Culture

LONDON DAILY MAIL

by Sam Lawley, News Reporter –  5 October 2025 | 

Laying bare the extent of Glasgow‘s substance crisis, a disturbing video showed the drug-taking hotspot in grim detail with needles, spoons and other drug paraphernalia strewn over the ground – and all just round the corner from a popular student accommodation.

Glasgow is home to the UK’s first and only drug consumption facility, The Thistle, less than half a mile from the location of the clip, posted to X on Saturday by Reform councillor Thomas Kerr.

The centre is already open 365 days a year from 9am to 9pm but its operators told MSPs this week that they may have to extend hours as so many addicts are bingeing on cocaine later in the day and evening.

Run jointly by Glasgow City Council and the NHS, The Thistle allows users to inject hard drugs under medical supervision without fear of prosecution.

More than 400 addicts have so far had 5,000 ‘injecting episodes’, with cocaine taken three times as much as heroin. There have also been 60 ‘medical emergencies’ on site.

But it seems drug use is still spilling onto the streets and parks of Scotland’s largest city.

A squalid drug den featuring a tree covered in dirty heroin syringes has been discovered just yards from Scotland’s only ‘safe’ consumption room in Glasgow

‘But as you can see this is student accommodation and look at this,’ he says.

The camera pans from a block of student flats towards a tree loaded with syringes like darts lodged on a board.

Speaking with hundreds of pieces of rubbish scattered across the ground, Ms Dempsey adds: ‘To think this is what we are driving people to is just outrageous. It’s worse than outrageous.’

Seemingly criticising The Thistle consumption room, she sayd: ‘This is where the road to recovery comes right in. The right to enable should not count, it should not be a factor in it.

‘And that’s what we’re doing because all this equipment here, the packaging, the boxes, the syringes, the spoons for burning and the naloxone packages. These are all stuff that is given out freely in the safe consumption room.’

Mr Kerr adds: ‘Scotland’s drug crisis is here for everybody to witness. We need to start focussing on recovery as Audrey said, and not driving into despair where they’re sitting taking needles apparently safely down in the Calton, where you can see the state that people have been driven into.

‘This is absolutely scandalous and this is what’s going on in the streets of Glasgow, just around the corner from a so-called safe consumption facility.’

Ms Dempsey says: ‘This is outrageous. This makes you physically sick to think this is what we are pushing people into, and it tells you all the more that the Right to Recovery Bill should stand because people have a right to recover from this. They shouldn’t be driven to this, it’s just awful.’ 

The Right to Recovery Bill, if passed, would ‘establish a right in law to treatment for addiction for anyone in who is addicted to either alcohol, or drugs or both’. It is currently at stage one, the committee stage, of the process.

The Daily Mail has approached Cllr Casey for comment. 

The Thistle, which opened in January, also stepped up demands for an ‘inhalation space’ for people to smoke crack. 

Responding to calls for longer opening hours, Glasgow Tory MSP Annie Wells said: ‘Local residents will be terrified at the prospect of a 24/7 drug room on their doorsteps. 

‘The Thistle is making lives a misery for those living near it, with dirty needles and anti-social behaviour plaguing the community.

‘Expanding state-sponsored drug taking is not the answer – that’s why it’s crucial that MSPs back our Right to Recovery Bill which would enshrine in law a right to life-saving rehab.’

SNP drugs policy minister Maree Todd later MSPs she was confident the Thistle had already saved lives.

She said: ‘We’re seeing more smoking than we have before, more inhalation routes, so we just need to remain agile. Things are not static.

‘It’s a challenging situation to stay ahead of, quite a dynamic situation that’s out there.’

Tricia Fort, chair of Calton Community Council, said the Thistle was ‘doing good’, but there were concerns about it drawing drug dealers to the area.

Morrisons security boss Steve Baxter said the chain’s nearby supermarket had seen a 94 per cent drop in dirty needles in its car park since the Thistle opened.

Source: https://www.dailymail.co.uk/news/article-15163757/drug-den-tree-heroin-syringes-Scotland-glasgow-consumption-room.html

 

The UK government has launched a new campaign to alert young people to the dangers of ketamine, counterfeit medicines and adulterated THC vapes.
  • New campaign to alert young people to the dangers of ketamine, counterfeit medicines and adulterated THC vapes
  • Ketamine use and drug poisonings highest on record with 8 times more people seeking treatment since 2015
  • Government investing £310 million into drug treatment services alongside awareness campaign

Young people are being warned that they risk irreparable bladder damage, poisoning and even death if they take ketamine, synthetic opioids or deliberately contaminated THC vapes, as part of a new anti-drugs campaign.

Launching today (16 October 2025), the campaign, which includes online films, will target 16 to 24 years olds and social media users, following a worrying rise in the number of young people being harmed by drugs. There has been an eight-fold increase in the number of people requiring treatment for ketamine since 2015.

Supported by £310 million investment in drug treatment services, this initiative directly supports the government’s Plan for Change mission to create safer streets by reducing serious harm and protecting communities from emerging drug threats.

Health Minister Ashley Dalton said:

Young people don’t always realise the decision to take drugs such as ketamine can have profound effects. It can destroy your bladder and even end your life.

We’ve seen a worrying rise in people coming to harm from ketamine as well as deliberately contaminated THC vapes and synthetic opioids hidden in fake medicines bought online.

Prevention is at the heart of this government’s approach to tackling drugs and this campaign will ensure young people have the facts they need to make informed decisions about their health and safety, so they think twice about putting themselves in danger.

As part of the campaign, experts will highlight particular risks, including the:

  • potentially irreparable damage ketamine can cause to your bladder
  • dangers of counterfeit medicines containing deadly synthetic opioids purchased online
  • risks from so-called ‘THC vapes’ that often contain dangerous synthetic cannabinoids like spice rather than THC

Resources will be available for schools, universities and local public health teams with content available on FRANK, the drug information website.

There are growing concerns about novel synthetic opioids, particularly nitazenes, which are increasingly appearing in counterfeit medicines sold through illegitimate online sources. Users purchasing these products are typically younger and more drug-naïve.

Reports of harms from THC vapes have also increased, with many products containing synthetic cannabinoids (commonly known as ‘spice’) that have higher potency and unpredictable effects.

Katy Porter, CEO, The Loop, said:

The Loop welcomes the further investment in evidence-based approaches and support to reduce drug-related harm.

Providing accurate, non-judgemental information equips and empowers people to make safer choices and can help reduce preventable harms.

Drug poisoning deaths reached 5,448 in England and Wales in 2023, the highest number since records began in 1993. The campaign emphasises that while complete safety requires avoiding drug use altogether, those who may still use substances should be aware of the risks and know how to access help and support.

The campaign underlines that ketamine’s medical applications do not make illicit use safe, with urologists increasingly concerned about young people presenting with severe bladder problems from recreational ketamine use.

Resources will be distributed to local public health teams, drug and alcohol treatment services, youth services, schools and universities. The campaign provides clear information on accessing help and support for those experiencing drug-related problems or mental health issues.

This year the Department of Health and Social Care is also providing £310 million in additional targeted grants to improve drug and alcohol treatment services and recovery support in England, including specialist services for children and young people.

For information and support on drug-related issues, visit www.talktofrank.com or call the FRANK helpline on 0300 123 6600.

Background information

How to watch this YouTube videoThere’s a YouTube video on this page. You can’t access it because of your cookie settings.You can change your cookie settings or watch the video on YouTube instead:Ket: while each high lasts minutes, for some the damage to their bladder could last forever

How to watch this YouTube videoThere’s a YouTube video on this page. You can’t access it because of your cookie settings.You can change your cookie settings or watch the video on YouTube instead:Synthetic opioids: what are they and why are they so dangerous?

Additional resources for professionals and educators will be available through local public health networks.

The £310 million additional funding for drug treatment services is separate from the public health grant.

Source: https://www.gov.uk/government/news/young-people-given-stark-warning-on-deadly-risks-of-taking-drugs

 

by Ryan Hesketh – Talking Drugs – Posted on September 15, 2025

In November, the World Health Organisation (WHO) will issue its long-awaited recommendation on whether the coca leaf should remain listed under the UN’s most restrictive drug controls.

For decades, the coca leaf has been treated in international law as little more than raw material for cocaine. The 1961 Single Convention on Narcotic Drugs, following the advice of a deeply flawed 1950 WHO report, placed coca in Schedule I, equating its potential harm from use with that of heroin. This decision criminalised traditional use by Indigenous peoples in the Andes, despite millennia of practice, ignoring both its cultural and medical significance. 

Now, with WHO experts due to report their findings in September, attention is turning to whether the organisation can finally correct the record.

Critical timeline

Bolivia’s government initiated the review in 2023, arguing that coca’s scheduling was based on flawed information and infringed on indigenous rights. Since then, the WHO has tasked independent experts with conducting research on coca, its harms, and the potential impacts of change. Those experts are due to report their findings to the Executive Committee in late September, a crucial step on the pathway to potential change.

From there, the Expert Committee will meet in late October, finalising its report and recommendation in time for member states to consider ahead of the UN Commission on Narcotic Drugs’ (CND) reconvened session in December. The formal vote on coca’s scheduling, however, won’t take place until March 2026 in Vienna.

Luis Arce, the former president of Bolivia, holding coca leaves in 2022. Author: Vice Ministry of Communication of Bolivia

Uncertain outcomes

There are essentially three potential outcomes from the review. First, no action. Either the WHO makes no recommendation, which would result in no possibility of a vote, or states vote to maintain coca’s current Schedule I classification. Few expect the WHO to recommend keeping coca in its current schedule. “It’s hard to imagine they’d come to the conclusion that coca belongs where it is,” according to John Walsh, Director for Drug Policy and the Andes at the Washington Office on Latin America (WOLA).

If the review recommends a change in Coca’s scheduling, it would likely move down to either a Schedule II or III – still keeping its classification as a ‘narcotic drug’ subject to most treaty provisions. However, such a move would allow for certain traditional uses of coca and could be seen as a political compromise between those favouring full rescheduling and those favouring prohibition. This would create a clear difference in the scheduling for Coca and cocaine, similar to how opium products and the opium poppy are scheduled. Opium poppies are in Schedule II, while heroin is in Schedule I, reflecting the differing harms of the plant and its derivatives. Though rescheduling might be the most politically expedient outcome, and may align more closely with the UN’s Declaration on the Rights of Indigenous Peoples, it would still be very short of full removal, according to Walsh.

Finally, the result hoped for by many states and drug policy reform advocates: coca could be completely removed from the drug control treaties. This would mean that coca “would no longer be considered a controlled substance. It would open the way to legal natural commerce,” according to Walsh. 

While the size of such a market is hard to estimate, its significance would be massive. Coca teas, flours, and medicinal extracts already circulate domestically in the Andes – only legally within Bolivia as the country had left and re-joined the UN drug control conventions in 2013 – but international markets remain blocked by treaty restrictions. 

Yet there are also risks. Walsh cautions: “There’s a concern, even among those who want coca removed, that those who have guarded the tradition could be undermined.” Comparisons to the cannabis market loom large, where capital from the Global North has quickly moved into spaces originally meant by marginalised communities. The vision of a future un-criminalised market for coca opens future concerns, such as control mechanisms that avoid biopiracy and endorse fair benefit-sharing, particularly with communities that have been destroyed by the plant’s prohibition. The Nagoya Protocol, which addresses protections against the exploitation of genetic resources and Indigenous knowledge, is often cited as a model for future control.

Even in the case of full removal, coca wouldn’t be completely free of international prohibition. “Coca destined to become cocaine would still be illegal; that wouldn’t be optional,” according to Walsh. Better controls to determine the end use of coca would have to be developed.

Politics and removal

In theory, removing coca from Schedule I requires only a simple majority of CND member states. In practice, however, bloc politics loom large. “As a formal matter, there’s no veto. But in a practical matter, the EU looms large,” Walsh explains, given the bloc’s significant role in driving global demand for cocaine. If European states vote together against rescheduling, the motion would be unlikely to pass. However, if the EU allows states to vote individually, the change is much more likely to happen.

The United States’ position is also critical. As Walsh puts it, “It would be difficult to imagine if the US would be supportive of removing coca entirely.” But, though the US was once the world’s biggest supporter of draconian drug laws, its international influence may be waning. The current administration’s defunding of global aid, much of which supported harm reduction and drug prevention programmes, have reduced the US’ ability to enact soft power internationally. President Trump’s “transactional” politics, according to Walsh, may be a signal to countries that they can go their own way on policy while the US is pursuing a more isolationist approach to international relations.

Russia, too, will be notably absent. Having not achieved sufficient votes to remain part of the CND in April 2025, Russia will not be voting on UN drug-related matters from 2026 onwards. Walsh said that “Russia has taken the mantle from the US as ‘drug warrior’” and could’ve stood staunchly against coca’s reclassification. Their absence, therefore, may open new horizons.

The coca review is primarily supported by Bolivia and Colombia, with Canada, Czechia, Malta, Mexico, and Switzerland publicly supporting their position. Some coca-producing nations, notably Peru, are not in favour of reclassification. The country’s drug control agency, DEVIDA, recently argued that reclassifying coca “could become a perverse incentive to increase its diversion to the production of cocaine,” as well as increasing deforestation and food insecurity, especially for indigenous people.

But for some, Peru’s lack of support for the review has more to do with its political priorities than any attempt at harm reduction. “Peru’s denial to support this is indeed very odd, but is a reflection of the kind of political regime it is living under,” says Pien Metaal of the Transnational Institute (TNI). “The Boluarte government is the typical white Lima elite that has ruled Peru over the past decades, with no connection to the hearts and minds of the Peruvian people.”

Indigenous resistance

The roots of the current review go back to decades of Indigenous advocacy. The UN Declaration on the Rights of Indigenous Peoples recognises the right to maintain and protect traditional medicines and cultural practices. Yet international drug treaties continue to criminalise coca chewing and related practices in many countries. 

“There has never been a credible medical or scientific basis for the prohibition of coca leaf,” according to Metaal. “Its inclusion in the 1961 Convention was a political act, not a scientific one.”

Underlying the review is a reckoning with the colonial assumptions that shape global drug control to this day. The 1950 WHO study that underpinned coca’s prohibition dismissed Indigenous practices as harmful and regressive, ignoring evidence of its benign cultural role. For many advocates, the current review is an overdue opportunity to correct that record. As Metaal argues, “This is not just about drug policy. It is about dignity, cultural survival, and Indigenous rights.”

Impending Change

For coca-using and growing communities, the implications are immediate. Continued criminalisation undermines cultural practices, justifies militarised eradication, and fuels human rights abuses. Removing the plant from international control could finally legitimise its traditional use, defund eradication policies, and unlock new economic opportunities grounded in heritage rather than prohibition.

As Walsh reflects: “In five years, I hope that we’re able to see a genuinely growing understanding of how natural coca products can really bring a lot of help to people around the world. I hope those markets can open up and can be beneficial to those communities that are most identified with coca.”

With the WHO’s deadlines fast approaching, the question is whether the international drug control system can rise to meet the moment—or whether it will once again fall back on outdated prejudices, leaving another generation of Indigenous peoples to fight for recognition of what they already know: that prohibition, not the coca leaf, is the problem.

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Source:  https://www.talkingdrugs.org/upcoming-who-coca-review-a-turning-point-for-global-drug-policy/

by Allysia Finley       Wall Street Journal          Sept. 14, 2025

What causes a young man to spiral from success toward loneliness, self-destruction and violence?

A police officer guards Tyler Robinson’s apartment complex in Washington, Utah, Sept. 12. Photo: andrew hay/Reuters

The descent of Tyler Robinson, the 22-year-old man suspected of murdering Charlie Kirk, is itself a tragedy worth mourning. How did a high-school whiz kid devolve into an assassin?

Such spirals aren’t so uncommon among young men, even if Mr. Robinson’s played out in a more calamitous and public way than most. Political violence is a problem. But so is the atomized culture in which young men retreat into confused inner worlds and virtual realities, which can be as addictive and destructive as any drug.

Mr. Robinson’s relatively normal background makes his actions jarring. He came from a good middle-class family. Having excelled in high school, he was awarded a scholarship to Utah State University, though he dropped out after one semester.

At some point, he appears to have become steeped in a dark digital world and videogames. He inscribed ammunition with obscure online memes (“Notices bulges OwO what’s this?”), lyrics to an anti-Fascist Italian song, and an apparent reference to the videogame “Helldivers 2,” a satire of a fascist interstellar empire inspired by the 1997 movie “Starship Troopers.”

Marinating in an internet cesspool can’t be good for the young and malleable male mind. Might killing villains in videogames desensitize the conscience? Studies have found an association between playing violent videogames and aggressive behavior, though most people who assume online avatars and fight monsters don’t become violent.

A broader problem, as Jonathan Haidt explains in his book “The Anxious Generation,” is that videogames cause boys to get lost in cyberspace. They have “put some users into a vicious cycle because they used gaming to distract themselves from feelings of loneliness,” Mr. Haidt notes. “Over time they developed a reliance on the games instead of forming long-term friendships.” They “retreat to their bedrooms rather than doing the hard work of maturing in the real world.”

The same is true of social-media platforms like Discord and Reddit, where young men often seek fraternity under pseudonyms. The platforms become substitutes for real-world camaraderie and can lead men down dark holes. Frequent social-media use has been found to rewire neurological pathways in young brains and compromise judgment.

Mr. Robinson’s spiral recalls Luigi Mangione, the 27-year-old University of Pennsylvania graduate who allegedly shot and killed UnitedHealthcare CEO Brian Thompson on a New York City street. Attractive and athletic, Mr. Mangione developed an obsession with self-improvement even as he suffered bouts of excruciating back pain. He was also an avid videogame player and active on Reddit.

Prior to the shooting, he cut off communications with family and friends. Men in their late teens and 20s sometimes experience psychotic breaks. Mr. Mangione’s apparent mental-health struggles, however, seem to have gone unnoticed as he got lost in a digital wilderness.

Or consider Thomas Crooks, the 20-year-old who attempted to assassinate President Trump at a rally last summer. Crooks graduated high school with high honors and scored 1530 on the SAT, then enrolled in an engineering program at a community college. His father said his mental health began declining in the year before the shooting.

Crooks lost social connections as he started spending more time online, visiting news sites, gaming platforms, Reddit and weapons blogs. He at one point searched for information on “major depressive disorder” and “depression crisis,” suggesting he suspected he had a mental illness. Instead of psychiatric treatment, he turned to the internet.

Like drugs, the internet can fuel delusions. Patrick Joseph White, 30, last month opened fire on the Centers for Disease Control and Prevention headquarters in Atlanta, then fatally shot himself. He was apparently exercising his rage against Covid shots, which he wrote were “always meant to indiscriminately murder as many as possible” and believed had caused his depression.

He had threatened self-harm numerous times in the previous year. In April police officers came to his home after he called a veterans’ crisis line and said he had been drinking and taking medication. White told officers he had called the crisis line “just to talk to someone.”

Videogames and the digital world may not cause mental illness, but they can be a form of self-medication that provides illusory relief from emotional troubles even as they propel antisocial behavior. The solution isn’t to ban them, but to create social structures that prevent young men from falling through the cracks.

Lost boys pose a broader cultural problem. The share of men 20 to 34 who work has been declining over the past 30 years, even as employment among young women has increased. Too many young men spend their days playing videogames, watching porn, smoking pot and trolling the internet rather than engaging with the real world.

Mr. Kirk sought to bring young people like Mr. Robinson out of their virtual caves. It’s harder to hate someone you meet in the flesh than an avatar in a digital dystopia.

Source:  Drug Watch International – www.drugwatch.org

by Liz Mineo – Harvard Staff Writer -September 16, 2025

Study examining potential solution to treatment gap — especially in rural areas — gets federal funding cut

Between 1999 and 2023, approximately 806,000 Americans died from opioid overdoses, according to the Centers for Disease Control and Prevention. Yet of the estimated 2.4 million U.S. adults with opioid use disorder, only one in four receives medications that can reduce overdose risk.

Telehealth has shown promise as a potential tool to prevent opioid overdose deaths, but funding for a study launched last year by health economist Haiden Huskamp examining its use and impact was terminated as part of the mass cancellation of federal research grants by the Trump administration in May.

“A lot of our research, including that for this grant, is looking at why so few people are getting evidence-based treatments for substance use disorder,” said Huskamp, Henry J. Kaiser Professor of Health Care Policy at Harvard Medical School. “Medications for opioid use disorder are highly efficacious. They reduce opioid use; they reduce overdose risk and other negative outcomes. These medications save lives.”

A shortage of clinicians specialized in treating opioid use disorders — particularly in rural areas — presents a major barrier to receiving care, she said.

“Our work has been trying to understand, since the pandemic in particular, who was using telemedicine for opioid use disorder,” said Huskamp, “and whether the availability of care, via telemedicine, has meant that clinicians who treat substance use disorders are now seeing more patients in areas where there aren’t enough doctors who do this work.”

217Americans, on average, died each day from an opioid overdose in 2023, according to the CDC

For the past five years Huskamp, Ph.D. ’97, has been studying telemedicine as a strategy to expand access to opioid use disorder treatment and life-saving medications such as methadone, buprenorphine, and the quick overdose-reversal drug naloxone.

“Given the opioid epidemic that we are still in the middle of, telemedicine might be an answer because it could address a number of barriers to treatment access,” said Huskamp.

Although in May the CDC reported that opioid overdose deaths dropped from 83,140 in 2023 to 54,743 in 2024, the death toll remains high. According to the CDC, in 2023, on average, 217 people died each day from an opioid overdose.

The goal of Huskamp’s terminated four-year study, launched last year with a team of 15 researchers, was to provide evidence-based information on the efficacy of telemedicine that can guide policymakers as they address the opioid epidemic. It was a renewal of a previous grant, which yielded 24 different publications whose findings have informed new rules by the Drug Enforcement Agency to expand telemedicine access for treating opioid dependence. Funded by the National Institute on Drug Abuse, the latest research sought to examine quality of care and clinical outcomes by analyzing data from Medicare, Medicaid, commercial insurance, and national pharmacy claims.

Telemedicine for opioid use disorder became more widespread across the country during the COVID-19 pandemic, and researchers have been eager to probe the data to find out if it improved access to care for patients in remote areas, and how the quality of care compared to traditional in-person care.

“Anything we can do to try to improve the healthcare system to more effectively allow people to access care and to do so in a more efficient way is really important,” said Huskamp. “We need research like this to guide policymaking, so that we can improve the system as much as possible for people to get the treatment that they need.”

 

Source:  https://news.harvard.edu/gazette/story/2025/09/only-1-in-4-addicted-to-opioids-takes-life-saving-meds-why/

Received from DFAF – 16 September 2025

The swift legalization of marijuana across the United States is impacting the rates of use and increasing the social acceptance among veterans 65 and older. A recent study is shining a light on this group of individuals whose struggle with marijuana use had largely flown under the radar.

The study included more than 4,500 Veterans Health Administration (VHA) patients nationwide, revealing a concerning picture of marijuana use and cannabis use disorder (CUD) in this population. Over half of respondents (57%) reported having used marijuana at some point in their lives, and 1 in 10 had used it within the past 30 days—a rate nearly double the national average for adults 65 years or older in the general population. Among these recent users, more than half were frequent users (defined as using on 20 or more days in the past month), and the majority (72%) consumed marijuana by smoking.

Perhaps most concerning was the prevalence of CUD. Among those who reported recent use:

  • One-third (36.3%) met the criteria for CUD, including 10.9% with moderate CUD and 2.5% with severe disorder CUD.

The risks were even higher among those who consumed marijuana through smoking or vaping, those who reported anxiety symptoms, and those with functional impairments in daily activities. Veterans aged 65–75 were also more likely to meet criteria for CUD compared to those over 76, and risk increased among individuals who used other substances or faced economic hardship.

Geography mattered as well: veterans living in states with legal recreational marijuana use were more than twice as likely to report use compared to those in non-legal states. In contrast, living in a medical-only state did not significantly increase odds of use—suggesting that broader legalization may be a key driver of accessibility and behavior.

The findings highlight the need for veterans to understand the risks associated with use and to receive screening for CUD, which could help identify problematic use early and connect patients with evidence-based treatment.

 

Source:  Drug Free America Foundation | 333 3rd Ave N Suite 200 | St. Petersburg, FL 33701 US

By Sage Journals – September 19, 2025

 Abstract

This article presents a study exploring the prevention of alcohol and drug (AOD)-facilitated sexual violence. A participatory action research/appreciative inquiry method, World Café Forum, was used to take a multi-stakeholder approach to explore prevention initiatives. Thirty-two individuals from 14 stakeholder organizations attended. Analysis established five recurring themes, overlayed by power imbalances: education and training; policy-led initiatives; holding people accountable; social information campaigns; and cultural change. Responsibility for addressing the issue is contested. The greatest opportunity to address AOD-facilitated sexual violence lies with organizations, with a focus on restorative justice. Policy frameworks and place-based initiatives are required.

Introduction

Sexual violence is a global health issue mostly affecting women (World Health Organisation, 2021). In Australia, 23% of women will experience sexual violence across their lifetime, compared to 8% of men (Australian Bureau of Statistics, 2021). Sexual violence is reported to be higher in rural than urban areas, although prevalence is still relatively unknown, particularly for young women (Australian Bureau of Statistics, 2017; Hooker et al., 2019).

The World Health Organisation defines sexual violence as “any sexual act, attempt to obtain a sexual act, unwanted sexual comments or advances, or acts to traffic, or otherwise directed, against a person’s sexuality using coercion, by any person regardless of their relationship to the victim” (World Health Organisation, 2013). It has significant psychological and physical health impacts for women, including posttraumatic stress disorder (PTSD) and gastrointestinal issues (Dworkin, 2020; Tarzia et al., 2017; World Health Organisation, 2014). Sexual violence is most frequently experienced by women and LGBTQ+ people (Ison et al., 2025a), and those who face intersecting forms of inequality can experience higher rates of sexual violence. For example, women with disabilities or trans women of color have experienced higher rates of sexual violence (Australian Institute of Health and Welfare, 2024; Hindes et al., 2025; Ledingham et al., 2022).

Increasingly, it is being recognized that alcohol and drugs (AOD) are used to facilitate sexual violence. Alcohol and other drug facilitated sexual violence includes what is often colloquially known as “drink spiking” (Ison et al., 2024). Perpetration can be opportunistic, such as where the perpetrator takes advantage of a person who is intoxicated, and/or proactive, such as intentionally administering a substance to incapacitate a person (Gee et al., 2006). The victim may consume AOD voluntarily or be unaware that they have been administered them (Caluzzi et al., 2025). Alcohol and other drug facilitated sexual violence can also include the perpetrator encouraging the victim to become further intoxicated (Ison et al., 2025b). Available evidence indicates the most likely substance used by perpetrators is alcohol, but they may also use other sedative substances such as flunitrazepam (Rohypnol) or other benzodiazepines and gamma-hydroxybutyrate (GHB) (Anderson et al., 2017; Recalde-Esnoz et al., 2024; Wolitzky-Taylor et al., 2011).

Responses to AOD-facilitated sexual violence have often been piecemeal. The service system response often lacks continuity of care, and while staff may be passionate and caring, they are often overworked and have limited knowledge or training on AOD-facilitated sexual violence (Ison et al., 2025c). There have been some attempts at programs to address AOD-facilitated sexual violence, though there have been limited rigorous evaluations. These interventions have tended to focus on bars and clubs, particularly through training bar staff as bystanders (Davis et al., 2024), including a resource for bar staff that we designed for the larger project that this study is part of (detailed below) (Hooker et al., 2024). Interventions also include “solutions” to drink spiking, such as a scrunchie to cover one’s drink, or nail polish to test whether there are substances in your drink. These supposed solutions often place the onus on women to keep themselves safe through feminized products, which have troubling victim-blaming undertones (Clinnick et al., 2024).

Beyond such examples, the vast majority of interventions are focused on alcohol consumption in US college settings. While they may have some specific focus on AOD-facilitated sexual violence, they are generally concerned with minimizing the intake of alcohol. Very few interventions are focused on prevention (Hooker et al., 2020) or on response that goes beyond individuals to consider how to change broader sociocultural contexts (Dworkin & Weaver, 2021).

Study Context

There has been growing interest in and reporting on “drink spiking” in the media. In 2021, the media highlighted “drink spiking” as an issue in a regional town in Victoria (Cunningham & Koob, 2021; Lawrence & Findlay, 2021). Some young women came forward to talk to journalists about their experiences of drink spiking in a local club and the subsequent negative interactions they had with health and justice services. These media reports also indicated that drink spiking is an issue in rural communities broadly and that victims face significant barriers when seeking assistance through health and justice services. As with sexual violence broadly, increased media reporting does not necessarily mean there is an increased prevalence, but rather that people may feel empowered to come forward (Clinnick et al., 2024). The stories of the young women in the media reports inspired the research team to conduct a study focused on regional and rural experiences of AOD-facilitated sexual violence. To date, little research has been conducted on rural and remote communities’ experiences of AOD-facilitated sexual violence. However, research has shown that rural and regional Australia have distinct issues relating to sexual violence compared to urban areas, such as dominance of rural hegemonic masculinity and sexual violence revictimization (Corbett et al., 2023; Saunders & Easteal Am, 2013). The study underpinning this paper explored how a regional community could respond to, and ultimately prevent, AOD-facilitated sexual violence (Hooker et al., 2024). This article reports the findings from one part of the study: the use of a multi-stakeholder participatory action method known as a World Café Forum.

Methods

The World Café Forum is a collaborative qualitative method used to foster “constructive dialogue, accessing collective intelligence, and creating innovative possibilities for action” (Brown, 2005). It derives from participatory action research and appreciative inquiry methods that aim to guide a large group of diverse stakeholders toward solutions (Aldred, 2011). It has been used in community development (Aldred, 2011) and where interprofessional collaboration is required, for example, in healthcare and violence against women (Breitbach et al., 2017; Forsdike & Fullagar, 2021). The method brings together multiple small conversational groups to build one collective conversation of different perspectives (Brown, 2005). To build a collective conversation, participants are required to move between groups and discussion topics, so that previous conversations are built upon and include new perspectives for action (Brown, 2005).

A World Café forum was held in 2022 in a regional town in Victoria, Australia, bringing together multiple stakeholders to consider AOD-facilitated sexual violence and how it could be prevented in the region. The forum was conducted over the course of a full day and consisted of two parts. The first half of the day included presentations by members of the research team on sexual violence and AOD-facilitated sexual violence, as well as evidence of the issue in the local community. The presentations were used to engage participants and disseminate existing knowledge about the phenomena and focus on the local region. The second half of the day, the results of which this article reports, incorporated World Café method discussion groups informed by the information provided earlier in the day. The project received ethical approval from the first author’s institution (approval reference: HEC22254).

One of the key features of the World Café method is that participants rotate around the tables every 20–30 min (Fouché & Light, 2011). A host remains at their designated table to support discussion, continuity, and the development of ideas arising from previous conversations (Brown, 2005). Such varied perspectives on issues and the ideas developed are unlikely without facilitated interaction between a broad and diverse range of participants (Brown, 2005).

There are seven principles in the method’s application which were followed on the day (see Table 1).

Firstly, two questions informed by the earlier presentations were posed to the discussion groups to introduce AOD-facilitated sexual violence and establish a collective understanding of what it is in the region and how it is currently responded to by the organizations participants were representing (Brown, 2005).

Secondly, the key question then posed to the discussion groups, and which we present in the results below, was “What can we do?” Records of participants’ ideas were pinned to the walls to enable participants to reflect upon the discussions in other groups (Fouché & Light, 2011). Research team members took photos of these records for analysis.

Analysis

Analysis was informed by the socioecological model. The model was originally developed by Bronfenbrenner to reflect the relational and multiple forces that shape experience across individual, relationship, community, and sociocultural levels (Bronfenbrenner, 1977). It was further developed by Heise to provide a framework for understanding violence against women (Heise, 1998). Heise argued that we need to understand the different levels and their integration to improve responses to a complex issue (Heise, 1998). The model has since been adapted to consider imbalances of power within and between the socioecological levels (Forsdike & Giles, 2024).

The records were transcribed by co-author Jessica Ison and thematically analyzed by co-authors Kirsty Forsdike and Elena Wilson (Braun & Clarke, 2022), with co-authors Jessica Ison and Kirsty Forsdike meeting to finalize themes once co-author Jessica Ison had reviewed the initial themes developed.

Results

Thirty-two stakeholders from 14 different organizations attended the World Café Forum, with an additional seven facilitators attending from the project team. Of the 32 stakeholder attendees, 78% (n = 25) were women. The range of organizations or services from which they derived is presented in Table 2, and included specialist violence prevention and response services, health services, police and justice representatives, students, and student services.

We generated five recurring themes through analysis: (a) training and education, (b) policy-led initiatives, (c) holding people accountable, (d) social information campaigns, and (e) cultural change. When aligning these with the socioecological model (Table 3), it is clear that forum participants considered the organizational level to be the area of greatest opportunity for initiatives, followed by the sociocultural level. The individual and relational levels of the model were not identified as providing many pathways for addressing AOD-facilitated sexual violence in the community.

Education and Training

Unsurprisingly, education and training were dominant themes in discussions. Education refers to building understanding around AOD-facilitated sexual violence, while training refers to skill capacity building to respond to AOD-facilitated sexual violence. Some of the educational measures proposed addressed how people relate with each other, aligning with the relational level of the socioecological model. Here, participants discussed parenting education, engaging with the parent–child relationship to address AOD-facilitated sexual violence. Participants also referred to embedding such education within existing education programs, such as Respectful Relationships and sexual consent: “Comprehensive sexual consent education embedded into all educational institutions, i.e., what consent looks like and the nuances around this when using AOD.”

There was a focus by participants on peer education so that boys would educate boys in understanding and addressing AOD-facilitated sexual violence. Education of AOD-facilitated sexual violence also sits within the organizational level of the socioecological model, whereby it should form part of lifelong learning throughout early years education, primary school, secondary, and tertiary education.

Skills development within organizations such as police and healthcare, and places such as the workplace, at music events, sports clubs, and LGBTQIA+ events were also identified by participants. At the individual level, training was identified as essential for those working in hospitality security specifically (including developing the skills in “identifying and acting on AOD-facilitated sexual violence”), bystander training and safe substance use training for individuals.

Policy-Led Initiatives

Participants identified an absence of policy frameworks and initiatives in relation to AOD-facilitated sexual violence and argued that this was required at the organizational level and across various domains, including hospitality, health systems, and taxation. Discussions among participants produced some specific suggestions for initiatives such as “bringing alcohol service in line with food service (quality control, etc.)” and “align planning laws with hospitality, e.g., co-located supports for AOD-facilitated sexual violence.”

The latter initiative of a co-located support referred to venues being close to support services. Participants discussed co-location at length, detailing planning applications for hospitality venues such as pubs requiring recognition of where there were support services or requiring new venues to co-locate with support services. There were several participants in attendance who worked in specialist violence prevention and response, and women’s services, and they raised that alcohol and other drug services should be integrated with family violence, sexual violence, and mental health services at both the policy and service system levels.

Threaded throughout these discussions was the need for culturally specific responses to alcohol and drug issues. Tax policy initiatives proposed related to a “big alcohol tax” and the profits from tax being “used in harm minimization.” The remaining subthemes within policy-led initiatives align more with the sociocultural level of the socioecological model. This incorporated suggestions such as decriminalizing illicit drugs, normalizing safe substance use, limiting or regulating alcohol, and reporting guidelines for the media.

Holding People Accountable

The discussions were particularly forceful when considering the need to hold people accountable. At the organizational level, participants were most concerned with holding licensed venues accountable or requiring them to take some responsibility for preventing AOD-facilitated sexual violence. Harsher enforcement of penalties for venues where AOD-facilitated sexual violence takes place was proposed alongside an independent body (“watch dog”) to hold venues accountable, which includes “access to CCTV—and allow it to be viewed openly.” But more often, the participants discussed the need for initiatives that were led by or took place in licensed venues; for example, mandated AOD-facilitated sexual violence programs for licensed venues and safety officers located at venues. Another specific initiative suggested bringing licensed venues together “to create a shared onus of responsibility/plan.” In relation to perpetrators, at the individual level, participants considered the need to hold “abusers accountable within systems that actually rehabilitate” and ensuring that there are sufficient resources “to speed up processing perpetrators of AOD-facilitated sexual violence.” Linked to this was the focus on victim-led responses, for example, local restorative justice or “alternative pathways for justice for victim survivors.”

Social Information Campaigns

Participants specified initiatives for their local region when discussing social information campaigns. While general ideas were generated and proposed for public health campaigns around male behaviors, or awareness-raising campaigns in venues and public toilets, taxis, and social media, the rural focus of the project generated interesting locations for such campaigns. The need to focus on male behaviors was emphasized rather than what was seen as the current focus on women’s behaviors. For example, participants reported on an art exhibition they had seen in the news that was held at the United Nations Headquarters in New York City. The exhibition showcased the variety of clothing women who have been raped were wearing to dispel long-held rape myths. Participants attending the World Café Forum wanted campaigns on the back of toilet doors that directly questioned men: “have you used substances to manipulate some into sex?”

The region where the World Café was conducted has a well-known recreation area [Rosalind Park] where major events are held, and participants suggested that campaigns could be linked to popular events in this location. They suggested that including safe space tents should be required when holding an event. Similarly, participants suggested encouraging the city council “to focus on this as part of community safety week.”

Cultural Change

Cultural change, as part of the sociocultural level, was recognized across the discussion groups as difficult but necessary to address AOD-facilitated sexual violence. Cultural change was argued to be needed around gender inequality. It was well recognized by the specialist and women’s health services in the room that gender inequality is associated with sexual violence. In particular, participants highlighted male entitlement and control with the need to “address male entitlement in relation to respect for women,” “change ideas of male ownership/control,” and “believing women.” Participants also reflected on shifting narratives, for example, “shift the narrative” in relation to cultural attitudes around drugs and alcohol, “changing alcohol culture,” and “shifting student culture so people can speak out.” These narrative shifts identify two concepts: the Australian collective attitude toward AOD, and the ability of an individual within the culture to speak up, particularly in rural and regional areas. One participant group specifically noted that there was a “Reluctance among men to dob mates in and this is a bigger challenge in rural towns where men can then be ostracized from their community.”

Power

In recognition of the development of the socioecological model and its adaptation to consider imbalances of power within and between the socioecological levels, we were sensitive to this concept as we considered the themes detailed above (Forsdike & Giles, 2024).

Throughout the forum, power was a recurring topic discussed overtly in terms of who holds power over victims of AOD-facilitated sexual violence. For example, participants discussed how licensed venues hold power over their patrons, particularly over women who frequent them and are subjected to AOD-facilitated sexual violence. Alongside discussion of power imbalances, participants drew out some of the more covert power imbalances. In particular, participants talked about how the broader patriarchal cultural contexts see men holding power over women, which is at times heightened in rural communities and for minorities. We reflect on this more in the discussion below.

Discussion

The World Café method brings together people from a variety of perspectives and backgrounds to discuss an issue of importance. Our forum produced important findings on how to respond to and prevent AOD-facilitated sexual violence, particularly in regional and rural communities. Participants were candid about how AOD-facilitated sexual violence is a topic that can be challenging to tackle. Even those from specialist services can struggle to integrate the two issues of (a) alcohol and other drugs and (b) sexual violence. Those working in AOD-facilitated sexual violence need support for greater understanding of the term and to be able to tackle it from a cohesive perspective rather than from either an AOD or a sexual violence perspective.

As noted in the results, power was a recurring topic in terms of who holds power, for example, licensed venues holding power over women patrons. Yet, venues are unlikely to be expected to deal with or be held accountable for AOD-facilitated sexual violence that occurs at their venue. An unwillingness to assume responsibility is reflected in broader gender-based violence. For example, organizations such as universities or workplaces are often reluctant to acknowledge, let alone take responsibility for, preventing and responding to sexual harassment. As a result, victims struggle to find integrated service systems and are often forced to engage with multiple services when seeking support, resulting in poor continuity of care (García-Moreno et al., 2015). The issue of who is responsible for preventing, responding to, and supporting victims of AOD-facilitated sexual violence needs further exploration, discussion, and recognition, given the number of stakeholders involved (Ison et al., 2025c).

With regard to covert power imbalances, there are often troubling power imbalances that victim-survivors of sexual violence face at all levels of the socioecological model (Tarzia, 2020). This was identified through Australia’s patriarchal cultural context, recognized as particularly dominant in rural communities and for minorities. This understanding of sexual violence allowed participants to consider how to address AOD-facilitated sexual violence beyond just standard approaches of behavioral change to considering how to prevent sexual violence through broader cultural change, often referred to as primary prevention (Hooker et al., 2020).

One suggestion for addressing power imbalances was to implement transformative justice responses to victim-survivors. This reflects the demographics of the participants, with many working in the gender-based violence sector and in feminist advocacy, which has engaged in transformative justice work (Rasmussen, 2022). Transformative justice, as used in feminist advocacy, comes from anticarceral approaches, particularly those led by Indigenous people and people of color (Davis, 2019). Approaching sexual violence perpetration from a noncarceral perspective is something being taken up—though at times removed from these decolonial and antiracist approaches—by universities and other institutions (McMahon et al., 2024). To date, transformative justice for victim-survivors of AOD-facilitated sexual violence has been underexplored and offers a possible new avenue of research and advocacy. Restorative justice processes could also be an opportunity for perpetrators of AOD-facilitated sexual violence to recognize their behaviors and their impact. Transformative justice response broadly highlights the investment from those working with victim-survivors to considering alternative approaches outside of the current criminal-legal approach. Participants advocated for such an approach to focus on restoring power to victim-survivors.

Integrated prevention and response systems that are place-specific while also addressing both specific initiatives and broader issues, such as gender inequality, are key across all ages, stages, and places. Participants talked about needing responses to AOD-facilitated sexual violence that were culturally specific, particularly to the regional and rural context. Such an interconnected prevention approach system must consider the nuanced and place-specific, addressing both specific initiatives and broader issues such as gender inequality. It is crucial to develop strategies that are adaptable to the unique needs of different communities to be effective.

Given that participants were predominantly from regional areas, it is unsurprising that they advocated for location-specific responses relevant to their local community. They suggested embedding responses to and preventing AOD-facilitated sexual violence at key local events as well as having them embedded in community hubs, co-located service spaces. Community responses to sexual violence have been identified as an important approach for prevention (Hooker et al., 2021). However, to date, community-based responses have been underresourced with limited evaluations (DeGue et al., 2016). Existing programs tend to focus on troubling victim-blaming approaches such as drink cover (Clinnick et al., 2024) or training bar staff (Davis et al., 2024; Hooker et al., 2024). Given that drink spiking often garners significant media attention (Clinnick et al., 2024), including in the region where this study took place, it offers an opportunity for large-scale community engagement in prevention.

One of the limitations of the World Café Forum was the voices that were missing in the room. Despite invitations, no one from hospitality attended. Given this is a prominent location for AOD-facilitated sexual violence, it was disappointing that those working in hospitality locally did not attend, but it is perhaps reflective of their unwillingness to see a role in addressing the issue. The other limitation of a World Café Forum is the potential imbalance of power in the room. This can lead to dominant voices, reduced opportunity for dissenting voices, and the potential for certain voices to be silenced. For example, those facilitating discussions were aware that older and more experienced people in the work tended to dominate some of the conversations. This meant that facilitators based at each group discussion needed to deftly negotiate the voices, but there could have been some voices lost in the process.

Conclusion

This article reports findings from a World Café forum that brought together stakeholders from a variety of perspectives and backgrounds to discuss AOD-facilitated sexual violence. The aim of the forum was to produce conditions whereby participants could share knowledge and views on what ought to be done to respond to the issue in their regional area. The findings from discussions have implications for public health. Reflecting a shared view that sexual violence signals deeply embedded gendered power imbalances in society, participants overwhelmingly saw that responding to and preventing AOD-facilitated sexual violence should be chiefly undertaken at the organizational and sociocultural level. A dearth of policy frameworks and initiatives responding to the problem was identified, and it was evident there was a lack of agreement concerning who should assume responsibility for tackling the problem, alongside concern that powerful stakeholders such as licensed venues were rarely held to account. A range of measures were suggested, with a particular focus on the implementation of restorative justice approaches—reflecting the view that social policy and service delivery should restore power to victim-survivors. The importance of community-based responses relevant to local communities was also emphasized alongside targeting the behavior of men (not women)—a perspective that locates responsibility for AOD-facilitated sexual violence with perpetrators.

The full study can be accessed by clicking the ‘Source’ link below

Source: https://journals.sagepub.com/doi/10.1177/10778012251379421

by Boston Herald editorial staff – September 17, 2025

There’s a renewed push to legalize overdose prevention centers  on Beacon Hill, with advocates touting supervised drug use as harm prevention.

That depends on how one defines harm.

At these centers, trained health care workers would supervise individuals who use pre-obtained illicit drugs — and they could intervene and prevent fatal overdoses.

Yes, addicts could avoid overdosing and live another day — another day in which they’d steal or prostitute themselves to buy drugs, another day in which opioids could further damage their mind and body, and another day to stumble through the degradation of a life ruled by drugs.

The real winners? Drug dealers and traffickers. Their clientele may have access to rehabilitative services through these centers, but that cry for help may not come for a long time. Meanwhile, they are willing customers for those “pre-obtained” drugs.

In these progressive parts, the law is to be followed except if you don’t like it. Therefore, these proposals would provide legal protections for workers, drug users accessing the facilities, government officials and other stakeholders. Because the drugs being injected are, of course, illegal.

Rep. Mindy Domb, co-chair of the Joint Committee on Mental Health, Substance Use and Recovery, said Massachusetts last year recorded fewer than 2,000 fatal overdoses, breaking a grim years-long trend.

Yes, naloxone is an amazing thing, and distribution of Narcan has saved many lives from overdoses. But making drug addiction safer with the added net of Narcan is like putting a bandage on a deep wound.

One can’t fight the opioid crisis by prolonging addiction. Keeping up the demand for drugs fuels the supply and the crime that comes with trafficking. And the drug market only gets worse.

Nitazenes have entered the chat.

Last year, a state-funded drug checking program in Massachusetts has found opioids up to 25 times stronger than fentanyl, according to WBUR. In a bulletin, public health officials say the number of drug samples testing positive for nitazenes is small — but growing quickly.

“The more that we crack down on things like fentanyl and heroin, that’s going to lead to the rise of other things that are infiltrating the drug supply,” said Sarah Mackin, director of harm reduction at the Boston Public Health Commission.

“Nitazenes is just the newest thing to come through,” after xylazine, the animal tranquilizer found in 9% of overdose deaths in 2023.

However, an investigation of records from hospital emergency departments published by the JAMA Network found it often takes more doses of naloxone to reverse an overdose when nitazene is involved than it would take to reverse a fentanyl overdose. Further study is needed.

Keeping the drug cycle going, however “safely,” isn’t a step in the right direction, it’s just another foot forward on the addiction treadmill.

We need addiction reduction, stat. We need to fund programs such as Boston Medical Center’s Faster Paths to Treatment, its substance use disorder urgent care program. And we need more of them.

True harm reduction comes from helping addicts get clean so they can live full, productive lives.

Source: https://www.bostonherald.com/2025/09/17/editorial-rehab-is-the-best-harm-prevention-for-addicts/?

by JENNIFER PELTZ Associated Press – September 25, 2025

Every year, tons of heroin, cocaine, methamphetamine and other drugs flow around the world

UNITED NATIONS — Every year, tons of heroin, cocaine, methamphetamine and other drugs flow around the world, an underground river that crisscrosses borders and continents and spills over into violence, addiction and suffering. Yet when nations’ leaders give the U.N. their annual take on big issues, drugs don’t usually get much of the spotlight.

But this was no usual year.

First, U.S. President Donald Trump touted his aggressive approach to drug enforcement, including decisions to designate some Latin American cartels as foreign terrorist organizations and to carry out deadly military strikes on speedboats that he says said were carrying drugs in the southern Caribbean.

“To every terrorist thug smuggling poisonous drugs into the United States of America: Please be warned that we will blow you out of existence,” he boasted at the U.N. General Assembly on Tuesday.

Hours later, his Colombian counterpart fired back that Trump should face criminal charges for allowing an attack on unarmed “young people who were simply trying to escape poverty.”

The U.S. “anti-drug policy is not aimed at the public health of a society, but rather to prop up a policy of domination,” Colombia’s Gustavo Petro bristled, accusing Washington of ignoring domestic drug dealing and production while demonizing his own country. The U.S. recently listed Colombia, for the first time in decades, as a nation falling short of its international drug control obligations.

The barbs laid bare, on global diplomacy’s biggest stage, the world’s wide and pointed differences over how to deal with drugs.

“The international system is extremely divided on drug policy,” said Vanda Felbab-Brown, who has followed the topic as a senior fellow at the Washington-based Brookings Institution think tank. “This is not new, but it’s really just very intense at this UNGA.”

While the wars in Gaza and Ukraine, climate change and other crises got much of the focus in the U.N.’s marathon week of speeches and meetings, the topic of drugs turned up from Trump’s and Petro’s tough talk to side events on such themes as gender-inclusive drug policy and international cooperation to fight organized crime.

Some 316 million people worldwide used marijuana, opioids and/or other drugs in 2023, a 28% rise in a decade, according to the most recent statistics available from the U.N. Office on Drugs and Crime. The figures don’t count alcohol or tobacco use.

The specifics vary by region, with cocaine use growing in Europe, methamphetamine on the rise in Southeast Asia, and synthetic opioids making new inroads in West and Central Africa and continuing to trouble North America, though opioid-related deaths have been falling.

The U.N. drug office says trafficking is increasingly dominated by organized crime groups with tentacles and partnerships around the world, and nations need to think just as broadly about trying to tackle the syndicates.

“Governments are increasingly seeing organized crime and drug trafficking as threats to national and regional security and stability, and some are coming around to the fact that they need to join up diplomatic, intelligence, law enforcement and central-bank efforts to push back,” agency chief of staff Jeremy Douglas said by email.

Although organized crime hasn’t featured very prominently in top-level discussions at the General Assembly to date, he said, “we’re at a point where this needs to, and hopefully will, change.”

Nations pair up in various joint counternarcotics operations and working groups and sometimes form regional coalitions, but some experts and leaders see a need to go global.

Countries need to “pool resources in a fight that must be a common cause among all nations,” Panamanian President José Raúl Mulino told the assembly. He said his nation had seized a “historic and alarming” total of 150 tons of cocaine and other drugs this year alone.

To be sure, there is already some global-scale collaboration on drug control. The U.N. Commission on Narcotic Drugs decides what substances are supposed to be internationally regulated under decades-old treaties, and it can make policy recommendations to the U.N.’s member countries. The International Narcotics Control Board monitors treaty compliance.

But the U.N. is big-tent politics at its biggest, so even as some components of the world body deal with drug enforcement, others emphasize public health programs — substance abuse treatment, overdose prevention and other services — over prohibition and punishments.

The U.N. High Commissioner for Human Rights, Volker Türk, has advocated for decriminalizing at least some drug use while clamping down on illegal markets. Given that policing hasn’t reduced substance use or crime, “the so-called war on drugs has failed, completely and utterly,” he said last year.

Separately, a U.N. Development Programme report last week said punitive drug control had led to deaths and disease among users who shied from seeking help, racial disparities in enforcement, and other societal downsides.

At a gathering marking the report’s release, former Mexican President Ernesto Zedillo deplored that “the global drug control regime has become a substantial part of the problem.”

“The question is: Do governments have the wisdom and courage to act?” asked Zedillo, now a Yale professor and a commissioner of the Global Commission on Drug Policy, a Geneva-based anti-drug-war advocacy group.

The other question is whether they could ever agree on what action to take.

Even if countries agree — or say they do — with ending the drug trade and resulting ills, “the objectives might be different, and certain means, tools, resources they’re willing to devote to them, are different,” Felbab-Brown said.

Nations’ own drug laws vary widely. Some impose the death penalty for certain drug crimes. Others have legalized or decriminalized marijuana. At least one — Thailand — legalized it only to have second thoughts and tighten the rules. Countries’ openness to needle exchange programs, safe injection sites and other “harm reduction” strategies is similarly all over the map.

As leaders took their turns at the assembly rostrum this week, observers got occasional glimpses of the world’s different views of its drug problem.

Tajikistan’s president, Emomali Rahmon, called drug trafficking “a serious threat to global security.” Guyanese President Irfaan Ali endorsed international efforts to address drug trafficking, which he counted among the ”crimes that are destroying the lives of our people, especially young people.”

Syria’s new president, Ahmad al-Sharaa, noted that his administration closed factories that produced the amphetamine-like stimulant Captagon, also known as fenethylline, during his now-ousted predecessor’s time. Costa Rican Foreign Minister Arnoldo André Tinoco said drug smuggling networks are exploiting routes traveled by migrants and “taking advantage of the vulnerability of those seeking international protection.”

“Isolated responses are insufficient,” as the traffickers just go elsewhere and create new hotspots of crime, Tinoco said.

Reviewing the challenges facing Peru, President Dina Boluarte listed transnational organized crime and drug trafficking alongside political polarization and climate change.

“None of these problems is merely national, but rather global,” she said. “This is why we need the United Nations to once again be a forum for dialogue and cooperation.”

Source: https://abcnews.go.com/Health/wireStory/issue-drugs-showcased-general-assembly-year-125919663

Outdated views of addiction hurt patients. Dr. Roger Starner Jones, Jr. and others are working to change that.

Despite decades of medical research, public awareness campaigns, and growing national concern, many people still see addiction through a distorted lens. “Addict” remains a pejorative label. Misconceptions persist that addiction is a choice, a character flaw, or the result of bad parenting. These outdated ideas don’t just misinform—they actively harm. They delay care, deepen stigma, and make recovery even more complicated to reach.

But addiction is not a moral failing. It is a complex brain disease, and understanding it as such is crucial to saving lives.

A Medical Diagnosis, Not a Personal Weakness

Addiction, clinically known as substance use disorder (SUD), alters brain chemistry in ways that impact decision-making, impulse control, and the experience of pleasure and reward. According to the National Institute on Drug Abuse (NIDA), addiction is a chronic, relapsing disorder characterized by compulsive drug seeking, continued use despite harmful consequences, and long-lasting changes in the brain.

Yet societal attitudes lag behind the science. More than three-quarters of Americans surveyed believe that substance use disorder (SUD) is not a chronic medical illness, and more than half said they believe SUD is caused by bad character or lack of moral strength, according to findings from the 2024 Shatterproof Addiction Stigma Index Report. This belief system creates barriers to treatment by fueling shame, encouraging secrecy, and often leading families and employers to distance themselves rather than lean in with support.

The Real Risks of Misunderstanding

Misconceptions don’t just alienate people—they endanger them. Fear of judgment keeps many individuals from seeking help until their condition worsens. Delayed treatment can lead to job loss, relationship breakdowns, homelessness, overdose, and even death.

“Shame is one of the biggest enemies of recovery,” says Dr. Roger Starner Jones, Jr., a board-certified emergency and addiction medicine physician based in Nashville. “When patients think they’ll be judged instead of treated, they wait too long. They spiral. By the time they reach us, their situation is often much more severe than it needed to be.”

Dr. Jones has seen this pattern play out thousands of times. After a decade in emergency medicine, he pursued a fellowship in addiction medicine at Vanderbilt University Medical Center, driven by both clinical experience and personal history. Starner Jones’ father, who once faced 11 DUIs in seven years, found lasting sobriety after being committed to a state hospital and undergoing physician-led detox. That experience changed the course of both their lives—and led Dr. Jones to dedicate his career to compassionate, customized addiction care.

Rewriting the Narrative: Care That Meets Patients Where They Are

Through his practices—Nashville Addiction Recovery and Belle Meade AMP—Starner Jones delivers concierge-level, judgment-free care. His model includes in-home detox, private hotel suite treatment, and office-based services designed to remove as many barriers as possible between a patient and their recovery. His focus is on meeting patients where they are, not where the system dictates they should be.

“There’s no one-size-fits-all in addiction treatment,” Dr. Jones says. “Some people need a quiet, safe space to detox privately. Others need a highly structured plan for relapse prevention. What they don’t need is bureaucracy or blame.”

Starner Jones’s approach is part of a broader shift happening in the addiction medicine field. More physicians are advocating for low-threshold treatment models—services that reduce wait times, eliminate unnecessary paperwork, and avoid rigid abstinence requirements. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), these models have been shown to increase engagement and retention in care, particularly among people with co-occurring mental health conditions.

While not a clinician in the traditional sense today, Dr. Gabor Maté is one of the most influential voices advocating for a trauma-informed approach to addiction. His book, In the Realm of Hungry Ghosts, explores how early childhood trauma, not moral weakness, underpins most substance use. He argues that addiction is not the problem itself, but rather a misguided attempt to solve internal pain. His philosophy underpins many treatment programs worldwide.

The Hazelden Betty Ford Foundation is one of the most established names in addiction treatment and has evolved to embrace an integrated model that combines medical detox, medication-assisted treatment (MAT), therapy, and mental health services. They openly reject the idea of addiction as a character flaw and emphasize long-term support and relapse prevention, rooted in compassion, not control.

Dispelling Common Myths

Several deeply ingrained myths continue to distort how addiction is viewed and treated. Let’s set the record straight:

  • Myth: Addiction is a choice.
    Reality: While the initial decision to use a substance may be voluntary, the progression to addiction is driven by changes in brain circuitry, not moral weakness.

  • Myth: You have to hit “rock bottom” to recover.
    Reality: Early intervention improves outcomes. Waiting for someone to “bottom out” can be fatal, especially in the era of fentanyl-laced street drugs.

  • Myth: Medication-assisted treatment is trading one addiction for another.
    Reality: FDA-approved medications like buprenorphine and methadone reduce cravings and withdrawal, allowing patients to stabilize their lives. They’re widely considered best practice in treating opioid use disorder.

  • Myth: Recovery is rare.
    Reality: Millions of Americans are living in recovery today. In the United States, 9.1%, or 22.35 million adults have reported resolving a substance use problem.

Compassion Is Evidence-Based

What ultimately works in addiction care isn’t punishment or shame—it’s connection. “When you treat addiction like the disease it is, you empower people to get better,” Dr. Starner Jones says. “You stop asking ‘What’s wrong with you?’ and start asking ‘What happened to you?’”

At Nashville Addiction Recovery, the ethos of compassion is baked into every interaction. From discreet intake to 24/7 physician supervision, the patient experience is defined by dignity and respect. Many of the patients Dr. Jones sees are high-profile professionals—athletes, musicians, executives—whose careers demand confidentiality. But the underlying need is universal: to be seen, respected, and supported through one of the most complex challenges a person can face.

A Call for Better Understanding

Changing how society views addiction won’t happen overnight, but it starts with how we talk about it. Swapping judgment for empathy, punishment for treatment, and generalizations for science can change not just conversations—but lives.

Source: https://www.bbntimes.com/science/what-most-people-get-wrong-about-addiction

Although I’ve been deeply concerned about this problem since my days in Sacramento, over the past nearly 8 years, I’ve focused mainly on education, on prevention, and on the need to change attitudes.

NANCY REAGAN
Remarks at the White House Conference for a Drug Free America Washington, D.C. 02/29/1988

The White House

People finally are facing up to drug abuse. They’re banding together, and they’re making real progress. And I just want to say a heartfelt ‘thank you’ to all those people out there who are working so hard to get drug abuse under control.

NANCY REAGAN
Radio Address to the Nation on Federal Drug Policy 10/02/1982

As First Lady, Nancy Reagan focused on fighting drug and alcohol abuse among youth. She expanded the drug awareness campaign to the international level when she invited First Ladies from around the world to the First Lady Conference on Drug Abuse April 24-25, 1985.

“Just Say No”

Thank you for being part of the first international ‘Just Say No’ walk. Look around at how many young people are walking with you today. And just think, there are groups as big as yours, or even bigger, doing the same thing all over the world! Can you imagine just how many children are saying ‘Just Say No’ today? Children everywhere are learning about drug abuse at an early age. And that’s a good thing.

NANCY REAGAN
Remarks at the Just Say No International Walk 05/22/1986

First Lady Nancy Reagan urged the nation’s youth to “just say no.” She appeared on television talk shows, attended rallies and sporting events, taped public service announcements, and wrote guest articles.

Signings

This legislation allows us to do even more. Nevertheless, today marks a major victory in our crusade against drugs – a victory for safer neighborhoods, a victory for the protection of the American family.

President Ronald Reagan
Remarks on Signing the Anti-Drug Abuse Act of 1986 10/27/1986

The United Nations

In your deliberations, I urge you not to be diplomatic for the sake of diplomacy, but to speak the truth about the effects of drugs on our peoples and our governments. I urge you to be tough and firm in the recommendations you make.

Nancy Reagan
Remarks to the Third Committee of the United Nations General Assembly 10/25/1988

On October 21, 1985, during the United Nation’s 40th anniversary, Nancy Reagan hosted a second international drug conference.

On October 25, 1988, she addressed the Third Committee of the United Nations General Assembly where she spoke about the illegal use of drugs and its impact on families.

The picture below shows the various trips Nancy Regan made in promoting her campaign.

Issued by U.S. Customs and Border Protection  – Thu, 08/21/2025

NEW YORK — U.S. Customs and Border Protection Deputy Commissioner John Modlin delivered remarks at a National Fentanyl Prevention and Awareness Day event today in Times Square.

The annual event, hosted by the nonprofit Facing Fentanyl, brings together impacted families and federal, state, and local law enforcement to draw national attention to the synthetic opioid epidemic.

“On behalf of the more than 65,000 fathers and mothers, and sons and daughters, who are also agents, officers and professional staff of CBP, we mourn with those who have lost a loved one to fentanyl poisoning,” said Deputy Commissioner Modlin. “Every hour of every day of the year, CBP is enforcing the law, across the land, in the air, and on the sea. Fentanyl is not just a public health threat – it’s a weapon. Any group that tries to poison Americans will face U.S. law enforcement and national security authorities.”

CBP supports the nation’s fight against fentanyl by prioritizing counter-fentanyl efforts across all operational environments. This includes stopping the ingredients, equipment, and the drug itself from entering or moving through the U.S. CBP has significantly increased its efforts to find and seize fentanyl at border crossings and checkpoints, using a variety of methods, such as officers’ instincts, drug-sniffing dogs, advanced scanning technology, artificial intelligence, and intelligence gathering to target and stop smugglers.

CBP’s approach to combatting fentanyl has grown to also include taking down the criminal groups that ship fentanyl, its ingredients, and pill-making equipment into the U.S. By working closely with law enforcement agencies both within the U.S. and in other countries, CBP helps investigate the larger criminal organizations, not just the individuals caught smuggling drugs at the border.

Fentanyl is a very dangerous drug that CBP first encountered in its final form around 2013-2014. Even a very small amount can be deadly. It’s cheap and easy to make, and there’s a high demand for it. Just one kilogram (about 2.2 pounds) of fentanyl already mixed into pills makes just over 9,000 pills. In contrast, one kilogram of fentanyl powder can make roughly 80,000 pills.

National Fentanyl Prevention and Awareness Day serves as a vital platform to highlight the devastating impact of synthetic opioids and the ongoing efforts to combat this epidemic. CBP’s participation underscores its unwavering commitment to protecting American communities and saving lives.

For more information on National Fentanyl Prevention and Awareness Day, visit DEA Fentanyl Awareness.

 

Social media often gets a bad reputation when it comes to how much time children and teens spend glued to their phones – but there are lots of ways that social media can be a tool for good in the hands of a teen.
The Ups and Downs of Teens and Social Media

Social media issues for teenagers can be rife, and most parents are aware of the dangers. Cyber-bulling is a real problem, and studies show that too much time spent on social media can lead to feelings of low self-esteem and depression amongst teens who compare themselves to unrealistic ideals they see online.

While these are serious concerns, as a foster carer, you can make social media a positive experience for your foster teen by helping them to be aware of the risks and empowering them to take advantage of the benefits. You can also help your teen to limit the negative consequences by encouraging them to enjoy social media in moderation. Teens need time to enjoy life offline – exercise and face-to-face socialisation are both important for their growing brains and bodies.

In fact, a 2019 study found a strong link between the negative effects of social media and a lack of exercise brought about by too much time spent online. That means balancing time on devices with plenty of physical activity can help mitigate some of social media’s more harmful effects.

How to Encourage Healthy Social Media Habits for Teens?

Empower your teen to use social media safely

Talk about what is safe to share online and what isn’t, and make sure your foster teen knows what to watch out for to avoid online predators, scammers, and cyberbullies. Teach them to recognise false information and to think critically about what they read and see online.

Help them understand the risks to their mental health and self-image and decide together how to deal with these feelings if they come up. Make sure they know how to change their privacy settings on different platforms.

Looking for more guidance on internet safety? The UK Safer Internet Centre has a host of resources for teens from 11-19.

Encourage self-expression

Not only can social media be a great way for teens to explore new things like art, culture, and history, it’s also a versatile tool for self-expression. Many creative teens use social media to showcase their own art and performances, while others use it as a platform for building a unique personal brand through what they share and how they engage with online communities.

Using social media in this way can teach a teen digital skills and build an online presence that will put them in a good position for future education and job prospects. You can help your teen build their digital skills through online and in-person courses, such as photo/video editing and content creation. Check out BT’s Skills for Tomorrow portal for a host of free family resources.

Keep connected

For foster children, social media can be a useful way to keep in touch with old friends and family members and build important connections for the future. It also helps many teens strengthen friendships and build communities around shared experiences and interests – particularly when it’s not possible to see one another in person (like when schools are closed, or across long distances).

Being a teen can be lonely if you feel like you don’t fit in, but you can always find someone who’s interested in the same things you are online – whether that’s someone who loves the same band you do or someone from a similar cultural background.

Inspire your foster teen to do good

With the world more connected through social media, teens today have access to a lot more information on global issues – and many more ways to have an impact. Consider 17-year-old Greta Thunberg; in two years, she’s been able to reach a global audience with her message of fighting climate change and now has an Instagram following of over 10 million.

Help your teen find an issue that they care about and encourage them to get involved and have a positive impact, such as promoting community initiatives and organisations.

Be involved

Model healthy social media use by not looking at your phone during meals or family activities, and limit screen time close to bedtime.

Follow your foster teen on social media and make time to chat with them – in person and in a non-judgemental way – about what they and their friends are posting and seeing online. Share interesting and educational feeds with them and keep communication open so your teen knows they can talk to you if they see or experience anything upsetting online.

Teenagers can be truly inspiring with the passion and energy they bring, but many teens suffer without a safe space to grow up. If you have the room to give a young person a stable and supportive home, get in touch today. You can also read our article about fostering teenagers here.

Source:  https://www.compassfostering.com/advice/teenagers-and-social-media

 

Filed under: Culture,Social Media,USA,Youth :

by Kevin Sabet  August 22, 2025 

In 2018, 27-year-old Bryn Spejcher, an inexperienced marijuana smoker in California, killed her boyfriend Chad O’Melia by stabbing him 108 times, a crime the local district attorney described as “horrific” and “one of the worst our medical examiner has ever seen.” A jury found Spejcher guilty of involuntary manslaughter, but she received only probation at sentencing because of a compelling presentation of her defense of cannabis-induced psychosis. Prior to the violent incident, Spejcher had taken two hits of legal marijuana from a bong, and claimed that she began “seeing things that weren’t there” and lost touch with reality. She also stabbed herself repeatedly in the neck, and stabbed her own dog. Law enforcement agents called to the scene had to break her arm with a metal baton to get her to let go of the knife; multiple Taserings had no effect. 

Cases like Spejcher’s illustrate the stakes involved in the federal reclassification of marijuana. If President Trump follows through with such a move, the drug would remain illegal on the federal level, but would receive an imprimatur of being safer and face fewer restrictions, with significant commercial and social implications.  

Yet voices across public discourse persist in asking: why should anyone care if President Trump does just that? 

Celebrities like Mike Tyson and Joe Rogan and hedge-fund bosses like Andrew Lahde tell us that marijuana is no big deal. Numerous states have already legalized it for medical and recreational usage, and they claim to be regulating it well. If we are to believe the advocates, marijuana is a miracle cure for PTSD, anxiety, depression, and bipolar disorder — not to mention an unbeatable salve for the pain suffered by cancer patients.

So what sense does it make for this drug to sit in the same federal category as PCP and heroin? Isn’t marijuana’s placement in Schedule I, the most serious category, merely a relic of discredited thinking from the bad old days of the War on Drugs? It isn’t. To understand why it isn’t, and why a Trump move to reclassify weed would risk unmitigated harm to American health and safety, it’s first important to clear up some common misunderstandings around how and why drugs end up classified as they do.  

Under the Controlled Substances Act of 1971, a five-part schedule was established for classification of potentially dangerous drugs. This schedule is emphatically not an index either of a drug’s “hardness” or a kind of unofficial charging and sentencing guide for prosecutors and judges. Placement is earned specifically through consideration of a drug’s accepted medical use and its abuse risk. Drugs with no accepted medical use and a high risk of abuse get placed in Schedule I.  

That’s the commonality between marijuana and heroin; under federal law, the relevant agencies necessarily view them that way.  

Neither has an accepted medical use, though both drugs have approved medicines derived from them that remain in lower schedules (the medicine dronabinol, for example, is synthesized THC, the active ingredient in marijuana, and is in Schedule III). Both have high risks of abuse. The argument that one is a “hard” drug and the other is not  — which is debatable, especially given today’s ultra-high-potency weed — simply doesn’t come into play.  

Nor does the criminal-justice question. Keeping marijuana in Schedule I isn’t, as critics have it, a carceral strategy; conversely, moving it into Schedule III isn’t a de-carceral one. Under a move to Schedule III, the drug would remain federally illegal, still subject to the enforcement power of the Drug Enforcement Administration and the Department of Justice. No low-level offender would see his sentence commuted. This is sort of beside the point anyway, since most low-level marijuana users never receive a sentence for anything. 

But how can it be, another objection runs, that the drug has no medical use? Most US states currently allow doctors to recommend it. 

That, again, is technically correct. But the decisions those states made to allow doctors (and in some cases, “designated caregivers”) to recommend marijuana to treat pain and other issues were political decisions, not medical or scientific ones. Voters stated a preference; that has no effect on how federal agencies are required by current law to view the question. The facts of just how those recommendations get handed out drive home that political aspect. In 2022, Pennsylvania saw some 132,000 medical-marijuana certifications, a third of the state’s total for that year, issued by only 17 doctors.

Those decisions, taken in the aggregate, don’t constitute an accepted medical use. Or at least, they didn’t until October 2022. That was the month the Biden administration directed its Department of Health and Human Services to look into a possible reclassification of the drug.  

“This schedule is emphatically not an index either of a drug’s ‘hardness’ or a kind of unofficial charging and sentencing guide.”

Again, history is important here. Before the Biden process, the federal government had used an eight-factor test to determine how to schedule various drugs. Those factors focus on what the current and historical patterns of its abuse look like, as well as what that means for individual users, what risk it presents to public health, how likely it is to cause dependence (either physical or psychological), the state of the science around the drug and its pharmacology, and whether it’s a chemical precursor or “analogue” of another controlled substance.  

By these metrics, marijuana is precisely where it belongs in Schedule I. The best science shows that it isn’t an effective medical treatment. One of the most frequent conditions it’s used to treat is chronic pain. But the 2017 study cited to prove its efficacy there has seen dozens of subsequent meta-analyses and reviews fail to support its conclusions; a 2022 study of a decade’s worth of surgical records from a Cleveland hospital even found that using marijuana actually increases pain after surgery. 

The data also demonstrate that marijuana poses a significant risk of dependency: addiction rates are around 30% of all users and rising. Addiction in this case means exactly what it does for other substances: inability to quit, a need for ever more of the drug to achieve the same effect, and even withdrawal symptoms. Given the recent avalanche of data cataloguing marijuana’s harms specifically to cardiac and mental health — like a June British Medical Journal review  connecting it to a two-fold risk of cardiovascular death or the massive Danish study from 2023 suggesting that as much as 30% of schizophrenia cases among men between 21 and 30 were linked to cannabis-use disorder — its wider public-health risks are glaringly clear.  

The Biden administration supplanted the eight factors with a new system seemingly designed to push the drug into a less restrictive schedule. The Biden recommendation — likely a political compromise between the status quo and full legalization, timed just before Joe Biden’s re-election bid — also incorporated the shaky argument that because so many states have made political decisions to allow medical marijuana, that constitutes an accepted medical use.

An incisive article in JAMA Neurology, by the Harvard addiction scientist Bertha Madras, took a hard look at the process and found disturbing evidence of politicization. This included the fact that a high-ranking Biden DOJ official, Acting Assistant Attorney General Peter Hyun, argued that “cannabis has not been proven in scientific studies to be a safe and effective treatment for any disease or condition” — six months before the rescheduling directive appeared. Yet the science Hyun cites certainly had not changed in the interim.  

The federal government has long held the position Hyun laid out. Under the Obama administration, Jay Inslee and Gina Raimondo — then the governors of Washington and Rhode Island, respectively — petitioned the federal government to reclassify marijuana. The administration’s response made clear that federal drug schedules reflect what the science says, not “danger” or “severity.” Obama’s then-DEA chief, Chuck Rosenberg, announcing the denial of the petition, used language Hyun would later echo: “This decision isn’t based on danger. This decision is based on whether marijuana, as determined by the FDA, is a safe and effective medicine . . . and it’s not.”

Suggested reading

I have seen the damage cannabis does

By Peter Hurst

But let’s assume, for the sake of argument, that Trump reverses years of federal precedent to follow the logic of the rescheduling argument. What happens then? 

The truth: no one knows.  

It’s clear that the marijuana industry believes that rescheduling will be an enormous benefit to its shareholders. In one sense, that’s likely correct. Businesses selling substances in Schedule I face severe commercial restrictions under the tax code. A provision of the tax code prevents any such business from taking normal deductions at tax time on expenses like advertising. Lifting those restrictions seems sure to provide an enormous boost to revenues and reach for businesses selling marijuana products.

The impact on society is a different matter. The available evidence suggests that this will be a significant negative for society, especially given the research around how the young start using the drug: data published in June by researchers from the University of Southern California and Rutgers University show that exposure to marijuana social-media content plays a huge role in teens initiating use.  

But there are other externalities in play.  

If marijuana moves into Schedule III, it will be the only substance there without Food and Drug Administration approval. Will that play out in a similar way to the case of opium-poppy straw (i.e., the entirety of the plant, as it exists prior to the processes that turn it into heroin or opium)? Poppy straw is listed in Schedule II, but it also lacks an FDA approval — and it’s regularly seized by drug and border authorities, with a massive shipment grabbed up just in May. Though weed entrepreneurs clearly expect smooth sailing after a reclassification, they may well be in for a rough ride.

Then there’s the fact that substances listed in Schedule III face additional regulatory and enforcement power: Not only from the DEA and DOJ, but also from the FDA. There are strict rules around what sellers of Schedule III substances can and can’t say in advertisements. They’re forbidden from advertising off-label uses — and since marijuana lacks an FDA approval, all therapeutic uses are off-label. It’s easy to imagine another operator in the Schedule III space filing a lawsuit demanding precisely that kind of enforcement. 

In other words, rescheduling opens the door to regulatory chaos, even as it seems certain to add commercial firepower to an industry whose products, on the evidence, are extraordinarily harmful. How this combination will produce the benefits promised by proponents of rescheduling also remains unclear. 

The federal government shouldn’t signal to the American people that a drug that lacks medical or scientific imprimatur somehow possesses such approval. Others disagree — and vocally. They have a lot of money riding on it. But we should be crystal clear about what their preferred policy would  actually mean for American society — nothing good. 

Kevin Sabet, a former three-time White House senior drug-policy adviser, is president of Smart Approaches to Marijuana.

Source:  https://unherd.com/2025/08/the-illusion-of-safe-marijuana/?edition=us?

CHARLES CITY COUNTY, Va. (WRIC) — The Charles City County Elementary School will soon re-introduce a program focused on drug prevention and awareness for the 2025-26 academic year.

According to a release from the sheriff’s office, the program, DARE — Drug Abuse Resistance Education program — will come to the elementary school for the upcoming school year.

SRO Corporal Tramayne Mayo, who developed a curriculum to teach the program, reportedly attended a two-week training course as required by DARE to instruct.

“We are excited to get this program back into our school system,” said Jayson Crawley, Sheriff of Charles City County. “We feel that early education of the dangers of drugs should be taught to our youths and can have a significant positive impact on the decisions they make when faced with drugs. This is just part of our continued efforts to deter illegal drug activity in our county.”

Opioid settlement money awarded to all jurisdictions in the Commonwealth from a reported lawsuit filed against prescription drug companies will help fund the program, per the sheriff’s office.

8News previously reported that, in June, Virginia joined all other states and some U.S. territories in agreeing to sign a $7.4 billion settlement with Purdue Pharma and members of the Sackler family who own the company for their part in perpetuating the opioid crisis.

As a result, the state will receive as much as $103.8 million from this settlement over the next 15 years — funding which will go toward local prevention, treatment and recovery efforts, as previously reported by 8News.

Source:  https://www.wric.com/news/local-news/charles-city-county/dare-program-charles-city-elementary-2025-2026/

by Emily Murray – August 11, 2025

Fake pills remain a threat, with 5 out of 10 pills tested containing potentially lethal doses of fentanyl.

OMAHA, Nebraska – As students across the state prepare to return to school, the Drug Enforcement Administration (DEA) Omaha Division is encouraging families to have open conversations about the potentially lethal consequences of drug experimentation and the threat posed by drug dealers on social media.

In Nebraska, DEA has seized more than 145,000 fentanyl pills in the first seven months of 2025. This number is more than triple the amount seized by DEA in Nebraska in all of 2024 and represents close to 85,000 deadly doses of fentanyl removed from communities.

Social media plays a significant role in the life of students and cartels are taking advantage of this audience. Parents and caregivers are encouraged to emphasize the dangers associated with buying pills online. In Nebraska, DEA has seized fentanyl pills made to resemble common prescription medications such as Xanax ®, Adderall ® and Oxycodone ®. Never trust your eyes to determine if a pill is legitimate or counterfeit. The only safe medications are prescribed by a trusted medical professional and dispensed by a licensed pharmacist.

“We know that a lot of families sit down at the start of a new school year to go over things like dealing with bullies, taking precautions when walking home and staying organized with classes,” DEA Omaha Division Acting Special Agent in Charge Rafael Mattei said. “We want families to engage on the tough topics including the use of social media for buying and selling drugs. One pill can kill. Let’s raise awareness in our communities and prevent families from suffering a tragic loss of life.”

For families unsure how to begin a conversation on the dangers of drug use, the DEA has resources and fact sheets available online: https://www.dea.gov/onepill/partner-toolbox. Conversation starters, information on drugs including street names and side effects, and helpful tips on ways to stay engaged in these important conversations year-round, are available based on age and grade.

Source:  https://www.dea.gov/press-releases/2025/08/11/drug-enforcement-administration-encourages-open-conversations-dangers

by Nathan Mol­loy – 14 Aug 2025

PREVENTION is Bet­ter is a sub­stance abuse pre­ven­tion train­ing pro­gramme. Their mis­sion is to break the cycle of sub­stance use dis­order by provid­ing evid­ence based pre­ven­tion edu­ca­tion in schools, work­places, and com­munit­ies world­wide.

Its CEO and founder, Ryan Ulrich, has over 20 years of exper­i­ence work­ing in addic­tion and treat­ment and drug pre­ven­tion space. Speak­ing to the Sligo Week­ender, Ryan says that he uses his own lived exper­i­ence of over­com­ing addic­tion to treat people and that he has worked in this field across many dif­fer­ent coun­tries.

Its CEO and founder, Ryan Ulrich, has over 20 years of exper­i­ence work­ing in addic­tion and treat­ment and drug pre­ven­tion space. Speak­ing to the Sligo Week­ender, Ryan says that he uses his own lived exper­i­ence of over­com­ing addic­tion to treat people and that he has worked in this field across many dif­fer­ent coun­tries.

“I have my own lived exper­i­ence of over­com­ing my own sub­stance use addic­tion and I’ve been in healthy recov­ery for over 24 years. I’ve been work­ing in this field in the US and I spent quite a long time, 16 years in China, work­ing there and about four years here in Ire­land. So I’ve worked with many schools and in dif­fer­ent coun­tries across the world deliv­er­ing these kind of pro­grams.”

The ideal Pre­ven­tion is Bet­ter pro­gramme in a school accord­ing to its CEO is one which is run over the course of a week. After that, Ryan says that he hopes either schools or cor­por­a­tions keep them on for a period of three years as that is when they can note the changes in atti­tude in people towards sub­stance abuse.

The ideal Pre­ven­tion is Bet­ter pro­gramme in a school accord­ing to its CEO is one which is run over the course of a week. After that, Ryan says that he hopes either schools or cor­por­a­tions keep them on for a period of three years as that is when they can note the changes in atti­tude in people towards sub­stance abuse.

“Ideally, we would love to work with the school or cor­por­a­tion over a two to three year period. That’s where we can really see the changes in atti­tudes and beha­vior just to really pre­vent and make an impact. That’s really our mis­sion. So it’s quite flex­ible depend­ing on the needs of the school or the cor­por­a­tion.”

“Ideally, we would love to work with the school or cor­por­a­tion over a two to three year period. That’s where we can really see the changes in atti­tudes and beha­vior just to really pre­vent and make an impact. That’s really our mis­sion. So it’s quite flex­ible depend­ing on the needs of the school or the cor­por­a­tion.”

Pre­ven­tion is bet­ter than the cure is a com­monly used pro­verb defined by that it is bet­ter to stop something bad hap­pen­ing than to deal with it after it has happened. Ryan believes that in his field, it is massively import­ant to pre­vent someone get­ting addicted to alco­hol or drugs as it can have a dev­ast­at­ing impact not only them but their fam­ily and friends.

“I think it’s very import­ant and it’s abso­lutely pos­sible [to pre­vent sub­stance abuse].

“I think it’s very import­ant and it’s abso­lutely pos­sible [to pre­vent sub­stance abuse].

“There’s a very evid­ence based way to go about that as well because as we all know when some­body’s addicted to even vap­ing or cigar­ettes or alco­hol, it’s dev­ast­at­ing, not only for the indi­vidual, but for the fam­ily and the com­munity.

“From a health per­spect­ive, each euro inves­ted in pre­ven­tion saves about nine times that in terms of costs over­all, jails or health care. That doesn’t even include the impact on the com­munity. So it’s kind of an over­looked but extremely import­ant part of the broader part of health care and treat­ment over­all.”

Efforts to stop people using drugs has changed over the years. In the 1970s, the phrase “War on Drugs” was pop­ular­ised by then US Pres­id­ent

Efforts to stop people using drugs has changed over the years. In the 1970s, the phrase “War on Drugs” was pop­ular­ised by then US Pres­id­ent

Richard Nixon when he declared drug abuse “pub­lic enemy num­ber one” in June 1971. Accord­ing to Ryan, sub­stance abuse pre­ven­tion has changed a lot since then and that now they’re using a trauma based approach which is more evid­ence based.

“I think even longer, maybe about 40 years ago from the US there was kind of just say no or these scare tac­tics in terms of pre­ven­tion, which was shown sci­en­tific­ally to not work at all. And then there more of an edu­ca­tion approach, which is good.”

“But now we’re mov­ing more towards a trauma-informed approach, where we under­stand the impact both on the fam­ily and the com­munity, the impact on the body in car­ry­ing the trauma. So we take all those evid­ence-based approaches into the classroom. And that’s shown to be more and more effect­ive and have greater impact.”

“But now we’re mov­ing more towards a trauma-informed approach, where we under­stand the impact both on the fam­ily and the com­munity, the impact on the body in car­ry­ing the trauma. So we take all those evid­ence-based approaches into the classroom. And that’s shown to be more and more effect­ive and have greater impact.”

The rise of AI has also help Pre­ven­tion is Bet­ter to get more data to help with their pro­grammes.

“I think the rise of AI and data has had a sig­ni­fic­ant impact as well. So now we can col­lect more GDPRcom­pli­ant data. We can make more impact assess­ments. And that’s part of everything that we do, very datadriven as an organ­iz­a­tion.”

Earlier this year, the HSE’s clin­ical lead on addic­tion, Pro­fessor Eamon Keenan said that approx­im­ately 20% of young people show­ing up to addic­tion ser­vices are using HHC, syn­thetic marijuana. Accord­ing to Ryan, his organ­isa­tion are see­ing this becom­ing more of a prob­lem along with dual addic­tion issues which affects people’s men­tal health.

“So we’re see­ing, espe­cially with the leg­al­iz­a­tion of marijuana in the US, in other coun­tries, that’s become more of a prob­lem. There’s new sub­stances, new psy­cho­act­ive sub­stances that are com­ing into the mar­ket. Dual addic­tion and issues around addic­tion and men­tal health, which has always been there.

“These are becom­ing more pre­val­ent. And so these are just some of the trends that we’re see­ing and the changes over the years.”

Vap­ing and cocaine use has caught the national media’s atten­tion over the past few years. Accord­ing to the rehab­il­it­a­tion facil­ity, Rut­land Centre, women rep­res­ent one of the fast­est grow­ing groups seek­ing treat­ment for cocaine. Treat­ment for the drug as a primary addic­tion rose from 17% in 2023 to 23% in 2024, sig­nalling one of the sharpest single year increases recor­ded for any sub­stance at the centre.

Accord­ing to Ryan, both vap­ing and cocaine have a lot of mis­in­form­a­tion online which makes people think they’re not harm­ful.

“Young women look­ing at cocaine, cocaine has no cal­or­ies, is the typ­ical thing they’ll say. And sure, but that’s not, it’s not a healthy option, to say the least. So there’s these mis­per­cep­tions about these sub­stances being safe or not very harm­ful. There’s a tre­mend­ous amount of mis­in­form­a­tion, espe­cially with things like Tik­Tok or social media. The same with vap­ing as well.”

“For the young kids, they see celebrit­ies vap­ing or blow­ing smoke rings. It looks very attract­ive and all the dif­fer­ent fla­vors. That’s abso­lutely not the case.

“Nicot­ine is one of the most addict­ive sub­stances. Even using a vape one or two times with a high con­cen­tra­tion of nicot­ine is enough to get some­body addicted for life. It’s dif­fi­cult to quit after that.”

“Nicot­ine is one of the most addict­ive sub­stances. Even using a vape one or two times with a high con­cen­tra­tion of nicot­ine is enough to get some­body addicted for life. It’s dif­fi­cult to quit after that.”

Source:  https://www.pressreader.com/ireland/sligo-weekender/20250814/281977498705333

OPINION: Eric Adams is right 
Charles Fain Lehman is a fellow at the Manhattan Institute and senior editor of City Journal.

Can New York clean up its public drug-use problem?

Mayor Eric Adams aims to try: On Thursday, he called on the state Legislature to allow clinicians and judges to compel people into treatment when their drug use is hurting them and the city.

“We must help those struggling finally get treatment, whether they recognize the need for it or not,” Adams said at an event hosted by the Manhattan Institute (where I work).  

“Addiction doesn’t just harm individual users; it tears apart lives, families and entire communities, and we must change the system to keep all New Yorkers safer.”

Adams’ proposed state law, the Compassionate Interventions Act, may face an uphill battle in Albany, as “harm reduction” advocates assail it as coercive and dangerous.

But involuntary treatment should be a tool in New York’s arsenal for dealing with the public drug use that has plagued it for years.

Last year it reported nearly 4,000 homeless residents with a history of chronic substance use — probably an undercount, as such people are less likely to be identified by the city’s annual late-night census.

Regardless, it’s not hard to find people shooting up on New York’s streets — just visit the Hub in The Bronx or Washington Square Park in Manhattan.

Such behavior makes whole swaths of the city unlivable.

Public drug use hurts both users — there were more than 2,100 overdose deaths in the five boroughs last year — and the places where they use.

It deters commerce, and creates environments conducive to more serious crime.

Too often the city has responded to these situations with benign neglect, exemplified by its two “supervised consumption sites,” which give people a place to use with Narcan-wielding staff standing by.

These sites continue to operate, in spite of the fact that they don’t work and violate federal law.

Leaving people free to abuse drugs, it turns out, doesn’t save lives.

 

 

 

 

Involuntary treatment, by contrast, tries to correct the behavior that drives drug users to hurt both themselves and others.

That’s why 37 other states already permit it — and why New York under Adams’ plan would join them.

Critics will insist that involuntary drug treatment doesn’t work, and that people have to want to change.

But the balance of the evidence suggests that involuntary treatment performs as well as voluntary treatment.

That’s backed up both by older research on California’s involuntary-treatment scheme, and by strong indications that drug courts, which route drug offenders into treatment instead of prison, can reduce recidivism.

Opponents will also say that it’s immoral to compel people to get treatment they don’t want, and that it violates their “bodily autonomy.”

But there’s no right to shoot up in public spaces, or to ruin your body with fentanyl. And New Yorkers should have the right to expect their public spaces to be free from disorder, including public drug use.

The biggest challenge for Adams, though, may be the state’s limited treatment capacity.

New York state as a whole has only 134 long-term residential treatment facilities.

As of 2023, the most recent available data, they were serving 2,935 clients — fewer than the city’s tallied homeless drug-addict population.

Implementing the Compassionate Interventions Act will almost certainly require more funding for treatment beds, much as Adams’ previous efforts to institutionalize the seriously mentally ill did. That will have to be part of any ask in Albany.

But the mayor’s proposal will also allow diversion to outpatient treatment programs, including a new $27 million investment in contingency management therapy — an evidence-based intervention that has been shown to help treat drug addiction.

What happens if Albany says no to Adams’ proposal? Or if Adams is out of the mayoralty come the next legislative session?

The NYPD can still work to clear encampments. And the city can still try to divert drug users into its drug-courts system, which, while useful, faces administrative problems and lacks transparency.

But actually getting drug users the help they need, rather than just cycling them through the city’s jails, will be hard — much as the administration struggled to handle the seriously mentally ill before it had the power to compel them into treatment.

SOURCE: https://nypost.com/2025/08/14/opinion/involuntary-treatment-can-solve-the-public-drug-scourge/

by  Shalini Ramachandran  and Betsy McKay – Wall Street Journal – July 31, 2025

Hundreds of thousands of veterans with PTSD have been prescribed simultaneous doses of powerful psychiatric drugs. The practice, known as “polypharmacy,” can tranquilize patients to the point of numbness, cause weight gain and increase suicidal thoughts when it involves pharmaceuticals that target the central nervous system, according to scientific studies and veterans’ accounts. 

The VA’s own guidelines say no data support drug combinations to treat PTSD. The Food and Drug Administration warns that combining certain medications such as opioids and benzodiazepines can cause serious side effects, including death.

Nonetheless, prescribing cocktails of such drugs is one of the VA’s most common treatments for veterans with PTSD, and the number of veterans on multiple psychiatric drugs is a growing concern at the agency, according to interviews with more than 50 veterans, VA health practitioners, researchers and former officials, and a review of VA medical records and studies.

Polypharmacy has multiple definitions when it comes to central nervous system drugs. The VA defines it as taking five or more medications at the same time, while some medical researchers say it’s two or more and the American Geriatrics Society defines it as three or more. 

There is an emerging medical consensus among VA doctors and researchers that taking multiple central nervous system drugs can wreak havoc on patients. Interactions between such drugs aren’t well understood, and their effects in combination can be unpredictable and extreme.

SOME CASE HISTORIES …

Mark Miller

U.S. Navy, Security Forces (1992-2007)

In 2007, Mark Miller was diagnosed with PTSD. The military put him on fluoxetine, otherwise known as Prozac. He became suicidal. Miller eventually weaned himself off medications and used “neuroplasticity” therapy which forms new connections in the brain. This April, returning suicidal thoughts prompted Miller to visit a VA hospital in San Antonio. A nurse practitioner prescribed a powerful antipsychotic in a five-minute appointment. Six days later, Miller returned, stepped off a shuttle bus and fatally shot himself in the head. “He did it clearly to speak for all the veterans who have no voice,” his father said.

  • Aripiprazole
  • Bupropion
  • Cyclobenzaprine
  • Fluoxetine
  • Lithium
  • Quetiapine
  • Tramadol

‘They did not even listen to anything I said — just prescribed stuff. Unreal’— Text from Mark Miller to his father days before his suicide

The VA maintains that the best treatment for PTSD is talk therapy. But therapists are scarce and wait times are long, so overwhelmed doctors default to pills. Because there is no single drug designed specifically to treat PTSD, veterans often end up on drug cocktails as multiple specialists try to ease a variety of symptoms and prevent harm or suicide, according to VA clinical staff, studies and veterans. 

“When it comes to the challenge of polypharmacy in these populations, it’s constantly chasing your tail,” said Dr. Ryan Vega, a chief healthcare innovation official at the VA until 2023, who still treats veterans. “It is where medicine is more art than science. We have medications that treat those symptoms but are we addressing the root cause?”

Nearly 60% of VA patients with PTSD were taking two or more central nervous system drugs at the same time in 2019, the latest year for which data are publicly available, according to a VA study. That works out to more than 520,000 patients, up 62% from a decade earlier, driven by a near doubling of the number of VA patients with PTSD due to more combat tours and better screening. 

One silver lining highlighted by the study was that the percentage of PTSD veterans on five or more CNS medications declined to 7% from 12%, largely due to internal efforts to deprescribe opioids and benzodiazepines. (Central nervous system drugs affect the brain and spinal cord; psychiatric medications are a subset of CNS drugs). The VA declined requests from The Wall Street Journal to provide more recent polypharmacy numbers for veterans in its care. 

The VA has long been aware of the risks of overprescribing, and has internal research since at least 2016 showing the potential harms, including increased risk of suicide. The internal polypharmacy data “was pretty concerning,” said Dr. Shereef Elnahal, who headed the VA health system until early this year. He recalled a veteran advocate who told him about three veterans on more than five psychiatric drugs each who died by suicide, one after the other. They had been “walking around like zombies” before they took their own lives, the advocate told him. 

The VA’s use of psychiatric drugs has come under scrutiny from members of Congress and advocacy groups as the veteran suicide rate is roughly double that of U.S. adults who didn’t serve. Studies by VA researchers link the simultaneous use of multiple psychiatric drugs to suicide risk among veterans, including a 2016 paper that found Iraq and Afghanistan war veterans taking five or more central nervous system drugs faced higher risks of overdose and suicidal behaviors.

Lucas Hamrick

U.S. Army, Special Forces (1996-2019)

Lucas Hamrick was diagnosed with PTSD in the Army. There, and then at the VA, he was prescribed multiple central nervous system drugs. Some put him in a daze, others made him feel like he might want to kill himself. After losing 12 friends on similar drug combinations to suicide, Hamrick quit all the medications by 2023 and turned to meditation, mindfulness and breathing exercises. “It’s about structuring life around how not to let things spill over,” he said.

  • Chlordiazepoxide
  • Diazepam
  • Gabapentin
  • Hydrocodone-acetaminophen
  • Lorazepam
  • Naltrexone
  • Paroxetine
  • Phenobarbital
  • Prazosin
  • Propranolol
  • Rizatriptan
  • Sertraline
  • Trazodone

‘The quality of mental health care made me feel like I was there to check a box and complete the process instead of working toward any type of changes in perspective or disposition.’

Yet the agency has been slow to mandate changes. It has failed to implement nationwide electronic systems to alert doctors when they prescribe multiple psychiatric drugs, despite evidence from its own studies that these alerts improve care. The VA doesn’t uniformly require written informed consent for all psychiatric drugs with suicide risk, something that veterans groups and some members of Congress are urging. Some veterans who have resisted taking cocktails of drugs say they were warned by VA and military doctors that refusing them could jeopardize their eligibility for disability benefits, which can reach $4,500 a month.

“I’ve been mortified by practically every veteran I’ve seen having been prescribed multiple psychiatric medications, often without a timely referral to therapy or without any referral at all,” said Janie Gendron, a therapist who worked for the Defense Department and has seen hundreds of active-duty service members and veterans in the past 25 years.

A VA spokesman said the agency is looking into the issues raised by the Journal, and that the Trump administration is seeking to address serious problems it has identified in veterans’ healthcare that weren’t solved by the Biden administration. 

VA Secretary Doug Collins said at a congressional hearing in May that the agency is pursuing the potential use of alternative therapies, such as psychedelics, to offer more options and reduce the risk of suicide among veterans. 

The rise of the combat cocktail for PTSD has its roots in the overreliance on a single class of drugs: benzodiazepines. By the 1970s, the military and VA relied heavily on Valium and, later, Xanax as a primary treatment for traumatized service members and veterans returning from deployment. But in the 1990s, Defense Department researchers observed that high doses often yielded poor clinical outcomes, and, along with the VA, ultimately advised against their long-term use on veterans in 2004.

Still, against the guideline, the VA has doled out benzodiazepines to more than 1.7 million patients with PTSD diagnoses since 2005, its own data show. It took nearly a decade for the use of those drugs to start to decline.

At the same time, prescriptions to veterans with PTSD rose for other powerful psychiatric drugs.

VA doctors and patients say that existing tools to limit the number of psychiatric drugs a patient takes, and guidance to avoid the use of benzodiazepines and certain antipsychotics for veterans with PTSD, are frequently ignored.

A friend’s suicide

After his best friend’s suicide in 2013, Iraq war veteran Doug Gresenz was diagnosed with PTSD and borderline personality disorder and eventually put on six psychotropic drugs. After one medication’s dosage was increased, he attempted suicide and was hospitalized. When he protested the volume of medications there, he said VA doctors questioned his commitment to recovery and told him he needed the pills to lead a normal life. “I was guilt-tripped,” he said. 

Doug Gresenz

U.S. Marine Corps, Assaultman (2006-2010)

  • Baclofen
  • Bupropion
  • Citalopram
  • Clonazepam
  • Clonidine
  • Cyclobenzaprine
  • Divalproex
  • Doxepin
  • Erenumab-aooe
  • Eszopiclone
  • Gabapentin
  • Hydroxyzine
  • Melatonin
  • Methocarbamol
  • Mirtazapine
  • Olanzapine
  • Oxycodone
  • Prazosin
  • Propranolol
  • Sumatriptan
  • Quetiapine
  • Tizanidine
  • Tramadol
  • Trazodone
  • Venlafaxine
  • Zolpidem

‘I remember thinking: I’m literally poisoning myself.’

In 2016 alone, VA doctors prescribed him more than a dozen drugs, including antidepressants, antipsychotics, muscle relaxants and medications for nightmares, anxiety, pain and sleep, medical records show. Over little more than a decade, he received more than two dozen central nervous system medications. He recalled complaining to VA doctors that he was “so doped up” he would have accidents before getting to the bathroom.

“I remember thinking: I’m literally poisoning myself,” he said. In 2018, he quit benzodiazepines cold turkey and began to taper off the other drugs.

Within a couple of weeks, he collapsed, unable to use his legs. He developed a stutter and extreme light sensitivity. Violent spasms led to another fall, which caused complications that resulted in a severe foot injury and, eventually, an amputation last year.

The VA recommends any one of three antidepressants for PTSD—sertraline (Zoloft), paroxetine (Paxil) and venlafaxine (Effexor). But doctors are free to prescribe other additional drugs off-label—and many do.

“It’s super normal to see someone on five or six medications,” said Mary Neal Vieten, a retired Navy psychologist who has worked with thousands of members of the military and veterans. “That’s like an everyday thing.” Trauma has been medicalized, she said. “They’re acting as if the problem is in the person,” she said. Instead, it’s a normal response to an overwhelming experience, she said.

‘Stop-and-go’ pills

The culture of combat cocktails begins for some who are diagnosed with PTSD while still on active duty. In the military, too, drugs have long been given priority over psychotherapy, according to many veterans, former VA officials and therapists. 

One Navy chaplain said his repeated calls to the Navy for more mental health resources went unanswered despite his documentation of more than 70 critical events, including suicide attempts, at a high-stress installation with nuclear submarines. When the chaplain himself grew suicidal, Navy doctors suggested that refusing the three-medication cocktail they prescribed could lead to discharge without benefits, instead of medical retirement with care. 

Some veterans enter VA care dependent on psychiatric drugs that they were prescribed to improve combat readiness. They include Air Force veterans given “stop-and-go” pills—stimulants followed by sleeping pills. 

Michael Valentino, who was chief pharmacist at the VA until 2021, said he grew alarmed by the rising numbers of service members entering VA care on stimulants without a diagnosis justifying it. “Then the VA has the burden of trying to undo it.”

Heather King

U.S. Air Force, Aircraft Maintenance Craftsman (2001-2010)

Heather King struggled with sleep after the Air Force prescribed Ambien following long flights. After her discharge, she was diagnosed with PTSD, and the VA added eight central nervous system drugs by 2020. King begged for help weaning off. Her VA doctor’s response: “Heather, under no circumstances are you ever going to be a person who is going to operate without meds.” She’s lately been sleeping soundly without pills for the first time, thanks to cognitive behavioral therapy for insomnia—something the VA only told her about recently.

  • Amitriptyline
  • Buspirone
  • Cyclobenzaprine
  • Doxazosin
  • Doxepin
  • Duloxetine
  • Fluoxetine
  • Gabapentin
  • Hydroxyzine
  • Lamotrigine
  • Lorazepam
  • Mirtazapine
  • Prazosin
  • Propranolol
  • Ramelteon
  • Trazodone
  • Zaleplon
  • Zolpidem

‘It was like a death sentence. All these medications, they just made me numb. I wanted to feel my feelings, I wanted to actually heal.’

A Pentagon official said several medications at once are sometimes necessary for patients with multiple medical problems or who are treatment-resistant, adding that “records are reviewed to determine if the treating provider has provided clinical justification for the use of polypharmacy.” Service members and their families are offered “a robust and comprehensive array” of mental health programs, the official said.

Chemical messengers

Psychiatric drugs work by affecting levels of chemical messengers in the brain called neurotransmitters, which send signals between nerve cells and other cells in the body. For instance, many antidepressants increase levels of serotonin, a neurotransmitter associated with mood. Benzodiazepines enhance the activity of a neurotransmitter called GABA, while some antipsychotics block dopamine receptors. Layering on several of these central nervous system agents at once can magnify their effects. 

Combining an antipsychotic drug that activates dopamine receptors with one that blocks dopamine can exacerbate psychosis, said Dr. Sanket Raut, a research fellow specializing in polypharmacy at Gallipoli Medical Research in Brisbane, Australia. By the same token, benzodiazepines and opioids taken together can increase the risk of overdose. “Polypharmacy is a big problem,” said Raut. “There are many side effects: cognitive impairment, dizziness and the risk of falls.”

Erika Downey

U.S. Army, Military Police (2007-2013)

Amphetamine-Dextroamphetamine

  • Clonazepam
  • Erenumab-aooe
  • Fluoxetine
  • Lorazepam
  • Trazodone

‘They give out these giant paper bags filled with medicine after your first psychiatrist appointment.’

“They give out these giant paper bags filled with medicine after your first psychiatrist appointment,” said Erika Downey, a 35-year-old retired Army sergeant with PTSD. Women are more likely to be prescribed multiple drugs concurrently against guidelines, VA researchers have found. 

Downey’s bouts of suicidal ideation while taking antidepressants, benzodiazepines and stimulants were so bad she once called a friend to come take away her gun. After that, she decided talk therapy would be the best medicine. She weaned herself off the drugs on her own over two years. She had to wait three years for a VA psychotherapy appointment. “At the VA, you are more quick to get into a psychiatrist”—someone who can prescribe meds—“than a psychologist,” she said. Gray for WSJ

Only 15% of veterans diagnosed with depression, PTSD or anxiety are offered psychotherapy in lieu of medication, according to a 2019 report by the Government Accountability Office. “They’re really leveraging the prescribing to keep up with patient demand,” said Derek Blumke of the Grunt Style Foundation, a nonprofit veterans’ care group. Many VA providers’ impulse is to “get them in and get them out,” said Chris Figura, a patient advocate at a VA in St. Louis.

Navy veteran Dick Johnson, in the VA system for three decades and diagnosed with PTSD and bipolar disorder, was prescribed more than 25 different central nervous system drugs, including antipsychotics, antidepressants and epilepsy medications, sometimes on six concurrently, his medical records show. He blames them for the collapse of his two marriages. “They pretty much destroyed my life,” Johnson said. When he worsened on one antipsychotic and experienced intense withdrawal tapering off, VA doctors tried to patch him up with a cocktail of other medicines including benzodiazepines. In 2006, he started a prolonged dose of Seroquel, a powerful antipsychotic, to get off benzodiazepines, because doctors said it was supposed to be easier to stop. His weight soared and he developed diabetes. Quitting Seroquel “nearly killed” him, as he suffered intense vomiting, diarrhea and a near-inability to digest. He’s still tapering off Paxil and Tegretol today, using a jewelry scale and sandpaper.

Drugged for Decades

Dick Johnson, who joined the Navy in 1989, was diagnosed with bipolar disorder. After he was medically discharged in 1994, the VA put him on a heavy regimen of psychiatric drugs that made matters worse.

  • Medications prescribed, by class and date
  • Mood Stabilizers Anti- Psychotics Anti- Anxiety Anti-Depressant Medicated with lithium, which makes him severely ill 1995
  • Lithium Divorce with first wife  2000
  • Second marriage ’05 PTSD diagnosis
  • Divorce with second wife Seroquel ’10
  • Retires with disability from power plant ’15
  • Side effects of medications lead to ICU visit. Seeks help outside VA to taper off meds ’20
  • After cutting backmeds, joinssupport groupsand shares hisexperience
  • Note: Does not include all medications, including those prescribed for short durations.

Dr. Saraswathy Battar, a VA geriatrician, launched a passion project in 2016 to decrease the use of potentially inappropriate medications. After noticing veterans suffering from debilitating symptoms that she attributed to overprescription, she developed an electronic tool that has helped providers discontinue more than three million prescriptions. About half of VA providers are using the optional tool, she said, but they’re mostly caring for older veterans or those in palliative care, while it’s been hard to get mental health providers to adopt the tool. Some said they were unaware of its existence. “Suicide and homicide get attention,” but “there’s no penalty for not prioritizing polypharmacy reduction,” she said.

A path forward

After years on psychiatric drug regimens prescribed by military and VA doctors, a growing number of veterans are taking healing into their own hands, often exploring unconventional treatments. Many veterans said they are frustrated and angry that the country spends heavily training them to be lethal, but there’s little support for their fragile mental health as they reintegrate back into society.

Scott Griffin, the former special operations soldier who contemplated suicide last year, reached out to a group called Veterans Exploring Treatment Solutions, or VETS, after the episode. Their suggestion: ibogaine, a powerful psychedelic derived from an African plant and illegal in the U.S., but only after tapering off his current medications. When Griffin asked his VA prescriber for help tapering, “he point-blank refused,” Griffin said.

He embarked on a gruelling self-taper. “I was white knuckling. I broke my teeth from clenching,” he recalled, battling intense vertigo and suicidality.

After 12 hours of altered consciousness on ibogaine in Mexico, Griffin took 5-MeO-DMT, a psychoactive compound most famously found in Colorado River toads’ poison, which he says was a profound spiritual experience. Since returning home in March, he has discarded his pills, prays daily and spends time with family, reconnecting after years of being “consumed by panic and anxiety.”

A Stanford study of 30 special operations forces veterans published last year found that ibogaine sharply reduced PTSD and related symptoms. A bipartisan bill in the House aims to fund VA research into psychedelics, which doctors caution remain largely unproven in clinical trials. 

Says Griffin, “How does bark from a tree and venom off the back of a toad beat all this crap, all these pharmaceuticals they push down your throat?”

Source:  Maggie Petito – www.drugwatch.org

new study from researchers at the Johns Hopkins Bloomberg School of Public Health sheds light on how people who inject drugs (PWID) are responding to the growing instability and danger in the U.S. illicit drug supply. Despite facing structural vulnerabilities, participants in the study demonstrated a keen awareness of changes in drug quality and content, and many are taking proactive steps to reduce their risk of overdose, injury, and other harms.

Published July 24, 2025, in the journal Health Promotion International, the qualitative study explores the experiences of 23 PWID in Baltimore City, where a growing number of opioid-related deaths and the emergence of new, harmful adulterants like xylazine have made drug use increasingly perilous. Participants reported encountering potent and unpredictable drug combinations and described cognitive, behavioral, and social strategies they use to navigate this new reality. Notably, the paper’s publication comes just two weeks after a mass overdose in Baltimore’s Penn North neighborhood sent dozens of people to the hospital in the span of a few hours and tests revealed unfamiliar ingredients.

“We found that people who inject drugs are not indifferent to the risks they face,” said lead author Abigail Winiker, PhD, MSPH, an assistant scientist in Health Policy and Management and program director for the Bloomberg Overdose Prevention Initiative. “They are making conscious decisions every day to protect their health, whether that’s testing a small dose, avoiding injecting alone, switching to less risky methods of use, or sharing safety information with peers. These are intentional harm reduction strategies grounded in knowledge and a desire to stay safe.”

The U.S. continues to grapple with a historic overdose crisis, with over 107,000 deaths reported in 2022 alone. Fentanyl and its analogs now dominate the opioid supply, but new substances, often unknown to users, are increasingly present. Participants in the study described a “wildcard” market where real heroin has been replaced by unpredictable blends, sometimes laced with benzodiazepines, dissociative agents, or tranquilizers like xylazine, which are not meant for human consumption.

The uncertainty has led to intense fear and physical harm among PWID, with many recounting a range of adverse reactions from illicit substance use, including blackouts, seizures, severe wounds, and overdose. Despite the increasing risk associated with these drug market changes, most participants reported having no access to a reliable source of information about the composition of the drug supply, making it challenging to adapt in the face of new additives. Most knowledge about specific risks or harmful batches was passed on through word of mouth, which could perpetuate rumors and the spread of misinformation.

Individual and Collective Adaptations 

The study highlights the wide array of harm reduction strategies participants use to mitigate risk. Cognitively, many indicated thinking about their drug use in terms of personal health and family responsibilities, with some expressing a motivation to seek treatment or abstain from use entirely in the face of an increasingly risky drug supply.

Behaviorally, PWID described strategies such as taking smaller test doses, sniffing instead of injecting, and having someone present who could administer naloxone if needed. Socially, trust played a critical role; participants emphasized returning to known sellers who warned them about potent batches and relying on peer networks to spread information about adverse events or dangerous batches in circulation. 

“These strategies reflect a deep sense of agency and adaptability,” said Winiker. “Our findings debunk the dangerous myth that individuals who use drugs are reckless or disconnected from their health. This false narrative perpetuates stigma and limits our ability as a society to recognize the incredible resilience and strength of people who use drugs.” 

Policy and Programmatic Implications 

The authors argue that these findings should inform more responsive public health policies and harm reduction programming. While fentanyl test strips can be an effective intervention, many participants noted that fentanyl’s presence is now expected, but what they fear are the unknown additives they cannot identify or test for, such as those that were found in the case of the mass overdose two weeks ago. Universal drug checking services, real-time supply surveillance, and mobile harm reduction outreach are critical next steps, the study concludes.

The research also points to the urgent need to remove structural barriers to harm reduction. In many states, drug checking equipment is still considered illegal paraphernalia. Criminalization and stigma continue to limit access to lifesaving services, especially among those who are unhoused or medically underserved. 

“People who inject drugs are doing their part to reduce harm,” said Winiker. “It’s time to reform our systems so they stop making it harder for them to do so, by legalizing drug checking, ensuring individuals with lived experience have leadership roles in overdose prevention and response efforts, investing in safer supply programs, and ensuring that stigma and punitive laws don’t block access to care.”

The study was conducted as part of the SCOPE Study, a project led by Susan Sherman, PhD, MPH, to design an integrated drug checking and HIV prevention intervention. It was supported by the National Institute on Drug Abuse and reflects growing interest in how PWID are adapting to the post-fentanyl era.

Source:  https://publichealth.jhu.edu/2025/in-the-face-of-a-volatile-drug-supply-people-take-harm-reduction-into-their-own-hands

by Rachel Girarda, PATHS Lab, Department of Psychology, University of Rhode Island, Kingston, RI, USA

Background: American Indian communities consistently identify adolescent substance use as a major concern. However, limited empirical work has examined how culturally specific protective factors – such as family disapproval and cultural affiliation – interact to influence substance use behavior. Given the importance of kinship networks and cultural continuity, understanding these dynamics is critical for informing culturally grounded prevention strategies.

Objectives: This study examines the moderating role of cultural affiliation in the association between family disapproval of substance use and actual use among American Indian adolescents, a population often excluded from national health datasets.

Methods: Secondary analysis was conducted using self-report data from the Our Youth, Our Future study, a nationally representative sample of American Indian adolescents attending schools on or near reservations (N = 8,950; 51% female; Mage = 14.64 years, SD = 1.77).

Results: Multilevel analyses revealed that family disapproval was negatively associated with lifetime alcohol (b = −0.15, p < .001) and cannabis use (b = −0.34, p < .001), controlling for age. Among adolescents who endorsed use, cultural affiliation moderated the relationship between family disapproval and past-year alcohol and cannabis use. Specifically, family disapproval was significantly associated with lower alcohol use at high (b = −0.01, p = .002) but not low (b = −0.07, p = .48) levels of cultural affiliation. For cannabis use, the association was stronger at high (b = −0.51, p < .001) versus low (b = −0.32, p = .005) levels.

Conclusions: Cultural affiliation strengthens the protective effects of family disapproval on substance use among American Indian youth. Findings support culturally responsive, family-based prevention efforts that promote cultural identity and intergenerational communication.

Source: https://www.tandfonline.com/doi/full/10.1080/00952990.2025.2535557?src=

“There’s no ID required. It’s odorless. It’s everything kids look for. They can afford it, they can get it, and it doesn’t show in mom and dad’s drug test.” 

Dana O’Rourke lost her 19-year-old daughter to “dusting,” a trend popularized on social media.1 Dusting is one of the many slang terms used to describe the use of inhalants. As O’Rourke says, inhalants are easy to get and generally undetectable, making it appealing to young people. Below, learn more about dusting and huffing, the signs of inhalant misuse, and how to keep your child safe.

Key Takeaways:

  1. Inhalant misuse: Huffing and dusting involve inhaling substances like aerosol sprays or household chemicals, posing serious health risks.
  2. Warning Signs: Look for unusual chemical odors, headaches, dizziness, slurred speech, and behavioral changes.
  3. Prevention: Educate loved ones, keep chemicals out of reach, monitor activities, and seek professional help if needed.

What Are Inhalants?

 Inhalants are everyday household products that some people misuse to get high. This dangerous practice has many slang names including “huffing,” “dusting,” “sniffing,” “whippets,” and “huff.” (see other terms at the end of this article) These products were never meant to be breathed in on purpose and using them this way can cause serious harm or even death.2

Common household items that get misused include:3

  • Computer keyboard cleaners (canned air)
  • Spray paint
  • Nail polish remover
  • Certain types of glue
  • Markers and correction fluid
  • Hair spray and deodorant
  • Cooking spray
  • Cleaning fluids
  • Gasoline
  • Whipped cream dispensers (the propellant)
  • Air conditioner fluid (Freon)

Why This Is Happening More Often

 Inhalant misuse has become more visible, especially among younger teens. There are several reasons why this is concerning:

Easy to Find: Unlike other substances, these products are legal and found in almost every home, school, and store. Kids don’t need to buy anything special or find a dealer.

Social Media Influence: Some social media challenges and videos show people using inhalants, making it seem normal or fun. These videos don’t show the real dangers or the people who get seriously hurt.

False Safety: Because these products are sold in stores, some people think they must be safe to use in any way. This is far from the truth. (There are stores dedicated to the sale of alcohol, for example, and alcohol comes with many health risks.)

Quick Effect: Inhalants work very fast – within seconds of breathing them in, a person feels intoxicated with effects similar to being drunk on alcohol. This quick effect can make them appealing to curious teens, but it’s also what makes them so dangerous. 

The Real Dangers

 Using inhalants is extremely risky, even the first time. Here’s what can happen:

  • Immediate Effects: Within seconds, users may experience slurred speech, inability to coordinate movements, dizziness, confusion, delirium, nausea, and vomiting. They may also have lightheadedness, hallucinations, and delusions.
  • Sudden Death: This can happen to anyone, even healthy people using inhalants for the first time. It’s called “sudden sniffing death syndrome.”
  • Brain Damage: Inhalants can permanently damage parts of the brain that control thinking, moving, seeing, and hearing. Effects can range from mild problems to severe dementia.
  • Heart Problems: These chemicals can cause irregular heartbeat and heart failure.
  • Suffocation: People can pass out and stop breathing.
  • Dangerous Behavior: Because the high only lasts a few minutes, people often keep using inhalants over several hours to maintain the feeling. This greatly increases the risk of losing consciousness and death.
  • Long-term Problems: Regular use can cause weight loss, muscle weakness, disorientation, trouble paying attention and other problems related to thinking, lack of coordination, irritability, and depression. After heavy use, people may feel drowsy for hours and have lasting headaches.  Their use can also lead to addiction.

Warning Signs Parents Should Watch For

 Parents and other caregivers should look out for these signs of inhalant misuse:

Physical Signs:

  • Chemical smell on breath or clothes
  • Paint stains on face, hands, or clothing
  • Red or runny nose and eyes
  • Spots or sores around the mouth
  • Drunk-like behavior without alcohol smell
  • Loss of appetite

Behavioral Changes:

  • Sudden mood swings
  • Becoming secretive or isolated
  • Declining grades
  • Loss of interest in hobbies or friends
  • Finding hidden cans, bottles, or rags

Items Around the House:

  • Empty spray cans or bottles
  • Missing household products
  • Rags or clothing that smell like chemicals
  • Hidden bags or balloons

What Parents Can Do

 Talk Early and Often: Have honest conversations about drugs and inhalants before problems start. Explain that legal doesn’t mean safe. Other important messages are:

    • No temporary feeling is worth risking your life or permanent brain damage.
    • Real friends won’t pressure you to try dangerous things. It’s okay to say no.
    • Remember that social media doesn’t show the whole story. Videos don’t show the people who got seriously hurt or died.
  • Secure Products: Keep inhalants locked up or in hard-to-reach places, especially if you suspect a problem.
  • Stay Involved: Know your child’s friends, activities, and where they spend time.
  • Monitor Online Activity: Be aware of what your kids see on social media and talk about dangerous trends.
  • Get Help: If you suspect inhalant misuse, contact your doctor, school counselor, or an addiction professional immediately.

If you discover that your child is under the influence of inhalants:

  • Don’t leave them alone if they seem confused or sick
  • Call 911 if they pass out or have trouble breathing
  • Encourage them to talk about why they are using inhalants
  • Connect with Partnership to End Addiction for guidance and resources 

Additional Terms and Information

 The following provides more information on inhalants from “The Clinical Assessment and Treatment of Inhalant Abuse”:4

  • Bagging: inhaling fumes from a soaked cloth sprayed with euphoria-inducing substances and deposited inside a paper or plastic bag.
  • Ballooning: inhaling a gas (usually nitrous oxide) from a balloon.
  • Chroming: spraying paint from an aerosol can into a plastic bag and then breathing the vapors from the bag.
  • Dusting: spraying an aerosol directly into the nose or mouth.
  • Gladding: inhaling air-freshener aerosols sprayed near the face.
  • Glue sniffer’s rash/huffer’s rash: refers to a skin condition that occurs around the mouth and midface. Glue or other chemicals dry out the skin and dissolve its natural oils, leading to inflammation, redness, and sometimes infections.
  • Huffing: inhaling a substance from a cloth or rags that have been soaked and are held close to the face.
  • Poppers/snappers: amyl nitrite packaged in small bottles that are opened to release the vapors; sold under trade names Super Rush, Locker Room, Bolt, Jungle Juice, Quick Silver, and Extreme Formula.5
  • Popper’s maculopathy: is damage to vision in the central part of the retina caused by using alkyl nitrites, which are chemicals often found in certain inhalants.
  • Sniffing/snorting: inhaling a substance from an open container directly through the mouth or nose.
  • Snotballs: inhaling smoke from the burning of rubber cement, where the adhesive is rolled into balls then burned to release the fumes.
  • Whippets: vials of nitrous oxide gas, most commonly from whipped cream aerosol canisters. The nitrous oxide can be extracted following whipped cream discharge, after which the released gas can be inhaled at close range or transferred to a balloon and then inhaled.

The Bottom Line

 Inhalant use might seem harmless because these products are common household items, but it’s one of the most dangerous forms of substance use. The risk of serious injury or death is real from the very first use. By understanding the dangers, staying informed, and learning how to spot the signs of inhalant misuse, parents can better protect their families.

Remember: There is no safe way to use inhalants. The only safe choice is not to use them at all. If you’re concerned about your loved one, don’t hesitate to reach out to us for support.

Source: https://drugfree.org/article/huffing-dusting-signs-of-inhalant-misuse-parents-should-know/

 

OPENING REMARK BY NDPA:

Dianova presents itself as a “Swiss NGO recognized as a Public Utility organization, committed to social progress”. Examination of their publications places them as an organisation which is less committed to primary prevention than to reactive approaches, such as harm reduction. A telling quote in this context comes in their publication entitledBetween Music and Substances: a Look at Drug Use at Festivals” they introduce this by saying Drug use is a common occurrence at most music festivals: how can we promote self-care and harm reduction among participants?”there is no mention of prevention as a policy option.

In their ‘history’ Dianova take a position found not infrequently in some other other critics of prevention i.e. any prevention program which does not achieve 100% success is deemed a failure … but no such assessment is made of reactive or accepting policies.

In this publication they dismiss the ‘Just Say No’ program as “…focusing mainly on white, middle-class children, it simply pointed the finger at others, particularly black communities, who were held responsible for the problem.” And yet immediately below this statement they include a photo of a White House ‘Just Say No’ rally, with Nancy Regan surrounded by black youngsters.

Dianova make judgemental remarks – without supporting evidence – in several places, and NDPA take would issue with several of these, but we have elected to retain this paper complete with their judgemental remarks, to illustrate their position on the ‘history’ as they see it.

by the Dianova.org team – 

From the early 20th century to the present day, an overview of the origins of drug use prevention, past mistakes and the current situation in this field

By the Dianova team – Over the past 40 years, prevention has become a key focus of public intervention in many areas, including responses to social issues such as alcohol and other drug use. Prevention strategies are now most often part of a comprehensive approach combining prevention, treatment and harm reduction, and taking into account the needs of people who use drugs and those of society as a whole.

These initiatives are developed on the basis of applied research in the humanities and social sciences, and their implementation and evaluation are based on scientifically validated strategies designed to answer one key question: do they work?

Understanding risk factors is crucial in modern drug prevention interventions, as it enables us to address the root causes of substance use and promote protective factors such as strong family bonds, engagement with school, and community support – Image by stokpic from pixabay, via Canva

Rather than raising awareness of the ‘dangers of drugs’, most initiatives today prefer to target risk factors and protective factors at the individual, family, community and environmental levels. These interventions are designed to be person-centred, while taking into account the many complex interactions between personal and environmental factors that may make certain populations more vulnerable to substance use or addiction. However, this has not always been the case. So what was prevention like before? Is prevention today so different from what it was in the past?

The origins of prevention: combating the ravages of alcohol

All forms of prevention stem from the 19th-century school of thought influenced by Pasteur’s work on the spread of disease: hygienism. This developed in a society plagued by diseases such as tuberculosis and cholera, which were widespread in most European countries, as well as in India, the United States and Canada.

With regard to substance use, it was alcohol that initially became the focus of efforts in Western countries. . In the countries concerned, the Industrial Revolution caused a profound change in drinking habits and exacerbated related problems. The advent of industrialization precipitated a period of exponential growth in the production, transportation and commercialization of alcohol. In urban areas, which experienced a significant increase in population following the rural exodus, millions of workers, reliant on their employers and lacking in social rights, found solace in alcohol, which had become readily available and inexpensive. Alcohol consumption increased significantly, as did the associated problems.

The temperance movement, a group of religious associations and leagues committed to combating the social ills of alcoholism, fought against the consumption of alcohol in the name of morality, good manners and the protection of the family unit. The influence of this movement grew until it reached its zenith in the early 20th century with the advent of alcohol prohibition laws, not only in the United States, but also in Canada, Finland and Russia – with the results we all know.

“The voluntary slave” – press illustration published in “La Fraternité” (France) for the Popular Anti-alcoholic league, author Adolphe Willette – circa 1875 – Adapted from screenshot from L’histoire par l’image

What about illegal drugs?

At the dawn of the 20th century, the concept of ‘illegal’ drugs had yet to be established. Europe and America had recently discovered a ‘remarkable substance’ – cocaine – lauded for its medicinal properties, touted as a panacea for all maladies. Initially imported in small quantities for medical research, its use grew rapidly, particularly within the medical community, and it was prescribed to treat a wide range of ailments, from toothache to morphine addiction. Sigmund Freud himself considered at the time cocaine to be a highly effective medicine for depression and stomach problems without causing addiction or side effects. With regard to cannabis and hashish, these were still available for purchase in all reputable pharmacies, while heroin, a registered trademark of the Bayer pharmaceutical company, was regarded as a sovereign remedy for… coughs.

It should be noted that the issue of substance addiction had not yet manifested itself in the context of affluent, colonizing nations. Elsewhere, the perspective was somewhat different: in a distant country – China – opium had already been wreaking havoc for several decades.

Introduced and marketed by Europeans, it had become a pervasive national scourge affecting millions of Chinese people. Opium  addiction is a prime example of the impact of colonialism on local societies: not only did it trigger two wars against Western powers concerned solely with their economic interests (profits from the opium trade), but it also had profound social and political consequences that are still felt today.

The Western countries’ ‘honeymoon’ with drugs was not to last. The problems they posed became apparent rapidly and, under the influence of American temperance leagues, they swiftly transitioned from being regarded as a universal remedy to being perceived as a threat to society and moral values. This marked the beginning of American policies predicated on drug control (or the war on drugs, depending on one’s perspective), which would shape global policies in this domain for over a century.

The demonization of ‘drugs’

The demonisation of drugs, the effects of which were felt from the beginning of the 20th century, is closely associated with a set of social, racial, political and economic dynamics that resulted in the stigmatization of both the substances themselves and the people who consumed them. As early as 1906, the United States initiated the legislative process, and the phenomenon grew until it culminated in a particularly restrictive and repressive international drug control policy – but that is another matter.

In the 1930s, the American government initiated a media offensive involving the use of racist stereotypes, sensationalist media, and political propaganda to portray cannabis as a dangerous substance that led to violence, insanity, and moral decay.

The process of demonizing drugs was gradual yet unstoppable. The discourse surrounding narcotics such as morphine, opium and heroin was initially shaped by their association with specific demographic groups, namely minorities, the economically disadvantaged, and migrants. This demonization continued over the following decades, fuelled by media sensationalism and public panic, particularly around the use of cocaine and cannabis – substances that were claimed to be the root cause of criminal behaviour and moral corruption.

The criminalization and stigmatization of substances and those who use them have had a profound impact. Not only have they perpetuated and reinforced racist prejudices against Afro-descendant, Latin American and other historically marginalized communities, but they have also completely distorted the approaches and prevention efforts implemented subsequently.

Early drug prevention initiatives

Before the 1960s, the ‘drug phenomenon’ was virtually non-existent in industrialised countries. Apart from a few opium enthusiasts, alcohol and tobacco reigned supreme in the field of substance addiction.

From the 1960s onwards, there was a rapid increase in the use of illegal drugs in the United States, particularly among the counterculture movement. The use of LSD and cannabis – and, to a lesser extent, amphetamines and heroin – spread and became a symbol of rebellion against authority, as part of a broader movement focused on social change.

Within the collective imagination, the 1960s are often regarded as the golden age of illegal drug use. This period was characterised by widespread use of cannabis, as well as the significant distribution of heroin among children in impoverished neighbourhoods. Notable figures such as Timothy Leary, a prominent Harvard professor, popularised the effects of LSD. However, an analysis of historical data reveals that the phenomenon was not as widespread as is commonly believed. Conversely, however, there was a marked increase in the perception of risk associated with drugs. For instance, in 1969, a mere 4% of American adults reported having used cannabis at least once. However, 48% of respondents indicated that drug use was a serious problem.

While many current prevention efforts have a solid theoretical basis and evidence of effectiveness, historic prevention strategies were often based on intuition and guesswork, with an emphasis on such scare tactics as the one depicted above (“Your brain on drugs” campaign, initially launched in 1987)

The notion of prevention as a concept was first developed in the early 1960s within the domain of mental health and behavioural disorders. In the context of drug policy, the first initiatives were echoing the pervasive fear of drugs that was prevalent in both America and Europe during that period. Logically, the primary initiatives were consistent with the propaganda campaigns initiated in previous decades with the objective of demonizing cannabis. The objective of these initial prevention initiatives was not to promote education, but rather to instil a sense of fear and intimidation.

Children and young people in the 1960s and 1970s were no more stupid than anyone else and just as observant. They quickly realised that the messages promoted by schools and families did not correspond to reality.

So simple, ‘Just Say No’.

In 1971, Richard Nixon declared drug abuse ‘public enemy number one’ and launched a widespread campaign against drug use, distribution and trafficking. This marked the beginning of a government policy that led to the incarceration of both traffickers and users. The policy would have far-reaching consequences for many countries, whilst in the United States it would have a disproportionately negative impact on the Black community.

The notion that one should ‘Just Say No’ to drugs is predicated on a rudimentary interpretation of the rational choice model, according to which people choose their behaviour in order to maximize rewards and minimize costs (negative consequences).

Nancy Reagan at a “Just Say No” rally at the White House in May 1986 – White House Photographic Collection, public domain

The D.A.R.E. programme: information is not enough

From 1983 onwards, this concept became central to the D.A.R.E. (Drug Abuse Resistance Education) programme. Initially implemented in Los Angeles, this school-based programme aimed to help young people understand that the harmful consequences of drug use far outweigh any perceived benefits. Young people can therefore avoid these consequences by refusing to take drugs.

The D.A.R.E programme’s model was based on three key elements: 1) drugs are bad; 2) when children understand how bad drugs are, they will avoid using them; and 3) the message is more effective when delivered by police officers, who are considered credible.

The programme was subsequently developed in the United Kingdom, and a similar model was adopted elsewhere in Europe during the same period — notably by associations of rehabilitated individuals — which replaced the credibility of police officers with that of former drug users ‘who could speak from experience’.

In response to findings on the ineffectiveness of the DARE programme, a new curriculum was developed (2009) with a stronger focus on interactive activities and decision-making skills, moving away from the traditional lecture-based approach by a police officer – AI-generated image, via Canva

Over the years, the programme has been the subject of extensive study. One study found that people who completed the programme had higher levels of drug use than those who did not. Another study found that teenagers enrolled in the D.A.R.E programme “were just as likely to use drugs as those who received no intervention”.

The impact of popular culture

The aim here is not to portray the D.A.R.E. programme or similar interventions solely in an unfavourable or ridiculous light. Even though it has lost its central position, the programme is still implemented in most US states, and according to its website, it has been developed in 29 countries since its creation. It is true that the programme has since been adapted to incorporate various aspects, such as resistance to peer pressure and the development of social skills.

However, these initiatives face a major difficulty from the outset. As we know, experimentation and risk-taking are part of normal adolescent development, which is why providing young people with detailed information about different substances is likely to arouse their interest in these drugs, especially if the information is not presented in an appropriate manner. Secondly, this type of strategy only has an impact on young people who are susceptible to alarmist messages because of their cognitive patterns, and is not effective for everyone else, as we now know.

Officers in the DARE programme would sometimes arrive in sports cars seized from drug traffickers to exemplify their message on drugs and crime (Crime does not pay) – A Pontiac Firebird in D.A.R.E. livery in Evesham Township, New Jersey – image: Jay Reed – Flickr, licence: CC BY-SA 2.0

Furthermore, when talking about drugs, one must also consider the influence of popular culture, which, without openly glorifying substance use, often portrays alcohol, tobacco, and other drugs in a favourable light, particularly at an age when young people are most receptive.

We now know that providing information about drugs is not enough to make for a good prevention policy. While education and awareness can always play an important role, they are not sufficient, nor even necessary, to prevent addiction.

Should we talk about drugs to prevent drug use?

According to Dr Rebecca Haines-Saah, who spoke at a webinar organised by Dianova last May, the most effective drug prevention strategies do not focus on drugs, but on much broader social issues, such as reducing poverty, combating discrimination and implementing targeted community programmes.

These approaches aim to create conditions that indirectly discourage drug use, particularly by strengthening social skills and improving people’s living conditions. For example, programmes focused on improving the school environment, teaching social skills or promoting healthy lifestyles can have a positive impact on reducing substance use without explicitly targeting drugs.

Similarly, family interventions that strengthen parent-child relationships and improve communication can also help prevent substance misuse by targeting underlying risk factors. These strategies highlight the importance of a holistic approach to prevention that goes far beyond direct drug education.

Prevention is a science

Preventing substance use – i.e. the use of all psychoactive substances regardless of their legal status –  involves helping people, particularly young people, to avoid using substances. If they have already used substances, the objective is to prevent them from developing substance use disorders (problematic use or dependence).

However, the overall objective is much broader, as highlighted by the UNODC in the second edition of the International Standards on Drug Use Prevention. It also involves ensuring that children and adolescents grow up healthy and safe, so they can fulfil their potential and become active and productive members of society.

Drug prevention is now grounded in research and evidence-based practices. This multi-disciplinary field has developed over the last forty years, aiming to improve public health by identifying risk and protective factors, assessing the efficacy of preventive interventions, and identifying optimal means for dissemination and diffusion –  AndreyPopov from Getty Images, via Canva

There is now a vast body of literature on substance use prevention. Its aim is to highlight effective and less effective strategies based on scientific evidence in order to guide decision-makers and practitioners in the field in their choices. Despite this, prevention activities are still sometimes poorly prepared and based primarily on beliefs or ideologies rather than scientific knowledge.

At Dianova, we believe that addiction prevention, particularly among young people, must take into account societal changes (new drugs, new patterns of use, changes in legislation, etc.) using scientifically validated strategies based on standards and methodological guidelines.

These strategies are based in particular on:

  • The acquisition of psychosocial skills (problem solving, decision-making, interpersonal skills, stress management, etc.),
  • Interventions aimed at developing parenting skills (e.g. communication skills, conflict management, setting boundaries, etc.),
  • Prevention strategies tailored to young people with vulnerability factors (e.g. those whose parents suffer from substance use disorders) and taking into account gender perspectives, abandoning androcentric strategies that obscure the situation of girls and LGBTQI+ communities.

In conclusion, we must bear in mind the mistakes of the past so as not to repeat them and, above all, understand that no prevention system is sufficient on its own. Whatever approach is chosen, effective prevention systems must be evidence-based and integrated into broader, balanced systems that focus on health promotion, the treatment of substance use disorders, risk and harm reduction, and countering drug trafficking.

Effective, science-based programmes that can make a real difference to people’s lives can only be developed by integrating all these elements.

Source: https://www.dianova.org/publications/a-brief-history-of-drug-prevention/

OPENING STATEMENT BY NDPA

We repeat this 2004 article by Stanton Peele as a useful position statement for us all.  Peele’s classic 1975  text ‘Addiction and Love’ (Peele and Brosky – Published: Taplinger, New York) is also well worth reading in this context.

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

By Stanton Peele Ph.D. published May 1, 2004

More people quit addictions than maintain them, and they do so on their own. People succeed when they recognize that the addiction interferes with something they value—and when they develop the confidence that they can change.

Change is natural. You no doubt act very differently in many areas of your life now compared with how you did when you were a teenager. Likewise, over time you will probably overcome or ameliorate certain behaviors: a short temper, crippling insecurity.

For some reason, we exempt addiction from our beliefs about change. In both popular and scientific models, addiction is seen as locking you into an inescapable pattern of behavior. Both folk wisdom, as represented by Alcoholics Anonymous, and modern neuroscience regard addiction as a virtually permanent brain disease. No matter how many years ago your uncle Joe had his last drink, he is still considered an alcoholic. The very word addict confers an identity that admits no other possibilities. It incorporates the assumption that you can’t, or won’t, change.

But this fatalistic thinking about addiction doesn’t jibe with the facts. More people overcome addictions than do not. And the vast majority do so without therapy. Quitting may take several tries, and people may not stop smoking, drinking or using drugs altogether. But eventually they succeed in shaking dependence.

Kicking these habits constitutes a dramatic change, but the change need not occur in a dramatic way. So when it comes to addiction treatment, the most effective approaches rely on the counterintuitive principle that less is often more. Successful treatment places the responsibility for change squarely on the individual and acknowledges that positive events in other realms may jump-start change.

Consider the experience of American soldiers returning from the war in Vietnam, where heroin use and addiction was widespread. In 90 percent of cases, when GIs left the pressure cooker of the battle zone, they also shed their addictions—in vivo proof that drug addiction can be just a matter of where in life you are.

Of course, it took more than a plane trip back from Asia for these men to overcome drug addiction. Most soldiers experienced dramatically altered lives when they returned. They left the anxietyfear and boredom of the war arena and settled back into their home environments. They returned to their families, formed new relationships, developed work skills.

Smoking is at the top of the charts in terms of difficulty of quitting. But the majority of ex-smokers quit without any aid––neither nicotine patches nor gum, Smokenders groups nor hypnotism. (Don’t take my word for it; at your next social gathering, ask how many people have quit smoking on their own.) In fact, as many cigarette smokers quit on their own, an even higher percentage of heroin and cocaine addicts and alcoholics quit without treatment. It is simply more difficult to keep these habits going through adulthood. It’s hard to go to Disney World with your family while you are shooting heroin. Addicts who quit on their own typically report that they did so in order to achieve normalcy.

Every year, the National Survey on Drug Use and Health interviews Americans about their drug and alcohol habits. Ages 18 to 25 constitute the peak period of drug and alcohol use. In 2002, the latest year for which data are available, 22 percent of Americans between ages 18 and 25 were abusing or were dependent on a substance, versus only 3 percent of those aged 55 to 59. These data show that most people overcome their substance abuse, even though most of them do not enter treatment.

How do we know that the majority aren’t seeking treatment? In 1992, the National Institute on Alcohol Abuse and Alcoholism conducted one of the largest surveys of substance use ever, sending Census Bureau workers to interview more than 42,000 Americans about their lifetime drug and alcohol use. Of the 4,500-plus respondents who had ever been dependent on alcohol, only 27 percent had gone to treatment of any kind, including Alcoholics Anonymous. In this group, one-third were still abusing alcohol.

Of those who never had any treatment, only about one-quarter were currently diagnosable as alcohol abusers. This study, known as the National Longitudinal Alcohol Epidemiologic Survey, indicates first that treatment is not a cure-all, and second that it is not necessary. The vast majority of Americans who were alcohol dependent, about three-quarters, never underwent treatment. And fewer of them were abusing alcohol than were those who were treated.

This is not to say that treatment can’t be useful. But the most successful treatments are nonconfrontational approaches that allow self-propelled change. Psychologists at the University of New Mexico led by William Miller tabulated every controlled study of alcoholism treatment they could find. They concluded that the leading therapy was barely a therapy at all but a quick encounter between patient and health-care worker in an ordinary medical setting. The intervention is sometimes as brief as a doctor looking at the results of liver-function tests and telling a patient to cut down on his drinking. Many patients then decide to cut back—and do!

As brief interventions have evolved, they have become more structured. A physician may simply review the amount the patient drinks, or use a checklist to evaluate the extent of a drinking problem. The doctor then typically recommends and seeks agreement from the patient on a goal (usually reduced drinking rather than complete abstinence). More severe alcoholics would typically be referred out for specialized treatment. A range of options is discussed (such as attending AA, engaging in activities incompatible with drinking or using a self-help manual). A spouse or family member might be involved in the planning. The patient is then scheduled for a future visit, where progress can be checked. A case monitor might call every few weeks to see whether the person has any questions or problems.

The second most effective approach is motivational enhancement, also called motivational interviewing. This technique throws the decision to quit or reduce drinking—and to find the best methods for doing so—back on the individual. In this case, the therapist asks targeted questions that prompt the individual to reflect on his drinking in terms of his own values and goals. When patients resist, the therapist does not argue with the individual but explores the person’s ambivalence about change so as to allow him or her to draw his own conclusions: “You say that you like to be in control of your behavior, yet you feel when you drink you are often not in charge. Could you just clarify that for me?”

Miller’s team found that the list of most effective treatments for alcoholism included a few more surprises. Self-help manuals were highly successful. So was the community-reinforcement approach, which addresses the person’s capacity to deal with life, notably marital relationships, work issues (such as simply getting a job), leisure planning and social-group formation (a buddy might be provided, as in AA, as a resource to encourage sobriety). The focus is on developing life skills, such as resisting pressures to drink, coping with stress (at work and in relationships) and building communication skills.

These findings square with what we know about change in other areas of life: People change when they want it badly enough and when they feel strong enough to face the challenge, not when they’re humiliated or coerced. An approach that empowers and offers positive reinforcement is preferable to one that strips the individual of agency. These techniques are most likely to elicit real changes, however short of perfect and hard-won they may be.

Source:  https://www.psychologytoday.com/gb/articles/200405/the-surprising-truth-about-addiction

Two large-scale surveys of California high school students found that teens who saw cannabis and e-cigarette content were more likely to start using those substances or to have used them in the past month

Teens who see social media posts showing cannabis or e-cigarettes, including from friends and influencers, are more likely to later start using those substances or to report using them in the past month, according to surveys done by researchers at the Keck School of Medicine of USC. Viewing such posts was linked to cannabis use, as well as dual use of cannabis and e-cigarettes (vapes). Dual use refers to youth who have used both cannabis and e-cigarettes at some point. The results were just published in JAMA Network Open.

The findings come amid a decline in youth e-cigarette use, reported in 2024 by the U.S. Food and Drug Administration (FDA) and U.S. Centers for Disease Control and Prevention. However, teen vaping, cannabis use and the dual use of e-cigarettes and cannabis remain a problem. 

“While the rate of e-cigarette use is declining, our study shows that exposure to e-cigarette content on social media still contributes to the risk of using e-cigarettes with other substances, like cannabis,” said Julia Vassey, PhD, a health behavior researcher in the Department of Population and Public Health Sciences at the Keck School of Medicine.

The study, funded by the National Institutes of Health, also helps clarify how certain types of social media posts relate to teen substance use. Researchers surveyed more than 7,600 teens across two studies: a longitudinal study to understand whether viewing cannabis or e-cigarette posts on TikTok, Instagram and YouTube relates to a teen’s later choice to start using either substance or both, and a second survey looking at whether an association exists between the source of the content— friends, influencers, celebrities or brands—and substance use.  

“Answering these questions can help federal regulators and social media platforms create guidelines geared toward preventing youth substance use,” Vassey said.

Links across substances

Data for the study came from California high school students, with an average age of 17, who completed questionnaires on classroom computers between 2021 and 2023. Researchers conducted two surveys, one focused on teens who used cannabis, e-cigarettes or both for the first time, the other focused on use during the past month.

In the first survey, which included 4,232 students, 22.9% reported frequently seeing e-cigarette posts on TikTok, Instagram or YouTube, meaning they saw at least one post per week. A smaller portion—12%—frequently saw cannabis posts.

One year later, researchers followed up with the students. Teens who had frequently seen cannabis posts—but had never tried cannabis or e-cigarettes—were more likely to have started using e-cigarettes, cannabis or both. Teens who had frequently seen e-cigarette posts on TikTok were more likely to have started using cannabis or started dual use of both cannabis and e-cigarettes. No such pattern was found for Instagram or YouTube. The data collected allowed researchers to look at platform-specific results for e-cigarettes posts, but not for cannabis posts.

“This is consistent with previous research showing that, of the three platforms, TikTok is probably the strongest risk factor for substance use,” Vassey said. That may be because TikTok’s algorithm pushes popular content broadly, including posts that feature e-cigarettes, even to users who don’t follow the accounts.

In the second survey, researchers asked 3,380 students whether they saw cannabis or e-cigarette posts from brands, friends, celebrities, or influencers with 10,000 to 100,000 followers. Teens who saw e-cigarette or cannabis posts from influencers were more likely than their peers to have used cannabis in the past month. Those who saw e-cigarette posts from friends were more likely to have been dual users of cannabis and e-cigarettes in the past month. Those who saw cannabis posts from friends were more likely to have used cannabis in the past month or to have been dual users of cannabis and e-cigarettes.

The link between e-cigarette posts and cannabis use is what researchers call a “cross-substance association” and may be explained by the similar appearance of nicotine and cannabis vaping devices, Vassey said. 

The risks of influencer content

Influencer posts deserve special attention because they often slip through loopholes in federal rules and platform guidelines. For example, the FDA can only regulate content when brand partnerships are disclosed, but influencers—consciously or not—may skip disclosures in some posts.

Studies show that these seemingly unsponsored posts are seen as more authentic, Vassey said, making them particularly influential.

Most social media platforms already ban paid promotion of cannabis and tobacco products, including e-cigarettes. Some researchers say those bans should be extended to cover additional influencer content. Others want platforms to partner with regulators to find a comprehensive solution.

“So far, it’s a grey area, and nobody has provided a clear answer on how we should act and when,” Vassey said.

In future studies, Vassey plans to further explore cannabis influencer marketing, including whether changes to social media guidelines impact what teens see and how they respond.

About this research

In addition to Vassey, the study’s other authors are Junhan Cho, Trisha Iyer and Jennifer B. Unger from the Department of Population and Public Health Sciences, Keck School of Medicine of USC, University of Southern California; Erin A. Vogel from the TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City; and Julia Chen-Sankey from the Institute for Nicotine and Tobacco Studies and the School of Public Health, Rutgers University, New Brunswick, New Jersey.

This work was supported by National Institutes of Health [R01CA260459]and the National Institute on Drug Abuse [K01DA055073].

Source:  https://keck.usc.edu/news/e-cigarette-and-cannabis-social-media-posts-pose-risks-for-teens-study-finds/

itvx news – Tuesday 24 June 2025

Cannabis activists and entrepreneurs, hold cannabis plant as they march to Government House in Bangkok, Thailand in 2024.Credit: AP

Thailand is moving to pass new legislation banning cannabis for recreational use in a major reversal, three years after the country became the first in Asia to decriminalise the drug, local media reports.

On Tuesday, Public Health Minister Somsak Thepsuthin said he had signed an announcement limiting cannabis to medical use only, Bangkok news site Khaosod confirmed.

Under the changes, people wishing to purchase cannabis must have a doctor’s prescription and a medical certificate indicating their illness.

Operators selling the drug will need to have a doctor present at the shop to renew or apply for a license to sell.

Somsak also said that in the future, cannabis will return to being considered a narcotic.

It is not clear when the regulation will take effect or when it will be re-listed.

Banged up abroad: How many Brits are being arrested over alleged drug smuggling?

Thailand to crack down on cannabis after smuggling cases involving UK tourists

Is cannabis legal in Thailand?

Medical marijuana has been legal in Thailand since 2018, but decriminalisation in 2022 took things a step further, making it no longer a crime to grow and trade marijuana and hemp products, or to use any parts of the plant to treat illnesses.

It was a rarity in the region where many countries give long jail terms and even death sentences for people convicted of marijuana possession, consumption or trafficking.

Smoking marijuana in public remained illegal even under the relaxed laws.

Subscribe free to our weekly newsletter for exclusive and original coverage from ITV News. Direct to your inbox every Friday morning.

What happened when cannabis was decriminalised?

The relaxed laws saw a lucrative cannabis industry catering to locals and foreigners alike boom across the Southeast Asian nation, with thousands of cannabis dispensaries sprouting up across Thailand, as well as other cannabis-themed businesses like weed cafes and hemp spas, and beauty treatment.

Cities like Chiang Mai and the capital Bangkok have even held weed festivals, and decriminalisation has been a major draw for tourists.

Pro-legislation advocates have argued that the cannabis boom across Thailand has helped many Thais, from farmers to small business owners and workers behind the counter.

Critics say the decriminalisation was rushed through, causing confusion about the regulations.

Last year, a new conservative government vowed to tighten the rules around the drug after a string of alleged smuggling cases involving tourists.

Hundreds of British citizens are currently detained across the world, accused of narcotics smuggling offences.

Prisoners Abroad – a charity assisting Britons who are arrested and detained overseas – told ITV News it is currently supporting 431 people around the globe who are facing drugs charges.

This includes 22 people in Thailand.

 

Source:  https://www.itv.com/news/2025-06-24/thailand-to-ban-recreational-cannabis-three-years-after-decriminalisation

Opinion by Kevin Sabet – SAM (Smart Approaches to Marijuana) – July 10, 2025, 

President Donald Trump is facing a pivotal decision: whether to ease national restrictions on marijuana, a policy shift he hinted at during his 2024 campaign. But a major federal bust this week in Massachusetts — where the FBI arrested seven Chinese nationals connected with a multimillion-dollar pot-growing conspiracy — shows why loosening the rules would be a soft-power disaster.

First, some context.

The federal government, under the Controlled Substances Act, uses a five-part schedule to classify various drugs and other potentially addictive items. Drugs with no accepted medical use and high potential for abuse get listed on Schedule I.

That’s where marijuana is now placed — right where it belongs.

FDA-approved marijuana-based medications are rightly classified on lower schedules.

Raw weed, however, has no accepted medical use (whatever may be claimed in states that have legalized it), and addiction rates are around 30% and rising, with younger people hit hard.

That didn’t concern President Joe Biden’s Health and Human Services Department, which recommended moving cannabis to Schedule III, the list of drugs with an accepted medical use and a lower risk of abuse.

Now celebrities, star athletes and some MAGA influencers are pushing Trump to follow the Biden-era recommendation.

But this president — who correctly grasps the multifaceted strategic threat China poses to the United States — should reject their urgings.

Look at this week’s Justice Department charges.

Federal law enforcement on Tuesday rolled up a network of marijuana grow houses in Massachusetts and Maine, allegedly run by Chinese nationals and staffed with illegal immigrants pressed into what amounts to indentured servitude.

The operations generated millions of dollars in profits, which the growers sank into assets like jewelry, cars and real estate that expanded their criminal enterprise.

Chinese criminals played a major role in the US fentanyl crisis by manufacturing the drug’s precursor chemicals and selling them to Mexican cartels. Trump slammed China with a 20% tariff over that very fact.

Marijuana is looking like another big-time business unit for Beijing.

But it gets worse: China’s communist government appears to have significant links with these criminal weed enterprises.

Two Chinese nationals charged with running an illegal grow operation in Maine in 2023 had deep links to the Sijiu Association, a Brooklyn-based non-profit reportedly connected to China’s New York consulate and to the United Front Work Department — the branch of the CCP’s Central Committee that handles influence operations abroad.

Another report in 2024 tracked the connections of Zhu Di, one of China’s top US diplomats, to an Oklahoma cultural association that Sooner State authorities investigated for its links to the illicit weed business.

It’s beyond clear that Beijing smells the skunky funk of a tactical play against the United States rising from the red-hot marijuana trade.  

That’s what makes rescheduling weed such a risk.

Moving marijuana to Schedule III would supercharge the pot market, letting canna-businesses take regular deductions — including on advertising — at tax time, and easing their access to banking and credit.

In other words, it would be a major step towards commercially normalizing Big Weed, and a massive boost for Chinese organized criminals with apparent CCP connections.

Worse — as New York has seen first-hand — far from eliminating the drug dealers, a juiced-up legal weed market leads to a bigger illegal market.

Post-legalization in the Empire State, New York City alone contains an estimated 3,600 illegal pot stores, dwarfing the mere dozens of legal ones. California and Michigan have seen a similar trend.

That’s yet another way rescheduling would hand an unforced victory to China, which is already elbow-deep in illegal weed operations stateside.

The worst part is that there’s no domestic benefit to this trade-off.

If weed goes on Schedule III, it will do nothing except help addiction profiteers get rich — and damage public health irreparably, even as a flood of new data confirms that marijuana is as bad as it gets for users’ mental and physical well-being.

Heart disease, schizophrenia, dementia, even tooth rot: Weed truly is the drug that does it all.

Yes, the American public seems to be waking up. Every state considering recreational marijuana at the ballot box in 2024 rejected it.

But Trump should remember that Beijing will exploit any and every policy misstep we make to the utmost.

That’s as true of spy balloons as it is of public-health policies with nothing but negative domestic implications.

Rescheduling marijuana would put Americans last, at home and abroad — and usher in the very opposite of the Golden Age the president has so memorably promised.

Kevin Sabet is president of Smart Approaches to Marijuana and a former White House drug policy adviser.

Source:  https://nypost.com/2025/07/10/opinion/easing-weed-rules-will-harm-golden-age-and-boost-china/

  • by Oritro Karim (United Nations) – 

UNITED NATIONS, Jun 27 (IPS) – Since 1989, the United Nations (UN) has recognized June 26 as the International Day Against Drug Abuse and Illicit Trafficking in an effort to raise awareness around the global drug problem and foster a more compassionate world, free of drug abuse. Through this year’s campaign, “Break the Cycle. #StopOrganizedCrime”, the UN underscores the importance of addressing the root causes of global drug abuse and illegal drug trading, and investing in reliable systems that prioritize prevention, education, and health.

Concurrently, the United Nations Office on Drugs and Crime (UNODC) released its annual World Drug Report, in which it analyzed the current trends in global drug abuse amid a “new era of global instability”. In the report, UNODC emphasizes the wide ranging implications of drug use on the economy, the environment, global security, and human society.

According to the report, roughly 316 million people used drugs (excluding tobacco and alcohol) around the world in 2023. UNODC also estimates that nearly half a million people around the world die annually as a result of drug use disorders, indicating a “global health crisis”. Roughly 28 million years of life are lost annually from disabilities and premature deaths due to addiction. Furthermore, there is an overwhelming lack of healthcare and education resources for individuals with drug use disorders, as only one in twelve people are estimated to have received treatment in 2023.

Cocaine has been described as the world’s fastest growing illicit drug in terms of global usage, production, and seizures. In 2023, approximately 3,708 tons of cocaine were produced, marking a 34 percent increase from the previous year. Roughly 2,275 tons were seized in 2023, a 68 percent increase from 2019’s figures. Additionally, global usage of cocaine has inflated to 25 million users in 2023.

As nations began to implement harsher crackdowns on drug production, the use and transportation of synthetic drugs, such as fentanyl and methamphetamine, has reached record-highs, accounting for nearly half of all global drug seizures. Drug trafficking groups have found ways to chemically conceal these drugs, making distribution much easier.

UNODC Executive Director Ghada Fathi Waly states that organized drug trafficking groups around the world continue to exploit global crises, disproportionately targeting the most vulnerable communities. With worldwide synthetic drug consumption having surged in recent years, the UNODC forecasts that civilians displaced by armed conflicts face heightened risks of drug abuse and addiction.

Although the cocaine market was once contained in Latin America, trade has extended through to Asia, Africa, and Western Europe, with Western Balkans having greater shares in the market. This is a testament to the influence of organized crime groups in areas facing instability, natural disasters, and economic challenges.

According to the report, since the end of the Assad regime in Syria and the subsequent political transition, nationwide use of fenethylline — also known as captagon, a cheap, synthetic stimulant — has soared. Although the transitional government of Syria has stated that there is zero tolerance for captagon trade and consumption, UNODC warns that Syria will remain a significant hub for drug production.

Angela Me, the Chief of Research and Analysis at UNODC, states that captagon use in the Arabian peninsula was spurred by regional violence, with members of terrorist organizations using it on battlefields to stay alert. Due to its highly addictive properties, as well as its severe impacts on physical and mental health, the drug has seen widespread consumption over the past several years.

“These groups have been managing Captagon for a long time, and production is not going to stop in a matter of days or weeks,” said Me. “We see a lot of large shipments going from Syria through, for example, Jordan. There are probably still stocks of the substance being shipped out, but we’re looking at where the production may be shifting to. We’re also seeing that the trafficking is expanding regionally, and we’ve discovered labs in Libya.”

Global drug trafficking is estimated to generate billions of dollars per year. National budgets to combat drug trafficking, in terms of law enforcement and prosecution, cost governments millions to billions annually as well. Healthcare systems, which are often underfunded for addiction-related treatments, are overwhelmed by the vast scale of needs. Furthermore, damages related to theft, vandalism, violence, and lost productivity in the workplace have significant impacts on gross domestic products.

Additionally, increased rates of deforestation and pollution are linked with global drug cultivation. Additional adverse environmental impacts include ecosystem damage from drug waste, which yields notable costs in environmental restoration efforts.

It is imperative for governments, policymakers, and other stakeholders to invest in programs that disrupt illicit drug trafficking groups and promote increased security, especially along borders, which are critical hubs for transporting concealed substances. Furthermore, cooperation at an international level is instrumental for the transfer of information and promoting a joint and multifaceted approach.

“We must invest in prevention and address the root causes of the drug trade at every point of the illicit supply chain. And we must strengthen responses, by leveraging technology, strengthening cross-border cooperation, providing alternative livelihoods, and taking judicial action that targets key actors driving these networks,” said Waly. “Through a comprehensive, coordinated approach, we can dismantle criminal organizations, bolster global security, and protect our communities.”

Source:  https://www.globalissues.org/news/2025/06/27/40295

 by Andrew Yockey, Assistant Professor of Public Health, University of Mississippi July 3, 2025

Once associated with high-profile figures like John Belushi, River Phoenix and Chris Farley , this dangerous polysubstance use has become a leading cause of overdose deaths across the United States since the early- to mid-2010s.

I am an assistant professor of public health who has written extensively on methamphetamine and opioid use and the dangerous combination of the two in the United States.

As these dangerous combinations of drugs increasingly flood the market, I see an urgent need and opportunity for a new approach to prevention and treatment.

Why speedballing?

Dating back to the 1970s, the term speedballing originally referred to the combination of heroin and cocaine. Combining stimulants and opioids – the former’s “rush” with the latter’s calming effect – creates a dangerous physiological conflict.

According to the National Institute on Drug Abuse, stimulant-involved overdose fatalities increased markedly from more than 12,000 annually in 2015 to greater than 57,000 in 2022, a 375% increase. Notably, approximately 70% of stimulant-related overdose deaths in 2022 also involved fentanyl or other synthetic opioids, reflecting the rising prevalence of polysubstance involvement in overdose mortality.

Users sought to experience the euphoric “rush” from the stimulant and the calming effects of the opioid. However, with the proliferation of fentanyl – which is far more potent than heroin – this combination has become increasingly lethal. Fentanyl is often mixed with cocaine or methamphetamine, sometimes without the user’s knowledge, leading to unintentional overdoses.

The rise in speedballing is part of a broader trend of polysubstance use in the U.S. Since 2010, overdoses involving both stimulants and fentanyl have increased 50-fold, now accounting for approximately 35,000 deaths annually.

This has been called the fourth wave of the opioid epidemic. The toxic and contaminated drug supply has exacerbated this crisis.

A dangerous combination of physiological effects

Stimulants like cocaine increase heart rate and blood pressure, while opioids suppress respiratory function. This combination can lead to respiratory failure, cardiovascular collapse and death. People who use both substances are more than twice as likely to experience a fatal overdose compared with those using opioids alone.

The conflicting effects of stimulants and opioids can also exacerbate mental health issues. Users may experience heightened anxiety, depression and paranoia. The combination can also impair cognitive functions, leading to confusion and poor decision-making.

Speedballing can also lead to severe cardiovascular problems, including hypertension, heart attack and stroke. The strain on the heart and blood vessels from the stimulant, combined with the depressant effects of the opioid, increases the risk of these life-threatening conditions.

Addressing the crisis

Increasing awareness about the dangers of speedballing is crucial. I believe that educational campaigns can inform the public about the risks of combining stimulants and opioids and the potential for unintentional fentanyl exposure.

There is a great need for better access to treatment for people with stimulant use disorder – a condition defined as the continued use of amphetamine-type substances, cocaine or other stimulants leading to clinically significant impairment or distress, from mild to severe. Treatments for this and other substance use disorders are underfunded and less accessible than those for opioid use disorder. Addressing this gap can help reduce the prevalence of speedballing.

Implementing harm reduction strategies by public health officials, community organizations and health care providers, such as providing fentanyl test strips and naloxone – a medication that reverses opioid overdoses – can save lives.

These measures allow individuals to test their drugs for the presence of fentanyl and have immediate access to overdose-reversing medication. Implementing these strategies widely is crucial to reducing overdose deaths and improving community health outcomes.

Source: https://theconversation.com/speedballing-the-deadly-mix-of-stimulants-and-opioids-requires-a-new-approach-to-prevention-and-treatment-257425

Disclosure statement

Andrew Yockey does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

Joseph M Kress exposes the dark reality of America’s drug crisis

 

TORONTO, ONTARIO, CANADA, June 23, 2025 /EINPresswire.com/ — In his compelling and illuminating new book, “Single Handed,” retired lieutenant and police detective Joseph M. Kress reveals the stark realities of America’s ongoing drug crisis and the concerning shortcomings of the nation’s drug prevention programs. Inspired by true events, the story uncovers a journey shaped by tragedy and the hardened years in law enforcement.

The book begins with a very personal and tragic event: Joe Kress’s brother Greg was murdered while on his honeymoon following a robbery in New Orleans. This shocking act of violence sparks Joe’s determination to join the police force. What follows is a vivid, rapid-fire narrative of Joe’s years as an officer, exploring a diverse array of cases that unveil the most sinister aspects of society, from child disappearances to horrific sexual assaults. Despite suffering a gunshot wound to his leg and having to retire early due to injury, Joe is shown to be a man who is motivated by duty throughout it all.

However, “Single Handed” does not conclude with Joe’s time in uniform. In fact, the narrative takes a turn into thrilling and audacious realms. After leaving official service, Joe sets off on a unique journey of his own creation: pursuing drug dealers nationwide. Utilizing his SWAT training and special operations background, he embarks on a mission to tackle the soaring drug-related crime rates affecting American neighborhoods. This unfolds a vigilante crusade, crafted from genuine frustration and moulded by years of direct involvement in law enforcement and profound personal grief.

Amazon reviewer Sanjin highlights the book as crucial and relevant, praising the author’s direct and engaging storytelling that sheds light on an ongoing crisis affecting communities today. In a similar vein, reader Clarence Joseph shares this sentiment, highlighting that the story’s expertly crafted pace not only amplifies its suspense but also provides a captivating and delightful reading journey.

Source:  https://fox59.com/business/press-releases/ein-presswire/824883015/joseph-m-kress-exposes-the-dark-reality-of-americas-drug-crisis-through-his-latest-candid-memoir/

 

If you’re a small business owner, you probably wear a lot of hats: manager, mentor, HR rep, sometimes even IT support. You already know that building a successful company today means adapting to change, especially when it comes to supporting your team. How we approach substance use and mental health on the job is where workplaces need to be evolving quickly!

You might think serious conversations about substance use, behavioral health, and mental wellness are reserved for big corporations with large HR departments and employee wellness budgets. But in today’s world, even the smallest teams need modern, compassionate policies.

Why? Because the way we work—and what employees expect—has changed. Employees today want to know that their employer cares about their whole well-being, not just their productivity. That includes creating space to talk about tough topics like stress, burnout, and yes, substance use.

Modern leadership means recognizing that substance use is something that impacts real people—people you may work with every day. It doesn’t always look like someone missing work or failing a drug test. It can be more subtle: someone relying on alcohol to decompress every night, using prescription stimulants to keep up with unrealistic demands, or struggling quietly with a dependence on marijuana.

Ignoring these issues won’t make them go away. But addressing them with care and structure? That’s leadership.

Here’s how small business owners can modernize their workplace by making room for this kind of support:

 

1. Update Your Workplace Culture, Not Just Your Tech

You wouldn’t run your business on a five-year-old software system. So why stick with outdated workplace norms around health and performance?

A modern workplace recognizes that stress, mental health, and substance use challenges are part of the human experience—and responds with resources, not judgment. Whether that’s offering access to support programs or simply encouraging open dialogue, small steps make a big difference.

 

2. Create a Clear, Supportive Policy

Yes, even small businesses should have a written policy about substance use. Not to scare people—but to protect them. A good policy:

·    Explains your company’s stance (supportive, not punitive)

·    Details how employees can seek help confidentially

·    Trains supervisors to spot concerns and respond appropriately

·    Builds in support and resources—like referrals, time off for treatment, or check-ins

It shows employees that they don’t have to hide what they’re going through.

 

3. Lead With Curiosity, Not Control

You don’t need to be a counselor. But you can ask thoughtful questions, listen without judgment, and point people in the right direction. A curious, compassionate conversation can open the door to real change—especially when someone is already feeling vulnerable.

Modern support means meeting people where they are. Whether someone is cutting back, abstaining, or just starting to question their habits, having your workplace be part of the solution helps them take the next step.

 

4. Set the Tone From the Top

As a business owner, your attitude sets the culture. Talking openly about stress, supporting mental health days, and encouraging balance gives your employees permission to take care of themselves. And when people feel safe, they perform better. It’s that simple.

Addressing substance use isn’t about policing your team. It’s about building a workplace where people can show up as they are, get the support they need, and grow. That’s what today’s employees are looking for—and it’s how small businesses build loyalty, retention, and a reputation for doing things the right way.

Source: McConnell, K. (2024, April 1). The Challenge of Change: How employers can modernize workplace substance use support. How Employers Can Modernize Workplace Substance Use Support | Spring Health. https://www.springhealth.com/blog/how-employers-can-modernize-workplace-substance-use-support 

 

Source:  Drug Free America Foundation | 333 3rd Avenue N Suite 200 | St. Petersburg, FL 33701 US

<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<DFAF>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

NATIONAL DRUG-FREE WORKPLACE ALLIANCE

As the workplace division of Drug Free America Foundation, NDWA’s mission is to be a national leader in the drug-free workplace industry by directly assisting employers and stakeholders, providing drug-free workplace program resources and assistance, and supporting a national coalition of drug-free workplace service providers.

For more information and drug-free workplace resources, visit NDWA at www.ndwa.org.

 

By Joe Rossiter – The Mail on Sunday-  29 June 2025 

More than a quarter of police and crime commissioners have written to the policing minister calling for cannabis to be upgraded to a class A substance, The Mail on Sunday can reveal.

In the stark letter to Dame Diana Johnson MP, seen exclusively by this newspaper, 14 police chiefs claim the effect of the drug in society ‘may be far worse’ than heroin.

They warn that ‘we cannot allow this to become the Britain of the future’. And they also hit out at the recent report by the London Commission – backed by Labour London mayor Sir Sadiq Khan – which suggested decriminalising small amounts of cannabis, which is currently a class B drug.

‘Heroin can kill quickly but the cumulative effect of cannabis in our society may be far worse,’ the letter states. 

It adds that class A status – which comes with potential life sentences for suppliers – was the way forward ‘rather than effective decriminalising’.

And renowned psychiatrist Professor Sir Robin Murray, of King’s College London, told The Mail on Sunday that the UK may now be ‘at the beginnings of an epidemic of cannabis-induced psychosis’ which could overwhelm NHS mental health services.

The commissioners also pointed to other countries where laws are laxer, warning that the US has seen ‘unofficial pharmacies’ selling cannabis and the powerful opiate fentanyl alongside one another, while Portugal has been forced to consider reversing drug decriminalisation after a 30-fold increase in psychosis.

They said cannabis’s effects were so devastating it had ‘more birth defects associated with it than thalidomide’ – the notorious morning sickness drug which caused deformities among thousands of babies in the 1950s and 1960s.

More than a quarter of police and crime commissioners have written to the policing minister calling for cannabis to be upgraded to a class A substance (file pic)

Marcus Monzo, 37, was last week found guilty of 14-year-old Daniel Anjorin’s murder while in a state of cannabis-induced psychosis Monzo attacked the teenager with a samurai sword in Hainault, east London, last May

Their warnings came after Marcus Monzo, 37, was last week found guilty of 14-year-old Daniel Anjorin’s murder after he attacked him with a samurai sword in Hainault, east London, while in a state of cannabis-induced psychosis.

David Sidwick, Police and Crime Commissioner for Dorset, said cannabis legislation was ‘clearly not fit for purpose’ and likened it to ‘using a machete for brain surgery’. 

He added the public wanted to see ‘tougher measures’ for cannabis possession because it was a gateway to harder drugs.

His Devon and Cornwall counterpart Alison Hernandez said: ‘The fact that we’ve been so blase about cannabis in society means that people think it’s legal and normal, and it’s not. 

‘We’ve got to show them that it’s not, and the way you do that is to be quite fierce in your enforcement arrangements.’

Latest figures show three in four people caught with cannabis avoid appearing in court, while 87 per cent of children and young people in alcohol and drug treatment cited cannabis dependency, compared to 39 per cent for alcohol.

In the stark letter to Dame Diana Johnson MP, 14 police chiefs claim the effect of the drug in society ‘may be far worse’ than heroin

David Sidwick, Police and Crime Commissioner for Dorset, said he wanted to see ‘tougher measures’ for cannabis possession because it was a gateway to harder drugs (file pic)

Stuart Reece, an Australian clinician and cannabis researcher quoted in the letter said more than 90 per cent of hard drug addicts he encountered had started with cannabis.

He said pro-cannabis campaigners had the view it was ‘my right to use drugs and destroy my body and you will pay for it through the NHS’.

Dr Karen Randall, a physician in the US state of Colorado where recreational cannabis was legalised in 2012, said healthcare costs linked to the drug are ‘exorbitant’.

A Home Office spokesman said: ‘We work with partners across health, policing and wider public services to drive down drug use, ensure more people receive timely treatment and support, and make our streets and communities safer.’

Source: https://www.dailymail.co.uk/news/article-14857305/Cannabis-worse-society-heroin-police-tsars-upgrade-class.html

by Haoliang Cui1;  Jianyi Zhang1;  Wenkai Luo1;  Erri Du2;  Zhongwei Jia1, , and Corresponding Author Zhongwei Jia, jiazw@bjmu.edu.cn 

Author affiliations

The recognition of drug use as a global challenge requiring coordinated international response began with the first international conference on narcotic drugs held in Shanghai in 1909. Throughout the 20th century, three pivotal United Nations (UN) conventions on drug control (1961, 1971, and 1988) established the legal and institutional framework for a comprehensive multilateral system addressing prevention and enforcement. The creation of the United Nations Office on Drugs and Crime (UNODC) in 1997 further underscored the widespread nature of drug-related challenges confronting societies worldwide (12).

As nations develop more sophisticated approaches to addressing global drug challenges, international surveillance data continue to underscore both the magnitude of the problem and the critical importance of prevention strategies. The global population using drugs has reached 292 million in 2022, representing a 20% increase over the past decade (3). Particularly concerning is the finding that cannabis use prevalence among adolescents aged 15–16 years exceeds that of adults worldwide (3). It was estimated that 84 million adults aged 15–64 in Europe had used cannabis at least once, including approximately 15.3 million young adults aged 15–34 based on the European Drug Report 2023. (4). Similarly, in 2022, an estimated 70.3 million individuals aged 12 or older in the United States reported illicit drug use within the past year, with peak prevalence occurring among young adults aged 18 to 25. These statistics demonstrate the urgent need for targeted prevention investments, particularly among youth populations (5).

China has actively contributed to and responded to these global drug control initiatives. The Anti-Drug Law of the People’s Republic of China (6) was enacted in 2007, establishing a comprehensive triadic strategy that encompasses prevention, punishment, and rehabilitation. Following the law’s implementation, the number of newly identified drug users increased steadily, reaching its peak in 2015 (Figure 1). However, a series of national initiatives — including the “People’s War on Drugs,” the “Sword Action” (Liangjian Project), and the deployment of “Skynet” surveillance systems — led to a significant decrease in newly identified drug users. This decline was particularly pronounced during and after the COVID-19 pandemic, when the number of newly found drug users experienced a sharp drop (Figure 1).

The theme of this year’s International Day Against Drug Abuse and Illicit Trafficking — “The evidence is clear: invest in prevention, Break the cycle, Stop Organized Crime” (7) — underscores the public health nature of the drug problem and emphasizes the critical importance of preventive measures (Figure 2). The evolution of these annual themes reflects a fundamental shift in global attitudes toward drug policy. From 1996 to 2009, themes primarily emphasized the dangers and harmful consequences of drug use. The second stage (2010 to 2015) began treating the drug problem as a public health issue rather than solely a criminal justice matter. Since 2016, the focus has shifted toward prevention, early intervention, and youth-centered strategies, reflecting a more comprehensive and evidence-based approach to drug policy.

Nevertheless, emerging risks continue to challenge existing frameworks. Recent cases of adolescent substance abuse involving compounds not yet under formal regulatory control, such as nitrous oxide and etomidate, have been documented across China (8). Since January 2021, Guangzhou in Guangdong Province has implemented targeted enforcement measures against nitrous oxide distribution, resulting in 46 investigated cases by June 2022 (9). These novel psychoactive substances present distinct challenges due to their accessibility through online platforms, ambiguous legal classification, and limited public awareness — particularly among adolescents. In response to these evolving threats, the Ministry of Justice issued a national directive in early 2025 emphasizing “intensified drug prevention campaigns targeting adolescents” (10). Through strategic investments in early education programs, enhanced cross-sector collaboration, and implementation of evidence-based policy frameworks, China is proactively adapting its approach to address the dynamic landscape of emerging drug-related risks.

  • FIGURE 1.  Trends in newly identified drug users in China, 2007–2022.

    Note: Data from 2007 to 2013 were sourced from the Drug Abuse Population Estimation in the Key Cities of the Ministry of Public Security, while data from 2014 to 2022 were obtained from the respective annual editions of the Drug Situation in China report.

Associated Information:

Contrary to the popular narrative, President Nixon’s comprehensive approach to drug policy provided an effective solution to a growing problem.

In the 1970s, the United States faced a growing heroin epidemic. By 1970, there were an estimated 600,000 heroin addicts and 7,200 overdose deaths—a crisis that demanded a national response.

President Richard Nixon took decisive action to address this crisis. While he did  declare drug abuse “public enemy number one,” the phrase “war on drugs” was largely a media invention. The public perception that Nixon launched a punitive campaign against drugs has overshadowed the more nuanced reality of his policy and its measurable success.

Judge Robert Bonner, former DEA administrator and U.S. District Court judge, addressed this misconception during remarks at the Nixon Library on August 22,  2023. In his research into President Nixon’s drug policy, Bonner found that Nixon used the term “war on drugs” only once—in a little-known speech to Customs personnel in Texas. As Bonner put it, “The ‘war on drugs’ is a horrid metaphor. We’ve never treated it as a war, never funded it like one, and there’s no ultimate victory.” 

Journalist Charles Fain Lehman, a Robert Novak Journalism Fellow, echoed this sentiment: “Despite what critics claim, there is no fifty-year straight line from Nixon to Reagan’s drug war.”

Instead of approaching the acute drug crisis like a war, President Nixon developed a strategic, two-pronged approach aimed at reducing heroin addiction in America. His strategy targeted both demand and supply. On the demand side, he expanded treatment and prevention programs. On the supply side, he cracked down on drug trafficking through law enforcement and international diplomacy. As Lehman puts it, “his policy agenda was responsive to a real and substantial drug epidemic, one which merited a proportional government response.”

One of President Nixon’s earliest legislative achievements was the Controlled Substances Act of 1970, the first comprehensive federal drug law. Contrary to later tough-on-crime narratives, this law actually eliminated mandatory minimum sentences for drug offenses—sentences that would only return with the Drug Abuse Act of 1986 under a different administration.

To enforce drug laws more effectively, President Nixon created the Drug Enforcement Administration (DEA), the first federal agency with a singular mission to combat drug trafficking. Under his leadership, the DEA partnered with international allies to curb the global heroin trade. In just two years, Nixon’s team helped disrupt heroin routes through France and negotiated efforts to ban opium production in Turkey. According to Bonner, these efforts helped reduce the number of heroin addicts in the U.S. from approximately 600,000 to fewer than 100,000—a number that remained low for over a decade.

Further busting the myth of a drug war, compassion was core to President Nixon’s drug policy. “Heroin addiction is a problem that demands compassion, not simply condemnation,” he said. To put that compassion into action, he created the Special Action Office for Drug Abuse Prevention and appointed Dr. Jerome Jaffe—a pioneer in addiction treatment—to lead it. One of the key objectives President Nixon assigned to Jaffe was addressing the treatment of servicemen returning from Vietnam with heroin addiction—an issue that, according to a 1971 congressional report, affected an estimated 30,000 to 40,000 veterans. Under President Nixon’s leadership, federally funded heroin treatment and education programs expanded dramatically. As Lehman noted, “Nixon spent more on drug treatment than enforcement year after year, and pioneered the use of methadone maintenance treatment.”

Richard Nixon’s approach—combining treatment, enforcement, and diplomacy—laid the groundwork for a more balanced and effective drug policy. As Bonner concluded, “In short, Nixon understood the problem. He also did something about it. It was a whole government effort—and it worked.”

View Judge Robert Bonner’s full remarks:

Sources

Bonner, Robert. Judge. 23 August 2023. Keynote Remarks by Judge Robert Bonner, YouTube, August 23, 2023.

Lehman, Charles Fain. “What Was the War on Drugs? Part I.” The Causal Fallacy, May 6, 2025.

Lehman, Charles Fain. “What Was the War on Drugs? Part II.”The Causal Fallacy, May 7, 2025.

While many of the conversations surrounding marijuana revolve around younger generations and their patterns of use, a growing body of research is starting to include older adults in the conversation. Two recent studies show an increase in the use of marijuana among older adults and a link to various health conditions.

 

The first study, out of the University of California, included data from 15,689 adults aged 65 and older. This study found a sharp increase in the prevalence of marijuana use over the past-month among this population – rising from 4.8% to 7.0%. This study identified a link between this rise and various factors, including residing in a state with legal medical marijuana, being a woman, and several health issues such as heart conditions, diabetes, hypertension, in addition to other sociodemographic and clinical outcomes.

 

The second study out of Ontario, Canada, where marijuana has been legal for recreational use since 2018, used health data from over 6 million individuals and focused on adults aged 45 and older over a 14-year period to assess whether marijuana use that led to an emergency department (ED) visit or hospitalization could be associated with future dementia diagnoses.

The study showed that between the years of 2008 to 2021, marijuana-related emergency care increased dramatically in adults aged 65 and older, with a 26.7-fold increase. Even among adults aged 45 to 64, the rate increased fivefold. This surge reflects both the growing normalization of marijuana and the growing number of older adults experimenting with or becoming dependent on its use. But as use has increased, so too has concern about its potential consequences for brain health.

 

This study found that those who required emergency care for marijuana-related reasons were significantly more likely to develop dementia. Within 5 years, 5% of marijuana-related acute care patients were diagnosed with dementia compared to 3.6% among individuals with other types of hospital visits, and just 1.3% in the general population.

 

Even after adjusting for factors like age, gender, chronic health conditions and mental health history, the elevated risk remained: Compared to peers hospitalized for any reason, marijuana users had a 23% higher risk of dementia. Compared to the general population, their risk was 72% higher. By 10 years, nearly one in five (18.6%) of those with marijuana-related hospital visits had developed dementia.

 

Although the specific biological mechanisms are still unknown, many studies have shown an association between heavy marijuana use and memory and cognitive decline, and this study adds to the concern that long-term use, heavy use or cannabis use disorder (CUD) may also accelerate long-term neurodegeneration. With chronic marijuana exposure possibly altering the brain structure, reducing cognitive reserve and interfering with key processes involved in memory and learning, this growing use is leaving older adults more vulnerable due to age-related changes in the brain and the possibility of unknown interactions with other health conditions or medications.

 

As marijuana use grows in this age group, targeted prevention and education strategies are urgently needed.

 

Source: Drug Free America Foundation | 333 3rd Ave N Suite 200 | St. Petersburg, FL 33701 US

OPENING REMARKS BY NDPA:

This book, and its review, engage with differing viewpoint s about addiction and addicts. Flanagan prefers to avoid the word ‘disease’ – characterising the condition as a behavioural ‘disorder’ – much in the way that Stanton Peele, in his classic 1975 text ‘Love and Addiction’ – (Peele and Brodsky – Pubd, Taplinger, New York) similarly views the condition. But in the professional field of today additional concepts have been introduced, what some might call ‘influencers’ – longest established is the notion of ‘harm reduction’ – this (in our opinion) has a valid purpose in limiting harm that users can experience, but it has also been ‘abused’ by campaigners who argue that ‘laws are harmful, so legalisation reduces harm’. More recently the notion of ‘stigma’ has become more prominent in the drug policy arena … and again, whilst there is a valid role for addressing gratuitous stigmatisation of users, the liberalising campaigners can be seen to abuse the notion, arguing that ‘all stigma is bad, therefore all stigma should be removed.’ In fact, society has long rationally deployed stigma where it can be seen as criticising an individuals drug abuse when this damages and jeopardises a healthful society, or threatens the health of people around the user … this is echoed in Flanagan’s text where, for example he says addicts are ‘… are by no means blameless just because they supposedly have a disease’. This dialogue will of course run and run, and NDPA will endeavour to maintain a balanced and rational journey through this jungle!

A new book looks at addiction through the lens of choice and responsibility.

 Reason Magazine – 

Owen Flanagan’s new book, What Is It Like To Be an Addict?, should be welcomed by anyone concerned with these issues. Despite its modest size, this is a work of large ambition and broad range informed not just by the author’s long career as a prominent philosopher but by his many years as a desperately addicted abuser of alcohol and sedatives.

“This is a deeply personal book,” he writes. “I was addicted to booze and benzos for twenty years on and off from the late 1970s until the early 2000s. The last years were especially ugly, requiring several hospitalizations, and involving constant self-loathing and suicidal despair.”

Unsurprisingly given his experience, Flanagan stresses that we should pay close attention to what the addicted have to tell us. And among the most important things addicts say is that they are by no means blameless just because they supposedly have a disease. On the contrary, many feel shame (for being an addict) and guilt (for behaviors that are slowly destroying them and harming their loved ones).

To Flanagan, these feelings are right and good. That stance may inspire horror from some people, who will see it as victim-blaming. But it’s consistent with Flanagan’s view that addicts can’t be reduced to flesh-and-blood automatons jerked about by their cravings. As he notes, even people who claim to believe this will then earnestly implore an addict to get help—a plea that could only be directed at someone presumed to have the ability to make choices. “Every treatment that works to unseat addiction,” he writes, “assumes that addicts are responsible and must participate in undoing their own addiction.”

Flanagan doesn’t even think addiction is a disease, exactly—more of a multifactorial disorder of enormous social, physical, psychological, and pharmacological complexity. Indeed, one of his book’s main points is that addiction cannot be seen as any one simple thing. But he doggedly insists that addicts retain some agency during their plight.

“Practices of compassion, forgiveness, and excusing are distinct from whether or not we hold the addict responsible,” he writes. “We hold addicts responsible in many respects and rightly so. Thus, the determination that addiction is a disease or mental disorder is much less consequential as far as holding addicts responsible goes than many suggest.”

Flanagan takes care to distinguish between unwilling addicts, willing addicts, and resigned addicts, helping us through these categories to think about what we mean by addiction and how best to mitigate it. Particularly notable are the minority who are willing addicts—he mentions as an example Keith Richards, who has said he was a longtime heroin user. At least some of these individuals are in control of the consequences of their habit and satisfied with their lives. Is their addiction any more meaningful than a coffee habit?

Unwilling addicts want to quit, and many will eventually succeed. And resigned addicts are those who wanted to quit, couldn’t, and just gave up, surrendering to hopelessness. They are in a sense beyond unwilling; by not trying to quit, they effectively acquiesce. Here, the author says, a kind of accommodation may help. One nonprofit in Europe helps resigned addicts to lead orderly lives through more disciplined consumption—in one methadone-like program, six pints of beer spread throughout the day—as well as suitable paid employment.

As for himself, the author credits Alcoholics Anonymous with saving his life by enabling his sobriety, but he also thinks it has a certain cultishness; like any good rationalist, he insists on “the distinction between the belief in a Higher Power having an effect and the Higher Power having an effect.”

Flanagan is also a capable researcher and reporter. Who knew that many addicts call the rest of us “earth people”? Or, more significantly, that there is so much overlap between addiction and other psychiatric disorders? “Twenty-five percent of individuals with severe mental illness, defined as a disorder that severely compromises normal functioning—schizophrenia with delusions or immobilizing depression—have a substance use disorder,” the author says. “In the other direction, 15 percent of individuals with a substance use disorder also have a severe mental illness.”

This book’s focus is substance abuse rather than, say, Facebook addiction, if such a thing exists. Flanagan is properly skeptical of the movement to medicalize all of life’s setbacks and sadnesses. He notes that men in most cultures are more likely than women to abuse alcohol and drugs, but that women are gaining. “There is no country where female alcoholism…rates are near 10 percent. But there are many countries in which the male alcoholism rate is above 10 percent and a few that top 13 percent: Russia (16.29 percent), Hungary (15.29 percent), Lithuania (13.35 percent), and South Korea (13.10 percent).”

He reminds us that while the war on drugs appears to be a costly failure, we can’t say for sure that many addictions wouldn’t be worse in its absence. And he notes some of the problems that have accompanied legalization initiatives. In Portugal, after a decade of good results, “substance use is on the rise, and fewer and fewer people in need are getting treatment. Recent data indicate that both overall drug use and drug overdose rates are up.” In Oregon, decriminalization Measure 110 “is being unwound” after evictions and fentanyl supplies surged. But he cautions: “The data do not mean, as some are quick to insist, that decriminalization, harm reduction, and treatment are not for the best.”

What Is It Like To Be an Addict? has its shortcomings, which largely stem from the author’s academic tribe. The book is not particularly well-organized or well-written; again and again, Flanagan tells us what he’s going to tell us, and then tells us the thing a couple more times to be on the safe side. And the book can be heavy on jargon. At one point, despite his professed sobriety, he writes: “When I report on the experiences of fellow addicts based on their autophenomenological reports, I am doing heterophenomenology.”

Particularly nettlesome is the author’s claim that, although addicts are responsible for their addiction, the rest of us are responsible too because of the woeful conditions we’ve allowed to persist. He wheels out the usual suspects including “social displacement,” poverty, inequality, racism, depression, “lack of good life options,” and other all-purpose woes that “are not caused by addicts.”

Blinkered by his ready-made list of villains, the author takes little account of other potential factors. Affluence in particular seems at least as likely a culprit as poverty. Today’s poor are often richer than middle-class Americans were in the middle of the last century, and today’s American middle class is extraordinarily affluent by historical and global standards. That means more of us can afford substance abuse of all kinds, not to mention addictions to shopping and other costly behaviors.

How about changes to family life or to levels of church attendance? Isn’t it possible that the religious and familial dimensions of A.A. are essential to its remarkable success? It’s noteworthy that the author’s own salvation came not from any arm of government but from a private, apolitical institution operating on a shoestring and making no attempt to end inequality or racism. Drunks come to A.A. and somehow get sober anyway.

But in truth, the author’s gestures toward collective responsibility feel more obligatory than emphatic. What he really wants is a humane, evidence-based approach to the problem of addiction consistent with individual agency, and that’s an approach fully in accord with a faith in human liberty. At the same time, we might as well recognize that voters will quickly lose their enthusiasm for legalizing drugs if they blame it for public chaos. Freedom always and everywhere relies on self-regulation. 

These are tough times for individual agency. Many philosophers and psychologists scoff at the notion of free will, which others seem to regard as the sole province of the “privileged.” A therapeutic culture and the nanny state give us all incentives to see ourselves as victims, helpless in the face of implacable forces of oppression. It is refreshing to read a book that refuses to dehumanize addicts by depriving them of responsibility or delegitimizing the shame they feel for their actions.

Source:  https://reason.com/2025/06/15/how-freedom-lovers-can-reckon-with-addicts-and-addiction/

  Lisbon 20.06.2025

 This week, the EUDA and the University of Limerick’s REPPP team (1) officially launched ‘Safe futures’, a project focused on identifying effective ways to prevent youth involvement in European drug markets.

The initiative responds to growing public and policy concern about the increasing recruitment and exploitation of young people by criminal drug networks across Europe. These networks often target the most vulnerable young people, leading to significant security, social and public health consequences.

The two-year project brings together policymakers, researchers, law enforcement agencies and practitioners from across Europe to collaborate in a new multi-disciplinary Community of Practice conceived to share knowledge and research and inform and design future interventions in this complex policy area. This week’s meeting involved a cross-section of these groups to examine the issue across different jurisdictions, share information and begin collaborative problem-solving.

The agenda featured a dynamic mix of presentations, group work and plenary discussions designed to highlight both existing challenges and promising solutions. Participants also explored knowledge gaps and discussed next steps for the Community of Practice.

The overall purpose of the project is to enhance drug-related crime prevention efforts in Europe by:

  • evaluating existing models and strategies for the involvement of young people in drug markets and drug-related crime;
  • supporting linked networking building activities; and
  • identifying possible facilitators and barriers to the implementation of programmes in this area. 

The project outputs are expected to contribute to a better understanding of future research, policy and developmental needs and inform future investments in this area at national and European level.

In November 2024, following the first European conference on the topic, the EUDA issued a Call to action to break the cycle of drug-related violence. This underlined the urgent need for cross-sector collaboration to ensure a safer and more secure Europe. It also stressed that targeted prevention mechanisms should focus on young people and other at-risk groups, including prevention of their recruitment into organised crime. ‘Safe futures’ responds to this call.

Forming healthy habits and building strong character is a top priority for students at Dr. Martin Luther King Jr. Elementary School in Santa Ana — and they have found a creative way to share that message with their peers.

Set to the tune of Raffi’s “Down By the Bay,” the Santa Ana Unified School District students wrote and performed their own rendition, “Here at King School,” to showcase what they have learned about drug prevention and healthy decision-making. Written by the students themselves, the lyrics highlight setting goals, making positive choices, resisting peer pressure and saying no to drugs. Watch their music video above.

Their message was inspired by a similar public service announcement titled “Stop and Think” created by Hope View Elementary students in the Ocean View School District. Hope View’s prevention song was shared with King Elementary students as part of King’s own curriculum, and it sparked an idea. After watching it in teacher Pam Morita-Hicks’ class, the fifth-graders were inspired to create a musical project of their own. 

The fifth-graders recently completed a 10-week curriculum called Too Good for Drugs presented by OCDE’s Youth Substance Use Prevention program. Starting in January and wrapping up in March, the lessons helped students develop healthier coping strategies and life skills through activities and discussions. The curriculum also educated the class on the dangers of alcohol, nicotine, marijuana and medication misuse, and how these substances can have long-term effects.

“Our goal is to build students’ health literacy by strengthening their knowledge and providing opportunities to practice real-life skills,” said Lisa Nguyen, project assistant at OCDE. “We want young people to feel more confident in setting reachable goals, making smart choices, managing feelings and saying no when it counts.”

After completing the curriculum, students were given the opportunity to plan a youth prevention project to share this message with their peers. Led by Nguyen and the OCDE team, Mrs. Morita-Hicks’ class participated in planning meetings where the students wrote their own lyrics, brainstormed visuals and rehearsed their performance. Their ideas came to life in a music video captured and produced by OCDE’s Media Services team.

Through sharing their performance, students from the class said they hoped to inspire other students to make healthy choices and spread awareness among their peers about the importance of staying drug-free.

OCDE’s Youth Substance Use Prevention Services brings free drug and alcohol education to schools and youth organizations in Santa Ana, Garden Grove, Irvine, Tustin, Orange, Stanton and Westminster.

Thanks to funding from the Orange County Health Care Agency, the program offers classroom presentations, peer-led projects, parent workshops and staff training at no cost. Additional support is also available through a network of regional providers, making it easy for schools and communities to get involved.

Source:  https://newsroom.ocde.us/watch-santa-ana-fifth-graders-promote-drug-free-message-in-music-video/

by Shane Varcoe – Executive Director for the Dalgarno Institute


Why do people continue with behaviours or substances, such as alcohol or drugs, even when they openly wish to stop? This question cuts to the heart of understanding addiction. The disparity between intention and action reveals contradictions central to addiction behaviour, often oversimplified by two prevalent views.

For decades, addiction has been described through the lens of brain disease models, focusing on how substance use alters brain function to make drug use compulsive. While these models uncover meaningful insights, they are just one part of the story. On the other hand, some reduce addiction to an issue of morality or simple bad decisions, claiming people use substances solely out of selfish indulgence. Both these views highlight partial truths but fail to complete the picture.

Instead, a deeper understanding must combine these perspectives, recognising both the complex brain changes involved and the environmental and social factors that shape behaviour.

Paths to Recovery: Understanding addiction through the lens of decision-making opens new pathways for support. Instead of framing individuals as broken or helpless, this perspective views people in the context of their environment.
Encouragingly, it shows recovery is possible by increasing the availability, visibility, and value of non-drug alternatives. This may include offering accessible education, creating stable job opportunities, or fostering supportive communities. By making these changes, we shift focus away from stigma and towards empowering individuals to make better-informed choices.

While the psychology of addiction is undeniably complex, treating those impacted with empathy and focusing on promoting meaningful alternatives is the way forward. The path to recovery is not simple, but it’s one that can be supported through understanding human behaviour and its environmental influences. Source: https://nobrainer.org.au/…/1448-understanding-addiction… )

(Also a must read Research Report on this; Drug Use, Stigma & Proactive Contagions to Reduce Both https://nobrainer.org.au/…/364-drug-use-stigma-and-the… also containing Dealing with Addiction. Models, Modes, Mantras & Mandates – A Review of Literature Investigating Models of Addiction Management)
Source: Shane Varcoe – Executive Director for the Dalgarno Institute
by Pavani Rangachari, Alvin Tran –  Department of Population Health and Leadership, University of New Haven, 300 Boston Post Road, West Haven, CT, USA, – 14 February 2025

Abstract: The opioid crisis in the United States remains a major public health emergency, claiming over 100,000 lives annually, with potent synthetic opioids like fentanyl driving the surge in overdose deaths. In response, the US Food and Drug Administration’s (FDA) approval of over-the-counter (OTC) Narcan represents a pivotal step toward expanding access to naloxone, a life-saving medication that reverses opioid overdoses. However, maximizing the public health impact of this measure requires more than increasing availability—it demands a comprehensive, systemic approach that fosters community engagement, advances harm reduction, and transforms healthcare delivery. This paper applies the Robert Wood Johnson Foundation’s (RWJF) Culture of Health (COH) model to provide a structured framework for optimizing Narcan’s impact. Through its four interconnected pillars, (1) making health a shared value, (2) fostering cross-sector collaboration, (3) ensuring equitable access, and (4) transforming healthcare systems, the COH model offers critical insights into building sustainable, community-wide overdose prevention strategies. Central to this effort is stigma reduction, as negative perceptions of opioid use disorder continue to undermine both public willingness to seek naloxone and healthcare providers’ readiness to offer it. Within the COH framework, the paper examines evidence-based interventions that normalize naloxone use, innovative cross-sector partnerships that foster acceptance, and policy initiatives that expand access while addressing systemic inequities. By synthesizing real-world success stories, including community-based naloxone distribution programs, law enforcement-assisted interventions, and hospital-based harm reduction initiatives, this paper outlines a strategic blueprint for translating the FDA’s Narcan ruling into lasting public health outcomes. It concludes with actionable recommendations for healthcare systems, policymakers, and public health agencies to institutionalize harm reduction practices and dismantle barriers to care. Only by embedding a Culture of Health into the fabric of healthcare, public health, and community systems can we achieve lasting progress against the opioid crisis and foster healthier, more equitable communities.

Keywords: opioid crisis, naloxone access, harm reduction, Narcan, culture of health model, substance use disorder, overdose prevention, health equity

Introduction

The opioid crisis continues to devastate the United States, with over 100,000 annual deaths linked to drug overdoses—75% involving opioids.1 Potent synthetic opioids like fentanyl exacerbate the crisis, often requiring multiple doses of naloxone to reverse an overdose. Naloxone, sold under the brand name Narcan, is a life-saving medication that quickly reverses opioid overdoses by blocking opioid receptors.2 With the surge in opioid-related deaths, harm reduction strategies like Narcan have become crucial tools in the fight against opioid addiction.2,3 Timely administration of Narcan can mean the difference between life and death, making widespread distribution and education on its use essential in combating the opioid crisis.

The COVID-19 pandemic intensified the opioid crisis, increasing substance use and overdose deaths due to isolation, economic instability, and disrupted healthcare services. Overdose death rates spiked nearly 30% between 2020 and 2021, underscoring the urgent need for accessible interventions.4 In March 2023, the US Food and Drug Administration (FDA) approved Narcan for over-the-counter (OTC) use, making it the first naloxone product available without a prescription. This landmark decision aimed to enhance harm reduction by expanding naloxone access to individuals at risk of overdose, their families, and communities.5

However, the OTC rollout has faced challenges. While major retailers now stock Narcan, the high price (around $45 per two-dose kit) remains a barrier.6 Rural and low-income pharmacies struggle with consistent availability, exacerbating disparities.7 Stigma surrounding opioid use and Narcan also persists, deterring some pharmacists from recommending or stocking it.8–10 Beyond access, awareness and confidence in using Narcan remain limited. Many potential users lack proper training, emphasizing the need for public education campaigns.11–13 Calls for naloxone training, similar to Cardiopulmonary Resuscitation (CPR) certification, highlight the importance of ensuring more people can effectively administer this life-saving intervention.14

The Robert Wood Johnson Foundation’s (RWJF) Culture of Health (COH) model provides a valuable framework for addressing these challenges.15 Developed through interdisciplinary consultation, evidence reviews, and stakeholder engagement, the COH model was designed to promote cross-sector collaboration, address social determinants of health, and foster equitable opportunities for well-being in all communities. It is particularly relevant to the opioid crisis, where stigma, fragmented systems, and entrenched inequities impede progress. Since its introduction in 2015, the COH model has been widely applied in public health, community development, and health equity efforts, demonstrating its utility as both a conceptual and practical guide for systemic change.16,17

While models such as the Social Ecological Model (SEM) and Social and Behavior Change Communication (SBCC) approaches emphasize the importance of multilevel interventions and sustainable behavior change, they often remain abstract and narrowly focused on programmatic strategies.18,19 In contrast, the COH model operationalizes these principles into a tangible, systems-level blueprint for driving long-term societal transformation. Applying the COH model to overdose prevention offers a comprehensive approach for shifting societal values, strengthening healthcare and community systems, and promoting resilience.

The four pillars of the COH model, (1) making health a shared value, (2) fostering cross-sector collaboration, (3) ensuring equitable healthcare access, and (4) transforming healthcare systems, are deeply interconnected rather than mutually exclusive. Some thematic overlap across the pillars is therefore expected and reflects real-world dynamics where key stakeholders, including pharmacies, healthcare providers, law enforcement, and community organizations, intersect across multiple strategies to address opioid overdose prevention. Drawing upon this framework, this paper examines how the COH model can guide the translation of the FDA’s Narcan ruling into meaningful public health impact. It explores challenges, opportunities, and evidence-based interventions aligned with each pillar, offering strategic insights for overcoming stigma, expanding naloxone distribution, promoting cross-sector partnerships, and embedding harm reduction within healthcare and community systems.

Purpose and Significance

Building on this framework, this paper applies the COH model to examine how the four pillars—making health a shared value, fostering cross-sector collaboration, ensuring equitable access, and transforming healthcare systems—can guide the translation of the FDA’s over-the-counter approval of Narcan into sustained public health impact.

By examining each pillar, this paper identifies key challenges, opportunities, and evidence-based strategies for creating a culture of health that prioritizes opioid overdose prevention and recovery. It highlights how stigma, access disparities, and systemic barriers can be overcome through targeted interventions, collaboration across sectors, and an integrated approach to harm reduction and treatment.

The significance of this work lies in its potential to guide stakeholders in translating the FDA ruling into actionable and sustainable solutions. The COH model provides a unique lens through which to address the structural inequities and social determinants of health that underlie the opioid crisis. By offering a comprehensive roadmap for building healthier, more equitable communities, this paper contributes to the broader public health effort to reduce overdose deaths and support individuals on their path to recovery. Given the interconnectedness of the COH pillars, some thematic overlap is expected, particularly regarding key strategies such as stigma reduction, cross-sector collaboration, and harm reduction integration, which span multiple domains of action.

Pillar 1: Making the Prevention of Opioid Overdose Deaths a Shared Value

The first pillar of the COH model, making health a shared value, emphasizes the need for a collective mindset in addressing public health crises.20 Preventing opioid overdose deaths requires not only access to Narcan but also a cultural shift where opioid overdose is seen as a community issue rather than an individual failing. Overcoming stigma surrounding opioid use disorder (OUD) is central to fostering shared responsibility.21

Addressing Stigma in Communities and Pharmacies

Stigma remains a major barrier to naloxone access. Many individuals hesitate to seek naloxone due to fear of being judged, while some pharmacists are reluctant to dispense it, believing it enables risky opioid use.22 Studies show that low-income and rural pharmacies are less likely to stock naloxone, limiting access in the very communities that need it most.23

However, promising initiatives demonstrate that stigma reduction can improve naloxone uptake. For example, in San Francisco, robust harm reduction messaging and naloxone distribution programs have helped normalize overdose prevention.24 These initiatives illustrate how treating overdose as a medical emergency rather than a moral failure can encourage individuals to seek naloxone without fear.25

The Role of Harm Reduction

Harm reduction is a crucial framework in changing societal views about opioid use. It emphasizes the importance of helping individuals where they are without judgment or discrimination.26 Harm reduction approaches, like the distribution of Narcan, aim to reduce the immediate harm caused by opioid use while acknowledging that recovery is a long-term process.25 Naloxone is increasingly recognized as a first-aid tool that can save lives in the same way as Cardio-Pulmonary Resuscitation (CPR) or an EpiPen does, shifting public perception of overdose response from an individual issue to a community responsibility.9

For example, in Massachusetts, a statewide overdose education and naloxone distribution program trained community members and law enforcement in Narcan administration.27 Thousands of overdoses have been reversed through these efforts, proving that equipping communities with the right tools can save lives.28

Shifting the Law Enforcement Perspective

Law enforcement officers are often the first responders to overdose emergencies, and their role in administering Narcan is pivotal. However, some police departments have been slow to adopt naloxone due to concerns about enabling drug use.12

Yet, success stories like those in Seattle, Washington, have demonstrated how law enforcement can become part of the solution.29 By adopting harm reduction principles, the Seattle Police Department began equipping officers with naloxone, saving over 100 lives in just one year.29 Changing police training to prioritize harm reduction over punitive measures can help officers view overdose prevention as part of their public duty rather than an enforcement challenge.30

The Role of Public Education

Public education campaigns are crucial in making naloxone use a shared responsibility. Initiatives in Rhode Island and Ohio have successfully increased community engagement by distributing naloxone kits alongside instructional materials.31,32 These efforts emphasize that anyone—a family member, friend, or bystander—can intervene in an overdose and save a life.

In summary, the first pillar of the COH model calls for a cultural shift in how opioid overdose prevention is perceived. Reducing stigma, fostering harm reduction, engaging law enforcement, and expanding public education are essential strategies in making naloxone access a shared value. Success stories from community pharmacy programs, law enforcement adoption, and public health initiatives underscore the importance of collaboration in changing societal attitudes. By making overdose prevention a collective responsibility, communities can create a culture of health that prioritizes saving lives.

Pillar 2: Fostering Cross-Sector Collaborations to Improve the Well-Being of People Affected by Opioid Overdose

The second pillar of the COH model emphasizes the importance of fostering cross-sector collaborations to address complex public health challenges.15 In the case of opioid overdose prevention, cross-sector collaboration is essential to ensure that individuals affected by OUD receive not only immediate overdose reversal via Narcan but also access to long-term treatment and recovery options. The FDA’s approval of OTC Narcan has opened new avenues for collaboration, particularly between traditional healthcare settings and community-based organizations that can distribute and educate the public about naloxone.5 However, challenges remain, in effectively coordinating these efforts across different sectors to maximize impact.33

Pharmacies and Public Health Agencies: A Crucial Partnership

Pharmacies play a pivotal role in the distribution of Narcan, as they are often the most accessible healthcare providers in many communities.34 However, their effectiveness depends on partnerships with public health agencies to address stigma, insurance coverage gaps, and disparities in access. Some community pharmacies work with local health departments to ensure naloxone availability, particularly in high-risk areas.35 For example, in Ohio, collaboration between pharmacies and the state health department has expanded naloxone distribution and pharmacist education.35,36

However, many rural and low-income urban pharmacies struggle to stock naloxone due to financial constraints. The state of Massachusetts has addressed this by funding pharmacy naloxone programs and mandating availability. Expanding such initiatives to other states could further reduce access barriers.37

Engaging Law Enforcement in Overdose Prevention

Law enforcement officers are often first responders to overdoses, making their involvement crucial.33 However, law enforcement participation in overdose prevention has been uneven due to concerns about enabling drug use and a lack of clarity on the role of harm reduction in public safety. Nevertheless, successful cross-sector collaborations between law enforcement and public health advocates have demonstrated the potential for law enforcement officers to play a vital role in overdose prevention.33,38

One example of effective collaboration is the Law Enforcement Assisted Diversion (LEAD) program, implemented in multiple cities, allowing officers to divert individuals with substance use disorders to treatment rather than jail.38 In Seattle, Washington, this approach has led to fewer drug-related arrests and greater engagement in recovery services.38

Similarly, Ohio police officers carrying naloxone have reversed thousands of overdoses with support from local health agencies providing training and supplies. Expanding naloxone training for law enforcement officers and integrating harm reduction into policing can further strengthen overdose response efforts.39

Hospitals and Community-Based Organizations: Bridging the Treatment Gap

Hospitals are another key player in overdose prevention, as they are often the first point of contact for individuals following a non-fatal overdose.40 However, ensuring that individuals receive follow-up care and access to long-term treatment remains a significant challenge. Cross-sector collaboration between hospitals and community-based organizations can help bridge this gap.41

For example, the “Warm Handoff” model, implemented in states like Pennsylvania and Rhode Island, involves connecting individuals who have experienced an overdose with peer recovery specialists before they are discharged from the hospital.42 In Rhode Island, this model has resulted in a significant increase in treatment engagement among individuals who have experienced a non-fatal overdose.43

Additionally, some hospitals now include naloxone kits and harm reduction education in discharge protocols. Expanding partnerships between hospitals and harm reduction organizations in the community can improve long-term outcomes for individuals at high risk of overdose.44

Schools and Educational Institutions: Expanding Naloxone Training

Schools have an important role to play in overdose prevention, particularly in areas where opioid use is prevalent among youth.45 Cross-sector collaborations between schools, public health agencies, and harm reduction organizations can help ensure that naloxone training is integrated into educational curricula and that students are equipped with the knowledge to respond to an overdose.46 In New Jersey, the Department of Education partnered with local health agencies to provide naloxone training to students and staff, increasing awareness and preparedness.47 Expanding similar programs nationwide could further strengthen community overdose response.48

In summary, fostering cross-sector collaboration is essential for expanding Narcan use and improving overdose prevention. Pharmacies, public health agencies, law enforcement, hospitals, and schools each play a critical role. Programs like LEAD, Warm Handoff, and school-based naloxone training demonstrate the effectiveness of collaboration in saving lives and promoting harm reduction. However, challenges remain, particularly in addressing disparities in naloxone access and shifting attitudes toward harm reduction. Continued investment in cross-sector partnerships is necessary to ensure that naloxone reaches those who need it most.

Pillar 3: Creating Healthier Communities by Investing in Efforts to Ensure Equitable Access to Narcan

The third pillar of the COH model emphasizes creating healthier communities by advancing policies and practices that promote well-being for all.15 Equitable access to life-saving interventions like Narcan is central to addressing the opioid crisis in the United States. While Narcan has proven to reduce opioid overdose deaths, barriers to access persist, especially among vulnerable populations.6,8 Addressing these barriers is essential for building healthier, more resilient communities.

Insurance Coverage and Affordability Barriers

Despite the FDA’s approval of over-the-counter Narcan, cost remains a significant barrier, particularly for those without insurance.49 Medicaid and Medicare generally cover naloxone, but private insurance coverage is inconsistent, and out-of-pocket costs can exceed $120 for a single box, making it unaffordable for low-income individuals and families in areas most impacted by the opioid epidemic.50

Many pharmacies in low-income communities do not carry Narcan due to limited demand, driven partly by high costs and lack of insurance coverage.10 Some states, like New York, have programs such as the Naloxone Co-payment Assistance Program (N-CAP), which covers up to $40 of co-payments for naloxone prescriptions.51 However, uninsured individuals still face significant challenges. Expanding public funding and mandating insurance coverage for naloxone could reduce these disparities.52

Geographic Disparities in Naloxone Access

Naloxone availability also varies significantly by region, with rural and low-income urban areas facing the greatest challenges.53 Pharmacies in these regions are less likely to stock naloxone due to lower demand and limited resources, leaving high-risk communities without access to this life-saving medication.23

To address these disparities, some states have implemented standing orders allowing pharmacies to dispense naloxone without a prescription.54 In Massachusetts, a statewide standing order has substantially increased naloxone distribution, particularly in rural areas.55 Harm reduction organizations have also stepped in to fill gaps in access.25 For instance, in West Virginia, harm reduction programs have distributed thousands of naloxone kits to rural communities, reducing overdose deaths.56

The Role of Independent and Chain Pharmacies

A stark contrast exists between independent and chain pharmacies in naloxone availability. Independent pharmacies, especially in rural areas, are less likely to stock naloxone due to financial constraints and concerns about serving individuals who use drugs.57 In contrast, chain pharmacies like CVS and Walgreens are more likely to stock naloxone and have policies in place to ensure availability.58

CVS, for example, launched a public education campaign to increase awareness of Narcan’s availability and its role in saving lives.59 However, independent pharmacies in underserved areas still require targeted support, including financial incentives and education programs, to address these disparities and ensure naloxone reaches communities in need.60

Overcoming Stigma and Promoting a Culture of Health

Stigma remains one of the most significant barriers to naloxone access. Many individuals who use opioids hesitate to seek naloxone out of fear of judgment or being labeled as drug users. This stigma extends to healthcare providers, pharmacists, and law enforcement officials, some of whom are reluctant to stock or distribute naloxone due to misconceptions that it enables risky opioid use.21

Shifting public perceptions is critical to overcoming these barriers. Public health campaigns, like California’s “Know Overdose” initiative, educate communities about naloxone’s role as a harm reduction tool that saves lives.61 These campaigns emphasize that opioid overdoses are medical emergencies requiring immediate intervention, similar to heart attacks or strokes. By changing attitudes, such initiatives help normalize naloxone use and encourage greater distribution in communities affected by the opioid crisis.62

Success Stories: Expanding Naloxone Access Through Public Policy

Several states and cities have successfully expanded naloxone access through innovative public policy initiatives. In Rhode Island, the Department of Health allows community organizations to distribute naloxone directly to individuals without requiring them to visit a pharmacy.43 This approach has been particularly effective in reaching homeless individuals and those living in poverty.

Similarly, Illinois runs a statewide program providing free naloxone kits to people at risk of overdose and their loved ones. These kits are distributed through a network of healthcare providers, harm reduction groups, and community organizations, ensuring naloxone reaches those who need it most.63

In Philadelphia, the city’s health department partnered with local businesses to distribute naloxone at convenience stores, libraries, and recreation centers, improving access in neighborhoods with high overdose rates. Such efforts demonstrate the potential for innovative strategies to reduce opioid-related deaths by ensuring naloxone is readily available in underserved communities.64 Similarly, in Minnesota, public health officials have launched Narcan vending machines in Minneapolis, ensuring 24/7 access to the medication in high-risk areas, further demonstrating how innovative distribution strategies can improve equitable naloxone access.65

In summary, creating healthier communities through equitable access to Narcan requires addressing cost, insurance coverage, and geographic disparities while reducing stigma. Public policy initiatives, partnerships between pharmacies and public health agencies, and public education campaigns are all essential components. Success stories from states like Massachusetts, Rhode Island, and Illinois highlight the impact of these efforts, but continued investment is needed to expand access to all at-risk populations. By prioritizing equitable access to naloxone, communities can take significant steps toward reducing overdose deaths and improving public health outcomes.

Pillar 4: Transforming Health and Healthcare Systems for Treatment of Opioid Use Disorder

The fourth pillar of the COH model emphasizes integrating healthcare and public health services to ensure equitable access to quality, affordable care. This is particularly critical for addressing OUD, which requires transforming healthcare systems to deliver comprehensive, evidence-based treatment that includes harm reduction, medication-assisted treatment (MAT), and long-term recovery support.66 The FDA’s approval of over-the-counter Narcan is a step in this direction, but systemic changes are needed to address the broader opioid crisis.66

Integrating Harm Reduction Into Healthcare Systems

Harm reduction, including naloxone distribution, is central to OUD care. However, healthcare systems must go beyond providing naloxone to integrate harm reduction into routine care. Hospitals play a crucial role through initiatives like “warm handoffs”, where overdose patients in emergency departments (EDs) are connected with addiction specialists or recovery services before discharge.67 This approach ensures follow-up care, including MAT and access to harm reduction tools such as fentanyl test strips.53,68

In Rhode Island, hospitals have integrated naloxone distribution into discharge protocols for OUD patients, reducing repeat overdoses and increasing engagement in recovery services. Such efforts demonstrate how transforming hospital protocols can embed harm reduction as a standard part of care.67,69

Expanding Access to Medication-Assisted Treatment (MAT)

MAT, which combines medications like methadone or buprenorphine with behavioral therapies, is one of the most effective treatments for OUD. However, access to MAT is uneven, particularly in rural and underserved areas.53 Telemedicine has emerged as a valuable solution, especially during the COVID-19 pandemic when regulatory changes allowed for remote MAT delivery.70 Permanently adopting telehealth flexibilities can further expand MAT access for those in areas with limited healthcare infrastructure.

Community-based pharmacies have also begun dispensing buprenorphine, providing additional access points for individuals who lack specialized addiction treatment centers. This model increases accessibility and helps normalize OUD treatment within the broader healthcare system, reducing stigma.71

Training Healthcare Providers to Address OUD

A significant barrier to improving OUD treatment is the lack of provider training. Many doctors, nurses, and pharmacists receive little education on substance use disorders, leading to missed intervention opportunities.72 States like Massachusetts have started addressing this gap by requiring prescribers to complete training on opioid safety, naloxone use, and MAT referrals.73 Expanding such requirements to include all healthcare providers, including behavioral and allied health professionals, would strengthen the workforce’s capacity to address OUD.74

Healthcare systems can also leverage online training modules and virtual workshops to keep providers updated on evidence-based practices.75 By investing in training, healthcare systems can create a more informed and effective workforce capable of meeting the needs of individuals with OUD.

Using Data to Drive Systemic Change

Leveraging data is essential for transforming healthcare systems to address OUD. Electronic health records (EHRs) and claims data can identify high-risk patients and enable targeted interventions. For example, pharmacies can track opioid prescriptions and provide naloxone or MAT to patients identified as at-risk.76

Public health agencies can collaborate with healthcare systems to implement data-driven strategies. In Pennsylvania, the Prescription Drug Monitoring Program (PDMP) has been used to track prescriptions, reduce overprescribing, and identify individuals at risk of overdose.76 By integrating PDMP data with public health initiatives, Pennsylvania has reduced opioid-related deaths and improved access to treatment.76,77

By combining harm reduction, MAT expansion, provider training, and data-driven strategies, healthcare systems can play a pivotal role in addressing the opioid crisis and supporting individuals with OUD.78

Discussion

The application of the four pillars of the COH model provides significant insights into the multifaceted strategies needed to address the opioid crisis through the wider use of Narcan. Each pillar emphasizes different dimensions of collaboration, equity, and system transformation, all of which are essential for reducing opioid overdose deaths and supporting individuals with OUD. Notably, success stories across different states demonstrate how the four pillars can operate synergistically to improve overdose outcomes. In Massachusetts and Rhode Island, comprehensive strategies integrating public health, healthcare, and community partners have expanded naloxone access, reduced stigma, and improved care transitions. In San Francisco, robust harm reduction messaging and community-based naloxone distribution initiatives have shifted cultural perceptions. Similarly, Ohio and Seattle, Washington, have demonstrated the importance of law enforcement engagement and cross-sector partnerships in supporting overdose prevention and recovery efforts. These examples illustrate that while each pillar offers distinct insights, their real-world application often occurs in combination, reinforcing the need for integrated, place-based approaches to building a Culture of Health. At the same time, each pillar addresses a unique dimension of systemic change: making health a shared value fosters societal norms that reduce stigma; cross-sector collaboration mobilizes diverse resources and leadership; equitable access ensures that life-saving interventions reach marginalized populations; and transforming healthcare systems embeds harm reduction and recovery support into clinical practice. Recognizing the distinct role of each pillar is critical to designing comprehensive and sustainable public health strategies to address the opioid crisis.

Summary of Insights and Takeaways from the Four Pillars

Pillar 1 emphasizes making opioid overdose prevention a shared value by overcoming stigma and fostering community-wide responsibility. Stigma in pharmacies and law enforcement discourages individuals from seeking naloxone.17,20 Successful harm reduction efforts in San Francisco and Massachusetts demonstrate that community support and education can normalize naloxone as a life-saving intervention, akin to other emergency medical tools.9,24,27

Pillar 2 underscores the importance of cross-sector collaborations in promoting Narcan’s use. Partnerships among pharmacies, law enforcement, hospitals, and community organizations have proven effective in programs like the LEAD program and hospital-based naloxone distribution. These collaborations increase access to timely overdose interventions and long-term treatment.38

Pillar 3 highlights the need to address economic and geographic barriers to Narcan access in rural and low-income communities. Initiatives in Rhode Island, New York, and Massachusetts have improved access by reducing costs and promoting community collaborations. Addressing disparities and ensuring pharmacies stock naloxone are essential to saving lives.43,51,54,55

Pillar 4 focuses on transforming healthcare systems to integrate harm reduction and MAT. Telemedicine has expanded MAT access in underserved areas, while hospital “warm handoff” programs connect overdose survivors to treatment. Systemic changes are vital for delivering comprehensive, patient-centered care for individuals with OUD.53,66–70

Implications for Practice

The insights gained from applying the COH model to opioid overdose prevention highlight several critical implications for practice across different sectors. For pharmacies, both chain and independent, there is a need to ensure that naloxone is readily available and affordable. Pharmacies should collaborate with public health departments37 to promote naloxone access, provide patient counseling, and participate in community education campaigns to reduce stigma.

For healthcare providers, including hospitals, clinics, and primary care practices, integrating harm reduction strategies like naloxone distribution and MAT into routine care is essential. Hospitals should implement protocols for overdose patients that include naloxone distribution and referrals to recovery services upon discharge.66,68,70

For law enforcement, adopting harm reduction principles and collaborating with healthcare providers and community organizations, as seen in LEAD programs, can help officers view overdose prevention as part of their public safety duties.38

Families and communities also play a key role in overdose prevention by learning how to use naloxone and supporting loved ones struggling with OUD. Public education campaigns should target families and at-risk communities to increase awareness and reduce stigma.31,32

Implications for Policy

Policymakers should prioritize expanding insurance coverage for naloxone, including making it available at no cost for uninsured individuals. States should consider mandating the stocking of naloxone in all pharmacies, particularly in high-risk areas, and provide financial support to independent pharmacies to ensure affordability.14,33,37,57 Additionally, telemedicine should be made a permanent option for MAT to improve access in underserved regions.70

Implications for Future Research

Further research is needed to evaluate the long-term effectiveness of cross-sector collaborations in reducing opioid overdose deaths. Additionally, studies should explore the impact of public education campaigns on reducing stigma and increasing naloxone usage. Understanding the barriers to naloxone access in rural and low-income areas will also be critical to developing more targeted interventions.53

In summary, addressing the opioid crisis requires coordinated efforts across all sectors of society. By applying the COH model’s four pillars—shared values, cross-sector collaboration, equitable access, and healthcare system transformation—communities can create a sustainable framework for reducing overdose deaths and supporting long-term recovery for individuals with Opioid Use Disorder.15,17,20

Conclusion

The US opioid epidemic remains one of the most urgent public health challenges of our time, demanding a shift from conventional healthcare interventions to broader system-level and cultural change. The FDA’s approval of over-the-counter Narcan represents a pivotal milestone, but its potential will be realized only through strategic efforts to make naloxone truly accessible, affordable, and normalized within communities. Applying the RWJF Culture of Health (COH) model, this paper presents a comprehensive roadmap for advancing harm reduction strategies, promoting equitable access, and integrating systemic reforms to combat opioid overdose deaths.

Evidence reviewed in this paper demonstrates that stigma remains a profound barrier to naloxone access and utilization, deterring both individuals and healthcare providers. Community-based naloxone distribution programs and public education campaigns, such as those implemented in San Francisco, Rhode Island, and Philadelphia, offer powerful models for increasing public uptake and saving lives. Nevertheless, challenges persist: Narcan’s price point, geographic disparities in availability, and limited public awareness continue to undermine the promise of OTC access. While national policy efforts have prioritized naloxone expansion, the full potential of these initiatives will depend on addressing these systemic barriers through multi-sector collaboration and sustained public health investment.

Ultimately, addressing the opioid crisis demands both urgent action and long-term cultural change. The COH model provides a guiding framework for engaging stakeholders across healthcare, public health, law enforcement, and community organizations to create a system where overdose prevention is a shared value and recovery pathways are accessible to all. Though uncertainties remain about how quickly OTC Narcan adoption will scale, the collective lessons from harm reduction and cross-sector collaboration are clear: building healthier, more resilient communities requires persistence, innovation, and a commitment to health equity.

Looking ahead, sustained and coordinated action across sectors will be critical to achieving the systemic and cultural changes needed to end the opioid epidemic. By fostering a culture of health that embraces harm reduction, advances equitable access, and transforms healthcare systems, we can help turn the tide on the opioid epidemic. The journey toward a healthier and more compassionate society will require sustained collaboration, innovation, and a commitment to addressing the social and structural determinants that perpetuate opioid-related harm. With deliberate and coordinated action, we can build a future where life-saving interventions like Narcan are universally accessible, and every individual has a fair opportunity for recovery and wellness.

Ethics Statement: Not Applicable: Ethics/IRB approval does not apply to this Perspective paper as this work did not involve human subjects.

Disclosure: The authors report no conflicts of interest in this work.

Source:  https://www.dovepress.com/transforming-opioid-overdose-prevention-in-the-united-states-leveragin-peer-reviewed-fulltext-article-RMHP

“Since the failed war on drugs began more than 50 years ago, the prohibition of marijuana has ruined lives, families and communities, particularly communities of color,” House Minority Leader Hakeem Jeffries (D-N.Y.) recently said while announcing a bipartisan bill to legalize cannabis that the federal level. Jeffries added that the bill “will lay the groundwork to finally right these wrongs in a way that advances public safety.”  

But the growing body of evidence on cannabis’s effects on kids suggests this is not true at all.  

Cannabis legalization efforts across the U.S. have greatly accelerated over the last 15 years. Despite some recent success at anti-legalization efforts (e.g., Florida and North Dakota voters rejected in 2024 an adult use bill), the widespread public support for cannabis reform has translated to nearly half of U.S. states permitting adult use of cannabis, and 46 states with some form of a medical cannabis program. 

Though all legal-marijuana states have set the minimum age at 21, underage use has become a significant health concern. National data indicate that in 2024, 16.2 percent of 12th graders reported cannabis use in the past 30 days, and about 5.1 percent indicated daily use. To compound matters, product potency levels of the main intoxicant in the cannabis plant, THC (or Delta-9), have skyrocketed, from approximately 5 percent in the 1970s to upwards of 95 percent in THC concentrate products today. Even street-weed is routinely five to six times more potent than it was back in the day. 

The pro-cannabis landscape has likely moved teen perceptions of cannabis use. A prior encouraging trend of the 1970s and 1980s, when more and more teens each year perceived use of cannabis to be harmful, is now in reverse. Only 35.9 percent of 12th graders view regular cannabis use as harmful, compared to 50.4 percent in 1980. 

This is happening even as research is showing that cannabis is more deleterious to young people than we previously believed.  

The negative effects of cannabis use on a teenager can be seen across a range of behaviors. Changes may be subtle at first and masked as typical teenage turmoil. But ominous signs can soon emerge, including changes in friends, loss of interest in school and hobbies, and use on a daily basis. The usual pushback against parental rules and expectations becomes anger and defiance. For many, underlying issues of depression and anxiety get worse.

And there is a vast body of scientific research indicating that teen-onset use of THC use significantly increases the risk of addiction and can be a trigger for developing psychosis, including schizophrenia.

The pro-cannabis trend is not occurring in a vacuum. Those entrusted with protecting the health and well-being of youth — parents, community leaders, policy makers — have dropped the ball on the issue. Policymakers tout exaggerated claims that THC is a source of wellness and safer than alcohol or nicotine. In some states, cannabis-based edibles are sold in convenience stores. Many parents have a rear-view-mirror perception of cannabis, as they assume the products these days are the water-downed versions from the 1960’s and ’70s.  

Aggravating matters are the influences of some business interests. The playbook from Big Tobacco is now being used by Big Cannabis: political donations, legislative lobbying, media support, and claims that solutions to social problems will follow legalization. 

The debate on the public health impact of legalizing cannabis will continue. We hope the discourse and policies will follow the science and give priority to the health and well-being of youth. An international panel of elite researchers on cannabis recently concluded that there is no level of cannabis use that is safe, and if use occurs, it’s vital to refrain until after puberty. The National Academy of Sciences and the National Institute on Drug Abuse also agree with these guidelines. One state — Minnesota — is requiring school-based drug prevention programs to include specific information on cannabis harms, a hopeful trend for other states to follow.

When recreational cannabis is made available to adults, perhaps we assume that legal restrictions to those age 21 and older is a sufficient guardrail. But history tells us that youth will indulge in adult-only activities. The pro-cannabis environment in the U.S. poses a public health challenge to young people. There isn’t a single challenge of being a teenager that cannabis will help solve. Sadly, this is a message that is not getting enough attention. 

Naomi Schaefer Riley is a senior fellow at the American Enterprise Institute, where she focuses on child welfare and foster care issues. Ken Winters is a senior scientist at the Minnesota branch of the Oregon Research Institute and is the co-founder of Smart Approaches to Marijuana Minnesota. This essay is adapted from a chapter in the forthcoming edited volume, “Mind the Children: How to Think About the Youth Mental Health Collapse.” 

Source:  https://thehill.com/opinion/healthcare/5347506-the-case-for-restricting-cannabis-age/

From National Public Radio – by Brian Mann – June 10, 2025

Justin Carlyle, age 23, photographed on the street in Kensington, a neighborhood of Philadelphia, has lived with addiction to fentanyl and other drugs for a decade. After a decade when overdoses devastated young Americans, drug deaths among people in the U.S. under age 35 are plummeting. The shift is saving thousands of young lives every year.

PHILADELPHIA — When Justin Carlyle, 23, began experimenting with drugs a decade ago, he found himself part of a generation of young Americans caught in the devastating wave of harm caused by fentanyl addiction and overdose.

“I use fentanyl, cocaine, crack cocaine, yeah, all of it,” Carlyle said, speaking to NPR on the streets of Kensington, a working class neighborhood in Philadelphia where dealers sell drugs openly. “I was real young. I was 13 or 14 when I tried cocaine, crack cocaine, for the first time.”

As an elevated train rumbled overhead, Carlyle described turning to fentanyl, xylazine and other increasingly toxic street drugs. “I’ve had three overdoses, and two of the times I was definitely Narcaned,” he said, referring to a medication, also known as naloxone, that reverses potentially fatal opioid overdoses.

Carlyle’s teens and early 20s have been wracked by severe drug use, but the fact that he’s still alive means he’s part of a hopeful new national trend.

“What we’re seeing is a massive reduction in [fatal] overdose risk, among Gen Z in particular,” said Nabarun Dasgupta, an addiction researcher at the University of North Carolina. “Ages 20 to 29 lowered the risk by 47%, cut it right in half.”

This stunning drop in drug deaths among people in the U.S.is being tracked indata compiled by the Centers for Disease Control and Prevention and other federal agencies.

The latest available records found fentanyl and other drugs killed more than 31,000 people (see chart) under the age of 35 in 2021. By last year, that number had plummeted to roughly 16,690 fatal overdoses, according to provisional CDC data.

The life-saving shift is welcome news for parents like Jon Epstein, who lost his son Cal to fentanyl in 2020. “What has happened with the 20- to 29-year-olds? They beat fentanyl,” said Epstein, who works with a national drug awareness group focused on young people called Song for Charlie.

Cal Epstein (right) died from a fentanyl overdose in 2020 when he was 18. His father, Jon Epstein, and mother, Jennifer Epstein, joined a movement of activist parents in a group called Song for Charlie that works to raise awareness about the risks of fentanyl and other street drugs. Also shown is Cal’s brother, Miles Epstein.

For America’s young, a decade of unprecedented carnage

To understand the significance of this promising trend, it’s important to recall the terror and devastation wrought by fentanyl among families and communities in the U.S.

Beginning around 2014, U.S. officials say Mexican drug cartels began smuggling large quantities of fentanyl into American communities, often disguising the street drug as counterfeit prescription pills resembling OxyContin or Percocet.

Over the past decade, drug overdoses among young people surged, killing more than 230,000 people under the age of 35. For many families and whole communities, the losses felt catastrophic.

“We went to check on [Cal] and he was unresponsive,” Jon Epstein recalled. “We made it to the hospital, but he didn’t make it home. It was a bolt out of the blue.”

Portraits on “The Faces of Fentanyl” wall, displays photos of Americans who died from a fentanyl overdose, at the Drug Enforcement Administration (DEA) headquarters in Arlington, Va.

Cal Epstein was 18, a college student. According to the family, it’s not clear why he decided to take an opioid pill. He tried to purchase a prescription-grade pill from a dealer on social media. In fact, it was a counterfeit pill containing a deadly dose of fentanyl.

While grieving, Jon Epstein started learning about fentanyl, digging through public health data. He found other kids in his town of Beaverton, Ore., were dying. “They had lost four students [to fatal overdoses in the local school district] in the preceding year,” he recalled.

Jon and his wife, Jennifer Epstein, connected with a growing network of shattered parents around the country who were waking up to a terrifying fact: Fentanyl, often sold on social media platforms, was making it into their homes and killing their kids.

Like many grieving families, they turned their sorrow into activism. Through the group Song for Charlie, they worked to educate young people and parents about the unique dangers of fentanyl.

“The game has completely changed, especially for kids who are going through an experimental phase,” Jon Epstein warned in a video distributed nationally. “An experimental phase is now deadly.” This message — summed up by the phrase One pill can kill — began spreading in schools and on social media nationwide but for years the wave of death seemed unsolvable.

In a study published last month in the journal Pediatrics, researcher Noa Krawczyk at the NYU Grossman School of Public Health found deaths attributed entirely to fentanyl “nearly quadrupled” among people people age 15 to 24 from 2018 through 2022.

“In your generation, people used drugs. In my generation people used drugs, we just didn’t use to die as much from them,” Krawcyzk said.

Especially among teenagers in the U.S., fentanyl deaths seemed stuck at catastrophic levels, between 1,500 and 2,000 fatal overdoses a year. Then last year, federal data revealed a stunning decline, with 40% fewer teens experiencing fatal overdoses. “We’re super heartened to finally see teens dropping,” Epstein said.

While the improvement is dramatic, Dasgupta at the University of North Carolina, found the recovery among teens appears uneven.

Some teens and twenty-somethings are seeing far fewer deaths, but he identified one cluster born between 2005 and 2011 who actually saw a slight uptick in deaths over the past two years. The increase is relatively small — about 300 additional fatalities nationwide over two years — but Dasgupta said it’s an area of concern that needs more study to determine why.

The question now is what changed that is suddenly saving so many young lives? Drug policy experts are scrambling to understand the shift.

Many U.S. kids appear more cautious about drug use

Theories include the wider distribution of Narcan, or naloxone; a trend of weaker, less deadly fentanyl being sold by dealers; more readily available addiction healthcare; and also the loss of so many vulnerable young people who have already died.

Many researchers believe another key factor may be less risky drug and alcohol use among teens and twenty-somethings, a pattern that emerged during the years of the COVID epidemic. One study by a team at the University of Michigan found the number of teens abstaining from substance grew to its highest level in 2024.

“This trend in the reduction of substance use among teenagers is unprecedented,” Nora D. Volkow, who has served as director of the U.S. government’s National Institute on Drug Abuse since 2003, said in a statement last December.

Keith Humphreys, an addiction researcher at Stanford University, credits this apparent behavioral shift with helping save lives. “There’s fewer people initiating with these substances. That should work in our favor,” he told NPR.

According to Dasgupta at the University of North Carolina, years of devastation caused by fentanyl and other opioids might mean more people in their teens and twenties are choosing to experiment with less risky drugs.

“Alcohol and opioids are on the outs with Gen Z, and instead we see [a shift to] cannabis and psychedelics, and those are inherently safer drugs,” he said.

Overall, this positive trend among younger Americans is outpacing the wider opioid recovery in the U.S., which saw 27% fewer fatal overdoses across all age groups in 2024.

Will drug deaths keep dropping for young Americans?

While this news is promising — roughly 15,000 fewer drug deaths among young people in the U.S. in 2024, according to preliminary data, compared with the deadliest year 2021 — researchers say sustaining progress may be difficult.

That’s because many of the young people still most at risk, like Justin Carlyle in Philadelphia, aren’t just experimenting with drugs. They’re struggling with full blown addiction.

“What I’m used to is getting high, you know?” he said.

Despite the danger of a fatal overdose, Carlyle told NPR he has tried to quit fentanyl repeatedly, even using the medication suboxone to to try to curb his opioid cravings, so far without success.

“I wish I had the answer to that. I know all of us fighting addiction right now wish we had the answer,” he said.

But many experts, activists and front-line healthcare workers say there’s more hope on the streets, too. The spread of Narcanis helping. Researchers studying street drugs say the fentanyl being sold by dealers in the U.S. is less potent, less deadly, than it once was.

That matters because studies show people who survive addiction long enough do typically recover.

There are also growing efforts around the U.S. aimed at reaching young people experiencing severe addiction, programs that ramped up over the past four years with federal funding from the Biden administration.

On a recent afternoon, two city drug response workers in Philadelphia, Kevin Howard and Dominick Maurizio, offered counseling to a young man huddled in a bus shelter.

“Anything we can help you with? Want to go in-patient?” Howard said. “Want to go to a shelter?”

Dominick Maurizio (left) and Keven Howard work for the city of Philadelphia’s Mobile Outreach and Recovery Services program, doing street outreach to people, including many young people, living with severe addiction. Both survived cocaine and heroin use when they were in their 20s and say they believe programs like this one are helping people recover.

Howard and Maurizio are themselves in recovery after surviving what they describe as their own battles with heroin and crack cocaine addiction when they were young men in their 20s.

Both said they believe this kind of outreach is helping. “If we help one person, we’re winning in some capacity,” Maurizio said.

“I see it as me saving lives,” Howard said. “Any time I give someone Narcan or just check on them to see if they’re alive, I believe we’re winning.”

But experts point to one other uncertainty in this first hopeful moment since the fentanyl crisis began.

The Trump administration wants to cut billions of dollars in funding for science and health agencies responding to the fentanyl crisis. The federal government has already moved to freeze or end grants that support front-line drug treatment and harm reduction programs.

In a statement, the U.S. Department of Health and Human Services said the goal is to “streamline resources and eliminate redundancies, ensuring that essential mental health and substance use disorder services are delivered more effectively.”

But doctors, researchers and harm reduction activists told NPR if addiction services are scaled back or shut down, the promising recovery among teens and young adults could unravel.

Source:  https://www.npr.org/2025/06/10/nx-s1-5414476/fentanyl-gen-z-drug-overdose-deaths

by Amy Norton – May 14, 2025

The trends are clear: Americans are in the midst of a marijuana high. Over the past 30 years, daily or near-daily marijuana use soared 15-fold, surpassing daily alcohol use for the first time in 2022. That same year, marijuana use reached historic levels among Americans aged 19-50 — with 11% of 19- to 30-year-olds saying they used the drug every day.

A key reason for the surge is that more states are legalizing both medical and recreational marijuana use. Another driver, which is closely tied to legalization, is the changing public perceptions around marijuana: Many people just don’t see much harm in the habit, or at least view a daily marijuana joint as safer than smoking cigarettes.

And they’re not necessarily wrong: Although it’s obvious marijuana use can have consequences — including intoxication, dependence, and respiratory symptoms such as chronic bronchitis — there is little, or not enough, evidence to definitively conclude that it’s a cancer risk.

But that also doesn’t mean marijuana is completely in the clear.

“Insufficient evidence doesn’t mean the risk isn’t there,” said Nigar Nargis, PhD, senior scientific director of tobacco control research, American Cancer Society (ACS).

‘The Crux of the Problem’

Marijuana smoke does contain many of the same carcinogens found in tobacco smoke, so it seems logical that a cannabis habit could contribute to some cancers. Yet studies have largely failed to bear that logic out.

In 2017, the National Academies of Sciences, Engineering, and Medicine (NASEM) published a comprehensive research review on cannabis smoking and cancer risk. It found modest evidence of an association with just one cancer: a subtype of testicular cancer. In the cases of lung and head and neck cancers, studies indicated no significant association between habitual cannabis use and risk for these cancers. When it came to other cannabis-cancer relationships, the evidence was mostly deemed insufficient or simply absent.

However, the overarching conclusion from the NASEM review was that studies to date have been hampered by limitations, such as small sample sizes and survey-based measurements of cannabis use that lack details on frequency and duration of use. In addition, many marijuana users may also smoke cigarettes, making it difficult to untangle the effects of marijuana itself.

“That’s the crux of the problem,” Nargis said. “We have a huge knowledge gap where existing evidence doesn’t allow us to draw conclusions.”

That long-standing gap is becoming more concerning, she said, because legalization may now be sending a “signal” to the public that cannabis is safe.

This concern prompted Nargis and her colleagues to explore whether studies conducted since the 2017 NASEM report have lifted the marijuana-cancer risk haze at all. Their conclusion, published in February in The Lancet Public Health: not really.

“Unfortunately, the evidence base hasn’t improved much,” Nargis said. However, she added, some studies have hinted at links between cannabis use and certain cancers beyond testicular. Although these studies have their own limitations, Nargis stressed, they do point to directions for future research.

Head and Neck Cancers

While the NASEM report cited reassuring data on head and neck cancers, a study published last year in JAMA Otolaryngology-Head & Neck Surgery reached a different conclusion. The researchers tried to overcome some limitations of prior research — including small sample sizes and relatively light and self-reported marijuana use — by analyzing records from patients diagnosed with cannabis use disorder at 64 US healthcare organizations.

The study involved over 116,000 patients with cannabis use disorder, matched against a control group without that diagnosis. Head and neck cancers were rare in both groups, but the overall incidence over 20 years was about three times higher among patients with cannabis use disorder (0.28% vs 0.09%).

After propensity score matching — based on factors such as age and tobacco and alcohol use — patients with cannabis use disorder had a 2.5-8.5 times higher risk for head and neck cancers, especially laryngeal cancer: any type (risk ratio [RR], 3.49), laryngeal cancer (RR, 8.39), oropharyngeal cancer (RR, 4.90), salivary gland cancer (RR, 2.70), nasopharyngeal cancer (RR, 2.60), and oral cancer (RR, 2.51).

But although the study was large, “it’s not particularly strong evidence,” said Gideon Meyerowitz-Katz, MPH, PhD, an epidemiologist and senior research fellow at the University of Wollongong, Australia.

Meyerowitz-Katz pointed to some key limitations, including the focus on people with cannabis use disorder, who are not representative of users in general. The study also lacked information on factors that aren’t captured in patient records, such as occupation — which, Meyerowitz-Katz noted, is known to be associated with both head and neck cancer risk and cannabis use.

Beyond that, the risk increases were generally small, even with extensive use of the drug.

“If we assume the study results are causal,” Meyerowitz-Katz said, “they suggest that people who use cannabis enough to get a diagnosis of cannabis use disorder get head and neck cancer at a rate of around 3 per 1000 people, compared to 1 per 1000 people who don’t use cannabis.”

Cannabis and Childhood Cancers

As marijuana use has shot up among Americans generally, so too has prenatal use. One study found, for instance, that the rates almost doubled from about 3.4%-7% of pregnant women in the US between 2002 and 2017. Many women say they use it to manage morning sickness.

Given the growing prenatal use, however, there is a need to better understand the potential risks of fetal exposure to the drug, said Kyle M. Walsh, PhD, associate professor in neurosurgery and pediatrics, Duke University School of Medicine, Durham, North Carolina.

The fortunate rarity of childhood cancers makes it challenging to study whether maternal substance use is a pediatric cancer risk factor. It’s also hard to define a control group, Walsh said, because parents of children with cancer often have difficulty recollecting their exposures before and during pregnancy.

To get past these limitations, Walsh and his colleagues took a different approach. Instead of trying to track cannabis use and tie it to cancer risk, Walsh’s team focused on families of children with cancer to see whether prenatal substance use was associated with any particular cancer subtypes. Their study, published last year in Cancer Epidemiology, Biomarkers & Prevention, surveyed 3145 US families with a child diagnosed with cancer before age 18. The study, however, did not focus on just marijuana; it looked at illicit drug use during pregnancy more generally. Although the authors assumed that would mostly mean marijuana, it could include other illicit drugs, such as cocaine.

Overall, 4% of mothers reported using illicit drugs during pregnancy. Prenatal use of illicit drugs was associated with an increased prevalence of two tumor types: intracranial embryonal tumors, including medulloblastoma and primitive neuroectodermal tumors (prevalence ratio [PR], 1.94), and retinoblastoma (PR, 3.11).

“Seeing those two subtypes emerge was quite interesting to us, because they’re both derived from a cell type in the developing fetal brain,” Walsh said. That, he added, “aligns in some ways” with research finding associations between prenatal cannabis use and increased frequencies of ADHD and autism spectrum disorders in children.

Interestingly, Walsh noted, prenatal cigarette smoking — which was also examined in the study — was not associated with any cancer subtype, suggesting that smoking might not explain the observed associations between prenatal drug use and central nervous system tumors. But, he stressed, it will take much more research to establish whether prenatal marijuana use, specifically, is associated with any childhood cancers, including studies in mice to examine whether cannabis exposure in utero affects neurodevelopment in ways that could promote cancer.

Testicular Cancer

Testicular cancer is the one cancer that has been linked to cannabis use with some consistency. But even those findings are shaky, according to Meyerowitz-Katz.

A 2019 meta-analysis in JAMA Network Open concluded that long-term marijuana use (over more than a decade) was associated with a significantly higher risk for nonseminomatous testicular germ cell tumors (odds ratio, 1.85). But the authors called the strength of the evidence — from three small case-control studies — low. All three had minimal controls for confounding, according to Meyerowitz-Katz.

“Whether this association is due to cannabis or other factors is hard to know,” he said. “People who use cannabis regularly are, of course, very different from people who rarely or never use it.”

In their 2025 Lancet Public Health review, Nargis and her colleagues pointed to a more recent study, published in 2021 in BMC Pharmacology and Toxicology, that looked at the issue in broader strokes. The study found parallels between population marijuana use and testicular cancer rates, as well as higher rates of the cancer in US states where marijuana was legal vs those where it wasn’t.

However, Nargis said, observational studies such as this must be interpreted with caution because they lack data on individuals.

If regular cannabis use does have effects on testicular cancer risk, the mechanisms are speculative at best. Researchers have noted that the testes harbor cannabinoid receptors, and there is experimental evidence that binding those receptors may alter normal hormonal and testicular function. But the path from smoking weed to developing testicular cancer is far from mapped out.

Risk for Other Cancers?

The recent Lancet Public Health overview also highlights emerging evidence suggesting a relationship between cannabis use and risks for a range of other cancer types.

A handful of observational studies, for instance, showed correlations between population-level cannabis use and risks for several cancers, such as breast, liver, thyroid, and prostate. The observational studies, mostly from a research team at the University of Western Australia, made headlines last year with a perspectives piece published in Addiction Biology, claiming there is “compelling” evidence that cannabis is “genotoxic” and raises cancer risk.

But, as Meyerowitz-Katz pointed out, the paper is only a perspective, not a study. And the human data it cites are from the same limited evidence base critiqued in the NASEM and ACS reports.

Meyerowitz-Katz does not discount the possibility that marijuana use contributes to some cancers. “I wouldn’t be surprised if we find that extensive cannabis use — particularly smoking — is related to cancer risk,” he said. But based on the existing evidence, he noted, the risk, if real, is “quite small.”

Where to Go From Here?

What’s needed, Nargis said, are large-scale cohort studies like those that showed cigarette smoking is a cancer risk factor. For the ACS, she said, the next step is to analyze decades of data from its own Cancer Prevention Studies, which included participants with a history of cannabis use and cancer diagnoses verified using state registries.

Nargis also noted that nearly all studies to date have focused on marijuana smoking, and “almost nothing” is known about the long-term health risks of newer ways to use cannabis, including vaping and edibles.

“What’s concerning,” she said, “is that the regulatory environment is not keeping up with this new product development.”

With the evolving laws and attitudes around cannabis use, Nargis said, it’s the responsibility of the research community to find out “the truth” about its long-term health effects.

“People should be able to make their choices based on evidence,” she said.

 

Source:  https://www.medscape.com/viewarticle/marijuana-use-rising-it-cancer-risk-2025a1000br5?

by Pat Aussem, L.P.C., M.A.C., Vice President, Consumer Clinical Content Development – June 2025

Teen substance use trends are always changing, and staying informed can help parents have better conversations with their kids. The good news? Teen substance use is at an all-time low! According to the Monitoring the Future survey, fewer teens are drinking, vaping, or using drugs compared to previous years.1 So, the next time your teen says, “Everyone is doing it,” you can ask how they’re seeing substance use in their world and what their peers are saying. The truth is, most teens are making healthy choices.

That said, it’s still important to keep an eye on emerging trends. New products, shifting laws, and the influence of social media continue to shape how young people perceive and access substances. What was true when we were growing up may no longer apply today. This article breaks down the key trends for 2025—no scare tactics, just real information to help you guide and support your teen. Let’s explore what’s on the horizon together.

Trend #1: VAPING EVOLUTION

Vaping is not new, but it’s evolving. Today’s e-cigarettes are more discreet than ever, often resembling USB drives, pens, or even watches.

The biggest concerns? Flavors that mask the harshness of nicotine make it easier for first-time users. And nicotine concentrations have skyrocketed, as one pod can contain as much nicotine as an entire pack of cigarettes.

Signs of vape use can include increased thirst, sweet smells, unfamiliar tech devices, small cartridges or pods.

You can start a conversation with your child by asking, “Vaping devices keep changing. What are you seeing at school these days?”

Trend #2: NICOTINE POUCHES

Nicotine pouches are one of the fastest-growing nicotine products among young people. These small, tobacco-free pouches are placed between the lip and gum and contain nicotine powder delivered directly into the bloodstream.

Nicotine pouches come in small white pouches the size of Mentos or Chicklets gum. They are packaged in circular containers. In addition to seeing packaging, be aware of white stains on clothing and frequent spitting that are signs of use.

With flavors like mint and fruit, they’re designed to appeal to teens and young adults. In addition, because they’re tobacco-free, they face fewer regulations than traditional tobacco products.

If you see people using nicotine pouches or brands like Zyn on social media or TV shows, you could ask your child, “What have you heard about nicotine pouches?”

Trend #3: CANNABIS LANDSCAPE

With more states legalizing adult use of marijuana (cannabis), many people no longer see it as being risky. But today’s cannabis is not what it was decades ago.

Modern strains can have THC levels more than 3-4 times higher than in the 1990’s. And the ways to use it have expanded beyond smoking with options like edibles, vapes, drinks, salves and concentrates.

Marijuana use during adolescence has been linked to negative impacts on brain development and mental health problems like depression, anxiety, suicidal thinking and psychosis. And at the age when teens are becoming new drivers, remember that driving under the influence of marijuana is illegal, not to mention extremely dangerous.  It can impact a person’s ability to make split-second decisions, even to stay in their lane without weaving.

You can talk about safety with your child by offering options should they be in a situation where the driver is impaired. For example, you can come up with an emoji symbol that they can text you to let you know they need to be picked up with no questions asked until the next day.

Trend #4: ALCOHOL AWARENESS

Even today, alcohol is still the most commonly used substance among teens. While overall use has declined in recent years, the way teens consume alcohol has changed dramatically.

Today’s alcohol landscape is dominated by sweet, flavored options that mask the taste of alcohol, like hard seltzers, alcopops and coolers, and spirit-based ready-to-drink cocktails. Many teens don’t even consider these to be “real alcohol.” And social media-driven drinking games and challenges have made dangerous drinking patterns like binge drinking more normalized.

You may be able to use yourself as a way to open a conversation. Think back to when you first tried alcohol or share a situation you experienced with alcohol. Ask about what types of alcohol kids your age are talking about.

Trend #5: PRESCRIPTION DRUG MISUSE

Prescription medications—particularly ADHD stimulants like Adderall—continue to be misused, often for studying or weight loss.  School pressure can be intense, and some teens see these medications as performance enhancers rather than drugs of misuse.

Parents should secure medications, count pills regularly, and be aware of “study drug” culture. Teens often consider these medications “safe” because doctors prescribe them. But no one should take medication unless it is prescribed to them.

You may consider asking: “I’ve heard about students using medications to help with studying. What’s that like at your school?”

Trend #6: FENTANYL CRISIS

Fentanyl—a lab-made opioid 50 times stronger than heroin—is being found in counterfeit pills and mixed with other drugs like heroin and methamphetamine. These fake pills are flooding the U.S. and can look nearly identical to prescription medications like Xanax and Oxycontin.  Even one counterfeit pill can be fatal.

One way to support your child is by practicing or role playing with them how to manage peer pressure and how to decline a potential offer of any pills.

Trend #7: SOCIAL MEDIA INFLUENCE

Social media has transformed how substances are marketed and normalized. Content providers can push content making substance use look fun and cool, and teens are often exposed to misinformation.

What’s concerning? “Challenges” (like the Benadryl challenge) involving substances can go viral, and influencers may promote alcohol brands or cannabis products.

It’s helpful to stay familiar with your teen’s social platforms. Follow some of the same accounts they do. Create a family social media plan that includes critical thinking about sponsored content.

A conversation starter can be: “I noticed some of those social media videos show people partying with certain drinks or substances. Do you and your friends ever talk about whether that stuff is real or staged?”

Practical Tips:

What can you actually do with this information?

  1. Build trust through ongoing conversations, by finding opportunities to talk about substance misuse and risk – not just one big “drug talk”
  2. Focus on health and safety, not just rules
  3. Always stay curious, not judgmental
  4. Educate yourself on warning signs of substance use and mental health symptoms
  5. Roleplay scenarios involving peer pressure, saying “no” and planning an exit plan
  6. Identify trusted adults that your child can go to if you’re not available

The reality is that young people are going to encounter substances. Your goal isn’t to create fear around substance use, but to build trust and communication. With honest dialogue and good information, you’re giving them the tools to make better decisions.

 

Source:  https://drugfree.org/article/top-7-teen-substance-use-trends-parents-need-to-know-in-2025/

By: Oman News Agency – Thursday 29/May/2025

Dhank: The Wilayat of Dhank in Al Dhahirah Governorate on Thursday hosted an awareness seminar
titled “Your Mind is Your Identity – Don’t Lose It to Drugs,” held under the auspices of
Sheikh Musallam Ahmed Al Ma’shani, Wali of Dhank.

The event was organised as part of ongoing community efforts to strengthen national belonging and reinforce Omani identity while addressing the dangers of drugs and psychotropic substances.

The seminar featured two main thematic discussions. The first segment addressed critical perspectives on the issue, examining the health consequences, legal implications, and religious rulings regarding drug abuse. The session began with an impactful theatrical performance by the Wahj Al Khayal team, illustrating the devastating effects of narcotics on individuals and society at large.

The second part of the seminar focused on identity and citizenship values. A working paper was presented about this theme that emphasised the fundamental role of national identity in building an aware and cohesive society capable of overcoming various challenges.

A highlight of the event was the official unveiling of the winning logo for Dhank’s Community Competition Team to Combat Drug Abuse. This initiative aims to enhance community awareness and support youth-driven projects in drug prevention efforts, reflecting the local commitment to addressing this critical social issue.

Source:  https://timesofoman.com/article/158685-anti-drug-awareness-seminar-held-in-al-dhahirah

NDPA opening statement:

This piece by AALM (Americans Against Legalisation of Marijuana) counters the assertion that legalisation would bring fairness to people of colour.

To access the full document:

  1. Click on the ‘Source’ link below.
  2. An image  – the front page of the full document will appear.
  3. Click on the image to open the full document.

Source:  AALM statement on pot

by Ch28 May 2025

Police Commissioner says drug should be Class A over long-term health impacts

Cannabis should be upgraded to a class A drug because of the harm it can cause, a policing chief has said.

As Sir Sadiq Khan calls for possession of the drug to be decriminalised, David Sidwick, Dorset’s police and crime commissioner, has urged that cannabis, currently a Class B drug, should be put on a par with crack cocaine and heroin.

Such a move would see the maximum penalties for possession increase from five to seven years in jail, while the maximum penalty for supplying cannabis would rise from 14 years in prison to life.

Sir Mark Rowley, the Met Commissioner, also opposed Sir Sadiq’s call for cannabis to be decriminalised. He pointed out that drugs were “at the centre of a lot of crime” and said drug use was one of the main drivers of antisocial behaviour.

Sir Sadiq, the Mayor of London, has proposed that the possession of small amounts of natural cannabis should no longer be a criminal offence. Dealing in or producing the drug would remain illegal.

Mr Sidwick sets out his demand in a foreword to a new book by Albert Reece and Gary Hulse, two Australian professors of medicine and psychiatry, who have linked cannabis to mental ill-health, autism and cancer.

He said there was growing evidence linking psychosis, cancer and birth defects to cannabis use, particularly with the development of more potent strains.

Mr Sidwick warned it was also a “gateway” drug used by crime gangs to lure in users. They then entice them on to addictive class A drugs such as crack that not only provide more profit per unit but also give the gangs greater power to leverage them into criminal activity.

“Cannabis needs to be taken seriously on a national scale because of the danger it presents, and there needs to be money put into prevention and education to ensure people are aware of these dangers,” he said.

“Currently, Class A drugs take precedence when it comes to enforcement and treatment, but it is my view that there is no point focusing on the destination of addiction if we don’t stop people getting on the first two or three carriages of the train in the first place.

“Only through reclassifying cannabis will it be treated with the severity it deserves.”

The London Drugs Commission, set up by Sir Sadiq, ruled out full legalisation of cannabis in its report because it said any benefits from tax revenues and reduced police workload were outweighed by the potential longer-term health impacts on users.

Instead, it proposed that natural cannabis would be removed from the Misuse of Drugs Act and brought under the Psychoactive Substances Act.

This would mean possession of small amounts of cannabis for personal use would no longer be a criminal offence, but importing, manufacturing and distributing the drug would remain a criminal act.

The Home Office has ruled out any reclassification of cannabis.

Mr Sidwick’s proposals have been backed by Janie Hamilton, a Dorset mother who has campaigned for upgrading cannabis to class A.

Her son James died when he was 36 after refusing treatment for testicular cancer. It followed years of battling mental illness, which his family believes was triggered by his addiction to cannabis, which he started using at 14.

Ms Hamilton said: “My beloved son James was a fun-loving, mischievous, clever, tender-hearted boy who wanted to fit in with his peers and be part of the ‘in’ crowd. This was to be his undoing.

“At the age of 14, unbeknown to us, living at a boarding school where his father taught, he started smoking cannabis. He became arrogant, rude, secretive, rebellious and unpredictable. I remember thinking how I loved him, but that I didn’t like him.

“He dropped out of university after one term and took job after job, worrying us with his bizarre behaviour. He shaved his hair, his eyebrows, cut his eyelashes and became aggressive. He would stay in his room all day and come out at midnight to shower and cook.

“One day, he came home from his job on a building site, turning in circles in the garden and all that night. He told me he had spent all his wages on cannabis. I called the doctor the next day and James was sectioned within an hour, diagnosed with schizophrenia.”

She said there had been a 16-year cycle of medical treatment, relapses and trouble with the police before her son died.

“Cannabis is everyone’s problem. It destroys lives and families. Let no one say that cannabis is harmless – cracking down on this destructive drug is one of the greatest and most urgent needs facing us all,” she said.

Source:  https://www.telegraph.co.uk/gift/32da88934bd58598

by Michael Deacon       Columnist & Assistant Editor  – The Telegraph of London (UK)        28 May 2025

The Mayor of London has called for law reform because he believes that stop-and-search powers disproportionately affect black communities

Mayor of London Sadiq Khan walking through cannabis plants at a licensed factory in Los Angeles Credit: PA

Sadiq Khan, the Mayor of London, says he believes the police should stop arresting people for possessing cannabis. Frankly, I’m shocked.

Mainly because I didn’t know the police were arresting people for it in the first place.

It certainly doesn’t smell like it. These days, practically all our towns and cities – including the one run by Mr Khan – stink of weed. Which suggests that a very large number of people now feel able to smoke it with absolutely no fear of getting arrested. Whether this is because the police can no longer be bothered to enforce the law, or they’re too busy carrying out dawn raids on the bookshelves of Spectator readers, I don’t know. But either way, it hardly seems worth clamouring for decriminalisation, when in effect we’ve already got it.

Even so, Mr Khan has backed calls to change the law. And these calls seem to have something to do with race.

According to an independent commission, set up by the Mayor, the policing of cannabis use is shamefully unjust to people who aren’t white. In a new report, the commission says: “The law with respect to cannabis possession is experienced disproportionately by those from ethnic minority (excluding white minority) groups, particularly London’s black communities. While more likely to be stopped and searched by police on suspicion of cannabis possession than white people, black Londoners are no more likely to be found carrying the drug.”

If so, that plainly is unfair. But it’s not an argument for decriminalisation. It’s an argument for stopping and searching greater numbers of white people. Which, of course, would be completely fine. Go right ahead. Even if today’s over-anxious police chiefs would probably misunderstand such an edict, and tell their officers: “When investigating crime, we must never treat any community with more suspicion than any other. Which is why, this afternoon, I’m sending you all to a WI jumble sale, to search little old ladies for machetes.”

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None the less, the report maintains that the way forward is to decriminalise possession. At the same time, though, it says producing and dealing should remain illegal. Which is odd, because it implies that the blame for the trade lies solely with the people doing the latter. But if it weren’t for all the people wishing to possess the drug, no one would produce or deal it. Ultimately, therefore, it’s their fault.

Anyway, if possession does get decriminalised, you can bet there’ll soon be calls to loosen the law further. Which would be even more unwise. Just look at what’s happened to New York, which in 2021 decided not only that people should be allowed to smoke cannabis, but that shops should be granted licences to sell it. Has this put criminals out of business, while raising lots of lovely extra cash through tax?

Funnily enough, no. Illegal vendors simply undercut the legal ones. Kathy Hochul, who is New York’s governor (and a Democrat, rather than some stereotypically stuffy Republican), has called it “a disaster”. Even The New Yorker, proud tribune of liberal America, ran a dismayed article asking: “What happened?”

All the same, the Mayor of London insists that his commission’s report makes a “compelling” case. I don’t think it does. And I especially think we could have done without the irrelevant wittering about ethnicity. We’ve got quite enough “community tensions” in this country as it is. So we certainly don’t want people thinking: “What? They want to allow possession of a dangerous drug, just because they think it will improve ‘police relations’ with ‘black communities’? That sounds awfully like special treatment. Mind you, I suppose they need to free up the cells, to make more space for middle-aged women who post problematic opinions on the internet.”

This, in short, is why Mr Khan’s plan for cannabis isn’t just naive. It’s dangerously divisive.

I note, incidentally, that the Mayor has just proposed a 20 per cent rise in London’s congestion charge. But don’t worry. I’ve prepared a report arguing that the charge is unjust, because it’s experienced disproportionately by the motoring community, while the cycling and walking communities get off scot-free. So the whole thing should be scrapped.

 

Source: (Via Drugwatch International): www.telegraph.co.uk

The Organisation Internationale Dianova, or Dianova International, is a public utility Swiss NGO committed to social progress. Through its members operating on four continents, Dianova International supports the development of activities aimed at improving people’s lives.

Introduction: Let’s Get One Thing Straight Forget the outdated slogans. “Just say no” doesn’t cut it anymore. Today’s teens and young adults live in a world of pressure, performance, and constant scrolling — and they deserve real strategies, not scare tactics. Evidence shows that drug prevention targeting youth needs to be science-based, stigma-free, and deeply human. That’s what the new wave of prevention is all about. That’s what #VoicesWithoutStigma is here to launch.

PART I

Why We Need a New Conversation

According to the UNODC, around 90% of adult substance use disorders begin in adolescence. That’s why early prevention isn’t optional — it’s essential. But not any kind of prevention: the kind that’s rooted in evidence, compassion, and the real-life experiences of young people.

From the WHO-UNODC International Standards for Drug Use Prevention, we know what works:

  • Early childhood development programs that support parents and help kids develop emotional and cognitive skills.
  • Life skills training in schools, including emotional regulation, problem-solving, and resisting social pressure.
  • Community strategies to reduce access and increase awareness — think youth centers, mentorship programs, and safe recreational spaces.
  • Digital campaigns that meet youth on their terms — mobile-first, meme-friendly, and emotionally honest.

 

The Science Behind the Shift

Prevention is no longer about “bad kids” making “bad choices.” The real risk factors are often trauma, inequality, exclusion, and untreated mental health issues. That’s why the UN, PTTC Network, and others are calling for a new approach that’s inclusive, respectful, and developmentally informed. As highlighted by the United Nations Chronicle, strategies that empower communities — especially youth — are the most sustainable.

#VoicesWithoutStigma: Speak. Share. Shift the Culture.

Launching globally on June 26, 2025, by Dianova International, the #VoicesWithoutStigma campaign is about rewriting the narrative. Young people from 17 countries will take the mic — literally and digitally — to speak about:

  • Mental health and asking for help
  • Coping with anxiety, trauma, and depression
  • Navigating social pressure without losing their sense of self
  • Reclaiming their identity through music, dance, podcasts, and storytelling

The campaign’s launch video sets the tone: young people in silence, whispers of stigma — then rhythm, color, voice. A girl declares: “They told me feeling was weakness. But my voice is strong. And yours is too.”

Breaking the Taboo ≠ Being Alone

Whether you’re 16 or 26, it’s not weird to feel overwhelmed. The Listen First campaign by UNODC reminds us that starting with empathy — not judgment — is how we win hearts, minds, and futures.

Feeling low? Not sure how to support a friend? Talking honestly — and listening with compassion — are the strongest tools we’ve got. That’s how we build resilience and community.

No Drama, Just Data: Environmental Strategies That Work

According to this UNODC framework, community-wide strategies — like regulating alcohol sales to minors, setting up youth-focused events, and positive norm campaigns — can reduce substance use before it starts. Add peer mentoring and digital outreach, and you’ve got a full-circle prevention plan.

A Final Word: You’re Not the Problem. You’re the Power.

You don’t have to be perfect. You just have to be real. Drug prevention today is about showing up for yourself, and others, with truth, humor, and heart. Whether you’re creating a Reel, starting a support group, or just learning more — you’re part of the solution.

✨ Join us. Share your truth. Inspire others. #VoicesWithoutStigma isn’t a campaign. It’s a movement. And it’s made for you.

Want to know more? Check the UNODC-WHO standards or EUDA’s library. It’s prevention — but make it real, and make it yours.

 

PART II

Voices Without Stigma: Breaking the Silence, Building the Future

Introduction: More Than Just Say No

Let’s get real — telling young people to “just say no” to drugs isn’t working. Not because they’re reckless, but because they’re smart. Smart enough to know that life is complicated, that pain is real, and that decisions are rarely black or white. That’s why youth drug prevention today isn’t about preaching. It’s about listening, empowering, and building trust. And that’s exactly what #VoicesWithoutStigma is all about.

Why It Matters: The Real Stats Behind the Talk

According to the UNODC-WHO International Standards on Drug Use Prevention, effective prevention is rooted in science, not scare tactics. Research shows that adolescence is a critical period: 90% of adult substance use disorders begin during this phase. Prevention efforts must be developmentally appropriate, engaging, and embedded in the realities of young people’s lives.

So, What Works? A Look at Evidence-Based Prevention

The United Nations and World Health Organization have spent years studying what actually prevents drug use. Spoiler alert: the most effective strategies have nothing to do with guilt or shame. Here’s what the research tells us:

  • Family-based programs that build parenting skills and family bonding.
  • School-based life skills education, focusing on emotional regulation, decision-making, and peer resistance.
  • Community-wide environmental strategies like reducing access to substances and strengthening local support systems.
  • Digital and peer-to-peer outreach that speaks in the language of youth.

These aren’t just theories — they’re approaches with measurable impact across cultures and contexts. Check the UNODC’s breakdown of international standards here.

Let’s Talk Urban: Prevention in a Real-World Context

Today’s young people are navigating pressures their parents never imagined — social media, performance culture, identity exploration, and mental health challenges. Prevention has to meet them where they are: in the group chat, on TikTok, in the locker room, at home after a hard day.

That means:

  • Creating safe, shame-free spaces to talk about anxiety, depression, and trauma.
  • Highlighting relatable stories from young people who’ve overcome challenges without glamorizing drug use.
  • Using influencers, creatives, and peers to drive positive narratives.

#VoicesWithoutStigma: A Movement in the Making

Dianova’s 26 June 2025 global campaign — #VoicesWithoutStigma — is here to flip the script on stigma. With the slogan “Your Voice is Power”, it invites young people around the world to share their truth, their way — through spoken word, memes, music, reels, or just real talk.

The campaign’s goals are bold:

  • Inspire creative expression around mental health and substance use.
  • Normalize seeking help, showing it as strength rather than weakness.
  • Mobilize schools, NGOs, families and social platforms to amplify youth voices.

And the teaser? A powerful video where silence gives way to rhythm, movement, art, and voices that say, “We don’t hide how we feel — we transform it.”

#VoicesWithoutStigma is not just a campaign. It’s a cultural wave.

Curious Yet? Stay Tuned.

On June 26, something big is dropping. A campaign made of real voices, raw stories, and bold creativity. If you’ve ever felt misunderstood, judged, or silenced — this is your moment.

Get ready to join the voices that refuse to be labeled. To cry, to laugh, to heal, to shout back with truth.

Follow the campaign. Join the lives. Share your story. Explore the science, feel the voices, join the movement:

Because when we speak with compassion instead of judgment, and with facts instead of fear, we don’t just prevent drug use — we create a future worth living for.

#VoicesWithoutStigma | #YourVoiceIsPower | #June26 | #MentalHealthMatters | #PreventionWorks

 

Source: https://www.dianova.org/news/real-talk-real-tools-drug-prevention-that-actually-works-for-todays-youth/

Updated estimates indicate a greater need for treatment.

A new study reveals that a large number of American children are growing up in homes where at least one parent struggles with alcohol or drug use. This troubling environment may increase the chances that these children will face similar challenges later in life.

Using the latest available data from 2023, researchers estimate that 19 million children in the United States — that’s one in four kids under the age of 18 — live with a parent or caregiver who has a substance use disorder.

Even more concerning, around 6 million of these children are living in households where the adult also has a diagnosed mental illness along with their substance use disorder.

Alcohol is the most commonly misused substance among parents. The data suggests that about 12 million parents meet the criteria for some form of alcohol use disorder. Cannabis use disorder follows, affecting over 6 million parents. Additionally, approximately 3.4 million parents are struggling with the use of multiple substances at once.

Rising Numbers and Growing Concern

The number living with a parent who had any substance use disorder in 2023 is higher than the 17 million estimated in a paper published just months ago that used data from 2020.

“The increase and fact that one in four children now live with parental substance use disorder brings more urgency to the need to help connect parents to effective treatments, expand early intervention resources for children, and reduce the risk that children will go on to develop substance use issues of their own,” said Sean Esteban McCabe, lead author of the new study and senior author of the recent one.

The new findings are published in the journal JAMA Pediatrics by a team from the University of Michigan Center for the Study of Drugs, Alcohol, Smoking, and Health, which McCabe directs. He is a professor in the U-M School of Nursing and Institute for Social Research, and a member of the U-M Institute for Healthcare Policy and Innovation.

Both studies used data from the National Survey on Drug Use and Health, a federal program that has tracked U.S. drug and alcohol use since the 1970s, yielding data that researchers and policymakers have used.

That survey faces an uncertain future due to staff and budget cuts at the federal agency where it’s based, the Substance Abuse and Mental Health Services Administration, or SAMHSA. The survey’s entire staff received layoff notices in April.

Drug Categories and Their Impact

In addition to alcohol and cannabis, McCabe and his colleagues estimate that just over 2 million children live with a parent who has a substance use disorder related to prescription drugs, and just over half a million live with a parent whose use of illicit drugs such as cocaine, heroin and methamphetamine meets criteria for a substance use disorder.

The researchers include Vita McCabe, the director of University of Michigan Addiction Treatment Services in the Department of Psychiatry at Michigan Medicine, U-M’s academic medical center.

“We know that children raised in homes where adults have substance use issues are more likely to have adverse childhood experiences, to use alcohol and drugs earlier and more frequently, and to be diagnosed with mental health conditions of their own,” said Vita McCabe, a board-certified in addiction medicine and psychiatry. “That’s why it’s so important for parents to know that there is effective treatment available, including the medications naltrexone and/or acamprosate for alcohol use disorder, cognitive behavioral therapy for cannabis use disorder, and buprenorphine or methadone for opioid use disorder including both prescription and non-prescription opioids.”

Both the new paper and the one published in March in the Journal of Addiction Medicine based diagnoses of substance use disorders and major mental health conditions on the criteria contained in the Diagnostic and Statistical Manual of Mental Disorders 5, or DSM-5.

In the March study, the authors showed that the change in how substance use disorder was defined in DSM-5 compared with its previous version led to a major increase in the number of children estimated to be living with a parent with a substance use issue.

Ty Schepis, an addiction psychologist at Texas State University, was the lead author of the earlier paper and is senior author of the new paper.

“Our new findings add to the understanding of how many children are living with a parent who has a severe and comorbid substance use disorder and other mental illness such as major depression,” he said. “This is important to note because of the additional risk that this creates for children as they grow into adults.”

The research was funded by the National Institute on Drug Abuse, part of the National Institutes of Health (R01DA031160, R01DA043691).

Source: https://scitechdaily.com/1-in-4-kids-lives-with-a-parent-battling-addiction-alarming-study-finds/

by Shane W. Varcoe , Director@dalgarnoinstitute.org.au – 23 May 2025

“I was talking to a tradesman in my home on Wednesday and he asked me what I did…. After explanation about Weed…. He said.. “I wen to a local doctor and just said I had trouble sleeping and can I have cannabis… got a script, no more questions asked.”  This is so utterly corrupt and it’s ubiquitous  now! ”    Shane W. Varcoe

Comment by Jo Baxter, DFA (Australia)

This is a very serious situation for the US and the world generally. Such a softening is akin to what the then Federal Health Minister, Sussan Ley did when she passed the law that allowed Medicinal Cannabis to be legalised in Australia. Now we are seeing a misuse of the ‘legal’ system with doctors overprescribing and not even consulting in person with patients to whom they prescribe the drug.

On Fri, May 23, 2025 at 7:51 AM Herschel Baker <hmbaker1938@hotmail.com> wrote:

The evidence is in Cannabis must remain Schedule 1 Epidemiology of Cannabis Albert Stuart Reece, Gary Kenneth Hulse

https://shop.elsevier.com/books/epidemiology-of-cannabis/reece/978-0-443-13492-0

WASHINGTON, D.C. – During his confirmation hearing before the Senate Judiciary Committee on April 30, DEA administrator nominee Terrance Cole declined to commit to the proposed federal rescheduling of cannabis, leaving a critical policy question unresolved as the process transitions to new leadership under the Trump administration.

The popular and game-changing rescheduling proposal backed by Donald J. Trump to reclassify cannabis from Schedule I to Schedule III under the federal Controlled Substances Act (CSA) remains formally active but administratively paused by a DEA judge.

If enacted, rescheduling cannabis to Schedule III would formally acknowledge the accepted medical use of cannabis under federal law. It would also allow for FDA-supervised research and development of cannabis-based drugs.

Although cannabis would still be classified as a controlled substance and remain under the oversight of the DEA and FDA, reclassifying it to Schedule III would significantly benefit legal cannabis businesses by changing how they are treated under federal tax law.

Specifically, it would exempt them from the limitations of Section 280E of the Internal Revenue Code, which currently bars businesses trafficking in Schedule I or II substances from deducting ordinary business expenses. Due to this restriction, legitimate cannabis companies paid over $1.8 billion more in federal taxes in 2022 than comparable non-cannabis businesses, according to data from Whitney Economics.

Reclassification would not federally legalize recreational cannabis, authorize interstate commerce, or override any state-level prohibitions.

Reclassification was initiated nearly three years ago during the Biden administration. Still, on January 13, 2025, one week before President Trump took office, the DEA’s Chief Administrative Law Judge cancelled a public hearing scheduled for January 21 and ordered parties to check back in with him in 90 days.

There is no statutory deadline for the DEA to complete the rescheduling process, so the current pause could extend indefinitely.

Cole, a longtime DEA official nominated to be administrator in February, told lawmakers on April 30 that reviewing the agency’s stalled administrative process to move cannabis from Schedule I to Schedule III would be “one of [his] first priorities.”

Though cannabis was not mentioned in Cole’s opening remarks, he emphasized a focus on combating the fentanyl crisis and leveraging his 30 years in law enforcement to address cartel-related threats. “It’s time to move forward,” he said of the stalled rescheduling process.

But when pressed by US Senator Alex Padilla (D-CA) on whether he would ensure the proposed rescheduling is carried out, Cole would not commit. Here is a bit of back and forth between the two:

“I need to understand more where they are and look at the science behind it and listen to the experts and really understand where they are in the process,” Cole said.

Padilla, referencing the directive initiated in 2022, reiterated: “We know where we are. We know what the directive is: Get it to Schedule III. Are you committed to seeing it to fruition?”

Cole responded, “So, I don’t know. I haven’t seen that, sir.”

“So, you’re leaving the door open to changing course as to—?” Padilla asked.

“I’m leaving the door open to studying everything that’s been done so far, so I can make a determination, sir,” Cole said.

Padilla concluded the exchange by stating: “So, make myself a note here—no answer to that particular question.”

 

Source:  Shane W. Varcoe , Director@dalgarnoinstitute.org.au – 23 May 2025 

 

by Letitia James – Office of the New York State Attorney General – May 22, 2025

NEW YORK – New York Attorney General Letitia James today co-led a bipartisan coalition of 40 other attorneys general from across the country in calling on Congress to pass the Youth Substance Use Prevention and Awareness Act, bipartisan legislation to reduce youth drug use through research-based public education campaigns and strategic community outreach. In a letter to Democratic and Republican leadership in the House and Senate, Attorney General James and the coalition emphasize the importance of proactive, science-based prevention efforts at a time when young people face increased risk of exposure to dangerous narcotics like fentanyl and xylazine.

“Too many young people know first-hand just how deadly drugs like fentanyl can be,” said Attorney General James. “As the opioid epidemic continues to tear apart families and communities, attorneys general remain on the front lines protecting our youth, and we need all levels of government to help fight back. The Youth Substance Use Prevention and Awareness Act is a common-sense bipartisan measure that will provide significant resources to help save lives and educate young people about the dangers of drug use.”

The legislation, introduced by U.S. Senators Mark Kelly (D-AZ) and Thom Tillis (R-NC), would amend the Omnibus Crime Control and Safe Streets Act of 1968 to provide targeted federal funding for public service announcements (PSAs), youth-led campaigns, and other outreach tools that help prevent early substance use. All campaigns funded under the bill must be grounded in evidence, designed for cultural relevance, and adapted to meet the specific needs of local communities.

Attorney General James and the coalition argue that youth substance use remains a growing public health and safety concern, especially amid a rise in fentanyl-related overdoses and the increasing availability of synthetic drugs. Research consistently shows that young people who begin using drugs at an early age are more likely to develop long-term substance use disorders, and the consequences can be devastating for families, schools, and communities.

The Youth Substance Use Prevention and Awareness Act would fund a range of efforts to better reach young people with timely, credible, and accessible information, including:

  • Culturally relevant PSAs tailored specifically to youth;
  • Youth-led PSA contests to drive peer-to-peer engagement and creativity;
  • Federal grants for outreach across TV, radio, social media, streaming platforms, and other media; and
  • Annual reporting requirements to measure reach and effectiveness, ensuring transparency and accountability.

The letter is led by Attorney General James and the attorneys general of Connecticut, New Hampshire, and South Dakota. Joining the letter are the attorneys general of Alabama, Alaska, Arkansas, California, Colorado, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Nebraska, Nevada, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Utah, Vermont, Virginia, West Virginia, Wisconsin, Wyoming, and American Samoa.

Source:  https://ag.ny.gov/press-release/2025/attorney-general-james-co-leads-bipartisan-coalition-urging-congress-pass

image003

Published by NIH/NIDA 14 May 2025

 

Cannabis vaping is making headlines worldwide, often promoted as a “safer” alternative to smoking. Meanwhile, Drug Trends data from Australia reveal that non-prescribed cannabis use remains high among people who regularly use drugs. But are wider permission models and positive propaganda about cannabis leading to greater engagement, especially among those most at risk? This article dives into Australian data from the Ecstasy and Related Drugs Reporting System (EDRS) and Illicit Drugs Reporting System (IDRS), exploring what’s really happening with cannabis products, vaping, and why honest health education is more critical than ever.

Cannabis Vaping and Drug Trends in Australia (2014–2024): What the Data Tells Us

Cannabis vaping, once an afterthought, now claims a growing share of the global market. Many believe vaping to be less harmful, with marketers highlighting vaping’s lack of smoke and alleged respiratory benefits. However, recent Drug Trends research in Australia challenges some of these assumptions and uncovers troubling patterns.

The Rise of Electronic Vaping Products

Electronic vaping products started as oversized gadgets in the late 1990s. Initially intended to vaporise dried cannabis herb, they eventually shrank, morphing into today’s sleek e-cigarettes. While vaping nicotine products has become mainstream, cannabis vaping is following close behind, spurred in part by changes to medicinal and recreational cannabis laws overseas.

A North American review found a seven-fold increase in monthly cannabis vaping among adolescents, with notable shifts from dried herb to potent cannabis oils. However, the situation in Australia is different, shaped by stricter regulations and unique market conditions.

Drug Trends in Non-Prescribed Cannabis Use

Australia’s EDRS and IDRS surveys collect real-world data on non-prescribed cannabis and cannabinoid-related products. Between 2014 and 2024, most participants in both systems reported using cannabis recently, with rates as high as 90% in the EDRS and 74% in the IDRS.

Hydroponic and Bush Cannabis Still Dominate

  • Hydroponic cannabis was the most popular, with usage rates ranging from 63%–83% among EDRS respondents, and a remarkable 88%–94% for IDRS participants.
  • Bush cannabis also stayed common, with 51%–77% (EDRS) and 37%–54% (IDRS) reporting use.
  • Other cannabis products, such as THC extracts and commercially-prepared edibles, have appeared in recent years, showing increased product diversity—but are far less popular than traditional forms.

Cannabis Vaping Emerges, But Smoking Prevails

Despite media attention around cannabis vaping, the majority of Australians captured in these studies still smoke cannabis. From 2014 to 2024:

  • Smoking remained the dominant route of administration (ROA) in both groups.
  • Cannabis vaping (inhaling/vaporising) trended upward, but stayed a minority choice. Vaporising among EDRS participants increased from 12% to 25%, and from 2% to 9% for IDRS.

Notably, few users chose vaping as their only method. Most combined it with smoking, suggesting the rise in vaping hasn’t replaced traditional habits.

Concerns About Cannabis Vaping and Permission Models

The Problem with Changing Perceptions

There is growing concern that permission models and positive messaging around cannabis use (whether through legislation or social media) may downplay its risks. Vaping, in particular, is surrounded by claims of being a “safer” alternative to smoking. While it’s true that vaping doesn’t involve combustion and may expose users to fewer toxic chemicals, it’s not risk-free.

Key Issues Include:

  • Potency extremes: Some vape oils and extracts reach THC concentrations of 70–90%, far higher than the average 10%–20% in cannabis herb. Highly potent products carry greater risks for dependence, anxiety, and psychosis.
  • Unknown health risks: The long-term effects of inhaling cannabis vapour, especially from unregulated or home-made devices, are not fully understood.
  • Discreet use and normalisation: Portability and subtlety make vaping easier to hide, particularly from parents and teachers. For some users, this can enable more frequent use or uptake at a younger age.
  • Unhealthy dual use: Most vapers continue smoking, increasing overall exposure to both methods. (for complete research WRD News)

Source: https://www.dalgarnoinstitute.org.au/index.php/resources/drug-information-sheets/2672-cannabis-vaping-and-drug-trends-among-youth-in-australia-2014-2024-a-growing-concern?

From clincoln-dfaf.org@shared1.ccsend.com – 15 May 2025

 

For the first time in years, there’s encouraging news in the fight against the overdose crisis. According to provisional data from the Centers for Disease Control and Prevention, an estimated 80,000 people died from drug overdoses in 2024—30,000 fewer than the year before, marking a 27% decrease and the largest single-year decline ever recorded. This milestone reflects the impact of prevention, treatment, and recovery efforts across the country and reinforces the urgent need to continue investing in strategies that save lives.

 

Drug Free America Foundation proudly joins communities nationwide in recognizing National Prevention Week 2025, a public education platform led by the Substance Abuse and Mental Health Services Administration (SAMHSA). Held annually during the second week of May, National Prevention Week showcases the incredible work of individuals, organizations, and communities who are committed to preventing substance use and misuse and promoting positive mental health.

Why Prevention Matters Now More Than Ever

The need for strong prevention strategies has never been more urgent. According to the 2023 National Survey on Drug Use and Health, an estimated 70.5 million people aged 12 or older (that’s nearly 1 in 4 Americans) used illicit drugs in the past year. Marijuana was the most commonly used, followed by hallucinogens and the misuse of prescription pain relievers. These findings underscore the critical importance of investing in prevention today to protect the health and well-being of future generations.

Prevention in Action: Raising Awareness and Building Resilience

This observance highlights the importance of raising awareness about substance use and mental health challenges through data-driven prevention strategies and evidence-based programs that have proven effective in creating healthier, safer communities. It also serves as a reminder of the power of collaboration and community experience in improving public health outcomes and building strong, lasting partnerships.

National Prevention Week is about more than just awareness—it’s about sharing knowledge, disseminating high-quality resources, and empowering people with the tools they need to live healthy, substance-free lives.

 

Showcasing our newest initiative: The Trauma & SUD Action Force Initiative (TSAFI)

The Trauma & SUD Action Force Initiative (TSAFI) is an international effort committed to bridging the gap in trauma-informed care within Substance Use Disorder (SUD) services—from prevention and treatment to recovery—using approaches grounded in neuroscience and scientific evidence.

TSAFI unites experts, organizations, and decision-makers to promote the recognition and integration of trauma within all aspects of SUD care.

By combining insights from neuroscience and psychology, TSAFI addresses the neurological and social dimensions of trauma, ensuring a comprehensive and informed response to its role in SUD.

Discover more here or get involved by reaching out to tsafi@wfad.se or visiting https://tsafi.wfad.se/.

Source: From clincoln-dfaf.org@shared1.ccsend.com – 15 May 2025 

 

 

Dianova and G2H2 launched a series of debates with a session dedicated to prevention and treatment initiatives for children and adolescents – 16/05/2025

Substance use prevention targeting children and adolescents is a science that relies on evidence-based interventions to address the complex factors contributing to substance use disorders – Photo by Ernest Brillo on Unsplash

On Tuesday 12 May, the first session in a series of debates organized by G2H2 was opened. Entitled ‘People, power and policies in global health: perspectives from civil society’, the series was organized in the run-up to the 78th World Health Assembly, held from 19 to 27 May.

Co-hosted by Dianova and the Geneva Global Health Hub (G2H2) , the session ‘Growing up safe: public health approaches to drug use prevention and treatment for children and adolescents’ brought together high-level participants, including Anja Busse (WHO) and Wadih Maalouf, (UNODC).

G2H2 is a network of civil society organisations based in Geneva that promotes information exchange and joint political action on global health issues – Dianova International is a member of G2H2.

The main objective of the session, as outlined by Gisela Hansen (moderator, Dianova International), was to reconnect drug policies with public health, focusing on the prevention and treatment of substance use among children and adolescents. The aim was to promote models centred on health and human rights, especially in vulnerable or disadvantaged contexts around the world.

Contributions follow from each of the following experts:

  • Anja Busse (World Health Organization)
  • Oriel Esculies (Proyecto Hombre, Spain)
  • Shrook Mansour Ali (Psychiatric Care Development Foundation, Yemen)
  • Cristina von Sperling Afidi (KKAWF, Pakistan)
  • Rajesh Kumar (SPYM, India)
  • Cressida de Witte (WFAD, Sweden)
  • Rebecca Haines-Saah (University of Calgary, Canada)
  • Wadih Maalouf (United Nations Office on Drugs and Crime)

Anja Busse (WHO)

Head of the Unit on Drugs, Alcohol and Addictive Behaviours at the WHO. Anja has been involved in this field at the global level since 2005 and has been supporting science-based strategies for the treatment and care of drug dependence.

Anja took the floor and began by reminding  the WHO’s commitment to promoting global health, particularly among the most vulnerable. The WHO Constitution (1946) emphasizes the importance of healthy child development: “Healthy  development of the child is of basic importance, the ability to live harmoniously in a changing total environment is essential to such development.”

“A public health response to substance use prevention and treatment means reaching the highest number of people with the most effective, least costly, and least invasive strategy or intervention” 

This involves creating environments in which children and adolescents can grow up healthy and safe, and where it is easier for them to avoid alcohol, tobacco and drugs. The burden of responsibility should primarily be placed on the system and on all of us rather than on the individual.

Safer is an initiative launched by the World Health Organization (WHO) in 2018, aiming to prevent and reduce alcohol-related harm in various countries – image: excerpt from presentation by Anja Busse, WHO

UNODC data also reveal that, in 2021, around 5.3% of 15–16-year-olds had used cannabis in the previous year, and that, in most countries and regions, cannabis use is more prevalent among young people than in the general population.

  • Download .pdf presentation by Anja Busse

Anja highlighted that the UNODC and the WHO have published several documents on the health and development of children and adolescents, as well as international standards on drug use prevention. These include strategies targeting the population as a whole, as well as those used in schools, the health system, the workplace, the community, and finally, families. She emphasised one of the basic principles of prevention: ‘The earlier we act, the better’, although it is never too late to implement interventions.

Science based strategies targeting the general population have the widest impact, but they must also consider implementing interventions for the most at-risk groups.

Children and adolescents face several obstacles when seeking mental health and drug services – image: excerpt from presentation by Anja Busse, WHO

According to Anja, the most effective strategies target multiple and multi-level vulnerabilities rather than limiting themselves to narrow interventions in single settings. Finally, Anja emphasised the need for well-conducted planning involving many stakeholders and for an effective social and health system providing accessible mental healthcare services at all levels, which is not the case everywhere.

While it is acceptable for a government to restrict or regulate the availability, distribution and production of drugs, it is important to avoid the unnecessary punishment of people who use drugs.

After reviewing various organizational prevention methods and their effectiveness, Anja also highlighted interventions that research has found to be ineffective or of questionable or unproven effectiveness. These include media awareness campaigns (not effective); use of social media and influencers (effectiveness unknown); information sessions on the consequences or harms of drugs (not effective); sports and other leisure activities (lack of evidence, controversies) strategies targeting children/youth particularly at risk (lack of evidence) and drug testing in schools (no evidence).

Documents

  • Guidelines on mental health promotive and preventive interventions for adolescents (available in six languages)
  • Global Accelerated Action for the Health of Adolescents
  • Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)
  • UNODC/WHO International Standards on Drug Use Prevention
  • A Global Health Strategy for 2025-2028

Oriol Esculies – Proyecto Hombre (Spain)

Oriol is a psychologist with over thirty years’ experience of helping people with addiction problems. He is the International Commissioner of the Proyecto Hombre association and coordinator of the Oviedo Declaration.

The impact of drugs, including tobacco and other legal substances, is enormous. This is not only an issue of security, economics or the law, but also a health issue affecting millions of people, including children and adolescents, in all aspects of their health: physical, emotional, intellectual and social.

We must invest in health now, while our children are healthy; otherwise, the future problem of substance use will be greater, not only for them, but for society as a whole – this is the paradox of prevention.

Some of the stakeholders involved in the Oviedo Declaration, following its presentation at the Commission for the Study of the Constitution (CND) in March 2024 – Photo: Proyecto Hombre, all rights reserved

This also presents a significant challenge to decision-makers and governments, as it necessitates planning and governance with a long-term vision. Launched last year, the Oviedo Initiative is a declaration comprising ten proposals in line with international standards on prevention. It is also a global mobilisation to incorporate prevention into drug policies once and for all. It is an inclusive, collective campaign that is already supported by over 3,000 institutions and several observers, including the UNODC.

  • Read article on the Oviedo Declaration and support the Declaration, available in 48 languages

The main strength of this initiative, which builds bridges between local and global levels, lies in the voluntary work of 174 focal points within countries. At Dianova International, we are honoured to contribute to this initiative as the focal point for Switzerland.

We hope that the resolution on prevention recently adopted by the CND in Vienna last March will mark a turning point towards the accelerated implementation of effective and forward-looking drug prevention policies.


Shrooq Mansour Ali, Psychiatric Care Developmental Foundation (Yemen)

As a public health expert and the Yemen focal point for the Oviedo Initiative, Shrooq works for the Yemeni NGO, the Psychiatric Care Developmental Foundation, providing mental health and psychological support services to vulnerable young people.

She points out that, after ten years of conflict, Yemen is facing one of the world’s worst humanitarian crises, exacerbated by ongoing violence, the consequences of climate change and the collapse of the economy, institutions and services. According to the 2024 Humanitarian Needs Assessment, approximately half of Yemen’s population, or more than 18 million people, require humanitarian assistance.

Research has shown that populations affected by armed conflict are at a higher risk of using drugs as a coping mechanism in response to such dramatic situations.

Furthermore, factors such as prolonged psychological trauma, disrupted education, unemployment and chronic poverty in Yemen further increase the risks. Despite this, mental health and substance use issues remain highly neglected. Therefore, ensuring adequate care for substance use issues in humanitarian contexts is a priority.

As the focal point for the Oviedo Declaration in Yemen, Shrook and her colleagues face significant challenges in advancing the initiative within government structures due to the many divisions between the government recognised by international institutions in the south and the de facto authorities in the north. This means that all activities must be coordinated with different entities, which is made more difficult by the sensitive nature of the issue.

Yemen lacks reliable data on substance use. As one of the Oviedo Declaration’s recommendations highlights, there is a need to focus on evidence-based strategies grounded in the collection and evaluation of data. This data would serve as a basis for implementing prevention programmes and national policies in this area.

Problems associated with substance use exist in Yemen and can no longer be ignored or denied.


Cristina von Sperling Afridi, Karim Khan Afridi Welfare Foundation (KKAWF), Pakistan

Following the tragic loss of her son, Karim, in 2015, Cristina established the Karim Khan Afridi Welfare Foundation (KKAWF) to support young people and raise awareness of addiction. The foundation’s work is based on five pillars: drug awareness, sport, the environment, art and culture, and civic engagement.

Currently in Pakistan And across the region Drug use prevention strategies are significantly underrepresented In public policies agendas. The Oviedo declaration launched in 2024 represents a timely and powerful call to action urging nations to prioritize prevention in the drug policies For Pakistan this framework offers a critical opportunity to redirect focus towards long-term sustainable solutions.

Cristina emphasised the urgency of the situation: Pakistan lies at the heart of the Golden Crescent, one of the world’s most notorious drug producing region. Of all the countries in the region, Pakistan is the most affected by the drug menace. It harbors the largest heroin consuming population in the region, a crisis now compounded by the rise of crystal meth.

The growing threat of drug use among young people poses considerable social, health, and economic challenges for the nation. The KKAWF Foundation plays an active role in preventing drug use. It raises awareness among policymakers, civil society and other stakeholders of the importance of prevention.

Prevention must become the central pillar of national drug policies, but this requires essential resources, coordination and commitment — and urgently so!

The KKAWF develops numerous partnerships in its advocacy work for prevention. Here, the Foundation’s president, Cristina Von Sperling Afridi (right), with a representative of the Green Crescent Federation – Photo: KKAWF, all rights reserved

One of the Foundation’s main areas of focus is fostering collaboration between the government, civil society organisations, and the private sector, as only a unified, strategic approach can effectively address this public health crisis. It is also crucial to integrate drug education into school curricula at secondary and higher education levels.

The KKAWF advocates an evidence-based, stigma-free approach that promotes emotional intelligence, resilience, and critical thinking.

Cristina believes that prevention must become a way of life, not just a programme. She believes that only by cultivating a culture of prevention will it be possible to protect future generations.


Rajesh Kumar, Society for the Promotion of Youth and Masses (SPYM), India

Rajesh is the executive director of SPYM, an NGO that has worked in the field of addiction for over 40 years, receiving several national awards for its work with marginalised communities. SPYM has consultative status with ECOSOC, and Dr Kumar has served on numerous government and international bodies.

India’s proximity to the Golden Crescent and Golden Triangle has made the country a destination for large quantities of drugs. Substance use is therefore on the rise, particularly among children. In response to this serious violation of children’s rights, SPYM began working with children suffering from addiction in 2010.

In India, approximately 4 million children use opiates, 2.6 million inhale drugs, and 2 million use cannabis. Even with a population of over 1.4 billion, these figures represent a huge problem, particularly given that only 1% of affected children seek help.

While it is estimated that 99.9% of children do not use drugs, it is essential to invest in treatment and scientifically validated prevention strategies based on collaboration with families, communities and schools to ensure they stay on this path. These groups have a duty to ensure that substance use prevention and mental health are part of their regular activities, which is why SPYM has developed the Navchetna programme under the auspices of the Ministry of Social Justice and Empowerment.

  • Download .pdf presentation by Rajesh Kumar

The Navchetna school programme is designed with different modules tailored to students according to their age. It is run by trained teachers under the supervision of the Ministry of Education.

A significant part of SPYM’s work is carried out for the benefit of the well-being of the most disadvantaged children and adolescents – Photo: SPYM, all rights reserved

Once their training is complete, the ‘master trainers’ must in turn train up to 100 teachers within two years, with the ultimate goal of training one million teachers, although so far, only 100,000 have been trained. The programme also uses videos, which are currently available in English and Hindi and will soon be available in 12 regional languages.

SPYM also develops numerous programmes and activities to help vulnerable people, particularly children and teenagers. These include a community-based early intervention programme run by peers in nearly 300 districts in the country most affected by drug use, residential treatment centres for various populations including children and adolescents in conflict with the law, activities focused on life skills and rehabilitation, and advocacy activities.

SPYM and KKAWF are both associate members of Dianova International.


Cressida de Witte – World Federation Against Drugs (WFAD, Sweden)

Cressida is the project coordinator and communications manager for the WFAD. She leads projects for this organisation in various countries, including the Democratic Republic of Congo, Kenya, India, and Georgia. She is also a member of the WFAD committees on gender and youth.

The continuum of care includes a wide range of interventions, from health promotion to recovery and follow-up, including various prevention strategies and different phases or modalities of treatment.

Diagram produced by Dr Audrey Begun – Theories and Biological Basis of Substance Misuse

The Continuum of Care in addiction treatment refers to a comprehensive approach that guides and tracks patients over time through various levels and intensities of care – Image: excerpt from presentation by Cressida de Witte

Although prevention programmes for young people generally target school-age children, adolescents and young adults due to the high risk of experimenting with substances, research has shown that prevention efforts should start even earlier.

The early years of a child’s life are a critical period for brain development. This is when the foundations of decision-making, impulse control and resilience are laid. As younger children learn to manage their emotions, resolve conflicts and set goals, they develop skills that will inform healthier choices in adolescence and adulthood.

However, prevention is not solely the responsibility of the child; it also depends on their environment, which is why action must be taken at all levels, from the macro to the micro, and from family dynamics to community support.

The WFAD is a multilateral community with ECOSOC consultative status, composed of over 470 NGOs in 73 countries. The organisation’s three pillars are capacity building through webinars, training courses and forums; advocacy at national, regional and international levels to strengthen prevention, treatment and recovery; and project development, particularly international projects. One such project is a youth project in the Democratic Republic of Congo: Sober Youth and Healthy Communities: Transforming Violent Youth in Kinshasa. Learn more about the project.

Within the framework of these advocacy efforts, the organisation launched the ‘Global Youth Declaration on Prevention, Treatment and Recovery’. Presented at the 68th session of the CND in March 2025, the declaration is based on six recommendations aimed at ‘ensuring access to prevention, treatment, rehabilitation and recovery services that are youth-friendly and respectful of their rights, in order to ensure a healthy, safe and drug-free future for all young people worldwide’. The declaration is available in seven languages.


Rebecca Haines-Saah – University of Calgary (Canada)

Rebecca is a public health sociologist and associate professor at the University of Calgary. Her research interests include youth drug use, harm reduction approaches, and drug policy reform.

As a teenager, she was cast in a popular Canadian television programme in which her character experimented with substance use. This, in some way, launched her career and her commitment to supporting young people she said.

Rebecca believes that we need to radically rethink drug prevention for young people. Unfortunately, in North America as elsewhere, prevention has long been based on values rather than scientifically validated evidence of what works and what doesn’t. Past prevention campaigns, such as Nancy Reagan’s ‘Just Say No’ motto, were never evidence-based or evaluated.

“Prevention has been based on values rather than evidence for too long, which is why we need to radically rethink drug prevention for young people” – excerpt from presentation by Rebecca Haines-Saah

Even worse, an evaluation of the D.A.R.E. (Drug Abuse Resistance Education) programme – a series of lessons delivered by police officers in schools – showed that it was associated with a slight increase in substance use! It was hypothesised that the most marginalised young people reacted badly to the presence of police officers in the classroom. These campaigns primarily relied on stereotypes and stigmatisation of young people.

“In Canada, it has been highlighted that the most effective drug prevention programmes have very little to do with drugs” 

If we want to improve prevention outcomes among young people, she stresses, we need to focus less on educating them about specific substances, and instead strive to promote community well-being, as well as individual and family resilience. That’s where we need to invest.

Scientific research indicates that effective strategies include psychosocial and developmental interventions that enhance conflict resolution and problem-solving abilities, social-emotional learning, and anything else that helps teenagers manage challenging situations with their peers and cope with trauma and community conflict. These strategies have demonstrated several positive long-term outcomes.

Rebecca also highlighted the implementation of a community-based prevention model in Calgary and other parts of the country. Planet Youth, the model implemented in Calgary and elsewhere, was developed based on the Icelandic prevention model: a participatory, evidence-based approach that has dramatically reduced substance use, particularly tobacco and alcohol.

Finally, Rebecca presented a slide on the ‘prevention pyramid’, particularly focusing on the first level: the more effort made to create equitable social and economic conditions, the better the results. She believes that this is a much more ambitious and difficult goal to achieve than simply setting up a programme or activity. However, it is on this point that our vision must be aligned.

The more effort that is made to create equitable social and economic conditions in prevention, the better the results.

In addition to prevention needs, Rebecca emphasised the urgent need to address young people’s harm reduction needs to prevent drug poisoning deaths. Drug poisoning is currently the leading cause of death among 10- to 18-year-olds in western Canada, ahead of cancer and car accidents, so this is a public health emergency.


Dr Wadih Maalouf – UNODC

Wadih is a public health professional who holds a PhD in mental health and drug epidemiology from the Johns Hopkins School of Public Health. With over 25 years’ experience, he is now the global coordinator of the addiction prevention programme at UNODC, and is one of the world’s leading prevention experts.

Wadih began by emphasising the importance and timeliness of this conversation because it is based on scientific evidence. A large number of standards have now been developed for prevention and treatment, thanks to collaboration between UNODC and WHO, and the science is available. He also noted that science is receiving greater recognition, not only from organisations working in the field, but also from civil society. This is evident in the 3,000 stakeholders who have rallied around the common agenda promoted by the Oviedo Declaration.

This recognition is also evident at government level, as demonstrated by the Commission on Narcotic Drugs’ resolutions, which call for early prevention to target different stages of development rather than drug use. These resolutions also call for multisectoral prevention, despite all the challenges posed by multilateralism.

There is now a desire to develop science-based, multisectoral prevention programmes for young people.

In his view, there is a real desire to prioritise science and prevention, particularly for young people, and to work across multiple sectors. With the right ingredients — science, political commitment, and action on the ground — it is possible to turn this knowledge into action.

As a people-centred approach, prevention must also focus on the environment and context in which people live, as well as their level of vulnerability. This systemic approach must aim to leave no one behind.

To achieve this, we must focus on different age groups, contexts of vulnerability and gender. This is an important consideration in the context of vulnerabilities, particularly for children, whose developmental trajectories may be affected in different ways.

The current generation of young people has the highest potential ever seen, which is why it is essential that they are meaningfully engaged in prevention efforts.

Young people are not only the beneficiaries of prevention; they must also be its agents because every child has the right to grow up healthy, and we have the means to make that happen.

by Dr Max Pemberton (The Mind Doctor) in the Daily Mail on 17 March 2025

Source: Daily Mail – 17 March 2025

United Nations – Office on Drugs and Crime

March 14th 2025

Ms. Ghada Waly, Executive Director of UNODC, welcomed the youth, reaffirming the organization’s steadfast commitment to their participation in drug prevention efforts. Encouraging them to fully embrace the experience, she stated, “I encourage you to make the most of this opportunity. Speak up. Ask questions. Challenge perspectives.”

Over the course of three days, participants attended interactive sessions focused on evidence-based prevention, rooted in the UNODC/WHO International Standards on Drug Use Prevention. Through collaborative activities, they exchanged best practices from their communities, analyzed challenges, and explored ways to strengthen youth-led prevention efforts. Utilizing the UNODC Handbook on Youth Participation in Drug Prevention Work, they shared past experiences of work and brainstormed on ways to be better be engaged and consulted as youth in prevention initiatives.

A new addition this year was the recently developed Friends in Focus programme, introduced as a resource and tool developed to support global youth be actively involved in evidence-informed prevention work. Youth participants had a sneak peek into some of the interactive activities, directly experiencing parts of the programme themselves. They reflected on the role that group dynamics have in peer selection, and learned to recognize risk and protective factors to drug use. Participants showed interest in being involved in Friends in Focus, including in their potential involvement in future pre-pilots or implementation of the programme. Participants also had the opportunity to attend CND side events, such as the event on “Engaging Youth as Agents of Change in Crime and Drug Use Prevention: Experiences of the Regional Youth Network for Central Asia” and “Ringing Out Hope and Unity: The Peace Bell’s 30-Year Message in Addressing Drug Abuse”.

Another key highlight of the Youth Forum was their collaboration for the creation of the Youth Statement, which captured the collective voices and recommendations of youth participants. The statement emphasized the urgent need for effective prevention, as new and emerging substances continue to impact individuals, families, and communities. Youth participants urged policymakers to invest in evidence-based prevention strategies, create protective environments at home, school, and in communities, and advocated for multiple sectors to converge and harmoniously work together.

UNODC congratulates the Youth Forum 2025 participants for their dedication, insightful contributions, and commitment throughout the three days. Their engagement throughout the Youth Forum highlights the crucial role that young people play in shaping effective drug prevention strategies and being implicated in the policy-making arena. Through the Youth Initiative and the growing alumni network, UNODC remains committed to fostering meaningful youth participation, providing opportunities for learning and development, and supporting young leaders in their efforts to create safer and healthier communities.

Read the Youth Statement below, and click here for more information about the Youth Forum 2025.

Youth Statement 2025 at the Opening Ceremony of the 68th Session of the CND

Your Excellencies, distinguished delegates, ladies and gentlemen,

As 32 youth from 25 countries, we gather here today as a unified voice to address the issue of substance use within our respective communities. This is not a new challenge, and has been tackled over the past decades. Despite efforts, everyday there are new substances that threaten not only individuals, but also society as a whole. It creates a ripple effect where individuals, families, communities are all directly and indirectly negatively affected. The consequences could lead to disruptive environments, higher rates of crime and violence, unemployment, economic challenges, and homelessness.

Therefore, prevention measures are essential to stop substance use before it takes hold. There are many risk factors that can lead to drug use, pushing a person to an extreme. Anyone could have these vulnerabilities, and thus none of them should be neglected. Effective prevention involves creating positive climates at school, home, and in the community to promote social, psychological and physical well-being. It cultivates opportunities, builds a brighter future, and represents a sustainable solution for a long-term problem. Moreover, it flourishes through collaboration among schools, families, communities, workplaces, the health sector, youth institutions, and social media – channels of communication which are closest to us. When prevention is a priority, resilience becomes a reality.

According to research, evidence-based prevention has proven to be, systematically, the most cost-effective. We urge Member States to prioritize funding to substance use prevention policies and solutions, and to invest in further research for drug prevention in aspects that do not have sufficient evidence, such as cultural, geographical, and demographical areas.

Our collective goal is to drive practical solutions, innovative strategies, and youth-led actions. Prevention efforts must not only be about us, but led by us. Why don’t we reflect: how many youth delegates do we have seated amongst us? How many youths have been directly involved in decision-making processes such as in this Commission? As youth, we are a key element of change: we urge you to actively involve young people in prevention efforts, and ensure that financial constraints do not exclude us. We have no political bias, we bring innovation and youth perspectives, and we care about our future. And this is not a one-time investment. Continuous engagement and co-creation can help us collectively reach our mission together.
Standing now in front of you, we ask you to help us have more access to capacity building, to voice our opinion, and to actively listen to us. Please be open to collaborating because we do want to create partnerships and evolve together. Every young person, regardless of their background, should have the opportunity to reach our full potential and positively impact our communities.
Source: https://www.unodc.org/unodc/drug-prevention-and-treatment/news-and-events/2025/March/youth-forum-2025_-when-prevention-is-a-priority–resilience-becomes-a-reality.html

by Lindsey Leake  August 27, 2024 at 4:30 PM EDT

While the modern marijuana consumer may be shedding that lazy stoner stereotype, new research shows that employees who use and abuse the drug are more likely to miss work.
The findings were published Monday in the American Journal of Preventive Medicine.

For the study, researchers at the UC San Diego School of Medicine and the New York University Grossman School of Medicine analyzed data from the 2021–22 National Survey on Drug Use and Health on 46,500 adults employed full-time in the U.S. Recent and frequent cannabis use, as well as cannabis use disorder (CUD), they found, was associated with greater workplace absenteeism.

Work absences included days missed due to illness or injury in addition to skipped days when employees “just didn’t want to be there.” Respondents were a majority or plurality white (62%), male (57%), ages 35 to 49 (35%), married (52%), had at least a college degree (42%), and had an annual household income exceeding $75,000 (55%). About 16% of employees had reported using cannabis within the last month, with about 7% of whom meeting CUD criteria (mild: 4%; moderate: 2%; severe: 1%).
People who said they had never used cannabis missed an average 0.95 days of work in the past 30 days due to illness/injury and skipped 0.28 days. Cannabis users, by comparison, recorded the following absences:
  • Past-month use: 1.47 illness/injury, 0.63 skipped
  • Mild CUD: 1.74 illness/injury, 0.62 skipped
  • Moderate CUD: 1.69 illness/injury, 0.98 skipped
  • Severe CUD: 2.02 illness/injury, 1.83 skipped

The results also showed that people who used cannabis most frequently skipped the most work. For instance, those who consumed it once or twice per month skipped 0.48 days, while those who consumed it 20 to 30 days per month skipped 0.7 days. People who used cannabis three to five days per month had the highest prevalence of missed days due to illness/injury (1.68). Cannabis use longer than a month ago had no bearing on employee absence.

“These findings highlight the need for increased monitoring, screening measures, and targeted interventions related to cannabis use and use disorder among employed adults,” researchers wrote. “Moreover, these results emphasize the need for enhanced workplace prevention policies and programs aimed at addressing and managing problematic cannabis use.”

Researchers said that while their latest work supports much of the existing literature on cannabis use and workplace absenteeism, it also contrasts with other studies. One previous study, for example, showed a decline in sickness-related absences in the wake of medical marijuana legislation, while another found no link between the two.

One limitation of the new study, the authors note, is that it relied on participants’ self-reported answers. In addition, the data don’t reflect whether cannabis was used for medicinal or recreational purposes, whether it was consumed during work hours, or address other factors that may have affected a person’s cannabis use patterns.

What are the signs of cannabis use disorder?

That marijuana isn’t addictive is a myth. People with CUD are unable to stop using cannabis even when it causes health and social problems, according to the Centers for Disease Control and Prevention (CDC). Cannabis consumers have about a 10% likelihood of developing CUD, a disorder impacting nearly a third of all users, according to previous research estimates. At higher risk are people who start using cannabis as adolescents and who use the drug more frequently.

The CDC lists these behaviors as signs of CUD:
  • Continuing to use cannabis despite physical or psychological problems
  • Continuing to use cannabis despite social or relationship problems
  • Craving cannabis
  • Giving up important activities with friends and family in favor of using cannabis
  • Needing to use more cannabis to get the same high
  • Spending a lot of time using cannabis
  • Trying but failing to quit using cannabis
  • Using cannabis even though it causes problems at home, school, or work
  • Using cannabis in high-risk situations, such as while driving a car
  • Using more cannabis than intended

In addition to interfering with everyday life, CUD has been linked to unemployment, cognitive impairment, and lower education attainment. People with CUD often have additional mental health problems, including other substance abuse disorders. In this study, for example, 14% of respondents reported having alcohol use disorder within the past year.

Source: https://fortune.com/well/article/marijuana-abuse-cannabis-use-disorder-workplace-absenteeism-sick-days/

March 12, 2025

What is the Hyannis Consensus Blueprint?

The Hyannis Consensus Blueprint is a groundbreaking framework designed to guide international efforts in addressing the devastating impact of addiction. Key pillars shape this balanced drug policy, including prevention, intervention, treatment, recovery, supply reduction, and enhanced global collaboration. With addiction now at catastrophic levels in many regions, the blueprint represents a vital roadmap for sustainable change.

The principles outlined in the blueprint prioritise strategies that discourage drug use while addressing underlying systemic challenges. It promotes innovating criminal justice systems, encourages adopting evidence-based treatment options, and advocates uniting globally to combat addictive substances.

The Cost of Ignoring Addiction

Failing to address addiction comes with an enormous human and economic cost. The transcript from the Hyannis Consensus launch highlights a pressing need to move beyond toxic cycles of permissive drug policies and normalisation. Legalisation of drugs, as seen in North America, has reportedly led to devastating effects, particularly among young people, and prioritised corporate profits over public health.

The Hyannis Consensus Blueprint stands as a counterpoint to this trend. It promotes a world where communities can thrive without the shadow of addiction, empowering individuals to recover fully and lead drug-free lives.

Prevention and Recovery as Pillars of Change

At its core, the Hyannis Consensus Blueprint revolves around prevention and recovery. Prevention aims to stop drug use before it starts, while recovery offers individuals a path to rebuild their lives. This proactive approach aims to not only reduce harm but also transform lives for the better.

The blueprint urges balancing efforts across criminal justice and public health systems. Effective drug courts alongside harm-reduction interventions serve as vital tools in discouraging drug use and fostering recovery. Nations serious about tackling addiction must consider these solutions to safeguard future generations.

Governments Urged to Prioritise Resilient Societies

Governments worldwide are now being urged to realign their national drug policies with the principles of the Hyannis Consensus Blueprint. Countries are encouraged to reaffirm their commitment to international drug conventions, reject legalisation experiments that prioritise private interests, and expand programmes rooted in criminal justice reform and effective public health measures.

The launch of this blueprint serves as a rallying cry for nations determined to prioritise human dignity and community wellbeing. By adopting the Hyannis Consensus Blueprint, countries can pave the way for healthier, more resilient societies.

Why the Hyannis Consensus Matters

Addiction is more than an individual struggle; it’s a societal challenge that affects families, economies, and futures. The Hyannis Consensus Blueprint is a bold step towards reversing the tide of permissive drug policies and ineffective strategies. For countries looking to protect their citizens, this balanced drug policy provides the tools and vision necessary for meaningful change.

Organisations like the Dalgarno Institute and WFAD are at the forefront of this global effort, highlighting the importance of this significant, timely initiative. Communities deserve policies that prioritise recovery, not exploitation, and the Hyannis Consensus Blueprint is uniquely positioned to achieve this goal.

Learn more here.

Source: https://wrdnews.org/the-hyannis-consensus-blueprint-a-landmark-in-balanced-drug-policy/

AddictionPolicyForum.png

Updated: Mar 12
 
A randomized clinical trial published in JAMA Network Open found that incorporating online group mindfulness sessions into buprenorphine treatment for opioid use disorder (OUD) significantly reduced opioid cravings compared to treatment as usual.
The study, led by Dr. Zev Schuman-Olivier and colleagues from Cambridge Health Alliance and Harvard Medical School, examined the effectiveness of a 24-week virtual mindfulness-based program compared to a standard recovery support group using evidence-based practices. The trial included 196 participants across 16 U.S. states.

The mindfulness-based program showed similar levels of opioid use and anxiety reduction compared to standard best-practice groups but significantly outperformed in reducing self-reported opioid craving (67 percent vs. 44 percent, P<0.001). Study results indicate that mindfulness is a potent treatment option that can help reduce opioid craving during buprenorphine treatment.

“These findings are compelling evidence that trauma-informed mindfulness groups can be offered as an option for people during medication treatment for opioid use disorder,” said Dr. Zev Schuman-Olivier, MD, principal investigator of the study, founding director of the Center for Mindfulness and Compassion, and director of addiction research at Cambridge Health Alliance. “Mindfulness should be strongly considered for patients experiencing residual cravings after starting buprenorphine.”
As one participant reported, “This program helped me learn new techniques that I didn’t even know existed before I began. I still meditate all the time and don’t even need to have any sound on. I just lay down and push away all of my stress. It was well worth every minute I spent there.”

OUD remains a major public health crisis in the U.S., with over 100,000 opioid overdose deaths each year. Medications for opioid use disorder (MOUD), such as buprenorphine, are evidence-based treatments for opioid use disorder (OUD). Opioid craving is a risk factor for relapse for patients receiving MOUD. Experts highlight that further research is needed to explore how mindfulness can be integrated into existing OUD treatment frameworks to improve long-term recovery outcomes.

Source: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2829421
Cathy Deacon
Writer states that primary prevention, heading off drinking problems before they start, should be a focus

In the fall of 2024, the Yukon’s chief medical officer stated that the Yukon government’s first substance use surveillance report indicated that alcohol’s burden “far exceeds” other substances. The report contains data related to EMS (emergency medical services), hospital and emergency admissions and reports from the chief coroner. Dr. Sudit Ranade says that the Yukon has a more substantial burden of substance abuse than the Canadian average. (Nov. 29/2024 Yukon News).

Dr. Sudit wisely pointed out that alcohol use in the Yukon starts early and while getting treatment is good, it takes the focus away from prevention. The Yukon government spends millions on secondary prevention; primary prevention aims to prevent the onset of disease or illness and secondary prevention attempts to manage the disease and reduce progression once present.

I have lived in the Yukon since 1970, graduated from FH Collins in 1975. I started drinking when I was 15 years old, it became a problem very quickly yet I didn’t quit drinking until I was 30 years old. Alcohol and mental illness ran in my family and seven years ago I lost my son to suicide in Whitehorse; he was drinking that fateful night.

I have been a social worker and criminologist in the Yukon for the last 40 years. I have worked in Whitehorse and rural communities in the Yukon. I have seen the suffering that that both alcohol and drugs brings upon families and communities. It’s not uncommon to hear of mothers drinking themselves to death, leaving their children motherless.

We spend millions on secondary prevention programs — EMS, mental health and substance abuse programs, shelters, police, medical system — the list goes on. I would like to see a thoughtful analysis of how successful mental health and substance abuse services programs are for people with substance abuse issues. I can guarantee that we would find dismal results, we keep doing the same thing over and over again, expecting different results. Secondary prevention provides employment for a whole lot of us, but at what cost?

Primary prevention programs aimed at preventing the problem before it starts is often overlooked. The main point in me writing this letter is to encourage the Yukon government to prevent the harm and one of the ways to do that, is to educate people about the serious harm that alcohol causes.

In Nov. 2017, a federally-funded study in Yukon, which was the first of its kind in Canada, saw colourful labels affixed to all alcohol bottles and cans inside a Whitehorse liquor store. There were two types of labels: one that warned that alcohol can cause cancer, including breast and colon cancer (there are other cancers as well); another label informed purchasers of the recommended maximum number of drinks per day. But just four weeks later, the Yukon Liquor Corporation decided to “pause” the label study after hearing concerns from national alcohol organizations.

The concerns included whether Yukon had the authority to affix the warnings and possible defamation, said the minister responsible for the liquor corporation, John Streicker.

“We have to weigh the costs that we will have to put towards litigation, costs which could go towards trying to reduce the harm of alcohol and promote education,” he said.

Timothy Stockwell, a University of Victoria researcher involved in the study, said he felt “extreme disappointment’ when he learned the project was being put on hold. The liquor industry was afraid that the graphic warning labels on booze could curb alcoholism. The label phase was supposed to run for eight months followed by a survey to assess the impact. The colourful labels included graphics, as opposed to U.S. messages that are text only. There was concern about putting the word cancer on the labels yet the International Agency for Research on Cancer, a World Health Organization body, has classified alcohol as a group-one carcinogen, along with tobacco, asbestos and many other materials. (Canadian Press – Laura Kane Posted Jan. 3, 2018).

We are now being told that there is no safe level of alcohol. I am pleased to see that there appears to be increasing numbers of people who are recognizing this fact and choosing to forgo the use of alcohol. I have lived in the Yukon for over 50 years and always wondered why there was so much cancer in such a beautiful pristine land. Could alcohol use have something to do with that? Not to mention the costs alcohol misuse does to families, children, teenagers, including suicide, mental health issues, FASD, incarceration, child abuse, problems in school attendance and missing work, the list goes on. Drinking alcohol can raise your risk of developing these cancers: mouth, laryngeal, breast, liver, pharyngeal, esophageal, stomach, pancreatic and colorectal. Tobacco and alcohol together are worse for you than either on its own. (Canadian Cancer Society).

I propose that we give this study another try, for at least a year. It held promise, can’t we at least try something that would cost peanuts, putting a label on a bottle? Education is key and morally, how can we not try prevention for the sake of Yukon people’s health?

Ms. Clarke encourage your fellow MLAs to be brave and try this inexpensive primary prevention project again; it could save lives, lower health care costs and all other related costs that the Chief Medical Officer spoke about. Don’t let the liquor industry bully you, it might give Yukoners the impression that money from the sale of alcohol is more important than people’s health.

Sincerely, Cathy Deacon, Whitehorse, Canada.

Vienna (Austria), 13 March 2025 – “Investing in your health, safety, and well-being is an investment in a stronger, more sustainable world.”

Ms. Ghada Waly, the Executive Director of the UN Office on Drugs and Crime (UNODC), emphasized the vital role of youth in substance use prevention. Speaking at the Opening of the Youth Forum 2025 in the margins of the Commission on Narcotic Drugs (CND), Ms. Waly highlighted that “it is your contribution – your ideas and your actions – that will drive real progress” in building resilience and fostering evidence-based prevention efforts.

The Youth Forum at the CND brings together young leaders from around the world to engage in discussions with UNODC experts on substance use prevention and meaningful youth involvement. Participants learn to recognize vulnerabilities to drug use, what effective prevention aims to target and prosocial and healthy behaviours within their communities.

Over three days, youth engaged in interactive sessions based on the UNODC/World Health Organization (WHO) International Standards on Drug Use Prevention, examining the science behind substance use disorders, understanding risk and protective factors that can make an individual become more vulnerable and reflecting on the extent to which their prevention experiences are aligned with evidence-based practices. They also discussed ways to strengthen their role as youth in prevention work, ensuring that young people are actively involved in shaping policies and initiatives that promote well-being and resilience.

Additionally, participants were introduced to Friends in Focus, UNODC’s newly developed youth-based prevention programme. They explored innovative ways to engage their peers, promote positive social norms, and contribute to substance use prevention efforts in their communities. Shaped through insights and feedback from previous Youth Forum participants, Friends in Focus aims to equip young people with the knowledge, training, and tools to drive meaningful change.

Youth leading in communities

Youth participants shared their experiences and inspirations that led them in their journey of substance use prevention work, exchanging best practices from their communities. Through group activities, they learned from each other, identifying what worked and what didn’t in prevention efforts.

Nathan Christoff-Omar Morris, one of the youth representatives that delivered the joint Youth Statement, shared how his work in Jamaica focused on educating students. “Everyone’s life is unique, and so are their experiences — youth-led initiatives allow peer-to-peer interactions, which is an effective way of communicating. This can create a ripple effect of positive influence in communities,” he emphasized. His efforts back home led to greater presence of prevention messaging in schools and increased student engagement with counselling services.

Nathan, reflecting on his time at the Youth Forum, emphasized how youth-led approaches make prevention efforts more relatable and effective. “Young people understand the challenges we face—whether it’s family struggles, academic pressure, or peer influence. That’s why youth must be at the forefront of prevention work and policymaking.”

Inspired by the diverse ideas and initiatives shared during the Youth Forum, Nathan left with a renewed vision. “This experience will forever be etched into my mind. I plan to bring back my learnings, advocate for more investment in youth-led prevention and introduce programmes like Friends in Focus in my country.”

Youth voices at the forefront

During the Plenary of the 68th CND, young leaders delivered their jointly drafted Youth Statement: “Prevention efforts must not only be about us but led by us,” they declared, urging policymakers to invest in evidence-based strategies and prioritize youth participation in prevention and decision-making processes. “Standing now in front of you, we ask you to help us have more access to capacity building, to voice our opinions and to actively listen to us.”

The Youth Statement passionately called on Member States to recognize that prevention is the most cost-effective approach to addressing substance use. “When prevention is a priority, resilience becomes a reality.”

The youth further stressed the need for youth-led actions, ensuring that prevention efforts reach all young people, regardless of their background, enabling them to reach their full potential and opportunities.

Source: https://www.unodc.org/unodc/frontpage/2025/March/youth-forum-2025_-youth-taking-the-lead-in-peer-led-drug-prevention.html

United Nations

Prevention, Treatment, and Rehabilitation Section

 

March 14th 2025

Just this week, the Youth Forum 2025 took place during 10 – 12 March on the sidelines of the 68th Session of the Commission on Narcotic Drugs (CND). This year, 32 youths from 25 countries were selected through a rigorous process, aiming to invite youths that had high interests and/or prior experience in drug prevention. The Youth Forum provided a platform for these dedicated young leaders to learn about effective prevention, share their experiences, and learn from each other.

Ms. Ghada Waly, Executive Director of UNODC, welcomed the youth, reaffirming the organization’s steadfast commitment to their participation in drug prevention efforts. Encouraging them to fully embrace the experience, she stated, “I encourage you to make the most of this opportunity. Speak up. Ask questions. Challenge perspectives.”

Over the course of three days, participants attended interactive sessions focused on evidence-based prevention, rooted in the UNODC/WHO International Standards on Drug Use Prevention. Through collaborative activities, they exchanged best practices from their communities, analyzed challenges, and explored ways to strengthen youth-led prevention efforts. Utilizing the UNODC Handbook on Youth Participation in Drug Prevention Work, they shared past experiences of work and brainstormed on ways to be better be engaged and consulted as youth in prevention initiatives.

A new addition this year was the recently developed Friends in Focus programme, introduced as a resource and tool developed to support global youth be actively involved in evidence-informed prevention work. Youth participants had a sneak peek into some of the interactive activities, directly experiencing parts of the programme themselves. They reflected on the role that group dynamics have in peer selection, and learned to recognize risk and protective factors to drug use. Participants showed interest in being involved in Friends in Focus, including in their potential involvement in future pre-pilots or implementation of the programme. Participants also had the opportunity to attend CND side events, such as the event on “Engaging Youth as Agents of Change in Crime and Drug Use Prevention: Experiences of the Regional Youth Network for Central Asia” and “Ringing Out Hope and Unity: The Peace Bell’s 30-Year Message in Addressing Drug Abuse”.

Another key highlight of the Youth Forum was their collaboration for the creation of the Youth Statement, which captured the collective voices and recommendations of youth participants. The statement emphasized the urgent need for effective prevention, as new and emerging substances continue to impact individuals, families, and communities. Youth participants urged policymakers to invest in evidence-based prevention strategies, create protective environments at home, school, and in communities, and advocated for multiple sectors to converge and harmoniously work together.

As they reminded global policymakers that “Prevention efforts must not only be about us, but led by us”, they called on Member States to actively include young people in decision-making processes and prevention work. And they further highlighted their readiness in being equal partners with adult stakeholders in addressing the world drug problem, as they said: “We have no political bias, we bring innovation and youth perspectives, and we care about our future. And this is not a one-time investment. Continuous engagement and co-creation can help us collectively reach our mission together.”

UNODC congratulates the Youth Forum 2025 participants for their dedication, insightful contributions, and commitment throughout the three days. Their engagement throughout the Youth Forum highlights the crucial role that young people play in shaping effective drug prevention strategies and being implicated in the policy-making arena. Through the Youth Initiative and the growing alumni network, UNODC remains committed to fostering meaningful youth participation, providing opportunities for learning and development, and supporting young leaders in their efforts to create safer and healthier communities.

Read the Youth Statement below, and click here for more information about the Youth Forum 2025.

Youth Statement 2025 at the Opening Ceremony of the 68th Session of the CND

Your Excellencies, distinguished delegates, ladies and gentlemen,

As 32 youth from 25 countries, we gather here today as a unified voice to address the issue of substance use within our respective communities. This is not a new challenge, and has been tackled over the past decades. Despite efforts, everyday there are new substances that threaten not only individuals, but also society as a whole. It creates a ripple effect where individuals, families, communities are all directly and indirectly negatively affected. The consequences could lead to disruptive environments, higher rates of crime and violence, unemployment, economic challenges, and homelessness.

Therefore, prevention measures are essential to stop substance use before it takes hold. There are many risk factors that can lead to drug use, pushing a person to an extreme. Anyone could have these vulnerabilities, and thus none of them should be neglected. Effective prevention involves creating positive climates at school, home, and in the community to promote social, psychological and physical well-being. It cultivates opportunities, builds a brighter future, and represents a sustainable solution for a long-term problem. Moreover, it flourishes through collaboration among schools, families, communities, workplaces, the health sector, youth institutions, and social media – channels of communication which are closest to us. When prevention is a priority, resilience becomes a reality.

According to research, evidence-based prevention has proven to be, systematically, the most cost-effective. We urge Member States to prioritize funding to substance use prevention policies and solutions, and to invest in further research for drug prevention in aspects that do not have sufficient evidence, such as cultural, geographical, and demographical areas.

Our collective goal is to drive practical solutions, innovative strategies, and youth-led actions. Prevention efforts must not only be about us, but led by us. Why don’t we reflect: how many youth delegates do we have seated amongst us? How many youths have been directly involved in decision-making processes such as in this Commission? As youth, we are a key element of change: we urge you to actively involve young people in prevention efforts, and ensure that financial constraints do not exclude us. We have no political bias, we bring innovation and youth perspectives, and we care about our future. And this is not a one-time investment. Continuous engagement and co-creation can help us collectively reach our mission together.

Standing now in front of you, we ask you to help us have more access to capacity building, to voice our opinion, and to actively listen to us. Please be open to collaborating because we do want to create partnerships and evolve together. Every young person, regardless of their background, should have the opportunity to reach our full potential and positively impact our communities.

Behind every statistic there is a story. If you want to change the statistics, listen to the stories. Recognize the vulnerability, don’t neglect it. Strengthen it. And the time to act is now, for the future begins with the choices made today.

Source: https://www.unodc.org/unodc/drug-prevention-and-treatment/news-and-events/2025/March/youth-forum-2025_-when-prevention-is-a-priority–resilience-becomes-a-reality.html

 

by Mia Holloman, Directorate of Prevention, Resilience and Readiness – March 11, 2025

A strong Army starts with healthy Soldiers and communities. When Soldiers are at their best, they’re ready for any mission. The Army Substance Abuse Program is committed to preventing substance misuse before it becomes a problem, giving leaders the tools to recognize risks and take action early.

Prevention starts with awareness and the right support. ASAP provides education and resources to help Soldiers, leaders and units work together to address alcohol and drug misuse. Commanders play a vital role in creating positive, substance-free environments and encouraging activities that strengthen resilience and teamwork. By taking a proactive approach, Soldiers stay focused, engaged and mission-ready.

“Take advantage of services that the Army offers before there is an incident,” said Georgina Gould, Army Substance Abuse Program Specialist, Ready and Resilient Integration and Training division.

“If there are indicators that problematic substance misuse is getting in the way at work or at home, schedule an appointment to meet with a provider at your assigned embedded behavioral health clinic, where you can be assessed for voluntary care without command involvement.”

The Substance Use Disorder Clinical Care Program, a vital resource for Soldiers and their Families impacted by substance misuse, complements ASAP’s prevention initiatives.

SUDCC is the Army’s model for delivering substance use treatment in a manner that is integrated, aligned with unit needs and conveniently co-located. Substance use disorder treatment is part of a comprehensive plan aimed at achieving rapid recovery and restoring individuals to full readiness.

“SUDCC’s mission of providing treatment and returning Soldiers to the fight is congruent with the ASAP mission of strengthening the overall fitness and effectiveness of the Army workforce, (conserving) manpower and enhancing Soldier combat readiness,” Gould said.

SUDCC provides care tailored to the unique needs of the Total Army, ranging from initial assessment and counseling to outpatient and inpatient treatment options. Gould said the SUDCC program has a low recidivism rate, meaning individuals are less likely to return to the program.

“There is a low number of Soldiers returning for further treatment after services are completed, which means they are successful in returning to the mission and their Families with enhanced coping skills and wellness,” Gould said.

Together, ASAP and SUDCC demonstrate the important role of the Army community in prevention, awareness and recovery. Substance misuse is not just a personal issue; it can impact entire teams, communities and missions. ASAP and SUDCC bring together partners from different sectors and engage stakeholders to build a strong, united effort against substance misuse.

Source: https://www.army.mil/article/283651/strengthening_the_army_community_through_substance_misuse_prevention_treatment_options

Photo: UNODC
Member states voting at the 68th session of the CND.

Vienna (Austria), 14 March 2025 — The sixty-eighth session of the Commission on Narcotic Drugs (CND) concluded today after five days of intensive discussions on global drug policy, international cooperation and the implementation of international drug policy commitments. The strong engagement and high level of participation from governments and stakeholders in Vienna, 2,000 of whom gathered to exchange views and shape collective responses to evolving drug-related challenges, demonstrates the Commission’s relevance as the global platform for addressing the complexities of the world drug problem in an evidence-based, forward-looking manner.

In her closing remarks, United Nations Office on Drugs and Crime (UNODC) Executive Director Ghada Waly emphasized the importance of strengthening the CND. “In times of division and uncertainty, we need effective multilateral institutions more than ever,” she said. “And the level of engagement at this session has once again confirmed the enduring relevance of this Commission as the global forum for drug policy.”

She urged Member States to redouble their efforts, commitment and cooperation, recognizing that the evolution of the world drug problem demands a renewed and determined response. “UNODC will remain committed to working for a healthier and safer world, guided by the decisions of Member States,” she concluded.

Six New Substances under Control

In fulfilling its normative functions under the international drug control conventions, the Commission acted on recommendations from the World Health Organization (WHO), deciding to place six substances under international control. These include four synthetic opioids –  N-pyrrolidino protonitazene, N-pyrrolidino metonitazene, etonitazepipne, and N-desethyl isotonitazene – which have been linked to fatal overdoses. The Commission also placed hexahydrocannabinol (HHC), a semi-synthetic cannabinoid with effects similar to THC that has been found in a variety of consumer products, under Schedule II of the 1971 Convention. Additionally, carisoprodol, a centrally acting skeletal muscle relaxant, widely misused in combination with opioids and benzodiazepines, was placed under Schedule IV of the 1971 Convention due to its potential for dependence and health risks. These scheduling decisions reflect the Commission’s ongoing efforts to respond to emerging drug threats and protect public health.

Six resolutions adopted

The Commission on Narcotic Drugs (CND) also adopted six resolutions, reinforcing global efforts to address drug-related challenges through evidence-based policies and strengthened international cooperation.

To protect children and adolescents, the Commission encouraged the implementation of scientific, evidence-based drug prevention programs, emphasizing the need for early interventions and cross-sectoral collaboration to build resilience against non-medical drug use.

Recognizing the growing impact of stimulant use disorders, another resolution promoted research into effective, evidence-based treatment options, calling on Member States to invest in innovative pharmacological and psychosocial interventions to improve care for those affected.

The importance of alternative development was reaffirmed with a resolution aimed at modernizing strategies that help communities transition away from illicit crop cultivation, ensuring long-term economic opportunities while addressing broader issues like poverty and environmental sustainability.

In response to the rising threat of synthetic drugs, the Commission adopted a resolution to protect law enforcement and first responders dismantling illicit synthetic drug labs and advocating for stronger safety protocols, enhanced training and international cooperation to reduce risks.

To strengthen the implementation of international drug control conventions and policy commitments, the Commission decided to establish an expert panel tasked with developing a set of recommendations to strengthen the global drug control system.

Additionally, recognizing the environmental damage caused by illicit drug-related activities, the Commission adopted another resolution calling on Member States to integrate environmental protection into drug policies and address the negative impacts on the environment resulting from the illicit drug-related activities.

These resolutions reflect the Commission’s commitment to providing concrete, coordinated responses and ensuring that drug control policies remain effective, adaptive and aligned with contemporary challenges.

Source: https://www.unodc.org/unodc/frontpage/2025/March/cnd-68-concludes_-six-new-substances-controlled-six-resolutions-adopted.html

    Delegation of the European Union to the International Organisations in Vienna

Statement by Press and information team of the Delegation to UN and OSCE in Vienna:

It is an honour to be here and to speak on behalf of the European Union and its Member States. Albania, Andorra, Bosnia and Herzegovina, Georgia, Iceland, Montenegro, North Macedonia, Republic of Moldova, San Marino and Ukraine align themselves with this statement.

Mr Chair,

We remain committed to strengthening the global cooperation to address drug-related challenges in accordance with an evidence-based, integrated, balanced and comprehensive approach. We acknowledge the important role of UNODC in monitoring the world drug situation, developing strategies on international drug control and recommending measures to address drug-related challenges.

As we meet today, conflicts and violence are unfolding in numerous parts of the world. The EU and its Member States call for the full respect for the UN Charter andinternational law, including international humanitarian law, whether in relation to Russia’s war of aggression against Ukraine, or the ongoing conflicts in the Middle East, Sudan, Ethiopia, DRC and elsewhere.

Drug trafficking controlled by organised crime groupsthreatens public health, our security, our economies and prosperous development worldwide, and even our democratic institutions and the rule of law. This is an important security challenge that Europe is currently facing. As demonstrated by the European Drug Report 2024, as a consequence of the high availability of drugs, large-volume trafficking and competition between criminal groups in Europe, some countries are experiencing an increase in violence and other forms of criminality linked to the operation of the drug market.

To address this concern, last November the EU hosted the European Conference on Drug-related Violenceas part of the implementation of the EU Roadmap to combat drug trafficking and organised crime. At the conference, the EU Drugs Agency called for action on drug-related violence, to encourage and support efforts to enhance safety and security across all sectors of society with measures to anticipate, alert, respond and learn from the growing complexities of drug-related violence. This initiative reflects our collective determination to address the increasing violence linked to drug trafficking.

In line with the pledge of the Global Coalition to address Synthetic Drug Threats that the EUcommitted to in September 2024, we are currently closely monitoring the risks of a potential increase in the supply and demand for synthetic opioids in Europe. This possible shift could represent unique challenges for public health systems and law enforcement.

Among such challenges is the growing number of illegal laboratories that produce synthetic drugs. Considering the threat they pose, Poland – on behalf of the EU – has tabled a resolution that draws attention to the protection of all those that are at the forefront of dismantling drug laboratories. Our aim is to set the ground for global standards in ensuring the safety of law enforcement officers, and we count on your support for this important resolution.

The EU and its Member States also call for greater consideration of development-oriented drug policies and alternative development measures, as well as the environmental damage linked to the direct and indirect impact of illicit drug crop cultivation, drug production and manufacture and drug policy responses. Conscious of the realities that shape our world, a resolution addressing the environmental impact of drugs has been tabled by France on behalf of the EU. This is atopic that needs more engagement from all of us, and we hope that you will back this resolution as well.

The EU and its Member States continue to emphasise that States are obliged to protect, promote and fulfilhuman rights, including when they develop and implement drug policies. All human beings are born free and equal in dignity and rights, and the EU and its Member States recall that the death penalty should be abolished globally. We condemn the use of capital punishment at all times and under all circumstances, including for drug-related offences. Additional measures should be taken for people in vulnerable and marginalised situations and to reduce stigma and discrimination. We underline that substance use disorders are a health issue requiring compassionateand evidence-based interventions. Stigmatisation and criminalisation of individuals with substance use disorders should be replaced with a health-centredapproach to reduce risks and harm.

Addressing drug-related harm also remains an important pillar of EU drug policy and the EU Drugs Strategy. The EU and its Member States are implementing a human rights-based approach with a range of measures in compliance with the three international drug conventions. The aim is to reduce drug supply and to take prevention, treatment, care and recovery measures, to reduce risk and harm to society and to the individual. We also ensure a meaningful involvement of scientific experts, civil society and affected communities. We urge the international community to further embrace pragmatic measures aimed at reducing the health and social harms, both for the individual and for society, associated with drug use. From needle and syringe exchange programmes to opioid agonist therapies, such evidence-based initiatives are essential for safeguarding public health and dignity. Prevention, treatment, care and recovery measures, risk and harm reduction must be expanded, adequately resourced, and firmly rooted in respect for human rights, as also set out in last year’s CND resolution 67/4 [on preventing and responding to drug overdose through prevention, treatment, care and recovery measures, as well as other public health interventions, to address the harms associated with illicit drug use as part of a balanced, comprehensive, scientific evidence-based approach].

In the context of current global drug-related challenges, it is important to stress that effective solutions can only be achieved through a balanced and whole-of-society approach as well as by engaging all relevant stakeholders, including health-care personnel, who provide critical support to those affected by substance use disorders; law enforcement officers, who risk their lives in targeting organised crime groups involved in drug production and trafficking; academia, which contributes with evidence-based research and innovative solutions; civil society organisations, which play an important role in prevention, and in risk and harm reduction initiatives. International cooperation is also indispensable to tackle the global drugs phenomenon and we count on the close involvement ofall relevant United Nations entities, including human rights bodies, to foster coordinated international action and inter-agency cooperation.

As set out in the high-level declaration by the CND on the 2024 mid-term review, we stress the urgent need for further ambitious, effective, improved and decisive actions as well as for more proactive, scientific evidence-based, comprehensive, balanced approaches to address drug-related challenges.

For that, we emphasise the critical importance of thorough data collection, monitoring, and scientific research. The European Union Drugs Agency is therefore key in developing Europe’s capacity to react to both current and future drug-related challenges, and we have made a concrete pledge in this regard at last year’s High-level segment of the CND.

Mr. Chair, to conclude,

Continuous drug-related challenges require our united front and cooperation to address them in the most effective and sustainable manner, and we count on global efforts to do so together. The EU and its Member States reaffirm their own commitment to fostering a comprehensive, inclusive, and balanced approach to addressing the world drug situation. We call on all Member States and stakeholders to join us in prioritising health, dignity, and human rights in all aspects of drug policy.

Thank you.

SOURCE: https://www.eeas.europa.eu/delegations/vienna-international-organisations/eu-statement-general-debate-68th-session-commission-narcotic-drugs-10-march-2025_en

After achieving six months of sobriety, Horning has become a vocal advocate for comprehensive substance use prevention and education programs aimed at helping students in Warren County lead substance-free lives.

His initiative, developed in collaboration with Dr. Patricia Hawley-Mead and district officials, seeks to implement substance use prevention and education services across the school district. The goal of the initiative is to provide students, teachers, and parents with the education, community resources, and intervention strategies needed to prevent substance use and promote healthier lifestyle choices.

“If you were to tell me eight months ago I would be standing in front of you talking about substance abuse prevention and putting Narcan in AED boxes, I would have said you were crazy,” Horning shared with the audience during a recent school board meeting.

Horning’s passion for substance use prevention stems from his own difficult experience with addiction. He has openly shared his struggles with substance use, depression, and unhealthy coping mechanisms that led him down a painful path.

“My addiction was full of loss, hardships, and failures,” Horning explained. “Nothing seemed to work, nothing was helping me, and most importantly, I wasn’t helping myself. I’ve been in and out of psychiatrists’ offices, tried different medications, and felt completely lost. The only way I found recovery was by chance, but it shouldn’t be that way. We need a system in place to give students a way out before it’s too late.”

Looking back on his darkest moments, Horning admitted he never imagined he would be advocating for change in front of a crowd.

“I was not a great person at that moment in time,” he said, becoming emotional. “I made a lot of mistakes. My family, who is sitting behind me today, can tell you that. People inside and outside of school districts saw me at my worst. The disease of addiction is a lifelong battle that I will face until the day I die. But that does not mean it has to end in tragedy. That is why I am standing here today – to fight for others like me.”

Horning recognizes that many students turn to substances for a variety of reasons–whether out of boredom, depression, anxiety, or as a way to cope with personal struggles. His initiative is designed not only to educate students on the dangers of substance use but also to provide them with the tools and support systems they need to make better, healthier choices.

“This initiative will not only help students stay alive in case of an overdose, but it will help them find a way out of addiction and into a new life,” he emphasized. “Even if this helps just one person, it will all be worth it.”

INITIATIVE’S INSPIRATION

The inspiration behind Horning’s initiative came after a district-wide program held on September 18, 2024. During the event, public speaker Stephen Hill presented the First Choice & A Second Chance program to high school students. The program aimed to break the stigma surrounding substance use disorder, raise awareness about the ongoing drug epidemic, and encourage students to make healthier decisions.

Following the event, Horning was motivated to take action. He reached out to district administrators, safety officers, the school nurse department head, and a Family Services of Warren County drug and alcohol counselor to begin crafting a proposal for a comprehensive Substance Use Prevention and Education Service in the district.

The proposal calls for the establishment of educational programs that would teach students about the risks associated with substance use, provide early intervention services, and offer mental health support. Additionally, Horning’s plan includes provisions for Narcan to be available in school AED boxes, ensuring that life-saving measures are ready in case of an overdose emergency.

Hawley-Mead, who has worked closely with Horning on the initiative, stressed the importance of early intervention and prevention.

“The increasing prevalence of substance use among young people is a growing concern,” Mead said. “It poses a significant risk to their academic success, emotional well-being, and future prospects. Early prevention and education efforts have been shown to reduce substance use, improve student decision-making, and help create a more supportive and empathetic learning environment.”

Mead believes that by fostering a collaborative effort among educators, parents, and community partners, the district can proactively address the issue of substance use and equip students with the knowledge and support they need to thrive.

“This initiative will provide students, teachers, and parents with education, resources, and intervention strategies to support healthy choices and foster a positive, drug-free environment,” Mead said.

Horning concluded his speech with an emotional reflection on his own personal journey and the importance of offering help to others who may be struggling.

“What drove me to do this was really a lot of depression and unhealthy coping skills,” he shared. “I was not in the right mindset when I first used. I was not okay. If somebody had sat me down and told me, ‘We can help you,’ it could have saved me years of pain. That’s why we need this now. We need to offer students the opportunity to get help before it’s too late.”

Horning is determined to ensure that no student has to face the same struggles he did. His initiative is not only aimed at providing support for those already struggling with substance use but also preventing others from ever going down that difficult path.

“The only way I found recovery was by chance,” he admitted. “That’s the best way I can put it. Recovery is important, but when you are in an active addiction, it feels impossible to get through to someone. That’s why, eight months ago, I would have called you crazy if you told me I’d be standing here today. But now, I’m here. I have made myself a better person, and I want to give back for what I have found.”

Horning and district officials are now seeking approval from the school board and the community to bring this initiative to life in Warren County schools. Their goal is to integrate substance use prevention education into the curriculum, provide resources for students and families, and ensure that Narcan is available in AED boxes to help prevent potential overdose deaths.

“We don’t have to live in tragedy like other schools have,” Horning said. “We need to teach students how to use Narcan, how to stay alive, and most importantly, how to find a way out of addiction. Recovery is possible, and I want to show others that they don’t have to suffer alone.”

HORNING’S PROPOSAL

Horning’s written proposal outlines five key goals for the pilot initiative: Enhance school safety by increasing access to Narcan for emergency overdose response. Educate the school community about substance use prevention, intervention, and response strategies. Establish a student club focused on substance use awareness, prevention, and peer education to increase awareness and reduce stigma surrounding substance use disorder. Actively engage stakeholders, including students, staff, families, and community partners, to establish an anonymous and supportive program where students can learn about and advocate for substance use prevention. Create a district-sponsored club dedicated to promoting substance use prevention and education.

Hawley-Mead emphasized that while Narcan is already available in nurse’s offices during school hours, having it in AED boxes would ensure it’s accessible during after-school activities and weekend events.

“This proposal aims to make Narcan more widely available and accessible to first responders during emergencies, regardless of the time of day,” she said. “We want to ensure that this life-saving measure is available whenever and wherever it’s needed.”

Horning also reached out to Family Services of Warren County, which has expressed strong support for the initiative.

“They are very, very responsive towards this program,” Horning said. “I’ve spoken with counselors, including Nicole Neukum, executive director, and they’re all willing to give us whatever we need to make this a success.”

School board member Mary Passinger asked Horning if he felt comfortable sharing the personal story behind his addiction.

“It was really a lot of depression and unhealthy coping skills,” Horning responded. “I was not in the right mindset when I first used. If someone had told me, ‘We can help you,’ it could have saved me from years of pain.”

Board member John Wortman commended Horning for his bravery in speaking out and bringing this important issue to the district’s attention.

“There is nothing more important than standing up for what you believe in,” Wortman said. “The proposals outlined here will help make a significant, positive impact on students in Warren County. And that’s something we can all support.”

Superintendent Gary Weber also voiced his strong support for the initiative.

“We are 100% behind this initiative,” he said. “It’s clear that Jessie and Dr. Mead have worked hard to bring together stakeholders and develop a plan that will have a lasting and positive impact. We want to make sure this program is sustainable, and we’re committed to supporting it every step of the way.”

The district is currently reviewing Horning’s proposal, and community members are encouraged to get involved in supporting this critical initiative. For updates and information on how to help, individuals can reach out to district officials or Family Services of Warren County.

With this initiative, Horning hopes to not only save lives but also inspire others to break free from addiction and reclaim their futures.

“Recovery is possible,” he said. “And I want to show others that they don’t have to suffer alone.”

Source: https://www.timesobserver.com/news/local-news/2025/03/student-leads-charge-for-substance-use-prevention/

Arizona State University


Children seen from behind sit next to each other with their arms around each other while looking out at a large body of water.

Over the past 20 years, science-based interventions and treatments using a statistical method called mediation analysis have contributed to reduced rates of smoking and drinking among teenagers and young adults in the U.S. Research from Arizona State University has developed these statistical techniques, which save time and money and are now used widely in psychology, sociology, biology, education and medicine. Many of available medical treatment options are the result of clinical trials that used mediation to figure out what worked.

Image by Duy Pham/Unsplash

by Kimberlee D’Ardenne –

Smoking rates among teenagers today are much lower than they were a generation ago, decreasing from 36% in the late 1990s to 9% today. The rates of alcohol consumption among underage drinkers have also decreased. At the turn of the century, people aged 12–20 years drank 11% of all the alcohol consumed in the U.S. Today, they only drink 3%.

These decreases are in part the result of science-based interventions that were designed to prevent substance use. But these interventions would not have been possible without statistical methods, including a statistical method called mediation analysis that lets researchers understand why an intervention or treatment succeeds or fails. Mediation analysis also identifies how aspects of a substance use reduction program or medical treatment cause its success.

About this story

There’s a reason research matters. It creates technologies, medicines and other solutions to the biggest challenges we face. It touches your life in numerous ways every day, from the roads you drive on to the phone in your pocket.

The ASU research in this article was possible only because of the longstanding agreement between the U.S. government and America’s research universities. That compact provides that universities would not only undertake the research but would also build the necessary infrastructure in exchange for grants from the government.

That agreement and all the economic and societal benefits that come from such research have recently been put at risk.

Prevention makes our lives better — and it saves money. Though smoking and drinking rates among adolescents are on the decline, there is still room for mediation analyses to save the U.S. more money. According to the National Institute on Alcohol Abuse and Alcoholism, misusing alcohol costs the U.S. $249 billion. The Centers for Disease Control and Prevention report that cigarette smoking costs the U.S. around $600 billion, including $240 billion in health care spending and over $300 billion in lost productivity from smoking-related deaths and illnesses.

David MacKinnon, Regents Professor of psychology at Arizona State University, has been studying and using mediation analyses for the past 35 years because of the many practical applications — and because they work really well.

“I like using science and math to address serious health problems like smoking, drug abuse and heart disease,” MacKinnon said. “Mediation analyses let us extract a lot of information from data and have the promise of identifying mechanisms by which effects occur that could be applicable to other situations.”

Unlike a third wheel, third variables are crucial — and causal

There are many paths to a teenager ending up struggling with substance abuse. They might struggle with impulsivity in general — or they might have parents who fight often, or maybe their friends get drunk most weekends.

Because there is more than one way to connect risk factors to substance use, scientists often have to take an indirect path that considers variables like parenting style or peer influences.

“Most research looks at the relationship between two variables — like risk-taking and substance use — but there can be a lot happening in between, and those ‘third variables’ can cause the outcome,” MacKinnon explains.

Long-lasting impacts

Adolescents who experiment with drugs and alcohol at a young age are more likely to develop lifelong substance abuse problems. A psychology department research team led by Nancy Gonzales, executive vice president and university provost, used mediation to create a program that decreases alcohol use in teenagers who started drinking at a young age.

The program brought families to their child’s school for a series of interactive sessions. Each session taught a skill, such as good listening practices or strategies for talking about difficult topics, and parents and students practiced as a family. Just spending 18 hours in the program produced protective effects against teenage alcohol misuse that lasted at least five years. By their senior year, kids who had participated in the program as seventh graders were drinking less.

This reduced alcohol consumption is important because even small reductions in adolescent drinking can have a cascade effect on other public health problems like alcoholism and drug abuse disorders, risky sexual behavior and other health problems.

Helping children of divorce

Close to half of all marriages in the U.S. end in divorce, affecting over 1 million children each year. These children are at an increased risk of struggling in school, experiencing mental health or substance use problems and engaging in risky sexual behavior. Mediation analyses have shown that a lot of these risks stem from conflict between divorced or separated parents, which creates fear of abandonment in children and contributes to future mental health symptoms.

Prevention scientists working in ASU’s Research and Education Advancing Children’s Health Institute leveraged decades of work using mediation to create an online parenting skills program for separated or divorced couples. The program reduces interparental conflict and decreases children’s anxiety and depression symptoms.

The answers to ‘why’ and ‘how’ questions save time and money

How much do school-based prevention programs decrease teen vaping rates? Why do monetary incentives and mobile clinics increase local vaccination rates?

Answering “how” and “why” questions like these require scientists to figure out what exactly caused a decrease in teen vaping or the reasons that caused more people to roll up their sleeves and get vaccinated. Causation can happen in many ways and can even be indirect, and mediation can accurately find the cause.

Mediation analysis strategies MacKinnon has developed are now used widely, in medicine, psychology, sociology, biology and education. And, many of the treatment options our doctors can offer us are possible because of clinical trials that used mediation to figure out what worked.

Mediation analysis lets researchers pull more information from scientific studies, which is why the National Institutes of Health recommends research proposals include a section evaluating why and how treatments or interventions work.

Source: https://news.asu.edu/20250304-science-and-technology-asu-research-helps-prevent-substance-abuse-mental-health-problems

By Tina Underwood – February 23, 2025

Data from the Centers for Disease Control and Prevention show there were about 107,000 drug overdose deaths in the United States in 2023. Of those, about 75 percent, or 81,000, involved opioids.

With the aim of reducing those statistics, Lauren Jones ’22, who is in a post-baccalaureate at Harvard University, Brenna Outten ’22, a third-year doctoral student at Caltech and Leah Juechter ’24, who is working temporarily as a medical assistant, used computational chemistry as undergraduates at Furman to study the impacts of synthetic opioids.

Their work, with collaborators at Hendrix College and California State University, Los Angeles, was published in December in The Journal of Physical Chemistry B.

To say the project was formative for Jones and Outten is an understatement. They laid the foundation for the study during the height of COVID when traditional wet labs were all but shuttered.

“It’s amazing we were able to continue the work virtually during the pandemic,” said Jones, who researches sensory processing in children with autism and brain activity in children with rare neurodevelopmental and neurogenetic disorders at Boston Children’s Hospital.

Outten said the project “opened my eyes to how a scientist can contribute to fields like neuroscience, chemistry, biology and physics in ways I had never considered before.”

The paper focuses on work targeting the mu opioid receptor, or MOR. It resides mainly in the central nervous system and the GI tract. It’s like a molecular lock waiting for the right key (a drug like morphine or fentanyl) to unlock or activate a favorable response, such as reduced pain signals. But the same drugs can activate negative responses like drug tolerance, constipation, respiratory depression, addiction and overdose.

“There’s a lot we don’t understand about how opioids interact with the receptors embedded on nerves that mitigate the pain-signaling process,” Juechter said. “So the more we can uncover about how these drugs are interacting with the receptors in our bodies and the responses we feel, the better we’re able to help create pain therapeutics with reduced adverse effects and more beneficial safety profiles.”

What makes the researchers’ study unique is the application of both quantum mechanics conducted by Juechter, Outten and Jones, led by chemistry Professor George Shields, and molecular dynamics carried out by teams at Cal State and Hendrix College.

“It was interesting to see two drugs (morphine and fentanyl) that elicit almost identical effects are binding to the receptor in completely different ways,” Juechter said. “And to demonstrate that with highly accurate quantum mechanics was one of the first times we’ve seen that done.”

The manner in which opioids bind to MOR is diverse and complex. “So the need for a precise computing model becomes essential,” Juechter explained. “Even slight variations in calculations can drastically affect the data and subsequent conclusions.”

The ability to do research computationally can make drug development faster and cheaper, Juechter added. “Being able to paint the picture of what’s going on using empirically-supported mathematical theories, we can streamline the initial process of drug development.”

Impactful undergraduate research is a hallmark of The Furman Advantage, a four-year approach to education that creates a pathway for students to determine who they want to be and how they want to contribute to the world once they leave the university.

Juechter spent about eight months post-graduation fine-tuning the work with her co-authors before the paper was published.

“It was exceedingly evident Dr. Shields wanted to elevate me and give me the opportunity to pursue research,” Outten said.

Juechter hopes the project will set the tone for organic chemists involved in drug research and development.

“I want a role in the health care industry because I like the idea of affecting someone’s life in real time, in a positive way,” she said.

 

Source: https://www.furman.edu/news/neuroscience-grads-studied-how-to-make-opioids-safer

George Soros and his Open Society Foundations have been significant supporters of drug policy reform, including efforts to legalize marijuana, but exact figures specifically earmarked for “legalization lobbyists” are not always broken out distinctly in public records. Instead, contributions are typically reported as broader donations to organizations advocating for drug policy reform, which includes lobbying as part of their activities.
Based on available information, Soros has personally funded drug reform efforts since the 1990s, with estimates suggesting he has contributed at least $80 million to the broader legalization movement since 1994. This figure comes from analyses of his foundation’s tax filings and includes support for various initiatives, not just lobbying. His Open Society Foundations have donated roughly $200 million globally to drug policy reform since 1994, with about $25 million specifically focused on marijuana-related reforms, including decriminalization, medical use, and full legalization. These funds have primarily flowed through organizations like the Drug Policy Alliance (DPA), which Soros has supported with approximately $4 million annually in recent years.
The DPA, a leading advocate for ending the war on drugs, uses these funds for a mix of research, public education, and lobbying efforts, though the precise portion allocated to lobbying isn’t always specified. Additionally, Soros has supported the American Civil Liberties Union (ACLU) and the Marijuana Policy Project (MPP), both of which engage in lobbying for legalization, though his donations to these groups are periodic rather than fixed annual amounts. For instance, in 2014, Soros teamed up with others to provide over 80% of the funding for a Florida medical marijuana ballot initiative, contributing significantly through the DPA.
Beyond these specifics, the Open Society Policy Center, a 501(c)(4) advocacy arm of the Foundations, has ramped up lobbying spending in recent years—tripling its budget between 2021 and 2022 to influence policy directly—but these efforts span multiple issues, not just drug legalization. While the Foundations’ total giving exceeds $32 billion since 1984, only a fraction ties directly to drug policy, and an even smaller slice to lobbying specifically for legalization.
So, while a precise dollar amount for “legalization lobbyists” alone isn’t fully isolated in the data, a reasonable estimate based on historical patterns suggests Soros and Open Society have channeled tens of millions—likely between $25 million and $80 million—into efforts that include lobbying for marijuana legalization over the past three decades, with the DPA’s $4 million annual contribution being a consistent anchor. The actual lobbying-specific figure could be lower, as these sums also cover advocacy, research, and grassroots campaigns. Without more granular public disclosures, this remains an educated approximation.
Source: https://x.com/i/grok/share/FyZ3V2g7xQXKuKO6Z3a21Jy5k
Opinion – by Hannah E. Meyers, Published Feb. 16, 2025, 6:19 a.m. ET

In November, Donald Trump made significant electoral gains in New York’s black and Latino neighborhoods, and in the city’s least affluent communities. Now he is poised to take an important step to improve public safety in these voters’ neighborhoods.

Rep. Nicole Malliotakis (R-SI) last week wrote to new Attorney General Pam Bondi, pleading for the administration to shut down the city’s two “safe injection sites.”

These facilities, located in East Harlem and Washington Heights, provide supervision to drug abusers as they consume harmful substances like fentanyl, meth, heroin and cocaine.

Yes, these are illegal drugs under federal law — and the aptly nicknamed federal “crack house statute” prevents individuals from retaining property for their consumption.

Indeed, Trump’s Justice Department successfully shuttered similar sites in the past – In 2019, his first administration sued to stop a Philadelphia injection center from opening, and in 2024 a US District Court judge in Pennsylvania finally agreed that the center was not exempt from federal drug laws.

Now Trump should listen to his NYC minority constituents and close the injection sites that are harming their neighborhoods.

New York’s two centers, both run by non-profit OnPoint, were the first in the nation, opening in 2021 under then-Mayor Bill de Blasio — who never met an injurious policy he wouldn’t support in the name of racial justice.

De Blasio gambled successfully that the Biden administration wouldn’t intervene.

OnPoint claims to have saved over 1,000 lives by preventing overdoses. But as my colleague Charles Fain Lehman has pointed out, the sites do not reduce addiction — so they are likely just delaying fatalities: More than 15% of those administered naloxone are dead within a year.

Indeed, data shows that NYC overdose rates have continued to rise since the centers opened.

That’s no surprise, since a rigorous look at the data from even the most touted injection sites in other countries provide no evidence of their effectiveness

But rigor has never been the calling card for politicians and advocates who happily sacrifice other people’s communities in the name of compassion.

State Sen. Gustavo Rivera (D-Bronx) has had the chutzpah to claim that “public drug use, syringe litter and drug-related crime goes down” around sites. In 2023, Rivera urged Gov. Hochul to expand supervised consumption sites statewide, and sponsored Senate legislation — still in committee — to do so.

In 2023, Mayor Eric Adams also proposed adding three more facilities to NYC — but he might be amenable to updating his views with some pressure from Washington.

And that pressure will come if Trump cares about the lives of local residents.

While major crimes fell 13% in northern Manhattan over the past two years, the predominantly black and Hispanic precinct around the East Harlem drug site has seen an almost 8% rise in major crime.

I’ve toured that location with the Greater Harlem Coalition. Members pointed out the large early-childhood education center directly across the street from the injection site, as parents hurried their tots into school in plain view of ongoing drug deals.

The perimeter of the block is dotted with addicts nodding off. Nearby restaurants have had to invest in private security to defend against the criminality the center attracts to the neighborhood.

What’s been keeping this site open despite four years in which the only evidenced change is neighborhood degradation?

Shameless advocacy by pompous, ideologically motivated and race-obsessed elites . . . whose kids don’t go to preschool in Harlem.

In August, Greater Harlem Coalition co-founder Shawn Hill was interviewed by one such far-left advocate: Ryan McNeil, director of harm reduction research at Yale’s School of Medicine.

McNeil was conducting funded “research” into safe injection sites — but a “hot mic” recording revealed his and his colleagues’ woke bias in favor of supporting safe injection sites (and drug decriminalization, more broadly).

With no sense of irony, McNeil — who is himself Caucasian — scorned Harlemites’ concerns over open drug abuse as nothing but “white discomfort,” and derided Hill for suggesting that the Yale researchers should walk around and speak with actual local residents.

But Trump has every reason to listen to these locals, three-quarters of whom are black or Latino.

And it would behove Adams, who faces a crowded primary race this summer, to reverse his past stance and voice support for a federal closure of the city’s two drug consumption sites.

In East Harlem, Trump won about 860 more votes last year than in 2020. Now these supporters, and their neighbors he has yet to persuade, are depending on his help.

 

Source: https://nypost.com/2025/02/16/opinion/inject-some-common-sense-shut-down-nycs-safe-drug-sites/

by  Steven T. Bell,  Special Agent in Charge – Omaha Drug Enforcement Administration, and Emily Murray.
February 18, 2025


In an effort to build on drug education messaging to tribal communities, the Drug Enforcement Administration (DEA) Omaha Division worked with the Ponca Tribe of Nebraska and Mandaree High School of North Dakota to develop a poster that blends Native Indian imagery with wording emphasizing the importance of culture over drug use.

During visits to tribal communities, DEA’s community outreach specialist noticed posters sounding the alarm to human trafficking, domestic violence and missing  and murdered indigenous women at schools and buildings across Reservations. The common thread tying each poster together was an emphasis on native culture.

Looking to build on the Good Medicine Bundle

Culture-based prevention resources available through DEA’s Operation Prevention, conversation began on how best to help tribal communities relate to important messaging on drug use. Elders were consulted and the vision of a poster, reflecting youth, culture and the DEA mission, began to take shape.
With permission from the Ponca Tribe of Nebraska, photos reflecting tribal values were taken in Norfolk. Youth from the Ponca Tribe of Nebraska highlighted the significant role dance plays in Native Indian Culture. Dancing is used to tell stories, honor ancestors and celebrate important events. A photo of a drum from Mandaree High School places importance on the sacred instrument often used to symbolize the heartbeat of the earth. The wording at the top of the poster, “Drumming and Dance: The Heartbeat of our Culture, NOTDRUGS,” was written for tribal members to feel connected with the poster.
“It’s critical that we find ways to communicate with all members of our communities about the dangers of drug use,” DEA Omaha Division Special Agent in Charge Steven T. Bell said. “Our hope is that this poster resonates with tribal communities and sparks conversation about life choices and their ensuing consequences.”

Source: https://www.dea.gov/press-releases/2025/02/18/dea-works-tribal-communities-advance-drug-education

Wall Street Journal      by Patricia Kowsmann, Dylan Tokar and Brian Spegele                      Feb. 18, 2025   

Chinese money brokers are teaming up with Mexican cartels, greasing the wheels of the fentanyl trade, U.S. officials say

On an October morning in 2022, an alleged drug trafficker drove a white pickup truck into the parking lot of a Global Fresh Market in San Gabriel, Calif., and stopped alongside a blue Maserati.

After a quick discussion with a woman in the Maserati, the man placed a large black bag in the sportscar’s back seat. Members of a U.S. government task force, who were watching, say it contained some $300,000 in cash.

The drop was part of what U.S. officials say is a new front in America’s war on drugs: an emerging partnership that has made China a crucial pit stop for dirty money flowing from the U.S.’s fentanyl crisis, according to law-enforcement officials and court documents.

Chinese money brokers, part of an underground banking system that has long served the country’s immigrant diaspora, have become go-to partners for fentanyl traffickers and other criminal groups needing to launder illicit drug profits, officials say.

Long operating in the shadows, the Chinese brokers use intermediaries, such as the woman in the Maserati, to collect drug profits from fentanyl dealers. Then, through a series of transactions, they sell those dollars to Chinese customers who want cash in the U.S. for purposes such as buying real estate or other investments, but can’t legally send money directly from China because of capital controls there.  The drug dealers end up with clean money in the process, law-enforcement officials say.

In the case involving the Maserati, dubbed “Operation Fortune Runner,” members of the Drug Enforcement Administration task force spent years investigating one such network, including thousands of hours of street-level surveillance. Traffic stops of suspects turned up cash stowed in a Fruity Pebbles cereal box and a gift bag with “Happy Birthday” printed on the side.

The investigation eventually led to indictments of 24 individuals last year, involving more than $50 million in drug proceeds prosecutors say Chinese brokers were laundering for associates of Mexico’s Sinaloa drug cartel.

Evidence of a deepening relationship between drug cartels and Chinese money brokers presents a challenge for President Trump, who has vowed to end the fentanyl crisis that causes the death of tens of thousands of Americans every year.

So far, his focus has been on cutting off the flow of fentanyl and the precursor ingredients that are used to make it into the U.S., imposing tariffs against producing countries, including a new 10% tariff on Chinese imports to the U.S. earlier this month.

But shutting down the sprawling network of money brokers, who U.S. officials think are critical to greasing the wheels of the trade, could also prove difficult.

In testimony to the House Select Committee on the Chinese Communist Party last year, a former DEA official estimated global drug sales reach $500 billion to $750 billion annually. The official said he believed Chinese networks were laundering a sizable chunk of it.

“The fentanyl crisis starts in China, and it ends in China,” Jarod Forget, DEA’s acting chief of operations, said in an interview.

China’s Foreign Ministry, in a written response to questions, didn’t directly address the role of Chinese nationals laundering drug proceeds. It said the root of the fentanyl crisis lies in the U.S. itself, and Trump’s tariffs ignored the results of U.S.-China cooperation, which has included cracking down on fentanyl production in China.

“Blaming others will not solve this problem,” the Foreign Ministry said. “Pressure and threats are not the right way to deal with China.”

While deaths from overdoses have fallen, fentanyl remains the U.S.’s deadliest drug. Last year, the amount of fentanyl the DEA seized—more than 55 million pills and nearly 8,000 pounds of powder—was estimated by the DEA to be enough to kill every American.

How the system works 

Drug cartels have always faced the problem of getting their profits from illegal sales in the U.S. converted into clean money and sent back home. Some have tapped middlemen who charge a high commission to help launder the money through a series of transactions that involve Colombian pesos, in what is known as the black-market peso exchange, according to U.S. officials.

Chinese money brokers came in with a much faster and cheaper service. They had a competitive edge because so many people in China want U.S. dollars, U.S. officials say.

The transaction begins in the U.S. Drug traffickers sell fentanyl or other narcotics to U.S. customers for cash. They then turn over that cash to a Chinese money broker.

The Chinese money broker now advertises the U.S. dollars on WeChat, a Chinese app. To buy them, a Chinese customer will transfer yuan, including a commission, into the broker’s bank account in China.

The Chinese broker then releases the U.S. dollars to Chinese customers who want to spend money in the U.S., acquiring real estate, paying college tuition, gambling, or making other investments.

Now the Chinese money broker needs to get the yuan to the drug traffickers in Mexico. One way to do that is for the broker to exchange the yuan for pesos in Mexico through a business that is looking to buy Chinese goods for export to Mexico.

The Chinese goods are exported to Mexico and sold. The Chinese broker now has Mexican pesos, which it can hand over to the Mexican cartel, minus a 1–2% commission.

Under China’s capital controls, meant to keep too much money from flowing out of the country, Chinese citizens are limited to buying only $50,000 worth of foreign currency each year. As China’s economy slows and its real-estate and stock markets languish, more Chinese want to move money overseas to protect their wealth. Tapping into underground banks connected to the fentanyl trade is a way to do that, U.S. officials say.

This is how it works: The Mexican cartels’ U.S. operatives provide the U.S. cash they received from selling fentanyl to a broker working for a Chinese money-laundering ring, all in the U.S. Through the Chinese messaging app WeChat, the brokers advertise the cash to people in China who could use the money on U.S. soil, according to current and former law-enforcement officials.

Once a Chinese buyer of the U.S. dollars is found, that person transfers the equivalent in Chinese yuan, plus a hefty commission, to a bank account in China belonging to the money launderers. The Chinese customer then receives access to the cash bought in the U.S.

The cartel’s money, now clean, is sitting in the Chinese money broker’s bank account in China. The money can then get back to the cartel in a couple of ways. It can be used to buy fentanyl precursors for the cartel, starting the cycle again.

Or, the yuan can be used to buy Chinese manufactured goods that are then shipped to Mexico and sold for pesos, which are then handed to the cartels.

Some Chinese nationals using the service might not know it involves drugs, U.S. officials say.

“This is now one of the most prominent, if not the most prominent way in the world that people launder money,” said Craig Timm, a former money-laundering official in the U.S. Department of Justice who is now at the Association of Certified Anti-Money Laundering Specialists.

Chinese money brokers have also differentiated themselves from competitors by taking on some of the risk associated with this multistep process. Instead of waiting until the process is complete to release pesos to Mexican cartels, they operate essentially on credit, transferring money to drug traffickers soon after receiving a cash delivery in the U.S., officials say.

The commission they charge drug traffickers is small, because they also make money from selling U.S. dollars to customers of their underground banking network.

“When the Colombians controlled it, it cost 7% to 10%. The Chinese were charging 1% to 2%. It was unheard of,” said Chris Urben, a former DEA agent who saw firsthand the emergence of Chinese money launderers in the New York area.

“All of a sudden, we were seeing Chinese money launderers picking up drug money all across the U.S.,” added Urben, now a managing director at private investigations firm Nardello & Co.

Many former law-enforcement officials say more cooperation with China is needed.

“A lot of the money under the scheme is flowing through banks in China where the Chinese have oversight,” said Anthony Ruggiero, a former senior U.S. Treasury official now at the Foundation for Defense of Democracies.

The DEA and other agencies have launched a spate of investigations in the U.S. In one case, two Chinese nationals were charged with laundering money for Mexican cartels after agents went undercover as money couriers. Both were later convicted, with one of the men receiving a 10-year sentence in December for taking part in efforts to launder $62 million.

The task force surveilling the cash drop in San Gabriel, Calif., in 2022 was part of a special DEA team that worked wiretaps on drug trafficking investigations. Their target was an alleged Chinese money-laundering ring run by a man named Sai Zhang who did business with alleged drug dealers, including the Sinaloa cartel, and cash runners such as the woman in the blue Maserati, who wasn’t identified in court records.

Officers spent several years following the suspects, watching them pick up and drop off bags throughout the Los Angeles area.

On the October morning in San Gabriel, officers said they were relying on a wiretapped phone conversation between two members of Zhang’s ring who were organizing the pick up of $300,000.

After the bag was handed off to the blue Maserati, agents followed the car to a residence, where the money was allegedly mixed with other drug proceeds and parceled out to underground banking customers, people familiar with the matter said. Later, police pulled over a driver who had left the residence and found $25,000, according to court documents.

Zhang was among the people charged with laundering money, running an unlicensed money transmitting business and facilitating drug trafficking. He has pleaded not guilty and is awaiting trial. A lawyer for Zhang didn’t respond to requests for comment.

Chinese authorities said in June they had arrested in the mainland one of the men indicted for allegedly working with the network.

Source: https://www.wsj.com/world/china/china-fentanyl-trade-network-9685fde2?mod=hp_lead_pos5

  • Published Updated 20 February 2025

James McMillan and Lisa McCuish grew up next to each other and now they lie side by side in Pennyfuir Cemetery

James McMillan grew up next door to Lisa McCuish in a neat cul-de-sac on a hillside above Oban Bay. Now they lie side by side in Pennyfuir Cemetery.

The newest headstones on the freshly-dug fringes of the graveyard tell an alarming story of a lost generation in this pretty tourist town on Scotland’s west coast.

Oban is home to just 8,000 people and at least eight recent confirmed or suspected victims of drug misuse were buried here. The youngest was 26, the oldest was 48.

The population of the town is about the same as the total number of overdose deaths recorded in Scotland in the past seven years – by far the worst rate in Europe.

The deaths have led to calls for urgent action to tackle addiction in rural Scotland with relatives citing problems accessing vital services.

Scotland’s Health Secretary Neil Gray has told BBC News that he accepts more needs to be done to tackle drug misuse in rural areas.

For James’ mother, Jayne Donn, the nightmare began before dawn on a freezing night in December 2022 when she was woken by the doorbell.

“At 10 to five in the morning, when it was snowing and my Christmas tree was up, the police came to my door,” she says.

The officers had come, as Jayne had long dreaded they would, to tell her that her 29-year-old son was dead of an overdose.

James was another victim of a crisis that has been raging across Scotland for almost a decade, claiming 1,172 lives in 2023.

“As a little boy he was blonde-haired, blue-eyed, full of mischief,” Jayne tells me in the living room of the family home.

The young James loved “fishing, music and his skateboard,” she says.

“As a man, there’s not so many good memories,” says Jayne.

“He was very mixed up. He was very angry. He was very lost.”

James McMillan, who died in December 2022, with his mother Jayne Donn
Image source,Jayne Donn

James’ father left the family home when he was seven.

He struggled at school with dyslexia and mental health challenges and later began to dabble with cannabis.

He started to get into trouble, first with teachers, then with the police.

As he grew into adulthood, James drifted away from Oban and from his family, losing a job as an apprentice bricklayer because of poor attendance and concentration, and disappearing to England.

Jayne says she knew little about what was happening there. In truth, her son’s life was unravelling.

He had been diagnosed with attention deficit hyperactivity disorder, bipolar disorder and drug-induced psychosis.

He was struggling with suicidal tendencies, taking more and harder drugs and increasingly turning to crime.

As a result he was in and out of custody for drug offences, breach of the peace, break-ins and theft, at one point serving a two-year prison sentence.

James died in Glasgow on 16 December 2022 – less than two days after he was released from custody following eight months on remand in Barlinnie prison.

James’ mother says she doesn’t know the details of the last charges he had faced or why he was released – but she believes more could have been done to support her son, as he had overdosed on release from custody on three previous occasions.

A Scottish Prison Service source pointed out that decisions taken at the end of a period of remand are a matter for the courts not the prison.

Jayne describes a web of organisations which dealt with her son: charities, local authorities, the NHS, addiction services, housing providers and more.

But she says: “He was released into a city he didn’t know with no jacket, no money and nobody aware.

“He lasted less than 36 hours.”

Lisa McCuish grew up in Oban.                                                                                                         Image source, MKC Photocreations 

Lisa McCuish grew up next to James in a street looking down on Oban Bay, where red and black Caledonian MacBrayne ferries bustle to and from the islands of the Hebrides.

Oban was recently named Scotland’s town of the year by an organisation which promotes smaller communities.

Today, Lisa’s sister Tanya is sitting in Jayne’s living room, tears in her eyes, recalling her sibling as “a larger than life character” with “a heart of gold”.

“Lisa was never into drugs, you know, that wasn’t her,” says Tanya.

Things began to go wrong only after Lisa was prescribed diazepam, which is typically used to treat anxiety, seizures or muscle spasms.

“She ended up buying it off the streets because she felt she needed more,” Tanya remembers.

“She kept on saying that she needed more help, more support.”

Then, she says, her sister started taking heroin.

Lisa had a cardiac arrest on 13 September 2022 and died four days later in hospital in Paisley. She was 42 years old.

She had prescription drugs in her system and also Etizolam, a benzodiazepine-type substance commonly known as street Valium because it is often sold illicitly.

Tanya and Jayne take us to the spot where they both mourn, pointing out other nearby graves where recent drug death victims are buried.

They include James’s best friend, who lies alongside him and Lisa. He was 30 when he died of a drug overdose.

“It’s just awful to think there’s at least 10 around here that we can think of,” says Jayne.

There is no official breakdown of how many lives have been claimed by drugs in small communities such as Oban.

We have been able to confirm that at least eight of the deaths occurred within just a year-and-a-half and were related to drugs, or are still under investigation.

This is the reality of Scotland’s drug deaths crisis in just one small community and both Tanya and Jayne say the Scottish government must do more to save lives.

“I personally believe that a lot of addiction is to do with mental health first,” says Tanya.

“There’s no continuity in support from addiction services or mental health services. There’s no link up.”

Jayne, who is a drugs support worker herself, says she spent years trying to bring James home to Oban where she felt he would have a better chance of recovery and survival.

A particular challenge, she says, was that Argyll and Bute Council offered James housing places in Dunoon and Helensburgh – both about two hours away – making it very difficult for his family to support him.

The local authority said it had offered “appropriate” services to James.

The council added that it had housing services throughout the area, but could not always satisfy “individual and sometimes changing criteria”.

Scotland’s Health Secretary Neil Gray says that both families have his deepest sympathies and he accepts that rural drug services could be improved.

“I think that the two cases that you’ve highlighted tell me that there’s more that can be done,” he said.

“I recognise that not everything is available in all parts of Scotland.”

Mr Gray added: “We support alcohol and drug partnerships across Scotland, whether they’re in rural areas or urban areas.

“I would obviously want us to be continuing to do more to make sure that there is access to facilities and services in rural and island areas.”

 

For Justina Murray, chief executive of the charity Scottish Families Affected by Alcohol and Drugs, the problems do not lie with strategy or funding but with culture and delivery, especially in NHS addiction services.

“People want services that are in their own community, they can access when they need them, they’re going to be met at the door by a friendly face,” she says.

“They’re going to be treated with dignity and respect.

“That’s not necessarily the experience you’re going to have engaging with an NHS or a statutory treatment service.”

According to the latest available figures, released in September 2024, there is capacity for 513 residential rehabilitation beds in Scotland, across 25 facilities.

Only 11 of those beds are available in what are considered by the Scottish government to be very remote rural areas, although the majority of facilities do accept referrals from any part of Scotland.

I ask Jayne and Tanya about the argument that individuals and their families, rather than the state, should take more responsibility for their own choices.

“Nobody sets out in life to be a drug addict,” replies Jayne.

“Nobody chooses it. The mental health issue was what led James to try and escape reality.

“He then no longer had capacity to make his choices. He wasn’t James any more.

“These are vulnerable adults who are unable to protect themselves from danger or harm,” adds Tanya.

“Why is more not being done?”

“Something’s got to change,” agrees Jayne.

“We’re losing far too many young people.”

Source: https://www.bbc.co.uk/news/articles/c20pwd04zy4o

Dangerous but common misconceptions can prevent crucial early addiction treatment.

Key points:

  • Misconceptions and the ignoring of research-based evidence prevent crucial early treatment of addiction.
  • Drugs of abuse cause health, life, and relationship problems with many long-lasting effects.
  • Teen and young adult drug prevention is necessary and needs funding.

Research published in high-quality peer-reviewed journals reveals key information on the realities of addiction, exposing pervasive myths and misconceptions, as in these examples.

False Belief 1: Drug experimentation is normal for teens and shouldn’t alarm parents.

Drug use and experimentation among teens often is ignored by many—even parents, who then may be unaware that any use places adolescent brains in jeopardy. For today’s teens, life often feels overwhelming, but avoiding alcohol, tobacco, marijuana, and other drugs is their one best choice to promote continued healthy physical and mental development. Preventing or delaying all teenage substance use not only reduces their current risks for depression, psychosis, and school/learning problems, but it also significantly decreases their probability of addiction as adults.

Harvard’s Sharon Levy, MD, MPH, and founding National Institute of Drug Abuse Director Robert DuPont, MD, strongly advocate a zero-tolerance approach to youth substance use. They emphasize that no amount of drug use is safe for young people. They promote the One Choice initiative encouraging adolescents to avoid substance use: alcohol, tobacco, marijuana, and other drugs.

It’s now known that THC in marijuana interferes with the developing brain circuits responsible for regulating behavior, leading to increased risk-taking and poor decision-making. Even infrequent teen use can impede judgment, increasing the probability of risky behaviors and accidents. Adolescents also are more likely than adults to develop cannabis use disorder (CUD) due to their heightened neuroplasticity during this developmental stage. The resulting impairment may lead to academic underperformance and problematic interpersonal relationships.

False Belief 2: Addiction is a personal weakness.

Addiction is not about people being weak-minded. It’s far more complicated. Becoming addicted depends on the drug used, dose, route, frequency, and risk factors like ages of users. Also, the same drug at the same dose affects people differently because of personal differences, as well as the presence/absence of traumatic past life experiences.

Yale’s Joel Gelernter identified genetic variants associated with vulnerability to addictions. However, genetic characteristics themselves interact with environmental factors in developing substance use disorders (SUDs). As Nora Volkow, director of NIDA, has said, “Addiction is a complex disease of a complex brain; ignoring this fact will only hamper our efforts to find effective solutions …”

False Belief 3: People must hit “rock bottom” to recover from addiction.

No, no, and no! Roadside alcohol testing has prevented thousands of deaths and helped many people with alcohol use disorders (AUD) obtain help, sometimes by coercion of courts. About 50 percent of those arrested for DUI have an AUD. Users often deny they have a problem with drugs or alcohol and believe they are truthful. But they are lying to themselves.

Addiction is a chronic, relapsing condition driven by changes in brain circuitry, particularly in areas controlling reward, stress, and decision-making. While some people seek help after suffering dire consequences, others are compelled into treatment by the courts, based on a past offense. Waiting to hit “rock bottom” increases major risks of harming the person’s relationships, job, and health—and strengthens the hold of the drug over the person.

False Belief 4: Addiction treatment never works.

Researchers from the University of British Columbia and Harvard Medical School recently analyzed survey data from nearly 57,000 participants in 21 countries over 19 years, providing clear data. They discovered that the number-one barrier to treatment was addicted people themselves: Most were in denial and did not recognize they needed treatment.

Alcoholics Anonymous is often successful, non-judgmentally providing new members a roadmap, role models, hope, and social connections. Successful people actively involved in AA complain that their friends kept asking them why they “weren’t cured yet” since they went to so many meetings. But going to meetings is what works.

Even among experts, there’s no consensus on what constitutes successful treatment. To some, success is that the person is still alive and hasn’t been rushed to the emergency room because of an overdose in the past 6 months or year. To others, it is taking treatment medications. And to still others, only abstinence and a full resumption of all family and work obligations counted as success.

Another issue is that most people with SUDs have multiple addictions. Even when they overdosed, most took multiple drugs. It’s also true that many people come to treatment also needing treatment for other medical, addiction, and psychiatric problems. Yet only rarely are patients evaluated and treated for all issues.

False Belief 5: Overdoses of drugs don’t cause brain damage.

Drugs of abuse can harm the brain. Overdose survivors may suffer from undetected brain damage and hypoxic brain injury caused by opioid-induced respiratory depression. As a society, we better understand hypoxia as associated with drowning or choking than its much more common occurrence in drug overdoses with loss of consciousness.

Recent studies estimate that at least half of people using opioids have illicitly experienced a non-fatal overdose or witnessed an overdose. People who regularly use drugs are at elevated risk of brain injury due to accidents, fights, and overdoses. A single fentanyl overdose could cause hypoxia, brain injury, and memory and concentration problems.

Overdoses with counterfeit pills, cocaine, methamphetamine, xylazine, or heroin usually also include fentanyl, making neurologically compromising overdoses more common.

Summary

Myths and misconceptions increase stigma and decrease the likelihood that someone with an addictive illness will receive prompt, effective treatment. We need early intervention and treatment during the preaddiction phase. Bottom line: Preventing teen and young adult use is crucial.

Mark Gold M.D.

Mark S. Gold, M.D., is a pioneering researcher, professor, and chairman of psychiatry at Yale, the University of Florida, and Washington University in St Louis. His theories have changed the field, stimulated additional research, and led to new understanding and treatments for opioid use disorders, cocaine use disorders, overeating, smoking, and depression.

Source: https://www.psychologytoday.com/intl/blog/addiction-outlook/202502/5-common-false-beliefs-about-drug-use-users-and-addiction

by Dan Krauth WABC logo    Eyewitness News – Friday, February 14, 2025

Dan Krauth has more on the letter sent to the newly confirmed attorney general asking her to shut down safe injection sites in New York City.

NEW YORK (WABC) — There are places people can go take illegal drugs under the watchful eye of supervisors to ensure they don’t die.

They are called Overdose Prevention Centers, or also known as safe injection sites, and there are two of them in New York City — the first of its kind in the nation.

Now, after more than three years of operating, there’s a new effort under a new president to shut down the centers that are run by a non-profit organization.

It’s called OnPoint NYC and they have two locations in Washington Heights and East Harlem.

Drug users can take their drug of choice from heroin to cocaine inside the centers and supervisors intervene, most times with oxygen, if the user starts to overdose. They also provide test strips for drugs to ensure they don’t have fatal doses of fentanyl inside.

Since opening in 2021, the executive director said they’ve intervened in more than 1,700 overdoses. They also provide services like medical help, substance abuse treatment and housing assistance.

Opponents say the centers encourage people to do illegal drugs.

“They’re encouraging people to use by giving them a community center to go to and to use heroin, it’s something that’s encouraging addicts not helping them,” said Congresswoman Nicole Malliotakis.

She sent a letter to the newly confirmed attorney general, asking her to shut down both locations along with any others that have opened across the country.

“They don’t work, these heroin injection centers, in fact they attract crime to the neighborhood but also drug dealing, it just does not make sense and they should be shut down,” Malliotakis said.

In response, the executive director of OnPoint NYC sent Eyewitness News a statement:

“OPCs save lives. At OnPoint NYC, our staff has intervened in over 1,700 overdoses, providing life-saving care to mothers, fathers, and loved ones,” said OnPoint NYC Executive Director Sam Rivera. “Every single one of them deserves compassion and a chance at healing. I’m incredibly proud of our team and continually inspired by the dedication they show every day. They don’t just look at the overdose epidemic and wonder what can be done-they don’t have that luxury. They act, because they have lives to save. This work is not just vital; it’s transformational. Lives are being saved, hope is being restored, and healing is possible.”

 

Source:  https://abc7ny.com/post/president-trump-asked-shut-down-overdose-prevention-centers-have-operated-3-years-nyc/15907033/

COMMENTARY:  Public Health  – Feb 14, 2025

by Paul J. Larkin – Rumpel Senior Legal Research Fellow and Bertha K. Madras, PhD – Professor of psychobiology at Harvard Medical School, based at McLean Hospital and cross appointed at the Massachusetts General

Key Takeaways

Today, some members of America’s political class are desensitized to the drug crisis. They tolerate normalizing psychoactive substance use.

The relentless movement to legalize drug use has succeeded, largely by appealing to the goodwill and sympathies of the American public.

For supply reduction, the U.S. must send a clear message to the world that we are not an open market for drugs.

The federal government has long sought to prevent the horrors of drug addiction by interdicting the supply of dangerous psychoactive drugs—and reducing demand for them.

One step was the Anti-Drug Abuse Act of 1988. It established the Office of National Drug Control Policy (ONDCP) within the Executive Office of the President. Headed by a director colloquially known as “drug czar,” ONDCP had the task of developing a national drug-control strategy to reduce drug use. Its creation symbolized a strong bipartisan effort to prevent illicit drugs from destroying lives and weakening the nation.

Sadly, we have lost that shared mission. No president since George W. Bush has publicly demonstrated a deep and firm support for ONDCP and its mission.

The agency does not reside in the White House office building, let alone the West Wing. The federal government has largely been a bystander despite the unraveling of restrictive opioid prescribing, state implementation of medical/recreational marijuana programs in violation of federal laws, and the incipient movement by states to legalize psychedelics. Most presidents have largely ignored these trends.

The first Trump administration assembled a commission to combat drug addiction and the opioid crisis. The current one should support a comprehensive effort led by ONDCP to overhaul drug policies and strengthen America’s commitment to reducing and delegitimizing drug use. We need a revitalized ONDCP equipped with innovative goals and measurable outcomes to disrupt the pipeline to addiction and to cease preventable, premature deaths and mental health decline. A single centralized agency ensures coordination across federal agencies, state, and local levels to maximize efficiency and accountability.

Today, some members of America’s political class are desensitized to the drug crisis. They tolerate normalizing psychoactive substance use and the addiction, health crises, deaths, and collateral damage to families that follow.

Reformers advocate destigmatizing regular use of hazardous psychoactive drugs. “Harm reduction” practices, initially framed as temporary measures, now are uncritically promoted in some quarters without clear boundaries or outcome goals.

This “Meet drug users where they are” approach has regressed to a “Leave them where they are” one. The grim realities of “tranq”-induced catatonia on the streets of Philadelphia’s Kensington neighborhood, San Francisco’s Tenderloin district, Boston’s Mass and Cass intersection, and other drug-ridden homeless encampments lay bare the stark failure of America’s waning resolve to minimize drug use.

Among other nations, we are an outlier. America’s drug crisis has escalated dramatically since ONDCP was born. Overdose deaths surged from 3,907 (1.6 per 100,000) in 1987 to a record 107,543 (32.2 per 100,000) in 2023, with teen rates doubling recently. Among twelfth-graders, 13 percent use marijuana daily, despite heightened risks for addiction and psychosis. In 2023, daily use of marijuana and regular use of hallucinogens among 19- to 30-year-olds reached record levels, fueled by pervasive myths about “safety” or “medical” efficacy

Whether used for medical or recreational purposes, or both, 25 percent of cannabis users have a cannabis-use disorder; among twelve- to 24-year-olds, such a disorder is more prevalent than alcohol-use disorder. Over 90 percent of individuals with substance-use disorders (48.7 million people) neither recognize their need for help nor seek treatment.

Topping it off, seizures of fentanyl-laced pills exploded from 49,000 in 2017 to a staggering 115 million in 2023. Reversing this runaway train demands a transformative political and cultural shift led by the president, ONDCP, and Congress.

How?

Start by learning from past mistakes. The relentless movement to legalize drug use has succeeded, largely by appealing to the goodwill and sympathies of the American public. In 1996, activists persuaded California’s voters to adopt marijuana as a medicine by labelling it as “compassionate use” for end-stage cancer and HIV-AIDS wasting.

That success gave legalizers a foothold. Slowly, the movement persuaded other states to adopt medical-use marijuana for myriad purposes without a shred of evidence; this later morphed into recreational-use programs. Dual-purpose “dispensaries” now sell marijuana for any reason. Activists persuaded the medical profession that pain was the “fifth vital sign” and pressured caregivers to prescribe highly addictive opioids liberally for any type of pain. We know where that went.

Finally, recent campaigns to use political means to normalize hallucinogens for medical use bear a striking resemblance to the two campaigns noted above, including media hype and their tendency to lampoon cautious Cassandras. Compassion is a virtue, except when it leads to long-term harm.

Those who are driving the normalization of substance use as a chemical shortcut for pleasure or relief are willing to sacrifice long-term well-being for short-term escapism. Without prevention strategies to disrupt this pathway of use, addiction, and death, no amount of treatment or law enforcement will resolve the crisis.

We should oppose efforts to destigmatize drug use but support destigmatization of individuals with substance-use disorders to ease their entry into treatment and recovery. To end the frequently heard lament of parents—“If only I knew”—we need a national educational campaign that counters the myths promulgated by proponents.

We need more research to understand why substance-use disorders are resistant to treatment- and recovery. Harm-reduction strategies that don’t show objective reductions in disordered use should be challenged. And we must recognize that minorities are hurt, not helped, by liberalizing drug use because it can worsen the conditions in already suffering neighborhoods.

Finally, we should strengthen ONDCP by returning it to cabinet-level status and empowering it to adopt a results-driven business model. Steps would include, on the demand side, ensuring that federal funding is allocated to prevention and treatment programs that prioritize objective, evidence-based positive outcomes.

For supply reduction, the U.S. must send a clear message to the world that we are not an open market for drugs. This will involve stopping the smuggling of fentanyl, dismantling illegal markets, and seizing traffickers’ ill-gotten gains. Incentives and penalties can persuade nations that produce drugs and their precursor chemicals to curb their export of substances poisoning Americans.

President Trump has a unique opportunity to pivot and reform America’s recurring drug crises. A bold approach will signal America’s commitment to reversing our damaging trajectory.

This piece originally appeared in the National Review

Source:  https://www.heritage.org/public-health/commentary/the-drug-crisis-hasnt-gone-away-the-trump-administration-should-confront

(1)    Use of Alternative Payment Models for Substance Use Disorder Prevention in the United States: Development of a Conceptual Framework

Journal: Substance Abuse Treatment, Prevention, and Policy, 2025, doi: 10.1186/ s13011-025-00635-z

Authors: Elian Rosenfeld, Sarah Potter, Jennifer Caputo, Sushmita Shoma Ghose, Nelia Nadal, Christopher M. Jones, … Michael T. French

Abstract:

Background: Alternative payment models (APMs) are methods through which insurers reimburse health care providers and are widely used to improve the quality and value of health care. While there is a growing movement to utilize APMs for substance use disorder (SUD) treatment services, they have rarely included SUD prevention strategies. Challenges to using APMs for SUD prevention include underdeveloped program outcome measures, inadequate SUD prevention funding, and lack of clarity regarding what prevention strategies might fit within the scope of APMs.

Methods: In November 2023, the Substance Abuse and Mental Health Services Administration (SAMHSA), through a contract with Westat, convened an expert panel to refine a preliminary conceptual framework developed for utilizing APMs for SUD prevention and to identify strategies to encourage their adoption.

Results: The conceptual framework agreed upon by the panel provides expert consensus on how APMs could finance a variety of prevention programs across diverse populations and settings. Additional efforts are needed to accelerate the support for and adoption of APMs for SUD prevention, and the principles of health equity and community engagement should underpin these efforts. Opportunities to increase the use of APMs for SUD prevention include educating key groups, expanding and promoting the SUD prevention workforce, establishing funding for pilot studies, identifying evidence-based core components of SUD prevention, analyzing the cost effectiveness of APMs for SUD prevention, and aligning funding across federal agencies.

Conclusion: Given that the use of APMs for SUD prevention is a new practice, additional research, education, and resources are needed. The conceptual framework and strategies generated by the expert panel offer a path for future research. SUD health care stakeholders should consider ways that SUD prevention can be effectively and equitably implemented within APMs.

To read the full text of the article, please visit the publisher’s website.

(2)     Quitline-Based Young Adult Vaping Cessation: A Randomized Clinical Trial Examining NRT and mHealth

Journal: American Journal of Preventive Medicine, 2025, doi: 10.1016/j.amepre.2024 .10.019

Authors: Katrina A. Vickerman, Kelly M. Carpenter, Kristina Mullis, Abigail B. Shoben, Julianna Nemeth, Elizabeth Mayers, & Elizabeth G. Klein

Abstract:

Introduction: Broad-reaching, effective e-cigarette cessation interventions are needed.

Study design: This remote, randomized clinical trial tested a mHealth program and nicotine replacement therapy (NRT) for young adult vaping cessation.

Setting/participants: Social media was used from 2021 to 2022 to recruit 508 young adults (aged 18-24 years) in the U.S. who exclusively and regularly (20+ days of last 30) used e-cigarettes and were interested in quitting.

Intervention: All were offered 2 coaching calls and needed to complete the first call for full study enrollment. Participants were randomized to one of 4 groups in the 2×2 design: mailed NRT (8 weeks versus none) and/or mHealth (yes versus no; stand-alone text program including links to videos and online content).

Main outcome measures: Self-reported 7-day point prevalence vaping abstinence at 3 months.

Results: A total of 981 participants were eligible and randomized; 508 (52%) fully enrolled by completing the first call. Enrolled participants were 71% female, 31% non-White, and 78% vaped daily. Overall, 74% completed the 3-month survey. Overall, 83% in the mailed NRT groups and 24% in the no-mailed NRT groups self-reported NRT use. Intent-to-treat 7-day point prevalence abstinence rates (missing assumed vaping) were 41% for calls only, 43% for Calls+mHealth, 48% for Calls+NRT, and 48% for Calls+NRT+mHealth. There were no statistically significant differences for mailed NRT (versus no-mailed NRT; OR=1.3; 95% CI=0.91, 1.84; p=0.14) or mHealth (versus no mHealth; OR=1.04; 95% CI=0.73, 1.47; p=0.84).

Conclusions: This quitline-delivered intervention was successful at helping young adults quit vaping, with almost half abstinent after 3 months. Higher than anticipated quit rates reduced power to identify significant group differences. Mailed NRT and mHealth did not significantly improve quit rates, in the context of an active control of a 2-call coaching program. Future research is needed to examine the independent effects of coaching calls, NRT, and mHealth in a fully-powered randomized control trial.

To read the full text of the article, please visit the publisher’s website.

(3)     The Alcohol Exposome

Journal: Alcohol, 2025, doi: 10.1016/j.alcohol.2024.12.003

Authors: Nousha H. Sabet, & Todd A. Wyatt

Abstract:
Science is now in a new era of exposome research that strives to build a more all-inclusive, panoramic view in the quest for answers; this is especially true in the field of toxicology. Alcohol exposure researchers have been examining the multivariate co-exposures that may either exacerbate or initiate alcohol-related tissue/organ injuries. This manuscript presents selected key variables that represent the Alcohol Exposome. The primary variables that make up the Alcohol Exposome can include comorbidities such as cigarettes, poor diet, occupational hazards, environmental hazards, infectious agents, and aging. In addition to representing multiple factors, the Alcohol Exposome examines the various types of intercellular communications that are carried from one organ system to another and may greatly impact the types of injuries and metabolites caused by alcohol exposure. The intent of defining the Alcohol Exposome is to bring the newly expanded definition of Exposomics, meaning the study of the exposome, to the field of alcohol research and to emphasize the need for examining research results in a non-isolated environment representing a more relevant manner in which all human physiology exists.

To read the full text of the article, please visit the publisher’s website.

(4)     Neural Variability and Cognitive Control in Individuals with Opioid Use Disorder

Journal: JAMA Network Open, 2025, doi: 10.1001/jamanetworkopen.2024.55165

Authors: Jean Ye, Saloni Mehta, Hannah Peterson, Ahmad Ibrahim, Gul Saeed, Sarah Linsky, … Dustin Scheinost

Abstract:

Importance: Opioid use disorder (OUD) impacts millions of people worldwide. Prior studies investigating its underpinning neural mechanisms have not often considered how brain signals evolve over time, so it remains unclear whether brain dynamics are altered in OUD and have subsequent behavioral implications.

Objective: To characterize brain dynamic alterations and their association with cognitive control in individuals with OUD.

Design, setting, and participants: This case-control study collected functional magnetic resonance imaging (fMRI) data from individuals with OUD and healthy control (HC) participants. The study was performed at an academic research center and an outpatient clinic from August 2019 to May 2024.

Exposure: Individuals with OUD were all recently stabilized on medications for OUD (<24 weeks). Main outcomes and measures: Recurring brain states supporting different cognitive processes were first identified in an independent sample with 390 participants. A multivariate computational framework extended these brain states to the current dataset to assess their moment-to-moment engagement within each individual. Resting-state and naturalistic fMRI investigated whether brain dynamic alterations were consistently observed in OUD. Using a drug cue paradigm in participants with OUD, the association between cognitive control and brain dynamics during exposure to opioid-related information was studied. Variations in continuous brain state engagement (ie, state engagement variability [SEV]) were extracted during resting-state, naturalistic, and drug-cue paradigms. Stroop assessed cognitive control.

Results: Overall, 99 HC participants (54 [54.5%] female; mean [SD] age, 31.71 [12.16] years) and 76 individuals with OUD (31 [40.8%] female; mean [SD] age, 39.37 [10.47] years) were included. Compared with HC participants, individuals with OUD demonstrated consistent SEV alterations during resting-state (99 HC participants; 71 individuals with OUD; F4,161 = 6.83; P < .001) and naturalistic (96 HC participants; 76 individuals with OUD; F4,163 = 9.93; P < .001) fMRI. Decreased cognitive control was associated with lower SEV during the rest period of a drug cue paradigm among 70 participants with OUD. For example, lower incongruent accuracy scores were associated with decreased transition SEV (ρ58 = 0.34; P = .008). Conclusions and relevance: In this case-control study of brain dynamics in OUD, individuals with OUD experienced greater difficulty in effectively engaging various brain states to meet changing demands. Decreased cognitive control during the rest period of a drug cue paradigm suggests that these individuals had an impaired ability to disengage from opioid-related information. The current study introduces novel information that may serve as groundwork to strengthen cognitive control and reduce opioid-related preoccupation in OUD.

To read the full text of the article, please visit the publisher’s website.

Source: https://drugfree.org/drug-and-alcohol-news/research-news-roundup-february-13-2025/

by CNN Health (selected text) – February 12, 2025

A legal loophole is allowing children who access social media to see enticing advertisements for marijuana with potentially dangerous consequences, according to experts.

Under the Controlled Substances Act, it’s illegal to advertise the sale or use of marijuana using federal airwaves or across state lines. But that hasn’t stopped social media ads on cannabis websites from reaching youth of all ages who use screens, said Alisa Padon, research director for the Prevention Policy Group, a health equity and prevention association in Berkeley, California.

“Businesses are allowed to make their own pages and then post ads on their feed. Youth are bypassing age restrictions and seeing the ads for products they’re not legally allowed to buy. They can like, comment and share those posts with their friends,” Padon said.

“Research shows that type of engagement is related to an increased likelihood of wanting to use and using cannabis,” she added. “It’s a perfect storm, and regulators are doing nothing about it.”

According to a 2024 national survey, over 7% of eighth graders, nearly 16% of 10th graders and almost 26% of 12th graders said they have used cannabis in the past 12 months. When marijuana use occurs during the teen years, it’s more likely the individual will become addicted, according to the National Institute on Drug Abuse.

Cannabis use during adolescence can interfere with memory, cognition and brain growth at a critical time in a child’s natural development, said pediatrician Dr. Megan Moreno, a professor and academic chair of the Division of General Pediatrics and Adolescent Medicine at the University of Wisconsin School of Medicine and Public Health in Madison.

“There’s a dose response, so heavier users have longer-term effects, and there are concerns these developmental impacts may not reverse after abstinence,” Moreno said.

“It’s the wild west out there,” she added. “If you put an ad on your own little marijuana website, and it spreads virally through social media, there are no regulations against that.”

Effective advertising tactics

Marijuana stores and manufacturers are marketing their wares to youth using tested techniques popularized by the alcohol, tobacco and food industries, experts say.

“The marketing that we’re seeing in California for cannabis looks just like the marketing that is nationwide for alcohol and for e-cigarettes,” Padon said.

When it comes to social media advertising, however, the cannabis industry has excelled, said Moreno, who has studied the impact of marijuana ads on youth.

“The cannabis industry came into the market with traditional advertisements already illegal, so they became incredibly creative on social media,” she said. “The content is expertly crafted to appeal to youth.”

Moreno researched how marijuana sellers in four states where recreational marijuana is legal (Alaska, Colorado, Oregon and Washington) have advertised to underage adolescents.

A key method was the use of young-looking salespeople called “budtenders” who help clients in the store pick out their marijuana products.

“Budtender is a riff on bartender. Advertisers tend to photograph budtenders who look like they are 16,” Moreno said.

“Also, the crossover between food and tobacco industry advertising and cannabis marketing really stands out — both use enticing color schemes and flavors,” she said.

“And they are using the alcohol industry’s playbook to send messages hinting it’s sexy to use marijuana.”

Padon quizzed 409 California youth between the ages of 16 and 20 about their reaction to various online cannabis ads. The research was published in the March edition of the International Journal of Drug Policy.

Overall, illustrations and food and flavor references were extremely appealing to youth, Padon said. Depictions of heavy cannabis use and positive sensations from that use were also a hit with young audiences. Advertisements focusing on the health benefits of cannabis, however, fell flat.

An advertisement placing marijuana in the middle of a burst of red cherries and bright colors was the most appealing ad to kids in the study, Padon said. Another popular ad showed an attractive young man who appeared to be 14 to 15 years old displaying cannabis products in a store.

“Another theme we found in our past studies was tying cannabis to athletics and being active, which is appealing to youth,” Moreno said. “Teens are in that phase of identity development trying to figure out who they are. So if part of an adolescent’s identity is a sport or being outdoorsy, the cannabis product is tying into something that’s valuable to them.”

A problem that may only worsen

According to a 2024 report, daily or near daily marijuana use by California adults tripled and marijuana use during pregnancy nearly doubled in the past decade. This occurred despite warnings to expectant moms about the dangers of cannabis on an unborn fetus.

During a four-year period between 2015 and 2019, cannabis-related visits to emergency rooms increased by 70% in older adults, the report stated.

Nationally, the rate of use has been rising steadily, with 15% of all American adults saying they smoke marijuana, according to a Gallup poll. A 2022 study found people in states where recreational cannabis is legal use it 20% more frequently than those in states that have not passed legislation.

Increases in cannabis use can result in unforeseen dangers, Padon said: “Nationwide, there have been skyrocketing rates of accidental ingestion of gummies and chocolate edibles among very small kids because they look like candy.”

Calls to poison control centers about children age 5 and younger consuming edibles containing tetrahydrocannabinol, or THC, rose from 207 to 3,054 in four years — a 1,375% increase, according to a January 2023 study.

In fact, many edibles are packaged to look exactly like their candy and chip counterparts on store shelves. One bag of gummies looks virtually identical to the popular candy Gushers, said Danielle Ompad, a professor of epidemiology at NYU School of Global Public Health, in a prior interview.

“The Nerd Rope knockoffs I have personally seen looked just like the licensed product,” Ompad said.

However, small print included on the label of the Gushers knockoff said the bag contained 500 milligrams of THC, she said. A look-alike bag of Doritos contained 600 milligrams.

“The (knockoff) Doritos were shaped just like the real thing and had a crunch as well. If I ate that whole package, I would be miserable. People who are using edibles recreationally aren’t typically eating more than 10 milligrams,” Ompad said.

If a child ingests edibles, they can become “very sick,” according to the US Centers for Disease Control and Prevention. “They may have problems walking or sitting up or may have a hard time breathing.”

 

Source: https://www.cnn.com/2025/02/12/health/marijuana-ads-child-danger-wellness/index.html

by Brian Mann –  NPR’s first national addiction correspondent – published January 29, 2025 at 7:00 AM EST

When Robert F. Kennedy Jr. talks about the journey that led to his growing focus on health and wellness — and ultimately to his confirmation hearings this week for U.S. secretary of health and human services — it begins not with medical training or a background in research, but with his own addiction to heroin and other drugs.

“I became a drug addict when I was 15 years old,” Kennedy said last year during an interview with podcaster Lex Fridman. “I was addicted for 14 years. During that time, when you’re an addict, you’re living against conscience … and you kind of push God to the peripheries of your life.”

Kennedy now credits his faith; 12-step Alcoholics Anonymous-style programs, which also have a spiritual foundation; and the influence of a book by philosopher Carl Jung for helping him beat his own opioid addiction.

If confirmed as head of the Department of Health and Human Services after Senate hearings scheduled for Wednesday and Thursday, Kennedy would hold broad sway over many of the biggest federal programs in the U.S. tackling addiction: the Centers for Disease Control and Prevention, the National Institute on Drug Abuse and the Substance Abuse and Mental Health Services Administration.

While campaigning for the White House last year, Kennedy, now 71 years old, laid out a plan to tackle the United States’ devastating fentanyl and overdose crisis, proposing a sprawling new system of camps or farms where people experiencing addiction would be sent to recover.

“I’m going to bring a new industry to [rural] America, where addicts can help each other recover from their addictions,” Kennedy promised, during a film on addiction released by his presidential campaign. “We’re going to build hundreds of healing farms where American kids can reconnect with America’s soil.”

People without housing in San Francisco in May 2024. A film released by Robert F. Kennedy Jr.’s presidential campaign included a scene that 
appeared to blame methadone — a prescription medication used to treat opioid addiction — for some of the high-risk street-drug use visible
on the streets of San Francisco.

Some addiction activists — especially those loyal to the 12-step faith- and values-based recovery model — have praised Kennedy’s approach and are actively campaigning for his confirmation.

“RFK Jr is in recovery. He wants to expand the therapeutic community model for recovering addicts,” Tom Wolf, a San Francisco-based activist who is in recovery from fentanyl and opioid addiction, wrote on the social media site X. “I support him for HHS secretary.”

 

A focus on 12-step and spirituality, not medication and science-based treatment

 

But Kennedy’s approach to addiction care is controversial, described by many drug policy experts as risky, in part because it focuses on the moral dimension of recovery rather than modern, science-based medication and health care.

“He clearly cares about addicted people,” said Keith Humphreys, a leading national drug policy researcher at Stanford University. “But in terms of the plans he’s articulated, I have real doubts about them.”

According to Humphreys, Kennedy’s plan to build a network of farms or camps doesn’t appear to include facilities that offer proper medical treatments for seriously ill people facing severe addiction.

“That’s a risk to the well-being of patients, and I don’t see any merit in doing that,” Humphreys said.

“I think [Kennedy’s plan] would be an enormous step backward,” said Maia Szalavitz, an author and activist who used heroin and other drugs before entering recovery.

“We have spent the last 15, 20 years trying to move away from treating addiction as a sin rather than a medical disorder,” she said. “We’ve spent many years trying to get people to take up these medications that we know cut your death risk in half, and he seems to want to go backwards on all that.”

The vast majority of researchers, doctors and front-line addiction treatment workers agree that scientific data shows medications like buprenorphine, methadone and naloxone are game changers when it comes to treating the deadliest street drugs, including fentanyl and heroin.

The Biden administration moved aggressively to make medical treatments far more affordable and widely available. Many experts believe those programs are factors in the dramatic national drop in overdose deaths that began in 2023.

Kennedy, who studied law and political science, not health care, before becoming an activist on subjects ranging from pharmaceuticals and vaccines to the American diet, has remained largely silent on the subject of science-based medical treatments for opioid addiction.

His campaign film included a scene that appeared to blame methadone — a prescription medication that has been used to treat opioid addiction since the 1970s — for some of the high-risk street-drug use visible on the streets of San Francisco.

In public statements, Kennedy has also repeated the inaccurate claim that the addiction and overdose crisis isn’t improving. In fact, fatal overdoses have dropped nationally by more than 20% since June 2023, according to the Centers for Disease Control and Prevention, falling below 90,000 deaths in a 12-month period for the first time in half a decade.

“What we have mostly heard from Kennedy is a skepticism broadly of medications and a focus on the 12-step and faith-based therapy,” said Vanda Felbab-Brown, an expert on drug policy at the Brookings Institution, a Washington, D.C., think tank.

“That appeals to a lot of crucial groups that have supported President Trump in the election. But we know what is fundamental for recovery and stabilization of people’s lives and reducing overdose is access to medications,” Felbab-Brown said. “Unfortunately, many of the 12-step programs reject medications.”

She’s worried that under Kennedy’s leadership, the Department of Health and Human Services could shrink or eliminate funding for science-based medical treatment and instead focus on spirituality-based approaches that appear to help a relatively small percentage of people who experience addiction.

Kennedy’s views on other science-based treatments, including vaccines, have sparked widespread opposition among medical researchers and physicians.

 

Kennedy boosts an Italian model for addiction recovery that has faced controversy

 

Another concern about Kennedy’s addiction proposals focuses on his interest in a program for drug treatment created in Italy in the 1970s.

The San Patrignano community is a therapeutic rehabilitation community center in Italy for people with drug addictions. The center, which
was founded by Vincenzo Muccioli in 1978, received renewed media attention after a 2020 Netflix documentary described alleged abuses.
Robert F. Kennedy Jr. now describes the program as a model for recovery care in the United States.

“I’ve seen this beautiful model that they have in Italy called San Patrignano, where there are 2,000 kids who work on a large farm in a healing center, learning various trades … and that’s what we need to build here,” Kennedy said during a town hall-style appearance on the cable channel NewsNation last year.

According to Kennedy’s plan, outlined in interviews and social media posts, Americans experiencing addiction would go to San Patrignano-style camps voluntarily, or they could be pressured or coerced into accepting care, with a threat of incarceration for those who refuse care.

But the San Patrignano program has been controversial and was featured in a 2020 Netflix documentary that included images of people with addiction allegedly being held in shackles or confined in cages. The farm’s current leaders have described the documentary as biased and unfair.

Kennedy, meanwhile, has continued to use the program as a model for the camps he would like to build in the United States.

“I’m going to build these rehab centers all over the country, these healing camps where people can go, where our children can go and find themselves again,” he said.

Szalavitz, the author and activist who is herself in recovery, noted that the Italian program doesn’t include science-based medical care, including opioid treatment medications. She said Kennedy’s fascination with the model reflects a lack of medical and scientific expertise.

“It really is great to include people who have personal experience of something like, say, addiction in policymaking. But you don’t become an addiction expert simply because you’re someone who struggled with addiction,” Szalavitz said. “You have to engage with the research literature. You have to understand more beyond your own narrow anecdote. Otherwise you’re going to wind up doing harm to people.”

Copyright 2025 NPR

Source: https://www.ideastream.org/2025-01-29/rfk-jr-says-hell-fix-the-overdose-crisis-critics-say-his-plan-is-risky

January 14, 2025 

Forwarded by Shane Varcoe • 05.02.25

 

Breakthroughs in Addiction Science Over 50 Years

Addiction science has undergone tremendous progress over the past five decades, transforming our understanding of drugs and their impact on the brain and society. Recent advancements offer hope in addressing the escalating challenges of drug use, addiction, and overdose. However, the need for evidence-based prevention and treatment strategies remains crucial in combating this ongoing public health crisis.

Prioritising Drug Prevention

Prevention is one of the most effective ways to combat substance use disorders. Research consistently highlights how drug exposure can interfere with brain development from prenatal stages to young adulthood, setting the stage for lifelong challenges. Children and adolescents are particularly vulnerable, as early drug experimentation sharply increases the risk of addiction later in life.

Adverse childhood experiences—ranging from poverty to trauma—also contribute to substance use risks by disrupting brain development. Preventative measures can mitigate these risks and promote resilience. For example, school-based programmes and community initiatives have demonstrated significant success in reducing drug use among young people. Importantly, these interventions offer long-term benefits, improving mental health and reducing dependency rates across generations.

Scaling up these preventative approaches is vital. By investing in evidence-based prevention at schools, healthcare facilities, and community centres, society can safeguard future generations from the devastating impacts of drugs.

Challenges in Addressing Substance Use Disorders

One of the greatest hurdles today is the lack of access to effective addiction treatment. Millions of people struggle with substance use disorders, yet only a small percentage receive adequate care. This gap highlights the pressing need to expand addiction treatment services and eliminate barriers such as stigma and limited healthcare coverage.

Treatment options, including medication and behavioural therapies, have proven to be effective for many struggling with addiction. For instance, medications that address opioid dependency, combined with comprehensive care, can significantly improve recovery outcomes. However, these treatments remain inaccessible to many, especially in underserved communities.

Expanding treatment availability within prisons, rural areas, and low-income communities could swiftly reduce addiction rates and improve recovery success. Research also shows that offering treatment to individuals in justice systems can lower overdose risks after release and reduce reoffending, creating broader societal benefits.

The Role of Science in Combating Addiction

Scientific advancements are paving the way for more effective solutions to addiction. New innovations, such as brain stimulation therapies, target the neurological circuits disrupted by substance use, offering promising pathways for treatment. Additionally, cutting-edge pharmaceuticals like GLP-1 agonists, already used for managing diabetes, are showing potential in reducing cravings and dependency behaviours associated with addiction.

The use of artificial intelligence (AI) in addiction science is further revolutionising the field. AI tools can help detect overdose patterns, study drug impacts on mental health, and even guide personalised treatment interventions. Large-scale studies, such as those examining adolescent brain development, continue to shed light on how substance use affects young minds, offering invaluable insights for effective prevention.

Towards a Unified, Drug-Free Future

While remarkable progress has been made, the fight against addiction is far from over. Preventing drug use, providing accessible treatment, and investing in research remain paramount. By adopting a proactive, science-backed approach to addiction prevention, we can reduce the devastating effects of substance use disorders and create healthier, drug-free communities.

Addiction science offers the tools needed to address these challenges, but lasting change requires collective effort. Only through unified actions can we overcome this crisis and protect future generations from the harms of addiction.

Start prioritising prevention and treatment today to help build a safer, healthier world.

Source: https://wrdnews.org/breakthroughs-in-addiction-science-over-50-years/

They’re not old enough yet to drink in bars, but a group of Washington students wants to make nightlife in the state safer.

A bill in the state Legislature requested by Lake Washington High School students aims to protect people from drink spiking.

The measure would require some establishments selling alcohol, including bars and nightclubs, to have testing kits on hand so patrons can see if their drinks have been drugged. Sponsors amended the bill this week in light of concerns of overreach lodged by a hospitality trade group.

Businesses covered by the proposal would also have to post a notice that test kits are available.

Bars would sell the test strips, stickers or straws to customers for a “reasonable amount based on the wholesale cost of the device.”

Usually, the tests look for drugs like Rohypnol, also known as “roofies.” When placed in alcoholic drinks, the drugs can incapacitate people unexpectedly so they can’t resist sexual assault, according to the federal Drug Enforcement Administration. The tests also detect ketamine and gamma hydroxybutyric acid.

“As a group of young women entering college, we are scared for our future,” Lake Washington senior Ava Brisimitzis told a Senate panel last week. “While nightlife is still years away, there are thousands of Washingtonians right now affected by this problem. No one should question whether or not they might return home safely.”

Senate Bill 5330 would take effect Jan. 1, 2026. It has a committee vote set for Friday.

The proposal is patterned after a similar law passed in California that went into effect last July. That law affected 2,400 establishments.

When a drink is spiked, “many times, it’s too late to prevent that person from falling victim to another crime, and that’s why prevention awareness is so important,” said Sen. Manka Dhingra, D-Redmond, the bill’s prime sponsor.

Critics said the original bill in Washington goes far beyond the California law. The initial version included taverns, nightclubs, theaters, hotels and more. The California legislation only applies to establishments like nightclubs that exclude minors and aren’t required to serve food.

Last week, Washington Hospitality Association lobbyist Julia Gorton said the bill “needs many more conversations.”

The hospitality association would support a version like California’s law, said Jeff Reading, a spokesperson for the trade group.

Now, a revised version of the bill looks to more closely align Washington’s proposal with California’s by focusing on establishments that don’t allow minors.

Washington’s unusual liquor licensing system has made drafting the bill difficult, Dhingra said. The state simply has too many types of licenses. She wants to “clean up” Washington’s liquor license statute.

“This is really not meant to be onerous, but really meant to be a partnership to make sure all the patrons are safe,” Dhingra told the Senate Labor & Commerce Committee last week.

California’s legislation also stated the signage must say “Don’t get roofied! Drink spiking drug test kits available here.” But Dhingra felt that language may be seen as blaming the victim, so the new version of the Washington bill doesn’t require specific verbiage in the sign.

A 2016 study published in the American Psychological Association’s journal Psychology of Violence found nearly 8% of 6,064 students surveyed at three universities believed they’d been drugged.

Source: https://washingtonstatestandard.com/briefs/washington-could-require-bars-to-carry-spiked-drink-drug-tests/

INTRODUCTORY NOTE BY NDPA:

THIS ARTICLE IS INCLUDED FOR ITS INTERESTING DESCRIPTION OF THE CONSUMPTION ROOM PHILOSOPHY AND PRACTICE. NDPA HAS SEVERAL SERIOUS CONCERNS ABOUT SO-CALLED ‘CONSUMPTION ROOMS’ AND WOULD TAKE ISSUE WITH SOME OF THE CLAIMS MADE IN THIS ARTICLE, NOT LEAST THE HEADLINE CLAIM THAT THIS IS A ‘SAFE’ SITE … (SEE OTHER ARTICLES ON THE NDPA SITE), NEVERTHELESS, IT IS WORTH READING, IN ORDER TO BETTER UNDERSTAND THE ATTITUDE BEHIND THE PROVENANCE OF SUCH FACILITIES.

by  Rebecca. L. Root – December 24, 2024 – SOURCE PRISM

At 8 a.m. on a Monday morning, most of the soft recliners in the waiting area of the three-story East Harlem overdose prevention center (OPC) are already occupied by those who have come to consume their first dose of the day. Whether it’s for fentanyl, heroin, or another drug, people of all ages trickle into the consumption room at OnPoint NYC, where mirrored cubicles line opposite sides of the room and a staff station sits in the middle with trays of needles, elastics, and wipes organized in rows.

A man, who looks to be in his late 30s, unwraps today’s first fix of what most likely is the opioid fentanyl, which staff say is the most common drug used here. He simultaneously chats with the staff who welcome each visitor with familiarity. The calm ambiance is occasionally punctuated with noise as the metal doors swing, allowing another person to enter.

OnPoint NYC, which opened in 2021 as the country’s first overdose prevention site, aims to be a judgment- and persecution-free space for drug users to safely consume. The idea of preventing people from dying of an overdose is a controversial one. Last year, former U.S. attorney for the southern district of New York Damian Williams told The New York Times that OnPoint’s methods were illegal and hinted at a shutdown, while New York Gov. Kathy Hochul is also opposed, having repeatedly said the centers violate federal and state laws, putting their future operations in the balance.

But amid the national opioid epidemic, drastic measures are needed. More than 100,000 people die each year from drug overdoses in the U.S., according to the National Center for Health Statistics. In November, President-elect Donald Trump announced plans to impose further tariffs on Chinese imports in an attempt to curb what he believes are fentanyl deliveries into the U.S. It follows calls in 2022 from President Joe Biden to increase funding in the budget to address the overdose epidemic, while in 2023 New York Times editors declared that the U.S. had lost the war on drugs.

“Every 90 minutes…four New Yorkers die [of an overdose],” said Sam Rivera, the executive director of OnPoint NYC.

Advocates for OPCs say having a sanitary and safe place to consume drugs diminishes the element of haste or need for discretion that might exist in a public place. This reduces the risk of an overdose, but should one occur, medically trained staff dressed in jeans and leather are ready to respond.

Tilting a chair back, a staffer explains the importance of getting the blood circulating and offering rescue breaths before administering naloxone, which can reverse the effects of opioids. Since 2021, OnPoint NYC has reversed 1,600 overdoses, cleaned up community parks, and opened a sister center in Washington Heights.

Despite the progress, the center, and the few others like it in the U.S., remain controversial. When a similar center was opened in San Francisco in 2022, a group of local mothers protested while others posited that creating safe spaces to consume drugs only increases drug use.

However, research found that following the opening of an OPC in San Francisco, there was no visible increase in drug use, and a Brown University study found no affiliation between the centers and increased crime.

Instead, Michel Kazatchkine, a commissioner of the Global Commission on Drug Policy (GCDP), which advocates for drug policies to be more humane and prioritize public and individual health, believes it is the current approach of criminalizing drug users that is the problem.

“The criminal justice approach has sent hundreds of thousands of people to prison with no benefit for these people and no benefit for the society and huge expenses involved,” said Kazatchkine, who is also the former executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, France.

Over 1.16 million people each year are incarcerated in the U.S. on drug offenses, while globally, governments spend $100 billion annually on punitive drug policies. In spite of such policies, global drug use has risen from about 180 million people in 2002 to 292 million in 2022, according to a report by the GCDP.

In states like New York, the response to tackle the drug problem has predominantly been to fund the distribution of naloxone and fentanyl test strips, which can detect the presence of fentanyl in other drugs, explained Toni Smith, the New York state director at Drug Policy Alliance. The group works with grassroots groups to advance public health solutions to drug use. While such resources are critical, Smith emphasized that the state must offer a full range of life-saving tools and services. More OPCs, Smith believes, could save more lives.

The harm reduction quandary

Historically, the U.S. has pushed back on any initiatives under the harm reduction umbrella, Kazatchkine said. Harm reduction, according to the World Health Organization (WHO), focuses on offering a suite of interventions designed to minimize the negative impacts related to drug use. That could include providing people with clean needles and syringes, with naloxone, with HIV testing, or with access to opioid substitution therapy programs. OPCs—often referred to as safe consumption sites in Europe, where they are widely used—are not on the WHO’s list of recommended harm reduction interventions but are a harm reduction approach.

 

“The concept of harm reduction is acknowledging that people use drugs and that these people have risks, but it is prioritizing health approaches over criminalization,” Kazatchkine said. “Acknowledging that people use drugs, you acknowledge something that is prohibited under the law and actually under criminal law, so a government or an international entity finds itself in a very uncomfortable situation.”

“Many people would come in and be shocked…They open the door and think everybody’s just using drugs. They don’t expect this kind of structure and loving environment,” he said. “We’ve invited the governor for three years. [She] hasn’t been here once. But you’re going to sit around and tell us the program doesn’t work.”

Beyond a safe space for consumption

More than just a consumption space, the center offers a health clinic and, up a narrow staircase to a second floor, therapy rooms host complimentary holistic treatments such as reiki, massage, and sound baths. Rivera himself occasionally hosts one. All services, including health care, are free.

On this day, a woman sleeps deeply in a reclining chair as soft music tinkles in the background and candles burn in the corner; two others lie on massage tables awaiting their treatments. Shower facilities are available in another corner of the center, and an on-site psychologist offers mental health services in a bid to help tackle the underlying trauma behind the addiction. It’s “multidimensional” support to treat a problem that surpasses simply addiction but intersects with issues around housing, access to care, criminalization, food and nutrition, sleep, as well as structural racism, Smith said. And the services aren’t just for drug users but all local community members.

“Creating this community and this space around a loving environment is so impactful, and it changes the experience for folks who come in,” Rivera said.

In New York City, Rivera believes there have also been economic benefits. OnPoint’s data suggests a reduction in visits to the emergency room for overdoses that has relieved the burden on the health system and, Rivera said, potentially saved two New York City neighborhoods $45 million in less than three years.

More OPCs could benefit the U.S. and reduce the impact the drug crisis is having, said Kazatchkine, but amid what Rivera believes is a game of politics, whether that will happen remains to be seen. In the meantime, elsewhere in the U.S., people will shoot up in alleyways and parks, at increased risk of unnecessarily overdosing. But the reality, Rivera said, is that with OPCs, there’s the potential for no one to have to die this way again.

Source: https://www.nationofchange.org/2024/12/24/inside-the-countrys-first-official-safe-drug-consumption-site/

by Lauren Irwin – WNCT Greenville

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

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

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

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

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

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

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

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

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

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

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

 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Preventing drug use and addiction

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

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

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

Preventing overdose

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

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

Improving access to addiction treatment

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

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

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

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

Leveraging new treatments and technologies

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

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

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

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

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

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

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

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

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

No one could.

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

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

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

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

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

Marijuana rules to protect health up to the states

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

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

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

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

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

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

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

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

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

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

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

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

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

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

More people are using cannabis

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Lack of federal oversight

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

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

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

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

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

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

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

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

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

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

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

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

 

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

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

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

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

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

Take the following paragraph in this paper:

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

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

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

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

<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<NDPA>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

DREXEL PRIVATE UNIVERSITY TEXT:

December 11, 2024

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

destigmatized text

 

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

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

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

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

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

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

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

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

 

 

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

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

This is an RTE component

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

by Brian Anthony Hernandez   

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

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

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

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

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

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

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

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

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

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

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

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

 

At a glance

  • Cherokee Nation Action Network is using culture as prevention for youth substance use in Oklahoma.
  • The leading principle is “Walking in Balance,” which emphasizes balancing traditional Cherokee culture with modern contemporary culture in their everyday lives.

Cherokee Nation Community Action Network

The Cherokee Nation Community Action Network (CAN) coalition was originally developed in 2006 and became a Drug-Free Community coalition in 2018. The CAN uses culture as a strategy to prevent and reduce substance use in Cherokee communities. They partner with Sequoyah School, a tribal school in Tahlequah that young people can attend from anywhere within the reservation. The reservation includes some very rural and isolated communities with limited resources.

To increase community connectedness, the coalition teaches a National Association for Addiction Professionals-certified curriculum based on the book Walking in Balance by Abraham Bearpaw. Bearpaw was raised in one of the Cherokee Nation communities and, after coping with alcohol use for several years, decided it was time for a change. He reconnected with his culture by prioritizing mindfulness, health, and trust and has been in recovery for 12 years. He partners with different communities to teach his curriculum to young people in hopes of reducing the likelihood of them engaging in substance use. The curriculum includes 12 weekly lessons that teach students how to reconnect with culture, manage stress, and care for themselves. The leading principle is “Walking in Balance,” which emphasizes balancing traditional Cherokee culture with modern contemporary culture in their everyday lives.

The CAN coalition initially faced challenges with young people’s willingness to return to the ceremonial grounds. Due to some forbidden traditional practices, they felt they were too far removed. However, the coalition encouraged them to attend to learn and reconnect with their roots. Of the 100 young people living in the current town they serve, 75 showed up to participate in the curriculum. The day-to-day traditional and cultural activities include the making of clay beads, ribbon skirts, corn-bead necklaces, basket weaving, and stickball. The community activities are a source of Cherokee knowledge-building, sharing, and resiliency that helps build a culture of connectedness. The instructor teaches ceremonial values of youth and elder interaction, respect for ancestors, and the importance of taking care of the land. One community member said, “Our tribe has long known that building a sense of belonging, helping youth grow a connection to community, and cultural identity helps them grow into healthy adults.” The Cherokee Nation CAN will continue to foster safe and healthy environmental conditions, providing social support, encouraging school connectedness, and creating safe and caring communities on the reservation to improve the lives of those living there.

Source: https://www.cdc.gov/overdose-prevention/php/drug-free-communities/cherokee-nation.html

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