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  • Polly Ross, 32, suffered with Hyperemesis Gravidarum during second pregnancy
  • Mother smoked cannabis and magic mushrooms to ease pain, an inquest heard
  • ‘Talented and clever’ translator took her life in 2015 after battling with psychosis

A mother-to-be who took cannabis after developing the same morning sickness condition as the Duchess of Cambridge killed herself after developing a drug-induced psychosis, an inquest heard.  

Talented translator Polly Ross, 32, suffered Hyperemesis Gravidarum (HG), the condition which saw Kate Middleton rushed to hospital in August while visiting the queen in Aberdeen.

Hull Coroner’s Court in East Yorkshire was told today how a desperate Mrs Ross took cannabis and magic mushrooms in a bid to tackle the severe bouts of sickness.

However in July 2015, just a year after the birth of her second daughter, she died after stepping out in front of a train.  

A coroner heard Mrs Ross had developed ‘drug induced psychosis’ after taking cannabis to stop symptoms of HG.

Mrs Ross told her GP, Dr Daniella Malesknasr, she had taken cannabis during her pregnancy after visiting the doctors suffering from post natal depression.

Dr Malesknasr told the hearing: ‘She had told me when she was pregnant with her second child that she was taking cannabis and magic mushrooms to help combat HG during her pregnancy – but she was no longer taking it.’

Talented Polly Ross, 32, suffered the same condition but tried to soothe symptoms herself by taking cannabis and magic mushrooms

Professor Paul Marks, the senior coroner, questioned: ‘And does taking cannabis actual benefit those suffering from HG?.’

The doctor replied: ‘I can’t possibly comment on that.’

Dr Malesknasr said ‘alarm bells were ringing’ after Polly had told her she wanted to commit suicide on February 13, 2015.

Mrs Ross tried to take her life three times with self harm and taking an overdose twice in a three month period

The inquest heard the GP had called in at her home to find her in a psychotic episode and Mrs Ross was sectioned the following month.

By March 18, Dr Malesknasr said Mrs Ross was diagnosed with drug induced psychosis following the amounts of magic mushrooms and cannabis she had been taking.

The GP said she was then given Respiradon to help battle the psychosis.

Mrs Ross tried to take her life three times with self harm and taking an overdose twice in a three month period.

However, the court heard she was remarkably allowed to discharge herself voluntarily following the last attempt to take her own life.

Professor Marks said: ‘So after taking an overdose of paracetamol tablets, Polly was allowed to just leave voluntarily?’

Dr Malesknasr said: ‘I can’t comment on that because it is a hospital matter.’

However, in May 2015 a psychiatrist in the community said that psychosis was no longer a problem and she should come off the anti-psychosis drug Respiradon.

The translator was given help by a crisis team to give her a ‘higher and intense level of support’, but Mrs Ross had refused them entry to her house in Driffield, East Yorkshire.

Mrs Ross died on July 12, 2015, by stepping in front of a train in Hull, East Yorkshire, and ‘death was instant’, Hull Royal Infirmary Consultant Histopathologist Dr Ian Richmond told the hearing.

She had told mental health workers at the women-only care centre at Westlands voluntary care unit in Hull, East Yorkshire, that she was going to the shop.

Mrs Ross died on July 12, 2015, by stepping in front of a train in Hull, East Yorkshire

A statement from Mrs Ross’s aunt Emma May, who cared for her during her final months, read: ‘With the right guidance, medication and support, Mrs Ross could have made a full recovery.

‘There should be systems in place to protect that life especially because there are so many suicides attempts of post natal women.

‘I cannot understand why she was allowed to leave the hospital unit before she died.

‘Polly clearly said many times that she would kill herself, many months before she did.

‘I feel that she posed a significant risk to herself, did not have sufficient capacity to make decision and more should have been done to protect and care for her.’

Mrs Ross, who ran her own ‘very good’ translation business in Paris, was described as ‘an extremely intelligent lady and very driven in her own ambition’, by Mrs May.

She was also described as ‘frighteningly clever’.

She met her English husband Samuel Ross in 2011 in the French capital and the pair quickly married and had two daughters born in June 2012 and June 2014 respectively.

Mrs Ross suffered HG during pregnancy with both children and had post natal depression following the birth of both children.

The inquest, expected to last three days, continues.

WHAT IS HG?

Excessive nausea and vomiting during pregnancy is known as hyperemesis gravidarum (HG), and often needs hospital treatment.
Unlike regular morning sickness, HG may not get better by 14 weeks.
It may not clear up completely until the baby is born, although some symptoms may improve at around 20 weeks.
Some pregnant women be sick many times a day and be unable to keep food or drink down, which can have a negative effect on their daily life.
Exactly how many pregnant women get HG is not known as some cases may go unreported, but it’s thought to be around 1 in every 100.
Signs and symptoms of HG include prolonged and severe nausea and vomiting, dehydration and low blood pressure. Source: NHS Choices  

Source: https://www.dailymail.co.uk/news/article-5063227/Pregnant-mum-killed-developing-drug-habit.html November 2017

Abstract

Synthetic cannabinoids (SCs) are marketed worldwide as legal surrogates for marihuana. In order to predict potential health effects in consumers and to elucidate the underlying mechanisms of action, we investigated the impact of a representative of the cyclohexylphenols, CP47,497-C8, which binds to both cannabinoid receptors, on protein expression patterns, genomic stability and on induction of inflammatory cytokines in human lymphocytes. After treatment of the cells with the drug, we found pronounced up-regulation of a variety of enzymes in nuclear extracts which are involved in lipid metabolism and inflammatory signaling; some of the identified proteins are also involved in the endogenous synthesis of endocannabinoids. The assumption that the drug causes inflammation is further supported by results obtained in additional experiments with cytosols of LPS-stimulated lymphocytes which showed that the SC induces pro-inflammatory cytokines (IL12p40 and IL-6) as well as TNF-α. Furthermore, the proteome analyses revealed that the drug causes down-regulation of proteins which are involved in DNA repair. This observation provides an explanation for the formation of comets which was seen in single-cell gel electrophoresis assays and for the induction of micronuclei (which reflect structural and numerical chromosomal aberrations) by the drug. These effects were seen in experiments with human lymphocytes which were conducted under identical conditions as the proteome analysis. Taken together, the present findings indicate that the drug (and possibly other structurally related SCs) may cause DNA damage and inflammation in directly exposed cells of consumers.

Source: https://www.ncbi.nlm.nih.gov/pubmed/26194647 June 2016

University of Alberta led guideline warns health risks may outweigh benefits, provides guidance on when (and when not to) prescribe.

A new medical guideline published today suggests Canada’s family physicians should take a sober second thought before prescribing medical cannabis to most patients.

Published in Canadian Family Physician, “Simplified Guideline for Prescribing Medical Cannabinoids in Primary Care” states there is limited evidence to support the reputed benefits of medical marijuana for many conditions, and what benefits do exist may be balanced out or even outweighed by the harms.

“While enthusiasm for medical marijuana is very strong among some people, good-quality research has not caught up,” said Mike Allan, director of evidence-based medicine at the University of Alberta and project lead for the guideline.

The guideline was created after an in-depth review of clinical trials involving medical cannabis and will be distributed to roughly 30,000 clinicians across Canada. It was overseen by a committee of 10 individuals, supported by 10 other contributors, and peer reviewed by 40 others, each a mixture of doctors, pharmacists, nurse practitioners, nurses and patients. The review examined cannabinoids for the treatment of pain, spasticity, nausea and vomiting, as well as their side-effects and harms.

Researchers found that in most cases the number of randomized studies involving medical cannabis is extremely limited or entirely absent. The size and duration of the studies that do exist are also very narrow in scope.

“In general we’re talking about one study, and often very poorly done,” said Allan. “For example, there are no studies for the treatment of depression. For anxiety, there is one study of 24 patients with social anxiety in which half received a single dose of cannabis derivative and scored their anxiety doing a simulated presentation. This is hardly adequate to determine if lifelong treatment of conditions like general anxiety disorders is reasonable.”

According to the guideline, there is acceptable research for the use of medical cannabinoids to treat a handful of very specific medical conditions. They include chronic neuropathic (nerve) pain, palliative cancer pain, spasticity associated with multiple sclerosis or spinal cord injury, and nausea and vomiting from chemotherapy. Even in those specific cases, the benefits were found to be generally minor.

For nerve pain, 30 per cent of patients given a placebo saw a moderate improvement in their pain while 39 per cent experienced the same effect while on medical cannabinoids. In patients with muscle spasticity, 25 per cent of those taking a placebo saw a moderate improvement compared to 35 per cent on medical cannabis. The use of medical cannabis was best supported in its use for chemotherapy patients experiencing nausea and vomiting. Just under half of patients using cannabinoids for their symptoms had an absence of nausea and vomiting compared to 13 per cent on placebo.

“Medical cannabinoids should normally only be considered in the small handful of conditions with adequate evidence and only after a patient has tried of number of standard therapies,” said Allan. “Given the inconsistent nature of medical marijuana dosing and possible risks of smoking, we also recommend that pharmaceutical cannabinoids be tried first before smoked medical marijuana.”

While the researchers found evidence supporting the use of medical cannabinoids to be limited, side-effects were both common and consistent. About 11 per cent of patients were not able to tolerate medical cannabinoids, versus three per cent of those taking placebo. Common effects included sedation (50 per cent versus 30 per cent), dizziness (32 per cent versus 11 per cent) and confusion (nine per cent versus two per cent).

“This guideline may be unsatisfactory for some, particularly those with polarized views regarding medical cannabinoids,” said Allan.

He added that those who oppose the use of cannabinoids for medical therapy may be disappointed that the guideline considers medical cannabinoids in specific cases. Others, who feel cannabinoids are highly effective and don’t pose any risk, may be frustrated that the guideline doesn’t advocate their use sooner or for a broader range of conditions.

“Better research is definitely needed — randomized control trials that follow a large number of patients for longer periods of time. If we had that, it could change how we approach this issue and help guide our recommendations.”

Source: https://www.sciencedaily.com/releases/2018/02/180215153923.htm February 2018

The Centers for Disease Control (CDC) recently issued a warning about vaping following a multistate outbreak of severe lung problems linked to the use of electronic cigarettes. According to the CDC, there are, as of September 6, 450 reported cases of possible vaping-linked lung problems across 33 states and 1 territory, resulting in 6 deaths. Officials have not identified a specific e-cigarette product as a cause of the illnesses, meaning that various devices on the market could be contributing to this alarming pattern. Patients admitted for lung problems report difficulty breathing, fatigue, fever, nausea, and vomiting. Somehow, to proponents and purveyors of e-cigarettes, the very idea that vaping could be dangerous seems to have come as a surprise. 

The CDC updated its warning to suggest that e-cigarette and vaping device users refrain from using the products at all during the course of its investigation. It has also warned against buying counterfeit or street vaping products, including those with THC or other cannabinoids, and against modifying e-cigarette products. Moreover, the CDC urges youth, pregnant women, and adults who do not currently use tobacco products to refrain from using e-cigarette products, and encourages individuals who smoke and want to quit to use FDA-approved medications instead of e-cigarettes. Some health officials and experts believe that street vaping products with illicit or tainted substances may be behind the outbreak of lung problems, but no one can be certain at this point. Some patients have reported using vaping cartridges with THC or cannabinoids, but others have reported using different vaping cartridges without such substances. Most contain ingredients not generally tested for chronic inhalation in humans, and, to make matters worse, they can become contaminated in ways detrimental to respiratory and heart health. It is unlikely that any substance you inhale has been tested for safety for weeks, months, or over the long haul. But inhalation from vaping has effects on the lungs that are dramatic, can be easily seen on imaging, and do not seem easy to reverse.

Tobacco smoking in the English colonies of North America started early and peaked in the U.S. in the 1960s and 1970s, credible evidence proving its causal links to cancer, emphysema, and bronchitis emerging only over a century after its explosive growth and wild popularity. Why would boosters and defenders of today’s e-cigarettes, looking back at this history, believe that research would come to indicate the product’s benefits for the lungs, or for the respiratory health of those they may expose to vaping?

While experts and officials will continue to study this outbreak and may identify particular illicit substances as the culprit, the headlines have naturally raised questions for individuals who vape about long term consequences. What we know about cigarette smoking is bad enough, but there are few surprises. Here, we’re in uncharted territory. Yes, the FDA and other agencies will look at the broader health and safety of e-cigarette products and devices, but in the meantime, users will need to be evaluated and hope that their own lungs are not compromised in ways that only become clearly understood after they stop, or years down the line. While receiving considerably less media coverage, journalists recently found that the FDA began investigating vaping-associated seizures after some users of JUUL, the top-selling vaping product in the U.S., submitted claims of seizures to the administration’s safety portal.

It is important to note that Research You Can Use previously observed that there is not yet enough evidence to conclude whether e-cigarettes are suitable for smoking cessation. Some researchers now suggest that vaping nicotine may not be safer than smoking tobacco cigarettes. More recently, the FDA has agreed that JUUL’s claims of comparative safety are unproven. Other new studies have looked at the relative health of ingredients in some e-cigarette products, and the effects of vaping on the vascular system. The truth is that it’s risky and scientifically invalid to start from the premise that drugs are safe until proven dangerous. It reminds me of cocaine being touted as safe, or non-addicting, or even as “the champagne of drugs” until the aftermath of widespread use in the 1970s and 80s demonstrated that it was highly addictive and led to heart problems, brain damage, and other diseases.

What did these studies find?

One study, led by Yale’s Julie Zimmerman, found that chemical interactions in some of JUUL’s inhaled liquid nicotine mixtures yield unanticipated new chemicals that can cause breathing problems. In this study, researchers created a machine to trap JUUL aerosol and investigate its chemical composition. They found that the alcohols hosting flavors and nicotine in JUUL’s e-liquid react with vanillin, a flavor prohibited in tobacco cigarettes, to produce acetals. The effects of inhaling acetal chemicals are unknown, but the study notes that they can cause inflammation and lung irritation. The study found acetals in JUUL’s ‘Crème Brulée’ flavor. One researcher told Yale in an interview that the team was surprised to find such high vanillin chemical levels, pointing out that the detected levels reached those established for health limits on vanillin in bakeries and flavoring businesses.

This study also found menthol in 4 of the 8 JUUL flavors it tested. Menthol, the researchers note, can expand nicotine intake. This could be concerning in part because JUUL pods already have high nicotine content relative to other nicotine products—individuals absorb from one JUUL pod as much nicotine as an entire pack of cigarettes. The researchers also observe that the findings are notable because users of the product often believe that the ingredients and chemical makeup of e-liquids are stable, without realizing that the included chemicals can combine, alter each other, or produce potentially harmful new compounds. The study calls for vaping regulations that tackle the creation of new and possibly toxic chemical elements in e-liquids, exposure to flavorings, and menthol levels.

Another new study, this time from the University of Pennsylvania, examined the effects of vaping on the vascular system and found that e-cigarette use, even without nicotine, can damage blood flow. Researchers studied 31 nonsmokers between the ages of 18 and 35, with no prior history of cardiovascular problems, hypertension, asthma, respiratory tract infections, or cancer. Participants in the study inhaled from e-cigarette devices 16 times each, at three seconds per inhalation. The researchers then used MRIs to measure the participants’ blood vessel health, having evaluated it before and after the vaping exercises. In the participants’ post-vaping leg veins, oxygen levels fell 20 percent, and their peak blood flow velocity fell 17 percent. Their femoral arteries also dilated 34 percent less. The researchers call for additional research on the topic to corroborate their findings in larger groups, and their results focus only on the ECO e-cigarette device, but they nonetheless point to serious concerns about chronic use of vaping products, which may not give time for users’ blood vessel health to normalize or reset.

Why is this important?

Individuals who use vaping products can assume, on the basis consumer-focused “evidence,” that because e-cigarette makers claim that their products are a healthier alternative to tobacco products, they must be “healthy” overall. Some evidence does support the idea that vaping is preferable to smoking tobacco, which is why the United Kingdom’s government asserts that vaping is 95 percent less harmful than e-cigarette use and encourages e-cigarette users to switch to vaping. The dispute over this assertion may come down to the exact meaning of “less harmful,” but those with vaping-related lung disease would certainly argue that vaping is not safer than smoking tobacco. It’s also true that news reports on vaping can often overstate claims in the other direction, alleging or implying that e-cigarettes alone are responsible for severe lung distress. On this point, it may be useful to consider a similar research problem: attempting to determine whether smoking cannabis causes lung cancer when most cannabis smokers also smoke other drugs, and when many also smoke tobacco. By the time health officials and experts reach a definitive conclusion, it may be too late for those vaping. While exaggerations or misleading reports exist, they should not be used to support denial of mounting evidence, or instill confidence in vapers when new research shows obvious reasons to worry—and to worry about health more seriously than the “long-term effects are unknown” talking point.

The CDC’s overall position on vaping in recent years, subject to change,  is that e-cigarettes “have the potential” to help adult smokers quit if they are not pregnant and can entirely substitute vaping for smoking tobacco products. Again, the CDC is now suggesting that individuals avoid vaping while investigations into the associated outbreak continue. It also says that scientists still have much to learn about e-cigarettes and warns that they are not safe for youth. The CDC, FDA, NIDA, and other authorities have recognized youth vaping as a growing epidemic, and have begun taking measures to confront it. Federal officials are now reportedly creating a plan to ban flavored e-cigarette products, which have a particular appeal to youth. Given the recent outbreak of severe lung problems and continued youth interest in e-cigarettes, additional action on this front will likely be required. Another recent study, for example, found 25 distinct “vape tricks” in 59 sample videos on YouTube with a median count of over 32,000 views. “Vape tricks” are stylized and playfully affected techniques for vaping, such as exhaling clouds in unique shapes, that attract the young. 48 percent of the videos were linked to industry posting accounts. This study recommended restrictions on e-cigarette social media marketing to help curb youth vaping, which sounds like a promising avenue for public health. Officials may also find it beneficial to take account of new studies about vaping’s effects on lung and blood vessel health as they deal with the increasingly apparent reality that e-cigarette use is not merely problematic in associated outbreaks, but in legal use, too.

Source: https://www.addictionpolicy.org/blog/tag/research-you-can-use/vaping-and-lungs September 2019

The United States is confronting a public health crisis of rising adult drug addiction, most visibly documented by an unprecedented number of opioid overdose deaths. Most of these overdose deaths are not from the use of a single substance – opioids – but rather are underreported polysubstance deaths. This is happening in the context of a swelling national interest in legalizing marijuana use for recreational and/or medical use. As these two epic drug policy developments roil the nation, there is an opportunity to embrace a powerful initiative. Ninety percent of all adult substance use disorders trace back to origins in adolescence.a New prevention efforts are needed that inform young people, the age group most at-risk for the onset of substance use problems, of the dangerous minefield of substance use that could have a profound negative impact on their future plans and dreams.

MOVING BEYOND A SUBSTANCE-SPECIFIC APPROACH TO YOUTH PREVENTION

The adolescent brain is uniquely vulnerable to developing substance use disorders because it is actively and rapidly developing until about age 25. This biological fact means that the earlier substance use is initiated the more likely an individual is to develop addiction. Preventing or delaying all adolescent substance use reduces the risk of developing later addiction.

Nationally representative data from the National Survey on Drug Use and Health shows that alcohol, tobacco and marijuana are by far the most widely used drugs among teens. This is no surprise because of the legal status of these entry level, or gateway, drugs for adultsb and because of their wide availability. Importantly, among American teens age 12 to 17, the use of any one of these three substances is highly correlated with the use of the other two and with the use of other illegal drugs. Similarly for youth, not using any one substance is highly correlated with not using the other two or other illegal drugs.

For example, as shown in Figure 1, teen marijuana users compared to their non-marijuana using peers, are 8.9 times more likely to report smoking cigarettes, 5.6, 7.9 and 15.8 times more likely to report using alcohol, binge drink, and drink heavily, respectively, and 9.9 times more likely to report using other illicit drugs, including opioids. There are similar data for youth who use any alcohol or any cigarettes showing that youth who do not use those drugs are unlikely to use the other two drugs. Together, these data show how closely linked is the use by youth of all three of these commonly used drugs.


aAmong Americans age 12 and older who meet criteria for substance use disorders specified in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). bMarijuana remains illegal under federal law but is legal in some states for recreational use the legal age is 21, and in some states for medical use, the legal age is 18. Nationally the legal age for tobacco products is 18 and for alcohol it is 21.

Figure 1. Past Month Use of Other Drugs, if Marijuana is Used, Ages 12-17

These findings show that prevention messaging targeting youth must address all of these three substances specifically. Most current prevention efforts are specific to individual substances or kinds and amounts of use of individual drugs (e.g., cigarette smoking, binge drinking, drunk driving, etc.), all of which have value, but miss a vital broader prevention message. What is needed, based on these new data showing the linkage of all drug use by youth, is a comprehensive drug prevention message: One Choice: no use of any alcohol, nicotine, marijuana or other drugs for youth under age 21 for reasons of health. This no use prevention message provides clarity for young people, parents, physicians, educators, communities and for policymakers. It is not intended to replace public health prevention messages on specific substances, but enhances them with a clear focus on youth.

Some claim adolescent use of alcohol, cigarettes and marijuana is inevitable, a goal of no use of any drug as unrealistic and that the appropriate goal of youth prevention is to prevent the progression of experimentation to later heavy use or problem-generating use. These opinions are misleading and reflect a poor understanding of neurodevelopment that underpins drug use. Teens are driven to seek new and exciting behaviors which can include substance use if the culture makes them available and promotes them. This need not be the case. New data in Figure 2 (below) show over the last four decades, the percentage of American high school seniors who do not use any alcohol, cigarettes, marijuana or other drugs has increased steadily. In 2014, 52% of high school seniors had not used any alcohol, cigarettes, marijuana or other drugs in the past month and 26% had not used any alcohol, cigarettes, marijuana or other drugs in their lifetimes. Clearly making the choice of no use of any substances is indeed possible – and growing.

 

Key lessons for the future of youth prevention can be learned from the past. Substance use peaked among high school seniors in 1978 when 72% used alcohol, 37% used cigarettes, and 37% used marijuana in the past month. These figures have since dropped significantly (see Figure 3 below). In 2016, 33% of high school seniors used alcohol, 10% used cigarettes and 22% used marijuana in the past month. This impressive public health achievement is largely unrecognized.

Although the use of all substances has declined over the last four decades, their use has not fallen uniformly. The prevalence of alcohol use, illicit drug use and marijuana use took similar trajectories, declining from 1978 to 1992. During this time a grassroots effort known as the Parents’ Movement changed the nation’s thinking about youth marijuana use with the result that youth drug use declined a remarkable 63%. Rates of adolescent alcohol use have continued to decline dramatically as have rates of adolescent cigarette use. Campaigns and corresponding policies focused on reducing alcohol use by teens seem to have made an impact on adolescent drinking behavior. The impressive decline in youth tobacco use has largely been influenced by the Tobacco Master Settlement Agreement which provided funding to anti-smoking advocacy groups and the highly-respected Truth media campaign. The good news from these long-term trends is that alcohol and tobacco use by adolescents now are at historic lows.

It is regrettable but understandable that youth marijuana use, as well as use of the other drugs, has risen since 1991 and now has plateaued. The divergence of marijuana trends from those for alcohol and cigarettes began around the time of the collapse of the Parents’ Movement and the birth of a massive, increasingly well-funded marijuana industry promoting marijuana use. Shifting national attitudes to favor legalizing marijuana sale and use for adults both for medical and for recreational use now are at their highest level and contribute to the use by adolescents. Although overall the national rate of marijuana use for Americans age 12 and older has declined since the late seventies, a greater segment of marijuana users are heavy users (see Figure 4). Notably, from 1992 to 2014, the number of daily or near-daily marijuana uses increased 772%. This trend is particularly ominous considering the breathtaking increase in the potency of today’s marijuana compared to the product consumed in earlier decades. These two factors – higher potency products and more daily use – plus the greater social tolerance of marijuana use make the current marijuana scene far more threatening than was the case four decades ago.

Figure 4. Millions of Americans Reporting Marijuana Use, by Number of Days of Use Reported in the Past Month

Through the Parents’ Movement, the nation united in its opposition to adolescent marijuana use, driving down the use of all youth drug use. Now is the time for a new movement backed by all concerned citizens to call for One Choice: no use of any alcohol, nicotine, marijuana or other drugs for youth under age 21 for reasons of health. This campaign would not be a second iteration of the earlier “Just Say No” campaign. This new no-use message focuses on all of the big three drugs together, not singly and only in certain circumstances such as driving.

We are at a bitterly contentious time in US drug policy, with front page headlines and back page articles about the impact of the rising death rate from opioids, the human impact of these deaths and the addiction itself. At the same time there are frequent heated debates about legalizing adult marijuana and other drug use. Opposing youth substance use as a separate issue is supported by new scientific evidence about the vulnerability of the adolescent brain and is noncontroversial. Even the Drug Policy Alliance, a leading pro-marijuana legalization organization, states “the safest path for teens is to avoid drugs, including alcohol, cigarettes, and prescription drugs outside of a doctor’s recommendations.”

This rare commonality of opinion in an otherwise perfect storm of disagreement provides an opportunity to protect adolescent health and thereby reduce future adult addiction. Young people who do not use substances in their teens are much less likely to use them or other drugs in later decades. The nation is searching for policies to reduce the burden of addiction on our nation’s families, communities and health systems, as well as how to save lives from opioid and other drug overdoses. Now is precisely the time to unite in developing strong, clear public health prevention efforts based on the steady, sound message of no use of any alcohol, nicotine, marijuana or other drugs for youth under age 21 for reasons of health.

Robert L. DuPont, MD, President, Institute for Behavior and Health, Inc.

Source: https://www.ibhinc.org/blog/reducing-adult-addiction-youth-prevention  February 2018

Ontario’s proposal to allow people to consume marijuana in hotel rooms opens the door to a boom in cannabis tourism, says lawyer Matt Maurer.

Maurer heads the cannabis law group at Minden Gross in Toronto, and says he knows businesspeople who are interested in opening cannabis-friendly hotels and resorts.

Maurer says he was surprised by the province’s proposal to loosen up the ban on consuming cannabis anywhere other than private homes. The government has also asked for public comments on whether to allow cannabis lounges.

Maurer said he assumed the provincial government would eventually consider exemptions to the cannabis act passed in December, which bans consumption in public places.

 “I was surprised that it happened so quickly.”

Maurer calls consumption in hotels “step No. 1” in the development of a cannabis tourism industry.

“You could come to Ontario, go to the government-owned retail store, pick up your cannabis, head out to the hotel room, consume it there and head out to where ever you are going that evening, to a show or an event.”

The provincial regulations unveiled last month propose that cannabis could be consumed by residents and their guests at rooms in hotels, motels and inns, as long as the drug is not smoked or vaped. Smoking and vaping marijuana would be allowed in designated smoking rooms.

The regulations have been posted for public comment. The government plans to put them into effect when recreational marijuana is legalized across the country, expected in July.

Ontario has also opened the door to cannabis consumption lounges, asking for public comments on the idea. There’s no time frame for the lounges, but rules won’t be in place be by July. The province says the comments it receives will “inform future policy development and consultations.”

Abi Roach, who runs a cannabis vaping lounge in Toronto called Hotbox Cafe, says she’s interested in opening more if they become legal. She dreams of the day when lounges will be allowed to sell single servings of cannabis, just like drinks are served in a bar or restaurant. 

At the Hotbox (slogan: “serving potheads since … ahh I forget”), guests pay a $5 entry fee and bring their own pot.

If Ontario allows lounges, they probably won’t feature smoking inside because of concerns over the health dangers of second-hand smoke to both customers and employees, said Roach. “I don’t like to be in a big smoky room, either.”

At the Hotbox, only vaping is allowed inside. Pot smokers puff at an outdoor patio.

Roach also sees a demand for pot-friendly hotels. She’s helping design a cannabis-themed room at a hotel to be built in downtown Toronto. Each room in the hotel is owned by a private investor and offers a themed experience. If cannabis consumption is made legal in hotel rooms, they’ll go ahead with that project.

However, Roach said she doubts if Canada will see a big influx of cannabis tourists from the U.S. because we’ll be competing with a growing number of American states that are legalizing pot, some of which have taken a more creative, freewheeling approach. Ontario plans to sell cannabis from behind the counter at a restricted number of government-run stores. That won’t appeal to people who want convenience and innovative products from craft producers, said Roach.

“Canada really has to be careful in terms of blocking innovation in this industry.”

Roach said she recently drove from Vancouver to Washington State, where she stopped at a gas station and bought a joint. “To me as a tourist, it was like, ‘Wow, this is great!’ ”

In the lvillage of Embrun 40 kilometres southeast of Ottawa, Frank Medewar says he plans to open a lounge if they are made legal. He already runs InfoCannabis, a service that advises people about medical marijuana, and Seed 2 Weed, a store that sells growing equipment.

Medewar says his lounge will be modern and upscale, similar to an old-fashioned cigar lounge.

At the headquarters of the world’s largest medical marijuana company, Canopy Growth Corp. in Smiths Falls, spokesman Jordan Sinclair said the company would love to make the huge grow-op a tourist destination.

Canopy is in a former Hershey chocolate factory that was famous for tours taken by thousands of schoolchildren and tourists.

Canopy plans to have the plant open for public tours this summer, said Sinclair.

The company would also like to run a retail store on site, so the experience would be similar to a winery tour. However, the province has nixed that idea.

At Ottawa Tourism, spokesperson Jantine Van Kregten said the legalization of cannabis is on the radar. However, she hasn’t heard of any specific plans for hotels or other tourist ventures. “I think everybody is kind of taking a wait-and-see approach. I haven’t heard a lot of talk, a lot of scuttlebutt, in the industry of what their plans are. I think a lot of questions are unanswered about exactly how the legislation will roll out.”

Source: https://ottawacitizen.com/news/local-news/ontario-proposal-to-allow-cannabis-consumption-in-hotel-rooms-could-jump-start-pot-tourism February 2018

Study drawing on data from the Netherlands is the first to show how admissions to treatment centres rise and fall in line with cannabis strength

Many countries have seen far stronger cannabis come on to the market in the past few decades

Researchers have found fresh evidence to suggest that more potent strains of cannabis are at least partly to blame for the number of people seeking help from drug treatment programmes.

Scientists at King’s College London drew on data from the Netherlands to show that admissions to specialist treatment centres rose when coffee shops sold increasingly more potent cannabis, but fell again when the cannabis weakened.

The work is the first to investigate how admissions to drug treatment programmes rise and fall in line with the strength of cannabis available to users. It found that changes in demand for treatment typically lagged five to seven years behind changes to cannabis strength.

“This is the first study to provide evidence for an association between changes in potency and health-related outcomes,” said Tom Freeman, an addiction scientist at King’s.

The demand for specialist treatment among cannabis users has risen steadily in recent years, with more people now citing the drug on admission than any other illicit substance. In Europe, the number of first-time referrals for cannabis rose 53% from 2006 to 2014.

Cannabis plants produce more than 100 active compounds called cannabinoids but THC, or delta-9 tetrahydrocannabinol, is largely responsible for the drug-related high. A second compound called CBD, or cannabidiol, appears to reduce some of the mental health risks linked to heavy cannabis use by counterbalancing the effects of THC.

In work funded by the Society for the Study of Addiction, Freeman and others studied data gathered by the Trimbos Institute, a non-profit mental health and addiction organisation in the Netherlands. Each year, the institute conducts anonymous tests on cannabis for sale at a random selection of coffee shops in the country.

Writing in the journal, Psychological Medicine, the researchers show that THC levels in cannabis soared from an average of 8.6% to 20.4% from 2000 to 2004, then slowly fell to 15.3% by 2015. When the researchers looked at the impact on drug treatment programmes, they found that first-time cannabis admissions nearly quadrupled from seven to 26 per 100,000 inhabitants from 2000 to 2010, and then dropped to less than 20 per 100,000 inhabitants in 2015. It means that for every 1% increase in THC, about 60 more people entered treatment.

“We see a rapid increase in THC between 2000 and 2004 followed by a slower decline, and then you see a very similar profile in drug treatment admissions,” Freeman said. The rise in cannabis potency was one of a number of factors driving admissions to specialist drug services.

Val Curran, professor of psychopharmacology at UCL, said: “This adds to a growing number of scientific studies which suggest rising THC potency of cannabis is associated with greater incidence of mental health problems including addiction and possibly psychosis.”

But she added that stronger cannabis was not solely responsible for increasing demand for drug treatment. “Other factors include the marked decrease in levels of cannabidiol (CBD) in cannabis. There is evidence that CBD can protect against some mental health harms of THC,” she said.

Ian Hamilton, a mental health lecturer at the University of York, agreed that other factors beyond the potency of the drug were important. “It is possible that seeking help for problems with cannabis has become more acceptable by users and treatment providers. Over the same period that cannabis referrals to treatment have been increasing, referrals for problems with opiates such as heroin have been in decline. So although cannabis has traditionally been viewed as relatively benign by treatment workers they may now be more inclined to offer support,” he said.

Source: https://www.theguardian.com/science/2018/jan/31/stronger-cannabis-linked-to-rise-in-demand-for-drug-treatment-programmes January 2018

After Lynley Graham’s custody photo was posted to a police force’s Facebook page, horrified users were quick to discuss the harmful effects of hard drugs

Deep lines etched across a woman’s face and cheeks sunken to the bone – this one shocking image illustrates the effects of substance abuse.

Lynley Graham’s custody picture has been released by Humberside Police after she was jailed for 18 months for drug offences.
Graham was found in possession of class A drugs, including heroin and cocaine, and was subsequently charged with possessing a class A drug with intent to supply, Grimsby Live reports.

After the photo was posted to Humberside Police’s Facebook page on Wednesday, users were quick to discuss the 53-year-old’s weathered appearance.

Before and after pictures show a striking physical transformation.

One said: “I’m 64, I look young compared to her. Is she a lesson, perhaps, in what substance abuse can do to your skin?”

Another added: “Let’s hope some young people look at her and see what a life of drugs does apart from ruining entire families.”

Drug addiction and misuse contributed to more than 2,500 UK deaths in 2017.

Inhalants can cause damage to the kidneys, liver and bone marrow, and persistent drug consumption can result in abscesses, tooth decay – known as ‘meth mouth’ in the United States.

Other symptoms include premature ageing of the skin, often adding decades to someone’s appearance.

Rehabs.com, a US-based charity, has also published startling images of drug users to demonstrate the long-term toll narcotics have on one’s appearance.

Drugs can damage almost every system in the body; bloodshot eyes, dilated pupils, puffy faces and discoloured skin are all noticeable signs.

Some users suffer a rapid physical deterioration – with facial appearances sometimes ruined in just a matter of years.

Self-inflicted wounds, common among consumers of methamphetamine, can be caused by users picking at their skin to relieve the sensation of irritation – sometimes described as like crawling insects.

And a skeletal appearance can be the result of appetite-suppression.

Cocaine can commonly lead to chronic skin ulcers, pus-filled skin and the development of Buerger’s disease – an inflammation in small and medium-sized blood vessels.

Heroin has been known to dry the skin, leaving addicts with itchy and aged skin.

In May, Sir Angus Deaton, a world-leading economist, warned that drug abuse and alcoholism claim more lives of those in middle-age than heart disease.

‘Economic isolation’ is cited as one of the biggest contributors.

In 2017, a poll of 1,600 adults found that almost nine in ten said that seeing the physical effects of hard drugs made them less likely to take them.

The publication of such images is a common tactic among anti-addiction campaigners.

Scotland is experiencing its own drug crisis, with a 27 per cent rise in drug-related deaths, according to official statistics.

It puts Scotland’s drug mortality rate three times higher than the UK as a whole, and higher than any other country in the European Union.

The NHS offer services for drug and alcohol recovery, as do outside agencies, such as Addaction

Source: https://www.mirror.co.uk/news/uk-news/shocking-image-illustrates-how-drugs-18790997 July 2019

As more cases turn up, doctors are concerned about the extent to which memory loss may be undetected.

Just over five years ago, a man suffering from amnesia following a suspected drug overdose appeared at Lahey Hospital and Medical Center in Burlington, Massachusetts, a Boston suburb. He was 22, and had injected what he believed to be heroin. When he woke up the next morning, he was extremely confused, repeatedly asking the same questions and telling the same stories. Doctors at Lahey quickly diagnosed the man with anterograde amnesia—the inability to form new memories.

His brain scan revealed why. “I thought it was an extremely strange scan—it was almost hard to believe,” says Jed Barash, a neurologist working at Lahey at the time. In the scan, the twin, seahorse-shaped structures of the man’s hippocampi were lit up against the dark background of the rest of the brain—a clear sign of severe injury to just that one region.

“It was strange because that was all there was,” Barash says.

Memory researchers have known since the late 1950s that the hippocampi are responsible for turning short-term memories into lasting ones, so the amnesia was not surprising. Just how the damage occurred, however, remained a mystery. Lack of oxygen to the brain that would have occurred during the overdose could not be the only explanation. The number of survivors in the state that year could easily have numbered in the thousands, so why was there only one patient with this seemingly unique brain damage?

Along with his colleagues, Barash—now the medical director at the Soldiers’ Home health-care facility in Chelsea, Massachusetts—figured that the opioids must have played a role, and that hunch became only more acute as three more patients—each fitting the same pattern—appeared at Lahey over the next three years. All had the same unique destruction of the hippocampi, all had amnesia, and all were suspected to have overdosed. By that point, the doctors at Lahey faced two fundamental questions: What was causing the strange new syndrome? And precisely how rare was it?

Both questions remain unanswered, but a case report published Tuesday in the Annals of Internal Medicine adds to a growing body of evidence suggesting that the problem is far from isolated, and that a potent opioid variation could be involved. A total of 14 patients have now been identified in Massachusetts, one of whom was first admitted to a hospital in his home state of New Hampshire. The new case study reveals two more patients—one from Virginia, and one from Maryland. Both turned up at a medical facility in West Virginia.

Although many of the patients had taken a variety of drugs, all but one either have a history of opioid use or tested positive for opioids. The most recent case, a 30-year-old man examined last year in West Virginia, is the first patient proven to have taken fentanyl, an extremely potent and dangerous opioid that is rarely tested for in toxicology screens.

There are many barriers to determining the true scope of the problem, from lack of proper testing to the fact that many patients never come to attention in the first place. And amid a larger opioid crisis that some experts say could claim as many as 500,000 lives over the next decade, pinning down the cause of a dozen or so amnesia cases can seem trifling. “It’s sort of like the Titanic going down and you’re worried about some details,” says Alfred DeMaria, the state epidemiologist for Massachusetts.

At the same time, DeMaria suggests that, at the very least, these patients may offer a different route for understanding a disorder, as was the case with a small cluster of patients in the early 1980s who developed Parkinson’s disease after taking contaminated drugs—a misfortune that turned out to be limited to a few people, but which nonetheless gave Parkinson’s researchers a new tool for studying the disease. More worryingly, he also points to several examples of medical investigations that began with a small number of mysterious cases and turned out to have significant public health-implications, such as the appearance of West Nile Virus, or the AIDS epidemic.

Bertha Madras, a psychobiologist at McLean Hospital in Belmont, Massachusetts, and a member of President Donald Trump’s Commission on Combating Drug Addiction and the Opioid Crisis, agreed that getting to the bottom of these amnesia cases is crucial—particularly given that many cases may be going undetected since the type of cognitive testing needed to diagnose amnesia may not be routinely done in overdose survivors. She also suspects that with overdose-antidote drugs like naloxone becoming more widely available, it is possible that more patients, rather than turning up dead, will show up at hospitals.

And with more survivors, Madras said in an email message, “there conceivably will be more cases of brain damage, especially in the very oxygen-sensitive hippocampus, the ‘epicenter’ of initial learning and memory.”

* * *

After encountering more patients following that first one in 2012, Barash contacted the Massachusetts Department of Public Health in 2015, which put out a request to emergency-room physicians, neurologists, and radiologists statewide for information that might identify additional cases. By the end of 2016, a total of 14 people who matched the pattern had been identified. Then, in May of 2017, the DPH made what they called “an unusual amnestic syndrome” with “acute, bilateral hippocampal” damage a reportable disease syndrome—a status that requires any doctor who sees such a case to forward patients’ medical records for review.

As of today, however, DeMaria believes there is no such mechanism in place in other states, and that’s one of the barriers to getting a handle on the prevalence of the amnestic syndrome. Marc Haut, the neuropsychologist who examined the man from Virginia in 2015, and one of the authors on the new Annals paper, had no way of knowing about the investigation in Massachusetts and initially chalked up the damage to cocaine use. At the time, he saw no reason to consider opioids, in part because of the information the patient shared with him. “Patient reports about substance use [are] not always accurate for a couple of reasons, one being the patients themselves,” he says. “And the other being that patients often don’t know what they’re buying and using.”

So it was not until he received an email from Barash that Haut, the chair of the behavioral medicine and psychiatry department at West Virginia University, reconsidered whether opioids could have played a role. To date, only eight of the 16 patients reported in the cluster had cocaine in their system, making opioids a more consistent link than any other drug. Barash, who is also an author on the Annals paper, wonders if fentanyl—considered to be 50 times more potent than heroin—is a key component, in part because the timing and location of the appearance of these amnestic cases parallels the rise of fentanyl overdoses in two of the hardest hit regions in the country. Teasing this out is complicated with the ever-changing landscape of drugs that people are taking, often in combination. “Cocaine overdose deaths are escalating,” said Madras, “along with evidence of combined use of fentanyl, heroin, and cocaine in some deaths.”

And despite the fact that fentanyl abuse has become so common, routine toxicology screens don’t test for the presence of the drug. It was only because Haut had been tipped off that he requested the advanced toxicology screen for the 2017 patient, which found evidence that he had taken fentanyl in addition to cocaine. His MRI scan also revealed the signature hippocampal damage: “bright, big, and intense,” according to Haut.

Like Barash, Haut is concerned about the possibility that what they’ve seen so far could be just the tip of the iceberg. “We don’t know if this is a rare occurrence, or if this has occurred more, and people have not noticed,” he says, “because some of the folks who have these events are pretty marginalized in society. If they don’t have family to notice, it may not be noticed even though it’s pretty dense amnesia.”Several other doctors who contributed cases to the Massachusetts cluster have also raised the question of whether more patients are going undetected. They point to the fact that many illegal drug users don’t go to a hospital after an overdose. If they do, their confusion is likely to be chalked up to a temporary symptom of the overdose. If they don’t get to a hospital within a narrow window of approximately one week, the telltale signal may have faded from the brain and all evidence of drugs will likely have cleared the system.

Even if all those conditions are met, doctors across the country don’t know where or how to share the information. DeMaria, the state epidemiologist for Massachusetts, believes his is the only state that has notified physicians and is collecting cases. If doctors in other states are seeing cases that fit the pattern, they may assume that it’s a one-off phenomenon, just as Barash and others did when they first saw the cases.

Michael Lev, an emergency-room neuroradiologist at Massachusetts General Hospital who contributed cases to the Massachusetts cluster, thinks it’s possible that the appearance of this amnestic syndrome may date back far earlier than 2012. He recalls seeing similar brain images in a few sporadic cases between 1986 and 1989 when he was working at Boston City Hospital. The patient history was always the same, he says. “The history was ‘heroin found down,’”—emergency-room shorthand for an overdose victim.

* * *

For now, doctors can only go on the well-documented data that they have—the 16 patients identified between October 2012 and May 2017—and one key question is whether they represent just one narrow band along a spectrum of damage, which would have ramifications for the ability of addicts to get the treatment they need. “Getting a sense of the severity and scope of this is important,” Haut says. “If we find that these dense amnesias are really rare, that’s good. But if we find in the interim that they have significant memory problems even though they’re not amnestic as a result of these events, that have gone under the radar, then we have to take that into account when we’re trying to get people into treatment and staying in treatment.”

Barash agrees, pointing out that understanding the amnestic syndrome may give medical professionals insight into some of the larger problems that can accompany overdoses. “These cases are a very particular subset of brain damage that can occur from use of opioids,” he notes. “But I think more likely there are probably cases of patients who may not necessarily have this particular syndrome but suffer cognitive difficulties from longer-term use of opioids and it’s important to know the scope of that.” It’s also plausible that there are more extreme cases on the other end of the spectrum—people who have taken sublethal doses but are too far gone to have their memory tested.

Source: https://www.theatlantic.com/health/archive/2018/01/fentanyl-overdose-amnesia/551846/ January 2018

President Donald Trump took a few minutes in his State of the Union address to acknowledge what he called the “terrible crisis of opioid and drug addiction – never been has it been like it is now”.

The American President told Congress that “we have to do something about it”, stating that 174 drug-addiction caused  deaths a day meant that “we must get much tougher on drug dealers and pushers”.

This should come as no surprise. The crisis, which claimed well over 100,000 lives between 2015 and 2016, is now so widespread and catastrophic it was declared a public health emergency by President Trump in October.

The rate of American deaths caused by overdoses of heroin-like synthetic opioids has doubled since 2015, in a tragic symptom of the opioid epidemic ravaging the United States.

The US’s Centre for Disease Control and Prevention has published figures showing that the rate of deaths due to synthetic opioids excluding methadone, such as fentanyl and tramadol, jumped from 3.1 per 100,000 in 2015 to 6.2 per 100,000 in 2016.

The total number of deaths due to opioid overdoses also climbed from 52,400 to 63,600, a 21 per cent increase – marking a steady rise since 1999.

Synthetic opioids are the biggest killers

The dramatic rise in the use of synthetic opioids owes more to practicality than demand, Dr David Herzberg, a University of Buffalo expert in the history of drug addiction, told The Telegraph.

“Fentanyl [the most widely used synthetic opioid] is much easier to smuggle than heroin because you need less of it,” he said.

Since synthetic opioids are made in labs rather than from plants, like traditional heroin, they can be made anywhere in the world, and vary dramatically in strength.

Fentanyl is around 50 times stronger than heroin – and some new strains are up to 10,000 times stronger.

This huge variation in potency is what makes makes synthetic opioids so deadly, since users are often completely unaware of the strength of the substance they are injecting, said Dr Jon Zibbell, a Senior Public Health Scientist at RTI International, a nonprofit that funds opioid research.

“I know a kid who buys carfentanil [a newer strand of fentanyl] online and that’s all he injects; he argues it’s totally safe but people mixing it with other stuff don’t really know what they’re doing.

“It’s not the drugs themselves that are killing people but the inability of people to adapt to the uneven potency in the illicit market,” he said.

The rise in fentanyl dates back to 2013, when drug traffickers in Mexico started adding it to heroin to stretch their product further to meet growing demand.

Now fentanyl has also grown in popularity with small drug dealers within the US who buy it online from China, which Dr Zibbell said has led to a bloated supply of fentanyl with no standardization of strength.

Rise of drug overdose death most pronounced among men

Fentanyl is not the only heroin-like drug experiencing a boom in users in the US; the country’s mushrooming opioid crisis is well documented, with the overall rate of opioid drug overdoses increasing every year since 1999.

This owes much, Dr Herzberg said, to a history of over-prescription of painkillers dating back more than three decades to the Reagan administration, when tight controls on opioid sales were relaxed: “Opioid markets were opened up to the full range of strategies drug companies use to sell their products. So a large volume of these drugs were pumped into the market without adequate warnings about the risks.”

While data shows a higher rate of overdoses in men, recent research has found the serious health impacts for women are just as severe.

A recent paper by Dr Zibbell published in the American Journal of Public Health demonstrated that those regions of the US particularly ravaged by the opioid epidemic have also seen an outbreak of new cases of the degenerative blood disease hepatitis C.

While the rate of death by opioid overdose is lower for women, the rate of new hepatitis C cases developing is much higher. This is particularly concerning as researchers have also documented a large increase in babies born to infected mothers, along with a rise in neonatal abstinence syndrome (babies born physically dependent on opioids).

The trouble in poor, white states may be spreading

Rust belt states such as Ohio, Pennsylvania and West Virginia – with an astonishing rate of 52 drug overdose deaths per 100,000 – have shouldered the brunt of the opioid crisis.

This is partly due to the poverty of these states, but race is also a huge factor – areas with large white populations are disproportionately impacted since the epidemic is rooted in prescription drug abuse, said Dr Herzberg.

“Studies prove that physicians are less likely to prescribe opioids to African Americans or other racial minorities – even when they need them – because of the stereotypes associating them with drug abuse,” he said.

There are signs, however, that the problem has spread to other communities. The mostly non-white District of Columbia, for example, had a rate of death by drug overdose of 38.8 per 100,000 – almost most twice the national average of 19.8.

Dr Zibbell’s research also found high rates of drug treatment and new hepatitis C cases among hispanics. “That was a big deal because the epidemic has been described as mostly affecting the white population,” he said.

Experts say the spread of the opioid crisis beyond the mostly white rust belt states is particularly worrying as it highlights the nationwide extent of the crisis.

“The Trump administration is not putting action or money behind its pronouncements on the problem. If the present trajectory continues it will claim many more young lives,” he said.

President Trump remained defiant in his speech, however.

“The struggle will be long and it will be difficult,” he acknowledge, before adding “we will succeed”.

Source: https://www.telegraph.co.uk/news/2018/01/31/deadly-fentanyl-behind-dramatic-doubling-synthetic-opioid-death/ January 2018

A USA TODAY NETWORK-Wisconsin project

Heroin entered their lives so easily.

For 10 addicts, the hard part is staying clean.

They got the pills from their doctors, then kept using them until they couldn’t stop. They switched to heroin because it was cheaper, because a friend said it was an easier, better way to get high.

They went to parties as teens, took pills, snorted powders. They got bored with the drugs they were doing and then found heroin, the drug they loved the most.

They had faced abuse, poverty, tragedy. Their pain was deep, and psychological, and the drug was an escape.

The stories of 10 recovering heroin addicts from Wisconsin are the stories of millions of Americans who have been hooked on opiates and either died, or lived with the consequences. They’ve lost friends. They’ve been arrested. They’ve lost touch with their family and friends, lost custody of their children.

COUNTY BY COUNTY: Deaths and ODs in Wisconsin.

“It wasn’t what they always told us it was going to be,” said Moriah Rogowski, a 22-year-old recovering addict, about her first time using heroin. She didn’t develop an addiction right away. But somewhere, more gradually than she expected, she lost control.

Like the other nine recovering heroin users profiled in this special report from USA TODAY NETWORK-Wisconsin, Rogowski has taken back control of her life. She’s clean. She lives in a different city, imagines a different future for herself.

Recovery from opiate addiction is hard, filled with setbacks. But these 10 people from across Wisconsin have taken the first steps toward a life after heroin. In photos, in words and in their own voices, these are their stories about how they started on heroin and fought to get off the drug.

‘That was the only way I liked to get high’

Moriah Rogowski, Green Bay

Moriah Rogowski liked the feeling of downers: Percocet, Vicodin, Oxycontin. She and her friends, the summer before high school, would go out to parties and crush pills and snort them.

She and her three siblings lived in a rural home near Mosinee, where she was homeschooled until eighth grade. In high school, she found her place among the stoners. One night she found herself in a drug house in Marshfield with 33-year-olds. She was 15.

That was the day she first tried heroin. She was afraid of needles, so she let someone else shoot the drug into a vein in her arm.

“That was the only way I liked to get high after that,” she said.

Rogowski is now 22. She’s been in and out of programs in Minnesota and Green Bay as she tried to get clean. But she’d come home and hang out with the same friends; each time they led her back to the drug.

She sought treatment at the methadone clinic in Wausau, where she saw others abusing the methadone and still using heroin. She fell into the same pattern.

She mixed heroin, crack, Xanax. There is a week of her life she can’t remember. She took her brother’s car and got an OWI. Her license was suspended.

Then, from somewhere, she found the will to change. She called her mom to come get her because she wanted to get clean. She began to use the methadone program correctly, taking classes and attending therapy sessions.

Rogowski has lived in Green Bay for two years. She hopes to complete her GED. And she’s trying to help others by working toward becoming a recovery coach.

— Laura Schulte, leschulte@gannett.com

A soldier’s widow masks her pain

Sarah Bear, Wausau

Sarah Bear didn’t want to feel anymore.

Her husband, Jordan, was killed in Afghanistan in 2012 during an attack at his base in the Kandahar province. More than a year later, just when she started being able to grieve her husband’s death, her oldest son’s dad died.

Bear’s addiction started in the summer of 2014 with pills — Vicodin, Oxycontin, Percocet. They dampened the pain of her losses. A friend had been prodding her to try heroin: It was cheaper, he said, and she wouldn’t have to use as much. She swore she would never touch it.

One day, Bear couldn’t get any pills. The withdrawals hit. She got sick; she couldn’t take care of her children. Eventually, she called the friend, and within a half hour was snorting heroin for the first time in her Antigo apartment.

Then, she felt nothing, just like she wanted.

“I completely, seriously fell in love with that drug,” she said. “There was nothing that compared to it, honestly. Sadly.”

She did heroin every day, either snorting or smoking it, and eventually injecting it.



Beginning in January 2015, Bear was in and out of jail, and on and off heroin. She tried methadone treatment but it didn’t stick.

In October 2016, Bear’s four children were taken from her. Two went to stay with her mom, and two with her grandmother.

Almost a year later, Bear, 33, found herself in North Central Health Care’s Lakeside Recovery in Wausau, a 21-day medically monitored substance abuse treatment program. She believes she hit rock bottom.

She started the program in mid-September and could feel the change within her as her Oct. 6 graduation approached. She’s determined to get better.

“I remember a time when my life was good, and I know that I can be back there,” she said. “I know that I can have that again.”

— Haley BeMiller, hbemiller@gannett.com

He laughed at the idea he could be saved

Nathan Scheer, Fond du Lac

Nathan Scheer felt the bottom drop out the day before Christmas Eve 2016. His wife and kids watched the cops haul him away.

His probation officer had heard he would test dirty and showed up at his home unannounced.

“On the way to jail I was higher than I’d been in years, but I remember my probation officer telling me she was going to save my life,” he said. “I laughed and told her you can’t save someone who doesn’t want to be saved.”

He first used prescription opiates after a car crash. One day he didn’t have enough money for hydrocodone pills. In their place, he was offered “dog food” —  a street name for heroin.

A decade-long fling with heroin followed, and it turned the 35-year-old factory worker from a regular, middle-class guy into a liar and a thief.


“I once explained to my wife that it (heroin) felt like what I imagine looking into the eyes of God would feel like,” Scheer said. “It’s the most religious experience you could ever imagine.”

But since the day the probation officer showed up a little more than a year ago, Scheer got clean through counseling, group support and a local church. He learned to feed his addictive personality through the gratification that comes with community service.

Today, Scheer and his 4-year-old son, Bentley, have gained recognition in Fond du Lac by cleaning up parks and playgrounds. Giving back is his metaphor for recovery. Father and son call it #cleanstreetforkids.

“I call it my beautiful disaster, because the way everything happened, I was so lucky. I had people who stuck by me while I waged war on myself.”

— Sharon Roznik, sroznik@gannett.com

‘They just kept prescribing pain meds’

Rebecca Palmieri, Wisconsin Rapids

Rebecca Palmieri’s house is quiet now. In August, a court commissioner ordered her to give up her five children. It was the second time in two years that she lost them.

She’s lost everything since she started using heroin. She’s been homeless. She has a record.

Palmieri, 39, had medical complications when she had her fifth child. That was in 2013.

“They just kept prescribing pain meds for five months after I had my son. They did corrective surgery, but, by then, I was hooked.”

She used pills for about two years. In January 2015, a friend came to her Wisconsin Rapids apartment with heroin. He told her to hold out her arm. In the empty bedroom, with her children in another part of the house, he injected her.

Using wasn’t an everyday thing, she said, until it was. She would look around her apartment to see what she could sell or return for money to buy the drug.

The courts put her kids into foster care. She was homeless for about six months. The kids went to live with her husband; they came back to her when he went to prison. She got clean and found a house. But the courts sent the kids back to her husband when he got out.

Palmieri said she has been clean since November 2016. She goes to the YMCA every day to work out; she attends addiction support group meetings. She wants to get her kids back.

“It’s probably the hardest thing I ever had to do,” she said, “to get clean and stay clean.”

— Karen Madden, kmadden@gannett.com

Sacred fire lights a path to recovery

Joey Powless, Oneida

Joey Powless stood by the sacred fire burning under a tepee in the center of Oneida. He busied himself by keeping the fire steady and clean, moving ash and coals out of the flames.

Powless, 36, a member of the Oneida Nation, called it the Grandpa Fire, and without it, he said, he would not have been able to stay clean for the past five years or so.

The sacred fire represents the spirit of native people, a connection to the past and present, a source of strength, a place to pray, a gateway to understanding.

“Without fire, we couldn’t live,” Powless said. “This is what we cooked our food with. This is what gave us life. Gave us heat. So without it we could never live. This is our very first teaching right here.”

His mother abandoned him and his family when he was a kid, and he responded at a young age with anger, he said. He started drinking and smoking pot at age 13. By the time he was in his early 20s, he added opioid medications and cocaine to the mix.



Powless was 28 when he first tried heroin at a party. He was deep into drug culture, and selling drugs to pay for his own drugs. “Cocaine really wasn’t doing nothing for me no more,” he said. Snorting heroin seemed like a natural thing to do.

It made him sick at first, but as that feeling eased, he felt the high. “That’s when the magic happens,” he said. He continued to chase that high. He graduated from snorting heroin to shooting it into his veins.

He was about 31 when he was jailed, and put into solitary confinement. It was there that he decided he didn’t want to be an addict anymore. “Because I have children,” he said. (Powless is the father of two teenagers.) “I didn’t want to be out of their lives no more.”

— Keith Uhlig, kuhlig@gannett.com

Arrests pile up after friend overdoses

Jennifer Solis, Stevens Point

Jennifer Solis was out of pills and already felt sick.

In the bathroom of her friend’s house in Stevens Point, she crushed up a little heroin and snorted it. It was the first time she had tried the drug.

Her friend, close by, was injecting it. They didn’t talk.

Solis, who was in her mid-20s at the time, looked down on people who used needles. She told herself she wouldn’t cross that line. She would.

Solis, now 34, was born in Colorado but moved to Wisconsin as a teenager. She was already using drugs with her friends — first marijuana, then cocaine — by the time she was 16.

“I think I was always looking for the next best thing,” she said. “I didn’t see myself as an addict back then.”

Solis became addicted to pain pills after she suffered a serious back injury as a result of domestic abuse, she said. After her friend introduced her to heroin, she used it every day.

She called paramedics when a friend overdosed a few years ago, then watched as they used the counteracting drug naloxone to revive her. She was charged in that incident, and then arrests piled up quickly.

 

She joined Portage County’s drug court in May and stayed clean for her first three months. Then she relapsed by using heroin and methamphetamine. By October 2017, Solis had again been clean for three months.

Solis has five children but no contact with them. Her three oldest live with a relative and her two youngest were adopted as infants.

She wants to go back to school for interior design. But for now, Solis lives at the Salvation Army in Stevens Point, working to put her life back together.

— Chris Mueller, cmueller@gannett.com

‘I smoked pot with both my parents’

Kevin Williams, Wisconsin Rapids

Kevin Williams is 35 and lives in a Wisconsin Rapids assisted-care facility. His mother and father divorced when he was 8, and, he said, “I basically smoked pot with both my parents by the time I was 15.”
By the time Williams was an adult, he tried every drug he could.

Cocaine: “Why not? I was already stoned on weed.”

Meth: “I tell people I used meth once in my life for eight months.”

Opiates: A friend first gave him an oxycodone pill, “and I was like, ‘Why not?’ I crushed it up and snorted it. … It was like the absolute, most warmest hug I ever felt.”

He can’t remember when he first switched from prescription opiates to heroin. But shooting up the drug, he said, “was like stepping into the perfect temperature of bath water, and (the feeling) would go all the way up, and all the way down.”

Williams is disabled. He walks with a limp and his left arm hangs at his side.



“I went to prison a couple years back. I found out I had a brain tumor. They went in to take it out, and they cut a blood vessel … gave me a stroke.”

One day, two years ago, he ran out of money and got clean. He can’t explain why.

“These days … I feel better about my life than I ever have before. Which sounds pretty crazy, doesn’t it? I only got half a freakin’ body right now. … But I get by. I still joke and love and make it to the Dollar Tree. All my essentials are taken care of.”

— Keith Uhlig, kuhlig@gannett.com

Addiction becomes a legacy of abuse

Jodi Chamberlain, Stevens Point

Jodi Chamberlain couldn’t get pills. They cost too much.

She got heroin from a friend instead. She was alone in her bedroom the first time she snorted the drug.

She didn’t have to think or feel. She didn’t have to deal with anything. But, Chamberlain said, “when it ends, you just crave more.”

She used heroin again within a week.

Chamberlain was living in Stevens Point at the time. She was barely in her 20s, but was already a regular drug user — mostly pain pills, but also cocaine and other stimulants. Her addictions grew out of a turbulent childhood, which, she said, included incidents of sexual abuse by a relative.

“I was taught to lie and to not have feelings,” she said. “I’ve never felt feelings.”

Now 41, Chamberlain has been clean for about eight months. She moved back to Stevens Point late last year after living in Eau Claire. Sometimes she slept in a truck.

Chamberlain was arrested again and again. She was sentenced in May on felony drug charges, but instead of going to prison, a judge allowed her to participate in Portage County’s drug court. She’s never made it through treatment without going back to heroin. If she fails in drug court, she faces a prison sentence.

Chamberlain regrets how many people she hurt with her drug use, particularly her two children, who watched their mother struggle with addiction.

She wants to stay clean, but even she can’t say whether she will make it.

“I can’t make that promise to anyone, not even myself,” she said. “But I choose to have people in my life now who can help me when I am going through rough times.”

— Chris Mueller, cmueller@gannett.com

‘A very functional addict’ awaits prison

Kyle Keding, Wisconsin Rapids

Kyle Keding was 26 years old and had been a heavy user of drugs for years before he tried heroin.

He had been drinking and smoking marijuana for about half his life. He had been dependent on opiate painkillers such as Percodan and Oxycontin for about five years. The pills helped him get through long days as a welder and they helped him forget about the crap life handed him.

Keding was sexually molested when he was about 5 years old, first by a babysitter, then by a relative, he said. Those memories never left him, unless he was high. So he got high. A lot. For him, that was just part of life, in addition to work, being a parent and a husband.

 

“I was what you call ‘a very functional’ addict,” he said.

The heroin was a practical choice. Opiate painkiller manufacturers had changed the formula of their pills, making them more difficult to use to get high, and also created a huge opiate shortage.

“So I couldn’t find what I wanted. I called up my friend, and he was like, ‘Well, I’ve got some ‘ron (heroin). … (I was) kind of skeptical,” Keding said. “I had not done it before.”

He did not feel as if he had stepped over any kind of line. He had already liquefied prescription opiates and shot those up intravenously.

Shooting up, both synthetic opiates and heroin, gave him a stronger high. He chose the needle because his friend and dealer did not have enough pills to get Keding as high as he wanted.

“I can remember the words that came out of my mouth once I released the strap off my arm,” he said. “‘Oh, my God. This is amazing.’ And I knew right there, this is it. I was like, there was no turning back now. But there was.”

He used heroin for five years, until Dec. 2, 2014. That night he was with friends, getting high, and one of the people he was with died. He was charged with first-degree reckless homicide/deliver drugs. He accepted a plea deal on that charge on Dec. 1, 2017. He awaits sentencing in February and could face years in prison.

— Keith Uhlig, kuhlig@gannett.com

‘This is a lifelong battle’

Tommy Casper, Neenah

Tommy Casper said one of the main reasons he has stayed clean for more than seven months is because of his nephew Owen, who has only ever known him sober. Casper sees his sister Carly Fritsch, who overcame her own struggle with addiction, and Owen most days of the week after work. Casper plays on a recreational volleyball team with other recovering addicts and attends Narcotics Anonymous meeting three times a week.

Tommy Casper was alone in the basement of the two-story home where he grew up.

He sat on his bed and opened a small bag of heroin that had been on top of a dresser beside him. He hadn’t used the drug before, but at about $120 a bag, it was cheaper than the pills he used. He snorted it.

He found himself asking one thing as the feeling went away: “What do I need to do in order to feel that way again?” He used heroin again three hours later.

Casper was 21 years old and living in Muskego, a community of fewer than 25,000 people on the outskirts of Milwaukee. His mother had died about six months earlier and he struggled with the loss. His sporadic use of pain pills became an addiction.

“The first time I used (as a way) to cope — rather than using to have fun or go out — was at her funeral,” he said.

After he turned to heroin, Casper told himself he wouldn’t use a needle because “then I wasn’t as bad as other people.” He used a needle for the first time a year later.

After his mother died, Casper moved around — to a house in West Allis, then an apartment in Neenah. He began to steal to support his addiction, but got caught shoplifting at a Walmart in Fond du Lac. He was charged and went to treatment a few days later.

Casper hardly slept or ate for two weeks as he fought through the physical withdrawal from the drug.

 

Casper, now 29, has relapsed twice since going to treatment. He hasn’t used for about the last seven months and attends Narcotics Anonymous meetings three times a week. He has a full-time job at a call center in Appleton and hopes to use his story to help others.

“This is a lifelong battle that we’re going to be in,” he said.

— Chris Mueller, cmueller@gannett.com

About this project

Wisconsin has a heroin problem directly linked to its opioid epidemic. Every corner of the state has been affected, every taxpayer, every school district, every police department, every social service agency, every hospital.

But why do an estimated 6,600 Wisconsin residents regularly snort, inject or smoke heroin? And how do we get our state off this deadly drug?

A team of journalists from USA TODAY NETWORK-Wisconsin went to 10 people who know firsthand how heroin enters a person’s life, and how best to get away from its grip. Their stories are part of a project the news organization will continue in 2018 to investigate Wisconsin’s response to the opioid crisis and the most successful paths to recovery.

All photos and videos by Alexandra Wimley/USA TODAY NETWORK-Wisconsin

Send feedback to Robert Mentzer, project editor: rmentzer@gannett.com

How to get help

For people who want to get help with heroin addiction:

Emergency: In a life-threatening emergency, call 911.

United Way 2-1-1: If it’s not an emergency but you want information over the phone at any hour about local options, call 211.

Narcotics Anonymous: Local meetings can be found online at wisconsinna.org or by calling 1-866-590-2651.

Wisconsin Department of Health Services: Guide to treatment resources statewide, online at dhs.wisconsin.gov/opioids/.

Source: http://www.wisinfo.com/usat/heroin_addiction/?for-guid=7ba874c6-08dd-e611-b81c-90b11c341ce0#start

 

 

Millions of Americans are trapped in a cycle of drug abuse and addiction: In 2013, over 24 million reported that they had abused illicit drugs or prescription medication in just the past month. More than 1.7 million were admitted to treatment programs for substance abuse in 2012. The pursuit of a drug habit can cost these people everything – their friends and family, their home and livelihood. And nowhere is that impact more evident than in the faces of addicts themselves.

Here, the catastrophic health effects of drug abuse are plain to see, ranging from skin scabs to decayed and missing teeth. While meth is often seen as one of the most visibly destructive drugs, leading to facial wasting and open sores,various other illicit drugs, and even prescription medications can cause equally severe symptoms when continuously abused. The use of opioids like OxyContin or heroin can cause flushing and a rash of red bumps all over the skin, while cocaine abuse can result in a significant drop in appetite and dangerous malnutrition and weight loss. Ecstasy may cause grinding of teeth, and smoking cannabis releases carcinogens and other chemicals that can diminish skin collagen and produce an appearance of premature aging. Even alcohol abuse can lead to wrinkles, redness, and loss of skin elasticity.

Beyond the direct effects of substance abuse, perhaps its most damaging result is addiction itself. The compulsion of addiction makes drug use the most important purpose in an addict’s life, leading them to pursue it at any cost and treat anything else as secondary. Self-neglect becomes normal – an accepted cost of continuing to use drugs. And the consequences of addiction can remain etched in their very skin for years.

Click here for an animated infographic

Source: https://www.rehabs.com/explore/faces-of-addiction/

Abstract

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

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

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

Sorry, what?

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

The statement reads:

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

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

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

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

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

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

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

Here’s the catch

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

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

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

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

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

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

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

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

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

Abstract

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

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

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

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

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

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

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

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

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

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

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

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

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

Dear Friend, 

Let’s take a second to talk about Colorado. 

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

The pot industry has taken Colorado hostage

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

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

What is so concerning about this appointment?

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

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

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

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

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

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

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

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

All the best, 

Kevin Sabet, PhD

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

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

 Questions:

 Brain:

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

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

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

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

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

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

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

 Heart:

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

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

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

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

 Head:

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

 Chromosomes:

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

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

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

 Limbs:

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

What do these two states have in common??

 Drugs:

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

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

And which drug was the exception??

 Cancer:

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

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

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

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

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

 Reproduction:

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

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

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

Which smoked illicit drug is known to damage the epigenome?

For how many generations does epigenetic inheritance continue?

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

 

 Answers:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Source:  January 2019 edition of Family World News

 

What is synthetic cannabis?

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

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

Other names

Synthetic cannabis is marketed under different brand names.

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

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

How is it used?

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

Effects of synthetic cannabis

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

Synthetic cannabis affects everyone differently, based on:

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

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

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

Long-term effects

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

Withdrawal

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

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

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

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

Health and safety

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

Regulating intake

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

Misleading packaging

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

Mental health risks

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

When it absolutely shouldn’t be used

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

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

In an emergency

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

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

Ambulance officers don’t have to involve the police.

Synthetic cannabis statistics

National

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

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

Synthetic cannabis and the law

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

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

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

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

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

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

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

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

[ii] www.drugabuse.gov

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

California laws on marijuana cultivation inadvertently hurting the environment

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

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

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

Profits coming at expense of environment

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

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

Abstract

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

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

Abstract

BACKGROUND:

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

OBJECTIVES:

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

METHODS:

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

RESULTS:

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

CONCLUSIONS:

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

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

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

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

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

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

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

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

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

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

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

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

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


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

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

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

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

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

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

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

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


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

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

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


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

What is CBD Oil?

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

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

Cannabidiol

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

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

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

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

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

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

Cannabidiol (CBD) Oil

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

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

Hemp Seed Oil

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

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

Hemp Oil (Hash or Cannabis Oil)

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

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

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

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

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

CBD Oil Risks

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

Drug Contraindications

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

Side Effects

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

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

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

Perhaps this common belief is simply not true!

Psychoactive Effects of Cannabinoids

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

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

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

However, more recent research disputes this assumption.

Conversion of CBD to THC

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

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

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

Getting High on CBD?

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

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

Effects of THC Derived from CBD

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

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

Human Studies

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

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

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

Is CBD Oil Safe for Children?

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

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

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

CBD During Pregnancy

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

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

Always discuss any supplemental foods with a practitioner before use!

CBD from Hops and Other Non-Cannabis Plants

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

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

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

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

Is CBD Safe for Anyone?

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

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

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

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

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

Sarah Pope MGA

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

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

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

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

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Comments (115)

Anna

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

April 20th, 2019 2:14 pm Reply

Sarah Pope MGA

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

April 22nd, 2019 7:39 am Reply

rooislangwtf

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

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

April 10th, 2019 7:34 pm Reply

PATRICIA DONOVAN

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

February 13th, 2019 1:06 pm Reply

Sarah Pope MGA

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

February 13th, 2019 1:37 pm Reply

Tim Wolford

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

February 12th, 2019 11:23 am Reply

Sarah Pope MGA

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

February 13th, 2019 8:56 am Reply

Dela Baldwin

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

February 5th, 2019 9:52 am Reply

Sarah Pope MGA

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

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

February 5th, 2019 10:26 am Reply

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