscles get so tense their bodies feel hard. They suck hungrily but lack coordination to successfully feed. Or they lack an appetite. They sweat, tremble, vomit and suffer diarrhea. Some claw at their faces.

It’s because they were born drug-dependent and are suffering the painful process of withdrawal. “It’s very sad,” says Dr. Christiana Oji-Mmuo, who cares for them at Penn State Hershey Children’s Hospital. “You would have to see a baby in this condition to understand.”

As the heroin and painkiller addiction epidemic gripping Pennsylvania and the whole country worsens, the number of babies born drug dependent has surged.   Geisinger Medical Center in Danville, Pa. saw two or three drug-dependent babies annually when Dr. Lauren Johnson-Robbins began working there 17 years ago. Now Geisinger cares for about twice that many per month between its neonatal intensive care unit in Danville and the NICU at Geisinger Wyoming Valley Medical Center in Wilkes-Barre.

Penn State Children’s Hospital is averaging about 20 per year, although it had cared for 18 through last June, with the final 2016 number not yet available, says Oji-Mmuo.

PinnacleHealth System’s Harrisburg Hospital also sees about 20 per year. That’s less than a few years ago, but only because a hospital that used to transfer drug dependent babies to Harrisburg Hospital equipped itself to care for them. “Now everybody is facing it and trying to deal with it one way or another,” says Dr. Manny Peregrino, a neonatologist involved with their care.

The babies suffer from neonatal abstinence syndrome, or NAS, which results from exposure to opioid drugs while in the womb. An estimated 1 in 200 babies in the United States are born dependent on an opioid drug. More than half end up in a NICU, which care for unusually sick babies.

In 2015, 2,691 babies received NICU care in Pennsylvania as the result of a mother’s substance abuse, according to the Pennsylvania Health Care Cost Containment Council. That’s up from 788 in 2000, or a 242 percent increase in 15 years.

Nearly all babies born to opioid-addicted moms suffer withdrawal. The severity varies. About 60 percent need an opioid such as morphine or methadone to ease them through withdrawal. These babies typically spend about 25 days in the hospital.

Often, the only way to calm them is to hold them for long periods – so long that many hospitals enlist volunteer “cuddlers.” ”It really is a whole village. Everybody pitches in,” Peregrino says.

Giving medications to newborns can lead to other problems, so the preference is to get them through withdrawal without it. A scale based on their symptoms is used to determine which ones need medication. In cases where withdrawal isn’t so severe,

symptoms can be managed by keeping the baby away from noise and bright light, cuddling them, and using devices such as mechanical swings to sooth them.

Logan Keck of Carlisle feared the worst upon learning what her baby might face. The 23-year-old became addicted to heroin several years ago. She says it was prominent in her circle of high school classmates, and she became “desensitized” to the danger, figuring it couldn’t be as bad as some claimed.   Keck has been in recovery for more than two years with the help of methadone, a prescription drug used to prevent withdrawal and craving. She was a few weeks away from being fully tapered off methadone when Keck learned she was pregnant.

She was told stopping methadone during pregnancy would put her at risk of miscarriage. Keck further learned her baby might be born addicted. She gave birth on Feb. 1 at Holy Spirit-Geisinger in Cumberland County.

Her baby had difficulty latching on during breastfeeding and vomited milk into her lungs, but seemed fine otherwise. Keck expected she and her baby would go home soon after delivery.  But after a few days, withdrawal became obvious. Keck knows how withdrawal feels. “That’s when it really hit home for me – seeing her feel it,” she says.  Then she was hit again: she was discharged, but her baby remains in the NICU, possibly for several more weeks.

The opioid addiction epidemic affects people of all backgrounds and regions – rich, poor, urban, suburban. It’s prevalent in economically-stressed areas, including many of Pennsylvania’s rural counties.

Geisinger has found a bit of brightness within the 30-plus rural counties it serves. Some of the region’s doctors realized there was little access to methadone, which is dispensed from clinics usually located in more populated areas. That meant pregnant rural women lacked access to a legal drug that could keep them away from the risks of street drugs while also getting them onto the road to recovery. So the doctors became licensed to prescribe buprenorphine, another drug that staves off withdrawal and cravings for opioids. As a result, the majority of mothers of NAS babies at Geisinger have been taking buprenorphine during pregnancy, according to Johnson-Robbins.

Geisinger doctors have been pleased to find that buprenorphine, while it does cause NAS, withdrawal isn’t as severe as with methadone. It also impacts another major concern surrounding NAS babies: that the mother will continue to struggle with addiction and live a lifestyle that will prevent her from properly caring for her baby. Most Geisinger moms, being in recovery for a while, are better-equipped to care for their baby.

Still, there’s great concern about what happens to NAS babies after they leave the hospital. The mother might go back to heroin and become unable to properly care for her baby – there have been many news reports of addicted parents or fathers who neglected or otherwise hurt their babies, including a Pennsylvania woman who rolled over and suffocated her baby while high on opioids and other drugs. The mother might lack adequate housing or other means of having a stable home. There might be criminal activity in the home.

Delaware County woman says she didn’t know their whereabouts until news reports of their hospitalizations for alleged severe abuse.

“We are sending children out into compromised environments,” says Dr. Lori Frasier, who leads the division of child abuse paediatrics at Penn State Hershey Children’s Hospital. Those babies often return to the hospital as victims of abuse or neglect, Frasier says.

Another cause for worry is the fact that NAS babies can remain unusually fussy after leaving the hospital, potentially putting extra stress on a parent already dealing with the stress of addiction. “We know that crying, fussy babies can be triggers for abuse,” Frasier says. Cathleen Palm, founder of the Pennsylvania-based Center for Children’s Justice, said much more needs to done to provide help for mothers of NAS babies, and to monitor and protect the babies. “We have really been trying to get policy makers to understand the nuances,” she says.

Keck goes to Holy Spirit-Geisinger daily to breastfeed and hold her baby for one to two hours. Her time is limited by distance and the fact the baby’s father needs their only car for work. Looking forward, Keck says she’s in a stable relationship with the baby’s father, who is not an addict and accompanies her to the hospital. They have family support, and a Holy Spirit program will provide additional help.

Ultimately, Keck’s pregnancy and motherhood have taught her things that might have inspired her to make a different choice regarding heroin, including the fact it caused her newborn to suffer and forced her to go home without her baby. She agreed to be interviewed out of desire to get others to think and talk about such realities. “I want people to understand it’s something that’s not pretty,” Keck said. “It’s something that’s important to talk about.”

Source:  http://www.washingtontimes.com/news/2017/feb/18/born-addicts-opioid-babies-in-withdrawal

Researchers who tested marijuana sold in Northern California found multiple bacterial and fungal pathogens that can cause serious infections. The study was published this month in the journal Clinical Microbiology and Infection.

The mould and bacteria was so widespread and potentially dangerous that the UC Davis academics concluded that they cannot recommend smoking raw or dried weed. “We cannot recommend inhaling it,” says George Thompson III, an associate professor of clinical medicine at the university who helped conduct the cannabis research.

The findings might also apply to indoor, hydroponic marijuana popular at Southern California collectives, according to Thompson. Using pot in baked goods such as brownies might be “theoretically” safer because the products could be heated enough to kill bacteria and fungus, he says.

Asked if concentrates such as wax, honey oil, dabs and shatter would be safe because heat is involved in the production process of “butane extraction,” Thompson says he isn’t sure.

The key finding of the research  is that patients with weak immune systems, such as those with HIV or cancer, should avoid smoking raw and dried pot. Though Thompson told the Sacramento Bee that “for the vast majority of cannabis users, this is not of great concern,” he stresses that there really isn’t a safe way to smoke marijuana buds, even for those who are healthy.

He says it’s possible that filters used with tobacco cigarettes could help with marijuana: Tobacco and all natural plant products have these kinds of bacterial and fungal issues. Irradiated marijuana, though unappealing, also could be an answer, he adds.

Researchers sampled weed samples from Northern California dispensaries and found they tested positive for the fungi Cryptococcus, Mucor and Aspergillus, and for the bacteria E. coli, Klebsiella pneumoniae and Acinetobacter baumannii. The academics said these can lead to serious and lethal illness, noting that smoking the mould and bacteria can embed them directly where they can do the most damage — the lungs.

“Infection with the pathogens we found in medical marijuana could lead to serious illness and even death,” Joseph Tuscano, a professor of internal medicine at UC Davis, said in a statement. “Inhaling marijuana in any form provides a direct portal of entry deep into the lungs, where infection can easily take hold.” The state Department of Public Health is working on guidelines for marijuana testing with the goal that both medical and recreational pot sold next year at permitted dispensaries would be labelled as safe. It’s not clear how this research will affect those guidelines. Thompson says he has reached out to state officials to share his findings.

“We are aware of the study, and while it’s certainly concerning, this is exactly why we need regulation,” Alex Traverso, spokesman for the state Bureau of Medical Cannabis Regulation, said via email. “The Bureau is working with the Department of Public Health to develop strong standards for testing because patient safety is extremely important to us all.”

Source: http://www.laweekly.com/news/marijuana-is-not-safe-to-smoke-researchers-say-7927826 Wednesday, Feb. 14, 2017

Australia21 and the National Drug and Alcohol Research Centre (NDARC) have been telling politicians and the media of the ‘success’ of Portugal’s decriminalisation of all drugs.[i],[ii]  Their claim is that decriminalisation will not increase drug use. But here is what is really happening in Portugal.

Implemented in 2001, drug use in Portugal is reported, as with every other country in the European Union according to the requirements of the REITOX reporting network controlled by the European Monitoring Centre for Drugs and Drug Addiction.[iii]These reports are readily available on the worldwide web and are referenced below.

According to the first 2007 national survey in Portugal after decriminalisation, Portugal’s overall drug use rose, with a small rise in cannabis use but a doubling of cocaine and of speed and ice use as well for those aged 15-64.[iv] For those under the age of 34, use of speed and ice quadrupled. Admirably, heroin use decreased from the highest level in the developed world at 0.9% in 1998 to 0.46% by 2005, however much of these decreases already predated decriminalisation, moving to 0.7% by 2000, the year before decriminalisation.[v] It is important to note that use of all other illicit drugs in Portugal, other than heroin, had been well below European averages before decriminalisation.[vi]

In the second Portuguese national survey in 2012 overall drug use decreased 21% below 2001 levels for those aged 15-64. This is what prompts the campaign by Australia21 and NDARC. What they fail to mention is that the decreases are not as significant as for various other European nations at that same time.[vii]

Italy – Opiates                    0.8% (2005)                         0.48% (2011)

Spain – Opiates                  0.6% (2000)                         0.29% (2012)

Switzerland – Opiates     0.61% (2000)                      0.1% (2011)

Italy – Cocaine                    1.1% (2001)                         0.6% (2012)

Italy – Speed/Ice               0.4% (2005)                         0.09% (2012)

Austria – Speed/Ice         0.8% (2004)                         0.5% (2012)

They also fail to mention the alarming 36% rise in drug use by high-school-age children 16-18 years old from 2001 to 2011, accompanied by a smaller rise in drug use by 13-15 year olds off 2001 levels.[viii]

By comparison Australia’s Tough on Drugs policy, without decriminalisation of all drugs running interference as in Portugal, decreased overall drug use from 1998 to 2007 by 39%.[ix]

Decriminalisation has not worked for Portugal, whereas Tough on Drugs, which maintained criminal penalties as a deterrent to drug use, did.

We encourage all Australian Parliamentarians to check each of the references cited below, and also see Drug Free Australia’s evidence in ‘Why Australia Should Not Decriminalise Drugs’ indicating that drug use normatively increases after decriminalisation, whether in Australia or overseas at:   http://drugfree.org.au/images/13Books-FP/pdf/Decriminalisation.pdf.

Source:  Gary Christian , Secretary Drug Free Australia  Feb.2017

[i] https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/Decriminalisation%20briefing%20note%20Feb%202016%20FINAL.pdf

[ii] https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/Australia21%20background%20paper%20July%202012.pdf

[iii] http://www.emcdda.europa.eu/system/files/publications/695/EMCDDA_brochure_ReitoxFAQs_EN_326619.pdf

[iv] See REITOX report 2014 graphs (p 36) comparing surveys of drug use in the previous 12 months in 2001, 2007 and 2012  http://www.emcdda.europa.eu/system/files/publications/996/2014_NATIONAL_REPORT.pdf

[v] See World Drug Report  2004 http://www.unodc.org/pdf/WDR_2004/Chap6_drug_abuse.pdf

[vi] See United Nations’ World Drug Report 2004 tables for drug consumption pp 389-401 http://www.unodc.org/unodc/en/data-and-analysis/WDR-2004.html

[vii] Figures below are taken from United Nations’ World Drug Report drug consumption tables from various years from 2000 through 2013 https://www.unodc.org/wdr2016/en/previous-reports.html

[viii] Compare Portugal’s REITOX National Report 2008 for school age children’s use in the last month (p 23) http://www.emcdda.europa.eu/system/files/publications/522/NR_2008_PT_168550.pdf with 2014 (p 37)  http://www.emcdda.europa.eu/system/files/publications/996/2014_NATIONAL_REPORT.pdf

[ix] See Table 2.1 (p 8) –  ‘Any illicit’ comparing 1998 with2007 http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737421139&libID=10737421138

During her pregnancy, Stacey never drank alcohol or had a cigarette. But nearly every day, then 24, she smoked marijuana.

With her fiancé’s blessing, she began taking a few puffs in her first trimester to quell morning sickness before going to work at a sandwich shop. When sciatica made it unbearable to stand during her 12-hour shifts, she discreetly vaped marijuana oil on her lunch break.

“I wouldn’t necessarily say, ‘Go smoke a pound of pot when you’re pregnant,’” said Stacey, now a stay-at-home mother in Deltona, Fla., who asked that her full name be withheld because street-bought marijuana is illegal in Florida. “In moderation, it’s O.K.”

Many pregnant women, particularly younger ones, seem to agree, a recent federal survey shows. As states legalize marijuana or its medical use, expectant mothers are taking it up in increasing numbers — another example of the many ways in which acceptance of marijuana has outstripped scientific understanding of its effects on human health.

Often pregnant women presume that cannabis has no consequences for developing infants. But preliminary research suggests otherwise: Marijuana’s main psychoactive ingredient — tetrahydrocannabinol, or THC — can cross the placenta to reach the foetus, experts say, potentially harming brain development, cognition and birth weight. THC can also be present in breast milk.

“There is an increased perception of the safety of cannabis use, even in pregnancy, without data to say it’s actually safe,” said Dr. Torri Metz, an obstetrician at Denver Health Medical Center who specializes in high-risk pregnancies. Ten percent of her patients acknowledge recent marijuana use. In the federal survey, published online in December, almost 4 percent of mothers-to-be said they had used marijuana in the past month in 2014, compared with 2.4 percent in 2002. (By comparison, roughly 9 percent of pregnant women ages 18 to 44 acknowledge using alcohol in the previous month.)

Stacey’s son just had his first birthday. He’s walking, talking and breast-feeding, and she isn’t worried about his development. Credit Jennifer Sens for The New York Times

Young mothers-to-be were particularly likely to turn to marijuana: Roughly 7.5 percent of 18- to 25-year-olds said they had used pot in the past month in 2014, compared with 2 percent of women ages 26 to 44.

Evidence on the effects of prenatal marijuana use is still limited and sometimes contradictory. Some of the most extensive data come from two sets of researchers, in Pittsburgh and in Ottawa, who have long studied children exposed to THC in the womb.

In Pittsburgh, 6-year-olds born to mothers who had smoked one joint or more daily in the first trimester showed a decreased ability to understand concepts in listening and reading. At age 10, children exposed to THC in utero were more impulsive than other children and less able to focus their attention.

Most troubling, children of mothers who used marijuana heavily in the first trimester had lower scores in reading, math and spelling at age 14 than their peers.

“Prenatal exposure can affect the adolescent pretty significantly,” said Dr. Lauren M. Jansson, the director of paediatrics at the Center for Addiction and Pregnancy at the Johns Hopkins University School of Medicine.

Several studies have found changes in the brains of foetuses, 18 to 22 weeks old, linked to maternal marijuana use. In male foetuses that were exposed, for instance, researchers have noted abnormal function of the amygdala, the part of the brain that regulates emotion.

“Even early in development, marijuana is changing critical circuits and neurotransmitting receptors,” said Dr. Yasmin Hurd, a neuroscientist and the director of the addiction center at Icahn School of Medicine at Mount Sinai in Manhattan. “Those are important for regulation of emotions and reward, even motor function and cognition.”

It is already well documented that the developing brains of teenagers can be altered with regular marijuana use, even eventually reducing I.Q.

“The effects are not dramatic, but that doesn’t mean they are not important,” said Jodi Gilman, an assistant professor of psychiatry at Harvard Medical School who studies adolescent users of cannabis. “It could make the difference between getting an A and getting a B.”

“You could imagine that a similar subtle effect may be present in those who were exposed prenatally to marijuana,” she added. The American Academy of Paediatrics and the American College of Obstetricians and Gynaecologists both advise against prenatal cannabis use because of its links to cognitive impairment and academic underachievement. But many state and federal agencies avoid the topic.

Of five federal agencies, only the National Institute on Drug Abuse had any information about prenatal marijuana use on its website as of last February, according to a study published online in December in the journal Substance Abuse. Only 10 state health departments did. Until recently, the Centers for Disease Control and Prevention offered nothing.

“I don’t think public health officials should be alarming people,” said Marian Jarlenski, the study’s lead author and an assistant professor at the University Of Pittsburgh Graduate School Of Public Health. “They just have to say, ‘There have been studies done, and there is some risk.’”

In a statement, C.D.C. officials expressed concern about memory and attention problems among children exposed to THC in utero.

“While current evidence on health consequences is inconsistent, some studies have found risks associated with marijuana use during pregnancy, such as low birth weight or preterm birth,” the agency said. Dr. Marie McCormick, a paediatrician and the chairwoman of a new report on cannabis from the National Academies of Sciences, Engineering and Medicine, said smoking cannabis “does confer, in terms of birth weight, the same risk as cigarettes.”

Some of the gathering evidence is reassuring. So far, prenatal cannabis exposure does not appear to be linked to obvious birth defects. “That’s why some providers and lay

people alike think there’s no effect,” said Dr. Erica Wymore, a neonatologist at Children’s Hospital Colorado. But she warned, “Just because they don’t have a major birth defect or overt withdrawal symptoms doesn’t mean the baby’s neurological development is not impacted.”

Most research in this area was done when the drug was far less potent. Marijuana had 12 percent THC in 2014, while in 1995 it was just 4 percent, according to the National Institute on Drug Abuse.

“All those really good earlier studies on marijuana effects aren’t telling us what we need to know now about higher concentration levels,” said Therese Grant, an epidemiologist and director of the University of Washington’s foetal alcohol and drug unit. “We need to do a whole lot more research now.”

There are two additional problems with studies of maternal cannabis use. Research is often based on reports by pregnant women — instead of, say, tests of urine or the umbilical cord — and they consistently underreport their use. (Researchers know of underreporting because samples reveal discrepancies.) And pregnant women who roll joints also tend to smoke tobacco or drink alcohol; it can be hard to tease out the risks of cannabis itself.

Few realize that THC is stored in fat and therefore can linger in a mother’s body for weeks, if not months. It’s not known whether the foetus’s exposure is limited to the hours a woman feels high.

The American College of Obstetricians and Gynaecologists advises clinicians to ask pregnant women about marijuana use and to urge them to quit. To find out whether that’s happening, Dr. Judy Chang, an obstetrician-gynaecologist at the University of Pittsburgh, and her colleagues recorded more than 450 first visits with pregnant patients.

Medical staff were more likely to warn patients that child protective services might be called if they used marijuana, the researchers found, than to advise them of potential risks. When mothers-to-be admitted to marijuana use, almost half of obstetric clinicians did not respond at all.  Pregnant women aren’t eager to discuss it, either, because they are afraid of legal repercussions or a lecture. Depression, anxiety, stress, pain, nausea and vomiting were the most common reasons women reported using marijuana in a 2014 survey of low-income mothers getting federal nutrition help in Colorado. Roughly 6 percent were pot users; a third were pregnant. “Women are thinking of this as medical marijuana in that they are treating some condition,” said Elizabeth Nash, a policy analyst at the Guttmacher Institute who researches substance abuse in pregnancy.  “If you’re going to consider it like medicine,” she said, “then treat it like medicine and talk to your doctor about it.” Stacey’s son just had his first birthday. He’s walking, talking and breast-feeding, and she isn’t worried about his development.  She still smokes pot — indeed, her son plays on a rug emblazoned with a marijuana leaf. But the severe cramps that plagued her before pregnancy are easing now.  “I don’t have to smoke as much anymore,” she said.

Source: https://www.nytimes.com/2017/02/02/health/marijuana-and-pregnancy.

I totally agree that we all need to let Attorney General Jeff Sessions know that the majority of Americans suffer because of marijuana …. whether they choose to use it or not.  It is a factor in crime, physical and mental health, academic failure, lost productivity, et al.  American cannot be great again if we continue to allow poison to be grown and distributed to the masses.

The President has taken a position that “medical marijuana” should be a State’s right, because he is not yet enlightened on the reality of what that means.  If asked to define “medical marijuana” that has helped his friends, I doubt that he would say gummy bears, Heavenly brownies and other edibles with 60 to 80% potency, sold in quantities that are potentially lethal; smoked pot at 25% THC content; or waxes and oils used for dabbing and vaping that are as high as 98% potency that cause psychotic breaks, mental illness, suicides, traffic deaths and more.

Further, if states are to have a right to offer “medical marijuana”, it has to be done under tightly controlled conditions and the profit motive eliminated.  Privately owned cultivation and dispensaries must be banned … including one’s ability to grow 6 plants at home.  6 plants grown hydroponically with 4 harvests a year could generate 24 lbs of pot, the equivalent of about 24,000 joints. That obviously would not be for personal use.  We would just have thousands of new drug dealers, with more crime, more child endangerment, more BHO labs blowing up, more traffic deaths, et al.

Source:   Le