Prevalence

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/

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Preventing drug use and addiction

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

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

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

Preventing overdose

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

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

Improving access to addiction treatment

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

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

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

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

Leveraging new treatments and technologies

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

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

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

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

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

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

 

Contemporary issues on drugs

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

 

Key findings and conclusions

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

Sources:

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

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

by Miles Martin – 

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

Key findings include:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

What’s being said:

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

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

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

But:

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

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

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

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

 

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

 

Filed under: Latest News,Prevalence,USA :

 December 19, 2024 / 73(50);1147–1149

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

Summary

What is already known about this topic?

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

What is added by this report?

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

What are the implications for public health practice?

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

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

Investigation and Outcomes

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

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

Preliminary Conclusions and Actions

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

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

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


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

    DOI: 10.2105/AJPH.2022.307212

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

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

Illegal drugs are the source of immense human suffering. Those most vulnerable, especially young people, bear the brunt of this crisis. People who use drugs and those struggling with addiction face a multitude of challenges: the harmful effects of the drugs themselves, the stigma and discrimination they endure, and often, harsh and ineffective responses to their situation.

The global drug problem is a complex challenge affecting millions of people worldwide. According to the World Drug Report, there are nearly 300 million drug users globally.

The issue spans from individuals with substance use disorders to communities affected by drug trafficking and organized crime. The drug problem is deeply connected to organized crime, corruption, economic crime, and terrorism. To effectively address this challenge, it is crucial to adopt a science-based, evidence-driven approach that prioritizes prevention and treatment.

The drug trade problem was recognized early in the 20th century, leading to the first international conference on narcotic drugs in Shanghai in 1909. In the decades that followed, a multilateral system was established to control the production, trafficking, and abuse of drugs.

Evidence-based drug prevention programmes can safeguard individuals and communities. By reducing drug use, these programmes can also weaken the illicit economies that exploit human misery.

Types of Illegal Drugs

Drugs are chemical substances that affect the normal functioning of the body or brain. They can be legal, like caffeine, nicotine, and alcohol, or illegal. Legal drugs, such as medicines, help with recovery from illness but can also be abused. Illegal drugs are considered so harmful that international laws, under United Nations conventions, regulate their use, making it unlawful to possess, use, or sell them.

Illegal drugs often have various street names that can vary by region and change over time. Their effects include immediate physical harm and long-term impacts on psychological and emotional development, especially for young people. Drugs can impair natural coping mechanisms and potential, and mixing them can result in unpredictable and severe consequences.

Additionally, drug use can impair judgment, leading users to take risks such as unsafe sex, which increases the risk of contracting hepatitis, HIV, and other sexually transmitted diseases.

Most common illegal drugs include:

  • Cannabis;
  • Cocaine;
  • Ecstasy;
  • Heroin;
  • LSD (D-Lysergic Acid Diethylamide); and
  • Methamphetamine.

In recent years, New Psychoactive Substances (NPS) have become a global phenomenon. NPS are substances of abuse not controlled under international drug conventions, but may pose public health risks. The term “new” refers to substances recently introduced to the market, not necessarily newly invented.

Known as “designer drugs,” “legal highs,” or “bath salts,” NPS often mimic the effects of illicit or prescription drugs. They are created by modifying the chemical structures of controlled substances to bypass legal restrictions.

The rapid appearance of diverse NPS on the global market poses public health risks and challenges for drug policy. Limited knowledge about their effects complicates prevention and treatment efforts, while their chemical diversity makes identification and analysis difficult. Effective monitoring, information sharing, and early warning systems are critical for addressing these challenges.

UN Action

Since its founding, the United Nations has been tackling the global drug problem in a systematic manner.

The United Nations Commission on Narcotic Drugs (CND) was established in 1946 by the Economic and Social Council (ECOSOC) through resolution 9(I). Its purpose is to assist ECOSOC in overseeing the implementation of international drug control treaties.

Three drug control conventions were adopted under the auspices of the United Nations (in 1961, 1971 and 1988). Adherence is now almost universal.

The International Narcotics Control Board (INCB) is an independent, quasi-judicial expert body established under the 1961 Single Convention on Narcotic Drugs. It was formed by merging two earlier organizations: the Permanent Central Narcotics Board, created by the 1925 International Opium Convention, and the Drug Supervisory Body, established under the 1931 Convention for Limiting the Manufacture and Regulating the Distribution of Narcotic Drugs. The INCB monitors and assists governments in complying with international drug control treaties.

The World Health Organization (WHO) is a key player in the United Nations’ efforts to combat the global drug problem. Sustainable Development Goal 3, specifically Target 3.5, calls on governments to enhance prevention and treatment programs for substance abuse. WHO’s approach to addressing the global drug problem focuses on five key areas: prevention, treatment, harm reduction, access to controlled medicines, and monitoring and evaluation.

The United Nations Office on Drugs and Crime (UNODC) supports governments in implementing a balanced, health- and evidence-based approach to the world drug problem that addresses both supply and demand and is guided by human rights and the agreed international drug control framework. This approach involves: treatment, support, and rehabilitation; ensuring access to controlled substances for medical purposes; working with farmers who previously cultivated illicit drug crops to develop alternative sustainable livelihoods for them; and establishing adequate legal and institutional frameworks for drug control through using international conventions. UNODC works in all regions through balanced, evidence-based responses to address drug abuse and drug use disorders, as well as the production and trafficking of illicit drugs.

Recent Milestones

In 2009, governments adopted the Political Declaration and Plan of Action on International Cooperation Towards an Integrated and Balanced Strategy to Counter the World Drug Problem, which includes goals and targets for drug control.

Progress towards addressing the world drug problem and related issues is assessed at the United Nations General Assembly Special Session (UNGASS). All nations are encouraged to keep in mind the key principles of the 2030 Agenda for Sustainable Development and to leave no one behind. The Special Session in 2016 resulted in an outcome document, Our joint commitment to effectively addressing and countering the world drug problem.

In 2019, the Commission on Narcotic Drugs adopted the Ministerial Declaration on Strengthening actions at the national, regional and international levels to accelerate the implementation of joint commitments made to jointly address and counter the world drug problem. In the Declaration, governments reaffirmed their determination “to address and counter the world drug problem and to actively promote a society free of drug abuse in order to help ensure that all people can live in health, dignity and peace, with security and prosperity, and reaffirm our determination to address public health, safety and social problems resulting from drug abuse.” They also decided to review the progress made in implementing the policy commitments in 2029.

Global Response

National legislative frameworks govern the responses of criminal justice systems to the world drug problem. In the vast majority of countries, illicit cultivation of drug crops, diversion of precursors and drug trafficking are criminal offences, but the criminal nature of drug use or possession for use varies across countries and regions.

Drug use or possession is considered a criminal offence in about 40 per cent of the 94 countries where data are available, representing a significant proportion of the global population. Available data indicate that more punitive measures are imposed for drug use or possession in Asia compared with other regions, while the Americas and Asia are the most punitive regions for drug trafficking.

Long-term efforts to dismantle drug economies must focus on providing socioeconomic opportunities and alternatives that address the root causes of illicit crop cultivation, such as poverty, underdevelopment, and insecurity. These efforts should go beyond simply replacing illicit crops or incomes. Additionally, they must address the factors that lead to the recruitment of young people into the drug trade, as they are particularly vulnerable to synthetic drug use.

According to newly available estimates, in 2022 only about 1 in 11 people with drug use disorders received drug treatment globally. It is recommended that all individuals affected by the world drug problem, including women, who face disproportionate stigma and discrimination, are ensured their universal right to health. To achieve this, drug treatment, care, and services must be comprehensive, effective, voluntary, and accessible to everyone without discrimination. These services should be designed to uphold and preserve the dignity of all individuals, including those who use drugs, as well as their communities.

Role of Civil Society

The United Nations acknowledges the importance of fostering strong partnerships with civil society organizations to address the complex challenges of drug abuse and crime, which weaken the fabric of society. Active participation from civil society— non-governmental organizations, community groups, labour unions, indigenous groups, charitable organizations, faith-based groups, professional associations, and foundations — is crucial in supporting the UN’s efforts to fulfill its global mandates effectively.

UNODC supports NGOs participation in relevant drug-related policy discussions and meetings, particularly the CND regular and intersessional meetings and encourages the increased dialogue between NGOs, member states and UN entities, through the Vienna NGO Committee on Drugs (VNGOC).

Youth Engagement

Recognizing that youth are a vulnerable population, it is essential for the international community to address the issue of substance abuse effectively. Through the Youth Initiative, the UN provides opportunities for youth to actively participate in efforts to prevent substance use. This programme enables young people to join a community of peers committed to promoting health and well-being.

The Youth Forum is an annual event organized by the UNODC Youth Initiative as part of the broader framework of the Commission on Narcotic Drugs. It brings together young people from around the world, nominated by governments, who are actively engaged in drug use prevention, health promotion, and youth empowerment.

The forum provides a platform for participants to exchange ideas, share visions, and explore diverse perspectives on enhancing the health and well-being of their peers. Additionally, it offers an opportunity for youth to present their collective message to global policymakers, contributing their voices to international discussions and decisions.

Resources

 

Source: https://www.un.org/en/global-issues/drugs

Weekly / November 7, 2024 / 73(44);1010–1012

Alana M. Vivolo-Kantor, PhD1; Christine L. Mattson, PhD1; Maria Zlotorzynska, PhD1

What is already known about this topic?

Expanded availability of ketamine for management of treatment-resistant depression has resulted in increased use.

What is added by this report?

During July 2019–June 2023, ketamine was detected in <1% of overdose deaths and was the only drug involved in 24 deaths. During this period, the percentage of overdose deaths with ketamine detected in toxicology reports increased from 0.3% (47 deaths) to 0.5% (107 deaths). Approximately 82% of deaths with ketamine detected in toxicology reports involved other substances, including illegally manufactured fentanyls, methamphetamine, or cocaine.

What are the implications for public health practice?

Further investigation is needed to better understand the role of ketamine in drug overdoses, particularly when multiple substances are used before death.

Ketamine, a Schedule III controlled substance* that is Food and Drug Administration (FDA)–approved for general anesthesia, can produce mild hallucinogenic effects and cause respiratory, cardiovascular, and neuropsychiatric adverse events (1). In 2019, a form of ketamine (esketamine) was approved by FDA for use in treatment-resistant depression among adults (2). Ketamine use, poison center calls for ketamine exposure, and ketamine drug reports from law enforcement have increased through 2019 (3), but recent trends in ketamine involvement in fatal overdoses are unknown. Data from CDC’s State Unintentional Drug Overdose Reporting System (SUDORS) were analyzed to describe characteristics of and trends in overdose deaths with ketamine detected or involved during July 2019–June 2023.

Investigation and Findings

Data on drug overdose deaths with unintentional or undetermined intent come from SUDORS, which includes information from death certificates, medical examiner or coroner reports, and postmortem toxicology reports.§ Data are abstracted on all substances reported to cause death (i.e., involved) and substances detected through toxicology testing. Decedent demographics and other overdose characteristics were analyzed among 45 jurisdictions (44 states and the District of Columbia [DC]),** and trend analyses were conducted among 28 jurisdictions (27 states and DC).†† Analyses were restricted to deaths with toxicology reports or with ketamine listed as a cause of death on the death certificate. Ketamine detection included toxicology results for ketamine or its metabolites.§§ Among deaths with ketamine detected, drug involvement was analyzed to ascertain which drug or drugs caused death. This activity was reviewed by CDC, deemed not research, and was conducted consistent with applicable federal law and CDC policy.¶¶

During July 2019–June 2023, a total of 228,668 drug overdose deaths were identified in 45 jurisdictions. Ketamine was detected in 912 (0.4%) overdose deaths, listed as involved in 440 (0.2%) deaths, and was the only substance involved in 24 (0.01%) deaths (Table). A majority of deaths with ketamine detected involved illegally manufactured fentanyls (IMFs) (58.7%), followed by methamphetamine (28.8%) and cocaine (27.2%). Overall, 82.4% of deaths involved either IMFs, methamphetamine, or cocaine. Approximately one third (34.8%) of decedents in whom ketamine was detected were aged 25–34 years, and approximately three quarters were males (71.3%) and non-Hispanic White persons (73.7%).

Among 172,475 overdose deaths in 28 jurisdictions during July 2019–June 2023, <1% had ketamine detected (692 deaths; 0.4%) or were classified as ketamine-involved (348 deaths; 0.2%). The number and percentage of deaths with ketamine detected increased during July 2019–June 2023 from 47 (0.3%) to 107 (0.5%), with notable increases as early as July–December 2020

Conclusions and Actions

During July 2019–June 2023, although ketamine was detected or involved in <1% of all drug overdose deaths, overdose deaths with ketamine detected increased. Almost all overdose deaths with ketamine detected involved other substances, mostly IMFs or stimulants; however, the source of ketamine (e.g., illegally purchased or prescribed) is unknown. Because analyses included a subset of jurisdictions, findings might not be generalizable to the entire United States. In addition, the scope of postmortem toxicology testing varies within and across jurisdictions, and ketamine might not be included in testing panels or be tested for in all postmortem samples (4), which could lead to an underestimation of ketamine detection. Despite the lack of uniform testing, ketamine detection among overdose deaths has increased over time, yet both detection and involvement accounted for a small proportion of overdose deaths. As polysubstance use (5) and use of ketamine for treatment-resistant depression and in compounded formulations*** increase, continued monitoring is needed to identify potential changes in the detection and involvement of ketamine in overdose deaths and to better understand potential drug interactions or circumstances leading to death.

Source: https://www.cdc.gov/mmwr/volumes/73/wr/mm7344a4.htm?s_cid=mm7344a4_w

United Nations  –  Office on Drugs and Crime

PRESS RELEASE  – Kabul / Vienna, 6 November 2024

Opium cultivation in Afghanistan in 2024 increased by an estimated 19 per cent year-on-year to cover 12,800 hectares, according to a new survey released by the UN Office on Drugs and Crime (UNODC) today.

The increase follows on a 95 per cent decrease in cultivation during the 2023 crop season, when the de-facto Authorities of Afghanistan enforced a ban that virtually eliminated poppy cultivation across much of the country. Despite the increase in 2024, opium poppy cultivation remains far below 2022, when an estimated 232,000 hectares were cultivated.

“With opium cultivation remaining at a low level in Afghanistan, we have the opportunity and responsibility to support Afghan farmers to develop sustainable sources of income free from illicit markets,” said Ghada Waly, Executive Director of UNODC. “The women and men of Afghanistan continue to face dire financial and humanitarian challenges, and alternative livelihoods are urgently needed.”

According to the survey findings, the geographic centre of opium cultivation has also shifted, from the south-western provinces – long the heart of Afghanistan’s opium cultivation up to and including 2023 – to the north-eastern provinces, where 59 per cent of cultivation occurred in 2024. This represents a sharp 381 per cent increase in these provinces over 2023.

Dry opium prices have stabilized to around US $730 per kilogram in the first half of 2024, up from a pre-ban average of US $100 per kilogram.

The high prices and dwindling opium stocks may encourage farmers to flout the ban, particularly in areas outside of traditional cultivation centers, including neighboring countries.

“This is important further evidence that opium cultivation has indeed been reduced, and this will be welcomed by Afghanistan’s neighbours, the region and the world,” said Roza Otunbayeva, Special Representative of the Secretary-General and head of the United Nations Assistance Mission in Afghanistan.

“But this also requires us to recognize that rural communities across Afghanistan have been deprived of a key income source in addition to the many other pressures they are facing, and they desperately need international support if we want this transition to be sustainable,” Otunbayeva said.

Read the Afghanistan Drug Insights Volume 1 here.

Note to Editors: The remaining reports in the Afghanistan Drug Insights series will cover a range of topics related to the drug situation in Afghanistan, including opium production and rural development; the socioeconomic situation of farmers after the drugs ban; drug trafficking and potential opium stocks; and treatment availability and drug use.

* *** *

For further information please contact:

Sonya Yee
Chief, UNODC Advocacy Section
Mobile: (+43-699) 1459-4990
Email: unodc-press[at]un.org

* *** *

Source: https://www.unodc.org/unodc/en/press/releases/2024/October/afghanistan_-opium-cultivation-increased-by-19-per-cent-in-second-year-of-drugs-ban–according-to-unodc.html

Cultural, systemic and historical factors have converged to create the perfect storm when it comes to Black overdose deaths.

      By Liz Tung – June 14, 2024 Reporter at The Pulse

In this Jan. 23, 2018 photo, Leah Hill, a behavioral health fellow with the Baltimore City Health Department, displays a sample of Narcan nasal spray in Baltimore. The overdose-reversal drug is a critical tool to easing America’s coast-to-coast opioid epidemic. (AP Photo/Patrick Semansky)

From Philly and the Pa. suburbs to South Jersey and Delaware, what would you like WHYY News to cover? Let us know!

recent study from the Pennsylvania Department of Health has found that Black people who died from opioid overdoses were half as likely as white people to receive the life-saving drug naloxone, otherwise known as Narcan. The study also found that Black overdose deaths in Pennsylvania increased by more than 50% between 2019 and 2021, compared with no change in white overdose deaths.

In an email, a representative with the Department of Health said that similar rises in overdose deaths are being seen across the country, especially among Black, American Indian and Alaska Native populations. But researchers are still investigating what’s behind the spike.

“There does not appear to be a single reason why rates are increasing for Black populations and holding steady among white populations,” the statement reads. “The volatile and rapidly changing drug supply certainly has been a challenge as fentanyl is now found in every type of drug. Inequities in terms of treatment for substance use disorder may also play a factor as white people are more likely to have better access to the most evidence-based treatments and are more likely to stay in treatment.”

Fear of arrest

Abenaa Jones, an epidemiologist and assistant professor of human development and family studies at Penn State who was not involved in the study, has conducted similar research in Baltimore. She agreed that fentanyl-contaminated drugs — which are more common in lower-income neighborhoods — and less access to health care are likely factors in the growing number of overdose deaths among Black populations.

Jones said the criminal justice system, and its unequal treatment of Black people, also plays a role.

“We know that the intersection of criminal justice and substance use, and criminalization of drug use and how that disproportionately impacts minorities, can limit the accessibility of harm reduction services to racial-ethnic minorities for fear of harassment by police for drug paraphernalia,” Jones said, adding that even syringes obtained through needle-exchange programs can be considered illegal paraphernalia.

Fear of arrest, in turn, leads more people to using drugs in isolation.

“That may protect you from criminal legal involvement, but then in the event of an overdose, you may not have someone to help you,” Jones said. “So it could be that by the time the EMS come, it’s been too long for them to even consider administering naloxone.”

Contaminated drug supplies

An unexpected observation that Jones made in the course of her research could also be a factor in rising death rates — the fact that many of the Black people dying of opioid overdoses are older.

“For any other racial groups, overdose deaths peak around midlife — 35, 45,” she said. “For Black individuals, it’s more like 55, 64, and we were wondering what was going on with that.”

After investigating that question, Jones and her colleagues formulated a working theory.

“The running hypothesis for us is that this is a cohort effect,” she said. “Individuals who’ve been using drugs over time, particularly Black individuals back from the ‘80s and ‘90s with the cocaine epidemic, never stopped using.”

Those individuals may have remained relatively stable until fentanyl began to contaminate their drug supply without them knowing.

“So whatever harm reduction tools that you were using for so many years that’s been helping you, when fentanyl’s involved, it’s a different game,” Jones said. “You have to use less, but you have to also know that you have fentanyl in your drugs, right?

It’s a problem that Marcia Tucker, the program director of Pathways to Recovery — a partial hospitalization program focused on co-occurring substance use and mental health challenges — sees frequently among their mostly Black clients.

“If you come into treatment saying that I’m a cocaine user, or I’m a crack cocaine user, or I use marijuana, you’re not even thinking that an opioid overdose or fentanyl overdose could possibly happen to you,” Tucker said. “And it does happen.”

Fear, stigma and miseducation

In fact, Tucker said, she’s seen more of these kinds of overdoses over the past two years than in the three decades she’s spent working in addiction treatment. Despite that, there’s still a lack of education — and even stigma — surrounding both medication-assisted treatments (MATs) for opioid addiction, and the use of naloxone.

“I think sometimes culturally with the African American community, as far as MATs are concerned, there are some taboos about getting that extra help when they decide to come into treatment and get clean,” she said. “A lot of people feel like they want to do it from the muscle. They see it as another form of using.”

She said others may not know how to use naloxone, what kinds of effects it has or how to get it.

“I think a lot of folks don’t even know that they can walk into a pharmacy and get naloxone — you don’t have to have a prescription for that,” Tucker said. “And I think that information is just not always presented to communities, especially poor communities that don’t have a lot of resources.”

Other sources of hesitation are more immediate. Aaron Rice, a therapist at Pathways to Recovery, said that many of their clients fear naloxone because of its physical effects.

“I think they associate it with precipitated withdrawal at times,” Rice said, referring to the rapid-onset withdrawal that can cause symptoms including anxiety, pain, seating, nausea, vomiting and diarrhea.

“The only thing they’re thinking about is feeling better. And that feeling is going to supersede logic at that moment. It always does.”

Overcoming disparities in health care and mistrust of the system

The Department of Health acknowledged that the study only paints a partial picture, as it doesn’t include individuals whose overdoses were reversed by naloxone, and added that during the years of the study (2019–2021), naloxone was available by prescription only — a fact that likely played into the race-based disparity.

“There are recognized inequities in access to health care among persons of color, the concept of which likely extends to access to naloxone,” the Department of Health statement reads. “Historically, many public health materials and messaging more narrowly focused on persons using opioids. With people now taking two or more drugs together (whether intentionally or unintentionally), public health materials and messaging need to be more inclusive of all persons using drugs, regardless of the type.”

The study, researcher Abenaa Jones, Marcia Tucker and Aaron Rice all agreed on at least one intervention that could increase Black people’s access to naloxone — relying on trusted community leaders and institutions, like churches, to help educate residents and distribute the overdose-reversing drug.

“I just can’t stress enough how it’s a lifesaver — it’s the difference between life and death,” Tucker said. “I think people who aren’t medical professionals and find themselves in a situation where it might need to be used would probably be a little fearful — fearful about how to use it or how the person is going to react or whether it’s really going to work — just know that you’re better off with it and trying it. You don’t want to have to second guess yourself later and say, ‘I wish we had it. I wish we had gotten it,’ or, ‘I wish we had used it.’”

Source: https://whyy.org/articles/black-pennsylvanians-overdoses-naloxone-less-likely-to-receive/

 

By  BRUCE SCHREINER

Kentucky Attorney General Russell Coleman unveiled plans Tuesday to create a statewide drug prevention program, saying the youth-focused initiative would fill a hole in the Bluegrass State’s fight against an addiction epidemic that has claimed thousands of lives.

Coleman presented the plan’s details to a state commission, which unanimously approved his request for a $3.6 million investment over two years to implement it.

“With over one million Kentuckians under the age of 18, we are going to put every single dollar to good use,” Coleman said. “Our parents and grandparents schooled us that an ounce of prevention is worth a pound of cure. I fully believe this initiative lives up to that age-old sentiment.”

Substance abuse is a deadly scourge in Kentucky though there are signs of progress in fighting back.

A total of 1,984 Kentuckians died last year from a drug overdose, down 9.8% from the previous year, Gov. Andy Beshear announced in June, citing an annual report. Fentanyl — a powerful synthetic opioid — remained the biggest culprit, accounting for 79% of overdose deaths in 2023, according to the report.

While conceding the fight against drug abuse is far from over, officials credited recent gains on expanded efforts to treat addiction, plus illegal drug seizures by law enforcement.

Source:  https://apnews.com/article/drug-abuse-kentucky-a23d7452851a18aa2420c93ff99cdf34

 

Source: The Sunday Mail

By Ian Webster  Oct 28, 2024

Ian W Webster AO is Emeritus Professor of Public Health and Community Medicine of the University of New South Wales. He has worked as a physician in public and regional hospitals in Australia and UK and in NGOs dealing with homelessness, alcohol and drug problems and mental illness.

Please review Ian Webster’s paper which clearly shows that we need to learn from our success in the past that Prevention is the best way forward.

The second New South Wales Drug Summit will be held in regional centres for two days in October and the final two days will be in Sydney on the 4th and 5th December to be co-chaired by Carmel Tebbutt and John Brogden – a balance of politics.

Do summits achieve worthwhile outcomes?

The first Drug Summit in 1985 was national. It worked. It established the enduring principle of harm minimisation. It brought police, health, and education together, canvassed all drugs – including alcohol and tobacco, and it started funding for practicable and policy-based research.

It worked because Prime Minister Hawke needed it to, for family reasons. It worked because the Health Minister, Neal Blewett, needed it to work as he had carriage of its outcomes and the national response to burgeoning HIV/AIDS epidemic.

The 1999 NSW Drug Summit was in response to the rising prevalence of heroin use and opiate deaths. It worked because there was a political will to succeed. It included measures to deal with blood borne infections of HIV, hepatitis B and C; it expanded the state’s opioid treatment programs; expanded needle-syringe programs; introduced the antidote naloxone; and three seminal firsts – the first medically supervised injecting centre, drug courts, and court referral into treatment.

It worked because the Premier Bob Carr wanted it to. Which meant that the summit’s recommendations were managed through the Cabinet Office, supported by a ministerial expert advisory group. The ‘piper called the tune’ for all the state government departments; and they were made to work together.

The Alcohol Summit of 2003 was not as effective. Politicians were too close to the alcohol problem and implementation was handed to the Department of Health which meant other departments washed their hands of involvement. Police, on the other hand, carried the day with counterattacks on alcohol violence and behaviours at liquor outlets.

Contemporary drug problems

Now other substances must be dealt with – amphetamine type stimulants, especially crystalline methamphetamine, cocaine, hallucinogens, MDMA, pharmaceutical stimulants, the potent drug fentanyl, the even more potent nitrazenes, ketamine and unsanctioned use of psychiatric/neurological drugs. Cocaine is flooding the drug markets.

Heroin and alcohol remain as major problems. The Pennington Institute estimated there were 2,356 overdose deaths in 2022, 80% of which were unintended. And alcohol, not only damages the drinker, and the bystander, but creates extensive social harms in the lives of others.

NSW Ice Inquiry

Four and half years ago Commissioner, Dan Howard, reported on his Inquiry into the Drug Ice; he had started the Inquiry six years previously. His recommendations provide a scaffold for the upcoming Summit. The earlier NSW Drug Summit (1999) was followed by a strong impetus to implement its recommendations, but the Government dropped the ball 20 years ago. The last formal drug and alcohol plan was 10 years before the Ice Inquiry.

Fundamental to drug law reform is the decriminalisation of personal use and possession of drugs. This recommendation stands above all others in Dan Howard’s Report.

The thrust of the Inquiry’s recommendations centre on harm minimisation:

  • drug problems are health problems,
  • government departments across the board have responsibilities,
  • treatment, diversion, workforce initiatives, education and prevention programs must be adequately resourced,
  • accessible and timely data are needed,
  • Aboriginal communities, and other vulnerable communities, those in contact with the criminal justice system, all disproportionally affected by alcohol and other drugs, must be high priority population groups.

The NSW Liberal Government pushed back against decriminalising low-level personal drug use, against medically supervised injecting centres, against pill testing, cessation of drug detection dogs at music festivals, and needle and syringe programmes in prisons. Later it gave in-principle support to 86 of the recommendations.

Will the Summit achieve?

The hopes of the drug and alcohol sector are for easy access to naloxone (antidote to opiates), supervised drug-taking services, accessible sites for drug-checking, early surveillance on trends, better access to now available effective treatments, for the treatment of prisoners to equal that for all citizens, and a more equitable distribution of treatment and rehabilitation services across the state, and to ‘at-risk’ population groups.

Success will depend on the practicality of the recommendations and the preparedness of government to act on them in good faith.

It is trite to say, but this depends on political will. The will was strong in the earlier national Drug Summit (1985) and NSW Drug Summit (1999). But so far, Government responses to the Ice Inquiry have been late and weak-willed which does not bode well for the delivery of needed reforms.

There is now a Labor Government, also tardy in its response. It remains to be seen whether NSW Labor has the stomach to overturn past prejudicial stances on drug use and addiction, and whether it will put sufficient funds to this under-funded and stigmatised social and health problem.

What will not be achieved

The Summit and its outcome cannot attack the real drivers of drug problems – the incessant search by humankind for mind altering substances, the mysteries of addiction, and the abysmal treatment of people in unremitting pain.

The root causes of drug problems are socially determined. Action at this level will require an unimaginable upheaval of society and government. In western countries drug overdoses (including alcohol overdoses), suicide, and alcoholic liver disease, are regarded as ‘diseases of despair’. The desperation and despair which pervades vulnerable, and not so vulnerable, population groups, is the underground of drug use problems here and in other countries. Commissioner Howard said, we [society] are given “tacit permission to turn a blind eye on the factors driving the most problematic drug use: trauma, childhood abuse, domestic violence, unemployment, homelessness, dispossession, entrenched social disadvantage, mental illness, loneliness, despair and many other marginalising circumstances that attend the human condition.”

Somehow a better balance must be struck for law enforcement between the war on traffickers and the human rights of users. It is for the rest of us to treat drug using people as our fellow citizens.

Kind Regards

Herschel Baker

 

Source: Drug Free Australia

Even as officials hope tech can stem the tide of solitary drug fatalities, they know deploying these warning strategies could face obstacles.

By    and   

They die alone in bedrooms, bathroom stalls and cars. Each year in the United States, tens of thousands of fatal overdoses unfold as tragedies of solitude — with no one close enough to call 911 or deliver a lifesaving antidote.

Technology new and old might save some of those lives.

Motion detectors blare alarms when someone collapses inside a bathroom at a shelter or clinic. Biosensors detect slowed breathing triggered by an overdose and one day may be capable of automatically injecting overdose reversal medication. Simpler approaches — chat apps and hotlines — keep users connected to help if drugs prove too potent.

Source: https://www.washingtonpost.com/health/2024/10/19/fatal-drug-overdoses-alarms-sensors/

14 November 2024 Law and Crime Prevention

Marking the inaugural International Day for the Prevention of and Fight against All Forms of Transnational Organised Crime on Friday, the UN Office on Drugs and Crime (UNODC) has called for unified global efforts to counter these pervasive threats.
Proclaimed by the General Assembly in March 2024, the observance honours victims of organised crime – including law enforcement and judicial personnel who have lost their lives in pursuit of justice.
The inaugural theme: Organised crime steals, corrupts and kills. It’s time we pull together to push back, underscores the urgency of collective action.
Speaking to UN News, Candice Welsch, UNODC Regional Representative for the Andean Region and southernmost areas of South America, emphasised the global nature of the threat: “Almost all organised crime is transnational, it does not take place within a single country, but often crosses borders within regions and even beyond.”
“Therefore, this UN observance aims at boosting action by governments, the private sector, civil society and the public,” she said.

Pillar of international cooperation
The UN Convention against Transnational Organized Crime adopted in 2000 and ratified by 192 States, serves as the cornerstone of UNODC’s efforts to combat and eventually eliminate the scourge of transnational organised crime.
“We are working hard to strengthen cooperation between countries so that they can share information and intelligence between police forces, or so that border agencies and prosecutors can conduct joint operations,” said Ms. Welsch.
UNODC’s efforts include bolstering local, national and international capacities to better understand and combat these challenges.

Cocaine, deforestation, community impact
In the Andean region, Colombia and Ecuador face significant challenges with transnational criminal groups. Colombia’s coca cultivation reached 253,000 hectares in 2023, yielding an estimated 2,664 metric tons of cocaine in 2022, according to UNODC data.
However, the issue is not confined to drug trafficking. Illegal mining, deforestation and wildlife trafficking – particularly in the Galapagos Islands – are also on the rise.
These activities disrupt security for communities, exacerbate gang violence and contribute to high homicide rates, impacting indigenous communities and young people who face recruitment risks. Migrant flows through the region also make vulnerable populations susceptible to human trafficking and other abuses.
To address these challenges, UNODC supports alternative development programmes for farmers reliant on coca cultivation. These initiatives promote legal crops such as coffee, cocoa, vanilla and sacha inchi, a nutrient-rich Amazonian plant.
“What we are trying to do with alternative development programmes is to offer these communities ways to move towards licit economies and a more secure future,” said Ms. Welsch.

Opium resurgence in Afghanistan
Despite a 2022 Taliban ban that initially reduced opium cultivation by 95 per cent, 2024 saw a 19 per cent resurgence driven by economic hardship and rising prices.
Since 2016, UNODC has aided over 85,000 households through alternative development initiatives, such as poultry farming projects that provide both food security and income generation for families affected by drugs.

Southeast Asia: The Golden Triangle’s drug economy
Myanmar has surpassed Afghanistan as the world’s leading opium producer, with production rising 36 per cent in 2023.
Collaborating on security issues can be challenging for states, but the UN plays a crucial role in fostering dialogue
– Jeremy Douglas, UNODC
The country also leads global methamphetamine production, which has become the dominant drug according to UNODC data, with seizures quadrupling between 2013 and 2022.
Furthermore, criminal groups in the Golden Triangle – Myanmar, Lao People’s Democratic Republic, and Thailand – have expanded into online scams, wildlife trafficking, money laundering and human trafficking.
In response, UNODC has promoted regional cooperation through the establishment of approximately 120 border liaison offices to facilitate intelligence sharing and coordinated action.
“Collaborating on security issues can be challenging for States, but the UN plays a crucial role in fostering dialogue,” said Jeremy Douglas, former UNODC Regional Representative for Southeast Asia and the Pacific and now Chief of Staff and Strategy Advisor to the Executive Director.

Global drug crisis
The impact of transnational crime extends far beyond producer countries.
New synthetic drugs are on the rise, particularly in North America, which faces a fentanyl crisis, as well as in areas of Asia and Africa.
Western and Central European countries, particularly those with a North Sea coastline, also face considerable challenges, with their ports becoming major entry points for cocaine.
In the Sahel, illicit gold and fuel trafficking undermine governance and security and complicates sustainable development, depriving the nation of critical income.

Wildlife crimes, gold smuggling, and organised fraud are just a few examples of how these crimes converge, exploiting fragile ecosystems and vulnerable communities worldwide.
Nevertheless, UNODC remains committed to supporting global efforts.

People-centred approach
“Despite these challenges, there is hope,” Ms. Welsch said.
She highlighted the importance of public awareness campaigns targeting youth and community programmes involving parents and teachers, as well as the need to ensure that everyone who requires treatment for drug abuse can access it.
“The only way to overcome global problems is to galvanise international action. That is why UNODC is joining forces with partners to help secure our common future,” she concluded.

Source: https://news.un.org/en/story/2024/11/1156981

Vienna, 14 November 2024 – “The drug landscape is evolving and growing more complex,” stated Ghada Waly, the Executive Director of the United Nations Office on Drugs and Crime (UNODC) in opening remarks at the 2024 thematic discussions of the Commission on Narcotic Drugs (CND), delivered on her behalf by John Brandolino, Director for Treaty Affairs at UNODC.

“New and deadlier combinations of synthetic drugs are proliferating and destroying livelihoods. Criminals are finding new ways of evading regulations to divert precursor chemicals and concoct new substances, while gaps in oversight are enabling the misuse of pharmaceuticals for non-medical purposes,” she continued. “At the same time, drug trafficking is increasingly overlapping with other forms of organized crime, from human trafficking and child exploitation to money laundering and crimes that affect the environment. As these trends intensify, they pose increasing risks to public health, safety and security.”

The CND, the United Nations’ central drug policy-making body, held its thematic discussions from 12-14 November this week. These discussions provided a platform for close to 600 participants from Member States, international organizations, academics and civil society to exchange good practices, identify challenges and share lessons learned in the implementation of international drug policy commitments.

Noting the cross-cutting nature of the challenges faced by Member States in addressing and countering the world drug problem, the Executive Director highlighted the need to enhance international collaboration harness technological innovation, continue collecting and analysing data and invest in capacity-building and resource mobilization. She also stressed the importance of embracing a paradigm shift focused on prevention, especially among youths.

Also speaking at the opening segment, the President of the International Narcotics Control Board urged delegates to “keep the safeguarding of health and well-being at the forefront” of their discussions.

Thematic areas

The thematic discussions in 2024 focused on several pressing issues:  the expanding range of drugs and diversifying markets; synthetic opioids and non-medical use of prescription drugs; challenges in illicit cultivation and production of narcotic drugs and psychotropic substances; illicit trafficking in substances and precursors, as well as domestic diversion of precursor chemicals; and legal, scientific and regulatory challenges in scheduling substances.

The Member States who had made a pledge under the Pledge4Action initiative, launched at the CND Midterm Review earlier this year, were also provided with an opportunity to provide updates on the status of their pledges towards addressing and countering the world drug problem.

In addition, Member States also raised other substantive topics for discussion, namely: challenges to the identification of new illicit drugs; harm reduction measures; social determinants, disproportionate impacts and barriers to service access in drug policy; the current status of the critical review of coca leaf; the relevance of scientific evidence in the work of UN bodies and agencies in the implementation of the Global Drug Policy; and challenges to the integrity of the international drug control system.

About the CND thematic discussions

At its 62nd session in March 2019, the Commission adopted by consensus the Ministerial Declaration entitled “Strengthening Our Actions at the National, Regional and International Levels to Accelerate the Implementation of our Joint Commitments to Address and Counter the World Drug Problem.”

Following up on this declaration, the Commission held the Midterm Review in March 2024, during which it adopted the High-level declaration by the Commission on Narcotic Drugs on the 2024 midterm review, following up to the Ministerial Declaration of 2019. This declaration continues the dialogue initiated in 2019 and outlines the path toward the final review of progress made in the implementation of all international drug policy commitments in 2029. To maintain momentum and focus, the Commission plans to hold annual thematic discussions from now until 2028 based on the High-level Declaration and the subsequently adopted workplan. The Chair’s summary and a procedural report of the thematic discussions will be published on the website of the CND thematic discussions once available.

Source: https://www.unodc.org/unodc/frontpage/2024/November/addressing-the-evolving-drug-landscape-at-the-2024-cnd-thematic-discussions.html

In the early 2000s, vaping emerged as a popular alternative to smoking tobacco. E-cigarettes, marketed as nicotine delivery systems without the harmful chemicals found in traditional cigarettes, quickly gained popularity. As vaping technology evolved, so did its applications. By the mid-2010s, the marijuana industry began to adopt vaping as a method for consuming marijuana.

This shift was possibly driven by the increase in legalization across states, the perception that vaping was safer than smoking, and the convenience of discrete portable vapes. However, as the popularity of marijuana vaping grows, so does the rise in its health effects.

By 2019, reports of lung injuries associated with vaping began to surface. Studies found that the combination of vaping marijuana, smoking tobacco and smoking marijuana was linked to younger individuals experiencing lung conditions in a short period. The Centers for Disease Control and Prevention (CDC) then identified a condition known as EVALI (e-cigarette or vaping product use-associated lung injury), which was linked to THC containing vape products. A chemical used to dilute THC and create low-cost products contributed to an outbreak of EVALI. CDC reported that as of late 2019, approximately 77% of vaping-related injury cases involved THC-containing products. By February 2020, this number increased to 80%, highlighting a significant association between marijuana vaping and respiratory complications.

The increased access to marijuana through online retailers and the rise in marijuana legalization across states has contributed to the increase in marijuana use by young adults posing new challenges. A 2024 meta-analysis found that the passing of recreational marijuana laws led to an increase in past-month marijuana use of 13% among youth and 22% among young adults. In addition to this analysis, the Monitoring the Future Survey revealed that marijuana and hallucinogen use among 19–30-year-olds remained elevated compared to previous years. When including vaping of either nicotine or marijuana, both trends showed a consistent increase over the past five years and are now at record levels. Specifically, the percentage of 19–30-year-olds who vaped marijuana in the past 12 months rose from 11.5% in 2017 to 22.2% in 2023, while vaping marijuana in the past 30 days increased from 5.9% to 14.4% over the same period. This aligns with the growing perception that vaping is a healthier alternative, leading more young people to experiment with these substances, potentially leading to a higher incidence of lung-related health issues.

The increase in demand for marijuana products has also driven the development of efficient delivery methods, such as online retail, introducing new challenges for regulation. A study highlighting the significant gaps in regulatory compliance among online retailers of flavored tobacco and marijuana vape products showed that, out of 156 purchase attempts, 67.3% were successfully delivered, including to areas with flavor restrictions. Worryingly, only 1% of buyers had their ID scanned successfully by delivery personnel, as required by law, with most deliveries not conducting ID check or interacting with purchaser. These findings underscore the need for better enforcement of age verification and shipping restrictions, especially as youth and young adult use of marijuana vape products increase.

The story of vaping’s evolution from tobacco to marijuana serves as a reminder of the complexities and unforeseen consequences that can arise with new technologies and changing substance use trends. As legalization and acceptance of marijuana continue to grow, so does the need for comprehensive research, clear regulations and widespread education to ensure public safety and prevent unintended consequences.

References:
• Ali, F. (2021). Combination of vaping, cannabis and smoking exposure: shorter time to bullous lung disease and pneumothorax. Journal of Lung Health and Diseases, 5(1), 8-10. doi.org/10.29245/2689-999x/2021/1.1169
• Bando, J. (2024). Impact of marijuana use on lung health. Seminars in Respiratory and Critical Care Medicine. doi.org/10.1055/s-0044-1785679
• Centers for Disease Control and Prevention. (2020). Outbreak of lung injury associated with the use of e-cigarette, or vaping, products. Centers for Disease Control and Prevention. https://archive.cdc.gov/www_cdc_gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.htm
• Dai, H. (2020). Self-reported marijuana use in electronic cigarettes among us youth, 2017 to 2018. Jama, 323(5), 473. https://doi.org/10.1001/jama.2019.19571
• Harati, R., Ellis, S.E., Satybaldiyeva N., Mejorado, T., Benitez, G., Henriksen, L., Leas, E. (2024). Online Retailer Nonadherence to Age Verification, Shipping, and Flavor Restrictions on E-Cigarettes. JAMA. doi:10.1001/jama.2024.21597
• Friedman, A. and Morean, M. (2021). State marijuana policies and vaping associated lung injuries in the us. Drug and Alcohol Dependence, 228, 109086. doi.org/10.1016/j.drugalcdep.2021.109086
• Malouff, J., Rooke, S., & Copeland, J. (2014). Experiences of marijuana-vaporizer users. Substance Abuse, 35(2), 127-128. doi.org/10.1080/08897077.2013.823902
• Navon, L., Ghinai, I., & Layden, J. (2020). Notes from the field: Characteristics of tetrahydrocannabinol–containing e-cigarette, or vaping, products used by adults — Illinois, September–October 2019. MMWR Morbidity and Mortality Weekly Report, 69(29), 973–975. doi.org/10.15585/mmwr.mm6929a5
• Pawar, A., Firmin, E., Wilens, T., Hammond, C. (2024). Systematic Review and Meta-Analysis: Medical and Recreational Cannabis Legalization and Cannabis Use Among Youth in the United States. Journal of the American Academy of Child & Adolescent Psychiatry, Volume 63, Issue 11, 1084 – 1113. DOI: 10.1016/j.jaac.2024.02.016
• Patrick, M. E., Miech, R. A., Johnston, L. D., & O’Malley, P. M. (2024). Monitoring the Future Panel Study annual report: National data on substance use among adults ages 19 to 65, 1976-2023. Monitoring the Future Monograph Series. Ann Arbor, MI: Institute for Social Research, University of Michigan. Available at: https://monitoringthefuture.org/results/annual-reports/

 

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

“When President Biden and Vice President Harris took office, the number of drug overdose deaths was increasing 31% year-over-year. They immediately took action: making beating the overdose epidemic a key pillar of their Unity Agenda for the Nation and taking a comprehensive, evidence-based approach to strengthening public health and public safety. As an Administration, we have removed more barriers to treatment for substance use disorder than ever before and invested historic levels of funding to help crack down on illicit drug trafficking at the border. Life-saving opioid overdose reversal medications like naloxone are now available over-the-counter and at lower prices. We are at a critical inflection point. For the sixth month in a row, we are continuing to see a steady decline in drug overdose deaths nationwide. This new data shows there is hope, there is progress, and there is an urgent call to action for us all to continue working together across all of society to reduce drug overdose deaths and save even more lives.”

Abstract

In the 50 years since its establishment, the National Institute on Drug Abuse has made significant investment and strides toward improving individual and public health. Epidemiology serves as the foundation for understanding the how many, why, how, where, and who of drug use and its consequences, and effective epidemiology research and training are geared toward actionable findings that can inform real-world responses. Epidemiologic findings enhance clinicians’ ability to provide ongoing care by incorporating information about the patterns and outcomes of drug use that their patients may experience. The goal of this article is to provide a context for epidemiology of substance use as a foundation for prevention, with examples of how epidemiology can provide targets for prevention, and to set the stage for addressing the importance of prevention in clinical settings.
Source: https://psychiatryonline.org/doi/10.1176/appi.focus.20240018

Recognizing Overdose Awareness Day on Aug. 31, the Denver City Council passed a proclamation that called for numerous radical, unproven drug policies. The most notable of these was “safe supply,” a misnomer that provides free, pharmaceutical, addictive opioids to those with an opioid addiction. If it sounds like a bad idea, that is because it is.

Even worse, absent from the discussion is a promotion of evidence-based treatment and prevention services that prioritize recovery.

Denver’s proclamation encourages “prioritizing harm reduction initiatives such as naloxone, fentanyl testing strips, syringe services programs, overdose prevention sites, and a safe supply.” By lumping in these interventions together, radical extreme drug policy and harm reduction advocates are hoping we don’t notice some of these unproven policies that are nothing more than slippery slopes to full drug legalization.

Case in point: British Columbia, Canada, has already focused its attention almost exclusively on all of these harm reduction initiatives while reducing focus on prevention, treatment, and recovery.

The result? Overdose deaths have continued to rise in that province and it leads North America in its rate of overdose mortality. Focusing on harm reduction alone has not delivered on its promise as a solution to the drug crisis.

The most troubling of these proposals is “safe supply.” Anything but what its name suggests, “safe supply” provides opioids to people who use drugs on the premise that a medical-grade drug supply is better than one that may be mixed with other substances in the illicit market. It’s like giving away free booze to alcoholics in the hopes that they drink less.

In essence, Denver’s City Council members are echoing the calls of radical activists in proposing to give people in active addiction their drugs directly — and for free.

A recent study in JAMA Internal Medicine reviewed British Columbia’s so-called “safe supply” program. The researchers found that just as many people died from overdoses as before the policy took effect. Additionally, the “safe supply” drugs are often sold on the black market so those users can obtain what they really want — usually fentanyl. Even extreme harm reduction supporters in British Columbia have recognized its shortcomings. But instead of backtracking, they are doubling down on this unproven approach.

Dr. Bonnie Henry, the provincial health officer in British Columbia, recently called for the province to “enable access to non-prescribed alternatives to unregulated drugs.” In effect, they know the medical model of safe supply, also known as “prescribed alternatives,” has not worked, so they want to increase access to legalized drugs in retail stores, clubs, and community centers. They’d place life-threatening drugs in neighborhoods across the province.

Denver’s City Council could be headed down this path.

Instead, we should wake up — and favor an evidence-based approach that is comprehensive: both supply reduction, which includes enforcing the law on open-air drug markets and dealers, and demand reduction, which includes prevention, treatment, and recovery services. Of course, harm reduction interventions like naloxone have a role to play, but they cannot be the only leg of the stool.

Prioritizing a comprehensive approach will send a clear message that in Denver we actually want to achieve something in honor of the many victims of overdose.

Many readers may be shocked to learn that the proclamation in Denver overlooked many of these common-sense interventions.

The word “treatment” was referenced only once. The concept of “drug use prevention,” such as empirically proven programs discouraging use among minors and non-users, was completely absent. And the word “recovery” was not referenced at all.

Many recognize the tragedy of the drug crisis, which took the lives of more than 100,000 Americans in 2022. To overcome this crisis, policymakers must support a comprehensive approach that favors a wide range of responses, including demand reduction, supply reduction, and harm reduction. Denver’s City Council has chosen to proclaim the extreme proposals of activists over real solutions.

Let’s hope they reverse course soon.

Yes, we should meet people where they are in their addiction. But we cannot leave them there.

Luke Niforatos is the executive vice president of the Foundation for Drug Policy Solutions and an international drug policy expert.

Source: https://gazette.com/opinion/safe-supply-only-will-deepen-denver-s-drug-crisis/article_65ce5e4c-6705-11ef-997f-6f63e2ef75a3.html

By  Charlotte Caldwell

LIMA — The Lima Police Department recently posted on its Facebook page about an increase in overdoses in Lima over the past few weeks.

With September being National Recovery Month, where organizations try to increase public awareness about mental health and addiction recovery, local organizations and law enforcement agencies shared their experiences with addiction and overdoses and the help that is available.

The problem

Lima Fire Chief Andy Heffner said his department responded to 85 overdoses so far this year. He said the overdose numbers have risen and fallen throughout the year, with about one-week breaks in between. He believed the numbers were based on the drugs available in the area.

Project Auglaize County Addiction Response Team Project Coordinator/Peer Support Specialist Brittany Boneta spoke on the reason for the overdose spikes.

“When it comes to overdoses, one is too many,” Boneta said. “I think the number of overdoses comes in waves. There could be a really bad batch of heroin or fentanyl that gets distributed throughout the county that could lead to a spike in overdoses.”

Heffner cited the Drug Enforcement Administration’s website, which said seven out of every 10 pills seized by the DEA contain a lethal dose of fentanyl. The website also said 2 milligrams of fentanyl can be enough to kill someone.

“It only takes one time when Narcan is not available that you could lose your life. If you get clean, you will never have to worry about an overdose, and neither will the people that love you,” Heffner said.

Bath Township Fire Chief Joe Kitchen said his department used Narcan 21 times on patients from August 2023 to August 2024. The department also distributes Narcan to families just in case an overdose occurs.

“Although we have only left behind a few kits so far, I think it gives the family of a known addict some peace of mind that they could assist them in the event of an OD prior to EMS arrival,” Kitchen said.

Another problem is a tranquilizer called Xylazine is being mixed with fentanyl, which does not respond to the usual methods of reversal.

“There are always new drugs/drug combinations being introduced on the streets that make it difficult for those in the treatment world to keep up with and know how to effectively treat,” said Jamie Declercq, the vice president of clinical operations for Lighthouse Behavioral Health Solutions. “Right now, we are seeing an increase in substances (such as Xylazine) across the county which does not respond to Narcan, so that is likely one reason for the increase in overdose deaths.”

Their stories

Boneta was addicted to opiates and crack cocaine over a seven-year period, and her addiction journey started when she was prescribed Percocet by a cardiologist for a heart condition when she was 18.

“There wasn’t a drug I wouldn’t use,” Boneta said. “I was an honor roll student in high school with more trauma than almost anyone I know, and when I went off to college I wasn’t educated on the true dangers of drugs, the thirst to fit in, and all of my trauma stuffed down.”

When her doctor stopped prescribing Percocet, she bought them from drug dealers, not knowing they were laced with heroin.

“When the drug supply of the fake Percocet ran out, I was just buying actual heroin. The heroin was starting to have fentanyl added to it, and before long that was all I was consuming,” Boneta said.

Boneta was eventually sent to prison for drugs, and during that time her 6-year-old son was involved in a house fire and suffered serious injuries.

“I was transported from the prison, in my orange jumpsuit and shackles on my wrists and ankles, to say my goodbyes to my son. I think seeing him lying there in a coma covered in bandages was something so soul-shaking that I knew this was my rock bottom,” Boneta said.

“My son had countless surgeries and was getting better and stronger as the months went by, so I decided I was going to completely reset my life and work my butt off just as hard,” Boneta continued. “I completed as many recovery groups and classes as possible and started learning coping skills and tools to use when I was released from prison. I knew that I wanted to help other people like me and show them that people can understand what they are going through and not have judgment towards them.”

Diane Urban, of Delphos, the founder/president of the Association of People Against Lethal Drugs, started APALD because her youngest son died from a fentanyl overdose. Her older son is also a former addict, and her niece is in active addiction.

“He was clean for the last nine months of his life, he came to live with me, and he relapsed due to an ingrown wisdom tooth that was coming in, his face was swelling up, and because he had Medicaid, we couldn’t find him any help anywhere except for a place in Van Wert, and it was a two-week out appointment. Unfortunately, unbeknownst to me, he relapsed, and I found him dead in his bedroom from a fentanyl overdose,” Urban said.

Challenges to get help

Transportation, not enough of a variety of local recovery options available and financial barriers were all cited as issues addicts face when they decide to get help.

“For peers that are needing inpatient treatment or sober living, we have to send them to other counties for help,” Boneta said. “There is definitely a need for more substance abuse treatment in our county.”

Declercq said Allen County also has a need for inpatient or residential treatment, and people who need that care have to go to one of the major cities nearby.

Urban dealt with having to go outside the area when her son got help.

“Seven years ago when I had to get help for my son, we had to go to Columbus. There was no help to get in right away because (Coleman Health Services) was so backed up,” Urban said. “There can never be enough resources because what happens is all these resource centers and rehabilitation centers, they keep you for a period of time then they release you, and a lot of people when they get released like that, they don’t have adequate support for more of a long-term stay, more of them tend to relapse.”

Urban said her son got treatment for free with Medicaid, but in her experience, organizations prioritize people who have insurance.

Auglaize County Sheriff Mike Vorhees also mentioned a challenge with people not having a way to get to treatment.

“We don’t provide transportation yet, but that’s something that we’re working on,” Vorhees said in regard to the services Project ACART provides. “It depends on who it is. If it’s an elderly person, we can work with the Council on Aging; if it’s a veteran we go through Veterans Services.”

Financially, Declercq said Lighthouse Behavioral Health Solutions’ case managers help people apply for Medicaid, or the local mental health board has options for those who don’t qualify for Medicaid.

“One of the most frustrating barriers for seeking treatment is those with commercial insurance or Medicare, as those companies only pay for very limited services,” Declercq said. “Commercial plans typically pay for a short detox stay and limited individual/group counseling sessions, but do not pay for the intensive level of treatment that a program like Lighthouse offers.”

“Thirty days of treatment and/or 10 individual counseling sessions are not enough to truly treat a person who has been in active addiction for years,” Declercq continued. “Oftentimes even one year of intense treatment only touches the surface of the issues that someone in addiction needs to address.”

Available help

Project ACART has only been around about a year, and Boneta is working part-time and is the only employee. She has reached out to 19 people so far, and only two have denied treatment. She put together a resource guide in 2023 including mental health and substance abuse centers; residential detox treatment centers; 24/7 support services; substance use support groups; where to find Narcan; food pantries, hot meals and clothing; housing assistance and shelters; and low income and subsidized housing.

Boneta received help from peer support specialists through Coleman Health Services during her addiction. Now, as a peer support specialist, she uses a combination of her own experiences and formal training. She equated her role to being like a cheerleader. She is available to clients day and night to connect them to agencies to get help or just talk about their struggles.

“I meet people where they’re at and treat every situation differently. Some of the things I do are assessing needs and struggles, setting goals, advocating for my peers, giving resources, facilitating engagement with my peers and their families or service providers, and encouraging and uplifting them,” Boneta said.

Project ACART’s services are also free because of an Ohio grant.

“Many people in active addiction do not have housing, food, clothing, money or insurance, but they should still have the opportunity to get the help they need,” Boneta said.

Declercq said Lighthouse Behavioral Health Solutions also recently opened a peer support center in Lima for clients to have a place to go for sober activities.

“Downtime/boredom is often a trigger for people who are early in recovery, so this gives them a place to fill that time in a positive way,” Declercq said. “Our peer supporters offer a unique support system to our clients because they are people with past lived experience in addiction who are able to show them that life beyond addiction is achievable and fulfilling.”

Coleman’s seemed to be the go-to choice for law enforcement referrals, and Urban also directs people to the organization.

“My oldest son was a success story, he went to Coleman’s, got treatment, got on the MAT (medication-assisted treatment) program, Suboxone, and he’s thriving today. Owns his own house, owns his own business, married, doing absolutely wonderful. He’s like eight years clean,” Urban said.

Ohio Department of Commerce Division of Securities Recovery Within Reach program also provides a list of recovery resources and offers ways to pay for treatment.

 

Source: https://www.limaohio.com/top-stories/2024/09/06/local-organizations-share-addiction-experiences-challenges-resources/

Cryptocurrency Tether enables a parallel economy that operates beyond the reach of U.S. law enforcement

Wall Street Journal     Angus Berwick  and Ben Foldy       Sept. 10, 2024

A giant unregulated currency is undermining America’s fight against arms dealers, sanctions busters and scammers. Almost as much money flowed through its network last year as through Visa cards. And it has recently minted more profit than BlackRock, with a tiny fraction of the workforce. Its name: tether. The cryptocurrency has grown into an important cog in the global financial system, with as much as $190 billion changing hands daily.

In essence, tether is a digital U.S. dollar—though one privately controlled in the British Virgin Islands by a secretive crew of owners, with its activities largely hidden from governments.

Known as a stablecoin for its 1:1 peg to the dollar, tether gained early use among crypto aficionados. But it has spread deep into the financial underworld, enabling a parallel economy that operates beyond the reach of U.S. law enforcement.

Wherever the U.S. government has restricted access to the dollar financial system—Iran, Venezuela, Russia—tether thrives as a sort of incognito dollar used to move money across borders.

Russian oligarchs and weapons dealers shuttle tether abroad to buy property and pay suppliers for sanctioned goods. Venezuela’s sanctioned state oil firm takes payment in tether for cargoes. Drug cartels, fraud rings and terrorist groups such as Hamas use it to launder income.

Yet in dysfunctional economies such as Argentina and Turkey, beset by hyperinflation and a shortage of hard currency, tether is also a lifeline for people who use it for quotidian payments and as a way to protect their savings.

Tether is arguably the first successful real-world product to emerge from the cryptocurrency revolution that began over a decade ago. It has made its owners immensely rich. Tether has $120 billion in assets, mostly risk-free U.S. Treasury bills, along with positions in bitcoin and gold. Last year it generated $6.2 billion in profit, outearning BlackRock, the world’s largest asset manager, by $700 million.

Tether’s CEO, Paolo Ardoino, boasted earlier this year that, with under 100 employees, it earned more profit per person than any company ever.

Tether wants “to build a fairer, more connected, and accessible global financial system,” Ardoino said in a May press release. He claims over 300 million people are using the currency.

With sanctions, Washington can cut adversaries off from the dollar and thus much of the global trading system, since all dollar transactions involve U.S. regulated banks. Tether’s popularity subverts those powers.

“We need a regulatory framework that doesn’t allow offshore dollar-backed stablecoin providers to play by a different set of rules,” Deputy Treasury Secretary Wally Adeyemo told The Wall Street Journal. Adeyemo singled out tether in April testimony before Congress.

For this article, the Journal spoke with tether users, researchers and officials, and reviewed messages exchanged between intermediaries, court and corporate records, and blockchain data.

Tether didn’t respond to requests for comment. The company said in May it collaborates with law enforcement and was upgrading its capacity to monitor transactions for sanctions evasion. Tether voluntarily freezes digital wallets used to transfer its tokens that were connected with sanctioned entities, it says. Ardoino said Tether has a “proactive approach to safeguarding our ecosystem against illicit activities.”

How Tether works: The company behind tether, Tether Holdings, issues the virtual coins to a select group of direct customers, mostly trading firms, who wire real-world dollars in exchange. Tether uses those dollars to purchase assets, mostly U.S. Treasurys, that back the coin’s value.

Once in the wider market, tether can be traded for other tokens or traditional currencies through exchanges and local brokerages. In Iran, for example, a crypto exchange called TetherLand allows Iranians to swap rials into tether.

Tether vets the identities of its direct customers, but much of its vast secondary market goes unpoliced. The tokens can be pinged near-instantaneously along chains of digital wallets to obfuscate the source. A United Nations report this January said tether was “a preferred choice” for Southeast Asian money launderers.  The company says it can track every transaction on public blockchain ledgers and can seize and destroy tether held in any wallet.

But freezing wallets is a game of Whac-A-Mole. Between 2018 and this June, Tether blacklisted 2,713 wallets on its two most popular blockchains that had received a total of about $153 billion, according to crypto data provider ChainArgos. Of that massive sum, Tether could only freeze $1.4 billion because the rest of the funds had already been sent on.

Tether’s founders—a group that included a former plastic surgeon called Giancarlo Devasini—created the currency back in 2014. Uptake for a stable token was initially slim. The prospect of profiting from billions of accumulated dollars was a “fantasy,” said William Quigley, an investor who was part of the founding team.

He and other co-founders sold their stakes soon after to Devasini, who has run Tether ever since, according to people familiar with the company. The reclusive billionaire lives at a modernist villa in the French Riviera enclave of Roquebrune-Cap-Martin, corporate records show. Ardoino, a fellow Italian, has become Tether’s public face.

Tether’s entry into the crypto mainstream came during the market’s 2020-2021 bull run, as traders used tether to buy and sell out of risky bets. Its market capitalization exploded from $4 billion to almost $80 billion.

The dollar for all: In Venezuela, financially isolated by sanctions and economic mismanagement, Tether found a ready user base.

President Nicolás Maduro’s government was under siege in 2020 from U.S. measures that targeted state oil firm Petróleos de Venezuela, or PdVSA. That October, Maduro’s parliament passed an “Anti-Blockade Law” that authorized the government to use crypto to protect its transactions.

PdVSA began demanding payment for oil shipments in tether, according to people familiar with its activities and transaction records. Purchase orders authorized by PdVSA often instructed buyers to transfer tether to a certain wallet address. Another method was for intermediaries to swap deliveries of cash for tether and load the tokens onto prepaid travel cards, which enabled holders to use crypto for purchases. Venezuelan President Nicolás Maduro’s parliament passed a law allowing the government to use crypto to protect its transactions. The company’s adoption of tether was so pervasive it had another effect: instead of sending oil revenues back to the government, the middlemen that PdVSA used for the sales diverted funds for themselves, leading to a scandal that toppled the oil minister.

“This cryptocurrency’s use only has served to perpetuate gigantic levels of corruption,” Rafael Ramírez, a former oil minister under Maduro, said in an interview.

Venezuela’s government didn’t respond to requests for comment. The country’s attorney general said in April that middlemen’s use of crypto made the stolen funds “undetectable” for authorities.

For regular Venezuelans, tether became a lifeline, too. Inflation that reached 2 million percent wiped out savings held in bolivars. Currency controls made bank transfers abroad impractical.

Guillermo Goncalvez, a 30-year-old Caracas graduate, runs a platform called El Dorado that offers Venezuelans peer-to-peer tether trading, which links buyers and sellers directly.  El Dorado has over 150,000 users, who pay fees that are a fraction of what traditional money remitters charge: local stores converting daily revenues into tether, Venezuelan migrants sending money back to families, and freelancers receiving salaries in USDT, as tether is also known. “USDT is the digital dollar for all Venezuelans,” Goncalvez said.

Enough money to fill a plane: In Russia, tether is a vital payment channel, the Journal has previously reported.

A confidential report drawn up this year by a government-backed Russian research center identified tether as one of the most popular ways for importers to convert rubles into foreign currencies. Major institutions are involved, too: Rosbank, a Russian lender, arranges tether transfers for clients to pay suppliers abroad, according to a company presentation circulated in June. Rosbank spokespeople didn’t respond to requests for comment.

It is also the go-to currency for Russia’s elite.

A glamorous fixer called Ekaterina Zhdanova told associates in Telegram messages in 2022 and 2023 that she was arranging huge ruble-for-tether deals for clients. Digital wallets she shared had transferred over $350 million in tether, according to blockchain data.

Born in a Siberian village, Zhdanova, 38 years old, ran a concierge service to help wealthy Russians get foreign visas, and a travel agency that organized luxury cruises. Her ex-husband was a top lieutenant for a billionaire Russian real-estate developer.

Russia’s invasion of Ukraine and the subsequent sanctions amplified demand for her services.

Two months into the war, Zhdanova relayed a request from a client to a group of large Russian crypto traders, according to chats on Telegram. The client, who she said had their own bank, wanted to buy about $10 million of tether each month, needing $300 million’s worth in total, in exchange for cash that would be handed over in the United Arab Emirates or Turkey.

After finding a trader willing to accept the deal, Zhdanova told the group she could coordinate the cash’s collection. “They will use planes to pick up the cash,” she said.

Treasury sanctioned Zhdanova late last year, accusing her of transferring crypto on behalf of unnamed oligarchs. Police in France detained her around that time at an airport there as part of a separate French money laundering investigation, people familiar with her arrest said. She remains in custody. A lawyer for Zhdanova declined to comment.

‘Everything. Everywhere.’: Tether is now investing in startups that use tether for everyday payments. The more Tether can encourage its usage, the more tokens it needs to issue, and so the more dollars it will have to put to work.

In Tbilisi, Georgia, a popular landing spot for Russian émigrés, the token’s symbol—an encircled green “T”—glimmers outside money-change shops with blacked-out windows. Cash machines advertise that users can deposit bills for the stablecoin.

Ardoino, the Tether CEO, visited Georgia last year and approached government officials with an offer to help expand the local crypto economy. They signed a cooperation deal that Ardoino said would make the former Soviet republic a flourishing payments hub. Tether invested $25 million in local startups, according to Georgia’s innovation agency.

The main recipient of Tether’s financing, CityPay.io, has rolled out tether-payment systems for thousands of Georgian businesses. Hotels including Tbilisi’s downtown Radisson Blu Iveria have CityPay point-of-sale terminals, and it has joined with a property venture there to sell premium apartments in tether.

CityPay also facilitates international payments in tether for companies, totaling as much as $50 million a month, according to Eralp Hatipoglu, its Turkish CEO. He said the pressure the U.S. applied on the global banking system created these opportunities. Companies exporting from Turkey to Georgia get hammered with questions from correspondent banks, he said, and wire transfers take days. CityPay’s website advertises “100% anonymous transactions,” though Hatipoglu said they check clients’ identities against sanctions lists and don’t accept Russian businesses.

Tether has said it aims for CityPay to expand into other emerging markets. At a crypto conference in a Tbilisi skyscraper this June, sponsored by Tether and attended by its head of expansion, banners promoted the currency’s use for daily payments on CityPay. Guests queued to buy coffee in tether. “Pay with USDT,” read one sign. “Everything. Everywhere.”

 

Source: Tether: The Cryptocurrency Fueling the Financial Underworld – WSJ

August 28, 2024

 

There have been “promising” declines in high school students’ overall use of illicit substances, concludes a report from the federal Centers for Disease Control and Prevention.

Since 2013, the percentage of students who reported drinking alcohol, using marijuana, or using select illicit drugs at any point has decreased. Since 2017 and 2019, respectively, the percentage of students who had ever misused or currently are misusing prescription opioids decreased, according to the CDC’s Youth Risk Behavior Survey.

That survey draws on data collected every two years among a nationally representative sample of U.S. high school students. The 2023 survey had more than 20,000 respondents and was conducted in the spring.

Still, many students continue to use substances and the lack of progress in some areas is concerning, according to the report.

The findings come as schools continue to face challenges in curbing students’ substance abuse, which could negatively affect learning, memory, and attention, according to experts. It could also be a sign of mental health challenges.

                                                                                                                   

 

While student substance abuse isn’t a new challenge for school districts, the substances that adolescents are experimenting with now are much more dangerous, said Darrell Sampson, the executive director of student services for the Arlington public schools in Virginia.

“It’s not necessarily that more kids are using substances than in prior years,” Sampson said. “It’s the lethality of the substance itself that has caused higher levels of concern.”

 

Research has shown rising overdose deaths among teens even as their substance use is declining. Those deaths have been linked to the increase in illicit fentanyl and other synthetic opioids. School districts have been pursuing several strands of legal action against companies that manufactured and marketed addictive opioids that have led to tens of thousands of deaths and countless more addiction struggles in the last two decades.

Beyond the legal actions, schools also continue to provide prevention and education programming for students and families, Sampson said. There’s “a glimmer of hope” that those measures are working, he said, based on the declines in the CDC data.

Experts recommend starting education about substance abuse as early as possible

In the Arlington, Va., district, students in grades 6 through 10 learn about substance abuse challenges as part of the health curriculum, Sampson said. The district has also slowly expanded that program to 5th and 4th grades and are looking into whether there’s capacity to start that education as early as 3rd grade.

“We know that the more we can at least open that conversation with our families and our students, the better off our students are going to be,” Sampson said. “It’s not just a message [they’re hearing] starting in middle school, but it’s a message [they’re hearing] over time.”

The district is expanding programming with 11th and 12th graders, too, because the information they got when they were in 10th grade could be outdated by then, Sampson said.

In addition, the district has substance abuse counselors who meet with students and try to explore the reasons they might be using substances, Sampson said.

Experts say it’s also important to think about how to incorporate student voice in any prevention or intervention programming.

Teens are more than twice as likely to go to their friends or peers for help or support when experiencing distress from their substance use than they are to go to a behavioral health provider or a family member, according to a survey from the Bipartisan Policy Center conducted in June among 932 teens (13- to 17-year-olds) and 1,062 young adults (18- to 26-year-olds). More than a quarter of teens said they didn’t go to anyone for help or support when they experienced distress from substance use.

Sophie Szew, a junior at Stanford University and the Bipartisan Policy Center’s mental health and substance use task force youth adviser, said those survey results “really underscore the importance of investing in those peer support networks and resources.”

DATA SOURCE: Bipartisan Policy Center

Source: https://www.edweek.org/leadership/teen-substance-use-is-declining-but-more-dangerous-drug-abuse-is-emerging/2024/08

Oct 29, 2014

The last week of October is Red Ribbon Week, celebrating a drug-free life (redribbon.org). It’s also the culmination of National Substance Abuse Prevention Month.

So why is substance abuse prevention important? According to the Office of National Drug Control Policy (ONDCP) Acting Director Michael Botticelli, “Preventing drug use before it begins – particularly among young people – is the most cost-effective way to reduce drug use and its consequences.” This matters to us as members of our community and our society.

But as parents, friends, family members – human beings – it’s not all about the money. Botticelli recognizes the cost of drug abuse is far-reaching beyond just our wallets. He goes on to say, “The best approach to reducing the tremendous toll substance abuse exacts from individuals, families and communities is to prevent the damage before it occurs.”

Parents want to help their kids avoid this “tremendous toll,” which could involve their health (physical or mental), family, other relationships, schooling, employment – the list goes on. Parents, however, often find themselves learning about a new drug trend and feel it’s just “one more thing to worry about.” One example would be the current heroin epidemic, especially among people who may have become addicted to prescription pain killers.

The good news is that parents don’t have to resort to worrying. Research has shown repeatedly that parents are a key factor in preventing drug abuse. When parents have open two-way communication with their kids and seek to provide accurate information, many are surprised to discover how much influence they can actually have. And young people are less likely to abuse drugs when they know their parents care, and that they have specific rules or expectations regarding drug use.

Some websites with helpful information on heroin and other drugs, as well as tips for talking to kids, include: www.fda.govwww.cdc.govwww.drugfree.orgteenshealth.org/teenwww.drugfreeactionalliance.org/knowcombatheroin.ny.gov; and www.drugabuse.gov.

Even when there has been substance abuse with resultant problems, it’s never too late to seek help. People recover from addiction every day and lead healthy, productive lives.

HFM Prevention Council, Johnstown

Source: https://www.dailygazette.com/leader_herald/opinion/letters/prevention-is-important/article_c5769b46-83c7-5907-a49b-bb4cf191f7aa.html?=/&subcategory=640%7CConcert

Written by Ania Wellere, Master of Public Health Candidate, UNC Gillings School of Global Public Health.

As many know, drinking alcohol in a licensed premise under the age of 18 is against the law in the UK, however those aged 16 or 17 and accompanied by an adult can drink but not buy beer, wine, or cider with a meal. However, with relatively high alcohol use among children and young people in the UK, is the flexibility of this law one of many factors contributing to heavy episodic drinking among this population?

Youth drinking

According to Truque et al. (2023), 25% of adolescents in Europe begin to consume alcohol as early as the age of 13, and depending on region and gender, the prevalence of weekly alcohol consumption from adolescents is anywhere from 2%-33%. In 2021, NHS England found that the proportion of 15-year-olds who reported drinking at least once a month was 36%, with 14% saying at least weekly. Specifically in England, the World Health Organization found that the proportion of 13-year-olds who had consumed alcohol was far higher than the Health Behaviour in School-aged Children (HBSC) average – which covers 44 countries – and in Scotland and Wales.

Several factors influence children and young people’s alcohol use. One of the primary reasons young people give for why they drink at a young age is because of their peers. Drinking interest stems from failure to miss out, pressure to drink, and an attempt to improve their social status.

There are also some non-consensual factors, particularly outdoor advertising, but also advertising in magazines and television, that could be fuelling underage drinking because of its appeal to younger audiences. Children and young people do not ask to be exposed to these advertisements, and they cannot always filter the advertisements that they see through these mediums.

Despite regulatory efforts and codes that have been in place to protect children from alcohol marketing, researchers believe that attempts to protect children through the regulatory system and codes are failing. Several councils across the UK have taken the initiative to establish local policies that restrict advertisements of unhealthy commodities, including alcohol. If more local authorities follow suit in creating policies to restrict alcohol advertising, it would protect children and young people from exposure and potential alcohol-related harms.

Effect on the adolescent brain

Although youth drinking is slowly decreasing across the UK, heavy episodic drinking and its health impact is still a concern amongst adolescents, especially the effect alcohol has on the adolescent brain. Research on the effect alcohol has on the adolescent brain is limited. Research has typically focused on the impact alcohol has on the adult brain and the relationship between alcohol dependence and increased risk of dementia and other chronic diseases.

Before diving into the specific impact alcohol has on adolescent brains, it is important to lay out the process of how alcohol even travels through the body. So envision this: you take your first sip, and the alcohol makes its way through the stomach and into your bloodstream through the walls of your small intestine, where the blood will take the alcohol throughout the rest of your body. Alcohol then makes its way quickly to your brain, kidneys, lungs, and liver via the bloodstream. The way these parts of the body act is also contingent on the amount of alcohol that is in the bloodstream. For the brain, alcohol can impact your thought processes, emotions, memory, and coordination.

For an adolescent, alcohol moves through the body and breaks down slower than other age groups. The brains of adolescents have an increased likelihood of being negatively impacted compared to adult brains, according to the National Institute on Alcohol Abuse and Alcoholism. For young heavy episodic drinkers, brain development, structure, and function could possibly be altered compared to young non-heavy episodic drinkers, as seen through neuroimaging.

This impact on the brain has been noted to significantly affect the executive function of the adolescent brain. Executive function is defined as the mental processes that help an individual set and carry out their goals. Scientific evidence shows that weakened executive functions cause young people to make more errors and struggle with their shifting abilities (i.e., the ability to adapt). In the long run, this can follow young heavy episodic drinkers to adulthood.

In more technical terms, adolescent heavy episodic drinking is associated with a greater risk of reductions in grey matter during adolescence and disrupts white matter integrity, impacting neurocognitive functioning, according to Chikritzhs et al. (2024). In simple terms, the brain’s grey matter that helps individuals control movement, memory, and emotions is reduced, and white matter that allows the brain to exchange information and gives the ability to concentrate and learn is disrupted.

With these types of tissues being impacted by alcohol at a young age, there is research that has highlighted some of the risk factors that have come to disturb the lives of young heavy episodic drinkers when they become adults. A study including about 488,000 Swedish men found that heavy episodic drinking in adolescence was one of the strongest risk factors for developing early-onset dementia in adulthood.

As adolescence is a critical phase of development, more protective measures are put in place to reduce alcohol use among adolescents and, as a result, reduce alcohol-related harm to their brains. These protective measures usually include regulation of youth’s access to alcohol and alcohol advertising.

As we know, alcohol marketing is causally linked to young people drinking more and at an earlier age, and much of this marketing is non-consensual. To protect children’s rights, ‘the state must do all it can, through passing legislation and creating administrative systems, to promote and protect children’s rights’, according to the United Nations Convention on the Rights of the Child.

The brain is a vital organ to the body, and adolescent brain health is critical. With alcohol being accessible to children and young people in the UK, a ban on alcohol marketing should be taken into consideration. In addition, the normalisation of alcohol use among young people has to be put to an end, and that may start in the home with parents reshaping how they communicate alcohol use with their children and not encouraging drinking behaviour. Furthermore, future research should look at the differences between light to moderate and heavy drinking among adolescents to see if the effects on the brain are drastically different.

Source: https://www.ias.org.uk/2024/08/01/alcohol-and-its-impact-on-the-adolescent-brain/

Background: Most violent crimes (52 %) are committed by adults aged 18-34, who account for 23 % of the US population and have the highest prevalence of cannabis use and cannabis use disorder (CUD). We examined whether and how associations of cannabis use, use frequency, and CUD with violent behavior (i.e., attacking someone with the intent to harm seriously) vary by sex in U.S. young adults.

Methods: Data were from 113,454 participants aged 18-34 in the 2015-2019 US National Surveys on Drug Use and Health, providing nationally representative data on cannabis use, CUD (using DSM-IV criteria), and violent behavior. Descriptive analyses and bivariate and multivariable logistic regression analyses were conducted.

Results: Among U.S. adults aged 18-34, 28.9 % (95 % CI = 28.5-29.2 %) reported past-year cannabis use (with/without CUD), including 20.5 % (95 % CI = 20.2-20.8 %) with non-daily cannabis without CUD, 4.7 % (95 % CI = 4.5-4.8 %) with daily cannabis use without CUD, 2.1 % (95 % CI = 1.9-2.2 %) with non-daily cannabis use and CUD, and 1.7 % (95 % CI = 1.5-1.8 %) with daily cannabis use and CUD. Past-year adjusted prevalence of violent behavior was higher among males with daily cannabis use but without CUD (2.9 %, 95 % CI = 2.4-2.7 %; adjusted prevalence ratio (PR) = 1.7, 95 % CI = 1.3-2.2) and males with daily cannabis use and CUD (3.1 %, 95 % CI = 2.3-4.0 %; adjusted PR = 1.8, 95 % CI = 1.3-2.4) than males without past-year cannabis use (1.7 %, 95 % CI = 1.6-1.9 %). Adjusted prevalence of violent behavior was higher among females with cannabis use regardless of daily cannabis use/CUD status (adjusted prevalence = 1.6-2.4 %, 95 % CIs = 0.9-3.2 %; adjusted PRs = 1.6-2.4, 95 % CI = 1.3-3.2) than females without past-year cannabis use (1.0 %, 95 % CI = 0.9-1.1 %).

Conclusions: Research is needed to ascertain the directionality of the associations between cannabis use and violent behavior and underlying sex-specific mechanism(s). Our results point to complex sex-specific relationships between cannabis use frequency, CUD, and violent behavior and highlight the importance of early screening for and treatment of CUD and of preventive interventions addressing cannabis misuse.

Keywords: Attacking someone with the intent to seriously hurt them; Cannabis use; Cannabis use disorder; Violent behavior.

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Source: https://pubmed.ncbi.nlm.nih.gov/38677161/

As the population ages, we have to face a growing, generally overlooked crisis of drug abuse among seniors.

What once were considered problems for the younger generation are increasingly found in our older population. The reasons behind this troubling trend are complex and multifaceted, but understanding them holds the key to developing effective prevention strategies.

According to statistics from the United Nations Department of Economic and Social Affairs (2019), there are approximately 2.2 million people aged 60 years and above in Kenya.

Globally, one of the major reasons cited as being behind the increasing cases of drug abuse among elderly people is an increased incidence of chronic pain. As one grows older, the body becomes more prone to a whole range of problems, from arthritis to back issues.

Doctors prescribe very strong opioids for treating the related pain. Where they are highly effective in delivering relief, they come with the dangerous possibility of dependence. Too often, many of these seniors are caught in this vicious circle of addiction when all they were looking for was relief from physical suffering.

There is also the emotional wear and tear associated with growing older. This may be an empty feeling—lack of purpose and loss of social contacts—with retirement, even when well-planned.

A state of depression or anxiety can result from the death of the spouse or friend, or reduced mobility and increasing isolation. Some turn to alcohol or drugs, mistakenly seeking temporary relief from the pain of loneliness or fear of mortality.

Furthermore, stigma against mental health conditions in elderly persons often acts as a barrier to care. The vast majority were raised in an era where little, if any, emotional matters were discussed, and as such, self-medication was the rule rather than the presence of professionals. This lack of dealing directly with issues of mental health can perpetuate substance abuse problems.

It can also be a factor of financial stress. With fixed incomes and increasing healthcare costs, some seniors might turn to cheaper, illicit drugs to manage pain or emotional stress when they can no longer afford prescribed medications. Such substitution is dangerous and, therefore, leads to many other additional serious health and legal problems.

This means we must consider the intergenerational effects of attitudes in their relationships with drugs from one generation to the next.

The baby-boomer generation is entering old age now, but they were raised during times of increased experimentation with drugs. Some carry this behavior over into old age and may view recreational drug use as normal in life, rather than a potential danger. This is a complex issue that calls for a multi-faceted approach. First, there is a dire need to promote education and awareness of the dangers of drug abuse among seniors. This would involve not only the seniors themselves but also their families, caregivers, and even healthcare providers.

Substantial training should be provided to healthcare professionals regarding spotting the symptoms of substance abuse in older patients and looking for alternative methods for managing pain with lower addiction risks.

Steps could include physical therapy, acupuncture, or using pain relievers not having opioids. Regular medication review identifies potential drug interactions and minimises the risk of possible misuse in cases of accidental ingestion or use.

We have a lot of work to do in taking away the stigma associated with mental health treatment for older adults. Encourage seniors to seek counseling or support groups, giving them a healthy outlet to deal with life.

Community centers and senior living facilities can also play important roles in the creation of social connections and engaging activities to replace isolation and boredom. Underpin systems of financial support allow seniors to afford needed medication and treatments; otherwise, they may resort to dangerous alternatives. This could be done through Medicare coverage expansion or the creation of subsidies for essential prescriptions.

The need to educate family members and caregivers about the warning signs and symptoms of drug abuse among seniors is of the essence, and fostering an open, non-judgmental conversation regarding substance use is called for.

A supportive environment shall therefore have to be set up so that a senior feels comfortable discussing difficulties to be able to carry out early intervention effectively.

Such senior preventive programs should be designed and practiced universally. These can consist of workshops on healthy aging, handling stressful situations, and medication alternatives to alleviate pain. Peer support groups led by recovered senior addicts could serve as a powerful testimony and mentorship.

We have to change the attitude toward aging in our society. If we teach people that the later years of life can be the growth time, learning period, and the beginning of new experiences, then the older persons continue to feel a sense of purpose and identity in life. All this optimism can work very strongly against substance abuse.

Treatment of drug abuse in seniors is not just a public health imperative, it is also a moral one. A group of people who have contributed so much to our society all their lives deserve to enjoy their later years with dignity and support.

Understanding the roots of senior drug abuse and implementing comprehensive strategies of prevention can help ensure that our elders experience the quality of life they deserve.

Mr. Mwangi is Deputy Director, Corporate Communications, NACADA 

Source: Simon Mwangi 

In a significant move towards strengthening drug prevention initiatives in Pakistan, the First Meeting of the National Narcotics Control Committee (NNCC) witnessed notable mentions of the Karim Khan Afridi Welfare Foundation (KKAWF). Constituted under the National Anti-Narcotics Policy 2019 by the Ministry of Narcotics Control, the NNCC aims to consolidate and coordinate nationwide efforts against narcotics. The KKAWF’s impactful work in drug prevention and awareness among the youth has been prominently recognized, reflecting the foundation’s growing influence and contribution to this critical issue.A particularly commendable mention was made in a letter from the Ministry of Federal Education and Professional Training, highlighting the inclusion of KKAWF’s ‘Hum Sath Hain’ prevention program. This innovative initiative has already made substantial strides in combating drug abuse at the grassroots level. Over 300 teachers from public schools have been trained under this program, equipping them with the necessary skills and knowledge to educate and guide their students about the dangers of drug abuse. These trained educators are now actively implementing the ‘Hum Sath Hain’ program in their respective schools, directly impacting thousands of students and fostering a drug-free culture among the youth.

The Ministry’s letter, which was attached to the Minutes of the First Meeting of the NNCC, further highlighted the certification of three Master Trainers from the Federal Directorate of Education (FDE) by KKAWF. This certification is a testament to the foundation’s commitment to quality and sustainable training programs.

The Foundation’s efforts were not only acknowledged through official documentation but also received commendation from key figures at the meeting. The Director General of Excise, Taxation and Narcotics Control Punjab, who was among the participants, praised KKAWF’s relentless efforts in drug prevention. This recognition from a high-ranking official underscores the importance and effectiveness of KKAWF’s initiatives.

KKAWF has consistently been at the forefront of drug prevention and awareness in Pakistan, focusing on educating young people about the dangers of drug use. The foundation’s programs are designed to address the root causes of drug abuse, providing youth with the tools and support they need to make informed choices. By collaborating with schools and educational institutions, KKAWF ensures that its messages reach young people in a structured and impactful manner.

The mention of KKAWF at the NNCC meeting signifies a broader acceptance and endorsement of its programs at the national level. Such recognition not only validates the foundation’s hard work but also provides it with a platform to expand its reach and influence. It opens doors for more collaborations with government bodies, educational institutions, and other stakeholders, thereby enhancing the collective efforts against drug abuse in the country.

In conclusion, the First Meeting of the National Narcotics Control Committee marked a significant milestone for the Karim Khan Afridi Welfare Foundation. The inclusion of their ‘Hum Sath Hain’ program in the official records, along with commendations from high-ranking officials, highlights the foundation’s vital role in drug prevention. As KKAWF continues to expand its initiatives and impact, it sets a commendable example for other organizations working towards a drug-free Pakistan.

Source: https://www.dianova.org/news/unite-for-a-drug-free-pakistan/

Suicide rate among Native American population is second-highest in the state

UPDATED: 

In 2020, Assemblymember James C. Ramos, D-San Bernardino, celebrated the creation of the state’s new Office of Suicide Prevention.

Four years later, more work remains to be done, he and other Native American leaders say.

Despite making up only 3.6% of Californians in 2020, American Indians or Alaskan Natives made up 9.8% of those who killed themselves that same year, according to the California Department of Public Health. Nationally, Native American populations are more than twice as likely as Black or White populations to die due to deaths of “despair” — suicidedrug overdoses and alcoholic liver disease — according to a UCLA Health survey released in April.

On Wednesday, July 17, Ramos — author of  Assembly Bill 2112, which created the Office of Suicide Prevention — gathered with representatives of Inland Empire tribes at the Morongo Band of Mission Indians’ Tribal Council Chambers in a roundtable to discuss the need for more help preventing suicide among Native Americans.

“We’ve had incidents where young members have taken their lives,” said Soboba Band of Luiseno Indians Chairperson Isaiah Vivanco. “Life is so precious, and when we have young ones taking their own lives, it has to be (a warning), it has to be an issue.”

Tribal leaders said that, too often, health professionals don’t understand native culture, and end up pushing those who need help away.

“Culture is healing as well,” said Soboba tribal secretary Monica Herrera. “Sometimes (mental health) facilities don’t recognize that (patients) are Native American and that sweat lodge or praying or some type of cultural healing is not encouraged. ‘We can’t take you to the sweat lodge; it’s against our policies.’ “

California health officials vowed to do better at the meeting.“Our traditional behavioral health system has woefully failed Native American populations,” California Health and Human Services Deputy Secretary of Behavioral Health Stephanie Welch told the tribal leaders. “There are high rates of suicide, there are high rates of self-harm as I have heard in the room, and there are high rates of drug misuse and overdose.”

Native communities aren’t using existing mental and behavioral health resources, state officials reported.

“When I see statistics around low utilization of behavioral health services, that’s on us,” Welch said. “Behavioral health services has not traditionally reflected the acceptance of (the) cultural, linguistic and geographical diversity that’s needed to address the needs of Native Americans communities.”

The department knows that it isn’t reaching many groups that need its mental health services and has embarked on a new initiative, “Mental Healthcare for All,” she said.

“And that truly means all of us and it needs to be inclusive of California Native Americans,” Welch said. “Everybody should have access to affordable, equitable, and most importantly, culturally responsive mental health and substance use disorder (treatment).”

As part of the effort, the state is investing in mobile clinics to bring services directly to tribal communities.

Within five years, Welch said, her agency hopes to have culturally appropriate mental health counselors available on mental health crisis lines in the state. In the meantime, her team is examining gaps in existing services when it comes to meeting the needs of California’s Native American population, along with identifying barriers that prevent the community from accessing healthcare options.

More mental health resources should be on the way.

Voters approved Proposition 1 in the March 5 primary election this year, authorizing a nearly $6.4 billion bond for facilities for mental health or substance abuse treatment.

“We want to make sure that California’s first people are not left out of that equation,” Ramos said.

Source: https://www.eastbaytimes.com/2024/08/04/california-needs-to-do-more-to-prevent-suicide-among-native-americans-tribal-leaders-say/

In 2023, 1.5 million adolescents aged 12 to 17 initiated nicotine vaping in the past year.

The U.S. Department of Health and Human Services’ (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA) released the results of its annual National Survey on Drug Use and Health (NSDUH), which shows how people living in America reported about their experience with mental health conditions, substance use, mental health and pursuit of treatment in 2023. The report includes selected estimates by race, ethnicity, and age group. The 2023 sample size was 67,679 and used varied collection methods in gathering data from respondents who are noninstitutionalized and age 12 or older.

Key findings of people aged 12 or older who used tobacco products or vaped nicotine in the past month:

  • Among people aged 12 or older- 22.7 % (or 64.4 million people) was highest among young adults aged 18 to 25 – 30.0 % or 10.2 million people
  • Adults aged 26 or older -23.4% or 52.3 million people
  • Adolescents aged 12 to 17 – 7.4% or 1.9 million people
  • Higher among American Indian or Alaska Native (34 %) or Multiracial people (30.6 %) than among White (24.7%), Black (24.2%), Hispanic (17.9%), or Asian people (10.3%)
  • The percentage of people who vaped nicotine was higher among young adults aged 18 to 25 (24.1% or 8.2 million people) than among adults aged 26 or older (7.4% or 16.6 million people) or adolescents aged 12 to 17 (6.8% or 1.8 million people)

Legislation in December 2019 raised the federal minimum age for sale of tobacco products (along with e-cigarettes) from 18 to 21 years.25 All 50 states and the District of Columbia prohibit the sale of tobacco products to people younger than 21.

  • In 2023, 1.5 million adolescents aged 12 to 17, 1.4 million young adults aged 18 to 25, and 3.1 million adults aged 26 or older initiated nicotine vaping in the past year.
  • About two thirds (62.5%) of the 5.9 million people in 2023 who initiated nicotine vaping in the past year did so at age 21 or older (3.7 million people) compared with 37.5 percent (or 2.2 million people) who did so before age 21.

It is evident that several safety and mental health concerns have arisen due to the growing popularity of e-cigarettes. E-cigarettes heat liquids known as vape juices or e-liquids and transform them into an inhalable vapor containing nicotine and other hazardous compounds. It has been purported by the National Institute on Drug Abuse (NIDA), that Vaping, which was originally marketed to quit smoking, has become a problematic behavior in itself. Vaping can be harmful to a person’s physical and mental health, self-control, mindfulness, and other interventions can help people resist the lure of vaping.

Vaping can be especially dangerous for young people because their brains are still developing. Nicotine is highly addictive and can harm brain development until around age 25 and can negatively impact a developing brain in terms of mood/impulse control disorders, interference with memory and attention processing and negatively affect planning and decision-making.

Find out what’s happening in Glen Covewith free, real-time updates from Patch.

As individuals, being mindful, prevention education and making health choices and cultivating self-control can play an important role safeguarding our well-being. At the societal level, grassroot efforts for increased regulation over entities seeking to profit from harmful products and promote interventions that are accessible and beneficial to all is most effective. There is a large body of research that tackling nicotine dependence with vaping with the same vigor as combustibles is a growing need.

According to SAFE, the best method of protecting is prevention education and encouraging a goal to “Live SAFE” and substance free and changing the societal norms regarding these products to help curb youth initiation and a lifelong nicotine addiction.

For information on how to quit smoking or vaping tobacco or nicotine, the NYS Smoker’ provides free and confidential services that include information, tools, quit coaching, and support in both English and Spanish. Services are available by calling 1-866-NY-QUITS (1-866-697-8487), texting (716) 309-4688, or visiting www.nysmokefree.com, for information, to chat online with a Quit Coach, or to sign up for Learn2QuitNY, a six-week, step-by-step text messaging program to build the skills you need to quit any tobacco product. Individuals aged 13 to 24 can text “DropTheVape” to 88709 to receive age-appropriate quit assistance.

SAFE, Inc. is the only alcohol and substance abuse prevention, intervention, and education agency in the City of Glen Cove. The Coalition is concerned about all combustible and electronic products with marijuana and tobacco. The Agency is employing environmental strategies to educate and update the community regarding the negative consequences in collaboration with Carol Meschkow, Manager- Tobacco Action Coalition of Long Island. To learn more about the SAFE Glen Cove Coalition please follow www.facebook.com/safeglencove or to learn more about electronic products visit the Vaping Facts and Myths Page of SAFE’s website to learn more about how vaping is detrimental to your health www.safeglencove.org.

Drug-involved overdose deaths increased by over 500 percent in 2022 according to a study at Columbia University Mailman School of Public Health, with trends attributed to synthetic opioids. National data shows that fentanyl and heroin in particular attributed substantially to the rise particularly since 2014. However, the study also reports that income protection policies, can have a supportive role in preventing fatal drug overdoses. The findings are reported in the International Journal of Drug Policy.

Over 73,000 people died from an overdose in 2020, which subsequently increased to 106,699 people in 2021, a record for the highest number of overdose deaths in one year.

And in fact, more recently, we entered a fourth wave of the overdose crisis, characterized by fatal overdoses in the context of polysubstance use.”

Silvia Martins, MD, PhD, Professor of Epidemiology at Columbia Public Health

The COVID-19 pandemic exacerbated economic hardship; and as a result, the U.S, government enacted income protection programs in conjunction with existing unemployment insurance (UI) to dampen COVID-19-related economic consequences.

“In the context of financial and economic stressors which are known to increase overdose risk we hypothesized that we would observe lower levels of overall overdose and opioid deaths given that robust unemployment insurance benefits could be a buffer,” said Martins., who is also director of the Substance Use Epidemiology Unit of the Department of Epidemiology at Columbia.

The researchers used data based on responses of 89,914 individuals 18 years of age or older from the pooled 2014 – 2020 Detailed Restricted Mortality files for all counties from the Centers for Disease Control and Prevention, aggregating at the county-quarter level. Included were deaths from any drug overdose, any opioid overdose, and any stimulant overdose. Data on unemployment insurance were obtained from the U.S. Department of Labor as well as statutes by the individual states.

Data from 30 states collected by the CDC indicate rates were persistently stable or even increasing, suggesting that increases in overdose deaths observed after the start of the pandemic show minimal signs of abating. “In fact, treatment disruptions and closures of harm reduction organizations in compliance with social distancing ordinances may have also contributed to worsening substance use morbidity and mortality during this period,” noted Martins.

“We also theorized that states and counties with limited safety net policies may increase an individual’s social, psychological, and biological vulnerability to develop a drug use disorder, including opioid and stimulant use disorders. Such policies likely play a significant role in substance use initiation and subsequent development of substance use disorders as well as treatment access for such disorders,” Martins noted.

An earlier study that examined the relationship between state-level UI robustness and fatal opioid overdoses from 1999 to 2012 support the current findings although the research used data from earlier in the overdose epidemic and also different methods were used.

“While their earlier analysis shows that, between 1999 to 2012, UI was associated with lower rates of opioid overdoses, our study builds and expands on findings from that research, as we examined the relationship between UI and any drug-involved mortality — including all other drug overdoses and stimulant overdoses — during the 4th wave of the epidemic intertwined with the COVID-19 period,” observed Martins. In addition, the earlier study only examined fatal overdoses among “prime-age” people aged 25-54, whereas Martins and her team expanded our inclusion criteria to include everyone ages 18 and older.

“Our results therefore reinforce the notion in a call for a broader discussion on the protective role of the safety net programs to buffer drug-related harms,” stated Martins.

Co-authors are Luis E. Segura, Megan E. Marziali, Emilie Bruzelius,Natalie S. Levy, Sarah Gutkind, and Kristen Santarin, Columbia Mailman School of Public Health; Katherine Sacks, Milken Institute; and Ashley Fox, University at Albany, SUNY.

The study was funded by the Columbia University Mailman School of Public Health Calderone Health Equity Award and NIH-NIDA grants R01DA059376 and T32DA031099.

Source: https://www.news-medical.net/news/20240805/Study-Drug-involved-overdose-deaths-increased-by-over-50025-in-2022.aspx

As the new school year starts, officials are alerting parents to be vigilant of innovative ways kids might conceal drugs, such as in candy boxes and soda cans

With the onset of the new school year, there’s a growing concern among school officials about the creative methods some students might use to conceal drugs. Parents are being asked to stay alert to the possibility of everyday items being used for these purposes.

Creative Concealments

During a recent awareness campaign, officials highlighted how items that appear mundane, like candy boxes, soda cans, and water bottles, can actually be specialized containers designed to hide drugs. “At first glance, these items might look like ordinary snacks or drinks, but they’re increasingly being used to conceal substances,” noted a spokesperson from the organization SCAN, which is dedicated to substance abuse prevention.

Types of Disguised Containers

The variety of containers mentioned includes those designed to look like everyday objects. Water bottles, soda containers, and even chip bags can be modified with hidden compartments. These products are often marketed discreetly and can be easily overlooked by the untrained eye.

Signs of Substance Abuse

In addition to being aware of potential hidden containers, officials are advising parents to watch for changes in their child’s behavior which may indicate substance abuse. “Changes in attitude, energy, and social circles can be red flags,” the spokesperson added, emphasizing the importance of open communication and observation.

Community and School Involvement

Schools are working closely with local law enforcement and organizations like SCAN to provide resources and education to parents. Workshops, informational meetings, and resource materials are being offered to help parents and guardians recognize both the signs of drug use and the unlikely places drugs might be hidden.

Call to Action

Parents and guardians are encouraged to engage with their children about the dangers of drugs and the pressures they may face. By maintaining an open dialogue and staying informed about the latest drug concealment methods, parents can play a crucial role in preventing drug abuse.

For more tips on how to detect hidden drug containers and support children in staying drug-free, stay with Fox News Rio Grande Valley and follow us on your favorite social network.

Source: https://foxrgv.tv/hidden-in-plain-sight-officials-warn-parents-of-disguised-drug-containers/

A recent poll, conducted by Gallup, found that there has been a shift in public opinion regarding marijuana.

This is SAM’s  The Drug Report’s Friday Fact report

 

The first asked the question, “What effect do you think the use of marijuana has on most people who use it – very positive, somewhat positive, somewhat negative or very negative?” Gallup focused on several demographic subgroups and found that all of them were less likely in 2024 than in 2022 to say that marijuana had a positive effect on users. Here’s a breakdown for each subgroup:

This poll revealed a 12% drop among Independents, a 7% drop among young adults,  and a 13% drop among nonreligious people. Likewise, as the percentage of Americans that say marijuana has a positive effect on most people who use it has declined, there has been an increase in the percentage that say it has a negative effect on them. This increased from 45% in 2022 to 51% in 2024, with the remainder answering that they had “no opinion.” A majority of Americans now recognize that marijuana has harmful effects on users, which include cannabis use disorder, depression, anxiety, and impairment, among others.

 

A second question asked, “What effect do you think the use of marijuana has on society – very positive, somewhat positive, somewhat negative or very negative?” It found that the percentage of Americans that thought it was “very negative” or “somewhat negative” increased from 50% in 2022 to 54% in 2024, as the percentage that thought it had a “very positive” or “somewhat positive” effect declined from 49% to 41%.

 

More and more Americans are waking up to the harmful effects of marijuana. Now a majority of Americans believe that marijuana is harmful for both users and society. Public opinion is clearly shifting as more families have seen first-hand the results of marijuana use.

Source: Smart Approaches to Marijuana (SAM) – Friday Fact – Fri 30/08/2024

Vaping among younger adults and binge drinking among mid-life adults also maintained historically high levels, NIH-supported study shows

August 29, 2024

 

Past-year use of cannabis and hallucinogens stayed at historically high levels in 2023 among adults aged 19 to 30 and 35 to 50, according to the latest findings from the Monitoring the Future survey. In contrast, past-year use of cigarettes remained at historically low levels in both adult groups. Past-month and daily alcohol use continued a decade-long decline among those 19 to 30 years old, with binge drinking reaching all-time lows. However, among 35- to 50-year-olds, the prevalence of binge drinking in 2023 increased from five and 10 years ago. The Monitoring the Future study is conducted by scientists at the University of Michigan’s Institute for Social Research, Ann Arbor, and is funded by the National Institutes of Health.

Reports of vaping nicotine or vaping cannabis in the past year among adults 19 to 30 rose over five years, and both trends remained at record highs in 2023. Among adults 35 to 50, the prevalences of nicotine vaping and of cannabis vaping stayed steady from the year before, with long-term (five and 10 year) trends not yet observable in this age group as this question was added to the survey for this age group in 2019.

For the first time in 2023, 19- to 30-year-old female respondents reported a higher prevalence of past-year cannabis use than male respondents in the same age group, reflecting a reversal of the gap between sexes. Conversely, male respondents 35 to 50 years old maintained a higher prevalence of past-year cannabis use than female respondents of the same age group, consistent with what’s been observed for the past decade.

“We have seen that people at different stages of adulthood are trending toward use of drugs like cannabis and psychedelics and away from tobacco cigarettes,” said Nora D. Volkow, M.D., director of NIH’s National Institute on Drug Abuse (NIDA). “These findings underscore the urgent need for rigorous research on the potential risks and benefits of cannabis and hallucinogens – especially as new products continue to emerge.”

Since 1975, the Monitoring the Future study has annually surveyed substance use behaviors and attitudes among a nationally representative sample of teens. A longitudinal panel study component of Monitoring the Future conducts follow-up surveys on a subset of these participants (now totaling approximately 20,000 people per year), collecting data from individuals every other year from ages 19 to 30 and every five years after the participants turn 30 to track their drug use through adulthood. Participants self-report their drug use behaviors across various time periods, including lifetime, past year (12 months), past month (30 days), and other use frequencies depending on the substance type. Data for the 2023 panel study were collected via online and paper surveys from April 2023 through October 2023.

Full data summaries and data tables showing the trends below, including breakdowns by substance, are available in the report. Key findings include:

Cannabis use in the past year and past month remained at historically high levels for both adult age groups in 2023. Among adults 19 to 30 years old, approximately 42% reported cannabis use in the past year, 29% in the past month, and 10% daily use (use on 20 or more occasions in the past 30 days). Among adults 35 to 50, reports of use reached 29%, 19%, and 8%, respectively. While these 2023 estimates are not statistically different from those of 2022, they do reflect five- and 10-year increases for both age groups.

Cannabis vaping in the past year and past month was reported by 22% and 14% of adults 19 to 30, respectively, and by 9% and 6% of adults 35 to 50 in 2023. For the younger group, these numbers represent all-time study highs and an increase from five years ago.

Nicotine vaping among adults 19 to 30 maintained historic highs in 2023. Reports of past-year and past-month vaping of nicotine reached 25% and 19%, respectively. These percentages represent an increase from five years ago, but not from one year ago. For adults 35 to 50, the prevalence of vaping nicotine remained steady from the year before (2022), with 7% and 5% reporting past-year and past-month use.

Hallucinogen use in the past year continued a five-year steep incline for both adult groups, reaching 9% for adults 19 to 30 and 4% for adults 35 to 50 in 2023. Types of hallucinogens reported by participants included LSD, mescaline, peyote, shrooms or psilocybin, and PCP.

Alcohol remains the most used substance reported among adults in the study. Past-year alcohol use among adults 19 to 30 has showed a slight upward trend over the past five years, with 84% reporting use in 2023. However, past month drinking (65%), daily drinking (4%), and binge drinking (27%) all remained at study lows in 2023 among adults 19 to 30. These numbers have decreased from 10 years ago. Past-month drinking and binge drinking (having five or more drinks in a row in the past two week period) decreased significantly from the year before for this age group (down from 68% for past month and 31% for binge drinking reported in 2022).

Around 84% of adults 35 to 50 reported past-year alcohol use in 2023, which has not significantly changed from the year before or the past five or 10 years. Past-month alcohol use and binge drinking have slightly increased over the past 10 years for this age group; in 2023, past-month alcohol use was at 69% and binge drinking was at 27%. Daily drinking has decreased in this group over the past five years and was at its lowest level ever recorded in 2023 (8%).

Additional data: In 2023, past-month cigarette smoking, past-year nonmedical use of prescription drugs, and past-year use of opioid medications (surveyed as “narcotics other than heroin”) maintained five- and 10-year declines for both adult groups. Among adults 19 to 30 years old, past-year use of stimulants (surveyed as “amphetamines”) has decreased for the past decade, whereas for adults 35 to 50, past-year stimulant use has been modestly increasing over 10 years. Additional data include drug use reported by college/non-college young adults and among various demographic subgroups, including sex and gender and race and ethnicity.

The 2023 survey year was the first time a cohort from the Monitoring the Future study reached 65 years of age; therefore, trends for the 55- to 65-year-old age group are not yet available.

“The data from 2023 did not show us many significant changes from the year before, but the power of surveys such as Monitoring the Future is to see the ebb and flow of various substance use trends over the longer term,” said Megan Patrick, Ph.D., of the University of Michigan and principal investigator of the Monitoring the Future panel study. “As more and more of our original cohorts – first recruited as teens – now enter later adulthood, we will be able to examine the patterns and effects of drug use throughout the life course. In the coming years, this study will provide crucial data on substance use trends and health consequences among older populations, when people may be entering retirement and other new chapters of their lives.”

View more information on data collection methods for the Monitoring the Future panel study and how the survey adjusts for the effects of potential exclusions in the report. Results from the related 2023 Monitoring the Future study of substance use behaviors and related attitudes among teens in the United States were released in December 2023, and 2024 results are upcoming in December 2024.

 

Source:  https://nida.nih.gov/news-events/news-releases

By Lauraine Langreo, Staff Writer,  Education Week — August 28, 2024  

There have been “promising” declines in high school students’ overall use of illicit substances, concludes a report from the federal Centers for Disease Control and Prevention.

Since 2013, the percentage of students who reported drinking alcohol, using marijuana, or using select illicit drugs at any point has decreased. Since 2017 and 2019, respectively, the percentage of students who had ever misused or currently are misusing prescription opioids decreased, according to the CDC’s Youth Risk Behavior Survey.

That survey draws on data collected every two years among a nationally representative sample of U.S. high school students. The 2023 survey had more than 20,000 respondents and was conducted in the spring.

Still, many students continue to use substances and the lack of progress in some areas is concerning, according to the report.

The findings come as schools continue to face challenges in curbing students’ substance abuse, which could negatively affect learning, memory, and attention, according to experts. It could also be a sign of mental health challenges.

___________________________________________________________________________________________________________

Teen substance use

Percentage of high school students who ...

*Question introduced in 2017.
**Question introduced in 2019.

DATA SOURCE: CDC

____________________________________________________________________________

While student substance abuse isn’t a new challenge for school districts, the substances that adolescents are experimenting with now are much more dangerous, said Darrell Sampson, the executive director of student services for the Arlington public schools in Virginia.

“It’s not necessarily that more kids are using substances than in prior years,” Sampson said. “It’s the lethality of the substance itself that has caused higher levels of concern.”

Research has shown rising overdose deaths among teens even as their substance use is declining. Those deaths have been linked to the increase in illicit fentanyl and other synthetic opioids. School districts have been pursuing several strands of legal action against companies that manufactured and marketed addictive opioids that have led to tens of thousands of deaths and countless more addiction struggles in the last two decades.

Beyond the legal actions, schools also continue to provide prevention and education programming for students and families, Sampson said. There’s “a glimmer of hope” that those measures are working, he said, based on the declines in the CDC data.

Experts recommend starting education about substance abuse as early as possible

In the Arlington, Va., district, students in grades 6 through 10 learn about substance abuse challenges as part of the health curriculum, Sampson said. The district has also slowly expanded that program to 5th and 4th grades and are looking into whether there’s capacity to start that education as early as 3rd grade.

“We know that the more we can at least open that conversation with our families and our students, the better off our students are going to be,” Sampson said. “It’s not just a message [they’re hearing] starting in middle school, but it’s a message [they’re hearing] over time.”

The district is expanding programming with 11th and 12th graders, too, because the information they got when they were in 10th grade could be outdated by then, Sampson said.

In addition, the district has substance abuse counselors who meet with students and try to explore the reasons they might be using substances, Sampson said.

Experts say it’s also important to think about how to incorporate student voice in any prevention or intervention programming.

Teens are more than twice as likely to go to their friends or peers for help or support when experiencing distress from their substance use than they are to go to a behavioral health provider or a family member, according to a survey from the Bipartisan Policy Center conducted in June among 932 teens (13- to 17-year-olds) and 1,062 young adults (18- to 26-year-olds). More than a quarter of teens said they didn’t go to anyone for help or support when they experienced distress from substance use.

Sophie Szew, a junior at Stanford University and the Bipartisan Policy Center’s mental health and substance use task force youth adviser, said those survey results “really underscore the importance of investing in those peer support networks and resources.”

______________________________________________________________________________________________

Teenagers who have experienced distress from substance use

Who have teens gone to for help/support when experiencing distress from substance use?

Category Percent

Friend/peer                                                             43

Behavioural health provider                                 19

Parent, care givers, other family members        18

Primary care provider                                              9

Religious/spiritual leader                                       9

School counsellor                                                     8

Teacher                                                                       6

Coach/mentor                                                           6

Crisis services (988, crisis text line)                     5

Virtual app or website services                             4

Other adult n the community                               8

Other                                                                         2

No one                                                                    27

____________________________________________________________________________
Source: https://www.edweek.org/leadership/teen-substance-use-is-declining-but-more-dangerous-drug-abuse-is-emerging/2024/08

By Kalleen Rose Ozanic, Staff Writer  July 20, 2024

 

NORWALK — While drug overdoses have decreased year over year in the Nutmeg state, the city’s Family and Children’s Agency is concerned about how new popular substances will impact the state and its clients.

Two substances in particular, xylazine and kratom, worry Jess Vivenzio, behavioral health director at Family and Children’s Agency. She said nearly half of the clients in its outpatient program self-reported using kratom, a U.S Food and Drug Administration-unregulated substance associated with five Connecticut overdoses last year, a state Department of Public Health representative said.

And about three of the clients’ drug screens were positive for xylazine, also known by street name “tranq;” they were shocked to learn their drugs had been cut with it, she said.

“Very surprised, scared, concerned,” Vivenzio said. “A lot of them do have some trust in who they’re purchasing their drugs from, and so sometimes there’s a lot of feelings of guilt and shame there, as well.”

Xylazine caused 284 deaths statewide last year and over 100 people have overdosed from the drug from January to May this year, DPH data show.

Kratom is a powdery substance made from a tropic tree grown in Southeast Asia, the U.S. Drug Enforcement Agency reports. Because the substance isn’t regulated by the FDA, it can easily be purchased at gas stations, convenience stores, smoke and vape shops.

“Just because it’s natural doesn’t mean it’s safe,” Vivenzio said.

Family and Children’s Agency is a charitable nonprofit that aids children and families throughout Fairfield County with after-school and summer programming, foster care, and intensive psychiatric services, education, family guidance, adoption, mental health counseling, substance abuse treatment, and homelessness prevention through wraparound support and partnerships with other local aid groups.

Vivenzio said increasing awareness about both xylazine and kratom are among FCA’s priorities this year, in hopes of limiting its harms and preventing more overdoses.

Project Reward

FCA’s outpatient program, Project Reward, aids its 27 clients in their journeys to sobriety with treatment recommendations, referrals, medication management, intervention, drug and alcohol screens, early intervention programming, and a 10-week intensive outpatient program where patients meet for nine hours of group therapy each week, Vivenzio said.

“We’re a gender-specific and trauma-informed, co-occurring substance use and mental health treatment program for women,” Vivenzio said. “We really provide as much wraparound support as possible, connecting (clients) with other resources and recovery support.”

The program, over everything, prioritizes trust, she said. Many women in the program have histories fraught with trauma, abuse and domestic violence.

Project Reward reveals the frequent intersection of drug abuse and other traumas, Vivenzio said; no patients were available to speak with Hearst Connecticut Media Group in the interest of protecting their privacy and not interrupting their progress in the recovery program.

Much of the program revolves around psychoeducation, which is “really just a fancy word for information, but it’s a little bit more therapeutic,” Vivenzio said.

Program staff equip patients with the resources and knowledge to approach sobriety as well as educate them on the risks of drugs, including substances like xylazine and kratom.

‘Kratom is not something we should be sleeping on’

Chris Boyle, Department of Public Health communications director, said that last year kratom was the sole cause of one overdose death last year and was among other substances in four other overdose deaths.

“Kratom use affects the central nervous system and causes mind-altering symptoms,”  Boyle said in an email. “The symptoms include dizziness; drowsiness; hallucinations; delusions; depression; trouble breathing; confusion, tremors and seizures.”

Users report that kratom acts as a stimulant, according to Mayo Clinic. It can also produce opioid-like effects in high doses, the Centers for Disease Control and Prevention report.

“Kratom is more along the lines of alcohol, in that it is legal, but that doesn’t mean that it’s not addictive, and that doesn’t mean that it can’t cause a problem for some people,” Vivenzio said. “(That) can make it more dangerous, because you can use it responsibly. And so people need to understand that there is the risk that your responsible use will turn into something that you can’t control.”

She’s concerned that increased kratom use can cause tragic outcomes, like that of a Florida father that overdosed and died, leaving a high-needs daughter and wife behind.

In data the CDC referenced from July 2016 to December 2017, 152 overdoses where at least kratom was reported in the toxicology report were identified; in 91 of them, kratom was determined to be a cause of death.

“Kratom is not something we should be sleeping on,” Vivenzio said.

Boyle said that DPH has no current efforts with prevention of kratom associated overdoses, but directed Hearst to the state’s Department of Mental Health and Addiction Services.

While Krystin DeLucia, DMHAS communications and legislative program manager, did not articulate any kratom-specific programming in an email, she said that the department is aware of the drug and monitors its impact.

“The Department of Mental Health and Addiction Services routinely reviews the state of knowledge about the impact of Kratom on mental health and its potentially dangerous adverse effects, as well as how to identify and manage Kratom withdrawal,” the DMHAS statement said. “DMHAS remains vigilant to identify trends related to the devastating crisis of opioid misuse and overdose in our state.”

Xylazine in Connecticut

Vivenzio said xylazine use is among FCA’s top priorities and Boyle said the state tracks its use.

“DPH shares updated surveillance and trend data on xylazine-involved drug overdose deaths with state stakeholders, opioid task forces and local health departments to create awareness about the dangers of using xylazine,” he said.

“Tranq” can extend the “high” that results from fentanyl — a drug that lasts a shorter time compared to heroin and other opioids, Boyle said.

He echoed Vivenzio’s concerns about clients not knowing their drugs contain xylazine.

“Not everyone who uses fentanyl is intentionally seeking out xylazine,” Boyle said. “In many cases, people are not aware that xylazine is in the drugs they are buying and using.”

Now, the Connecticut Public Health Lab is testing urine from those who report to emergency rooms in the state for nonfatal overdoses for xylazine, among other illicit substances, Boyle said.

Vivenzio said that the drug is “across the board, it’s incredibly risky,” especially because it is not an opioid and its effects cannot be reversed with Narcan.

The drug is responsible for 1,252 overdose deaths from 2015 to 2025, DPH reports — with five in Norwalk.

To address the harms of drug use in Connecticut and in FCA’s resident city, Vivenzio said programs like Project Reward need more funding to increase advocacy efforts, harm reduction tools and intervention strategies.

Kalleen Rose Ozanic

Reporter

Kalleen Rose Ozanic is a local reporter at the Norwalk Hour. She covers health, business, cannabis and education. She previously covered cannabis at WSHU Public Radio in Fairfield, Connecticut. She graduated with a B.A. and M.S in Journalism in 2022 and 2023 from Quinnipiac University. She loves to read, snorkel, try new foods and go to Mets games.

 

Source: https://www.ctinsider.com/news/article/norwalk-family-childrens-agency-kratom-xylazine-19564963.php

Biden’s drug czar is in West Virginia this week.

This story was originally published by Mountain State Spotlight. Get stories like this delivered to your email inbox once a week; sign up for the free newsletter at mountainstatespotlight.org/newsletter

CHARLESTON — Dr. Rahul Gupta is back in West Virginia. The state’s former health officer has ventured west of Washington this week, hosting seven public discussions in Martinsburg and Charleston as part of his new role as White House Office of Drug Control Policy Director.

Over the last three years, Gupta and the Biden administration have taken significant steps to address the country’s devastating overdose crisis. They’ve promoted harm reduction aggressively, even finding ways to test out hard-sell, evidence-based strategies like safe injection sites.

Still, the addiction crisis continues to ravage U.S. families, especially in Gupta’s former state. Last year, about four West Virginians died of a drug overdose every day.

As the nation’s “drug czar,” Gupta is in a better position to advocate for addiction-related changes than just about anyone else.

Here are five steps the federal government could take to help abate West Virginia’s overdose crisis.

Change opioid treatment program restrictions

West Virginia has policies and regulations that restrict access to opioid addiction treatment. The state makes it difficult for some people with opioid use disorders to receive medications like methadone, which is considered a “gold standard” of treatment. Since 2007, West Virginia has limited the number of methadone clinics, the only places methadone can be prescribed to treat addiction, to nine locations.

But while that’s a state law, federal law is the reason methadone can only be prescribed for treating substance use disorder at these clinics.

People who research addiction have called on Congress to change this policy to allow doctors to prescribe methadone for addiction treatment outside of specialized clinics. Because West Virginia’s moratorium is focused on methadone clinics and not the medication itself, that type of change could make the treatment more accessible to state residents.

Last winter, when Gupta was asked in an interview about a federal bill that would accomplish parts of this goal, he stopped short of endorsing the proposed legislation. Instead, he said it’s important for Congress to “let the science and the data guide policy-making.”

Change restrictions on treatment for methamphetamine addiction

A decade ago, less than 5% of West Virginia fatal overdoses were related to methamphetamine. But that’s changed dramatically; last year, more than 50% of the state’s nearly 1,400 drug deaths involved meth.

That presents a difficult public health problem for West Virginia. Scientists have yet to develop reliable medications for treating methamphetamine addiction.

Of the available treatments, the most effective options are behavior training programs, also known as contingency management. These types of programs reward people regularly with money or other incentives for abstaining from a drug.

Dr. Philip Chan, an addiction and infectious disease researcher at Brown University, said if he could provide patients with $400 to $500 every two to three months, it would be more effective at keeping them from using meth. But the federal government caps contingency management payments at $75 a year.

Repeal the federal funding ban for syringes and needles

West Virginia has many restrictions around needle exchanges. In 2021, the Legislature passed a law that forces syringe service programs to offer a variety of other harm reduction services, and it instructs them to deny service to those who don’t have valid state IDs or return their used needles.

The additional requirements led many programs across the state to shutter. For the ones that remain, restrictions at the national level make it even more difficult to operate.

Needle exchanges are already prohibited from using federal funds to purchase clean needles and syringes. And there have been pushes, including from West Virginia Senator Joe Manchin, to extend the prohibition to safe smoking devices as well.

Nikki Dolan, the Greenbrier Health Department administrator, said this policy makes it more difficult to fund her county’s only syringe service program.

“We’ve been doing harm reduction since 2018 and have never been able to purchase needles with grant funding,” she said.

Include West Virginia in the Ending the HIV Epidemic initiative

West Virginia’s recent drug-related HIV outbreaks have been among the worst in the nation. In 2019, the U.S. Centers for Disease Control and Prevention stepped in to help with a Cabell County outbreak. A couple years later, the agency returned to address cases in Kanawha County, with one top health official calling the outbreak the “most concerning in the United States.”

West Virginia HIV cases have decreased over the last two years, but many doctors and researchers worry about undetected spread, especially in rural parts of the state.

Despite the national attention, no West Virginia counties are included in the federal government’s Ending the HIV Epidemic initiative. The program is designed to direct additional funding and resources to communities heavily impacted by the infectious disease.

Gregg Gonsalves, a Yale University School of Public Health professor who studies HIV transmission, said he was surprised to learn West Virginia and its counties weren’t included in the program.

He said Gupta, using his position in the federal government, could ask Health and Human Services Secretary Xavier Becerra and CDC Director Mandy Cohen to include West Virginia or some of its counties in the initiative.

More funding for recovery residences

Even if state residents with addictions find and receive treatment, sustaining recovery can be challenging. West Virginians in recovery can struggle to find places to live where they aren’t around drugs or alcohol.

Recovery residences, also known as sober living houses, can help with that. The state and federal governments have said the housing units can help people in recovery avoid relapsing.

But in West Virginia, recovery residences often face financial barriers. A survey of state sober living homes last year found that the biggest challenge the organizations faced was financial resources, and the surveyed organizations said only 12% of their revenue comes from federal grants.

Jon Dower, the executive director of West Virginia Sober Living, said the federal government could make these grants easier for recovery residences to win, especially for people who are looking to start state-certified homes.

“If we look at what’s most needed in the recovery housing space in West Virginia, in my opinion it’s capacity,” he said.

Reach reporter Allen Siegler at allen@mountainstatespotlight.org

Source: https://www.timeswv.com/news/west_virginia/bidens-drug-czar-is-in-west-virginia-this-week-here-are-five-things-the-federal/article_43e1fe42-4b80-11ef-8ce1-6b4a5826d699.html

The number of drug overdoses in this country went down in 2023. But not enough.

Key points

  • While overdoses from fentanyl went down in 2023, overdoses from cocaine and methamphetamine went up.
  • Increased availability of Narcan, harm-reduction practices, and drug seizures likely decreased deaths.
  • The best way to save lives and end the opioid epidemic is to prevent addiction in the first place.

With this tragic news just in, there are several important things to say about the drug overdose situation in this country.

The first is this: It is important that we don’t talk about the more than 107,000 overdose deaths in the United States last year like it’s just a statistic.

These are people’s lives that ended, people like you and me. People with friends and loved ones who cared about them, and who wanted them to succeed.

Evidence of an ongoing tragedy

This is where we are with the continuing drug epidemic, according to the recently released Centers for Disease Control and Prevention (CDC) data from 2023:

  • 107,543 people died from drug overdose deaths compared to 111,029 in 2022. That is a 3 percent decline.
  • 2023 witnessed the first annual decrease in five years (since 2018).
  • Indiana, Kansas, Maine, and Nebraska each saw overdose deaths decrease by at least 15 percent. Note: We need to determine what’s working in those states, and replicate it elsewhere.
  • Alaska, Oregon, and Washington each saw overdose deaths increase by at least 27 percent. Note: We need to determine what’s not working in those states, and figure out solutions including by sharing best practices from states with lower overdose rates.)
  • While overdoses from fentanyl (the main driver of drug deaths) went down in 2023, overdoses from cocaine and methamphetamine went up.

Three developments that are helping to reduce deaths

1. Greater availability of Narcan: I’m a huge advocate for this overdose reversal drug, which is naloxone in nasal spray form. I have argued often that it should be as ubiquitous as the red-boxed automated external defibrillators (AEDs) you now see in malls, hotel lobbies, schools, airports, and workplaces.

The U.S. Food and Drug Administration (FDA) took a big and meaningful step in that direction when it approved Narcan for over-the-counter use in March 2023. I have no doubt the increased availability of Narcan has helped bring the overdose numbers down, since Narcan targets opioids like fentanyl and heroin.

2. The stepping up of harm-reduction efforts: Harm reduction means reducing the health and safety dangers around drug use. The goal is to save lives and protect the health of people who use drugs through such measures as fentanyl test strips, overdose prevention sites, and sterilized injection equipment and services.

Harm reduction was a key plank of the White House’s 2022 National Drug Control Strategy aimed directly at the overdose epidemic. Countless harm-reduction efforts have gained traction at the local and state level as well. Again, this continued push may have helped bring down the overdose numbers last year.

3. Increased efforts around law enforcement drug seizures: Of the 107,543 people who overdosed in 2023, 74,702 (70 percent) of them did so after using the synthetic opioid fentanyl, which is many times more potent than heroin. For the first time in years, that number of deaths was lower than the year before.

Why? No doubt in part because 115 million pills containing fentanyl were seized by law enforcement in 2023. That compared to 71 million fentanyl-laced pills seized in 2022. These seizure efforts seem to be working, and they need to be stepped up even more.

Drug use prevention efforts must increase also

Ultimately, the best way to save lives, end the opioid epidemic, and halt the spread of substance use disorder is to stop people from becoming addicted in the first place.

The big news: Statistics show that drug use may be trending down among young people. Even delaying the onset of addiction can change the trajectory of the problem, says Nora Volkow, MD, director of the National Institute on Drug Abuse.

When asked recently about the lower number of overdose deaths last year, Volkow said: “Research has shown that delaying the start of substance use among young people, even by one year, can decrease substance use for the rest of their lives. We may be seeing this play out in real time [in 2023]. The trend is reassuring.”

Final thoughts on turning the tide of addiction

As the antismoking campaign that began in the 1960s showed us, massive and well-coordinated public health efforts can work.

Surgeon General warning labels, hard-hitting public service announcements, school-based programs—all of those had a cumulative effect on smoking habits in this country, especially among young people. Those efforts all targeted one thing: prevention.

We need to do much more of that in 2024 around opioids, methamphetamines, cocaine, and other lethal drugs. Lives depend on it.

Source: https://www.psychologytoday.com/us/blog/use-your-brain/202407/a-closer-look-at-107543-lives-lost-to-drug-overdoses

A silent revolution is taking place in the heart of Pakistan where communities are tightly knit and traditions run deep. Grassroots and community-based initiatives are emerging as beacons of hope in the fight against drug abuse, transforming lives and fostering resilience in ways top-down approaches often cannot achieve.

Pakistan faces a significant drug abuse problem, with millions affected by the scourge of addiction. The United Nations Office on Drugs and Crime estimates that 40 per cent of all heroin and morphine trafficked out of Afghanistan transits through Pakistan. This has contributed to a rise in addiction rates and related health issues, including the spread of HIV. Health professionals report an increasing number of new HIV positive cases each year, emphasising the urgent need for effective intervention strategies.

The International Narcotics Control Board annual report stresses the importance of governments giving greater attention to fighting drug abuse, particularly the rising use of date-rape drugs. The INCB has called for the implementation of a 2009 resolution to combat the misuse of pharmaceutical products for sexual assault and to remain vigilant about the increase in date-rape drug abuse.

Amidst this crisis, numerous grassroots organisations have sprung up, leveraging the power of community and local knowledge to combat drug abuse. These initiatives are often founded by passionate individuals who have witnessed the devastating effects of addiction firsthand. Their work is characterised by personalised care, cultural sensitivity and a deep understanding of the local context.

One such initiative is Nai Zindagi (New Life). The organisation has been at the forefront of drug rehabilitation and harm reduction since 1989. Nai Zindagi focuses on providing health and social services to people who inject drugs (PWID) and their families. Their approach includes needle exchange programmes; HIV testing and counseling; and vocational training to help individuals reintegrate into society.

Through community outreach and peer-led education, Nai Zindagi has significantly reduced the spread of HIV among the PWID. Their model emphasises dignity and respect, fostering an environment where individuals feel safe and supported in their journey towards recovery.

At the forefront of these efforts is Akmal Ovaisi, head of Tanzeem-al Fajr, a prominent NGO in Pakistan. Under his leadership, Tanzeem-al Fajr has become a pivotal force in drug prevention efforts across the country. Ovaisi’s vision and dedication have galvanised a movement, bringing together diverse organisations to tackle drug abuse through a unified approach.

Akmal Ovaisi believes in the power of community involvement in addressing drug abuse. By engaging local leaders, volunteers and affected families, Tanzeem-al Fajr creates a support system that fosters recovery and prevention.

Ovaisi prioritises educational campaigns to raise awareness about the dangers of drug abuse. These campaigns target schools, colleges and community centres, aiming to reach young people before they fall into the trap of addiction.

Recognising that no single organisation can combat drug abuse alone, Ovaisi has built a strong network of NGOs that collaborate and share resources. This network enhances the capacity to deliver comprehensive services, from rehabilitation to vocational training.

Ovaisi actively engages with policymakers to advocate for stronger drug prevention policies and better support systems for addicts. His efforts have been instrumental in shaping national strategies that reflect the needs of those on the ground.

Aghaz-i-Nau (New Beginning) is another remarkable community-based initiative dedicated to drug abuse prevention and rehabilitation. Located in Islamabad, Aghaz-i-Nau has a holistic approach to addiction treatment, combining medical care, psychological support and spiritual healing. Their residential treatment programme is tailored to meet the needs of each individual, ensuring that recovery is sustainable.

Aghaz-i-Nau also works extensively on awareness campaigns, targeting schools and colleges to educate young people about the dangers of drug abuse. By fostering a dialogue on addiction and breaking down stigmas, they empower communities to tackle the issue head-on.

Rozan, a non-profit organisation based in Islamabad, addresses the psychological and emotional aspects of drug abuse. Their programmes are designed to build emotional health and resilience, particularly among vulnerable populations such as women and children. Rozan’s community-based approach involves training local volunteers to provide psychological first aid and support to individuals affected by drug abuse.

Through workshops, counselling sessions and community events, Rozan helps individuals develop coping mechanisms and rebuild their lives. Their work highlights the importance of addressing the root causes of addiction, such as trauma and mental health issues, in order to achieve lasting recovery.

The success of these grassroots initiatives lies in their ability to mobilise community resources and create networks of support. Unlike large-scale interventions, which can often feel impersonal, community-based programs are deeply embedded in the local context. This allows them to respond more effectively to the specific needs and challenges of their communities.

These initiatives often adopt a multi-faceted approach, addressing not just the symptoms of addiction but also its underlying causes. By providing education, vocational training and emotional support, they help individuals build a foundation for a healthier, drug-free life.

Despite their successes, grassroots organisations in Pakistan face numerous challenges. Limited funding, societal stigma and bureaucratic hurdles can often obstruct their efforts. However, their resilience and innovation continue to inspire hope.

There is a pressing need for greater collaboration between government bodies, international organisations and community-based initiatives. By pooling resources and sharing best practices, it is possible to create a more coordinated and effective response to drug abuse.

In the fight against drug abuse, Pakistan’s grassroots and community-based initiatives are making a profound difference. Through their dedication, empathy and ingenuity, they are transforming lives and creating a ripple effect of positive change. As these pioneers continue their work, they remind us that the strength of a community lies in its ability to come together and support its most vulnerable members.

Support these initiatives by volunteering, donating or spreading awareness about their work.

Source: https://www.thenews.com.pk/tns/detail/1204770-pioneering-drug-abuse-prevention-and-support

By: Imtiyaz Maqbool Banday @ KI News

As we continue to grapple with the scourge of drug abuse, it’s essential to reexamine our approach to prevention and treatment. While raising awareness about the dangers of drugs is crucial, we must also consider if our efforts are inadvertently glamorizing drug use. Islam teaches us to avoid excess and extravagance (Israaf) and seek refuge in Allah from harmful substances (Khabeeth).

The Glamorization of Drugs: A Contravention of Islamic Values

By constantly talking about drugs, we may be inadvertently glamorizing them, which goes against Islamic values. Young Muslims, in particular, may be drawn to the thrill and excitement associated with drug use, neglecting the Islamic emphasis on self-care and preservation (Hifz).

The Danger of Glamorization

Glamorizing drug addiction can have severe consequences, including:

– Normalizing drug use among young people

– Encouraging experimentation and risky behavior

– Creating a culture of sympathy for drug users, rather than support for recovery

– Distracting from the real issues and solutions

Instead of perpetuating the glamorization of drug addiction, we must focus on promoting a culture of recovery, support, and Islamic values.

A New Approach: Promoting Islamic Values and Support

Rather than solely focusing on the dangers of drugs, let’s shift our attention to promoting Islamic values and supporting those who have overcome addiction. By sharing stories of hope and resilience, we can create a more positive narrative and inspire others to seek help. This approach acknowledges the complexities of addiction and offers a more comprehensive solution, aligned with Islamic principles:

– Tawakkul (Trust in Allah): Encouraging individuals to trust in Allah’s mercy and guidance

– Sabr (Patience): Supporting individuals in their struggles and recovery

– Shukr (Gratitude): Fostering gratitude for health and well-being

– Ihsan (Excellence): Promoting self-care and personal growth

Additional Content:

– The Prophet Muhammad (peace be upon him) said, “A person who guides others to virtue will receive a reward similar to that of the one who follows it, without lessening the reward of either.” (Muslim)

– Islam teaches us to care for our physical and mental health, as part of our duty to preserve our faith (Deen) and our bodies (Badaan)

– The Quran emphasizes the importance of seeking help and support from others, saying, “And help one another in goodness and righteousness.” (5:2)

By incorporating these Islamic principles and values, we can create a more comprehensive and effective approach to drug abuse prevention and recovery.

Conclusion

Let us work together to create a society that values recovery, support, and Islamic principles, rather than perpetuating the cycle of drug abuse. We must avoid glamorizing drug use, promote a culture of recovery and support, encourage seeking help and guidance, foster gratitude for health and well-being, and support individuals in their struggles and recovery. By adopting a more balanced approach, we can create a brighter future for all, free from the shackles of drug abuse.

Kashmir Images is an English language daily newspaper published from Srinagar (J&K), India. The newspaper is one of the largest circulated English dailies of Kashmir and its hard copies reach every nook and corner of Kashmir Valley besides Jammu and Ladakh region.

Source: https://thekashmirimages.com/2024/07/04/rethinking-our-approach-to-drug-abuse-prevention-an-islamic-perspective/

July 7, 2024 6:05 am

The Glamorization of Drugs: A Contravention of Islamic Values

By constantly talking about drugs, we may be inadvertently glamorizing them, which goes against Islamic values. Young Muslims, in particular, may be drawn to the thrill and excitement associated with drug use, neglecting the Islamic emphasis on self-care and preservation (Hifz).

The Danger of Glamorization

Glamorizing drug addiction can have severe consequences, including:

– Normalizing drug use among young people

– Encouraging experimentation and risky behavior

– Creating a culture of sympathy for drug users, rather than support for recovery

– Distracting from the real issues and solutions

Instead of perpetuating the glamorization of drug addiction, we must focus on promoting a culture of recovery, support, and Islamic values.

Promoting Islamic Values and Support

Rather than solely focusing on the dangers of drugs, let’s shift our attention to promoting Islamic values and supporting those who have overcome addiction. By sharing stories of hope and resilience, we can create a more positive narrative and inspire others to seek help. This approach acknowledges the complexities of addiction and offers a more comprehensive solution, aligned with Islamic principles:

– Tawakkul (Trust in Allah): Encouraging individuals to trust in Allah’s mercy and guidance

– Sabr (Patience): Supporting individuals in their struggles and recovery

– Shukr (Gratitude): Fostering gratitude for health and well-being

– Ihsan (Excellence): Promoting self-care and personal growth

Additional Content

– The Prophet Muhammad (peace be upon him) said, “A person who guides others to virtue will receive a reward similar to that of the one who follows it, without lessening the reward of either.” (Muslim)

– Islam teaches us to care for our physical and mental health, as part of our duty to preserve our faith (Deen) and our bodies (Badaan)

– The Quran emphasizes the importance of seeking help and support from others, saying, “And help one another in goodness and righteousness.” (5:2)

By incorporating these Islamic principles and values, we can create a more comprehensive and effective approach to drug abuse prevention and recovery.

Source: https://www.greaterkashmir.com/opinion/islamic-perspective-to-drug-abuse-prevention/

 

360info: 05/07/2024 23:30 MYT

Countries are looking at evidence-based alternatives, with a shift towards public health strategies, to fight the drug scourge – Michael Joiner/360info
THE UN’s annual World Drug Report warns of a rise in drug use and trafficking globally.
The report, released in conjunction with the International Day against Drug Abuse and Illicit Trafficking, or World Drug Day on June 26, found the number of drug users reached 292 million in 2022, with cannabis being the most common drug used.
However, the emergence of new synthetic opioids such as nitazenes is causing concern due to their potency and potential for overdose deaths.
The report also highlighted how drug cartels in Southeast Asia are weaving themselves into a web of illegal activities, including wildlife trafficking and deforestation. This devastates the environment and displaces communities. Increased cocaine production fuels violence along transportation routes, while high-THC cannabis legalisation in some countries is associated with a rise in attempted suicides.
The traditional criminal justice approach, prioritising arrests and punishment, is proving ineffective. Countries are looking at evidence-based alternatives, with a shift towards public health strategies.
This week, Malaysia tabled new amendments to the Drug Dependants (Treatment and Rehabilitation) Act 1983 which would empower officers from the country’s drug agency to arrest, treat, and rehabilitate “drug dependants or misusers” in a bid to ease overcrowding in prisons.
The bill is seen as a step away from the country’s draconian anti-drug laws, shifting the focus from locking up people who use drugs to treatment and rehabilitation. But experts are worried about making rehabilitation mandatory for all and whether the current rehabilitation centres are well equipped to accommodate the influx of patients.
Australia offers a fascinating case study on the complexities of drug policy reform. While the government allocates significant resources to law enforcement, harm reduction and prevention programmes receive a fraction of the funding. This imbalance raises questions about the effectiveness of the current approach.
Pill testing will be introduced in the state of Victoria later in the year, aimed at reducing the risk of overdose deaths, especially at music festivals. It follows similar schemes in the Australian Capital Territory and Queensland which have so far shown to save lives. This has encouraged the state of New South Wales to implement a similar approach.
Australia has also taken a progressive step by making naloxone, a life-saving medication that reverses opioid overdoses, free and available without a prescription, although uptake has been slow.
The illegal drug trade poses a significant threat to national security in some countries. India’s northeast states, bordering Myanmar, serve as a stark example. The drug trade fuels violence and instability, highlighting the need for a comprehensive approach that addresses security concerns and public health.
The situation in Punjab also struggles with widespread substance use and trafficking. Addressing the underlying factors that contribute to drug use, such as lack of economic opportunities, is crucial to tackling this issue effectively.
This year’s World Drug Day theme acknowledges that it is crucial to adopt a scientific evidence-based approach that prioritises prevention and treatment as a step for drug policy reform.
A public health approach that prioritises harm reduction, treatment, prevention, and dismantling accessibility barriers offers a more promising path forward, promoting public health and safety while fostering global stability.

By Shahirah Hamid: Senior Commissioning Editor at 360info Southeast Asia

Source: https://www.astroawani.com/berita-dunia/rethinking-drug-policy-punishment-public-health-477633

By FOX TV Digital Team

Published  July 8, 2024 7:26am EDT

 

Demand for high-potency marijuana causing concerns

Cary Quashen, Owner of Action Family Counseling, joins LiveNOW’s Austin Westfall to dive deep into concerns over the rising demand for high-potency marijuana.

As marijuana use becomes more prevalent, a severe illness linked to frequent cannabis use is also on the rise. 

Cannabinoid (or Cannabis) hyperemesis syndrome, also known as CHS, is an often debilitating condition that affects a small but growing number of chronic marijuana users. 

People with CHS experience severe nausea and vomiting, in some cases 20-24 times a day. It can last days or even weeks and is hard to control – often the only thing that brings relief is a hot shower or bath. 

RELATED: Frequent marijuana use linked to increase in heart attack and stroke risk

Signs of cannabis hyperemesis syndrome

In National Library of Medicine literature, doctors outlined the following criteria for diagnosing CHS: 

  • Long-term cannabis use (often daily)
  • Cyclic nausea and vomiting
  • Relief when stopping marijuana
  • Hot showers/baths relieve symptoms
  • Abdominal pain

RELATED: Teen use of delta-8, an unregulated marijuana alternative, is rising

Ironically, marijuana is often used to treat two key symptoms of CHS: Recent data compiled by the U.S. Food and Drug Administration concluded there is “credible scientific support” for the use of marijuana to treat pain, anorexia, nausea and vomiting

Doctors are seeing a rise in serious illness linked to heavy marijuana use (Photo by Lauren DeCicca/Getty Images)

Three cycles of cannabis hyperemesis syndrome

There are three phases of CHS, according to Connecticut state’s Adult Cannabis Use website

  • Prodromal – Nausea and vomiting following long-term cannabis use. This often leads to a person using more cannabis to reduce nausea.
  • Hyperemetic – Triggered by increased cannabis use, nausea, abdominal pains and vomiting increase
  • Recovery – Once a person stops using cannabis, symptoms may take several weeks to decrease and disappear until they begin using again, which starts the cycle over.

What causes cannabis hyperemesis syndrome?

Researchers are still early in their exploration of what causes CHS. Dr. Sushrut Jangi, a gastroenterologist at Tufts Medical Center, told The Boston Globe it has something to do with the “somewhat mysterious” endocannabinoid system, which regulates critical bodily functions like sleep, mood, pain control, immune response, appetite and more. 

READ MORE: Michigan dog attacks, nearly kills owner after being fed THC gummy

A lot of receptors in the brain and the gut bind to THC, the substance in cannabis that makes people feel high. Those receptors evolve after long-term cannabis use, Jangi told The Globe. 

Jangi said although it’s hard to calculate, he estimates somewhere between 5% and 20% of chronic marijuana users will experience CHS. 

According to the National Library of Medicine, after Colorado legalized recreational marijuana, ER visits for cyclic vomiting nearly doubled.

 

Source: https://www.livenowfox.com/tag/cannabis

The city is gripped in an opioid crisis worse than America’s. Locals say overly liberal drug laws have sparked a catastrophe

“Yes, I feel fine,” she replies.

“Okay, hold still.”

Eyes wide and hands trembling, Larry, 32, flicks the syringe’s needle before crouching over his friend and injecting a mixture of fentanyl and benzodiazepines into a prominent vein in her neck.

Hailey, 38, is lying on a grimy pavement, surrounded by graffiti, filth, and other drug users. She inhales deeply, curls into a foetal position, and sucks on her thumb to hold her breath.

As the discoloured liquid enters her bloodstream, her body relaxes and her eyes lose focus.

“June 7th,” she murmurs. “I’m counting down the days until I can finally go to detox.”

Hailey and Larry are two of approximately 5,000 active drug users who reside in Vancouver’s Downtown Eastside, a 10-block corridor that runs through the heart of the city along Hastings Street.

Walking the half-mile stretch is profoundly shocking. Bodies lie scattered on the tree-lined streets, some scarcely breathing. Discarded needles are everywhere, and the detritus from makeshift encampments – tents, cardboard, sleeping bags – clutter alleys and verges. The scream of sirens is unrelenting.

The crisis is being fuelled by fentanyl, a synthetic opioid that is 50 times stronger than heroin. Manufactured in numerous illicit labs in Canada’s wilderness, fentanyl is now so common in Vancouver’s Downtown Eastside that you can literally pick it up off the street.

Vancouver once topped the charts of the world’s “most desirable places to live”. Its reputation is that of a city which provides the perfect balance – a metropolis “perched on the edge of nature” combining “outdoor recreation and a great cultural diversity”, as one local website puts it.

But a landmark experiment to decriminalise the possession of certain drugs in public – including fentanyl, heroin, cocaine, methamphetamines, and ecstasy – has allowed an opioid crisis to take hold that surpasses even the epidemic in the United States.

In April, David Eby, British Columbia’s premier announced that halfway into the three-year trial, the province would recriminalise drug use in public spaces.

With a severe backlash from police, politicians, and the public showing no sign of abating, Mr Eby is now under pressure to scrap the pilot scheme altogether.

Since last month, police once again have the power to approach and arrest drug users in hospitals, restaurants, parks, and beaches. But people are still able to legally consume 2.5 grams of hard drugs in their homes and in designated public shelters. It also remains unclear how the revised rules will be meaningfully enforced by the police.

Despite the province’s best efforts, opioid overdoses have become the leading cause of death for people aged 10-59 in British Columbia, and now account for more deaths than homicides, suicides, accidents, and natural diseases combined.

Last year, the province recorded 2,511 drug-related overdoses, 87 per cent of them down to fentanyl. The death rate in Vancouver itself now stands at 56 per 100,000 people – nearly three times the national average. And in the Downtown Eastside, the rate is nearly 30 times higher than the rest of the country.

For comparison, England and Wales have a drug-related mortality rate of 8.4 per 100,000 people. In Scotland – the worst in Europe – it stands at 19.8. The only G7 country with anything close to a comparable rate is the United States, at 32.6 per 100,000 people.

With the city gripped in an opioid epidemic nearly twice as fatal as America’s, the Downtown Eastside is becoming a key battleground for the province’s decriminalisation debate. As overdose numbers continue to rise, many view the liberal rollout as fuel to the fire. Yet others argue there are wider societal issues at play that are far more insidious than fentanyl.

Now entrenched in a public health emergency, Canadians of nearly all political stripes are asking, “How did we get here?”

Decriminalisation ‘not about drugs anymore’

In the first year of British Columbia’s decriminalisation rollout, public drug use exploded – with reports of people injecting heroin on family beaches and smoking crack in maternity wards.

Fiona Wilson, the deputy chief constable of the Vancouver Police Department, says the experiment has tied the hands of police across the city, leaving the wider community at risk. Despite having seized over 1,000 kilos of fentanyl from dealers in 2023 alone, officers are powerless to intervene when they see it used on the streets.

“Decriminalisation has been a massive challenge for the police because it’s taken away our ability to arrest someone. We don’t have any grounds to approach a person who is publicly using illicit drugs in the absence of any other criminality,” she says.

“If someone is sitting at a coffee shop and wants to snort a line of cocaine, we don’t have any authority to intervene in that situation. This presents a real problem because families don’t necessarily want to sit next to somebody in a restaurant who’s shooting up fentanyl.”

On the other side of the debate, left-wing advocates for liberalisation have sought to frame the debate around privilege and class.

Brittany Graham, the executive director of the Vancouver Area Network of Drug Users (VANDU), says bigger societal issues – namely, a lack of housing and inadequate welfare services – are to blame.

“Decriminalisation will always exist for the upper class. When someone has enough money to snort cocaine in the privacy of their own home, the police are never going to get them. What we are witnessing right now is a homelessness crisis on top of a toxic and unregulated drug supply.

“The right-wing is blaming everything on decriminalisation, but the reality is Vancouver has seen a 32 per cent increase in homelessness since the beginning of Covid. But the government continues to label poor drug users as the scapegoats for everything wrong in our province.

“Decriminalisation is not about drugs anymore, it’s about power and control. Drugs have been killing people for decades, now it’s toxic politics.”

Elenore Sturko, the shadow minister for mental health and addictions, says decriminalisation has been a “dangerous and disastrous” policy failure.

“The entire policy was politically motivated. Clearly, the government didn’t do the work on decriminalisation. In fact, they ignored the advice of the police. Now, we end up where we are today – not only failing to reduce death and overdoses, but actually causing increased harm.”

‘I never wanted to use fentanyl’

Beyond the issue of decriminalisation, British Columbia has introduced a raft of “harm reduction” measures in a bid to solve the public health emergency – but these too have proved controversial.

The backbone of the province’s harm reduction project revolves around “safe injection sites” where users can access clean needles and a regulated supply of drugs. In these government-run locations, drug users are able to consume their illicit substance of choice – predominantly fentanyl – while being monitored by healthcare workers with an opioid antidote on hand.

Tiffany, 37, says VANDU’s safe injection site has saved her life many times over. Shortly after moving to Vancouver at 15, she got hooked on heroin. Now, almost two decades later, fentanyl is her drug of choice.

“I never wanted to switch over to fentanyl, but it’s everywhere,” says Tiffany, preparing her needle at VANDU’s site. She’s already crushed and melted down her mixture of benzodiazepines and fentanyl.

“I use drugs as a way of coping with my emotions, and being separated from my son. But I do love myself – that’s why I can’t do this anymore. I refuse to become another statistic,” she says.

Vancouver has long been a pioneer in harm reduction. Over 30 years ago, during the heroin and HIV epidemic, the city opened its first safe injection facility in the Downtown Eastside – the only one of its kind in North America.

But what once helped stem the tide of HIV does not appear to be working now.

Some policymakers claim that harm reduction initiatives have become politicised and are perpetuating the problems of addiction, homelessness, and public disorder – specifically in the Downtown Eastside, which they argue has become a death trap for drug users.

Ms Graham from VANDU accepts that harm reduction can be hard to quantify, but continues to believe Vancouver’s clinics do some good.

“In principle, harm reduction is meeting a person where they’re at, no matter what substance they’re using or harm they’re causing. Inherently, we know that drugs are harmful, so it’s crucial to help them mitigate that harm – for example, providing clean needles and a sanitary space,” she says.

Tiffany shoots up twice in the VANDU facility before slumping over. As the mix of fentanyl and benzodiazepines takes control of her senses, she whispers, “The high feels like a warm hug.”

‘No question’ of drug diversion

While many users like Tiffany in the Downtown Eastside source their drugs from the street, the government has launched a “safer supply” program which allows users to receive pharmaceutical-grade opioids free of charge from a physician.

The initiative is “preventing overdoses, saving lives, and connecting drug users to health and social services”, the province says.

But according to those on the ground, safer supply has created many unexpected consequences. The Vancouver Police Department says a significant portion of the opioids being freely prescribed by doctors are not actually being consumed by their intended recipients.

Instead, the drugs are being resold on the black market at rock-bottom prices – in a process called “diversion” – typically to fund the ongoing purchase of fentanyl.

Deputy Wilson says “there is no question” that these drugs are being diverted to the streets, specifically the Downtown Eastside. In fact, she says that 50 per cent of hydromorphone seizures in British Columbia have originated from the government.

Not only are safer supply drugs being diverted to active users, there are also reports of these powerful opioids falling into the hands of children. Ms Sturko explains that highly addictive drugs are freely going out into every corner of the community, allowing new users to develop opioid use disorders.

“Parents in Vancouver are telling me stories of their children using high quantities of dillies [hydromorphone] because they thought the opioid was ‘safe’ under the government’s label of ‘safer supply’,” she says.

“It’s horrifying. It makes me angry because we’re talking about the lives of our children who may start experimenting with an opioid that won’t kill them, but it eventually leads them to use fentanyl which will kill them.

“It’s a potential pathway of serious addiction. These safer supply drugs are subsidising the fentanyl market.”

But Ms Graham from VANDU claims that banning safer supply drugs is not the answer. She says removing government-regulated opioids from the system would taint the drug supply to an even greater degree.

“It’s clear that stamping out the [regulated] drug supply doesn’t stop people from using the substances. It just makes the quality of the substances they can access less reliable.”

Ms Graham goes as far as to claim that the police are against a regulated drugs market and because it threatens their jobs.

“We need to solve the toxic drugs crisis by providing the substances,” she insists.

Stuck in a ‘detox limbo’

Andrew, a paramedic in the Downtown Eastside, has responded to hundreds – if not thousands – of overdose calls during his time as a first responder. In his view, the government is “subsidising and enabling” the fentanyl crisis by throwing money at it instead of solving it.

He says he can only speak anonymously, as the local health authority has cracked down on interviews in the lead up to the provincial election later this year.

“This is all our fault. We’ve created a system where people can wake up and get high everyday – why would they want to leave the Downtown Eastside? It’s a free ride in life that’s funded by taxpayers.

“You would never see anything like this in a poor country. The government is giving people enough slack so they don’t have to change – this perpetuates the problem that will never be solved.

“The Downtown Eastside is like a warzone. It’s unbelievable the depravity people will endure to simply exist.”

But getting clean is certainly not easy.

Mark Ng Shun from Vancouver Detox explains that “walk-ins” are not permitted in government-funded locations. Instead, drug users are told to join a waiting list that can average anywhere from three to six weeks.

To secure a spot, it’s mandatory to call every day, and users must start detoxing before being admitted.

“Vancouver’s detox system is not working for those who need it the most,” says Mr Ng Shun.

“Many Downtown Eastside residents are stuck in the ‘detox limbo’ – they have a desire to seek a different kind of life, but they’re told they have to wait six weeks. Many people can give up during that time.

“Plus, there is still a stigma attached to Downtown Eastside residents who are seeking help. The services themselves are tailored towards upper- and middle-class white people.

“Only certain lives are supported in detox. The system is oppressive. People who are the least advantaged have the least access to it.”

Lisa Weih lost her 29-year-old daughter, Renée, to an opioid overdose in 2020. She says the city’s detox and recovery systems are inadequate.

“Renée never stopped trying to get better. She put herself through the tortures of detox several times, but there was nothing there for her afterwards… our leaders want to get away with murder.”

On the frontlines of Vancouver’s fentanyl crisis, there is not much sign of change.

Ms Graham, who witnesses the carnage of the Downtown Eastside on a daily basis, says hope is the one thing she can’t afford to lose sight of.

“I’ve lost a school bus full of people to opioids. But there is a way forward, and it’s increased harm reduction,” she insists.

“This isn’t a political debate, it’s a human rights debate.”

Source:  https://www.telegraph.co.uk/global-health/climate-and-people/vancouver-opioid-crisis-drug-addiction-british-columbia-canada/

PHOENIX – The fentanyl and opioid crisis cost Arizona an estimated $58 billion for 2023, according to a Common Sense Institute Arizona report published Monday. The nonpartisan think tank’s report included the costs of fatalities, opioid use disorder, hospitalizations and border security.The report analyzed data from the Centers for Disease Control and Prevention, Arizona Department of Health Services and the National Institute on Drug Abuse, among others.

It showed a decline across the U.S. in opioid prescriptions over the past decade. In Arizona, drug-related seizures have decreased since 2020.

“Naively, you should be able to assume that there are fewer drugs, but that isn’t the case,” said Glenn Farley, lead author of the report, at a Monday news briefing.

The report cited the southern border migrant crisis as an underlying cause for more drugs making their way across the border, noting that Customs and Border Protection has been strained due to the increased number of individuals and fewer checkpoints. “As a result of these resource shifts, the ability of CBP to prevent the smuggling of drugs like fentanyl into the United States is likely compromised,” the report said.

Farley said the amount of fentanyl in the United States is unknown, but deaths from the highly addictive synthetic opioid continue to rise.

Fentanyl-related overdose deaths have increased drastically in the U.S. since 2014. The National Institute on Drug Abuse reported almost 74,000 deaths in 2022. Opioid deaths have hovered around 2,000 per year since 2020 in Arizona, according to ADHS.

Source: https://cronkitenews.azpbs.org/2024/06/24/report-estimates-fentanyl-crisis-costs-arizona-2023/

Filed under: Fentanyl,Prevalence,USA :

 By KEVIN A. SABET, PH.D., President of the Foundation for Drug Policy Solutions

June 25, 2024

From Oregon to Canada to Thailand, policymakers and the public alike are waking up to the consequences of lenient and irresponsible drug policies. Whether it is the commercialization of marijuana or the decriminalization of all other drugs, policymakers are learning the hard way that public health and safety must remain a jurisdiction’s priority. As we approach the International Day Against Drug Abuse and Illicit Trafficking, on June 26, policymakers elsewhere should learn from these lessons and avoid making these same mistakes.

 

Just over a year ago, British Columbia received an exemption from Canada’s Controlled Drugs and Substances Act, allowing the province to decriminalize the public use of dangerous illicit drugs, including fentanyl, methamphetamine, heroin, and cocaine. The public policy was viewed as a triumph by so-called “harm reduction” activists, who push dangerous perceptions that drug use should be normalized and condoned.

 

Parents were understandably outraged to witness people using drugs in a host of public spaces, including parks where their young children were playing. In short order, British Columbia saw a record 2,511 overdose deaths last year and the Deputy Chief of the Vancouver Police Department warned “there have been concerns from small businesses about problematic drug use,” among other consequences.  In turn, public pushback, alongside the pressure of an upcoming election, compelled policymakers to respond and reverse course.

 

Though this sounds like a common-sense move, officials in Canada have been misled into believing that mass decriminalization of drugs would somehow improve public health. The addiction-for-profit industry has fueled this belief via a massive misinformation campaign about the harms of marijuana and other drugs. Elected officials in BC were reminded about the importance of protecting the interests of non-users and the broader community.

 

Officials in Oregon, United States, recently learned a similar lesson, backtracking their experiment with the decriminalization of all illicit drugs. Passed under the guise of an activist-driven ballot measure in 2020, Oregon took a hands-off approach to its drugcrisis, allowing people to do as they pleased with drugs. Like in British Columbia, public drug use skyrocketed. Perhaps unsurprisingly, the number of overdose deaths increased, as did the prevalence of substance use and crime.

 

In April, acknowledging that this policy had not gone as promised, liberal Governor Tina Kotek signed legislation to repeal Measure 110 and recriminalize drug possession, despite promising to uphold Measure 110 just months before. In its place is a framework to increase access to treatment. Elected officials in Oregon were reminded about the importance of treatment.

 

Thailand, the first and only country in Asia to legalize recreational marijuana, is now backtracking and aims to ban recreational marijuana by the end of the year. Reuters reported, “tens of thousands of cannabis shops have sprung up.” Likewise, the illicit market has expanded, and numerous illicit marijuana shops have emerged throughout communities. And psychosis related to marijuana has doubled to more than 20,000 cases since legalization.

 

Officials in Thailand were alarmed to find the marijuana industry aggressively marketing its products, prioritizing its profits ahead of public health. The industry’s predatory practices have led to higher rates of marijuana use among minors. Elected officials in Thailand were reminded about how the interests of the profit-driven marijuana industry are at odds with public health and safety.

 

Policymakers elsewhere should learn from the unintended consequences of these experiments to implement better, safer drugpolicies. It should not be controversial to prohibit public drug use or to implement policies that guide people into treatment. It should not be controversial to say we distrust the motives of emerging addiction-for-profit industries. Countries continue to contemplate extreme policy measures like drug legalization and decriminalization, they would do well to heed the lessons learned by Thailand, British Columbia, Oregon, and more.

 

International Day Against Drug Abuse and Illicit Trafficking is also a fitting time to recognize the importance of supply reduction. Law enforcement agencies in the US and around the world should be commended for standing up to the cartels and their affiliates, and they should be further empowered to crack down on those trafficking dangerous psychoactive drugs.

 

We must recommit ourselves to implementing evidence-based drug policies focused on prevention, treatment, harm reduction, and recovery, as well as supply reduction. Doing so would help elected officials remember the importance of public health and oppose the for-profit interests of emerging industries. Oregon, British Columbia, and Thailand are reminders of what happens when these common-sense messages are forgotten or ignored.

Kevin A. Sabet, Ph.D. is  a former drug policy advisor to U.S. Presidents Obama, Bush and Clinton. 

 

Source: https://gooddrugpolicy.org/

26 June 2024

 

Drugs are at the root of immeasurable human suffering.

Drug use eats away at people’s health and wellbeing. Overdoses claim hundreds of thousands of lives every year.

Meanwhile, synthetic drugs are becoming more lethal and addictive, and the illicit drug market is breaking production records, feeding crime and violence in communities around the world.

At every turn, the most vulnerable people — including young people — suffer the worst effects of this crisis. People who use drugs and those living with substance abuse disorders are victimized again and again: by the drugs themselves, by stigma and discrimination, and by heavy-handed, inhumane responses to the problem.

As this year’s theme reminds us, breaking the cycle of suffering means starting at the beginning, before drugs take hold, by investing in prevention.

Evidence-based drug prevention programmes can protect people and communities alike, while taking a bite out of illicit economies that profit from human misery.

When I was Prime Minster of Portugal, we demonstrated the value of prevention in fighting this scourge. From rehabilitation and reintegration strategies, to public health education campaigns, to increasing investment in drug-prevention, treatment and harm-reduction measures, prevention pays off.

On this important day, let’s recommit to continuing our fight to end the plague of drug abuse and trafficking, once and for all.

 

Source: https://www.unodc.org/islamicrepublicofiran/en/the-secretary-general-message-on-the-occasion-of-the-international-day-against-drug-abuse-and-illicit-trafficking.html

Israel, now the largest per capita consumer of opioids, faces a rising crisis. Learn about the challenges, responses from health authorities, and the need for improved treatment and prevention.

When in 2021, the US Centers for Disease Control and Prevention counted the deaths of over a million Americans from overdosing with opioids – synthetic, painkilling prescription drugs including fentanyl (100 times more powerful than morphine), oxycodone, hydrocodone and many others – Israel’s Health Ministry was asked whether it could happen here. No, its spokesperson said, even though nearly every negative and positive phenomenon in North America inevitably arrives here within a couple of years.

The epidemic began about 25 years ago when drug and healthcare companies began to enthusiastically promote these very-addictive chemicals, claiming they were effective in relieving suffering and did not cause dependency.

A study published this past May by researchers at the Johns Hopkins Bloomberg School of Public Health found that one out of every three Americans have lost someone – a relative or a friend – to an opioid or other drug overdose. The US National Institute on Drug Abuse found that more than 320,000 American children have lost parents from overdoses in the past decade, and the annual financial costs to the US of the opioid crisis is $1 trillion.

Largest consumers of opioids per capita

Incredibly, Israelis today are the largest consumers per capita in the world of opioids, and an untold number of them are addicted or have already died. No one knows the fatality figures here, as the causes of death are described as organ failures, seizures, heart attack or stroke – not listed by what really caused them.

Is this another example of a “misconception” – wishful thinking on the scale of the belief by the government, the IDF, and the security forces that Hamas would “behave” if regularly paid off with suitcases full of cash? Is Israel headed to where the US already is? Perhaps. What is clear is that our various health authorities now have to somehow clean up the opioid mess.

The scandal has been indirectly embarrassing for Israel because among the most notorious companies involved in the opioid disaster is the Sackler family, who own the Purdue Pharma company that manufactured and promoted the powerful and addictive opioid OxyContin and who are now drowning in huge lawsuits. Tel Aviv University’s Medical Faculty that was for decades known as the Sackler Faculty has deleted it from its name.

Last year, the Knesset Health Committee met to discuss the rise in opioid consumption here, with testimony from Ben-Gurion University of the Negev School of Public Health dean and leading epidemiologist Prof. Nadav Davidovitch, who is also the principal researcher and chairman of the Taub Center Health Policy Program. He stressed that inappropriate use of strong pain medications leads to addiction and other severe negative consequences and noted that while most of the rise in consumption is among patients of lower socioeconomic status, the well-off are also hooked. Davidovitch called for the launching of serious programs to treat addicted Israelis based on the experiences of other countries with the crisis.

Opioids attach themselves to opioid-receptor proteins on nerve cells in the brain, gut, spinal cord, and other parts of the body. This obstructs pain messages sent from the body through the spinal cord to the brain. While they can effectively relieve pain, they can be very addictive, especially when they are consumed for more than a few months to ease acute pain, out of habit, or from the patients’ feeling of pleasure (they make some users feel “high”). Patients who suddenly stop taking them can sometimes suffer from insomnia or jittery nerves, so it’s important to taper off before ultimately stopping to take them.

The Health Ministry was forced in 2022 to alter the labels on packaging of opioid drugs to warn about the danger of addiction after the High Court of Justice heard a petition by the Physicians for Human Rights-Israel and the patients’ rights organization Le’altar that claimed the ministry came under pressure from the pharmaceutical companies to oppose this. After ministry documents that showed doctors knew little about the addictions caused by opioids were made public by the petitioners, psychiatrist Dr. Paola Rosca – head of the ministry’s addictions department – told the court that the synthetic painkillers cause addiction. She has not denied the claim that the ministry was squeezed by the drug companies to oppose label changes.

No special prescription, no time limit, no supervision

In an interview with The Jerusalem Post, Prof. Pinhas Dannon – chief psychiatrist of the Herzog Medical Center in Jerusalem and a leading expert on opioid addiction – noted that anyone with a medical degree can prescribe synthetic painkillers to patients. “There is no special prescription, no time limit, no supervision,” he said.

“A person who undergoes surgery who might suffer from serious pain is often automatically given prescriptions for opioids – not just one but several,” Dannon revealed. “Nobody checks afterwards whether the patient took them, handed them over to others (for money or not), whether they took several kinds at once, or whether they stopped taking them. They are also prescribed by family physicians, orthopedists treating chronic back pain, urologists, and other doctors, not only by surgeons.”

Dannon, who runs a hospital clinic that tries to cure opioid addiction, said there are only about three psychiatric hospitals around the country that have small in-house departments to treat severely addicted patients. “Not all those addicted need inpatient treatment, but when we build our new psychiatry center, we would be able to provide such a service.”

Since opioids are relatively cheap and included in the basket of health services, the four public health funds that pay for and supply them have not paid much attention. Once a drug is in the basket, it isn’t removed or questioned. Only now, when threatened by lawsuits over dependency, have the health funds begun to take notice and try to promote reductions in use.

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Dannon declared that the health funds, hospitals, and pharmacies must seriously supervise opioid use by tracking and be required by the ministry to report who is taking them, how much, what ages, and for how long. Opioids are meant for acute pain, not for a long period. “The Health Ministry puts out fires but is faulty in prevention and supervision,” he said.

A Canadian research team has just conducted a study at seven hospital emergency departments in Quebec and Ontario to determine the ideal quantity of prescription opioids to control pain in discharged patients and reduce unused opioids available for misuse.

They recommended that doctors could adapt prescribing quantity to the specific condition causing pain, based on estimates to alleviate pain in 80% of patients for two weeks, with the smallest quantity for kidney or abdominal pain (eight tablets) and the highest for back pain (21 tablets) or fractures (24 tablets), and add an expiry date for them. Since half of participants consumed even smaller quantities, pharmacists could provide half this quantity to further reduce unused opioids available for misuse.

No medical instruction on the issue

Rosca, who was born in Italy where she studied medicine and came on aliyah in 1983, has worked in the ministry since 2000; in 2006, she became head of the addictions department.

“In Italy, every psychiatrist must learn about alcohol and other drug addictions including opioids,” she said. “Here, there is no mandatory course in any medical school on the subject. We tried to persuade the Israel Medical Association and its Scientific Council, which decides on curricula and specializations, but we didn’t succeed. Maybe now, in the face of the crisis, it will change its mind. We run optional courses as continuing medical education for physicians who are interested.”

Her department wanted pharmacists to provide electronic monitoring of opioid purchases, but “the Justice Ministry opposed it on the grounds that it would violate privacy. I wasn’t asked for my opinion.”

She concedes that the ministry lacks statistics on the number of addicted people, and Arabs have been excluded from estimates until now. “We’re doing a study with Jerusalem’s Myers-JDC-Brookdale Institute to find out how many. Some say one percent, some say five percent. We hope that by December, we will get more accurate figures. Before the COVID-19 pandemic, the ministry set up a committee on what to do about opioids, but its recommendations were never published, and there was no campaign,” Rosca recalled.

In 1988, the government established the statutory Anti-Drug Authority that was located in Jerusalem’s Givat Shaul neighborhood. It was active in fighting abuse and shared research with foreign experts, but seven years ago, its name was changed to the National Authority for Community Safety and became part of the Ministry for National Security, losing much of its budgets – and, according to observers, its effectiveness as well.

The Health Ministry used to be responsible for setting up and operating clinics for drug rehabilitation, but it handed this over in 1997 to a non-profit organization called the Israel Public Health Association, which employs numerous former ministry professionals. Its director-general, lawyer Yasmin Nachum, told the Post in an interview that the IPHA is very active in fighting drug addiction.

“Israel can’t deny anymore that we are in a worrisome opioid epidemic like that in the US: We are there,” he said. “We see patients every day. Some used to take heroin and other street drugs, but with the easy access and low price, they have switched to opioids. If they are hospitalized for an operation and don’t use all the prescriptions they are given, they sell them to others. We want to have representation in every hospital to warn doctors and patients.”

Of a staff of 1,100, the IPHA has 170 professionals – narcotics experts, social workers, occupational therapists, and others working with 3,000 addicted patients every day. Its other activities include mental health, ensuring safety of food and water, and rehabilitation.

Stopping after six months

“We work in full cooperation with the ministry,” Nachum said. “Our approach is that when opioids are taken for pain for as long as six months, it’s the time to stop taking them. The doctors provide addicted patients with a drug called buprenorphine, sold under the brand name Subutex, which is used to treat opioid-use disorder, acute pain, and chronic pain.”

Buprenorphine is a mixed opioid agonist and antagonist. That means it has some of the effects of opioids but also blocks some of their effects. Before the patient can take it under direct observation, he must have moderate opioid-withdrawal symptoms. The drug relieves withdrawal symptoms from other opioids and induces some euphoria, but it also blocks the efficacy of many other opioids including heroin, to create an effect.

Buprenorphine levels in the blood stay consistent throughout the month. Nachum said the replacement drug is relatively safe, with some side effects, but fortunately, there is no danger of an overdose.

NARCAN (NALOXDONE) is another prescription drug used by some professionals to fight addiction. Not in Israel’s basket of health services, it blocks the effects of opioids by temporarily reversing them, helping the patient to breathe again and wake up from an overdose. While it has saved countless lives, new and more powerful opioids keep appearing, and first responders are finding it increasingly difficult to revive people with it.

Now, US researchers have found an approach that could extend naloxone’s lifesaving power, even in the face of continually more dangerous opioids by using potential drugs that make naloxone more potent and longer lasting. Naloxone is a lifesaver, but it’s not a miracle drug; it has limitations, the team said.

After the Nova massacre on October 7, when significant numbers of participants who were murdered were high on drugs, the IPHA received a huge number of calls. In December, Nachum decided to open a hotline run by professionals about addiction that has been called monthly by some 300 people. “We also hold lectures for pain doctors, family physicians, and others who are interested, because there has been so little awareness.”

All agree that the opioid crisis has been seriously neglected here and that if it is not dealt with seriously and in joint efforts headed by healthcare authorities, it will snowball and add to Israel’s current physical and psychological damage.

Source: https://www.jpost.com/health-and-wellness/article-811126

May 09, 2024

WASHINGTON – Today, DEA Administrator Anne Milgram announced the release of the 2024 National Drug Threat Assessment (NDTA), DEA’s comprehensive strategic assessment of illicit drug threats and trafficking trends endangering the United States.

 

For more than a decade, DEA’s NDTA has been a trusted resource for law enforcement agencies, policy makers, and prevention and treatment specialists and has been integral in informing policies and laws. It also serves as a critical tool to inform and educate the public.

 

DEA’s top priority is reducing the supply of deadly drugs in our country and defeating the two cartels responsible for the vast majority of drug trafficking in the United States. The drug poisoning crisis remains a public safety, public health, and national security issue, which requires a new approach.

 

“The shift from plant-based drugs, like heroin and cocaine, to synthetic, chemical-based drugs, like fentanyl and methamphetamine, has resulted in the most dangerous and deadly drug crisis the United States has ever faced,” said DEA Administrator Anne Milgram. “At the heart of the synthetic drug crisis are the Sinaloa and Jalisco cartels and their associates, who DEA is tracking world-wide. The suppliers, manufacturers, distributors, and money launderers all play a role in the web of deliberate and calculated treachery orchestrated by these cartels. DEA will continue to use all available resources to target these networks and save American lives.”

Drug-related deaths claimed 107,941 American lives in 2022, according to the Centers for Disease Control and Prevention (CDC). Fentanyl and other synthetic opioids are responsible for approximately 70% of lives lost, while methamphetamine and other synthetic stimulants are responsible for approximately 30% of deaths.

 

Fentanyl is the nation’s greatest and most urgent drug threat. Two milligrams (mg) of fentanyl is considered a potentially fatal dose. Pills tested in DEA laboratories average 2.4 mg of fentanyl, but have ranged from 0.2 mg to as high as 9 mg. The advent of fentanyl mixtures to include other synthetic opioids, such as nitazenes, or the veterinary sedative xylazine have increased the harms associated with fentanyl.

Seizures of fentanyl, in both powder and pill form, are at record levels. Over the past two years seizures of fentanyl powder nearly doubled. DEA seized 13,176 kilograms (29,048 pounds) in 2023. Meanwhile, the more than 79 million fentanyl pills seized by DEA in 2023 is almost triple what was seized in 2021. Last year, 30% of the fentanyl powder seized by DEA contained xylazine. That is up from 25% in 2022.

 

Social media platforms and encrypted apps extend the cartels’ reach into every community in the United States and across nearly 50 countries worldwide. Drug traffickers and their associates use technology to advertise and sell their products, collect payment, recruit and train couriers, and deliver drugs to customers without having to meet face-to-face. This new age of digital drug dealing has pushed the peddling of drugs off the streets of America and into our pockets and purses.

 

The cartels have built mutually profitable partnerships with China-based precursor chemical companies to obtain the necessary ingredients to manufacturer synthetic drugs. They also work in partnership with Chinese money laundering organizations to launder drug proceeds and are increasingly using cryptocurrency.

 

Nearly all the methamphetamines sold in the United States today is manufactured in Mexico, and it is purer and more potent than in years past. The shift to Mexican-manufactured methamphetamine is evidenced by the dramatic decline in domestic clandestine lab seizures. In 2023, DEA’s El Paso Intelligence Center (EPIC) documented 60 domestic methamphetamine clandestine lab seizures, which is a stark comparison to 2004 when 23,700 clandestine methamphetamine labs were seized in the United States.

 

DEA’s NDTA gathers information from many data sources, such as drug investigations and seizures, drug purity, laboratory analysis, and information on transnational and domestic criminal groups.

Click here to read the DEA’s Threat Assessment report

Source: https://www.dea.gov/press-releases/2024/05/09/dea-releases-2024-national-drug-threat-assessment

Research published earlier this week in the monthly peer-reviewed scientific journal “Addiction,” showed that more than 17.7 million Americans used marijuana daily or near-daily in 2022 as compared to 14.7 million who reported drinking alcohol at the same rate.

Far more people consume alcohol than cannabis, research showed, but “high-frequency” drinking is less common. In 2022, the “median drinker” reported drinking on 4 to 5 days in the past month, compared to 15 to 16 days in the past month for the median cannabis user.

Regular cannabis use still pales in comparison to daily use of cigarettes, researchers noted. More than 24.1 million people smoked cigarettes daily or near-daily compared to the 17.7 million Americans who used cannabis regularly.

The research also showed that older Americans are using more regularly than younger.

“In 2022, people 35 and older accounted for (slightly) more days of use than did those under the age of 35,” the study notes.

Researchers used data compiled over more than 40 years from the National Household Survey on Drug Abuse, which showed cannabis use began to rise at a corresponding rate to changes in cannabis policies.

As of 2024, 24 states and the District of Columbia have legalized recreational marijuana use, according to the Pew Research Center. Another 14 states allow for medical use only.

Last week, the U.S. Department of Justice proposed new regulations that would designate cannabis a Schedule III drug, rather than its current designation of a Schedule I drug. Cocaine, methamphetamine and fentanyl are among the drugs that have received the Schedule II designation.

Schedule I drugs are those with the highest potential to create dependency issues and are considered to have “no currently accepted medical use.” The DOJ decision cites the use of marijuana in the medical field as one of the reasons it warrants reclassification.

The recently published research concluded that long-term trends in cannabis use have paralleled cannabis policy changes, with declines during periods of “greater restriction and growth during periods of policy liberalization.”

But researchers stressed that changes in laws regarding cannabis can’t be definitely attributed to the rise in use.

“Both could have been manifestations of changes in underlying culture and attitudes. However, whichever way causal arrows point, cannabis use now appears to be on a fundamentally different scale than it was before legalization,” researchers wrote.

To read the full study and read more about the findings and methodology used, click here.

Copyright 2024 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

Source:https://www.yahoo.com/news/daily-cannabis-surpasses-daily-alcohol-211954850.html?

Christian Haserot has tried to get clean a handful of times.

But during his most recent attempt, the once aspiring cyber security researcher encountered an insurmountable obstacle.

Everywhere he turned in Portland, he saw people smoking fentanyl.

Even when hunkered down in his sheltered housing bedroom, the fumes would waft up to his window.

“The temptation of having people outside my building, standing in a group smoking in plain sight.. it was too hard for me”, he says, dejected. “I relapsed.”

Three-years-ago Oregon became the first US state in history to decriminalise hard drugs after 58 per cent of voters backed the lenient legislation.

Measure 110 was meant to transform the “war on drugs”, with addicts given treatment and support instead of incarceration.

Tax income from cannabis sales were meant to fund drug treatment programmes.

But with few users seeking help and others flocking to the state in light of its relaxed laws, the state’s biggest city has transformed into a “zombie apocalypse” of drug addicts getting high in broad daylight.

Within 30 seconds of setting off on a patrol of the downtown area with Portland police Sergeant Jerry Cioeta, we see someone keeled over on the cold pavement, their arms wrapped around a red pole.

“This person is really high on fentanyl. That’s why they’re licking a telephone pole”, he says.

Pointing to a group of five men in hats, he adds: “These guys were dealing, that’s why they’re running away from me.”

Around them is a smattering of tents, a shopping trolley and a number of sleeping bags strewn in front of what used to be a hotel.

A significant number of local businesses are boarded up, with those that remain hiring private security to keep watch.

Before Measure 110 came into effect, Portland was “just like any other normal place”, said Mr Haserot, 29.

Dressed in a burgundy puffer jacket and clutching a woolen Oregon hat to protect from the cold, he adds: “Maybe there were some alcoholics out and about, but you didn’t see people holding foils in public and hitting stuff on foil.

“You didn’t see meth pipes out on the street. That was not around. And now it’s, you know, it’s everywhere.”

He says he also meets a “lot of people who moved here because of the drug laws”.

Under Measure 110, anyone caught with small amounts of hard drugs like fentanyl, heroin or meth is given a $100 ticket.

But, if they call a 24-hour hotline to complete an addiction screening within 45 days, the fine disappears. There is no penalty for failing to pay.

“We’ve written over 700 tickets since May, and to the best of our knowledge not a single one has called up and gone to treatment”, Sgt Cieota says. “Two out of two people don’t want help.”

Sgt Cioeta has been an officer in Portland for more than 26 years. When he started out he would respond to alcoholics or domestic violence, now more than 90 per cent of his job is taken up by open air fentanyl use and dealing.

Sgt Cioeta and a team of four other officers are tasked with tackling drug use on the streets, what he describes as a game of “whack-a-mole”.

Around another corner, a drug user is sitting between two carefully manicured city flower pots. He is desperately trying to scrape fentanyl residue out of a metal tin.

Behind him, around a metre a way, a man high on the synthetic opioid has passed out – the only thing keeping him upright is the pressure of his forehead leaning against a red, brick wall.

“Can you smell that?” Sgt Cioeta says. “It kind of smells like weed, but it isn’t, that’s fentanyl.”

Sgt Cioeta said things have become so bad because of a “perfect storm”: the pandemic, Measure 110 and the prevalence of fentanyl.

“It’s a drug like we have never seen on this planet. It’s highly addictive, that withdrawal is sudden, and is super cheap”, he says.

Areas of the city have been “decimated” by fentanyl use, where they’ve transformed “from vibrant to zombie land”.

“One time we had four fatal overdoses in three minutes within five feet of each other.”

Accidental drug overdose death rates in the state doubled from 472 in 2020 to 955 in 2022.

While residents had been in favour of Measure 110 initially, in a survey of 1,000 locals by Emerson College earlier this year [2023], 56 per cent said they wanted it repealed.

But for some, the drug laws are not relaxed enough.

User Quentin Sweet, who has just received a ticket for smoking fentanyl at a tram stop, said he thinks the only place people shouldn’t be able to smoke the drug is a nursery.

“Drugs are not bad for someone, but instead are enjoyable, and even so far as to say a healthy experience that is good for someone”, he says.

Mr Sweet, 23, who has painted his fingernails, and the skin around them, red, says he has no intention of paying the fine or calling the number on the back of the ticket.

“I’ve completely dismissed it as unimportant,” he says.

Keith Humphreys, professor of psychiatry and behavioral sciences who has studied the impact of Measure 110, says decriminalisation has been a “complete failure”.

“They’ve let drugs run the state”, he says.

Mr Humphreys said before the introduction of Measure 110, Oregon’s drug laws were already some of the most lenient in the country.

The complete overhaul “represented a misunderstanding of the nature of being addicted to fentanyl,” he says.

“Because drugs feel good in the short term, even though in the long term they’re wrecking your life, people are much more ambivalent about seeking treatment.

“You can’t throw away all those sticks and just hand out carrots. If you want people to access addiction treatment, there has to be some press from the other side. Otherwise they’ll just continue using drugs until they die.”

 

Source: https://www.telegraph.co.uk/world-news/2023/12/23/counting-the-cost-of-decriminalising-drugs-in-oregon/

This is The Drug Report’s Friday Fact report – The rate of violent behavior in daily marijuana users aged 18-34 was nearly twice the violent behavior rate of non-users

The study “Associations of cannabis use, use frequency, and cannabis use disorder with violent behavior among young adults in the United States” was recently published by Nora D. Volkow and the team at NIDA. The study found that the rate of violent behavior in daily marijuana users aged 18-34 was nearly twice the violent behavior rate of non-users.

The study consisted of 113,434 participants, aged 18 to 34, and relied on data from the 2015-2019 National Surveys on Drug Use and Health (NSDUH).

The datasets provided information on the rates of daily marijuana use, whether the participants had Cannabis Use Disorder, and violent behavior. The study found:

The violence behavior rates for both males and females who were daily marijuana users and had Cannabis Use Disorder were close to doubling that of males and females who were non-marijuana users.

Source: Email from Smart Approaches to Marijuana (SAM) reply@learnaboutsam.org May 2024

By

U.S. News & World Report

By Ernie Mundell HealthDay Reporter

 American teenagers cite stress as the leading reason they might get drunk or high, a new report reveals.

That only underscores the need for better adolescent mental health care, according to the research team behind the study.

Better “access to treatment and support for mental health concerns and stress could reduce some of the reported motivations for substance use,” concluded investigators from the U.S. Centers for Disease Control and Prevention.

In the study, a team led by CDC researcher Sarah Connolly looked at 2014-2020 data on over 9,500 people ages 13 to 18, all of who were being treated for a substance use disorder.

Teens were using a myriad of substances, including alcohol, marijuana, prescription painkillers (often opioids), prescription stimulants (for example, Ritalin), or prescription sedatives (such as Valium or Xanax).

The teens were also asked why they thought they were using or abusing substances.  Easing stress in their lives was the leading factor cited.

“The most commonly reported motivation for substance use was “to feel mellow, calm, or relaxed” (73%), with other stress-related motivations among the top reasons, including “to stop worrying about a problem or to forget bad memories” (44%) and “to help with depression or anxiety” (40%),” Connolly’s team reported.

Stress relief wasn’t the only motivator, of course: Half of the teens reported using substances “to have fun or experiment.” This reason for using substances was more often cited for alcohol or nonprescription drug use than it was for the use of marijuana or other drugs.

Substance abuse with the aim of easing stress was most often cited for marijuana (76% of teens), prescription pain meds (61%) and sedatives/tranquilizers (55%), the study found.

Half of the teens surveyed said they often used drugs or alcohol alone, but 81% said they also used them with friends, a boyfriend or girlfriend (24%), or “anyone who has drugs” (23%).

According to the researchers, prior data has long shown that “anxiety and experiencing traumatic life events have been associated with substance use in adolescents.”

But with burgeoning rates of substance abuse and related overdoses, the consequences of turning to substances to ease stress can be tragic.

“Harm reduction education specifically tailored to adolescents has the potential to discourage using substances while alone and teach how to recognize and respond to an overdose in others,” the team said.

Such interventions might “prevent overdoses that occur when adolescents use drugs with friends from becoming fatal,” they added.

If you or a loved one is stressed by a mental health crisis, confidential 24/7 help is on hand at the 988 Suicide & Crisis Lifeline.

The findings were published in the Feb. 9 issue of the CDC journal Morbidity and Mortality Weekly Report.

More information

There’s tips to identifying stress in your teen at the American Psychological Association.

SOURCE: Morbidity and Mortality Weekly Report, Feb. 9, 2024

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Tags: parentingdrug abuseanxietystressalcohol

Source: https://www.usnews.com/news/health-news/articles/2024-02-09/stress-main-factor-driving-teens-to-abuse-drugs-alcohol

By      Feb. 16, 2024, at 7:53 a.m.

U.S. News & World Report

Smoking Now Fuels More Drug Overdoses than Injecting Does

By Robin Foster HealthDay Reporter

Despite stereotypical images of addicts injecting heroin and then dying, new government research finds that smoking drugs such as fentanyl is now the leading cause of fatal overdoses.

In the new research, published Thursday in Morbidity and Mortality Weekly Report, scientists from the U.S. Centers for Disease Control and Prevention found the percentage of overdose deaths between January 2020 and December 2022 linked to smoking increased 73.7% — going from from 13.3% to 23.1% — while the percentage of overdose deaths linked to injection decreased 29.1% — going from from 22.7% to 16.1%.

These changes were most pronounced when fentanyl was the drug of choice: In those cases, the percentage with evidence of injection decreased 41.6%, while the percentage with evidence of smoking increased 78.9%.

CDC officials explained in their report that they decided to tackle the topic after seeing reports from California suggesting that smoking fentanyl was becoming the preferred way to use the deadly drug.

Fentanyl accounts for nearly 70% of overdose deaths in the United States, they noted.

Some early research has suggested that smoking fentanyl is somewhat less deadly than injecting it, and any reduction in injection-related overdose deaths is a positive, report author Lauren Tanz, a CDC senior scientist who studies overdoes, told the Associated Press.

However, “both injection and smoking carry a substantial overdose risk,” and it’s not clear if a shift toward smoking fentanyl will lower the number of U.S. overdose deaths, Tanz said.

Fentanyl is a powerful drug that, in powder form, is cut into heroin or other drugs. In recent years, it’s been fueling the U.S. overdose epidemic. Drug overdose deaths climbed slightly in 2022 after two big leaps during the pandemic, and provisional data for the first nine months of 2023 suggests it inched up again last year, the AP reported.

For years, fentanyl has been injected, but drug users often smoke it now. Users put the powder on tin foil or in a glass pipe, heated from below, and inhale the vapor, Alex Kral, a RTI International researcher who studies drug users in San Francisco, told the AP.

Smoked fentanyl is not as concentrated as fentanyl in a syringe, but some users see upsides to smoking, Kral explained, including the fact that people who inject drugs often deal with pus-filled abscesses on their skin and risk infections with hepatitis and other diseases.

“One person showed me his arms and said, ‘Hey, look at my arm! It looks beautiful! I can now wear T-shirts and I can get a job because I don’t have these track marks,’” Kral said.

In the new report, investigators were able to cull data from the District of Columbia and 27 states for the years 2020 to 2022. From there, they tallied how drugs were taken in about 71,000 of the more than 311,000 total U.S. overdose deaths over those three years.

By late 2022, 23% of the deaths occurred after smoking, 16% after injections, 16% after snorting and 14.5% after swallowing, the researchers reported.

Tanz said she feels the data is nationally representative because it came from states in every region of the country, and all showed increases in smoking and decreases in injecting. Smoking was the most common route in the West and Midwest, and roughly tied with injecting in the Northeast and South, the report found.

Kral noted the study has some limitations.

It can be difficult to determine the exact cause of an overdose death, especially if no witness was present, he said, and injections might be more reported more often because it is easy to spot needle marks on the body. To detect smoking as a cause of death, “they likely would need to find a pipe or foil on the scene and decide whether to write that down,” he said.

Kral added that many people who smoke fentanyl use a straw, and it’s possible investigators saw a straw and assumed it was snorted.

More information

The National Institute on Drug Abuse has more on drug overdose deaths.

SOURCE: Morbidity and Mortality Weekly Report, Feb. 16, 2024; Associated Press

Copyright © 2024 HealthDay. All rights reserved.

Source: https://www.usnews.com/news/health-news/articles/2024-02-16/smoking-now-fuels-more-drug-overdoses-than-injecting-does

Filed under: Prevalence,USA :

Description:

Browse state-level percentage estimates based on the 2021-2022 National Surveys on Drug Use and Health (NSDUH). The 37 tables include estimates for 35 measures of substance use and mental health, by age group, along with 95% confidence intervals. The percentages are based on small area estimation (SAE) methods, in which state-level NSDUH data are combined with other data from smaller geographies. The combined data are used to create modeled state estimates of the civilian, noninstitutionalized population ages 12 and older, or adults 18 and older for mental health measures. Each table covers a single measure by state, region, and age group.

The indicators are presented in the following 37 tables:

Drug use and Perceived Risk

  1. Illicit Drug Use in the Past Month
  2. Marijuana Use in the Past Year
  3. Marijuana Use in the Past Month
  4. Perceptions of Great Risk from Smoking Marijuana Once a Month
  5. First Use of Marijuana in the Past Year (among those at risk for initiation)
  6. Illicit Drug Use Other than Marijuana in the Past Month
  7. Cocaine Use in the Past Year
  8. Perceptions of Great Risk from using Cocaine Once a Month
  9. Heroin Use in the Past Year
  10. Perceptions of Great Risk from Trying Heroin Once or Twice
  11. Hallucinogen Use in the Past Year
  12. Methamphetamine Use in the Past Year
  13. Prescription Pain Reliever Misuse in the Past Year
  14. Opioid Misuse in the Past Year

Alcohol

  1. Alcohol Use in the Past Month
  2. Binge Alcohol Use in the Past Month
  3. Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week
  4. Alcohol Use, Binge Alcohol Use in the Past Month, and Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week (among people aged 12 to 20)

Tobacco

  1. Tobacco Product Use in the Past Month
  2. Cigarette Use in the Past Month
  3. Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day

Substance Use Disorders

  1. Substance Use Disorder in the Past Year
  2. Alcohol Use Disorder in the Past Year
  3. Alcohol Use Disorder in the Past Year (among people aged 12 to 20)
  4. Drug Use Disorder in the Past Year
  5. Pain Reliever Use Disorder in the Past Year
  6. Opioid Use Disorder in the Past Year

Substance Use Treatment

  1. Received Substance Use Treatment in the Past Year
  2. Classified as Needing Substance Use Treatment in the Past Year
  3. Did Not Receive Substance Use Treatment in the Past Year among those Classified as Needing Substance Use Treatment

Mental Illness

  1. Any Mental Illness in the Past Year
  2. Serious Mental Illness in the Past Year
  3. Received Mental Health Treatment in the Past Year
  4. Major Depressive Episode in the Past Year

Suicidality

  1. Had Serious Thoughts of Suicide in the Past Year
  2. Made Any Suicide Plans in the Past Year
  3. Attempted Suicide in the Past Year
Publication Date: February 15, 2024
Collection Date: 2021-2022
Report Type: Data Table
Source:  https://www.samhsa.gov/data/report/2021-2022-nsduh-state-prevalence-estimates

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