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by Lauren Irwin – WNCT Greenville

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

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

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

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

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

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

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

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

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

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

Source:  https://www.msn.com/en-us/health/medical/nearly-1-in-3-americans-have-reported-losing-someone-to-a-drug-overdose-study/ar-BB1nsfVP?

 

                          More than half of study subjects experienced homelessness in the past six months.

ATLANTA — A new study led by a Georgia State University researcher finds that the opioid epidemic and rural homelessness are exacerbating each other with devastating consequences.

School of Public Health Assistant Professor April Ballard and her colleagues examined data from the Rural Opioid Initiative on more than 3,000 people who use drugs in eight rural areas across 10 states. They found that 54 percent of study participants reported experiencing homelessness in the past six months, a figure that suggests Point in Time Counts used to allocate state and federal funding significantly underestimate homeless populations in rural areas. The findings appear in the January edition of the journal Drug and Alcohol Dependence.

“Rural houselessness is very much an issue in the United States, and there are unique challenges that come with it, such as lack of awareness and a lack of resources,” said Ballard, who co-leads GSU’s Center on Health and Homelessness. “When you add the opioid epidemic on top of it, it really exacerbates the problem.”

Ballard explained that the unemployment, financial ruin and loss of family and social networks that often accompany opioid use disorder and injection drug use can precipitate housing instability and homelessness. The uncertain and harsh living conditions experienced by people without stable housing can perpetuate drug use as a coping mechanism. The result can be a self-reinforcing cycle that contributes to poorer health and shorter lifespans.

Ballard and her colleagues found that study subjects with unstable housing were 1.3 times more likely to report being hospitalized for a serious bacterial infection and 1.5 times more likely to overdose than those with stable housing. She explained that a lack of access to clean water to wash the skin and prepare drugs makes infections more likely, and that using drugs alone and furtively can increase the risk of an accidental overdose.

The Rural Opioid Initiative surveyed people about their experiences with homelessness over the past six months, while Point in Time Counts mandated by the federal Department of Housing and Urban Development quantify the number of people experiencing homelessness on a single night in January. Despite this methodological difference, Ballard said her study’s findings suggest that Point in Time Counts significantly underestimate homeless populations in rural areas.

In Kentucky, for example, the researchers counted up to five times as many people experiencing homelessness than Point in Time Counts, even though their sample of people who use drugs constituted less than 1 percent of the adult population. In three counties that estimated zero people experiencing homelessness using Point in Time Counts, Ballard and her colleagues quantified more than 100 people who use drugs who had experienced homelessness in the past six months.

The dispersed nature of rural areas makes Point in Time Counts difficult, Ballard acknowledged, but the undercounting of people experiencing homelessness can result in fewer federal and state resources reaching vulnerable people and communities.

“House-lessness in rural areas is a major problem,” Ballard said, “but we’re not allocating resources in a way that is proportionate to the problem.”

The research was supported by the National Institute on Drug Abuse with co-funding from the Centers for Disease Control and Prevention, Substance Abuse and Mental Health Services Administration, and the Appalachian Regional Commission.

Source:  https://news.gsu.edu/2025/01/13/study-examines-links-between-opioid-epidemic-and-rural-homelessness/

Over the last weekend of April 2024, something in Austin’s drug supply went horribly wrong. The first deaths passed largely unnoticed by anyone other than the families and friends of those who consumed the tainted substances. An 8-year-old girl who’d been playing outside her apartment in northeast Travis County on the evening of Sunday, April 28, came home to find her 50-year-old father dead in bed. In a homeless encampment in a wooded area of East Austin, paramedics revived two people with naloxone, the overdose reversal drug known commonly as Narcan. But, hours later, one of them, a 51-year-old woman, was found dead inside her tent—a short walk from a 53-year-old man who likely died around the same time.

A clearer picture wouldn’t emerge, however, until 911 calls began flooding in the following morning.

Most Mondays, the Sixth Street entertainment district would be quietly nursing the hangover from another rowdy weekend, the only souls on the street those who sleep in the shelters, alleys, and sidewalks. But emergency dispatchers were getting repeated reports of people in distress.

The first call came in just after 9 a.m. from someone calmly describing an overdose in an alley. But, as the minutes dragged on, panic crept into the caller’s voice. “I’m scared,” she blurted out. “Oh, my gosh, I’m so fucking scared. Somebody’s going to die because of these people.”

“What happened?” asked the operator.

“Somebody tried to say ‘Don’t call the ambulance,’” the caller responded. “Oh, my God. Oh, my God.”

A little before 10 a.m., a security guard flagged down one of the Austin police officers flooding the district. Two men were sitting on the ground next to a trash bin in an alley near Sixth and Red River Street, slumped forward. Only 20 minutes earlier, both men had been walking and chatting. Now, they weren’t breathing.

The officer administered naloxone and began performing CPR. Paramedics took one to a hospital. The other, 51-year-old Benjamin Arzo Gordon, couldn’t be revived.

The alley where Gordon died had become the epicenter of a mass casualty event. During a two-hour span that Monday morning, at least six others overdosed and were revived with naloxone in a four-block radius in downtown Austin. Over 72 hours, Austin police reported more than 70 overdose calls. Records from Travis County, which includes most of Austin, and neighboring Williamson County indicate that as many as 12 may have died. The culprit: a bad batch of crack cocaine.

Through dozens of open records requests and interviews, the Texas Observer and Texas Community Health News have pieced together what happened during those deadly days—and how changes to state law might have saved lives. Across the capital city, people who consume crack, a stimulant, were suffering symptoms consistent with poisoning from opioids like heroin or fentanyl, the incredibly potent prescription painkiller.

The adulterated crack impacted Central Texans from many walks of life. Among the people who died were a construction worker from Honduras and a young man from Wimberley, who passed away in his parked truck with the engine running. Crack rocks found at the scene of some of the deaths tested positive for fentanyl.

A small, inexpensive item might have averted some of these deaths. Fentanyl testing strips can be used to check for the presence of the synthetic opioid. With an appearance similar to an at-home COVID-19 test, the strips are dipped in water in which a small amount of the drug has been dissolved. A line indicates if fentanyl is present.

But such testing strips are illegal in Texas. They’re considered paraphernalia, and possessing one is a Class C misdemeanor. While the Texas House passed a bill that would have legalized them in 2023, the Senate declined to vote on it.

In general, Texas has been reluctant to embrace the strategy of harm reduction, a broadly defined term for helping people who use drugs without stigmatizing or imposing strict parameters, while also involving drug users in planning and implementation. Harm reduction has been promoted in the United States since at least the 1980s. A classic early example is teaching people who inject drugs to clean needles with bleach, preventing the spread of HIV. The overall approach is sometimes pitched as a means to keep people alive long enough to get off drugs, but many practitioners simply seek to keep substance users safe and healthy, regardless of plans to enter treatment.

Under the administration of President Joe Biden, the federal government embraced aspects of harm reduction. Some states have as well. But policies favored by many Texas officials reflect the singular goal of making it as difficult as possible to use drugs. As it turns out, research and interviews with both experts and users of drugs show, making drug use more difficult also makes it more dangerous. Though Texas ranks low among states in fatal overdose rates, federal data shows the Lone Star State’s rate stayed nearly flat from 2023 to 2024, while overdose deaths fell significantly nationwide.

Among those calling for more humane drug policies in Texas and beyond is a coalition of academics, activists, service providers, and people who use drugs who argue criminalization endangers people with little benefit. Some members of this coalition identify as harm reductionists, while others identify as advocates for drug user health. Some argue that stigma and marginalization do more harm than drugs themselves; many believe that, while kicking drug habits should be the ultimate goal, the best tactic is to meet people where they are. These advocates push for more access to naloxone, legalized drug checking, and reduced stigma so that policymakers, service providers, and drug users and their families can have real conversations about how to stay alive.

In recent months, top Texas officials have not only rejected harm reduction but have also openly antagonized those who practice it.

The prevailing attitude in the state is, “Why should we try and save their lives? They’re just going to use again,” said Joy Rucker, a nationally known advocate who launched Texas’ largest harm reduction nonprofit. In California, where she used to work, harm reduction organizations get robust public funding and operate openly.

“Texas was just a rude awakening,” she said.

A tall, thin Houston native with a quick sense of humor, Benjamin Arzo Gordon had been living on the streets of Austin for years. A January 2024 photo in the Austin American-Statesman shows him with a close-cropped white beard and a gray beanie, at Central Presbyterian Church downtown, looking pensive as he discusses harsh winter weather.

Andi Brauer, who oversees the church’s homeless outreach programs, said Gordon was a regular at weekly free breakfasts, cracking jokes with her and other volunteers and taking a genuine interest in her wellbeing.

“He’d always say, ‘You need to sit down and eat,’” Brauer recalled. “Or, if somebody was sometimes threatening or rude to me, he would say, ‘Don’t mess with Andi.’” She once printed out a photo of the two of them and used it to make a card for him.

In the alley where he died, Gordon was known to stop by with meals from the nearby food truck where he worked. “He used to help people in the alley,” said Loretta, a 55-year-old Austinite who herself suffered an overdose after Gordon.

Bokhee Chun, a Central Presbyterian volunteer, remembered Gordon would sing her hymns. Some months before he passed, Brauer said, Gordon came in to fill out a volunteer application.

Like many who died last April, Gordon was an experienced drug user. His drug of choice, crack, put him at little risk of sudden death by itself. But the crack he smoked that spring day was laced with a substance that has become synonymous with America’s failed drug policies.

In the latter half of last century, as states and the federal government increased penalties for drug sale and use, overdose death rates stayed relatively flat. That raised questions about whether deterrence policies did anything to reduce drug use. Then, this century, overdose rates skyrocketed, driven by synthetic opioids including fentanyl. Fentanyl had been around for decades, but in the 2010s it increasingly caused deaths in northeastern states. As it moved west, the nation’s drug supply transformed.

Initially, fentanyl was used alone or to boost the potency of other opioids and depressants like heroin and prescription pain pills. But, in recent years, people killed by fentanyl are increasingly found to have stimulants like cocaine or methamphetamine in their systems. Explanations for this vary. Stimulants may be intentionally adulterated to hook users on fentanyl. A stimulant user might take opioids to come down. An unsophisticated dealer with a small stimulant supply may add fentanyl to stretch it. And failure to clean scales or surfaces can also mix fentanyl with another drug.

In Texas, overdose rates increased dramatically starting in 2020. From June 2023 to June 2024, more than 5,000 people died of an overdose in the state, with Travis County recording the highest fentanyl-related death rate among Texas’ most populous counties in recent years. Though Texas has one of the lower overdose rates in the nation, deaths in the state declined by less than 3 percent from 2023 to 2024, while the rest of the nation saw a drop of nearly 15 percent, per the federal Centers for Disease Control and Prevention. In October, the Texas Department of Health and Human Services (HHS) announced that it recorded a 13-percent drop in the state over the same period—but its figures include only those overdoses deemed accidental, not those labeled intentional, suicide, or of undetermined cause.

Experts also question the general accuracy of Texas’ numbers. In much of the state, underfunded and under-trained justices of the peace are charged with death investigations. Overdoses, which require costly autopsies and toxicology reports, are easy to overlook.

In response to the overdose increase, HHS in 2017 launched the Texas Targeted Opioid Response (TTOR) initiative. HHS is also part of a state awareness campaign using billboards and social media ads focused on cautionary tales of young Texans who overdosed. At the same time, state leaders have doubled down on criminalization.

In 2023, the Legislature passed a law allowing prosecutors to bring murder charges in fentanyl overdose cases. Critics say this discourages people from reporting emergencies, and research shows such laws harm public health. Some who overdosed in Austin last April had shared drugs, putting survivors at risk of being charged. In 2021, the Legislature passed a good samaritan law ostensibly meant to protect people who call 911 to report an overdose. The law created a defense for people arrested for low-level possession, but it has so many caveats—you can only use it once in your life, it doesn’t apply if you’ve been convicted of a drug-related felony, you can’t use it if you’ve reported another overdose in the last 18 months—that you’d need a flow chart to understand it. Critics say the statute’s of little use.

“The fentanyl-induced or the drug-induced homicide laws, that jacks up the consequences and the intensity so much more,” said Alex White, director of services at the Texas Harm Reduction Alliance, an Austin non-profit that does street outreach, operates a drop-in center, and provides supplies including for hygiene and wound care.

Some states, like Maryland and Vermont, make a point of prioritizing input from people who use or have used drugs while crafting policy. Harm reduction advocates say this is lacking in Texas, though HHS does have a low-profile advisory committee that is required to include members who’ve received mental health or addiction treatment.

“If you’re thinking that you know how to serve folks, and you don’t have those folks at the table when you’re trying to serve them, it’s not going to work,” said Stephen Murray, a paramedic and overdose survivor on Massachusetts’ Harm Reduction Advisory Council.

Rapid changes in the drug supply can make it difficult to conclusively track policy impacts. Critics blame Texas’ persistent overdose rate at least partly on punitive laws, but a few western states including liberal Oregon—which famously passed a drug decriminalization ballot measure in 2020—actually saw overdoses increase between 2023 and 2024. To this, some experts and at least one study counter that fentanyl’s delayed arrival on the West Coast has distorted the death rates, and that Oregon specifically did not implement sufficient services alongside decriminalization.

Texas Governor Greg Abbott’s office did not respond to a request for comment for this story.

Loretta woke up on the morning of Monday, April 29, in the alley where she often goes to smoke crack and sometimes spends the night. She grew up in East Austin, only blocks away.

Loretta said she lent her pipe that morning to a friend who’d just purchased drugs. Then she heard someone ask, “What’s wrong?” and saw the friend staring up, trance-like.

“He stayed looking at the sky,” Loretta said, reclining and rolling back her eyes to demonstrate. “The next thing I know he just went like this,” she said, as she pantomimed slumping limply to the side. “I was shaking him, and I said, ‘What’s wrong, what’s wrong?’ And after that he just didn’t answer.”

Despite fear she’d be held responsible, Loretta yelled to a friend to call 911. Police and paramedics swarmed the area. Loretta watched as someone else collapsed. “She hurt herself hard on the concrete and I said, ‘Oh, my God, hell no, this is not happening.’”

Soon, an acquaintance ran up to say Loretta’s boyfriend had also collapsed in a nearby portable toilet. “He was slurring like a baby, like a little boy,” Loretta said. “He started to lose consciousness. I slapped him hard. It hurt my hand. And I shook him and I started praying.”

Around the time that Loretta was calling out for help for her boyfriend, and EMTs were trying unsuccessfully to save Gordon, Adam Balboa showed up to work at an Austin-Travis County EMS (ATCEMS) station in south Austin. A case manager for a unit focused on substance use, Balboa heard the overdose reports and symptoms being described and knew what would save the most lives. “We needed to flood the downtown area with as much Narcan as possible,” he said.

Opioids in the bloodstream bind to receptors in the brain, creating euphoria. But by a quirk of physiology, excessive opioids bound to those receptors interfere with the body’s ability to measure its need for oxygen, slowing breathing—to the point where it can be fatal. Mouth-to-mouth resuscitation can keep someone alive. Narcan temporarily blocks the receptors to opioids, essentially short-circuiting an overdose if delivered in time.

The medics and police officers in downtown Austin were running out of naloxone, but Balboa didn’t just want to get them more. He also wanted to get it in the hands of people who use drugs, along with their friends, family, and neighbors. So he and colleagues began throwing together kits containing Narcan, a CPR mask, and instructions, and he hurried downtown with his SUV loaded up with the blue zippered pouches. “Everybody was super receptive,” he said. “They were clipping it to their belts and … going about their normal business.”

As common-sense as that response seems, it’s one strongly associated with harm reduction. By handing out naloxone downtown, Balboa was helping those most vulnerable to the tainted drugs help one another. It’s also a response that would have been impossible a few years ago.

Balboa’s unit is the brainchild of Mike Sasser, a 51-year-old ATCEMS captain who’s been in recovery for 21 years. A longtime paramedic who often worked with Austin’s unhoused population, Sasser became friends in 2018 with Mark Kinzly, a lion of the Texas harm reduction movement. Kinzly, who passed away in 2022, had helped start the Texas Overdose Naloxone Initiative, which was getting grants to distribute the medication. He had a seemingly simple idea for Sasser: ATCEMS could use grant money to buy Narcan, pass it out, and train people how to use it.

“My mind was blown,” Sasser said. “Why have I never thought about this? That would save so many lives.”

ATCEMS doctors then wrote prescriptions that allowed medics to hand out naloxone (today, it’s available over the counter). Sasser’s unit also began reaching out directly to overdose survivors and administering a maintenance drug that reduces opioid cravings, and it now includes two full-time case managers who run an overdose reversal education program called Breathe Now.

All of this fits under the philosophy of harm reduction, which can also include teaching people to use drugs more safely and providing supplies like clean glass pipes, which help prevent disease and infection. Providing food, water, hygiene products, or wound care to people who feel stigmatized in doctor’s offices is another tenet.

“We want to provide people with what they need, so we can build that trust,” said Em Gray, whose NICE Project provides supplies to Austinites, many of them unhoused, and stocks Narcan vending machines. “That’s how we show that we are there for them; we’re there to improve their quality of life, there to reduce their overdose death rates.”

There’s little funding available in Texas for the nonprofits and mutual aid groups that do this work. Across the state, harm reductionists often operate out of backpacks or car trunks.

To the state’s credit, Texas has taken some steps to increase naloxone distribution. TTOR does this with an annual federal grant of about $5.5 million. In 2019, TTOR, whose Narcan distribution program is administered by the University of Texas Health Science Center at San Antonio, gave about 40 percent of its naloxone to law enforcement agencies—even as research shows it’s more effective to give the medication to laypeople, who are typically first on the scene and present no threat of arrest—an analysis by Texas Community Health News found. By 2022, TTOR’s emphasis had shifted, with law enforcement making up only about 15 percent of its distribution.

But police are still prioritized in Texas’ long-term naloxone plan. Under a different state program started in April 2023, the Texas Department of Emergency Management (TDEM) began distributing $75 million worth of the medication over 10 years. That naloxone, donated by a pharmaceutical company as part of a court settlement over opioid deaths, is largely earmarked for first responders. Of the more than 150,000 doses that TDEM distributed from April 2023 to September 2024, 118,000 went to law enforcement agencies, mostly sheriff’s offices. Many of these offices cover areas that lack other harm reduction infrastructure, but records provided by TDEM show sheriffs aren’t using the naloxone. Of 13 counties in which agencies reported using doses from TDEM by September, the highest rate of use was 3 percent. Much of that naloxone will expire later this year. In an email, a TDEM spokesperson said the agency had “yet to turn down a request for naloxone” and that “Administration or disposition of distributed naloxone is up to the receiving entity how they see fit, in accordance with manufacturer’s guidance.”

When it set the state’s two-year budget in 2023, the Legislature allocated an additional $18 million in opioid settlement funds to UT Health San Antonio, but it’s not clear the appropriation will be renewed.

In the meantime, harm reductionists rely on a patchwork of naloxone sources, including local governments.

“Had we not saturated Austin with Narcan leading up to [the April] event, then that event would have been a lot more detrimental than it was,” said Sarah Cheatham, a peer support specialist with The Other Ones Foundation, an Austin nonprofit serving the unhoused. “Even when it was hard to get in our hands, we were out there doing this communication for months before this happened.”

By late morning on April 29, the Austin Police Department (APD) had some idea what was happening. Crack rocks and pipes had been found at the scene of a number of overdoses in an area known for its use, and officers had interviewed some who’d been revived with naloxone. They began looking for people seen on surveillance cameras and suspected of selling the tainted crack. While responding to an overdose, detectives found one suspect standing in front of a tent, just a block from police headquarters.

While cops made arrests, harm reductionists tried frantically to figure out what was going on. A little after noon that Monday, Claire Zagorski, a graduate research assistant at the University of Texas at Austin who’s worked in harm reduction for years, messaged a group chat: “Austin folks there’s a bad batch downtown as of this AM. Not sure on specifics but it does respond to naloxone.”

Groups started handing out Narcan and warning the communities they serve, but without any official information from local governments. “We were really just kind of going in blind,” Cheatham said. “We were all talking to each other about, ‘Who’s going to these camps? Where is it happening? Is it happening downtown?’ And I was mainly reaching out to the people that I know.”

Research shows that, given the chance, drug users will reduce their risk of overdose—including by carrying naloxone, not using alone, or taking a small tester dose. But, lacking detailed information, harm reduction workers in Austin were constrained. “It’s distressing that the thing that got everyone activated was me being notified by a backchannel,” Zagorski said.

When local officials finally made public statements hours after the flood of 911 calls, they only addressed some questions. Whatever was killing people was responding to Narcan, officials said, in a news release and press conference. But they were vague about which drug was adulterated, and there was no mention of test strips.

“It was a very chaotic scene at first,” APD Lieutenant Patrick Eastlick told the Observer. “Something we can look at in the future is, if this happens again, that we reach out to these different groups where we can spread the word.”

Open conversations about drugs are difficult in a state where top elected officials are cracking down on services for people who use them. In late November, state Attorney General Ken Paxton filed a headline-grabbing lawsuit to shut down a homeless navigation center at a south Austin church. The suit specifically blames the Texas Harm Reduction Alliance’s needle exchange program for “the prevalence of drug paraphernalia, including used needles, littering the surrounding area.” Drug use around the church “fuels criminality, and creates an environment where nearby homes and businesses are at constant risk of theft,” the complaint states.

Critics say efforts like Paxton’s just push drug use out of sight, creating greater risk. “It sends the message to people who use drugs that they should hide it, they should be kept in the dark and in the closet,” said Aaron Ferguson of the Texas Drug User Health Union. “The closet is a very dangerous place for people who use drugs. It’s where overdoses happen. It’s where stadiums full of people die every year.”

At least two who died in the Austin overdose outbreak were found alone. Family members of at least two others who perished at home told police they didn’t know their loved one had used drugs that day.

How state officials talk about drug use, critics note, also suggests that only some lives matter. For example, in a 2023 legislative hearing, GOP state Senator Drew Springer—in a successful attempt to woo conservative support for requiring school districts to stock naloxone in middle and high schools—distinguished between different groups of Texas children. “I think the general public, when they hear ‘overdosing,’ they think ‘That’s just a druggie, and that’s a druggie kid’s problem,’” he said. “No, it’s your kid’s [problem], because he may be taking a Xanax or an Adderall” without knowing fentanyl was present.

Claudia Dambra, who runs Street Value, a drug user health organization in Houston, criticized messaging that condemns certain substance users. “All it’s doing is creating more separation,” she said. “It feels like this weird, forced social Darwinism. … It feels like they’re picking us off.”

In an email, an HHS spokesperson said the agency does not discriminate: “[HHS] substance use programs offer treatment and recovery support for people, regardless of substance use duration.”After the horror of watching her boyfriend taken away in an ambulance, Loretta wandered through downtown Austin. Near APD HQ, in the area where police had arrested their suspect earlier, she was offered crack that her friend insisted came from a reliable source. Stressed and scared, she took a hit.

“I started getting a headache right away, like oh, my God, I’ve got a migraine or something. And I started throwing up,” she said. “I said, ‘Call the police, I’m sick.’”

Loretta didn’t lose consciousness, but she was vomiting as police questioned her. Eventually, she was taken to a hospital. She would be among the survivors.

Today, Loretta says that she gets test strips from harm reduction organizations, which quietly distribute them despite state law, and she gives them to friends. But, at the time, she knew little about them. Organizations that distribute strips generally can’t use grant money for their purchase, and government agencies, like ATCEMS, don’t distribute them.

Back in 2023, it seemed Texas was poised to legalize the strips. Before that year’s legislative session, Abbott said he supported allowing the tests, and legislators in both chambers introduced bills to legalize equipment for checking a range of drugs. One by Houston-area Republican Tom Oliverson, which was limited to fentanyl strips only, sailed through the House.

Oliverson, an anesthesiologist who has prescribed fentanyl to patients, said he’d heard from family members of people who purchased black-market pills without knowing they included the powerful opioid.

“That’s literally like stepping on a landmine,” Oliverson told the Observer. “You heard a click and the next thing you know, you were gone.  Nothing you could have done could have saved you. You didn’t know it was there, right? Except for the fact that there are test strips.”

The bill received tepid support from harm reductionists, who were frustrated by its narrowness. The drug supply is constantly changing: Today, the dangerous veterinary tranquilizer xylazine is increasingly used to supplement other drugs. “We’re really trying to craft language that’s inclusive,” said Cate Graziani, former head of the Texas Harm Reduction Alliance and current co-director of a spinoff advocacy group, Vocal TX. “We don’t want to go back to the Legislature every time we have a new overdose prevention tool.”

Oliverson said the bill only applied to fentanyl “because it is that much more dangerous, because it is that much more powerful. … People say to me, ‘I don’t like the idea of giving people test strips because it gives them confidence in the illegal drugs that they’re buying, and I want to discourage people from using illegal drugs,’” he said. “Well, I want to discourage people from using illegal drugs too, but having them insta-killed by a mislabeled pill that they bought, the first time they took it, is not an effective strategy for recovery.”

While other drug-checking legislation failed that session, Oliverson’s bill passed the House 143-2—but it never received a hearing in the Senate Criminal Justice Committee. “They just could not get over the idea that you are making it safer for people to use illegal drugs and that we shouldn’t make it safe for people to use illegal drugs,” Oliverson said, “because they shouldn’t be using illegal drugs at all.”

Oliverson said he’ll introduce a similar bill this session and may rewrite it to include xylazine, but he made it clear he doesn’t support other harm reduction measures like needle exchanges. Such a bill will simply fizzle again, though, barring a change of heart in the Senate, which is run with an iron fist by Republican Lieutenant Governor Dan Patrick, whose office did not respond to arequest for comment for this article.

“It’s so demoralizing to live in a state where your elected leadership is so unwilling to do something so small as legalizing fentanyl test strips, because there’s so much stigma around drug users,”  Graziani said.

By the afternoon of April 29, the tainted crack had made its way to south Austin. Loretta Mooney, another ATCEMS case manager in the substance use unit, was off work but rushed in. Dispatchers could see a new cluster of calls developing on Oltorf Street, east of Interstate 35.

By the time Mooney responded to her first call, at an apartment complex, medics had administered naloxone and revived a woman. Mooney handed out a few doses, then responded to another call from a fast food restaurant across the street. Someone had flagged down police, concerned about a man collapsed against the restaurant’s wall. Officers began CPR and administered Narcan. Mooney gave the man an additional dose and continued life-saving measures. Still, the 53-year-old died.

The situation was starting to look similar to downtown earlier in the day. Teenagers at another apartment complex began waving down Mooney and the officer. They ran over. Mooney administered naloxone to an unconscious woman and helped the officer deploy a breathing bag and mask. After a few minutes, the woman began breathing on her own again.

With Balboa now on his way to meet her and most of the calls near her covered, Mooney came to the same conclusion Balboa had that morning. “I was like, ‘Bring me all the Narcan you have and we’re going to start teaching these kids,’” she said.

On the lower level of a terraced parking lot, Mooney and the officer spread out naloxone kits and gathered the teenagers who had flagged them down.

“I’m telling the kid that came to get me specifically … ‘Because of you, this woman is alive,’”  Mooney said. “We’re on the side of [the road] with, you know, ages 10 to 16, teaching them how to use Narcan.”

While Mooney and then Balboa, too, instructed people in the neighborhood how to use naloxone, a new crisis emerged. Some of the people who had bought the tainted crack were now behind the wheel. First responders were rushing to car wrecks and stalled vehicles.

Responding to the new calls, Mooney and Balboa saw the results of their impromptu training. As Balboa headed to a pawn shop where someone was overdosing, he got stopped in traffic. With his lights and sirens going, trying to weave through vehicles, he saw the teenagers they’d trained earlier.

“Before I can clear an intersection, they’d already sprinted over, pulled out a kit, and started giving Narcan,” he said. “Not only were they excited and ready to help and empowered to be able to do so, but when that opportunity finally came for them, they ran at it.”

As evening fell, the dying slowed. Behind closed doors, away from passersby armed with naloxone, however, it wasn’t through yet. A woman staying at a motel on Oltorf woke up during the night and called her 61-year-old husband, only to hear his phone ringing in the bathroom, then find him lying on the floor. The partner of a 57-year-old man got out of bed to get him warm milk after she noticed his nose bleeding, but, when she came back, he wasn’t breathing. A 36-year-old parked his truck in a lot in north Austin; when a security guard called 911 hours later, he was already dead. Around midnight, a son found his 63-year-old father deceased in an Oltorf apartment.

Later that same Tuesday, Loretta was released from the hospital. Downtown again, she found out her boyfriend had also survived and been released.

The following day, a man in southeast Austin woke up in the afternoon to find that a friend he’d let stay in his apartment had died while he slept. After agonizing for nearly two hours, he called the cops. That afternoon, a 34-year-old resident of Williamson County, just north of Austin, was found on the floor of his bedroom, where police found crack laced with fentanyl. Between April 28 and May 6, nine people in Travis County died from the toxic effects of fentanyl and cocaine, according to Travis County Medical Examiner records, in addition to the Williamson County death. At the request of APD, the Travis medical examiner withheld the cause of death in two other fatal overdoses that may have been related.

In the aftermath, APD made a handful of arrests. In some cases, police affidavits show, detectives were following information about who may have sold the tainted crack; in others, undercover officers simply went to known drug markets and arrested anyone who would sell to them. Eastlick, the APD lieutenant, said investigators believe the crack was adulterated at the local level, not higher up the drug supply chain, but that police had been unable to prove anyone intentionally sold tainted drugs. “It was a short surge … so our thinking is that it was not intentional,” he said.

As the tainted substance faded from the Austin drug supply, Cheatham said she and others heard stories of people who overdosed and were revived by naloxone without the authorities ever being alerted. In Austin’s camps and alleys, anonymous drug users helped one another.

Many of those who died remained anonymous as well, victims of an event whose details remained unclear and which took its toll mostly on the sort of people society tends to lose in its cracks.

Brauer and Chun, with the Central Presbyterian church, didn’t learn of Benjamin Arzo Gordon’s death until months afterward, when contacted for this story. In early November, the pair traveled to the indigent burial cemetery in northeast Travis County. In the wide, level graveyard, rows of nondescript markers rested flush to the ground. By Gordon’s, they left a bouquet of artificial flowers and a potted plastic plant.

“Just being able to picture him so clearly, knowing him as somebody that I value, that I enjoyed seeing, that was full of life and laughter despite the situation he was in—to hear about the way that he died of a drug overdose, probably fairly anonymously, just was incredibly sad to me,” Brauer said. “So because I didn’t get a chance to say goodbye … it just felt like something we needed to do to honor him.”

Editor’s Note: This article was produced in collaboration with Texas Community Health News and Public Health Watch. Daniel Carter contributed reporting.

Source:  https://www.texasstandard.org/stories/texas-war-on-drug-users-fentanyl-overdoses-narcan-austin/

by  Charles Hymas         Home Affairs Editor                  14 January 2025           Telegraph, London

Watchdog warns weapons and phones are being delivered to inmates with the devices, posing a threat to national security

HMP Manchester is among the prisons that have allowed basic security to fall into disrepair making it easier for gangs to access the grounds.

Drone-flying drug gangs have seized control of prison airspace in a move that threatens national security, a watchdog has warned.

Charlie Taylor, the chief inspector of prisons, said the service had “in effect ceded the airspace” to two high-security category A jails, allowing organised crime gangs to deliver drugs, phones and weapons to inmates who included organised crime bosses and terrorists.

He said HMP Long Lartin, in Worcestershire, and HMP Manchester had thriving illicit economies of drugs, mobile phones and weapons because basic security measures such as protective netting and CCTV had been allowed to fall into disrepair.

At Manchester, almost four in 10 (39 per cent) of prisoners had tested positive in mandatory drug tests. Half of inmates at Long Lartin, one of Britain’s top security jails, told inspectors it was easy to get drugs and alcohol. Some 27.2 per cent had tested positive for drugs.

Long Lartin has housed some of Britain’s most notorious prisoners, including hate preachers Abu Qatada and Abu Hamza. Among those currently being there are Jordan McSweeney, the murderer of law graduate Zara Aleena, and serial killer Steve Wright, jailed for life for the murder of five women in Ipswich in 2016. Mr Taylor said violence and self-harm at both jails had increased, in part driven by drugs and the accompanying debt prisoners found themselves in.

There had been six self-inflicted deaths at Manchester since 2021, with a seventh taking place a few weeks after the inspectors’ visit.

At Long Lartin, violence had increased by about 50 per cent since the last inspection in 2022. It was higher than at other category A jails, with more than 200 assaults on staff or prisoners in the last year. Forty per cent of prisoners said they felt unsafe.

“It is highly alarming that the police and prison service have, in effect, ceded the airspace above two high-security prisons to organised crime gangs which are able to deliver contraband to jails holding extremely dangerous prisoners including some who have been designated as high-risk category A,” he said. “The safety of staff, prisoners and ultimately that of the public, is seriously compromised by the failure to tackle what has become a threat to national security.

“The prison service, the police and other security services must urgently confront organised gang activity and reduce the supply of drugs and other illicit items which so clearly undermine every aspect of prison life.”

Charlie Taylor said violence and self harm had increased inside the prisons in part due to the rise of drug use and associated debt.

The scale of the problem at HMP Manchester, previously known as Strangeways, included inmates burning holes in windows to receive drone deliveries which prompted Mr Taylor to last year tell the Justice Secretary to put the prison into emergency measures.

The latest warning comes after Mr Taylor likened high-security jail HMP Garth in Lancashire to an “airport” because there were so many drones flying in drugs.

A report from Independent Monitoring Boards (IMB) – made up of volunteers tasked by ministers with scrutinising conditions in custody – into “crumbling” jails in England and Wales said delays in fixing broken prison windows were making it easier for drones to be used to deliver drugs and weapons. In December, MPs heard contraband was being taken into HMP Parc in South Wales in “children’s nappies”, while there were “industrial specification drone drops being organised by organised crime gangs”.

Source:  https://www.telegraph.co.uk/news/2025/01/14/drone-flying-drug-gangs-seize-control-of-prison-airspace/

by Nora Volkow, Director, NIDA – January 14, 2025

Dr. Nora Volkow outlines a new roadmap for cannabis and cannabis policy research. In this uncertain and rapidly changing landscape, Dr. Volkow emphasizes that research on cannabis and cannabis policy is badly needed to guide individual and public health decision-making.

The greatly increased availability of cannabis over the last two decades has outpaced our understanding of the public-health impacts of the drug. It is now available for medical purposes in most states, and adults may now purchase it for recreational use in nearly half the states. With greater availability has come decreased public perception of harm, as well as increased use.

In this uncertain and rapidly changing landscape, research on cannabis and cannabis policy is badly needed to guide individual and public health decision-making.

The National Survey on Drug Use and Health reported that between 2012 and 2019, past-year use of cannabis among people 12 and older rose from 11 percent to over 17 percent, and although trend comparisons aren’t possible because of changes in the survey’s methodology, in 2022, nearly 22 percent of people had used the drug in the past year. Very steep increases are also being seen in the number of people 65 and older who use cannabis.

At the same time, the cannabis industry is producing an ever-wider array of products with varying and sometimes very high concentrations of delta-9-tetrahydrocannabinol (THC) Greater harms from cannabis use are associated with regular consumption of high-THC doses. And there is a cornucopia of other intoxicating products available to the public, some containing other cannabinoids about which we still know very little.

To create a roadmap for research in this space, NIDA along with the National Center for Complementary and Integrative Health (NCCIH), the National Cancer Institute (NCI), and the Centers for Disease Control and Prevention (CDC), sponsored an independent consensus study by the National Academies of Sciences, Engineering, and Medicine (NASEM). The study resulted in a comprehensive report, Public Health Consequences of Changes in the Cannabis Policy Landscape, that was published in September.

The report describes in detail the different regulatory frameworks that exist in different states, and it draws on prior research to identify policies that are likeliest to have the greatest impact protecting public health. Those include approaches like restrictions on retail sales, pricing, and marketing; putting limits or caps on THC content in products; and laws about cannabis-impaired driving. They also could include different forms of taxation and even state monopolies. While state monopolies have not yet been tried with cannabis, they have proven effective at reducing the public health impacts of alcohol.

But the report also underscores that few conclusions can yet be drawn about the impacts of legalization or the different ways it been implemented. It is clear that people are consuming cannabis more and in a wider variety of ways, and there is some evidence of increases in emergency department visits due to accidental ingestion, car accidents, psychotic reactions, and a condition of repeated and severe vomiting (hyperemesis syndrome). But we are hindered in our further understanding because policy details vary so much between states and because data are collected and reported in so many different ways, making interpretation difficult.

Consequently, the report enumerates recommendations for research that should be conducted by federal, state, and tribal agencies to provide greater clarity and inform policy, including several domains within the purview of the NIH.

The report underscores the need for more detailed information on health and safety outcomes associated with specific policy frameworks. This includes more data on outcomes associated with different regulations for how cannabis products are sold and marketed, whether they can be used in public spaces, and whether more restrictive rules about how cannabis can be sold, such as those existing in other countries like Uruguay, are associated with improved health and safety outcomes. Many states have developed approaches to promote health and social equity, including programs to expunge or seal records of cannabis offenses and preferential licensing for individuals or groups most adversely impacted by the disparities in criminal penalties, but whether these programs will achieve their intended goals also requires careful evaluation.

Finally, more research is needed on the health effects of cannabis use by specific groups like youth, pregnant women, older adults, and veterans, and on its effects in individuals with various medical conditions for which medicinal cannabis might be used. Studies are also needed on health effects of the high-potency and synthetic or semi-synthetic cannabinoid products that are emerging. But the authors underscore that the focus cannot solely be that of risks—it must also include research on potential benefits of cannabis in managing some chronic mental or physical health conditions as well as interactions with prescription drugs that patients may already be taking to manage their health issues.

Much of this research will require or benefit from better surveillance of cannabis cultivation, product sales, and patterns of use. Existing surveillance, as the report points out, has suffered from a lack of funding and coordination, producing gaps in our knowledge. There is also a need for better tests for detecting cannabis impairment. Unlike alcohol, THC remains in the body long after its psychoactive effects have worn off. So, unlike commonly used alcohol sobriety tests, blood tests for cannabis that are currently widely used in law enforcement and employment screening cannot distinguish between recent or past use. Better surveillance and improved tests can inform research on interventions to mitigate risks to health and safety associated with cannabis use. They can also help inform the development of cannabis product safety and quality standards.

Some of the pressing questions identified by the NASEM report are already research priority areas for NIDA. For instance, our medicinal cannabis registry, which was funded starting in 2023, will be able to inform research, policy, and practice by gathering longitudinal data about cannabis use and outcomes from a cohort of people using the drug medicinally. The project will include a program to test the composition and potency of cannabis products used and will integrate registry data with other data sources.

The NIDA-funded Monitoring the Future survey has tracked nationwide cannabis use trends in adolescents and young adults for decades. The survey has recently recorded reduction in teenage use of substances in general, including cannabis, and recent surveys have also shown increases in disapproval of cannabis use and perception of its harms in this age group. However, it continues to show that cannabis is one of the most-used drugs by teenagers, with a quarter of 12th graders reporting use in the past year.

Since its launch nearly a decade ago, the trans-NIH Adolescent Brain Cognitive Development (ABCD) study has been collecting longitudinal data on drug use and its developmental impacts in a large national cohort from late childhood through early adulthood. More recently, ABCD has been complemented by a similar study on the first decade of life, the multi-Institute Healthy Brain and Child Development (HBCD) study. HBCD is recruiting a cohort of pregnant participants across the country and will use neuroimaging and other tools to track the impacts of prenatal exposure to cannabis and other environmental influences on the developing brain. By identifying risk and resilience factors for cannabis use in youth, the data from ABCD and HBCD will be extremely valuable in informing prevention programs in these age groups.

Advances in cannabis and cannabis policy research could be aided by wider adoption of the standard 5mg unit of THC required in research studies funded by NIDA and other NIH Institutes. Adoption of this standard was based on the need for consistency across research studies, which will facilitate more real-world-relevant research and translation of findings into policy and clinical practice. Research using this standard could also provide better insights into the effects of cumulative exposure and long-term developmental and cognitive effects of prenatal exposure.

Scientific research should always drive best practices in public health. To that end, NIDA and other NIH institutes will continue to support essential research on cannabis, the health effects of new products, and the effects of policy changes around this drug. It is essential to ensure that, where they are legal, product contents are accurately represented to the consumer in an environment where public health takes precedence over profits.

Source:  https://nida.nih.gov/about-nida/noras-blog/2025/01/new-roadmap-cannabis-cannabis-policy-research

by Kenneth Griffin, Professor, Department of Global and Community Health,

New research from Professor  Kenneth Griffin shows that the  Virtual Reality (VR) program helps students handle complex social situations. This success has led to a new research grant to continue the study.

Health-risk behaviors such as binge drinking, drug use, and violence are common among college students. These issues are especially prevalent among first-year students living away from their families for the first time. According to the American Addiction Centers, nearly half of all college students would qualify for at least one substance use disorder.

A pilot and feasibility study by Kenneth W. Griffin and colleagues found that using VR technology to prevent substance misuse and violence is both feasible and engaging. 100% of participants agreed that the program could be implemented on college campuses.

“VR for reducing adolescent risk behaviors is an emerging area of research, focusing mostly on developing VR modules that are appealing and feasible,” Griffin explains. “This study is novel in that it examines the viability of VR technology to provide virtual role-play and skills practice opportunities to supplement an existing evidence-based drug and violence prevention approach.”

VR has been shown to help treat mental health conditions like anxiety, phobias, and PTSD. Griffin and colleagues are testing whether this technology can effectively prevent substance misuse and violence.

In the pilot study, researchers developed a series of VR modules that put users in different virtual social situations. For example, participants might witness someone being drugged at a party or see a classmate cheating. In choosing the best response for each situation, they practice cognitive-behavioral skills for preventing risk behaviors with their virtual peers. These skills may include assertive communication, negotiation, compromise, conflict resolution, or bystander intervention strategies. The VR sessions supplemented online e-learning modules lessons based on the LifeSkills Training program.

Before and after the training, participants took the same assessment. Results showed improved decision-making and stronger anti-violence attitudes.

Due to the program’s success, the research team secured additional grant funding from the CDC’s National Center for Injury Prevention and Control. Griffin emphasizes the need for more research. “While VR may be a useful tool for reducing youth health risk behaviors, more rigorous controlled trials are needed to determine whether VR technologies can produce behavioral outcomes and the duration of these effects. The new funding will allow us to conduct a rigorous test of this innovative technology for preventing substance misuse and violence among university students.” Griffin says.

The study dovetails with the College of Public Health’s commitment to harnessing the power of immersive technologies to improve health and health education. The College is home to the Center for Immersive Technologies and Simulation. There, students are trained to use VR in nursing, social work, health administration, and public health. Griffin’s study was not conducted in this Center.

“Using virtual reality technology to prevent substance misuse and violence among university students: A pilot and feasibility study” was published in Health Informatics Journal in October 2024. The study was funded by the Centers for Disease Control and Prevention’s National Center for Injury Prevention and Control and developed in collaboration with National Health Promotion Associates (NHPA), a research and development company that developed and markets the LifeSkills Training program. Griffin, a former employee and current consultant with NHPA, worked closely with the team in this pilot and feasibility study of the VR modules.

Additional authors, all from NHPA, include: Gilbert J. Botvin, Weill Cornell Medical College; Christopher Williams, Purchase College, State University of New York; Sandra M. Sousa.

Source:  https://publichealth.gmu.edu/news/2025-01/virtual-reality-pilot-program-shows-promise-preventing-substance-misuse-and-violence

by researchers Joaquín Rodríguez-Ruiz and Raquel Espejo Siles – University of Córdoba – 14-Jan-2025

A team at the University of Cordoba analyzed more than 8,000 scientific papers on substance use and adolescence to look for the factors that protect adolescents from using them when they are encouraged to do so by those in their social circles, issuing a call for prevention policies to be updated to include vaping and social media

According to the Health Ministry’s Survey on Drug Use in Secondary Education in Spain (ESTUDES 2023), the average at which young people begin to consume alcohol is 13.9 years of age; tobacco, 14.1; and cannabis, 14.9. One of the risk factors for substance use is the influence of those who are already using, and who share common characteristics, among young people’s social peers or equals, with these including classmates and others friends.

Not all young people, however, decide to take these substances, so the question arises of what factors protect an adolescent from using substances when others around them are. This question was also posed by Raquel Espejo Siles and Joaquín Rodríguez-Ruiz at the University of Cordoba’s Coexistence and Violence Prevention Studies Lab (LAECOVI), proving that, although there is a great variety of protective factors (including individual, family and school ones), there are, in fact, two aspects that should guide prevention policies: age and type of substance.

Espejo and Rodríguez-Ruiz confirmed this after a bibliographic analysis that began with more than 8,000 research articles, reduced to 50 after discarding those that did not meet the inclusion criteria set down in the systematic review. Based on all this scientific evidence, they  concluded that age is essential, since an adolescent does not relate to substances in the same way at age 10 as they do at age 17, for example. Family or school factors, such as parental supervision and feelings of attachment to one’s school, protect against substance use in early adolescence, but they lose their influence and cease to do so as the years go by.

“As adolescence progresses and peers become more influential, prevention strategies should place more emphasis on peer culture. As of the age of 16, when their development is more advanced, they can address individual issues such as promoting self-control and responsible decision-making,” Rodríguez-Ruiz added.

Similarly, the type of substance must also be taken into account. According to all the studies analyzed, an individual factor like assertiveness is not effective against the separate consumption of alcohol, tobacco, or cannabis, but it does protect against polyconsumption.

In addition to taking into account the substance, and age, prevention strategies should also be updated taking into account vaping and the influence of social media. As Espejo Siles explains: “we are dealing with a changing phenomenon, with new forms of consumption and new ways in which adolescents relate to each other”.

Published in the journal Adolescent Research Review, the study also delves into the need for studies to unify their criteria (such as defining adolescence in the same way) and to expand their geographical diversity, since most are based on  American culture.

Source:  https://www.eurekalert.org/news-releases/1070392

President, Foundation for Drug Policy Solutions
Trump Selects Robert F. Kennedy Jr. To Head of Health and Human Services

Prevention is key, and we cannot forget that today’s marijuana is highly potent. In 2025 and beyond, federal agencies must prioritize public health and safety and work to undo legalization’s harmful consequences.

The Department of Health and Human Services (HHS) is positioned to implement a wide range of policy initiatives to prevent marijuana use and hold the industry accountable. For example, marijuana legalization has re-elevated the conversation about second-hand smoke. California recently passed a law permitting “cannabis cafes” in which users can openly smoke marijuana. Second-hand marijuana smoke has been found to be more harmful than second-hand tobacco smoke and contains many of the same cancer-causing substances. Our country has legally and culturally rejected indoor cigarette smoking. HHS must stand on science and reject indoor marijuana smoking by publishing strict guidelines prohibiting it, just as it did with indoor cigarette smoking.

Transparency within the “medical” marijuana industry is also desperately needed. As it did with opioids, HHS should create a registry of medical marijuana recommendation practices and make the information available to the public. The database could include information regarding regional breakdowns, a list of overprescribing doctors, and pot-industry kickbacks received by doctors.

Sunlight is the best disinfectant when it comes to quack doctors. In August, a Spotlight PA article uncovered Pennsylvania medical pot doctors who were doling out thousands of medical marijuana cards per year. These are similar to the “pill mills” that fueled the opioid epidemic.

Last year, the Food and Drug Administration (FDA) bucked federal legal precedent around marijuana rescheduling by inventing new, lower standards. Its flawed marijuana rescheduling review was designed to permit marijuana rescheduling. The ramifications of changing this precedent aren’t limited to marijuana; other dangerous drugs (e.g., psychedelics) could be reclassified to a lower schedule based on the new lax standards. HHS should issue internal agency guidance that advises FDA to adhere to the established five-factor test for determining currently accepted medical use. This will ensure that drug scheduling, which has direct implications for the availability of drugs, remains science based.

The Trump-Vance administration must soundly reject moving marijuana from Schedule I to Schedule III for one simple reason: marijuana fails to meet the legal definition of a Schedule III drug. It has not been approved by the FDA for the treatment of any disease or condition. Moving marijuana to Schedule III is a handout to corporations, as it would allow companies to deduct advertising and other expenses from their taxes, fueling the growth of an industry that profits from addiction.

Far from being a legitimate medicine, marijuana is harming the millions of Americans who misuse it. Given that 3 in 10 users develop a marijuana use disorder, better known as addiction to marijuana, the incoming administration needs to focus on helping connect Americans to treatment.

Federal law enforcement also plays a crucial role in curbing marijuana legalization and its effects. In 2013, the Obama administration issued the Cole Memo, a document that cemented the federal government’s non-enforcement policy on marijuana. The first Trump administration rescinded the memo, but more must be done to enforce federal laws already on the books. The Justice Department has the power to prevent distribution to minors, curtail drugged driving, and investigate state-legal dispensaries being used as a cover for illegal drug trafficking—all things the Obama administration promised to do. By beginning with this targeted enforcement strategy, law enforcement can shut down the operations of the industry’s worst actors.

To promote public safety, the Trump-Vance administration should also crack down on illegal marijuana grows, particularly those in remote areas on federal lands. These operations are often controlled by cartels and poison the surrounding natural environment with toxic chemicals.

We also need a new national anti-drug media campaign, updated for the 21st century. This campaign must broadcast messages widely through traditional and social media and talk about the dangers and truth behind the use of drugs. The Office of National Drug Control Policy (ONDCP), the drug policy office within the White House, has a key role to play, too, particularly in drug use prevention. ONDCP helps oversee the Drug-Free Communities Support Program, which is responsible for much of our federally funded drug prevention work. In an era in which drugs are sold and marketed via social media, it’s more important than ever that effective anti-drug prevention messages reach young people. ONDCP also oversees the High Intensity Drug Trafficking Areas program, which forms a crucial partnership between local, state, and federal law enforcement to curtail drug trafficking. Both these programs’ funding should be protected and prioritized.

A good strategy must focus on all drugs, but we can’t ignore the politically inconvenient ones. If President Trump wants to make America healthy again, the conversation must include marijuana, a drug with an addiction rate of up to 30 percent that is being pushed by a profit-driven industry that desperately needs federal accountability.

Dr. Kevin Sabet is the President of Smart Approaches to Marijuana (SAM) and the Foundation for Drug Policy Solutions (FDPS) and a former White House drug policy advisor to Presidents Obama, Bush and Clinton.

SOURCE:  https://www.newsweek.com/making-america-healthy-again-must-start-better-drug-policy-opinion-2014657

Nora’s Blog  January 8, 2025 – By Dr. Nora Volkow
This past year, NIDA commemorated its 50th anniversary, which made me reflect on how far addiction science has come in a half century—from the barest beginnings of an understanding of how drugs work in the brain, and only a few treatment and prevention tools, to a robustly developed science and multiple opportunities to translate that science into clinical practice. Yet the challenges we face around drug use and addiction have never been greater, with annual deaths from overdose that have vastly exceeded anything seen in previous eras and the proliferation of increasingly more potent addictive drugs.

Our 50th year brought hope, as we finally saw evidence of a sustained downturn in drug overdose deaths. From July 2023 to July 2024, the number of fatal overdoses dropped nearly 17 percent, from over 113,000 to 94,000. We still don’t know all the factors contributing to this reversal, so investigating the drivers of this decline will be crucial for sustaining and accelerating the downturn. We also need to recognize that the decline is not homogenous across populations: Black and American Indian/Alaskan Native persons continue to die at increased rates. And 94,000 people dying of overdose in a year is still 94,000 too many.

As we begin a new year, I see four major areas deserving special focus for our efforts: preventing drug use and addiction, preventing overdose, increasing access to effective addiction treatments, and leveraging new technologies to help advance substance use disorder (SUD) treatment and the science of drug use and addiction.

Preventing drug use and addiction

The brain undergoes continuous development from the prenatal period through young adulthood, and substance exposures and myriad other environmental exposures can influence that development. Prenatal drug exposure can lead to learning and behavioral difficulties and raise the risk of later substance use. Adverse childhood experiences, including neglect, abuse, and the impacts of poverty, as well as childhood mental disorders, can negatively impact brain development in ways that make an individual more vulnerable for drug use and addiction. Early drug experimentation in adolescence is also associated with greater risk of developing an SUD.

Early intervention in emerging psychiatric disorders as well as prevention interventions aimed at decreasing risk factors and enhancing protective factors can reduce initiation of drug use and improve a host of mental health outcomes. Research on prevention interventions has shown that mitigating the impact of socioeconomic disadvantage counteracts the effects of poverty on brain development,1 and some studies have even documented evidence of intergenerational benefits, improving outcomes for the children of the children who received the intervention.2 Studies have also shown them to be enormously cost-effective by reducing later costs to healthcare and other services, providing health and economic benefits to communities that put them in place.3

Yet, in the United States, efforts to prevent substance use have been largely fragmented, and the infrastructure and funding required to bring effective programs to scale is lacking. What kinds of policy innovations could we put into place to ensure that everyone who could benefit from evidence-based prevention services has access to them, whether through school, healthcare, justice, or community settings?  NIDA, along with other NIH Institutes, the Centers for Disease Control and Prevention, and the Substance Abuse and Mental Health Services Administration, have charged the National Academy of Sciences, Engineering, and Medicine with creating an actionable blueprint for supporting the implementation of prevention interventions that promote behavioral health. The report is due out early this year and has the potential for tremendous public health impact.4

Preventing overdose

We also need to continue research toward mitigating fatal overdoses. Comprehensive data on overdose reversals do not currently exist, but recipients of SAMHSA State Opioid Response grants alone reported more than 92 thousand overdose reversals with naloxone in the year ending March 31, 2023, and this is likely just a small fraction of the lives saved. We do not yet know the extent to which greater use of naloxone has played a role in the recent declines in overdose fatalities, but this medication, the first intranasal formulation of which was developed by NIDA in partnership with Adapt Pharma, is a real public health success.

NIDA is supporting research to evaluate approaches to naloxone distribution, for instance through mobile vans and peer-run community services that also provide sterile injection equipment to prevent HIV and HCV transmission. We are also supporting research on new approaches to reversing drug overdoses, such as wearable devices that would auto-inject naloxone when an overdose is detected and electrical stimulation of the phrenic nerve to restore breathing, a method already used in resuscitation devices.5 We are also supporting research on compounds that could potentially reverse methamphetamine overdoses, such as monoclonal antibodies and molecules called sequestrants that bind and encapsulate methamphetamine in the body.6

Improving access to addiction treatment

In 2023, only 14.6 percent of people with an SUD received treatment, and only 18 percent of people with an opioid use disorder (OUD) received medication.7 Stigma, along with inadequate coverage of addiction treatment by both public and private insurers, contributes to this gap. To fix this will require partnering with payors to develop and evaluate new models for incentivizing the provision of evidence-based SUD care.

Increased access to methadone is a particularly high priority in the era of fentanyl and other potent synthetic opioids. Results from a recent study in British Columbia showed that risk of leaving treatment was lower for methadone than for buprenorphine. Risk of dying was similarly low for both groups.8 Currently in the United States, methadone is only available from specialized opioid treatment centers, but studies piloting access through pharmacies have shown promise.

OUD medications also need to be accessible to people with SUD in jails and prisons. Research conducted in justice settings has shown that providing access to all three FDA-approved medications for OUD during incarceration reduced fatal overdose risk after release by nearly 32 percent.9 Access to buprenorphine during incarceration was also associated with a 32 percent reduction in recidivism risk.10 Through NIDA’s  Justice Community Overdose Innovation Network (JCOIN), we continue to promote research into innovative models and strategies for integrating medications for OUD in justice settings.

I am also hopeful that we will soon see increased utilization of contingency management for treating stimulant use disorders. Providing incentives for treatment participation and negative drug tests is the most effective treatment we have for methamphetamine and cocaine addictions, but implementation has been hindered by regulatory ambiguities around caps on the dollar value of those incentives. However, demonstration projects underway in four states (California, Washington, Montana, and Delaware) are implementing contingency management with higher incentives and could further bolster evidence for the effectiveness—including cost effectiveness—of this approach.

Leveraging new treatments and technologies

There are many promising new technologies that could transform the treatment of addiction, including central and peripheral neuromodulation approaches. Transcranial magnetic stimulation (TMS) was already approved by the FDA as an adjunct treatment for smoking cessation and peripheral auricular nerve stimulation was approved for the treatment of acute opioid withdrawal. TMS, transcranial direct current stimulation (tDCS), and peripheral vagal nerve stimulation are under investigation for treating other SUDs. Low-intensity focused ultrasound—a non-invasive method that can reach targets deep in the brain—is also showing promise for the treatment of SUD. NIDA is currently funding clinical trials to determine its safety and preliminary efficacy for treating cocaine use disorder11 and OUD with or without co-occurring pain.12 

Advances in pharmacology have helped identify multiple new targets for treating addiction that are not limited to a specific SUDs like OUD. Instead, these targets aim to modulate brain circuits that are common across addictions; they include among many others D3 receptor partial agonists/antagonists, orexin antagonists and glucagon-like peptide 1 (GLP-1) agonists. The latter are particularly promising, as these types of drugs, including semaglutide and tirzepatide, are already being used for the treatment of diabetes and obesity.

Anecdotally, patients taking GLP-1 agonists report less interest in drinking, smoking, or consuming other drugs. Recent studies based on electronic health records have revealed that people with SUDs taking GLP-1 medications to treat their obesity or diabetes had improved outcomes associated with their addiction, such as reduced incidence and recurrence of alcohol use disorder,13 reduced health consequences of smoking,14 and reduced opioid overdose risk.15 NIDA is currently funding randomized clinical studies to assess the efficacy of GLP-1 agonists for the treatment of opioid and stimulant use disorders and for smoking cessation.

Creation of large data sources and repositories in parallel with advances in computation and analytical modeling including AI are helping in the design of new therapeutics based on the 3D molecular structure of addictive drugs and the receptors they interact with.16 NIDA-funded researchers have published studies showing that AI could be used to provide more timely, comprehensive data on overdose, such as by using social-media to predict overdose deaths.17 It could be used to enable higher-resolution analyses in basic neuroscience research18 and facilitate studies using large data sources like electronic health records.19 AI is also being used to support delivery of behavioral therapies and relapse prevention in virtual chatbots and is being studied in wearable devices. Although there is much work to be done to ensure that AI is deployed safely and ethically, particularly in clinical settings, this technology has considerable potential to enhance and expand access to care.

AI will also be transformative for analyzing big data sets like those being generated by the Adolescent Brain Cognitive DevelopmentSM (ABCD) Study and HEALthy Brain and Child Development Study. These landmark NIH-funded studies are gathering vast quantities of neuroimaging, biometric, psychometric, and other data across the first two decades of life. They will be able to answer important questions about the impacts of drugs and other environmental exposures on the developing brain, inform prevention and treatment interventions, and establish a valuable—and unprecedented—baseline of neurodevelopment that will be a crucial resource in pediatric neurology.

The field of addiction science has progressed at a breathtaking pace. These advances could not have been made without the commitment of an interconnected community of people. Researchers, clinicians, policymakers, community groups, and people living with SUDs and the families that support them all play a role in collaboratively finding solutions to some of the most challenging questions in substance use and addiction research. Together, we turn our eye to 2025 and the challenges and opportunities ahead.

 

Contemporary issues on drugs

As well as providing an in-depth analysis of key developments and emerging trends in selected drug markets, the Contemporary issues on drugs booklet looks at several other developments of policy relevance. The booklet opens with a look at the 2022 Taliban ban on the cultivation and production of and trafficking in drugs in Afghanistan and its implications both within the country and in transit and destination markets elsewhere. This is followed by a chapter examining the convergence of drug trafficking and other activities and how they affect natural ecosystems and communities in the Golden Triangle in South-East Asia. The chapter also assesses the extent to which drug production and trafficking are linked with other illicit economies that challenge the rule of law and fuel conflict. Another chapter analyses how the dynamics of demand for and supply of synthetic drugs vary when the gender and age of market participants are considered. The booklet continues with an update on regulatory approaches to and the impact of legalization on the non-medical cannabis market in different countries, and a review of the enabling environment that provides broad access to the unsupervised, “quasi-therapeutic” and non-medical use of psychedelic substances. Finally, the booklet offers a multi-dimensional framework on the right to health in the context of drug use; these dimensions include availability, accessibility, acceptability, quality, non-discrimination, non-stigmatization and participation.

 

Key findings and conclusions

The Key findings and conclusions booklet provides an overview of selected findings from the analysis presented in the Drug market patterns and trends module and the thematic Contemporary issues on drugs booklet, while the Special points of interest fascicle offers a framework for the main takeaways and policy implications that can be drawn from those findings.

Sources:

Issues:  https://www.unodc.org/unodc/en/data-and-analysis/wdr2024-contemporary-issues.html

Findings and Conclusions: https://www.unodc.org/unodc/en/data-and-analysis/wdr2024-key-findings-conclusions.html

  by DFAF.org

 

The Colombo Plan has issued a health alert regarding the growing global threat posed by Benzimidazole (Nitazene) opioids. These highly potent synthetic compounds, which far exceed the strength of fentanyl, are driving significant increases in overdose deaths and public health crises across multiple regions.

 

Nitazene tablets containing 29 mg of metonitazene (equivalent to containing 145 times the lethal dose of fentanyl) heading to Florida, Connecticut, and Brazil were seized from international express mail. Public health and safety officials are urged to remain vigilant against this emerging danger.

 

Hear from Thom Browne, CEO of the Colombo Plan, as he addresses this emerging threat during his session at the upcoming National Prevention Summit. This discussion is especially pertinent for Florida. Click here to register for the conference to stay informed and be part of the solution.

 

Key Insights:

·    Potency and Risk: Nitazenes, also known as Benzimidazoles, are synthetic opioids estimated to be 1.5–20 times more potent than fentanyl. A single tablet seized in 2023 contained metonitazene levels equivalent to 290 mg of fentanyl — 145 times the estimated fatal dose.

·    Global Spread: Reports from North America, Brazil, Europe, Australia, New Zealand, and West Africa reveal a sharp rise in nitazene-related deaths.

·    Distribution and Adulteration: Nitazenes are typically found in tablet or powder form, often mixed with fentanyl, other synthetic drugs, or designer benzodiazepines like Bromazolam, further compounding the risks.

·    Sample Testing: U.S. Crime Lab data shows 2.6% of analyzed cases (55 exhibits) contained 19 or more substances in addition to the principal nitazene compound.

·    Adverse Effects: Like other synthetic opioids, nitazenes cause profound sedation and respiratory depression, often leading to fatal overdoses.

 

Naloxone and Treatment:

Naloxone remains effective in reversing nitazene overdoses but may require multiple doses due to the drug’s extreme potency.

 

Emerging Analogs:

Since 2019, a range of nitazene analogs has surfaced in the U.S., including metonitazene, isotonitazene, protonitazene, and N-pyrrolidino protonitazene. The NPS Discovery program at CFSRE tracks these trends quarterly, with protonitazene, metonitazene, and N-pyrrolidino protonitazene among the most common in late 2024.

 

Call to Action:

Stakeholders must collaborate to monitor, educate, and implement strategies to mitigate the escalating threat of nitazenes. Effective policy, public awareness, and access to life-saving tools like naloxone are critical in addressing this public health emergency, as the spread of these synthetic opioids could significantly worsen the opioid epidemic or spark new outbreaks in unsuspecting countries and regions.

Source: https://www.dfaf.org/

 

by Miles Martin – 

A recent study analyzing data from the National Survey on Drug Use and Health (NSDUH) found that past-year recreational ketamine use among adults has increased dramatically since 2015, including significant shifts in associations with depression and sociodemographic characteristics such as race, age and education status. Ketamine use has shown promise in clinical trials therapy for several mental illnesses, including treatment-resistant depression, and the new research suggests that ongoing monitoring of recreational use trends is crucial to balancing these clinical benefits against the risk of unmonitored recreational use.

Key findings include:

  • Overall past-year recreational ketamine use increased by 81.8% from 2015 to 2019 and by 40% from 2021 to 2022.
  • Adults with depression were 80% more likely to have used ketamine in the past year in 2015-2019, but this association weakened in later years. In 2021-2022, ketamine use increased only among those without depression.
  • In 2021-2022, adults aged 26-34 were 66% more likely to have used ketamine in the past year compared to adults aged 18-25. Those with college degrees were more than twice as likely to have used ketamine compared to people with a high school education or less.
  • People were more likely to use ketamine if they used other substances, such as  ecstasy/MDMA, GHB, and cocaine.

The researchers recommend expanding prevention outreach to settings like colleges, where younger adults may be at heightened risk, as well as providing education on the harms of polydrug use, particularly in combination with opioids. As medical ketamine becomes more widely available, they also emphasize the need for continued surveillance of recreational ketamine use patterns and further research to understand the factors that contribute to ketamine use.

The study, published online in the Journal of Affective Disorders, was led by Kevin Yang, M.D., a third-year resident physician in the Department of Psychiatry at UC San Diego School of Medicine. The research was supported by the National Institute on Drug Abuse of the National Institutes of Health.

Source: https://today.ucsd.edu/story/ketamine-use-on-the-rise-in-u.s-adults-new-trends-emerge

Maia Davies, BBC News, Published 7 January 2025

Ketamine could be upgraded to a Class A drug as the government seeks expert advice on its classification, the Home Office has said.

Illegal use of the drug has reached record levels in recent years, with an estimated 269,000 people aged 16-59 reporting ketamine use in the year ending March 2024.

Increasing ketamine’s classification would bring it in line with drugs including cocaine, heroin and ecstasy (MDMA) and mean up to life in prison for supply and production.

The policing minister will ask the Advisory Council on the Misuse of Drugs whether its classification should be changed and “carefully consider” its findings.

Ketamine can cause serious health problems including irreversible damage to the bladder and kidneys.

It is also one of the most detected drugs in incidents of spiking.

While commonly used on animals and in healthcare settings, ketamine is also thought of as a party drug due to its hallucinogenic effects.

An estimated 299,000 people aged 16-59 reported ketamine use in the year ending March 2023 – the highest on record.

Ketamine was upgraded from a Class C substance in 2014 due to mounting evidence over its physical and psychological dangers.

Currently, the maximum penalty for producing and supplying ketamine is up to 14 years in prison. Possession can carry up to five years in prison, an unlimited fine, or both.

Should it be upgraded to a Class A drug, supply and production of it could carry up to life in prison,, external while possession could carry up to seven years in prison, an unlimited fine, or both.

A coroner’s prevention of future deaths report called for action over the drug’s classification, after a man died from sepsis caused by a kidney infection that was “a complication of long-term use of ketamine”.

Greater Manchester South senior coroner Alison Mutch noted that James Boland, 38, started taking the drug as he believed it to be “less harmful” than Class A drugs.

She wrote , externalin November: “Maintaining its classification as a Class B drug was likely to encourage others to start to use it or continue to use it under the false impression it is “safer”.”

Policing minister Dame Diana Johnson has pledged to “work across health, policing and wider public services to drive down drug use and stop those who profit from its supply.

“It is vital we are responding to all the latest evidence and advice to ensure people’s safety and we will carefully consider the ACMD’s recommendations before making any decision.”

Source: https://www.bbc.co.uk/news/articles/cp8306prgy6o

Irish teenagers whose friends use cannabis are 10 times more likely to consume the drug themselves, according to the findings of new research.

The study by researchers found that 7.3 per cent of students aged 15-16 had used cannabis within the previous 30 days with no significant difference in use of the drug between males and females.

It also highlighted how teenagers who felt it was necessary to use cannabis to fit in with their friends were almost twice as likely to use the drug compared to those who did not feel peer pressure to use cannabis.

Teenagers who believed their parents would be ambivalent towards their use of cannabis were also almost four times more likely to be current users of the drug than those students who thought their parents were strongly against cannabis use.

The findings are based on the responses by over 4,400 students in fourth and fifth year to a questionnaire issued as part of the Planet Youth survey carried out in late 2021.

The respondents were based across 40 schools in north Dublin, Cavan and Monaghan.

The study highlighted how current cannabis users among such an age group were significantly more likely to also be consuming alcohol, smoking or vaping.

It also reveals that low parental supervision was significantly associated with higher odds of current cannabis use.

The authors of the study, whose findings are published in the Irish Journal of Psychological Medicine, said its rationale was to examine individual, familial, peer, school and community factors associated with cannabis use by adolescents in Ireland in order to provide measures for prevention and early intervention.

They claimed several of the risk factors identified by the research have the potential to be modified through drug prevention strategies.

The researchers noted that earlier studies had found that long-term use of cannabis has the potential to lead to addiction with one in three regular adolescent users becoming addicted to the drug, while also having the potential to exacerbate mental health issues such as psychosis.

The study observed that cannabis-related psychiatric admissions for people aged 15-34 in the Republic rose by 140 per cent between 2011 and 2017 and have remained at the same elevated level ever since.

Despite the evidence of increased health risks associated with cannabis use, the study said adolescents continue to use cannabis for a number of various factors including boredom relief, appetite increase, sleep improvements and increased social opportunities.

Other factors can include low self-esteem and insecurity or family problems.

Asked to assess their own mental health, almost three-quarters of the teenagers (72.4 per cent) who do not use cannabis said it was good or OK compared to 54.6 per cent among cannabis users.

In contrast, 45.0 per cent of cannabis users assessed their mental health as bad or very bad compared to 27.1 per cent of those who do not use the drug.

Similarly, only 16.6 per cent of cannabis users perceived the drug to be harmful, while 67.2 per cent of non-users surveyed believed it could have a negative impact on their health.

Among cannabis users, 90.4 per cent reported that their friends also use the drug compared to 29.3 per cent of students who do not use it.

One of the report’s main authors, Teresa O’Dowd, said they believed it was the first study in an Irish setting which found no significant difference in cannabis use between males and females.

Dr O’Dowd, a specialist in public health medicine with HSE North West, said the lack of association between gender and cannabis use was a notable finding as historically male gender had been noted as a risk factor for use of the drug.

She said the finding that the odds of cannabis use were higher for those who also consume alcohol, smoke and use e-cigarettes was in keeping with other research.

“The fact that adolescents are likely to engage in polysubstance use is significant and needs to be factored into any interventions targeting cannabis prevention among adolescents in Ireland,” said Dr O’Dowd.

The study also claimed there has been a cultural shift both nationally and internationally over the past decade towards legalising cannabis.

Dr O’Dowd said it had led to an attitude among many adolescents and adults that cannabis is a relatively harmless drug.

“This shift in perception regarding cannabis-related harm may impact Irish adolescents’ decision to use cannabis, as suggested by our findings,” she added.

The authors of the study said its findings had demonstrated the importance of parental attitudes to cannabis and claimed many factors including parental supervision and perception that parents are against cannabis use were “modifiable.”

They called for the public health community and policymakers to act to ensure greater awareness of cannabis harms among both teenagers and their parents.

“A tailored public health messaging campaign addressing the known harms and complications of cannabis use in young people, is urgently required,” they added.

Source: https://www.breakingnews.ie/ireland/irish-teens-whose-friends-use-cannabis-10-times-more-likely-to-consume-the-drug-themselves-1714776.html

Public News Service  – Terri Dee, Anchor/Producer  – Monday, January 6, 2025

One popular New Year’s resolution is to quit alcohol consumption.

Although easier said than done, one recovery center said there are modifications to try if previous attempts are not working. A good start is taking a hard look at what has worked and what has not.

Marissa Sauer, a licensed clinical addiction counselor at Avenues Recovery, a Fort Wayne recovery center, pointed out if there was a simple answer, everybody would use it. She added other influences are linked to alcohol and substance abuse.

“There’s genetics. Were my parents and my grandparents struggling with substances? Does someone have maybe adverse childhood experiences that have led to substances being a coping mechanism of some kind?” Sauer explained. “Maybe there are these mental health diagnoses.”

Sauer mentioned people, places, or things which could inhibit or enable someone to abuse drugs or alcohol, making it complicated to simply walk away. Medication, therapy or conversations with people who have beaten their addictions are all effective measures for recovery.

The US Surgeon General’s 2025 Advisory Report indicates alcohol consumption is the third leading preventable cause of cancer after tobacco and obesity and the public is taking notice.

There is a growing momentum of the “sober curious” movement, avoiding happy hours at bars, ordering a low or no-alcohol drinks known as mocktails, or completely abstaining from alcohol for 30 days for “dry January.” Sauer said longtime substance abusers fear change and she wants them to know there is hope.

“Whether you’re 21 or whether you’re 51, that ability to heal is there,” Sauer emphasized. “The best gift that you could give yourself for a healthy 2025 is to give your loved ones the absolute best version of yourself.”

An Indiana State Epidemiological report from 2021-2022 revealed almost 24% of residents aged 12 and older have participated in binge drinking, with the highest rate among young adults aged 18 to 25.

Source: https://www.publicnewsservice.org/2025-01-06/alcohol-and-drug-abuse-prevention/in-substance-recovery-center-supports-sober-existence/a94456-1

The Children’s Mercy Hospital psychiatrist more often hears from parents wondering if cannabis could help their child’s anxiety, autism or OCD.

“I tell them there are no studies,” said Batterson, the medical associate director of the hospital’s Division of Developmental and Behavioral Health. “A lot of hype, but no studies.”

And even if Children’s Mercy allowed its doctors to prescribe weed (it doesn’t), Batterson wouldn’t know what dose to recommend. He also couldn’t say which patient might experience a marijuana-induced psychotic episode or other serious reaction.

No one could.

Years of federal prohibition and the resulting limits on research mean the science about marijuana is skimpy at best. Public health experts say that should trigger caution in a world where legal marijuana is increasingly accessible and more widely consumed.

“There has been relatively little research on cannabis,” said Steven Teutsch, who chaired a year-long study for the National Academies of Sciences, Engineering and Medicine about the impact legal cannabis is having on public health. “Many of the benefits are often over-promoted and are iffy in many cases. And the harms are often not fully appreciated.”

Despite a well-known and largely accepted narrative that marijuana is safe and not addictive, the reality — especially when people consume greater and stronger amounts of the drug — is often different, health experts said.

Some 30% of cannabis users report having a physical dependency on the drug, according to the U.S. Centers for Disease Control and Prevention. Scientists believe the drug could hurt brain function, heart health and can lead to impaired driving. It also correlates with social anxiety, depression and schizophrenia.

The federal government, which Teutsch said has “ largely been missing in action in all of this,” needs to step in with campaigns to educate the public, with model legislation to help states regulate the drug and with research funding to study health effects — good and bad.

Marijuana rules to protect health up to the states

Marijuana is still illegal at the federal level, and classified by federal law as a Schedule I drug, defined as a highly addictive substance with no known medical use. Hearings on a proposal to reclassify it as a Schedule III drug will begin in January.

That change would remove barriers — and free more money — for research that could give doctors a better understanding of the health effects of all those gummies, pre-rolled joints and THC-spiked drinks at your neighborhood dispensary.

It also could pave the way for more drug development. To date, the U.S. Food and Drug Administration has only approved three drugs related to cannabis.

Some experts also contend that Congress needs to undo federal law adopted in 2018 that allowed hemp products containing THC (tetrahydrocannabinol), the primary psychoactive compound in cannabis, to be sold in gas stations and grocery stores, free from regulatory oversight.

Under the current system, every state with legal weed takes a different approach to the drug.

California became the first to legalize medical marijuana in 1996. And Colorado and Washington led the way in legalizing recreational pot in 2012.

In the years since, only a handful of states, including Kansas, have resisted passing some level of legalization. Missouri voters adopted a constitutional amendment allowing medical marijuana use in 2018, and one legalizing recreational weed in 2022.

The state has a responsibility, said Dr. Heidi Miller, chief medical officer for the Missouri Department of Health and Senior Services, to make sure people know the risks that come with marijuana.

“Cannabis has multiple potential therapeutic effects, but also potential adverse effects,” she said. “We need to inform the public of what we know and what we don’t know.”

Missouri has budgeted $2.5 million (less than 0.2% of what people in the state spend on weed in a year) for a public information campaign to get this message out.

Miller said the campaign, which is in early planning stages and not yet scheduled, should warn vulnerable populations — young people, pregnant or breastfeeding women and people with a personal or family history of mental illness — about the risks of getting high.

It should also alert people, she said, that the marijuana they may have smoked a few decades ago has little resemblance to the potent variety sold at dispensaries.

The stuff sold today may have four times more THC. And that doesn’t include concentrates, which can have THC levels reaching 90%.

“Clearly, the adverse effects are going to be heightened, the higher the potency,” Miller said. “We can’t assume that all cannabis is safe because it’s, quote, natural. We also want folks to understand that cannabis is potentially addictive.”

More people are using cannabis

Since sales began in Missouri four years ago, the Division of Cannabis Regulation says more than $3 billion has been spent on cannabis products in the state. In fiscal year 2024, recreational sales, referred to as “adult use,” reached $1.16 billion, while medical weed sales totaled just under $166 million.

As in other states that have legalized cannabis, use of the drug is on the rise.

Dutchie, a technology company whose software powers the payment platforms and other backend systems in dispensaries, reported that on the Wednesday before Thanksgiving — known in the industry as “Green Wednesday” — average orders in Missouri dispensaries jumped 18% above a regular Wednesday to more than $84.

The number of people using the drug, which experts said will only continue to rise, is raising alarms.

A November 2023 report from the Substance Abuse and Mental Health Services Administration found that 61.9 million Americans — 22% of those 12 and older — reported using cannabis in the past year. More than 13 million 18 to 25 year olds — 38% — said they’d used the drug. The same was true for 11.5% of 12 to 17 year olds.

As people consume marijuana more frequently and in higher doses, anecdotal stories related to health problems are becoming more common. They include reports of cannabinoid hyperemesis syndrome, a gastrointestinal condition that leads to bouts of vomiting and intense pain, and instances of cannabis-induced psychosis, a mental illness that can lead to violence and suicide.

“They didn’t legalize old school hippy weed,” said Aubree Adams, a Colorado mother whose son became psychotic after using marijuana. “We’re dealing with a really hard drug.”

Every day, Adams said, the organization she founded to educate the public about the dangers of marijuana use, receives inquiries from a handful of families across the country dealing with issues related to marijuana use.

Her organization, Every Brain Matters, is pushing for potency caps on the marijuana being sold in the United States; an end to the sale of edibles, which often look like candy; and a ban on sugary-flavored vapes.

Adams also wants it to be illegal for marijuana companies to market products as medicine that have not been approved for medical use. States need to be out front telling the public the truth, she said.

“I don’t know why we have to sugar coat things and play politics,” she said. “Tell them the truth. Tell them the science.”

Her son is 24 now. He’s come in and out of sobriety since first getting into trouble “dabbing” highly concentrated marijuana when he was 15. She believes he would be fine if he hadn’t used the drug.

“My son fights for his mental well being on a daily basis,” she said.

Adams wants other parents to know the potential risks. And she wants adolescents and young adults — who she believes are a primary target of marijuana companies — to realize what they might be getting into. Doctors say that developing brains are more vulnerable to problems

“This is not a soft drug,” she said. “This is a hard drug that can change your brain chemistry.”

Lack of federal oversight

But getting meaningful regulatory change in an industry that lacks federal oversight is difficult.

Under the current system, every state has its own set of rules about everything from how cannabis products are packaged, tested and sold to what training the budtender at your local cannabis store needs to have. States decide who can buy cannabis, how much someone can buy during a certain period and how potent weed can be.

The states also oversee what’s in the marijuana, including setting maximum levels for contaminants like heavy metals and pesticides. Missouri’s Cannabis Division established rules based on the amendments voters adopted.

The state has licensed 10 private laboratories, which marijuana producers hire to test products for compliance with state rules. Cannabis regulators also are opening a “reference laboratory” by mid-2025 to verify those results.

Because the state legalized weed later than other states, it adopted standards that are among the most stringent in the country, said Anthony David, chief operations officer with Green Precision Analytics, a private marijuana testing lab in Kansas City. Before opening the lab with three partners, he grew marijuana in the Pacific Northwest.

“Cannabis that Missourians are smoking,” he said, “is safer than probably anywhere in the world.”

The National Academies of Sciences’ report on cannabis and public health, which was commissioned by the CDC and the National Institutes of Health, recommended several policy changes states could make to protect the public.

Those include things like limiting the potency of marijuana (Missouri has no such limit), and restricting retail hours at dispensaries. While Kansas City limits how late a dispensary can stay open, the state does not, and some weed shops in neighboring communities offer 24-hour-a-day drive-thrus. Other suggested policies from the report involve implementing strategies to protect kids. In short, they want cannabis products to be controlled much like alcohol and tobacco.

“Almost every state does something right, but there are a lot of things they don’t do,” Teutsch said. “We advise the states to look at what was done for tobacco and alcohol because there’s many years of experience there implementing policies that have a public health focus.”

David G. Evans, a New Jersey attorney representing people who claim they’ve been harmed by marijuana, also believes there is wisdom to be gained from what unfolded in the tobacco industry.

He contends that the legal system needs to step in where regulators have failed. Evans is suing marijuana companies for harming clients and marshalling lawyers across the country to do the same. He hopes the legal actions will bring public awareness about risks of marijuana and rein in the industry.

“The marijuana industry is low-hanging fruit,” Evans said. “They’ve been allowed to be reckless. They’ve not been controlled, not disciplined. And the state governments have played right along with them. Now there’s starting to be a reckoning.”

 

Source: https://www.ksmu.org/news/2024-12-28/with-weed-legal-missouri-is-now-looking-at-the-public-health-consequences

This story was originally published by The Beacon, a fellow member of the KC Media Collective.

 

New York Times    DNYUZ        December 26, 2024

The cartel operatives came to the homeless encampment carrying syringes filled with their latest fentanyl formula. The offer was simple, according to two men living at the camp in northwest Mexico: up to $30 for anyone willing to inject themselves with the concoction.

One of the men, Pedro López Camacho, said he volunteered repeatedly — at times the operatives were visiting every day. They watched the drug take effect, Mr. López Camacho said, snapping photos and filming his reaction. He survived, but he said he saw many others who did not.

“When it’s really strong, it knocks you out or kills you,” said Mr. López Camacho of the drugs he and others were given. “The people here died.”

This is how far Mexican cartels will go to dominate the fentanyl business.

Global efforts to crack down on the synthetic opioid have made it harder for these criminal groups to find the chemical compounds they need to produce the drug. The original source, China, has restricted exports of the necessary raw ingredients, pushing the cartels to come up with new and extremely risky ways to maintain fentanyl production and potency.

The experimentation, members of the cartels say, involves combining the drug with a wider range of additives — including animal sedatives and other dangerous anesthetics. To test their results, the criminals who make the fentanyl for the cartels, often called cooks, say they inject their experimental mixtures into human subjects as well as rabbits and chickens.

If the rabbits survive beyond 90 seconds, the drug is deemed too weak to be sold to Americans, according to six cooks and two U.S. Embassy officials who monitor cartel activity. The American officials said that when Mexican law enforcement units have raided fentanyl labs, they have at times found the premises riddled with dead animals used for testing.

“They experiment in the style of Dr. Death,” said Renato Sales, a former national security commissioner in Mexico. “It’s to see the potency of the substance. Like, ‘with this they die, with this they don’t, that’s how we calibrate.’”

To understand how criminal groups have adapted to the crackdown, The New York Times observed fentanyl being made in a lab as well as a safe house, and spent months interviewing several people directly involved in the drug’s production. They included nine cooks, three chemistry students, two high-level operatives and a recruiter working for the Sinaloa Cartel, which the U.S. government blames for fueling the synthetic opioid epidemic.

The people connected to the cartel spoke on the condition of anonymity for fear of retaliation.

One cook said he recently started mixing fentanyl with an anesthetic often used in oral surgery. Another said the best additive he had found was a sedative for dogs and cats.

Another cook demonstrated for Times reporters how to produce fentanyl in a cartel safe house in Sinaloa State, in northwest Mexico. He said that if the batch was too weak, he added xylazine, an animal tranquilizer known on the street as “Tranq” — a combination that American officials warn can be deadly. “You inject this into a hen, and if it takes between a minute and a minute and a half to die, that means it came out really good,” the cook said. “If it doesn’t die or takes too long to die, we’ll add xylazine.”

The cooks’ accounts align with data from the Mexican government showing a rise in the use of fentanyl mixed with xylazine and other substances, especially in cities near the U.S. border.

“The illicit market gets much more benefit from its substances by cutting them with different things such as xylazine,” said Alexiz Bojorge Estrada, deputy director of Mexico’s mental health and addiction commission.

“You enhance it and therefore need less product,” said Ms. Bojorge, referring to fentanyl, “and you get more profit.”

U.S. drug researchers have also noticed a rise in what one called “weirder and messier” fentanyl. Having tested hundreds of samples in the United States, they found an increase in the variety of chemical compounds in fentanyl on the streets.

“It’s just a wild west of experimentation,” said Caleb Banta-Green, a research professor at the University of Washington School of Medicine, who helped coordinate the testing of more than 580 samples of drugs sold as fentanyl in Washington State this year.

He called it “absolute chaos.”

The Experiments: The synthetic opioids that reach American streets often begin in cartel labs, where precision is not always a priority, cooks say. They mix up vats of chemicals in rudimentary cook sites, exposing themselves to toxic substances that make some cooks hallucinate, wretch, pass out and even die. The cartels are actively recruiting university chemistry students to work as cooks. One student employed by the cartel revealed that to test their formulas, the group brought in drug users living on the street and injected them with the synthetic opioid. No one has ever died, the student said, but there have been bad batches. “We’ve had people convulse, or start foaming at the mouth,” the student said.

Mistakes by cooks were met with severe punishment, she added: Armed men locked the offenders in rooms with rats and snakes and left them there for long stretches with no food or water.

The cooks and high-level operatives described the Sinaloa Cartel as a decentralized organization, a collection of so many disparate cells that no single leader or faction had complete control over the group’s fentanyl production.

Some cooks said they wanted to create a standardized product that wouldn’t kill users. Others said they didn’t see the lethality of their product as a problem — but as a marketing tactic.

In a U.S. federal indictment against the sons of the notorious drug lord Joaquín Loera Guzmán (known as El Chapo) who lead a powerful faction of the Sinaloa Cartel, prosecutors said the group sent fentanyl to the United States even after an addict died while testing it in Mexico.

Instead of scaring people off, cartel members, drug users and experts say that many American users rush to buy a particularly deadly batch because they know it will get them high.

“One dies, and 10 more addicts are born,” said one high-level operative for the cartel. “We don’t worry about them.”

The Boss: The boss knew something was wrong when the hens stopped keeling over. He said he’d been in the drug business since he was 12, when he started apprenticing at a heroin processing site.

Now a soft-spoken 22-year-old, the boss said he taught himself how to produce illicit drugs by studying the older, more experienced men he worked with. Eventually, he started his own business with a friend.

The boss said his business grew so fast that soon he was running three fentanyl labs. The drug has made him millions, he said.

Every time he goes to one of his labs, he said he brings four or five rabbits from the local pet store. If the fentanyl his people make is potent enough, he has to inject and kill only one to be sure it is fit for sale.

Two pet store employees in Sinaloa, who spoke on the condition of anonymity for fear of retaliation from cartel members, confirmed that the cheapest rabbits are known to be purchased for drug testing.

The boss’s other test subjects are hens from a nearby ranch. Many fentanyl cooks test their product on chickens, according to the two U.S. Embassy officials.

Until recently, the boss said every time he injected the hens with fentanyl they would either die, fall over or stumble around as if they were drunk. All the locals knew not to eat the chickens or the eggs from the ranch.

But recently, the animals weren’t having a strong reaction to the drug, even though his process hadn’t changed.

His employees were logging the same hours at the same modest lab in the mountains, starting at 5 a.m. and sleeping there for days on end. They were working with the same equipment — laboratory shakers, trays, large containers and a blender to mix up the final product.

The boss said he eventually concluded that the culprit was a “very diluted” supply of the chemical ingredients from China. The result was a bunk product. “It’s too weak,” he said.

To fix the problem, the boss first tried combining fentanyl with ketamine, a short-acting anesthetic, but said users didn’t like the bitter taste that came with smoking the mix. It worked much better to add procaine, he said, a local anesthetic often used to numb small areas during dental procedures. When asked whether he felt guilty about producing a drug that causes mass death, the boss said all he was doing was giving his customers what they wanted.

“If there weren’t all those people in the United States looking to get high, we wouldn’t sell anything,” he said. “It’s their fault, not ours. We just take advantage of the situation.”

The Cook

One cook we spoke with said he got into the fentanyl business a few years ago to pay off growing debts. At first, the former shop owner regularly got sick from the exposure to the fumes. He said the armed cartel members in charge had no patience for it.

“You may throw up at the beginning when you start, and you take a quick break and take some air,” said the cook, but soon enough “one of them will scream at you to get back to work.”

A boss once shot him just because he didn’t answer a question quickly enough, he said, pulling up his shirt to reveal a stomach scar.

He is constantly experimenting with ways to make fentanyl stronger, tweaking his formula and testing it on his lab assistants, many of whom have become addicted in the process, he said. If the product comes out strong, he passes it on to his supervisors to try.

The cook said he knows all the improvisation adds up to an unpredictable product. Each batch he makes is different, he said, meaning clients who buy the exact same fentanyl pills may get wildly different doses from week to week.

He’s never fully disclosed his job to his family, simply saying he’s off to work and then returning weeks later with a lot of cash. He believes the money and the fear evident in his expression deter any questions.

“There is no retirement here,” the cook said, adding that the cartel would likely kill him for trying to stop. “There is just work and death.”

 

Source: https://dnyuz.com/2024/12/26/how-mexican-cartels-test-fentanyl-on-vulnerable-people-and-animals/

__


www.drugwatch.org
drug-watch-international@googlegroups.com

Author(s):  Hannah Elmore, PharmD,John Handshaw, PharmD, BCACP  –  December 23, 2024

Pharmacists can help address nicotine addiction by recommending FDA-approved smoking cessation methods and educating on the risks associated with electronic cigarette use.

Electronic cigarettes (E-cigarettes) have emerged as a popular alternative to traditional smoking. This method, known as vaping, involves inhaling an aerosol that contains nicotine, flavorings, and harmful chemicals including carcinogens, toxic substances, and metals. Nicotine is a highly addictive compound that activates the brain’s reward center by increasing dopamine levels, which creates sensations of pleasure and satisfaction. These euphoric feelings are often what leads to nicotine addiction.1

Although vaping is often perceived as a safer option, it actually carries significant health risks similar to those of traditional cigarettes. Pharmacists can play a vital role in educating patients on the dangers of vaping and providing guidance on safe and effective smoking cessation methods.

E-cigarettes trace back to the 1960s when British American Tobacco created a smoking device under the codename Ariel. At that time, researchers were already aware of nicotine’s addictive properties, but new evidence linking smoking to lung cancer prompted cigarette companies to try and explore alternative products with less risks. They aimed to create an inhalation device with filters to reduce carcinogens and tar. However, it was discovered that filtered cigarettes were not a healthier alternative because all components of cigarette smoke have proven to be harmful. Additionally, if the device only contained pure nicotine, it would warrant classification as a drug-delivery system, subjecting it to stricter regulations. The company wanted to avoid this in order to bypass the stringent safety evaluations and extensive clinical trials required by drug delivery systems, which would allow the company to reduce their manufacturing costs, speed up production, and take this device to the market quicker. They were able to produce a product with 24% nicotine, which is 6 times the concentration found in traditional cigarettes. Despite this innovation, Ariel was discontinued to protect the company’s profitable traditional cigarette market. This marked the first instance of companies exploring the manipulative potential of nicotine.2

E-cigarettes were officially authorized for sale by the FDA in 2007 with over 460 brands. The most popular brand is Juul, accounting for nearly 75% of the e-cigarettes on the market.3,4 In 2022, the FDA banned the sale of Juul products due to conflicting evidence regarding its associated risks, including the potential to cause strokes, respiratory failure, seizures, and cases of e-cigarette or vaping-use-associated lung injury (EVALI).4 EVALI is a condition in which the lungs become severely damaged and often results in admission to the intensive care unit (ICU) on mechanical ventilation.3,4

Additionally, there is also a lack of long-term safety data for these products.5 Although originally marketed as a healthier alternative to cigarettes, e-cigarettes have not demonstrated efficacy as a smoking cessation aid and rather, have led to a rise in the youth vaping epidemic.1

There has been a lack of data correlating successful smoking cessation rates among those who use e-cigarettes. There have been a few studies that suggest that vaping may aid in quitting tobacco but is not effective for quitting nicotine use altogether.6 One study found that those who utilized e-cigarettes in combination with nicotine replacement therapy (NRT) and counseling were 24.3% less likely to quit smoking compared to those who used only NRT and counseling. Additionally, those who used e-cigarettes were 15.1% more likely to become dual users utilizing both tobacco and vaping products. Those who are considered dual users are at an even higher risk for health complications including myocardial infarction and a 4-fold increase in developing lung cancer.6

In another survey of 800 people who utilized vaping as a smoking cessation agent, it was reported that only 9% successfully quit when asked 1 year later, compared to 19.8% who utilized NRT.1,7 These findings help highlight that vaping is not a reliable method for eliminating nicotine use entirely and can even lead to utilizing both traditional and electronic cigarette products.8

Vaping is now the most commonly used form of nicotine among adolescents. A study was conducted that showed high schoolers who had used e-cigarettes were 16.7% more likely to start smoking cigarettes within the next year.9 Nicotine’s impact on the developing brain can cause mood disorders, affect attention and learning, and amplify the desire for other mood-enhancing drugs such as cocaine or methamphetamine.1 In 2018, e-cigarette use among high school students increased by 78%, which led the FDA to enforce stricter regulations on the sale of nicotine products. Despite their efforts, vaping remains a leading challenge that teens face today as they have already fallen victim to nicotine addiction.4

The FDA currently lists 7 approved quit aids that are safe and effective for smoking cessation. These include several forms of NRT as well as pharmacologic therapy with bupropion and varenicline. Some of the agents, including the NRT gum, patch, and lozenge, are even available OTC. Pharmacists can play a vital role in smoking cessation, especially in patients who lack access to a primary care provider to obtain prescription medications. Therefore, it is crucial for pharmacists to stay up to date on the current smoking cessation guidelines, dosing recommendations, and counseling points for these agents.

The primary goal of pharmacist-driven smoking cessation should always be to support the patient’s desire to quit smoking. Pharmacists should guide patients toward the FDA-approved agents, either prescription medications through a provider, or OTC therapies in the pharmacy, rather than electronic cigarettes due to lack of supportive data and increased risk for adverse health events. The appropriate selection of FDA-approved agent should be individualized based on the patient’s specific factors, contraindications, and goals of therapy. Pharmacists should educate the patient extensively on the appropriate options for smoking cessation and should not recommend the use of e-cigarettes. However, if a patient decides to use e-cigarettes, pharmacists should still serve as a support system for the patient by being the primary educator and providing extensive counseling on the associated risks of vaping. Patients should be made aware of both the known and unknown adverse reactions associated with electronic cigarettes as well as highlighting that the goal of vaping should be to achieve complete smoking cessation.10

Vaping e-cigarettes has become a popular alternative to traditional cigarettes, with unknown efficacy and safety surrounding these products.10 Pharmacists should continue to stay up to date on new literature published on e-cigarettes and should follow the FDA’s suggestions on smoking cessation methods. Pharmacists are the most widely accessible health care professionals available to patients. Therefore, pharmacists have the power and knowledge to be the most influential providers available to advise patients on the correct paths to smoking cessation. By offering education and support, pharmacists can help patients live healthier lives and take steps towards reversing the youth smoking epidemic one education at a time.

Source: https://www.pharmacytimes.com/view/clearing-the-air-the-influence-of-vaping-on-smoking-cessation

The stats: Provisional data from the Centers for Disease Control and Prevention (CDC) estimates there were 94,112 overdose deaths in the year ending July 2024, a 16.9% decrease from the prior year.

  • All states except Washington, Oregon, Nevada, Utah, Montana and Alaska saw decreases.

What’s being said:

  • Senior Biden administration officials credited a combination of policies such as higher investment in preventing drug use among young people, making naloxone more accessible, getting more people into treatment early and disrupting the supply of illicit drugs and precursor chemicals.

The details: It is possible the government’s efforts to disrupt drug trafficking and provide improved prevention, harm reduction and treatment services are beginning to achieve their desired effect.

  • The White House’s efforts to distribute naloxone have helped reverse 500,000 overdoses.
  • The administration has been historically supportive of harm reduction, providing support for syringe exchange and drug checking equipment and looking the other way on supervised consumption sites.
  • It has overhauled methadone regulations, eliminated the buprenorphine waiver requirement and expanded access to treatment via telehealth.

But:

  • Other potential reasons for the decline include a change in the drug supply and a shift toward more cautious drug use behavior based on years of experience with fentanyl.
  • Progress could be threatened by the reemergence of carfentanil, which is 100 times more powerful than fentanyl. A CDC study found that overdose deaths with carfentanil remain rare but increased approximately 7-fold from January-June 2023 to January-June 2024.

The larger context: The decrease is the largest in history, but the death toll remains high and disparities persist.

  • The ~94,000 deaths is nearly 40% more than when deaths began rising in Jan. 2019 and about the same as it was in Jan. 2021, when Biden took office.

Source: White House takes credit for a big drop in fatal overdoses (Politico); Biden officials take credit for ‘largest drop’ in overdose deaths. Experts are more cautious (STAT); Future Threats (Politico)

 

Source: https://drugfree.org/drug-and-alcohol-news/policy-news-roundup-december-19-2024/

 

Filed under: Latest News,Prevalence,USA :

Gamblers Anonymous meetings are filling up with people hooked on trading and betting. Apps make it as easy as ordering takeout.

Wall Street Journal      by Gunjan Banerji         Dec. 20, 2024

A new type of addict is showing up at Gamblers Anonymous meetings across the country: investors hooked on the market’s riskiest trades.

At Gamblers Anonymous in the Murray Hill neighborhood of Manhattan, one man called options “the crack cocaine” of the stock market. Another said he faced hundreds of thousands of dollars in trading losses after borrowing from a loan shark to double down on stocks.  And one young man brought his mom and girlfriend to celebrate one year since his last bet.

They were among a group of about 60 people, almost all men, who sat in rows of metal folding chairs in a crowded church basement that evening. Some shared their struggle with addiction—not on sports apps or at Las Vegas casinos—but using brokerage apps like Robinhood.

Many of the men, and scores of others around the country, discovered trading and betting during the pandemic boom that began in 2020. Some were drawn in by big wins in meme stocks and other viral stock sensations, leading them into even higher-octane wagers that offer the chance to put up a small amount of cash for a potentially mammoth return—or more often, a crushing loss.

Others bought and sold cryptocurrencies on apps that make trading as easy as ordering takeout on Uber Eats or toiletries on Amazon. In an age where sports betting has become an accepted pastime—accessible by the flick of the thumb on an iPhone app—they found the same rush betting on dogecoin, Tesla or Nvidia as wagering on Patrick Mahomes to carry the Kansas City Chiefs to the Super Bowl.

Doctors and counselors say they are seeing more cases of compulsive gambling in financial markets, or an uncontrollable urge to bet. They expect the problem to worsen. The stock market has climbed 23% this year and bitcoin recently topped $100,000  for the first time, tempting many people to pile into speculative trades. Wall Street keeps introducing newer and riskier ways to play the market through stock options or complex exchange-traded products that use borrowed money and compound the risk for investors.

Some who are desperate to stop trading are turning to self-help groups like Gamblers Anonymous. A GA pamphlet advises members to stay away from bets on stocks, commodities and options as well as raffle tickets and office sports pools. Sometimes members hand over retirement accounts to their spouses.

Modeled after Alcoholics Anonymous, GA dates back to 1957 and now has hundreds of chapters in every U.S. state. Attendees at local GA meetings from Ponca City, Okla., to Allentown, Pa., subscribe to a 12-step program. It begins with accepting that they are powerless over gambling and can include a financial review in a so-called pressure relief group meeting. New attendees are peppered with calls from others and latch onto veteran members who commit to helping them stay on track.

‘Hi, my name is Mitch’

More than 30 people interviewed by The Wall Street Journal, many of whom regularly attend GA meetings, said they’ve struggled with compulsive gambling in financial markets. At times, the trading led to mood swings, sleepless nights and even depression. Their trades—and spiraling losses—became a shameful secret that they kept from their partners or other loved ones.

I asked Gamblers Anonymous for permission to attend some meetings. Attendees introduced me to the groups at the start of the meetings, and I observed the discussions. Members introduced themselves by their first names, according to GA practices.

“Hi, my name is Mitch, and I’m a compulsive gambler,” one said at a GA meeting this month near Ozone Park, N.Y. “Hi Mitch,” the group responded in unison.

The suburban dad of three, slightly balding with a big smile, stood in front of more than a dozen members in a church basement. He is haunted by the rising price of bitcoin—and the riches that could have been his, he said. Up around 40% since Election Day, bitcoin prices are on a wild ride. What would have happened, he wondered out loud, if he had just left his bitcoin in a digital wallet and handed it over to his wife?

Then he reminded himself and the group that he was never able to just buy and hold. “I needed more and more,” Mitch told the group. “I’m a sick, compulsive gambler. That’s why I keep making these meetings. I don’t trust myself.”

One attendee told him to stop eyeing cryptocurrency prices. Another reminded him of the toll trading had taken on his family and asked: “What’s more important, crypto or your kids?”

The entrepreneur, based in Long Island, N.Y., said cryptocurrencies caught his eye when he was in his late 40s and had gone more than 20 years since placing his last bet. He had sworn off gambling after a penchant for bold bets had led him to Gamblers Anonymous meetings in his early 20s. He invested $100 in bitcoin and watched it soar. He poured thousands of dollars into ether and smaller, more speculative coins. Something kept him from sharing with his GA group that he was trading.

When his portfolio rose above $1 million, he thought to himself, “That’s four Lambos.” He flew to Florida to look at potential vacation homes for his family near Walt Disney World.

Within months, he found himself in a familiar cycle. The rush of adrenaline he got when he bought and sold tokens pushed him to trade more frequently—to the point where he was trading hundreds of times a day—and taking bigger risks. He would wake at 4 a.m. to monitor his portfolio.

He parked his car in the lot of a Long Island shopping plaza near his home to trade in isolation. His neck grew tense from hunching over the screen.

When crypto prices started tumbling, snowballing losses left him sullen. “Sometimes I would get a passing thought as I went to bed: I hope I don’t wake up in the morning,” he said. His portfolio had fallen around $1 million from its peak.

Desperate for a way out, he typed “crypto gambling treatment center” into Google. He confessed to his GA mentors that he had been gambling.

A spiking problem

Pennsylvania’s gambling hotline has fielded more calls tied to gambling in stocks and crypto since 2021 than it did in the prior six years combined. At a New York-based treatment center, Safe Foundation, clinical director Jessica Steinmetz estimates about 10% of patients are seeking help for addictions tied to trading. Before 2020, there were no such patients.

Lyndon Aguiar, a clinical director at Williamsville Wellness, a gambling treatment center in Hanover, Va., said counselors sit down with traders and delete dozens of stock, sports and financial news apps from their phones when they walk in the doors for its inpatient treatment program. The center has seen a 25% increase in gambling tied to markets since 2020, compared with the prior four years. Patients might install Gamban, an app that locks individuals out of gambling on their phones. The app started blocking Robinhood and Webull in July 2021.

A Robinhood spokesperson said it includes “robust safeguards to help customers make informed decisions” and that individuals deserve the freedom to become stewards of their own finances. A spokesperson for Webull said the platform offers educational tools to foster responsible investment decisions.

New patients often suffer from withdrawal symptoms including severe anxiety and depression when they first stop trading, he said. Some start fidgeting or repeatedly tapping their fingers against a table, itching to place a trade.

Abdullah Mahmood, administrative coordinator of a gambling program at the Maryhaven addiction treatment center in Columbus, Ohio, said he has seen several clients enter the treatment center’s doors this year for trading addictions. Options are particularly problematic, he said.

Activity in options is on track to smash another record this year.  Trading in contracts expiring the same day, which are the riskiest, has soared to make up more than half of all trades in the market for S&P 500 index options this year, according to figures from SpotGamma. These trades are more electric than traditional stocks, with the potential to rocket higher or plunge to zero within minutes.

Similar to wagering on how many points Mavericks point guard Luka Dončić will score in the first quarter of an NBA game, traders are increasingly using options to speculate how stocks will fare during the trading session, rather than at the closing bell.

This year, “a client came down to my office, suicidal,” Mahmood said. “He had lost $14,000 in just five minutes in options trading on the app Robinhood.”

Doug Royer, 61, has been attending Mahmood’s  group counseling sessions every Monday.

He initially entered the center’s doors for help with his drinking. Then, he saw signs for a gambling program while walking the halls of Maryhaven’s treatment center. Immediately, the six figures he lost trading came to mind.

After selling his house in 2022, he had poured thousands of dollars into investments like the Grayscale Bitcoin Trust, Lockheed Martin and Texas Pacific Land before amping up the risk with options trading. He traded in and out of companies such as Spirit Airlines and Estée Lauder, while borrowing on margin in an attempt to magnify his bets, brokerage statements show.

Eventually, he said he had almost no money left to trade with after losses in options and lotteries. He said he has been working part-time as a massage therapist near Columbus, Ohio.  “It’s very easy to make a lot of money,” Royer said. “It’s also easy to lose everything really fast.”

Addiction counselors say gambling in financial markets often goes undetected and can be tough to track because individuals confuse their actions with investing. Unlike sports betting apps such as FanDuel and DraftKings, most brokerage apps don’t post warnings about gambling or offer hotlines to seek help. The proliferation of financial instruments, along with flashy brokerage apps that make them easy to trade, has also helped some gamblers convince themselves that they weren’t actually placing bets.

The National Council on Problem Gambling started including questions about investing in its annual survey in 2021, after its gambling hotline received an influx of calls during the meme-stock mania. The council’s executive director, Keith Whyte, said NCPG reached out to apps like Robinhood to suggest they adopt consumer protections ingrained in gambling apps. “In some cases, the consumer protections in the gambling industry exceed that in the financial markets,” Whyte said.

Like the anticipation of sex or delicious food, a financial gamble like an options trade can flood your brain with feel-good chemicals, said Brian Knutson, a professor of psychology and neuroscience at Stanford University. The bigger the financial payout or tastier the dish, the stronger the rush. That anticipation can keep a trader going back to place another bet, forming a reinforcing habit, added Knutson, who has studied risk-taking in financial markets for more than two decades.

“It’s not just the release, per se, of the dopamine, but the speed of the release that’s reinforcing,” Knutson said.

Chris Cachia, a 38-year-old power-plant technician in Ontario, Canada, got swept up with trading during the meme-stock mania in 2021. After turning around 7,000 Canadian dollars into roughly 50,000 trading stocks like GameStop and BlackBerry, he found short-dated stock options when he went hunting for fatter profits. He scored some early wins. Before long, the thousands he made evaporated and his account sank into a deep hole. Yet he said he couldn’t walk away—he was consumed by a fear of missing out on the riches that others boasted about online.

One week while his wife was traveling, he holed up in his home office for days trading. He grew desperate for a win and bet more money than he had in his brokerage account. It didn’t work out.

The subsequent loss left him so depressed that he skipped his brother’s bachelor party. “It was causing erratic changes in my behavior as I got deeper and deeper in,” Cachia said. “I was basically a full-out gambling addict.” He said he tried to quit countless times since his trading ramped up during the pandemic, deleting brokerage and social-media apps from his phone, only to quickly download them again. He wasn’t able to pull away until his wife threatened to leave him. “She gave me an ultimatum: You need to stop this, or I’m done,” Cachia said.

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Source: More Men Are Addicted to the ‘Crack Cocaine’ of the Stock Market – WSJ

www.drugwatch.org
drug-watch-international@googlegroups.com

Khat falls into the class C drug category but it isn’t recorded as a specific drug in seizure data

A decade ago, a stimulative drug that sold for just a few pounds, was banned in the UK. Known as khat, it’s a plant that’s chewed, giving similar effects to amphetamine.

Ten years on from the drugs reclassification, experts say it is still being sold in the UK, in places for ten times more than it cost in 2014.

But there is little data to help understand the true impact of the ban.

Dr Neil Carrier, who carried out postdoctoral research on the drug at the University of Oxford, said it has largely been “forgotten” by authorities and “in terms of understanding drug policy, the bans’ impact should really be researched”.

Mohammed, not his real name, 25, told the BBC that he tried khat in 2018, four years after the ban.

He said: “The thing is, there’s actually quite a lot of it readily available in the UK.

“You can get it in little silver sachet bags that are air-sealed and marketed as herbal facial products, but it’s literally just khat.”

He chewed the drug in a dried form, which has become more common during the past 10 years.

Dr Carrier, who currently works as a social anthropology professor at the University of Bristol, said fresh khat leaves were sold for “around £3 a bundle (250g)” during the 2000s and 2010s.

It was often chewed by Somali, Yemeni and Ethiopian men in group sessions at designated khat cafes, called mafrishes.

He helped produce a government-published literature review around khat’s social harms and legislation in 2011: “Very often as anthropologists, when we think about drugs, we don’t just focus on the drug itself but also how it gets caught up in the wider cultural meanings, wider relationships and power.

“We look at how it becomes a commodity and how the substance fits into society.”

He felt that the ban was a “missed opportunity” to investigate alternative methods of regulating recreational drugs.

“We could see how khat was associated with various issues that were very challenging with communities using khat in the UK.

“But at the time I felt the drug was blamed for these wider issues,” he said.

In the early 2000s Dr Carrier said he often heard people attribute khat to family and social integration problems.

“I would hear things like ’men are not being good fathers as they chewed khat’.

“And ‘people who are chewing khat might, as a consequence, not be looking for work’.

“But in reality, this is only half the picture.

“We often in society give drugs so much power and label them as the cause of problems when really the picture tends to be more blurred and complicated.”

Last year Border Force seized 2,760 hauls of class C drugs.

A Home Office spokesperson said: “Border Force and police work relentlessly to stop illegal drugs from coming into the country and keep them off our streets.

“We have seen a record level of seizures as we continue to use advanced technology, data and greater intelligence to ensure these drugs do not enter the country.”

The UK was one of the last EU countries to reclassify the khat in June 2014.

Prior to this date, more than 2,500 tonnes was annually imported, according to the Advisory Council of the Misuse of Drugs (ACMD).

That is the equivalent weight of around 208 double-decker buses worth of the stimulative drug.

Most of the shipments are thought to have been distributed and sold amongst east-African diaspora communities in Britain, such as Somalis and Ethiopians.

Dr Carrier said khat and cannabis, both plant-based drugs, have a similar policing system which could have contributed to a lack of data on how prevalent less drugs like khat may be.

“A lot of the drugs data gets conflated with data around cannabis and they tend to get pooled together.

“As far as I understand anyways,” he said.

UK Border Force tend to place khat into an “other class ” category, when reporting the drug.

Dr Carrier added: “What people suspected would happen at the time of the ban has happened.

“Khat is now being smuggled in, especially a dried khat, mostly coming in from Ethiopia, and it seems to have become quite popular.

“The people that do still want to consume, even though it’s been banned, can still consume it in a different form.”

Dried khat is less potent than the fresh plant and is said to provide a “less pleasant user experience” in terms of taste and texture.

Dr Carrier said that meant there is still a market for the drug: “Some people, if they can afford it, will still chew the fresh stuff.

“The fresh stuff is £30 to £40 a bundle.

“But there are people still willing to spend that kind of money on it.

“People are still accessing khat.”

Source: https://www.bbc.co.uk/news/articles/c4gpl62dn26o?utm_source=firefox-newtab-en-gb

Filed under: Khat,Latest News,UK :

 December 19, 2024 / 73(50);1147–1149

Yijie Chen, PhD1; Xinyi Jiang, PhD1; R. Matthew Gladden, PhD1; Nisha Nataraj, PhD1; Gery P. Guy Jr., PhD1; Deborah Dowell, MD1

Summary

What is already known about this topic?

From 2020 to 2022, among overdose deaths with only illegally manufactured fentanyl (IMF) detected, those with evidence of smoking IMF increased by 78.9%, and those with evidence of injection decreased by 41.6%.

What is added by this report?

From July–December 2017 to January–June 2023, the percentage of persons injecting IMF sharply declined across all U.S. Census Bureau regions, with region-specific differences in magnitude; correspondingly, IMF snorting or sniffing increased in the Northeast, and IMF smoking increased in the Midwest, South, and West regions.

What are the implications for public health practice?

Whereas avoiding injection likely reduces infectious disease transmission, noninjection routes might still contribute to overdose. Provision of locally tailored messaging and linkage to medical treatment is important among persons using IMF through non-injection routes.

During 2019–2023, U.S. overdose deaths involving fentanyl have more than doubled, from an estimated 35,474 in 2019 to 72,219 in 2023 (1). From 2020 to 2022, overdose deaths with only illegally manufactured fentanyl (IMF) detected and evidence of smoking IMF increased by 78.9%; deaths with evidence of injection decreased by 41.6% (2). Smoking, however, could not be linked specifically to IMF use when deaths involved multiple drugs (e.g., methamphetamine co-used with IMF). To characterize IMF administration routes among all persons who use IMF, with or without other drugs, IMF administration routes were examined among adults assessed for substance use treatment who used IMF during the past 30 days.

Investigation and Outcomes

The National Addictions Vigilance Intervention and Prevention Program’s Addiction Severity Index-Multimedia Version (ASI-MV) tool* includes a convenience sample of adults aged ≥18 years assessed for substance-use treatment. CDC analyzed treatment assessments conducted between July 1, 2017, and June 30, 2023, which were restricted to 14 states with at least 100 assessments reporting past 30-day IMF use (16,636)§ and stratified by administration routes (swallowed, snorted or sniffed, smoked, and injected). The percentage of persons reporting each administration route was calculated for 6-month periods by U.S. Census Bureau region.** Significant (p-value <0.05) trends by administration route were identified using Joinpoint (Joinpoint version 5.1.0; National Cancer Institute) and Pearson correlations. This activity was reviewed by CDC, deemed not research, and was conducted consistent with applicable federal law and CDC policy.††

In the Midwest, South, and West U.S. Census Bureau regions, increases in smoking (from 7.8% during July–December 2017 to 38.2% during January–June 2023 [Midwest]; from 15.4% during January–June 2020 to 54.0% during January–June 2023 [South]; and from 45.7% during January–June 2018 to 85.7% during January–June 2023 [West]) were strongly negatively correlated with decreases in injection (Pearson correlation coefficient [r] = −0.96; p<0.001 [Midwest]; −0.98; p<0.001 [South]; and −0.74; p<0.01 [West]). Injection decreased from 75.2% during January–June 2020 to 41.2% during January–June 2023 in the Midwest U.S. Census Bureau region; from 54.2% during July–December 2020 to 30.3% during January–June 2023 in the South; and from 65.6% during July–December 2018 to 9.1% during January–June 2023 in the West, but timing of changes across each census region varied (Figure). In the Northeast, increases in snorting or sniffing (from 18.9% during July–December 2017 to 45.5% during January–June 2023) were strongly negatively correlated (r = −0.89; p<0.001) with a decrease in injection (from 83.8% during July–December 2017 to 63.4% during January–June 2023).

Preliminary Conclusions and Actions

Consistent with other fatal overdose investigations (2), the percentage of persons injecting IMF sharply declined across all U.S. Census Bureau regions between 2017 and 2023, although the magnitudes of these declines were region-specific. Some persons who use IMF reportedly believe that smoking is safer than injecting IMF (3). Whereas avoiding injection likely reduces the risk for acquiring bloodborne viruses (e.g., HIV or HCV) and soft tissue infections (2,4), noninjection routes might contribute to overdose or other health problems (e.g., orofacial lesions associated with snorting) (5). Compared with injection, smoking IMF is associated with a higher frequency of use throughout the day and potentially higher daily dosages consumed (3). Substantial shifts to smoking IMF in the Midwest, South, and West, and sniffing or snorting IMF in the Northeast (i.e., Massachusetts) highlight the need to understand local trends in drug use and tailor local messaging, outreach, and linkage to medical care, including effective treatment for opioid use disorder in persons using IMF through noninjection routes.

Corresponding author: Yijie Chen, mns7@cdc.gov.

Source: https://www.cdc.gov/mmwr/volumes/73/wr/mm7350a4.htm?s_cid=mm7350a4_w


1Division of Overdose Prevention, National Center for Injury Prevention and Control, CDC.

All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.

Provided by GlobeNewswire  

Millburn, NJ, Dec. 17, 2024 (GLOBE NEWSWIRE) — Thousands of residents from New Jersey and throughout the country, including many health care professionals, are now better informed and prepared to act in the fight against the nationwide opioid crisis thanks to the Knock Out Opioid Abuse Day Learning Series.

The Learning Series’ monthly webinars drew more than 10,000 attendees in 2024, including participants from fields including health care, education and law enforcement, as well as prevention, treatment and recovery professionals Organized by the Partnership for a Drug-Free New Jersey (PDFNJ) in collaboration with the Opioid Education Foundation of America (OEFA) and the Office of Alternative and Community Responses (OACR), the series covers a broad range of topics, from prevention and recovery to trauma, stigma and building resilience in those working on the front lines.

“The attendance represent thousands of people who are now better equipped to make a difference,” said Angelo Valente, Executive Director of PDFNJ.

Beyond educating the general public about the opioid epidemic, the series provided tools and strategies specific to health care workers and other professionals in related fields to help them make informed decisions in their work. Participants earned more than 6,000 continuing education credits, a testament to the program’s commitment to empowering professionals to drive real-world change in their communities.

The Learning Series provided credits for various professions including physicians, dentists, nurses, nurse practitioners, pharmacists, optometrists, social workers, certified health education specialists and EMTs.

In 2024, the webinars brought together experts from various prestigious institutions and organizations, including the New Jersey State Police, the Veterans Affairs Administration, and the Substance Abuse and Mental Health Services Administration (SAMHSA). These speakers, including Christopher M. Jones, Director of the Center for Substance Abuse Prevention at SAMHSA, shared practical solutions and cutting-edge research, ensuring participants left with insights that could be immediately applied in their communities.

“The Learning Series has grown steadily since it began in 2020, thanks to the incredible speakers and organizations that have shared their time and expertise,” Valente said. “Their contributions have made this series an invaluable resource for professionals in New Jersey and beyond, providing practical strategies and real-world insights to address the opioid crisis.”

The series also serves as part of the annual Knock Out Opioid Abuse Day initiative, held every October 6 to raise awareness about the risks of opioid misuse and educate residents and prescribers statewide. Its growth year over year underscores the need for evidence-based education and practical solutions to combat this epidemic.

The 2025 series will kick off at 11 a.m. on Thursday, January 30, 2025, with a webinar exploring the latest trends in the national opioid crisis. To learn more about Knock Out Opioid Abuse Day and for a schedule of webinars, please visit knockoutday.drugfreenj.org.

Source: https://www.morningstar.com/news/globe-newswire/9320021/2024-learning-series-drives-conversations-and-solutions-in-the-fight-against-opioid-misuse

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Best known for its statewide anti-drug advertising campaign, the Partnership for a Drug-Free New Jersey is a private not-for-profit coalition of professionals from the communications, corporate and government communities whose collective mission is to reduce demand for illicit drugs in New Jersey through media communication. To date, more than $200 million in broadcast time and print space has been donated to the Partnership’s New Jersey campaign, making it the largest public service advertising campaign in New Jersey’s history. Since its inception the Partnership has garnered 230 advertising and public relations awards from national, regional and statewide media organizations.

New NIH-funded data show lower use of most substances continues following the COVID-19 pandemic

After declining significantly during the COVID-19 pandemic, substance use among adolescents has continued to hold steady at lowered levels for the fourth year in a row, according to the latest results from the Monitoring the Future Survey, which is funded by the National Institutes of Health (NIH). These recent data continue to document stable and declining trends in the use of most drugs among young people.

“This trend in the reduction of substance use among teenagers is unprecedented,” said Nora D. Volkow, M.D., director of NIH’s National Institute on Drug Abuse (NIDA). “We must continue to investigate factors that have contributed to this lowered risk of substance use to tailor interventions to support the continuation of this trend.”

Reported use for almost all measured substances decreased dramatically between 2020 and 2021, after the onset of the COVID-19 pandemic and related changes like school closures and social distancing. In 2022 and 2023, most reported substance use among adolescents held steady at these lowered levels, with similar trends and some decreases in use in 2024.

The Monitoring the Future survey is conducted by researchers at the University of Michigan, Ann Arbor, and funded by NIDA. The survey is given annually to students in eighth, 10th, and 12th grades who self-report their substance use behaviors over various time periods, such as past 30 days, past 12 months, and lifetime. The survey also documents students’ perceptions of harm, disapproval of use, and perceived availability of drugs. The survey results are released the same year the data are collected. From February through June 2024, the Monitoring the Future investigators collected 24,257 surveys from students enrolled across 272 public and private schools in the United States.

When breaking down the data by specific drugs, the survey found that adolescents most commonly reported use of alcohol, nicotine vaping, and cannabis in the 12 months prior to the survey, and levels generally declined from or held steady with the lowered use reported over the past few years. Compared to levels reported in 2023, data reported in 2024 show:

  • Alcohol use remained stable for eighth graders, with 12.9% reporting use in the past 12 months. Alcohol use declined among the other two grades surveyed, with 26.1% of 10th graders reporting alcohol use in the past 12 months (compared to 30.6% in 2023), and 41.7% of 12th graders reporting alcohol use in the past 12 months (compared to 45.7% in 2023).
  • Nicotine vaping remained stable for eighth and 12th graders, with 9.6% of eighth graders and 21.0% of 12th graders reporting vaping nicotine in the past 12 months. It declined among 10th graders, with 15.4% reporting nicotine vaping in the past 12 months (compared to 17.6% in 2023).
  • Nicotine pouch use remained stable for eighth graders, with 0.6% reporting use within the past 12 months. It increased among the two older grades with 3.4% of 10th graders reporting nicotine pouch use in the past 12 months (compared to 1.9% in 2023) and 5.9% of 12th graders reporting nicotine pouch use in the past 12 months (compared to 2.9% in 2023).
  • Cannabis use remained stable for the younger grades, with 7.2% of eighth graders and 15.9% of 10th graders reporting cannabis use in the past 12 months. Cannabis use declined among 12th graders, with 25.8% reporting cannabis use in the past 12 months (compared to 29.0% in 2023). Of note, 5.6% of eighth graders, 11.6% of 10th graders, and 17.6% of 12th graders reported vaping cannabis within the past 12 months, reflecting a stable trend among all three grades.
  • Delta-8-THC (a psychoactive substance found in the Cannabis sativa plant) use was measured for the first time among eighth and 10th graders in 2024, with 2.9% of eighth graders and 7.9% of 10th graders reporting use within the past 12 months. Reported use of Delta-8-THC among 12th graders remained stable with 12.3% reporting use within the past 12 months.
  • Any illicit drug use other than marijuana declined among eight graders, with 3.4% reporting use in the past 12 months compared to 4.6% in 2023). It remained stable for the other two grades surveyed, with 4.4% of 10th graders and 6.5% of 12th graders reporting any illicit drug use other than marijuana in the past 12 months. These data build on long-term trends documenting low and declining use of illicit substances reported among teenagers – including past-year use of cocaine, heroin, and misuse of prescription drugs, generally.
  • Use of narcotics other than heroin (including Vicodin, OxyContin, Percocet, etc.) are only reported among 12th graders, and decreased in 2024, with 0.6% reporting use within the past 12 months (reflecting an all-time low, down from a high of 9.5% in 2004).
  • Abstaining, or not using, marijuana, alcohol, and nicotine in the past 30 days, remained stable for eighth graders, with 89.5% reporting abstaining from use of these drugs in the past 30 days prior to the survey. It increased for the two older grades, with 80.2% of 10th graders reporting abstaining from any use of marijuana, alcohol, and nicotine over the past 30 days (compared to 76.9% in 2023) and 67.1% of 12th graders reporting abstaining from use of these drugs in the past 30 days (compared to 62.6% in 2023).

“Kids who were in eighth grade at the start of the pandemic will be graduating from high school this year, and this unique cohort has ushered in the lowest rates of substance use we’ve seen in decades,” said Richard A. Miech, Ph.D., team lead of the Monitoring the Future survey at the University of Michigan. “Even as the drugs, culture, and landscape continue to evolve in future years, the Monitoring the Future survey will continue to nimbly adapt to measure and report on these trends – just as it has done for the past 50 years.”

The results were gathered from a nationally representative sample, and the data were statistically weighted to provide national numbers. This year, 35% of students who took the survey identified as Hispanic. Of those who did not identify as Hispanic, 14% identified as Black or African American, 1% as American Indian or Alaska Native, 4% as Asian, 1% as Middle Eastern, 37% as white, and 7% as more than one of the preceding non-Hispanic categories. The survey also asks respondents to identify as male, female, other, or prefer not to answer. For the 2024 survey, 47% of students identified as male, 49% identified as female, 1% identified as other, and 3% selected the “prefer not to answer” option.

All participating students took the survey via the web – either on tablets or on a computer – with 99% of respondents taking the survey in-person in school in 2024. The 2024 Monitoring the Future data tables highlighting the survey results are available online from the University of Michigan.

The 2024 Monitoring the Future data tables highlighting the survey results are available online from the University of Michigan.

Source: https://nida.nih.gov/news-events/news-releases/2024/12/reported-use-of-most-drugs-among-adolescents-remained-low-in-2024

  Polytechnique insights: A REVIEW BY INSTITUT POLYTECHNIQUE DE PARIS

             assisted by Sophie Podevin
            Journaliste Scientifique, Ginkio
Key points:
  • Addictions are widespread among the French population: in 2020, 25.5% of adults smoked every day and 10% drank at least one glass of alcohol a day.
  • Addiction is based on criteria such as craving, continued consumption despite the dangers, or a withdrawal syndrome when the substance is stopped.
  • In France, the most commonly used addictive substances are tobacco (responsible for 75,000 deaths a year), alcohol (41,000 deaths a year) and cannabis.
  • There has been a marked increase in the use of psychostimulant drugs among adults since 2010, and diversion of opiate-based medicines is on the rise.
  • Current research is focusing on studies specifically dedicated to drug users, to better identify effective therapies tailored to their profiles.

As the leading cause of a deregulation in the brain’s reward circuit, addictions are still widespread among the French population. This is largely due to the widespread use of legal psychoactive substances: tobacco and alcohol, which are the two leading causes of premature death in France. In 2020, nearly 25.5% of adults smoked every day (12 million people) and 10% drank at least one glass of alcohol a day (5 million people). So, what is the situation for substance addictions in France for the coming year?

A restricted definition

First of all, to qualify as an addiction, a person must meet at least 2 of the 11 criteria set out in the Diagnostic and Statistical Manual of Mental Disorders (DSM‑5), including: craving, a compelling need to consume the substance or perform the activity; loss of control over the quantity and time devoted to consumption; increased tolerance to the product; a strong desire to reduce doses; continued use despite the damage; or the presence of a withdrawal syndrome when the addictive behaviour is abruptly stopped…

To date, only addictions to substances (tobacco, alcohol, cannabis, cocaine, opium and derivatives) or to video games and gambling are recognised as “addictions”. Social networking, sexual hyperactivity and sugar are not considered as such due to a lack of data and scientific evidence.

Top three

In France, the most widely used addictive substances are still tobacco, alcohol and cannabis. The first two are responsible for 75,000 and 41,000 deaths a year respectively. These are terrifying figures, known but ignored because of habit.

In an article published on 20 October 2024, Doctor Bernard Basset, chairman of the Addictions France association, and psychiatrist and addictologist Amine Benyamina, chairman of the Fédération Française d’Addictologie (FFA), proposed a series of measures combining public health and government debt, such as taxing drinks according to their alcohol content, or introducing a minimum price per drink based on the Scottish model. “In France, we have a real cultural problem with alcohol and very powerful lobbies,” says Amine Benyamina. “All public prevention policies are stifled or censored.” And yet, according to data collected by the Constances epidemiological cohort, which numbered almost 200,000 people in 2018, 19.8% of men and 8% of women in the working population are thought to have a harmful use of alcohol.

While the problem persists, it is changing. Starting with a major positive point made by Guillaume Airagnes, Director of the French Observatory of Drugs and Addictive Tendencies (OFDT) and Doctor of Psychiatry and Addictology: “The general consumption of substances such as tobacco and alcohol has been falling among young people since 2010.” However, there was a downside at the time of Covid, when several addictive activities were on the increase during confinement.

On the other hand, a clear increase in the use of psychostimulant drugs has been observed among adults since 2010, “although the levels of use in the general population remain incomparably lower than those for tobacco, alcohol or cannabis” points out Guillaume Airagnes.

These substances, like ecstasy, have benefited from their image becoming much more commonplace. This is also the case for cocaine, the availability of which has risen steadily over the last ten years, and which used to be the social marker of a wealthy economic category. In 2021, 26.5 tonnes of cocaine were seized, a 67% increase on 2018. “Cocaine benefits from the tenacious stereotype that it does not produce dependence. In reality, while the signs of physical withdrawal are almost non-existent, it is one of the most psychologically tyrannical substances, with extremely powerful cravings,” describes Amine Benyamina, who is also head of the psychiatry and addictology department at the Paul-Brousse hospital in Paris. This increase is set to continue. The 2020 lockdowns demonstrated the adaptability of the drug trade, with home delivery services, marketing, attractive packaging, the use of social networks and instant messaging, and even payments in cryptocurrency.

Misuse of medicines as a new drug

Another less well-known development is the misuse of certain opiate-based drugs, such as codeine or tramadol, which are intended for therapeutic purposes. These are morphine derivatives with a less powerful analgesic effect than morphine. “Paradoxically, this makes them more addictive,” explains Guillaume Airagnes. “As the psychoactive effects are less intense, this leads to greater compulsive consumption.” Misuse of these drugs has been documented for around ten years and remains under close surveillance, although it still only concerns a “very small proportion of users” the director of the OFDT points out.

In his department, Amine Benyamina also sees new types of drug misuse: “More marginal but just as problematic is the use of pregabalin or LYRICA. This is a product designed to treat neuropathic pain or post-traumatic stress syndromes.” This analgesic, which this time is not a morphine derivative, also has a strong addictive potential, encouraging patients to continue taking it beyond the prescription period.

One of the first problems facing carers is the lack of information about drug users themselves. In fact, most of the data on addiction in France comes from surveys carried out on the general population to be more representative. But not for much longer! In April 2024, the first national e‑cohort open only to drug users was launched: ComPaRe Pratiques Addictives. “We already have several thousand subscribers,” says Guillaume Airagnes, who is heading up the study. “The only condition to be eligible is to be a psychoactive substance user at the time of inclusion in the study. Of course, our aim is to follow up participants for at least 5 years, regardless of whether they continue to use substances.”

The responses and the long-term follow-up will enable Guillaume Airagnes and his teams to explore several avenues of research: the question of multiple drug use, which seems to be the rule rather than the exception; the relationship between drug use and economic, demographic or professional situation; the study of the very strong stigmatisation phenomenon among these users, etc. These data will also enable us to better target effective therapies that are adapted to each profile.

In its Guide pratique de psychothérapies les plus utilisées en addictologie of May 2022, the Fédération Française d’Addictologie lists and ranks the different therapies according to their clinical relevance. The behavioural and cognitive therapy (BCT) approach remains the most popular, with a method that can be adapted to addictions with and without substances and solid results confirmed by scientific studies.

But other avenues of treatment are being explored, such as the surprising use of LSD derivatives. “The initial results are surprising and encouraging,” says Professor Amine Benyamina with satisfaction. “Of course, it’s important to remember that these studies are very closely supervised” warns the professor, who is working with his team on the effect of psilocybin on alcohol addiction. “They should not be reproduced at home!”

SAM Drug Report’s Friday Fact report – 11:31 Friday 10th Jan 2025

A study that was published last week in Addictive Behaviors found that alcohol and tobacco are more likely to be used on days when marijuana is used.

The study found that individuals consumed an average of 0.45 more alcoholic drinks on days when marijuana was used, compared to days when marijuana was not used. Similarly, the study found that individuals smoked an average of 0.63 more cigarettes on days when marijuana was used. Both of these findings were statistically significant (p=0.01).

Seeking to explain these findings, the researchers posited that “the impact of cannabis use on the endocannabinoid system may reinforce the use of alcohol and tobacco through mechanisms related to psychological reward.” They added that “bidirectionality must be considered,” given that the use of one substance may influence the effect of an additional substance––it may enhance a high, for example.

The researchers noted that “the observed within-person positive associations between cannabis use and same-day alcohol consumption and cigarettes smoked are consistent with previous research that has shown a tendency for substance use behaviors to co-occur.”

Indeed, cross-tabs from the 2023 National Survey on Drug Use and Health found that those who used marijuana in the past 30 days were three times as likely to have smoked cigarettes in the past 30 days (30.8% vs. 10.4%) and 63% more likely to have used alcohol in the past 30 days (70.7% vs. 43.4%), compared to those who did not use marijuana in the past 30 days.

Source: SAM Drug Report’s Friday Fact report – 11:31 Friday 10th Jan 2025 – The Drug Report’s

 

 

Smart Approaches to Marijuana (SAM) is an alliance of organizations and individuals dedicated to a health-first approach to marijuana policy. We are professionals working in mental health and public health. We are bipartisan. We are medical doctors, lawmakers, treatment providers, preventionists, teachers, law enforcement officers and others who seek a middle road between incarceration and legalization. Our commonsense, third-way approach to marijuana policy is based on reputable science and sound principles of public health and safety.

People smoke the stuff perfectly openly, without fear, with the threatened £90 fine seemingly a remote possibility.                                                                                                                           

by Zoe Strimpel – The Telegraph London author – 14 December 2024 4:09pm GMT

Sir Elton John Credit: Ben Gibson

Zoe Strimpel writes: I was about 23 and was still finding my feet socially in London. I’d always really been a champagne girl at heart but cannabis smoking was common in some of the circles I spent time in. It seemed so tacky and boring, the province of the sorts of bores one met while “travelling”, so I usually said no.

But one night in a run-down flat somewhere in north London, I went along with everyone else. Not long afterwards my heart began to pound like never before and a wave of horrible panic crashed over me, like I was trapped in a physiological nightmare and might die.

This was combined with a much more familiar sense of self-recrimination: why had I got myself into this? It wasn’t tempting in the first place and it could never have been worth it. And now I was paying the price – and so was the friend, now more like a sister to me, who had to tend to me in my tearful panic.

Since then, the pressure to imbibe cannabis has only grown and spread, from tatty student settings to (upper)-middle class and middle-aged environs.

Those who prefer to avoid the smoke element can still mainline the active ingredient – THC – by choosing from a wide range of edibles, which are generally like jelly babies. These make you (me) feel just as dreadful as the smoke sort, though mercifully without the stink.

All of which is why I am in full agreement with Elton John who, as Time magazine’s “icon of the year”, has lambasted the legalisation of pot in North America as “one of the greatest mistakes of all time”.

Sir Elton, himself an addict until he got sober 34 years ago, pointed out that: “It leads to other drugs. And when you’re stoned – and I’ve been stoned – you don’t think normally.”

This is a statement of blinding obviousness, and yet in our strange society it sounds reactionary, refreshing, courageous. How is it that a drug known – outside of carefully managed medical settings where it can help with pain and sleep – to trigger psychosis and turn people into paranoiacs and dullards, and, when smoked, to cause damage to the lungs and body, came to be considered safe by North American lawmakers?

To be seen as so perfectly respectable, fine and dandy that states explicitly give their blessing to recreational use of it? And this in an America that doesn’t let people drink until they are 21 or even touch containers of alcohol till that age, or in public.

In the UK, it is not legal and classed as a class B drug. But that does not mean that ‘it is not ubiquitous’.

This is depressing. I’m all for the exploration and titration of psychoactive drugs to help people in desperate need of pain relief. I am interested in, though not yet convinced by, use of mushrooms (psilocybin) and ecstasy (MDMA) in treating depression.

But the general prevalence of cannabis is a much drearier, bigger, more worrying issue, connected to a general sense of inconsistency and disconnected logic among law-makers and enforcers on one hand, and a sense that all we want to do is bury ourselves in escapist hedonism that alters our minds and our worlds so as to reduce the stress associated with, for instance, responsibility, reality and work.

Labour has indicated that it does not wish to legalise cannabis. But it seems happy, as do the police, with the fact that nobody cares about its technical illegality. People smoke the stuff perfectly openly, without fear, with the threatened £90 fine seemingly a remote possibility. Children therefore have to inhale it in parks. It is a gateway drug for hard drugs and criminality, and forms a familiar backdrop for the insouciant menace of gangs.

But according 2023 figures from the ONS, cannabis was by far the most-commonly used recreational drug in the UK, with 7.4 per cent of adults aged 16 to 59 saying they had consumed it in the last year.

The counter-currents in state attitudes to recreational drugs are just weird. Why does the state look benignly on the smoking of this illegal substance, and fail to promote information about the dangers of inhaling it via smoke (and edibles), but noisily pursue the outlawing of cigarette smoking for those born after a certain date?

Fags are toxic and cancer-causing, and nobody should have to regularly breathe second-hand smoke. But so long as the harm of smoking (the tar in tobacco) is limited to the smoker, and those who voluntarily inhale their smoke, the wider mental effects are not disturbing.

Nicotine alone doesn’t tend to ‘alter personality beyond recognition’ or induce fits of paranoia, depression, criminality or addiction to other substances.

And let’s face it: a waft of cigarette smoke is quite pleasant. Cigarettes retain a kind of aesthetic glamour; their use is not at odds with beauty, comfort, decadence and good conversation. Pot-smokers, instead, give off a polluting stink that lowers the tone of whatever environment one is in, makes conversation a thousand times more inane, and seems to celebrate the urge to do less, or nothing, smugly. Cannabis is deadening, however it is consumed.

Even among those who work hard and have children, cannabis rules, becoming a fixation without which no relaxation is possible, whipped out as soon as the working day ends or the children are asleep. Perhaps what we need is to find other ways to relax, like reading a good book. Or, of course, to stop chasing relaxation and indolence at all costs, full stop.

SOURCE: https://www.telegraph.co.uk/news/2024/12/14/elton-john-is-right-cannabis-deadening-to-soul/

COMMENT BY NATIONAL DRUG PREVENTION ALLIANCE ON THE ARTICLE BY DREXEL – 15 DECEMBER 2024:

 NDPA has significant reservations about his article. Drexel (a ‘private university’ in Philadelphia) are asserting that all drug use is stigmatised ,and that such stigmatisation as they observe should be negated. But other specialists in the field counter by giving comments on stigma/human behaviour etc, as follows:

  • There is no doubt that language which stigmatises a situation or a person is something to be avoided, and there should be an un-stigmatised opening for people to access healthful interventions, but
  • Drug use and addiction is a ‘chicken and egg’ situation, and
  • Writers like this one start half way through the situation, when a person has made a decision to stop being a ‘drug-free’ person; they are already moving down a path which can lead to consequences which were not what they wanted when deciding to use, so
  • They are already a user, and what one might call the ‘pre-addictive’ stage is ignored. Addicted users are portrayed as no less or more than victims, seduced by profiteering suppliers, which
  • Circumvents the initial chapter in the story i.e. the stage in which a person decides to use a substance which
  • In retrospect ca be seen as a bad decision, which should be the target of productive prevention. This is
  • ‘pre the event’ – the heart of the word ‘prevention’ which in its Latin-base (‘praevenire’) means ‘to come before’ – not to come ‘during’!

Take the following paragraph in this paper:

“Awareness of stigma as an impediment to treatment has grown in the last two decades. In the wake of America’s opioid epidemic — when strategic, deceitful marketing, promotion and overprescription of addictive painkillers resulted in millions of individuals unwittingly becoming addicted — the general public began to recognize addiction as a disease to be treated, rather than a moral failure to be punished — as it was often portrayed during the “War on Drugs” in the 1970s and ‘80s”.

Whilst we can harmonise with the authors of this paper in seeking to remove ‘stigma as an impediment to treatment’, we part company with them when they classify all addicts as ‘unwitting victims of deceitful marketing and promotion’. The simple fact is that they made a bad decision, for whatever reason … in some cases suckered, yes, or in other cases not looking down that road and its consequences on themselves and others around them (‘short termism’) – this was not a ‘moral  wrong’, it was what it was.

Prevention should therefore assist people to make healthful decisions – the kind of decision which countless former users make for themselves, thereby moving themselves off the ‘pre-addictive’ road onto a healthful one.

This paper does not include this wider picture, and is the less for that.

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DREXEL PRIVATE UNIVERSITY TEXT:

December 11, 2024

Researchers from Drexel’s College of Computing & Informatics have created large language model program that can help people avoid using language online that creates stigma around substance use disorder.

Drug addiction has been one of America’s growing public health concerns for decades. Despite the development of effective treatments and support resources, few people who are suffering from a substance use disorder seek help. Reluctance to seek help has been attributed to the stigma often attached to the condition. So, in an effort to address this problem, researchers at Drexel University are raising awareness of the stigmatizing language present in online forums and they have created an artificial intelligence tool to help educate users and offer alternative language.

Presented at the recent Conference on Empirical Methods in Natural Language Processing (EMNLP), the tool uses large language models (LLMs), such as GPT-4 and Llama to identify stigmatizing language and suggest alternative wording — the way spelling and grammar checking programs flag typos.

“Stigmatized language is so engrained that people often don’t even know they’re doing it,” said Shadi Rezapour, PhD, an assistant professor in the College of Computing & Informatics who leads Drexel’s Social NLP Lab, and the research that developed the tool. “Words that attack the person, rather than the disease of addiction, only serve to further isolate individuals who are suffering — making it difficult for them to come to grips with the affliction and seek the help they need. Addressing stigmatizing language in online communities is a key first step to educating the public and reducing its use.”

According to the Substance Abuse and Mental Health Services Administration, only 7% of people living with substance use disorder receive any form of treatment, despite tens of billions of dollars being allocated to support treatment and recovery programs. Studies show that people who felt they needed treatment did not seek it for fear of being stigmatized.

“Framing addiction as a weakness or failure is neither accurate nor helpful as our society attempts to address this public health crisis,” Rezapour said. “People who have fallen victim in America suffer both from their addiction, as well as a social stigma that has formed around it. As a result, few people seek help, despite significant resources being committed to addiction recovery in recent decades.”

Awareness of stigma as an impediment to treatment has grown in the last two decades. In the wake of America’s opioid epidemic — when strategic, deceitful marketing, promotion and overprescription of addictive painkillers resulted in millions of individuals unwittingly becoming addicted — the general public began to recognize addiction as a disease to be treated, rather than a moral failure to be punished — as it was often portrayed during the “War on Drugs” in the 1970s and ‘80s.

But according to a study by the Centers for Disease Control and Prevention, while stigmatizing language in traditional media has decreased over time, its use on social media platforms has increased. The Drexel researchers suggest that encountering such language in an online forum can be particularly harmful because people often turn to these communities to seek comfort and support.

“Despite the potential for support, the digital space can mirror and magnify the very societal stigmas it has the power to dismantle, affecting individuals’ mental health and recovery process adversely,” Rezapour said. “Our objective was to develop a framework that could help to preserve these supportive spaces.”

By harnessing the power of LLMs — the machine learning systems that power chatbots, spelling and grammar checkers, and word suggestion tools— the researchers developed a framework that could potentially help digital forum users become more aware of how their word choices might affect fellow community members suffering from substance use disorder.

To do it, they first set out to understand the forms that stigmatizing language takes on digital forums. The team used manually annotated posts to evaluate an LLM’s ability to detect and revise problematic language patterns in online discussions about substance abuse.

Once it has able to classify language to a high degree of accuracy, they employed it on more than 1.2 million posts from four popular Reddit forums. The model identified more than 3,000 posts with some form of stigmatizing language toward people with substance use disorder.

Using this dataset as a guide, the team prepared its GPT-4 LLM to become an agent of change. Incorporating non-stigmatizing language guidance from the National Institute on Drug Abuse, the researchers prompt-engineered the model to offer a non-stigmatizing alternative whenever it encountered stigmatizing language in a post. Suggestions focused on using sympathetic narratives, removing blame and highlighting structural barriers to treatment.

The programs ultimately produced more than 1,600 de-stigmatized phrases, each paired as an alternative to a type of stigmatizing language.

 

destigmatized text

 

Using a combination of human reviewers and natural language processing programs, the team evaluated the model on the overall quality of the responses, extended de-stigmatization, and fidelity to the original post.

“Fidelity to the original post is very important,” said Layla Bouzoubaa, a doctoral student in the College of Computing & Informatics who was a lead author of the research. “The last thing we want to do is remove agency from any user or censor their authentic voice. What we envision for this pipeline is that if it were integrated onto a social media platform, for example, it will merely offer an alternate way to phrase their text if their text contains stigmatizing language towards people who use drugs. The user can choose to accept this or not. Kind of like a Grammarly for bad language.”

Bouzoubaa also noted the importance of providing clear, transparent explanations of why the suggestions were offered and strong privacy protections of user data when it comes to widespread adoption of the program.

To promote transparency in the process, as well as helping to educate users, the team took the step of incorporating an explanation layer in the model so that when it identified an instance of stigmatizing language it would automatically provide a detailed explanation for its classification, based on the four elements of stigma identified in the initial analysis of Reddit posts.

“We believe this automated feedback may feel less judgmental or confrontational than direct human feedback, potentially making users more receptive to the suggested changes,” Bouzoubaa said.

This effort is the most recent addition to the group’s foundational work examining how people share personal stories online about experiences with drugs and the communities that have formed around these conversations on Reddit.

“To our knowledge, there has not been any research on addressing or countering the language people use (computationally) that can make people in a vulnerable population feel stigmatized against,” Bouzoubaa said. “I think this is the biggest advantage of LLM technology and the benefit of our work. The idea behind this work is not overly complex; however, we are using LLMs as a tool to reach lengths that we could never achieve before on a problem that is also very challenging and that is where the novelty and strength of our work lies.”

In addition to making public the programs, the dataset of posts with stigmatizing language, as well as the de-stigmatized alternatives, the researchers plan to continue their work by studying how stigma is perceived and felt in the lived experiences of people with substance use disorders.

 

 

In addition to Rezapour and Bouzoubaa, Elham Aghakhani contributed to this research.

Read the full paper here: https://aclanthology.org/2024.emnlp-main.516/

This is an RTE component

Source: https://drexel.edu/news/archive/2024/December/LLM-substance-use-disorder-stigmatizing-language

Few patients know about evidence-based treatment—or have or seek access to it

Overview

Alcohol is the leading driver of substance use-related fatalities in America: Each year, frequent or excessive drinking causes approximately 178,000 deaths.1 Excessive alcohol use is common in the United States among people who drink: In 2022, of the 137 million Americans who reported drinking in the last 30 days, 45% reported binge drinking (five or more drinks in a sitting for men; four for women).2 Such excessive drinking is associated with health problems such as injuries, alcohol poisoning, cardiovascular conditions, mental health problems, and certain cancers.3

In 2020, many people increased their drinking because of COVID-19-related stressors, including social isolation, which led to a 26% increase in alcohol-related deaths during the first year of the pandemic.4

Figure 1

Alcohol‑Related Deaths Have Increased Since 2016

Growth is driven by increases in both acute and chronic causes of death

Stacked bar graph shows yearly increases in alcohol-related deaths attributed to both chronic and acute causes from 2016-17 through 2020-21. Deaths related to chronic causes increased from approximately 89,000 to approximately 117,000 (a 32% increase), while acute deaths increased from approximately 49,000 to approximately 61,000 (a 24% increase).

Notes: Chronic causes of death include illness related to excessive alcohol use such as cancer, heart disease, and stroke, and diseases of the liver, gallbladder, and pancreas. Acute causes include alcohol-related poisonings, car crashes, and suicide.

Source: Marissa B. Esser et al., “Deaths From Excessive Alcohol Use—United States, 2016-2021,” Morbidity and Mortality Weekly Report 73, no. 8154-61, https://www.cdc.gov/mmwr/volumes/73/wr/mm7308a1.htm#T1_down

© 2024 The Pew Charitable Trusts

Nationwide, nearly 30 million people are estimated to have alcohol use disorder (AUD); it is the most common substance use disorder. AUD is a treatable, chronic health condition characterized by a person’s inability to reduce or quit drinking despite negative social, professional, or health effects.5 While no single cause is responsible for developing AUD, a mix of biological, psychological, and environmental factors can increase an individual’s risk, including a family history of the disorder.6

There are well-established guidelines for AUD screening and treatment, including questions that can be asked by a person’s health care team, medications approved by the U.S. Food and Drug Administration (FDA), behavioral therapies, and recovery supports, but these approaches often are not put into practice.7 When policies encourage the adoption of screening and evidence-based medicines for AUD, particularly in primary care, the burden of alcohol-related health problems can be reduced across the country.8

The Spectrum of Unhealthy Alcohol Use

For adults of legal drinking age, U.S. dietary guidelines recommend that they choose not to drink or drink in moderation, defined as two drinks or fewer in a day for men, and one drink or fewer in a day for women.9 One drink is defined as 0.6 ounces of pure alcohol—the amount in a 12-ounce beer containing 5% alcohol, a 5-ounce glass of wine containing 12% alcohol, or 1.5 ounces of 80-proof liquor.10

Consumption patterns exceeding these recommended levels are considered:

  • Heavy drinking, defined by the number of drinks consumed per week: 15 or more for men, and eight or more for women.11
  • Binge drinking, defined by the number of drinks consumed in a single sitting: five or more for men, and four or more for women.12

Alcohol use disorder is defined by The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as having symptoms of two or more diagnostic criteria within a 12-month period.13 The diagnostic criteria assess behaviors such as trying to stop drinking but being unable to, alcohol cravings, and the extent to which drinking interferes with an individual’s life.14 AUD can be mild (meeting two or three criteria), moderate (meeting four or five criteria), or severe (six or more criteria).15

Identifying and preventing AUD

Primary care providers are well positioned to recognize the signs of unsafe drinking in their patients. The U.S. Preventive Services Task Force recommends that these providers screen adults 18 years and older for alcohol misuse.16 One commonly used evidence-based approach, SBIRT—or screening, brief intervention, and referral to treatment—is a series of steps that help providers identify and address a patient’s problematic substance use.17

Using a screening questionnaire, a provider can determine whether a patient is at risk and, if so, can deliver periodic brief behavioral interventions in an office setting. Such interventions have been shown to reduce heavy alcohol use among adolescents, adults, and older adults.18 When a patient meets the criteria for AUD, providers can offer medication, connect them to specialty treatment, refer them to recovery supports such as Alcoholics Anonymous or other mutual-help groups, or all of the above, depending on a patient’s needs and preferences.19 When these interventions are used in primary care settings, they can reduce heavy alcohol use.20

While screening for AUD is common, few providers follow up when a patient reports problematic alcohol use. From 2015 to 2019, 70% of people with AUD were asked about their alcohol use in health care settings, but just 12% of them received information or advice about reducing their alcohol use.21 Only 5% were referred to treatment.22

Emergency departments (EDs) are another important setting for identifying AUD, and to maintain accreditation they are required to screen at least 80% of all patients for alcohol use.23 Alcohol is the most common cause of substance-related ED visits, meaning many people in these settings are engaged in excessive or risky alcohol consumption and could be linked to care.24

The use of SBIRT in the ED can also reduce alcohol use, especially for people without severe alcohol problems.25 Providers who use SBIRT can help patients reduce future ED visits and also some negative consequences associated with alcohol use, such as injuries.26

Commonly cited barriers to using SBIRT in these health care settings include competing priorities and insufficient treatment capacity in the community when patients need referrals. Conversely, SBIRT use increases with strong leadership and provider buy-in, collaboration across departments and treatment settings, and sufficient privacy to discuss substance use with patients.27

Jails and prisons should also screen for AUD, as well as other SUDs, to assess clinical needs and connect individuals with care. However, screening practices may not be evidence based. A review of the intake forms used to screen individuals in a sample of jails in 2018-19 found that some did not ask about SUD at all, and of those that did, they did not use validated tools accepted for use in health care and SUD treatment settings.28

Withdrawal management

Up to half of all people with AUD experience some withdrawal symptoms when attempting to stop drinking.29 For many, common symptoms such as anxiety, sweating, and insomnia are mild.30 For a small percentage, however, withdrawal can be fatal if not managed appropriately.31 These individuals can experience seizures or a condition called alcohol withdrawal delirium (also referred to as delirium tremens), which causes patients to be confused and experience heart problems and other symptoms; if untreated, it can be fatal.32 People with moderate withdrawal symptoms can also require medical management to address symptoms such as tremors in addition to anxiety, sweating, and insomnia.33

To determine whether a patient with AUD is at risk of severe withdrawal or would benefit from help managing symptoms, the American Society of Addiction Medicine recommends that providers evaluate patients with positive AUD screens for their level of withdrawal risk.34 Based on this evaluation, providers can offer or connect patients to the appropriate level of withdrawal management.35

At a minimum, high-quality withdrawal management includes clinical monitoring and medications to address symptoms.36 Providers may also offer behavioral therapies.37 Depending on the severity of a patient’s symptoms and the presence of co-occurring conditions such as severe cardiovascular or liver disease that require a higher level of care, withdrawal management can be provided on either an inpatient or an outpatient basis.38

According to the U.S. Department of Justice’s Bureau of Justice Assistance and the National Institute of Corrections, jails should also use evidence-based standards of care to address alcohol withdrawal. These standards include screening and assessing individuals who are at risk for withdrawal and, if the jail cannot provide appropriate care, transferring them to an ED or hospital.39

Withdrawal management on its own is not effective in treating AUD, and without additional services after discharge, most people will return to alcohol use.40 Because of this, providers should also connect people with follow-up care, such as residential or outpatient treatment, after withdrawal management to improve outcomes. Continued care helps patients sustain abstinence, reduces their risk of arrests and homelessness, and improves employment outcomes.41

Patients face multiple barriers to this follow-up care, however. For example, withdrawal management providers from the Veterans Health Administration cited long wait times for follow-up care, inadequate housing, and lack of integration between withdrawal management and outpatient services as reasons patients couldn’t access services.42 Patients have also cited barriers such as failure of the withdrawal management provider to arrange continued care, lengths of stay that were too short to allow for recovery to begin, insufficient residential treatment capacity for continued care, and inadequate housing.43

Promising practices for improving care continuity include: providing peer recovery coaches—people with lived expertise of substance use disorder who can help patients navigate treatment and recovery; psychosocial services that increase the motivation to continue treatment; initiating medication treatment before discharge; reminder phone calls; and “warm handoffs,” in which patients are physically accompanied from withdrawal management to the next level of care.44

Treating AUD

In 2023, 29 million people in the U.S. met the criteria for AUD, but less than 1 in 10 received any form of treatment.45 Formal treatment may not be necessary for people with milder AUD and strong support systems.46 But people who do seek out care can face a range of barriers, including stigma, lack of knowledge about what treatment looks like and where to get it, cost, lack of access, long wait times, and care that doesn’t meet their cultural needs.47

For those who need it, AUD treatment can include a combination of behavioral, pharmacological, and social supports designed to help patients reach their recovery goals, which can range from abstaining from alcohol to reducing consumption.48

While for many the goal of treatment is to stop using alcohol entirely, supporting non-abstinence treatment goals is also important, because reduced alcohol consumption is associated with important health benefits such as lower blood pressure, improved liver functioning, and better mental health.49

Services for treating AUD—including medication and behavioral therapy—can be offered across the continuum of care, from primary care to intensive inpatient treatment, depending on a patient’s individual needs.50

Medications

Medications for AUD help patients reduce or cease alcohol consumption based on their individual treatment goals and can help improve health outcomes.51 Medications can be particularly helpful for people experiencing cravings or a return to drinking, or people for whom behavioral therapy alone has not been successful.52 But medications are not often used: Of the 30 million people with AUD in 2022, approximately 2% (or 634,000 people) were treated with medication.53

The FDA has approved three medications to treat AUD:

  • Naltrexone reduces cravings in people with AUD.54 This medication is also approved to treat opioid use disorder, and because it blocks the effects of opioids and can cause opioid withdrawal, patients who use these substances must be abstinent from opioids for one to two weeks prior to starting this treatment for AUD.55 It can be taken daily or as needed in a pill or as a monthly injection.56 Oral naltrexone is effective at reducing the percentage of days spent drinking, the percentage of days spent drinking heavily, and a return to any drinking.57 Injectable naltrexone can reduce the number of days spent drinking and the number of heavy drinking days.58 Additionally, naltrexone can reduce the incidence of alcohol-associated liver disease—an often-fatal complication of heavy alcohol use—and slow the disease’s progression in people who already have it.59
  • Acamprosate is taken as a pill.60 It reduces alcohol craving and helps people with AUD abstain from drinking.61 It reduces the likelihood of a return to any drinking and number of drinking days.62
  • Disulfiram deters alcohol use by inducing nausea and vomiting and other negative symptoms if a person drinks while using it.63 It is also taken as a pill.64 There is insufficient data to determine whether a treatment is more effective than a placebo at preventing relapses in alcohol consumption or other related issues.65 However, for some individuals, knowing they will get sick from consuming alcohol while taking disulfiram can increase motivation to abstain.66 As medication adherence is a challenge for patients, supervised administration of disulfiram by another person—for example, a spouse—can improve outcomes in patients who are compliant.67

Additionally, some medications used “off-label” (meaning they were approved for treating other conditions) have also effectively addressed AUD. A systematic review found that topiramate, a medication approved for treating epilepsy and migraines, had the strongest evidence among off-label drugs for reducing both any drinking and heavy drinking days.68 Like naltrexone, it can reduce the incidence of alcohol-related liver disease.69

Despite the benefits that medications provide, they remain an underutilized tool for a variety of reasons—such as lack of knowledge among patients and providers, stigma against the use of medication, and failure of pharmacies to stock the drugs.70

Behavioral therapies

Behavioral therapies can also help individuals manage AUD, and they support medication adherence:

  • Motivational enhancement therapy focuses on steering people through the stages of change71 by reinforcing their motivation to modify personal drinking behaviors.72
  • Cognitive behavioral therapy addresses people’s feelings about themselves and their relationships with others and helps to identify and change negative thought patterns and behaviors related to drinking, including recognizing internal and external triggers. It focuses on developing and practicing coping strategies to manage these triggers and prevent continued alcohol use.73
  • Contingency management uses positive reinforcement to motivate abstinence or other healthy behavioral changes.74 It can help people who drink heavily to reduce their alcohol use.75

All of these approaches can help address AUD, and no one treatment has proved more effective than another in treating this complicated condition.76 Combining behavioral therapies with other approaches such as medication and recovery supports, as described below, can improve their efficacy.77

Recovery supports

Peer support specialists and mutual-help groups can also help people achieve their personal recovery goals:

  • Peer support specialists are individuals with lived expertise in recovery from a substance use disorder who provide a variety of nonclinical services, including emotional support and referrals to community resources.78 The inclusion of peer support specialists in AUD treatment programs has been found to significantly reduce alcohol use and increase attendance in outpatient care.79
  • Mutual-help groups, such as Alcoholics Anonymous (AA) and Self-Management and Recovery Training (SMART), support individuals dealing with a shared problem. People may seek out these groups more than behavioral or medication treatment for AUD because they can join on their own time and at no cost, and they may better cater to people’s needs related to varying gender identities, ages, or races.80 Observational research shows that voluntary attendance at peer-led AA groups can be as effective as behavioral treatments in reducing drinking.81

People with AUD can use recovery supports on their own, in combination with behavioral treatment or medication, or as a method to maintain recovery when leaving residential treatment or withdrawal management.82

While the U.S. records more than 178,000 alcohol-related deaths each year, some populations have a higher risk of alcohol-related deaths, and others face greater barriers to treatment.83

American Indian and Alaska Native communities

Despite seeking treatment at higher rates than other racial/ethnic groups, American Indian and Alaska Native people have the highest rate of alcohol-related deaths.84

Figure 2

American Indian and Alaska Native Individuals Have Persistently Higher Alcohol‑Related Death Rates Compared With Other Racial and Ethnic Groups

Alcohol‑related deaths per 100,000 people

A clustered column chart displays the rate of alcohol-related deaths per 100,000 people by racial and ethnic group for four years: 2012, 2016, 2019, and 2022. While the chart shows increasing rates for all included racial and ethnic groups (American Indian/Alaska Native, White, Hispanic, Black, and Asian or Pacific Islander), the mortality rates are highest each year for American Indian/Alaska Natives.

© 2024 The Pew Charitable Trusts View image

Risk factors that impact these communities and can contribute to these deaths include historical and ongoing trauma from colonization, the challenges of navigating both native and mainstream American cultural contexts, poverty resulting from forced relocation, and higher rates of mental health conditions than in the general population.85 Substances, including alcohol, are sometimes used to cope with these challenges.86

However, American Indian/Alaska Native communities also have rich protective factors such as their cultures, languages, traditions, and connections to elders, which can help reduce negative outcomes associated with alcohol use, especially when treatment services incorporate and build on these strengths.87

For example, interviews with American Indian/Alaska Native patients with AUD in the Pacific Northwest revealed that many participants preferred Native-led treatment environments that incorporated traditional healing practices and recommended the expansion of such services.88

To improve alcohol-related outcomes for American Indians and Alaska Natives, policymakers and health care providers must develop a greater understanding of the barriers and strengths of these diverse communities and support the development of culturally and linguistically appropriate services. The federal Department of Health and Human Services Office of Minority Health defines such an approach as “services that are respectful of and responsive to the health beliefs, practices, and needs of diverse patients.”89

People living in rural areas

Rural communities are another group disproportionately affected by AUD. People living in rural areas have higher alcohol-related mortality rates than urban residents but are often less likely to receive care.90 They face treatment challenges including limited options for care; concerns about privacy while navigating treatment in small, close knit communities; and transportation barriers.91

Figure 3

Alcohol‑Related Deaths Have Increased Faster in Rural Areas

2012‑22 change in alcohol‑induced death rate per 100,000 by urban and rural areas

A graph with four bars shows the increase in alcohol-related deaths per 100,000 people in urban and rural areas from 2012 to 2022. In urban areas, the rate increased from 8.6 to 14.9 per 100,000 people, a 73% increase. In rural areas, the rate increased from 10.1 to 19.6 per 100,000 people, a 94% increase.

Telemedicine can help mitigate these barriers to care.92 Cognitive behavioral therapy and medications for AUD can be delivered effectively in virtual settings.93 People with AUD can also benefit from virtual mutual-help meetings, though some find greater value in face-to-face gatherings.94

Despite the value of virtual care delivery, people living in rural areas also often have limited access to broadband internet, which can make these interventions challenging to use.95 Because of this, better access to in-person care is also needed.

Next steps

To improve screening and treatment for patients with AUD, policymakers, payers, and providers should consider strategies to:

  • Conduct universal screenings for unhealthy alcohol use and appropriately follow up when those screenings indicate a problem. Less than 20% of people with AUD proactively seek care, so health care providers shouldn’t wait for patients to ask them for help.96
  • Connect people with continued care after withdrawal management so that they can begin their recovery. People leaving withdrawal management settings should have a treatment plan that meets their needs—whether that’s behavioral treatment, recovery supports, medication, or a combination of these approaches.
  • Further the use of medications for AUD. With just 2% of people with AUD receiving medication, significant opportunities exist to increase utilization and improve outcomes.97
  • Address disparities through culturally competent treatment and increased access in rural areas. The populations most impacted by AUD should have access to care that meets their needs and preferences.

AUD is a common and treatable health condition that often goes unrecognized or unaddressed. Policymakers can improve the health of their communities by supporting providers in increasing the use of evidence-based treatment approaches.98

If you are concerned about your alcohol consumption, you can use the Check Your Drinking tool created by the Centers for Disease Control and Prevention to assess your drinking levels and make a plan to reduce your use.

Source: https://www.pewtrusts.org/en/research-and-analysis/fact-sheets/2024/12/americas-most-common-drug-problem-unhealthy-alcohol-use

PublishedContact:Jared Culligan – jculligan@nahb.org
This December, join NAHB in recognizing National Drunk and Drug Impaired Driving Prevention Month and be aware of the devastating consequences that result from impaired driving.

From 2018 to 2022, the National Highway Traffic Safety Administration (NHTSA) recorded more than 4,700 deaths in drunk driving traffic crashes during the month of December. In addition, a study by NHTSA found more than 54% of injured drivers had some amount of alcohol or drugs in their system at the time of the incident.

Although this month focuses primarily on reducing impaired driving on the road, it’s also crucial to extend this conversation to safety in the workplace and how drunk and drug-impaired driving can impact the construction industry.

What can your organization do to prevent drunk and drug-impaired driving incidents?

  • Provide education and training materials on the effects of certain substances.
  • Perform post-incident drug and alcohol testing and have a recovery-ready workplace to engage and support employees in stopping substance misuse whenever possible.

NAHB has several Video Toolbox Talks available in English and Spanish regarding drunk and drug-impaired driving. Please be sure to check out our content and help spread awareness as we approach the holidays:

In addition, several government establishments are promoting materials during this time of year. Check out their available resources:

If you know of anybody that needs immediate help, please reach out to the 988 Suicide and Crisis Lifeline or SAMHSA’s National Helpline, 1-800-662-HELP (4357).

Source: https://www.nahb.org/blog/2024/12/promote-safe-driving-resources

 

by Brian Anthony Hernandez   

Published on December 28, 2024 08:00AM EST
Teen cigarette use in 2024 was the lowest ever recorded since the Monitoring the Future study started tracking it in the 1970s. A national study discovered that teens in the United States consumed significantly less alcohol and drugs in 2024 compared to past years.

Teen alcohol use has steadily decreased from 2000 to 2024 — falling from 73% to 42% in 12th grade, 65% to 26% in 10th grade and 43% to 13% in 8th grade — according to data from Monitoring the Future (MTF), an annual federally funded study.

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Every year, the University of Michigan’s Institute for Social Research uses grant money from the National Institute on Drug Abuse to conduct the MTF main study, which surveys more than 25,000 8th, 10th and 12th graders to monitor behaviors, attitudes and values of adolescents.

Meanwhile, the MTF’s panel study does follow-up surveys with roughly 20,000 adults ages 19 to 65 to continue to track trends over time.

The main study found that aside from the “long-term, overall decline” in teen alcohol use, in 2024, “alcohol use significantly declined in both 12th and 10th grade for lifetime and past 12-month use. In 10th grade, it also significantly declined for past 30-day use.”

Binge drinking, which researchers defined as “consuming five or more drinks in a row at least once during the past two weeks,” among teens also declined in 2024 for all three grades compared to 2023 and the past two-and-half decades.

Since 2000, binge drinking has fallen from 30% to 9% in 12th grade, from 24% to 5% in 10th grade and from 12% to 2% in 8th grade.

Teen cigarette use in 2024 was the lowest ever recorded since the survey started tracking 12th graders in 1975 and 10th and 8th graders in 1991.

“The intense public debate in the late 1990s over cigarette policies likely played an important role in bringing about the very substantial downturn in adolescent smoking that followed,” researchers said, adding that “an important milestone occurred in 2009 with passage of the Family Smoking Prevention and Tobacco Control Act, which gave the U.S. Food and Drug Administration the authority to regulate the manufacturing, marketing, and sale of tobacco products.”

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Researchers emphasized that “over time this dramatic decline in regular smoking should produce substantial improvements in the health and longevity of the population.”

Teen marijuana use (non-medical) in 2024 also declined for all three grades, with the percentage of students using marijuana in the last 12 months at 26% in 12th grade, 16% in 10th grade and 7% in 8th grade.

“Levels of annual marijuana use today are considerably lower than the historic highs observed in the late 1970s, when more than half of 12th graders had used marijuana in the past 12 months,” researchers reported.

 

OPENING STATEMENT BY AUTHOR: Dec 31, 2024

Drug Free Australia has launched a new Substack where we start out with the foundational failure of Australia’s 1985 Harm Minimisation experiment which has literally seen thousands of families (5,400 between 2000 and 2007 alone) needlessly grieving for a lost loved one – all directly as a result of our adoption of Harm Reduction measures.  If you think this is fanciful, you need to look at the cold, hard evidence.

If you live in another country, this is precisely a drug policy approach you need to fight to avoid and you may need to use this data to do it.

Gary Christian, President, Drug Free Australia. Phone: 0422 163 141

A study of nearly 10,000 adolescents funded by the National Institutes of Health (NIH) has identified distinct differences in the brain structures of those who used substances before age 15 compared to those who did not. Many of these structural brain differences appeared to exist in childhood before any substance use, suggesting they may play a role in the risk of substance use initiation later in life, in tandem with genetic, environmental, and other neurological factors.

This adds to some emerging evidence that an individual’s brain structure, alongside their unique genetics, environmental exposures, and interactions among these factors, may impact their level of risk and resilience for substance use and addiction. Understanding the complex interplay between the factors that contribute and that protect against drug use is crucial for informing effective prevention interventions and providing support for those who may be most vulnerable.”

Nora Volkow M.D., Director of NIDA

Among the 3,460 adolescents who initiated substances before age 15, most (90.2%) reported trying alcohol, with considerable overlap with nicotine and/or cannabis use; 61.5% and 52.4% of kids initiating nicotine and cannabis, respectively, also reported initiating alcohol. Substance initiation was associated with a variety of brain-wide (global) as well as more regional structural differences primarily involving the cortex, some of which were substance-specific. While these data could someday help inform clinical prevention strategies, the researchers emphasize that brain structure alone cannot predict substance use during adolescence, and that these data should not be used as a diagnostic tool.

The study, published in JAMA Network Open, used data from the Adolescent Brain Cognitive Development Study, (ABCD Study), the largest longitudinal study of brain development and health in children and adolescents in the United States, which is supported by the NIH’s National Institute on Drug Abuse (NIDA) and nine other institutes, centers, and offices.

Using data from the ABCD Study, researchers from Washington University in St. Louis assessed MRI scans taken of 9,804 children across the U.S. when they were ages 9 to 11 – at “baseline” – and followed the participants over three years to determine whether certain aspects of brain structure captured in the baseline MRIs were associated with early substance initiation. They monitored for alcohol, nicotine, and/or cannabis use, the most common substances used in early adolescence, as well as use of other illicit substances. The researchers compared MRIs of 3,460 participants who reported substance initiation before age 15 from 2016 to 2021 to those who did not (6,344).

They assessed both global and regional differences in brain structure, looking at measures like volume, thickness, depth of brain folds, and surface area, primarily in the brain cortex. The cortex is the outermost layer of the brain, tightly packed with neurons and responsible for many higher-level processes, including learning, sensation, memory, language, emotion, and decision-making. Specific characteristics and differences in these structures – measured by thickness, surface area, and volume – have been linked to variability in cognitive abilities and neurological conditions.

The researchers identified five brain structural differences at the global level between those who reported substance initiation before the age of 15 and those who did not. These included greater total brain volume and greater subcortical volume in those who indicated substance initiation. An additional 39 brain structure differences were found at the regional level, with approximately 56% of the regional variation involving cortical thickness. Some brain structural differences also appeared unique to the type of substance used.

While some of the brain regions where differences were identified have been linked to sensation-seeking and impulsivity, the researchers note that more work is needed to delineate how these structural differences may translate to differences in brain function or behaviors. They also emphasize that the interplay between genetics, environment, brain structure, the prenatal environment, and behavior influence affect behaviors.

Another recent analysis of data from the ABCD study conducted by the University of Michigan demonstrates this interplay, showing that patterns of functional brain connectivity in early adolescence could predict substance use initiation in youth, and that these trajectories were likely influenced by exposure to pollution.

Future studies will be crucial to determine how initial brain structure differences may change as children age and with continued substance use or development of substance use disorder.

“Through the ABCD study, we have a robust and large database of longitudinal data to go beyond previous neuroimaging research to understand the bidirectional relationship between brain structure and substance use,” said Alex Miller, Ph.D., the study’s corresponding author and an assistant professor of psychiatry at Indiana University. “The hope is that these types of studies, in conjunction with other data on environmental exposures and genetic risk, could help change how we think about the development of substance use disorders and inform more accurate models of addiction moving forward.”

Journal reference:

Miller, A. P., et al. (2024). Neuroanatomical Variability and Substance Use Initiation in Late Childhood and Early Adolescence. JAMA Network Opendoi.org/10.1001/jamanetworkopen.2024.52027.

Source: https://www.news-medical.net/news/20241230/Structural-brain-differences-in-adolescents-may-play-a-role-in-early-initiation-of-substance-use.aspx

Sima Patra • Sayantan Patra • Reetoja Das • Soumya Suvra Patra

Published: December 31, 2024

DOI: 10.7759/cureus.76659

Cite this article as: Patra S, Patra S, Das R, et al. (December 31, 2024) Rising Trend of Substance Abuse Among Older Adults: A Review Focusing on Screening and Management. Cureus 16(12): e76659. doi:10.7759/cureus.76659

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Abstract

There is undoubtedly an alarmingly rising trend of substance use among older adults. This has necessitated a paradigm shift in healthcare and propelled strategies aimed at effective prevention and screening. Age-related physiological changes, such as diminished metabolism and increased substance sensitivity, make older adults particularly vulnerable to adverse effects of substances. This not only has adverse psychological consequences but also physical consequences like complicating chronic illnesses and harmful interactions with medications, which lead to increased hospitalization.

Standard screening tools can identify substance use disorders (SUDs) in older adults. Tools like the Cut-down, Annoyed, Guilty, and Eye-opener (CAGE) questionnaire and Michigan Alcohol Screening Test-Geriatric (MAST-G) are tailored to detect alcoholism, while the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) and Alcohol Use Disorders Identification Test (AUDIT) assess abuse of illicit and prescription drugs. Since older adults are more socially integrated, screening should be done using non-stigmatizing and non-judgmental language.

Prevention strategies include educational programs, safe prescribing practices, and prescription drug monitoring. Detection of substance abuse should be followed by brief interventions and specialized referrals. In conclusion, heightened awareness, improved screening, and preventive measures can mitigate substance abuse risks in this demographic. Prioritizing future research on non-addictive pain medications and the long-term effects of substances like marijuana seems justified.

 

Source: https://www.cureus.com/articles/322781-rising-trend-of-substance-abuse-among-older-adults-a-review-focusing-on-screening-and-management?score_article=true#!/

SCOPE was formed in 2019 to help prevent opioid addiction, conducting cutting-edge research and education according to the announcement.
Ohio Attorney General Dave Yost issued an announcement commemorating Scientific Committee on Opioid Prevention and Education (SCOPE) for reaching its first five years of educating the public of opioids.

SCOPE was formed in 2019 to help prevent opioid addiction, conducting cutting-edge research and education according to the announcement.

“The breakthroughs emerging from SCOPE’s work are paving the way for a future in which fewer families suffer the heart-wrenching loss of a loved one to an opioid overdose,” said Yost.

In addition to the announcement, Yost also shared a five-year report of SCOPE’s impact.

The SCOPE team includes Beth Delaney, Caroline Freiermuth, Tessa Miracle, Rene Saran, Jon E. Sprague, Donnie Sullivan, Julie Teater and Arthur B. Yeh.

The report includes four major sections titled “raising public awareness”, “educating future health-care professionals”, “emphasizing proper drug storage, disposal” and “prioritizing pharmacogenomics”.

Raising Public Awareness

The first section of the report outlines background information on the opioid issue the SCOPE was founded on. It also states that an underlying issue were illicitly manufactured fentanyls (IMFs) that are often added to other drugs.

The report goes on to state that work conducted by the Chemistry Unit in the Ohio Bureau of Criminal Investigation’s Laboratory found noteworthy comparisons of polydrug samples that included IMFs.

The most present IMFs in the polydrug samples during this study were fentanyl and para-fluorofentanyl.

In 2013, 2.2% of polydrug samples containing heroin and cocaine also contained IMFs. However, in 2022, more than 89% of polydrug samples contained IMFs. This is described as a 335-fold increase according to the report.

Also included in this section of the report was findings the committee reported when they conducted a longitudinal study of opioid overdose data from the Ohio Department of Health death records going back to 2007.

The findings included the fact that the death rate from opioid use per 100,000 reached 14.29 in the second quarter of 2020, the highest statistic to date in Ohio.

 

To help raise public awareness of these statistics and dangers, SCOPE:
  • Created public service announcements
  • Submitted letters to the editors of scientific journals
  • Increased cautioning efforts to health-care professionals and scientists state-wide about the dangers of purchasing illegal drugs on the streets

Educating Future Health-Care Professionals

In December 2019, SCOPE surveyed students enrolled in health-care professional programs at 49 of Ohio’s universities to see how many of these students were learning about “Opioid Use Disorder” (OUD).

The survey reportedly covered four main categories:

  • Initial screening of patients
  • Training in OUD
  • Training in care for patients at high risk for OUD
  • Education in evaluating patients for “Adverse Childhood Experiences” (ACEs)

Results of the survey showed a need for a standardized curriculum discussing OUD.

SCOPE partnered with Assistant Professor Dr. Kelsey Schmuhl of Ohio State University’s College of Pharmacy to develop the “Interprofessional Program on Opioid Use Disorder”.

The more than 2,000 students that completed the course were suggested to understand more about OUD and the factors that contribute to it.

Emphasizing Proper Drug Storage, Disposal

A large danger that SCOPE wanted to address was the potential danger of having unsecured opioids available at home from left over prescriptions.

A study conducted by the Wisconsin Poison Control in which calls were fielded between 2002 and 2016 relating to unintended opioid exposure revealed that 61% of cases involved children aged zero to 5-years-old, and 29% involved teens between 13 and 19 years.

SCOPE partnered with the U.S. Drug Enforcement Administration to create the “Attorney General Drug Dropoff Days” which combine with the DEA’s Drug Take-back Days.

The report reflects on a map depicting a snapshot from the second quarter of 2020, showing that Ohio counties such as Scioto, Fayette and Franklin had the largest amounts of opioid overdose deaths.

Mahoning County and Trumbull County are also listed on this graphic.

With this data in hand, organizers began the Drug Dropoff Day events. In 2020, a snapshot of the collection numbers for all of the counties in the map above. Trumbull and Mahoning Counties had a collection total of 300 pounds.

To date, these events have been held in 11 counties throughout Ohio and have yielded over 2,600 pounds of unwanted and unsecured prescription medications.

Source: https://www.wfmj.com/story/52096722/scope-looks-back-on-the-progress-developments-of-its-past-five-years

Filed under: Latest News,USA :

In 2022 the White House Office of National Drug Control Strategy (ONDCP) published its first National Drug Control Strategy, which outlined seven goals to be achieved by 2025. On December 30, 2024, the ONDCP released the National Drug Control Strategy Performance Review System (PRS) Report—essentially a progress update on the Biden administration response to the overdose crisis between 2020 and 2022.

Though the ONDCP published an updated Strategy in May 2024, the new PRS report is intended to span data through 2022, corresponding to the original version. It has a tendency to veer into data from more recent years, however, which reflect a turnaround in overdose rates and as such look a lot better than the years the report is meant to cover.

The seven goals outlined in the original Strategy contain 25 objectives, most of which are assessed as on track. Five are already completed; five are behind schedule.

Viewed in the context of the recent drop in overdose mortality, the PRS updates would suggest that reducing drug-related deaths doesn’t actually require reducing access to drugs, but that’s probably beyond the scope of the ONDCP’s analysis.

 

Goal 1: Less drug use

The first objective for this goal was to reduce overdose deaths by 13 percent by 2025. The most recent Centers for Disease Control and Prevention data show a decrease of 16.9 percent, which according to the report is “[t]hanks in significant part to actions by the Administration.”

The second objective was to reduce prevalence of substance use disorders (SUD) specific to opioids, methamphetamine and cocaine by 25 percent.

The ONDCP attributed cocaine use disorder to 0.5 percent of the population in 2021, based on responses to the 2021 National Drug Use Survey. Which evolved between 2020 and 2021, and identifies different SUD by somewhat convoluted means, but the ONDCP doesn’t acknowledge non-problematic use of those substances and so approached use and SUD as the same thing. It attributed methamphetamine use disorder to 0.6 percent of the population, and opioid use disorder to 2 percent.

Per 2022 data, there’s been no change in baseline use of cocaine and meth. Opioid use increased to 2.2 percent, meaning “accelerated action” would be needed to finish on time.

 

Goal 2: More prevention

While the previous goal applied to ages 12 and up, this goal of ensuring that “Prevention efforts are increased in the the United States,” refers to youth drinking and vaping.

The first objective was to get youth alcohol consumption, measured by past 30-day use, under 6.5 percent by 2025. Data show that between 2021 and 2022 the rate decreased from 7.2 percent to 6.8 percent, which put it on track.

The second objective was to reduce youth use of nicotine vapes by 15 percent by 2025. Data show that in 2021, around 7.6 percent of middle- and high-school students reported having vaped within the past month. In 2022 this rose to 9.4, but the target for 2025 was anything under 11.1, so ONDCP considers this objective already met and the 2022 increase doesn’t change that.

 

Goal 3: More harm reduction

The first objective here was an 85-percent increase in the number of counties disproportionately affected by overdose that had at least one syringe service program (SSP). Data show that in 2020, 130 counties with high overdose death rates had at least one SSP; by 2022 this had increased to 180 counties, which was on track for the ONDCP goal of 241 counties by 2025.

The second objective was a 25-percent increase in SSP offering “some type of drug safety checking support service.” The 2025 target of 21.3 percent had already been met by 2021, but over the next year the number of SSP offering drug-checking services nearly doubled—2022 data show 46.7 percent of SSP met that criteria.

However, “some type” of drug-checking refers largely to fentanyl test strips, which are most useful to people who do not regularly use opioids. The more useful drug-checking service for people who do regularly use opioids—the population that SSP primarily serve—is on-site forensic analysis. This requires more expensive equipment, to which only a handful of SSP have access.

 

Goal 4: More treatment

The first objective was a 100-percent increase in admissions to treatment facilities among people considered at high risk for overdose involving opioids, methamphetamine or cocaine. This doesn’t include methadone maintenance or outpatient buprenorphine prescriptions. In 2021, treatment facilities reported 637,589 admissions among people using primarily opioids, methamphetamine, cocaine or other “synthetics,” which was already about one-third short of the target for that year. In 2022 admissions dropped to 604,096.

The second objective was to ease the shortage of behavioral health providers by 70 percent. The PRS report finds that this been pretty steadily on track and is projected to stay that way.

 

Goal 5: More recovery initiatives

The first objective here is to have at least 14 states operating a “recovery-ready workplace initiative” by 2025. The term refers to a Biden administration push for more equitable employment policies for workers with substance use disorder, which led to the creation of a national Recovery-Friendly Workplace Initiative in 2023. Data show this goal was met in 2022 with 16 states reporting a qualifying initiative, up from 13 in 2021.

The second objective was to increase the number peer-led recovery organizations to at least 194. This has been completed, as there were 232 as of 2022.

The third objective was to increase the number of recovery high schools to at least 47, which was on track with 45 operational as of 2022.

The fourth objective was to increase the number of collegiate recovery programs to at least 165, which was similarly on track with 149 as of 2022.

The fifth and final objective was to have at least 8,600 residential recovery programs operational by 2025. This too was on track as of 2022, with 7,957 programs.

 

Goal 6: “Criminal justice reform efforts include drug policy matters”

Despite the extremely broad title, this goal had pretty narrow objectives. The first was to have 80 percent of drug courts complete equity and inclusion trainings by 2025. As of 2022 we were at 19 percent, considerably behind schedule. The PRS report attributes this to a combination of COVID-19 pandemic restrictions and bureaucratic restrictions, which it expects to resolve.

The second objective was a 100-percent increase in access to medications for opioid use disorder (MOUD) in federal Bureau of Prisons facilities, and a 50-percent increase for in state prisons and local jails.

The PRS report does not differentiate between access to methadone and buprenorphine, which have been shown to decrease overdose risk, and naltrexone—which has been shown to increase overdose risk, and of the three Food and Drug Administration-approved MOUD is by far the favorite among corrections departments. With that in mind, the ONDCP goal is on track for federal and state prisons.

“Currently, there is no single data source that can be used to track progress in increasing the percent of local jails offering MOUD,” the report states. “For illustrative purposes, [the figure below] shows the estimated percent of local jails offering MOUD in the United States from 2019 to 2022.”

 

 

Goal 7: Less drugs

The first objective for this goal was a 365-percent increase in the “number of targets identified in counternarcotics Executive Orders and related asset freezes and seizures made by law enforcement.” This refers to people and entities associated with transnational drug-trafficking organizations. Per the report, 46 had been identified by 2022, and the administration was on track to identify 96 by 2025.

The second objective was a 14-percent increase in the number of people convicted of felonies as a result of Drug Enforcement Administration investigations using data from the Financial Crimes Enforcement Network (FinCEN). Per the DEA, as of 2022 it had used FinCEN data in investigations that led to the convictions of 6,529 people. This surpassed the goal of 5,775 people convicted by 2025.

The third objective was to have at least 70 percent of the DEA’s active priority investigations “linked to the Sinaloa or Jalisco New Generation cartels, or their enablers.” This was also on track, at 62 percent in 2022.

The fourth objective was to decrease “potential production” of cocaine by 10 percent, and that of heroin by 30 percent.

“The United States Government is internally realigning responsibility for conducting illicit crop estimates. As a result of the change in responsibility, there will be a temporary gap in data for 2022 and 2023,” the report states in reference to both cocaine and heroin. “This gap in data does not reflect a change in priorities.”

Potential cocaine production was decreased only slightly between 2020 and 2021, but was projected to be on track as of 2021.

“[I]t is important to note that provisional estimates of drug overdose deaths involving cocaine for the 12-month period ending in July 2024 were 14.1 percent lower compared to a year prior,” the ONDCP added. “The Administration will continue its efforts to reduce the supply of cocaine.”

Heroin interdiction was not on track, but the ONDCP made the same statement verbatim for heroin-involved deaths.

The fifth objective was to have a total of at least 14 incident reports—like seizures or stopped shipments—involving fentanyl precursors from China or India. From 2021 to 2022 the number dropped from 11 to two, but the ONDCP notes that this data is voluntarily reported by other entities and as such is unreliable. And also that preliminary estimates for 2023 look a lot higher.

Source: https://filtermag.org/ondcp-national-drug-control-strategy/

An official website of the United States government
January 03, 2025

Updated: Jan. 03, 2025, 12:02 p.m.|

By Julie Washington, cleveland.com

CLEVELAND, Ohio — Do music therapy and acupuncture help patients manage pain without opioids? University Hospitals will use a nearly $1.5 million federal grant to find out.

The grant allows UH to develop an Alternatives to Opioids program that educates caregivers about how music therapy and acupuncture can be used to decrease the use of opioids in the emergency department, the hospital system recently announced. The program also includes outpatient follow-up.

The goal is to reduce the use of prescribed opioids in emergency departments, UH said.

“When prescribing opioids there is always the potential for abuse,” said Dr. Kiran Faryar, director of research in the department of emergency medicine. “Data shows both music therapy and acupuncture improve pain and anxiety for patients with short-term and long-term pain. This will be an evidence-based technique we can offer patients without the potential risk of substance use disorder.”

UH’s comprehensive approach to combating the opioid crisis comes as the Centers for Disease Control and Prevention reported that 2023 drug overdose deaths in the United States decreased 3% from 2022. It was the first annual decrease in drug overdose deaths since 2018, the CDC said.

The trend was also seen in Ohio.

The number of people who died of drug overdoses in Ohio was 4,452 in 2023, a 9% decrease from the previous year, according to the state’s latest unintentional drug overdose report.

This was the second consecutive year of a decrease in deaths in Ohio. In 2022, overdose deaths declined by 5%, state officials said. Early data for 2024 suggest unintentional drug overdose deaths are falling even further this year.

In November, the state announced that agencies across Ohio would split $68.7 million in grants to combat opioid use and overdoses. The state is distributing the federal funding, part of the fourth round of the State Opioid and Stimulant Response grants, to support local organizations that offer prevention, harm reduction, treatment, and long-term recovery services for Ohioans struggling with an opioid or stimulant use disorder, the state announced.

Julie Washington covers healthcare for cleveland.com.

Source: https://www.cleveland.com/metro/2025/01/can-music-therapy-replace-opioids-for-pain-university-hospitals-investigates-with-15m-federal-grant.html

Source : https://marijuanahealthreport.colorado.gov/literature-review/evidence-statements May 2018

By Sherry Larson, People’s Defender –

“An ounce of prevention is worth a pound of cure.” Cliché – sure – truthful – absolutely! And when it comes to youth and alcohol, vaping and drug use, it is crucial to begin prevention efforts from an early age.

The Adams County Medical Foundation, under the direction of Sherry Stout, recognized a gap in youth prevention services and applied for a grant that focused on prevention. In 2015, a collective of professionals and retired professionals established a Data Prevention Committee to obtain information regarding youth drug, alcohol, vaping and tobacco usage. The Committee partnered with local schools and the Adams County Health Department to obtain data through surveys, resulting in a detailed database of information, including information on vaping, tobacco, and underage drinking.

The Committee recognized a need for more comprehensive funding to develop prevention strategies. Beginning in 2015, the Committee worked towards growing and qualifying for The Drug-Free Communities (DFC) grant, which supported their plans for future endeavors. “The Drug-Free Communities Support Program was created in 1997 by the Drug-Free Communities Act. Administered by the White House Office of National Drug Control Policy (ONDCP) and managed through a partnership between ONDCP and CDC, the DFC program provides grants to community coalitions to reduce local youth substance use.” (cdc.gov)

In October 2023, the Committee voted to form the Adams County Youth Prevention Coalition to meet the requirements to apply for DFC funds. The Coalition needed to be active for six months before applying for funding. The Coalition was mandated to have representatives from 12 community sectors who were not a part of the Medical Foundation. Those sectors are: Youth, Parents, Businesses Media, School, Youth-serving organizations, Law enforcement, Religious/fraternal organizations, Civic and volunteer organizations, Healthcare professionals, State, local, and Tribal governments and other organizations involved in reducing illicit substance use.

Three individuals will partner with the sectors to facilitate the grant: Tami Graham, Program Director; Billy Joe McCann, leader of the Youth Coalition; and Danielle Poe, the community’s only credentialed prevention professional, to represent education and school data collection through OHYES surveys.

In January 2024, The Adams County Youth Prevention Coalition hired Thrive Consulting to assist with the grant process. The grant application took extensive time and data to complete, resulting in an over 100-page document due and submitted in April 2024. Among demonstrating membership from the twelve sectors, the application required proof of consistent meetings and minutes showing that these representatives were actively working on strategizing prevention. Poe said, “A level of community readiness is expected.” Stout clarified that the funding is a community grant and should be led by the community and not isolated by a committee. Stout explained, “This is the first time Adams County qualified to receive the grant. It is a once-in-a-lifetime opportunity where significant funds are available to address prevention issues.”

The Coalition was notified in September 2024 that Adams County would receive the Drug-Free Communities Grant. Graham explained that the grant, which went into effect in October 2024, would reimburse $125,000 a year for 5 years of prevention work. Expecting a successful five years of prevention efforts, the Coalition would be eligible to reapply for a second term.

Poe and Graham discussed plans for the first year of executing the grant. Poe stated that the primary focus will be education, the Coalition’s learning responsibilities, and strategic planning for years two through five.

Carrying on with the Prevention Committee’s concentrations, the Coalition will examine data-proven prevention strategies, media campaigns, and differences between good and bad prevention techniques. In August 2025, the Coalition will submit a yearly progress report to the Drug-Free Communities Grant.

Stout said, “I would encourage widespread involvement of anyone who cares about our youth and their future.” The public is welcome to attend and share comments or concerns at Coalition meetings on the first Monday of every month. The sessions take place at noon in the FRS community room.

Source: https://www.peoplesdefender.com/2024/12/12/drug-free-communities-start-with-youth/

CDC warns of carfentanil, an opioid that’s 100 times more potent than fentanyl
by Fox News – Published Dec. 10, 2024, 11:13 a.m. ET
Originally Published by Centers for Disease Control

Fentanyl has made headlines for driving overdose deaths, but the and Prevention (CDC) is warning of the rise of an even deadlier drug.
Last year, nearly 70% of all U.S. overdose deaths were attributed to illegally manufactured fentanyls (IMFs).
One of those was carfentanil, an altered version of fentanyl that is said to be 100 times more potent, the CDC warned in a Dec. 5 alert.
Deaths from carfentanil rose by more than 700% in the past year, according to the same source — there were 29 deadly overdoses between January and June 2023, and 238 in that same time frame in 2024.
This data came from the CDC’s State Unintentional Drug Overdose Reporting System (SUDORS).
The numbers could actually be higher, as the 2024 data is preliminary and not all overdose deaths have been reported, the agency noted.
Since an outbreak of carfentanil-linked deaths in 2016 and 2016, the drug had “largely disappeared” until this recent reemergence, the CDC noted.
Based on the increase in fatal overdoses, the CDC is calling for “rigorous monitoring” of carfentanil and other opioids more potent than fentanyl.
Fentanyl has made headlines for driving overdose deaths, but the Centers for Disease Control and Prevention (CDC) is warning of the rise of an even deadlier drug.MOLEQL – stock.adobe.com
As with other illicit drugs, its “high profitability” likely drives its prevalence, according to Dr. Chris Tuell, clinical director of addiction services at the University of Cincinnati College of Medicine.
“Very small amounts can produce thousands of doses,” he told Fox News Digital.
“Synthetic opioids like carfentanil are relatively easy to manufacture in illicit labs,” Tuell went on. “Since the drug is a synthetic, it is easier to produce — unlike heroin, which is dependent on a plant like opium.”
Why is carfentanil so dangerous?
Carfentanil is 10,000 more times more potent than morphine and 100 times more potent than fentanyl, Tuell confirmed.
“Even a small amount can be fatal, as it can cause respiratory failure,” he said.
Last year, nearly 70% of all U.S. overdose deaths were attributed to illegally manufactured fentanyls (IMFs).Seth Harrison, The Journal News
One of the major concerns with carfentanil and fentanyl is that they are frequently mixed with other drugs, such as benzodiazepines, cocaine and opioids, which can lead to accidental overdoses, according to Tuell.
“Carfentanil can also resemble cocaine and heroin, so it blends right in with the other drugs,” he warned.
“Even a tiny amount can increase the potency of a drug mixture, leading to a stronger and longer-lasting high.”
Carfentanil often appeals to drug users who have a high tolerance to opioids because they seek a stronger substance, “making the drug attractive despite the risk,” Tuell noted.
How is the drug administered?
Carfentanil can be injected and is frequently mixed with other opioids or heroin, Tuell said. In a powder form, it can be inhaled.
“Inhaling the drug can be quickly risky because it can enter the bloodstream, resulting in an overdose,” Tuell warned. “This can happen intentionally or accidentally, as the drug can become easily airborne.”
Carfentanil can sometimes be in the form of “pressed pills” that resemble prescription medications, the expert said.
“Carfentanil can be lethal at the 2-milligram range depending on the route of administration,” he cautioned.
What parents should know
“Children are now the generation of artificial intelligence and deepfakes, as illicit drugs are posing like regular prescription medications,” Tuell cautioned.
To help protect kids from the dangers of illicit drugs, the expert emphasized the importance of open communication and education.
“Educate your child about the dangers and risks of drug use, including synthetic opioids like carfentanil,” he advised.
Parents should provide monitoring and supervision of their children, be aware of their social circles and limit unsupervised online activities, Tuell recommended.
“I also believe it is important that parents realize that 84% of individuals with a substance use disorder also have a co-occurring mental health issue,” he added.
Carfentanil often appeals to drug users who have a high tolerance to opioids because they seek a stronger substance, “making the drug attractive despite the risk,” Tuell noted.luchschenF – stock.adobe.com
“Seeking out mental health services for your child could help address the underlying issues that may have led to a substance use disorder.”
The CDC called for specific efforts in preventing deaths from illegally manufactured fentanyls, “such as maintaining and improving distribution of risk reduction tools, increasing access to and retention of treatment for substance use disorders, and preventing drug use initiation.”

Source: https://nypost.com/2024/12/10/us-news/cdc-warns-rise-in-opioid-thats-100-times-more-potent-than-fentanyl/

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

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

    DOI: 10.2105/AJPH.2022.307212

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

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

EXECUTIVE HIGHLIGHTS
Today’s highly potent marijuana represents a growing and significant threat to public health and safety, a threat that is amplified by a new
marijuana industry intent on profiting from heavy use.
State laws allowing marijuana sales and consumption have permitted the marijuana industry to flourish, and in turn, the marijuana industry has influenced both policies and policy-makers. While the consequences of these policies will not be known for decades, early indicators are
troubling.
This report, reviewed by prominent scientists and researchers, serves as an evidence-based guide to what we currently observe in various states. We attempted to highlight studies from all the “legal” marijuana states (i.e., states that have legalized the non-medical use of marijuana). Unfortunately, data does not exist for several “legal” states, and so this document synthesizes the latest research on marijuana impacts in states where information is available

For more information please read the full information below:

2019LessonsFinal

Source: https://learnaboutsam.org/wp-content/uploads/2019/07/2019LessonsFinal.pdf July 2019

PBS Commentary:

Dec 1, 2024 3:51 PM EST

MEXICO CITY (AP) — It’s been called the closest the world has ever come to a vaccine against the AIDS virus.

The twice-yearly shot was 100 percent effective in preventing HIV infections in a study of women, and results published Wednesday show it worked nearly as well in men.

Drugmaker Gilead said it will allow cheap, generic versions to be sold in 120 poor countries with high HIV rates — mostly in Africa, Southeast Asia and the Caribbean. But it has excluded nearly all of Latin America, where rates are far lower but increasing, sparking concern the world is missing a critical opportunity to stop the disease.

“This is so far superior to any other prevention method we have, that it’s unprecedented,” said Winnie Byanyima, executive director of UNAIDS. She credited Gilead for developing the drug, but said the world’s ability to stop AIDS hinges on its use in at-risk countries.

In a report issued to mark World AIDS Day on Sunday, UNAIDS said that the number of AIDS death last year — an estimated 630,000 — was at its lowest since peaking in 2004, suggesting the world is now at “a historic crossroads” and has a chance to end the epidemic.

The drug called lenacapavir is already sold under the brand name Sunlenca to treat HIV infections in the U.S., Canada, Europe and elsewhere. The company plans to seek authorization soon for Sunlenca to be used for HIV prevention.

While there are other ways to guard against infection, like condoms, daily pills, vaginal rings and bi-monthly shots, experts say the Gilead twice-yearly shots would be particularly useful for marginalized people often fearful of seeking care, including gay men, sex workers and young women.

“It would be a miracle for these groups because it means they just have to show up twice a year at a clinic and then they’re protected,” said UNAIDS’ Byanyima.

Such was the case for Luis Ruvalcaba, a 32-year-old man in Guadalajara, Mexico, who participated in the latest published study. He said he was afraid to ask for the daily prevention pills provided by the government, fearing he would be discriminated against as a gay man. Because he took part in the study, he’ll continue to receive the shots for at least another year.

“In Latin American countries, there is still a lot of stigma, patients are ashamed to ask for the pills,” said Dr. Alma Minerva Pérez, who recruited and enrolled a dozen study volunteers at a private research center in Guadalajara.

How widely available the shots will be in Mexico through the country’s health care system isn’t yet known. Health officials declined to comment on any plans to buy Sunlenca for its citizens; daily pills to prevent HIV were made freely available via the country’s public health system in 2021.

“If the possibility of using generics has opened, I have faith that Mexico can join,” said Pérez.

Byanyima said other countries besides Mexico that took part in the research were also excluded from the generics deal, including Brazil, Peru and Argentina. “To now deny them that drug is unconscionable.” she said.

In a statement, Gilead said it has “an ongoing commitment to helping enable access to HIV prevention and treatment options where the need is the greatest.” Among the 120 countries eligible for generic version are 18 mostly African countries that comprise 70 percent of the world’s HIV burden.

The drugmaker said it is also working on establishing “fast, efficient pathways to reach all people who need or want lenacapavir for HIV prevention.”

On Thursday, 15 advocacy groups in Peru, Argentina, Ecuador, Chile, Guatemala and Colombia wrote to Gilead, asking for generic Sunlenca to be made available in Latin America, citing the “alarming” inequity in access to new HIV prevention tools while infection rates were rising.

While countries including Norway, France, Spain and the U.S. have paid more than $40,000 per year for Sunlenca, experts have calculated it could be produced for as little as $40 per treatment once generic production expands to cover 10 million people.

Dr. Chris Beyrer, director of the Global Health Institute at Duke University, said it will be enormously useful to have Sunlenca available in the hardest-hit countries in Africa and Asia. But he said the rising HIV rates among groups including gay men and transgender populations constituted “a public health emergency” in Latin America.

Hannya Danielle Torres, a 30-year-old trans woman and artist who was in the Sunlenca study in Mexico, said she hoped the government would find a way to provide the shots. “Mexico may have some of the richest people in the world but it also has some of the most vulnerable people living in extreme poverty and violence,” Torres said.

Another drugmaker, Viiv Healthcare, also left out most of Latin America when it allowed generics of its HIV prevention shot in about 90 countries. Sold as Apretude, the bi-monthly shots are about 80 percent to 90 percent effective in preventing HIV. They cost about $1,500 a year in middle-income countries, beyond what most can afford to pay.

Asia Russell, executive director of the advocacy group Health Gap, said that with more than 1 million new HIV infections globally every year, established prevention methods are not enough. She urged countries like Brazil and Mexico to issue “compulsory licenses,” a mechanism where countries suspend patents in a health crisis.

It’s a strategy some countries embraced for previous HIV treatments, including in the late 1990s and 2000s when AIDS drugs were first discovered. More recently, Colombia issued its first-ever compulsory license for the key HIV treatment Tivicay in April, without permission from its drugmaker, Viiv.

Dr. Salim Abdool Karim, an AIDS expert at South Africa’s University of KwaZulu-Natal, said he had never seen a drug that appeared to be as effective as Sunlenca in preventing HIV.

“The missing piece in the puzzle now is how we get it to everyone who needs it,” he said.

Cheng reported from London.

 JooHee Yoon for Vox

Land of the free, home of the blazed.

How weed became America’s drug of choice | Vox

VOX Writer:  Marin Cogan         Dec 3, 2024

In the last few decades, marijuana’s had a major glow-up.

In 1992, less than 1 million people were using it daily or nearly every day — a low point, according to an analysis of data from the US National Survey on Drug Use and Health, which began surveying Americans in the 1970s. Ten times as many people, meanwhile, reported drinking alcohol daily or almost daily.

In the 1990s, weed was illegal nationally and in every state. But marijuana’s since had a major rebrand: Three decades later, it’s legal for recreational adult use in nearly half of the 50 states. Now, it’s even challenging alcohol for its status as America’s favorite daily intoxicant.In 2022, for the first time, more Americans were using marijuana daily, or near daily, than consuming alcohol at the same rate, according to a study by Jonathan Caulkins, a professor at Carnegie Mellon University. The number of daily or near daily marijuana users has grown from less than 1 million in 1992 to 17.7 million in 2022; in terms of per capita rate, that’s a 15-fold increase.

Marijuana is having a moment just as Americans reconsider their relationship toward alcohol. As public awareness of the toxic effects of even moderate alcohol consumption grows, many people are turning to THC products as an alternative. The THC industry touts its wares as a more natural alternative to alcohol with myriad health benefits, including decreased nausea, pain, and sleeplessness.

The rise in daily smokers (and vapers, and edible enjoyers, if you will) is also driven by the explosion of the industry. Millions of Americans live in cities and counties with retail shops offering a range of products that make the dimebags of yesteryear seem quaint by comparison: vape cartridges, edibles, oils, and waxes, offering more highly concentrated THC doses. The rise of marijuana retail has opened new doors for people who might have once shied away because they didn’t like smoking or were worried about breaking the law.

For many people, the rapid shift toward liberalization of marijuana policy, and the swiftness with which Americans have taken up consumption, has been great. But it’s also caught researchers off guard. Society has moved more quickly than they’ve been able to keep up with. That means millions of daily users are essentially conducting a real-time experiment on their own bodies. Marijuana isn’t benign for everyone, though. Some of the results of the real-time experiment are already becoming apparent, both to regular users and people working in health care.

“It is very desirable to believe that there is a drug that can make you feel good, that can relax you, and has absolutely no negative outcomes,” says Dr. Nora Volkow, director of the National Institute on Drug Abuse at the National Institutes of Health. “But in biology, there are no free lunches.”

Take the emergence of cannabinoid hyperemesis syndrome, a condition marked by intense and prolonged bouts of nausea and vomiting and brought on by regular, long-term marijuana use. While once extremely rare, some doctors are saying they now see patients with symptoms frequently. “It emerged because people were consuming marijuana regularly with high [THC] content,” Volkow says. “And similarly, there is now evidence that consumption in those patterns is associated with higher risk of stroke or cardiovascular disease.”

Maybe the most worrying studies about frequent, heavy marijuana use involve teens and young adults. (While experts say marijuana use appears to be less risky for middle-aged adults, there’s still a lot they don’t know that needs to be researched further. Some note that more research is needed on older adults in particular.) Studies show regular marijuana use among adolescents and teens can predict increased risk of the development of schizophrenia and other psychotic disorders. Others have shown an increased likelihood of depression and suicidal ideation, disrupted dopamine function, and disruptions in the anatomy of the brain.

And marijuana, contrary to popular belief, can be habit forming. It can also increase the risk of dependence on other substances. A recent analysis by Columbia University for the New York Times estimated that as many as 18 million people in the US may have some form of cannabis use disorder, or addiction.

Getting a handle on who might be harming their health is tricky. Even the findings that point to a major rise in daily users leave a lot of questions unanswered, especially around how often they’re smoking, vaping, or ingesting, and how potent the THC is.

Caulkins, the Carnegie Mellon professor who published the research showing that more Americans are using marijuana daily, says there are different categories of daily or near daily users. There are the people who use marijuana similar to the way someone might pop a melatonin before going to bed at night — a small, daily dose to help with sleep or pain. And then there are those who are more like heavy cigarette smokers, consuming marijuana multiple times a day, morning or night, before or after meals, on breaks from work, or out with friends.

His previous research has found that daily or near daily users are a small portion of overall users, but make up about three-quarters of all marijuana purchases.

But just how many of the 17.7 million daily or near daily marijuana users are truly heavy users remains a mystery, because the US National Survey on Drug Use and Health doesn’t ask about how many times a day someone is using, or what they’re taking.

“We can have people who are using near daily, but they’re taking a puff off their vape pen right before they go to sleep,” says Ziva Cooper, a researcher and director for the UCLA Center for Cannabis and Cannabinoids, “versus somebody who’s using daily or near daily and they’re using five to 10 one-gram pre-rolls every day. You can imagine that the health outcomes are going to be quite different.”

It’s not just that researchers are often unsure of how much people are taking. The consumers are also often not sure what they’re putting in their bodies. That’s partly because what’s being sold in stores is way stronger than the weed that millennials and previous generations grew up with. Over the last 25 years, government data shows, the percentage of THC in marijuana seized by the Drug Enforcement Agency (DEA) has more than tripled, from 5 percent to 16 percent. And a lot of the products for sale in dispensaries can be even more potent — with vendors selling concentrated products, some claiming 90 or close to 100 percent THC. Some teens who’ve used those products have struggled with vomiting and substance abuse.

Cooper says it’s not uncommon for her to end up on the phone with her patients as they read the label aloud to her and she searches the internet to try to find out what exactly they’re taking.

“As researchers,” Cooper says, “we are trying to catch up with what’s actually happening in the world of cannabis. And we are woefully behind.”

Though humans have been using cannabis for at least 10,000 years — it was widely used for medical purposes in the United States in the late 19th century — the demonization of marijuana under the Nixon administration in the 1970s pushed the plant into the shadows.

Nixon, according to secretly reported tapes, knew at the time that marijuana was “not particularly dangerous.” But his “war on drugs,” carried on by the administrations of Ronald Reagan, George H.W. Bush, and Bill Clinton forced consumers and their providers to stop or risk arrest.

The drug’s public image was less threatening — smoking pot was played for laughs in movies and TV shows — but the reality of its criminalization was much darker. Hundreds of thousands of people were arrested and incarcerated each year for selling and dispensing marijuana, with the harms falling disproportionately on Black people.

Public awareness of the harms caused by criminalizing marijuana grew, and so too did a movement to raise awareness about the medicinal benefits of its use, especially for chemotherapy and cancer parents, who found marijuana use helpful for combatting nausea. Meanwhile, advocates focused on reducing mass incarceration and addressing racial disparities in the judicial system pushed states to begin decriminalizing marijuana and revising the sentences for people serving time for it. After getting the states to approve marijuana for medicinal purposes, organizations began pushing for it to be legal for all adults. Today, marijuana is legal for medical use in 38 states and for recreational use for adults in roughly half of the states, plus the District of Columbia.

But marijuana is still illegal on the national level, where it is classified as a Schedule I drug — meaning the government doesn’t recognize it for medical use. That’s made getting the safety approvals and government funding necessary to study the drug difficult. Researchers say it’s made it harder to study potential risks of long-term marijuana use. But it’s made it harder to study the potential benefits, too. Earlier this year, the Biden administration proposed changing marijuana to a Schedule III, which will put it in a lower-risk category with drugs like ketamine.

In 2022, President Joe Biden signed the Medical Marijuana and Cannabidiol Research Expansion Act, hoping to reduce some of the federal barriers that have stymied research in the past. The legislation required the DEA to register and approve more researchers, and more manufacturers who can provide them with marijuana or cannabidiol (CBD). In addition to creating more opportunities and resources for researchers, the bill asked the DEA to assess whether there is enough marijuana to meet researchers’ experimental needs, and allowed doctors to discuss the benefits and harms of marijuana with their patients.

The federal government’s approach to marijuana has also meant that each state is doing its own regulation of its markets, without a concrete set of federal safety guidelines. The piecemeal nature of legalization, absence of national regulation, and lack of public awareness has contributed to the uncertainty around marijuana use and its long-term consequences.

The market is also changing rapidly. The 2018 farm bill, for example, legalized hemp, which inadvertently popularized delta-8 THC. Delta-8 THC, which is similar to delta-9 THC, is less potent in its natural form, but producers have been able to extract and synthesize the delta-8 THC in hemp, converting it into more potent concentrates. Manufacturers are now selling products the FDA says have serious health risks. But that isn’t the only thing that the government can and should be doing.

In September, the National Academies of Sciences, Engineering, and Medicine issued a report outlining what state and federal governments could do to establish better public policy around marijuana and minimize potential negative public health consequences over the next five years.

The report outlined specific actions, such as closing the loophole in the 2018 farm bill that legalized delta-8 THC and clarifying that all forms of THC are subject to regulation under the Controlled Substances Act. More broadly, the report calls for states that have legalized, public health officials, and government agencies like the CDC to come together and establish more unified guidelines for marijuana, working to develop a set of regulations around the production and sale. Marijuana, the report argues, should be regulated the same way as alcohol and tobacco.

The report also recommends that the federal government support more research into marijuana use, along with a public health campaign to educate people about individual risks for different populations, including teens and older people.

It’s a tall order, but even that doesn’t capture everything researchers want to know. Caulkins, for one, has other questions.

“Cannabis intoxication impairs short-term memory formation. When cannabis was only being used as a social drug on weekends, who cares if it reduced effective performance on intellectual tasks?” he says. “Now, roughly half of cannabis is consumed by people who use often enough that they spend perhaps 50 percent of their waking hours under the influence of the drug. A lot of those hours of cannabis intoxication are while people are on the job or in school. How does that impact your functioning, how much you’re learning in college? We underinvest in thinking about the consequences of so many billions of hours of work and school time being, in some form, under the influence.”

It’s a question that might be hard to answer empirically right now. But it matters — maybe most of all for the millions of people taking part in America’s real-time marijuana experiment. “Maybe it’s not a problem,” Caulkins says. “But possibly, it’s affecting people’s abilities to meet their life goals in some subtle ways.”

Source: https://www.vox.com/the-highlight/379637/marijuana-daily-drug-americans-alcohol

Emphatic Rejection by DrugWatch International

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

From: drug-watch-international@googlegroups.com

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

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

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

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

That pretty much says it all.

John Coleman

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The findings are still valid as to why marijuana should not be rescheduled as determined in the Denial of Petition To Initiate Proceedings To Reschedule Marijuana, by the Drug Enforcement Administration (DEA), 81 FR 53767-01(August 12, 2016)

Human Physiological and Psychological Effects of Marijuana

MARIJUANA AND MENTAL ILLNESS

Recent studies show a connection between marijuana use and mental illness. In 2017, the National Academy of Sciences (NAS) concluded after a review of over 10,000 peer-reviewed academic articles, that marijuana use is connected to mental health issues (like psychosis, social anxiety, and thoughts of suicide). [1]

A study discussed in an October 2017 Scientific American shows that people who had consumed marijuana before age 18 developed schizophrenia approximately 10 years earlier than others. The more marijuana you take – and the higher the potency – the greater the risk. [2]

A November 2017 report on a study found that marijuana use in youth is linked to bipolar symptoms in young adults. [3]

References

[1] Health Effects of Cannabis and Cannabinoids: Current State of Evidence and Recommendations for Research.
http://nationalacademies.org/hmd/~/media/Files/Report%20Files/2017/Cannabis-Health-Effects/Cannabis-chapter-highlights.pdf

[2] https://www.scientificamerican.com/article/link-between-adolescent-pot-smoking-and-psychosis-strengthens/

[3] http://www.newswise.com/articles/view/685947/?sc=dwtn November 2017

THERE IS A LINK BETWEEN MARIJUANA USE AND OPIATE USE

Marijuana use is associated with an increased risk for substance use disorders. [1] Marijuana use appears to increase rather than decrease the risk of developing nonmedical prescription opioid use and opioid use disorder. [2] In 2017, the National Academy of Sciences (NAS) landmark report written by top scientists concluded after a review of over 10,000 peer-reviewed academic articles, that marijuana use is connected to progression to and dependence on other drugs, including studies showing connections to heroin use. [3]

New research suggests that marijuana users may be more likely than nonusers to misuse prescription opioids and develop prescription opioid use disorder. The investigators analyzed data from more than 43,000 American adults. The respondents who reported past-year marijuana use had 2.2 times higher odds than nonusers of meeting diagnostic criteria for prescription opioid use disorder. They also had 2.6 times greater odds of initiating prescription opioid misuse. [4]

References

[1] JAMA Psychiatry. 2016 Apr;73(4):388-95. doi: 10.1001/jamapsychiatry.2015.3229.
Cannabis Use and Risk of Psychiatric Disorders: Prospective Evidence From a US National Longitudinal Study. Blanco C1, Hasin DS2, Wall MM2, Flórez-Salamanca L3, Hoertel N4, Wang S2, Kerridge BT2, Olfson M2. https://www.ncbi.nlm.nih.gov/pubmed/26886046

Cadoni C, Pisanu A, Solinas M, Acquas E, Di Chiara G. Behavioural sensitization after repeated exposure to Delta 9-tetrahydrocannabinol and cross-sensitization with morphine. Psychopharmacology (Berl). 2001;158(3):259-266. Available from: https://www.researchgate.net/publication/11640927_Behavioral_sensitization_after_repeated_exposure_to_D9-tetrahydrocannabinol_and_cross-sensitization_with_morphine

[2] Cannabis Use and Risk of Prescription Opioid Use Disorder in the United States, Mark Olfson, M.D., M.P.H., Melanie M. Wall, Ph.D., Shang-Min Liu, M.S., Carlos Blanco, M.D., Ph.D. Published online: September 26, 2017at: https://doi.org/10.1176/appi.ajp.2017.17040413

[3] Health Effects of Cannabis and Cannabinoids: Current State of Evidence and Recommendations for Research. See: http://nationalacademies.org/hmd/~/media/Files/Report%20Files/2017/Cannabis-Health-Effects/Cannabis-chapter-highlights.pdf

[4] https://www.drugabuse.gov/news-events/news-releases/2017/09/marijuana-use-associated-increased-risk-prescription-opioid-misuse-use-disorders

MARIJUANA USE BEFORE, DURING OR AFTER PREGNANCY CAN CAUSE SERIOUS MEDICAL CONDITIONS

Prenatal marijuana use has been linked with:

1. Developmental and neurological disorders and learning deficits in children.
3. Premature birth, miscarriage, stillbirth.
4. An increased likelihood of a person using marijuana as a young adult.
5. The American Medical Association states that marijuana use may be linked with low birth weight, premature birth, behavioral and other problems in young children.
6. Birth defects and childhood cancer.
7. Reproductive toxicity affecting spermatogenesis which is the process of the formation of male gamete including meiosis and formation of sperm cells.

References

Volkow ND, Compton WM, Wargo EM. The risks of marijuana use during pregnancy. JAMA. 2017;317(2):129-130.

https://www.drugabuse.gov/publications/research-reports/marijuana/letter-director

https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Marijuana-Use-During-Pregnancy-and-Lactation

Source: Email from Dave Evans to Drug Watch International April 2018

Attached is a submission from Professor Stuart Reece to the Food and Drug Administration in USA for forwarding to the World Health Organization relating to the re-scheduling of cannabis

FDA Federal Register Submission for WHO Review and Consideration – Colorado Teratogenicity Patterns Illustrated

Email from Stuart Reece April 2018

Medical research can sometimes become disconnected from the interests and needs of the people it is intended to serve. This is true across diseases and disorders, and addiction research is no exception. Too often, scientists who study drugs and addiction have not meaningfully engaged people with lived and living experience of substance use. And when people who use substances are engaged, the experience may leave them feeling exploited or traumatized, such as when they are not adequately compensated for their time or when they are asked to recall distressing life events. It is also rare for researchers to follow up with participants to let them know what was learned in a research project.

Such experiences contribute to a feeling that research is a one-way transaction benefiting scientists but giving little back to the community. Lack of meaningful community engagement also compromises the quality of the science by not incorporating the valuable ideas and insights of people who use drugs.

NIDA is committed to improving community engagement in all parts of the research process. For that reason, we have asked the National Advisory Council on Drug Abuse (NACDA)—the body of experts that advises on NIDA’s scientific research priorities—to convene a working group to recommend ways to enhance the meaningful engagement of people who have experience with drug use in the research our Institute funds. The workgroup will inform the creation of resources that outline NIDA’s expectations regarding community engagement and help both applicants and community partners navigate this critical work.

NIDA has long encouraged community-engaged research, and it is required element in various NIDA research funding opportunities, including those supported through our Racial Equity Initiative. The evolving opioid overdose crisis has underscored the importance of ensuring that people’s lived experience of substance use is centered in the science we support. For example, one of the pillars of the NIH Helping to End Addiction Long-term (HEAL) Initiative is that research must be relevant and responsive to the individuals, families, and communities it aims to help. One way HEAL studies are doing this is by drawing on the input of community advisory boards to ensure that the research is best tailored to the needs of the people most impacted by it.

The NIDA-funded Harm Reduction Research Network is a nationwide set of projects to enhance the impact of harm-reduction efforts, and its community advisory boards have already helped shape some of the studies. One project involves the development of a survey instrument to capture experiences of people who use drugs, and advisory board members helped tailor the wording of the instrument so that it reflected language more likely to be used by people who use drugs. Another study aimed at reducing overdose and increasing engagement in harm reduction and treatment services had originally been limited to people who use methamphetamine. Based on the input of advisors with more up-to-date knowledge of drug-use in their community, the study was broadened to include people who use cocaine, as that was identified as an emerging stimulant in their area.

The Integrative Management of Chronic Pain and OUD for Whole Recovery (IMPOWR) project is addressing the needs of people with substance use disorders and pain via a network of multidisciplinary team science collaborations. Its community advisory boards weigh in on funding decisions for pilot studies, and some of these studies have included a community partner as a co-investigator. Based on community input about the important role of PTSD and discrimination in healthcare settings in pain and opioid misuse and addiction, IMPOWR researchers added PTSD and stigma/discrimination items to their common data elements (the standardized questions that facilitate data-sharing across studies).

The Native Collective Research Effort to Enhance Wellness (NCREW) Initiative is partnering with Tribal organizations to support community-driven research projects that address opioid misuse and pain in Native communities. By providing needed training, technical assistance, and tools, the NCREW project is building capacity within Native communities to conduct locally prioritized research that incorporates indigenous knowledge and lived experience, with the aim of building effective, sustainable, and strengths-based interventions.

As outlined in NIDA’s Strategic Plan, NIDA is committed to partnering with people with lived and living experience in the development of new treatments for substance use disorder. Consistent with that goal, NIDA is funding four Patient Engagement Resource Centers (PERCs) to test various models of patient engagement that can inform research on SUD treatment services. Each PERC will recruit members of a particular patient population to understand what prevents them from finding or receiving evidence-based treatment services. This information will be used to pilot test patient-informed solutions to these challenges that can ultimately serve as models for the development of interventions in other settings.

There are many other ways that partnering with people with living experience of substance use could benefit both science and the community. Surveillance is one example. The drug market is rapidly changing, and people who actively use drugs and live this reality are best poised to provide information on the drug supply and its effects. And through their engagement in surveillance efforts, participants could gain information on new adulterants and contaminants that could help inform their own decisions.

In these, as with other research efforts, people who use drugs need to be treated with respect, and their confidentiality must be protected. They must also be compensated fairly for their time, their input, and their commuting and childcare costs.

Including people with experience of substance use and addiction in the scientific workforce—and making sure they feel safe and recognized as valuable members of the research team—must also become a priority for our science. As some of my colleagues at NIDA’s Intramural Research Program argued two years ago in the Journal of Addiction Medicine, people with lived and living experience of substance use disorders have unique perspectives that are invaluable in making sure that the right research questions are asked.

These are just some of the possible topics that may be discussed in the new NACDA workgroup. For that group, we are seeking individuals who identify as having experience with substance use or a substance use disorder or as a family or caregiver of someone who does. Participants will meet virtually three or four times during 2025 and potentially early 2026 and will be compensated for their time during the meetings. If you are interested in participating, further information is available on the Council Workgroups page. We are accepting application statements through January 10, 2025.

Associated links:

<https://links-1.govdelivery.com/CL0/https:%2F%2Fwww.facebook.com%2FNIDANIH/1/010001935f514dad-3bc896f6-09a3-4a99-9a57-650fc67cd8ad-000000/gZawcxuqmqpVxlDYl5KRA6aAb0F6qaVMf-PxgI6LnuI=380>  <https://links-1.govdelivery.com/CL0/https:%2F%2Fx.com%2FNIDAnews/1/010001935f514dad-3bc896f6-09a3-4a99-9a57-650fc67cd8ad-000000/mpqUEYpIuhc9JFHxEKtJYgd0sO2MkRK2lTyjYLfCx1E=380>  <https://links-1.govdelivery.com/CL0/https:%2F%2Fwww.linkedin.com%2Fcompany%2Fthe-national-institute-on-drug-abuse-nida/1/010001935f514dad-3bc896f6-09a3-4a99-9a57-650fc67cd8ad-000000/MDAOeV4b9UqgdTQKqsv8NP1IxaNy1-VJZf0pPGIdSLM=380>  <https://links-1.govdelivery.com/CL0/https:%2F%2Fwww.youtube.com%2Fuser%2FNIDANIH/1/010001935f514dad-3bc896f6-09a3-4a99-9a57-650fc67cd8ad-000000/XDdTYlTHjOr7nahEQDBsHClsGu3q7NdUBzatmgv6P7E=380>

 

Source: Forwarding Agency:

Herschel Baker, International Liaison Director & Queensland Director

Drug Free Australia

Web: https://drugfree.org.au/

mailto:drugfreeaust@drugfree.org.au

mailto:drugfree@org.au

Policy News Roundup: November 14, 2024

by drugfree.org

The main point: Overall, a Trump administration is likely to be more focused on law enforcement and supply side responses to the overdose crisis, rather than approach the challenge from a public health perspective.

The details:

  • Treatment: We do not expect there will be efforts to remove barriers and expand access to methadone. There could be some efforts to expand buprenorphine (particularly telemedicine models).
  • Harm Reduction: Harm reduction received unprecedented federal support under the Biden administration. It is unlikely that such support will continue. Efforts to expand naloxone distribution may continue, but other harm reduction strategies (e.g., syringe service programs, overdose prevention sites) are not likely to receive support in a Trump administration.
  • Criminal Legal System: The use of Medicaid to provide medications for opioid use disorder in jails/prisons will likely face increased scrutiny. As part of a broader effort to limit Medicaid costs, a Trump administration may push to restrict federal funding for these programs. Drug courts and diversion programs will likely continue to receive support.
  • Insurance: There could be major changes to the Affordable Care Act (ACA), which includes some of the strongest insurance protections available for addiction, and Medicaid, which covers more addiction treatment than any other insurer. The enhanced ACA premium subsidies that led to record levels of insurance enrollment are not likely to be extended after they expire next year, and there may be efforts to slash funding for enrollment outreach, promote short-term health plans with skimpier coverage and allow insurers to charge sicker people higher premiums. Medicaid is likely to be targeted for funding cuts, and the Trump administration is likely to revive efforts to implement work requirements for Medicaid coverage.
  • Marijuana: It is not clear what a Trump administration will mean for marijuana. While previously strongly opposed to easing restrictions, Trump more recently came out in support of the legalization initiative in Florida (his home state) and the Biden administration’s push to reschedule marijuana.
  • Penalties: A Trump administration could push for harsher penalties for drug offenses.
  • Drug Trafficking: Combatting drug trafficking is likely to be the main focus for the administration on this issue. Rhetoric will likely focus on the U.S.-Mexico border, even though evidence has shown that most drugs are brought into the U.S. at legal ports of entry by U.S. citizens. There is likely to be continued pressure on Mexico and China for their role in fentanyl and precursor trafficking.
  • Federal Agencies: If the Trump administration takes action on plans to scale back federal agencies, it could lead to a reduced role for the Office of National Drug Control Policy, potentially in favor of the Department of Justice or Drug Enforcement Administration. Department of Health and Human Services agencies are also likely in for budget cuts and major changes in authority and focus, which could reduce the role of health agencies like the Centers for Disease Control and Prevention, the National Institutes of Health and the Food and Drug Administration in addressing the addiction crisis and the funding available to do so.

Why it’s important:

  • Federal funding for addiction has remained stable but shifts between law enforcement/interdiction and treatment, depending on the administration’s priorities. An increased focus on law enforcement/interdiction could mean less funding and focus on treatment. Funding for prevention has remained small and relatively the same.

A caveat: It is early. Trump’s campaign did not focus heavily on policy proposals or on this issue, and we do not know yet who will be appointed to top health roles in the administration.

In the states: drug policy backlash

Several states also had drug-related ballot initiatives on their ballots this election.

The main point: In recent elections, ballot measures focused on liberalizing drug policies (e.g., legalizing marijuana, decriminalizing drugs) have passed. This time, however, these types of measures failed, signaling concerns about these drug policies.

The details:

  • Marijuana: Florida, North Dakota and South Dakota all rejected measures to legalize recreational marijuana. Nebraska did approve a measure to legalize medical marijuana, but a judge could invalidate the results due to a pending lawsuit. Opponents cited concerns about crime, addiction and becoming like liberal states that have legalized marijuana. While most Americans continue to support marijuana legalization, the downsides of marijuana production and negative health impacts of high-potency marijuana and teen use have recently been in the spotlight.
  • Psychedelics: Massachusetts rejected a measure to legalize therapeutic use of certain psychedelics (psilocybin, psilocin, DMT, ibogaine, mescaline). Voters in more than a dozen Oregon cities also voted to ban sales and use of psilocybin, after the state approved licensed psilocybin treatment centers four years ago. Psychedelics have gained increased support across the political spectrum, but concerns are growing about allowing psychedelics to proliferate before there has been adequate research.
  • Penalties: California passed a measure to repeal a 2014 ballot initiative that had lessened penalties for certain drug offenses. The new measure reclassifies certain theft- and drug-related crimes as felonies, rather than misdemeanors. It also establishes court-mandated treatment for those with repeat drug offenses. Voters perceive social disruption from public drug use and want more law and order.

Another thing: Daniel Lurie won his race to be mayor of San Francisco, beating incumbent London Breed. Much of the campaign focused on debates about how to address public drug use in the city. Lurie ran on promises to expand police staffing, build more homeless shelter beds and shut down open-air drug markets.

Why it’s important: This is part of the broader recent backlash toward efforts to liberalize drug policies and emphasize treatment and harm reduction over punitive responses.

  • Increases in visible homelessness, mental illness and substance use following COVID, the rise of fentanyl and the continuing high level of overdose deaths have led many to feel that recent efforts are not working. This is exacerbated by rhetoric tying “failed” drug policies to supposed spikes in crime and drug use.

 

California report warns of high-potency marijuana health dangers

What’s new: A report by scientists convened by the California Department of Public Health suggests that state policymakers must do more to warn consumers of the health dangers of high-potency marijuana and deter its use.

The background:

  • Most of the marijuana sold in California is high potency, with a concentration of THC five to ten times greater than the marijuana of the 1970s and 1980s.
  • High-potency marijuana is more likely to be addictive and cause serious health problems, like psychosis or cannabis hyperemesis syndrome.

The takeaways: The authors say policymakers should take lessons from successful campaigns to reduce smoking and drinking. Among other ideas, they recommend:

  • Restricting marijuana advertising, packaging and marketing
  • Barring flavored products that appeal to kids
  • Limiting THC content
  • Raising taxes on high-potency products
  • Launching a public education campaign about high-potency marijuana’s health effects

What’s next: The authors say they are lobbying the California Department of Public Health, the California Department of Cannabis Control, the state legislature and other state agencies to boost regulation.

 

Source: https://drugfree.org/drug-and-alcohol-news/policy-news-roundup-november-14-2024/

Workplaces have a unique opportunity to make subtle yet meaningful adjustments to better support employees who may be in recovery or experiencing challenges. When businesses make small changes in their events, management style, and overall culture, they create an environment that respects and uplifts employees facing SUDs. Here are three impactful ways to make the workplace more welcoming:

# 1: Host Inclusive Gatherings with Non-Alcoholic Options

Work events can inadvertently center around alcohol, creating uncomfortable situations for employees who don’t drink and/or are in recovery. Making a few simple shifts can help ensure everyone feels included:
• Avoid holding meetings in bars or pubs. Instead, choose locations that aren’t centered on alcohol, such as coffee shops, casual restaurants, or outdoor spaces.
• Offer a variety of non-alcoholic drinks that are as enjoyable as alcoholic options. These could include mocktails, sparkling water with unique flavors, or other festive drinks. This small touch shows thoughtful consideration and signals that the event is meant for everyone.
• Consider alcohol-free events. Not every event needs to feature alcohol to be fun. Think of team-building activities like escape rooms, game nights, or cooking classes, which naturally focus on engagement without the need for alcohol.

#2: Encourage Supervisors to be Allies

Supervisors play a critical role in creating a compassionate, supportive workplace. By actively supporting employees rather than judging them, supervisors can contribute significantly to a culture of empathy and openness. Here’s how they can help:
• Listen without judgment. If an employee opens up about their challenges, supervisors should approach the conversation with empathy, focusing on support rather than consequences, while of course maintaining safety.
• Respect privacy and confidentiality. Supervisors should reassure employees that their personal issues will remain private and will only be discussed on a need-to-know basis, which helps foster trust.
• Share personal experiences if appropriate. For supervisors in recovery, sharing their stories can inspire others, showing that it’s possible to face challenges and succeed. Authentic, relatable leadership can be incredibly powerful for employees who may feel isolated.

#3: Encourage Coworkers to Support Each Other

Sometimes, coworkers are the first to notice changes in behavior or attendance. They can be crucial sources of support, helping to create a culture that’s proactive and understanding:
• Encourage open, honest communication. Rather than approaching a struggling coworker with judgment, a simple “I’m here if you need anything” can make a huge difference.
• Assist with resources. Coworkers can help each other navigate employment policies, find helpful information, or locate support groups if needed. Being informed and sharing resources can be invaluable.
• Respect boundaries and avoid gossip. Gossip or speculation only adds stigma to those facing SUDs. A culture of respect encourages coworkers to redirect conversations if someone starts gossiping or making assumptions about another’s struggles. For more on the importance of language on stigma, check out the National Institute of Drug Abuse’s resource, Words Matter as well as Drug Free America Foundation’s resource on Stigma here.

These small adjustments—hosting inclusive events, training supervisors as allies, and encouraging a supportive culture among coworkers—can help a business become a welcoming, stigma-free environment for employees with SUDs working towards recovery. By focusing on inclusivity, empathy, and respect, workplaces can create meaningful, positive changes that support both individual well-being and the company’s overall success.

Sources:

Drug Free America Foundation, Inc. “Stigma.” https://www.dfaf.org/wp-content/uploads/2024/09/Stigma-2024.pdf

O’Connor, P., PhD. (2023, November 23). Human resource departments can help or hinder employees with SUDs. Psychology Today. https://www.psychologytoday.com/us/blog/philosophy-stirred-not-shaken/202311/substance-use-disorders-and-the-work-place

Words matter: preferred language for talking about addiction | National Institute on Drug Abuse. (2023, November 15). National Institute on Drug Abuse. https://nida.nih.gov/research-topics/addiction-science/words-matter-preferred-language-talking-about-addiction

 

One in 3 adults who responded to a new nationwide survey said they had suffered “secondhand harm” from another person’s drinking, and more than 1 in 10 said a loved one’s drug use had harmed them. PHI’s William Kerr shares insights on how secondhand harms from alcohol and drug use can affect families, relationships and communities.

“Think of it as collateral damage: Millions of Americans say they have been harmed by a loved one’s drug or alcohol use.

One in 3 adults who responded to a new nationwide survey said they had suffered “secondhand harm” from another person’s drinking. And more than 1 in 10 said they had been harmed by a loved one’s drug use.

That’s close to 160 million victims — 113 million hurt by loved one’s drinking and 46 million by their drug use, according to the survey published recently in the Journal of Studies on Alcohol and Drugs.

There are more harms than people think… They affect families, relationships and communities.William Kerr
Scientific Director, Center Director & Study Co-Author, Alcohol Research Group’s National Alcohol Research Center, Public Health Institute

He said it makes sense that risky drinking and drug use have far-reaching consequences, but researchers only began looking at the secondhand harms of alcohol in recent years. Less has been known about the damage done by a loved one’s drug use.

The new study is based on a survey of 7,800 U.S. adults. They were questioned between September 2019 and April 2020, before the pandemic became a factor in Americans’ substance use.

People were asked if they had been harmed in any of several ways due to someone else’s substance use.

In all, 34% of respondents said they had suffered secondhand harm from someone else’s alcohol use. The harms ranged from marriage and family problems to financial fallout, assault and injury in a drunken-driving accident.

Meanwhile, 14% of respondents said they’d suffered similar consequences from a loved one’s drug abuse.

The two groups overlapped, too — 30% of respondents reporting secondhand harm from alcohol also said they were affected by someone’s drug use.

Kerr said in a journal news release that the differences probably owe to the fact that drinking and alcohol use disorders are more common than drug use and disorders. But, he added, researchers want to learn more and are launching a new survey with more questions about the harms related to individual drugs.”

Source: https://www.phi.org/press/us-news-phi-study-shows-nearly-160-million-americans-harmed-by-anothers-drinking-drug-use/

MEDIA ADVISORY

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

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

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

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

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

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

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

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

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

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

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

We targeted drug cartels to stop fentanyl. Now, overdose deaths are dropping. | Opinion


Anne Milgram  |  Opinion contributor

This fight may seem daunting, and it is unbearable for the families who have lost a loved one. The opioid epidemic has led to tragic deaths across the nation for decades.

In recent years, however, we’ve witnessed Americans being poisoned by fentanyl. Two Mexican cartels are responsible for almost all the fentanyl found in the United States. These cartels press fentanyl into pills to look like prescription medications and they hide fentanyl powder in other drugs like cocaine.

This deception drives addiction, leading to more sales and profit. Of the more than 107,000 drug-related deaths last year, 69% of them involved fentanyl. That is about 200 American lives lost every day to fentanyl.

But today, we are making significant progress in this battle.

Drug deaths decline by more than 14%

According to new provisional data from the Centers for Disease Control and Prevention, drug deaths in the United States have fallen for the first time in five years. The United States has seen a more than 14% decrease in deaths between June 2023 and June 2024.

While several contributors led to the decline, this marks an important milestone in DEA’s fight to save lives.

When I joined DEA more than three years ago, it was clear that this unprecedented threat required a new approach. We transformed our operations to meet the moment and quickly built a plan to attack the cartels.

We launched counter threat teams focused on a whole network approach to disrupt and defeat the Sinaloa and Jalisco cartels, the Mexican gangs responsible for the deadly influx of fentanyl and methamphetamine into the United States.

While the harm is felt in the United States, the global fentanyl supply chain spans more than 65 countries. Our goal is simple: Take action across the entire supply chain and make it impossible for the cartels to do business.

DEA’s investigations have resulted in charges against Chinese chemical companies and Chinese nationals responsible for the production and sale of chemicals used to manufacture fentanyl; the leaders, money launderers, transporters and enforcers of the Sinaloa and Jalisco cartels; thousands of individuals across the United States who work for the cartels and pedal fentanyl on social media and on our streets; and the money launderers moving billions of dollars in drug money across the globe.

DEA is proud to lead this fight to stop deadly drugs from coming into our communities. Our agency has some of the most highly skilled professionals in the world – special agents, intelligence analysts, data scientists, cyber specialists, social media analysts and forensic scientists – working together to take down these multinational criminal drug networks.

Top drug cartel leaders arrested

Working with our law enforcement partners, our approach has led to the arrests of top cartel leaders and record drug and money seizures.

Last year, DEA seized 80 million fentanyl pills and 12,000 pounds of fentanyl powder, which is the equivalent to 390 million doses. That is enough to kill every single American.

DEA has disrupted global drug trafficking operations from China to Mexico by arresting and indicting cartel members at the highest levels of leadership ‒ including Joaquin Guzman Lopez, son of notorious drug kingpin “El Chapo,” and Ismael Zambada García, or “El Mayo.”

Since 2021, four out of the seven top Sinaloa cartel members have been taken into custody, and three will soon face justice in the United States. DEA has also uncovered and taken down significant global money laundering operations, cutting off funding to the cartel’s operations.

Since launching DEA’s One Pill Can Kill campaign in 2021, we have focused on raising awareness about the dangers of fentanyl.

We also have partnered with families who have lost loved ones to fentanyl. This has been a game changer. The families have been key to sharing lifesaving information and resources in communities across the country. These parents, children, grandparents and siblings continue to turn tragedy into action by working to prevent other families from experiencing their pain.

Recently, at the National Family Summit on Fentanyl, I was thrilled to share with the families another major step in our progress in this fight. We have seen a significant drop in the lethality of counterfeit pills seized in our communities this past year. In 2023, DEA found that 7 out of 10 pills contain a deadly dose of fentanyl. Today, 5 out of 10 pills are potentially deadly.

Seeing a decline in the number of deadly pills on the streets of America is further proof that our efforts are working.

While DEA is proud of the progress we are seeing, we are focused on the work that still needs to be done. Every life lost is one too many. DEA and our partners will continue to fight every day to protect our communities and save lives.

This fight is winnable, but it requires everyone pulling in the same direction. We need everyone to educate themselves, their loved ones and their communities on the dangers of fentanyl.

Anyone can use DEA’s One Pill Can Kill resources to spread the message about the dangers of fentanyl and to educate themselves.

DEA also has recently launched a new resource for families. The Together For Families Network will serve as a one-stop shop to connect advocates and share information, because we know each of us can make a difference.

This recent news shows that together we can save lives, and that it takes all of us working together to win this fight.

Anne Milgram is the administrator of the U.S. Drug Enforcement Administration.

 

Source: https://eu.usatoday.com/story/opinion/2024/11/26/dea-drug-deaths-fentanyl-mexican-cartels/75487168007/

Illegal drugs are the source of immense human suffering. Those most vulnerable, especially young people, bear the brunt of this crisis. People who use drugs and those struggling with addiction face a multitude of challenges: the harmful effects of the drugs themselves, the stigma and discrimination they endure, and often, harsh and ineffective responses to their situation.

The global drug problem is a complex challenge affecting millions of people worldwide. According to the World Drug Report, there are nearly 300 million drug users globally.

The issue spans from individuals with substance use disorders to communities affected by drug trafficking and organized crime. The drug problem is deeply connected to organized crime, corruption, economic crime, and terrorism. To effectively address this challenge, it is crucial to adopt a science-based, evidence-driven approach that prioritizes prevention and treatment.

The drug trade problem was recognized early in the 20th century, leading to the first international conference on narcotic drugs in Shanghai in 1909. In the decades that followed, a multilateral system was established to control the production, trafficking, and abuse of drugs.

Evidence-based drug prevention programmes can safeguard individuals and communities. By reducing drug use, these programmes can also weaken the illicit economies that exploit human misery.

Types of Illegal Drugs

Drugs are chemical substances that affect the normal functioning of the body or brain. They can be legal, like caffeine, nicotine, and alcohol, or illegal. Legal drugs, such as medicines, help with recovery from illness but can also be abused. Illegal drugs are considered so harmful that international laws, under United Nations conventions, regulate their use, making it unlawful to possess, use, or sell them.

Illegal drugs often have various street names that can vary by region and change over time. Their effects include immediate physical harm and long-term impacts on psychological and emotional development, especially for young people. Drugs can impair natural coping mechanisms and potential, and mixing them can result in unpredictable and severe consequences.

Additionally, drug use can impair judgment, leading users to take risks such as unsafe sex, which increases the risk of contracting hepatitis, HIV, and other sexually transmitted diseases.

Most common illegal drugs include:

  • Cannabis;
  • Cocaine;
  • Ecstasy;
  • Heroin;
  • LSD (D-Lysergic Acid Diethylamide); and
  • Methamphetamine.

In recent years, New Psychoactive Substances (NPS) have become a global phenomenon. NPS are substances of abuse not controlled under international drug conventions, but may pose public health risks. The term “new” refers to substances recently introduced to the market, not necessarily newly invented.

Known as “designer drugs,” “legal highs,” or “bath salts,” NPS often mimic the effects of illicit or prescription drugs. They are created by modifying the chemical structures of controlled substances to bypass legal restrictions.

The rapid appearance of diverse NPS on the global market poses public health risks and challenges for drug policy. Limited knowledge about their effects complicates prevention and treatment efforts, while their chemical diversity makes identification and analysis difficult. Effective monitoring, information sharing, and early warning systems are critical for addressing these challenges.

UN Action

Since its founding, the United Nations has been tackling the global drug problem in a systematic manner.

The United Nations Commission on Narcotic Drugs (CND) was established in 1946 by the Economic and Social Council (ECOSOC) through resolution 9(I). Its purpose is to assist ECOSOC in overseeing the implementation of international drug control treaties.

Three drug control conventions were adopted under the auspices of the United Nations (in 1961, 1971 and 1988). Adherence is now almost universal.

The International Narcotics Control Board (INCB) is an independent, quasi-judicial expert body established under the 1961 Single Convention on Narcotic Drugs. It was formed by merging two earlier organizations: the Permanent Central Narcotics Board, created by the 1925 International Opium Convention, and the Drug Supervisory Body, established under the 1931 Convention for Limiting the Manufacture and Regulating the Distribution of Narcotic Drugs. The INCB monitors and assists governments in complying with international drug control treaties.

The World Health Organization (WHO) is a key player in the United Nations’ efforts to combat the global drug problem. Sustainable Development Goal 3, specifically Target 3.5, calls on governments to enhance prevention and treatment programs for substance abuse. WHO’s approach to addressing the global drug problem focuses on five key areas: prevention, treatment, harm reduction, access to controlled medicines, and monitoring and evaluation.

The United Nations Office on Drugs and Crime (UNODC) supports governments in implementing a balanced, health- and evidence-based approach to the world drug problem that addresses both supply and demand and is guided by human rights and the agreed international drug control framework. This approach involves: treatment, support, and rehabilitation; ensuring access to controlled substances for medical purposes; working with farmers who previously cultivated illicit drug crops to develop alternative sustainable livelihoods for them; and establishing adequate legal and institutional frameworks for drug control through using international conventions. UNODC works in all regions through balanced, evidence-based responses to address drug abuse and drug use disorders, as well as the production and trafficking of illicit drugs.

Recent Milestones

In 2009, governments adopted the Political Declaration and Plan of Action on International Cooperation Towards an Integrated and Balanced Strategy to Counter the World Drug Problem, which includes goals and targets for drug control.

Progress towards addressing the world drug problem and related issues is assessed at the United Nations General Assembly Special Session (UNGASS). All nations are encouraged to keep in mind the key principles of the 2030 Agenda for Sustainable Development and to leave no one behind. The Special Session in 2016 resulted in an outcome document, Our joint commitment to effectively addressing and countering the world drug problem.

In 2019, the Commission on Narcotic Drugs adopted the Ministerial Declaration on Strengthening actions at the national, regional and international levels to accelerate the implementation of joint commitments made to jointly address and counter the world drug problem. In the Declaration, governments reaffirmed their determination “to address and counter the world drug problem and to actively promote a society free of drug abuse in order to help ensure that all people can live in health, dignity and peace, with security and prosperity, and reaffirm our determination to address public health, safety and social problems resulting from drug abuse.” They also decided to review the progress made in implementing the policy commitments in 2029.

Global Response

National legislative frameworks govern the responses of criminal justice systems to the world drug problem. In the vast majority of countries, illicit cultivation of drug crops, diversion of precursors and drug trafficking are criminal offences, but the criminal nature of drug use or possession for use varies across countries and regions.

Drug use or possession is considered a criminal offence in about 40 per cent of the 94 countries where data are available, representing a significant proportion of the global population. Available data indicate that more punitive measures are imposed for drug use or possession in Asia compared with other regions, while the Americas and Asia are the most punitive regions for drug trafficking.

Long-term efforts to dismantle drug economies must focus on providing socioeconomic opportunities and alternatives that address the root causes of illicit crop cultivation, such as poverty, underdevelopment, and insecurity. These efforts should go beyond simply replacing illicit crops or incomes. Additionally, they must address the factors that lead to the recruitment of young people into the drug trade, as they are particularly vulnerable to synthetic drug use.

According to newly available estimates, in 2022 only about 1 in 11 people with drug use disorders received drug treatment globally. It is recommended that all individuals affected by the world drug problem, including women, who face disproportionate stigma and discrimination, are ensured their universal right to health. To achieve this, drug treatment, care, and services must be comprehensive, effective, voluntary, and accessible to everyone without discrimination. These services should be designed to uphold and preserve the dignity of all individuals, including those who use drugs, as well as their communities.

Role of Civil Society

The United Nations acknowledges the importance of fostering strong partnerships with civil society organizations to address the complex challenges of drug abuse and crime, which weaken the fabric of society. Active participation from civil society— non-governmental organizations, community groups, labour unions, indigenous groups, charitable organizations, faith-based groups, professional associations, and foundations — is crucial in supporting the UN’s efforts to fulfill its global mandates effectively.

UNODC supports NGOs participation in relevant drug-related policy discussions and meetings, particularly the CND regular and intersessional meetings and encourages the increased dialogue between NGOs, member states and UN entities, through the Vienna NGO Committee on Drugs (VNGOC).

Youth Engagement

Recognizing that youth are a vulnerable population, it is essential for the international community to address the issue of substance abuse effectively. Through the Youth Initiative, the UN provides opportunities for youth to actively participate in efforts to prevent substance use. This programme enables young people to join a community of peers committed to promoting health and well-being.

The Youth Forum is an annual event organized by the UNODC Youth Initiative as part of the broader framework of the Commission on Narcotic Drugs. It brings together young people from around the world, nominated by governments, who are actively engaged in drug use prevention, health promotion, and youth empowerment.

The forum provides a platform for participants to exchange ideas, share visions, and explore diverse perspectives on enhancing the health and well-being of their peers. Additionally, it offers an opportunity for youth to present their collective message to global policymakers, contributing their voices to international discussions and decisions.

Resources

 

Source: https://www.un.org/en/global-issues/drugs

November 29th 2024
Young people are not only the leaders of tomorrow but also a powerful force for change today. Their engagement in drug prevention efforts is crucial in not only identifying the challenges faced by the younger generation; it can also shed light on the various ways that youth can be meaningfully involved as agents of change. In this regard, the UNODC Youth Initiative is proud to have supported youth mainstreaming through the publication of “Formación en Liderazgo Juvenil para la Prevención (Youth Leadership Training for Prevention) in 2024. Featuring stories of action and contributions from UNODC Youth Forum alumni, this publication emphasizes the importance of empowering youth to take an active role in prevention, which can help to foster resilience, community cohesion, and social change.

Originally a project proposed to UNODC to highlight ‘Youth in Prevention’, the Youth Initiative extended this proposal to the alumni network of the Youth Forum, to take leverage on the opportunity to highlight and feature the commendable work done by young people. As highlighted in the publication, meaningful youth participation paves the way for innovative solutions that are tailored to the needs of adolescents, their peers, and communities. And by investing in their leadership, we create opportunities for young people to become advocates for healthier lifestyles, role models for their peers, and key contributors to building a more inclusive society.

The publication features contributions from five UNODC Youth Forum alumni who bring their unique perspectives and experiences to various dimensions of prevention. The contributors – Alexandra Bravo Schroth (Peru), Maya Nujaim(Canada), Vinayak Menon (USA), Karthika Pillai (India), and Adrian Milic (Norway) – worked collaboratively over many months to develop their contributions to the book’s chapter, “Empowering and Supporting Global Youth Participation in Prevention Activities.Through weekly virtual meetings, young leaders exchanged ideas, refined their key concepts, and supported one another in the shared goal of advocating for evidence-based prevention.

One of the contributors, Maya Nujaim from Canada, provides a compelling account of her work as a substance use prevention counselor in Montreal. Reflecting on her experiences, she shares: “Being a youth helping other youths is empowering for me, and I believe we need more young people in drug use prevention…I work with a team of young people who also want to make a difference in the lives of youth, and thanks to our life experiences and knowledge, we can easily connect with young people in schools and encourage them to participate in drug prevention activities.

Maya’s prevention activities are rooted in the key principles of the UNODC/WHO International Standards on Drug Use Prevention, ensuring a science-informed approach that strengthen social skills, address vulnerabilities, and foster open discussions amongst young people. She has seen the direct  impacts of her work, including through reductions in substance use among students, improved peer relationships and peer resistance skills, as well as increased engagement in other creative activities.

The youth contributions within the publication provide a glimpse into the diversity of youth-led and youth-focused activities and experiences as witnessed through the lens of the UNODC Youth Initiative. Further to their motivation to be active as agents of change, youth have also showcased their ability to adapt their skills and potential to meet the challenges of other youths in their local contexts. Armed with proper knowledge, skills and science, youths are truly meeting other youths and peers where they are at, and where they can best reach them. By amplifying the voices of young leaders and showcasing the substantive impact that youth can have on their peers and communities; and this publication underscores the importance of creating spaces for youth to contribute to local, national, and global prevention efforts.

UNODC commends the efforts of the youth contributors for their dedication, innovation, and leadership. To young people worldwide: this is a call to action to look around to see where you can be involved, and know that it can start small but have meaningful impact. To policy-makers and stakeholders: it is a reminder to involve youth in prevention efforts (as more than end-beneficiaries) and listen to youth in decision-making processes.

Join us in celebrating youth as agents of change and their good work in contributing towards a healthier, more resilient future for all. For more information on ‘Formación en Liderazgo Juvenil para la Prevención , please visit here.

Source: https://www.unodc.org/unodc/prevention/youth-initiative/youth-action/2024/november/from-inspiration-to-action_-5-youth-forum-alumni-champion-prevention-efforts.html

     Too many families know the pain of losing a loved one to a drunk or drug-impaired driving accident.  Each year, more than 10,000 Americans lose their lives in these preventable tragedies.  During National Impaired Driving Prevention Month, we remind everyone that they can save lives by driving only when sober, calling for a ride, planning ahead, and making sure friends and loved ones do the same.

In 2022, over 13,000 people were killed in drunk-driving accidents.  Still, millions of people drive under the influence each year, not only putting themselves in harm’s way but also endangering passengers, pedestrians, and first responders. Even just one drink or one pill can ruin lives.

My Administration is committed to preventing accidents and impaired driving.  The National Highway Traffic Safety Administration has raised awareness about its risks and consequences through media campaigns, including “If You Feel Different, You Drive Different”; “Drive Sober or Get Pulled Over”; and “Buzzed Driving is Drunk Driving.”  Furthermore, since the beginning of my Administration, we have dedicated over $100 billion to disrupt the flow of illicit drugs and expand access to the prevention and treatment of substance use disorder.

Reducing fatalities and injuries in impaired driving accidents also means improving the safety of our Nation’s vehicles.  That is why my Bipartisan Infrastructure Law invests in technologies that can detect and prevent impaired driving and requiring new passenger cars to include collision warnings and automatic braking to prevent accidents.  The Department of Transportation also released a National Roadway Safety Strategy to eliminate traffic deaths and make crashes less destructive.

This holiday season, let us recommit to doing right by our neighbors, friends, and families by driving sober.  For those planning on drinking, arrange a sober ride home beforehand — ride-sharing apps are a convenient way to get home safely.  If you have had alcohol or used substances, do not get behind the wheel — one accident can cost someone their life.  If you are responsible for driving yourself or others, stay sober, buckle up, put the phone away, and drive the speed limit.  And if you witness a friend, loved one, colleague, or anyone putting themselves or others in danger, lend a hand to keep them safe. You could save a life.

NOW, THEREFORE, I, JOSEPH R. BIDEN JR., President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim December 2024 as National Impaired Driving Prevention Month.  I urge all Americans to make responsible decisions and take appropriate measures to prevent impaired driving.

IN WITNESS WHEREOF, I have hereunto set my hand this twenty-ninth day of November, in the year of our Lord two thousand twenty-four, and of the Independence of the United States of America the two hundred and forty-ninth.

JOSEPH R. BIDEN JR.

 

Source: https://www.whitehouse.gov/briefing-room/presidential-actions/2024/11/29/a-proclamation-on-national-impaired-driving-prevention-month-2024/

 

These TC experts emphasize the critical need for a more proactive approach to substance use education

More than 40,000 youth used nicotine pouches last year alone, a staggering increase from 2021. The relatively new and less detectable product’s increasing prevalence among youth underscores an urgent need for informed discussion and intervention regarding adolescent substance use more broadly. Data shows that 59 percent of people 12 or older used tobacco, vaped nicotine, alcohol or illicit drugs in 2023, despite proof that substance use during these formative years poses a severe threat to cognitive function. “Early drug use can impair neurocognitive development and increase youth vulnerability to later use of illicit substances, and even academic failure,” shares John Allegrante, the Charles Irwin Lambert Professor of Health Behavior and Education at Teachers College, who examines the topic in his latest research with an international group of Nordic investigators.“With each generation, the messaging and campaigns around these dangerous products change to target those most vulnerable: our youth. We [educators] need to work with parents to provide more support resources and surveillance during such critical years.”We spoke with Allegrante and other TC experts about the risks and ways educators, parents and communities can address these challenges together.

 

A Call to Action: Reimagining Awareness, Prevention, and Intervention 

While interventions like the “Just Say No” campaign and the D.A.R.E. programs of the ’80s and ’90s have proven to be unsuccessful, the desire for more effective and youth-informed approaches to preventing  substance use among youth in the U.S. continues to grow.

Influencer marketing and social media promotions for e-cigarettes have increased the risk of youth vaping. Studies show that social media platforms often glamorize e-cigarettes with trendy flavors like cotton candy, attracting young users. TC’s Ayorkor Gaba, Assistant Professor of Counseling & Clinical Psychology, notes that there is a rise in innovative approaches, like media literacy education, to help youth critically analyze media and reject harmful messages.

She explains that social media can also share science-based health messages, enhancing prevention and treatment of substance use.  For example, influencers frequently share their lived experience with overdose,  the harmful effects of vaping, and recovery. Though “impactful,” the overall quality, accuracy and reliability of this content posted can be poor. “The lack of evidence-based content on social media reinforces the need for expert involvement (e.g., public health, psychology, etc.) in disseminating evidence-based content on social media,” notes Gaba. “Due to the significant influence of social media on youth, experts and researchers should integrate youth perspectives in developing social media-based intervention and prevention that can reach millions of youth. “

The CDC notes that a high majority of adolescent substance use (81 percent) occurs during socialization with friends. “As teens, we’re all looking to fit in,” adds TC doctoral student Treasure Tannock. “Between ages 15-25, we seek to cling to anything that gives us a better understanding of self-identity. If we can use that same mindset better to reach young people about the dangers of use through a more holistic, relatable lens, we might be able to make progress.”

To start, Tannock recommends getting youth involved in creative outlets that pique their interest, a concept she implemented during her clinical work at Rikers Island. “We asked individuals: Who are you now? Who do you want to be? What obstacles do you face with substance use? And how can you receive support?” explained Tannock, a Clinical Psychology student. “We then collaborated with music and art therapists to help express their stories. Over time, many became open to support and envisioned a new path forward.”

 

How Parents, Schools and Communities Can Help

Although there is much work to be done, parents, communities and educators can start by laying the groundwork for more proactive dialogue and means of support. 

Allegrante explains that during the pandemic, increased supervision at home led to a decrease in adolescent substance use, an observation from his post-pandemic research. “As young people return to school and socialize more, we’re seeing a resurgence in use,” he explains. “Many prevention efforts start too late; by the time we address it, habits are ingrained. We must start these conversations in middle or even elementary school.”

With so much at stake, schools are tasked with a greater responsibility to address the crisis. A recent survey by the American Addiction Centers revealed that schools are the primary setting where youth receive informative substance use education. However, out of the 500 students surveyed, only 75 percent had a substance-use-focused curriculum in their health class. 

“School is still a prime captive audience location for prevention, but it requires an interdisciplinary approach, resources and a theory-driven, evidence-based curriculum across the board,” Allegrante adds. “We need to work with communities, public health agencies and even local government officials to bridge the gap.”

Yet, prevention must extend beyond the classroom. It’s imperative for parents to stay informed about their children’s habits, as research shows that parental involvement is key to mitigating peer pressure and promoting informed decision-making. “Parenting practices (e.g., monitoring, communication) have been linked to youth substance use, yet there are few accessible supports to help the busy parent develop skills in this area. Gaba recommends an app by the Substance Abuse Mental Health Services Administration called “Talk. They Hear You.,” specifically designed to help parents and caregivers turn everyday situations into opportunities to discuss alcohol and drugs with their children. “It gives them the skills, confidence, and knowledge to start and maintain these conversations as their kids grow.”

Gaba also highlights the need to address disparities,  urging, “It’s a matter of life and death.” Between 2018 and 2022, drug overdose deaths among youth more than doubled, particularly impacting Latinx and Black communities. “Many still mistakenly believe opioids do not affect these groups, leading to decreased awareness and access to vital resources like Naloxone (Narcan), which can reverse overdoses,” she notes. “Additionally, substance use is notably higher among lesbian, gay, and bisexual (LGB) youth compared to their non-LGB peers.” To address these challenges, Gaba advocates for culturally tailored interventions that actively involve marginalized youth in the design process and target the social determinants of health that contribute to their elevated risks.

“Community support is also vital,” notes Tannock. “Having safe, accessible community spaces like libraries or after-school programs can make a significant difference. It’s a team effort.” She urges parents to inquire about local prevention resources. 

Although substance use among youth is an ongoing challenge, the National Institute on Drug Abuse (NIH) reports that adolescent substance use continues to fall below pre-pandemic levels, an encouraging statistic.

“If we look at how drastically cigarette smoking has declined as a consequence of culture change, especially in advanced economies of the world, it’s a testament to just how far we’ve come,” concludes Allegrante. “But it took a concerted effort over many years, and we can certainly chart a similar path forward with this next generation.”  — Jacqueline Teschon

Source: https://www.tc.columbia.edu/articles/2024/november/why-we-need-to-modernize-substance-use-education/

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

Hi Stuart

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

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

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

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

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

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

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

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

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

Consider:

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

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

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

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

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

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

Thanks and God bless – and spare us all,

Stuart.

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

 – PERSPECTIVE

 CO-AUTHORS:

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

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

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

ABSTRACT:

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

KEYWORDS:   cannabis, chromothripsis, micronucleus


MAIN ARTICLE TEXT:

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


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


 

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


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

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


13691600, 2024, 11, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/adb.70003 by National Health And Medical Research Council, Wiley Online Library on [14/11/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License


 

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

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

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

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

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

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

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

Concrete action needed

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

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

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

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

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

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

                                 Image: PIXABAY

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

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

October 31, 2024

 

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

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

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

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

Stephen Boyle, Auditor General for Scotland, said:

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

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

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

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

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

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

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

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

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

What is already known about this topic?

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

What is added by this report?

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

What are the implications for public health practice?

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

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

Investigation and Findings

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

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

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

Conclusions and Actions

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

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

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

Published 

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

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

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

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

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

‘Still work to be done’

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

By Gabrielle M. Etzel

November 6, 2024 10:45 am

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

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

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

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

Nebraska medical marijuana is only victory

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

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

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

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

Future of federal drug policy

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

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

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

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

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

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

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

Source: CLICK HERE TO READ MORE FROM THE WASHINGTON EXAMINER

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

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

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

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

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

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

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

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

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

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

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



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

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

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

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

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

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

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

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

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

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

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

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

United Nations  –  Office on Drugs and Crime

PRESS RELEASE  – Kabul / Vienna, 6 November 2024

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

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

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

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

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

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

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

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

Read the Afghanistan Drug Insights Volume 1 here.

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

* *** *

For further information please contact:

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

* *** *

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

by Chloe Marklay, Katie Amrhein, WKRC

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

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

 

(WKRC)

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

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

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

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

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

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

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

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

 

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

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

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

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

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

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

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

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

Fear of arrest

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

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

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

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

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

Contaminated drug supplies

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

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

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

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

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

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

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

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

Fear, stigma and miseducation

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

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

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

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

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

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

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

Overcoming disparities in health care and mistrust of the system

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

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

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

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

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

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

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

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

Here is what President Trump had to say

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

We will address these four statements made by President Trump.

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

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

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

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

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

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

 

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

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

President Trump got that wrong

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

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

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

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

Source: www.drugwatch.org

10Sep2024

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

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

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

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

Key Takeaways:

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

Transcript:

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

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

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

We hope you enjoy this episode.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

Source: Drug Free America Foundation

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