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Abstract

Marijuana is the most commonly abused illicit drug by pregnant women. Its major psychoactive constituent, Delta(9)-THC (Delta(9)-tetrahydrocannabinol), crosses the placenta and accumulates in the foetus, potentially harming its development. In humans, marijuana use in early pregnancy is associated with miscarriage, a fetal alcohol-like syndrome, as well as learning disabilities, memory impairment, and ADHD in the offspring. Classical studies in the 1970 s have reached disparate conclusions as to the teratogenic effects of cannabinoids in animal models. Further, there is very little known about the immediate effects of Delta(9)-THC on early embryogenesis. We have used the chick embryo as a model in order to characterize the effects of a water-soluble Delta(9)-THC analogue, O-2545, on early development. Embryos were exposed to the drug (0.035 to 0.35 mg/ml) at gastrulation and assessed for morphological defects at stages equivalent to 9-14 somites. We report that O-2545 impairs the formation of brain, heart, somite, and spinal cord primordia. Shorter incubation times following exposure to the drug show that O-2545 interferes with the initial steps of head process and neural plate formation. Our results indicate that the administration of the cannabinoid O-2545 during early embryogenesis results in embryotoxic effects and serves to illuminate the risks of marijuana exposure during the second week of pregnancy, a time point at which most women are unaware of their pregnancies.

Source: https://www.ncbi.nlm.nih.gov/pubmed/19040278 October 2008

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.”

Abstract

Background: Given current drug policy reforms to decriminalize or legalize cannabis in numerous countries worldwide, the current study assesses the relation between cannabis use and the development of testicular cancer.

Methods: The study included a population-based sample (n = 49,343) of young men ages 18–21 years who underwent conscription assessment for Swedish military service in 1969–1970. The conscription process included a nonanonymous questionnaire eliciting information about drug use. Conscription information was linked to Swedish health and administrative registry data. Testicular cancers diagnosed between 1970 and 2011 were identified by International Classification of Diseases-7/8/9/10 testicular cancer codes in the Swedish National Patient Register, the Cancer Register, or the Cause of Death Register. Cox regression modeling was used to estimate the hazards associated with cannabis use and time to diagnosis of testicular cancer.

Results: No evidence was found of a significant relation between lifetime “ever” cannabis use and the subsequent development of testicular cancer [n = 45,250; 119 testicular cancer cases; adjusted HR (aHR), 1.42; 95% confidence interval (CI), 0.83–2.45]. “Heavy” cannabis use (defined as usage of more than 50 times in lifetime, as measured at conscription) was associated with the incidence of testicular cancer (n = 45,250; 119 testicular cancer cases; aHR 2.57; 95% CI, 1.02–6.50).

Conclusions: The current study provides additional evidence to the limited prior literature suggesting cannabis use may contribute to the development of testicular cancer.

Impact: Emerging changes to cannabis drug policy should consider the potential role of cannabis use in the development of testicular cancer. Cancer Epidemiol Biomarkers Prev; 26(11); 1644–52. ©2017 AACR.

Source: http://cebp.aacrjournals.org/content/26/11/1644 November 2017

New research from Northern Medical Program Professor Dr. Russ Callaghan has found that use of marijuana is associated with the development of testicular cancer.

As part of a retrospective study, Dr. Callaghan and his team looked at data from young men conscripted for military service in Sweden in 1969 and 1970, and tracked their health conditions over the following 42 years. They found that heavy cannabis use (defined as more than 50 times in a lifetime, as measured at conscription) was associated with a 2.5-fold increased risk of developing testicular cancer.

“At this time, surprisingly little is known about the impacts of cannabis on the development of cancer in humans,” said Dr. Callaghan, the study’s lead author. “With Canada and other countries currently experimenting with the decriminalization or legalization of recreational cannabis use, it is critically important to understand the potential harms of this type of substance use.”

The results from the recent study, as well as three prior case-control studies in this area, suggest that cannabis use may facilitate later onset of testicular cancer.

“Our study is the first longitudinal study showing that cannabis use, as measured in late adolescence, is significantly associated with the subsequent development of testicular cancer. My hope is that these findings will help medical professionals, public health officials and cannabis users to more accurately assess the possible risks and benefits of cannabis use.”

The project included an international team of researchers from Karolinska University in Sweden and the Division of Cancer Epidemiology and Genetics at the National Cancer Institute in the U.S. The study is part of Dr. Callaghan’s ongoing research assessing the potential health risks associated with cannabis use and the potential impacts of cannabis legalization on use and related harms.

Source: https://www.unbc.ca/newsroom/unbc-stories/research-finds-link-between-marijuana-use-and-testicular-cancer November 2017

Dear Friend, 

Let’s take a second to talk about Colorado. 

As you know, Colorado was the first state to commercialize the marijuana industry – and today it stands as the top state in the country for first-time youth marijuana use. The state also suffers from record stoned driving crashes, increased workplace drug positives, and unprecedented levels of opioid deaths.

The pot industry has taken Colorado hostage

A few days ago, Colorado Governor Jared Polis announced he had appointed Ean Seeb to serve as the state’s new “Special Adviser on Cannabis.” From this position, he will help guide Governor Polis’ position on bills as they move through the legislature. 

An example of one such bill is presumably HB 1230 – a bill that would exempt bars, restaurants, and other public places from the Clean Air Indoor Act and allow marijuana use indoors

What is so concerning about this appointment?

You see, Mr. Seeb has been profiting from marijuana for more than a decade. He is a two-time chair of the National Cannabis Industry Association, a former co-owner of Denver Relief dispensary and Denver Relief Consulting. He has lobbied in the past in support of pot deliveries, loosening restrictions on investments into then industry, and social consumption – better known as pot bars. 

The Colorado Springs Gazette stated that this is “like the Marlboro Man monitoring cigarette sales.” I couldn’t agree more.

The fact is, in the short years since it was implemented, legalization in Colorado has been a disaster. Traffic deaths from marijuana-impaired driving have skyrocketed. Emergency room visits from high potency marijuana are through the roof. There has been a 400% increase in exposure of children less than nine years old to the drug. 

The overwhelming majority of pot shops are located in minority and low-income communities and they are recommending highly potent pot to pregnant mothers. Criminal gangs and foreign cartels are setting up shop in housing developments and on public land to grow illegal marijuana next to legal grows and law enforcement is being stretched to its limits to combat the thriving black market. 

And now Governor Polis chooses to put an industry lackey in an oversight position to regulate the industry.

SAM and our Colorado affiliate, the Marijuana Accountability Coalition (MAC), are working tirelessly to combat the industry as it moves to oppose any form of regulation it once favored being imposed on it. We have begun an awareness campaign by covering Denver with billboards pointing out the failures of the marijuana industry in Colorado to help convince Coloradans and Governor Polis to wake up and take action. 

You can help take action, too. Click here to send an email to your member of Congress telling them to oppose legalization of marijuana at the federal level and prevent the spread of this addiction-for-profit industry nationwide. Once you have done that, click here to chip in with a tax-deductible gift to help SAM continue educating lawmakers and the public on the failures of marijuana legalization. 

The industry is strong and deceptive, but together, we can push back,beat them at their own game, and save lives.

All the best, 

Kevin Sabet, PhD

Source: Email from SAM (Smart Approaches to Marijuana) <reply@learnaboutsam.org> May 2019

Why don’t we start with a short quiz of general knowledge of current events and topical issues in the community??

 Questions:

 Brain:

Which American state has 500 students with autism in every graduating year group across the whole state?

Which American state has current legislation afoot to declare autism at epidemic proportions in their state?

Which American state has the fastest growing autism epidemic by recent metrics (at 30% every two years)?

Which smoked illegal drug is now linked with causing strokes???

Which smoked illegal drug is linked with causing most major psychiatric diseases – including schizophrenia, bipolar disorder, depression and anxiety.

Which illicit drug is known to cause failure of achievement of major life goals – forming a long term stable relationship, getting a job, having a career, paying tax???

In which US state have city after city been trashed by out of control mental illness, drug use, homelessness, poverty and law enforcement and social relief services completely overwhelmed?

 Heart:

Which American state is amongst the top four for rates of children born with holes in their heart (known as atrial septal defect)?

In which American state did the rate of holes in the heart (atrial septal defect) increase more than threefold from 299 to 912 cases 2000-2012?

Which smoked illegal drug is now recognized to cause heart attacks?

Which illegal drug is known to stop the heart by causing major cardiac arrythmias?

 Head:

Which two American states share the highest rates of children born without ears or with tiny little ears (like peas – called anotia or microtia)???

 Chromosomes:

Which four American states have the highest rates of Downs syndrome in the nation??

What do all four of these states have in common??

Which American state has the highest rates in the nation for all four major chromosomal abnormalities of birth namely Trisomies 13, 18, 21 (Down’s syndrome) and Turner’s syndrome???

 Limbs:

Which are the two leading states for babies born without arms??

What do these two states have in common??

 Drugs:

Drug use is known to damage babies when they are growing inside their mothers. 

In which leading American state, which was also home to most of the above waves of recent deformed babies, was the rate of all drug use actually falling – all except one drug.  Which state was that?

And which drug was the exception??

 Cancer:

Drug use is well recognized as leading to cancer in many organs.  This is widely recognized for both tobacco and alcohol. 

Which drug has been linked with causing cancer of the testicles in 100% of the studies – four out of four – which have examined this question?

Which is the only illicit drug linked to four inheritable cancers in the children born to infants exposed in utero exposed?

Which drug was examined in detail in a 150 page report by the Californian environmental Protection agency and found to be a proven carcinogen in 2009?

Why are virtually all carcinogens considered teratogens – known to harm developing babies?

 Reproduction:

Which smoked illicit drug causes major genetic damage to both eggs and sperm?

Which smoked illicit drug reduces fertility in both males and females?

Our genes not only carry our DNA sequence, but also the software which programs those genes and turns them on and off – which scientists call the “epigenome”. 

Which smoked illicit drug is known to damage the epigenome?

For how many generations does epigenetic inheritance continue?

Is this period more or less than 100 years???

 

 Answers:

 The above series of questions relate to the recent experience of the US state of Colorado following its progressive legalization of cannabis over the period 2000-2014. 

If you answered “Colorado” to most of the questions about congenital defects you were correct.  The two exceptions were the question about babies born without limbs – the two commonest US states for these defects are Alaska and Oregon; and babies born with tiny ears – which are Alaska and Oregon.

 The leading states for cannabis use according to major recent US surveys are Colorado, Alaska, Oregon, Maine, Vermont and Washington.  Scarily Alaska comes at or near the top of the list for: Down’s syndrome, atrial septal defect (ASD), ventricular septal defect (VSD) a defect called Encephalocoele where babies are born with a big bubble blown out the back of their skull where the neck joins, no arms, no ears and gastroschisis which is where the bowels are hanging out.  Colorado leads or co-leads the charge on the three chromosomal trisomies trisomy 21, 18 and 13 and no ears (anotia).  The four states which lead the pack on Downs syndrome are all cannabis liberal states: Colorado, Alaska, Oregon and Massachusetts.

 Downs syndrome, ASD and VSD are relatively common congenital defects.  Congenital defects as a whole affect around 3% of the community – unless you live in Colorado which up until September 2018 reported a major congenital abnormality rate four times higher than that at 12.6%.  One notes that after that the problem “went away” because the state then changed all of their official congenital anomaly figures for the past 15 years after attention was drawn to these facts internationally.

And one cannot attribute these severe changes in Colorado to the use of other drugs as the national survey showed that the use of most other drugs has actually fallen across this recent period.  So it is obviously a cannabis signal.

 This strong “red flag” warning signal for cannabis also shows up loud and clear in the US nation’s leading mental health survey where cannabis use grew most strongly across the nation in the 18-25 year age group, which was also the age group with by far the worse mental health, which was also declining most rapidly.  This implies that the decline in both the US nation’s minds and their gene pool is occurring in close relationship to cannabis use both across the nation geographically, across time with temporal variability, and also within defined demographic groups.

Cannabis is known to damage the epigenome of the sperm in a way which affects brain heart and immune development and has also been traced in human foetal tissue from live born babies.  This damage is presently believed to be inheritable for four generations or 100 years.  Scientists are very concerned about this serious risk.  In one study over 6,000 sites of DNA methylation were affected and thus reprogrammed, and that is a substantial number compared to our around 25,000 genes.

And most worryingly it was recently reported from Ain in the east of France near the Swiss border that the incidence of babies born without arms is 58 times higher than the normal background.  And the same thing was seen in the cattle in the area.  However this was not seen in nearby Switzerland where it is not permitted to add hemp to the food chain via stock feed.  Cannabis has previously been linked with such defects in a major Hawaiian study of over 300,000 births published in 2007.

Most of the cannabis teratological literature is fairly conservative.  The Centres for Disease Control in Atlanta Georgia have admitted in 2014 that cannabis is linked with four defects – no brain (anencephaly – babies die within an hour or two mostly), bowels having out (|gastroschisis) diaphragmatic hernia and oesophageal atresia with or without tracheooesophageal fistula.  The American Academy of paediatrics has issued a position statement in 2007 saying that both ventricular septal defect (holes in the heart) and Ebsteins anomaly (damaged tricuspid valve) are known to be linked with cannabis use. 

And the three longitudinal studies of babies born after prenatal cannabis exposure presently being conducted in Pittsburgh, Ottawa and Netherlands, all very consistently find persistent and subtle brain damage of executive functioning to be major issues.  This finding in three nations is the most concerning and likely by far the most common of all.

Certainly physicians in both Colorado and in Australia are seeing just this pattern of subtle brain abnormalities in the patients who present to our clinics.  This is therefore the most concerning aspect of the cannabis free for all which is being falsely foisted on the west by a relentless media mantra.  If India has its holy cows, then the theistically allergic media are no less as enamoured with their own devoutly protected “deep green god” – regardless of the painfully obvious fallout.

Most worryingly of all – consider these few final major issues.  Of the two perspective described above – the conservative one espoused by well recognized international authorities – and the more worrying picture of 21 defects reported from the massive epidemiological Hawaiian study – which one is the more correct – especially in an era when as is widely known cannabis, cannabis oils and hashish butane oils are rapidly becoming so much more concentrated than in past eras??  It is said that the most stringent test of any theory is its ability to make predictions about future events.  By this criterion only the 2007 Hawaiian report by Forrester predicted the links in Ain in France with the armless defect, and the patterns of chromosomal abnormalities, atrial septal defect and anotia / microtia across USA.  In this important respect then the Forrester – Menz report is more accurate – and of course much more concerning – than the “standard received wisdom”.  It appears to be acting as a kind of a roadmap – as the tide both of cannabis use and of cannabis concentration – rises all around us.

And most concerning of all is that many papers in the cannabinoid genotoxicity literature show an exponential relationship between cannabis dose exposure and the genotoxic damage which is directly responsible for cancers in patients, their children and foetal abnormalities including mental retardation and brain damage.  That is to say that beyond a certain threshold dose doubling the exposure produces not twice as much genetic damage- but 10-20 times as much. Cannabis use during pregnancy has been linked with the following four cancers which are all believed to be due to genotoxic damage uncurred during in utero exposure: acute lymphatic leukaemia, acute myelomonocytic leukemia, neuroblastoma and rhabdomyosarcoma.

 It is very important to appreciate that these concerns relate not just to Δ9 -tetrahydrocannabinol itself, but, since cannabis contains at least 108 cannabinoids, all of them have been implicated in genotoxic damage through the above mentioned epidemiological studies.  Studies in animals and cells have found that cannabidiol, cannabinol, cannabidivarin and cannabichromene – at least – all have direct genotoxic and / or epigenetic effects which are of great concern.  In many cases this effect is worse than that observed with Δ9 -tetrahydrocannabinol.  They all also damage mitochondrial function which exerts severe indirect genotoxicity partly by limiting energy supply to growing, dividing and metabolically active tissues, and partly by close and multichannel signaling from the mitochondria directly to the nucleus and its architecture and genetic management machinery.

And… despite what one might think from the deafening silence from the popular press, the genotoxicity of cannabinoids is not even controversial!  Serious warnings relating to reproductive health are prominently featured in the formally registered patient information inserts for both cannabidiol “Epidiolex” and the cannabidiol / THC mixture “Sativex”.

All of which paints an horrific and ghoulish picture of the drug-wrecked future.  In the USA it is obvious that the guardians of the culture are radically missing in action.  CDC which is charged with protecting the public health; FDA which are charged with protecting the food and pharmaceutical supply and the USA President all seem be absent from the foray.  One can only wonder why…  Intimidated??  Cultural groupthink??  Personal money at stake?? Careers on the line??

My father always taught me:  “If everybody else was jumping over a cliff, would you jump to??”  Paradoxically indeed in 1958 it was the FDA which protected the USA from the holocaust that became the completely avoidable international thalidomide teratogenesis epidemic, whilst societies in Australia, England and in Europe were duped and succumbed to the commercial marketing campaign and the deliberate subversion of the then known truth.  Cannabis was recently been found to be recommended to 78% of pregnant women in Colorado.  Just as in that era, thalidomide was also used for anxiety, sleeplessness, nausea, unwellness and “dis-ease”.  Today America has obviously succumbed to the siren voice of the modern media darling – the “green holy cow” of the west. 

 One can only wonder if anyone in this country has the courage to see the obvious and call “Enough Already” and insist that our public agencies do their duty and discharge their office with honour.       Dr. Stuart Reece.

Source:  January 2019 edition of Family World News

 

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

People who are mentally ill or addicted can’t work effectively, if at all, so they have to turn to crime and/or public support for survival.  Marijuana escalates the risk of mental illness 5 times.[i] On average, 17% of adolescents and 9% of adults  will become addicted.[ii]Based on federal research  7,000 people use marijuana for the first time each day.[iii] Taking an average of 13%, nationally over 332,000 new marijuana addicts will be created.  California’s share at 13% of the population will be over 33,000 new addicts annually, adding another 1.3 billion in cost at $40,000 each.  Instead of preventing these problems, we can expect more academic failure, lost productivity, mental illness, addiction and crime. In Sacramento, 59% of all arrestees for any crime tested positive just for marijuana; 83% for any drug[iv]. Jail overcrowding is also a factor as those deemed mentally ill languish there for weeks and months, waiting for space in a mental health facility.

Marijuana causes permanent brain damage and loss of IQ for anyone under 25.[v]  It causes psychotic breaks leading to gruesome acts, including decapitations, stabbings, mass murders and suicides. Other harms include DNA damage causing birth abnormalities[vi] not just in the next generation, but the next four (100 years).  Because marijuana is fat soluble, it stays in the body and brain for one month, compounding with each additional use.  The impairment adversely affects cognition, judgement and memory all of which contribute to traffic deaths. [vii]

MARIJUANA – THE ECONOMIC COSTS 
Aside from the devastating environmental cost, the social costs are huge.  For alcohol and tobacco, the social costs exceed tax revenues by 9 to 1. The black market won’t disappear. In Colorado the black market is still about 50% of the total.  In California only about 16% of cultivators have signed up to be licensed and taxed. The rest will avoid taxes and sell to the black market throughout the US. In 2009, a study called Shoveling Up: The Impact of Substance Abuse on Federal, State and Local Governments[viii] was done which showed in 2005, California spent 19.5% of its budget ($19.9 billion) on substance abuse, of which only $38 million (1/3rd of 1%) on prevention, and the rest shoveling up the damage. This is horrible economic policy, and its much worse today.  Instead of preventing this preventable disease, we cultivate it.

Voters bought the Gavin Newsom lie that Prop 64 would be a good thing. The orchestrated legislative analysis, approved by our Attorney General, Secretary of State, et al., suggested the state would save $100 million in prison costs, get rid of the black market and earn up to $1 billion in tax revenues. No mention of the environmental devastation and reclamation costs.  It outrageously suggested marijuana had no serious health impacts.  To cap it off, the illicit drug trade and out-of-state billionaires spent $35 million to back the campaign. If we care about our kids, and our future, its time to fight back.

[i] https////health.harvard.edu/Teens who smoke pot at risk for later schizophrenia

[ii] www.drugabuse.gov

[iii] www.theatlantic.com/Everyday 7,000 Americans try weed for the first time

[iv] www.ncjrs.gov/pdfiles1/ondcp/ADAMII Arrestee Drug Abuse Monitoring Program

[v] www.healthline.com.  The Effects of Marijuana on your body.

[vi] www.sciencedaily.com.  Marijuana Damages DNA and may cause cancer

[vii] www.nbcnews.com/health/healt-news/Pot Fuels Surge In Driving Deaths

[viii] www.casacolumbia.org/Shoveling Up:  The Impact of Substance Abuse on Federal, State and Local Budgets

Source: http://tbac.us/2018/09/15/marijuana-causes-mental-illness-and-addiction-in-turn-more-homelessness-poverty-and-crime/ September 2018

Estimated reclamation costs in Calaveras County California alone could reach $2 billion for 1,200 grow sites. 50,000 grow sites in the state could amount to over $50 billion, according to the Calaveras County study (www.silentpoison.com/CultivatingDisaster).

Aside from killing wildlife, fish and depleting streams and water tables, the poisons seeping into the ground are contaminating watersheds that serve farm animals and millions of people.  Poisons are also decimating the famed spotted owl that shut down the lumber industry.  Money and manpower for reclamation are non-existent.      

Our national forests are no longer safe. Millions of birds, animals and fish are essentially murdered. Pristine ecosystems are being destroyed. Poisons and fertilizers seeping into the soil are contaminating streams that serve millions of people while our federal and state governments stand on the sidelines.

Under the guise of medicine, at the end of 2017, produced 8 times more pot than is consumed within our own borders. California supplies 60 to 75% of the entire US black market for marijuana, 93% of which is known to be contaminated with pesticides.  Rather than limit production, in the 1st quarter 2018, the state issued 2,000 additional licenses to grow pot, obviously to serve export markets. In the meantime, Congress is withholding funds for federal enforcement of their own laws.  The FDA and EPA have done nothing to protect the people and planet.  Now, contrary to federal laws which he is supposed to enforce, the President unwisely says States have a right to set their own marijuana laws.  Then, is it OK that California has become a cartel, bigger than all others combined?

The nation has been hijacked. We have become a lawless, narco nation where money for personal political futures is more important than an oath to defend the constitution and protect the people.   To the chagrin or our international allies, the US is now a rogue nation in violation of three international treaties. Unless America returns to the rule of law, the America will never regain its former glory.

Don’t Believe It?  Please take 11 ½ minutes and watch Youtube.com/Environmental Damage of Marijuana In the West.

Source: http://tbac.us/2018/09/15/californias-ill-conceived-marijuana-program-has-inflicted-irreparable-environmental-human-and-economic-harm-on-our-once-fine-state/ September 2018

Smaller cities and towns carry a unique burden when it comes to drug addiction.

I grew up in Mounds, Ill. It’s a small farming community of about 800 people in the southernmost part of the state. It may seem an unlikely place for a drug epidemic, but opioid addiction and substance abuse have plagued families there for decades. Years ago, the first of my close relatives died after a long struggle with prescription opioids.

That’s one reason why, as deputy secretary of the U.S. Department of Health and Human Services, or HHS, I keep the victims of this crisis close to my heart.

Under President Donald Trump, HHS has made the opioid crisis a top priority because it leaves no corner of our country untouched. When the crisis began, we worked mostly in rural areas to address overdoses and opioid-use disorder. The opioid crisis is nationwide and claimed approximately 116 American lives every day in 2016.

The most recent data from the Centers for Disease Control and Prevention provides even more grim details. Nearly 64,000 Americans died of drug overdoses in 2016, a 21 percent increase from the previous year and the largest increase on record. More than 42,000 of those deaths involved opioids, more than the total number of all drug overdose deaths in 2012. Further, provisional data indicate that approximately 72,000 Americans died of drug overdoses in 2017. In 2015, there were more than 1 million opioid-related hospital stays and emergency-room visits in the U.S.

A publication from the University of Minnesota’s College of Pharmacy brings the crisis closer to this region. Titled “Combating the Opioid Crisis in Northern Minnesota,” it found that the Duluth area in particular has been hit hard. St. Louis County has the highest opioid overdose death rate in the state.

As part of the Trump administration’s focused mission to support states and local communities on the front lines of this fight, one of our primary strategies is to learn directly from those on the ground so we may be able to benefit from the experience and understanding of local leaders and communities. Over the last few months I have traveled to Illinois, Ohio, Florida, Texas, California, Kentucky, Minnesota, and Wisconsin to exchange ideas with medical experts, local officials, and, especially, individuals currently receiving treatment for opioid addiction.

My visit to Duluth in July was part of the same journey — and a personal one as well. My mother was born in Esko. I consider your remarkable region a second home.

While I was there, one family told me of tragic loss. Their son was injured on the job, was prescribed opioids for pain, and soon became addicted. After only a few months, he lost his life to opioid overdose.

I also heard inspiring stories of people in recovery and how well they know the severe hurdles to battling addiction. They are now providing crucial help by connecting others to treatment and educating the public about lifesaving overdose-reversing drugs.

I was particularly encouraged visiting Duluth’s Lake Superior Health Clinic and learning how grants from the Health Resources and Services Administration at HHS are aiding in the clinic’s vital mission of care.

My message that day was clear: HHS stands ready to assist local heroes helping to end this epidemic in their communities. We are backing up that commitment in Minnesota by awarding more than $10.7 million in state-targeted opioid-crisis grants, $6 million in medication-assisted treatment, and more than $24 million in substance-abuse prevention and treatment block grants last year. Additional awards will be announced in the coming months.

As an indication of the priority he places on this effort, President Trump donated a quarter of his salary last year to the planning and design of a large-scale public-awareness campaign to enhance understanding of the dangers of opioid misuse and addiction. He hopes his example will spur Congress to take even more action.

We at HHS recognize that the American people, in local communities like Duluth and all across our great country, will be the ones to end this terrible crisis. It will require nothing less than a united effort from not just government but the business community, our churches, our schools, and all of civil society.

We can win this battle in Minnesota and all across the country.

Source: https://www.duluthnewstribune.com/opinion/columns/4481662-deputy-secretarys-view-opioids-battle-can-be-won-beginning-minnesota-and August 2018

People who turn to medical marijuana are often drawn to the fact that it’s natural. This is indeed a great quality from a health standpoint, but environment-minded marijuana buyers, take note: New research shows that marijuana farming in remote locations is having a negative effect on the environment.

After studying the ecological consequences that marijuana farming had in Northern California, researchers from Ithaca College discovered that small farms were having a surprisingly big impact.

In a press release, the college’s Environmental Science Associate Professor Jake Brenner wrote that cannabis has significant environmental impacts despite its small spatial footprint. He suggests that policymakers put land-use and environmental regulations in place to help control the expansion of cannabis crops before the situation grows more widespread, given the increase in legalization and popularity of the plant. Cannabis now enjoys legalization for varying degrees of medicinal and/or recreational use across 30 states in the U.S. and several other countries.

They reached their conclusions after comparing cannabis cultivation’s environmental effects, including forest fragmentation, the loss of habitats, and deforestation. In fact, the researchers pointed out that cannabis causes bigger changes in several key metrics in terms of unit area compared to timber, although the latter’s overall landscape impact remains greater.

For example, after looking at pot farms in 62 random watersheds in Humboldt County from 2000 to 2013, the crop was shown to cause 1.5 times greater forest loss and 2.5 times more forest fragmentation than timber harvest.

California laws on marijuana cultivation inadvertently hurting the environment

Little is known about the long-term impact of marijuana farming or regulations in the industry as policymaking struggles to stay on top of the industry’s growth. Part of the problem is that California laws state marijuana cultivation must be confined to just one acre per land parcel. By preventing wide-scale industrial marijuana farms, this law is actually encouraging small farms with big environmental impacts to proliferate, breaking up the forest and hurting wildlife habitats.

This adds on to previous studies carried out by the same research team showing that the pesticides used on marijuana farms to keep rodents away can hurt mammals in the area, while irrigation is having a negative impact on local wildlife. Moreover, because their locations are typically quite remote, access roads must be created and land must be cleared for production. That report suggested that growing marijuana in places with gentler slopes, plenty of water sources, and better access to roads could help reduce the threats to the environment significantly. Marijuana can also be cultivated indoors.

Those growing the crop should avoid using chemical pesticides for obvious reasons. It’s not just bad for the environment; it’s also terrible for your health. Indeed, pesticide exposure could be behind the cancer that spurs many people to seek medical marijuana in the first place. Some illegal forest growers have been using pesticides like carbofuran, which has long been banned in the country, and it’s now making its way into the water. This causes headaches, vomiting, muscle twitches, dizziness, convulsions and even death in some cases. California is home to more than 90 percent of the illegal pot farms found in the nation.

Profits coming at expense of environment

Unfortunately, there are a lot of profits to be made here, and some of the less scrupulous growers are focusing on profits at the expense of the environment. By raising awareness about the potential impact, it is hoped that such parties will turn to more responsible growing practices in the future. As the scientists in these studies point out, however, there isn’t much research available about land-use science when it comes to cannabis agriculture.

Source: https://www.naturalnews.com/2017-11-20-marijuana-farmers-are-destroying-natural-ecosystems-as-quest-for-profits-outweighs-green-agricultural-practices.html November 2017

Abstract

Major self-mutilation (amputation, castration, self-inflicted eye injuries) is frequently associated with psychiatric disorders and/or substance abuse. A 35-year-old man presented with behavioral disturbances of sudden onset after oral cannabis consumption and major self-mutilation (attempted amputation of the right arm, self-enucleation of both eyes and impalement) which resulted in death. During the enquiry, four fragments of a substance resembling cannabis resin were seized at the victim’s home. Autopsy confirmed that death was related to hemorrhage following the mutilations. Toxicological findings showed cannabinoids in femoral blood (tetrahydrocannabinol (THC) 13.5 ng/mL, 11-hydroxy-tetrahydrocannabinol (11-OH-THC) 4.1 ng/mL, 11-nor-9-carboxy-THC (THC-COOH) 14.7 ng/mL, cannabidiol (CBD) 1.3 ng/mL, cannabinol (CBN) 0.7 ng/mL). Cannabinoid concentrations in hair (1.5 cm brown hair strand/1 segment) were consistent with concentrations measured in chronic users (THC 137 pg/mg, 11-OH-THC 1 pg/mg, CBD 9 pg/mg, CBN 94 pg/mg). Analysis of the fragments seized confirmed that this was cannabis resin with high levels of THC (31-35%). We discuss the implications of oral consumption of cannabis with a very high THC content.

Source: https://www.ncbi.nlm.nih.gov/pubmed/29125965 January 2018

Abstract

BACKGROUND:

Medical cannabis refers to the use of cannabis or cannabinoids as medical therapy to treat disease or alleviate symptoms. In the United States, 23 states and Washington DC (May 2015) have introduced laws to permit the medical use of cannabis. Within the European Union, medicinal cannabis laws and praxis vary wildly between Countries.

OBJECTIVES:

To provide evidence for benefits and harms of cannabis (including extracts and tinctures) treatment for adults in the following indications: control of spasticity and pain in patients with multiple sclerosis; control of pain in patients with chronic neuropathic pain; control of nausea and vomiting in adults with cancer receiving chemotherapy.

METHODS:

We searched the Cochrane Central Register of Controlled Trials, PubMed, and EMBASE from inception to September 2016. We also searched for on-going studies via ClinicalTrials.gov and the World Health Organization and International Clinical Trials Registry Platform (ICTRP) search portal. All searches included also non-English language literature. All relevant randomized controlled trials (RCTs) evaluating the safety and efficacy of cannabis (including extracts and tinctures) compared with placebo or other pharmacological agents were included. Three authors independently evaluated the titles and abstracts of studies identified in the literature searches for their eligibility. For studies considered eligible, we retrieved full texts. Three investigators independently extracted data. For the assessment of the quality of evidence, we used the standard methodological procedures recommended by Cochrane and GRADE working Group.

RESULTS:

41 trials (4,550 participants) were included; 15 studies considered efficacy and safety of cannabis for patients with multiple sclerosis, 12 for patients with chronic pain, and 14 for patients with cancer receiving chemotherapy. The included studies were published between 1975 and 2015, and the majority of them were conducted in Europe. We judged almost 50% of these studies to be at low risk of bias. The large majority (80%) of the comparisons were with placebo; only 8 studies included patients with cancer receiving chemotherapy comparing cannabis with other antiemetic drugs. Concerning the efficacy of cannabis (compared with placebo) in patients with multiple sclerosis, confidence in the estimate was high in favour of cannabis for spasticity (numerical rating scale and visual analogue scale, but not the Ashworth scale) and pain. For chronic and neuropathic pain (compared with placebo), there was evidence of a small effect; however, confidence in the estimate is low and these results could not be considered conclusive. There is uncertainty whether cannabis, including extracts and tinctures, compared with placebo or other antiemetic drugs reduces nausea and vomiting in patients with cancer requiring chemotherapy, although the confidence in the estimate of the effect was low or very low. In the included studies, many adverse events were reported and none of the studies assessed the development of abuse or dependence.

CONCLUSIONS:

There is incomplete evidence of the efficacy and safety of medical use of cannabis in the clinical contexts considered in this review. Furthermore, for many of the outcomes considered, the confidence in the estimate of the effect was again low or very low. To give conclusive answers to the efficacy and safety of cannabis used for medical purposes in the clinical contexts considered, further studies are needed, with higher quality, larger sample sizes, and possibly using the same diagnostic tools for evaluating outcomes of interest.

Source: https://www.ncbi.nlm.nih.gov/pubmed/29119763 November 2017

You’re aware America is under siege, fighting an opioid crisis that has exploded into a public-health emergency. You’ve heard of OxyContin, the pain medication to which countless patients have become addicted. But do you know that the company that makes Oxy and reaps the billions of dollars in profits it generates is owned by one family?

The newly installed Sackler Courtyard at London’s Victoria and Albert Museum is one of the most glittering places in the developed world. Eleven thousand white porcelain tiles, inlaid like a shattered backgammon board, cover a surface the size of six tennis courts. According to the V&A;’s director, the regal setting is intended to serve as a “living room for London,” by which he presumably means a living room for Kensington, the museum’s neighborhood, which is among the world’s wealthiest. In late June, Kate Middleton, the Duchess of Cambridge, was summoned to consecrate the courtyard, said to be the earth’s first outdoor space made of porcelain; stepping onto the ceramic expanse, she silently mouthed, “Wow.”

The Sackler Courtyard is the latest addition to an impressive portfolio. There’s the Sackler Wing at New York’s Metropolitan Museum of Art, which houses the majestic Temple of Dendur, a sandstone shrine from ancient Egypt; additional Sackler wings at the Louvre and the Royal Academy; stand-alone Sackler museums at Harvard and Peking Universities; and named Sackler galleries at the Smithsonian, the Serpentine, and Oxford’s Ashmolean. The Guggenheim in New York has a Sackler Center, and the American Museum of Natural History has a Sackler Educational Lab. Members of the family, legendary in museum circles for their pursuit of naming rights, have also underwritten projects of a more modest caliber—a Sackler Staircase at Berlin’s Jewish Museum; a Sackler Escalator at the Tate Modern; a Sackler Crossing in Kew Gardens. A popular species of pink rose is named after a Sackler. So is an asteroid.

The Sackler name is no less prominent among the emerald quads of higher education, where it’s possible to receive degrees from Sackler schools, participate in Sackler colloquiums, take courses from professors with endowed Sackler chairs, and attend annual Sackler lectures on topics such as theoretical astrophysics and human rights. The Sackler Institute for Nutrition Science supports research on obesity and micronutrient deficiencies. Meanwhile, the Sackler institutes at Cornell, Columbia, McGill, Edinburgh, Glasgow, Sussex, and King’s College London tackle psychobiology, with an emphasis on early childhood development.

The Sacklers’ philanthropy differs from that of civic populists like Andrew Carnegie, who built hundreds of libraries in small towns, and Bill Gates, whose foundation ministers to global masses. Instead, the family has donated its fortune to blue-chip brands, braiding the family name into the patronage network of the world’s most prestigious, well-endowed institutions. The Sackler name is everywhere, evoking automatic reverence; the Sacklers themselves, however, are rarely seen.

The descendants of Mortimer and Raymond Sackler, a pair of psychiatrist brothers from Brooklyn, are members of a billionaire clan with homes scattered across Connecticut, London, Utah, Gstaad, the Hamptons, and, especially, New York City. It was not until 2015 that they were noticed by Forbes, which added them to the list of America’s richest families. The magazine pegged their wealth, shared among twenty heirs, at a conservative $14 billion. (Descendants of Arthur Sackler, Mortimer and Raymond’s older brother, split off decades ago and are mere multi-millionaires.) To a remarkable degree, those who share in the billions appear to have abided by an oath of omertà: Never comment publicly on the source of the family’s wealth.

That may be because the greatest part of that $14 billion fortune tallied by Forbes came from OxyContin, the narcotic painkiller regarded by many public-health experts as among the most dangerous products ever sold on a mass scale. Since 1996, when the drug was brought to market by Purdue Pharma, the American branch of the Sacklers’ pharmaceutical empire, more than two hundred thousand people in the United States have died from overdoses of OxyContin and other prescription painkillers. Thousands more have died after starting on a prescription opioid and then switching to a drug with a cheaper street price, such as heroin. Not all of these deaths are related to OxyContin—dozens of other painkillers, including generics, have flooded the market in the past thirty years. Nevertheless, Purdue Pharma was the first to achieve a dominant share of the market for long-acting opioids, accounting for more than half of prescriptions by 2001.

According to the Centers for Disease Control, fifty-three thousand Americans died from opioid overdoses in 2016, more than the thirty-six thousand who died in car crashes in 2015 or the thirty-five thousand who died from gun violence that year. This past July, Donald Trump’s Commission on Combating Drug Addiction and the Opioid Crisis, led by New Jersey governor Chris Christie, declared that opioids were killing roughly 142 Americans each day, a tally vividly described as “September 11th every three weeks.” The epidemic has also exacted a crushing financial toll: According to a study published by the American Public Health Association, using data from 2013—before the epidemic entered its current, more virulent phase—the total economic burden from opioid use stood at about $80 billion, adding together health costs, criminal-justice costs, and GDP loss from drug-dependent Americans leaving the workforce. Tobacco remains, by a significant multiple, the country’s most lethal product, responsible for some 480,000 deaths per year. But although billions have been made from tobacco, cars, and firearms, it’s not clear that any of those enterprises has generated a family fortune from a single product that approaches the Sacklers’ haul from OxyContin.

Even so, hardly anyone associates the Sackler name with their company’s lone blockbuster drug. “The Fords, Hewletts, Packards, Johnsons—all those families put their name on their product because they were proud,” said Keith Humphreys, a professor of psychiatry at Stanford University School of Medicine who has written extensively about the opioid crisis. “The Sacklers have hidden their connection to their product. They don’t call it ‘Sackler Pharma.’ They don’t call their pills ‘Sackler pills.’ And when they’re questioned, they say, ‘Well, it’s a privately held firm, we’re a family, we like to keep our privacy, you understand.’ ”

The family’s leaders have pulled off three of the great marketing triumphs of the modern era: The first is selling OxyContin; the second is promoting the Sackler name; and the third is ensuring that, as far as the public is aware, the first and the second have nothing to do with one another.

To the extent that the Sacklers have cultivated a reputation, it’s for being earnest healers, judicious stewards of scientific progress, and connoisseurs of old and beautiful things. Few are aware that during the crucial period of OxyContin’s development and promotion, Sackler family members actively led Purdue’s day-to-day affairs, filling the majority of its board slots and supplying top executives. By any assessment, the family’s leaders have pulled off three of the great marketing triumphs of the modern era: The first is selling OxyContin; the second is promoting the Sackler name; and the third is ensuring that, as far as the public is aware, the first and the second have nothing to do with one another.


If you head north on I-95 through Stamford, Connecticut, you will spot, on the left, a giant misshapen glass cube. Along the building’s top edge, white lettering spells out ONE STAMFORD FORUM. No markings visible from the highway indicate the presence of the building’s owner and chief occupant, Purdue Pharma.

Originally known as Purdue Frederick, the first iteration of the company was founded in 1892 on New York’s Lower East Side as a peddler of patent medicines. For decades, it sustained itself with sales of Gray’s Glycerine Tonic, a sherry-based liquid of “broad application” marketed as a remedy for everything from anemia to tuberculosis. The company was purchased in 1952 by Arthur Sackler, thirty-nine, and was run by his brothers, Mortimer, thirty- six, and Raymond, thirty-two. The Sackler brothers came from a family of Jewish immigrants in Flatbush, Brooklyn. Arthur was a headstrong and ambitious provider, setting the tone—and often choosing the path—for his younger brothers. After attending medical school on Arthur’s dime, Mortimer and Raymond followed him to jobs at the Creedmoor psychiatric hospital in Queens. There, they coauthored more than one hundred studies on the biochemical roots of mental illness. The brothers’ research was promising—they were among the first to identify a link between psychosis and the hormone cortisone—but their findings were mostly ignored by their professional peers, who, in keeping with the era, favored a Freudian model of mental illness.

Concurrent with his psychiatric work, Arthur Sackler made his name in pharmaceutical advertising, which at the time consisted almost exclusively of pitches from so-called “detail men” who sold drugs to doctors door-to-door. Arthur intuited that print ads in medical journals could have a revolutionary effect on pharmaceutical sales, especially given the excitement surrounding the “miracle drugs” of the 1950s—steroids, antibiotics, antihistamines, and psychotropics. In 1952, the same year that he and his brothers acquired Purdue, Arthur became the first adman to convince The Journal of the American Medical Association, one of the profession’s most august publications, to include a color advertorial brochure.

In the 1960s, Arthur was contracted by Roche to develop an advertising strategy for a new antianxiety medication called Valium. This posed a challenge, because the effects of the medication were nearly indistinguishable from those of Librium, another Roche tranquilizer that was already on the market. Arthur differentiated Valium by audaciously inflating its range of indications. Whereas Librium was sold as a treatment for garden- variety anxiety, Valium was positioned as an elixir for a problem Arthur christened “psychic tension.” According to his ads, psychic tension, the forebear of today’s “stress,” was the secret culprit behind a host of somatic conditions, including heartburn, gastrointestinal issues, insomnia, and restless-leg syndrome. The campaign was such a success that for a time Valium became America’s most widely prescribed medication—the first to reach more than $100 million in sales. Arthur, whose compensation depended on the volume of pills sold, was richly rewarded, and he later became one of the first inductees into the Medical Advertising Hall of Fame.

As Arthur’s fortune grew, he turned his acquisitive instincts to the art market, quickly amassing the world’s largest private collection of ancient Chinese artifacts. According to a memoir by Marietta Lutze, his second wife, collecting, exhibiting, owning, and donating art fed Arthur’s “driving necessity for prestige and recognition.” Rewarding at first, collecting soon became a mania that took over his life. “Boxes of artifacts of tremendous value piled up in numerous storage locations,” she wrote, “there was too much to open, too much to appreciate; some objects known only by a packing list.” Under an avalanche of “ritual bronzes and weapons, mirrors and ceramics, inscribed bones and archaic jades,” their lives were “often in chaos.” “Addiction is a curse,” Lutze noted, “be it drugs, women, or collecting.”

When Arthur donated his art and money to museums, he often imposed onerous terms. According to a memoir written by Thomas Hoving, the Met director from 1967 to 1977, when Arthur established the Sackler Gallery at the Metropolitan Museum of Art to house Chinese antiquities, in 1963, he required the museum to collaborate on a byzantine tax-avoidance maneuver. In accordance with the scheme, the museum first soldArthur a large quantity of ancient artifacts at the deflated 1920s prices for which they had originally been acquired. Arthur then donated back the artifacts at 1960s prices, in the process taking a tax deduction so hefty that it likely exceeded the value of his initial donation. Three years later, in connection with another donation, Arthur negotiated an even more unusual arrangement. This time, the Met opened a secret chamber above the museum’s auditorium to provide Arthur with free storage for some five thousand objects from his private collection, relieving him of the substantial burden of fire protection and other insurance costs. (In an email exchange, Jillian Sackler, Arthur’s third wife, called Hoving’s tax-deduction story “fake news.” She also noted that New York’s attorney general conducted an investigation into Arthur’s dealings with the Met and cleared him of wrongdoing.)

In 1974, when Arthur and his brothers made a large gift to the Met—$3.5 million, to erect the Temple of Dendur—they stipulated that all museum signage, catalog entries, and bulletins referring to objects in the newly opened Sackler Wing had to include the names of all three brothers, each followed by “M.D.” (One museum official quipped, “All that was missing was a note of their office hours.”)

Hoving said that the Met hoped that Arthur would eventually donate his collection to the museum, but over time Arthur grew disgruntled over a series of rankling slights. For one, the Temple of Dendur was being rented out for parties, including a dinner for the designer Valentino, which Arthur called “disgusting.” According to Met chronicler Michael Gross, he was also denied that coveted ticket of arrival, a board seat. (Jillian Sackler said it was Arthur who rejected the board seat, after repeated offers by the museum.) In 1982, in a bad breakup with the Met, Arthur donated the best parts of his collection, plus $4 million, to the Smithsonian in Washington, D. C.


Arthur’s younger brothers, Mortimer and Raymond, looked so much alike that when they worked together at Creedmoor, they fooled the staff by pretending to be one another. Their physical similarities did not extend to their personalities, however. Tage Honore, Purdue’s vice-president of discovery of research from 2000 to 2005, described them as “like day and night.” Mortimer, said Honore, was “extroverted—a ‘world man,’ I would call it.” He acquired a reputation as a big-spending, transatlantic playboy, living most of the year in opulent homes in England, Switzerland, and France. (In 1974, he renounced his U. S. citizenship to become a citizen of Austria, which infuriated his patriotic older brother.) Like Arthur, Mortimer became a major museum donor and married three wives over the course of his life.

Mortimer had his own feuds with the Met. On his seventieth birthday, in 1986, the museum agreed to make the Temple of Dendur available to him for a party but refused to allow him to redecorate the ancient shrine: Together with other improvements, Mortimer and his interior designer, flown in from Europe, had hoped to spiff up the temple by adding extra pillars. Also galling to Mortimer was the sale of naming rights for one of the Sackler Wing’s balconies to a donor from Japan. “They sold it twice,” Mortimer fumed to a reporter from New York magazine. Raymond, the youngest brother, cut a different figure—“a family man,” said Honore. Kind and mild-mannered, he stayed with the same woman his entire life. Lutze concluded that Raymond owed his comparatively serene nature to having missed the worst years of the Depression. “He had summer vacations in camp, which Arthur never had,” she wrote. “The feeling of the two older brothers about the youngest was, ‘Let the kid enjoy himself.’ ”

Raymond led Purdue Frederick as its top executive for several decades, while Mortimer led Napp Pharmaceuticals, the family’s drug company in the UK. (In practice, a family spokesperson said, “the brothers worked closely together leading both companies.”) Arthur, the adman, had no official role in the family’s pharmaceutical operations. According to Barry Meier’s Pain Killer, a prescient account of the rise of OxyContin published in 2003, Raymond and Mortimer bought Arthur’s share in Purdue from his estate for $22.4 million after he died in 1987. In an email exchange, Arthur’s daughter Elizabeth Sackler, a historian of feminist art who sits on the board of the Brooklyn Museum and supports a variety of progressive causes, emphatically distanced her branch of the family from her cousins’ businesses. “Neither I, nor my siblings, nor my children have ever had ownership in or any benefit whatsoever from Purdue Pharma or OxyContin,” she wrote, while also praising “the breadth of my father’s brilliance and important works.” Jillian, Arthur’s widow, said her husband had died too soon: “His enemies have gotten the last word.”


The Sacklers have been millionaires for decades, but their real money—the painkiller money—is of comparatively recent vintage. The vehicle of that fortune was OxyContin, but its engine, the driving power that made them so many billions, was not so much the drug itself as it was Arthur’s original marketing insight, rehabbed for the era of chronic-pain management. That simple but profitable idea was to take a substance with addictive properties—in Arthur’s case, a benzo; in Raymond and Mortimer’s case, an opioid—and market it as a salve for a vast range of indications.

In the years before it swooped into the pain-management business, Purdue had been a small industry player, specializing in over-the-counter remedies like ear-wax remover and laxatives. Its most successful product, acquired in 1966, was Betadine, a powerful antiseptic purchased in industrial quantities by the U. S. government to prevent infection among wounded soldiers in Vietnam. The turning point, according to company lore, came in 1972, when a London doctor working for Cicely Saunders, the Florence Nightingale of the modern hospice movement, approached Napp with the idea of creating a timed-release morphine pill. A long-acting morphine pill, the doctor reasoned, would allow dying cancer patients to sleep through the night without an IV. At the time, treatment with opioids was stigmatized in the United States, owing in part to a heroin epidemic fueled by returning Vietnam veterans. “Opiophobia,” as it came to be called, prevented skittish doctors from treating most patients, including nearly all infants, with strong pain medication of any kind. In hospice care, though, addiction was not a concern: It didn’t matter whether terminal patients became hooked in their final days. Over the course of the seventies, building on a slow-release technology the company had already developed for an asthma medication, Napp created what came to be known as the “Contin” system. In 1981, Napp introduced a timed-release morphine pill in the UK; six years later, Purdue brought the same drug to market in the U. S. as MS Contin.

“The Sacklers have hidden their connection to their product,” said Keith Humphreys, a professor of psychiatry at Stanford University School of Medicine. “They don’t call it ‘Sackler Pharma.’ They don’t call their pills ‘Sackler pills.’”

MS Contin quickly became the gold standard for pain relief in cancer care. At the same time, a number of clinicians associated with the burgeoning chronic-pain movement started advocating the use of powerful opioids for noncancer conditions like back pain and neuropathic pain, afflictions that at their worst could be debilitating. In 1986, two doctors from Memorial Sloan Kettering hospital in New York published a fateful article in a medical journal that purported to show, based on a study of thirty-eight patients, that long-term opioid treatment was safe and effective so long as patients had no history of drug abuse. Soon enough, opioid advocates dredged up a letter to the editor published in The New England Journal of Medicine in 1980 that suggested, based on a highly unrepresentative cohort, that the risk of addiction from long-term opioid use was less than 1 percent. Though ultimately disavowed by its author, the letter ended up getting cited in medical journals more than six hundred times.

As the country was reexamining pain, Raymond’s eldest son, Richard Sackler, was searching for new applications for Purdue’s timed-release Contin system. “At all the meetings, that was a constant source of discussion—‘What else can we use the Contin system for?’ ” said Peter Lacouture, a senior director of clinical research at Purdue from 1991 to 2001. “And that’s where Richard would fire some ideas—maybe antibiotics, maybe chemotherapy—he was always out there digging.” Richard’s spitballing wasn’t idle blather. A trained physician, he treasured his role as a research scientist and appeared as an inventor on dozens of the company’s patents (though not on the patents for OxyContin). In the tradition of his uncle Arthur, Richard was also fascinated by sales messaging. “He was very interested in the commercial side and also very interested in marketing approaches,” said Sally Allen Riddle, Purdue’s former executive director for product management. “He didn’t always wait for the research results.” (A Purdue spokesperson said that Richard “always considered relevant scientific information when making decisions.”)

Perhaps the most private member of a generally secretive family, Richard appears nowhere on Purdue’s website. From public records and conversations with former employees, though, a rough portrait emerges of a testy eccentric with ardent, relentless ambitions. Born in 1945, he holds degrees from Columbia University and NYU Medical School. According to a bio on the website of the Koch Institute for Integrative Cancer Research at MIT, where Richard serves on the advisory board, he started working at Purdue as his father’s assistant at age twenty-six before eventually leading the firm’s R&D; division and, separately, its sales and marketing division. In 1999, while Mortimer and Raymond remained Purdue’s co-CEOs, Richard joined them at the top of the company as president, a position he relinquished in 2003 to become cochairman of the board. The few publicly available pictures of him are generic and sphinxlike—a white guy with a receding hairline. He is one of the few Sacklers to consistently smile for the camera. In a photo on what appears to be his Facebook profile, Richard is wearing a tan suit and a pink tie, his right hand casually scrunched into his pocket, projecting a jaunty charm. Divorced in 2013, he lists his relationship status on the profile as “It’s complicated.”

When Purdue eventually pleaded guilty to felony charges in 2007 for criminally “misbranding” OxyContin, it acknowledged exploiting doctors’ misconceptions about oxycodone’s strength.

Richard’s political contributions have gone mostly to Republicans—including Strom Thurmond and Herman Cain—though at times he has also given to Democrats. (His ex-wife, Beth Sackler, has given almost exclusively to Democrats.) In 2008, he wrote a letter to the editor of The Wall Street Journaldenouncing Muslim support for suicide bombing, a concern that seems to persist: Since 2014, his charitable organization, the Richard and Beth Sackler Foundation, has donated to several anti-Muslim groups, including three organizations classified as hate groups by the Southern Poverty Law Center. (The family spokesperson said, “It was never Richard Sackler’s intention to donate to an anti-Muslim or hate group.”) The foundation has also donated to True the Vote, the “voter-fraud watchdog” that was the original source for Donald Trump’s inaccurate claim that three million illegal immigrants voted in the 2016 election.

Former employees describe Richard as a man with an unnerving intelligence, alternately detached and pouncing. In meetings, his face was often glued to his laptop. “This was pre-smartphone days,” said Riddle. “He’d be typing away and you would think he wasn’t even listening, and then all of the sudden his head would pop up and he’d be asking a very pointed question.” He was notorious for peppering subordinates with unexpected, rapid-fire queries, sometimes in the middle of the night. “Richard had the mind of someone who’s going two hundred miles an hour,” said Lacouture. “He could be a little bit disconnected in the way he would communicate. Whether it was on the weekend or a holiday or a Christmas party, you could always expect the unexpected.”

Richard also had an appetite for micromanagement. “I remember one time he mailed out a rambling sales bulletin,” said Shelby Sherman, a Purdue sales rep from 1974 to 1998. “And right in the middle, he put in, ‘If you’re reading this, then you must call my secretary at this number and give her this secret password.’ He wanted to check and see if the reps were reading this shit. We called it ‘Playin’ Passwords.’ ” According to Sherman, Richard started taking a more prominent role in the company during the early 1980s. “The shift was abrupt,” he said. “Raymond was just so nice and down-to-earth and calm and gentle.” When Richard came, “things got a lot harder. Richard really wanted Purdue to be big—I mean really big.”

To effectively capitalize on the chronic-pain movement, Purdue knew it needed to move beyond MS Contin. “Morphine had a stigma,” said Riddle. “People hear the word and say, ‘Wait a minute, I’m not dying or anything.’ ” Aside from its terminal aura, MS Contin had a further handicap: Its patent was set to expire in the late nineties. In a 1990 memo addressed to Richard and other executives, Purdue’s VP of clinical research, Robert Kaiko, suggested that the company work on a pill containing oxycodone, a chemical similar to morphine that was also derived from the opium poppy. When it came to branding, oxycodone had a key advantage: Although it was 50 percent stronger than morphine, many doctors believed—wrongly—that it was substantially less powerful. They were deceived about its potency in part because oxycodone was widely known as one of the active ingredients in Percocet, a relatively weak opioid- acetaminophen combination that doctors often prescribed for painful injuries. “It really didn’t have the same connotation that morphine did in people’s minds,” said Riddle.

A common malapropism led to further advantage for Purdue. “Some people would call it oxy-codeine” instead of oxycodone, recalled Lacouture. “Codeine is very weak.” When Purdue eventually pleaded guilty to felony charges in 2007 for criminally “misbranding” OxyContin, it acknowledged exploiting doctors’ misconceptions about oxycodone’s strength. In court documents, the company said it was “well aware of the incorrect view held by many physicians that oxycodone was weaker than morphine” and “did not want to do anything ‘to make physicians think that oxycodone was stronger or equal to morphine’ or to ‘take any steps . . . that would affect the unique position that OxyContin’ ” held among physicians.

Purdue did not merely neglect to clear up confusion about the strength of OxyContin. As the company later admitted, it misleadingly promoted OxyContin as less addictive than older opioids on the market. In this deception, Purdue had a big assist from the FDA, which allowed the company to include an astonishing labeling claim in OxyContin’s package insert: “Delayed absorption, as provided by OxyContin tablets, is believed to reduce the abuse liability of a drug.”

The theory was that addicts would shy away from timed-released drugs, preferring an immediate rush. In practice, OxyContin, which crammed a huge amount of pure narcotic into a single pill, became a lusted-after target for addicts, who quickly discovered that the timed-release mechanism in OxyContin was easy to circumvent—you could simply crush a pill and snort it to get most of the narcotic payload in a single inhalation. This wasn’t exactly news to the manufacturer: OxyContin’s own packaging warned that consuming broken pills would thwart the timed-release system and subject patients to a potentially fatal overdose. MS Contin had contended with similar vulnerabilities, and as a result commanded a hefty premium on the street. But the “reduced abuse liability” claim that added wings to the sales of OxyContin had not been approved for MS Contin. It was removed from OxyContin in 2001 and would never be approved again for any other opioid.

The year after OxyContin’s release, Curtis Wright, the FDA examiner who approved the pharmaceutical’s original application, quit. After a stint at another pharmaceutical company, he began working for Purdue. In an interview with Esquire, Wright defended his work at the FDA and at Purdue. “At the time, it was believed that extended-release formulations were intrinsically less abusable,” he insisted. “It came as a rather big shock to everybody—the government and Purdue—that people found ways to grind up, chew up, snort, dissolve, and inject the pills.” Preventing abuse, he said, had to be balanced against providing relief to chronic-pain sufferers. “In the mid-nineties,” he recalled, “the very best pain specialists told the medical community they were not prescribing opioids enough. That was not something generated by Purdue—that was not a secret plan, that was not a plot, that was not a clever marketing ploy. Chronic pain is horrible. In the right circumstances, opioid therapy is nothing short of miraculous; you give people their lives back.” In Wright’s account, the Sacklers were not just great employers, they were great people. “No company in the history of pharmaceuticals,” he said, “has worked harder to try to prevent abuse of their product than Purdue.”


Purdue did not invent the chronic-pain movement, but it used that movement to engineer a crucial shift. Wright is correct that in the nineties patients suffering from chronic pain often received inadequate treatment. But the call for clinical reforms also became a flexible alibi for overly aggressive prescribing practices. By the end of the decade, clinical proponents of opioid treatment, supported by millions in funding from Purdue and other pharmaceutical companies, had organized themselves into advocacy groups with names like the American Pain Society and the American Academy of Pain Medicine. (Purdue also launched its own group, called Partners Against Pain.) As the decade wore on, these organizations, which critics have characterized as front groups for the pharmaceutical industry, began pressuring health regulators to make pain “the fifth vital sign”—a number, measured on a subjective ten-point scale, to be asked and recorded at every doctor’s visit. As an internal strategy document put it, Purdue’s ambition was to “attach an emotional aspect to noncancer pain” so that doctors would feel pressure to “treat it more seriously and aggressively.” The company rebranded pain relief as a sacred right: a universal narcotic entitlement available not only to the terminally ill but to every American.

The company rebranded pain relief as a sacred right: a universal narcotic entitlement available not only to the terminally ill but to every American. By 2001, annual OxyContin sales had surged past $1 billion.

OxyContin’s sales started out small in 1996, in part because Purdue first focused on the cancer market to gain formulary acceptance from HMOs and state Medicaid programs. Over the next several years, though, the company doubled its sales force to six hundred—equal to the total number of DEA diversion agents employed to combat the sale of prescription drugs on the black market—and began targeting general practitioners, dentists, OB/GYNs, physician assistants, nurses, and residents. By 2001, annual OxyContin sales had surged past $1 billion. Sales reps were encouraged to downplay addiction risks. “It was sell, sell, sell,” recalled Sherman. “We were directed to lie. Why mince words about it? Greed took hold and overruled everything. They saw that potential for billions of dollars and just went after it.” Flush with cash, Purdue pioneered a high-cost promotion strategy, effectively providing kickbacks—which were legal under American law—to each part of the distribution chain. Wholesalers got rebates in exchange for keeping OxyContin off prior authorization lists. Pharmacists got refunds on their initial orders. Patients got coupons for thirty- day starter supplies. Academics got grants. Medical journals got millions in advertising. Senators and members of Congress on key committees got donations from Purdue and from members of the Sackler family.

It was doctors, though, who received the most attention. “We used to fly doctors to these ‘seminars,’ ” said Sherman, which were, in practice, “just golf trips to Pebble Beach. It was graft.” Though offering perks and freebies to doctors was hardly uncommon in the industry, it was unprecedented in the marketing of a Schedule II narcotic. For some physicians, the junkets to sunny locales weren’t enough to persuade them to prescribe. To entice the holdouts—a group the company referred to internally as “problem doctors”—the reps would dangle the lure of Purdue’s lucrative speakers’ bureau. “Everybody was automatically approved,” said Sherman. “We would set up these little dinners, and they’d make their little fifteen-minute talk, and they’d get $500.”

Between 1996 and 2001, the number of OxyContin prescriptions in the United States surged from about three hundred thousand to nearly six million, and reports of abuse started to bubble up in places like West Virginia, Florida, and Maine. (Research would later show a direct correlation between prescription volume in an area and rates of abuse and overdose.) Hundreds of doctors were eventually arrested for running pill mills. According to an investigation in the Los Angeles Times, even though Purdue kept an internal list of doctors it suspected of criminal diversion, it didn’t volunteer this information to law enforcement until years later.

As criticism of OxyContin mounted through the aughts, Purdue responded with symbolic concessions while retaining its volume-driven business model. To prevent addicts from forging prescriptions, the company gave doctors tamper-resistant prescription pads; to mollify pharmacists worried about robberies, Purdue offered to replace, free of charge, any stolen drugs; to gather data on drug abuse and diversion, the company launched a national monitoring program called RADARS.

Critics were not impressed. In a letter to Richard Sackler in July 2001, Richard Blumenthal, then Connecticut’s attorney general and now a U. S. senator, called the company’s efforts “cosmetic.” As Blumenthal had deduced, the root problem of the prescription-opioid epidemic was the high volume of prescriptions written for powerful opioids. “It is time for Purdue Pharma to change its practices,” Blumenthal warned Richard, “not just its public-relations strategy.”

It wasn’t just that doctors were writing huge numbers of prescriptions; it was also that the prescriptions were often for extraordinarily high doses. A single dose of Percocet contains between 2.5 and 10mg of oxycodone. OxyContin came in 10-, 20-, 30-, 40-, and 80mg formulations and, for a time, even 160mg. Purdue’s greatest competitive advantage in dominating the pain market, it had determined early on, was that OxyContin lasted twelve hours, enough to sleep through the night. But for many patients, the drug lasted only six or eight hours, creating a cycle of crash and euphoria that one academic called “a perfect recipe for addiction.” When confronted with complaints about “breakthrough pain”—meaning that the pills weren’t working as long as advertised—Purdue’s sales reps were given strict instructions to tell doctors to strengthen the dose rather than increase dosing frequency.

Sales reps were encouraged to downplay addiction risks. “It was sell, sell, sell,” recalled Sherman. “We were directed to lie. Why mince words about it?”

Over the next several years, dozens of class-action lawsuits were brought against Purdue. Many were dismissed, but in some cases Purdue wrote big checks to avoid going to trial. Several plaintiffs’ lawyers found that the company was willing to go to great lengths to prevent Richard Sackler from having to testify under oath. “They didn’t want him deposed, I can tell you that much,” recalled Marvin Masters, a lawyer who brought a class-action suit against Purdue in the early 2000s in West Virginia. “They were willing to sit down and settle the case to keep from doing that.” Purdue tried to get Richard removed from the suit, but when that didn’t work, the company settled with the plaintiffs for more than $20 million. Paul Hanly, a New York class-action lawyer who won a large settlement from Purdue in 2007, had a similar recollection. “We were attempting to take Richard Sackler’s deposition,” he said, “around the time that they agreed to a settlement.” (A spokesperson for the company said, “Purdue did not settle any cases to avoid the deposition of Dr. Richard Sackler, or any other individual.”)

When the federal government finally stepped in, in 2007, it extracted historic terms of surrender from the company. Purdue pleaded guilty to felony charges, admitting that it had lied to doctors about OxyContin’s abuse potential. (The technical charge was “misbranding a drug with intent to defraud or mislead.”) Under the agreement, the company paid $600 million in fines and its three top executives at the time—its medical director, general counsel, and Richard’s successor as president—pleaded guilty to misdemeanor charges. The executives paid $34.5 million out of their own pockets and performed four hundred hours of community service. It was one of the harshest penalties ever imposed on a pharmaceutical company. (In a statement to Esquire, Purdue said that it “abides by the highest ethical standards and legal requirements.” The statement went on: “We want physicians to use their professional judgment, and we were not trying to pressure them.”)

Fifty-three thousand Americans died from opioid overdoses in 2016, more than the thirty-six thousand who died in car crashes in 2015 or the thirty-five thousand who died from gun violence that year.

No Sacklers were named in the 2007 suit. Indeed, the Sackler name appeared nowhere in the plea agreement, even though Richard had been one of the company’s top executives during most of the period covered by the settlement. He did eventually have to give a deposition in 2015, in a case brought by Kentucky’s attorney general. Richard’s testimony—the only known record of a Sackler speaking about the crisis the family’s company helped create—was promptly sealed. (In 2016, STAT, an online magazine owned by Boston Globe Media that covers health and medicine, asked a court in Kentucky to unseal the deposition, which is said to have lasted several hours. STAT won a lower-court ruling in May 2016. As of press time, the matter was before an appeals court.)

In 2010, Purdue executed a breathtaking pivot: Embracing the arguments critics had been making for years about OxyContin’s susceptibility to abuse, the company released a new formulation of the medication that was harder to snort or inject. Purdue seized the occasion to rebrand itself as an industry leader in abuse-deterrent technology. The change of heart coincided with two developments: First, an increasing number of addicts, unable to afford OxyContin’s high street price, were turning to cheaper alternatives like heroin; second, OxyContin was nearing the end of its patents. Purdue suddenly argued that the drug it had been selling for nearly fifteen years was so prone to abuse that generic manufacturers should not be allowed to copy it.

On April 16, 2013, the day some of the key patents for OxyContin were scheduled to expire, the FDA followed Purdue’s lead, declaring that no generic versions of the original OxyContin formulation could be sold. The company had effectively won several additional years of patent protection for its golden goose.


Opioid withdrawal, which causes aches, vomiting, and restless anxiety, is a gruesome process to experience as an adult. It’s considerably worse for the twenty thousand or so American babies who emerge each year from opioid-soaked wombs. These infants, suddenly cut off from their supply, cry uncontrollably. Their skin is mottled. They cannot fall asleep. Their bodies are shaken by tremors and, in the worst cases, seizures. Bottles of milk leave them distraught, because they cannot maneuver their lips with enough precision to create suction. Treatment comes in the form of drops of morphine pushed from a syringe into the babies’ mouths. Weaning sometimes takes a week but can last as long as twelve. It’s a heartrending, expensive process, typically carried out in the neonatal ICU, where newborns have limited access to their mothers.

But the children of OxyContin, its heirs and legatees, are many and various. The second- and third-generation descendants of Raymond and Mortimer Sackler spend their money in the ways we have come to expect from the not-so-idle rich. Notably, several have made children a focus of their business and philanthropic endeavors. One Sackler heir helped start an iPhone app called RedRover, which generates ideas for child-friendly activities for urban parents; another runs a child- development center near Central Park; another is a donor to charter-school causes, as well as an investor in an education start-up called AltSchool. Yet another is the founder of Beespace, an “incubator for emerging nonprofits,” which provides resources and mentoring for initiatives like the Malala Fund, which invests in education programs for women in the developing world, and Yoga Foster, whose objective is to bring “accessible, sustainable yoga programs into schools across the country.” Other Sackler heirs get to do the fun stuff: One helps finance small, interesting films like The Witch; a second married a famous cricket player; a third is a sound artist; a fourth started a production company with Boyd Holbrook, star of the Netflix series Narcos; a fifth founded a small chain of gastropubs in New York called the Smith.

Holding fast to family tradition, Raymond’s and Mortimer’s heirs declined to be interviewed for this article. Instead, through a spokesperson, they put forward two decorated academics who have been on the receiving end of the family’s largesse: Phillip Sharp, the Nobel-prize-winning MIT geneticist, and Herbert Pardes, formerly the dean of faculty at Columbia University’s medical school and CEO of New York-Presbyterian Hospital. Both men effusively praised the Sacklers’ donations to the arts and sciences, marveling at their loyalty to academic excellence. “Once you were on that exalted list of philanthropic projects,” Pardes told Esquire, “you were there and you were in a position to secure additional philanthropy. It was like a family acquisition.” Pardes called the Sacklers “the nicest, most gentle people you could imagine.” As for the family’s connection to OxyContin, he said that it had never come up as an issue in the faculty lounge or the hospital break room. “I have never heard one inch about that,” he said.

Pardes’s ostrichlike avoidance is not unusual. In 2008, Raymond and his wife donated an undisclosed amount to Yale to start the Raymond and Beverly Sackler Institute for Biological, Physical and Engineering Sciences. Lynne Regan, its current director, told me that neither students nor faculty have ever brought up the OxyContin connection. “Most people don’t know about that,” she said. “I think people are mainly oblivious.” A spokesperson for the university added, “Yale does not vet donors for controversies that may or may not arise.”

In May, a dozen lawmakers in Congress sent a bipartisan letter to the World Health Organization warning that Sackler-owned companies were preparing to flood foreign countries with legal narcotics.

The controversy surrounding OxyContin shows little sign of receding. In 2016, the CDC issued a startling warning: There was no good evidence that opioids were an effective treatment for chronic pain beyond six weeks. There was, on the other hand, an abundance of evidence that long-term treatment with opioids had harmful effects. (A recent paper by Princeton economist Alan Krueger suggests that chronic opioid use may account for more than 20 percent of the decline in American labor-force participation from 1999 to 2015.) Millions of opioid prescriptions for chronic pain had been written in the preceding two decades, and the CDC was calling into question whether many of them should have been written at all. At least twenty-five government entities, ranging from states to small cities, have recently filed lawsuits against Purdue to recover damages associated with the opioid epidemic.

The Sacklers, though, will likely emerge untouched: Because of a sweeping non-prosecution agreement negotiated during the 2007 settlement, most new criminal litigation against Purdue can only address activity that occurred after that date. Neither Richard nor any other family members have occupied an executive position at the company since 2003.

The American market for OxyContin is dwindling. According to Purdue, prescriptions fell 33 percent between 2012 and 2016. But while the company’s primary product may be in eclipse in the United States, international markets for pain medications are expanding. According to an investigation last year in the Los Angeles Times, Mundipharma, the Sackler-owned company charged with developing new markets, is employing a suite of familiar tactics in countries like Mexico, Brazil, and China to stoke concern for as-yet-unheralded “silent epidemics” of untreated pain. In Colombia, according to the L.A. Times, the company went so far as to circulate a press release suggesting that 47 percent of the population suffered from chronic pain.

Napp is the family’s drug company in the UK. Mundipharma is their company charged with developing new markets.

In May, a dozen lawmakers in Congress, inspired by the L.A. Timesinvestigation, sent a bipartisan letter to the World Health Organization warning that Sackler-owned companies were preparing to flood foreign countries with legal narcotics. “Purdue began the opioid crisis that has devastated American communities,” the letter reads. “Today, Mundipharma is using many of the same deceptive and reckless practices to sell OxyContin abroad.” Significantly, the letter calls out the Sackler family by name, leaving no room for the public to wonder about the identities of the people who stood behind Mundipharma.

The final assessment of the Sacklers’ global impact will take years to work out. In some places, though, they have already left their mark. In July, Raymond, the last remaining of the original Sackler brothers, died at ninety-seven. Over the years, he had won a British knighthood, been made an Officer of France’s Légion d’Honneur, and received one of the highest possible honors from the royal house of the Netherlands. One of his final accolades came in June 2013, when Anthony Monaco, the president of Tufts University, traveled to Purdue Pharma’s headquarters in Stamford to bestow an honorary doctorate. The Sacklers had made a number of transformational donations to the university over the years—endowing, among other things, the Sackler School of Graduate Biomedical Sciences. At Tufts, as at most schools, honorary degrees are traditionally awarded on campus during commencement, but in consideration of Raymond’s advanced age, Monaco trekked to Purdue for a special ceremony. The audience that day was limited to family members, select university officials, and a scrum of employees. Addressing the crowd of intimates, Monaco praised his benefactor. “It would be impossible to calculate how many lives you have saved, how many scientific fields you have redefined, and how many new physicians, scientists, mathematicians, and engineers are doing important work as a result of your entrepreneurial spirit.” He concluded, “You are a world changer.”

Source: https://www.esquire.com/news-politics/a12775932/sackler-family-oxycontin/ October 2017

Last week Scotland’s leading law officer, the Lord Advocate, brought a shuddering halt to a proposal from Glasgow City Council to develop a safe injecting centre in the city. Such a centre would have required a change in UK drug laws to enable individuals in possession of illegal drugs to use those drugs within the centre without fear of prosecution. Supporters of this initiative will be disappointed by the outcome, but they need to recognise that the provision of some level of legal protection covering the possession of illegal drugs within the injecting centre would also, by implication, need to be extended to all of those who might claim, legitimately or otherwise, that their drug possession should be green-lighted because they were en route to the injecting centre. In effect, such an initiative would deliver what many of its supporters actually desire – the legalisation of illegal drugs within at least some part of the UK.

In his judgement, the Lord Advocate has not ruled against setting up a centre where doctors can prescribe opiate drugs to addicts. Rather he has simply pointed out that he is not prepared to offer legal protection to a centre where illegal drugs are being used. The Glasgow proposal sought unwisely to tie the proposal for a doctor-led heroin prescribing clinic, which would be legal, with a setting where individuals are allowed to use illegal drugs which would break UK drug laws. There will be many who rightly question the wisdom (and the cost to the public purse) of linking those two proposals.

It is often said by the supporters of these centres that where they have been established in other countries no individual has actually died in a drug consumption room. That might be so, but the lack of such deaths is not the high-water mark of success for drug treatment services. The rise in addict deaths in Scotland and in England shows that we need to do much more by way of engaging drug users in services. Doing more should entail taking services to drug users themselves wherever they are living and wherever they are using illegal drugs. Setting up a city-centre location where people can use illegal drugs under some level of legal protection betrays a worrying lack of knowledge both about Glasgow itself and about the life of an addict. Glasgow is a territorial city par excellence and there are addicts who cross into different parts of the city at their genuine peril. Similarly, when addicts secure the drugs they so desperately need their first thought is not ‘How do I travel to a city-centre location where I may use these drugs without fear of prosecution?’ but ‘Where is the needle that will enable me to inject now?’ It is for both of those reasons that we should be talking about how to take services to the addicts rather than how to get the addicts to go to the services.

Glasgow’s addiction services have been slow to adopt a focus on recovery, and even to date they are unable to report how many drug users they have treated have managed to overcome their addiction – this despite having a strategy which for the last ten years has emphasised the importance of enabling drug users to become drug-free. That strategy is now being reviewed by the Scottish Government with the real risk that the commitment to abstinence-based recovery will be diluted in preference to the much woollier goal of seeking to reduce the harm associated with addicts’ continued drug use.

Within Scotland we spend more than £100million a year on drug treatment. We should be asking why our services seem to be achieving so little in terms of getting addicts into long-term recovery and why, in the face of that failure, public officials are seeking to promote centres where illegal drug use can take place without fear of prosecution. Injecting on the streets is a terrible reality but the response to that problem should not be the provision of a centre where injecting can occur beyond public view, but actively to discourage injecting at all.

The reason we need to be doing much more to discourage drug injecting is because the substances addicts are injecting are often manufactured, stored, and transported in dreadfully unhygienic conditions with the result that they often contain serious and potentially fatal bacterial contaminants. These drugs do not become safe when they are used in a drug consumption room, but remain harmful wherever they are injected. We need to do all we can to discourage drug use, to discourage injecting, and to ensure that as many addicts as possible are in contact with services focused on assisting their recovery. We need to be very wary of developing initiatives that run the real risk of normalising illegal drug use and driving a possible further increase in the number of people using illegal drugs.

Professor Neil McKeganey is Director of the Centre for Substance Use Research, Glasgow

Source: https://www.conservativewoman.co.uk/neil-mckeganey-good-sense-kills-not-safe-injecting-centre/ November 2017

 

Researchers have long known that there is a link between nicotine and alcohol consumption. But the nature of the connection—how long it lasts, which begets which—remains a mystery.

A new Tel Aviv University study finds that nicotine exposure during adolescence can predict increased alcohol intake in adulthood. This suggests that memories of smoking tobacco as a teenager alter the brain’s reaction to alcohol even after a prolonged nicotine withdrawal. The research indicates that these nicotine “memories” may even lead to a tendency toward heavier drinking later in life.

The research was led by Dr. Segev Barak and his research team at TAU’s School of Psychological Sciences and Sagol School of Neuroscience. It was published in Scientific Reports.

The influence of memory

“Previously, it was believed that the mere consumption of nicotine during adolescence could trigger the use of other drugs—cocaine, heroin and alcohol,” Dr. Barak said. “Our study shows that nicotine ‘memories’ from adolescence are the culprit, not the nicotine itself.”

The researchers found that nicotine “memories” caused long-lasting changes in the brain, long after the cessation of nicotine consumption. A brief exposure to the nicotine environment triggered a robust decrease in the expression of the growth factor GDNF in the brain’s pleasure center. “We have previously shown that GDNF serves as a brain regulator of alcohol consumption,” Dr. Barak said. “We assume that this drop in GDNF following the retrieval of nicotine memories leads to loss of control, thus boosting drinking.”

The researchers used rat models to test the link between nicotine and alcohol consumption. To study the effects on alcohol consumption, the researchers installed an experimental self-serve alcohol dispenser, operated by a lever press. When placed in this “bar,” rats were free to consume unlimited amounts of alcohol.

Group 1 received nicotine during adolescence in Chamber B, and then drank alcohol in adulthood in Chamber A—in other words, drinking alcohol in an environment different to that in which they used nicotine. Conversely, Group 2 received nicotine during adolescence in Chamber A, and then in adulthood drank alcohol in the same chamber (that is, in the nicotine-associated environment), triggering a reminder of the nicotine experience.

“The rats eagerly drink alcohol,” said Yossi Sadot-Sogrin, who contributed to the research. “During the daily one-hour sessions, most of them consumed the amount of alcohol equivalent to a glass or two of wine.”

But when the self-serve alcohol dispenser was installed in the same chamber in which rats received nicotine during their adolescence, the amount of alcohol consumed rose sharply.

“In the nicotine-associated environment, rats drank the amount of alcohol that corresponded to four glasses of wine, and even more,” said Koral Goltseker, who collaborated on the study.

The team is currently researching the specific changes to the brain caused by nicotine memories. “If we can prevent these brain changes, we hope we can prevent the long-term increase in alcoholconsumption,” said Dr. Barak. “It will also teach us a lot about the brain mechanisms that lead to alcoholism.”

Source: https://medicalxpress.com/news/2017-11-consumption-nicotine-adolescence-alcohol-intake.html November 2017

Abstract

BACKGROUND:

With the Canadian government legalizing cannabis in the year 2018, the potential harms to certain populations-including those with opioid use disorder-must be investigated. Cannabis is one of the most commonly used substances by patients who are engaged in medication-assisted treatment for opioid use disorder, the effects of which are largely unknown. In this study, we examine the impact of baseline and ongoing cannabis use, and whether these are impacted differentially by gender.

METHODS:

We conducted a retrospective cohort study using anonymized electronic medical records from 58 clinics offering opioid agonist therapy in Ontario, Canada. One-year treatment retention was the primary outcome of interest and was measured for patients who did and did not have a cannabis positive urine sample in their first month of treatment, and as a function of the proportion of cannabis-positive urine samples throughout treatment.

RESULTS:

Our cohort consisted of 644 patients, 328 of which were considered baseline cannabis users and 256 considered heavy users. Patients with baseline cannabis use and heavy cannabis use were at increased risk of dropout (38.9% and 48.1%, respectively). When evaluating these trends by gender, only female baseline users and male heavy users are at increased risk of premature dropout.

INTERPRETATION:

Both baseline and heavy cannabis use are predictive of decreased treatment retention, and differences do exist between genders. With cannabis being legalized in the near future, physicians should closely monitor cannabis-using patients and provide education surrounding the potential harms of using cannabis while receiving treatment for opioid use disorder.

Source: https://www.ncbi.nlm.nih.gov/pubmed/29117267 November 2017

University of Pennsylvania researchers performed Internet searches for slightly more than a month in 2016 to identify CBD products that displayed contents on their labels and were for sale online. They bought 84 products from 31 companies, blinded their labels, and had their contents tested.

A full 70 percent of the labels turned out to be incorrect. The products either contained more CBD than their labels specified, or less. Thirty percent of the labels were “accurate” within a range of 10 percent.

Of particular concern was that testing detected THC in 18 of the 84 samples, and the amounts of THC in some products were sufficient to cause intoxication or impairment, especially in children.

The publication of this article in JAMA took place just days after the FDA sent warning letters to four major CBD producers asking them to eliminate all medical claims they make for their products. All have been marketing their products with unproven medical claims. They have 15 business days from last week to remove the claims or FDA can seize their merchandise and put them out of business.

Source: Email from National Families In Action http://www.nationalfamilies.org November 2017

Psychologist Robert Margolis, PhD, has spent the past 40 years treating substance abuse disorders in adolescents. He founded and ran Solutions, an after-school alcohol and drug treatment program for young people in Atlanta, Georgia. When he retired recently, he merged Solutions with Caron Treatment Center, a nonprofit organization with treatment facilities in several states.

Dr. Margolis wrote an op-ed for the Atlanta Journal Constitution in 2002 calling for careful, reasoned debate about the legalization of marijuana. Today, he writes that that debate still hasn’t happened. He lays out what science says about the impact of marijuana use on young people and asks if we are prepared to allow next generations to be so drug damaged.
 
Read his essay here.

Source: Email from National Families In Action http://www.nationalfamilies.org November 2017

Researchers from the University of Connecticut Health Center studied data from 1,165 young adults who took part in the Collaborative Study on the Genetics of Alcoholism. People in the alchol study were assessed at age 12 and then every two years over a span of the next 13 to 22 years.

Those who became dependent on both marijuana and alcohol were found to have lower levels of educational achievement, were less likely to be employed full time, less likely to be married, and had lower social and economic potential.

“This study found that chronic marijuana use in adolescence was negatively associated with achieving important developmental milestones in young adulthood. Awareness of marijuana’s potential deleterious effects will be important moving forward given the current move in the U.S. toward marijuana legalization for recreational / medicinal use,” says study author Elizabeth Harari, MD.

She presented her study at the annual meeting of the American Public Health Association being held in Atlanta, Georgia this week.

Read abstract here.

Email from National Families In Action http://www.nationalfamilies.org November 2017

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 November 2017

The costs of using hard drugs are worse and more horrific than the costs of prohibition. There are times in life when ideas are overtaken by events, when the hard experience of reality meets and overcomes the hopefulness of ideas. Now is just such a time. As the opioid crisis takes lives on a historic scale, it’s time to kill a bad idea. Just say no to legalizing hard drugs.

To be sure, there’s not a large constituency in support of legalizing any drugs other than marijuana, but their legalization, including that of narcotics, has been a topic of lively intellectual debate ever since the war on drugs truly took off. The editors of National Review have long supported legalization, libertarians have argued vociferously for legalization for decades, and a number of influential thinkers on the left and the right have joined in agreement on this one issue.

Outside of college dorms, the argument for legalization, in general, isn’t that drugs should be legalized because they’re fun and people can be trusted to use them responsibly. Rather, it’s that the costs of the war on drugs — in lives lost, lives squandered in prison, and civil liberties curtailed — outweigh the probable harm of legalization. Here are the editors of National Review in 1996: “It is our judgment that the war on drugs has failed, that it is diverting intelligent energy away from how to deal with the problem of addiction, that it is wasting our resources, and that it is encouraging civil, judicial, and penal procedures associated with police states.”

Intelligent supporters of legalization know that drug use would increase, but would it increase so much as to overtake the cost of homicide, robbery, and incarceration? Well, after years of experimenting with opioid prescriptions so promiscuous that they functioned as a form of quasi-legalization, the answer appears to be yes. The costs of drug use are worse and more horrific than the costs of prohibition.

OxyContin. Opioid prescriptions skyrocketed and addiction rates increased, and as addiction increased, so did overdoses. To be clear: Not all these new addicts were the actual patients. Simply put, families and communities were suddenly awash in narcotics, with extraordinarily potent drugs filling medicine cabinets from coast to coast. I distinctly remember the change. I remember my confusion when an emergency-room nurse asked me to measure my pain on a scale from 1 to 10 after a friend scraped my eyeball in a pickup basketball game. It all seemed so subjective. Since I’d never experienced ultimate agony, how could I measure? I said “seven” and got a bottle of Vicodin. In reality, I probably could have managed with a shot of bourbon and a few Advil. Later that same year, I asked my secretary at my law firm if she had some Tylenol to help a stress headache. Her response? “No, but I have some Percocet.”

 As Robert VerBruggen notes in his own piece rethinking drug libertarianism, it seems that most addicts don’t actually get their pain pills from a doctor. Why bother? The drugs were simply everywhere, with enough pill bottles prescribed to provide one to every American, many times over. And once addiction took hold, greater restrictions on prescriptions meant that addicts just switched to a cheaper and deadlier drug, heroin. The numbers are startling.   And now, as virtually every American knows, we face a national crisis.

In 2016 drug-overdose deaths increased 11 percent over 2015’s already-high number. A stunning 52,404 Americans lost their lives. To compare, that’s almost 15,000 more than died in car crashes and roughly 16,000 more than died to guns, including homicides and suicides. In fact, that number probably undercounts the toll from drug abuse, since doubtless some number of suicides represented addicts who’d hit rock bottom and saw no way out but through the barrel of a gun or the bottom of the pill bottle. In other words, opioids are monstrous inventions that overpower the human will on a mass scale. There are no “rational actors” among addicts, and the substances are extraordinarily addictive. Do you know an opioid addict? Then you’ve seen them slide slowly away from reality. The formula is simple — flood the market with pills, and you’ll flood the country with addicts.

A number of smart (no, brilliant) people thought that the costs of enforcement outweighed the costs of legalization. That may well be true of marijuana, but can we make that argument any longer with opioids? If people have access to pills, they tend to take pills, and an uncomfortably large proportion of them get so hooked on them that if you take them away, they move to even harder and more powerful drugs. A horrifying percentage overdose and die. That’s not to say that fighting the war on drugs means winning the war on drugs. It may mean that we do nothing more than contain the problem, preventing it from spiralling out of control even further. And, as Lopez notes in Vox, arguing against legalization isn’t the same thing as arguing against reform, including reforming the way in which the criminal-justice system deals with drug offenders.

There is much room for creativity and thoughtfulness in dealing with the crisis. I see no room for broader availability and greater ease of access. Last year I sat next to a man on a plane who lost his daughter to a combination of Xanax and Lortab. She’d taken both drugs for years, to deal with anxiety and chronic pain. As he told the story, every year she grew more tolerant. Every year she had to take more to achieve the same effect. One terrible and stressful night, she took an extra dose to force herself to sleep. She never woke up. If we legalize hard drugs, there will be more stories like that — many more. Opioids make slaves of men. There is no choice but to continue the fight.

Source:  http://www.nationalreview.com/article/447190/opioid-crisis-legalization-drugs-marijuana-narcotics-pain-killers April 2017

Abstract:

Purpose: This study aims to assess potential health care costs and adverse health effects related to cannabis use in an acute care community hospital in Colorado, comparing study findings to those medical diagnoses noted in the literature. Little information is available about specific hospital health care costs, thus this study will add to the knowledge gap and describe charges and collections from visits of these patients in one hospital’s Emergency Department (ED).

Objective: Review diagnoses of cannabis users visiting a local ED and outline the potential financial and health effects of these patients on the health care system.

Design: An Institutional Review Board (IRB) approved retrospective observational study of patients seen in the ED from 2009 to 2014 with cannabis diagnoses and positive urine drug analyses (UDA) matched with hospital billing records. Randomized patient records were reviewed to determine completeness of documentation and coding related to cannabis use.

Setting: An acute care hospital in one city in Colorado. The city has nearly 100 medical marijuana dispensaries, but has not legalized recreational cannabis use. The city decided to not allow recreational stores in city limits as they were allowed to make that determination as a result of Amendment 64, which allowed municipalities to determine if they wanted recreational marijuana in their town. As of this publication, more than 70% of Colorado’s municipalities have opted out of recreation marijuana sales.

Participants: Subjects seen through the ED who had both a diagnosis code listing cannabis and a positive UDA for cannabis. Exclusions were subjects with UDA for cannabis but also tested positive for other substances, subjects who had cannabis diagnosis but no UDA result or those who had no UDA but did have a cannabis diagnosis.

Conclusion: Subjects seen in the ED had similar diagnoses as those reviewed in the literature, confirming the serious side effects of marijuana use. During the study period, the study hospital incurred a true loss of twenty million dollars in uncollected charges after allowing for contractual obligations. While adverse health effects have been described in the literature, there is little data on the financial impact of marijuana use on the health care system. This study demonstrated an increasing number of patients who are seen in the ED also have used cannabis. These patients are not always able to pay their bills, resulting in a financial loss to the hospital. The authors encourage the collection of hospital financial data for analysis in the states where medicinal (MMJ) and/or recreational marijuana is legal

https://www.researchgate.net/publication/314140400_The_Hidden_Costs_of_Marijuana_Use_in_Colorado_One_Emergency_Department’s_Experience

Kenneth Finn, MD,

The problem of increased marijuana use has origin in its purported use for pain, but the medical literature is completely void of evidence for the treatment.

Pain is the most common diagnosis associated with marijuana being recommended for medical use. With more states moving towards accepting marijuana use for medical purposes, there is a call from the
medical and scientific community for more research and evidence that it actually works for common pain conditions.

Out of the top 20 medical diagnoses presenting to the primary care physician nationally, there are only three that are associated with a painful condition:
spinal disorders (i.e., lower back pain), arthropathies and related disorders (i.e., knee arthritis), and abdominal pain.

There were no other pain diagnoses in the top 20 diagnoses that present to the primary care physician for treatment, including cancer pain or neuropathic pain. What does the medical literature tell us about the
use of marijuana for pain? In 2011, The British Journal of Pharmacology released a paper looking at the use for cannabinoids for the treatment of chronic non-cancer pain.

They narrowed a broad literature review to only 18 trials with a total of 925 participants. Most of the trials studied neuropathic pain (72%), including HIV neuropathy and multiple sclerosis related neuropathy (three trials), with single studies looking at arthritis and chronic spinal pain.

There were four studies that looked at smoked cannabis and neuropathic pain only. Six studies evaluated synthetic cannabinoids (Dronabinol, Nabilione) for pain (offlabel use).
From these trials, the average number of patients was 49 with average duration of 22 days, some of which were one week long. Despite their conclusion that cannabinoids may help for chronic non-cancer pain, they noted study limitations of small sample size, modest effects, and the need for larger trials of longer duration to determine safety and efficacy.

In 2015, the Journal of the American Medical Association (JAMA) released an article on cannabinoids for medical use.4 Chronic pain was assessed in 28 studies, involving 63 reports and 2,454 participants. Thirteen studies evaluated nabiximols (not available in the United States), four smoked THC, six synthetic THC, three oromucosal spray, one oral THC, and one vaporized cannabis. The majority of studies looked at some form of neuropathic pain or cancer pain. Two studies were at low risk of bias, nine at unclear risk, and 17 at high risk. Studies generally suggested improvements in pain measures associated with cannabinoids but did not reach statistical significance in most individual studies.

Despite these difficulties, the authors concluded there was moderate-quality evidence to suggest that cannabinoids may be beneficial for the treatment of chronic neuropathic or cancer pain (smoked THC and nabiximols). Note these are less common pain conditions presentimg to the physician for treatment nationally. The authors noted an increased risk of short-term adverse effects with cannabinoid use, including some serious adverse effects. Common adverse effects included asthenia, balance problems, confusion, dizziness, disorientation, diarrhea, euphoria, drowsiness, dry mouth, fatigue, hallucination, nausea, somnolence, and vomiting.

In 2017, the National Academies of Science, Engineering, and Medicine released a paper on the health effects of cannabis and cannabinoids. It may be important to note that none of the authors had a background in Anesthesia or Pain Medicine. The authors felt the referenced JAMA article was the most comprehensive and that the medical condition most often associated with chronic pain in that article was neuropathy, and a majority of studies evaluated treatment with nabiximols, which are not available in the United States. The committee found that only a handful of studies evaluated the use of cannabis and that many of the cannabis products sold in state regulated markets bear little resemblance to the products available for research at the federal level in the United States. They also note that very little is known regarding efficacy, dose, routes of administration, or side effects of commonly used and commercially available products in the U.S. Despite this, they concluded that “cannabis is an effective treatment for chronic pain in adults.” The above noted papers demonstrate the limited data available to the public and medical community, and represent the only information available regarding treatment of pain with marijuana. Despite that, the public has embraced that marijuana can treat all pain conditions, and state governments have followed suit, without scientific evidence, and have allowed an industry to prosper on the thin ice of what is currently and scientifically available.

It is important to understand that pain covers a broad spectrum of disorders and pain of different origins does not necessarily respond the same to different medications. Additionally, dispensary cannabis is considered a generic substance without defined or accepted dosing guidelines, and will vary in purity as well as potency. It may also contain hundreds of other compounds, some of which may have physiologic activity. Cannabinoids are purified components of the plant which have been isolated in a laboratory and have more scientific foundation, but are currently not available for study or use in pain conditions in the U.S.

Since de facto legalization in Colorado in 2009, there has been a significant increase in public health and safety concerns, which include utilization of the health care system, an increase in adolescent substance use treatment for cannabis, and an increase in marijuana-related driving fatalities. The addiction rates are reportedly 9% in the adult and roughly 18% in the adolescent, which was based on the potency of marijuana from nearly 20 years ago. The potency has significantly increased in the past five years alone, so we are now in uncharted waters and unable to predict the long term effects or addiction rates of currently available, highly potent products, with variable delivery systems.

As the number of medical marijuana patients increased in Colorado, there appeared to be a parallel increase in the number of adolescents needing substance use treatment, most often for cannabis. Colorado is now contending with a huge opioid and heroin epidemic, and despite the widespread availability of Narcan, does not appear to have leveled off or curbed the number of opioid or heroin deaths in the state which continue to rise.

Although the concept of using marijuana to decrease opioid use is attractive, there is little data to suggest that may be the case. According to the Centers for Disease Control, the number of drug overdose deaths in Colorado has continued to increase, ahead of the national average. The above problems are now falling into the laps of other groups including law enforcement and mental health providers who are pushing back and straining their respective resources.

In summary, the problem of increased marijuana use has origin in its purported use for pain, but the medical literature is completely void of evidence for the treatment of common pain conditions with cannabinoids or cannabis. Current medical literature suggests benefit in less common pain conditions, with products not commercially available in the U.S., or with synthetic THC, not with dispensary cannabis. The variability of available products changes regularly and their use in medicine, particularly pain, is unproven. The end game is in the court of law enforcement, mental health providers, the medical community, and our educational systems, at unknown societal costs, which are only now becoming apparent.

Source: http://www.omagdigital.com/publication/?i=450168#{%22issue_id%22:450168,%22page%22:8} September/October 2017

The House of Delegates of the Medical Association of Georgia (MAG) passed a strongly worded resolution opposing the expansion of “medical” marijuana at its annual meeting October 20-21. Passed unanimously, the resolution sends a clear signal to legislators to reject a Georgia House of Representatives resolution introduced in the 2017 session that carries over to next year. That resolution, if passed, would enable legislators to place a constitutional amendment on the state’s November 2018 ballot to cultivate, process, and sell marijuana for medical use throughout the state.

 
The issue has evolved in each legislative session since 2014. Current law allows people with 14 different conditions to apply to the Georgia Department of Public Health for a card that provides legal immunity for possessing 20 fluid ounces of “medicinal cannabis” that can contain 5 percent THC.
 
The MAG House of Delegates’ resolution notes that “calling marijuana ‘medical cannabis’ or ‘low THC oil’ does not alter its psychoactive, neurotoxic, and addictive effects. Marijuana at THC levels of 3 percent, 4 percent, or 5 percent has resulted in hundreds of thousands of Americans experiencing cannabis use dependence since the 1980s.”
 
It points out that “THC has been contraindicated for use in treatment of conditions of children in studies by Children’s Hospital Colorado, Boston Children’s Hospital, Harvard Medical School and Duke University.” It adds that marijuana-related fatal road crashes have increased in Colorado and Washington since those two states fully legalized the drug.
 
The resolution begins by stating, “Legislators or voters should not decide what medical conditions should be treated by a non-standardized, un-tested drug, namely artisanal THC Oil and related marijuana products, and then base treatment on non-scientific anecdotal information.”
 
For these and other reasons, the resolution:
 
“RESOLVED, that the Medical Association of Georgia oppose the expansion of the legalization of non-standard and non-FDA approved use of cannabis for medical use in Georgia and educate physicians and other clinicians on the risks of artisanal cannabis products lacking FDA approval.”
 
And “RESOLVED, that the Georgia Delegation submit a resolution to the American Medical Association to work with the National Institutes of Health to ease some of the barriers to medical research regarding chemical components of marijuana such as cannabidiol that show great promise.”
 
The House of Delegates is MAG’s primary legislative and policy-making body, according to its website. It consists of county and specialty medical societies. Dr. Craig Kerins of the Richmond County Medical society introduced the resolution, which was written by Susan Blank, MD, president of the Georgia Society of Addiction Medicine and Gregg Raduka, PhD, executive director of Let’s Be Clear Georgia.
 
Read full text here.

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

 

U.S. marijuana growers’ and processors’ greatest fear has just been realized. One of the largest international producers and marketers of beer, wine, and spirits, Constellation Brands, has bought a 9.9 percent stake in a Canadian marijuana grower, Canopy Growth Corporation. The two companies plan to develop a line of marijuana-infused drinks to sell in Canada, expected to legalize the drug for recreational use in 2018

US marijuana growers and processors have long feared that mega corporations like those that make up the alcohol and tobacco industries would swoop in and put them out of business if pot is legalized nationwide. They just didn’t think it would happen in Canada first.
 
Business analysts say this is a smart move on the part of Constellation Brands, given now-Prime Minister Justin Trudeau’s campaign promise to legalize the drug if elected.
 
Whether parents, public health officials, scientists, and doctors agree is another matter. Marijuana beverages being marketed by an alcoholic beverages company with Constellation Brand’s clout is hardly likely to reduce auto traffic injuries and deaths.
 
Read story here and here.

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

MOUNT SHASTA, Siskiyou County (KPIX 5) — It’s happening in the shadow of Mount Shasta — hundreds of marijuana gardens pockmarking the landscape in neighborhoods that have little in the way of housing.

For law enforcement officials in Siskiyou County, it’s a state of emergency.

“This is a monumental effort but, then again, we’ve got a monumental problem,” says Sheriff Jon E. Lopey.

What’s unfolding in this county is a race between growers and the law to see who can get to the countless grow gardens first.

“We’re in harvest season. We’re really putting a lot of resources into it and a lot of personnel, trying to take out as much as we can before it gets harvested and goes off back east or wherever it’s going,” said Siskiyou County Sheriff’s Deputy Mike Gilley.

You can see the enormous extent of the grow gardens from space. Fire up Google Earth and you can count grow after grow dotting the high desert landscape like an outbreak of measles.

“I have a one-mile-square photograph and you can pick out 80 gardens in that one square mile,” said Sgt. Gilley.

All of this is happening in a county that is decidedly not part of the “Emerald Triangle.” In fact, elected officials and voters have passed laws aimed at keeping marijuana out of Siskiyou County.

“Our county does not allow outdoor cultivation of cannabis,” asserts Sheriff Lopey.

Siskiyou County has some of the cheapest — as well as most scenic — land you can find in California. You can purchase nearly three acres for about $16,000. That brings in people who see an opportunity. The sheriff thinks those people represent a nationwide problem.

“I think … that this is an organized-crime effort. (They) basically take over large geographic areas to grow illegal marijuana. That’s basically what it amounts to,” Lopey said.

Source: https://sanfrancisco.cbslocal.com/2017/10/27/marijuana-illegal-grow-mount-shasta-siskiyou-county/(contains video report)  October 2017

MEDICINAL cannabis is no better than conventional drugs for treating children with severe epilepsy, according to a top Victorian doctor.

After months of treatment, none of the 29 Victorian children accessing $1 million worth of medicinal cannabis product, imported from Canada, has been seizure free.

FIRST COMMERCIAL CANNABIS CROP TO HELP VICTORIAN CHILDREN

UNIVERSITY OF MELBOURNE GETS $500K FROM TURNBULL GOVERNMENT FOR RESEARCH INTO MEDICINAL CANNABIS PLANTS

Paediatric neurologist Professor Ingrid Scheffer told the Sunday Herald Sun medicinal cannabis had been effective in some of the cases by reducing fits among some of the group.

However, the results had been similar to outcomes achieved on other pharmaceutical drugs and it was not the miracle solution families were hoping for

Families hear the news kids who need cannabis to help with chronic illness will gain access. Picture: Jason Edwards

“Initially we all had a sense of hope but that didn’t last but that is the nature of these diseases,” Prof Scheffer said.

For more http://www.heraldsun.com.au/news/victoria/medicinal-cannabis-not-miracle-epilepsy-drug-says-professor-treating-victorian-children/news-story/9107a6249aec2e59a7c0a49f6c8b0b71 October 2017

Pain and pleasure rank among nature’s strongest motivators, but when mixed, the two can become irresistible. This is how opioids brew a potent and deadly addiction in the brain.

Societies have coveted the euphoria and pain relief provided by opioids since Ancient Sumerians referred to opium poppies as the “joy plant” circa 3400 B.C.But the repercussions of using the drugs were ever present, too. For centuries, Chinese patients swallowed opium cocktails before major surgeries, but by 1500, they described the recreational use of opium pipes as subversive. The Chinese emperor Yung Cheng eventually restricted the use of opium for medical purposes in 1729.

READ MORE: America Addicted

Less than 100 years later, a German chemist purified morphine from poppies, creating the go-to pain reliever for anxiety and respiratory conditions. But the Civil War and its many wounds spawned mass addiction to the drugs, a syndrome dubbed Soldier’s Disease. A cough syrup was concocted in the late 1800s — called heroin — to remedy these morphine addictions.

Doctors thought the syrup would be “non-addictive.” Instead, it turned into a low-cost habit that spread internationally. More than 70 percent of the world’s opium — 3,410 tons — goes to heroin production, a number that has more than doubled since 1985. Approximately 17 million people around the globe used heroin, opium or morphine in 2016.

Today, prescription and synthetic opioids crowd America’s medicine cabinets and streets, driving a modern crisis that may kill half a million people over the next decade. Opioids claimed 53,000 lives in the U.S. last year, according to preliminary estimates from the Centers for Disease Control and Prevention — more than those killed in motor vehicle accidents.

How did we arrive here? Here’s a look at why our brains get hooked on opioids.

The pain divide

Let’s start with the two types of pain. They go by different names depending on which scientist you ask. Peripheral versus central pain. Nociceptive versus neuropathic pain.

The distinction is the sensation of actual damage to your body versus your mind’s perception of this injury.

Stuff that damages your skin and muscles — pin pricks and stove burns — is considered peripheral/nociceptive pain.

Pain fibers sense these injuries and pass the signal onto nerve cells — or neurons — in your spine and brain, the duo that makes up your central nervous system.

In a normal situation, your pain fibers work in concert with your central nervous system. Someone punches you, and your brain thinks “ow” and tells your body how to react. Stress-relieving hormones get released. Your immune system counteracts the inflammation in your wounded arm.

Your body quiets your pain nerves through the production of natural opioids called endorphins. The trouble is when these pain pathways become overloaded or uncoupled.

One receptor to rule them all

Say you have chronic back pain. Your muscles are inflamed, constantly beaming pain signals to your brain. Your natural endorphins aren’t enough and your back won’t let up, so your doctor prescribes an opioid painkiller like oxycodone.

Prescription opioids and natural endorphins both land on tiny docking stations — called receptors — at the ends of your nerves. Most receptors catch chemical messengers — called neurotransmitters — to activate your nerve cells, triggering electric pulses that carry the signal forward.

But opioid receptors do the opposite. They stop electric pulses from traveling through your nerve cells in the first place. To do this, opioids bind to three major receptors, called Mu, Kappa and Delta. But the Mu receptor is the one that really sets everything in motion.

The Mu-opiate receptor is responsible for the major effects of all opiates, whether it’s heroin, prescription pills like oxycodone or synthetic opioids like fentanyl, said Chris Evans, director of Brain Research Institute at UCLA. “The depression, the analgesia [pain numbing], the constipation and the euphoria — if you take away the Mu-opioid receptor, and you give morphine, then you don’t have any of those effects,” Evans said.

Opioids receptors trigger such widespread effects because they govern more than just pain pathways. When opioid drugs infiltrate a part of the brain stem called the locus ceruleus, their receptors slow respiration, cause constipation, lower blood pressure and decrease alertness.

Addiction begins in the midbrain, where opioids receptors switch off a batch of nerve cells called GABAergic neurons.

GABAergic neurons are themselves an off-switch for the brain’s euphoria and pleasure networks.

Once opioids shut off GABAergic neurons, the pleasure circuits fill with another neurotransmitter called dopamine. At one stop on this pleasure highway — the nucleus accumbens — dopamine triggers a surge of happiness. When the dopamine rolls into amygdala, the brain’s fear center, it relieves anxiety and stress. Both of these events reinforce the idea that opioids are rewarding.

These areas of the brain are constantly communicating with decision-making hubs in the prefrontal cortex, which make value judgments about good and bad. When it hears “This pill feels good. Let’s do more,” the mind begins to develop habits and cravings.

Taking the drug soon becomes second nature or habitual, Evans said, much like when your mind zones out while driving home from work. The decision to seek out the drugs, rather than participate in other life activities, becomes automatic.

The opioid pendulum: When feeling good starts to feel bad

Opioid addiction becomes entrenched after a person’s neurons adapt to the drugs. The GABAergic neurons and other nerves in the brain still want to send messages, so they begin to adjust. They produce three to four times more cyclic AMP, a compound that primes the neuron to fire electric pulses, said Thomas Kosten, director of the division of alcohol and addiction psychiatry at the Baylor College of Medicine.

That means even when you take away the opioids, Kosten says, “the neurons fire extensively.”

The pendulum swings back. Now, rather than causing constipation and slowing respiration, the brain stem triggers diarrhea and elevates blood pressure. Instead of triggering happiness, the nucleus accumbens and amygdala reinforce feelings of dysphoria and anxiety. All of this negativity feeds into the prefrontal cortex, further pushing a desire for opioids.

While other drugs like cocaine and alcohol can also feed addiction through the brain’s pleasure circuits, it is the surge of withdrawal from opioids that makes the drugs so inescapable.

Could opioid addiction be driven in part by people’s moods?

Cathy Cahill, a pain and addiction researcher at UCLA, said these big swings in emotions likely factor into the learned behaviors of opioid addiction, especially with those with chronic pain. A person with opioid use disorder becomes preoccupied with the search for the drugs. Certain contexts become triggers for their cravings, and those triggers start overlapping in their minds.

“The basic view is some people start with the pain trigger [the chronic back problem], but it gets partially substituted with the negative reinforcement of the opioid withdrawal,” Cahill said.

That’s why Cahill, Evans and other scientists think the opioid addiction epidemic might be driven, in part, by our moods.

Chronic pain patients have a very high risk of becoming addicted to opioids if they are also coping with a mood disorder. A 2017 study found most patients — 81 percent — whose addiction started with a chronic pain problem also had a mental health disorder. Another studyfound patients on morphine experience 40 percent less pain relief from the drug if they have mood disorder. They need more drugs to get the same benefits.

People with mood disorders alone are also more likely to abuse opioids. A 2012 survey found patients with depression were twice as likely to misuse their opioid medications.

“So, not only does a mood disorder affect a person’s addiction potential, but it also influences if the opioids will successfully treat their pain,” Cahill said.

Meanwhile, the country is living through sad times. Some research suggests social isolation is on the rise. While the opioid epidemic started long before the recession, job loss has been linked to a higher likelihood of addiction, with every 1 percent increase in unemployment linked to a 3.6 percent rise in the opioid-death rate.

Can the brain swing back?

As an opioid disorder progresses, a person needs a higher quantity of the drugs to keep withdrawal at bay. A person typically overdoses when they take so much of the drug that the brain stem slows breathing until it stops, Kosten said.

Many physicians have turned to opioid replacement therapy, a technique that swaps highly potent and addictive drugs like heroin with compounds like methadone or buprenorphine (an ingredient in Suboxone).

These substitutes outcompete heroin when they reach the opioid receptors, but do not activate the receptors to the same degree. By doing so, they reduce a person’s chances for overdosing. These replacement medications also stick to the receptors for a longer period of time, which curtails withdrawal symptoms. Buprenorphine, for instance, binds to a receptor for 80 minutes while morphine only hangs on for a few milliseconds.

Science correspondent Miles O’Brien discovers future pain treatments may rely on virtual reality.

For some, this solution is not perfect. The patients need to remain on the replacements for the foreseeable future, and some recovery communities are divided over whether treating opioids with more opioids can solve the crisis.

Plus, opioid replacement therapy does not work for fentanyl, the synthetic opioid that now kills more Americans than heroin. Kosten’s lab is one of many working on a opioid vaccine that would direct a person’s immune system to clear drugs like fentanyl before they can enter the brain. But those are years away from use in humans.

And Evans and Cahill said many clinics in Southern California are combining psychological therapy with opioid replacement prescriptions to combat the mood aspects of the epidemic.

“I don’t think there’s going to be a magic bullet on this one,” Evans said. “It’s really an issue of looking after society and looking after of people’s psyches rather than just treatment.”

Source: https://www.pbs.org/newshour/science/brain-gets-hooked-opioids October 2017

With no age restrictions on its use, some people – even children – are likely consuming CBD on a very frequent basis.

While a growing chorus of voices recommend CBD oil for all manner of ailments with glowing reviews and assurances of its safety, consumers would be wise to think very carefully before jumping on the bandwagon.

This article seeks to pull back the curtain on the CBD story and reveal the very real potential dangers of use by otherwise healthy people so that you can make a truly informed decision for your family.

Please note that I am not disputing the benefits of cannabis in this article. I know it helps a lot of very sick people manage their illness in a comfortable way without the need for pharmaceuticals. What I am presenting is the other side of the story that is usually not discussed – even glossed over in favor of aggressive marketing to otherwise healthy people.

What is CBD Oil?

CBD oil is an alternative remedy for inflammation, pain, seizures and many other conditions. It is gaining widespread popularity over pharmaceutical drugs to treat the same ailments.

Manufacturers make CBD oil by diluting the active ingredient cannabidiol with a carrier fat such as coconut oil. Depending on what carrier oil is used (i.e., saturated fats or vegetable oils), the remedy then appeals to a wider variety of people. In other words, CBD fans can find an oil that fits their particular food philosophy on fats.

Cannabidiol

You might be surprised to learn that cannabidiol is one of over a hundred compounds known as cannabinoids. The buds, flowers, leaves and stalks (not seeds) of the hemp plant contain them. Other common names for this plant are marijuana or cannabis.

Tetrahydrocannabinol, better known as THC, is another well known cannabinoid in hemp plant matter. It is best known for its mind altering effects, which pot smokers experience firsthand. (1)

Fans of CBD oil claim that cannabidiol is safe because it has zero inherent psychoactive properties like THC. However, this is disputable, if not downright false, in light of research on both animals and humans. More on this later.

Hash (Cannabis) Oil vs CBD Oil vs Hemp Seed Oil

It is important to understand the key differences between the three primary oils derived from the hemp or marijuana plant. These characteristics determine whether the oil is used as food or medicine and, in turn, whether it is even legal or not.

CBD oil falls in the gray area, which is why it is so confusing and potentially dangerous for anyone except those who are gravely ill with few other treatment options. Hopefully, the discussion below will help clear things up for you!

Cannabidiol (CBD) Oil

As described above, manufacturers create medicinal CBD oil by blending cannabidiol with a carrier oil. This active ingredient is either isolated or alcohol extracted from whole cannabis plant matter.

CBD was legalized in all 50 states by the 2014 Farm Bill, which served as the springboard for its explosive growth. However, this approval came with an important caveat. The legislation required extraction of CBD for academic research or under a state pilot program. Since then, a number of states broadened this narrow definition, which legalized other CBD manufacturing processes. (2)

Hemp Seed Oil

CBD oil is vastly different from hemp seed oil, which is a food and not medicine. It is made by cold pressing the seeds on the cannabis plant. The resulting oil is high in inflammatory omega-6 fats. Hemp seeds contain no THC and hence the oil should technically not contain any either.

Some countries require testing for THC in hemp seed oil to verify purity. Typical requirements are that there are no more than 5-10 or even zero parts per million (ppm) detected in the final product.

Hemp Oil (Hash or Cannabis Oil)

In comparison, hash or cannabis oil does contain high inducing THC. It is also misleadingly known as honey oil.

It comes from aerial parts of the marijuana plant except the seeds. This medicinal or recreational oil can be made from any of the three sub-species of the cannabis plant – Cannabis sativa, Cannabis indica, and more rarely Cannabis ruderalis.

Hash oil is illegal for recreational use in most states but is approved for medicinal use by a growing list of others. It is usually consumed by eating or smoking. It is also sold in cartridges for use in vaping pens.

In summary, while hemp seed oil is widely recognized as safe and available on healthfood store shelves all across the country, hemp oil is still regulated as as a medicinal only drug in some states and completely outlawed in others. CBD oil falls in the gray area somewhere between the two.

The question that remains to be answered is its safety. Does the narrow legalization of CBD in the 2014 Farm Bill guarantee its safety? Or is it actually more risky than consumers have been led to believe?

CBD Oil Risks

The side effects of consuming cannabidiol are very real though commonly glossed over by those selling it.

Drug Contraindications

CBD oil may potentially interact in a negative way with anti-epilepsy drugs. As of now, only in vitro (test tube) observations exist with no living organism testing proving safety. Drugs that may interact include: (3)
•carbamazepine (Tegretol)
•phenytoin (Dilantin)
•phenobarbital (Luminal, Solfoton, Tedral)
•primidone (anti-seizure)

Side Effects

According to a review of existing research by the journal Cannabis and Cannabinoid Research, the most common side effects of consuming CBD or CBD oil include:
•fatigue
•nausea or vomiting
•diarrhea
•dizziness
•anxiety or depression
•changes in appetite/weight
•Psychosis

While there is a well known link between psychotic disorders and pot, CBD is generally regarded as anti-psychotic. (4)

How can this be if a CBD side effect is psychosis? (5)

Perhaps this common belief is simply not true!

Psychoactive Effects of Cannabinoids

Perhaps cannabinoid oil purveyors tend to ignore the well established reactions because the side effect profile of CBD is better than pharmaceutical drugs used to treat similar conditions.

In addition, proponents of CBD oil use insist on its safety because cannabidiol is not mind altering like its cousin cannabinoid THC.

Research from the 1970s seems to confirm that CBD is well tolerated up to 600 mg without psychotic episodes. (6)

However, more recent research disputes this assumption.

Conversion of CBD to THC

Researcher Kazuhito Watanabe, PhD and his team at Daiichi College of Pharmaceuticals, Japan discovered a disturbing problem with cannabidiol. (7)

They found that CBD converts into THC, the same psychosis inducing substance found in weed. In addition, CBD converted into two other THC-like cannabinoids known as HHCs (hexahydroxycannabinols). All three produced high inducing symptoms in mice.

This research indicates that THC is not the only mind altering cannabinoid in hemp. It also suggests the possibility that a person can be exposed to brain altering, high inducing substances by simply consuming CBD.

Getting High on CBD?

Acidity is necessary for the conversion of CBD to THC and the two psychoactive HHCs. Researchers performed this conversion using artificial digestive juices. The change accelerated in the presence of some kind of sugar (or alcohol).

In people consuming CBD oil, this would parallel as acidity in the stomach. Since people commonly consume CBD oil in sugary lattes, candy, goodies, smoothies or alcoholic beverages, this situation mimics the reality of many people who use it.

Effects of THC Derived from CBD

To test the effects of these components, the researchers then injected mice with small quantities of the THC and HHCs converted from CBD. The researchers tested for the four most common symptoms of THC exposure including:
•Catalepsy – loss of sensation or consciousness
•Hypothermia – drop in body temperature
•Prolonged sleep
•Reduced pain perception

Mice injected with small amounts of THC and HHCs converted in artificial gastric juices from CBD tested positively for all 4 pot exposure symptoms.

Human Studies

Follow-up research in 2016 published in the journal Cannabis and Cannabinoid Research gives additional pause.

More than 40% of epileptic children orally administered CBD exhibited adverse events, with THC like symptoms the most common. In their conclusion, researchers challenged the accepted premise that CBD is not high-inducing.

Gastric fluid without enzymes converts CBD into the psychoactive components Δ9-THC and Δ8-THC, which suggests that the oral route of administration may increase the potential for psychomimetic adverse effects from CBD. (8)

Is CBD Oil Safe for Children?

The takeaway of existing research as of this writing seems to indicate extreme caution when it comes to ingestion of CBD oil especially by children.

Research definitively shows that THC exposure affects their developing brains in a negative way – perhaps permanently. The important point here is that consuming CBD or CBD infused oil can initiate this THC exposure – not just smoking or vaping pot. The Journal of Current Pharmaceutical Design warns:

The literature not only suggests neurocognitive disadvantages to using marijuana in the domains of attention and memory that persist beyond abstinence, but suggest possible macrostructural brain alterations (e.g., morphometry changes in gray matter tissue), changes in white matter tract integrity (e.g., poorer coherence in white matter fibers), and abnormalities of neural functioning (e.g., increased brain activation, changes in neurovascular functioning). (9)

CBD During Pregnancy

The Journal Future Neurology warns that cannabis exposure crosses the placenta. “Human epidemiological and animal studies have found that prenatal cannabis exposure influences brain development and can have long-lasting impacts on cognitive functions.” (10)

Since CBD partially converts to THC under acidic conditions, women who consume CBD oil for morning sickness or other discomforts of pregnancy should understand that use may mimic using pot directly. Just because CBD oil is natural and works effectively to alleviate symptoms does not mean it is safe for your baby.

Always discuss any supplemental foods with a practitioner before use!

CBD from Hops and Other Non-Cannabis Plants

Some CBD products and oil come from plants other than cannabis. Hops is one that is popular currently. (11)

People that use non-cannabis CBD mistakenly believe that they are safe from THC. False marketing of these products encourages this line of thinking.

Be warned that no matter where CBD comes from, the potential for conversion of CBD to THC in the digestive tract exists. CBD is ultimately a cannabinoid no matter what plant it comes from. Thus, unless the CBD is applied transdermally or intravenously to avoid the acidic conditions within the digestive tract, the risk for THC exposure and brain-altering effects still exists.

To give you a example of how this works, consider how beta carotene converts to Vitamin A in the digestive tract. It doesn’t matter if the beta carotene comes from carrots, peppers or squash. This nutrient will still potentially convert to Vitamin A. The same principle applies to CBD that is consumed orally. The digestive process can result in conversion to THC no matter what plant is the source of the CBD.

Is CBD Safe for Anyone?

Consumers desperately need more research about the high-inducing effects of CBD-to-THC that could manifest as a result of the digestive process.

The half life of oral CBD in the body is about 2 days. Thus, depending on how much a person consumes and how often, the potential risk of psychosis could increase over time depending on individual metabolism.

It seems that, as of this writing, the prudent course of action for the cautious consumer is to adopt a wait and see attitude toward CBD and CBD oil products pending further research on the very real potential for mind altering, pot-like effects.

Some companies are already working to develop synthetic transdermal CBD. Such a drug would bypass the gastrointestinal tract and avoid bioconversion to psychoactive THC and/or HHCs. Of course, this treatment likely has its own set of yet unknown dangers!

While the risks of THC exposure from CBD oil and other products are likely of little concern for gravely ill people who desperately need it, for otherwise healthy people and children, beware! It seems wise until further research is concluded to treat CBD oil, candy, and other products just like any other high inducing drug. Just. Say. No.

Sarah Pope MGA

Since 2002, Sarah has been a Health and Nutrition Educator dedicated to helping families effectively incorporate the principles of ancestral diets within the modern household.

Sarah was awarded Activist of the Year at the International Wise Traditions Conference in 2010.

Sarah received a Bachelor of Arts (summa cum laude, Phi Beta Kappa) in Economics from Furman University and a Master’s degree in Government (Financial Management) from the University of Pennsylvania.

Mother to three healthy children, blogger, and best-selling author, her work has been covered by USA Today, The New York Times, National Review, ABC, NBC, and many others.

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Comments (115)

Anna

Well, by now Healthline has corrected the article you reference as evidence for CBD causing psychosis, after I (and maybe others, who knows) pointed out to them that they had mistakenly put the side effects of THC for those of CBD. Now it lists only diarrhoea, changes in appetite and fatigue. Time for you to follow suit? You both reference the same scientific article, and now that this is the only remaining reference to back up your claim, I think it is time you actually looked at it and realised that it does not support your claim either. Could you then still go on and claim to have truth on your side, knowing that your claim is based on nothing at all? And keep on calling people who disagree with you biased? It’s pretty clear to me who is the biased one here, and probably to most others as well.
Sarah, you may have good intentions but you are not making the world a better place by publishing misinformation. Maybe a few people will be kept from trying CBD due to reading it, but most people will realise right away how ridiculous it is. It will just contribute to their mistrust of official information and authority figures on the subject of drugs. Because fact is that a lot of fairly harmless drugs have been needlessly demonised along with the genuinely dangerous ones since Nixon started his war on drugs. You might believe otherwise, but people who try them know better. And the more misinformation they see around them, the more they will be inclined to disbelieve also the genuine warnings about those drugs which can actually be really harmful. Especially now in this age of ‘fake news’ where people are more and more unsure of what information they can trust. People actually end up harming themselves much more due to ignorance than they would if they had full knowledge of the whole subject in advance! Proper education is the way to reduce the harm from drugs the most, not waging a war against them with misinformation – isn’t it obvious by now that this war has totally failed, because it is unwinnable?

April 20th, 2019 2:14 pm Reply

Sarah Pope MGA

I actually cited a scientific study about CBD converting to THC in the gut! You are welcome to believe anything you like, but the fact is that some people do experience psychosis from CBD. Read through the comments and read the referenced research study.

April 22nd, 2019 7:39 am Reply

rooislangwtf

The effort the Japanese study went to, to convert cbd to thc makes me wonder what the likelihood is of it actually happening in the human body (ph of 1.2 that’s lower than normal gastric acid and then a heck of a lot of purification). The epilepsy study didn’t go past observation to indicate thc effects (urine tests would’ve helped).

So the real conclusion to draw is until more tests are done:
Dont take cbd with alcohol or a lot of sugars or get a way to take cbd non orally (a patch or a suppository maybe).

April 10th, 2019 7:34 pm Reply

PATRICIA DONOVAN

I believe you picked and chose your so-called info from a multitude of sources without validating ANY of it. You are doing an extreme dis-service to those who use CBD effectively. People have to do their own research and find what works for them. Not all brands are created equal. I could write a book, with VALID sources, disputing virtually every point you made.

February 13th, 2019 1:06 pm Reply

Sarah Pope MGA

I find it amusing that people who disagree with an article frequently get in a huff and claim that “all” the sources/references are invalid and that they could “write a book” disputing every point. LOL Go read a site then that confirms all your biases. You don’t want the truth .. you want an article validating your belief system.

February 13th, 2019 1:37 pm Reply

Tim Wolford

I believe failed to include that the types of CBD oils in question are the Full Spectrum which has THC properties. The two other types will NOT produce THC and they are Broad Spectrum and Isolate Spectrum. The majority of CBD oils on the market today are Full Spectrum with THC compounds, however when the THC is extracted from the CBD Oils you have a Broad Spectrum product which may cost more, but will NOT have THC period! Do your homework and don’t always believe everything you read, especially when the Spectrums were never discussed

February 12th, 2019 11:23 am Reply

Sarah Pope MGA

Please read the article. You have apparently missed the point completely as have several other commenters. There is NO BRAND of CBD oil that is safe. ANY cannabidiol even if from another plant (like hops) will potentially trigger a conversion to THC in the gut. When NYC just banned CBD from edibles sold at restaurants, healthfood stores etc, there was NO distinction between “full spectrum” and isolate spectrum.

February 13th, 2019 8:56 am Reply

Dela Baldwin

Not all CBDs are created equal. Not all CBD has THC. A lot have trace amounts however not all. My company is 100% 0.00000 % THC free.

February 5th, 2019 9:52 am Reply

Sarah Pope MGA

I don’t think you understood the article! I am not suggesting that any CBD oil has THC in it … it DOESN’T MATTER how your CBD oil is produced … some CAN AND DOES CONVERT to small amounts of THC in the acidity of the digestive tract when consumed. Some people have a HUGE negative reaction to this.

Beta carotene partially converts to Vitamin A in the digestive tract too as do many other substances.

February 5th, 2019 10:26 am Reply

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