Prevention and Intervention

by Barbara A. Preston | www.themontynews.orgJune 6, 2025

Montgomery Police and Health Department officials are partnering to raise awareness about the dangers of vaping and substance abuse. They sponsored a program at Montgomery High School on Friday, June 6, aimed at educating teens about the risks.

Experts say vaping weed, and nicotine, are very popular with teens across the country — however, users are often uninformed about the risks and harm associated with the trend.

According to the CDC and the Food and Drug Administration (FDA), Tobacco companies and e-cigarette companies are targeting youth. The problem goes beyond nicotine. The delivery device, commonly referred to Electronic Nicotine Delivery Systems (ENDS) is a major part of the problem. Also called electronic cigarettes, e-cigarettes, vaping devices, or vape pens, ENDS are battery-powered devices used to smoke or “vape” a flavored or unflavored solution which usually contains nicotine or marijuana, or both. The American Academy of Family Physicians (AAFP) recognizes the increased use of ENDS, especially among youth and young adults.

Montgomery Township Police Chief Silvio Bet said the Vaping Program at the high school is one of many important initiatives the police and health department plan to roll out.
“Our continued initiatives symbolize our commitment to fostering a culture of awareness that benefits all community members,” Chief Bet said. The programs also build a stronger relationship between the police department, the health department, and the community, he said.

ThinkFast Interactive, an educational consultant company based in Kent County, Michigan, led the assembly portion of the program. They gave a lively, loud, and fun interactive presentation to the MHS freshman and sophomores in the school auditorium.

The ThinkFast MCs and DJs raised student awareness on everything from the harmful chemicals found in e-cigarettes to the potency of today’s marijuana.

Chemicals Found in Vapes

According to ThinkFast and Prevention Resources Inc data, the following chemicals are commonly found in vape devices:
       – Diacetyl (The chemical associated with the disease “popcorn lung.”)
       – Heavy Metals ( Lead and nickel can build-up in the body to fatal levels.)
       – Formaldehyde (A toxic chemical component used in the embalming process.)

Potency of Today’s THC (Marijuana)

Teens are overdosing from vaping THC in our community, according to Prevention Resources. They have ended up in local hospitals for emergency care because of the very high concentration of THC in today’s weed.
Some studies show the percentage of THC in cannabis has more than quadrupled since 1995. Samples seized by the Drug Enforcement Administration in 1995 contained 3.96% of THC. By 2022, the percent of TCH increased to 16.14%, according to The National Institute on Drug Abuse.
Addictive Drugs such as nicotine and THC (marijuana), are known to cause brain changes, which are most harmful to adolescents. Research shows that about one in six teens who repeatedly use cannabis can become addicted, as compared to one in nine adults
Marcantuono summed up the program, telling The Montgomery News, “Our goal is to educate, raise awareness, and change the trajectory to prevent ENDS device initiation and ultimately, to end tobacco and marijuana use.”

Source:  https://www.themontynews.org/single-post/teens-learn-about-the-many-risks-of-vaping-nicotine-and-thc-more-potent-addictive-and-dangerous-t

by  Kabeer Bello,  Daily Post, Nigeria –   

The Drug-Free Arewa Movement (DFAM) has appealed to the leaders of Northern Nigeria to join forces in confronting the growing threat of drug trafficking and substance abuse taking root in the region.

In his Eid-el-Kabir message on Friday in Abuja, DFAM Lead Convener, Ibrahim Yusuf, expressed deep concern over the devastation drug abuse is inflicting on Northern Nigeria.

He described drug abuse as an epidemic that is “silently slaughtering the future of the region.”

While congratulating the Muslim faithful in the celebration of Eid, Yusuf called on leaders and stakeholders across all levels of society: politicians, traditional leaders, legislators, religious institutions, civil society, and families—treat the battle against drug abuse as a national emergency.

“This menace has paralyzed development and development opportunities, provided avenues for social vices, and mental health crises,” stated Yusuf.

“We are losing our youth—the greatest asset to addiction, unemployment, and/or hopelessness.”

Yusuf made it clear that DFAM isn’t just doing advocacy, it is collaborating with communities, schools, and religious institutions to implement evidence-based substance demand reduction strategies.

He called on the Northern States Governors’ Forum, their spouses, the Northern Traditional Rulers Council, not to run away nor be afraid to respond. He observed that

“Drug abuse does not discriminate based on ethnicity, politics, or religion… It is a monster that rides into the home, the school, the street and place of worship.”

He said that he had to honour the past North leaders like Sir Ahmadu Bello and Sir Abubakar Tafawa Balewa and he said that today’s generation learned and be influenced by the leaders’ legacies of unity, vision, and purpose.

He challenged the stakeholders to take the following steps: reintegrate out-of-school children, build rehabilitation centres, implement school based drug prevention programs, and create real economic opportunities for youths.

“Say no to drugs, it is a slow killer that steals your future and your peace. To those of you that are already addicted, you can quit! DFAM is here to help.”

 

Source:  https://dailypost.ng/2025/06/07/drug-abuse-silently-killing-northern-youths-dfam/

by Amy Norton – May 14, 2025

The trends are clear: Americans are in the midst of a marijuana high. Over the past 30 years, daily or near-daily marijuana use soared 15-fold, surpassing daily alcohol use for the first time in 2022. That same year, marijuana use reached historic levels among Americans aged 19-50 — with 11% of 19- to 30-year-olds saying they used the drug every day.

A key reason for the surge is that more states are legalizing both medical and recreational marijuana use. Another driver, which is closely tied to legalization, is the changing public perceptions around marijuana: Many people just don’t see much harm in the habit, or at least view a daily marijuana joint as safer than smoking cigarettes.

And they’re not necessarily wrong: Although it’s obvious marijuana use can have consequences — including intoxication, dependence, and respiratory symptoms such as chronic bronchitis — there is little, or not enough, evidence to definitively conclude that it’s a cancer risk.

But that also doesn’t mean marijuana is completely in the clear.

“Insufficient evidence doesn’t mean the risk isn’t there,” said Nigar Nargis, PhD, senior scientific director of tobacco control research, American Cancer Society (ACS).

‘The Crux of the Problem’

Marijuana smoke does contain many of the same carcinogens found in tobacco smoke, so it seems logical that a cannabis habit could contribute to some cancers. Yet studies have largely failed to bear that logic out.

In 2017, the National Academies of Sciences, Engineering, and Medicine (NASEM) published a comprehensive research review on cannabis smoking and cancer risk. It found modest evidence of an association with just one cancer: a subtype of testicular cancer. In the cases of lung and head and neck cancers, studies indicated no significant association between habitual cannabis use and risk for these cancers. When it came to other cannabis-cancer relationships, the evidence was mostly deemed insufficient or simply absent.

However, the overarching conclusion from the NASEM review was that studies to date have been hampered by limitations, such as small sample sizes and survey-based measurements of cannabis use that lack details on frequency and duration of use. In addition, many marijuana users may also smoke cigarettes, making it difficult to untangle the effects of marijuana itself.

“That’s the crux of the problem,” Nargis said. “We have a huge knowledge gap where existing evidence doesn’t allow us to draw conclusions.”

That long-standing gap is becoming more concerning, she said, because legalization may now be sending a “signal” to the public that cannabis is safe.

This concern prompted Nargis and her colleagues to explore whether studies conducted since the 2017 NASEM report have lifted the marijuana-cancer risk haze at all. Their conclusion, published in February in The Lancet Public Health: not really.

“Unfortunately, the evidence base hasn’t improved much,” Nargis said. However, she added, some studies have hinted at links between cannabis use and certain cancers beyond testicular. Although these studies have their own limitations, Nargis stressed, they do point to directions for future research.

Head and Neck Cancers

While the NASEM report cited reassuring data on head and neck cancers, a study published last year in JAMA Otolaryngology-Head & Neck Surgery reached a different conclusion. The researchers tried to overcome some limitations of prior research — including small sample sizes and relatively light and self-reported marijuana use — by analyzing records from patients diagnosed with cannabis use disorder at 64 US healthcare organizations.

The study involved over 116,000 patients with cannabis use disorder, matched against a control group without that diagnosis. Head and neck cancers were rare in both groups, but the overall incidence over 20 years was about three times higher among patients with cannabis use disorder (0.28% vs 0.09%).

After propensity score matching — based on factors such as age and tobacco and alcohol use — patients with cannabis use disorder had a 2.5-8.5 times higher risk for head and neck cancers, especially laryngeal cancer: any type (risk ratio [RR], 3.49), laryngeal cancer (RR, 8.39), oropharyngeal cancer (RR, 4.90), salivary gland cancer (RR, 2.70), nasopharyngeal cancer (RR, 2.60), and oral cancer (RR, 2.51).

But although the study was large, “it’s not particularly strong evidence,” said Gideon Meyerowitz-Katz, MPH, PhD, an epidemiologist and senior research fellow at the University of Wollongong, Australia.

Meyerowitz-Katz pointed to some key limitations, including the focus on people with cannabis use disorder, who are not representative of users in general. The study also lacked information on factors that aren’t captured in patient records, such as occupation — which, Meyerowitz-Katz noted, is known to be associated with both head and neck cancer risk and cannabis use.

Beyond that, the risk increases were generally small, even with extensive use of the drug.

“If we assume the study results are causal,” Meyerowitz-Katz said, “they suggest that people who use cannabis enough to get a diagnosis of cannabis use disorder get head and neck cancer at a rate of around 3 per 1000 people, compared to 1 per 1000 people who don’t use cannabis.”

Cannabis and Childhood Cancers

As marijuana use has shot up among Americans generally, so too has prenatal use. One study found, for instance, that the rates almost doubled from about 3.4%-7% of pregnant women in the US between 2002 and 2017. Many women say they use it to manage morning sickness.

Given the growing prenatal use, however, there is a need to better understand the potential risks of fetal exposure to the drug, said Kyle M. Walsh, PhD, associate professor in neurosurgery and pediatrics, Duke University School of Medicine, Durham, North Carolina.

The fortunate rarity of childhood cancers makes it challenging to study whether maternal substance use is a pediatric cancer risk factor. It’s also hard to define a control group, Walsh said, because parents of children with cancer often have difficulty recollecting their exposures before and during pregnancy.

To get past these limitations, Walsh and his colleagues took a different approach. Instead of trying to track cannabis use and tie it to cancer risk, Walsh’s team focused on families of children with cancer to see whether prenatal substance use was associated with any particular cancer subtypes. Their study, published last year in Cancer Epidemiology, Biomarkers & Prevention, surveyed 3145 US families with a child diagnosed with cancer before age 18. The study, however, did not focus on just marijuana; it looked at illicit drug use during pregnancy more generally. Although the authors assumed that would mostly mean marijuana, it could include other illicit drugs, such as cocaine.

Overall, 4% of mothers reported using illicit drugs during pregnancy. Prenatal use of illicit drugs was associated with an increased prevalence of two tumor types: intracranial embryonal tumors, including medulloblastoma and primitive neuroectodermal tumors (prevalence ratio [PR], 1.94), and retinoblastoma (PR, 3.11).

“Seeing those two subtypes emerge was quite interesting to us, because they’re both derived from a cell type in the developing fetal brain,” Walsh said. That, he added, “aligns in some ways” with research finding associations between prenatal cannabis use and increased frequencies of ADHD and autism spectrum disorders in children.

Interestingly, Walsh noted, prenatal cigarette smoking — which was also examined in the study — was not associated with any cancer subtype, suggesting that smoking might not explain the observed associations between prenatal drug use and central nervous system tumors. But, he stressed, it will take much more research to establish whether prenatal marijuana use, specifically, is associated with any childhood cancers, including studies in mice to examine whether cannabis exposure in utero affects neurodevelopment in ways that could promote cancer.

Testicular Cancer

Testicular cancer is the one cancer that has been linked to cannabis use with some consistency. But even those findings are shaky, according to Meyerowitz-Katz.

A 2019 meta-analysis in JAMA Network Open concluded that long-term marijuana use (over more than a decade) was associated with a significantly higher risk for nonseminomatous testicular germ cell tumors (odds ratio, 1.85). But the authors called the strength of the evidence — from three small case-control studies — low. All three had minimal controls for confounding, according to Meyerowitz-Katz.

“Whether this association is due to cannabis or other factors is hard to know,” he said. “People who use cannabis regularly are, of course, very different from people who rarely or never use it.”

In their 2025 Lancet Public Health review, Nargis and her colleagues pointed to a more recent study, published in 2021 in BMC Pharmacology and Toxicology, that looked at the issue in broader strokes. The study found parallels between population marijuana use and testicular cancer rates, as well as higher rates of the cancer in US states where marijuana was legal vs those where it wasn’t.

However, Nargis said, observational studies such as this must be interpreted with caution because they lack data on individuals.

If regular cannabis use does have effects on testicular cancer risk, the mechanisms are speculative at best. Researchers have noted that the testes harbor cannabinoid receptors, and there is experimental evidence that binding those receptors may alter normal hormonal and testicular function. But the path from smoking weed to developing testicular cancer is far from mapped out.

Risk for Other Cancers?

The recent Lancet Public Health overview also highlights emerging evidence suggesting a relationship between cannabis use and risks for a range of other cancer types.

A handful of observational studies, for instance, showed correlations between population-level cannabis use and risks for several cancers, such as breast, liver, thyroid, and prostate. The observational studies, mostly from a research team at the University of Western Australia, made headlines last year with a perspectives piece published in Addiction Biology, claiming there is “compelling” evidence that cannabis is “genotoxic” and raises cancer risk.

But, as Meyerowitz-Katz pointed out, the paper is only a perspective, not a study. And the human data it cites are from the same limited evidence base critiqued in the NASEM and ACS reports.

Meyerowitz-Katz does not discount the possibility that marijuana use contributes to some cancers. “I wouldn’t be surprised if we find that extensive cannabis use — particularly smoking — is related to cancer risk,” he said. But based on the existing evidence, he noted, the risk, if real, is “quite small.”

Where to Go From Here?

What’s needed, Nargis said, are large-scale cohort studies like those that showed cigarette smoking is a cancer risk factor. For the ACS, she said, the next step is to analyze decades of data from its own Cancer Prevention Studies, which included participants with a history of cannabis use and cancer diagnoses verified using state registries.

Nargis also noted that nearly all studies to date have focused on marijuana smoking, and “almost nothing” is known about the long-term health risks of newer ways to use cannabis, including vaping and edibles.

“What’s concerning,” she said, “is that the regulatory environment is not keeping up with this new product development.”

With the evolving laws and attitudes around cannabis use, Nargis said, it’s the responsibility of the research community to find out “the truth” about its long-term health effects.

“People should be able to make their choices based on evidence,” she said.

 

Source:  https://www.medscape.com/viewarticle/marijuana-use-rising-it-cancer-risk-2025a1000br5?

by Robert Colonna a,* , Zuha Pathan a , Anupradi Sultania a , Liliana Alvarez b

a Health and Rehabilitation Sciences, Western University, London, Canada

b School of Occupational Therapy, Western University, London, Canada

ARTICLE INFO:
Keywords:
Cannabis
Driving under the influence of cannabis
young drivers
systematic review
impaired driving

ABSTRACT:
Background: With recreational cannabis legalized across Canada, concerns persist about youth driving under the
influence of cannabis (DUIC). However, the extent of DUIC education and prevention efforts aimed at young
Canadians remains unclear. This systematic review examines recent Canadian initiatives (2017 onwards) focused
on reducing DUIC among youth. Specifically, we investigate (1) the types of initiatives and target audiences, (2)
content and delivery methods, (3) sustainability, and (4) evidence of impact.

Methods: A comprehensive search was conducted across MEDLINE, PsycINFO, CINAHL, SCOPUS, and EMBASE
(January 1, 2017–July 10, 2023), along with various grey literature sources. Initiatives were included if they
targeted DUIC behaviour among youth aged 16 to 24, were developed and delivered in Canada by reputable
organizations or individuals with institutional support, and aimed to address DUIC behaviour or its enabling
conditions. Data extraction and quality appraisal were performed.

Results: Fifteen Canadian initiatives were identified: seven educational programs and eight awareness campaigns,
encompassing national and regional levels. Delivery methods included in-person workshops, digital tools, online
programs, and smartphone applications. While some initiatives increased awareness and influenced perceptions
of DUIC, evidence of behaviour change remained limited. Challenges related to sustainability, particularly
concerning long-term funding and digital platform maintenance, were noted.

Conclusions: This research highlights the progress made in addressing youth DUIC in Canada. Examining current
DUIC educational initiatives is crucial for refining strategies, shaping policy, and allocating resources to prioritize the safety of young Canadians. Future efforts should focus on assessing behavioural impacts and ensuring financial sustainability and program longevity.

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Source:   Stoned on the road

29 May 2025

Possession of hard drugs such as cocaine and heroin treated as a health issue rather than a criminal matter by UK forces

It represents a six-fold increase in drug users escaping prosecution since 2016, when the proportion was only 7.5 per cent.

In some forces, more than 80 per cent caught with cocaine, heroin or other class A drugs escaped any criminal punishment.

They were instead handed community resolutions, which do not result in a criminal record and only require an offender to accept “responsibility” for their crime, or were let off “in the public interest”.

Only a third of class A drug possession offences resulted in a charge.

The data reflects a shift by police to treat drug possession of any type as a health issue rather than criminal one and comes days after Sir Sadiq Khan, the Labour Mayor of London, called for possession of small amounts of natural cannabis to be decriminalised.

But critics have warned police against “decriminalising drugs via the back door by ignoring tens of thousands of offences”.

At least a quarter of the 43 police forces in England and Wales have adopted “diversion” schemes where users caught with small amounts of drugs like cannabis are “diverted” to treatment or education programmes rather than prosecuted, particularly for first-time offences.

Nearly three-quarters (72.1 per cent) of those caught in possession of cannabis were let off without any criminal sanctions.

Thames Valley, West Midlands and Durham are among the dozen forces to have adopted diversion schemes, which could be rolled out nationally if successful.

The Treasury and Cabinet Office have put £1.9 million into evaluating the approach in partnership with five universities, the National Police Chiefs’ Council (NPCC) and the College of Policing, the standards body for forces in England and Wales.

The College said the aim of the diversion scheme was to “reduce re-offending and wider harms by approaching substance use as a health issue rather than a criminal justice issue”.

The research will compare re-offending rates, hospital and treatment admissions with the aim of establishing “whether and how drug diversion works, for whom, when and why”.

‘Devastated by soft policy’

But Chris Philp, the Tory shadow home secretary, warned the move amounted to decriminalisation by stealth.

“Parliament has rightly legislated that certain drugs are illegal because they cause serious harm to health, lead to antisocial behaviour and fuel acquisitive crime like theft, burglary and shoplifting as addicts steal to fund buying drugs,” he said.

“Police should not be decriminalising drugs via the back door by ignoring tens of thousands of offences. People who break the law should be prosecuted, and a magistrate or judge can decide what to do.

“Options a magistrate has available include fines, community service and addiction treatment requirements as well as prison.

“We have seen many US and Canadian cities devastated by soft drugs policies. These have allowed ghettos to develop where zombified addicts loiter unpunished and law abiding members of the public fear to go. We can’t allow the UK to go the same way through weak policing.

“We need a zero tolerance approach to crime, including a zero tolerance approach to drug taking.”

But the College of Policing defended its approach and pointed to research, based on 16 different studies, that showed drug diversion had resulted in a “small but significant” reduction in drug use, particularly among young people.

The Telegraph analysis showed that Warwickshire had the lowest proportion of offenders caught with class A drugs who were let off, at just 9.2 per cent, while Dyfed Powys had the highest at 88.6 per cent.

Nerys Thomas, Director of Research at the College of Policing, said:“We are focussed on cutting crime and keeping the public safe. Class A drugs are the most harmful category and being found in possession of them is a criminal offence.

“The government has provided funding to understand what initiatives could be used to reduce offending and protect the public. This includes a piece of work between the College,  the University of Sheffield and 11 other agencies across the criminal justice system to interview hundreds of officers and drug offenders and analyse police data to understand if diversion schemes can reduce crime.

“The results of this study will be made publicly available next year.”

Source:  https://www.telegraph.co.uk/gift/6e423b9614e616f8

 

This paper was forwarded to NDPA by Gary Hulse of Drug Free Australia, with his remark that this is “an  important recent paper in JAMA from Dr Volkow on Cannabis Brain Damage Deficits

 

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Source:  Brain Function Outcomes of Recent and Lifetime Cannabis Use

System dynamics modeling to inform implementation of evidence-based prevention of opioid overdose and fatality: A state-level model from the New York HEALing Communities Study

Highlights

  • Simulations showed fentanyl spread challenges reducing overdoses in the short run.
  • Prevention of opioid misuse among opioid-exposed individuals should be prioritized.
  • Combined strategies effectively reduce fatalities and OUD prevalence.
  • Bolstering community awareness mitigates possible rise of fatalities in the future.

Abstract

Background

As part of the New York HEALing Communities Study, we modeled the opioid epidemic in New York State (NYS) to help coalition members understand short- and long-term capacity-building needs and trade-offs in choosing the optimal mix of harm reduction, treatment, and prevention strategies.

Methods

We built and validated a system dynamics simulation model of the interdependent effects of exposure to opioids, opioid supply and overdose risk, community awareness of overdose risk, naloxone supply and use, and treatment for opioid use disorder (OUD). We simulated overdose and fatality rates, OUD prevalence, and related measures from 2012 to 2032 for the NYS population aged ≥12 and tested policy scenarios for reducing future overdose deaths.

Results

Increasing naloxone distribution by 50 % led to a 10 % decrease in overdose deaths, but only minimally reduced OUD prevalence (1 %) by 2032. Enhancing by 50 % medications for OUD (MOUD) initiations and prevention efforts each led to substantial decreases in deaths (29 % and 25 %, respectively) and OUD prevalence (27 % and 6 %) by 2032. Simultaneously increasing naloxone distribution and MOUD initiations by 50 % resulted in 38 % fewer deaths, while adding prevention efforts alongside resulted in 56 % fewer fatalities. Sensitivity analyses of the models’ feedback loops demonstrated similar relative impacts.

Conclusions

A combination of evidence-based strategies while also promoting prevention should be prioritized to reduce overdose fatality. Sustained community awareness and prevention efforts are needed even as overdoses and deaths decline due to the significant effects of the community awareness feedback loop on the epidemic trends.

Introduction

Although opioid-related fatalities decreased in the United States (US) and New York State (NYS) from 2022 to 2023, fatality remains high (81,083 (US) and 5,308 (NYS) in 2023) after years of unprecedented increases of fatal and non-fatal overdoses (Centers for Disease Control and Prevention, National Center for Health Statistics, 2021, 2024; National Institute on Drug Abuse, 2023). A dramatic rise in the availability of illicitly manufactured fentanyl has also been documented in the US and NYS, resulting in a more potent opioid supply (Kilmer et al., 2022; New York State Department of Health, 2023a). Intentional and unintentional exposure to fentanyl among people who use drugs has been associated with increased risk of overdose and death (Hughto et al., 2022). Fentanyl co-involved with psychostimulants, benzodiazepines, and xylazine may characterize a new wave of the opioid epidemic (Ciccarone, 2021a; Friedman & Shover, 2023; Jenkins, 2021).
In 2019, the National Institute on Drug Abuse (NIDA) funded the HEALing (Helping to End Addiction Long-term®) Communities Study (HCS), a large implementation research project designed to reduce opioid fatalities, increase access to medications for opioid use disorder (MOUD), and reduce stigma toward people on MOUD (National Institutes of Health HEAL Initiative, n.d.; The HEALing Communities Study Consortium, 2020). The HCS employed a coalition-driven intervention to inform the deployment of evidence-based practices to rapidly reduce opioid-related overdoses and fatalities in 67 highly affected communities in NYS, Kentucky, Massachusetts, and Ohio. Through a data-driven approach to community-engaged planning and action, the HCS sought to learn how to increase the reach of evidence-based harm reduction and treatment interventions (Chandler et al., 2023; Chandler et al., 2020; El-Bassel et al., 2021).
System dynamics (SD) modeling was incorporated to support the HCS in NYS to engage community coalitions. SD models use feedback loops (i.e., closed sequences of time-dependent causal relationships) to hypothesize the endogenous drivers of a system’s behavior over time (Richardson, 2011). These feedback loops are able to capture accumulation processes, nonlinearities, and time delays to gain insight into the causal nature of complex problems (Yasarcan, 2023). SD models also serve as tools to help diverse community members build a shared appreciation of why systems problems manifest and persist, how such problems can be resolved, and what can be done to mitigate unintended consequences of policies and practices (Forrester & Senge, 1980; Senge & Sterman, 1992). Simulation analyses can then test policy interventions and assess possible intended and unintended consequences (Sterman, 2006).
Prior publications have described SD models of earlier waves of the US opioid and non-opioid drug epidemics (Levin et al., 1972, 1975; Homer, 1993, 1997; Wakeland et al., 2011, 2013, 2015, 2016; Homer & Wakeland, 2021; Lim et al., 2022; Stringfellow et al., 2022; Sabounchi et al., 2023). The earliest model examined the 1970s heroin epidemic in a New York City neighborhood characterized by high rates of youth heroin use (Levin et al., 1972, 1975). This model included feedback loops capturing the heroin supply, community education, policing, and incarceration, among others. Though not calibrated to historical data, the model suggested that a comprehensive set of policy interventions were needed to curb the epidemic. Another early illicit drug model studied the US cocaine epidemic of the 1970s and 1980s (Homer, 1993, 1997). A key feedback loop of this model showed how the popularity of cocaine drove an increase in its use. By highlighting time delays and gaps in data reporting of drug use, the model pushed back against the then-current idea that drug seizure policies were effective at reducing cocaine use prevalence.
More recently, Wakeland et al (2011, 2013, 2015, 2016) modeled excessive opioid prescribing practices in the US and the diversion of pharmaceutical opioids to the illicit market through 2011. An update extended the model’s boundary to include the effects of fentanyl in the illicit drug supply after 2013 (Homer & Wakeland, 2021). Another update incorporated additional structures for MOUD, naloxone use, supply-side changes on prescription opioids, and the perceived risk of overdose fatality (Lim et al., 2022; Stringfellow et al., 2022).
Building upon these earlier SD models and adding additional structures identified in our preparatory qualitative modeling of the opioid epidemic (Sabounchi et al., 2023), we present here an opioid SD model built to support implementation of the HCS in NYS and the short- and long-term effects of simulated strategies around opioid overdose education and naloxone distribution (OEND) and MOUD.

Section snippets

Model development

We developed and validated an SD model that simulated opioid overdose and fatality trends of the NYS population aged ≥12 years from 2012 through 2023 and their potential evolution to 2032. We iteratively revised the model’s structure in consultation with subject-matter experts, county staff and coalition members, and literature review, while also comparing simulated output to opioid-related historical data series (Table 1). This iterative model building process helped to ensure sufficient

Base run

Fig. 2 shows selected base run results and the fit to available NYS time series data. The base run showed an increasing trend in the number of annual opioid overdose deaths with a peak of 3,111 in 2017 and a second peak of 5,383 deaths in 2022, followed by a continuous decline to 4,189 in 2032 (Fig. 2A). Annual overdose-related ED visits and hospitalizations (Fig. 2B) and naloxone administrations by emergency medical services and law enforcement (Fig. 2C) showed similar trends. Naloxone

Discussion

We have presented a generalized opioid SD model structure that captures the main drivers of the opioid epidemic including the effects of fentanyl and the COVID-19 pandemic. When calibrated to NYS, the model replicated historical trends in opioid-specific overdose and fatality from 2012 to 2023 and generated plausible projected trends of key variables through 2032.
The model also serves as a unique analytical tool to facilitate an understanding of the underlying dynamics of the opioid epidemic

Limitations

Limited data availability led to higher uncertainty in calibrated parameters related to the opioid supply, exposure to opioids, and community awareness model sectors. Known limitations and uncertainty in the number of individuals using illicit opioids reported in national surveillance data (e.g., National Survey on Drug Use and Health) may have led to an underestimation of opioid use prevalence.
Our model does not explicitly inform questions or policies around health equity due to limited

Conclusions

Our model has revealed important insights about likely trajectories in NYS opioid overdose fatality rates, which have worsened with the COVID-19 pandemic and a growing supply of cheaper, more lethal illicit synthetic opioids. Simulated policies that simultaneously build capacity for OEND and MOUD and foster efforts around community awareness and prevention were shown to be most effective over time. Simulated results indicated a clear challenge in substantially reducing overdose death rates in

Acknowledgements

This research was supported by the National Institutes of Health (NIH) and the Substance Abuse and Mental Health Services Administration through the NIH HEAL (Helping to End Addiction Long-term®) Initiative under award number UM1DA049415 (ClinicalTrials.gov Identifier: NCT04111939). This study protocol (Pro00038088) was approved by Advarra Inc., the HEALing Communities Study single Institutional Review Board. We wish to acknowledge the participation of the HEALing Communities Study communities,
Source:  https://www.sciencedirect.com/science/article/abs/pii/S0955395925001434

By: Oman News Agency – Thursday 29/May/2025

Dhank: The Wilayat of Dhank in Al Dhahirah Governorate on Thursday hosted an awareness seminar
titled “Your Mind is Your Identity – Don’t Lose It to Drugs,” held under the auspices of
Sheikh Musallam Ahmed Al Ma’shani, Wali of Dhank.

The event was organised as part of ongoing community efforts to strengthen national belonging and reinforce Omani identity while addressing the dangers of drugs and psychotropic substances.

The seminar featured two main thematic discussions. The first segment addressed critical perspectives on the issue, examining the health consequences, legal implications, and religious rulings regarding drug abuse. The session began with an impactful theatrical performance by the Wahj Al Khayal team, illustrating the devastating effects of narcotics on individuals and society at large.

The second part of the seminar focused on identity and citizenship values. A working paper was presented about this theme that emphasised the fundamental role of national identity in building an aware and cohesive society capable of overcoming various challenges.

A highlight of the event was the official unveiling of the winning logo for Dhank’s Community Competition Team to Combat Drug Abuse. This initiative aims to enhance community awareness and support youth-driven projects in drug prevention efforts, reflecting the local commitment to addressing this critical social issue.

Source:  https://timesofoman.com/article/158685-anti-drug-awareness-seminar-held-in-al-dhahirah

NDPA opening statement:

This piece by AALM (Americans Against Legalisation of Marijuana) counters the assertion that legalisation would bring fairness to people of colour.

To access the full document:

  1. Click on the ‘Source’ link below.
  2. An image  – the front page of the full document will appear.
  3. Click on the image to open the full document.

Source:  AALM statement on pot

by Ch28 May 2025

Police Commissioner says drug should be Class A over long-term health impacts

Cannabis should be upgraded to a class A drug because of the harm it can cause, a policing chief has said.

As Sir Sadiq Khan calls for possession of the drug to be decriminalised, David Sidwick, Dorset’s police and crime commissioner, has urged that cannabis, currently a Class B drug, should be put on a par with crack cocaine and heroin.

Such a move would see the maximum penalties for possession increase from five to seven years in jail, while the maximum penalty for supplying cannabis would rise from 14 years in prison to life.

Sir Mark Rowley, the Met Commissioner, also opposed Sir Sadiq’s call for cannabis to be decriminalised. He pointed out that drugs were “at the centre of a lot of crime” and said drug use was one of the main drivers of antisocial behaviour.

Sir Sadiq, the Mayor of London, has proposed that the possession of small amounts of natural cannabis should no longer be a criminal offence. Dealing in or producing the drug would remain illegal.

Mr Sidwick sets out his demand in a foreword to a new book by Albert Reece and Gary Hulse, two Australian professors of medicine and psychiatry, who have linked cannabis to mental ill-health, autism and cancer.

He said there was growing evidence linking psychosis, cancer and birth defects to cannabis use, particularly with the development of more potent strains.

Mr Sidwick warned it was also a “gateway” drug used by crime gangs to lure in users. They then entice them on to addictive class A drugs such as crack that not only provide more profit per unit but also give the gangs greater power to leverage them into criminal activity.

“Cannabis needs to be taken seriously on a national scale because of the danger it presents, and there needs to be money put into prevention and education to ensure people are aware of these dangers,” he said.

“Currently, Class A drugs take precedence when it comes to enforcement and treatment, but it is my view that there is no point focusing on the destination of addiction if we don’t stop people getting on the first two or three carriages of the train in the first place.

“Only through reclassifying cannabis will it be treated with the severity it deserves.”

The London Drugs Commission, set up by Sir Sadiq, ruled out full legalisation of cannabis in its report because it said any benefits from tax revenues and reduced police workload were outweighed by the potential longer-term health impacts on users.

Instead, it proposed that natural cannabis would be removed from the Misuse of Drugs Act and brought under the Psychoactive Substances Act.

This would mean possession of small amounts of cannabis for personal use would no longer be a criminal offence, but importing, manufacturing and distributing the drug would remain a criminal act.

The Home Office has ruled out any reclassification of cannabis.

Mr Sidwick’s proposals have been backed by Janie Hamilton, a Dorset mother who has campaigned for upgrading cannabis to class A.

Her son James died when he was 36 after refusing treatment for testicular cancer. It followed years of battling mental illness, which his family believes was triggered by his addiction to cannabis, which he started using at 14.

Ms Hamilton said: “My beloved son James was a fun-loving, mischievous, clever, tender-hearted boy who wanted to fit in with his peers and be part of the ‘in’ crowd. This was to be his undoing.

“At the age of 14, unbeknown to us, living at a boarding school where his father taught, he started smoking cannabis. He became arrogant, rude, secretive, rebellious and unpredictable. I remember thinking how I loved him, but that I didn’t like him.

“He dropped out of university after one term and took job after job, worrying us with his bizarre behaviour. He shaved his hair, his eyebrows, cut his eyelashes and became aggressive. He would stay in his room all day and come out at midnight to shower and cook.

“One day, he came home from his job on a building site, turning in circles in the garden and all that night. He told me he had spent all his wages on cannabis. I called the doctor the next day and James was sectioned within an hour, diagnosed with schizophrenia.”

She said there had been a 16-year cycle of medical treatment, relapses and trouble with the police before her son died.

“Cannabis is everyone’s problem. It destroys lives and families. Let no one say that cannabis is harmless – cracking down on this destructive drug is one of the greatest and most urgent needs facing us all,” she said.

Source:  https://www.telegraph.co.uk/gift/32da88934bd58598

Opening comment by NDPA: Although this item is a fairly unashamed promo for AI, it nevertheless gives a useful summary of how AI can be applied to this field, so we have retained it.

 

A New Era in Health Begins with Intelligence — Artificial and Human

Artificial Intelligence (AI) is not just a buzzword — it’s one of the most transformative forces reshaping modern healthcare. From revolutionizing diagnostics and personalizing treatments to advancing drug prevention strategies, AI is enhancing the way we understand, predict, and treat human health. As the world embraces the potential of AI, organizations working in prevention and treatment must also evolve — strategically and ethically.

  1. Artificial Intelligence in Healthcare: The Global Landscape

AI is redefining care on a global scale. According to the European Commission, AI technologies are already supporting physicians, analyzing large datasets in seconds, and optimizing hospital workflows. Countries like the US, UK, Canada, China, and the EU are implementing large-scale AI integration strategies to support digital health systems.

The AI Act of the European Union is the world’s first legal framework on AI, emphasizing risk-based regulation. For health-focused organizations, this framework ensures safety, transparency, and human oversight in the deployment of AI tools.

  1. AI’s Role in Drug Discovery, Prevention, and Treatment

AI accelerates drug discovery and improves accuracy in substance use disorder (SUD) diagnosis and treatment planning. According to ScienceDirect, machine learning models can predict relapse risks, personalize therapy plans, and even detect substance use through digital biomarkers such as speech or behavioral patterns.

As Gubra outlines, AI is enabling:

  • Simulation of molecular interactions to discover new therapeutic targets
  • Automation in toxicology screenings
  • Integration of patient data for tailored treatment
  1. Best Practices in AI-Driven Drug Prevention and Education

From chatbots offering 24/7 counseling to AI-curated educational content, innovative prevention models are emerging worldwide:

  • USA: The NIH’s 2025 HHS AI Strategic Plan promotes AI for early screening of addiction risks, especially in underserved populations.
  • Denmark: National efforts combine AI with social data to map out drug-use hotspots and target community outreach.
  • India & Brazil: AI is integrated into mobile health (mHealth) apps that detect mood changes and alert caregivers, reducing dropout rates in prevention programs.

Platforms like Listen First by UNODC could benefit from AI enhancements to deliver content tailored to emotional tone and local language patterns.

  1. AI and the Prevention of Drug Use and Online Gaming Disorders

One of the most exciting — and necessary — frontiers of AI is its application in preventing drug use and behavioral addictions such as online gaming disorder. Emerging research shows how predictive algorithms can identify vulnerable individuals and intervene early.

According to a 2023 article in the American Journal of Preventive Medicine, AI tools are being developed to detect substance use behaviors through digital footprints, social media interactions, and app usage patterns. These tools can flag at-risk youth in real time, prompting early outreach.

The Ashdin Foundation reports that AI-powered interventions, including conversational agents and real-time behavioral monitoring, are revolutionizing how we approach drug prevention — making it more personalized, scalable, and responsive.

In Portugal, the NOVA University Lisbon project is pioneering AI models that track user behavior on gambling platforms to intervene before addiction escalates. This approach is equally relevant for youth struggling with excessive gaming — an issue increasingly associated with anxiety, depression, and even substance use.

As a recent Nature Medicine article highlights, AI is becoming a cornerstone in the personalization of behavioral health interventions, offering adaptive content, peer support suggestions, and gamified learning modules.

A comprehensive review confirms that AI algorithms can be trained to predict not only who is likely to use substances but also who is most likely to benefit from specific prevention programs. Moreover, NACADA Kenya is investing in AI to power community mapping tools that identify high-risk zones and recommend targeted prevention messaging.

  1. Ethical and Educational Considerations

AI offers vast promise, but not without limitations. As explored in BMC Medical Education, there is a growing need to train healthcare professionals and community workers to interpret AI results critically. Meanwhile, UMaryland highlights challenges around algorithmic bias, data privacy, and accountability.

Source:  https://www.dianova.org/news/how-ai-is-transforming-drug-prevention-and-healthcare-worldwide/

Dianova is a Swiss-based NGO.

 

 

by Benedikt Fischer, Wayne Hall, Didier Jutras-Aswad, Bernard Le Foll – The Lancet – Volume 47. – 101141 – July 2025
For a decade, Canada, like the United States, has experienced a public health crisis from drug overdose deaths (DODs), mostly due to toxic synthetic opioids (SOs; e.g., fentanyl/analogues), commonly combined with other (e.g., methamphetamines, benzodiazepines) substances.1 This crisis has claimed >50,000 lives over the past decade in Canada alone, rendering DODs the primary population-based cause of non-natural deaths. Despite the vast implementation and expansion of prevention and treatment interventions, annual DOD tolls have steadily increased, i.e. from 2832 in 2016 to 8606 in 2023.2
Now, recent data indicate a sudden over-year decline of approximately 13% in DODs (to a projected 7501 in 2024) in Canada; this coincides with a similar approximate 17% reduction in DODs in the US.2,3 However, this development is not regionally consistent in Canada, as DOD decreases are concentrated mostly in Western/Central provinces (i.e., BC to Ontario), while Eastern provinces (e.g., Quebec) have experienced increases in DODs—regions that, notably, had reported disproportionately lower rates of SO-related DODs previously.2,4 The DOD decrease is a welcome development, yet its drivers are currently unclear while important for identification towards informing intervention development. Possibly relevant factors for consideration might include.

Risk population changes

The decline may reflect a reduction in the size of the risk population exposed to DOD risks, based on several factors. The cumulative DOD toll—mostly comprised of young/middle-aged individuals — may have substantively decimated the SO-user population.2 Its deadly consequences may have also amplified the impact of SO-related prevention messaging. In addition, restrictive policies have halved the volume of prescription opioids (i.e., 30,540 Defined Daily Doses [DDD] in 2012–2014 to 16,475 DDD in 2020–2022) in Canada, which may have reduced the population pool developing iatrogenic problems and transitioning to non-medical (e.g., SO) opioid use.

Supply dynamics

Changing SO supply dynamics may play a role. Originally, SO-products were mostly imported to North America from other source countries (e.g., China, Mexico), but there appear be shifts towards domestic production and distribution, for example as a consequence of increased production and precursor control abroad.3 Recent reports indicate increasing fentanyl production in Canada, including so-called ‘super-labs’, recently rendering it a ‘net exporter’ of fentanyl.5,6 Domestically produced fentanyl may differ in key characteristics like composition or dosing from the SOs produced abroad in ways that influence and reduce DOD-related risks.

Pharmacology

The pharmacological profiles of SOs consumed may have changed. While the vast majority of recent DODs in Canada have involved fentanyl/fentanyl-analogues, most DOD events involve other psychoactive (e.g., psychostimulant or sedative) substances either as contaminants or from concurrent use1,2 that may affect DOD-related outcomes in different ways. In the US, SO-products increasingly include xylazine, a sedative that may increase DOD risks but also extends SOs’ psychoactive effects of SOs and so may reduce use frequency and risk exposure.

Risk behaviours

Changes in DOD-relevant risk behaviours may be a factor. For example, while SO use was previously common to occur unintentionally due to distribution as counterfeit pills or mixed with other drugs, improved recognition of SO products by their consumers (e.g., through drug-checking or generally enhanced awareness) may have facilitated more cautious use practices.7 In addition, many SO consumers have switched from injecting to inhalation use, thereby reducing the DOD-related risks by decreased bio-absorption, or undertook other behaviour changes.4 However, these risk-behaviour changes have been observed for some time, and majorities of recent DODs have been shown to be associated with non-injection modes in Canada.

Interventions

In response to the toxic drug death crisis, Canadian jurisdictions have vastly expanded the availability of multiple intervention measures — such as supervised consumption, overdose prevention services, naloxone distribution and drug checking, all evidenced to contribute to DOD-related risk reductions.1,8 In addition, access to different modalities of — mostly opioid agonist-based—addiction treatment has been ramped up, also known to be protective for overdose risk.9 These expansions have occurred continuously through the DOD crisis, reducing their likelihood as a principal driver for the observed sudden DOD decrease. A more novel intervention implemented in select Canadian jurisdiction have been ‘safer drug supply’ programs which distribute pharmaceutical-grade opioids to at-risk users for DOD prevention.10 While these initiatives are documented to reduce DOD-related risk in participants, their reach in existing risk populations remains starkly limited (e.g., <5% in BC), moderating likely population-level DOD reduction effects.
Previous measures have been insufficient in curtailing the massive DOD-toll in Canada over a decade.1 The projected short-term decline in DODs is an encouraging development, though it is notably limited to only some (i.e., mostly Western/Central) regions. The tangible drivers behind the decline are not readily evident; however, similar declines in the US hint at a role of more structural (e.g., drug supply-related) factors operating across North America rather than Canada-specific determinants. The possible contributions of the factors considered, or others, should be rigorously investigated by way of robust (e.g., epidemiologic/modelling, drug toxicology, use-behavioral) examinations and analysis to guide possible development of or scaling up related further improved measures where possible towards additional, sustained reductions in the DOD toll.

Contributors

The authors jointly developed the concept for the article, and collected and interpreted related data for the study. BF led the manuscript writing; WH, DJA and BLF edited and revised the manuscript for substantive intellectual content. All authors approved the final manuscript submitted for publication.

Declaration of interests

Dr. Fischer and Dr. Jutras-Aswad have held research grants and contracts in the areas of substance use, health, policy from public funding and government organizations (i.e., public-only sources) in the last five years. Dr. Fischer acknowledges general research support from the Waypoint Centre for Mental Health Care; he was temporarily employed by Health Canada (2021–2022). Dr. Hall does not have any conflicts to declare. Dr. Jutras-Aswad acknowledges a clinical scientist career award from Fonds de Recherche du Québec (FRQS); he has received study materials from Cardiol Therapeutics for clinical trials. Dr. LeFoll has obtained research support (e.g., research funding/in-kind supports, expert consultancy, other supports) from Indivior, Indivia, Canopy Growth Corporation, ThirdBridge and Shinogi; he furthermore acknowledges general research support from CAMH, the Waypoint Centre for Mental Health Care, a clinician-scientist award from the Dept. of Family and Community Medicine and a Chair in Addiction Psychiatry from the Department of Psychiatry, University of Toronto.

Acknowledgements

The present study was not supported by any specific funder or sponsor.

References

1.
Fischer, B.
The continuous opioid death crisis in Canada: changing characteristics and implications for path options forward
Lancet Reg Health Am. 2023; 19, 100437
2.
Government of Canada
Opioid- and stimulant-related harms

Available from: https://health-infobase.canada.ca/substance-related-harms/opioids-stimulants/

Date accessed: May 15, 2025
3.
Drug Policy Alliance
Fact sheet: why overdose deaths are decreasing

Available from: https://drugpolicy.org/resource/fact-sheet-health-harm-reduction-approaches-pivotal-to-decrease-in-national-drug-overdose-deaths/

Date accessed: February 5, 2025
4.
Fischer, B. ∙ Robinson, T. ∙ Jutras-Aswad, D.
Three noteworthy idiosyncrasies related to Canada’s opioid-death crisis, and implications for public health-oriented interventions
Drug Alcohol Rev. 2024; 43:562-566
5.
Financial Transactions and Analysis Report Centre of Canada
Operational Alert: laundering the proceeds of illicit synthetic opioids
His Majesty the King in Right of Canada
2025
Cat. No. FD4-39/2024E-PDF; ISBN 978-0-660-72670-0
6.
CBC News
Criminal networks are shifting from fentanyl imports to Canadian-made product
2024

Available from: https://www.cbc.ca/news/politics/fentanyl-produced-in-canada-1.7275200

Date accessed: February 5, 2025
7.
Brar, R. ∙ Grant, C. ∙ DeBeck, K. ∙ et al.
Changes in drug use behaviors coinciding with the emergence of illicit fentanyl among people who use drugs in Vancouver, Canada
Am J Drug Alcohol Abuse. 2020; 46:625-631
8.
Irvine, M.A. ∙ Kuo, M. ∙ Buxton, J.A. ∙ et al.
Modelling the combined impact of interventions in averting deaths during a synthetic-opioid overdose epidemic
Addiction. 2019; 114:1602-1613
9.
Pearce, L.A. ∙ Min, J.E. ∙ Piske, M. ∙ et al.
Opioid agonist treatment and risk of mortality during opioid overdose public health emergency: population based retrospective cohort study
BMJ. 2020; 368, m772
10.
Slaunwhite, A. ∙ Min, J.E. ∙ Palis, H. ∙ et al.
Effect of Risk Mitigation Guidance for opioid and stimulant dispensations on mortality and acute care visits during dual public health emergencies: retrospective cohort study
BMJ. 2024; 384, e076336

The Organisation Internationale Dianova, or Dianova International, is a public utility Swiss NGO committed to social progress. Through its members operating on four continents, Dianova International supports the development of activities aimed at improving people’s lives.

Introduction: Let’s Get One Thing Straight Forget the outdated slogans. “Just say no” doesn’t cut it anymore. Today’s teens and young adults live in a world of pressure, performance, and constant scrolling — and they deserve real strategies, not scare tactics. Evidence shows that drug prevention targeting youth needs to be science-based, stigma-free, and deeply human. That’s what the new wave of prevention is all about. That’s what #VoicesWithoutStigma is here to launch.

PART I

Why We Need a New Conversation

According to the UNODC, around 90% of adult substance use disorders begin in adolescence. That’s why early prevention isn’t optional — it’s essential. But not any kind of prevention: the kind that’s rooted in evidence, compassion, and the real-life experiences of young people.

From the WHO-UNODC International Standards for Drug Use Prevention, we know what works:

  • Early childhood development programs that support parents and help kids develop emotional and cognitive skills.
  • Life skills training in schools, including emotional regulation, problem-solving, and resisting social pressure.
  • Community strategies to reduce access and increase awareness — think youth centers, mentorship programs, and safe recreational spaces.
  • Digital campaigns that meet youth on their terms — mobile-first, meme-friendly, and emotionally honest.

 

The Science Behind the Shift

Prevention is no longer about “bad kids” making “bad choices.” The real risk factors are often trauma, inequality, exclusion, and untreated mental health issues. That’s why the UN, PTTC Network, and others are calling for a new approach that’s inclusive, respectful, and developmentally informed. As highlighted by the United Nations Chronicle, strategies that empower communities — especially youth — are the most sustainable.

#VoicesWithoutStigma: Speak. Share. Shift the Culture.

Launching globally on June 26, 2025, by Dianova International, the #VoicesWithoutStigma campaign is about rewriting the narrative. Young people from 17 countries will take the mic — literally and digitally — to speak about:

  • Mental health and asking for help
  • Coping with anxiety, trauma, and depression
  • Navigating social pressure without losing their sense of self
  • Reclaiming their identity through music, dance, podcasts, and storytelling

The campaign’s launch video sets the tone: young people in silence, whispers of stigma — then rhythm, color, voice. A girl declares: “They told me feeling was weakness. But my voice is strong. And yours is too.”

Breaking the Taboo ≠ Being Alone

Whether you’re 16 or 26, it’s not weird to feel overwhelmed. The Listen First campaign by UNODC reminds us that starting with empathy — not judgment — is how we win hearts, minds, and futures.

Feeling low? Not sure how to support a friend? Talking honestly — and listening with compassion — are the strongest tools we’ve got. That’s how we build resilience and community.

No Drama, Just Data: Environmental Strategies That Work

According to this UNODC framework, community-wide strategies — like regulating alcohol sales to minors, setting up youth-focused events, and positive norm campaigns — can reduce substance use before it starts. Add peer mentoring and digital outreach, and you’ve got a full-circle prevention plan.

A Final Word: You’re Not the Problem. You’re the Power.

You don’t have to be perfect. You just have to be real. Drug prevention today is about showing up for yourself, and others, with truth, humor, and heart. Whether you’re creating a Reel, starting a support group, or just learning more — you’re part of the solution.

✨ Join us. Share your truth. Inspire others. #VoicesWithoutStigma isn’t a campaign. It’s a movement. And it’s made for you.

Want to know more? Check the UNODC-WHO standards or EUDA’s library. It’s prevention — but make it real, and make it yours.

 

PART II

Voices Without Stigma: Breaking the Silence, Building the Future

Introduction: More Than Just Say No

Let’s get real — telling young people to “just say no” to drugs isn’t working. Not because they’re reckless, but because they’re smart. Smart enough to know that life is complicated, that pain is real, and that decisions are rarely black or white. That’s why youth drug prevention today isn’t about preaching. It’s about listening, empowering, and building trust. And that’s exactly what #VoicesWithoutStigma is all about.

Why It Matters: The Real Stats Behind the Talk

According to the UNODC-WHO International Standards on Drug Use Prevention, effective prevention is rooted in science, not scare tactics. Research shows that adolescence is a critical period: 90% of adult substance use disorders begin during this phase. Prevention efforts must be developmentally appropriate, engaging, and embedded in the realities of young people’s lives.

So, What Works? A Look at Evidence-Based Prevention

The United Nations and World Health Organization have spent years studying what actually prevents drug use. Spoiler alert: the most effective strategies have nothing to do with guilt or shame. Here’s what the research tells us:

  • Family-based programs that build parenting skills and family bonding.
  • School-based life skills education, focusing on emotional regulation, decision-making, and peer resistance.
  • Community-wide environmental strategies like reducing access to substances and strengthening local support systems.
  • Digital and peer-to-peer outreach that speaks in the language of youth.

These aren’t just theories — they’re approaches with measurable impact across cultures and contexts. Check the UNODC’s breakdown of international standards here.

Let’s Talk Urban: Prevention in a Real-World Context

Today’s young people are navigating pressures their parents never imagined — social media, performance culture, identity exploration, and mental health challenges. Prevention has to meet them where they are: in the group chat, on TikTok, in the locker room, at home after a hard day.

That means:

  • Creating safe, shame-free spaces to talk about anxiety, depression, and trauma.
  • Highlighting relatable stories from young people who’ve overcome challenges without glamorizing drug use.
  • Using influencers, creatives, and peers to drive positive narratives.

#VoicesWithoutStigma: A Movement in the Making

Dianova’s 26 June 2025 global campaign — #VoicesWithoutStigma — is here to flip the script on stigma. With the slogan “Your Voice is Power”, it invites young people around the world to share their truth, their way — through spoken word, memes, music, reels, or just real talk.

The campaign’s goals are bold:

  • Inspire creative expression around mental health and substance use.
  • Normalize seeking help, showing it as strength rather than weakness.
  • Mobilize schools, NGOs, families and social platforms to amplify youth voices.

And the teaser? A powerful video where silence gives way to rhythm, movement, art, and voices that say, “We don’t hide how we feel — we transform it.”

#VoicesWithoutStigma is not just a campaign. It’s a cultural wave.

Curious Yet? Stay Tuned.

On June 26, something big is dropping. A campaign made of real voices, raw stories, and bold creativity. If you’ve ever felt misunderstood, judged, or silenced — this is your moment.

Get ready to join the voices that refuse to be labeled. To cry, to laugh, to heal, to shout back with truth.

Follow the campaign. Join the lives. Share your story. Explore the science, feel the voices, join the movement:

Because when we speak with compassion instead of judgment, and with facts instead of fear, we don’t just prevent drug use — we create a future worth living for.

#VoicesWithoutStigma | #YourVoiceIsPower | #June26 | #MentalHealthMatters | #PreventionWorks

 

Source: https://www.dianova.org/news/real-talk-real-tools-drug-prevention-that-actually-works-for-todays-youth/

by Shane W. Varcoe , Director@dalgarnoinstitute.org.au – 23 May 2025

“I was talking to a tradesman in my home on Wednesday and he asked me what I did…. After explanation about Weed…. He said.. “I wen to a local doctor and just said I had trouble sleeping and can I have cannabis… got a script, no more questions asked.”  This is so utterly corrupt and it’s ubiquitous  now! ”    Shane W. Varcoe

Comment by Jo Baxter, DFA (Australia)

This is a very serious situation for the US and the world generally. Such a softening is akin to what the then Federal Health Minister, Sussan Ley did when she passed the law that allowed Medicinal Cannabis to be legalised in Australia. Now we are seeing a misuse of the ‘legal’ system with doctors overprescribing and not even consulting in person with patients to whom they prescribe the drug.

On Fri, May 23, 2025 at 7:51 AM Herschel Baker <hmbaker1938@hotmail.com> wrote:

The evidence is in Cannabis must remain Schedule 1 Epidemiology of Cannabis Albert Stuart Reece, Gary Kenneth Hulse

https://shop.elsevier.com/books/epidemiology-of-cannabis/reece/978-0-443-13492-0

WASHINGTON, D.C. – During his confirmation hearing before the Senate Judiciary Committee on April 30, DEA administrator nominee Terrance Cole declined to commit to the proposed federal rescheduling of cannabis, leaving a critical policy question unresolved as the process transitions to new leadership under the Trump administration.

The popular and game-changing rescheduling proposal backed by Donald J. Trump to reclassify cannabis from Schedule I to Schedule III under the federal Controlled Substances Act (CSA) remains formally active but administratively paused by a DEA judge.

If enacted, rescheduling cannabis to Schedule III would formally acknowledge the accepted medical use of cannabis under federal law. It would also allow for FDA-supervised research and development of cannabis-based drugs.

Although cannabis would still be classified as a controlled substance and remain under the oversight of the DEA and FDA, reclassifying it to Schedule III would significantly benefit legal cannabis businesses by changing how they are treated under federal tax law.

Specifically, it would exempt them from the limitations of Section 280E of the Internal Revenue Code, which currently bars businesses trafficking in Schedule I or II substances from deducting ordinary business expenses. Due to this restriction, legitimate cannabis companies paid over $1.8 billion more in federal taxes in 2022 than comparable non-cannabis businesses, according to data from Whitney Economics.

Reclassification would not federally legalize recreational cannabis, authorize interstate commerce, or override any state-level prohibitions.

Reclassification was initiated nearly three years ago during the Biden administration. Still, on January 13, 2025, one week before President Trump took office, the DEA’s Chief Administrative Law Judge cancelled a public hearing scheduled for January 21 and ordered parties to check back in with him in 90 days.

There is no statutory deadline for the DEA to complete the rescheduling process, so the current pause could extend indefinitely.

Cole, a longtime DEA official nominated to be administrator in February, told lawmakers on April 30 that reviewing the agency’s stalled administrative process to move cannabis from Schedule I to Schedule III would be “one of [his] first priorities.”

Though cannabis was not mentioned in Cole’s opening remarks, he emphasized a focus on combating the fentanyl crisis and leveraging his 30 years in law enforcement to address cartel-related threats. “It’s time to move forward,” he said of the stalled rescheduling process.

But when pressed by US Senator Alex Padilla (D-CA) on whether he would ensure the proposed rescheduling is carried out, Cole would not commit. Here is a bit of back and forth between the two:

“I need to understand more where they are and look at the science behind it and listen to the experts and really understand where they are in the process,” Cole said.

Padilla, referencing the directive initiated in 2022, reiterated: “We know where we are. We know what the directive is: Get it to Schedule III. Are you committed to seeing it to fruition?”

Cole responded, “So, I don’t know. I haven’t seen that, sir.”

“So, you’re leaving the door open to changing course as to—?” Padilla asked.

“I’m leaving the door open to studying everything that’s been done so far, so I can make a determination, sir,” Cole said.

Padilla concluded the exchange by stating: “So, make myself a note here—no answer to that particular question.”

 

Source:  Shane W. Varcoe , Director@dalgarnoinstitute.org.au – 23 May 2025 

 

by Letitia James – Office of the New York State Attorney General – May 22, 2025

NEW YORK – New York Attorney General Letitia James today co-led a bipartisan coalition of 40 other attorneys general from across the country in calling on Congress to pass the Youth Substance Use Prevention and Awareness Act, bipartisan legislation to reduce youth drug use through research-based public education campaigns and strategic community outreach. In a letter to Democratic and Republican leadership in the House and Senate, Attorney General James and the coalition emphasize the importance of proactive, science-based prevention efforts at a time when young people face increased risk of exposure to dangerous narcotics like fentanyl and xylazine.

“Too many young people know first-hand just how deadly drugs like fentanyl can be,” said Attorney General James. “As the opioid epidemic continues to tear apart families and communities, attorneys general remain on the front lines protecting our youth, and we need all levels of government to help fight back. The Youth Substance Use Prevention and Awareness Act is a common-sense bipartisan measure that will provide significant resources to help save lives and educate young people about the dangers of drug use.”

The legislation, introduced by U.S. Senators Mark Kelly (D-AZ) and Thom Tillis (R-NC), would amend the Omnibus Crime Control and Safe Streets Act of 1968 to provide targeted federal funding for public service announcements (PSAs), youth-led campaigns, and other outreach tools that help prevent early substance use. All campaigns funded under the bill must be grounded in evidence, designed for cultural relevance, and adapted to meet the specific needs of local communities.

Attorney General James and the coalition argue that youth substance use remains a growing public health and safety concern, especially amid a rise in fentanyl-related overdoses and the increasing availability of synthetic drugs. Research consistently shows that young people who begin using drugs at an early age are more likely to develop long-term substance use disorders, and the consequences can be devastating for families, schools, and communities.

The Youth Substance Use Prevention and Awareness Act would fund a range of efforts to better reach young people with timely, credible, and accessible information, including:

  • Culturally relevant PSAs tailored specifically to youth;
  • Youth-led PSA contests to drive peer-to-peer engagement and creativity;
  • Federal grants for outreach across TV, radio, social media, streaming platforms, and other media; and
  • Annual reporting requirements to measure reach and effectiveness, ensuring transparency and accountability.

The letter is led by Attorney General James and the attorneys general of Connecticut, New Hampshire, and South Dakota. Joining the letter are the attorneys general of Alabama, Alaska, Arkansas, California, Colorado, Delaware, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Nebraska, Nevada, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Utah, Vermont, Virginia, West Virginia, Wisconsin, Wyoming, and American Samoa.

Source:  https://ag.ny.gov/press-release/2025/attorney-general-james-co-leads-bipartisan-coalition-urging-congress-pass

 

The proceedings of their discussion can be accessed via the links shown below
Source: https://www.kbbi.org/podcast/coffee-table/2025-05-14/the-seward-prevention-coalition-and-the-icelandic-prevention-model-for-youth-drug-abuse

 

 

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Published by NIH/NIDA 14 May 2025

 

Cannabis vaping is making headlines worldwide, often promoted as a “safer” alternative to smoking. Meanwhile, Drug Trends data from Australia reveal that non-prescribed cannabis use remains high among people who regularly use drugs. But are wider permission models and positive propaganda about cannabis leading to greater engagement, especially among those most at risk? This article dives into Australian data from the Ecstasy and Related Drugs Reporting System (EDRS) and Illicit Drugs Reporting System (IDRS), exploring what’s really happening with cannabis products, vaping, and why honest health education is more critical than ever.

Cannabis Vaping and Drug Trends in Australia (2014–2024): What the Data Tells Us

Cannabis vaping, once an afterthought, now claims a growing share of the global market. Many believe vaping to be less harmful, with marketers highlighting vaping’s lack of smoke and alleged respiratory benefits. However, recent Drug Trends research in Australia challenges some of these assumptions and uncovers troubling patterns.

The Rise of Electronic Vaping Products

Electronic vaping products started as oversized gadgets in the late 1990s. Initially intended to vaporise dried cannabis herb, they eventually shrank, morphing into today’s sleek e-cigarettes. While vaping nicotine products has become mainstream, cannabis vaping is following close behind, spurred in part by changes to medicinal and recreational cannabis laws overseas.

A North American review found a seven-fold increase in monthly cannabis vaping among adolescents, with notable shifts from dried herb to potent cannabis oils. However, the situation in Australia is different, shaped by stricter regulations and unique market conditions.

Drug Trends in Non-Prescribed Cannabis Use

Australia’s EDRS and IDRS surveys collect real-world data on non-prescribed cannabis and cannabinoid-related products. Between 2014 and 2024, most participants in both systems reported using cannabis recently, with rates as high as 90% in the EDRS and 74% in the IDRS.

Hydroponic and Bush Cannabis Still Dominate

  • Hydroponic cannabis was the most popular, with usage rates ranging from 63%–83% among EDRS respondents, and a remarkable 88%–94% for IDRS participants.
  • Bush cannabis also stayed common, with 51%–77% (EDRS) and 37%–54% (IDRS) reporting use.
  • Other cannabis products, such as THC extracts and commercially-prepared edibles, have appeared in recent years, showing increased product diversity—but are far less popular than traditional forms.

Cannabis Vaping Emerges, But Smoking Prevails

Despite media attention around cannabis vaping, the majority of Australians captured in these studies still smoke cannabis. From 2014 to 2024:

  • Smoking remained the dominant route of administration (ROA) in both groups.
  • Cannabis vaping (inhaling/vaporising) trended upward, but stayed a minority choice. Vaporising among EDRS participants increased from 12% to 25%, and from 2% to 9% for IDRS.

Notably, few users chose vaping as their only method. Most combined it with smoking, suggesting the rise in vaping hasn’t replaced traditional habits.

Concerns About Cannabis Vaping and Permission Models

The Problem with Changing Perceptions

There is growing concern that permission models and positive messaging around cannabis use (whether through legislation or social media) may downplay its risks. Vaping, in particular, is surrounded by claims of being a “safer” alternative to smoking. While it’s true that vaping doesn’t involve combustion and may expose users to fewer toxic chemicals, it’s not risk-free.

Key Issues Include:

  • Potency extremes: Some vape oils and extracts reach THC concentrations of 70–90%, far higher than the average 10%–20% in cannabis herb. Highly potent products carry greater risks for dependence, anxiety, and psychosis.
  • Unknown health risks: The long-term effects of inhaling cannabis vapour, especially from unregulated or home-made devices, are not fully understood.
  • Discreet use and normalisation: Portability and subtlety make vaping easier to hide, particularly from parents and teachers. For some users, this can enable more frequent use or uptake at a younger age.
  • Unhealthy dual use: Most vapers continue smoking, increasing overall exposure to both methods. (for complete research WRD News)

Source: https://www.dalgarnoinstitute.org.au/index.php/resources/drug-information-sheets/2672-cannabis-vaping-and-drug-trends-among-youth-in-australia-2014-2024-a-growing-concern?

By Kevin Sabet – President, Foundation for Drug Policy Solutions – 

To maximize their effectiveness, prevention programs must reach adolescents before they are exposed to substance use in their peer groups. Yet nearly one-third of 12- to 17-year-olds reported that they did not see or hear any substance use prevention messages in school, according to the 2023 National Survey on Drug Use and Health. This lack of prevention education has serious implications for health equity, as racial and ethnic minority youth are less likely to report seeing these messages in their schools.

Prevention takes a village. All sectors of a community must be aligned in order to set healthy norms. This approach guides the Drug-Free Communities Support Program, which involves sectors from businesses and media to schools and religious organizations.

Unfortunately, numerous actors that pursue private profits at the expense of public health actively undermine these efforts. These include marijuana shops and, more recently, psychedelics shops. Our children are given conflicting messages when we tell them not to use addictive substances now being promoted throughout their neighborhoods.

Given the increasing embrace of mind-altering drugs at the state level, it’s no surprise that drug use has risen. A study published in the Journal of the American Academy of Child and Adolescent Psychiatry found that recreational marijuana legalization was associated with a 13 percent increase in past-month marijuana use among youth ages 12 to 17, and a 22 percent increase among young adults ages 18 to 25. Between 2012 and 2023, the prevalence of marijuana use among 19- to 30-year-olds increased from 28.1 percent to 42.4 percent, while it more than doubled from 13.1 percent to 29.3 percent among 35- to 50-year-olds, according to the Monitoring the Future survey. Over this same period, annual overdose deaths nationwide more than doubled from 41,502 to 105,007.

As highlighted in the Foundation for Drug Policy Solutions’ The Hyannis Consensus: The Blueprint for Effective Drug Policy, the nation’s drug policy “should promote a health standard that normalizes the non-use of substances.” Our drug policies should not make it easier to use licit and illicit substances.

A person holds a glass pipe used to smoke meth following the decriminalization
of all drugs in downtown Portland, Oregon on January 25, 2024. 
                                                                                  PATRICK T. FALLON/AFP/Getty Images

 

Other things being equal, the harms of drug use will decline as the prevalence of drug use declines. Notably, the White House recently estimated that the societal cost of illicit opioids was $2.7 trillion––with a “t”––in 2023, which is “equivalent to 9.7 percent of GDP.” Viewed through this lens, prevention is essential and must remain central to drug policy efforts. A proactive, upstream approach premised on prevention will also reduce strain on downstream systems like treatment and recovery.

Policymakers must remember that prevention programs are cost-effective. A 2016 report from the surgeon general explained:

Interventions that prevent substance use disorders can yield an even greater economic return than the services that treat them. For example, a recent study of prevention programs estimated that every dollar spent on effective, school-based prevention programs can save an estimated $18 in costs related to problems later in life.

National Prevention Week is also a fitting time to spotlight novel approaches to prevention. The Icelandic Model is particularly promising. A 2019 study explained that “by working to increase social and environmental protective factors associated with preventing or delaying substance use and decreasing corresponding risk factors, the model prevents substance use by intervening on society itself and across a broad spectrum of opportunities for community intervention.” In practice, this approach may encourage youth to join community groups and participate in extracurricular activities, which are protective factors against substance use.

To scale what we know works, White House Office of National Drug Control Policy director nominee Sara Carter should relaunch a national prevention campaign, similar to the National Youth Anti-Drug Media Campaign. Those public awareness efforts were particularly effective in reducing rates of tobacco use, and will help set strong anti-drug cultural norms and promote health.

The current administration deserves praise for centering prevention in a recent statement of its drug policy priorities. We fully support its plan to “encourage educational campaigns and evidence-based prevention programs, particularly in schools and communities.” But it’s time we back it up with dollars and programs. As we recognize National Prevention Week, we must not forget about the importance of prevention and its role in helping more Americans live healthy, drug-free lives.

Dr. Kevin Sabet is President of Smart Approaches to Marijuana (SAM) and the Foundation for Drug Policy Solutions (FDPS) and a former White House drug policy advisor across three administrations.

The views expressed in this article are the writer’s own.

Source: https://www.newsweek.com/save-americas-youth-lawmakers-should-invest-drug-prevention-opinion-2071582

From clincoln-dfaf.org@shared1.ccsend.com – 15 May 2025

 

For the first time in years, there’s encouraging news in the fight against the overdose crisis. According to provisional data from the Centers for Disease Control and Prevention, an estimated 80,000 people died from drug overdoses in 2024—30,000 fewer than the year before, marking a 27% decrease and the largest single-year decline ever recorded. This milestone reflects the impact of prevention, treatment, and recovery efforts across the country and reinforces the urgent need to continue investing in strategies that save lives.

 

Drug Free America Foundation proudly joins communities nationwide in recognizing National Prevention Week 2025, a public education platform led by the Substance Abuse and Mental Health Services Administration (SAMHSA). Held annually during the second week of May, National Prevention Week showcases the incredible work of individuals, organizations, and communities who are committed to preventing substance use and misuse and promoting positive mental health.

Why Prevention Matters Now More Than Ever

The need for strong prevention strategies has never been more urgent. According to the 2023 National Survey on Drug Use and Health, an estimated 70.5 million people aged 12 or older (that’s nearly 1 in 4 Americans) used illicit drugs in the past year. Marijuana was the most commonly used, followed by hallucinogens and the misuse of prescription pain relievers. These findings underscore the critical importance of investing in prevention today to protect the health and well-being of future generations.

Prevention in Action: Raising Awareness and Building Resilience

This observance highlights the importance of raising awareness about substance use and mental health challenges through data-driven prevention strategies and evidence-based programs that have proven effective in creating healthier, safer communities. It also serves as a reminder of the power of collaboration and community experience in improving public health outcomes and building strong, lasting partnerships.

National Prevention Week is about more than just awareness—it’s about sharing knowledge, disseminating high-quality resources, and empowering people with the tools they need to live healthy, substance-free lives.

 

Showcasing our newest initiative: The Trauma & SUD Action Force Initiative (TSAFI)

The Trauma & SUD Action Force Initiative (TSAFI) is an international effort committed to bridging the gap in trauma-informed care within Substance Use Disorder (SUD) services—from prevention and treatment to recovery—using approaches grounded in neuroscience and scientific evidence.

TSAFI unites experts, organizations, and decision-makers to promote the recognition and integration of trauma within all aspects of SUD care.

By combining insights from neuroscience and psychology, TSAFI addresses the neurological and social dimensions of trauma, ensuring a comprehensive and informed response to its role in SUD.

Discover more here or get involved by reaching out to tsafi@wfad.se or visiting https://tsafi.wfad.se/.

Source: From clincoln-dfaf.org@shared1.ccsend.com – 15 May 2025 

 

 

Issued by DEA Public Affairs – May 15, 2025

Dianova and G2H2 launched a series of debates with a session dedicated to prevention and treatment initiatives for children and adolescents – 16/05/2025

Substance use prevention targeting children and adolescents is a science that relies on evidence-based interventions to address the complex factors contributing to substance use disorders – Photo by Ernest Brillo on Unsplash

On Tuesday 12 May, the first session in a series of debates organized by G2H2 was opened. Entitled ‘People, power and policies in global health: perspectives from civil society’, the series was organized in the run-up to the 78th World Health Assembly, held from 19 to 27 May.

Co-hosted by Dianova and the Geneva Global Health Hub (G2H2) , the session ‘Growing up safe: public health approaches to drug use prevention and treatment for children and adolescents’ brought together high-level participants, including Anja Busse (WHO) and Wadih Maalouf, (UNODC).

G2H2 is a network of civil society organisations based in Geneva that promotes information exchange and joint political action on global health issues – Dianova International is a member of G2H2.

The main objective of the session, as outlined by Gisela Hansen (moderator, Dianova International), was to reconnect drug policies with public health, focusing on the prevention and treatment of substance use among children and adolescents. The aim was to promote models centred on health and human rights, especially in vulnerable or disadvantaged contexts around the world.

Contributions follow from each of the following experts:

  • Anja Busse (World Health Organization)
  • Oriel Esculies (Proyecto Hombre, Spain)
  • Shrook Mansour Ali (Psychiatric Care Development Foundation, Yemen)
  • Cristina von Sperling Afidi (KKAWF, Pakistan)
  • Rajesh Kumar (SPYM, India)
  • Cressida de Witte (WFAD, Sweden)
  • Rebecca Haines-Saah (University of Calgary, Canada)
  • Wadih Maalouf (United Nations Office on Drugs and Crime)

Anja Busse (WHO)

Head of the Unit on Drugs, Alcohol and Addictive Behaviours at the WHO. Anja has been involved in this field at the global level since 2005 and has been supporting science-based strategies for the treatment and care of drug dependence.

Anja took the floor and began by reminding  the WHO’s commitment to promoting global health, particularly among the most vulnerable. The WHO Constitution (1946) emphasizes the importance of healthy child development: “Healthy  development of the child is of basic importance, the ability to live harmoniously in a changing total environment is essential to such development.”

“A public health response to substance use prevention and treatment means reaching the highest number of people with the most effective, least costly, and least invasive strategy or intervention” 

This involves creating environments in which children and adolescents can grow up healthy and safe, and where it is easier for them to avoid alcohol, tobacco and drugs. The burden of responsibility should primarily be placed on the system and on all of us rather than on the individual.

Safer is an initiative launched by the World Health Organization (WHO) in 2018, aiming to prevent and reduce alcohol-related harm in various countries – image: excerpt from presentation by Anja Busse, WHO

UNODC data also reveal that, in 2021, around 5.3% of 15–16-year-olds had used cannabis in the previous year, and that, in most countries and regions, cannabis use is more prevalent among young people than in the general population.

  • Download .pdf presentation by Anja Busse

Anja highlighted that the UNODC and the WHO have published several documents on the health and development of children and adolescents, as well as international standards on drug use prevention. These include strategies targeting the population as a whole, as well as those used in schools, the health system, the workplace, the community, and finally, families. She emphasised one of the basic principles of prevention: ‘The earlier we act, the better’, although it is never too late to implement interventions.

Science based strategies targeting the general population have the widest impact, but they must also consider implementing interventions for the most at-risk groups.

Children and adolescents face several obstacles when seeking mental health and drug services – image: excerpt from presentation by Anja Busse, WHO

According to Anja, the most effective strategies target multiple and multi-level vulnerabilities rather than limiting themselves to narrow interventions in single settings. Finally, Anja emphasised the need for well-conducted planning involving many stakeholders and for an effective social and health system providing accessible mental healthcare services at all levels, which is not the case everywhere.

While it is acceptable for a government to restrict or regulate the availability, distribution and production of drugs, it is important to avoid the unnecessary punishment of people who use drugs.

After reviewing various organizational prevention methods and their effectiveness, Anja also highlighted interventions that research has found to be ineffective or of questionable or unproven effectiveness. These include media awareness campaigns (not effective); use of social media and influencers (effectiveness unknown); information sessions on the consequences or harms of drugs (not effective); sports and other leisure activities (lack of evidence, controversies) strategies targeting children/youth particularly at risk (lack of evidence) and drug testing in schools (no evidence).

Documents

  • Guidelines on mental health promotive and preventive interventions for adolescents (available in six languages)
  • Global Accelerated Action for the Health of Adolescents
  • Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)
  • UNODC/WHO International Standards on Drug Use Prevention
  • A Global Health Strategy for 2025-2028

Oriol Esculies – Proyecto Hombre (Spain)

Oriol is a psychologist with over thirty years’ experience of helping people with addiction problems. He is the International Commissioner of the Proyecto Hombre association and coordinator of the Oviedo Declaration.

The impact of drugs, including tobacco and other legal substances, is enormous. This is not only an issue of security, economics or the law, but also a health issue affecting millions of people, including children and adolescents, in all aspects of their health: physical, emotional, intellectual and social.

We must invest in health now, while our children are healthy; otherwise, the future problem of substance use will be greater, not only for them, but for society as a whole – this is the paradox of prevention.

Some of the stakeholders involved in the Oviedo Declaration, following its presentation at the Commission for the Study of the Constitution (CND) in March 2024 – Photo: Proyecto Hombre, all rights reserved

This also presents a significant challenge to decision-makers and governments, as it necessitates planning and governance with a long-term vision. Launched last year, the Oviedo Initiative is a declaration comprising ten proposals in line with international standards on prevention. It is also a global mobilisation to incorporate prevention into drug policies once and for all. It is an inclusive, collective campaign that is already supported by over 3,000 institutions and several observers, including the UNODC.

  • Read article on the Oviedo Declaration and support the Declaration, available in 48 languages

The main strength of this initiative, which builds bridges between local and global levels, lies in the voluntary work of 174 focal points within countries. At Dianova International, we are honoured to contribute to this initiative as the focal point for Switzerland.

We hope that the resolution on prevention recently adopted by the CND in Vienna last March will mark a turning point towards the accelerated implementation of effective and forward-looking drug prevention policies.


Shrooq Mansour Ali, Psychiatric Care Developmental Foundation (Yemen)

As a public health expert and the Yemen focal point for the Oviedo Initiative, Shrooq works for the Yemeni NGO, the Psychiatric Care Developmental Foundation, providing mental health and psychological support services to vulnerable young people.

She points out that, after ten years of conflict, Yemen is facing one of the world’s worst humanitarian crises, exacerbated by ongoing violence, the consequences of climate change and the collapse of the economy, institutions and services. According to the 2024 Humanitarian Needs Assessment, approximately half of Yemen’s population, or more than 18 million people, require humanitarian assistance.

Research has shown that populations affected by armed conflict are at a higher risk of using drugs as a coping mechanism in response to such dramatic situations.

Furthermore, factors such as prolonged psychological trauma, disrupted education, unemployment and chronic poverty in Yemen further increase the risks. Despite this, mental health and substance use issues remain highly neglected. Therefore, ensuring adequate care for substance use issues in humanitarian contexts is a priority.

As the focal point for the Oviedo Declaration in Yemen, Shrook and her colleagues face significant challenges in advancing the initiative within government structures due to the many divisions between the government recognised by international institutions in the south and the de facto authorities in the north. This means that all activities must be coordinated with different entities, which is made more difficult by the sensitive nature of the issue.

Yemen lacks reliable data on substance use. As one of the Oviedo Declaration’s recommendations highlights, there is a need to focus on evidence-based strategies grounded in the collection and evaluation of data. This data would serve as a basis for implementing prevention programmes and national policies in this area.

Problems associated with substance use exist in Yemen and can no longer be ignored or denied.


Cristina von Sperling Afridi, Karim Khan Afridi Welfare Foundation (KKAWF), Pakistan

Following the tragic loss of her son, Karim, in 2015, Cristina established the Karim Khan Afridi Welfare Foundation (KKAWF) to support young people and raise awareness of addiction. The foundation’s work is based on five pillars: drug awareness, sport, the environment, art and culture, and civic engagement.

Currently in Pakistan And across the region Drug use prevention strategies are significantly underrepresented In public policies agendas. The Oviedo declaration launched in 2024 represents a timely and powerful call to action urging nations to prioritize prevention in the drug policies For Pakistan this framework offers a critical opportunity to redirect focus towards long-term sustainable solutions.

Cristina emphasised the urgency of the situation: Pakistan lies at the heart of the Golden Crescent, one of the world’s most notorious drug producing region. Of all the countries in the region, Pakistan is the most affected by the drug menace. It harbors the largest heroin consuming population in the region, a crisis now compounded by the rise of crystal meth.

The growing threat of drug use among young people poses considerable social, health, and economic challenges for the nation. The KKAWF Foundation plays an active role in preventing drug use. It raises awareness among policymakers, civil society and other stakeholders of the importance of prevention.

Prevention must become the central pillar of national drug policies, but this requires essential resources, coordination and commitment — and urgently so!

The KKAWF develops numerous partnerships in its advocacy work for prevention. Here, the Foundation’s president, Cristina Von Sperling Afridi (right), with a representative of the Green Crescent Federation – Photo: KKAWF, all rights reserved

One of the Foundation’s main areas of focus is fostering collaboration between the government, civil society organisations, and the private sector, as only a unified, strategic approach can effectively address this public health crisis. It is also crucial to integrate drug education into school curricula at secondary and higher education levels.

The KKAWF advocates an evidence-based, stigma-free approach that promotes emotional intelligence, resilience, and critical thinking.

Cristina believes that prevention must become a way of life, not just a programme. She believes that only by cultivating a culture of prevention will it be possible to protect future generations.


Rajesh Kumar, Society for the Promotion of Youth and Masses (SPYM), India

Rajesh is the executive director of SPYM, an NGO that has worked in the field of addiction for over 40 years, receiving several national awards for its work with marginalised communities. SPYM has consultative status with ECOSOC, and Dr Kumar has served on numerous government and international bodies.

India’s proximity to the Golden Crescent and Golden Triangle has made the country a destination for large quantities of drugs. Substance use is therefore on the rise, particularly among children. In response to this serious violation of children’s rights, SPYM began working with children suffering from addiction in 2010.

In India, approximately 4 million children use opiates, 2.6 million inhale drugs, and 2 million use cannabis. Even with a population of over 1.4 billion, these figures represent a huge problem, particularly given that only 1% of affected children seek help.

While it is estimated that 99.9% of children do not use drugs, it is essential to invest in treatment and scientifically validated prevention strategies based on collaboration with families, communities and schools to ensure they stay on this path. These groups have a duty to ensure that substance use prevention and mental health are part of their regular activities, which is why SPYM has developed the Navchetna programme under the auspices of the Ministry of Social Justice and Empowerment.

  • Download .pdf presentation by Rajesh Kumar

The Navchetna school programme is designed with different modules tailored to students according to their age. It is run by trained teachers under the supervision of the Ministry of Education.

A significant part of SPYM’s work is carried out for the benefit of the well-being of the most disadvantaged children and adolescents – Photo: SPYM, all rights reserved

Once their training is complete, the ‘master trainers’ must in turn train up to 100 teachers within two years, with the ultimate goal of training one million teachers, although so far, only 100,000 have been trained. The programme also uses videos, which are currently available in English and Hindi and will soon be available in 12 regional languages.

SPYM also develops numerous programmes and activities to help vulnerable people, particularly children and teenagers. These include a community-based early intervention programme run by peers in nearly 300 districts in the country most affected by drug use, residential treatment centres for various populations including children and adolescents in conflict with the law, activities focused on life skills and rehabilitation, and advocacy activities.

SPYM and KKAWF are both associate members of Dianova International.


Cressida de Witte – World Federation Against Drugs (WFAD, Sweden)

Cressida is the project coordinator and communications manager for the WFAD. She leads projects for this organisation in various countries, including the Democratic Republic of Congo, Kenya, India, and Georgia. She is also a member of the WFAD committees on gender and youth.

The continuum of care includes a wide range of interventions, from health promotion to recovery and follow-up, including various prevention strategies and different phases or modalities of treatment.

Diagram produced by Dr Audrey Begun – Theories and Biological Basis of Substance Misuse

The Continuum of Care in addiction treatment refers to a comprehensive approach that guides and tracks patients over time through various levels and intensities of care – Image: excerpt from presentation by Cressida de Witte

Although prevention programmes for young people generally target school-age children, adolescents and young adults due to the high risk of experimenting with substances, research has shown that prevention efforts should start even earlier.

The early years of a child’s life are a critical period for brain development. This is when the foundations of decision-making, impulse control and resilience are laid. As younger children learn to manage their emotions, resolve conflicts and set goals, they develop skills that will inform healthier choices in adolescence and adulthood.

However, prevention is not solely the responsibility of the child; it also depends on their environment, which is why action must be taken at all levels, from the macro to the micro, and from family dynamics to community support.

The WFAD is a multilateral community with ECOSOC consultative status, composed of over 470 NGOs in 73 countries. The organisation’s three pillars are capacity building through webinars, training courses and forums; advocacy at national, regional and international levels to strengthen prevention, treatment and recovery; and project development, particularly international projects. One such project is a youth project in the Democratic Republic of Congo: Sober Youth and Healthy Communities: Transforming Violent Youth in Kinshasa. Learn more about the project.

Within the framework of these advocacy efforts, the organisation launched the ‘Global Youth Declaration on Prevention, Treatment and Recovery’. Presented at the 68th session of the CND in March 2025, the declaration is based on six recommendations aimed at ‘ensuring access to prevention, treatment, rehabilitation and recovery services that are youth-friendly and respectful of their rights, in order to ensure a healthy, safe and drug-free future for all young people worldwide’. The declaration is available in seven languages.


Rebecca Haines-Saah – University of Calgary (Canada)

Rebecca is a public health sociologist and associate professor at the University of Calgary. Her research interests include youth drug use, harm reduction approaches, and drug policy reform.

As a teenager, she was cast in a popular Canadian television programme in which her character experimented with substance use. This, in some way, launched her career and her commitment to supporting young people she said.

Rebecca believes that we need to radically rethink drug prevention for young people. Unfortunately, in North America as elsewhere, prevention has long been based on values rather than scientifically validated evidence of what works and what doesn’t. Past prevention campaigns, such as Nancy Reagan’s ‘Just Say No’ motto, were never evidence-based or evaluated.

“Prevention has been based on values rather than evidence for too long, which is why we need to radically rethink drug prevention for young people” – excerpt from presentation by Rebecca Haines-Saah

Even worse, an evaluation of the D.A.R.E. (Drug Abuse Resistance Education) programme – a series of lessons delivered by police officers in schools – showed that it was associated with a slight increase in substance use! It was hypothesised that the most marginalised young people reacted badly to the presence of police officers in the classroom. These campaigns primarily relied on stereotypes and stigmatisation of young people.

“In Canada, it has been highlighted that the most effective drug prevention programmes have very little to do with drugs” 

If we want to improve prevention outcomes among young people, she stresses, we need to focus less on educating them about specific substances, and instead strive to promote community well-being, as well as individual and family resilience. That’s where we need to invest.

Scientific research indicates that effective strategies include psychosocial and developmental interventions that enhance conflict resolution and problem-solving abilities, social-emotional learning, and anything else that helps teenagers manage challenging situations with their peers and cope with trauma and community conflict. These strategies have demonstrated several positive long-term outcomes.

Rebecca also highlighted the implementation of a community-based prevention model in Calgary and other parts of the country. Planet Youth, the model implemented in Calgary and elsewhere, was developed based on the Icelandic prevention model: a participatory, evidence-based approach that has dramatically reduced substance use, particularly tobacco and alcohol.

Finally, Rebecca presented a slide on the ‘prevention pyramid’, particularly focusing on the first level: the more effort made to create equitable social and economic conditions, the better the results. She believes that this is a much more ambitious and difficult goal to achieve than simply setting up a programme or activity. However, it is on this point that our vision must be aligned.

The more effort that is made to create equitable social and economic conditions in prevention, the better the results.

In addition to prevention needs, Rebecca emphasised the urgent need to address young people’s harm reduction needs to prevent drug poisoning deaths. Drug poisoning is currently the leading cause of death among 10- to 18-year-olds in western Canada, ahead of cancer and car accidents, so this is a public health emergency.


Dr Wadih Maalouf – UNODC

Wadih is a public health professional who holds a PhD in mental health and drug epidemiology from the Johns Hopkins School of Public Health. With over 25 years’ experience, he is now the global coordinator of the addiction prevention programme at UNODC, and is one of the world’s leading prevention experts.

Wadih began by emphasising the importance and timeliness of this conversation because it is based on scientific evidence. A large number of standards have now been developed for prevention and treatment, thanks to collaboration between UNODC and WHO, and the science is available. He also noted that science is receiving greater recognition, not only from organisations working in the field, but also from civil society. This is evident in the 3,000 stakeholders who have rallied around the common agenda promoted by the Oviedo Declaration.

This recognition is also evident at government level, as demonstrated by the Commission on Narcotic Drugs’ resolutions, which call for early prevention to target different stages of development rather than drug use. These resolutions also call for multisectoral prevention, despite all the challenges posed by multilateralism.

There is now a desire to develop science-based, multisectoral prevention programmes for young people.

In his view, there is a real desire to prioritise science and prevention, particularly for young people, and to work across multiple sectors. With the right ingredients — science, political commitment, and action on the ground — it is possible to turn this knowledge into action.

As a people-centred approach, prevention must also focus on the environment and context in which people live, as well as their level of vulnerability. This systemic approach must aim to leave no one behind.

To achieve this, we must focus on different age groups, contexts of vulnerability and gender. This is an important consideration in the context of vulnerabilities, particularly for children, whose developmental trajectories may be affected in different ways.

The current generation of young people has the highest potential ever seen, which is why it is essential that they are meaningfully engaged in prevention efforts.

Young people are not only the beneficiaries of prevention; they must also be its agents because every child has the right to grow up healthy, and we have the means to make that happen.

From sfunes@drugfreeamericafoundation.ccsend.com – 16 May 2025

 

Today you can find marijuana everywhere, dispensaries around every corner or easily accessible through social media. This normalization is leading researchers to investigate its effects on various health conditions and the dangers associated with overconsumption of marijuana. This research shows that there is an association between marijuana use and the weakening of our immune system. Its consumption affects key parts of our defences against cancer while contributing to faster tumor progression, particularly for gastrointestinal conditions.

 

In general, individuals with substance use disorders, including cannabis use disorder (CUD), are more likely to experience delays in diagnosis and reduced involvement in their medical care. In addition, behavioral and psychiatric conditions linked to marijuana use such as anxiety and depression may prevent the adherence to the required treatment leading to negative prognosis.

 

Two recent studies, one on chronic pancreatitis and the other on colorectal cancer, highlight how CUD is linked to poorer outcomes in individuals suffering from chronic pancreatitis and colorectal cancer.

 

In the first study, researchers analyzed over 1,000 patients and found that those with pre-existing CUD were more likely to die within 5 years of receiving a colon cancer diagnosis. Among those who had a documented history of CUD prior to being diagnosed, the difference in outcomes were stark:

 

Five-year mortality rate:

  • Patients with CUD: 55.9%
  • Patients without CUD: 5.1%

 

In the second study, researchers linked CUD to worsened clinical outcomes in individuals with chronic pancreatitis, a painful and progressive condition where the pancreas becomes inflamed and damaged over time. These patients were found to be at greater risk of pancreatic flare up, pancreatic cancer, all-cause mortality, and pancreatic necrosis.

 

This association held firm even after the researchers accounted for opioid use, suggesting that marijuana itself may contribute to disease progression and complications.

 

CUD affects 3 in 10 users in the U.S., according to the CDC. As it becomes more normalized, the risks for vulnerable populations, in this case those with colon cancer and pancreatitis, continue to grow. These risks are too significant and call for more research, awareness and education, serving as a critical reminder that marijuana use is not harmless, especially when dependence develops.

 

For resources related to marijuana, check out www.dfaf.org/education.

 

Source:

From sfunes@drugfreeamericafoundation.ccsend.com

And for further related information. visit:

 

Drug use remains a persistent public health crisis affecting communities across the nation. The complexity of substance abuse requires a coordinated response from multiple agencies and sectors. When these entities work in isolation, gaps in care emerge and resources are used inefficiently. A collaborative approach offers the most promising path forward in addressing this multifaceted issue.The Current Landscape of Drug UseRecent data from the National Survey on Drug Use and Health indicates that approximately 59.3 million Americans aged 12 or older used illicit drugs in the past year. Even more concerning is that only about 10% of individuals with substance use disorders receive specialized treatment. These statistics underscore the magnitude of the challenge and the urgent need for comprehensive strategies.The opioid epidemic continues to claim lives at an alarming rate, with over 100,000 drug overdose deaths recorded annually in recent years. Meanwhile, methamphetamine use has surged in many regions, and the emergence of potent synthetic drugs has further complicated prevention and treatment efforts.Breaking Down Silos Between Agencies

Historically, responses to drug use have been fragmented across law enforcement, healthcare, social services, education, and community organizations. Each sector approaches the issue through its own specialized lens, often with limited awareness of complementary services or resources available elsewhere.

Breaking down these silos requires intentional structural changes. Joint task forces that bring together representatives from various agencies can facilitate information sharing and collective problem-solving. These coalitions should include representatives from public health departments, hospitals, mental health services, law enforcement, schools, community organizations, and recovery support services.

Regular interagency meetings allow stakeholders to share data, identify trends, and develop coordinated strategies. Shared databases and information systems enable real-time communication about emerging threats and available resources, while protecting client privacy through appropriate safeguards.

Collaborative Prevention Strategies

Prevention represents the most cost-effective approach to reducing substance use. When agencies collaborate on prevention initiatives, they can leverage their collective expertise and resources to maximize impact.

Schools can partner with public health departments and law enforcement to implement evidence-based prevention curricula. Community-based organizations can work with healthcare providers to identify and support at-risk youth. Faith communities can collaborate with social services to offer supportive environments and positive activities for young people.

Prevention efforts should address not only the risks of substance use but also underlying factors such as trauma, mental health issues, poverty, and social isolation. This holistic approach requires input from diverse agencies with expertise in these various domains.

Creating Seamless Pathways to Treatment

When someone seeks help for substance use, they often encounter a confusing maze of services spread across different agencies. Collaborative approaches can create more seamless pathways to appropriate care.

One successful model involves establishing centralized assessment and referral systems where individuals can receive comprehensive evaluations and be connected to appropriate services based on their specific needs. These “no wrong door” approaches ensure that regardless of which agency someone initially contacts, they can be guided to the full spectrum of available resources.

A Residential Treatment Center for Youth offers a critical component within this continuum of care. These specialized facilities provide structured environments where young people can receive intensive therapeutic interventions away from environments that may contribute to substance use. When integrated into a broader system of coordinated care, residential treatment centers can work closely with schools, juvenile justice systems, and community-based services to ensure smooth transitions and ongoing support for youth and their families.

Shared Funding and Resource Allocation

Limited resources often create competition between agencies addressing substance use. Collaborative approaches can help overcome this challenge through shared funding mechanisms and strategic resource allocation.

Pooled funding models allow agencies to combine resources for greater impact. Joint grant applications can access funding streams that might be unavailable to individual organizations. Cost-sharing arrangements for shared staff positions or facilities can extend limited budgets.

Some communities have established dedicated funding streams for substance use initiatives through tax measures or fees. These resources can be allocated through collaborative decision-making processes that ensure they address community priorities and gaps in services.

Data Sharing and Outcome Measurement

Effective collaboration requires shared data systems and agreed-upon outcome measures. When agencies use different metrics to evaluate success, it becomes difficult to assess the collective impact of their efforts.

Communities that have made progress in addressing substance use typically establish common data elements that all participating agencies collect and report. These might include measures of substance use prevalence, treatment access and completion, overdose rates, related criminal justice involvement, and social indicators such as employment and housing stability.

Regular analysis of this shared data allows partners to identify trends, evaluate the effectiveness of interventions, and make evidence-based adjustments to strategies. This approach transforms the collaborative from a mere networking group into a data-driven learning community.

Overcoming Barriers to Collaboration

Despite its benefits, interagency collaboration faces significant challenges. Differing organizational cultures, competing priorities, confidentiality concerns, and turf issues can impede cooperative efforts.

Successful collaborative address these barriers through formal agreements that clarify roles, responsibilities, and information-sharing protocols. Regular relationship-building activities help develop trust between partners. Training on confidentiality laws and regulations ensures that information can be shared appropriately while protecting client privacy.

Leadership commitment from the highest levels of participating organizations is essential to overcoming institutional resistance. When agency heads model collaborative behavior and allocate resources to support cooperative efforts, staff at all levels are more likely to embrace the approach.

Community Engagement as a Unifying Force

Community members, particularly those with lived experience of substance use, bring valuable perspectives to collaborative efforts. Their involvement can help ensure that strategies are culturally appropriate, respectful, and responsive to community needs.

Recovery community organizations, family support groups, and neighborhood coalitions should be equal partners in planning and implementing interagency initiatives. Their participation helps build public trust and ensures that services address the actual barriers and needs experienced by those seeking help.

Final Word

The fight against drug use requires the coordinated efforts of multiple agencies working together toward common goals. By breaking down silos, sharing resources, creating seamless pathways to care, and engaging the community, these collaborative can address substance use more effectively than any single agency working alone.

The most successful models recognize that substance use is influenced by complex biological, psychological, and social factors that cross traditional agency boundaries. Only through true collaboration can communities provide the comprehensive response needed to prevent drug use, support recovery, and promote health and wellbeing for all residents.

While challenges to collaboration exist, communities across the country have demonstrated that with commitment, creativity, and persistence, agencies can work together effectively to reduce the impact of substance use and build healthier communities for all.

Source: https://dailytrust.com/how-agencies-can-come-together-in-the-fight-against-drug-use/

by Dr Max Pemberton (The Mind Doctor) in the Daily Mail on 17 March 2025

Source: Daily Mail – 17 March 2025

The ex-England football manager reflects on his personal journey, belief and resilience …

During Sir Gareth’s football career as a defender and midfielder, he played for Crystal Palace, Aston Villa and Middlesbrough and was in the England squad between 1995 and 2004. He took over as manager in 2016 and led the team to the 2018 World Cup semi-final, 2022 World Cup quarter-final and Euro finals in 2020 and 2024.

He stepped down as Manager in July 2024,  two days after England lost to Spain in the Euros.

Sir Gareth has been credited with revitalising the England team and was knighted in the King’s New Year Honours in December.

He is the latest in a line of academics, business leaders and other notable figures to deliver the Richard Dimbleby Lecture, which has been held most years since 1972 in memory of the broadcaster.

Previous speakers have included King Charles III, when he was the Prince of Wales, tech entrepreneur and philanthropist Bill Gates, and Christine Lagarde, then the managing director of the International Monetary Fund (IMF).

‘Too many young men are isolated’

Sir Gareth’s talk focused on the importance of belief and resilience for young men, and he cited three things needed to build these: identity, connection and culture.

He referred to a report, released earlier this month by the Centre for Social Justice, which said boys and young men were “in crisis”, with a “staggering” increase in those not in education, employment or training.

“Too many young men are isolated,” Sir Gareth said in his talk. “Too many feel uncomfortable opening up to friends or family. Many don’t have mentors – teachers, coaches, bosses – who understand how best to push them to grow. And so, when they struggle, young men inevitably try to handle whatever situation they find themselves in, alone.”

“Young men end up withdrawing, reluctant to talk or express their emotions,” he added. “They spend more time online searching for direction and are falling into unhealthy alternatives like gaming, gambling and pornography.”

Referencing his own experiences, he said the UK needed to do more to encourage young people – especially young men – to make the right choices in life and to not fear failure.

Rather than turning to teachers, sports coaches or youth group leaders, Sir Gareth said he feared many young men were searching for direction online. There, he said they were finding a new kind of role model, one that too often did not have their best interests at heart.

“These are callous, manipulative and toxic influencers, whose sole drive is for their own gain,” he said.

“They willingly trick young men into believing that success is measured by money or dominance, that strength means never showing emotion, and that the world, including women, is against them.”

He also said young men don’t get enough opportunities to fail and learn from their mistakes.

“In my opinion, if we make life too easy for young boys now, we will inevitably make life harder when they grow up to be young men,” he said. “Too many young men are at risk of fearing failure, precisely because they’ve had so few opportunities to experience and overcome it. They fail to try, rather than try and fail.”

The ex-footballer also reflected on what his career has taught him about belief and resilience.

“If I’ve learned anything from my life in football, it’s that success is much more than the final score,” he said. “True success is how you respond in the hardest moments.”

 

Source: https://www.bbc.co.uk/news/articles/ceqjpzg0qwno

 

by Lisa Ryckman – NCSL’s associate director of communications. (National Conference of State Legislatures)

Somewhere in America right now, a teenager searches the internet for drugs. The pills they buy might look like the real thing—Xanax, maybe, or Adderall—but chances are, they’re not getting what they think they are.

The U.S. Drug Enforcement Administration estimates that six out of 10 pills bought online actually might contain lethal doses of the opioid fentanyl, says Rahul Gupta, director of the Office of National Drug Control Policy.

“So, the odds of dying from those pills is worse than playing Russian roulette with your life,” he told a session at the 2023 NCSL Legislative Summit.

“Substance use cuts across every geographic boundary, every sociocultural boundary. It doesn’t matter what race you are, how rich or poor you are, where you live.”

—Rahul Gupta, Office of National Drug Control Policy

More than 110,000 Americans died from drug overdoses in 2022, Gupta says.

“Substance use cuts across every geographic boundary, every sociocultural boundary. It doesn’t matter what race you are, how rich or poor you are, where you live,” he says. “It’s got your number.”

An iteration known as “tranq dope”—a potent cocktail of fentanyl, heroin and the animal tranquilizer xylazine—is the latest scourge to hit the streets, Gupta says. It is particularly problematic because the xylazine tends to increase the effect of the other drugs.

The costs of opioid addiction and trafficking fall mostly on the states: an economic loss of $1.5 trillion in 2020 alone, Gupta says. He outlines a two-pronged federal approach that includes treating addiction and disrupting drug trafficking profits. Making the drug naloxone, which can reverse an overdose, available over the counter has been a game-changer, he says, as have efforts to disrupt the fentanyl supply chain—chemicals from China, production in Mexico and sales in the U.S.

“We’re going after every choke point in this supply chain,” Gupta says, “and we’re putting sanctions on all of these folks to make sure that we’re choking off those important points the cartels and others depend on to create this deadly substance that kills Americans.”

Expanding Treatment Access

In Oklahoma, fentanyl overdose deaths increased sixfold from 2019 to 2021, and fentanyl was involved in nearly three out of four opioid-related deaths, compared with 10%-20% in previous years, says state Sen. John Haste, vice chair of the Health and Human Services Committee.

The Legislature focused on prevention and treatment by expanding access to naloxone, including requiring hospitals and prisons to provide it to at-risk patients and inmates upon release, he says. Telehealth can now be used for medication-assisted treatment, and fentanyl test strips have been legalized, Haste says.

The state Department of Mental Health and Substance Abuse has launched a campaign to reduce the number of accidental overdoses through education awareness and resource access, he says. As part of the campaign, the department is placing more than 40 vending machines in targeted areas that freely dispense naloxone and fentanyl test strips. “This is the largest program of its kind in the country,” Haste says. “All around Oklahoma, you can see messages reminding the public to utilize test strips and naloxone on billboards, buses, local businesses and other strategic locations.”

Opioid Alternatives

In Hawaii, legislators are looking at safe alternatives to opioids for pain relief.

“It’s easy to say, just stop opioids, stop all drugs,” says Rep. John Mizuno, chair of the Hawaii House Committee on Human Services. “We know that chronic pain is complex; in addition to pain, you’ve got mental health. We need to think about the person’s quality of life. We’ve got to balance the patient’s right to manage his or her pain.”

Mizuno suggests that legislators meet with their state’s top pain management physician to learn about safe pain alternatives, including nerve blocks, implanted medication pumps, physical therapy, acupuncture, massage therapy, chiropractic treatment and medical cannabis.

His state has asked that Medicaid expand coverage for native Hawaiian healing that previously has been covered only for tribal members.

Mizuno says coverage is the main barrier to safer treatments, many of which might not be paid for under private health insurance or federal programs.

“But the best thing to do is work with your colleagues, work with your medical providers, and try to get these safe alternatives (covered),” Mizuno says. “It’s a lot better than being addicted to opioids.”

Source: https://www.ncsl.org/events/details/states-and-feds-are-partners-in-fight-against-opioid-epidemic

March 18, 2025

This blog was also published in the American Society of Addiction Medicine (ASAM) Weekly, on March 18, 2025. 

For many people trying to recover from a substance use disorder, perhaps for the majority, abstinence may be the most appropriate treatment objective. But complete abstinence is sometimes not achievable, even in the long-term, and there is a need for new treatment approaches that recognize the clinical value of reduced use.

According to a recently published analysis of data from the 2022 National Survey on Drug Use and Health, two thirds (65.2 percent) of adults in self-identified recovery used alcohol or other drugs in the past month1. There is increasing scientific evidence to support the clinical benefits of reduced substance use and its viability as a path to recovery for some patients. Reducing drug use has clear public health benefits, including reducing overdoses, reducing infectious disease transmission, and reducing automobile accidents and emergency department visits, not to mention potentially reducing adverse health effects such as cancer and other diseases associated with tobacco or alcohol.

The FDA has historically favored abstinence as the endpoint in trials to develop medications for substance use disorders. Abstinence has been evaluated using absence of positive urine drug tests, absence of self-reported drug use, and regularly attending sessions where drug use is assessed. But abstinence is a high bar comparable to requiring that an antidepressant produce complete remission of depression or that an analgesic completely eliminate pain. Recognizing this limitation, the FDA encourages developers of opioid2 and stimulant3 use disorder medications to discuss with FDA alternative approaches to measure changes in drug use patterns.

A model for reduced use as an endpoint exists with treatments for alcohol use disorder. Reduction in alcohol use is relatively easy to measure since alcoholic beverages tend to be purchased and consumed in standard quantities, and substantial evidence supports the clinical benefit of reduction in heavy drinking days (defined as 5 or more drinks/day for men and 4 or more drinks/day for women). Consequently, the percentage of participants with no heavy drinking days is accepted by the FDA as a valid outcome measure in trials of medications for alcohol use disorder4. The FDA recently announced a new tool through which investigators can determine if proposed treatments for alcohol use disorder (AUD) work based on whether they reduce “risk drinking” levels. The new tool can be used as an acceptable primary endpoint in studies of medications to treat adults with moderate to severe AUD.

Use reduction could readily be used as an endpoint in the development of treatments for tobacco use disorder too, since the number of cigarettes smoked per day is easily measured and there is evidence that 50 percent reduction in cigarette use produces meaningful reduction in cancer risk5. Thus, the NIH and FDA have recently called for consideration of meaningful study endpoints in addition to abstinence in research on new smoking-cessation products6; though abstinence is still required as the main outcome for medication approval.

Objective assessment of use reduction for illicit substances presents a greater difficulty given variability and uncertainty of the composition and purity of illicit drugs purchased. This challenge may account for part of the reluctance of the pharmaceutical industry to invest in developing new medications aimed at reducing drug use. Also, anecdotally, the expectation that medications that can produce complete cessation are the only treatments that will advance to market has discouraged addiction neuroscientists and some in the pharmaceutical industry from advancing new medication targets or compounds relevant to reduced use or other endpoints besides abstinence. Nevertheless, there is increasing research demonstrating the relative strength of quantitative measures of drug use frequency versus binary measures of abstinence in assessing the efficacy of drug use disorder treatments.

A 2023 analysis of pooled data from 11 clinical trials of treatments for cocaine use disorder found that reduction in use, as defined by achieving at least 75 percent cocaine-negative urine screens, was associated with short- and long-term improvement in psychosocial functioning and measures of addiction severity7. A 2024 secondary analysis of data from 13 clinical trials of treatments for stimulant use disorders (cocaine and methamphetamine) found that reduced use was associated with improvement in several indicators of recovery, including measures of depression severity, craving, and domains of symptom improvement (legal, family/social, psychiatric, etc.)8.

A secondary analysis of seven clinical trials of treatments for cannabis use disorder found that reductions in use short of abstinence were associated with meaningful improvements in sleep quality and reduction of cannabis use disorder symptoms9. Fifty percent reductions in days of cannabis use and 75 percent reductions in amount of cannabis used were associated with the greatest clinician-rated improvement.

Little research has been conducted on alternative endpoints in opioid use disorder treatment, but it will be needed to advance medication development in this area. Among the important research questions that still need answering is whether treatment aimed at reducing opioid use could produce better overdose-related outcomes than treatment aimed at cessation of use, since many fatalities arise from a return to use after tolerance to the drug is lost following periods of abstinence. Even in the absence of clinical trial evidence, however, any reduction in illicit substance use can reasonably be argued as beneficial, entailing less risk of overdose or of infectious disease transmission, less frequent need to obtain an illegal substance with the attendant dangers, and so on10. Decreased substance use also makes it more likely that the individual can hold a job, be a supportive family member, and so on.

Broadening the goals of treatment to include reduced use or other clinically meaningful outcomes as a main outcome for medication approval could potentially expand therapeutic interventions and help increase the number of people in treatment. It could also reduce the stigma that is typically associated with return to use. Setting abstinence as the goal of treatment can be obstacle to treatment engagement for those who are unready or unwilling to make that commitment. And when attempts at abstinence falter, these expectations can compound the sense of failure the patient experiences.

There is little scientific evidence to support the stereotype that people who return to use after a period of abstinence inevitably do so at the same intensity. Some research on post-treatment patterns of alcohol and other drug use in adolescents suggests that returns to use, when they occur, are often at a lower intensity than before11. People in recovery sometimes draw a distinction between resumption of a heavy and compulsive use pattern and isolated, one-time returns to substance use, recognizing that brief “slips” or “lapses” don’t need to be catastrophic to recovery efforts and may even strengthen the person’s resolve to recover.

When returns to use are catastrophic, the sense of failure at living up to the abstinence expectation could play a role in exacerbating further substance use. So could the rules of treatment programs or recovery communities that require abstinence. It too often happens that patients are discharged from addiction treatment if they return to use, which as the American Society of Addiction Medicine notes in its recent guidance document Engagement and Retention of Nonabstinent Patients in Substance Use Treatment, is illogical and inconsistent with our understanding of addiction as a chronic disease: excluding a person from treatment for displaying symptoms of the disorder for which they are being treated12.

Recognizing that recovery is often nonlinear, a more nuanced view of treatment is needed, one that acknowledges that there are multiple paths to recovery. Expecting complete abstinence may be unrealistic in some cases and can even be harmful. It can pose a barrier to seeking and entering treatment and perpetuate stigma and shame at treatment setbacks. By the same token, reduction of substance use has important public health benefits as well as clinical benefits for patients, and recognition of this could greatly advance medication development for treatment of addiction and its symptoms.

Source: https://nida.nih.gov/about-nida/noras-blog/2025/03/advancing-reduction-drug-use-endpoint-in-addiction-treatment-trials

  • In trials to develop medications for substance use disorder, the Food and Drug Administration (FDA) has historically favored abstinence as the endpoint/goal, rather than reduced use.

The details: A model for evaluating treatments based on reduced use instead of abstinence exists with alcohol use disorder (AUD) and is in the works for smoking.

  • The percentage of participants with no heavy drinking days is accepted by FDA as a valid outcome measure in trials of medications for AUD. The National Institutes of Health and FDA have recently called for consideration of study endpoints in addition to abstinence in research for new smoking cessation products.
  • Reduction in alcohol or tobacco use is easy to measure since alcoholic beverages/tobacco products tend to be purchased and consumed in standard quantities. Substantial evidence supports the clinical benefit of reduction in heavy drinking days.

But:

  • Objective assessment of use reduction for illicit substances presents greater difficulty given variability and uncertainty of the composition and purity of illicit drugs.
  • Little research has been conducted on alternative endpoints in OUD treatment.

Why it’s important:

  • Reducing drug use has clear public health benefits, including reducing overdoses, infectious disease transmission, car accidents, and emergency department visits, as well as reducing adverse effects such as cancer and other diseases associated with tobacco or alcohol.
  • Broadening the goals of treatment could potentially expand treatment options, increase the number of people in treatment, and reduce stigma associated with return to use. Expecting complete abstinence may be unrealistic in some cases and can pose a barrier to treatment.
Source: https://drugfree.org/drug-and-alcohol-news/nida-director-rethinking-sud-treatment-goals/

by Gould, H., Zaugg, C., Biggs, M. A., Woodruff, K., Long, W., Mailman, K., Vega, J., & Roberts, S. C. M. (2025).

Mandatory warning signs for cannabis: Perspectives and preferences of pregnant and recently pregnant people who use cannabis. 

Marijuana and the Risks to Pregnancy & Breastfeeding

Marijuana contains almost 500 components including the psychoactive ingredient THC that can pass through the placenta to the baby during pregnancy, causing harm to the fetus. When a breastfeeding mother uses marijuana, the baby can be exposed to THC and other toxins stored in the mother’s fat tissues, which are slowly released over time, even after the mother has stopped using marijuana.

Explore the various risks of marijuana use during pregnancy and breastfeeding through the resources below. Access expert insights, research updates, training courses, videos, and our new PhotoVoice project—designed to empower mothers with knowledge and support.

We’re launching an empowering initiative for mothers and mothers-to-be with lived experience of substance use in Florida. Lived experience could mean in treatment, recovery or affected by substance use in any way. This transformative project combines photography and storytelling to give participants a platform to share their experiences, connect with others, and advocate for healthier, drug-free futures for their families.

Through this six-month journey, participants will have the opportunity to connect with a supportive community, explore the power of visual storytelling, and contribute to meaningful change. This project aims to raise awareness about the importance of substance use prevention, celebrate the strength of mothers, and inspire collective action for healthier communities.

A recent qualitative study exploring the perspectives of people who used marijuana before or during pregnancy in states where mandatory warning signs (MWS) are required found that fear-based signs were ineffective in discouraging the purchase and use of marijuana, highlighting a crucial gap between intent and impact.

 

The study, which included a small sample size of 34 interviews, found that these signs often left pregnant individuals feeling judged, stigmatized, and perhaps defensive. While these signs are intended to deter marijuana use during pregnancy, pre- and post-partum, they may instead alienate pregnant people.

 

According to participants in this study, many found the warning signs unhelpful, vague, and even misleading. Some questioned the credibility of the sources of the facts provided, while others pointed out that the signs did little to change behavior, particularly since many had already made up their mind before entering the dispensary. Instead of prompting reconsideration, the signs triggered distrust, and for some, even shame.

 

A cause for greater concern is the study’s suggestion that MWS- marijuana signs may discourage pregnant people from seeking care or discussing marijuana use with healthcare providers. Fear of punishment, especially for marginalized communities, can create barriers to open conversations about substance use, leaving pregnant individuals without guidance and the support they deserve.

 

So, if fear-based messages are not effective, what is? Participants in the study offered a clear answer: health information should be evidence-based, clear, and supportive of autonomy. Rather than vague threats or legal warnings, people preferred messages that provided specific, research-backed information on the potential risks, allowing them to make informed choices about their health. Sources such as the American College of Obstetrics and Gynecologists and the CDC were considered more trustworthy, especially when they explained the biological mechanisms that make marijuana harmful and explicitly stated what is known and what still needs to be studied.

 

While the sample size of this study is small, it underscores an important point: to effectively communicate the known risks of marijuana during pregnancy and postpartum, we need science-based messaging that is both transparent and compassionate. And while researchers are still uncovering the full picture of how marijuana affects pregnancy; the existing science strongly suggests that marijuana use during pregnancy and postpartum is linked to many health risks for both parent and child.

 

Public health research often suggests that emphasizing positive, health-promoting behaviors is more effective than focusing solely on risk and punishment. For people who are already skeptical of government messaging, a more transparent and supportive approach may be the key to building trust and fostering meaningful conversations about marijuana use during pregnancy.

To ensure that the message about the risks of marijuana use during pregnancy reaches those who need it most, it is essential to avoid stigmatizing or alienating language that could undermine trust. Instead, we should focus on presenting science clearly and empathetically to promote informed decision-making.

Source: https://www.marijuanaknowthetruth.org/marijuana-and-pregnancy/

This article gives a useful summary of the viewpoints of the various Canadian candidates for premiership
“After briefly approaching overdose deaths as a health problem, the ‘war on drugs’ appears to be making a comeback.”
Tyler Sekulic, a volunteer with the Tri-Cities Community Action Team, plants some of the 1,500 purple flags around Coquitlam’s Lafarge Lake April 14 to mark the the ninth anniversary of British Columbia’s declaration of a toxic drug emergency.
Close to 51,000 Canadians died from apparent opioid toxicity between January 2016 and September 2024, making the unregulated toxic drug supply one of the most pressing health issues in Canada.

For context, that’s nearly 16,000 more Canadians than were killed in the Second World War, and more than double the number of people killed in Canada by AIDS.

The spike in deaths began when the synthetic opioid fentanyl began to appear in illicit drugs sold on the street starting around 2014. Fentanyl can be relatively cheaply manufactured locally and is 20 to 40 times more potent than heroin. The illicit, unregulated supply has only become more unpredictable and deadly since.

Over the last decade there’s been a push in Canada to move addiction away from the realm of the criminal — what is often referred to as the “war on drugs” — and to recognize it as a public health problem. Broadly speaking, that means that instead of arresting people who use drugs for possession, doctors and advocates have pushed for people who use drugs to be able to access evidence-based harm reduction interventions, opioid agonist therapy and, in some cases, safer, predictable prescription drugs such as hydromorphone or benzodiazepines.

Today, however, the move away from the “war on drugs” seems to be in flux.

There’s widespread discontent in the visible increase in homelessness, mental health crises and drug use across the country, with people on the left criticizing the government for not rolling out more accessible harm reduction programs and housing solutions and people on the right calling for involuntary treatment and increased criminal sentences for drug-related offences.

As The Tyee waits for official platforms to drop, we take a look at how each federal party has been framing the crisis and fact check some of their proposed policies.

This article won’t be covering Bloc Québécois because the party doesn’t table policies that directly affect British Columbians.

The Liberal Party of Canada

The Liberals’ 2021 platform promised to introduce a comprehensive strategy to end the opioid crisis, invest $25 million in public education to reduce stigma, invest $500 million to support provinces and territories in providing evidence-based treatment, create standards for treatment programs and reform the Criminal Code to repeal mandatory minimum penalties for substance use-related infractions to keep lower-risk and first-time offenders out of the criminal justice system.

DJ Larkin, executive director of the Canadian Drug Policy Coalition, says that while the Liberals had some early commitments to evidence-based policy reform, such as support for decriminalization and prescribed alternatives, things fell flat because there was no followup.

The Liberals didn’t bother to explain what decriminalization or safer supply was, “or help the public understand and combat some of the misinformation around how those programs work,” Larkin said.

Funding ‘goes towards enforcement efforts’

In October 2023 the federal government released its Canadian Drugs and Substances Strategy, in which the “preponderance of funding goes towards enforcement efforts, with very little going towards harm reduction,” Larkin said.

Funding for “treatment” seems to go towards research and prison-based health care, Larkin added, noting “it’s quite unclear the extent to which they’ve really made that investment.”

Limited decriminalization

Health Canada supported B.C.’s request to implement a decriminalization pilot project in January 2023, and then-party leader Justin Trudeau said the government would support other provincial or territorial decisions implementing similar programs.

But in 2022, Health Canada denied the Drug User Liberation Front’s request for an exemption under the Controlled Drugs and Substances Act, which DULF had sought so it could buy, test and sell drugs at cost through its compassion club safer supply project.

From a policy perspective this was a “huge error,” Larkin said. The request was “well supported by evidence, it was well thought out and it was very well structured.” The exemption could have been a “huge turning point” in the crisis and would have helped generate evidence for how a compassion club model of safer supply distribution worked, Larkin said.

DULF asked pharmaceutical companies if it could buy pharmaceutical-grade drugs from them but was told it had to get permission from Health Canada first. When that permission was denied, DULF was punished for buying drugs illegally.

Harm reduction, treatment funding

In 2022 the federal government announced a $40-million investment for 73 community-led projects across Canada that focused on “evidence-informed” prevention, harm reduction and treatment.

It also invested $150 million over three years for an Emergency Treatment Fund in 2024, which helped municipalities and Indigenous communities respond to issues around substance use and overdoses.

The government has not yet published standards for treatment programs, something former chief coroner Lisa Lapointe emphasized a need for.

Larkin said the treatment industry has a “total lack of transparency,” where it’s not known how much a private facility is charging, what its policies are, what happens when someone is discharged or if they’re allowed to be on opioid agonist treatment.

The Conservative Party of Canada

The 2025 Conservative stance on drugs is dramatically different from the party’s 2021 platform, in which the party supported widespread distribution of naloxone, building 1,000 treatment beds and treating “the opioid epidemic as the health issue that it is.”

Back to criminalization

This time around, the party is framing the crisis as a criminal issue and promoting abstinence-only treatment while working to shut down harm reduction programs across the country.

Poilievre is “going back to criminalization” by proposing heavy criminal sentences for fentanyl and calling supervised consumption sites “drug dens,” Larkin said. This term has racist origins in 1907-era Vancouver, where Chinese and Japanese businesses were called “opium dens,” they added.

None of this rhetoric has been shown to decrease toxic drug deaths, Larkin said.

On April 6, Poilievre said he would prevent provinces and territories from opening overdose prevention sites, fire bureaucrats who support prescribed alternatives, introduce abstinence-only treatment and cut funding to federal supervised consumption sites and prescribed alternatives programs, according to the Globe and Mail.

Mandatory life sentences for amounts equivalent to less than half a baby Aspirin

In February, Poilievre said he’d introduce mandatory life sentences for anyone caught with 40 milligrams of fentanyl.

That’s “absurd,” said Leslie McBain, who co-founded Moms Stop the Harm after her son Jordan died from toxic drugs in 2014.

Forty milligrams is smaller than half a baby Aspirin, less than one-fifth of what someone with a regular fentanyl habit might use in a day, and 1.6 per cent of what a person can legally have to use in their own residence, a legal shelter or an overdose prevention site under B.C.’s decriminalization.

When it was first introduced, even the BC Association of Chiefs of Police gave decriminalization and its 2.5-gram limit the stamp of approval, saying that’s what a person who uses drugs might carry around for personal use.

The Tyee asked the association what it thought of the 40-milligram policy but did not hear back by press time.

McBain said many people sell drugs to fuel their own habit, not because they’re some “hardened criminal.”

Preventing the opening of overdose prevention sites — an unconstitutional promise?

When it comes to Poilievre’s promise to prevent provinces and territories from opening overdose prevention sites, he could do that if he lets an exemption under the Controlled Drugs and Substances Act expire in September, said M-J Milloy, an associate professor in the University of British Columbia department of medicine. The exemption is what gives provincial health officers the authority to open overdose prevention sites.

Stephen Harper tried to do the same thing in 2008 and in 2011 was ordered by the Supreme Court of Canada to grant the exemption because ending it would be unconstitutional.

B.C. currently has 39 overdose prevention sites, four supervised consumption sites (which are under federal jurisdiction) and additional unsanctioned sites being operated by doctors volunteering their time.

The day after Poilievre said he’d close the sites down, B.C. Health Minister Josie Osborne said she would not let a federal government shut down “life-saving overdose prevention sites.”

Governments can also “choke” the funding of harm reduction sites to close them down, as the Albertan and Ontarian governments have done, Milloy said.

Health Canada says more than 488,400 Canadians visited supervised consumption sites more than 5,103,000 times between January 2017 and November 2024, with 62,200 non-fatal overdoses and more than half a million referrals to drug treatment, rehabilitation and other health services, or referrals to social services like housing or employment supports.

Firing bureaucrats

Poilievre’s promise to fire bureaucrats who support safer supply would be difficult, Milloy said, because public service workers at the federal and provincial levels are unionized and protected by collective bargaining agreements and well-established labour rights.

Safer supply pilot projects rolled out through Health Canada and non-government initiatives have shown the program reduced participants’ risk of overdose and death, improved their health and well-being and helped participants stabilize their lives.

McBain said the BC Coroners Service has consistently said fentanyl is killing people — not hydromorphone, which is commonly prescribed for safer supply.

Around 3,900 British Columbians are being prescribed safer supply out of the 100,000 British Columbians estimated to have opioid use disorder.

Does Poilievre’s math on treatment add up?

On April 6, Poilievre said he’d fund treatment for 50,000 Canadians by defunding safer supply and supervised consumption sites and suing opioid manufacturers.

A Canada-wide lawsuit against pharmaceutical companies that downplayed the risks of opioids is already underway.

Funding for treatment would be “results-based,” where “organizations are going to be paid a set fee for the number of months they keep addicts drug-free,” Poilievre said, according to the Globe and Mail.

Abstinence-based treatment can be dangerous because opioid use disorder is a chronic relapsing disease, meaning people will generally cycle in and out of substance use in their life, Milloy said. Most people will go to treatment a number of times before they achieve periods of lasting sobriety, he added.

When a person stops using opioids, their body starts to lose its high tolerance for the drug in as little as three days, meaning they’re at much higher risk of overdose when they use again.

Opioid agonist treatment is considered the gold-standard treatment for opioid use disorder, but it’s not clear if it would be allowed under Poilievre’s definition of “drug-free.”

“Simply detoxing individuals and putting them into a 12-step program, which is what the majority of recovery houses do, is not recommended because of the risk of death,” Milloy said.

Poilievre said each patient would get around $20,000 for treatment, for a total of $1 billion in funding. The party’s 2021 platform pledged $325 million over three years to fund 1,000 treatment beds, meaning there was $325,000 per bed.

The B.C. Ministry of Health said in an email it currently has 3,751 publicly funded treatment beds and the cost of a single patient’s treatment is between $20,000 and $183,000 per year.

The New Democratic Party

In its 2021 platform the NDP said it would declare a national public health emergency, “end the criminalization and stigma of drug addiction,” create a national medically regulated safer supply program, support overdose prevention sites, expand access to treatment on demand and launch an investigation into the role of pharmaceutical companies in the current crisis.

Drugs not on the party’s radar

For the last two years drugs haven’t been on the NDP’s radar. The party puts out a press release roughly every two days, and the last one that directly addressed the toxic drug crisis was in November 2023, marking National Addictions Awareness Week. The party didn’t mark the week in 2024.

Defeated private member’s bill

Shortly after the 2021 election, NDP mental health and harm reduction critic Gord Johns tabled a private member’s bill to decriminalize certain substances nationally and to expunge certain drug-related convictions, but it was defeated.

The Green Party of Canada

As part of its 2021 platform, the Green Party of Canada said it would declare a national public health emergency, legislate decriminalization for personal possession and all use of drugs, increase funding for community drug checking, implement a national education and distribution program for naloxone and create a national safer supply program for “drugs of choice.” A regular criticism of safer supply from people who use drugs is that it offers a limited number of pharmaceuticals that often aren’t able to replace the unregulated substances people use. This policy would have addressed that issue.

Larkin said it was a “very good sign” that the Greens’ platform recognized the intersectionality and nuance of the crisis and promoted programs and policies that are “supported by considerable academic evidence,” such as supervised consumption sites, decriminalization, prescribed alternatives and access to regulated treatment.

No current drug-related policies

The Greens don’t currently have drug-related policies on their website. But in August 2024 the party put out a press release calling for Canada to adopt an evidence-based approach by offering safer supply, safe consumption sites and barrier-free regulated treatment facilities, integrating pharmacare and mental health care in Canada’s universal health care, increased harm reduction services and action to address poverty and homelessness like guaranteed livable income and affordable and accessible housing.

Source: https://www.bowenislandundercurrent.com/highlights/where-the-parties-stand-on-the-toxic-drug-crisis-10532543

As part of a ‘painful period’ of cuts, Trump and RFK Jr. plan on dismantling the agency that focuses on substance abuse.

I’m talking about a dramatic turnaround in America’s opioid crisis, the epidemic that began in the late 1990s with an explosion in the use of addictive prescription painkillers, and then got even worse with a surge in the use of heroin and its synthetic alternative, fentanyl. The effects have left families, communities, and in some cases whole regions of the country reeling, and more than 700,000 Americans dead from overdoses.

But recently the death rate from overdoses has started to fall. In the latest twelve-month period that the official data captures, the decline has been particularly steep: 24 percent.

In raw numbers, that’s 27,000 fewer deaths over the course of a year—a figure that, as Johns Hopkins University professor Brendan Saloner told me in an interview, is “astonishing.”

Pinpointing the cause of the drop is, as always, difficult. Researchers like Saloner think it’s most likely a combination of factors—like changes in the purity of fentanyl available from dealers and more effective interdictions of foreign smuggling chains. There’s also the grim possibility of a “burning out” effect, as the people most likely to overdose die off.

But another likely factor, in the view of most experts, has been a surge in federal support for substance abuse programs.

That includes the programs offering prevention, treatment, and recovery services, as well as those focusing on “harm reduction” strategies like the distribution of Naloxone, the fast-acting drug that can keep overdose victims alive long enough to get them emergency medical care.

The surge started with legislation that Barack Obama signed in the final year of his presidency, but in the years that followed the effort was relatively bipartisan. That included support from Donald Trump, who talked frequently about the opioid crisis during the 2016 campaign and then, as president, returned to the subject in a memorable October 2017 speech.

“As Americans, we cannot allow this to continue,” Trump said, citing his late brother’s difficulties with alcoholism as a personal connection to the issue. “It is time to liberate our communities from this scourge of drug addiction.” And although his record didn’t really live up to his rhetoric, his administration did launch several anti-opioid initiatives.

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But just nine days later, Kennedy announced sweeping layoffs designed to slash HHS staff by 25 percent, as part of a broader reorganization that will partly dismantle several of the department’s smaller agencies. One of them is an agency that’s been at the center of the federal opioid effort.


IT’S CALLED the Substance Abuse and Mental Health Services Agency, or SAMHSA. And if you’ve never heard of it, don’t feel bad. Most people haven’t.

But SAMHSA is the agency that awards and manages the big grant program that states use to finance their substance abuse efforts. It’s also the agency that runs the National Survey on Drug Use and Health, the gold-standard assessment that policymakers and researchers rely on to understand trends and shifts in how people are using drugs.

Other SAMHSA duties include establishing best practices for different types of substance abuse initiatives, offering training programs for substance abuse workers, and operating the new 988 hotline for suicide and mental health crises.1 In order to keep close tabs on what’s actually happening in the country—and maintain an ongoing dialogue with local officials—SAMHSA had staff in the ten HHS regional offices.

Now all of that is going to change. The plan Kennedy announced will eliminate SAMHSA as a separate entity, folding it and several other smaller agencies into a new division called the “Administration for a Healthy America.” It will also cut the number of HHS regional offices in half, leaving just five.

And while HHS officials have not specified publicly how many SAMHSA staff will lose their jobs, the New York Times has reported (and a source familiar with discussions has since confirmed to me) that Kennedy and his lieutenants have talked about reducing the agency’s headcount by half, with occasional mention of even bigger cuts.

The official rationale for the cuts and consolidation is that they will make SAMHSA work better: “Transferring SAMHSA to AHA will increase operational efficiency and assure programs are carried out because it will break down artificial divisions between similar programs,” an HHS press release said.

“This will be a painful period for HHS,” Kennedy acknowledged, although he vowed that the public won’t feel much of a pinch: “We’re going to do more with less. No American is going to be left behind.”

There’s absolutely nothing controversial about trying to reorganize the sprawling, frequently byzantine structure of HHS, or hacking away at the internal processes and rules that can impede rather than enable progress. Just three years ago, a blue-ribbon commission convened by the Commonwealth Fund—a well-respected, left-leaning think-tank—issued its own call for substantial changes at the department.

But that document was the result of lengthy, careful discussion of priorities and tradeoffs. There are few visible signs that the Trump administration engaged in such deliberations, and plenty of signs that it didn’t—especially at SAMHSA.


SAMHSA GOT ITS FIRST TASTE of cuts back in February, when the Trump administration ordered government-wide firings of “probationary” workers (which meant anybody, whether newly hired or newly promoted, who’d been in their position for less than a year).

Among those hit hardest were the ten regional offices, according to Scott Gagnon, who ran the New England division. SAMHSA’s staffing at several of them fell from four or three workers to one or none, he told me, undermining capabilities and responsiveness in a way that will only get worse with the new cuts HHS just announced.

“Imagine what that means—they’re still going to cover the whole country, but now every office is going to cover up to twelve states, instead of just five or six,” said Gagnon, who is now on administrative leave because the courts ordered the Trump administration to reinstate the probationary workers but HHS hasn’t put them on the job. “In my state of Maine, they would see me several times a year. Now they might be lucky to get one or two visits. It’s just really going to dilute that responsiveness and that connection,”

The damage to SAMHSA’s data collection work could be even more pernicious, several experts told me, because the data is so essential to public and private-sector leaders trying to craft substance abuse policy—and because projects like the big national survey require so much expertise and institutional knowledge to operate.

“That is the only national survey we have on drug use, and if the staff who does that work is cut, then we’re flying blind,” Regina LaBelle, a Georgetown University professor who served in the Obama and Biden administrations, told me.

“Good data actually takes a lot of manpower,” added Kathryn Poe, a health care researcher at the think tank Policy Matters Ohio. “You have to clean it, you have to evaluate it, you have to organize it. You have to make sure that you’re getting accurate reporting. You have to actually analyze it. And all of that is stuff that’s done by humans.”


THE BEST HOPE for the government’s opioid efforts is that all of the talk about making HHS more effective is genuine, that they will cut smartly and not arbitrarily, and that somewhere in the Trump administration there are officials mindful of recent progress and eager to—as Saloner put it to me—“be heroic and do something big and important to sustain what was already underway.”

But it’s awfully hard to imagine such thoughtful, deliberate reforms coming from leaders who wave around chainsaws while discussing their designs on government, or who say their ultimate goal is turning career civil servants into “villains.” And it’s hard to understand how HHS is going to get more efficient when it is shuttering so many offices—and firing so many people—whose very jobs are to watch over agency programs and make sure they are working properly.

“They have the know-how, in-house, to make decisions about how to steer resources, that institutional judgment . . . that’s intangible but super important,” Saloner said, adding that they are also the ones who handle the tedious, unglamorous and essential work “of making sure that there’s compliance with federal standards, that things are being correctly reported, that there’s no misuse or waste of funds.”

As for Trump, his interest in the opioid project also seems suspect at best. The rhetoric from his first campaign and term, whatever its authenticity, featured a discernible empathy for people with substance abuse problems—and a clear commitment to the proposition that an effective strategy included the kinds of investments SAMHSA has managed.

Now, whenever Trump talks about opioids, it’s to raise the specter of fentanyl as a foreign menace, justifying his border policies and posture towards other countries.

Trump is also behind congressional efforts to enact sweeping spending cuts, in order to offset the cost of his multitrillion-dollar tax cut. And although the Republicans in Congress are still arguing over how to do that, it’s easy to imagine them agreeing to cuts in substance abuse funds given that one element of the current strategy—harm reduction—already has loud critics among conservatives, who think it implicitly condones drug use.

And that’s to say nothing of the possibility, which Republicans in Congress have discussed explicitly, of cuts to Medicaid, the federal-state program that pays medical bills for more than 70 million mostly low-income Americans. It is the nation’s single biggest financier of mental health and substance abuse treatment.

If Medicaid shrinks and fewer people have coverage, either states will have to make up for the lost substance abuse funding by pulling funds from elsewhere, or they’ll just let the shortfalls stand. Either way, the result will likely be fewer people getting the help they need and, ultimately, more people dying from overdoses.

It doesn’t have to be that way, as the last two years have shown. But it’s not at all clear the Trump administration knows this—or that it cares.

Source: https://www.thebulwark.com/p/when-make-america-healthy-again-actually-means-opposite-rfk-trump-opioid-overdose-hhs-samhsa-painful

by Dr Max Pemberton (The Mind Doctor) in the Daily Mail on 17 March 2025.

Source: Dr Max Pemberton (The Mind Doctor) in the Daily Mail on 17 March 2025.  

by Drug and Alcohol Testing Association of CanadaMar 25, 2025

“If a young person is reporting very high levels of these traits, they’re more likely to use substances as a way to manage those traits,” said Dr. Patricia Conrod, founder of the PreVenture program, a psychiatry professor at the Université de Montréal and scientist at Sainte-Justine hospital in Montreal, in her interview with CBC News.

Specifically, the study showed that the program helped reduce the increase in the odds of substance use disorder by 35% year over year when compared to a control group. PreVenture helps teenagers manage traits that are linked to substance abuse, which include impulsivity, sensation seeking, anxiety sensitivity, and hopelessness. It includes two 90-minute workshops provided to Grade 7 students, helping them understand their personalities and teaching them tools to manage them. Moreover, PreVenture uses cognitive behavioural therapy, interactive exercises, and group discussions to find personality-specific coping strategies.

The program is currently offered in schools in five Canadian provinces, including Quebec, Ontario, and British Columbia, as well as in several U.S. states. “Some substance use disorders are preventable, and we should be making sure that young people have access to the programs and the resources they need,” said Dr. Conrod. However, she noted that despite the evidence of its effectiveness, Canadian schools need sustained funding from federal and provincial sources in order to be able to make the program more accessible.

According to Christine Schwartz, professor at the Children’s Health Policy Centre at Vancouver’s Simon Fraser University, policy-makers often prioritize treatment over prevention when it comes to substance use. “It’s a little bit harder for policy-makers to put the money towards prevention knowing they may not see the benefits — and there will be benefits in many of these cases, but they’re not going to see them for several years,” she said in her interview with CBC News. “There’s been a long history of using programs that haven’t necessarily been effective… What’s happening now is that policy-makers are increasingly turning to the research evidence.”

Source: https://datac.ca/prevention-program-has-reduced-odds-of-teen-drug-use-study/

Inhaling the vapors from chemical products has become a dangerous practice among teenagers and young adults. Often referred to as “huffing,” inhaling chemical vapors can become addictive — leading to both short-term and long-term health consequences including death. Most people have no idea how dangerous it is to inhale a chemical substance.

In the US:

  • Over 6 million children ages 12-17 use an inhalant each year to get high.
  • Inhalants tend to be a drug that is tried first by children.
  • 59% of children are aware of friends huffing at age 12.
  • Inhalants tend to be a drug that is tried first by children.
  • 1 in 4 students in America has intentionally abused a common household product to get high by the time they reach the 8th grade.
  • In Louisiana, according to the statewide Caring Communities Youth Survey, the reported inhalant usage (both lifetime and past 30-day usage) has decreased among 6th-, 8th-, 10th- and 12th-graders.

Louisiana’s Response – House Concurrent Resolution No. 24 of the 2016 Regular Legislative Session urged the Louisiana Department of Health, Office of Behavioral Health to raise awareness of addictive disorders involving abuse of inhalants and make efforts to reduce the prevalence of inhalant abuse.

What are Inhalants?

According to the National Institute on Drug Abuse of the National Institutes of Health, although other abused drugs can be inhaled, the term “inhalant” is reserved for a variety of substances including, but not limited to, solvents, gases, and aerosols that can alter moods and create a high. Nitrites (poppers and snappers) can also be inhaled and are believed to create sexual stimulation and enhancement.

How are Inhalants Abused?

People inhale chemical vapors through their nose, mouth, or both. This includes sniffing, snorting, or spraying the inhalant directly into the nose or mouth. Some people put the substance into a bag or other container and then inhale from there or put the vapor onto a rag to inhale.

How Do Inhalants Cause Medical Harm?

Inhalants are absorbed by parts of the brain and nervous system. They can slow down the body’s functions, similar to the effects of drinking alcohol. Other effects include:

Short-Term Long-Term
Seizures Weight loss
Nosebleeds Sores on nose and mouth
Loss of appetite Impaired kidneys
Headaches Impaired liver
Abdominal pain Lung damage

Source: https://ldh.la.gov/office-of-behavioral-health/inhalant-abuse-prevention

“Money alone won’t solve it,” Kennedy told attendees at a Nashville convention addressing addiction 

by J. Holly McCall – April 24, 2025 12:55 pm
Hecklers interrupted a speech Thursday by U.S. Health and Human Services Secretary Robert F. Kennedy, Jr. at a conference on opioid addiction in Nashville.

The Rx and Illicit Drug Summit 2025 drew law enforcement officials, addiction prevention counselors, social workers and public health officers to the Gaylord Opryland Resort & Convention Center for the three-day event.

For years, Kennedy has drawn ire and disapproval for his anti-vaccine messages and, more recently, for belittling comments about people with autism and budget cuts in his department.

“Believe science!,” shouted a protester before security rushed him from the room.Another protester held aloft a sign that read, “Vaccines save lives.”

Kennedy’s speech was apolitical and focused on his own history in recovery from an addiction to heroin and his recommendations for dealing with the nation’s opioid crisis — many of which focused less on medical or treatment solutions and more on the need to build community, embrace spirituality and take personal responsibility.

After touting a $4 billion budget at HHS, Kennedy said that “money alone won’t fix this.”

“We have a whole generation of children who have lost faith in our country and their future,” Kennedy said. “Policy should reestablish hope for the future.”

Alexis Pleus of Binghamton, New York, and another woman unfurled a banner saying “Cuts Kill” before being ejected.

Pleus, who came to Nashville with other members of a group called Moms United to End the War on Drugs, lost her son to a drug overdose and said budget cuts at HHS spurred her attendance.

The Trump administration — and Kennedy — have proposed to restructure HHS, including dismantling the Substance Abuse and Mental Health Services Administration (SAMHSA), cutting research funding and funding for addiction treatment and mental health care.

“All these changes are impacting people on the ground,” Pleus said. “People who are struggling with addiction can’t get help already and now they’re going to have an even harder time.”

The conference was sponsored by HMP Global, which provides continuing medical education.

Past speakers have included former Presidents Joe Biden, Barack Obama and Bill Clinton. President Donald Trump spoke to the group in 2019 during his first term in office.

In addition to Kennedy, 2025 speakers included U.S. Attorney General Pam Bondi, Tennessee senior U.S. Sen. Marsha Blackburn and Dr. Ralph Alvarado, commissioner of the Tennessee Department of Health.

Source: https://tennesseelookout.com/2025/04/24/health-and-human-services-secretary-robert-kennedy-jr-urges-community-as-fix-to-opioid-crisis/

by Health News Florida and by Associated Press – published April 25, 2025

Health and Human Services Secretary Robert F. Kennedy Jr. speaks at the Rx and Illicit drug Summit, Thursday, April 24, 2025, in Nashville, Tenn. Photo: George Walker IV – AP

Speaking at a conference on drug addiction, HHS Secretary Robert F. Kennedy Jr. said young people need a sense of purpose and a connection to family to prevent them from turning to drugs.

U.S. Health Secretary Robert F. Kennedy Jr. told a personal story of his own heroin addiction, spiritual awakening and recovery at a conference on drug addiction Thursday and emphasized that young people need a sense of purpose in their lives to prevent them from turning to drugs.

Kennedy called addiction “a source of misery, but also a symptom of misery.” In a speech that mentioned God more than 20 times, he pointed to his own experience feeling as though he had been born with a hole inside of himself that he needed to fill.

“Every addict feels that way in one way or another — that they have to fix what’s wrong with them, and the only thing that works are drugs. And so threats that you might die, that you’re going to ruin your life are completely meaningless,” he said.

Speaking to about 3,000 people at the Rx and Illicit Drug Summit in Nashville, Tennessee, Kennedy did not address recent budget and personnel cuts or agency reorganizations that many experts believe could jeopardize public health, including recent progress on overdose deaths.

Kennedy drew cheers when he said that we need to do “practical things” to help people with addictions, like providing them with Suboxone and methadone. He also said there should be rehabilitation facilities available for anyone who is ready to seek help. But he focused on the idea of prevention, signaling his view of addiction as a problem fueled by deteriorating family, community and spiritual life.

“We have this whole generation of kids who’ve lost hope in their future,” he said. “They’ve lost their ties to the community.”

Kennedy said policy changes could help reestablish both of those things. Though Kennedy offered few concrete ideas, he recommended educating parents on the value of having meals without cellphones and providing opportunities for service for their children.

The best way to overcome depression and hopelessness, he said, is to wake up each morning and pray “please make me useful to another human being today. ”

He suggested that cellphones are a pernicious influence on young people and that banning them in schools could help decrease drug addiction. He cited a recent visit to a Virginia school that had banned cellphones, saying that grades were up, violence was down and kids were talking to one another in the cafeteria.

Kennedy told attendees that he was addicted to heroin for 14 years, beginning when he was a teenager. During those years, he was constantly making promises to quit, both to himself and to his family.

“I didn’t want to be someone who woke up every morning thinking about drugs,” he said, noting that one of the worst parts of addiction was his total “incapacity to keep contracts with myself.”

Kennedy said he eventually stumbled upon a book by Swiss psychiatrist Carl Jung that claimed people who believed in God got better faster and had more enduring recoveries, so he worked to rekindle his faith and started attending 12-step meetings.

Kennedy was interrupted several times by hecklers shouting things like, “Believe science!” He has been heavily criticized by scientists and public health experts for pushing fringe theories about diet, vaccines, measles and autism, among other things.

One heckler was escorted out of the ballroom with a raised middle finger. Without responding directly to the hecklers, Kennedy said that he tries to learn from every interaction, even with people who give him the finger because they don’t like his driving.

“God talks to me most through those people,” he told the group.

University of Washington researcher Caleb Banta-Green was among those escorted out after he stood up and shouted, “Believe science! Respect spirituality! Respect choice! Respect government workers!” “Spirituality is an essential part of recovery for some people; 12 step works great for the people it works for, however, it should never be mandated,” Banta-Green said in an email after the program. He added, “We have decades of science-based interventions that are proven effective for supporting recovery and reducing death from substance use disorder. The problem we have is massive underfunding.”

Source: https://health.wusf.usf.edu/health-news-florida/2025-04-25/rfk-recounts-heroin-addiction-and-spiritual-awakening-urges-focus-on-prevention-and-community

Note:Links to References not given here.

Abstract

 Family separation has long served as a mechanism of social control and punishment in the United States, disproportionately targeting Black, Indigenous, and other marginalized families under the guise of child welfare. Family separation remains the family policing systems primary intervention in families, including families targeted because one parent is using substances. Recent legislation, such as the Families First Prevention Services Act, aims to reduce family separation by funding preventive services. However, the punitive approach entrenched in the family policing system remains resistant to reform. This Essay argues that the family policing system, steeped in a legacy of racialized control and punitive policies, fundamentally obstructs efforts to prioritize family preservation over child removal in cases of parental drug use.

Through an institutional theory lens, this Essay examines how the family policing systems historical emphasis on punishment and surveillance resists even well-intentioned legislative changes. Despite the inclusion of family-centered services in recent legislation addressing the opioid crisis, implementation barriers and institutional inertia within family policing agencies perpetuate default practices of policing and removal.

This Essay argues for a fundamental reimagining of family support systems that divests from punitive family policing frameworks and centers on family preservation.

Introduction

Chanetto Rivers smoked marijuana at a family barbecue before giving birth; New York City’s Administration for Children’s Services then placed her baby in foster care, even though marijuana was legal in New York at the time.1 Susan Horton ate a salad with poppy seeds before giving birth; California’s Sonoma County Human Services Department took her newborn into protective custody.2 Police and caseworkers from the Administration for Children’s Services raided L.B.’s Brooklyn home without a warrant at 5:30 A.M., terrorizing and traumatizing L.B. and her then-seven-year-old son after the state’s child welfare hotline received an anonymous and erroneous report of drug use.3 Alicia Johansen and Fred Thornten, whose child was removed due to their drug use, spent more than two years fighting the intervening foster parents for custody of their child, even after they met every requirement imposed by a Colorado judge for regaining custody.4

These parents experienced the all-too-common phenomenon of family surveillance and separation as a result of alleged drug use. Thirty-nine percent of all children forcibly removed from their parents’ care and custody in 2021 by so-called “child protective services”—more accurately called the family policing system5—were removed in whole or in part due to parental “drug abuse.”6 As of September 2022, in twenty-three states, evidence of parental “drug abuse” alone could be used to initiate child removal proceedings.7 Some state actors, like “child protective” agents,8 interpret “drug abuse” to include not only chaotic use9 of illicit drugs, but also recreational use of licit drugs (including alcohol and marijuana).10 Studies have found that substance use does not preclude people from being fit parents.11 Further, there is substantial evidence that the removal itself and the placement of the child in the foster-care system cause actual harm.12

If the risk of harm solely due to parental substance use or misuse is tenuous, and the harm to the child caused by removal and placement in state custody is a surety, why do state governments (aided by federal law and funds) remove children due to parental drug use alone? Professor Dorothy Roberts has convincingly argued that the family policing system is not designed to protect or to improve the welfare of children.13 Roberts argues: “‘Policing’ is the word that captures best what the system does to America’s most disenfranchised families. It subjects them to surveillance, coercion, and punishment. It is a family-policing system.”14

In this Essay, we apply an institutional theory lens15 to extend Roberts’s and others’16 assertions to the system’s treatment of parental drug use. We argue that punishment and social control are so deeply institutionalized in the family policing system that recent reform efforts will inevitably fail.17 While several articles have discussed the content, promises, and failures of the Families First Prevention Services Act (FFPSA),18 this Essay adds to the literature by providing an analysis of the legislative history and legislative discourse that gave rise to the enactment of FFPSA.

We support the claim that reform efforts will inevitably fail by first reviewing the family policing system’s history. We demonstrate that the system was created to remove children from parents whom the state deemed “undeserving” or “unworthy.”19 We show that, since the system’s creation, it has particularly targeted Black, Indigenous, and nonwhite immigrants.20 We describe how states have historically removed children from families as a form of social control and as punishment for conditions that are frequently rooted in the lasting impacts of enslavement, colonialism, structural racism, and poverty.

Second, we illustrate how decades of federal legislation (and funding) favored out-of-home placements over programs that prioritize providing services and keeping children within their homes. This approach further institutionalized surveillance, investigations into deservingness, and family separation as responsibilities of the agencies tasked with implementing these laws.21

Third, we address recent legislative attempts to respond to parental drug use in ways that preserve the family, such as by providing needed healthcare and assistance to parents who use drugs. The success of these attempts has been minimal. We attribute this lack of success to institutional inertia and to state family policing agencies’ incapacity to provide the family-centered services needed to support family preservation in cases of parental substance use.22 We conclude by recommending a new approach that would institutionalize the idea of family preservation and by describing what this reimagined approach might look like.23

I. the institutionalization of coercion and punishment in the family policing system

The current punitive approach to addressing parental substance use did not arise in a vacuum. Since the colonial era, American states have wielded family separation as an extractive tool of racialized social control and capitalism against Black, Indigenous, and nonwhite immigrant families.24 The system of family policing was designed to punish parents deemed “undeserving” of parenting because of their living conditions,25 which family policing agencies treated as individual failings or flaws.26 The removal of children from the home developed as part of that punishment.

Today, removal is a central tool of what we now call the “child welfare” or “child protection” system.27 Supporters of family policing as an institution have justified it as benevolent and necessary to protect children from actual harm.28 And yet the founding institutions—and the web of law, policies, and practices that make up family policing—continue to be rooted in the philosophies that children need protection from bad parents29 and that undeserving parents should lose their constitutional right to parent30 as a form of punishment.31 Early organizations and agencies created for “child protection” were developed to achieve these ends.32

Understanding the development of the institution of family policing is crucial to grasping why recent legislative reforms, which aim to address parental substance use without defaulting to child removal, face significant institutional inertia.33 Institutional theory suggests administrative agencies and the professionals operating within them will resist changes that contradict the systemically ingrained purposes of the institution.34 Here, as the desire for social control was institutionalized in the laws and policies of the family policing system, that desire became an element of the institution. As an element, it impacted the cultures, strategies, structures, and processes of regulatory bodies (such as state and federal legislatures and administrative agencies) and organizational participants (such as family policing agencies).35 Because the “child welfare” system was established to police families and punish those deemed unfit by permanently terminating parental rights, its strategies, structures, and processes inevitably incorporate punitive elements.36 Consequently, when reforms are introduced to prioritize family preservation, the regulatory and organizational bodies within the institution will often default to family policing—a phenomenon explored in depth in Part III.

A. Slavery, Colonialism, and the Birth of the Institution of Family Policing

The modern family policing system uses the threat of child removal and the permanent termination of parental rights as punitive measures for parental drug use.37 This type of family separation has a deep-rooted history in this country as a punitive tool to exercise racialized social control over Black, Indigenous, and other nonwhite immigrant families.38

Family policing existed long before the early predecessors of modern child protection agencies were created in the late nineteenth century.39 As Roberts wrote, “Family destruction has historically functioned as a chief instrument of group oppression in the United States.”40 Later in this Section, we will discuss the colonial history of the American family policing institution, which focused exclusively on the needs of white children living in poverty.41 However, for a more complete picture of the family policing institution, one must understand its inattention to Black families—who are now disproportionately policed by the modern family policing system.42 This disregard, combined with the existence of slavery, ensured that “child welfare institutions could develop in this country without concern for the majority of Black children,” creating the conditions for “an inherently racist child welfare system.”43 This system incorporated the brutal domination and destruction of Black families that the institution of slavery developed.44

As Professor Alan J. Detlaff has documented, during slavery, the tearing apart of families through sales of enslaved people served as “a means of maintaining power and control by a system of white supremacy that is foundational to this country’s origins.”45 Further, laws enacted during slavery monetized racial heritage by making the child of an enslaved person enslaved—thereby creating a perverse incentive for sexual violence as a means of enriching the enslaver and laying the foundation for family separation as a tool for racial capitalism, because enslavers would be financially enriched through the sales of enslaved people.46 Similarly, the history of land theft, displacement, and physical and cultural genocide of the Indigenous people in the United States created an enduring legacy in the development and function of child welfare institutions.47

These dual legacies of enslavement and genocide stretched beyond the period of land dispossession and slavery. This is evident from the advent of Black Codes, which compelled many newly emancipated Black families in the South to apprentice their children during the Reconstruction era,48 and the kidnapping and coercive placement of Indigenous children in Native American residential schools (guided by General Richard Henry Pratt’s infamous notion of “kill the Indian and save the man”).49 Each of these efforts was propelled by the idea that Black and Indigenous parents did not deserve their children and could not raise children who could productively serve society’s needs—a problem that could be remedied by children’s removal from their environments.50 This legacy of family separation as a tool of pain and punishment persists today.

As Roberts has argued, it is only against this backdrop and legacy of family separation as a “terroristic weapon against Black and Native communities” that we can consider “the emergence of modern child welfare agencies for white children in the United States.”51 James Morone’s Hellfire Nation describes how Puritan beliefs heavily influenced early American social welfare institutions, shaping policies that are deeply embedded in American institutions.52 These early Puritan beliefs led colonial society to view children living in poverty as needing salvation.53 However, it was not until the beginning of the nineteenth century—when waves of immigration and increasing industrialization turned wealthy reformers’ attention to the plight of poor, mostly white, immigrant children—that permanent family separation became a more widespread response to perceived parental deviance.54 These family separation efforts were primarily driven by anti-immigrant narratives that again characterized immigrant communities, much like families in poverty during the Puritan era, as prone to deviance.55 Rarely were efforts made to reunify families once children were removed.56

It was against this backdrop that the predecessors to modern foster care and child protection—organizational elements of the contemporary family policing system—were formed. Fueled by anti-immigrant sentiment, the Children’s Aid Society in New York developed a model of saving poor children from the “evils of urban life” by sending them to “good” Christian farmers in the country, where they could work and receive moral guidance.57 Substance use was understood as an innate sin that could be passed from mother to child.58 The New York Society for the Protection of Cruelty to Children sprung up in 1874, and by the 1910s, more than two hundred Societies for the Protection of Cruelty to Children (SPCCs) existed around the country.59 The SPCCs focused on investigating abuse allegations, instituting legal action, and encouraging the prosecution of the parents for “cruelty.”60 The vilification of parents, most of whom lived in poverty, and the use of child removal as a form of punishment reinforced the idea that it was the purpose of these child protection agencies to remove children from bad homes and put them in better homes; they operated with the intent to exert social control.61 Beginning in 1854, an estimated 100,000 children were sent on “Orphan Trains” from cities to smaller farm communities in the Midwest—marking the start of formalized foster care.62 This approach, however, was not concerned with reuniting children with their parents or even with ensuring that children’s welfare had improved.63

SPCCs created the institutional framework that gave rise to the modern family policing system: an institution that punished undeserving parents through permanent family separation. In 1935, the funding mechanism for state child protection systems became federalized through the Social Security Act,64 which encouraged states to create family policing agencies and programs modeled after the existing SPCCs, thereby incorporating these early models of family policing into the state and local agencies that exist today.65 In institutional-theory terms, the Act explicitly created structures and processes that were institutionalized into organizations, which adopted and incorporated the ethos of the SPCCs into the fabric of their operations. Thus, the family policing agencies were born.

B. Institutionalizing the Disproportionate Policing of Black and Indigenous Families

While Black and Indigenous children were largely not part of the equation for the SPCCs and other Progressive Era institutions focused on child-saving, this began to shift in the twentieth century.66 Ironically, Black liberation movements and civil rights advocacy opened the doors to the institutions that would become the family policing system, creating what Roberts has described as “a Pyrrhic victory.”67 At the root of this shift was a fight over federal financial support for low-income single mothers. In the early part of the twentieth century, Progressive Era feminists advocated for federal public welfare programs to benefit unmarried mothers. Black and Indigenous women were predominantly excluded from these benefits, either by law or practice.68 But in the mid-twentieth century, Black women and children were at the forefront of successful desegregation and civil rights movements that helped open the welfare system to Black and Indigenous mothers.69

In response, government officials, particularly in southern states, began to promote a racist and sexist narrative about Black mothers. For Black women, the institution of marriage was largely inaccessible due to structural racism, economic inequality, and public benefits laws that discouraged marriage. But rather than recognizing this reality, government officials often depicted Black mothers as draining public resources by accessing public benefits for their “illegitimate” children.70 In order to curtail Black women’s access to benefits, states enacted laws to police and surveil their behavior.71 For example, so-called “suitable home” laws deputized state family policing agencies to assess whether the home environments of children receiving public benefits were “suitable” based on whether unmarried mothers had ceased all “illicit” relationships.72 The purpose of these assessments was to evaluate each mother’s morality and, thus, her eligibility for public benefits; if public benefits ceased, her child would frequently be removed to foster care.73 These suitability laws share the same puritanical motivations that underpin many modern laws governing morality or perceived sins such as drug use.74 Additional research is needed to determine the full extent to which parental drug use motivated removals during this era. However, the stigmatizing depictions of Black women as “welfare queens” in the media and policy discourse, along with the depiction of the “crack-cocaine epidemic” as a problem affecting Black communities in the 1980s and 1990s, suggest that ideals of suitability and deservingness endured beyond the mid-twentieth century.75

Similar to Black mothers, as Native American mothers attempted to access welfare benefits, they opened themselves up to scrutiny and removal of their children to foster care.76 As historian Laura Briggs has written, involvement with welfare meant the application of white, heteronormative, middle-class standards to Native families:

Welfare workers disparaged the poverty of reservations and shamed unmarried mothers and others who cared for children because they thought heterosexual nuclear families were the only proper homes for children. They refused to acknowledge indigenous kinship systems and the important role of elders and other adults in child rearing.77 

Civil rights organizers appealed to the federal government to deem these suitability laws unconstitutional, calling attention to how suitability laws were fueling segregation (by driving Black families out of southern states) and starving Black children (by denying their mothers welfare benefits), but they were unsuccessful.78 Rather than address the inequities caused by these suitability laws, in 1961, Arthur Flemming, the Secretary of Health, Education, and Welfare for the Eisenhower Administration, found a workaround: states could deny mothers welfare benefits but could not leave their children without financial support simply because their caretakers were unsuitable.79 This so-called “Flemming Rule” required states either to (1) provide “services” to make a home suitable or (2) remove the child to “suitable” care while providing financial support to the child.80 It was not accompanied by additional allocations of federal funds to accomplish either of these objectives.81

Amendments to the Social Security Act in 1961 incentivized the removal of children from these homes (and from other families living in poverty) by permitting the use of federal funds to pay for removal and out-of-home placement of children (foster care).82 The 1961 Amendments did not include funding allocations to pay for services to make the home more suitable or to provide services to preserve the family unit.83

The influx of federal funding for foster care led to the formalization of the modern “foster care” system.84 As Roberts has documented, from 1945 to 1961, the proportion of Black children in foster care nearly doubled; yet from 1980 through 1999, the number of children total in foster care nearly doubled, and the proportion of Black children more than doubled.85 Further, “[f]rom 1960 through 1980, roughly 25-35 percent of Native children were separated from their families and placed in foster care, adoptive homes, or institutions, most of which were outside of their original communities and family system.”86

The history and analysis presented thus far demonstrate how the state increasingly punished parents it deemed undeserving through family separation and curtailment of their constitutional parental rights. Through a web of federal rules and legislation, federal dollars encouraged the creation of state and local family policing agencies and then encouraged family separation. In sum, separation was embedded into the framework for the modern family policing system, ensuring this approach would endure and fueling the influx of Black and Indigenous children into foster care.

C. The Institutionalization of Mandatory Reporting and Its Intersections with Healthcare

In 2019, thirty-four percent of all family policing investigations for infants were initiated by medical professionals.87 In some states, as many as eighty percent of these 2019 referrals were for parental substance use.88 As medical historian Mical Raz has demonstrated in her critical book, Abusive Policies: How the American Child Welfare System Lost Its Way, one cannot underestimate the legacy of Dr. C. Henry Kempe’s seminal 1962 article, The Battered Child Syndrome, which adopted a medicalized approach to child abuse that has been the framework for modern child protection efforts, including investigations of parental drug use.89

Kempe’s article argued that healthcare providers were uniquely situated to identify serious physical child abuse, which state child protection agencies could investigate.90 States swiftly responded, and by 1967, all fifty states had passed mandatory reporting laws. Some expanded what should be reported and investigated as alleged child abuse and neglect, reaching far beyond what Kempe had recommended.91

By 1974, Congress passed the Child Abuse Prevention and Treatment Act (CAPTA), which provided states with grant funding in exchange for compliance with specific requirements—including requirements that states implement mandatory reporting laws if they had not done so already.92 Although CAPTA did not explicitly include a mandatory reporting requirement for suspected parental substance use, federal guidance cautioned that parental drug use during pregnancy indicated a “high risk” for child maltreatment and encouraged physicians to “identify” infants who may be exposed to parental drug use during pregnancy so that the pregnant parent could be connected with needed services.93 CAPTA did not, however, provide any additional federal funding to cover the costs of necessary substance use or mental health services.94 It did, however, continue to fund out-of-home placements in foster care.95

A pause in the chronological sequence of this analysis is warranted because CAPTA was amended in 2003 to encourage states to develop policies and procedures that

address the needs of infants born and identified as being affected by illegal substance abuse or withdrawal symptoms resulting from prenatal drug exposure, including a requirement that health care providers involved in the delivery or care of such infants notify the child protective services system of the occurrence of such condition in such infants.96 

This notification requirement was accompanied by an express condition that the notification “shall not be construed to (I) establish a definition under Federal law of what constitutes child abuse; or (II) require prosecution for any illegal action.”97 Specifically, CAPTA provides:

The Secretary is authorized to make grants to States for the purpose of assisting child welfare agencies, social services agencies, substance use disorder treatment agencies, hospitals with labor and delivery units, medical staff, public health and mental health agencies, and maternal and child health agencies to facilitate collaboration in developing, updating, implementing, and monitoring plans of safe care described in section 5106(b)(2)(B)(iii) of this title.98 

Notably, this statutory language differs from CAPTA’s mandate in a different section that required states to enact laws to ensure child abuse and neglect are reported and investigated. This difference suggests that the notification requirement was not to be equated with a report of child abuse or neglect. Further, the statute’s emphasis on “developing, updating, implementing, and monitoring plans of safe care”99 signifies a focus on providing treatment and suggests that evidence of substance use is not per se child abuse or neglect.

But while the notification requirement was not intended to be a report of child abuse or neglect, it has increased the surveillance and policing of pregnancies by healthcare providers for reasons we explore in Part III.100 Most importantly for the current analysis, this requirement created additional processes and procedures in family policing agencies to deal with notifications from healthcare providers, further institutionalizing the policing function of these agencies.101 As is a recurring theme, the 2003 amendments did not include additional allocations to pay for services for the parent that would prevent removal—or even require that services to the parent be provided.102 In practice, it is not uncommon for these notifications to result in referrals for investigations of alleged child abuse and neglect, further driving families’ entanglement in the family policing system.103 As institutional theory predicts, family policing agencies—created for the purpose of policing parental behavior—implemented these notifications with the same punitive approach they had used for eighty years.104

Mandatory reporting has fueled the rapid expansion of the family policing system since the passage of CAPTA, as states have broadened their definitions of child maltreatment and expanded the categories of mandatory reporters.105 The influx of millions of reports each year—many of them unsubstantiated—overwhelms the system, leading to invasive investigations and child removals that often harm families without effectively preventing abuse and neglect.106 Studies also show that the discrimination and stigmatization that parents who use substances experience in seeking treatment, along with the very real legal risks of mandatory reporting and family separation, constitute a significant deterrent to seeking help or treatment.107

The influx of children into foster care, and the rising federal costs of financing it, prompted Congress in 1980 to consider the impacts that removals were having on parental rights while balancing the competing goal of providing children languishing in foster care with “permanency” (via the involuntary termination of parental rights and adoption).108 Congress enacted the Adoption Assistance and Child Welfare Act of 1980 (AACWA), which required agencies to make “reasonable efforts” to preserve the family before removing a child from the home. To support this requirement, the law also amended the Social Security Act (SSA) to fund services to prevent child removal, including parental counseling and substance use treatment, through what is commonly referred to as Social Security Title IV-B Programs funding.109 However, the reasonable effort requirement was secondary to AACWA’s emphasis on achieving the competing goal of “permanency” for children.110 And despite the amendment to the SSA, AACWA’s prevention and reunification services were and are still underfunded—an issue that we discuss further in Part III.111 AACWA did not contain a funded mandate to reunite families.112

AACWA was responsible for an estimated decline in the number of children in foster care from over 520,000 in 1977 to 275,000 by 1984.113 However, this decline is attributable to AACWA’s encouragement of more parental rights terminations and the facilitation of adoptions rather than the increase in reunifications.114 Near the turn of the century, Congress again intervened to facilitate more terminations of parental rights and adoption with the enactment of the Adoption and Safe Families Act of 1997 (ASFA).115

Rather than preventing child removal and providing services to keep families together, ASFA created mandatory timelines by which parents needed to reunify with their children or risk the termination of their parental rights and adoption of their children. The law did so by requiring states to file to terminate parental rights if a child had spent fifteen of the last twenty-two months in foster care.116 Advocates for ASFA fueled the imaginations of legislators with accounts of child abuse that allegedly occurred in homes where children were not removed due to family preservation efforts or after children were reunified with their parents following foster care.117 Although there was no systematic data presented to Congress to support these contentions,118 Congress passed AFSA anyway. And while ASFA has increased the number of family policing cases resulting in adoption,119 it has also created many “legal orphans”—youth whose parents’ legal rights were terminated but for whom no adoption is ever completed.120

The horrific impact of ASFA on families with a substance-using parent over the past twenty-six years cannot be underestimated. The timelines, coupled with the threat of termination of parental rights, greatly impacted parents who struggled with substance use for several reasons. First, it is not uncommon for parents to spiral into chaotic substance use121 as a result of family separation. When parents experience an episode of relapse into chaotic substance use, it prolongs foster care stays.122 Prolonged foster care stays, in turn, decrease the likelihood of reunification and, because of federally mandated timelines,123 increase the likelihood of parents having their parental rights terminated and losing their child forever.124 Rather than fund family preservation efforts or help families to reunify, ASFA further solidified the family policing system’s institutional commitment to removing children from “bad” parents, allegedly for the children’s safety and well-being.

In summary, the institutional history of the family policing system provides a clear map as to why the system is not only ill-suited to help parents who use substances but, in fact, is not designed to help them. As we have briefly reviewed above, federal funding mechanisms for the system have incentivized out-of-home placements and institutionalized a punitive approach that threatens parents who use substances with the termination of their parental rights to induce behavior change.125

Yet, by 2018, as overdose death rates remained high126 along with high rates of foster care placements due to parental opioid use,127 there was a documented shift in policy narratives about addiction. Rather than framing it as primarily a moral or criminal-legal issue, policymakers began to frame it as a public health issue.128 Unlike parental substance use more broadly, the opioid crisis was also characterized as a medical or health issue that impacts primarily the white middle class.129 Given this narrative shift and the health-oriented federal legislation to address the opioid epidemic,130 one might expect states to retreat from removals based on substance use alone—at least in the short term.

Although legislators claimed to have adopted a public health approach in response to the nation’s opioid overdose crisis,131 the approach failed to truly prioritize public health in the family policing context. Indeed, it merely tasked the family policing system with responsibilities that either reinforced its policing tendencies or exceeded what the system was equipped to handle. As public health researchers have shown, when policing agencies try to engage in public health efforts, they cannot help but resort to their policing training and functions.132 In the family policing context, a genuine public health approach to substance use would require addressing the upstream causes of parental drug use,133 employing a harm reduction approach to current substance use (which meets the person who is using drugs “where they are at”),134 and prioritizing providing services that do not necessitate removal when possible.

II. the opioid crisis and the not-so-public health approach to parental substance use

It was not until 2016—in response to an opioid crisis portrayed as predominantly affecting white communities in suburban America135—that Congress expanded the federal requirement to identify children exposed to substances in utero to include a mandate for developing Plans of Safe Care addressing the needs of both the infant and the mother. This addition came with the enactment of the Comprehensive Addiction and Recovery Act (CARA) of 2016.136 Along with the attention paid to the rising number of opioid overdose deaths, there was a new moral panic over infants exposed in utero to opioids.137 This panic was over Neonatal Abstinence Syndrome (NAS), which was initially attributed to prescription opioid use or side effects of medications to treat opioid-use disorder.138 Addiction medicine specialists warned that “[d]eclaring war on this condition risks stigmatizing effective therapy, leaving mothers more vulnerable to relapse, overdose, and death.”139 Their warnings were not heeded.

CARA also responded to the moral panic about NAS by expanding the notification requirements for infants “affected by substance abuse or withdrawal symptoms,” now requiring healthcare providers to identify infants exposed to both prescription and illicit drugs instead of just the latter.140 CARA explicitly included an acknowledgment by Congress that addiction and overdose were public health issues.141 And yet, in the same legislative breath, Congress expanded the population of infants and families subject to the family policing system.142

When answering questions about whether a notification or referral pursuant to this provision constitutes a report of abuse or neglect, the Administration for Children and Families (ACF), the federal agency charged with the enforcement and implementation of CAPTA, hedged. ACF responded:

Not necessarily. The CAPTA provision as originally enacted and amended requires the referral of certain substance-exposed infants to [child protective services] and makes clear that the requirement to refer infants affected by substance abuse does not establish a federal definition of child abuse and neglect. Rather, the focus of the provision is on identifying infants at risk due to prenatal substance exposure and on developing a plan to keep the infant safe and address the needs of the child and caretakers. (See CWPM, Section 2.1F, Questions 1 and 2.) Further, the development of a plan of safe care is required whether or not the circumstances constitute child maltreatment under state law.143 

This hedging implies that ACF knew that mandating notification risked increasing the likelihood that an investigation and removal would ensue.

In a positive step forward, CARA did require that the Plans of Safe Care also address the health and substance use disorder treatment needs of the infant’s family or caretakers.144 However, CARA still did not address the harm that interactions with the family policing system cause parents who use substances and their children. Although CARA purported to be public health-oriented, in reality, it maintained and reinforced the policing structure of all policy responses to drug use. 145 The law cloaked this policing structure by using public health rhetoric and shifting some of the policing and surveillance of parents to healthcare actors.146

In October 2018, Congress enacted the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT).147 The legislation included an amendment to CAPTA authorizing grants to states to facilitate collaboration in developing and implementing Plans of Safe Care—again reinforcing that legislators were interested and willing to amend CAPTA in order to better respond to the opioid crisis, but also signaling broad bipartisan support for increased surveillance and reporting.148

In 2021, Congress’s reauthorization of CAPTA updated the idea of Plans of Safe Care, renaming them Family Care Plans. Congress stated that the 2021 CAPTA “promotes a public health response for family care plans (formerly plans for safe care) to ensure the safety, permanency, and well-being of infants and their caregivers affected by substance use disorder.”149 Congress claimed CAPTA did this by appropriating additional monies to improve access to treatment.150 It stressed that the mandated reporting of substance exposure of the infant did not require an investigation by the agency and that CAPTA was not meant to provide a federal definition of child maltreatment that included parental substance use.151 However, the 2021 reauthorization did not recommend that infants remain with their parents while substance use treatment services are provided152—despite the evidence suggesting that these services can lead to better outcomes.153 And as scholars have noted, while the purpose of the CAPTA notification requirements for substance-exposed infants is to identify families who need services before removal becomes necessary and to do so in a nonpunitive way, this goal conflicts with current criminal legal approaches to substance use in pregnancy, which are focused on surveilling, reporting, and punishing pregnant parents.154

Further, there is ample evidence that mandatory reporting creates a significant disincentive for substance using pregnant people155 to seek prenatal medical care.156 This disincentive is particularly strong for Black pregnant people because of the pervasive and illegal reality that they and their babies are far more likely to be tested for substances, usually without consent.157

In sum, despite the widely available evidence that outcomes are better for children, parents, and the whole family when infants are not removed from their parents’ care due to exposure to a substance in utero,158 federal legislation has not gone so far as to require states to provide access to such evidence-based programs instead of out-of-home placement. Worse yet, federal law maintains healthcare providers as police and decreases the likelihood that pregnant people will seek healthcare.159

A. The Families First Prevention Services Act and the Promise of Reform

The Families First Prevention Services Act (FFPSA), enacted in 2018, was supposed to “begin a new era for the child welfare system.”160 It was first introduced in the House of Representatives in 2016, alongside several other pieces of legislation aimed at addressing the opioid overdose crisis.161 Its drafters wanted to redesign the current family policing system to emphasize a preventative model that kept children in their caretakers’ homes while providing the services that caretakers may need to keep children safe.162 To achieve this, the drafters of FFPSA proposed an amendment to current federal funding structures to provide more funding for “prevention services for children and families that are at risk for entering foster care.”163 The law amended Title IV-E of the SSA to allow family policing agencies to use federal funds to support evidence-based prevention efforts for mental health, substance-abuse prevention and treatment services, and in-home parenting skills training for a maximum of twelve months.164 FFPSA also permits agencies to use funds to pay for residential, family-based substance use treatment providers, which allow children to live with their parents while they undergo treatment for substance use disorder (SUD).165 This feature of the law was backed by evidence demonstrating that many parents with substance use disorders can safely care for their child without the child being separated from them.166 It was also supported by studies that have found that children, particularly infants born exposed to substances, fare worse if removed from their parents’ care and custody.167 Outcomes for both children and parents are significantly better when child protective services and courts use family-centered approaches to substance use treatment instead.168 These approaches allow children to remain in the care and custody of their parents while the parents receive evidence-based substance use treatment and support.169

Despite having support from many prominent family policing agencies as well as advocates in the Obama Administration’s Office of National Drug Control Policy, FFPSA passed in the House but did not make it out of committee in the Senate when it was first introduced in 2016.170 FFPSA had bipartisan support, and one of its drafters and primary sponsors was a Republican. Surprisingly, opposition to the bill came from Democrats over where its funding would come from. Democrats opposed using financial incentives previously awarded to the states for supporting adoption services to fund prevention services instead.171

FFPSA was introduced again in the Senate in 2017, where it died in committee.172 This is a common fate for legislation that does not have enough support among the chairs of committees of the controlling party, which in 2017 was the Republican Party. Most of the provisions of FFPSA were eventually enacted as part of Division E of the Bipartisan Budget Act of 2018.173 Congress has increasingly used “riders,” policy changes within budget legislation, mainly because some of the procedural hurdles to legislative enactment are suspended for appropriation bills, making them easier to pass than standalone legislation.174 The failure of FFPSA to make it out of committee suggests that the law did not have the congressional support that CARA or SUPPORT had. Despite this, FFPSA was enacted in 2018.

B. Implementation Barriers: Congressional Inquiries into the Implementation of FFPSA

FFPSA’s enactment has been flanked by implementation barriers. After the passage of FFPSA, the bill’s sponsors were quick to tout its success and claim credit for the declining number of foster care placements in 2018. In comments in front of Congress on November 20, 2019, Senator Grassley said: Mr. President, in recent years, the opioid epidemic has resulted in steadily climbing numbers of kids entering foster care. However, in 2018, the number of children in foster care has declined for the first time since 2011. This is evidence that prevention programs are working.175 Indeed, the number of children that have entered foster care has decreased from its height of 273,000 in 2016 to 207,000 in 2021.176 However, the numbers were trending down before the enactment of FFPSA, and FFPSAs funding provisions did not go into effect until October 1, 2018.177 The fact that the number of children entering foster care declined before FFPSA went into effect suggests that the initial downward trend cannot be attributed directly to FFPSA.

Further, FFPSA has been hard to implement, contributing to only seventeen states and one tribe using FFPSA funds in 2022.178 And FFPSA has fallen short of furthering actual systems reform for several institutional reasons.

First, FFPSA does not truly prevent removal, as it is not triggered unless there is an imminent risk of family policing involvement.179 Advocates have asked Congress to expand the definition of who is eligible for FFPSA services to any family who is at risk of family policing involvement as opposed to only those who are at imminent risk of family policing involvement.180 FFPSA gives states wide latitude to determine what imminent risk of harm means. The federal government has issued guidance stating it applies to anyone who would likely enter foster care without intervention.181

Second, as other advocates and experts have argued, the underfunding of Social Security Title IV-B Programs, which were created in the 1990s to support family support and family preservation services, is also stymying the systems change FFPSA aims to promote. Title IV-B programs have been leveraged to ensure that social workers visit children in foster care regularly rather than to support families to prevent removal.182 As the Executive Director of the Utah Department of Health and Human Services explained, Title IV-B funding offers states tremendous flexibility to meet the needs of families and prevent removal.183 During her congressional testimony, the Director gave the example of a family of five that was at risk for child removal.184 In that particular case, the social worker had identified that the cause of the removal was poverty-related and had used Title IV-B funds to provide short-term resources to pay rent and access medical care.185 Despite the benefits of these funds, the Director noted that they only make up 2.5% of Utah’s total family policing budget.186 As Dr. David Sanders, Executive Vice President of Systems Improvement at the Case Family Programs, explained to the Senate Finance Committee, “Family First focuses on children right at the doorstep of foster care, and Title IV-B provides more flexibility for [s]tates to address issues at an earlier point and strengthen families who might be at risk.”187

Third, the overall institutional structure financing the family policing system creates tremendous administrative complexity that may prevent states from applying for FFPSA funding. FFPSA funding comes with reporting requirements. State child welfare agency directors have explained that the current family policing systems federal funding structure—with different federal funding buckets accompanied by their own rigorous reporting requirements—is so complex that even small states have to hire twenty administrative personnel just to manage the federal financing and reporting requirements for all of the various streams of funding for family services.188 This complexity adds to the administrative burdens of an already-taxed system, and the siloing of budgets and social services makes it difficult for agencies to address upstream causes and prevent removal. In 2024, Senator Ron Wyden blamed the federal government for this administrative complexity, stating as part of a more extensive critique of the federal implementation of FFPSA: [L]ast year, the federal government spent just $182 million on prevention services, while we spent over $4 billion on traditional foster care. Clearly priorities are out of whack. The government can and must do better to get this funding out the door to states that ask for it.189 In sum, the administrative complexity may be preventing states from accessing FFPSA funds, which would provide an alternative to removal—leaving states to resort to their family policing functions.

Fourth, numerous stakeholders have explained that satisfying the rigorous requirements to receive confirmation that an intervention is “evidence-based,” and thus eligible for FFPSA funds, is time-intensive and costly. They have also described how the approval process is arduous and opaque.190 Based on communications between Congress and the Secretary of Health and Human Services (HHS), which Congress tasked with implementing the Act, members of Congress have argued that HHS has treated the legislative requirement that FFPSA fund only evidence-based programs as including a need for a rigorous, “academic” evaluation of each program.191 Congress has stated that HHS has frequently made decisions without communicating with study authors.192

This has led to HHS approving only a “relatively small number of interventions” for states to choose from.193 Even after interventions are cleared as fulfilling the arduous requirements of being “evidence-based,” many of these interventions may not be available in states because they are relatively new.194 HHS’s narrow interpretation of “evidence-based” means states must invest in the start-up costs of developing interventions from the ground up.195

Finally, a critique absent from the congressional discourse is that FFPSA leaves the current family policing system intact, including the expansion of reporting requirements for infants exposed to substances in utero. Miriam Mack, Policy Director of the Bronx Defenders’ Family Defense Practice, has written that FFPSA “in no way challenges the fundamental pillars upon which the family regulation system rests.”196 FFPSA does not fully separate the family policing system from its roots in centuries of institutionalization of racism and classism, reviewed in depth in Part II of this Essay. FFPSA continues to allow states wide latitude in defining child maltreatment, or the imminent risk of child maltreatment, as including parental drug use alone—rather than requiring states to demonstrate the risk of actual harm to the child resulting from that substance use.197 Some states, like Colorado, have explicitly stated in their substance legalization laws that possession or use of certain substances does not constitute child abuse or neglect unless it threatens the health or welfare of the child.198 Other states, like Michigan, have issued regulatory guidance stating that parental substance use alone does not meet the definition of child maltreatment.199 Yet despite these positive trends in some states, state legislatures continue to propose laws that would add parental substance use to definitions of child maltreatment.200

Moreover, agencies continue to remove children for parental drug use, often when it occurs in utero. FFPSA does nothing to address the punitive responses adopted by many states in addressing perinatal or maternal substance use. This continues despite evidence that these types of policies do not address either the underlying substance use or the potential risk of harm to the child—and could even make the problem worse.201

While FFPSA is an important step in permitting states to engage in family preservation activities for parents who use substances, it falls short of addressing the centuries of institutionalization of family policing and surveillance, which continue to shape the practices of local agencies responding to complaints of parental substance use. To actualize the goals of the drafters of FFPSA, we must interrogate the current system.

III. the path forward

In this Essay, we have outlined in detail both the deeply embedded structural problems with the current family policing model, including its longstanding focus on punishing parents deemed “undeserving,” and how federal legislation has further institutionalized this punitive approach in addressing problems that may be exacerbated by parental substance use. While FFPSA funding allocations for prevention services and substance use treatment that prioritize keeping children with their parents are commendable, the implementation barriers discussed above bolster the claims of scholars, advocates, and impacted families who are calling for the abolition of family policing rather than its continued reform.202 In envisioning a path forward, we join and amplify that chorus.

Family policing is not built to help families, particularly those with parents who use substances.203 As abolitionist lawyer and organizer Andrea J. Ritchie writes in Practicing New Worlds: Abolition and Emergent Strategies, “We can’t continue to organize in ways that replicate and legitimize the systems we are seeking to dismantle.”204 Thus, she explains, abolition is as much about envisioning and creating the world we wish to live in as it is about dismantling oppressive systems.205 Renowned activist and scholar Angela Y. Davis has explained that abolition “is not only, or not even primarily, about . . . a negative process of tearing down, but it is also about building up, about creating new institutions.”206 Accordingly, the remainder of this Essay is devoted to laying out a set of principled “non-reformist reforms”207 that should guide future policymaking to provide support and care to families with parents who use substances, rather than surveil and punish those families. Non-reformist reforms, as abolitionist scholar Ruth Wilson Gilmore has described, are “changes that, at the end of the day, unravel rather than widen the net of social control through criminalization[.]”208 These suggestions are not meant to be exhaustive, in part because, in the practice of abolitionism, the families most impacted by family policing must lead the way in designing the future path.

A. Families Are Calling for Abolition: Listen to Them!

A burgeoning movement of families impacted by the family policing system is calling for a radical reimagination of safety for families—namely, through the abolition of the family policing system.209 These families, including parents and (former) youth who have lived experience with the family policing system, are calling attention to the many harms perpetrated by the system, particularly for Black and Indigenous families.210 Although the family policing system is premised on the narrative that state intervention is benevolent and necessary for the care and protection of children, these families’ experiences underscore the many myths that are woven into the law, policy, and practice of family policing.211 Not only must states listen to families’ narratives, but the very families most impacted by family policing must help design new approaches that support families with parents who use substances. Some of the approaches to community care already identified by families most impacted are named below.

B. Decouple Access to Services from Family Policing and End Mandatory Reporting of Substance Use During Pregnancy

As discussed above, the current policy framework—as articulated by FFPSA and related federal and state family policing law—requires parents who use substances to engage, or risk engagement with, the family policing system to access help and treatment. Doing so comes at significant risk of mandatory reporting and family separation, and as a result, disincentivizes seeking help and care.212 Further, mandated reporting requirements for suspicions of infant exposure to substances in utero disincentivize pregnant persons who use substances from seeking both treatment for SUD and prenatal care.213 Parents who use substances need a way to access care that does not result in the punishment inherent in the family policing system. To meet that need, the state should provide parents with ways of accessing medical care, SUD treatment, and harm reduction services that do not automatically trigger mandatory reporting and possible family separation. For example, the Family-Based Recovery model includes “[i]n-home treatment that provides concurrent psychotherapy, substance use treatment and parent-child dyadic therapy.”214 Models like these offer evidence-based and effective alternatives to family separation.

Research shows that both parents who use substances and their children thrive when they are able to stay together while the parent receives treatment for their substance use.215 Rather than funneling federal money to the states via the family policing system and conditioning access to treatment on a finding of imminent risk of harm, funding should go to flexible, evidence-based treatment that prioritizes family stability and integrity and addresses the upstream causes of substance use and child maltreatment.

Ending mandatory reporting would make a significant difference in substance-using parents’ ability to access treatment. Since CAPTA’s inception, its requirements—especially its mandatory reporting provisions—have been a primary driver of family separation. Many have called for the end of this practice.216 As scholars and advocates have documented, because of the structural racism embedded in family policing, Black and Indigenous families are more likely to be reported and more likely to be separated as a result of family policing intervention.217 The racialized enforcement of the war on drugs further compounds these racial disparities. As explained in Part II, mandatory reporting can deter parents from accessing help and treatment.218 Ending mandatory reporting would focus service providers’ efforts on providing assistance and care to families, rather than acting as agents of family policing surveillance.219 As Joyce McMillan, who founded the New York City-based organization JMac for Families, has argued, we should have mandated support instead of mandatory reporting.220 Such an approach would permit parents who use substances to seek care, treatment, and other support without the very real risk of family policing involvement and family separation.

C. Prohibit the Use of Federal Funds to Pay for Removals and Neglect Findings Based Solely on Substance Use

As noted above, CAPTA creates a floor for states to define neglect, but it permits states to drastically expand their definitions of neglect—which they have done.221 Just as poverty should not be the basis for a finding of neglect, so too substance use should not be a per se basis for a finding of neglect. Most parents who use substances can safely care for their children. Congress should amend federal laws to reflect that reality. As previously discussed, the availability of federal funds to pay for foster care services dramatically shaped state behaviors in terms of prioritizing removal and foster-care placement as the appropriate response. By amending CAPTA to exclude federal funding for removals and foster care in cases with findings of neglect based solely on evidence of parental substance use, Congress can incentivize states to change their definitions of child maltreatment without infringing on states’ police powers.

Conclusion

As detailed throughout this Essay, there are numerous institutional and organizational barriers embedded in the family policing system that prevent it from being a source of meaningful help or care to families with parents who use substances. Reform efforts cannot overcome the impact of these institutional and organizational barriers. The failure of FFPSA and other piecemeal reforms demonstrates the family policing system’s inability to shed its institutional commitment to the punishment and surveillance of families.

The current family policing system does not work. Rather than institutionalizing existing approaches to substance use within the family policing system, we must pursue a new, family-centered approach that centers the lived experience of parents who use substances and is rooted in evidence—not in stigmatizing narratives and a desire to moralize and control. If we do not change our approach, we will continue to witness the impacts of an ineffective, costly, and inefficient system of family policing that harms families more than it helps them.

* * *

Dr. Taleed El-Sabawi is Assistant Professor of Law, Wayne State University, School of Law. Dr. El-Sabawi is supported by the National Institute of Health, National Institute of Drug Abuse, Grant No. 1K01DA057414-01A1. Professor Sarah Katz is Clinical Professor of Law, Temple University Beasley School of Law and Senior Fellow, Stoneleigh Foundation. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Stoneleigh Foundation. The authors are grateful for the able research assistance of Anna Manu Fineanganofo, J.D. Expected, May 2025, Temple University Beasley School of Law.

Source: https://www.yalelawjournal.org/forum/deinstitutionalizing-family-separation-in-cases-of-parental-drug-use

by United Nations – Office on Drugs and Crime – April 3rd 2025

The United Nations Office on Drugs and Crime (UNODC) recently developed Friends in Focus, a new youth-based peer-to-peer drug prevention programme that aims to meaningfully involve young people in prevention efforts. It was peer-reviewed by a global group of experts in the field of prevention, together with youth from the UNODC Youth Initiative. Starting in 2025, UNODC is prototyping the new programme by engaging with youths and local stakeholders from various countries. Building on its recent launch of the first pre-pilot conducted in Serbia (Empowering Serbian Youth to Lead in Prevention: First Pre-Pilot Implementation of UNODC’s Friends in Focus), UNODC also initiated the second pre-pilot testing of the new programme in Italy last week. From 25 to 27 March 2025, youths from northern Italy came together to receive a 3-day Training of Trainers workshop in Arco (Trentino), Italy.

made possible with the support of the government of Italy, this Phase 1 (Training of Trainers) brought together 18 youths eager to learn about Friends in Focus, its content, and facilitation techniques for their own delivery of sessions to their younger peers. Youths from various territories of Trentino, Parma and Lombardia gathered to learn about preventative thinking, understand the risk and protective factors to drug use, and reflect how group dynamics play a role on peer selection processes and peer influence regarding substance use. And through try-out sessions, they also directly experienced their role as future youth facilitators with the preparation and delivery of the mock sessions, giving each other feedback and examining trainer-trainee dynamics.

With the understanding and skills acquired through the three-day training, youth trainers will return to their hometowns to begin their own implementation of Friends in Focus with the support of the national coordinating team and partner organisations that are supporting this pre-pilot phase. In particular, a wide range of partners, including regional governments, municipalities, public welfare entities, non-profit organizations, social cooperative organizations, and local initiatives, came together to embrace the new programme into the region during this pre-pilot, in order to support the youth trainers and peers through the 6 sessions of Friends in Focus and beyond. This unique infrastructure, characterized by a multi-stakeholder approach, exemplifies the value of enhanced inter-regional collaboration and maximized sustainability. Local authorities and community-based organizations are integrating Friends in Focus into their communities, showcasing a commitment to fostering positive change, building resilience among youth, and supporting community development.

The motivation, reflections, and dynamic energy seen through the Training of Trainers demonstrated how participants resonated with the core messages and also discovered how interactive games could be transformed into insightful reflections on real-life scenarios. In addition to the feedback received on the 3-day training, further insights from the youths’ cascade trainings will feed into the enhancement process of the Friends in Focus prototype.

For more information about Friends in Focus, please click on the following:

Source: United Nations – Office on Drugs and Crime

 

 

 

The new top federal prosecutor in Massachusetts underscored her opposition this week to supervised drug use sites and issued a “guarantee” that the Trump administration will never allow states like Massachusetts to skirt the federal law criminalizing the long-debated facilities.

U.S. Attorney Leah Foley, who took office in January, issued a statement Wednesday responding to an editorial in which the Lowell Sun suggested the federal government could turn a “blind eye” to the issue and asked, “Has the time finally arrived to challenge prevailing federal law in an effort to save addicts’ lives?”

Foley, a former deputy chief of the office’s Narcotics & Money Laundering Unit who has previously said she would oppose supervised drug use sites, said her response was simple: “No.”

“As to the hope for a blind eye, I guarantee that such a time will never come during this Administration,” she said. “‘Safe injections sites,’ ‘harm reduction sites,’ or however they are branded by advocates, are categorically illegal and do nothing to help people overcome their addictions. To the contrary, they facilitate destructive behavior that ruins lives, consumes families and devastates communities.”

Activists have been pushing state government for years to pass a bill authorizing overdose prevention centers and federal law has consistently been identified as the primary barrier. In 2018, Trump-appointed U.S. Attorney Andrew Lelling said anyone who uses or works at such a facility could face federal charges “regardless of any state law or study.”

Gov. Maura Healey’s administration announced its support for the idea of supervised drug use sites in 2023, and the Senate approved language last year allowing municipalities to open locations as part of a broader addiction and substance use bill. That provision was dropped in negotiations with the House.

Supporters of the idea say allowing medically trained professionals to monitor street drug use, then intervene and try to prevent an overdose from turning fatal, would help prevent fatal overdoses as powerful synthetics flood the drug supply and could serve as an opportunity to connect addicts with treatment or other services.

Foley said Wednesday that policymakers needs to look only as far as the intersection of Massachusetts Avenue and Melnea Cass Boulevard to see “the direct result of the ill-conceived experiment allowing drug users to flout the law.”

“Businesses left and have not come back. Creating environments that assist people with pumping poisons into their bodies is neither compassionate nor constructive,” the U.S. attorney said. “We should continue to direct all our resources to the prevention efforts that steer people, especially our youth, away from drug use and treatment protocols that truly save peoples’ lives from their addictions.”

Source: https://franklinobserver.town.news/g/franklin-town-ma/n/297912/just-say-no

From NIHCM Newsletter / April 2025

Alcohol & Substance Use

Learn about the latest news on substance use, including views on alcohol, and how fentanyl deaths are declining.

  • Alcohol Awareness: April is alcohol-awareness month and an opportunity to reflect on the impacts of alcohol use and how alcohol-related deaths have increased over the last decade, with a sharp increase during early-pandemic years. A new Pew Research Center survey explores Americans’ views on the risks and benefits of alcohol consumption. A majority of routine drinkers, 59%, say their alcohol use increases their risk of serious physical health problems at least a little.
  • Fentanyl Deaths Declining: Recent preliminary data from the Centers for Disease Control and Prevention (CDC) indicates a 25% decrease in opioid overdose deaths for the 12-month period ending in October 2024, compared to the same timeframe in 2023. This is driven in large part by a reduction in the number of deaths involving fentanyl. The Wall Street Journal examines the decline in a series of charts. KFF Health News discusses how misinformation about fentanyl is impacting the overdose response.
  • Federal Funding: A federal judge has temporarily blocked the Department of Health and Human Services (HHS) from terminating a variety of public health funds that had been allocated to states during the Covid-19 pandemic, including funding that was being used to support opioid addiction and mental health treatments. The administration also closed the office that tracked alcohol-related deaths and harms and helped develop policies to reduce them.

Resources & Initiatives

  • The US Surgeon General’s 2025 Advisory, Alcohol and Cancer Risk, describes the scientific evidence for the causal link between alcohol consumption and an increased risk for cancer.
  • NPR dives into 8 theories from experts on why fentanyl overdose deaths are declining, including increased access to Naloxone, better public health, and the waning effects of the COVID pandemic.
  • The National Academy for State Health Policy’s State Opioid Settlement Spending Decisions tracker shares state-level settlement funding decisions and priorities.
  • With support from a $5.4 million Elevance Health Foundation grant, Shatterproof created an online training curriculum for healthcare professionals that aims to dispel myths and misunderstandings about substance use disorder, and promote person-centered, culturally responsive care.

Source: https://nihcm.org/newsletter/the-relationship-between-alcohol-and-health

by Raminta Daniulaityte – College of Health Solutions, Arizona State University, Phoenix, AZ, United States et al.

“I don’t know how you can overdose smoking them:” 

Highlights

  • Smoking was viewed as protective against overdose compared to other routes of use.
  • Beliefs about inconsistency of blues drove concerns about the overdose risks.
  • Some believed that the quality of blues improved recently, and they became safer.
  • Many aimed to avoid the fentanyl in powder form to reduce their overdose risks.
  • Dosing-related strategies emphasized personal responsibility and victim blaming.

Abstract

Aims

Illicitly manufactured fentanyl (IMF) remains the primary driver of overdose mortality in the US. Western states saw significant increases in IMF-laced counterfeit pain pills (“blues”). This qualitative study, conducted in Phoenix, Arizona, provides an in-depth understanding of how overdose-related risks are viewed and experienced by people who use “blues.”

Methods

Between 11/2022–12/2023, the study recruited 60 individuals who used “blues” using targeted and network-based recruitment. Qualitative interviews were recorded, transcribed, and analyzed using NVivo.

Results

The sample included 41.7 % women, and 56.7 % whites. 55.3 % had prior overdose, but most (62.2 %) rated their current risk as none/low. Risk perceptions centered on a multi-level calculus of drug market conditions, individual vulnerabilities, and behavioral factors. Smoking was considered a “normative” way of using “blues”, and most viewed it as protective against overdose in comparison to injection and other routes of use. Drug market conditions and the unpredictability of “blues” were emphasized as important factor of overdose risk. However, some believed that over time, the quality/consistency of “blues” improved, and they became less risky. Many also expressed fears about the emerging local availability of powder fentanyl and its risk. Views about safer dosing, polydrug use, tolerance, and health emphasized personal responsibility and individual vulnerability to overdose risks. Discussions of protective behaviors, including take-home naloxone, varied bases on the perceptions of overdose risks.

Conclusions

The findings emphasize the need for close monitoring of local IMF markets and design of comprehensive interventions and risk communication strategies to address perceptions that minimize IMF-laced counterfeit pill risks.

Introduction

Illicitly manufactured fentanyl (IMF) remains a critical driver of overdose mortality in the US (Spencer et al., 2024), and there are emerging concerns about its proliferation in other regions of the globe (Friedman & Ciccarone, 2025; Piatkowski et al., 2025). The spread of IMF in the local drug markets in the US has shown increasing complexity with notable regional differences in the types of IMF products available, and associated contamination risks (Kilmer et al., 2022). While powder IMF has been the predominant form in the Eastern part of the US, western states, including Arizona, have seen significant increases in the availability of IMF in counterfeit pill form, most commonly 30 mg oxycodone, referred to as “blues” or “M30s” (Daniulaityte et al., 2022; O’Donnell et al., 2023; Palamar et al., 2022, 2024). For example, between 2017 and 2023, the total number of IMF pill seizures in the US increased by 8509.7 %, and the increase was the steepest in the West (an 11,266.7 % increase) (Palamar et al., 2024). Increases in IMF pill presence have been especially dramatic in Arizona with retail-level seizures of IMF pills increasing from about 1000 in 2017, to 18,004 in 2019, and 155,572 pills in 2020 (Mully et al., 2020). In 2023, Arizona had the highest number of IMF pill seizures in the country (n = 1638), and the second highest in the total number of IMF pills seized (n = 36,525,410) (Palamar et al., 2024).
Along with the increasing availability of IMF in counterfeit pill form, Arizona experienced significant rise in overdoses. Overdose deaths in Arizona increased from 1532 in 2017 to 2550 in 2020, and 2664 in 2022 (Centers for Disease Control & Prevention, 2022). Available data on seized drugs in Arizona indicate that in 2022 seized counterfeit pills contained 2.5 mg of fentanyl on average, with a range of 0.03 to 5.0 mg/tablet (Drug Enforcement Administration, 2024). Nationally, in 2022, an estimated 6 in 10 seized counterfeit pills were found to contain at least 2 mg of fentanyl, which is considered a potentially lethal dose (Glidden et al., 2024). Arizona currently does not have community-based drug checking programs, and there is limited up-to date information on the changes in potency of counterfeit pills or on the types of other substances that may be present in them. Data from other regions suggest that besides fentanyl, the pills may contain other fentanyl analogs, acetaminophen, and other drugs (Wightman et al., 2024).
Prior studies have identified a broad range of behaviors and conditions that are associated with an increased likelihood of opioid overdose. Some of these established risk factors include prior overdose experiences, concurrent use of benzodiazepines or alcohol, returning to high doses after losing tolerance (e.g., individuals recently released from prison or inpatient drug treatment), and physical and mental health comorbidities (Carlson et al., 2020; Darke & Hall, 2003; Darke et al., 2014; Kline et al., 2021; Park et al., 2016). However, established frameworks and “expert knowledge” that guide overdose prevention interventions may not align with the perceptions and experiences of people who use drugs (Chang et al., 2024; Moallef et al., 2019). Risk assessment is not an objective and value free enterprise, but it is embedded in the individual histories and experiences, underlying socio-cultural values, and broader structural and environmental conditions (Agar, 1985; Rhodes, 2002). There is a need for qualitative studies to help increase the understanding of how people who use IMF view, experience and judge their overdose-related risks.
Several prior qualitative studies have examined overdose risks in the era of IMF spread, aiming to characterize how people who use drugs (PWUD) experience IMF risks, what harm reduction strategies they employ, and how broader social and structural factors contribute to the local environments of risk (Abadie, 2023; Bardwell et al., 2021; Beharie et al., 2023; Ciccarone et al., 2024; Collins et al., 2024; Fadanelli et al., 2020; Gunn et al., 2021; Lamonica et al., 2021; Latkin et al., 2019; Macmadu et al., 2022; Victor et al., 2020). Many of the prior studies on IMF-related overdose risk perceptions and experiences were conducted at the initial stages of IMF spread, and primarily focused on overdose risks associated with inadvertent exposures to IMF contaminated heroin or other drugs (Abadie, 2023; Ataiants et al., 2020; Carroll et al., 2017; Lamonica et al., 2021; Latkin et al., 2019; Stein et al., 2019; Victor et al., 2020). More research is needed to understand the perceptions of IMF-related overdose risks in the context of high market saturation with IMF, and among individuals who intentionally seek and use IMF-containing drugs. Further, most prior studies were conducted in the regions where IMF is primarily available in powder form and as a contaminant of or replacement for heroin Carroll et al. (2017); Ciccarone et al. (2024, 2017); Latkin et al. (2019); Mars et al. (2018); Moallef et al. (2019). A few recent studies conducted in California described an increasing trend of individuals who use opioids switching from injection to smoking route of using IMF in powder form. These emerging studies have highlighted health-related benefits that were linked to this transition, including potential reduction in overdose risks (Ciccarone et al., 2024; Kral et al., 2021; Megerian et al., 2024). In the context of these important findings, there remains a lack of data on overdose risk perceptions related to the use of IMF in a counterfeit pill form. This qualitative study, conducted in Phoenix, Arizona, aims to address these key gaps and provide an in-depth understanding of how overdose-related risks are viewed and experienced by people who intentionally seek and use IMF-laced counterfeit pain pills (blues).

Section snippets

Methods

This paper draws on data collected for a study on counterfeit drug use in Phoenix, Arizona. Semi-structured, qualitative interviews were completed between 11/2022–12/2023. To qualify for the study, individuals had to meet the following criteria: 1) at least 18 years of age; 2) currently residing in the Phoenix, Arizona, metro area; and 3) use of illicit and/or counterfeit/pressed opioid and/or benzodiazepines in the past 30 days. The study was approved by the Arizona State University (ASU)

Participant characteristics and patterns of drug use

Out of 60 study participants, 58.3 % were men, and the age ranged from 22 to 66-years-old, with a mean of 39.0 (SD 11.2). More than half reported that they were unemployed, and 90 % had lifetime experiences of homelessness. Most (90 %) reported having health insurance, and 65 % had experiences of accessing local harm reduction services in Arizona (Table 1).
Most participants reported their first use of blues about 2–3 years ago (mean years since first use 2.7, SD 1.5) (Table 1). All participants

Discussion

Participants who use IMF pills reported deploying a range of calculated tactics to reduce their overdose risk. Many shared attitudes that tended to minimize the risks and reinforce a sense of personal invulnerability. Some of the contextual and behavioral factors of risk that were emphasized by the study participants align with the prior studies conducted in other regions of the US (Abadie, 2023; Beharie et al., 2023; Ciccarone et al., 2024; Collins et al., 2024; Fernandez et al., 2023; Victor

Role of funding source

This study was supported by the National Institute on Drug Abuse (NIDA) Grant: 1R21DA055640-01A1 (Daniulaityte, PI). The funding source had no further role in the study design, in the collection, analysis and interpretation of the data, in the writing of the report, or in the decision to submit the paper for publication.

Declaration of ethics

The study received ethics approval from the Arizona State University Institutional Review Board.

CRediT authorship contribution statement

Raminta Daniulaityte: Writing – original draft, Validation, Supervision, Resources, Project administration, Methodology, Investigation, Funding acquisition, Formal analysis, Data curation, Conceptualization. Kaylin Sweeney: Writing – review & editing, Project administration, Formal analysis, Data curation. Patricia Timmons: Writing – review & editing, Project administration, Formal analysis, Data curation. Madeline Hooten: Writing – review & editing, Project administration, Formal analysis,

Declaration of competing interest

All authors declare that there are no conflicts of interest.
Source: https://www.sciencedirect.com/science/article/abs/pii/S0955395925001070

Experts warn of rising dependence on anti-anxiety medications, which often start as short-term solutions but lead to addiction; with withdrawal posing serious risks, specialists stress need for medical oversight, alternative treatments, and early intervention

by Eitan Gefen – 17th March 2025
Victoria Ratliff awakens in her lavish suite, the Thai sun piercing through the curtains. She blinks slowly, her head heavy. Was it too much wine again last night? Or was it the lorazepam? From the adjacent bathroom, her husband showers, oblivious to the small internal struggle playing out in her mind. The children? They lost interest in their mother long ago.
She closes her eyes for a moment, takes a deep breath, and imagines herself as someone else—someone who doesn’t need a pill to get through the day. But reality waits. As anxiety creeps in, she reaches for the bottle, pops a pill, washes it down with a sip of water, and lets the familiar calm settle in.
Top Videos
In the third season of HBO’s hit series The White Lotus, Victoria Ratliff grapples with a quiet addiction to lorazepam, a prescription sedative. Her character drifts through scenes in a daze, caught between sleep and wakefulness, her oversized sunglasses and bright smile masking the growing dependency beneath.
Though fictional, Ratliff’s story mirrors a harsh reality. In recent years, addiction to anti-anxiety medications such as Valium, Klonopin, and lorazepam (sold in Israel as Lorivan) has become a global concern, transcending age, class, and geography. What often starts as a “harmless pill for relaxation” can quickly spiral into dependence, making withdrawal a daunting challenge.
A growing crisis
The rise in prescription drug dependency highlights an alarming trend: an increasing reliance on medications to manage daily stressors. What begins as a short-term solution can become a chemical prison with devastating effects on mental and physical health. Why is quitting so difficult? How do people get hooked in the first place? And what can be done before the pills take over?
Dr. Chen Avni, a psychiatrist and deputy director of the psychiatric day treatment department at Ramat Hen Mental Health Center in Tel Aviv, explains that these medications belong to a class of drugs called benzodiazepines. “They enhance the activity of gamma-aminobutyric acid (GABA), a neurotransmitter that slows down brain activity. In low doses, they induce relaxation, but in higher doses, they can cause drowsiness, memory impairment, confusion, and loss of balance.”
While the effects are similar to alcohol, benzodiazepines lack the intoxicating high. However, prolonged use can lead to cognitive impairment, decreased alertness, and, in elderly patients, an increased risk of dangerous falls.
From medical use to dependence
According to Avni, addiction often develops when usage extends beyond the prescribed timeframe. “Initially, these medications are intended for short-term relief—typically no more than six weeks,” he says. “The problem arises when patients feel they can’t function without them. That’s when we see cases of dependency, sometimes at alarmingly high doses.”
Shahar Cohen, a clinical social worker specializing in addiction treatment, has seen this trend intensify. “Anxiety levels across the population have been rising, especially in the past year and a half,” she says. “This isn’t just an individual issue—it affects families, workplaces, and entire communities.”
Prescription drug addiction cuts across all demographics. Some users first receive medication for legitimate issues like insomnia or acute anxiety. Others turn to them following major life stressors such as job loss, divorce, or a child’s military enlistment. In many cases, what starts as a doctor-prescribed solution escalates into self-medication, leading to dependency.
A dangerous market
For many, obtaining benzodiazepines legally isn’t enough. “One former patient of mine was using 16 times the recommended dose,” Avni recalls. “He bought part of his supply through his healthcare provider and the rest on the black market.”
This underground trade of prescription medication underscores a major challenge: when patients become addicted, they will go to great lengths to maintain their supply. “People often don’t realize they’re dependent until it’s too late,” Cohen warns. “When the thought of being without the drug becomes unbearable, that’s a red flag.”
Breaking free from addiction
Experts emphasize that addiction must be treated holistically, addressing not just the physical dependency but also the underlying emotional triggers. “Addiction is never just about the drug,” Cohen explains. “It’s often about pain—whether emotional or psychological. The drug becomes a coping mechanism.”
For those struggling with benzodiazepine dependency, gradual withdrawal under medical supervision is crucial. “Abrupt discontinuation can be dangerous, leading to severe withdrawal symptoms like seizures and psychosis,” Avni cautions. “I’m currently treating a patient who experienced vivid hallucinations after trying to quit cold turkey. We had to introduce a slow, controlled tapering process.”
Beyond physical detoxification, long-term recovery requires psychological support. “Cognitive behavioral therapy (CBT) is an effective tool, especially for sleep disorders,” Avni says. “For chronic anxiety or post-traumatic stress disorder, alternative psychiatric treatments that are non-addictive should be considered.”
Shifting medical practices
Awareness around prescription drug dependency is growing, but change is slow. “There are still doctors who hesitate to confront addicted patients and continue writing prescriptions out of convenience or pressure,” Avni notes. “But every physician prescribing these drugs should recognize the long-term risks. This isn’t just a temporary fix—it can become a lifelong struggle.”
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The Israeli Health Ministry is currently working on reforms to address prescription drug addiction, including establishing specialized treatment clinics within health maintenance organizations (HMOs). These initiatives aim to provide better oversight, education, and intervention before patients spiral into dependency.
The need for early intervention
Ultimately, the best way to combat prescription drug addiction is prevention. “It’s crucial to start with the lowest effective dose and treat the root cause of the anxiety, insomnia, or distress,” Avni advises. “No one is immune to addiction. The key is to monitor usage, avoid increasing dosages without medical guidance, and seek alternative therapies when possible.”
Cohen echoes this sentiment. “Science still can’t predict who will become addicted and who won’t, so awareness is critical,” she says. “If you suspect dependence—whether in yourself or someone close to you—don’t ignore it. Seeking help early can make all the difference.”
Victoria Ratliff’s story may be fictional, but the crisis it highlights is very real. For countless individuals, the journey from prescription to addiction is deceptively short. The challenge now is ensuring that those in need receive the right treatment—before their escape becomes their prison.

Sunday، 16 March 2025 – 12:40 PM

 

Medhat Wahba, the official spokesperson for the Fund for Combating and Treating Addiction and Drug Abuse, confirmed on Sunday, March 16, 2025, that the United Nations’ selection of Egypt as the first country in the world to implement the CHAMPS initiative for children under the age of 18 reflects the pivotal role of the Egyptian state and its commitment to its national commitments and responsibilities to combat drugs and illicit trafficking.

In an interview with Sada El Balad TV, Wahba said, “The initiative to strengthen child prevention systems aims to enhance their resilience from birth through adolescence, protect them from drug abuse, and raise their awareness about drugs.” He noted that “the initiative contributed to showcasing the Egyptian experience, particularly the National Strategy to Combat Drug Abuse, which was recently launched under the auspices of President Abdel Fattah El Sisi and received praise from all countries’ representatives.”

Wahba pointed out that “the Egyptian Drug Control and Addiction Treatment Fund has received numerous Arab and Gulf delegations over the past months to learn about the Egyptian experience, both in treating and rehabilitating drug addicts and in learning about preventive programs.” He emphasized that “the issue of combating addiction has received significant attention from President Abdel Fattah El-Sisi, and Egypt has achieved significant progress over the past ten years, making the Egyptian experience a global leader.”

It is worth noting that the Egyptian Drug Control and Treatment Fund participated in the meetings of the 68th session of the International Commission on Narcotic Drugs, held at the United Nations headquarters in Vienna, to present the Egyptian experience, which was praised by representatives of the participating countries. The meeting was attended by a number of foreign ministers, and was opened by Ghada Wali, Under-Secretary-General of the United Nations and Head of the United Nations Office at Vienna.

Source:https://www.sis.gov.eg/Story/205576/Egypt-Selected-as-First-Country-to-Implement-Child-Prevention-Systems-Initiative?lang=en-us

 

United Nations – Office on Drugs and Crime

March 14th 2025

Ms. Ghada Waly, Executive Director of UNODC, welcomed the youth, reaffirming the organization’s steadfast commitment to their participation in drug prevention efforts. Encouraging them to fully embrace the experience, she stated, “I encourage you to make the most of this opportunity. Speak up. Ask questions. Challenge perspectives.”

Over the course of three days, participants attended interactive sessions focused on evidence-based prevention, rooted in the UNODC/WHO International Standards on Drug Use Prevention. Through collaborative activities, they exchanged best practices from their communities, analyzed challenges, and explored ways to strengthen youth-led prevention efforts. Utilizing the UNODC Handbook on Youth Participation in Drug Prevention Work, they shared past experiences of work and brainstormed on ways to be better be engaged and consulted as youth in prevention initiatives.

A new addition this year was the recently developed Friends in Focus programme, introduced as a resource and tool developed to support global youth be actively involved in evidence-informed prevention work. Youth participants had a sneak peek into some of the interactive activities, directly experiencing parts of the programme themselves. They reflected on the role that group dynamics have in peer selection, and learned to recognize risk and protective factors to drug use. Participants showed interest in being involved in Friends in Focus, including in their potential involvement in future pre-pilots or implementation of the programme. Participants also had the opportunity to attend CND side events, such as the event on “Engaging Youth as Agents of Change in Crime and Drug Use Prevention: Experiences of the Regional Youth Network for Central Asia” and “Ringing Out Hope and Unity: The Peace Bell’s 30-Year Message in Addressing Drug Abuse”.

Another key highlight of the Youth Forum was their collaboration for the creation of the Youth Statement, which captured the collective voices and recommendations of youth participants. The statement emphasized the urgent need for effective prevention, as new and emerging substances continue to impact individuals, families, and communities. Youth participants urged policymakers to invest in evidence-based prevention strategies, create protective environments at home, school, and in communities, and advocated for multiple sectors to converge and harmoniously work together.

UNODC congratulates the Youth Forum 2025 participants for their dedication, insightful contributions, and commitment throughout the three days. Their engagement throughout the Youth Forum highlights the crucial role that young people play in shaping effective drug prevention strategies and being implicated in the policy-making arena. Through the Youth Initiative and the growing alumni network, UNODC remains committed to fostering meaningful youth participation, providing opportunities for learning and development, and supporting young leaders in their efforts to create safer and healthier communities.

Read the Youth Statement below, and click here for more information about the Youth Forum 2025.

Youth Statement 2025 at the Opening Ceremony of the 68th Session of the CND

Your Excellencies, distinguished delegates, ladies and gentlemen,

As 32 youth from 25 countries, we gather here today as a unified voice to address the issue of substance use within our respective communities. This is not a new challenge, and has been tackled over the past decades. Despite efforts, everyday there are new substances that threaten not only individuals, but also society as a whole. It creates a ripple effect where individuals, families, communities are all directly and indirectly negatively affected. The consequences could lead to disruptive environments, higher rates of crime and violence, unemployment, economic challenges, and homelessness.

Therefore, prevention measures are essential to stop substance use before it takes hold. There are many risk factors that can lead to drug use, pushing a person to an extreme. Anyone could have these vulnerabilities, and thus none of them should be neglected. Effective prevention involves creating positive climates at school, home, and in the community to promote social, psychological and physical well-being. It cultivates opportunities, builds a brighter future, and represents a sustainable solution for a long-term problem. Moreover, it flourishes through collaboration among schools, families, communities, workplaces, the health sector, youth institutions, and social media – channels of communication which are closest to us. When prevention is a priority, resilience becomes a reality.

According to research, evidence-based prevention has proven to be, systematically, the most cost-effective. We urge Member States to prioritize funding to substance use prevention policies and solutions, and to invest in further research for drug prevention in aspects that do not have sufficient evidence, such as cultural, geographical, and demographical areas.

Our collective goal is to drive practical solutions, innovative strategies, and youth-led actions. Prevention efforts must not only be about us, but led by us. Why don’t we reflect: how many youth delegates do we have seated amongst us? How many youths have been directly involved in decision-making processes such as in this Commission? As youth, we are a key element of change: we urge you to actively involve young people in prevention efforts, and ensure that financial constraints do not exclude us. We have no political bias, we bring innovation and youth perspectives, and we care about our future. And this is not a one-time investment. Continuous engagement and co-creation can help us collectively reach our mission together.
Standing now in front of you, we ask you to help us have more access to capacity building, to voice our opinion, and to actively listen to us. Please be open to collaborating because we do want to create partnerships and evolve together. Every young person, regardless of their background, should have the opportunity to reach our full potential and positively impact our communities.
Source: https://www.unodc.org/unodc/drug-prevention-and-treatment/news-and-events/2025/March/youth-forum-2025_-when-prevention-is-a-priority–resilience-becomes-a-reality.html

National Crime Agency exposes increasing ketamine use in England amid surge in ‘drug cocktails’

by Tony Diver, Associate Political Editor, The Telegraph (London) 21 February 2025

 

Drug use in England

Ketamine

2023: 10,600 kilograms consumed

2024: 24,800 kilograms consumed

Hotspots: Norwich, Liverpool and Wakefield

Street value: Unknown

 

Cocaine

2023: 87,600 kilograms consumed

2024: 96,000 kilograms consumed

Hotspots: Liverpool and Newcastle

Street value: £7.7 billion

 

Heroin

2023: 25,300 kilograms consumed

2024: 22,400 kilograms consumed

Hotspots: Liverpool and Birmingham

Street value: £1.1 billion

 

Ketamine usage more than doubled in England last year amid the rising popularity of designer “drug cocktails”, The Telegraph can reveal.

The largest and most accurate study of its kind, conducted on behalf of the National Crime Agency (NCA), has exposed a dramatic rise in the popularity of the drug.

Almost 25 tonnes of ketamine were consumed in England last year, up from 10.6 tonnes in 2023.

The drug is now more popular than heroin, with the worst hotspots in Norwich, Liverpool, and Wakefield.

The findings are revealed in Home Office data, seen by The Telegraph, which will form part of the NCA’s annual threat assessment next week.

The agency, dubbed Britain’s FBI, will warn of a rise in the use of several recreational drugs in Britain, including a 10 per cent increase in cocaine.

The sharp increase in the prevalence of ketamine on Britain’s streets is thought to be driven by drug cocktails, including “pink cocaine” – a combination of ketamine and other substances taken by Liam Payne, the One Direction star, before his death last year.

Payne, who fell to his death from a hotel balcony in Argentina in October last year, had taken a mixture of methamphetamine, ketamine and MDMA along with crack cocaine and benzodiazepine before he died, a toxicology report found.

Liam Payne reportedly had ‘pink cocaine’ along with other drugs in his system when he fell to his death in Buenos Aires Credit: Marc Piasecki/GC Images

Mixing ketamine and other drugs can produce hallucinogenic effects, but presents a greater risk to partygoers because the substances can be laced with even stronger narcotics including fentanyl.

The Home Office sampled wastewater from 18 treatment plants across England and Scotland over three years to build the most accurate picture of drug consumption in Britain ever compiled.

The samples, which covered wastewater from more than a quarter of the population, were analysed and scaled up by scientists from Imperial College London.

Previous estimates were based on the quantity of drugs seized by police and self-reported drug surveys, which are less accurate.

The final report found that almost 100 tonnes of cocaine were consumed in England alone last year, up from 88 tonnes in 2023.

Liverpool and Newcastle were the heaviest consumers of cocaine. Usage peaked in London during Christmas, the Euro 2024 football tournament and the Eurovision song contest.

Adjusted for purity, quantities of cocaine consumed in England last year had an estimated street value of £7.7 billion.

That figure is almost double the NCA’s previous estimate and the equivalent of £100 spent on cocaine each year by every person in the country.

Over the same period, heroin consumption is estimated to have decreased by 11 per cent, from 25,300 kilograms in 2023 to 22,400 kilograms in 2024. The highest rates were measured in wastewater from Liverpool and Birmingham.

Experts have previously warned of the dangers of trendy designer drug cocktails, including pink cocaine and “Calvin Klein” or “CK”, which refers to a mixture of cocaine and ketamine.

The combination of drugs can make it more difficult for users to know what substances they have taken.

CK, which is growing in popularity in the UK, has been blamed for overdoses among young people in nightclubs.

It comes as in this week’s Crime and Policing Bill, the Government will propose banning “cuckooing” – when criminals seize a vulnerable person’s home and use it as a drug den or for other illegal activity.

The Home Secretary will also propose new measures to jail those convicted of using children for crime Credit: Jacob King

Yvette Cooper, the Home Secretary, will also propose a new offence of child criminal exploitation, which is thought to affect around 14,500 children each year.

Under the new measures, people convicted of using children for crime, including county lines drug dealing, will face ten years in prison.

Ms Cooper said: “The exploitation of children and vulnerable people for criminal gain is sickening and it is vital we do everything in our power to eradicate it from our streets.

“As part of our Plan for Change, we are introducing these two offences to properly punish those who prey on them, ensure victims are properly protected and prevent these often-hidden crimes from occurring in the first place.

“These steps are vital in our efforts to stop the grooming and exploitation of children into criminal gangs, deliver on our pledge to halve knife crime in the next decade and work towards our overall mission to make our streets safer.”

Ministers and the NCA are also concerned about the rise of drug importers, who bring classified substances into the UK through weaker entry points and sell them to distributors around the country.

Source: https://www.telegraph.co.uk/news/2025/02/21/true-scale-uk-illegal-drug-use/

March 12, 2025

What is the Hyannis Consensus Blueprint?

The Hyannis Consensus Blueprint is a groundbreaking framework designed to guide international efforts in addressing the devastating impact of addiction. Key pillars shape this balanced drug policy, including prevention, intervention, treatment, recovery, supply reduction, and enhanced global collaboration. With addiction now at catastrophic levels in many regions, the blueprint represents a vital roadmap for sustainable change.

The principles outlined in the blueprint prioritise strategies that discourage drug use while addressing underlying systemic challenges. It promotes innovating criminal justice systems, encourages adopting evidence-based treatment options, and advocates uniting globally to combat addictive substances.

The Cost of Ignoring Addiction

Failing to address addiction comes with an enormous human and economic cost. The transcript from the Hyannis Consensus launch highlights a pressing need to move beyond toxic cycles of permissive drug policies and normalisation. Legalisation of drugs, as seen in North America, has reportedly led to devastating effects, particularly among young people, and prioritised corporate profits over public health.

The Hyannis Consensus Blueprint stands as a counterpoint to this trend. It promotes a world where communities can thrive without the shadow of addiction, empowering individuals to recover fully and lead drug-free lives.

Prevention and Recovery as Pillars of Change

At its core, the Hyannis Consensus Blueprint revolves around prevention and recovery. Prevention aims to stop drug use before it starts, while recovery offers individuals a path to rebuild their lives. This proactive approach aims to not only reduce harm but also transform lives for the better.

The blueprint urges balancing efforts across criminal justice and public health systems. Effective drug courts alongside harm-reduction interventions serve as vital tools in discouraging drug use and fostering recovery. Nations serious about tackling addiction must consider these solutions to safeguard future generations.

Governments Urged to Prioritise Resilient Societies

Governments worldwide are now being urged to realign their national drug policies with the principles of the Hyannis Consensus Blueprint. Countries are encouraged to reaffirm their commitment to international drug conventions, reject legalisation experiments that prioritise private interests, and expand programmes rooted in criminal justice reform and effective public health measures.

The launch of this blueprint serves as a rallying cry for nations determined to prioritise human dignity and community wellbeing. By adopting the Hyannis Consensus Blueprint, countries can pave the way for healthier, more resilient societies.

Why the Hyannis Consensus Matters

Addiction is more than an individual struggle; it’s a societal challenge that affects families, economies, and futures. The Hyannis Consensus Blueprint is a bold step towards reversing the tide of permissive drug policies and ineffective strategies. For countries looking to protect their citizens, this balanced drug policy provides the tools and vision necessary for meaningful change.

Organisations like the Dalgarno Institute and WFAD are at the forefront of this global effort, highlighting the importance of this significant, timely initiative. Communities deserve policies that prioritise recovery, not exploitation, and the Hyannis Consensus Blueprint is uniquely positioned to achieve this goal.

Learn more here.

Source: https://wrdnews.org/the-hyannis-consensus-blueprint-a-landmark-in-balanced-drug-policy/

AddictionPolicyForum.png

Updated: Mar 12
 
A randomized clinical trial published in JAMA Network Open found that incorporating online group mindfulness sessions into buprenorphine treatment for opioid use disorder (OUD) significantly reduced opioid cravings compared to treatment as usual.
The study, led by Dr. Zev Schuman-Olivier and colleagues from Cambridge Health Alliance and Harvard Medical School, examined the effectiveness of a 24-week virtual mindfulness-based program compared to a standard recovery support group using evidence-based practices. The trial included 196 participants across 16 U.S. states.

The mindfulness-based program showed similar levels of opioid use and anxiety reduction compared to standard best-practice groups but significantly outperformed in reducing self-reported opioid craving (67 percent vs. 44 percent, P<0.001). Study results indicate that mindfulness is a potent treatment option that can help reduce opioid craving during buprenorphine treatment.

“These findings are compelling evidence that trauma-informed mindfulness groups can be offered as an option for people during medication treatment for opioid use disorder,” said Dr. Zev Schuman-Olivier, MD, principal investigator of the study, founding director of the Center for Mindfulness and Compassion, and director of addiction research at Cambridge Health Alliance. “Mindfulness should be strongly considered for patients experiencing residual cravings after starting buprenorphine.”
As one participant reported, “This program helped me learn new techniques that I didn’t even know existed before I began. I still meditate all the time and don’t even need to have any sound on. I just lay down and push away all of my stress. It was well worth every minute I spent there.”

OUD remains a major public health crisis in the U.S., with over 100,000 opioid overdose deaths each year. Medications for opioid use disorder (MOUD), such as buprenorphine, are evidence-based treatments for opioid use disorder (OUD). Opioid craving is a risk factor for relapse for patients receiving MOUD. Experts highlight that further research is needed to explore how mindfulness can be integrated into existing OUD treatment frameworks to improve long-term recovery outcomes.

Source: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2829421

The attached guide describes Planet Youth – a prevention model which has proved very successful in practice.

Planet Youth relies heavily on the Icelandic Prevention Model, as summarised below. (This graphic is borrowed from the ‘Planet Youth Guidance Program – Information Guide’) as attached.

To access the full Planet Youth document:

  1. Click on the ‘Source’ link below.
  2. An image  – the front page of the full document will appear.
  3. Click on the image to open the full document.

Source: Planet-Youth-Guidance-Program-Information-Guide-English.-Electronic-Edition.-2021.

 

United Nations

by Ioulia Kondratovitch – 10 March 2025 – Law and Crime Prevention

UNODCA “new black market” for synthetics and drug trafficking through war zones are fuelling instability around the world, the chief of the UN drugs and crime office said.
Today, the illicit drug market is becoming more unpredictable, driven by the impact of synthetic drugs,” Ghada Waly, Director-General of the UN Office on Drugs and Crime (UNODC), said, addressing the opening of the latest session of the Commission on Narcotic Drugs in Vienna.
“Trafficking routes run through war zones and rule of law vacuums, from Haiti to the Levant to the Golden Triangle, fuelling instability.”

Tracking the global illicit drug trade

With over 2,000 participants and 179 side events, the commission’s session takes place from 10 to 14 March, with experts from around the world taking stock of the narcotic drugs trade as countries grapple with deadly tides of opioids like fentanyl while also highlighting gains made through joint operations.
For its part, UNODC supports more than 180 border control units in 87 countries to intercept drug flows. In 2024, UN-facilitated seizures included 300 tonnes of cocaine, 240 tonnes of synthetic drugs and 100 tonnes of precursors.
“We are facilitating backtracking investigations, bringing together law enforcement agencies and prosecutors from source, transit and destination countries,” Ms. Whaly explained.

A new black market

She also warned of emerging threats. Technology is radically transforming and accelerating how drugs are sold and distributed, with the dark web having created a “new black market” for synthetic drugs and precursors, Ms. Whaly said.

“Cryptocurrencies allow traffickers to move illicit profits undetected, and social media platforms have become major channels for promoting and advertising drugs online, particularly targeting young people and vulnerable users,” she said.
She also cautioned that drug trafficking networks are capitalising on these changes to expand their reach.

Chasing the most urgent threat

One of the biggest threats is synthetic drugs, she said. Synthetic manufacturing labs are being uncovered in new countries and regions. Indeed, more than 1,300 distinct psychoactive substances have been reported to UNODC to date.
At the same time, amphetamine-type stimulants and pharmaceutical opioids are registering record seizures. Synthetic opioids of the nitazine class are on the rise, with 26 different substances reported to UNODC so far, she added.
“Synthetic drugs have become one of the most urgent and elusive drug challenges that we face,” Ms. Whaly said. “They are evolving every day, expanding in reach and growing in potency.”

Clandestine labs

Clandestine production laboratories are emerging in parts of the world typically not known to produce synthetic drugs, Ms. Whaly said.
The methods to manufacture drugs and the means to traffic them are constantly evolving. Now, the internet is growing as a marketplace for drugs as well as a platform to exchange knowledge on how to make them.
Unlike plant-based substances, synthetic drugs can be manufactured quickly, at a low cost, almost anywhere in the world. They can also be moved across borders in bulk, often concealed in legitimate exports or in such large quantities that individual seizures “barely make a dent”, Ms. Whaly said.
“Simply put, they are harder to identify, intercept and interrupt,” she added.

Fuelling instability

Every region has suffered from the spread of synthetic drugs, she said, citing several examples:
In the Middle East and Africa, the captagon trade – a highly addictive stimulant popular on the battlefield – has been fuelling instability, with production and smuggling now deeply intertwined with conflict, Ms. Whaly said.
In Iraq, seizures of the drug surged by more than 3,300 per cent between 2019 and 2023, with authorities seizing 4.1 tonnes in a single year.
Large stockpiles were discovered in Syria, she said, adding that the situation following the fall of Assad requires close monitoring and attention.
In Southeast Asia, authorities seized a record 190 tons of methamphetamine in 2023, with criminal networks exploiting the region’s porous borders to move their product. Meth products are often found in heroin, vapes and counterfeit tablets and can be even more potent than fentanyl.
The Commission on Narcotic Drugs was established by Economic and Social Council (ECOSOC) in 1946 to assist in supervising the application of the international drug control treaties.

 

Source: https://news.un.org/en/story/2025/03/1160971

Cathy Deacon
Writer states that primary prevention, heading off drinking problems before they start, should be a focus

In the fall of 2024, the Yukon’s chief medical officer stated that the Yukon government’s first substance use surveillance report indicated that alcohol’s burden “far exceeds” other substances. The report contains data related to EMS (emergency medical services), hospital and emergency admissions and reports from the chief coroner. Dr. Sudit Ranade says that the Yukon has a more substantial burden of substance abuse than the Canadian average. (Nov. 29/2024 Yukon News).

Dr. Sudit wisely pointed out that alcohol use in the Yukon starts early and while getting treatment is good, it takes the focus away from prevention. The Yukon government spends millions on secondary prevention; primary prevention aims to prevent the onset of disease or illness and secondary prevention attempts to manage the disease and reduce progression once present.

I have lived in the Yukon since 1970, graduated from FH Collins in 1975. I started drinking when I was 15 years old, it became a problem very quickly yet I didn’t quit drinking until I was 30 years old. Alcohol and mental illness ran in my family and seven years ago I lost my son to suicide in Whitehorse; he was drinking that fateful night.

I have been a social worker and criminologist in the Yukon for the last 40 years. I have worked in Whitehorse and rural communities in the Yukon. I have seen the suffering that that both alcohol and drugs brings upon families and communities. It’s not uncommon to hear of mothers drinking themselves to death, leaving their children motherless.

We spend millions on secondary prevention programs — EMS, mental health and substance abuse programs, shelters, police, medical system — the list goes on. I would like to see a thoughtful analysis of how successful mental health and substance abuse services programs are for people with substance abuse issues. I can guarantee that we would find dismal results, we keep doing the same thing over and over again, expecting different results. Secondary prevention provides employment for a whole lot of us, but at what cost?

Primary prevention programs aimed at preventing the problem before it starts is often overlooked. The main point in me writing this letter is to encourage the Yukon government to prevent the harm and one of the ways to do that, is to educate people about the serious harm that alcohol causes.

In Nov. 2017, a federally-funded study in Yukon, which was the first of its kind in Canada, saw colourful labels affixed to all alcohol bottles and cans inside a Whitehorse liquor store. There were two types of labels: one that warned that alcohol can cause cancer, including breast and colon cancer (there are other cancers as well); another label informed purchasers of the recommended maximum number of drinks per day. But just four weeks later, the Yukon Liquor Corporation decided to “pause” the label study after hearing concerns from national alcohol organizations.

The concerns included whether Yukon had the authority to affix the warnings and possible defamation, said the minister responsible for the liquor corporation, John Streicker.

“We have to weigh the costs that we will have to put towards litigation, costs which could go towards trying to reduce the harm of alcohol and promote education,” he said.

Timothy Stockwell, a University of Victoria researcher involved in the study, said he felt “extreme disappointment’ when he learned the project was being put on hold. The liquor industry was afraid that the graphic warning labels on booze could curb alcoholism. The label phase was supposed to run for eight months followed by a survey to assess the impact. The colourful labels included graphics, as opposed to U.S. messages that are text only. There was concern about putting the word cancer on the labels yet the International Agency for Research on Cancer, a World Health Organization body, has classified alcohol as a group-one carcinogen, along with tobacco, asbestos and many other materials. (Canadian Press – Laura Kane Posted Jan. 3, 2018).

We are now being told that there is no safe level of alcohol. I am pleased to see that there appears to be increasing numbers of people who are recognizing this fact and choosing to forgo the use of alcohol. I have lived in the Yukon for over 50 years and always wondered why there was so much cancer in such a beautiful pristine land. Could alcohol use have something to do with that? Not to mention the costs alcohol misuse does to families, children, teenagers, including suicide, mental health issues, FASD, incarceration, child abuse, problems in school attendance and missing work, the list goes on. Drinking alcohol can raise your risk of developing these cancers: mouth, laryngeal, breast, liver, pharyngeal, esophageal, stomach, pancreatic and colorectal. Tobacco and alcohol together are worse for you than either on its own. (Canadian Cancer Society).

I propose that we give this study another try, for at least a year. It held promise, can’t we at least try something that would cost peanuts, putting a label on a bottle? Education is key and morally, how can we not try prevention for the sake of Yukon people’s health?

Ms. Clarke encourage your fellow MLAs to be brave and try this inexpensive primary prevention project again; it could save lives, lower health care costs and all other related costs that the Chief Medical Officer spoke about. Don’t let the liquor industry bully you, it might give Yukoners the impression that money from the sale of alcohol is more important than people’s health.

Sincerely, Cathy Deacon, Whitehorse, Canada.

by Anonymous | Thursday, Mar 13, 2025

Drugs are everywhere—in movies, music videos, social media, and school hallways. Over the years, more young adults have been experimenting with substances at younger ages. The drugs of choice have also changed: before, the “cool” substances were tobacco and alcohol; nowadays, they’ve been replaced by marijuana, nicotine, and hallucinogens (Abrams, 2024). Back in high school, there were a lot of days when I would walk into the bathrooms and be hit by the smell of cotton candy and blueberry. The vaping problem got so bad that the administration implemented bathroom monitors to limit how many students could enter at a time. What irritated me the most was that everyone knew what was happening, but unless the students were caught red-handed, they never got in trouble. All those measures and for what? The number of students vaping didn’t decrease, and after a while, it felt like the school stopped caring altogether. My high school was not the only one with a substance-use issue; this is an issue amongst all schools and a major cause for concern for parents and students alike.

Ever since I was young, I’ve been aware of drugs and their effects, since both my parents were psychologists. My dad traveled around the country educating parents and teachers about substance use, early sex, and violence prevention, and my mom was a school psychologist. I considered myself lucky not to have anyone close to me struggle with addiction, however, two years ago, I found out my younger cousin had started using laughing gas and other substances recreationally. I actually discovered this through a fake account I created after noticing alarming social media posts. I didn’t tell her mom because I had previously reported her concerning behaviors, and nothing came of it. In fact, my cousin only distanced herself from me, hence the need to create a fake account. No matter what, I tried to keep communication open, despite her responses being brief. I don’t blame her for the way she reacted. Although I acted out of concern, she felt betrayed by my actions, and rebuilding trust will take time.

Over the past two years, I’ve thought a lot about what led to my cousin’s situation. First, I thought about why people use substances in the first place: people often use substances as a way to escape their life situations or traumas. Drugs provide a temporary “high,” which allows users to feel good, but the effects are fleeting. In the words of a famous rapper, Eminem, they “snap back to reality” and are forced to face their troubles all at once. Their discontent or distress with reality drives them to seek another “fix,” thus leading to a vicious cycle. As tolerance builds, higher doses are required to achieve the same effect. Drugs are dangerous because they distort emotions, cognition, memory, motor skills, perception, and behavior. All of these effects leave people vulnerable to making fatal mistakes and becoming victims of crimes.

There are several factors that can enhance the risk of substance abuse in youth: family history of addiction, poor parental involvement, associating with peers who use drugs, mental health issues, poverty, and childhood sexual abuse. Teens and young adults who abuse substances are more likely to engage in risky sexual behaviors, experience violence in interpersonal relationships, and face a higher risk for mental health issues and suicide. As if this weren’t enough, early drug use also increases the likelihood of substance use disorders in adulthood and problems with the justice system (Welty et al., 2024, p. 5).

On the other hand, protective factors like strong family support, high self-esteem, and good use of free time can help prevent young adults from abusing substances. While we might not always be able to prevent our loved ones from using substances, we can still be supportive family members they can turn to. Studies show that children with strong family support often find stability in adulthood (Chiang et al., 2024, p. 922). How can society address the issue of youth substance abuse? On a larger scale, we need to stop treating drugs as a taboo topic; keeping children in the dark about drugs does them a disservice because their lack of knowledge often leads to uninformed decisions and sometimes fatal consequences. Drug prevention programs educate youth about harm reduction techniques, healthy coping alternatives, and promote an honest discussion about substance use. Additionally, they teach children refusal strategies so that they can feel confident saying no without fearing they’ll be seen as “lame” by their peers. These prevention programs should also add a parental education component so that both parents and teachers could attend workshops on how to prevent, recognize, and address substance abuse. I believe education starts at home, and therefore, parents need the right tools to steer their kids away from drugs and know how to react if their child uses substances or asks questions about them. I also think the program should help kids plan and visualize their life goals, as establishing goals can be important for maintaining motivation and dedication. If a proper plan is set out for a child, they can identify what they need to do to get closer to their goals and what will set them back (e.g., drugs).

On a personal level, you can educate yourself about substance abuse to approach the issue with empathy rather than judgment. Most importantly, keep communication open, because sometimes just letting someone know you’re there for them can make a huge difference. If someone you know is struggling, encourage them to seek professional help, since addiction often requires counseling and medical intervention. Finally, set boundaries to protect yourself, because you cannot help others if you do not help yourself, and remember that you can be supportive without enabling dangerous behavior.

Source: https://www.google.com/url?rct=j&sa=t&url=https://www.fau.edu/thrive/students/thrive-thursdays/substance_abuse_among_teens/&ct=ga&cd=CAEYASoUMTQwNTE0OTI3NTUyNDQ1MjA2MTUyGjJiNzI5NDQxMGY0ZDBmNTc6Y29tOmVuOlVT&usg=AOvVaw2s994ac9kbEI-oVZO4FBmo

Vienna (Austria), 13 March 2025 – “Investing in your health, safety, and well-being is an investment in a stronger, more sustainable world.”

Ms. Ghada Waly, the Executive Director of the UN Office on Drugs and Crime (UNODC), emphasized the vital role of youth in substance use prevention. Speaking at the Opening of the Youth Forum 2025 in the margins of the Commission on Narcotic Drugs (CND), Ms. Waly highlighted that “it is your contribution – your ideas and your actions – that will drive real progress” in building resilience and fostering evidence-based prevention efforts.

The Youth Forum at the CND brings together young leaders from around the world to engage in discussions with UNODC experts on substance use prevention and meaningful youth involvement. Participants learn to recognize vulnerabilities to drug use, what effective prevention aims to target and prosocial and healthy behaviours within their communities.

Over three days, youth engaged in interactive sessions based on the UNODC/World Health Organization (WHO) International Standards on Drug Use Prevention, examining the science behind substance use disorders, understanding risk and protective factors that can make an individual become more vulnerable and reflecting on the extent to which their prevention experiences are aligned with evidence-based practices. They also discussed ways to strengthen their role as youth in prevention work, ensuring that young people are actively involved in shaping policies and initiatives that promote well-being and resilience.

Additionally, participants were introduced to Friends in Focus, UNODC’s newly developed youth-based prevention programme. They explored innovative ways to engage their peers, promote positive social norms, and contribute to substance use prevention efforts in their communities. Shaped through insights and feedback from previous Youth Forum participants, Friends in Focus aims to equip young people with the knowledge, training, and tools to drive meaningful change.

Youth leading in communities

Youth participants shared their experiences and inspirations that led them in their journey of substance use prevention work, exchanging best practices from their communities. Through group activities, they learned from each other, identifying what worked and what didn’t in prevention efforts.

Nathan Christoff-Omar Morris, one of the youth representatives that delivered the joint Youth Statement, shared how his work in Jamaica focused on educating students. “Everyone’s life is unique, and so are their experiences — youth-led initiatives allow peer-to-peer interactions, which is an effective way of communicating. This can create a ripple effect of positive influence in communities,” he emphasized. His efforts back home led to greater presence of prevention messaging in schools and increased student engagement with counselling services.

Nathan, reflecting on his time at the Youth Forum, emphasized how youth-led approaches make prevention efforts more relatable and effective. “Young people understand the challenges we face—whether it’s family struggles, academic pressure, or peer influence. That’s why youth must be at the forefront of prevention work and policymaking.”

Inspired by the diverse ideas and initiatives shared during the Youth Forum, Nathan left with a renewed vision. “This experience will forever be etched into my mind. I plan to bring back my learnings, advocate for more investment in youth-led prevention and introduce programmes like Friends in Focus in my country.”

Youth voices at the forefront

During the Plenary of the 68th CND, young leaders delivered their jointly drafted Youth Statement: “Prevention efforts must not only be about us but led by us,” they declared, urging policymakers to invest in evidence-based strategies and prioritize youth participation in prevention and decision-making processes. “Standing now in front of you, we ask you to help us have more access to capacity building, to voice our opinions and to actively listen to us.”

The Youth Statement passionately called on Member States to recognize that prevention is the most cost-effective approach to addressing substance use. “When prevention is a priority, resilience becomes a reality.”

The youth further stressed the need for youth-led actions, ensuring that prevention efforts reach all young people, regardless of their background, enabling them to reach their full potential and opportunities.

Source: https://www.unodc.org/unodc/frontpage/2025/March/youth-forum-2025_-youth-taking-the-lead-in-peer-led-drug-prevention.html

United Nations

Prevention, Treatment, and Rehabilitation Section

 

March 14th 2025

Just this week, the Youth Forum 2025 took place during 10 – 12 March on the sidelines of the 68th Session of the Commission on Narcotic Drugs (CND). This year, 32 youths from 25 countries were selected through a rigorous process, aiming to invite youths that had high interests and/or prior experience in drug prevention. The Youth Forum provided a platform for these dedicated young leaders to learn about effective prevention, share their experiences, and learn from each other.

Ms. Ghada Waly, Executive Director of UNODC, welcomed the youth, reaffirming the organization’s steadfast commitment to their participation in drug prevention efforts. Encouraging them to fully embrace the experience, she stated, “I encourage you to make the most of this opportunity. Speak up. Ask questions. Challenge perspectives.”

Over the course of three days, participants attended interactive sessions focused on evidence-based prevention, rooted in the UNODC/WHO International Standards on Drug Use Prevention. Through collaborative activities, they exchanged best practices from their communities, analyzed challenges, and explored ways to strengthen youth-led prevention efforts. Utilizing the UNODC Handbook on Youth Participation in Drug Prevention Work, they shared past experiences of work and brainstormed on ways to be better be engaged and consulted as youth in prevention initiatives.

A new addition this year was the recently developed Friends in Focus programme, introduced as a resource and tool developed to support global youth be actively involved in evidence-informed prevention work. Youth participants had a sneak peek into some of the interactive activities, directly experiencing parts of the programme themselves. They reflected on the role that group dynamics have in peer selection, and learned to recognize risk and protective factors to drug use. Participants showed interest in being involved in Friends in Focus, including in their potential involvement in future pre-pilots or implementation of the programme. Participants also had the opportunity to attend CND side events, such as the event on “Engaging Youth as Agents of Change in Crime and Drug Use Prevention: Experiences of the Regional Youth Network for Central Asia” and “Ringing Out Hope and Unity: The Peace Bell’s 30-Year Message in Addressing Drug Abuse”.

Another key highlight of the Youth Forum was their collaboration for the creation of the Youth Statement, which captured the collective voices and recommendations of youth participants. The statement emphasized the urgent need for effective prevention, as new and emerging substances continue to impact individuals, families, and communities. Youth participants urged policymakers to invest in evidence-based prevention strategies, create protective environments at home, school, and in communities, and advocated for multiple sectors to converge and harmoniously work together.

As they reminded global policymakers that “Prevention efforts must not only be about us, but led by us”, they called on Member States to actively include young people in decision-making processes and prevention work. And they further highlighted their readiness in being equal partners with adult stakeholders in addressing the world drug problem, as they said: “We have no political bias, we bring innovation and youth perspectives, and we care about our future. And this is not a one-time investment. Continuous engagement and co-creation can help us collectively reach our mission together.”

UNODC congratulates the Youth Forum 2025 participants for their dedication, insightful contributions, and commitment throughout the three days. Their engagement throughout the Youth Forum highlights the crucial role that young people play in shaping effective drug prevention strategies and being implicated in the policy-making arena. Through the Youth Initiative and the growing alumni network, UNODC remains committed to fostering meaningful youth participation, providing opportunities for learning and development, and supporting young leaders in their efforts to create safer and healthier communities.

Read the Youth Statement below, and click here for more information about the Youth Forum 2025.

Youth Statement 2025 at the Opening Ceremony of the 68th Session of the CND

Your Excellencies, distinguished delegates, ladies and gentlemen,

As 32 youth from 25 countries, we gather here today as a unified voice to address the issue of substance use within our respective communities. This is not a new challenge, and has been tackled over the past decades. Despite efforts, everyday there are new substances that threaten not only individuals, but also society as a whole. It creates a ripple effect where individuals, families, communities are all directly and indirectly negatively affected. The consequences could lead to disruptive environments, higher rates of crime and violence, unemployment, economic challenges, and homelessness.

Therefore, prevention measures are essential to stop substance use before it takes hold. There are many risk factors that can lead to drug use, pushing a person to an extreme. Anyone could have these vulnerabilities, and thus none of them should be neglected. Effective prevention involves creating positive climates at school, home, and in the community to promote social, psychological and physical well-being. It cultivates opportunities, builds a brighter future, and represents a sustainable solution for a long-term problem. Moreover, it flourishes through collaboration among schools, families, communities, workplaces, the health sector, youth institutions, and social media – channels of communication which are closest to us. When prevention is a priority, resilience becomes a reality.

According to research, evidence-based prevention has proven to be, systematically, the most cost-effective. We urge Member States to prioritize funding to substance use prevention policies and solutions, and to invest in further research for drug prevention in aspects that do not have sufficient evidence, such as cultural, geographical, and demographical areas.

Our collective goal is to drive practical solutions, innovative strategies, and youth-led actions. Prevention efforts must not only be about us, but led by us. Why don’t we reflect: how many youth delegates do we have seated amongst us? How many youths have been directly involved in decision-making processes such as in this Commission? As youth, we are a key element of change: we urge you to actively involve young people in prevention efforts, and ensure that financial constraints do not exclude us. We have no political bias, we bring innovation and youth perspectives, and we care about our future. And this is not a one-time investment. Continuous engagement and co-creation can help us collectively reach our mission together.

Standing now in front of you, we ask you to help us have more access to capacity building, to voice our opinion, and to actively listen to us. Please be open to collaborating because we do want to create partnerships and evolve together. Every young person, regardless of their background, should have the opportunity to reach our full potential and positively impact our communities.

Behind every statistic there is a story. If you want to change the statistics, listen to the stories. Recognize the vulnerability, don’t neglect it. Strengthen it. And the time to act is now, for the future begins with the choices made today.

Source: https://www.unodc.org/unodc/drug-prevention-and-treatment/news-and-events/2025/March/youth-forum-2025_-when-prevention-is-a-priority–resilience-becomes-a-reality.html

 

by Mia Holloman, Directorate of Prevention, Resilience and Readiness – March 11, 2025

A strong Army starts with healthy Soldiers and communities. When Soldiers are at their best, they’re ready for any mission. The Army Substance Abuse Program is committed to preventing substance misuse before it becomes a problem, giving leaders the tools to recognize risks and take action early.

Prevention starts with awareness and the right support. ASAP provides education and resources to help Soldiers, leaders and units work together to address alcohol and drug misuse. Commanders play a vital role in creating positive, substance-free environments and encouraging activities that strengthen resilience and teamwork. By taking a proactive approach, Soldiers stay focused, engaged and mission-ready.

“Take advantage of services that the Army offers before there is an incident,” said Georgina Gould, Army Substance Abuse Program Specialist, Ready and Resilient Integration and Training division.

“If there are indicators that problematic substance misuse is getting in the way at work or at home, schedule an appointment to meet with a provider at your assigned embedded behavioral health clinic, where you can be assessed for voluntary care without command involvement.”

The Substance Use Disorder Clinical Care Program, a vital resource for Soldiers and their Families impacted by substance misuse, complements ASAP’s prevention initiatives.

SUDCC is the Army’s model for delivering substance use treatment in a manner that is integrated, aligned with unit needs and conveniently co-located. Substance use disorder treatment is part of a comprehensive plan aimed at achieving rapid recovery and restoring individuals to full readiness.

“SUDCC’s mission of providing treatment and returning Soldiers to the fight is congruent with the ASAP mission of strengthening the overall fitness and effectiveness of the Army workforce, (conserving) manpower and enhancing Soldier combat readiness,” Gould said.

SUDCC provides care tailored to the unique needs of the Total Army, ranging from initial assessment and counseling to outpatient and inpatient treatment options. Gould said the SUDCC program has a low recidivism rate, meaning individuals are less likely to return to the program.

“There is a low number of Soldiers returning for further treatment after services are completed, which means they are successful in returning to the mission and their Families with enhanced coping skills and wellness,” Gould said.

Together, ASAP and SUDCC demonstrate the important role of the Army community in prevention, awareness and recovery. Substance misuse is not just a personal issue; it can impact entire teams, communities and missions. ASAP and SUDCC bring together partners from different sectors and engage stakeholders to build a strong, united effort against substance misuse.

Source: https://www.army.mil/article/283651/strengthening_the_army_community_through_substance_misuse_prevention_treatment_options

Photo: UNODC
Member states voting at the 68th session of the CND.

Vienna (Austria), 14 March 2025 — The sixty-eighth session of the Commission on Narcotic Drugs (CND) concluded today after five days of intensive discussions on global drug policy, international cooperation and the implementation of international drug policy commitments. The strong engagement and high level of participation from governments and stakeholders in Vienna, 2,000 of whom gathered to exchange views and shape collective responses to evolving drug-related challenges, demonstrates the Commission’s relevance as the global platform for addressing the complexities of the world drug problem in an evidence-based, forward-looking manner.

In her closing remarks, United Nations Office on Drugs and Crime (UNODC) Executive Director Ghada Waly emphasized the importance of strengthening the CND. “In times of division and uncertainty, we need effective multilateral institutions more than ever,” she said. “And the level of engagement at this session has once again confirmed the enduring relevance of this Commission as the global forum for drug policy.”

She urged Member States to redouble their efforts, commitment and cooperation, recognizing that the evolution of the world drug problem demands a renewed and determined response. “UNODC will remain committed to working for a healthier and safer world, guided by the decisions of Member States,” she concluded.

Six New Substances under Control

In fulfilling its normative functions under the international drug control conventions, the Commission acted on recommendations from the World Health Organization (WHO), deciding to place six substances under international control. These include four synthetic opioids –  N-pyrrolidino protonitazene, N-pyrrolidino metonitazene, etonitazepipne, and N-desethyl isotonitazene – which have been linked to fatal overdoses. The Commission also placed hexahydrocannabinol (HHC), a semi-synthetic cannabinoid with effects similar to THC that has been found in a variety of consumer products, under Schedule II of the 1971 Convention. Additionally, carisoprodol, a centrally acting skeletal muscle relaxant, widely misused in combination with opioids and benzodiazepines, was placed under Schedule IV of the 1971 Convention due to its potential for dependence and health risks. These scheduling decisions reflect the Commission’s ongoing efforts to respond to emerging drug threats and protect public health.

Six resolutions adopted

The Commission on Narcotic Drugs (CND) also adopted six resolutions, reinforcing global efforts to address drug-related challenges through evidence-based policies and strengthened international cooperation.

To protect children and adolescents, the Commission encouraged the implementation of scientific, evidence-based drug prevention programs, emphasizing the need for early interventions and cross-sectoral collaboration to build resilience against non-medical drug use.

Recognizing the growing impact of stimulant use disorders, another resolution promoted research into effective, evidence-based treatment options, calling on Member States to invest in innovative pharmacological and psychosocial interventions to improve care for those affected.

The importance of alternative development was reaffirmed with a resolution aimed at modernizing strategies that help communities transition away from illicit crop cultivation, ensuring long-term economic opportunities while addressing broader issues like poverty and environmental sustainability.

In response to the rising threat of synthetic drugs, the Commission adopted a resolution to protect law enforcement and first responders dismantling illicit synthetic drug labs and advocating for stronger safety protocols, enhanced training and international cooperation to reduce risks.

To strengthen the implementation of international drug control conventions and policy commitments, the Commission decided to establish an expert panel tasked with developing a set of recommendations to strengthen the global drug control system.

Additionally, recognizing the environmental damage caused by illicit drug-related activities, the Commission adopted another resolution calling on Member States to integrate environmental protection into drug policies and address the negative impacts on the environment resulting from the illicit drug-related activities.

These resolutions reflect the Commission’s commitment to providing concrete, coordinated responses and ensuring that drug control policies remain effective, adaptive and aligned with contemporary challenges.

Source: https://www.unodc.org/unodc/frontpage/2025/March/cnd-68-concludes_-six-new-substances-controlled-six-resolutions-adopted.html

    Delegation of the European Union to the International Organisations in Vienna

Statement by Press and information team of the Delegation to UN and OSCE in Vienna:

It is an honour to be here and to speak on behalf of the European Union and its Member States. Albania, Andorra, Bosnia and Herzegovina, Georgia, Iceland, Montenegro, North Macedonia, Republic of Moldova, San Marino and Ukraine align themselves with this statement.

Mr Chair,

We remain committed to strengthening the global cooperation to address drug-related challenges in accordance with an evidence-based, integrated, balanced and comprehensive approach. We acknowledge the important role of UNODC in monitoring the world drug situation, developing strategies on international drug control and recommending measures to address drug-related challenges.

As we meet today, conflicts and violence are unfolding in numerous parts of the world. The EU and its Member States call for the full respect for the UN Charter andinternational law, including international humanitarian law, whether in relation to Russia’s war of aggression against Ukraine, or the ongoing conflicts in the Middle East, Sudan, Ethiopia, DRC and elsewhere.

Drug trafficking controlled by organised crime groupsthreatens public health, our security, our economies and prosperous development worldwide, and even our democratic institutions and the rule of law. This is an important security challenge that Europe is currently facing. As demonstrated by the European Drug Report 2024, as a consequence of the high availability of drugs, large-volume trafficking and competition between criminal groups in Europe, some countries are experiencing an increase in violence and other forms of criminality linked to the operation of the drug market.

To address this concern, last November the EU hosted the European Conference on Drug-related Violenceas part of the implementation of the EU Roadmap to combat drug trafficking and organised crime. At the conference, the EU Drugs Agency called for action on drug-related violence, to encourage and support efforts to enhance safety and security across all sectors of society with measures to anticipate, alert, respond and learn from the growing complexities of drug-related violence. This initiative reflects our collective determination to address the increasing violence linked to drug trafficking.

In line with the pledge of the Global Coalition to address Synthetic Drug Threats that the EUcommitted to in September 2024, we are currently closely monitoring the risks of a potential increase in the supply and demand for synthetic opioids in Europe. This possible shift could represent unique challenges for public health systems and law enforcement.

Among such challenges is the growing number of illegal laboratories that produce synthetic drugs. Considering the threat they pose, Poland – on behalf of the EU – has tabled a resolution that draws attention to the protection of all those that are at the forefront of dismantling drug laboratories. Our aim is to set the ground for global standards in ensuring the safety of law enforcement officers, and we count on your support for this important resolution.

The EU and its Member States also call for greater consideration of development-oriented drug policies and alternative development measures, as well as the environmental damage linked to the direct and indirect impact of illicit drug crop cultivation, drug production and manufacture and drug policy responses. Conscious of the realities that shape our world, a resolution addressing the environmental impact of drugs has been tabled by France on behalf of the EU. This is atopic that needs more engagement from all of us, and we hope that you will back this resolution as well.

The EU and its Member States continue to emphasise that States are obliged to protect, promote and fulfilhuman rights, including when they develop and implement drug policies. All human beings are born free and equal in dignity and rights, and the EU and its Member States recall that the death penalty should be abolished globally. We condemn the use of capital punishment at all times and under all circumstances, including for drug-related offences. Additional measures should be taken for people in vulnerable and marginalised situations and to reduce stigma and discrimination. We underline that substance use disorders are a health issue requiring compassionateand evidence-based interventions. Stigmatisation and criminalisation of individuals with substance use disorders should be replaced with a health-centredapproach to reduce risks and harm.

Addressing drug-related harm also remains an important pillar of EU drug policy and the EU Drugs Strategy. The EU and its Member States are implementing a human rights-based approach with a range of measures in compliance with the three international drug conventions. The aim is to reduce drug supply and to take prevention, treatment, care and recovery measures, to reduce risk and harm to society and to the individual. We also ensure a meaningful involvement of scientific experts, civil society and affected communities. We urge the international community to further embrace pragmatic measures aimed at reducing the health and social harms, both for the individual and for society, associated with drug use. From needle and syringe exchange programmes to opioid agonist therapies, such evidence-based initiatives are essential for safeguarding public health and dignity. Prevention, treatment, care and recovery measures, risk and harm reduction must be expanded, adequately resourced, and firmly rooted in respect for human rights, as also set out in last year’s CND resolution 67/4 [on preventing and responding to drug overdose through prevention, treatment, care and recovery measures, as well as other public health interventions, to address the harms associated with illicit drug use as part of a balanced, comprehensive, scientific evidence-based approach].

In the context of current global drug-related challenges, it is important to stress that effective solutions can only be achieved through a balanced and whole-of-society approach as well as by engaging all relevant stakeholders, including health-care personnel, who provide critical support to those affected by substance use disorders; law enforcement officers, who risk their lives in targeting organised crime groups involved in drug production and trafficking; academia, which contributes with evidence-based research and innovative solutions; civil society organisations, which play an important role in prevention, and in risk and harm reduction initiatives. International cooperation is also indispensable to tackle the global drugs phenomenon and we count on the close involvement ofall relevant United Nations entities, including human rights bodies, to foster coordinated international action and inter-agency cooperation.

As set out in the high-level declaration by the CND on the 2024 mid-term review, we stress the urgent need for further ambitious, effective, improved and decisive actions as well as for more proactive, scientific evidence-based, comprehensive, balanced approaches to address drug-related challenges.

For that, we emphasise the critical importance of thorough data collection, monitoring, and scientific research. The European Union Drugs Agency is therefore key in developing Europe’s capacity to react to both current and future drug-related challenges, and we have made a concrete pledge in this regard at last year’s High-level segment of the CND.

Mr. Chair, to conclude,

Continuous drug-related challenges require our united front and cooperation to address them in the most effective and sustainable manner, and we count on global efforts to do so together. The EU and its Member States reaffirm their own commitment to fostering a comprehensive, inclusive, and balanced approach to addressing the world drug situation. We call on all Member States and stakeholders to join us in prioritising health, dignity, and human rights in all aspects of drug policy.

Thank you.

SOURCE: https://www.eeas.europa.eu/delegations/vienna-international-organisations/eu-statement-general-debate-68th-session-commission-narcotic-drugs-10-march-2025_en

This special section of the International Journal of Drug Policy brings together empirical and conceptual contributions to youth cannabis research through diverse methodological and critical social science approaches. Specifically, we present a collection of four empirical papers and three commentaries, all engaging with the central question, how can theoretical and methodological innovations advance youth and young adult-centered cannabis research, policy, and practice?
The current evidence base on cannabis use among youth and young adults under 30 years of age is limited by two key challenges. First, there is a strong emphasis on biomedical forms of knowledge production centred on individualistic understandings and abstinence-focused goals, with a tendency to overlook the broader social contexts that influence cannabis use patterns. Second, the incorporation of youth and young adult perspectives is lacking. In a shifting drug policy landscape where many nations and regions, including ours (Canada), have either legalized cannabis or are considering doing so, we need research approaches that can comprehensively examine the documented risks of cannabis use as well as those that can account for the social and structural contexts that shape youth and young adult substance use decision-making (Rubin-Kahana et al., 2022). To date; however, much of the research addressing youth and young adult cannabis use remains under-theorized, overly descriptive, and lacking in critical analysis of the links between substance use harms and social inequities (Kourgiantakis et al., 2024).
Over the last several decades, mounting research has documented the potential health harms of cannabis use, particularly for those who initiate early or consume regularly. This includes substantial evidence that identifies risks related to the onset of psychotic disorders, motor vehicle accidents, and cannabis use disorder as well as effects on educational and occupational outcomes (National Academies of Sciences, Engineering & Medicine, 2017). However, a focus on risks in the absence of considerations of lived experience or social-contextual influences restricts our understandings and may limit the development of impactful and supportive interventions for those who may benefit most.
At this juncture, we argue that in addition to rigorous examination of health impacts, there is a pressing need for inquiry using methodological approaches that meaningfully engage youth and young adults with lived experience of cannabis use in research, peer-based education, and advocacy and activism for policy and practice change. This is particularly important given that different populations experience varying levels of risk and protection based on their social and structural circumstances (Gunadi & Shi, 2022), while cannabis policy, education, and care continue to rely on a ‘one-size-fits-all’ approach, disregarding the diverse perspectives, experiences, patterns, and motivations of young people with regard to their cannabis use.
In preparing for this special section, we sought to collate research from diverse disciplines and geographic regions. We were particularly interested in highlighting research that moves beyond description towards theoretically engaged analyses, as well as research using participatory, arts-based, or youth engagement methodologies to understand youth and young adult cannabis use practices. Taken together, we envisioned that these papers would highlight new ways of theorizing, researching, and advocating in the global context of cannabis policy liberalization. We also hoped that this process would create new research connections among scholars with shared interests in this area. However, while various efforts were made to attract contributions from around the world, all but one of the final submissions were from Canada, with one additional contribution from Nigeria.
While the geographical representation is limited, the papers in this special section demonstrate innovative approaches to studying youth and young adult cannabis use while maintaining awareness of documented health risks. Bear and colleagues introduce “mindful consumption and benefit maximization” as a framework that acknowledges both potential risks and the importance of informed decision-making. They argue that harm reduction campaigns focused on cannabis risk, being received as stigmatizing or out of touch, given that cannabis is perceived by young consumers as a “relatively harmless drug” compared to other regulated substances, such as alcohol and tobacco. Instead of centering potential harms, mindful consumption and benefit maximization is presented as a strengths-oriented approach that aims to reduce stigma while promoting informed decision making to maximize positive experiences. Bear and colleagues offer that efforts to shift and better inform how young people make choices related to cannabis use can contribute new pathways for better preventing potential long-term consequences.
Another area of focus within the contributed articles included research problematizing the socio-structural contexts of cannabis use, foregrounding the perspectives of marginalized youth whose voices and life circumstances are often absent from the research literature, despite inequitably bearing the brunt of cannabis-related harms (Huang et al., 2020Jones, 2024Zuckermann et al., 2020). Haines-Saah and colleagues tackled the concept of “risk” among youth and young adults living with profound health and social inequities across several Canadian provinces. Using a youth-centred qualitative approach, this research makes visible the experiences of young people whose everyday lives are characterized by intersecting hardship and inequity. Within these circumstances, the risks of cannabis use are reconceptualised by the youth participants as they thoughtfully consider the ways that cannabis has served as a tool for survival while navigating historical and ongoing experiences of trauma and violence. Many of these youth also spoke to the ways that they engage in regular reflection about their cannabis use practices, informing efforts to reduce or abstain when recognizing that their use is too frequent or when experiencing adverse mental health effects.
Aligned with this focus on growing understandings of the cannabis use experiences and contexts of marginalized youth, Nelson and Nnam contributed a qualitative paper on cannabis use and harm reduction practices among youth and young adult women aged 21–35 living in Uyo, Nigeria. For young women in this setting, cannabis use was noted to progress quickly from more casual or social use, to frequent and heavy consumption. Aligned with the findings presented in Haines-Saah and colleagues’ Canadian research, the results of this study illustrate the ways that cannabis use and related risk is shaped by health and social contexts characterized by trauma and mental health challenges tied to marginalized social locations. Indeed, it is noted that in this setting, cannabis was used to “treat the psychological symptoms of structural inequalities”. Nelson and Nman powerfully argue that to make progress in supporting young people, interventions must target the social and structural roots of drug-related harms.
Examinations of the intersections between cannabis use and queer and trans youth identities was also a theme across several of the special section papers. Barborini and authors drew on community-based participatory research approaches, including photovoice, to examine how cannabis use features within the experiences of transgender, non-binary and gender non-conforming (TGNC) youth in the Canadian province of British Columbia. Barborini et al. identified how TGNC youth use cannabis in purposeful and strategic ways, including as they enact ‘non-normative’ gender expressions. They also found that TGNC youth use cannabis in to facilitate introspection, including as they advance personal discoveries about their gender identities and development. In their analysis, they describe how TGNC youth are using cannabis in emancipatory ways, with some of their sample describing how cannabis use is important for them in accessing moments of gender euphoria and affirmation, particularly given many of the broader social structural oppressions they face in their everyday lives.
London-Nadeau and colleagues’ research paper, led by their team of queer youth, presents a community-based qualitative study conducted in Quebec, Canada. In this paper, the authors demonstrate how certain populations face unique risks and challenges that require more tailored approaches. They action Perrin and colleagues’ (2020) Minority Strengths Model to advance understandings about how cannabis use features in queer and trans youth’s endeavours to “survive and thrive”. Here, cannabis was identified as supporting the production of an “authentic [queer and trans] self”, facilitating processes centering on self-exploration, introspection, and expression. Additionally, London-Nadeau and colleagues contributed a commentary presenting insights gained through conducting their empirical research. In this paper, they reflect on barriers and opportunities for cannabis research conducted by queer and trans youth, including the importance of “leading from the heart” in their efforts to connect with the shared cultures of their study participants while attuning to the ways that their experiences may differ, in part due to their academic affiliations that serve as a source of privilege within the context of knowledge production.
Finally, D’Alessio and colleagues offer details on their experiences with Get Sensible, a project of the Canadian Students for Sensible Drug Policy. In this reflection piece, the Get Sensible team describes how their work developing and implementing an educational toolkit challenged historical approaches to cannabis education by prioritizing young people’s voices, harm reduction, other evidence-based strategies, and peer-to-peer models. They also describe how, by drawing on a youth-led project design, the Get Sensible educational toolkit provides young people with the information they need to make empowered and informed decisions to minimize cannabis-related harms.
Across diverse geographical and drug policy contexts, cannabis remains one of the most widely used substances among youth and young adults. As such, there is a pressing need for knowledge generation that pushes boundaries to expand understandings beyond the confines of biomedical and risk-dominated paradigms. Moreover, drug policy scholarship, including that published in this journal, has advocated for research and practice that embodies the harm reduction principle of “nothing about us without us,” centering the expertise of people who use substances (e.g. Harris & Luongo, 2021Olding et al., 2023Piakowski et al., 2024Zakimi et al., 2024). When it comes to cannabis, or any substance use for that matter, it is our view that the impetus to protect youth from drug harms should not preclude their meaningful participation and leadership in drug prevention research and policy. The youth-centered scholarship and advocacy we highlight in this special issue is our contribution to prioritizing youth empowerment, not just their “protection.”
While our special section may not capture the full breadth of critical research being conducted with and for youth who use cannabis, the narrow geographical scope of the contributions underscores a degree of urgency for advancing innovative methodological approaches to youth and young adult cannabis research within and across global settings. We are nevertheless deeply inspired by the progress that has been made, as evidenced by the contributions in this special section, including those that critically challenge traditional approaches to cannabis use policy, education, and care via youth-centered research approaches. Ultimately, we hope that this issue will inspire a renewed research agenda that privileges the expertise of young people and engages with theories and methodologies that advance new understandings and possibilities for supporting cannabis use decision making and accompanying efforts to minimize potential harms.
Source: https://www.sciencedirect.com/science/article/pii/S0955395925000519

After achieving six months of sobriety, Horning has become a vocal advocate for comprehensive substance use prevention and education programs aimed at helping students in Warren County lead substance-free lives.

His initiative, developed in collaboration with Dr. Patricia Hawley-Mead and district officials, seeks to implement substance use prevention and education services across the school district. The goal of the initiative is to provide students, teachers, and parents with the education, community resources, and intervention strategies needed to prevent substance use and promote healthier lifestyle choices.

“If you were to tell me eight months ago I would be standing in front of you talking about substance abuse prevention and putting Narcan in AED boxes, I would have said you were crazy,” Horning shared with the audience during a recent school board meeting.

Horning’s passion for substance use prevention stems from his own difficult experience with addiction. He has openly shared his struggles with substance use, depression, and unhealthy coping mechanisms that led him down a painful path.

“My addiction was full of loss, hardships, and failures,” Horning explained. “Nothing seemed to work, nothing was helping me, and most importantly, I wasn’t helping myself. I’ve been in and out of psychiatrists’ offices, tried different medications, and felt completely lost. The only way I found recovery was by chance, but it shouldn’t be that way. We need a system in place to give students a way out before it’s too late.”

Looking back on his darkest moments, Horning admitted he never imagined he would be advocating for change in front of a crowd.

“I was not a great person at that moment in time,” he said, becoming emotional. “I made a lot of mistakes. My family, who is sitting behind me today, can tell you that. People inside and outside of school districts saw me at my worst. The disease of addiction is a lifelong battle that I will face until the day I die. But that does not mean it has to end in tragedy. That is why I am standing here today – to fight for others like me.”

Horning recognizes that many students turn to substances for a variety of reasons–whether out of boredom, depression, anxiety, or as a way to cope with personal struggles. His initiative is designed not only to educate students on the dangers of substance use but also to provide them with the tools and support systems they need to make better, healthier choices.

“This initiative will not only help students stay alive in case of an overdose, but it will help them find a way out of addiction and into a new life,” he emphasized. “Even if this helps just one person, it will all be worth it.”

INITIATIVE’S INSPIRATION

The inspiration behind Horning’s initiative came after a district-wide program held on September 18, 2024. During the event, public speaker Stephen Hill presented the First Choice & A Second Chance program to high school students. The program aimed to break the stigma surrounding substance use disorder, raise awareness about the ongoing drug epidemic, and encourage students to make healthier decisions.

Following the event, Horning was motivated to take action. He reached out to district administrators, safety officers, the school nurse department head, and a Family Services of Warren County drug and alcohol counselor to begin crafting a proposal for a comprehensive Substance Use Prevention and Education Service in the district.

The proposal calls for the establishment of educational programs that would teach students about the risks associated with substance use, provide early intervention services, and offer mental health support. Additionally, Horning’s plan includes provisions for Narcan to be available in school AED boxes, ensuring that life-saving measures are ready in case of an overdose emergency.

Hawley-Mead, who has worked closely with Horning on the initiative, stressed the importance of early intervention and prevention.

“The increasing prevalence of substance use among young people is a growing concern,” Mead said. “It poses a significant risk to their academic success, emotional well-being, and future prospects. Early prevention and education efforts have been shown to reduce substance use, improve student decision-making, and help create a more supportive and empathetic learning environment.”

Mead believes that by fostering a collaborative effort among educators, parents, and community partners, the district can proactively address the issue of substance use and equip students with the knowledge and support they need to thrive.

“This initiative will provide students, teachers, and parents with education, resources, and intervention strategies to support healthy choices and foster a positive, drug-free environment,” Mead said.

Horning concluded his speech with an emotional reflection on his own personal journey and the importance of offering help to others who may be struggling.

“What drove me to do this was really a lot of depression and unhealthy coping skills,” he shared. “I was not in the right mindset when I first used. I was not okay. If somebody had sat me down and told me, ‘We can help you,’ it could have saved me years of pain. That’s why we need this now. We need to offer students the opportunity to get help before it’s too late.”

Horning is determined to ensure that no student has to face the same struggles he did. His initiative is not only aimed at providing support for those already struggling with substance use but also preventing others from ever going down that difficult path.

“The only way I found recovery was by chance,” he admitted. “That’s the best way I can put it. Recovery is important, but when you are in an active addiction, it feels impossible to get through to someone. That’s why, eight months ago, I would have called you crazy if you told me I’d be standing here today. But now, I’m here. I have made myself a better person, and I want to give back for what I have found.”

Horning and district officials are now seeking approval from the school board and the community to bring this initiative to life in Warren County schools. Their goal is to integrate substance use prevention education into the curriculum, provide resources for students and families, and ensure that Narcan is available in AED boxes to help prevent potential overdose deaths.

“We don’t have to live in tragedy like other schools have,” Horning said. “We need to teach students how to use Narcan, how to stay alive, and most importantly, how to find a way out of addiction. Recovery is possible, and I want to show others that they don’t have to suffer alone.”

HORNING’S PROPOSAL

Horning’s written proposal outlines five key goals for the pilot initiative: Enhance school safety by increasing access to Narcan for emergency overdose response. Educate the school community about substance use prevention, intervention, and response strategies. Establish a student club focused on substance use awareness, prevention, and peer education to increase awareness and reduce stigma surrounding substance use disorder. Actively engage stakeholders, including students, staff, families, and community partners, to establish an anonymous and supportive program where students can learn about and advocate for substance use prevention. Create a district-sponsored club dedicated to promoting substance use prevention and education.

Hawley-Mead emphasized that while Narcan is already available in nurse’s offices during school hours, having it in AED boxes would ensure it’s accessible during after-school activities and weekend events.

“This proposal aims to make Narcan more widely available and accessible to first responders during emergencies, regardless of the time of day,” she said. “We want to ensure that this life-saving measure is available whenever and wherever it’s needed.”

Horning also reached out to Family Services of Warren County, which has expressed strong support for the initiative.

“They are very, very responsive towards this program,” Horning said. “I’ve spoken with counselors, including Nicole Neukum, executive director, and they’re all willing to give us whatever we need to make this a success.”

School board member Mary Passinger asked Horning if he felt comfortable sharing the personal story behind his addiction.

“It was really a lot of depression and unhealthy coping skills,” Horning responded. “I was not in the right mindset when I first used. If someone had told me, ‘We can help you,’ it could have saved me from years of pain.”

Board member John Wortman commended Horning for his bravery in speaking out and bringing this important issue to the district’s attention.

“There is nothing more important than standing up for what you believe in,” Wortman said. “The proposals outlined here will help make a significant, positive impact on students in Warren County. And that’s something we can all support.”

Superintendent Gary Weber also voiced his strong support for the initiative.

“We are 100% behind this initiative,” he said. “It’s clear that Jessie and Dr. Mead have worked hard to bring together stakeholders and develop a plan that will have a lasting and positive impact. We want to make sure this program is sustainable, and we’re committed to supporting it every step of the way.”

The district is currently reviewing Horning’s proposal, and community members are encouraged to get involved in supporting this critical initiative. For updates and information on how to help, individuals can reach out to district officials or Family Services of Warren County.

With this initiative, Horning hopes to not only save lives but also inspire others to break free from addiction and reclaim their futures.

“Recovery is possible,” he said. “And I want to show others that they don’t have to suffer alone.”

Source: https://www.timesobserver.com/news/local-news/2025/03/student-leads-charge-for-substance-use-prevention/

New Drug Prevention Guide issued to all schools to raise awareness about drug abuse

Abdulla Rasheed (Abu Dhabi Editor)  Last updated: 
The Ministry of Interior has warned adolescents and young individuals of both genders against the dangers of consuming certain medications, including sedatives, that can lead to addiction and even death due to excessive, non-prescribed use.Supplied

Abu Dhabi: The Ministry of Interior (MoI), in collaboration with the Drug Control Council and the National Drug Prevention Programme, has issued a Drug Prevention Guide, which has been distributed to all schools across the country.

Through the guide, the ministry has warned adolescents and young individuals of both genders against the dangers of consuming certain medications, including sedatives, that can lead to addiction and even death due to excessive, non-prescribed use.

What are sedatives?

Sedatives are medications designed to calm the patient and induce sleep by altering nerve signals in the central nervous system. They are commonly used to treat anxiety, stress, seizures, panic attacks, and sleep disorders.

Sedatives must be used with extreme caution. Misuse or mixing them with substances like alcohol can result in severe health complications, potentially life-threatening. Overuse can inhibit critical nerve signals to the heart, lungs, and other organs, leading to dangerous side effects.

Parents should be aware of the following indicators of sedative addiction:

• Unusual or aggressive behaviour.

• Lack of focus and attention.

• Health issues such as memory loss, movement difficulties, and low blood pressure.

Myths debunked

The guide also cautions against widespread misconceptions among students, such as the belief that these medications can treat depression, relieve physical fatigue, boost energy levels, or enhance memory. The ministry has clarified that such beliefs are entirely false and misleading. It said individuals who consume these drugs without a medical prescription risk falling into the trap of addiction, which can ultimately lead to fatal consequences.

The Ministry of Education has ensured its distribution to schools to assist parents in early detection of substance abuse, protect their children, and educate them on their role in safeguarding their kids from these harmful substances. It also raises legal awareness and provides details on how to access treatment and rehabilitation services within the country.

Additionally, the guide highlights seven key protective factors that can help prevent children from substance abuse. It warns against synthetic drugs disguised as dried leaves, which have devastating effects, as well as the misuse of prescription medications, which can lead to addiction and severe health complications, including death.

Risks of drug abuse

The first chapter of the “Parents’ Guide to Drug Prevention” provides information on the various substances that children might be exposed to and details their health consequences. These include:

• Physical effects: Heart and blood pressure disorders, digestive system complications, severe weight loss, liver infections, immune system deficiencies, epilepsy, and sudden death.

• Psychological effects: Sleep disorders, delusions, hallucinations, schizophrenia, anxiety, depression, social withdrawal, emotional instability, and suicidal tendencies.

• Economic effects: Reduced individual productivity and financial burdens associated with drug use and treatment.

The guide also covers different types of drugs, including inhalants, such as lighter gases, paint fumes, and glue, which are easily accessible but cause severe health risks, including brain and liver damage, limb numbness, headaches, nausea, hallucinations, kidney failure, respiratory failure, and allergic reactions around the nose and mouth.

Recognising signs of drug use

The guide outlines key indicators that can help identify drug abuse, such as:

• Excessive talking and hyperactivity without a clear reason.

• Unusual jaw movements (circular or counter-directional).

• High blood pressure, paranoia, and aggressive behavior.

The guide also warns against addiction to certain prescription medications like:

Painkillers, which can cause respiratory depression, brain damage, and even death.

Depressants, which may result in blurred vision, nausea, difficulty concentrating, and fatal consequences if combined with alcohol.

Stimulants, which can lead to high body temperature, paranoia, and other harmful effects when misused.

Parents can detect prevent drug addiction among children in the following ways:

     2. Open dialogue: Engaging in calm discussions with children about concerns without making accusations.

     3. Empathy and understanding: Being prepared for emotional reactions, such as anger or threats of leaving home, and responding with reassurance and support.

     4. Being firm but loving: Setting clear household rules while expressing care and concern.

     5. Persistence: If discussions become overwhelming, parents should take a break and resume later.

     6. Seeking professional guidance: If a child refuses to talk or get help, parents should consult treatment centers for advice.

     7.Consulting specialists: Parents should seek expert assistance to organise their thoughts and receive proper guidance.

 

Source: https://gulfnews.com/uae/government/uae-ministry-warns-students-against-consuming-sedatives-1.500050438

Authors:
Christopher Williams
Kenneth W. Griffin
Sandra M. Sousa
Gilbert J Botvin – Weill Cornell Medicine
  • February 2025
  • Psychology of Addictive Behaviors

Abstract and Figures

Objective: School-based health promotion programs can have a positive effect on behavioral and social outcomes among adolescents. Yet, limited classroom time and suboptimal program implementation can reduce the potential impact of these interventions. In the present randomized trial, we tested the effectiveness of a classroom-based substance use prevention program that was adapted for hybrid implementation. Method: The hybrid adaptation included eight asynchronous e-learning modules that presented didactic content and eight classroom sessions designed to facilitate discussion and practice of refusal, personal self-management, and general social skills. Nineteen high schools were randomly assigned to intervention or control conditions. Students (N = 1,235) completed confidential online pretest and posttest surveys to assess the effects of the intervention on tobacco and alcohol use and life skills. The sample was 50.7% female and 35.5% non-White with a mean age of 15.2 years. Results: Analyses revealed significant program effects on current cigarette smoking, alcohol use, drunkenness, and intentions for future use. There were also program effects for communication, media resistance, anxiety management, and refusal skills. Conclusions: Taken together, these findings suggest that hybrid approaches can produce robust prevention effects and may help reduce barriers to the widespread adoption and implementation of evidence-based prevention programs.

 

To access the full document:  Click on the ‘Source’ link below.

Source:  https://www.researchgate.net/publication/389399186_Preventing_tobacco_and_alcohol_use_among_high_school_students_through_a_hybrid_online_and_in-class_intervention_A_randomized_controlled_trial/fulltext/67c174cb207c0c20fa9ac7ba/Preventing-Tobacco-and-Alcohol-Use-Among-High-School-Students-Through-a-Hybrid-Online-and-In-Class-Intervention-A-Randomized-Controlled-Trial.pdf?

A vast majority of American adults say they have consumed alcohol at some point — yet experts warn that alcoholic beverages could be a “gateway drug” to more harmful substances.

More than 84% of adults in the U.S. report having drunk alcohol in their lifetime, according to the 2023 National Survey on Drug Use and Health (NSDUH).

That same survey found that among underage Americans (12 to 17 years of age), more than 21% had consumed alcohol.

What is a ‘gateway drug’?

Dr. Kenneth Spielvogel, senior medical officer at Carrara Treatment in California, defined a “gateway drug” as a substance that exposes someone to other drugs.

Man drinking alcohol

More than 84% of adults in the U.S. report having drunk alcohol in their lifetime, according to the 2023 National Survey on Drug Use and Health. (iStock)

Marijuana is often pegged as a “classic gateway drug,” he told Fox News Digital, as it can lead to cocaine, heroin and other “harder drugs” that present a greater threat to loss of life via impaired driving and other volatile behaviors.

“Alcohol maintains a firm grip on a large portion of the adult population.”

“Any substance that impairs judgment is potentially a gateway drug, in my opinion — however, alcohol is the king of this,” Spielvogel said. “It maintains a firm grip on a large portion of the adult population.”

“I personally have seen the ravages of this — hungover victims turn to meth, cocaine and other drugs for the ‘pick me up’ they feel they need.”

Why alcohol can be a ‘gateway’

For many young people, alcohol is the first substance they try, according to Chris Tuell, a clinical psychotherapist and a chemical and behavioral addiction specialist at the Lindner Center in Mason, Ohio. This makes them more likely to experiment with other drugs later.

“Most people can use alcohol and it does not become problematic — but for some, it is destroying their lives,” he said in an interview with Fox News Digital.

Smoking marijuana

Marijuana is often pegged as a “classic gateway drug,” but one expert said that “alcohol is the king” when it comes to impairing judgment. (iStock)

Consumption of alcohol impairs judgment and decision-making, which can lead to riskier behaviors, including trying other substances, Tuell noted.

“Studies indicate that alcohol alters brain chemistry in ways that increase susceptibility to drug addiction,” the expert cautioned.

Jeremy Klemanski, addiction specialist and CEO of Gateway Foundation in Chicago, echoes his belief that alcohol is a gateway drug.

“We often hear reports from patients that they only use or started using while drinking, or that they were first exposed to alcohol and then tried other drugs for greater physical symptoms and feelings,” he told Fox News Digital.

friends with drinks

Research from the National Institute of Drug Abuse suggests that early exposure to alcohol can “prime the brain” for heightened responses to other drugs. (iStock)

“It is also important to note that once a person has used one mind-altering substance, their general thinking skills are impaired on some level,” he went on. “Other things they might not normally do become easier to justify or accept as an idea to act on.”

There is also a neurological element that comes into play, according to Dr. David Campbell, clinical director and program director at Recover Together Bend in Oregon.

“Alcohol affects neurotransmitter systems that are involved in the reward pathways that are similarly targeted by other drugs,” he told Fox News Digital.

Research from the National Institute of Drug Abuse suggests that early exposure to alcohol can “prime the brain” for heightened responses to other drugs, perhaps increasing the risks of the “gateway effect,” Campbell added.

Other factors at play

Experts emphasized that correlation does not equal causation.

“Just because people who use harder drugs often drink alcohol first does not necessarily mean alcohol caused their drug use,” Tuell noted.

Refusing beer

“There are few drugs where the sudden stoppage of their use can be deadly — alcohol is one of these,” an addiction specialist warned. (iStock)

Campbell agreed, noting that many “contextual factors and psychosocial stressors” should be considered within the broader context of someone’s life.

“Social environment, stressors, ease and proximity to access, social influences, mental health conditions, childhood trauma, genetics and other biological factors may all play a role,” he told Fox News Digital.

When and how to stop

Spielvogel shared some warning signs that someone may be dependent on alcohol and more susceptible to trying other harmful substances.

“One sign is if they have ever tried to cut down on their drinking and failed,” he said. “Also, they may be annoyed when asked about their alcohol consumption.”

People with alcohol dependency may also feel guilty when they drink, or they might consume alcoholic beverages in the morning, he added.

“It is very important that if someone has a use disorder, they seek professional help for their detox and recovery.”

Stopping “cold turkey” may not be the healthiest route, Spielvogel cautioned.

“There are few drugs where the sudden stoppage of their use can be deadly — alcohol is one of these,” he said.

“I cannot stress this enough; it is very important that if someone has a use disorder, they seek professional help for their detox and recovery, whether it’s a private treatment facility or going to a medical professional.”

“Do not do this on your own.”

Home
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The United Nations Office at Geneva

 

Synthetic drugs are rapidly transforming the global drug trade, fuelling an escalating public health crisis, according to the UN administered International Narcotics Control Board (INCB).

In its 2024 Annual Report, released on Tuesday, the INCB explains that unlike plant-based drugs, these substances can be made anywhere, without the need for large-scale cultivation, making them easier and cheaper for traffickers to produce and distribute.

The rise of powerful opioids like fentanyl and nitazenes – potent enough to cause overdoses in tiny doses – has worsened the crisis, driving record-high deaths.

“We need to work together to take stronger action against this deadly problem which is causing hundreds of deaths and untold harm to communities,” he continued.

Traffickers stay ahead of regulations

Criminal groups are constantly adapting to evade law enforcement.

By exploiting legal loopholes, they develop new synthetic compounds and use artificial intelligence to find alternative chemicals for drug production.

New smuggling methods – including drones and postal deliveries – make these drugs harder to detect.

As a result, seizures of synthetic substances are now outpacing those of traditional plant-based drugs like heroin and cocaine.

Patchwork response

Despite efforts to curb synthetic drugs, responses remain fragmented, allowing traffickers to stay ahead.

The INCB is calling for stronger global cooperation, including partnerships between governments, private companies and international organizations, to disrupt supply chains and prevent harm.

Medication out of reach

While synthetic drugs flood illegal markets, millions of people in low- and middle-income countries still lack access to essential pain relief medication.

The report highlights that opioid painkillers such as morphine, remain unavailable in regions like Africa, South Asia and Central America – not due to supply shortages, but because of barriers in distribution and regulation.

The INCB is urging opioid-producing nations to increase production and affordability to improve palliative care and pain management.

Regional hotspots concerns

The report identifies several regions where synthetic drug trafficking is expanding.

In Europe, the looming heroin deficit following Afghanistan’s 2022 opium ban could push more users toward synthetic alternatives while in North America, despite efforts to curb the crisis, synthetic opioid-related deaths remain at record highs.

The manufacture, trafficking and use of amphetamine-type stimulants are increasing across the Middle East and Africa, where treatment and rehabilitation services are often inadequate.

Meanwhile, in the Asia-Pacific region, methamphetamine and ketamine trafficking continues to grow, particularly in the Golden Triangle.

Call for urgent action

The INCB is urging governments to strengthen international collaboration, improve data-sharing and expand drug prevention and treatment services.

Without decisive action, the synthetic drug trade will continue to evolve, putting more lives at risk.

 

Arizona State University


Children seen from behind sit next to each other with their arms around each other while looking out at a large body of water.

Over the past 20 years, science-based interventions and treatments using a statistical method called mediation analysis have contributed to reduced rates of smoking and drinking among teenagers and young adults in the U.S. Research from Arizona State University has developed these statistical techniques, which save time and money and are now used widely in psychology, sociology, biology, education and medicine. Many of available medical treatment options are the result of clinical trials that used mediation to figure out what worked.

Image by Duy Pham/Unsplash

by Kimberlee D’Ardenne –

Smoking rates among teenagers today are much lower than they were a generation ago, decreasing from 36% in the late 1990s to 9% today. The rates of alcohol consumption among underage drinkers have also decreased. At the turn of the century, people aged 12–20 years drank 11% of all the alcohol consumed in the U.S. Today, they only drink 3%.

These decreases are in part the result of science-based interventions that were designed to prevent substance use. But these interventions would not have been possible without statistical methods, including a statistical method called mediation analysis that lets researchers understand why an intervention or treatment succeeds or fails. Mediation analysis also identifies how aspects of a substance use reduction program or medical treatment cause its success.

About this story

There’s a reason research matters. It creates technologies, medicines and other solutions to the biggest challenges we face. It touches your life in numerous ways every day, from the roads you drive on to the phone in your pocket.

The ASU research in this article was possible only because of the longstanding agreement between the U.S. government and America’s research universities. That compact provides that universities would not only undertake the research but would also build the necessary infrastructure in exchange for grants from the government.

That agreement and all the economic and societal benefits that come from such research have recently been put at risk.

Prevention makes our lives better — and it saves money. Though smoking and drinking rates among adolescents are on the decline, there is still room for mediation analyses to save the U.S. more money. According to the National Institute on Alcohol Abuse and Alcoholism, misusing alcohol costs the U.S. $249 billion. The Centers for Disease Control and Prevention report that cigarette smoking costs the U.S. around $600 billion, including $240 billion in health care spending and over $300 billion in lost productivity from smoking-related deaths and illnesses.

David MacKinnon, Regents Professor of psychology at Arizona State University, has been studying and using mediation analyses for the past 35 years because of the many practical applications — and because they work really well.

“I like using science and math to address serious health problems like smoking, drug abuse and heart disease,” MacKinnon said. “Mediation analyses let us extract a lot of information from data and have the promise of identifying mechanisms by which effects occur that could be applicable to other situations.”

Unlike a third wheel, third variables are crucial — and causal

There are many paths to a teenager ending up struggling with substance abuse. They might struggle with impulsivity in general — or they might have parents who fight often, or maybe their friends get drunk most weekends.

Because there is more than one way to connect risk factors to substance use, scientists often have to take an indirect path that considers variables like parenting style or peer influences.

“Most research looks at the relationship between two variables — like risk-taking and substance use — but there can be a lot happening in between, and those ‘third variables’ can cause the outcome,” MacKinnon explains.

Long-lasting impacts

Adolescents who experiment with drugs and alcohol at a young age are more likely to develop lifelong substance abuse problems. A psychology department research team led by Nancy Gonzales, executive vice president and university provost, used mediation to create a program that decreases alcohol use in teenagers who started drinking at a young age.

The program brought families to their child’s school for a series of interactive sessions. Each session taught a skill, such as good listening practices or strategies for talking about difficult topics, and parents and students practiced as a family. Just spending 18 hours in the program produced protective effects against teenage alcohol misuse that lasted at least five years. By their senior year, kids who had participated in the program as seventh graders were drinking less.

This reduced alcohol consumption is important because even small reductions in adolescent drinking can have a cascade effect on other public health problems like alcoholism and drug abuse disorders, risky sexual behavior and other health problems.

Helping children of divorce

Close to half of all marriages in the U.S. end in divorce, affecting over 1 million children each year. These children are at an increased risk of struggling in school, experiencing mental health or substance use problems and engaging in risky sexual behavior. Mediation analyses have shown that a lot of these risks stem from conflict between divorced or separated parents, which creates fear of abandonment in children and contributes to future mental health symptoms.

Prevention scientists working in ASU’s Research and Education Advancing Children’s Health Institute leveraged decades of work using mediation to create an online parenting skills program for separated or divorced couples. The program reduces interparental conflict and decreases children’s anxiety and depression symptoms.

The answers to ‘why’ and ‘how’ questions save time and money

How much do school-based prevention programs decrease teen vaping rates? Why do monetary incentives and mobile clinics increase local vaccination rates?

Answering “how” and “why” questions like these require scientists to figure out what exactly caused a decrease in teen vaping or the reasons that caused more people to roll up their sleeves and get vaccinated. Causation can happen in many ways and can even be indirect, and mediation can accurately find the cause.

Mediation analysis strategies MacKinnon has developed are now used widely, in medicine, psychology, sociology, biology and education. And, many of the treatment options our doctors can offer us are possible because of clinical trials that used mediation to figure out what worked.

Mediation analysis lets researchers pull more information from scientific studies, which is why the National Institutes of Health recommends research proposals include a section evaluating why and how treatments or interventions work.

Source: https://news.asu.edu/20250304-science-and-technology-asu-research-helps-prevent-substance-abuse-mental-health-problems

 

Jennifer Carroll, a public health and addiction researcher at North Carolina State University, wrote a national guide on how counties can invest opioid settlement funds in youth-focused prevention. (Nathaniel Gaertner/TNS)
Jennifer Carroll, a public health and addiction researcher at North Carolina State University, wrote a national guide on how counties can invest opioid settlement funds in youth-focused prevention. (Nathaniel Gaertner/TNS)

A Kentucky county nestled in the heart of Appalachia, where the opioid crisis has wreaked devastation for decades, spent $15,000 of its opioid settlement money on an ice rink.

That amount wasn’t enough to solve the county’s troubles, but it could have bought 333 kits of Narcan, a medication that can reverse opioid overdoses. Instead, people are left wondering how a skating rink addresses addiction or fulfills the settlement money’s purpose of remediating the harms of opioids.

Like other local jurisdictions nationwide, Carter County is set to receive a windfall of more than $1 million over the next decade-plus from companies that sold prescription painkillers and were accused of fueling the overdose crisis.

County officials and proponents of the rink say offering youths drug-free fun like skating is an appropriate use of the money. They provided free entry for students who completed the Drug Abuse Resistance Education (D.A.R.E.) curriculum, recovery program participants, and foster families.

But for Brittany Herrington, who grew up in the region and became addicted to painkillers that were flooding the community in the early 2000s, the spending decision is “heartbreaking.”

“How is ice-skating going to teach [kids] how to navigate recovery, how to address these issues within their home, how to understand the disease of addiction?” said Herrington, who is now in long-term recovery and works for a community mental health center, as well as a regional coalition to address substance use.

She and other local advocates agreed that kids deserve enriching activities, but they said the community has more pressing needs that the settlement money was intended to cover.

Carter County’s drug overdose death rate consistently surpasses state and national averages. From 2018 to 2021, when overdose deaths were spiking across the country, the rate was 2.5 times as high in Carter County, according to the research organization NORC.

Other communities have used similar amounts of settlement funding to train community health workers to help people with addiction, and to buy a car to drive people in recovery to job interviews and doctors’ appointments.

Local advocates say $15,000 could have expanded innovative projects already operating in northeastern Kentucky, like First Day Forward, which helps people leaving jail, many of whom have a substance use disorder, and the second-chance employment program at the University of Kentucky’s St. Claire health system, which hires people in recovery to work in the system and pays for them to attend college or a certification program.

“We’ve got these amazing programs that we know are effective,” Herrington said. “And we’re putting an ice-skating rink in. That’s insane to me.”

A yearlong investigation by KFF Health News, along with researchers at the Johns Hopkins University Bloomberg School of Public Health and the national nonprofit Shatterproof, found many jurisdictions spent settlement funds on items and services with tenuous, if any, connections to addiction. Oregon City, Oregon, spent about $30,000 on screening first responders for heart disease. Flint, Michigan, bought a nearly $10,000 sign for a community service center building , and Robeson County, North Carolina, paid about $10,000 for a toy robot ambulance.

Although most of the settlement agreements come with national guidelines explaining the money should be spent on treatment, recovery, and prevention efforts, there is little oversight and the guidelines are open to interpretation.

A Kentucky law lists more than two dozen suggested uses of the funds, including providing addiction treatment in jail and educating the public about opioid disposal. But it is plagued by a similar lack of oversight and broad interpretability.

Chris Huddle and Harley Rayburn, both of whom are elected Carter County magistrates who help administer the county government, told KFF Health News they were confident the ice rink was an allowable, appropriate use of settlement funds because of reassurances from Reneé Parsons, executive director of the Business Cultivation Foundation. The foundation aims to alleviate poverty and related issues, such as addiction, through economic development in northeastern Kentucky.

The Carter County Times reported that Parsons has helped at least nine local organizations apply for settlement dollars. County meeting minutes show she brought the skating rink proposal to county leaders on behalf of the city of Grayson’s tourism commission, asking the county to cover about a quarter of the project’s cost.

In an email, Parsons told KFF Health News that the rink — which was built in downtown Grayson last year and hosted fundraisers for youth clubs and sports teams during the holiday season — serves to “promote family connection and healing” while “laying the groundwork for a year-round hockey program.”

“Without investments in prevention, recovery, and economic development, we risk perpetuating the cycle of addiction in future generations,” she added.

Icelandic Model of Prevention

Reneé Parsons went on to say that the rink, as well as an $80,000 investment of opioid settlement funds to expand music and theater programs at a community center, fit with the principles of the Icelandic prevention model, “which has been unofficially accepted in our region.”

That model is a collaborative community-based approach to preventing substance use that has been highly effective at reducing teenage alcohol use in Iceland over the past 20 years. Instead of expecting children to “just say no,” it focuses on creating an environment where young people can thrive without drugs.

Part of this effort can involve creating fun activities like music classes, theatrical shows, and even ice-skating. But the intervention also requires building a coalition of parents, school staffers, faith leaders, public health workers, researchers, and others, and conducting rigorous data collection, including annual student surveys.

About 120 miles west of Carter County, another Kentucky county has for the past several years been implementing the Icelandic model. Franklin County’s Just Say Yes program includes more than a dozen collaborating organizations and an in-depth annual youth survey. The project began with support from the Centers for Disease Control and Prevention and has also received opioid settlement dollars from the state.

Parsons did not respond to specific questions about whether Carter County has taken the full complement of steps at the core of the Icelandic model.

If it hasn’t, it can’t expect to get the same results, said Jennifer Carroll, a researcher who studies substance use and wrote a national guide on investing settlement funds in youth-focused prevention.

“Pulling apart different elements, at best, is usually going to waste your money and, at worst, can be counterproductive or even harmful,” she said.

At least one Carter County magistrate has come to regret spending settlement funds on the skating rink.

Millard Cordle told KFF Health News that, after seeing the rink operate over the holidays, he felt it was “a mistake.” Although younger children seemed to enjoy it, older kids didn’t engage as much, nor did it benefit rural parts of the county, he said. In the future, he’d rather see settlement money help get drugs off the street and offer people treatment or job training.

“We all learn as we go along,” he said. “I know there’s not an easy solution. But I think this money can help make a dent.”

As of 2024, Carter County had received more than $630,000 in opioid settlement funds and was set to receive more than $1.5 million over the coming decade, according to online records from the court-appointed settlement administrator.

It’s not clear how much of that money has been spent, beyond the $15,000 for the ice rink and $80,000 for the community arts center.

It’s also uncertain who, if anyone, has the power to determine whether the rink was an allowable use of the money or whether the county would face repercussions.

Kentucky’s Opioid Abatement Advisory Commission, which controls half the state’s opioid settlement funds and serves as a leading voice on this money, declined to comment.

Cities and counties are required to submit quarterly certifications to the commission, promising that their spending is in line with state guidelines. However, the reports provide no detail about how the money is used, leaving the commission with little actionable insight.

At a January meeting, commission members voted to create a reporting system for local governments that would provide more detailed information, potentially opening the door to greater oversight.

That would be a welcome change, said John Bowman, a person in recovery in northeastern Kentucky, who called the money Carter County spent on the ice ink “a waste.”

Bowman works on criminal justice reform with the national nonprofit Dream.org and encounters people with substance use disorders daily, as they struggle to find treatment, a safe place to live, and transportation. Some have to drive over an hour to the doctor, he said — if they have a car.

He hopes local leaders will use settlement funds to address problems like those in the future.

“Let’s use this money for what it’s for,” he said.

 

Source: https://www.timesfreepress.com/news/2025/mar/03/an-ice-rink-to-fight-opioid-crisis-drug-free-fun/

by Monte Stiles, drug-watch-international@googlegroups.com

In a decisive victory, the Idaho House of Representatives has passed HJR 4 with an overwhelming 58-10 vote.

HJR 4 proposes a constitutional amendment that would give Idahoans the power to proactively determine the state’s future regarding drug legalization and normalization. If approved by the Senate and ratified by voters in November 2026, this amendment will ensure that ONLY the Idaho Legislature has the authority to legalize the manufacture, sale, possession, and use of marijuana, narcotics, and other psychoactive substances—preventing outside influences from dictating Idaho’s future.

Idaho’s firm stance against foolish laws and policies has earned it the reputation of being “the most hostile state in America for drug legalization.” The passage of HJR 4 reinforces this position, further establishing Idaho as “an island of sanity in a sea of insanity.”

With 29 co-sponsors in the House and 19 in the Senate, the bill now moves to the Senate for consideration.

Note to readers in USA: Please take a moment to thank your Representatives for taking this important proactive stand in protecting Idaho’s future. And then let your Senators know of your support.

Source: Drug Watch International

By Tina Underwood – February 23, 2025

Data from the Centers for Disease Control and Prevention show there were about 107,000 drug overdose deaths in the United States in 2023. Of those, about 75 percent, or 81,000, involved opioids.

With the aim of reducing those statistics, Lauren Jones ’22, who is in a post-baccalaureate at Harvard University, Brenna Outten ’22, a third-year doctoral student at Caltech and Leah Juechter ’24, who is working temporarily as a medical assistant, used computational chemistry as undergraduates at Furman to study the impacts of synthetic opioids.

Their work, with collaborators at Hendrix College and California State University, Los Angeles, was published in December in The Journal of Physical Chemistry B.

To say the project was formative for Jones and Outten is an understatement. They laid the foundation for the study during the height of COVID when traditional wet labs were all but shuttered.

“It’s amazing we were able to continue the work virtually during the pandemic,” said Jones, who researches sensory processing in children with autism and brain activity in children with rare neurodevelopmental and neurogenetic disorders at Boston Children’s Hospital.

Outten said the project “opened my eyes to how a scientist can contribute to fields like neuroscience, chemistry, biology and physics in ways I had never considered before.”

The paper focuses on work targeting the mu opioid receptor, or MOR. It resides mainly in the central nervous system and the GI tract. It’s like a molecular lock waiting for the right key (a drug like morphine or fentanyl) to unlock or activate a favorable response, such as reduced pain signals. But the same drugs can activate negative responses like drug tolerance, constipation, respiratory depression, addiction and overdose.

“There’s a lot we don’t understand about how opioids interact with the receptors embedded on nerves that mitigate the pain-signaling process,” Juechter said. “So the more we can uncover about how these drugs are interacting with the receptors in our bodies and the responses we feel, the better we’re able to help create pain therapeutics with reduced adverse effects and more beneficial safety profiles.”

What makes the researchers’ study unique is the application of both quantum mechanics conducted by Juechter, Outten and Jones, led by chemistry Professor George Shields, and molecular dynamics carried out by teams at Cal State and Hendrix College.

“It was interesting to see two drugs (morphine and fentanyl) that elicit almost identical effects are binding to the receptor in completely different ways,” Juechter said. “And to demonstrate that with highly accurate quantum mechanics was one of the first times we’ve seen that done.”

The manner in which opioids bind to MOR is diverse and complex. “So the need for a precise computing model becomes essential,” Juechter explained. “Even slight variations in calculations can drastically affect the data and subsequent conclusions.”

The ability to do research computationally can make drug development faster and cheaper, Juechter added. “Being able to paint the picture of what’s going on using empirically-supported mathematical theories, we can streamline the initial process of drug development.”

Impactful undergraduate research is a hallmark of The Furman Advantage, a four-year approach to education that creates a pathway for students to determine who they want to be and how they want to contribute to the world once they leave the university.

Juechter spent about eight months post-graduation fine-tuning the work with her co-authors before the paper was published.

“It was exceedingly evident Dr. Shields wanted to elevate me and give me the opportunity to pursue research,” Outten said.

Juechter hopes the project will set the tone for organic chemists involved in drug research and development.

“I want a role in the health care industry because I like the idea of affecting someone’s life in real time, in a positive way,” she said.

 

Source: https://www.furman.edu/news/neuroscience-grads-studied-how-to-make-opioids-safer

Kentucky has battled the opioid crisis for decades, but a new drug prevention campaign targeting youth could protect future generations.

Attorney General Russell Coleman launched the “Better Without It” campaign in partnership with the University of Kentucky, the University of Louisville and Western Kentucky University Wednesday, Feb. 19 at the State Capitol. 

The statewide education campaign will encourage young people to be independent, make their own decisions and stay informed about the dangers of drug use, while also highlighting the positive effects of a drug-free lifestyle. The prevention campaign is modeled after a Florida initiative targeting youth ages 13-26. 

The “first-of-its-kind” campaign in Kentucky will include student-athletes from UK, UofL and WKU. 

 “To reach Kentucky’s young people with an effective statewide drug prevention message, we need the right messengers. That’s why we’re partnering with some of the biggest names in Kentucky’s college athletics to tell the commonwealth’s young people they are truly better without it,” Coleman said in a news release. “Whether you’re a Hilltopper, you throw an “L” or you bleed blue, this is our chance to come together to save lives.”

Through name, image and likeness agreements, or NIL, athletes such as UK basketball’s Trent Noah, UofL basketball’s J’Vonne Hadley and WKU basketball’s Tyler Olden will be some of the first participants in the “Better Without It” campaign. 

The main outlet of this campaign will be through social media platforms. Apps such as TikTokInstagram, and Snapchat will all be utilized to promote positive messages about a drug-free lifestyle. 

According to a Pew Research Center survey, in 2024, 96% of teens between the ages of 13 to 17 report using the internet daily, 73% report visiting YouTube daily, 57% said they visited TikTok daily, 50% said they visited Instagram daily and 48% said they visited Snapchat daily. In today’s world, social media is the most effective way to influence the opinions of the future generation.

Aside from social media content, the athletes will also attend on-campus and sporting events to promote their message.

The Kentucky Opioid Abatement Advisory Commission approved Coleman’s two-year, $3.6 million proposal to establish a research-backed youth drug prevention initiative in September.

The commission was created by the legislature in 2021 to distribute the state’s portion of the $900 million in settlements with opioid manufacturers and distributors. Half of the money goes to the state and the other half to local governments.

 “Partnering with our state universities and student-athletes is a great way to reach our youth to promote substance use prevention,” Cabinet for Health and Family Services Secretary and Opioid Commission member Eric Friedlander, said in the release. 

The “Better Without It” campaign will spread across Kentucky in the upcoming months, using the power of social media, popular athletes and influencers to fight against harmful drugs. 

In addition to the “Better Without It” campaign, the prevention program will also promote existing school-based programs and amplify the work of the commission to support youth-focused prevention efforts.

According to the Kentucky Office of Drug Control Policy, 1,984 Kentuckians died from an overdose death in 2023. Between 2021 and 2023, 101 of those deaths were in Kentuckians aged 24 and younger.

Ella Denton is a student at the University of Kentucky College of Public Health and a spring intern for Kentucky Health News, an independent news service of the Institute for Rural Journalism in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky. 

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Media at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Teen non-medical misuse of medications may be more common than we believed.

by Mark Gold M.D. – Professor of Psychiatry, Yale, Florida and Washington Universities

Updated  |  Reviewed by Gary Drevitch

Key points

  • Teen nonmedical misuse of medications may be more common than previously reported.
  • Adolescents misuse dextromethorphan (DXM) products for their dissociative/hallucinogenic effects and euphoria.
  • A recent alert highlights increasing adolescent interest in using DXM and promethazine together

According to Sharon Levy, MD,Harvard Medical School’s pediatric addiction expert, nonmedical medication misuse may be much more common than previously reported. One of the older fads is in the news again: getting high from cough and cold medicines containing dextromethorphan (DXM). This drug is sometimes combined with prescribed promethazine with codeine. At very high doses, DXM mimics the effects of illegal drugs like phencyclidine (PCP) and ketamine.

More than 125 over-the-counter (OTC) medicines for cough and colds contain DXM. It’s in Coricidin, Dimetapp DM, Nyquil, Robitussin Cough and Cold, and store brands for cough-and-cold medicines. These products are available in pharmacies, grocery stores, and other retail outlets. A safe dose of products with DXM is about 15-30 milligrams (mg) over 24 hours. It usually takes 10 times that amount to make a teenager high.

Teen DXM Slang

syrup head is someone using cough syrups with DXM to get high. Dexing is getting high on products with DXM. Orange Crush alludes to some cough medicines with DXM. (The name may stem from the orange-colored syrup—and packaging—Delsym.)

Poor man’s PCP and poor man’s X are also common terms, because these drugs are inexpensive, but can cause effects similar to PCP or ecstasy at high doses. Red devils refer to Coricidin tablets or other cough medicines. Robo usually refers to cough syrup with DXM. It derives from the brand name Robitussin but is common slang for any cough syrup. Robo-tripping alludes to abusing products with DXM and, specifically, to the hallucinogenic trips people can attain at high doses.

Parents who hear teens using these terms should ask questions when the child and parent are alone.

Prevalence and Trends

The Monitoring the Future (MTF) survey, conducted by the National Institute on Drug Abuse (NIDA) and the University of Michigan, provides insights into adolescent substance use. The survey began monitoring OTC cough-and-cold medication abuse every year in 2006. That year, the MTF reported that 4.2% of 8th-graders, 5.3% of 10th-graders, and 6.9% of 12th-graders misused OTC cough-and-cold medications in the previous year. In 2015, 2.6% of 8th-graders, 3.3% of 10th-graders, and 4.0% of 12th-graders reported past-year misuse. The most recent data, in 2024, indicate that the percentage dropped somewhat. However, a recent alert from the National Drug Early Warning System at the University of Florida (NDEWS) suggests a resurgence of interest in DXM and its combination with antihistamines.

DXM+ Combination Dangers

When taken alone, DXM’s dissociative and hallucinogenic effects may include euphoria, altered perception of time, paranoia, disorientation, and hallucinations. Physical symptoms of intoxication are hyperexcitability, problems walking, involuntary eye movements, and irritability. High doses can lead to impaired motor function, numbness, nausea and vomiting, increased heart rate, and elevated blood pressure. Chronic misuse results in dependence and severe psychological or physical health issues.

Combining DXM with other substances, especially alcohol, sleeping pills, antihistamines, or tranquilizers, is highly risky, as is combining DXM with antidepressants affecting serotonin, due to the risk of a possibly life-threatening serotonin syndrome.

Combining DXM With Promethazine

Combining the abuse of the prescribed antihistamine promethazine (Phenergan) with DXM may be increasing. The recent alert from the National Drug Early Warning System suggested that this new combination is an emerging threat.

The NDEWS recently checked for recent reports of saccharine (artificial sugar) being detected in abused drugs. Putting on their detective hats, the NDEWS team discovered that increased saccharine in drugs was caused by users adding cough syrup to promethazine. The signal for this combination was detected in more than double the number noted in early 2024.

Combining DXM and promethazine can amplify central nervous system depression, leading to increased drowsiness, dizziness, and impaired motor function. High doses may cause aggression, severe respiratory depression, hallucinations, delirium, paranoia, and cognitive impairments. Reddit social media reports noted an increased risks of falls and injuries due to severely impaired coordination and balance from the DXM-and-promethazine combination.

Promethazine with codeine is still available by prescription in the U.S., but access is restricted due to its classification as a Schedule V controlled substance at the federal level. Pharmacies and healthcare providers have become more cautious in prescribing promethazine with codeine due to its association with recreational use. Some manufacturers have discontinued production of promethazine with codeine, but generic versions remain on the market under tight regulation.

Purple drank is drug slang for the mixture containing codeine and promethazine mixed with a soft drink such as Sprite or Fanta—and sometimes with candy such as Jolly Ranchers. The drink gets its name from the purple color of some cough syrups. Purple drank has been popularized in certain music and hip-hop cultures, with some artists glorifying its use in their lyrics. However, many rappers who once promoted the drug later warned against its dangers after experiencing serious health consequences themselves or witnessing peers suffer from addiction and overdoses.

Professor Linda Cottler, Ph.D., M.P.H., director of NDEWS. commented: “Healthcare professionals should be aware of the potential for abuse and monitor for signs in patients, especially adolescents and young adults,”  Linda added: “Parents should be aware of these combinations and talk to their children about avoiding “cough” medicines acquired from friends, friend’s siblings, or friends’ parents.”

Summary

While the combination of DXM and promethazine is not commonly reported in drug abuse or emergency-room cases, misuse could lead to significant health risks. Stores have started to keep these cough and cold remedies behind the counter to reduce access and potential for teen abuse. Some makers of OTC medicines with DXM have put warning labels on their packaging about the potential for abuse. Many states have banned sales of meds with DXM to minors. These actions have helped reduce teen DXM abuse. However, recent teen interest in abuse of combined DXM and promethazine is concerning.

Source: https://www.psychologytoday.com/us/blog/addiction-outlook/202502/teenage-abuse-of-cough-medicines-and-promethazine

Comment by NDPA: The health-promoting benefit of prevention before treatment is well-founded. The latin root of the word ‘prevention’ is ‘praevenire’ which means ‘to come before’ – not ‘during’ or ‘after’ – reactive policies which have their place, but are at best ‘repair jobs’. The PreVenture program is to be welcomed in this context, and we wish it every success. Peter Stoker, Director, National Drug Prevention Alliance (UK).

PreVenture program has reduced odds by focusing on risky personality traits: study

A drug prevention program that began in Montreal has been found to reduce the risk of substance use disorders in teens by offering them tools and strategies to cope with personality traits like impulsivity and anxiety.

“If a young person is reporting very high levels of these traits, they’re more likely to use substances as a way to manage those traits,” said Patricia Conrod, founder of the PreVenture program, who is also a psychiatry professor at the Université de Montréal and a scientist at Sainte-Justine hospital in Montreal.

A recent study in the American Journal of Psychiatry looked at the impact of PreVenture in 31 Montreal-area high schools over a five-year period.

The study found the program helped reduce the growth in the odds of substance use disorder by 35 per cent year over year, compared with a control group.

Conrod told CBC News that the odds of developing a substance use disorder increase as students get older.

The program focuses on such traits as impulsivity, sensation seeking, anxiety sensitivity and hopelessness — all of which may lead teens to turn to substance use to cope. During two 90-minute workshops given in Grade 7, students gain insight into their own personalities and tools to manage them.

The program uses cognitive behavioural therapy, interactive exercises and group discussions to find personality-specific coping strategies.

‘I can deal with them, so I feel better’

Fara Thifault, 13, a Grade 7 student at Collège de Montréal, participated in a workshop last fall.

“I didn’t realize I had negative thoughts, and when I did that [workshop], I realized, ‘Yeah I get them a lot and this is how I can deal with them, so I feel better,'” she said.

Grade 10 student Romane Roussel, 16, said the workshops helped her, too.

“I’m less impulsive now because I use some techniques, I take a breather,” she said.

Conrod said while a growing body of evidence supports the PreVenture program and others like it, schools across the country need sustained funding, including from federal and provincial governments, to deliver them more widely.

“Some substance use disorders are preventable, and we should be making sure that young people have access to the programs and the resources they need,” she said.

The program is currently available in schools in five Canadian provinces, including Quebec, Ontario and British Colombia, as well as in several U.S. states.

“It’s a little bit harder for policy-makers to put the money towards prevention knowing they may not see the benefits — and there will be benefits in many of these cases, but they’re not going to see them for several years,” she said in an interview.

Schwartz was part of a team that examined school-based prevention programs around the world, including PreVenture.

“There’s been a long history of using programs that haven’t necessarily been effective,” she said. “What’s happening now is that policy-makers are increasingly turning to the research evidence.”

What’s missing, Schwartz said, is funding to maintain programs and put them in place more widely.

Prevention before treatment

Justin Phillips’s son Aaron died of a heroin overdose in 2013, when he was 20, in Indianapolis. She described him as an “impulsive, sensation-seeking kid.”

He once skateboarded off the roof of her house, Phillips recalled, but said he was also very sensitive and sometimes anxious.

These are all traits, she said, that young people and their families don’t always have the tools to recognize and manage.

“Had we had these tools, I absolutely believe things would have been different,” she said in an interview.

The year after her son’s death, Phillips founded an organization called Overdose Lifeline to support other families dealing with addiction and to promote prevention. She is also involved with PreVenture, training people to deliver the workshops and working to bring the program to more communities in the United States.

Source: https://www.cbc.ca/news/health/teens-drug-use-prevention-study-1.7470849

Opinion – by Hannah E. Meyers, Published Feb. 16, 2025, 6:19 a.m. ET

In November, Donald Trump made significant electoral gains in New York’s black and Latino neighborhoods, and in the city’s least affluent communities. Now he is poised to take an important step to improve public safety in these voters’ neighborhoods.

Rep. Nicole Malliotakis (R-SI) last week wrote to new Attorney General Pam Bondi, pleading for the administration to shut down the city’s two “safe injection sites.”

These facilities, located in East Harlem and Washington Heights, provide supervision to drug abusers as they consume harmful substances like fentanyl, meth, heroin and cocaine.

Yes, these are illegal drugs under federal law — and the aptly nicknamed federal “crack house statute” prevents individuals from retaining property for their consumption.

Indeed, Trump’s Justice Department successfully shuttered similar sites in the past – In 2019, his first administration sued to stop a Philadelphia injection center from opening, and in 2024 a US District Court judge in Pennsylvania finally agreed that the center was not exempt from federal drug laws.

Now Trump should listen to his NYC minority constituents and close the injection sites that are harming their neighborhoods.

New York’s two centers, both run by non-profit OnPoint, were the first in the nation, opening in 2021 under then-Mayor Bill de Blasio — who never met an injurious policy he wouldn’t support in the name of racial justice.

De Blasio gambled successfully that the Biden administration wouldn’t intervene.

OnPoint claims to have saved over 1,000 lives by preventing overdoses. But as my colleague Charles Fain Lehman has pointed out, the sites do not reduce addiction — so they are likely just delaying fatalities: More than 15% of those administered naloxone are dead within a year.

Indeed, data shows that NYC overdose rates have continued to rise since the centers opened.

That’s no surprise, since a rigorous look at the data from even the most touted injection sites in other countries provide no evidence of their effectiveness

But rigor has never been the calling card for politicians and advocates who happily sacrifice other people’s communities in the name of compassion.

State Sen. Gustavo Rivera (D-Bronx) has had the chutzpah to claim that “public drug use, syringe litter and drug-related crime goes down” around sites. In 2023, Rivera urged Gov. Hochul to expand supervised consumption sites statewide, and sponsored Senate legislation — still in committee — to do so.

In 2023, Mayor Eric Adams also proposed adding three more facilities to NYC — but he might be amenable to updating his views with some pressure from Washington.

And that pressure will come if Trump cares about the lives of local residents.

While major crimes fell 13% in northern Manhattan over the past two years, the predominantly black and Hispanic precinct around the East Harlem drug site has seen an almost 8% rise in major crime.

I’ve toured that location with the Greater Harlem Coalition. Members pointed out the large early-childhood education center directly across the street from the injection site, as parents hurried their tots into school in plain view of ongoing drug deals.

The perimeter of the block is dotted with addicts nodding off. Nearby restaurants have had to invest in private security to defend against the criminality the center attracts to the neighborhood.

What’s been keeping this site open despite four years in which the only evidenced change is neighborhood degradation?

Shameless advocacy by pompous, ideologically motivated and race-obsessed elites . . . whose kids don’t go to preschool in Harlem.

In August, Greater Harlem Coalition co-founder Shawn Hill was interviewed by one such far-left advocate: Ryan McNeil, director of harm reduction research at Yale’s School of Medicine.

McNeil was conducting funded “research” into safe injection sites — but a “hot mic” recording revealed his and his colleagues’ woke bias in favor of supporting safe injection sites (and drug decriminalization, more broadly).

With no sense of irony, McNeil — who is himself Caucasian — scorned Harlemites’ concerns over open drug abuse as nothing but “white discomfort,” and derided Hill for suggesting that the Yale researchers should walk around and speak with actual local residents.

But Trump has every reason to listen to these locals, three-quarters of whom are black or Latino.

And it would behove Adams, who faces a crowded primary race this summer, to reverse his past stance and voice support for a federal closure of the city’s two drug consumption sites.

In East Harlem, Trump won about 860 more votes last year than in 2020. Now these supporters, and their neighbors he has yet to persuade, are depending on his help.

 

Source: https://nypost.com/2025/02/16/opinion/inject-some-common-sense-shut-down-nycs-safe-drug-sites/

by  Steven T. Bell,  Special Agent in Charge – Omaha Drug Enforcement Administration, and Emily Murray.
February 18, 2025


In an effort to build on drug education messaging to tribal communities, the Drug Enforcement Administration (DEA) Omaha Division worked with the Ponca Tribe of Nebraska and Mandaree High School of North Dakota to develop a poster that blends Native Indian imagery with wording emphasizing the importance of culture over drug use.

During visits to tribal communities, DEA’s community outreach specialist noticed posters sounding the alarm to human trafficking, domestic violence and missing  and murdered indigenous women at schools and buildings across Reservations. The common thread tying each poster together was an emphasis on native culture.

Looking to build on the Good Medicine Bundle

Culture-based prevention resources available through DEA’s Operation Prevention, conversation began on how best to help tribal communities relate to important messaging on drug use. Elders were consulted and the vision of a poster, reflecting youth, culture and the DEA mission, began to take shape.
With permission from the Ponca Tribe of Nebraska, photos reflecting tribal values were taken in Norfolk. Youth from the Ponca Tribe of Nebraska highlighted the significant role dance plays in Native Indian Culture. Dancing is used to tell stories, honor ancestors and celebrate important events. A photo of a drum from Mandaree High School places importance on the sacred instrument often used to symbolize the heartbeat of the earth. The wording at the top of the poster, “Drumming and Dance: The Heartbeat of our Culture, NOTDRUGS,” was written for tribal members to feel connected with the poster.
“It’s critical that we find ways to communicate with all members of our communities about the dangers of drug use,” DEA Omaha Division Special Agent in Charge Steven T. Bell said. “Our hope is that this poster resonates with tribal communities and sparks conversation about life choices and their ensuing consequences.”

Source: https://www.dea.gov/press-releases/2025/02/18/dea-works-tribal-communities-advance-drug-education

Dangerous but common misconceptions can prevent crucial early addiction treatment.

Key points:

  • Misconceptions and the ignoring of research-based evidence prevent crucial early treatment of addiction.
  • Drugs of abuse cause health, life, and relationship problems with many long-lasting effects.
  • Teen and young adult drug prevention is necessary and needs funding.

Research published in high-quality peer-reviewed journals reveals key information on the realities of addiction, exposing pervasive myths and misconceptions, as in these examples.

False Belief 1: Drug experimentation is normal for teens and shouldn’t alarm parents.

Drug use and experimentation among teens often is ignored by many—even parents, who then may be unaware that any use places adolescent brains in jeopardy. For today’s teens, life often feels overwhelming, but avoiding alcohol, tobacco, marijuana, and other drugs is their one best choice to promote continued healthy physical and mental development. Preventing or delaying all teenage substance use not only reduces their current risks for depression, psychosis, and school/learning problems, but it also significantly decreases their probability of addiction as adults.

Harvard’s Sharon Levy, MD, MPH, and founding National Institute of Drug Abuse Director Robert DuPont, MD, strongly advocate a zero-tolerance approach to youth substance use. They emphasize that no amount of drug use is safe for young people. They promote the One Choice initiative encouraging adolescents to avoid substance use: alcohol, tobacco, marijuana, and other drugs.

It’s now known that THC in marijuana interferes with the developing brain circuits responsible for regulating behavior, leading to increased risk-taking and poor decision-making. Even infrequent teen use can impede judgment, increasing the probability of risky behaviors and accidents. Adolescents also are more likely than adults to develop cannabis use disorder (CUD) due to their heightened neuroplasticity during this developmental stage. The resulting impairment may lead to academic underperformance and problematic interpersonal relationships.

False Belief 2: Addiction is a personal weakness.

Addiction is not about people being weak-minded. It’s far more complicated. Becoming addicted depends on the drug used, dose, route, frequency, and risk factors like ages of users. Also, the same drug at the same dose affects people differently because of personal differences, as well as the presence/absence of traumatic past life experiences.

Yale’s Joel Gelernter identified genetic variants associated with vulnerability to addictions. However, genetic characteristics themselves interact with environmental factors in developing substance use disorders (SUDs). As Nora Volkow, director of NIDA, has said, “Addiction is a complex disease of a complex brain; ignoring this fact will only hamper our efforts to find effective solutions …”

False Belief 3: People must hit “rock bottom” to recover from addiction.

No, no, and no! Roadside alcohol testing has prevented thousands of deaths and helped many people with alcohol use disorders (AUD) obtain help, sometimes by coercion of courts. About 50 percent of those arrested for DUI have an AUD. Users often deny they have a problem with drugs or alcohol and believe they are truthful. But they are lying to themselves.

Addiction is a chronic, relapsing condition driven by changes in brain circuitry, particularly in areas controlling reward, stress, and decision-making. While some people seek help after suffering dire consequences, others are compelled into treatment by the courts, based on a past offense. Waiting to hit “rock bottom” increases major risks of harming the person’s relationships, job, and health—and strengthens the hold of the drug over the person.

False Belief 4: Addiction treatment never works.

Researchers from the University of British Columbia and Harvard Medical School recently analyzed survey data from nearly 57,000 participants in 21 countries over 19 years, providing clear data. They discovered that the number-one barrier to treatment was addicted people themselves: Most were in denial and did not recognize they needed treatment.

Alcoholics Anonymous is often successful, non-judgmentally providing new members a roadmap, role models, hope, and social connections. Successful people actively involved in AA complain that their friends kept asking them why they “weren’t cured yet” since they went to so many meetings. But going to meetings is what works.

Even among experts, there’s no consensus on what constitutes successful treatment. To some, success is that the person is still alive and hasn’t been rushed to the emergency room because of an overdose in the past 6 months or year. To others, it is taking treatment medications. And to still others, only abstinence and a full resumption of all family and work obligations counted as success.

Another issue is that most people with SUDs have multiple addictions. Even when they overdosed, most took multiple drugs. It’s also true that many people come to treatment also needing treatment for other medical, addiction, and psychiatric problems. Yet only rarely are patients evaluated and treated for all issues.

False Belief 5: Overdoses of drugs don’t cause brain damage.

Drugs of abuse can harm the brain. Overdose survivors may suffer from undetected brain damage and hypoxic brain injury caused by opioid-induced respiratory depression. As a society, we better understand hypoxia as associated with drowning or choking than its much more common occurrence in drug overdoses with loss of consciousness.

Recent studies estimate that at least half of people using opioids have illicitly experienced a non-fatal overdose or witnessed an overdose. People who regularly use drugs are at elevated risk of brain injury due to accidents, fights, and overdoses. A single fentanyl overdose could cause hypoxia, brain injury, and memory and concentration problems.

Overdoses with counterfeit pills, cocaine, methamphetamine, xylazine, or heroin usually also include fentanyl, making neurologically compromising overdoses more common.

Summary

Myths and misconceptions increase stigma and decrease the likelihood that someone with an addictive illness will receive prompt, effective treatment. We need early intervention and treatment during the preaddiction phase. Bottom line: Preventing teen and young adult use is crucial.

Mark Gold M.D.

Mark S. Gold, M.D., is a pioneering researcher, professor, and chairman of psychiatry at Yale, the University of Florida, and Washington University in St Louis. His theories have changed the field, stimulated additional research, and led to new understanding and treatments for opioid use disorders, cocaine use disorders, overeating, smoking, and depression.

Source: https://www.psychologytoday.com/intl/blog/addiction-outlook/202502/5-common-false-beliefs-about-drug-use-users-and-addiction

by Dan Krauth WABC logo    Eyewitness News – Friday, February 14, 2025

Dan Krauth has more on the letter sent to the newly confirmed attorney general asking her to shut down safe injection sites in New York City.

NEW YORK (WABC) — There are places people can go take illegal drugs under the watchful eye of supervisors to ensure they don’t die.

They are called Overdose Prevention Centers, or also known as safe injection sites, and there are two of them in New York City — the first of its kind in the nation.

Now, after more than three years of operating, there’s a new effort under a new president to shut down the centers that are run by a non-profit organization.

It’s called OnPoint NYC and they have two locations in Washington Heights and East Harlem.

Drug users can take their drug of choice from heroin to cocaine inside the centers and supervisors intervene, most times with oxygen, if the user starts to overdose. They also provide test strips for drugs to ensure they don’t have fatal doses of fentanyl inside.

Since opening in 2021, the executive director said they’ve intervened in more than 1,700 overdoses. They also provide services like medical help, substance abuse treatment and housing assistance.

Opponents say the centers encourage people to do illegal drugs.

“They’re encouraging people to use by giving them a community center to go to and to use heroin, it’s something that’s encouraging addicts not helping them,” said Congresswoman Nicole Malliotakis.

She sent a letter to the newly confirmed attorney general, asking her to shut down both locations along with any others that have opened across the country.

“They don’t work, these heroin injection centers, in fact they attract crime to the neighborhood but also drug dealing, it just does not make sense and they should be shut down,” Malliotakis said.

In response, the executive director of OnPoint NYC sent Eyewitness News a statement:

“OPCs save lives. At OnPoint NYC, our staff has intervened in over 1,700 overdoses, providing life-saving care to mothers, fathers, and loved ones,” said OnPoint NYC Executive Director Sam Rivera. “Every single one of them deserves compassion and a chance at healing. I’m incredibly proud of our team and continually inspired by the dedication they show every day. They don’t just look at the overdose epidemic and wonder what can be done-they don’t have that luxury. They act, because they have lives to save. This work is not just vital; it’s transformational. Lives are being saved, hope is being restored, and healing is possible.”

 

Source:  https://abc7ny.com/post/president-trump-asked-shut-down-overdose-prevention-centers-have-operated-3-years-nyc/15907033/

COMMENTARY:  Public Health  – Feb 14, 2025

by Paul J. Larkin – Rumpel Senior Legal Research Fellow and Bertha K. Madras, PhD – Professor of psychobiology at Harvard Medical School, based at McLean Hospital and cross appointed at the Massachusetts General

Key Takeaways

Today, some members of America’s political class are desensitized to the drug crisis. They tolerate normalizing psychoactive substance use.

The relentless movement to legalize drug use has succeeded, largely by appealing to the goodwill and sympathies of the American public.

For supply reduction, the U.S. must send a clear message to the world that we are not an open market for drugs.

The federal government has long sought to prevent the horrors of drug addiction by interdicting the supply of dangerous psychoactive drugs—and reducing demand for them.

One step was the Anti-Drug Abuse Act of 1988. It established the Office of National Drug Control Policy (ONDCP) within the Executive Office of the President. Headed by a director colloquially known as “drug czar,” ONDCP had the task of developing a national drug-control strategy to reduce drug use. Its creation symbolized a strong bipartisan effort to prevent illicit drugs from destroying lives and weakening the nation.

Sadly, we have lost that shared mission. No president since George W. Bush has publicly demonstrated a deep and firm support for ONDCP and its mission.

The agency does not reside in the White House office building, let alone the West Wing. The federal government has largely been a bystander despite the unraveling of restrictive opioid prescribing, state implementation of medical/recreational marijuana programs in violation of federal laws, and the incipient movement by states to legalize psychedelics. Most presidents have largely ignored these trends.

The first Trump administration assembled a commission to combat drug addiction and the opioid crisis. The current one should support a comprehensive effort led by ONDCP to overhaul drug policies and strengthen America’s commitment to reducing and delegitimizing drug use. We need a revitalized ONDCP equipped with innovative goals and measurable outcomes to disrupt the pipeline to addiction and to cease preventable, premature deaths and mental health decline. A single centralized agency ensures coordination across federal agencies, state, and local levels to maximize efficiency and accountability.

Today, some members of America’s political class are desensitized to the drug crisis. They tolerate normalizing psychoactive substance use and the addiction, health crises, deaths, and collateral damage to families that follow.

Reformers advocate destigmatizing regular use of hazardous psychoactive drugs. “Harm reduction” practices, initially framed as temporary measures, now are uncritically promoted in some quarters without clear boundaries or outcome goals.

This “Meet drug users where they are” approach has regressed to a “Leave them where they are” one. The grim realities of “tranq”-induced catatonia on the streets of Philadelphia’s Kensington neighborhood, San Francisco’s Tenderloin district, Boston’s Mass and Cass intersection, and other drug-ridden homeless encampments lay bare the stark failure of America’s waning resolve to minimize drug use.

Among other nations, we are an outlier. America’s drug crisis has escalated dramatically since ONDCP was born. Overdose deaths surged from 3,907 (1.6 per 100,000) in 1987 to a record 107,543 (32.2 per 100,000) in 2023, with teen rates doubling recently. Among twelfth-graders, 13 percent use marijuana daily, despite heightened risks for addiction and psychosis. In 2023, daily use of marijuana and regular use of hallucinogens among 19- to 30-year-olds reached record levels, fueled by pervasive myths about “safety” or “medical” efficacy

Whether used for medical or recreational purposes, or both, 25 percent of cannabis users have a cannabis-use disorder; among twelve- to 24-year-olds, such a disorder is more prevalent than alcohol-use disorder. Over 90 percent of individuals with substance-use disorders (48.7 million people) neither recognize their need for help nor seek treatment.

Topping it off, seizures of fentanyl-laced pills exploded from 49,000 in 2017 to a staggering 115 million in 2023. Reversing this runaway train demands a transformative political and cultural shift led by the president, ONDCP, and Congress.

How?

Start by learning from past mistakes. The relentless movement to legalize drug use has succeeded, largely by appealing to the goodwill and sympathies of the American public. In 1996, activists persuaded California’s voters to adopt marijuana as a medicine by labelling it as “compassionate use” for end-stage cancer and HIV-AIDS wasting.

That success gave legalizers a foothold. Slowly, the movement persuaded other states to adopt medical-use marijuana for myriad purposes without a shred of evidence; this later morphed into recreational-use programs. Dual-purpose “dispensaries” now sell marijuana for any reason. Activists persuaded the medical profession that pain was the “fifth vital sign” and pressured caregivers to prescribe highly addictive opioids liberally for any type of pain. We know where that went.

Finally, recent campaigns to use political means to normalize hallucinogens for medical use bear a striking resemblance to the two campaigns noted above, including media hype and their tendency to lampoon cautious Cassandras. Compassion is a virtue, except when it leads to long-term harm.

Those who are driving the normalization of substance use as a chemical shortcut for pleasure or relief are willing to sacrifice long-term well-being for short-term escapism. Without prevention strategies to disrupt this pathway of use, addiction, and death, no amount of treatment or law enforcement will resolve the crisis.

We should oppose efforts to destigmatize drug use but support destigmatization of individuals with substance-use disorders to ease their entry into treatment and recovery. To end the frequently heard lament of parents—“If only I knew”—we need a national educational campaign that counters the myths promulgated by proponents.

We need more research to understand why substance-use disorders are resistant to treatment- and recovery. Harm-reduction strategies that don’t show objective reductions in disordered use should be challenged. And we must recognize that minorities are hurt, not helped, by liberalizing drug use because it can worsen the conditions in already suffering neighborhoods.

Finally, we should strengthen ONDCP by returning it to cabinet-level status and empowering it to adopt a results-driven business model. Steps would include, on the demand side, ensuring that federal funding is allocated to prevention and treatment programs that prioritize objective, evidence-based positive outcomes.

For supply reduction, the U.S. must send a clear message to the world that we are not an open market for drugs. This will involve stopping the smuggling of fentanyl, dismantling illegal markets, and seizing traffickers’ ill-gotten gains. Incentives and penalties can persuade nations that produce drugs and their precursor chemicals to curb their export of substances poisoning Americans.

President Trump has a unique opportunity to pivot and reform America’s recurring drug crises. A bold approach will signal America’s commitment to reversing our damaging trajectory.

This piece originally appeared in the National Review

Source:  https://www.heritage.org/public-health/commentary/the-drug-crisis-hasnt-gone-away-the-trump-administration-should-confront

by CNN Health (selected text) – February 12, 2025

A legal loophole is allowing children who access social media to see enticing advertisements for marijuana with potentially dangerous consequences, according to experts.

Under the Controlled Substances Act, it’s illegal to advertise the sale or use of marijuana using federal airwaves or across state lines. But that hasn’t stopped social media ads on cannabis websites from reaching youth of all ages who use screens, said Alisa Padon, research director for the Prevention Policy Group, a health equity and prevention association in Berkeley, California.

“Businesses are allowed to make their own pages and then post ads on their feed. Youth are bypassing age restrictions and seeing the ads for products they’re not legally allowed to buy. They can like, comment and share those posts with their friends,” Padon said.

“Research shows that type of engagement is related to an increased likelihood of wanting to use and using cannabis,” she added. “It’s a perfect storm, and regulators are doing nothing about it.”

According to a 2024 national survey, over 7% of eighth graders, nearly 16% of 10th graders and almost 26% of 12th graders said they have used cannabis in the past 12 months. When marijuana use occurs during the teen years, it’s more likely the individual will become addicted, according to the National Institute on Drug Abuse.

Cannabis use during adolescence can interfere with memory, cognition and brain growth at a critical time in a child’s natural development, said pediatrician Dr. Megan Moreno, a professor and academic chair of the Division of General Pediatrics and Adolescent Medicine at the University of Wisconsin School of Medicine and Public Health in Madison.

“There’s a dose response, so heavier users have longer-term effects, and there are concerns these developmental impacts may not reverse after abstinence,” Moreno said.

“It’s the wild west out there,” she added. “If you put an ad on your own little marijuana website, and it spreads virally through social media, there are no regulations against that.”

Effective advertising tactics

Marijuana stores and manufacturers are marketing their wares to youth using tested techniques popularized by the alcohol, tobacco and food industries, experts say.

“The marketing that we’re seeing in California for cannabis looks just like the marketing that is nationwide for alcohol and for e-cigarettes,” Padon said.

When it comes to social media advertising, however, the cannabis industry has excelled, said Moreno, who has studied the impact of marijuana ads on youth.

“The cannabis industry came into the market with traditional advertisements already illegal, so they became incredibly creative on social media,” she said. “The content is expertly crafted to appeal to youth.”

Moreno researched how marijuana sellers in four states where recreational marijuana is legal (Alaska, Colorado, Oregon and Washington) have advertised to underage adolescents.

A key method was the use of young-looking salespeople called “budtenders” who help clients in the store pick out their marijuana products.

“Budtender is a riff on bartender. Advertisers tend to photograph budtenders who look like they are 16,” Moreno said.

“Also, the crossover between food and tobacco industry advertising and cannabis marketing really stands out — both use enticing color schemes and flavors,” she said.

“And they are using the alcohol industry’s playbook to send messages hinting it’s sexy to use marijuana.”

Padon quizzed 409 California youth between the ages of 16 and 20 about their reaction to various online cannabis ads. The research was published in the March edition of the International Journal of Drug Policy.

Overall, illustrations and food and flavor references were extremely appealing to youth, Padon said. Depictions of heavy cannabis use and positive sensations from that use were also a hit with young audiences. Advertisements focusing on the health benefits of cannabis, however, fell flat.

An advertisement placing marijuana in the middle of a burst of red cherries and bright colors was the most appealing ad to kids in the study, Padon said. Another popular ad showed an attractive young man who appeared to be 14 to 15 years old displaying cannabis products in a store.

“Another theme we found in our past studies was tying cannabis to athletics and being active, which is appealing to youth,” Moreno said. “Teens are in that phase of identity development trying to figure out who they are. So if part of an adolescent’s identity is a sport or being outdoorsy, the cannabis product is tying into something that’s valuable to them.”

A problem that may only worsen

According to a 2024 report, daily or near daily marijuana use by California adults tripled and marijuana use during pregnancy nearly doubled in the past decade. This occurred despite warnings to expectant moms about the dangers of cannabis on an unborn fetus.

During a four-year period between 2015 and 2019, cannabis-related visits to emergency rooms increased by 70% in older adults, the report stated.

Nationally, the rate of use has been rising steadily, with 15% of all American adults saying they smoke marijuana, according to a Gallup poll. A 2022 study found people in states where recreational cannabis is legal use it 20% more frequently than those in states that have not passed legislation.

Increases in cannabis use can result in unforeseen dangers, Padon said: “Nationwide, there have been skyrocketing rates of accidental ingestion of gummies and chocolate edibles among very small kids because they look like candy.”

Calls to poison control centers about children age 5 and younger consuming edibles containing tetrahydrocannabinol, or THC, rose from 207 to 3,054 in four years — a 1,375% increase, according to a January 2023 study.

In fact, many edibles are packaged to look exactly like their candy and chip counterparts on store shelves. One bag of gummies looks virtually identical to the popular candy Gushers, said Danielle Ompad, a professor of epidemiology at NYU School of Global Public Health, in a prior interview.

“The Nerd Rope knockoffs I have personally seen looked just like the licensed product,” Ompad said.

However, small print included on the label of the Gushers knockoff said the bag contained 500 milligrams of THC, she said. A look-alike bag of Doritos contained 600 milligrams.

“The (knockoff) Doritos were shaped just like the real thing and had a crunch as well. If I ate that whole package, I would be miserable. People who are using edibles recreationally aren’t typically eating more than 10 milligrams,” Ompad said.

If a child ingests edibles, they can become “very sick,” according to the US Centers for Disease Control and Prevention. “They may have problems walking or sitting up or may have a hard time breathing.”

 

Source: https://www.cnn.com/2025/02/12/health/marijuana-ads-child-danger-wellness/index.html

by Brian Mann –  NPR’s first national addiction correspondent – published January 29, 2025 at 7:00 AM EST

When Robert F. Kennedy Jr. talks about the journey that led to his growing focus on health and wellness — and ultimately to his confirmation hearings this week for U.S. secretary of health and human services — it begins not with medical training or a background in research, but with his own addiction to heroin and other drugs.

“I became a drug addict when I was 15 years old,” Kennedy said last year during an interview with podcaster Lex Fridman. “I was addicted for 14 years. During that time, when you’re an addict, you’re living against conscience … and you kind of push God to the peripheries of your life.”

Kennedy now credits his faith; 12-step Alcoholics Anonymous-style programs, which also have a spiritual foundation; and the influence of a book by philosopher Carl Jung for helping him beat his own opioid addiction.

If confirmed as head of the Department of Health and Human Services after Senate hearings scheduled for Wednesday and Thursday, Kennedy would hold broad sway over many of the biggest federal programs in the U.S. tackling addiction: the Centers for Disease Control and Prevention, the National Institute on Drug Abuse and the Substance Abuse and Mental Health Services Administration.

While campaigning for the White House last year, Kennedy, now 71 years old, laid out a plan to tackle the United States’ devastating fentanyl and overdose crisis, proposing a sprawling new system of camps or farms where people experiencing addiction would be sent to recover.

“I’m going to bring a new industry to [rural] America, where addicts can help each other recover from their addictions,” Kennedy promised, during a film on addiction released by his presidential campaign. “We’re going to build hundreds of healing farms where American kids can reconnect with America’s soil.”

People without housing in San Francisco in May 2024. A film released by Robert F. Kennedy Jr.’s presidential campaign included a scene that 
appeared to blame methadone — a prescription medication used to treat opioid addiction — for some of the high-risk street-drug use visible
on the streets of San Francisco.

Some addiction activists — especially those loyal to the 12-step faith- and values-based recovery model — have praised Kennedy’s approach and are actively campaigning for his confirmation.

“RFK Jr is in recovery. He wants to expand the therapeutic community model for recovering addicts,” Tom Wolf, a San Francisco-based activist who is in recovery from fentanyl and opioid addiction, wrote on the social media site X. “I support him for HHS secretary.”

 

A focus on 12-step and spirituality, not medication and science-based treatment

 

But Kennedy’s approach to addiction care is controversial, described by many drug policy experts as risky, in part because it focuses on the moral dimension of recovery rather than modern, science-based medication and health care.

“He clearly cares about addicted people,” said Keith Humphreys, a leading national drug policy researcher at Stanford University. “But in terms of the plans he’s articulated, I have real doubts about them.”

According to Humphreys, Kennedy’s plan to build a network of farms or camps doesn’t appear to include facilities that offer proper medical treatments for seriously ill people facing severe addiction.

“That’s a risk to the well-being of patients, and I don’t see any merit in doing that,” Humphreys said.

“I think [Kennedy’s plan] would be an enormous step backward,” said Maia Szalavitz, an author and activist who used heroin and other drugs before entering recovery.

“We have spent the last 15, 20 years trying to move away from treating addiction as a sin rather than a medical disorder,” she said. “We’ve spent many years trying to get people to take up these medications that we know cut your death risk in half, and he seems to want to go backwards on all that.”

The vast majority of researchers, doctors and front-line addiction treatment workers agree that scientific data shows medications like buprenorphine, methadone and naloxone are game changers when it comes to treating the deadliest street drugs, including fentanyl and heroin.

The Biden administration moved aggressively to make medical treatments far more affordable and widely available. Many experts believe those programs are factors in the dramatic national drop in overdose deaths that began in 2023.

Kennedy, who studied law and political science, not health care, before becoming an activist on subjects ranging from pharmaceuticals and vaccines to the American diet, has remained largely silent on the subject of science-based medical treatments for opioid addiction.

His campaign film included a scene that appeared to blame methadone — a prescription medication that has been used to treat opioid addiction since the 1970s — for some of the high-risk street-drug use visible on the streets of San Francisco.

In public statements, Kennedy has also repeated the inaccurate claim that the addiction and overdose crisis isn’t improving. In fact, fatal overdoses have dropped nationally by more than 20% since June 2023, according to the Centers for Disease Control and Prevention, falling below 90,000 deaths in a 12-month period for the first time in half a decade.

“What we have mostly heard from Kennedy is a skepticism broadly of medications and a focus on the 12-step and faith-based therapy,” said Vanda Felbab-Brown, an expert on drug policy at the Brookings Institution, a Washington, D.C., think tank.

“That appeals to a lot of crucial groups that have supported President Trump in the election. But we know what is fundamental for recovery and stabilization of people’s lives and reducing overdose is access to medications,” Felbab-Brown said. “Unfortunately, many of the 12-step programs reject medications.”

She’s worried that under Kennedy’s leadership, the Department of Health and Human Services could shrink or eliminate funding for science-based medical treatment and instead focus on spirituality-based approaches that appear to help a relatively small percentage of people who experience addiction.

Kennedy’s views on other science-based treatments, including vaccines, have sparked widespread opposition among medical researchers and physicians.

 

Kennedy boosts an Italian model for addiction recovery that has faced controversy

 

Another concern about Kennedy’s addiction proposals focuses on his interest in a program for drug treatment created in Italy in the 1970s.

The San Patrignano community is a therapeutic rehabilitation community center in Italy for people with drug addictions. The center, which
was founded by Vincenzo Muccioli in 1978, received renewed media attention after a 2020 Netflix documentary described alleged abuses.
Robert F. Kennedy Jr. now describes the program as a model for recovery care in the United States.

“I’ve seen this beautiful model that they have in Italy called San Patrignano, where there are 2,000 kids who work on a large farm in a healing center, learning various trades … and that’s what we need to build here,” Kennedy said during a town hall-style appearance on the cable channel NewsNation last year.

According to Kennedy’s plan, outlined in interviews and social media posts, Americans experiencing addiction would go to San Patrignano-style camps voluntarily, or they could be pressured or coerced into accepting care, with a threat of incarceration for those who refuse care.

But the San Patrignano program has been controversial and was featured in a 2020 Netflix documentary that included images of people with addiction allegedly being held in shackles or confined in cages. The farm’s current leaders have described the documentary as biased and unfair.

Kennedy, meanwhile, has continued to use the program as a model for the camps he would like to build in the United States.

“I’m going to build these rehab centers all over the country, these healing camps where people can go, where our children can go and find themselves again,” he said.

Szalavitz, the author and activist who is herself in recovery, noted that the Italian program doesn’t include science-based medical care, including opioid treatment medications. She said Kennedy’s fascination with the model reflects a lack of medical and scientific expertise.

“It really is great to include people who have personal experience of something like, say, addiction in policymaking. But you don’t become an addiction expert simply because you’re someone who struggled with addiction,” Szalavitz said. “You have to engage with the research literature. You have to understand more beyond your own narrow anecdote. Otherwise you’re going to wind up doing harm to people.”

Copyright 2025 NPR

Source: https://www.ideastream.org/2025-01-29/rfk-jr-says-hell-fix-the-overdose-crisis-critics-say-his-plan-is-risky

 

Copied from DRB bulletin 03.02.2025:

Source: https://assets.publishing.service.gov.uk/media/679a44136907bee181d31480/240125+Annex+A+-+Response+to+the+ACMD+Fifth+addendum+to+Advisory+Council+on+the+Misuse+of+Drugs+_ACMD_+report+on+the+use+and+harms+of+2-benzyl+benzimidazole+_nit.pdf

 

January 14, 2025 

Forwarded by Shane Varcoe • 05.02.25

 

Breakthroughs in Addiction Science Over 50 Years

Addiction science has undergone tremendous progress over the past five decades, transforming our understanding of drugs and their impact on the brain and society. Recent advancements offer hope in addressing the escalating challenges of drug use, addiction, and overdose. However, the need for evidence-based prevention and treatment strategies remains crucial in combating this ongoing public health crisis.

Prioritising Drug Prevention

Prevention is one of the most effective ways to combat substance use disorders. Research consistently highlights how drug exposure can interfere with brain development from prenatal stages to young adulthood, setting the stage for lifelong challenges. Children and adolescents are particularly vulnerable, as early drug experimentation sharply increases the risk of addiction later in life.

Adverse childhood experiences—ranging from poverty to trauma—also contribute to substance use risks by disrupting brain development. Preventative measures can mitigate these risks and promote resilience. For example, school-based programmes and community initiatives have demonstrated significant success in reducing drug use among young people. Importantly, these interventions offer long-term benefits, improving mental health and reducing dependency rates across generations.

Scaling up these preventative approaches is vital. By investing in evidence-based prevention at schools, healthcare facilities, and community centres, society can safeguard future generations from the devastating impacts of drugs.

Challenges in Addressing Substance Use Disorders

One of the greatest hurdles today is the lack of access to effective addiction treatment. Millions of people struggle with substance use disorders, yet only a small percentage receive adequate care. This gap highlights the pressing need to expand addiction treatment services and eliminate barriers such as stigma and limited healthcare coverage.

Treatment options, including medication and behavioural therapies, have proven to be effective for many struggling with addiction. For instance, medications that address opioid dependency, combined with comprehensive care, can significantly improve recovery outcomes. However, these treatments remain inaccessible to many, especially in underserved communities.

Expanding treatment availability within prisons, rural areas, and low-income communities could swiftly reduce addiction rates and improve recovery success. Research also shows that offering treatment to individuals in justice systems can lower overdose risks after release and reduce reoffending, creating broader societal benefits.

The Role of Science in Combating Addiction

Scientific advancements are paving the way for more effective solutions to addiction. New innovations, such as brain stimulation therapies, target the neurological circuits disrupted by substance use, offering promising pathways for treatment. Additionally, cutting-edge pharmaceuticals like GLP-1 agonists, already used for managing diabetes, are showing potential in reducing cravings and dependency behaviours associated with addiction.

The use of artificial intelligence (AI) in addiction science is further revolutionising the field. AI tools can help detect overdose patterns, study drug impacts on mental health, and even guide personalised treatment interventions. Large-scale studies, such as those examining adolescent brain development, continue to shed light on how substance use affects young minds, offering invaluable insights for effective prevention.

Towards a Unified, Drug-Free Future

While remarkable progress has been made, the fight against addiction is far from over. Preventing drug use, providing accessible treatment, and investing in research remain paramount. By adopting a proactive, science-backed approach to addiction prevention, we can reduce the devastating effects of substance use disorders and create healthier, drug-free communities.

Addiction science offers the tools needed to address these challenges, but lasting change requires collective effort. Only through unified actions can we overcome this crisis and protect future generations from the harms of addiction.

Start prioritising prevention and treatment today to help build a safer, healthier world.

Source: https://wrdnews.org/breakthroughs-in-addiction-science-over-50-years/

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/

Publication: American Journal of Psychiatry – 15 January 2024

Patricia Conrod, Ph.D. patricia.conrod@umontreal.caSherry H. Stewart, Ph.D.Jean Seguin, Ph.D.Robert Pihl, Ph.D.Benoit Masse, Ph.D.Sean Spinney, M.Sc., and Samantha Lynch, Ph.D.

Abstract

Objective:

Rates of substance use disorders (SUDs) remain significantly above national targets for health promotion and disease prevention in Canada and the United States. This study investigated the 5-year SUD outcomes following a selective drug and alcohol prevention program targeting personality risk factors for adolescent substance misuse.

Methods:

The Co-Venture trial is a cluster randomized trial involving 31 high schools in the greater Montreal area that agreed to conduct annual health behavior surveys for 5 years on the entire 7th grade cohort of assenting students enrolled at the school in 2012 or 2013. Half of all schools were randomly assigned to be trained and assisted in the delivery of the personality-targeted PreVenture Program to all eligible 7th grade participants. The intervention consisted of a brief (two-session) group cognitive-behavioral intervention that is delivered in a personality-matched fashion to students who have elevated scores on one of four personality traits linked to early-onset substance misuse: impulsivity, sensation seeking, anxiety sensitivity, or hopelessness.

Results:

Mixed-effects multilevel Bayesian models were used to estimate the effect of the intervention on the year-by-year change in probability of SUD. When baseline differences were controlled for, a time-by-intervention interaction revealed positive growth in SUD rate for the control group (b=1.380, SE=0.143, odds ratio=3.97) and reduced growth for the intervention group (b=−0.423, SE=0.173, 95% CI=−0.771, −0.084, odds ratio=0.655), indicating a 35% reduction in the annual increase in SUD rate in the intervention condition relative to the control condition. Group differences in SUD rates were reliably nonzero (95% confidence) at the fourth and fifth year of assessment. Secondary analyses revealed no significant intervention effects on growth of anxiety, depression, or total mental health difficulties over the four follow-up periods.

Conclusions:

This study showed for the first time that personality-targeted interventions might protect against longer-term development of SUD.
Despite having made some strides with respect to reducing adolescent drinking rates, substance use disorder (SUD) rates are significantly above national targets for health promotion and disease prevention in Canada and the United States (15). These data suggest that there is a pressing need for more targeted intervention strategies designed to help those most at risk of transitioning to SUD. Recent national surveys suggest an alarmingly high prevalence of SUD in the general population (16.5%), with the highest rates reported among young adults, and approximately 9% of the adolescent population screened positive for past-year SUD (13). There is also an ongoing crisis of nonmedical prescription drug use in North America, as indicated by the dramatic increase in the prevalence of past-year prescription drug misuse and overdose deaths from 2003 to 2022 (12) and the disproportionate growth of hospitalizations due to opioids among individuals 15–24 years of age (14). Furthermore, only ∼5% of respondents who report symptoms of SUD report having received any treatment for their SUD (1). As highlighted in numerous reports (59), including the U.S. Surgeon General’s 2016 report on addiction (2), evidence-based upstream solutions that prevent transition to SUD are desperately needed, considering the scale and severity of these public health concerns.
Most school-based prevention programs are universal and use some combination of alcohol and drug awareness, testimonials, flyers, brochures, peer education, and alcohol/drug-free activities. These have been shown to have weak positive or even negative effects (1011), but programs that promote general coping and drug-refusal skills are more promising (2101213). One possible contributing factor to poor outcomes of many prevention programs is that they target generic factors implicated in normal drinking and drug experimentation and fail to target factors linked to risk for the development of more severe substance use problems (2101418), despite well-supported evidence for robust predictors of substance use and misuse across several sociodemographic contexts (2). New approaches to prevention are needed that translate research on addiction vulnerability to personalized prevention and early intervention (2).
Longitudinal and machine learning prediction strategies have highlighted the role of both externalizing and internalizing traits in future risk for substance misuse (1923). A recent review suggests that distinct personality traits are related to risk for substance misuse through different motivational and cognitive risk profiles (23). Impulsivity and its cognitive correlate, poor response inhibition, appear to be specifically associated with conduct problems and misuse of stimulants (including prescription stimulant medications); sensation seeking and its neurocognitive correlate, reward sensitivity, are more associated with alcohol and cannabis misuse (22023). Anxiety sensitivity and hopelessness have been shown to be associated with risk for internalizing problems and preferential use/misuse of depressant drugs, such as alcohol, sedatives, and opioids (19202426).
The PreVenture Program is a brief (two group sessions) school-based cognitive-behavioral program focusing on building personality-specific skills and self-efficacy to reduce need on the part of a young person to use substances as a way to cope with interpersonal or intrapersonal challenges associated with each personality trait (2728). Given research indicating that different neurocognitive profiles mediate the relationship between specific personality factors and concurrent mental health conditions (2226), the program focuses on promoting personality-specific cognitive-behavioral skills (e.g., skills relevant to the management of poor response inhibition for teens who report high levels of impulsivity vs. skills relevant to the management of global negative attributional styles for teens who report high levels of hopelessness). Numerous randomized trials have shown that the program is effective in reducing alcohol and drug use and mental health symptoms by a notable 30%–80% among secondary students (1317212728). However, this approach has yet to be shown to prevent transition to SUDs, which is critical when informing comprehensive drug prevention and health promotion strategies.
As a primary outcome, this longitudinal cluster-randomized controlled trial examined the impact of personality-targeted preventive interventions in reducing risk for SUD in adolescents over a 5-year period (18). It is becoming increasingly recognized that treatment outcome research should focus on pragmatic outcomes to facilitate the translation of research findings to policy and practice, and this was an important aim of the present study. Therefore, in consultation with local stakeholders, we selected a validated measure of SUD that is used to screen for SUD and to guide the delivery of SUD interventions in schools throughout the region in which the study was conducted. The primary research hypothesis was that relative to a control condition, the intervention would be associated with a reduced risk of transitioning to SUD by the end of high school among youths who report personality risk factors. Secondary outcomes examined the intervention effects on mental health outcomes in the 4 years after the intervention.

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Source: https://www.psychiatryonline.org/doi/10.1176/appi.ajp.20240042

by AFP Bureau report – January 28, 2025

PESHAWAR: Speakers at a seminar shared strategies for drug prevention and fostering resilience, said a press release issued here on Monday.

The Welfare and Peace Society, City University of Science and Information Technology (CUSIT) in collaboration with the Higher Education Regulatory Authority (HERA), Anti-Narcotic Force Pakistan and Anti-Drug Social Welfare Organization had hosted the seminar.

It was part of the efforts to promote peace through combating drug abuse in educational institutes. The activity was under the “Community Resilience Building for Countering Violent Extremism” project.

European Union funds the project. Collaboration is struck with the National Counter-Terrorism Authority and the UN Office on Drugs Crime Country. Key speakers of the seminar included Azazud Din, the HERA Advisor for Drug Use Prevention/Lead Policies, Umair, the Da Haq Awaz organization’s member, Fukhraz of Anti-Narcotic Force, Ikram of Khyber Pakhtunkhwa Centre of Countering Violence Extremism, and Ms Maria of the HERA.

Source: https://www.thenews.com.pk/print/1276828-strategies-shared-for-drug-prevention

by David Evans, Senior Counsel, CIVEL (USA)

January12, 2025

Article forwarded by Hershel Baker, Drug Free Australia. He opens by saying: “Please find evidence below on a current project to make the marijuana industry legally accountable to their victims in the U.S. if they are SUCCESSFUL, it will become very useful to Victims in many other countries including Australia.” 

Legal Primer – Cannabis Industry Victims Educating Litigators (CIVEL) <https://www.civel.org/legalprimer>

 

The marijuana industry referred to here are those who illegally, negligently or fraudulently produce, market, or distribute marijuana products including those that have not been approved by the FDA or approved under federal law.

Today’s marijuana products can be high in potency and can reach 99% THC.

These products can be very destructive and cause addiction, mental illness, violence, crime, DUIs and many health and social problems. Young people are particularly vulnerable. We must protect them.

A first step is to educate lawyers and the community by providing legal and scientific guidelines for litigators so they can take the marijuana industry to court. We have produced six litigator guidelines:

  1. Product liability for the production and sale of dangerous and/or contaminated and poorly processed marijuana for medical or recreational use.
  2. Medical malpractice for the promotion and use of marijuana as a medicine without FDA approval.
  1. Environmental lawsuits to recover for environmental damage caused by marijuana growing.
  1. The federal Racketeer Influenced and Corrupt Organizations (RICO) Act prohibits a person (also a corporation) from investing in, acquiring, or participating in the affairs of an enterprise that engages in racketeering activity. RICO applies to “medical” marijuana and recreational marijuana as both are illegal under federal law. Damage claims for economic injuries can be filed.
  1. Server liability for marijuana stores that sell medical or recreational marijuana to customers who then kill or injure others in car crashes or other accidents
  2. Lawsuits under the Drug Dealer Liability Act – several states have passed laws that make drug dealers civilly liable to those injured by a driver under the influence of drugs or families who lose a child to illegal drugs and others injured by illegal drugs.

We will arm the legal profession to recognize cases, prepare them and then litigate as was done in the cases against big tobacco and is now being done against the opiate companies.

We will not conduct litigation. Our goal is to get the legal profession to initiate litigation by educating them as to the legal issues and strategies involved. We also plan to educate the public about how the marijuana industry has destroyed lives and families and to support the victims.

 

For more information contact Senior Counsel, David G. Evans, Esq.

Email: seniorcounsel@civel.org <mailto:seniorcounsel@civel.org>

 

Please see our legal primer on marijuana and federal law

 

LEGAL PRIMER <https://www.civel.org/s/LEGALPRIMERCSA2017.pdf>

 

Other Important Documents

*             CATEGORIES OF THE VICTIMS OF THE MARIJUANA INDUSTRY

<https://www.civel.org/list-of-marijuana-industry-victims>

*             MARIJUANA AS A MEDICINE – POLICY, SIDE EFFECTS, SPECIFIC ILLNESSES

<https://www.civel.org/s/2CIVELMARIJUANA-AS-A-MEDICINE-POLICY-SIDE-EFFECTS-S

PECIFIC-ILLNESSES.pdf>

*             THE FAILURES OF THE STATES TO REGULATE MARIJUANA

<https://www.civel.org/s/THE-FAILURES-OF-THE-STATES-TO-REGULATE-MARIJUANA-ST

UDIES-SHOW-THAT-MARIJUANA-PRODUCTS-HAVE-HIGH-LEVE.pdf>

*             INTERACTIONS BETWEEN MARIJUANA AND OTHER DRUGS

<https://www.civel.org/s/4-CIVELINTERACTIONS-BETWEEN-MARIJUANA-AND-OTHER-DRU

GS.pdf>

*             MARIJUANA AND VIOLENCE

<https://www.civel.org/s/5CIVELMARIJUANA-AND-VIOLENCE.pdf>

*             MARIJUANA USE AND MENTAL ILLNESS AND BRAIN DAMAGE

<https://www.civel.org/s/6CIVELMARIJUANA-USE-AND-MENTAL-ILLNESS-AND-BRAIN-DA

MAGE.pdf>

*             MARIJUANA USE AND DAMAGE TO HUMAN REPRODUCTION

<https://www.civel.org/s/7CIVEL-MARIJUANA-USE-AND-DAMAGE-TO-HUMAN-REPRODUCTI

ON.pdf>

*             CONCERNS ABOUT CBD

<https://www.civel.org/s/8CIVEL-CONCERNS-ABOUT-CBD.pdf>

 

DISCLAIMER OF LEGAL ADVICE

This should not be considered legal advice. This is for informational purposes only. Use of and access to these materials does not in itself create an attorney – client relationship between David G. Evans or CIVEL and the user or reader. Mr. Evans or CIVEL cannot vouch for any study cited herein since they did not do the study. The readers should consult the study and make their own interpretation as to its accuracy. Please also be advised that case law and statutory and regulatory laws cited herein may have been amended or changed by the time you read this.

David G. Evans, Esq. – Senior Counsel – Cannabis Industry Victims Educating Litigators (CIVEL) (USA)

Source: Email by Herschel Baker <hmbaker1938@hotmail.com> Sent: 11 January 2025 23:06

AUSTIN (Nexstar) – Fentanyl poisonings continue to kill thousands of people across Texas. But the latest statistics from the Centers for Disease Control and Prevention show an encouraging sign. The numbers show a slight decrease in deaths in Texas, mirroring a nationwide decline that started showing up earlier this year.

Part of the credit for the decline can be attributed to increased awareness of the dangers of the drug, DEA officials say.

Last year, Texas took a new step towards fentanyl awareness when Gov. Greg Abbott signed a bill known as Tucker’s Law that requires school districts to educate students in grades 6-12 about the drug. The bill is named after Tucker Roe, a 19 year old who died from fentanyl poisoning.

His mom, Stefanie Roe, helped push for the legislation. She founded the nonprofit Texas Against Fentanyl after Tucker’s death. Tucker was Stefanie’s firstborn and only son.

“He was born with just an adventurous little spirit, a lover of people, and just a real light in our family and in others,” Roe said.

After she lost her son in 2021, Stefanie founded Texas Against Fentanyl, a 501C3 founded to increase awareness, support and legislation surrounding the drug.

“In 2021 when I lost Tucker, I had no knowledge of illicit fentanyl. I had never heard of press pills. I did not know that teens were selling to teens, and seven out of 10 pills were lethal. And as a mom, that just struck me that I didn’t have the information to safeguard my son and give him knowledge of that poison,” Roe said.

Tucker’s Law took effect last year. Since then, Roe says schools have reached out to Texas Against Fentanyl to organize assemblies and bring in the Tucker Project to their school programming. Roe believes that knowledge about the drug is essential to save lives.

“If a student understands that, this is what it looks like. You can’t see it, you can’t taste it, you can’t smell it. It can be added to these things. This is the impact it has on the body. It’s not a just say no campaign. It’s to get educated so you can make better decisions,” Roe said.

Roe said there has been some confusion over how to teach the topic calling it an “unfunded mandate” for schools. She said Texas Against Fentanyl has been developing a curriculum alongside the Texas Education Agency to help schools.

With the next legislative session looming in January, Roe said there are changes to be made. She plans to push lawmakers to make improvements to Tucker’s Law along with implementing new legislation to improve testing at hospitals to increase accurate reporting on fentanyl deaths.

Roe said her group is also working to decriminalize fentanyl test strips. The test strips allow people to detect whether fentanyl is in the drugs they use. Texas is one of a few states where the strips are illegal, considered to be drug paraphernalia. Last session, a bill to decriminalize test strips passed the Texas House but failed to advance in the Senate.

Roe said Texas Against Fentanyl is relentless and will pull every stop to get legislation passed to help save lives. She compares the group to Mothers Against Drunk Driving, which leveraged the power of parents to make significant policy changes.

“We’re mad moms who have lost our children to something that we did not have education on, and we’re not backing down,” she said.

Source: https://www.kxan.com/state-of-texas/newsmaker-interviews/texas-mom-who-lost-son-not-backing-down-in-fight-for-fentanyl-education/

Note by NDPA: This article describes harm Reduction  as ” as an alternative to traditional abstinence-based education”. which is seen by NDPA as an unhelpful definition. The valid contribution of Harm Reduction can better be recognised as a strategy working in cooperation with Prevention i.e. it is case of applying ‘both’ rather than ‘either/or’.

  Head Office in London, UK
Substance abuse among adolescents is a significant public health concern, as it can lead to various negative health outcomes and hinder academic performance. School-based substance abuse prevention programs have emerged as a critical strategy to address this issue, leveraging the unique environment of schools to reach young people during a pivotal time in their development. Recent research has explored various approaches to these programs, focusing on their effectiveness, implementation, and the integration of innovative methods to enhance engagement and outcomes.

Recent Research

One of the key findings from recent studies is the effectiveness of different types of interventions in educational settings. A scoping review identified various approaches, including cognitive-behavioral skill enhancement, peer interventions, and family-school cooperation, all of which have shown varying degrees of success in reducing substance use among adolescents[2]. Notably, while electronic interventions yielded mixed results, traditional methods like curriculum-based programs and peer support have been beneficial in addressing substance use issues[2].

Another significant study examined the long-term effects of a selective personality-targeted alcohol prevention program called PreVenture. This program was designed for adolescents exhibiting high-risk personality traits and demonstrated sustained positive outcomes in reducing alcohol-related harms over a seven-year follow-up period[3]. The findings suggest that targeted interventions can effectively delay the onset of alcohol use and mitigate its associated risks, highlighting the importance of tailoring programs to the specific needs of students.

Additionally, innovative approaches such as hybrid digital programs that combine e-learning with in-person sessions have shown promise. A study evaluating this method found significant reductions in substance use and increases in health knowledge among middle school students[5]. This approach addresses common barriers to implementation, such as limited class time and inconsistent delivery, making it a viable option for schools looking to enhance their substance abuse prevention efforts.

Furthermore, harm reduction strategies have gained attention as an alternative to traditional abstinence-based education. A pilot study on a harm reduction curriculum revealed significant improvements in students’ knowledge and behaviors related to substance use, suggesting that engaging students with relevant and relatable content can lead to better outcomes[4]. This approach challenges the conventional views on substance education and emphasizes the need for programs that resonate with adolescents’ real-life experiences.

Technical Terms

Substance Abuse: The harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs, leading to significant adverse consequences.

Cognitive-Behavioral Skills: Techniques that help individuals recognize and change negative thought patterns and behaviors associated with substance use.

Harm Reduction: A set of practical strategies aimed at reducing the negative consequences associated with substance use, rather than focusing solely on abstinence.

Source: https://www.nature.com/research-intelligence/school-based-substance-abuse-prevention-programs

by William P. Barr & John P. Walters – 23 Jan 2025 | Hudson Institute

(This article forwarded to NDPA by Drug Free Australia)

 

Just weeks after the election, President-elect Trump announced that he would

impose a 25% tariff on all Mexican products, and an additional 10% tariff on

all Chinese products, until the flow of illegal narcotics from those

countries is stopped. These measures will do more to choke off the growing

scourge of illegal drugs than all steps taken in the “drug war” to date.

 

Over the past few years, the flow of illegal narcotics into our country has

become a tsunami, with seizures of fentanyl pills skyrocketing from 4

million in 2020 to 115 million last year. The devastation inflicted on

American society by this traffic is catastrophic.

 

The opioid crisis alone costs us over 100,000 overdose deaths and $1.5

trillion annually, while the flood of potent methamphetamine from Mexico

fuels a new wave of meth addiction, ravaging lives, families and

neighborhoods in its wake.

 

This deadly traffic happens by weakening our border defenses and ignoring

opportunities to choke off the supply chain for illicit drugs, now centered

in China and Mexico.

 

The U.S. policy has focused on “harm reduction” inside the U.S. – deploying

overdose medications, like Naxolone, and funding more treatment for

addiction. While these steps are unobjectionable in themselves, they are an

inadequate response to the flood of poison we are confronting. It is like

addressing violent crime by offering more bandages.

 

Real progress requires eliminating the drug supply at its source. Here the

U.S. has a golden opportunity because the supply chain for drugs poisoning

America has become highly concentrated and vulnerable. It depends entirely

on illegal activities in two countries – the manufacture of illicit drugs in

Communist China, and drug processing and distribution operations in the

cartels’ safe havens in Mexico.

 

All these illegal activities are carried out with – and indeed require – the

connivance or willful blindness of the host governments. As Trump’s

announced tariffs show, the U.S. has the tools and leverage to compel China

and Mexico to shut down these operations. Doing this would strike a decisive

blow: once these operations are dismantled, it would be impossible to

replicate them elsewhere at anywhere near their current scale.

 

China has become the hub of illegal drug production because illegal

narcotics are increasingly synthesized chemically, rather than made from

grown plants. China offers the two prerequisites needed to supply the U.S.

market: a large chemical industrial base, and a government willing to allow

its factories to make illegal narcotics and their precursors on a large

scale.

 

Chinese factories make the essential ingredients for virtually all the

fentanyl and other synthetic opioids, as well as 80% of the methamphetamine,

that come into the U.S. and are producing a new wave of drugs worse than

fentanyl, like nitazenes and xylazines (“tranq”). Simply put, without

China’s production, America’s drug problem would be mere fraction of what it

is.

 

Communist China could easily stop this activity if it wanted to. But a

recent report by the bipartisan Select Committee on the Chinese Communist

Party (CCP) shows that China’s participation in the illegal drug trade is a

deliberate policy.

 

According to the report, the Chinese government and the CCP has been

granting tax subsidies to encourage their drug companies to produce and

export – for consumption in the U.S. – fentanyl and other death-dealing

drugs that are illegal in China, the U.S. and throughout the world.

 

This is an intolerable situation. The U.S. must compel China to stop

producing these drugs by imposing an escalating series of consequences on

those involved.

 

The initial tariff announced by Trump is a critical first step. If it

doesn’t get results, further tools are available – imposing higher tariffs;

targeting sanctions against the Chinese drug companies involved, and

potentially indicting and seizing assets of those companies; sanctioning

Chinese banks found to be involved in laundering drug money; and

facilitating private lawsuits by fentanyl victims against Chinese companies

making the drugs.

 

The second major chokepoint in the drug supply chain lies in Mexico. The

Mexican cartels have become the “one-stop-shop” for processing and

distributing nearly all the illegal drugs coming into the U.S. – the

synthetic drugs made in China, as well as the cocaine from coca plants in

Latin America. Experience eliminating the Colombian Medellin and Cali

cartels in the early 1990s shows that the U.S. can dismantle these

organizations when it becomes directly involved, works jointly with the host

governments and local forces, and uses all available national security and

law enforcement tools.

 

But Mexico poses a particular challenge. Using bribery and terrorist

tactics, the cartels have cowed and co-opted the government to the point

that it is unwilling to confront them nor allow the U.S. to take effective

action against them. And, even if the Mexican government was willing to

tackle the cartels, their military and law enforcement is so rife with

corruption they are incapable of effective action by themselves.

 

Our country cannot tolerate a failed narco-state on our border flooding

America with poison. The only way forward is for the U.S. to use its massive

economic leverage to compel the Mexican government to take a stand against

the cartels. President Trump’s announced tariff does just this.

 

Because the Mexicans cannot do the job themselves, eliminating the cartels

will require a joint campaign through which the U.S. engages in direct

action against the cartels, using a range of our law enforcement,

intelligence and military capabilities. The Mexican cartels are more like

foreign terrorist groups, like ISIS, than they are the American mafia – and

it is heartening that President Trump has signed an executive order

designating them as such. It is time to confront them as national-security

threats, not a law-enforcement matter.

 

Attacking the source of the problem overseas does not mean we should pull

back from trying to dismantle trafficking operations inside the U.S. But

progress abroad will produce exponentially greater results than anything we

do at home. Trump’s tariff initiative shows, that, rather than dither with

America’s stubborn drug crisis and passing it on to his successor, Trump is

willing to tackle it head on with decisive action.

Source: https://drugfree.org.au/index.php

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

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

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

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

“What happened?” asked the operator.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Preventing drug use and addiction

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

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

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

Preventing overdose

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

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

Improving access to addiction treatment

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

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

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

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

Leveraging new treatments and technologies

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

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

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

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

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

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

 

Contemporary issues on drugs

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

 

Key findings and conclusions

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

Sources:

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

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

Provided by GlobeNewswire  

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

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

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

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

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

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

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

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

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

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

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

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

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

Sir Elton John Credit: Ben Gibson

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Take the following paragraph in this paper:

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

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

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

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

<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<NDPA>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

DREXEL PRIVATE UNIVERSITY TEXT:

December 11, 2024

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

destigmatized text

 

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

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

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

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

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

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

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

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

 

 

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

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

This is an RTE component

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

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

Overview

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

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

Figure 1

Alcohol‑Related Deaths Have Increased Since 2016

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

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

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

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

© 2024 The Pew Charitable Trusts

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

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

The Spectrum of Unhealthy Alcohol Use

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

Consumption patterns exceeding these recommended levels are considered:

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

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

Identifying and preventing AUD

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

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

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

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

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

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

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

Withdrawal management

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

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

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

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

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

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

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

Treating AUD

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

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

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

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

Medications

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

The FDA has approved three medications to treat AUD:

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

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

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

Behavioral therapies

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

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

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

Recovery supports

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

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

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

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

American Indian and Alaska Native communities

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

Figure 2

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

Alcohol‑related deaths per 100,000 people

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

© 2024 The Pew Charitable Trusts View image

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

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

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

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

People living in rural areas

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

Figure 3

Alcohol‑Related Deaths Have Increased Faster in Rural Areas

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

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

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

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

Next steps

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

OPENING STATEMENT BY AUTHOR: Dec 31, 2024

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

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

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

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

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

Nora Volkow M.D., Director of NIDA

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

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

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

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

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

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

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

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

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

Journal reference:

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

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

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

Published: December 31, 2024

DOI: 10.7759/cureus.76659

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

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Abstract

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

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

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

 

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

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

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

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

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

 

Goal 1: Less drug use

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

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

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

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

 

Goal 2: More prevention

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

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

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

 

Goal 3: More harm reduction

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

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

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

 

Goal 4: More treatment

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

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

 

Goal 5: More recovery initiatives

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

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

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

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

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

 

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

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

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

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

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

 

 

Goal 7: Less drugs

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

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

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

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

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

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

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

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

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

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

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

By Julie Washington, cleveland.com

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

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

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

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

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

The trend was also seen in Ohio.

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

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

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

Julie Washington covers healthcare for cleveland.com.

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

By Sherry Larson, People’s Defender –

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

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

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

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

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

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

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

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

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

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

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

“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

Medical research can sometimes become disconnected from the interests and needs of the people it is intended to serve. This is true across diseases and disorders, and addiction research is no exception. Too often, scientists who study drugs and addiction have not meaningfully engaged people with lived and living experience of substance use. And when people who use substances are engaged, the experience may leave them feeling exploited or traumatized, such as when they are not adequately compensated for their time or when they are asked to recall distressing life events. It is also rare for researchers to follow up with participants to let them know what was learned in a research project.

Such experiences contribute to a feeling that research is a one-way transaction benefiting scientists but giving little back to the community. Lack of meaningful community engagement also compromises the quality of the science by not incorporating the valuable ideas and insights of people who use drugs.

NIDA is committed to improving community engagement in all parts of the research process. For that reason, we have asked the National Advisory Council on Drug Abuse (NACDA)—the body of experts that advises on NIDA’s scientific research priorities—to convene a working group to recommend ways to enhance the meaningful engagement of people who have experience with drug use in the research our Institute funds. The workgroup will inform the creation of resources that outline NIDA’s expectations regarding community engagement and help both applicants and community partners navigate this critical work.

NIDA has long encouraged community-engaged research, and it is required element in various NIDA research funding opportunities, including those supported through our Racial Equity Initiative. The evolving opioid overdose crisis has underscored the importance of ensuring that people’s lived experience of substance use is centered in the science we support. For example, one of the pillars of the NIH Helping to End Addiction Long-term (HEAL) Initiative is that research must be relevant and responsive to the individuals, families, and communities it aims to help. One way HEAL studies are doing this is by drawing on the input of community advisory boards to ensure that the research is best tailored to the needs of the people most impacted by it.

The NIDA-funded Harm Reduction Research Network is a nationwide set of projects to enhance the impact of harm-reduction efforts, and its community advisory boards have already helped shape some of the studies. One project involves the development of a survey instrument to capture experiences of people who use drugs, and advisory board members helped tailor the wording of the instrument so that it reflected language more likely to be used by people who use drugs. Another study aimed at reducing overdose and increasing engagement in harm reduction and treatment services had originally been limited to people who use methamphetamine. Based on the input of advisors with more up-to-date knowledge of drug-use in their community, the study was broadened to include people who use cocaine, as that was identified as an emerging stimulant in their area.

The Integrative Management of Chronic Pain and OUD for Whole Recovery (IMPOWR) project is addressing the needs of people with substance use disorders and pain via a network of multidisciplinary team science collaborations. Its community advisory boards weigh in on funding decisions for pilot studies, and some of these studies have included a community partner as a co-investigator. Based on community input about the important role of PTSD and discrimination in healthcare settings in pain and opioid misuse and addiction, IMPOWR researchers added PTSD and stigma/discrimination items to their common data elements (the standardized questions that facilitate data-sharing across studies).

The Native Collective Research Effort to Enhance Wellness (NCREW) Initiative is partnering with Tribal organizations to support community-driven research projects that address opioid misuse and pain in Native communities. By providing needed training, technical assistance, and tools, the NCREW project is building capacity within Native communities to conduct locally prioritized research that incorporates indigenous knowledge and lived experience, with the aim of building effective, sustainable, and strengths-based interventions.

As outlined in NIDA’s Strategic Plan, NIDA is committed to partnering with people with lived and living experience in the development of new treatments for substance use disorder. Consistent with that goal, NIDA is funding four Patient Engagement Resource Centers (PERCs) to test various models of patient engagement that can inform research on SUD treatment services. Each PERC will recruit members of a particular patient population to understand what prevents them from finding or receiving evidence-based treatment services. This information will be used to pilot test patient-informed solutions to these challenges that can ultimately serve as models for the development of interventions in other settings.

There are many other ways that partnering with people with living experience of substance use could benefit both science and the community. Surveillance is one example. The drug market is rapidly changing, and people who actively use drugs and live this reality are best poised to provide information on the drug supply and its effects. And through their engagement in surveillance efforts, participants could gain information on new adulterants and contaminants that could help inform their own decisions.

In these, as with other research efforts, people who use drugs need to be treated with respect, and their confidentiality must be protected. They must also be compensated fairly for their time, their input, and their commuting and childcare costs.

Including people with experience of substance use and addiction in the scientific workforce—and making sure they feel safe and recognized as valuable members of the research team—must also become a priority for our science. As some of my colleagues at NIDA’s Intramural Research Program argued two years ago in the Journal of Addiction Medicine, people with lived and living experience of substance use disorders have unique perspectives that are invaluable in making sure that the right research questions are asked.

These are just some of the possible topics that may be discussed in the new NACDA workgroup. For that group, we are seeking individuals who identify as having experience with substance use or a substance use disorder or as a family or caregiver of someone who does. Participants will meet virtually three or four times during 2025 and potentially early 2026 and will be compensated for their time during the meetings. If you are interested in participating, further information is available on the Council Workgroups page. We are accepting application statements through January 10, 2025.

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Workplaces have a unique opportunity to make subtle yet meaningful adjustments to better support employees who may be in recovery or experiencing challenges. When businesses make small changes in their events, management style, and overall culture, they create an environment that respects and uplifts employees facing SUDs. Here are three impactful ways to make the workplace more welcoming:

# 1: Host Inclusive Gatherings with Non-Alcoholic Options

Work events can inadvertently center around alcohol, creating uncomfortable situations for employees who don’t drink and/or are in recovery. Making a few simple shifts can help ensure everyone feels included:
• Avoid holding meetings in bars or pubs. Instead, choose locations that aren’t centered on alcohol, such as coffee shops, casual restaurants, or outdoor spaces.
• Offer a variety of non-alcoholic drinks that are as enjoyable as alcoholic options. These could include mocktails, sparkling water with unique flavors, or other festive drinks. This small touch shows thoughtful consideration and signals that the event is meant for everyone.
• Consider alcohol-free events. Not every event needs to feature alcohol to be fun. Think of team-building activities like escape rooms, game nights, or cooking classes, which naturally focus on engagement without the need for alcohol.

#2: Encourage Supervisors to be Allies

Supervisors play a critical role in creating a compassionate, supportive workplace. By actively supporting employees rather than judging them, supervisors can contribute significantly to a culture of empathy and openness. Here’s how they can help:
• Listen without judgment. If an employee opens up about their challenges, supervisors should approach the conversation with empathy, focusing on support rather than consequences, while of course maintaining safety.
• Respect privacy and confidentiality. Supervisors should reassure employees that their personal issues will remain private and will only be discussed on a need-to-know basis, which helps foster trust.
• Share personal experiences if appropriate. For supervisors in recovery, sharing their stories can inspire others, showing that it’s possible to face challenges and succeed. Authentic, relatable leadership can be incredibly powerful for employees who may feel isolated.

#3: Encourage Coworkers to Support Each Other

Sometimes, coworkers are the first to notice changes in behavior or attendance. They can be crucial sources of support, helping to create a culture that’s proactive and understanding:
• Encourage open, honest communication. Rather than approaching a struggling coworker with judgment, a simple “I’m here if you need anything” can make a huge difference.
• Assist with resources. Coworkers can help each other navigate employment policies, find helpful information, or locate support groups if needed. Being informed and sharing resources can be invaluable.
• Respect boundaries and avoid gossip. Gossip or speculation only adds stigma to those facing SUDs. A culture of respect encourages coworkers to redirect conversations if someone starts gossiping or making assumptions about another’s struggles. For more on the importance of language on stigma, check out the National Institute of Drug Abuse’s resource, Words Matter as well as Drug Free America Foundation’s resource on Stigma here.

These small adjustments—hosting inclusive events, training supervisors as allies, and encouraging a supportive culture among coworkers—can help a business become a welcoming, stigma-free environment for employees with SUDs working towards recovery. By focusing on inclusivity, empathy, and respect, workplaces can create meaningful, positive changes that support both individual well-being and the company’s overall success.

Sources:

Drug Free America Foundation, Inc. “Stigma.” https://www.dfaf.org/wp-content/uploads/2024/09/Stigma-2024.pdf

O’Connor, P., PhD. (2023, November 23). Human resource departments can help or hinder employees with SUDs. Psychology Today. https://www.psychologytoday.com/us/blog/philosophy-stirred-not-shaken/202311/substance-use-disorders-and-the-work-place

Words matter: preferred language for talking about addiction | National Institute on Drug Abuse. (2023, November 15). National Institute on Drug Abuse. https://nida.nih.gov/research-topics/addiction-science/words-matter-preferred-language-talking-about-addiction

 

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

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

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

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

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

Types of Illegal Drugs

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

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

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

Most common illegal drugs include:

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

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

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

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

UN Action

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

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

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

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

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

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

Recent Milestones

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

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

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

Global Response

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

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

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

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

Role of Civil Society

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

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

Youth Engagement

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

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

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

Resources

 

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

November 29th 2024
Young people are not only the leaders of tomorrow but also a powerful force for change today. Their engagement in drug prevention efforts is crucial in not only identifying the challenges faced by the younger generation; it can also shed light on the various ways that youth can be meaningfully involved as agents of change. In this regard, the UNODC Youth Initiative is proud to have supported youth mainstreaming through the publication of “Formación en Liderazgo Juvenil para la Prevención (Youth Leadership Training for Prevention) in 2024. Featuring stories of action and contributions from UNODC Youth Forum alumni, this publication emphasizes the importance of empowering youth to take an active role in prevention, which can help to foster resilience, community cohesion, and social change.

Originally a project proposed to UNODC to highlight ‘Youth in Prevention’, the Youth Initiative extended this proposal to the alumni network of the Youth Forum, to take leverage on the opportunity to highlight and feature the commendable work done by young people. As highlighted in the publication, meaningful youth participation paves the way for innovative solutions that are tailored to the needs of adolescents, their peers, and communities. And by investing in their leadership, we create opportunities for young people to become advocates for healthier lifestyles, role models for their peers, and key contributors to building a more inclusive society.

The publication features contributions from five UNODC Youth Forum alumni who bring their unique perspectives and experiences to various dimensions of prevention. The contributors – Alexandra Bravo Schroth (Peru), Maya Nujaim(Canada), Vinayak Menon (USA), Karthika Pillai (India), and Adrian Milic (Norway) – worked collaboratively over many months to develop their contributions to the book’s chapter, “Empowering and Supporting Global Youth Participation in Prevention Activities.Through weekly virtual meetings, young leaders exchanged ideas, refined their key concepts, and supported one another in the shared goal of advocating for evidence-based prevention.

One of the contributors, Maya Nujaim from Canada, provides a compelling account of her work as a substance use prevention counselor in Montreal. Reflecting on her experiences, she shares: “Being a youth helping other youths is empowering for me, and I believe we need more young people in drug use prevention…I work with a team of young people who also want to make a difference in the lives of youth, and thanks to our life experiences and knowledge, we can easily connect with young people in schools and encourage them to participate in drug prevention activities.

Maya’s prevention activities are rooted in the key principles of the UNODC/WHO International Standards on Drug Use Prevention, ensuring a science-informed approach that strengthen social skills, address vulnerabilities, and foster open discussions amongst young people. She has seen the direct  impacts of her work, including through reductions in substance use among students, improved peer relationships and peer resistance skills, as well as increased engagement in other creative activities.

The youth contributions within the publication provide a glimpse into the diversity of youth-led and youth-focused activities and experiences as witnessed through the lens of the UNODC Youth Initiative. Further to their motivation to be active as agents of change, youth have also showcased their ability to adapt their skills and potential to meet the challenges of other youths in their local contexts. Armed with proper knowledge, skills and science, youths are truly meeting other youths and peers where they are at, and where they can best reach them. By amplifying the voices of young leaders and showcasing the substantive impact that youth can have on their peers and communities; and this publication underscores the importance of creating spaces for youth to contribute to local, national, and global prevention efforts.

UNODC commends the efforts of the youth contributors for their dedication, innovation, and leadership. To young people worldwide: this is a call to action to look around to see where you can be involved, and know that it can start small but have meaningful impact. To policy-makers and stakeholders: it is a reminder to involve youth in prevention efforts (as more than end-beneficiaries) and listen to youth in decision-making processes.

Join us in celebrating youth as agents of change and their good work in contributing towards a healthier, more resilient future for all. For more information on ‘Formación en Liderazgo Juvenil para la Prevención , please visit here.

Source: https://www.unodc.org/unodc/prevention/youth-initiative/youth-action/2024/november/from-inspiration-to-action_-5-youth-forum-alumni-champion-prevention-efforts.html

     Too many families know the pain of losing a loved one to a drunk or drug-impaired driving accident.  Each year, more than 10,000 Americans lose their lives in these preventable tragedies.  During National Impaired Driving Prevention Month, we remind everyone that they can save lives by driving only when sober, calling for a ride, planning ahead, and making sure friends and loved ones do the same.

In 2022, over 13,000 people were killed in drunk-driving accidents.  Still, millions of people drive under the influence each year, not only putting themselves in harm’s way but also endangering passengers, pedestrians, and first responders. Even just one drink or one pill can ruin lives.

My Administration is committed to preventing accidents and impaired driving.  The National Highway Traffic Safety Administration has raised awareness about its risks and consequences through media campaigns, including “If You Feel Different, You Drive Different”; “Drive Sober or Get Pulled Over”; and “Buzzed Driving is Drunk Driving.”  Furthermore, since the beginning of my Administration, we have dedicated over $100 billion to disrupt the flow of illicit drugs and expand access to the prevention and treatment of substance use disorder.

Reducing fatalities and injuries in impaired driving accidents also means improving the safety of our Nation’s vehicles.  That is why my Bipartisan Infrastructure Law invests in technologies that can detect and prevent impaired driving and requiring new passenger cars to include collision warnings and automatic braking to prevent accidents.  The Department of Transportation also released a National Roadway Safety Strategy to eliminate traffic deaths and make crashes less destructive.

This holiday season, let us recommit to doing right by our neighbors, friends, and families by driving sober.  For those planning on drinking, arrange a sober ride home beforehand — ride-sharing apps are a convenient way to get home safely.  If you have had alcohol or used substances, do not get behind the wheel — one accident can cost someone their life.  If you are responsible for driving yourself or others, stay sober, buckle up, put the phone away, and drive the speed limit.  And if you witness a friend, loved one, colleague, or anyone putting themselves or others in danger, lend a hand to keep them safe. You could save a life.

NOW, THEREFORE, I, JOSEPH R. BIDEN JR., President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim December 2024 as National Impaired Driving Prevention Month.  I urge all Americans to make responsible decisions and take appropriate measures to prevent impaired driving.

IN WITNESS WHEREOF, I have hereunto set my hand this twenty-ninth day of November, in the year of our Lord two thousand twenty-four, and of the Independence of the United States of America the two hundred and forty-ninth.

JOSEPH R. BIDEN JR.

 

Source: https://www.whitehouse.gov/briefing-room/presidential-actions/2024/11/29/a-proclamation-on-national-impaired-driving-prevention-month-2024/

 

These TC experts emphasize the critical need for a more proactive approach to substance use education

More than 40,000 youth used nicotine pouches last year alone, a staggering increase from 2021. The relatively new and less detectable product’s increasing prevalence among youth underscores an urgent need for informed discussion and intervention regarding adolescent substance use more broadly. Data shows that 59 percent of people 12 or older used tobacco, vaped nicotine, alcohol or illicit drugs in 2023, despite proof that substance use during these formative years poses a severe threat to cognitive function. “Early drug use can impair neurocognitive development and increase youth vulnerability to later use of illicit substances, and even academic failure,” shares John Allegrante, the Charles Irwin Lambert Professor of Health Behavior and Education at Teachers College, who examines the topic in his latest research with an international group of Nordic investigators.“With each generation, the messaging and campaigns around these dangerous products change to target those most vulnerable: our youth. We [educators] need to work with parents to provide more support resources and surveillance during such critical years.”We spoke with Allegrante and other TC experts about the risks and ways educators, parents and communities can address these challenges together.

 

A Call to Action: Reimagining Awareness, Prevention, and Intervention 

While interventions like the “Just Say No” campaign and the D.A.R.E. programs of the ’80s and ’90s have proven to be unsuccessful, the desire for more effective and youth-informed approaches to preventing  substance use among youth in the U.S. continues to grow.

Influencer marketing and social media promotions for e-cigarettes have increased the risk of youth vaping. Studies show that social media platforms often glamorize e-cigarettes with trendy flavors like cotton candy, attracting young users. TC’s Ayorkor Gaba, Assistant Professor of Counseling & Clinical Psychology, notes that there is a rise in innovative approaches, like media literacy education, to help youth critically analyze media and reject harmful messages.

She explains that social media can also share science-based health messages, enhancing prevention and treatment of substance use.  For example, influencers frequently share their lived experience with overdose,  the harmful effects of vaping, and recovery. Though “impactful,” the overall quality, accuracy and reliability of this content posted can be poor. “The lack of evidence-based content on social media reinforces the need for expert involvement (e.g., public health, psychology, etc.) in disseminating evidence-based content on social media,” notes Gaba. “Due to the significant influence of social media on youth, experts and researchers should integrate youth perspectives in developing social media-based intervention and prevention that can reach millions of youth. “

The CDC notes that a high majority of adolescent substance use (81 percent) occurs during socialization with friends. “As teens, we’re all looking to fit in,” adds TC doctoral student Treasure Tannock. “Between ages 15-25, we seek to cling to anything that gives us a better understanding of self-identity. If we can use that same mindset better to reach young people about the dangers of use through a more holistic, relatable lens, we might be able to make progress.”

To start, Tannock recommends getting youth involved in creative outlets that pique their interest, a concept she implemented during her clinical work at Rikers Island. “We asked individuals: Who are you now? Who do you want to be? What obstacles do you face with substance use? And how can you receive support?” explained Tannock, a Clinical Psychology student. “We then collaborated with music and art therapists to help express their stories. Over time, many became open to support and envisioned a new path forward.”

 

How Parents, Schools and Communities Can Help

Although there is much work to be done, parents, communities and educators can start by laying the groundwork for more proactive dialogue and means of support. 

Allegrante explains that during the pandemic, increased supervision at home led to a decrease in adolescent substance use, an observation from his post-pandemic research. “As young people return to school and socialize more, we’re seeing a resurgence in use,” he explains. “Many prevention efforts start too late; by the time we address it, habits are ingrained. We must start these conversations in middle or even elementary school.”

With so much at stake, schools are tasked with a greater responsibility to address the crisis. A recent survey by the American Addiction Centers revealed that schools are the primary setting where youth receive informative substance use education. However, out of the 500 students surveyed, only 75 percent had a substance-use-focused curriculum in their health class. 

“School is still a prime captive audience location for prevention, but it requires an interdisciplinary approach, resources and a theory-driven, evidence-based curriculum across the board,” Allegrante adds. “We need to work with communities, public health agencies and even local government officials to bridge the gap.”

Yet, prevention must extend beyond the classroom. It’s imperative for parents to stay informed about their children’s habits, as research shows that parental involvement is key to mitigating peer pressure and promoting informed decision-making. “Parenting practices (e.g., monitoring, communication) have been linked to youth substance use, yet there are few accessible supports to help the busy parent develop skills in this area. Gaba recommends an app by the Substance Abuse Mental Health Services Administration called “Talk. They Hear You.,” specifically designed to help parents and caregivers turn everyday situations into opportunities to discuss alcohol and drugs with their children. “It gives them the skills, confidence, and knowledge to start and maintain these conversations as their kids grow.”

Gaba also highlights the need to address disparities,  urging, “It’s a matter of life and death.” Between 2018 and 2022, drug overdose deaths among youth more than doubled, particularly impacting Latinx and Black communities. “Many still mistakenly believe opioids do not affect these groups, leading to decreased awareness and access to vital resources like Naloxone (Narcan), which can reverse overdoses,” she notes. “Additionally, substance use is notably higher among lesbian, gay, and bisexual (LGB) youth compared to their non-LGB peers.” To address these challenges, Gaba advocates for culturally tailored interventions that actively involve marginalized youth in the design process and target the social determinants of health that contribute to their elevated risks.

“Community support is also vital,” notes Tannock. “Having safe, accessible community spaces like libraries or after-school programs can make a significant difference. It’s a team effort.” She urges parents to inquire about local prevention resources. 

Although substance use among youth is an ongoing challenge, the National Institute on Drug Abuse (NIH) reports that adolescent substance use continues to fall below pre-pandemic levels, an encouraging statistic.

“If we look at how drastically cigarette smoking has declined as a consequence of culture change, especially in advanced economies of the world, it’s a testament to just how far we’ve come,” concludes Allegrante. “But it took a concerted effort over many years, and we can certainly chart a similar path forward with this next generation.”  — Jacqueline Teschon

Source: https://www.tc.columbia.edu/articles/2024/november/why-we-need-to-modernize-substance-use-education/

The martial language used by the government when presenting its plan to combat drug trafficking cannot mask the wide blind spots in its announcements, particularly in terms of health and social issues.

Published in Le Monde on November 9, 2024, at 12:46 pm (Paris), updated on November 9, 2024, at 2:14 pm 2 min read Lire en français

Gang warfare in a growing number of towns, repeated shootings punctuated by the deaths of ever-younger teenagers, drug traffickers with increased financial power and influence operating even from their prison cells… There can be little doubt that France, like other European countries, is grappling with the scourge of drugs on an unprecedented level. Criminal groups thrive on an illicit market estimated at over €3.5 billion, posing an ever-growing threat to the lives of entire neighborhoods, to public health and even to democracy.

Asymmetrical and unequal, the battle between drug traffickers prepared to do anything and a democracy based on the rule of law requires institutions and procedures to be strengthened and adapted. The announcements made in Marseille on Friday, November 8, by Interior Minister Bruno Retailleau and Justice Minister Didier Migaud are a step in this direction: The creation of a “national prosecutor” to combat organized crime, which would be subject to special criminal courts composed solely of magistrates to avoid pressure on juries. The system will also be improved for criminals who accept to collaborate with the justice system. Both of these procedures are among the logical proposals inspired by a Senate bill resulting from an inquiry commission report published in May, as well as by the former justice minister Eric Dupond-Moretti’s work.

There are, however, some grey areas surrounding this legislative measure, which is scheduled for parliamentary review in 2025, notably as regards the precise scope of the new prosecutor and the expansion of the current anti-drug office. As for the immediate measures announced on Friday, they remain imprecise, both in terms of the reinforcement of the Paris prosecutor’s office, to which a “coordination unit” would be attached, and the resources devoted to scrambling the telephone conversations of prisoners at the “top end” of the criminal spectrum, who would be assigned to specialized prison quarters.

Concrete action needed

But the martial language used by the two ministers to demonstrate their willingness to “join forces” over and above their political differences, cannot mask the blind spots in their announcements. Significantly, the health minister was not consulted. Information on addiction, risk reduction for drug users and providing care for people addicted to drugs are a few examples of these blind spots.

Cracking down on trafficking and putting pressure on the supply of illicit substances are essential, but they cannot be effective unless they are accompanied by strong action on demand and without a debate, informed by other countries, on the benefits and risks of partial decriminalization. At a time when consumption is becoming commonplace in many circles, from the most disadvantaged to the most privileged, public authorities should also strive to build and disseminate a counter-narrative to that of social ascent through trafficking.

A real “national cause,” the battle against drug trafficking requires France to build the conditions, if not for a consensus, at least for a political majority. This requires not only the addition of a strong preventive component but also that the government distances itself from the interior minister’s constant conflation of drugs and immigration.

Source: https://www.lemonde.fr/en/opinion/article/2024/11/09/france-s-drug-problem-both-repression-are-prevention-are-needed_6732224_23.html

 Supporters of psilocybin expressed dismay at the bans after thousands of people reported benefits from using the psychedelic drug

Oregon Capital Chronicle, November 7, 2024- by Ben Botkin and Lynne Terry.

                                 Image: PIXABAY

 Voters in more than a dozen Oregon cities, including in the Portland area, voted to ban the regulated sales and use of psilocybin mushrooms.

Anti-psilocybin measures were on the ballots in 16 cities and unincorporated Clackamas County, and are passing in coastal communities to urban Portland and central and southern Oregon by 55% to 70% of the vote.

Bans against psilocybin businesses are passing in  Brookings, Rogue River, Sutherlin, Redmond, Lebanon, Jefferson, Sheridan, Amity, Hubbard, Mount Angel, Estacada, Oregon City, Lake Oswego, Seaside and Warrenton. Redmond’s measure would enact a two-year moratorium on psilocybin businesses.

There was one notable outlier. The measure to ban psilocybin could fail in Nehalem, a small community in Tillamook County, according to initial returns. But it is failing by only three votes. The unofficial results on Wednesday were close: 80 voters oppose the ban and 77 voters support.

Comment was not immediately available from psilocybin opponents. Supporters of the drug expressed disappointment with the results Wednesday.

“I think it’s really unfortunate that local communities, often rural communities continue to prevent access to psilocybin services, especially given that we’ve seen over 7,000 people go through the Oregon program, and there’s been so many stories of healing and benefit for those who have done it,” said Sam Chapman, a longtime psilocybin advocate who is policy and development director for the Microdosing Collective, a nonprofit supporting use of the drug in small doses.

Chapman played a big role in getting Oregonians to approve licensed psilocybin treatment centers, facilitators and manufacturers with the passage of Measure 109 four years ago by 56% of the vote. The measure required the Oregon Health Authority to start a program to allow providers to administer psilocybin mushrooms and fungi products to people 21 or older.

To date, the health authority has licensed about 1,000 staff, including 350 facilitators who work directly with clinics while they’re on the hallucinogen. The agency has also licensed 30 psilocybin centers – from the Portland area to Eugene to Ashland and beyond – along with a dozen manufacturers and one lab.

Chapman said these centers give the state another “tool in the toolbox” to treat mental illness, especially depression, anxiety and PTSD, especially for veterans.

“We’re actually seeing the proof of concept for the people who are going through Oregon’s service centers now,” Chapman said. “I think the mental health crisis in rural communities is especially unique in that these rural communities are struggling not just for mental health but economically as well.”

The economy of the psilocybin industry has been soft, caused mainly by the cost of a single session, which can range from hundreds to several thousand dollars, with many customers flocking to Oregon from out of state.

Chapman said rejection of psilocybin is linked to a lack of education about the drug and how the industry works in Oregon. Consumers cannot buy the drug in stores, as they can for marijuana, and treatments are regulated.

They don’t understand psilocybin. They don’t understand the research and they don’t understand the Oregon program. And so in addition to the lack of that understanding, they make some assumptions. The biggest assumption is that this is just the same thing as cannabis. They assume this is for retail sales, which is not true,” Chapman said.

Healing Advocacy Fund, a nonprofit in Oregon and Colorado, will continue to push for the programs to grow, with state-regulated access to psychedelic healing. Heidi Pendergast, the group’s Oregon director, said the rollout in Oregon has been safe, with only four people needing emergency services out of thousands served.

“So while there may be some concerns, we haven’t seen that play out right now whatsoever in the program,” Pendergast said.

Oregon was the first state to decriminalize psilocybin in licensed settings and Colorado has followed suit. Massachusetts voters rejected a proposal to legalize the mushrooms and allow people to grow small quantities at their homes, National Public Radio reported.

Oregon Capital Chronicle is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. 

 

Source: The Lund Report – Latest Headlines | November 7, 2024

October 31, 2024

 

Scotland’s drug and alcohol deaths remain among Europe’s highest – despite an increase in spending and better national leadership.

The Scottish Government has made progress in increasing residential rehabilitation capacity and implementing treatment standards. However, it has been slow to progress key national strategies, such as a workforce plan and alcohol marketing reform. People in need still face many barriers to getting support. The workforce is under immense strain. And the increased focus on drug harm is shifting attention from tackling alcohol issues.

In 2023, there were 1,277 alcohol-specific deaths – the highest since 2008. And there were 1,172 drug misuse deaths, the second lowest number in the last six years. Scotland’s figures remain high compared to the rest of Europe despite alcohol and drug funding rising from £70.5 million in 2014/15 to £161.6 million in 2023/24.

Alcohol and drug services are co-ordinated by Alcohol and Drug Partnerships at a local level. But they have limited powers to influence change and direct funding, and their funding is falling in real terms due to inflation. Most alcohol and drug funding goes to NHS specialist services to treat people at crisis point. This means there is limited money to put into preventing people getting so ill in the first place.

Stephen Boyle, Auditor General for Scotland, said:

The Scottish Government needs to develop more preventative approaches to tackling Scotland’s harmful relationship with alcohol and drugs. That means helping people before they get to a crisis point.

Ministers also need to understand which alcohol and drug services are most cost-effective, and plan how they will be funded when the National Mission ends in 2026. That’s especially important at a time of increasing strain on the public finances.

With many alcohol and drug workers reporting feeling under-valued and at risk of burn-out, there is also an urgent need to put a timeline against plans to address the sector’s staffing challenges.

Christine Lester, a member of the Accounts Commission, said:

Alcohol and drug services are complex and delivered by a wide range of partners. But there needs to be more collective accountability across the system for how each body is helping people whose lives have been blighted by alcohol and drugs.

Better information is needed to inform service planning and where funding should be prioritised. There is also more to do to tailor services to individual needs, using the experience of service users. Right now, not everyone can access the services they need, and that experience is worse for people facing disadvantage.

Source: https://audit.scot/news/prevention-focus-needed-to-tackle-alcohol-and-drug-harm

Experts in Nigeria are increasingly concerned about the country’s rising drug abuse rates, urging the Federal Government to adopt a public health-centred approach. 

This proposed strategy prioritizes reducing drug use while establishing a supportive legal framework to empower health interventions.

With roughly 14.4 percent of the population or about 14.3 million Nigerians, affected by drug use, public health experts argued that a comprehensive legal structure is critical for the Federal Ministry of Health to address this crisis effectively.

At a one-day media sensitization workshop in Abuja, themed ‘Public Health Approach to Drug Control Response in Nigeria’ and organized by the Federal Ministry of Health and Social Welfare in partnership with Youth Rise Nigeria, experts advocated for treating drug dependency as a health issue rather than a criminal offence.

They stressed that many individuals struggling with drug dependency are dealing with health-related challenges.

The workshop highlighted the urgent need for a health-oriented approach to tackle what experts now view as a national drug dependency epidemic and the crucial role of the media in shaping public perception and reaction to drug abuse.

Chukwuma Anyaike, the Director of Public Health at the Federal Ministry of Health, argued that a public health approach is crucial for controlling drug issues in Nigeria.

He noted that existing supply-focused measures have limited access to treatment and prevention services, which has led to increased rates of HIV, tuberculosis, and hepatitis among people who inject drugs.

Anyaike called for a multidisciplinary approach integrating public health, legal, and social welfare frameworks and urged Nigeria to align with international standards such as the World Health Organization’s guidelines, the 2016 UN General Assembly Special Session on Drugs UNGASS), and the African Union (AU) Plan of Action to improve its response to drug abuse.

“This approach includes preventing drug use, providing treatment and care for individuals with substance use disorders, implementing harm reduction strategies, and ensuring access to controlled medications,” Anyaike explained.

Echoing these sentiments, Nonso Maduka, a Consultant with Youth Rise Nigeria, stressed the need for legislation that would facilitate a health-centered response to drug control.



Maduka argued that a supportive legal framework would help provide better resources and care for individuals, families, and communities affected by drug dependency, shifting away from the current punitive focus.

“Unfortunately, we have an unbalanced approach that targets mainly supply reduction, and the health sector lacks the legal authority to address demand, prevention, treatment, and harm reduction,” Maduka noted.

He highlighted that Nigeria’s current drug laws treat drug use as a criminal issue, which restricts health interventions and puts more strain on affected communities.

A public health perspective, he noted, could help curb drug dependency and reduce associated health risks like HIV and hepatitis.

Maduka also emphasized the importance of empowering local health initiatives and granting States authority to address drug challenges in their communities.

A health-focused legal framework, he noted, would allow targeted responses, including treatment, rehabilitation, and palliative care.

Such a framework, according to him, would create a balanced approach that not only reduces drug abuse but also mitigates its harmful effects, ultimately supporting a healthier future for the nation.

“If you want to solve it, it must be driven by evidence,” Maduka added, calling for an evidence-based approach that balances criminal justice with health-focused interventions, which includes drug demand reduction, harm reduction, and access to necessary medications.

“Understanding underlying causes, such as pain management needs and rural challenges, is essential for developing compassionate and comprehensive responses,” he added.

Oluwafisayo Alao, the Executive Director of Youth Rise Nigeria, underscored the crucial role of the media in changing public perceptions around drug dependency, saying, “The way we approach substance use in Nigeria impacts the lives of millions of people.

“This media partnership is a vital step toward a compassionate, health-focused response. By creating a framework that prioritizes health over punishment, we aim to protect individuals, families, and communities”.

Source: https://thenationonlineng.net/experts-propose-all-inclusive-approach-legal-framework-to-combat-drug-abuse/

by Chloe Marklay, Katie Amrhein, WKRC

CINCINNATI (WKRC) – A local mother who lost her son to fentanyl has spearheaded an initiative to bring a powerful billboard to Cincinnati.

The billboard is located in the Northgate area. It includes pictures of 20 people who lost their lives to fentanyl, many of whom are local. The billboard reads: “Synthetic opioids kill over 150 people every day” and “fentanyl steals families.”

 

(WKRC)

Tamara Bohl lost her son Brian when he was 33 years old. Bohl wrote a book titled “My Child Died, Now What?” to help parents like her and to honor those who have lost their lives.

“These are real people, not just a statistic—real people that had lives, dreams, aspirations, families, friends, and kids,” said Bohl.

Bohl worked alongside Rachel’s Angels to create the sign and bring it to Cincinnati. The nonprofit is focused on providing drug education, prevention resources, and support to families affected by addiction.

The billboard dedication is set for Wednesday. The event will include speeches from city leaders, the Center for Addiction Treatment, and other parents like Bohl.

Bohl also featured the names of more than 900 people who lost their lives to fentanyl in her poetry book. One of them is Jason Durkin. At 21 years old, Durkin died from the drug in 2018. His mother Jennifer Bishop attended the billboard dedication.

“It’s gut-wrenching to see him up there, but I feel good that I’m putting him out there because he mattered,” said Bishop.

The event will also include the distribution of Narcan kits and educational resources on drug prevention and harm reduction.

Bohl also taped additional photos of fentanyl victims around the billboard pole. The billboard will stay up throughout November.

 

Source: https://local12.com/news/local/fentanyl-steals-families-new-cincinnati-billboard-spreads-awareness-opioid-epidemic-northgate-joseph-chevrolet-tamara-bohl-book-brian-drug-drugs-addiction-education-rachels-angels

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

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

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

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

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

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

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

Fear of arrest

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

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

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

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

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

Contaminated drug supplies

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

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

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

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

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

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

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

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

Fear, stigma and miseducation

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

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

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

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

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

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

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

Overcoming disparities in health care and mistrust of the system

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

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

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

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

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

10Sep2024

In this special episode of the Pathways 2 Podcast, recorded live at the National Prevention Network (NPN) Conference, we bring you two insightful conversations with leaders who are making a significant impact in the field of prevention.

First, we sit down with Ben Stevenson, who oversees prevention and harm reduction services for Montgomery County, Maryland, and also runs his own consulting firm, Bess Consulting LLC. Ben shares his innovative approach to integrating youth empowerment with harm reduction, his journey in building a successful Youth Ambassador Program, and the challenges of overcoming stigma and navigating county government to drive meaningful change.

Next, we hear from Steve Miller, a prevention champion, podcaster, and man in long-term recovery. Steve takes us through his personal and professional journey, highlighting the powerful role music has played in his recovery and prevention work. He discusses how music serves as a muse, guiding his work and helping others find their path in prevention.

Whether you’re a prevention professional, a community leader, or simply interested in stories of resilience and innovation, this episode is packed with practical insights, inspiration, and a deep dive into what it takes to make a lasting impact in our communities.

Key Takeaways:

  • The power of youth-led initiatives in prevention and harm reduction.
  • Strategies for overcoming stigma and building community buy-in.
  • How music can influence behavior and serve as a tool for prevention.

Transcript:

Welcome back to another episode of the Pathways to Prevention podcast, where we shine a light on the people stories and strategy’s making a difference in the field of prevention. I’m your host, Dave Closson and today I am excited to bring you to insightful conversations recorded live from the National Prevention Network Conference, where the theme was shining a light on prevention.

In this episode, you’ll hear from two exceptional leaders who are driving impactful change in their communities and beyond. First, we have Ben Stevenson from Maryland who oversees prevention and harm reduction services in Montgomery county. We’ll also running his own consulting firm. Ben shares his experiences, challenges and successes in empowering youth. And integrating prevention with harm reduction in innovative ways. Then. I had the opportunity to sit down with Steve Miller. A true prevention champion. Long-term recovery advocate and fellow podcaster. Steve takes us on a journey through his work in prevention. The powerful role that music has played in his life and in his recovery. And how it continues to inspire his mission to help others. These conversations are full of wisdom, practical insights, and inspiration for anyone involved in prevention work. So let’s dive in. And hear from these incredible prevention leaders.

The Vision, a world where all people live free of the burden of drug abuse. This is the Drug Free America Foundation’s Pathway to Prevention podcast, where we are committed to developing strategies that prevent drug use and promote sustained recovery. Thank you for not only tuning in, but your continued support and efforts to help make this world a better place.

We hope you enjoy this episode.

Alright, so, first off, coming to folks here from the National Prevention Network Conference, would love for you to just introduce yourself.

Okay. All right. So I’m Ben Stephenson from Maryland. So I work in, oversee, prevention of harm reduction services for Montgomery County, Maryland and then I also own a best consulting LLC. All right, rock. And so tell me a little bit about the work that you do, whether it be through your consulting company or the harm reduction work, what do you do?

Sure. So, on the prevention side, oversee, all of our prevention, education and awareness efforts. So that includes community awareness campaigns, efforts around drug take back. Also oversee a youth ambassador program. So, we have used, we pretty much empower young people to use their voice to educate about the dangerous substances, mental health, wellness, and in advocacy, we train them in advocacy.

And then on the harm reduction side, oversee our Narcan training and distribution efforts. A syringe services program as well as our efforts to distribute, fentanyl test strips, xylazine test strips, currently working on expanding harm reduction services into vending machines, and other avenues to try to, you know, meet people where they are and support people until they’re ready to pursue their treatment and recovery.

And then on the consulting side, I’m a SAPS trainer, so I was a part of the consultants that, update the SAPS curriculum. So, now it’s the SPF application for prevention success training versus the substance abuse prevention skills training. I also, also an ethics trainer, and then I also do, you know, conference presentations.

But this week, I decided I just want to be a participant. So, you know, participating in the NPN. Taking it all in. Yeah. All right. You got a lot of work. You’re doing. I can only imagine that through doing that work, getting it started, maintaining, sustaining, growing that work. You’ve encountered some, some challenges or barriers.

What are a couple that come to mind? Yeah, I think that the main challenges you can think of are related to maybe stigma, still stigma around substance use. So people not necessarily understanding, how prevention or how harm reduction works. How they can be married together in a sense to build a stronger system.

I think it’s been a lot of like education on my end and my team’s end to try to educate people on how this, how it could look, how it could work together versus, hey, you have this funding. They have that funding and then you don’t really, you know, communicate. Then of course, you know, me working in county government, sometimes you have some extra hoops and hurdles to work through.

To overcome. Which is of course, you know, a challenge within itself. But, you know, you just still, you get up every day. You fight the good fight and the, and the joy of prevention is that it’s always changing. It’s never the same. So you just adapt to the times and figure out how you can be innovative and help your community.

What are some of those successes that you’ve seen? I think for me as of late, so, we’re moving into our fourth year of having a youth ambassador program. in totality, I’ve been with the county for 10 years. It’s something I’d always wanted to do because I knew the power of the youth voice.

So giving them that space, I think has been very rewarding for me. You know, working with adults, you can kind of burn yourself out, but working with kids, they energize you, right? So I think this past couple of years, you know, the youth really were in tune with, You know, what we’ve been experiencing as a country around opioids and overdose deaths and wanted to do something.

So, you know, I worked with a group of young people who wanted to change policy within the within the school system so that you could carry Narcan within school. So you, you can carry Narcan in our school system without feeling as if they’re going to get punished. Right. Then also all of the schools have are equipped with Narcan all the way down to the elementary school.

Then this past year, youth wanted to actually train their peers on identifying the signs and symptoms of an overdose, how to respond, and how to administer Narcan. So, we trained 11 of our youth ambassadors to train other, their peers, and they trained about 300 youth last year and adults. So, I think, you know, that has been a, a major success because now the school system has seen it and they’re like, Hey, we want to make sure that you have youth ambassadors from every high school in the county where there’s 26 high schools and I’ve had representatives from maybe 11 of them.

So trying to get across the entire county and then build up the infrastructure to where you build a pipeline of those youth having that same message from the middle school level all the way to the high school. So once the high school situation gets solidified, we can filter it down to the middle school level.

I’ll call it a 10 year journey that you’ve been on and still are on to get the youth ambassador program to where it is today What might be some tips or some things you’ve learned that you can share with our listeners? Yeah, I think one challenge that I ran into initially was trying to establish smaller youth ambassador chapters at each school Which of course in those situations Me being in such a large jurisdiction Those situations is hard because you got to have a sponsor at the school to oversee that.

So that was a challenge within itself. So I realized, okay, maybe I need to just pull it back and just do something countywide. knowing that, okay, you got youth from all over the county. How do you want to make sure they have the ability to meet without having to drive somewhere? So, luckily zoom has been, you know, or, you know, I think Google meets all kinds of platforms we use initially.

Have been phenomenal because it helps to keep youth engaged. but then also giving them the power to control it to not just having the voice, but they it’s their baby and let them know that, hey, we’re only going to be successful based off of you. I’m just here to support you and to put some fiscal, you know, money or put something behind you to support the strategies and initiatives you want to do.

So, I think having that youth co-chair model, Having youth officers, them leading the meetings, them pretty much recruiting, doing all those different things has been, you know, phenomenal. I just, I just sit back and just kind of watching it manifest, you know? Yeah, yeah. Well, I heard what sounded like a pretty good piece of wisdom, but you kind of just rolled right off your tongue.

You had a vision, the local chapter’s vision, but then you realized that that wasn’t the right path forward and you, you adjusted course. All still within that grander big picture vision of the youth advisory that not afraid to pivot. Right. Of course. And I think I learned that, from, you know, experiences with like larger organizations like CADCA and then seeing other organizations within my state that were doing youth initiatives that were maybe that jurisdiction wasn’t at the size of mine, but saying, Hey, They can do it.

We can do it too. and then just getting, you know, upper leadership to believe that it could be done. And now that they’re seeing it, they’re like, wow, how can we be a part? What can we do to support? Like, what do you need and things like that? And so, I think that has, you know, being able to put prevention in a place of prominence is important.

because you know, we have the, what the Institute of Medicine’s continuum of care. But sometimes people still don’t understand prevention because it’s not providing those immediate results. Right. And so, if you can see, if you can show some, some of those mild substance moments, you know, from, you know, kids sharing their experiences in the program from them sharing what they learn, to, you know, county leadership, seeing them present and articulate themselves in a way that they’re just like, wow, these are some and even trying to get, you know, to the kids who might be on the fence of if I want to use or not, Hey, this seems pretty cool.

And I can get community service hours and, you know, writing recommendation letters for college. And we’ve gotten to a place of giving honor cords for graduating seniors that could wear graduation. So when other kids are seeing it, they’re like, Hey, I want to be a part of that. I think that kind of speaks to.

The importance of like, not only addressing risk factors in our community, but also addressing those protective factors. So that positive opportunity to belong is important because I, I mean, I can see it, you know, I can see the importance of it, right? Yes. So I’ve got, I’ll say I’ve got four questions left.

Okay. You touched on two things that I hear from folks in the prevention field all the time as far as barriers, challenges, or how the heck are we supposed to do that? Yeah. One getting upper leadership on board, but then also the, the buy in and the, the youth taking ownership. Yeah. What kind of insights or experience could you share there for our listeners?

Yeah. So, I learned a lot from, you know, just some time working with, with CADCA and a really good friend of mine oversaw like the youth leadership initiative and that mantra of youth, youth led, but adult guided. And I really believed in that because. I could see how like the, like the youth that were working with, with CACA in those spaces, they were, they were very bright, phenomenal, and they were leading educational sessions, things like that.

And I was like, I know I have kids in my, or youth in my, in my county that can do that same thing. I just have to find them. it’s, it’s initially it kind of happened organically, but then, you know you started reaching out, Hey, I’m doing this project on such and such. And it’s related to fentanyl or whatever.

And I’m like, well, why are you not in my program? Like, what have you been doing? And then they’ll sign on and they like, Hey, I don’t know why I haven’t been here, but I’m happy to be here now. Right. Yeah. So I think really just understanding that it’s not going to happen overnight. You got to just continue to just keep, keep fighting a good fight.

Eventually those things that you want to change and manifest in your community will happen. Like Rich Lucey from DEA says prevention is about the long game. Yes. 10 years running. Yeah. I’m curious if you have a, a good story that really shows the impact of your work with the youth and stigma, whatever it may be. Just a story that talks about the, the impact. Yeah. So I used to get requests to, do presentations at high schools, right? And you never really know, you never really know the impact of those presentations because you might be presenting to like a parent group or something like that.

Right. And so, we eventually got to a place of wanting to train all of our bus operators in the lock zone administration so that they can have Narcan on the bus and things like that. Just in case overdose happens on the bus. Well, not knowing that one of the administrators or one of the managers of supervisors over the transit system was in one of my presentations at the high school because their daughter was a student at the high school.

it was a full circle moment because he basically said to me, he was like, a lot of the things you share that night helped me and my wife because our daughter eventually dealt with substance use disorder. But we knew what to do to help support her and navigate her through that space.

So that really like it was a real like aha moment to me that, you know, what we’re doing is working. And yes, if someone does go down that path, you still want to make sure you give them those tools and maybe you can help bring them back in and keep them safe and keep them alive.

Right. So, I think that was just, I mean, there’s been a lot of moments, literally you thought it gave me goosebumps. I can feel that, one last question, one last, but I promise, I promise, you mentioned earlier, you said it so eloquently about putting prevention in a prominent place.

The theme of this conference is shining a light on prevention. So can you give us, you know, a description of what does that, what does that mean to you? Yeah. I, I really feel like there’s a lot of opportunities for prevention out here, whether it’s through not only, you know, pursuit of grant fund is, but I think that’s mobilizing to say, Hey, you know, block grant funds haven’t changed in the past 20 years.

What? Maybe we need to advocate, you know, to get that shift. But I think making sure that we’re at the tables. of those who are in control of funding, right? And so, I think for me, I’ve been fortunate enough to be at some of those tables where, you know, we are gaining access to some of the, like the opioid abatement funds to build up the infrastructure of prevention in the county and to build up harm reduction in the county and things like that, which, you know, you know, treatment services and crisis services and other service areas, they’ve always had money to do the things that they needed to do.

But prevention never really had that. So I think, you know, continuing to, you know, do the work, advocate, you know, show, you know, positive results and get to those tables is important to help us get to that prominent level that, hey, we’re part of the continuum or the spectrum of services as well. We need to be funded in a way so that we can prevent all those people from having to go to treatment to him and experience recovery.

Right. So I think Not only, you know, advocating for ourselves, but also building up those allies to help us advocate, to show the power of prevention because it’s definitely a place for us. and, you know, we’re all in the same business of trying to, you know, promote optimal wellbeing in our communities, right?

The themes that I heard were persistence, perseverance. together. Yeah. And, and I would say a twofold listening and learning. Yes, of course. Cause I mean, we might be the experts on the process, but of course we’ve got to connect with those and collaborate with those people in the community because they’re the experts on the, on the story of that community.

We can’t really, you know, talking to a lot of my colleagues, we, we talk about shifting from being implementers to coaches or mentors so that, you know, you can sustain some of the efforts and outcomes that are in the communities, you know, so, so that’s the hope and goal, right? Yeah. All right.

What would be one final takeaway call to action to leave our listeners with? Yeah. I’ll just say that, you know, my experience in this field is that It’s important to network because you can always learn from somebody else. Something innovative, something creative that somebody else has done in another part of the country that you could maybe implement in your, your area.

and then always just, just making sure you stay abreast and up on top of, you know, language and evidence based practices and all those different things. Because I’ve only been in the field for 18 years and it’s changed exponentially over the course of that time. So. Just saying, staying abreast of that and staying engaged, mentors, having a mentor, I have multiple.

And if you feel burnt out, make sure you take care of yourself. Mom’s always said, if you don’t take care of yourself, you can’t take care of somebody else. So All right. Folks. That was, was an enlightening conversation with Ben. Who’s truly leading the way. In integrating prevention and harm reduction in his community. And I just loved hearing about his work with youth and this commitment to breaking down barriers is, is inspiring and really does offer us some valuable lessons for, for everyone in the prevention field.

But now we’re shifting gears to another powerful voice in prevention. Steve Miller is not only a longterm recovery advocate, but also someone who’s found a unique way. To incorporate his passion for music into his prevention work. Steve’s insights on the role of music and shaping behavior. And his own journey through recovery are both thought provoking and motivating. So let’s dive into my conversation with Steve Miller.

All right, folks, bringing you another conversation from the NPN conference. Where the theme is shining a light on prevention, and I’m honored to be hanging out here with the one and only Steve Miller, who is a prevention champion, prevention podcaster, man in long term recovery and is sharing his voice, his story, his wisdom to help make positive change in this world.

So without further ado, Steve, great to be talking to you again. Hey, thanks, Dave. I’m glad to be here. Yeah. Oh, all right. So we’re jumping right in. We’re jumping right in. I don’t want to, to really tell your background and why you work in prevention now, but I’m hoping you might be able to, to give us, we’ll say a cliff notes version of highlights real of.

What led you to working in prevention? That’s always an interesting question, Dave. And one of the things that I’ve realized, and this has been in the last couple of years, that I would have said, oh, there’s just been so many random things that have happened in my life. And then when I sat down and kind of looked at them on a timeline, I realized it was actually a straight line.

And it wasn’t something that was so haphazard. It was actually what was intended all along for me to be doing. And, and part of that is, is the natural evolution. As you said, I am a person in, in long term recovery. And so I’ve been working in either the treatment field or some variation of prevention for three decades now.

And so that’s really been my life’s focus is my own recovery. And, and then what I’ve learned in that journey is how do I kind of. Find my work through who I, who I really am. And one of the common denominators through all of this, before I was in recovery, since I’ve been in recovery and now in the prevention field has been this.

I call it the muse leading me through song, if you will, and I had to learn the prevention field. I didn’t know it existed. I didn’t know there was a science. I just kind of fit the description of what they were looking for as a new staff member. And I thought, Oh, I could do that. And it didn’t take me long to figure out that.

My guiding force through prevention is believing that by finding, we find our work through ourselves and when we do that kind of strengthens our commitment to do this kind of work, but it also strengthens the workforce because just like you, you’ve kind of found a path that leads you in the work that you’re doing.

But you started in prevention and I found a path by starting in prevention, learning the science, learning how the strategic prevention framework operates, all that kind of stuff. Then I stood back and I thought, does music belong in? And lo and behold, that’s kind of the answer has been, Oh yeah, it does.

Because it’s been such a powerful force in my life. I thought it’s got to be added into what I’m doing in prevention, added into your story, because like you said, it, it’s been a muse behind that straight line to prevention. So let’s just talk about that. Let’s, let’s go right there and talk about. Music.

You say it’s been your muse. What do you mean by that? How has it been your muse? People ask me when I talk about it, they go, so what instrument do you play? And I’m like, I play the radio really well. And if I want to, I can put a record on the turntable, but I am not a musician. I have been someone who has been an avid consumer of music like a lot of people since I was an adolescent.

And I tell a whole story through a training that I do about how music shaped my life, but how it shapes our lives. And then I just overlay that in the, into the prevention field, because there’s a lot of research that shows how music influences our choices. And when we’re adolescents and we’re trying to figure out who we are and what we want out of life and where we’re going to go, we’re very susceptible to outside stimulus and peer pressure is really what that comes down to.

And music can be a part of that music. Plays a part in helping us form our identity because we have such this creative bond with music. Everybody can think for themselves, what was that song that was the soundtrack to your life as an adolescent? Did you dance to? Who’d you fall in love to? Who’d you hang out with your buddies?

You know, what was the, what was playing in the background? And we all kind of have that somewhere inside of us. My choices happen to be very detrimental and that was a part of my addiction. And then when I found myself in a recovery process, it was music again, that kind of just woke me up and made me realize there are messages in all of these songs that are beneficial to who I am at this particular point in my life.

So that we’re kind of a meditative process. But then when I got into prevention, I started thinking, how could, how could my experience And how could the research that supports my experience be beneficial to a message that would target an audience that’s either adolescents, or I talk about how music is a part of the workforce development in my life, music, really.

I start my day with it and I probably end with it, but I start most days with a song. And I mean, to prove that to you this morning, I woke up with a song in my head. And I sat down in the, before I even really get out of bed, I write kind of a journal entry about that song and what it means to me and how it kind of feels like it’s guiding me for the day, what that intention would happen to be.

And I’ve just followed it because it’s fun. I feel like I’m kind of the only one that does it. I’ve shared these ideas with other people, but been very insightful for me. And, and, I still provide training and technical assistance through prevention to lots of audiences, but there’s this little niche that I talk about where the music kind of fits right in there, I’d like to, to zoom in and.

Wanna really. Invite you to share a great example of, of how music played a part in your addiction. You said you kind of, it kind of kicked you off and had a prominent role there. Can you give us that, that kind of that, that clear example, like what happened? I mean, think, and I was trying to get, we were talking about this for the, for the audience to kind of.

I was how to Get this in their mindset as well. If you think about a song that you hear and when you hear it, you’re kind of transported to a time and place in your life. Now, I have a song that always takes me to exactly the same memory and it’s, it’s uncanny that I actually, it was, it’s, it’s a song by ACDC and it takes me to the lake outside of the town I grew up in.

And it’s not just the song and the, and, and the association of that time in my life. I actually, I’m telling you right now, it’s almost like I can feel the air around the lake on my skin. It, it’s like, It’s being transported to that memory and reliving it again. And that’s how powerful music is. So I ask people all the time, what is that song for you?

And why do you have such a strong association with it? Maybe it’s because you fell in love, you know, that kind of thing. Maybe it’s the first dance you ever had, because I have that story as well. But there was a time in my life when if you’d have said, Oh, Steve, you’ll smoke cigarettes, or you’ll drink alcohol, or you’ll use some kind of substance.

I would have thought you’re, you’re crazy. Cause I was like any other kid that I grew up with. I played sports, hung out with my friends. We rode our bikes everywhere. I grew up in the 1970s. Anybody that’s listening probably knows what that was like. And one day, I mean, I know that it was a Saturday. I know that it was eight minutes after nine o’clock in the morning and an older brother To one of my friends came into the room and put on a song and in that moment, everything about what I thought life was changed.

And the song to me was rock and roll. And I thought it was about something that I wanted to pursue. And it was really about. In that moment, to me, it was about using drugs and alcohol. Now, I had some experience with it before then, but after that moment, everything changed. I mean, it was like a slipper slide.

It went downhill quick. And then years later, when I got curious about this topic we’re talking about, I got to looking at that specific song. And I realized that song is not a pro drug use anthem that I thought it was. It’s actually a very thought provoking message to one of the singer’s bandmates because he was concerned about his own health and his own life because of his substance use.

And I, so I point out to the audience that as adolescents, we kind of make a lot of things up based upon what we want to hear, because we’re looking for that, that identity, who are we, where are we going? How do I feel those kinds of things? And a song can slip right in there. And I’m not unique in that fashion.

I have talked to several people in the last 10 plus years that have told me stories about how they heard a song and made a decision in the moment. And sometimes I’ve stood back and said, you did what, and then they explain it to me and it makes perfect sense because of the time of their life, what they were experiencing, those kinds of things.

And so that song really impacted my life. In a very detrimental way, some people, it impacts their lives in a very positive. And I’ve talked to some that it, a song shaped their life in a way. It is very financially rewarding. So I think it’s across the board. The question is, is do we ever, do we ever really listen to what that song is actually saying to us or how we feel about it or what it means to us?

And I think that’s the key is really being in the moment and aware enough to know that this song may say one thing, but I may take it another way. And then when we’re adolescents, it might behoove us to ask someone, an adult or someone we trust. This is what I hear this song saying, as opposed to this is what I think this song is saying.

So getting some of that feedback and checking that out before I make some sort of a critical life decision. And that’s basically, we talk in prevention about media literacy. So that could be printed or television ads or radio or social media, whatever that looks like. I just put it under the heading of it’s really about music literacy and understanding the impact it has in our lives.

You just made me kind of understand about myself. There’s a lot of songs that I love and they make me feel a way when I hear them and they take me back to those moments like you talked about, but I can’t say I know all the lyrics. I may only know just the chorus or one line, but I love these songs because of the memories I have, the feelings I have associated to them, like the, for my, my wedding.

I asked for a, I call it a secret first dance. I wanted to dance a specific song before we went into the actual like dinner afterwards. And so it was just my wife and I, and the photographer and that’s it. And I don’t know the lyrics to that song. I know the title of it and the artist, but that’s it.

But I love it whenever I hear it. Come on. It takes me right back to that moment. We’re having our moment. Yeah. Yeah. But I don’t know the lyrics. And what’s interesting is I watched it was. A reel on one of the social media channels just in the last couple of days. And it was something that said as a Gen Xer actually listens to the song and, and you can see ’em kind of keying into what the message is and being like, oh, I didn’t realize that’s what that song was saying.

Right? Mm-Hmm. . Mm-Hmm. . And, and that, that fits the bill. Some of us know that hook and some of us know just the, the feeling that we get. That’s associated with the song, but there’s a lot of research out there that says, even if we’re not consciously aware of the lyrics, some part of our brain is picking up on the messaging of that.

Now, whether that’s detrimental or whether that’s inspiring or whatever that looks like is different for the individual. No two songs are the same. But like I said, I hear a song and, and the song I heard this morning is one that I really only know the hook to, like you just said, so I Googled the whole lyrics and then I sat down and wrote a little passage about it, but I have had experiences where I woke up and I had that same thought, you know, some, some, some statements going through my head and I’m like, I don’t even know if that’s a song and then I’ll say, I’ll Google lyric and then whatever it is I’m thinking, and if it comes up as a song and I yeah.

I’m amazed. There’s been times when I’ve done that and I swear to you, I have no recollection of ever hearing that song in my life. Now, where did I pick it up? Why did it come to me in my sleep? I don’t know. But I am fascinated by the fact that when I’ve been led to understanding that there’s some something stuck in my subconscious, if you will, and it ekes out when I wake up in the morning and it’s a song that I picked up somewhere along the way, I just don’t know where or when or why, but that’s why the why is like, well, why is this showing up?

And then I try to kind of analyze it, kind of meditate on it, gives me a way to set my intention for the day. And sometimes I might share that with other people if I find it a profound insight in some way or another, I’m going to draw a connection that might not be there or not, but I’m reaching for it.

And I know and trust that you’ll be like, ah, Dave, there’s no connection there. But I talk a lot about the power of storytelling and prevention, treatment, and recovery, both for the, the listeners, but then also for the actual storyteller themselves, but songs. They have the story element, they have the story factor too.

So wouldn’t that be sort of one in the same? I think so. I’ve, I’ve heard people talk about that songwriting really is a gift because I’ve seen interviews with artists or authors that have written books and they’re like, they can tell a story in three and a half, four minutes that takes me a chapter or two to tell, but they can synthesize it down in a way.

And that’s the part like that led up to anything really being, you know, like understanding how music impacts me emotionally as an adolescent, because my parents played music when I was growing up, but the songs that stick with me to this day are the ones that tell a very vivid story. And so I’m kind of a storyteller of sorts myself, but I like a song that tells a really powerful story.

So as an example, The first song that I really can remember, I wanted that song so bad. And it was a, it’s a singer named Jim Croce. And the song is bad, bad Leroy Brown. And I was a nine year old boy. And I mean, bad, bad Leroy Brown was the baddest man in the whole damn town. Badder than old King Kong and meaner than a junkyard dog.

And to a nine year old boy, it’s like. I want to be, you know, like to me, it was like the he’s respected and, you know, he’s a tough guy and, you know, kind of things that as a nine year old boy, you’re playing G. I. Joe and playing army with your buddies. You know, you’re kind of wanting to be that masculine kind of identity.

And that was what bad, badly Roy Brown was. But it’s a very vivid story song. And a lot of Jim’s work is story songs. And so I’ve always sought those out. I like all kinds of music. I don’t pick a genre, but the ones that seem to rise to the top are the ones that tell me a story about something that I don’t understand.

And I’m, as I’m explaining this, I watched a documentary about a group and, and they had on there as a guest, he was a professor of music of some sort from a university. And he said, I had a student that did a, master’s thesis on this particular subject. And he spent all semester long or all year long, however long that takes and wrote this thesis.

And he said, this singer captured the same essence in three and a half minutes. That’s the power of a song. And if you can deliver that and people can really kind of onboard that, it can be powerful in a lot of ways, or it can be, like I said, it can be, it can be harmful in ways. So it just depends on the listener and how you.

How you perceive it, how you receive it and, and how you may or may not act on it. I want to ask about a powerful song that if I remember correctly, as part of your journey as to where you are today. So if I, if I throw out the Beatles song help, where does that take you to in your life? Well, that’s the turning point.

I’ve actually written a short story for a friend of ours that’s doing a collection of legacy stories. And I kind of tell the story through two things, the, the song that was kind of the gateway into substance misuse. And then it was the song by the Beatles help that was kind of the book into it. And it was the one that really kind of illustrated to me that songs spoke to people in very unique ways.

And it was a Catholic priest that was talking about the fact that, the lyrics of a popular song could be the catalyst to get someone’s attention about their addiction. And I remember thinking in that moment, wow, I wonder if that would happen for me. Now, when I look back, the surprise is it was happening to me, right?

But that’s the desperation of, of that point when you’re asking for help in recovery and the Beatles song help is, was the song he illustrated. And if you look at those lyrics. Makes perfect sense. When I was much younger, so much younger than today, I never needed anybody’s helping. Well, here I am in a institution asking for help and realizing that someone has captured that essence of what I’m going through and put it in a song and it kind of planted that seed like, well, what other songs are in my life that might be signposts and.

Those kinds of things. And, and I was a huge consumer still lamb, but I had more time on my hands when I was younger. I was a huge consumer of music and I worked in television at the time and the general manager’s assistant just one day casually said to me, Steve, how long has it been since you listened to any music?

And I said, it’s kind of a strange question. And she said, your personality is different when you don’t listen to music for a period of time. And that’s another point in my life when I was like. What, what is this all about, you know, and I started at that point, not just listening to like a popular song that I liked, I started like listening to entire albums, like what’s being portrayed here and I read an article and, and the author had said that if you really want to understand The author that writes popular novels or something like that, read everything that they’ve ever written, and you’ll have some understanding of who they are as a person.

And so I started that through the lens of music and started thinking about some of the artists that I was enamored with and started listening to their entire albums and their entire catalogs, just to kind of seek out, like, What has been the path for this person and, and lo and behold, after doing that for years on end, it found its way into the prevention work.

To me, it’s really about following the muse, if you will, or following your own life’s path. And in prevention, that’s kind of where I started in, in prevention. If you stick around here and you find some attraction to it. I think you have to put yourself into the work at some. It has to start becoming a reflection of who you are.

You have to be vulnerable enough to really say, this is this is kind of who I am. And this thing that I do kind of all merged together because for me, prevention and my recovery, but. Prevention is really about people. Somebody I know says prevention is better together, and together we are stronger. And that says everything about prevention.

Because it doesn’t happen in a vacuum. You can’t go in and change a community’s rate of underage alcohol consumption just by telling the chief of police or having an article in the newspaper. You have to get people together in a concerted effort. Effort to make a difference. And that’s why I do the work that I do.

And that’s why I’m passionate about bringing the music into it, because I think we all, whether we’re as active in their consumption of music as I am, I think we all have been touched by music or love music in some form or fashion. And if I can just help people to see that maybe those songs are speaking to them about something, then, then that’s, that’s kind of how it’s played out in my life.

I say that I practice a two way communication with music. I listened to the song and then I asked the song, what is it that you want me to hear from this? And then I try to write about it. So I know we could talk for hours. But we’ve got a conference to get back to, so I want to just throw one more thing your way before we wrap up this chat as a to be continued.

But I’m curious, what’s final takeaway if you’re going to leave with one thing, what’s it going to be or call to action for our listeners from around the globe? Well, I love the call to action and it is think about that song. What is that song that stops you in your tracks and takes you to that moment?

And why is it so? Unbelievably powerful in your life. And, and like I’ve already said, think about what it might be saying to you, because it’s unique. I heard Dave Grohl, he’s the lead singer for the band Foo Fighters, and others might know him as the drummer from Nirvana, but he said, the amazing thing is, is he said, I can stand on stage and I know that I am singing this song to 80, 000 people.

But the beauty of music is. 80, 000 people are singing back their own interpretation of that song. To me, that really personalizes all of this in that I think music is a very powerful presence in our lives and it must serve some greater purpose because a question I’ll often ask is. Music doesn’t have to exist, but it does.

Think for a moment that music no longer is a part of your life. And I’ve never met anybody say, well, I won’t miss it. Most people are like, wow, that means there’s, there’s no soundtrack at the movie, the commercials are just talking heads. You don’t even know that birds chirp because that’s music. If all of that was gone from our lives, what a different world it would be.

So I turn it around and say, this must mean that there’s something here. And I would always challenge people just to ask themselves, what is the value that music plays? And with that listeners do some thinking, do some listening and have a conversation with some songs. Steve, thanks for taking time to chat.

Always, always, always a pleasure. Thanks, Dave. Always glad to be here.

That concludes this episode. Thanks for tuning in. Be sure to hit the subscribe button and share this episode with a friend before you leave. And we look forward to seeing you on social media because prevention is better together. Together, we are stronger.

 

Source: Drug Free America Foundation

 

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

 

Published July 11, 2024

By Andrew Hutchinson

 

X is taking another step in combating the promotion of illegal substances in the app, by signing up to the Prevent Alliance, which aims to establish more definitive rules and approaches to combat synthetic drug promotion within social apps.

Synthetic drugs aim to replicate the effects of more commonly known illicit substances, like cocaine, marijuana and LSD. Arguably, the most notorious synthetic drug is fentanyl, though there are many other dangerous variations of synthetic substances that have now established a market among drug users around the world.

And they can cause serious harm. Research shows that the repeated use of synthetics can cause “long term or irreversible damage to dopaminergic, adrenergic and serotonergic pathways in the brain”.

The more potent mixes can also lead to more serious side effects and harms. As per the CDC, synthetic opioids are now the primary driver of overdose deaths in the United States.

As such, it’s important for X, and indeed all social platforms to crack down on the promotion of synthetics, and this new initiative will ideally help to establish more detection and prevention processes among social apps.

Though, at the same time, X owner Elon Musk himself takes ketamine, a synthetic substance, and his high profile endorsement of this, and other synthetics, could run counter to the aims of this project.

Probably best to view the two in isolation (and Musk, it’s worth noting, uses ketamine in a prescribed capacity), though with Elon’s celebrity, and his desire for attention, that’s increasingly difficult.

Source: www.socialmediatoday.com

Attorney General Russell Coleman proposed a statewide, youth-focused addiction prevention initiative before the Kentucky Opioid Abatement Advisory Commission Tuesday.

The Commission unanimously approved the two-year, $3.6 million proposal, which is centered around a research-backed youth education campaign.

This campaign, called “Better Without It,” will feature data-driven outreach to engage with young Kentuckians where they are, including on social media, streaming platforms, college campuses and through partnerships with influencers. The campaign will showcase positive, Kentucky-focused messages designed specifically to encourage young people to fulfill their potential.

The Commission and Attorney General’s Office will partner with prevention experts and creative marketing professionals to build the educational campaign that is compelling to young Kentuckians.

“Our kids are growing up with no margin of error. As little as one pill can – and is – killing our neighbors. Today, the Opioid Commission joined with our Office to build a prevention program that will give young people the encouragement that they are better without it,” said Attorney General Coleman “We will reach Kentucky’s young people where they are with a message that resonates. I’m grateful to the Commission for their strong support for this program that can truly save lives.”

In addition to the education campaign, the prevention program will also promote existing school-based programs and amplify the work of the Commission to support youth-focused prevention efforts.

To date, the Commission has distributed more than $55 million to combat the drug crisis, directly helping Kentuckians overcome addiction and promote long-term recovery.

Source: https://nkytribune.com/2024/09/attorney-general-coleman-announces-statewide-youth-drug-prevention-campaign/

Source: https://www.dea.gov/redribbon?
Posted 

October is National Bullying Prevention Month. Bullying prevention programs begin locally, with communities and the individuals within them creating safe and supportive schools, organizations, neighborhoods and family units.

While this campaign is not as recognized as much as the months dedicated to overdose awareness and suicide prevention, it is equally as crucial. Bullying is linked to drug addiction and suicide. Bullying prevention campaigns help save people from substance abuse and increase awareness in local communities.

According to the PACER’s National Bullying Prevention Center, one in five students report being bullied, but the actual number of bullying incidents can be far more significant. Roughly 41 percent of students who reported being bullied at school indicated that they think the bullying would happen again.

Anyone can be the victim of bullying. A poll conducted by the American Osteopathic Association found that 31 percent of Americans have been bullied as an adult.

The most common reasons for being bullied reported most often by students included physical appearance, race, ethnicity, gender, disability, religion and sexual orientation. The effects of bullying are serious because bullying increases the risk of depression, anxiety, substance use and even suicidal ideation.

According to the NYS Health Department, suicide is the second leading cause of injury-related deaths among New York State residents. National drug abuse statistics coming from the NCDAS show that 8.3 percent of 12- to 17-year-olds reported using drugs in the last month in New York State, and 18- to 25-year-olds are 8 percent more likely to use drugs than the average American. While there are countless reasons why someone would use drugs or alcohol or struggle with suicidal ideation, bullying is often an underlying factor.

National Bullying Prevention Month strives to prevent childhood bullying and promote kindness, acceptance and inclusion. However, anyone can prevent bullying and be part of the solution.

Start by knowing the signs of bullying. This makes it easier to intervene quickly. Generally, you could see shifts in behavior, such as a student becoming more withdrawn. The person could lose self-esteem, become ill, or change eating or sleeping habits. Students begin to lose interest in school and their grades are impacted.

Self-destructive behavior is also typical, such as using drugs or alcohol, or committing self-harm. Parents might see unexplained injuries, or lost or destroyed property as a result of physical bullying. You might also notice the person has become anxious, stressed and even depressed.

Knowing the warning signs is the first step, and the second is intervening. Kids or adults who are being bullied are not quick to talk about it. It’s a good idea to listen to them, assure them you want to help, and let them know it is not their fault this is happening.

Understand that it is painful for anyone to speak up about this, but begin discussing what can be done. Encourage them to speak to someone, such as a teacher, co-worker, friend, counselor or someone in a position of authority who could step in and end the bullying.

Moreover, work to remedy the situation, get people involved and follow up, as bullying does not stop immediately. The bully should also be informed that their behavior is wrong, harmful and, in some instances, illegal; make it known that it will not be tolerated.

Look at some local anti-bullying resources, such as the Advocates for Children of New York, New York State’s Dignity for All Schools Act, and the NYS Center for School Safety.

Early intervention is vital and even more critical if the individual being bullied is using drugs or alcohol to cope. In addition to this, anti-bullying programs are excellent resources for schools, communities and the workplace, and should be implemented. These programs save lives and encourage more people to become aware and help others.

Marie Garceau has been working in the field of substance use and addiction recovery for over a decade. She works at DRS and primarily focuses on reaching out to the community and spreading awareness.

Source: https://riverreporter.com/stories/preventing-bullying-can-prevent-substance-abuse,167846

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

October 18, 2024

WASHINGTON – The U.S. Drug Enforcement Administration recognizes the Red Ribbon Campaign – the nation’s largest drug prevention effort – throughout the month of October by providing drug prevention, awareness, and education that encourages living healthy and drug-free.

DEA’s Red Ribbon Week is recognized October 23 through October 31 every year and honors the life of Special Agent Enrique “Kiki” Camarena who was tortured and brutally murdered by drug traffickers in Mexico in 1985.

“DEA honors Red Ribbon throughout the month of October to spread awareness and promote the importance of drug use prevention. We want to save lives by raising awareness about deadly drugs,” said DEA Administrator Anne Milgram. “The sacrifice DEA Special Agent ‘Kiki’ Camerena made motivates us to continue our important work to save American lives through our enforcement and outreach efforts. We know the work we do today will shape the future of our tomorrows.”

DEA’s Virtual National Red Ribbon Rally premiered on Tuesday, October 8, and is available for viewing throughout the month of October on www.DEA.gov/redribbon and www.getsmartaboutdrugs.com.

The National Red Ribbon Rally includes an opening video by DEA Administrator Anne Milgram; a musical performance by students from Volcano Vista High School in Albuquerque, New Mexico; the presentation of colors by the Greater Cleveland Color Guard in Cleveland, Ohio; the premiere of the “No Second Chance” fentanyl PSA from students in Tempe, Arizona; and the Red Ribbon Pledge led by students from the Richmond, California, Police Athletic and Activities League. The winners of DEA’s 2024 Community Drug Prevention Awards and Visual Arts Contest will be announced, and viewers will learn many ways community groups and families can get involved in this year’s Red Ribbon Campaign.

As part of the Red Ribbon Week campaign, DEA and the Substance Abuse and Mental Health Services Administration are sponsoring the 9th Annual Red Ribbon Campus Video PSA Contest. Last year’s winners and information on how campuses can submit a PSA can be found at www.campusdrugprevention.gov/psacontest. DEA is also a co-sponsor of the National Family Partnership’s annual Red Ribbon Week Photo Contest. More information is available at www.redribbon.org.

Red Ribbon Week began in 1985 in Kiki’s hometown of Calexico, California, and quickly gained momentum across the state and then across the rest of the country. The National Family Partnership turned Red Ribbon Week into a national drug awareness campaign, an eight-day event proclaimed by the U.S. Congress and chaired by then President and Mrs. Reagan.  Every year since, Red Ribbon Week has been celebrated in schools and throughout communities.

President Biden has designated October as National Youth Substance Use Prevention Month and the Red Ribbon Resolution for 2024 has been introduced in the U.S. Senate to support the goals and ideals of Red Ribbon Week.

Source: https://www.dea.gov/press-releases/2024/10/18/dea-supports-2024-red-ribbon-campaign-promote-healthy-drug-free

Counties will approach enforcement differently, providing yet another large-scale experiment in drug policy.

by Troy Brynelson|Oregon Public Broadcasting

October 17, 2024

Days after Oregon officially recriminalized drug possession, Douglas County Sheriff’s Deputy Ryan Gomez found himself helping with an arrest.

Officers in the town of Sutherlin stopped a car near a park, he recalled. They spotted fentanyl and methamphetamine inside. He and the officers arrested the man for misdemeanor drug possession.

Recriminalization went into effect Sept. 1. Before that date, drugs would have resulted in far less punishment. Officers would have ticketed the man.

“Now, there’s consequences to the actions,” Gomez said. “He has to face the judge and explain his actions.”

It may have been a different story for the man had he been stopped in a county deploying a new state program called “deflection.” It aims to get people criminally charged for possessing small amounts of drugs into treatment, in lieu of going to court.

Lawmakers over the summer offered counties state dollars in exchange for creating their own deflection programs. More than 20 counties applied, submitting plans that involved activities like establishing shelters and pairing police with substance use experts.

For example, a person in Multnomah County who has drugs, but no outstanding warrants, may be deflected away from the justice system. They go to treatment instead. A successful trip could result in the person never facing a criminal charge.

Other counties, like Douglas, didn’t apply at all.

What’s left is a patchwork of drug enforcement policies across the state. The contrasting approaches may look starkest at the border of Douglas and Lane counties. Both counties straddle Interstate 5 and are planning widely different approaches.

Lane County officials tell OPB they are planning a robust deflection program. Douglas County, on the other hand, plans to try policing illicit substances like the old days.

‘By golly, he‘s going to prosecute them’

In opting out of the state’s deflection program, Douglas County Sheriff John Hanlin is conscious that the county may look severe. He believes jail and the justice system can turn lives around.

To him, Measure 110, the voter-approved decriminalization of drugs in 2020, failed in its aim to improve drug users’ lives. He and his deputies had few means to get people into treatment without criminal charges looming over their heads.

“Don’t get me wrong; I believe treatment is an extremely important component to this drug problem that we’re dealing with,” Hanlin said. “Treatment works, but only if there are consequences that go along with that.”

While every deflection program will be different, criminal charges can still be leveled against a person if they don’t comply.

Hanlin noted that landing in jail for a drunken incident when he was a teenager proved a wakeup call. He also brought up his 31-year-old son’s ongoing addiction, which has led to a lengthy rap sheet of misdemeanors and felonies in Douglas County.

“If he got arrested and spent a day in jail and got out the next, that wasn’t even long enough for him to realize that he’d done anything wrong,” Hanlin said. Jail is “a necessity if you want to wake them up and get them to think, ‘You know what? I think this problem is getting out of hand.’”

Deputies made nine arrests in September under the new recriminalization statutes, according to a sheriff’s department spokesperson.

Overdose deaths have been rising. According to data from the Centers for Disease Control and Prevention, overdose deaths rose from 23 in 2020 to 43 in 2023. That’s less than 4 for every 10,000 people.

The sheriff, first elected in 2008, said it was a joint decision not to participate between himself, District Attorney Rick Wesenberg and the county’s Board of Commissioners. Wesenberg and the county commissioners did not respond to multiple requests for interviews.

Hanlin said he wanted to take a wait-and-see approach with deflection: Let other counties go first with their experiments. He added that the county worried about using one-time state grant dollars without assurances of ongoing funding.

He doubted empowering his deputies to enforce stricter penalties would lead to unintended consequences, such as crowding the jail.

“Most of these cases are going to be cite and release cases,” he said. “But the DA assures me that, by golly, he’s going to prosecute them.”

A drug user’s fate is then up to the courts, Hanlin said. Douglas County does offer diversion programs and a drug court that aim to soften punishment and help drug users get clean.

“I don’t think we can arrest our way out of the drug addiction problem,” Hanlin said. “But I know that, obviously, doing nothing isn’t going to cause the problem to go away either.”

‘A lot of folks just want to see people get help’

Crossing the county line north into Lane County, one will find a completely different approach. Officials there hope to get more people into treatment and keep them away from jail cells and courtrooms as much as possible.

Oregon gave Lane County $2.1 million to assist. That will help pay for housing, officials said, and for a team of substance use specialists, known as navigators, who work with police and decide if a person should be deflected.

Clint Riley, who is leading the program, said he has traveled to the county’s various police agencies to help train them on when to call a navigator.

“That’s a different training that most of us have never been to before,” Riley said. “Maybe five years ago, you would have taken this person to jail. Now, we’re using a different approach. So it’s crucial that the relationship between navigators and law enforcement is good.”

Law enforcement agencies seem to have bought in. Chris Parosa, the Lane County District Attorney, said officers are glad drug laws have more teeth yet they aren’t necessarily being asked to make many more arrests.

“That’s where the opportunity lies for them,” Parosa said. “Instead of having to – prior to ballot Measure 110 – have those people arrested, take them down to jail, fill out probable cause affidavits and immediately begin writing reports because that person is in custody, they can call out a person who is detached from the criminal justice system to take custody and control.”

Lane County is already home to one innovative first-responder program. CAHOOTS launched in the 1970s as one of the first-ever services dispatching mental health specialists through 9-1-1 to help people in crises.

Their deflection plans will effectively turn Riley and the navigator into case managers for low-level drug offenders. Parosa said the navigators will keep informing the county if people are actively pursuing treatment and not skirting responsibility.

“I’m not trained in the realm of substance abuse treatment,” Parosa said. “I’m a criminal attorney. It would be highly inappropriate for me as a criminal attorney to ultimately tell a substance abuse or behavioral health specialist how to do their job or what a person needs.”

Many of the navigators themselves will be ex-addicts, Riley said.

“Some law enforcement in our community might have arrested that navigator 15 years ago, when they were in that situation, and now they’ve completely changed their life,” he said. “They got help, got treatment, and now they’re working as a professional in our community with credentials.”

Lane County saw overdose deaths rise recently, too. From 2020 to 2023, deaths rose from 97 to 212, according to CDC figures. That’s about five-and-a-half deaths per 10,000 people.

The navigator program has not launched yet, according to Riley, but he envisions a system with wide latitude. A person facing criminal charges that aren’t inherently drug related – such as trespassing or theft, for example – may be able to get those charges deflected, too. The victim of a crime would have to agree, too.

“A lot of folks just want to see people get help, if they think it’s going to stop,” Riley said.

He doesn’t criticize counties like Douglas that are not participating in deflection. He acknowledged that many perceive Oregon’s drug decriminalization efforts to have failed. Another experiment can be daunting.

Riley formerly commanded the Lane County Sheriff’s Office jail. He said he saw firsthand that it was treatment, not jail in and of itself, that helped people. He said he helped launch new programs to get people medication and counseling.

“We started seeing people leave the jail in a better space, in a better place,” Riley said. “I’ve seen a lot of people spend a lot of time in jail and prison due to their addiction and, at some point, what stopped their addiction? For most people, they got treatment.”

Hanlin, the Douglas County Sheriff, said they are willing to learn from other counties if their programs succeed.

Source: This article was originally published by Oregon Public Broadcasting.

The recently released National Drug Control Strategy (2022) from the White House Office of National Drug Control Policy (ONDCP) lays out a comprehensive plan to, not only enhance access to treatment and increase harm reduction strategies, but also increase implementation of evidence-based prevention programming at the community level. Furthermore, the Strategy provides a framework for enhancing our national data systems to inform policy and to evaluate all components of the plan. However, not only are there several missing components to the Strategy that would assure its success, but there is a lack of structure to support a national comprehensive service delivery system that is informed by epidemiological data, and trains and credentials those delivering evidence-based prevention, treatment, and harm reduction/public health interventions within community settings. This paper provides recommendations for the establishment of such a structure with an emphasis on prevention. Systematically addressing conditions known to increase liability for behavioral problems among vulnerable populations and building supportive environments are strategies consistently found to avert trajectories away from substance use in general and substance use disorders (SUD) in particular. Investments in this approach are expected to result in significantly lower rates of SUD in current and subsequent generations of youth and, therefore, will reduce the burden on our communities in terms of lowered social and health systems involvement, treatment needs, and productivity. A national strategy, based on strong scientific evidence, is presented to implement public health policies and prevention services. These strategies work by improving child development, supporting families, enhancing school experiences, and cultivating positive environmental conditions.
Appeared originally in Clin Child Fam Psychol Rev 2023; 26:1–16
Source: https://psychiatryonline.org/doi/10.1176/appi.focus.24022020
The Narcotics Bureau (NB) and the Family Conflict and Sexual Violence Policy Unit of the Hong Kong Police Force have collaborated for the first time to stage a large-scale carnival, “Let’s T.A.L.K. LOL Party”, which will run for two consecutive days from today (November 16) at the West Kowloon Cultural District. The event will combine elements of sports, music and art to promote anti-drug and child protection messages to the public.


Officiating at the kick-off ceremony, the Commissioner of Police, Mr Siu Chak-yee, said that both anti-drug and child protection efforts have always been of paramount importance to the Police, and that the Force is committed to keeping children and young people away from drugs and violence, and to ensuring that they grow up in a safe and healthy environment. He also mentioned the importance of education as the first step in prevention. Enhancing the knowledge and awareness of children and young people about drug harm and violent behaviour is the key to effectively reducing drug abuse and child abuse incidents.

The Police emphasised that following the latest Policy Address, the listing of the emerging etomidate (i.e. “Space Oil”) as a dangerous drug is expected to take place in the first quarter of next year, and the implementation of the Mandatory Reporting of Child Abuse Ordinance is scheduled for January 2026. The Force will intensify its cross-territory enforcement efforts and multi-sector publicity campaigns, aiming to establish a stronger anti-drug cordon for children and young people.

In the first three quarters of this year, the number of young people committing drug-related offences recorded a year-on-year decline of 27 per cent, with about 100 arrestees aged under 21 for serious drug offences, while child abuse cases increased by 7 per cent year-on-year to 1 090, with the youngest victim of physical assault being under one year old. These demonstrate the effectiveness of anti-drug publicity and education initiatives, alongside heightened public awareness of child protection. Nevertheless, more significant outcomes require collective anti-drug and child protection efforts across all sectors to create a drug-free and violence-free community in Hong Kong filled with love.

The carnival’s kick-off highlight, “Love Our Children Yoga Challenge”, called for 640 participants performing partner yoga together, breaking the world record and bringing joyful moments to all involved. Other exciting activities include over 30 game booths set up by various departments, child welfare institutions, as well as 100 mentees from the Leadership Institute on Narcotics (L.I.O.N.); the “3D Post-Drug Simulation” on the anti-drug promotional truck; the child protection promotional truck, and sharing sessions by rehabilitating drug addicts, to convey the messages of love for life and “Drugs? Never ever!”.

Other officiating guests at the kick-off ceremony included the Director of Crime and Security of Police, Mr Yip Wan-lung; the Assistant Commissioner of Police (Crime), Ms Chung Wing-man; the Deputy Director of Public Prosecutions of the Department of Justice, Ms Catherine Ko; the Assistant Director (Family & Child Welfare) of the Social Welfare Department, Ms Wendy Chau; the Executive Chairman of the Hong Kong Youth Development Alliance, Ms Christine Lam; the Principal President of L.I.O.N., Mr Godfrey Ngai; Clinical Professor of the Department of Paediatrics and Adolescent Medicine of the University of Hong Kong, Dr Patrick Ip; Convenor of the Working Group on Child Protection of the Commission on Children, Ms Kathy Chung; and the Ambassadors of the Child Protection Campaign, Ms Linda Wong and Mr So Wa-wai.

This first collaborative anti-drug and child protection carnival by the Police carries triple significance: sustaining the efforts in the “Love Our Life – LOL Party” large-scale anti-drug exhibitions over the past two years to offer L.I.O.N. mentees a platform to showcase their learning outcomes; serving as the finale of NB’s Anti-Drug Campaign; and marking the launch of the “Let’s T.A.L.K. Child Protection Campaign 2024”.

Ends/Saturday, November 16, 2024
Issued at HKT 20:40
Source: https://www.info.gov.hk/gia/general/202411/16/P2024111600646.htm
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

The programs touch on various topics, including drug use and decision-making skills that could help youths avoid behaviors that put them at risk for substance use

NBC Universal, Inc.
Programs educating students about drug abuse and drug overdose prevention are now at San Diego schools, reports NBC 7’s Todd Strain.

Amid a rise in fatal fentanyl overdoses, a San Diego County task force convened to identify substance abuse prevention solutions for local youths. It released a report Monday outlining its recommendations for drug prevention programs at schools.

The report entitled “School-based Interventions for Substance Use and Overdose Prevention” was drafted by the San Diego County Substance Use and Overdose Prevention Taskforce, comprised of members of various entities including the San Diego County District Attorney’s Office, San Diego County Office of Education, California National Guard Counterdrug Task Force, Drug Enforcement Administration, and Center for Community Research.

With the goals in mind of preventing juvenile substance use and overdoses, the working group behind the report outlined five prevention programs identified for elementary, middle and high school populations: Positive Action, Project Towards No Drug Abuse, LifeSkills Training, DARE’s Keepin’ It Real, and Project Alert.

The programs touch on various topics, including drug use and decision-making skills that could help youths avoid behaviors that put them at risk for substance use.

Three other programs the report states may be instrumental to prevention efforts include:

  • Operation Prevention San Diego, a free DEA program with resources for educators that the report states “integrate seamlessly into classroom instruction.” The program addresses the impacts of drugs to the brain and body. The program is available to schools upon request or at operationprevention.com
  • I Choose My Future, a program offered by the San Diego County Office of Education that highlights substance abuse dangers and impacts at the individual, family, school, city, nation and global levels
  • A recommendation that all schools serving grades 6-12 have adequate supplies of naloxone, which the report states “has demonstrated effectiveness in reversing opioid overdoses and is recommended by the Centers for Disease Control and Prevention as a successful strategy for preventing an opioid overdose”

The task force says the recommendations have already been adopted by around two dozen San Diego County schools.

“It’s critical that we educate our youth through compelling and effective curriculum, giving them the tools they need to stay healthy and make decisions that can literally save their lives,” San Diego County District Attorney Summer Stephan said in a statement.

Source: https://www.nbcsandiego.com/news/local/san-diego-county-task-force-drug-prevention-programs-schools/3654778/
     While schools nationwide emphasize the importance of drug prevention, students at Watson Elementary took the lesson beyond textbooks.
Published: Oct. 28, 2024 at 9:21 AM CDT

HASTINGS, Neb. (KSNB) – While schools nationwide emphasize the importance of drug prevention, students at Watson Elementary took the lesson beyond textbooks and into the realm of costumes.

“It’s such a prevalent thing especially now going even younger with the older kids in fourth and fifth grade,” said Chris Hollister, a teacher at Watson. “So bringing that awareness to the kids, knowing that they have the power and the will to say no so it’s just a fun, good way to learn about something important but also have fun doing it.”

The Red Ribbon campaign has provided drug prevention education for children since the 1980s, with one of its most popular events, Red Ribbon Week, celebrated annually. This year, Watson Elementary marked the occasion with themed dress-up days.

“You don’t have to wear normal clothes to school,” said Ruby, a student at Watson.

“I think it’s just fun seeing how everyone dresses up different and see what everyone’s favorite movie character is,” said Chloe, another student.

“Yeah it’s fun to ask people like ‘what are you?’ and the other days were really fun too, just getting to put on something wacky is fun,” said Elijah, who is also a student.

“With elementary kids they love to do these crazy wacky dress up days, and they’re all kids at heart even the teachers that are here we’re all still big kids at heart,” said Hollister. “I tell myself I’m still a kid, even though I’m 36 years old, so it’s just fun to let them express themselves.”

As much fun as it was for the kids to dress up, Hollister said the teachers enjoyed getting to see what they came dressed as.

“It’s interesting just to see what all they come up with because like today. I had a kid that dressed up like ‘The Fonz’ and he’s in the fifth grade and that show was prevalent in the 70s and 80s,” said Hollister. “We have Marty McFly, we have TV characters, we have movie characters, it’s just cool to see the ways they take it to make it a fun day.”

‘What’s Cool in Your School?’ is sponsored by Hastings College Watch it Sunday night and Monday morning on Local4. If you have something or someone ‘cool in your school’ you’d like us to highlight, let us know by clicking here.

Source: https://www.ksnblocal4.com/2024/10/28/watson-elementary-uses-red-ribbon-week-teach-about-drug-prevention-fun-way/?outputType=amp

At a glance

  • Cherokee Nation Action Network is using culture as prevention for youth substance use in Oklahoma.
  • The leading principle is “Walking in Balance,” which emphasizes balancing traditional Cherokee culture with modern contemporary culture in their everyday lives.

Cherokee Nation Community Action Network

The Cherokee Nation Community Action Network (CAN) coalition was originally developed in 2006 and became a Drug-Free Community coalition in 2018. The CAN uses culture as a strategy to prevent and reduce substance use in Cherokee communities. They partner with Sequoyah School, a tribal school in Tahlequah that young people can attend from anywhere within the reservation. The reservation includes some very rural and isolated communities with limited resources.

To increase community connectedness, the coalition teaches a National Association for Addiction Professionals-certified curriculum based on the book Walking in Balance by Abraham Bearpaw. Bearpaw was raised in one of the Cherokee Nation communities and, after coping with alcohol use for several years, decided it was time for a change. He reconnected with his culture by prioritizing mindfulness, health, and trust and has been in recovery for 12 years. He partners with different communities to teach his curriculum to young people in hopes of reducing the likelihood of them engaging in substance use. The curriculum includes 12 weekly lessons that teach students how to reconnect with culture, manage stress, and care for themselves. The leading principle is “Walking in Balance,” which emphasizes balancing traditional Cherokee culture with modern contemporary culture in their everyday lives.

The CAN coalition initially faced challenges with young people’s willingness to return to the ceremonial grounds. Due to some forbidden traditional practices, they felt they were too far removed. However, the coalition encouraged them to attend to learn and reconnect with their roots. Of the 100 young people living in the current town they serve, 75 showed up to participate in the curriculum. The day-to-day traditional and cultural activities include the making of clay beads, ribbon skirts, corn-bead necklaces, basket weaving, and stickball. The community activities are a source of Cherokee knowledge-building, sharing, and resiliency that helps build a culture of connectedness. The instructor teaches ceremonial values of youth and elder interaction, respect for ancestors, and the importance of taking care of the land. One community member said, “Our tribe has long known that building a sense of belonging, helping youth grow a connection to community, and cultural identity helps them grow into healthy adults.” The Cherokee Nation CAN will continue to foster safe and healthy environmental conditions, providing social support, encouraging school connectedness, and creating safe and caring communities on the reservation to improve the lives of those living there.

Source: https://www.cdc.gov/overdose-prevention/php/drug-free-communities/cherokee-nation.html

Manuel Balce Ceneta/Associated Press by CARMEN PAUN – 10/27/2024 04:00 PM EDT

 

Traffickers are to blame, the candidates say. Virtually no one’s talking about treatment.

The Harris and Trump campaigns said the presidential candidates are talking about drug treatment, albeit more quietly than they are border security. |

There’s a rare point of agreement among Republican and Democratic candidates this election year: America has a drug problem and it’s fentanyl traffickers’ fault.

Republicans, including former President Donald Trump, are hammering Democrats over border policies they say have allowed fentanyl to surge into the country. Democrats, including Vice President Kamala Harris, respond that they, too, have cracked down on traffickers and want stricter border enforcement.

The consensus reflects the resonance of border control among voters — most of the country’s fentanyl comes from Mexico — and a hardening of the nation’s attitude toward addiction. Troubled by drug use, homelessness and crime, voters even in the country’s most progressive states favor cracking down. Politicians from Trump and Harris on down the ballot say they will.

“It’s one of those things that people don’t want in their community,” said Rep. Jahana Hayes, a Democrat running for a fourth term representing a district including suburbs of Hartford, Connecticut, and rural areas to their west, of illicit drugs. “They want a tough-on-crime stance on it. They want it to go away. They’re afraid for their families, they’re afraid for their children.”

That view worries public health experts and treatment advocates, who see a backsliding toward the law enforcement focus that once looked futile in the face of Americans’ insatiable appetite for drugs. They fear it bodes ill for additional efforts from Washington to expand addiction care.

“There are a lot of things that both parties can point to, as far as progress that’s been made in addressing overdoses: We’ve seen bipartisan efforts to expand access to treatment, to expand access to health services for people who use drugs, and I wish they would talk about that more,” said Maritza Perez Medina, federal affairs director at Drug Policy Action, an advocacy group that opposes the law enforcement-first approach.

Six years ago, when a bipartisan majority in Congress passed the SUPPORT Act to inject billions of dollars into treatment and recovery services, and then-President Trump signed it, the vibes in Washington around drug use were more empathetic.

President Donald Trump declared the opioid crisis a nationwide public health emergency in October 2017. | Brendan Smialowski/AFP via Getty Images But after it passed, fatal drug overdoses driven by illicit fentanyl skyrocketed, hitting a record 111,451 in the 12 months ending in August 2023 before starting to recede. Homelessness, sometimes tied to drug addiction, also spiked.

When the SUPPORT Act came up for renewal last year, Congress wasn’t as motivated. The Democratic Senate hasn’t voted on a bill, while a House-passed measure from the chamber’s GOP majority offers few new initiatives and no new money.

Attitudes are similar in the states. Oregon, where voters legalized drugs for personal use in 2020, reimposed criminal penalties this year after its largest city, Portland, was overrun with homeless drug users. Polls indicate California voters, frustrated, too, by homelessness and crime, are likely to boost penalties for drug users by ballot initiative next month.

Candidates aim to prove they share voters’ frustration.

Republicans have spent more than $11 million on TV ads in the past month attacking Democratic opponents on fentanyl trafficking, according to a tally by tracking firm AdImpact. And Democrats have spent nearly $18 million defending themselves, mostly by highlighting their efforts or plans to provide more resources and personnel to combat trafficking.

“It’s an easy shortcut in a 30-second commercial to tie a broader issue to one that has an easy explanation,” said Erika Franklin Fowler, a professor of government at Wesleyan University who directs a project analyzing political advertising.

Trump’s not talking about the SUPPORT Act, one of his most consequential legislative successes. Vice President Kamala Harris is not touting the treatment policies of the president she serves, Joe Biden, who expanded access to medications that help people addicted to fentanyl, as well as to drugs that can reverse overdoses. Some public health specialists credit increased access to the drugs with reducing overdose death rates in the past 12 months after years of grim ascent.

Trump used his first anti-Harris ad this summer to blame her for the more than 250,000 deaths from fentanyl during the Biden-Harris administration.

Vice President Kamala Harris met state attorneys general in July 2023 to discuss possible actions against fentanyl. | Saul Loeb/AFP via Getty Images Harris responded by touting her prosecution of drug traffickers when she was California’s attorney general and a promise to strengthen the border.

“Here’s her plan,” a deep-voiced narrator intoned in Harris’ ad: “Hire thousands more border agents, enforce the law and step up technology — and stop fentanyl smuggling.”

‘A political cudgel’

Similar attacks and responses have played out in Senate and House races across the country.

In the tight Arizona race to replace Sen. Kirsten Synema (I-Ariz.), Republican Kari Lake has accused her opponent, Democratic Rep. Ruben Gallego, of empowering drug cartels to import fentanyl by supporting Biden-Harris administration border policies.

“We’re losing an entire generation of people, and you should know better, Ruben,” Lake told Gallego in a debate earlier this month, referencing the deaths of teens who took counterfeit pills laced with fentanyl.

Gallego, who was elected to Congress in 2014 as a progressive but has shied from that label in his Senate run, responded by touting bills he’s supported or introduced to fund more technology at the border and track fentanyl money flows across Mexico and China, where chemicals to make the drug are manufactured.

A mother visit her son’s grave, who died of a fentanyl overdose at 15. | Jae C. Hong/AP In Colorado’s hotly contested 8th congressional district, which encompasses Denver suburbs and rural areas to the north, Republican state Rep. Gabe Evans has blamed the incumbent, Democrat Yadira Caraveo, for the fentanyl crisis.

“This is our reality now: a 100 percent increase in fentanyl deaths because liberals open the border, legalize fentanyl and let criminals out of jail,” says a police officer in an ad for Evans. “And Yadira Caraveo voted for it all,” Evans adds.

Caraveo defended herself in a debate with Evans earlier this month, noting the bill he’s referring to was state legislation that “tried to balance the need to punish drug dealers and cartels but not incarcerate every single person that is addicted.”

In Connecticut, the National Republican Congressional Committee attacked Hayes for voting against a bill to permanently subject fentanyl to the strictest government regulation, reserved for those drugs with high likelihood of abuse and no medical uses.

Hayes said she opposed the bill because it included mandatory minimum prison sentences for people caught with drugs and no provisions supporting prevention, treatment or harm reduction.

“I hate that this is being used as a political cudgel because we’re missing out on an opportunity to say: ‘How do we address the root causes?’” Hayes said in an interview.

Hayes said she has responded to the attacks on the campaign trail and talked to constituents about the need for treatment, despite some advice to the contrary.

“Even amongst Democrats, there were people who were like: ‘You don’t want the headache, you don’t want people to think that you’re soft on crime or soft on drugs.’ And I was like: ‘This has to be about more than optics if we truly are trying to save people’s lives,’” Hayes said. ‘If we don’t keep the momentum going’

Oregon, where voters legalized drugs for personal use in 2020, reimposed criminal penalties this year after its largest city, Portland, was overrun with homeless drug users. | Patrick T. Fallon/AFP via Getty Images The lesson the Drug Policy Action’s Medina takes from the campaigns is that talking about drug treatment doesn’t sell in American politics.

“People are struggling. Social services aren’t where they need to be, health services aren’t where they need to be,” she said. “It’s easier to run a fear-based campaign rather than talking about really tough issues,” like breaking the cycle of addiction.

Ironically, the tough talk on the border comes as policymakers, for the first time in years, have evidence that the tide of fatal drug overdoses is receding.

The CDC estimates that overdose deaths, most caused by fentanyl, declined by nearly 13 percent between May 2023 and May 2024, to just under 100,000.

Harris’ running mate, Tim Walz, mentioned the dip during his debate with Trump’s vice-presidential pick, JD Vance, earlier this month.

The number is now about where it was when Biden took office, though still 50 percent higher than when Trump did in January 2017.

Expanding access to treatment, the Food and Drug Administration’s decision to make the opioid-overdose-reversal medication naloxone available over the counter last year, increased fentanyl seizures at the border, and the arrest and sanctioning of Mexican drug cartel leaders have contributed to the recent drop, Biden said last month.

Advocates for drug treatment say that’s all good cause for candidates to tout their access-to-treatment efforts and promise to expand them.

“The worst outcome for overdose prevention coming out of this election would be if we don’t keep the momentum going,” said Libby Jones, who leads the Overdose Prevention Initiative, an advocacy group.

But there’s not the groundswell of interest on Capitol Hill that there was in 2018, when Congress passed the SUPPORT Act.

Congress has continued to fund opioid treatment authorized in that law, but it mostly hasn’t taken the law’s 2023 expiration as an opportunity to increase funding or try big new ideas.

The Food and Drug Administration decision to make the opioid-overdose-reversal medication naloxone available over the counter last year has contributed to a drop in fatal overdoses over the past year, President Joe Biden said last month. | Diane Bondareff/AP The 2024 federal funding law Congress passed in March included some minor changes in the form of bipartisan legislation to require state Medicaid plans to cover medication-assisted treatment for substance use disorder. It also created a permanent state Medicaid option allowing treatment of substance use disorder at institutions that treat mental illness, in an effort to expand access to care.

But bipartisan legislation approved by the Senate committee responsible for health care to make it easier for others to gain access to methadone, a drug effective in helping fentanyl users, hasn’t gone to the floor and faces opposition from key Republicans in the House.

The Harris and Trump campaigns said the presidential candidates are talking about drug treatment, albeit more quietly than they are border security.

Vice President Harris’ campaign pointed to her web site, where she touts her prosecution of drug traffickers and the Biden-Harris administration’s investment in “lifesaving programs.”

Republican National Committee spokesperson Anna Kelly said “President Trump is uniquely able to connect with families combating addiction,” pointing to times when he’s talked about his brother’s struggles with alcohol use disorder and to his administration’s efforts to contain the opioid crisis.

But she added that the tough talk on the border is relevant: “Combating fentanyl is a public health issue and stopping it begins with securing the border.”

 

Source: https://www.politico.com/news/2024/10/27/fentanyl-drugs-elections-00185576

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

Armed with knowledge and tools, parents are making a big difference in local school districts  

by  Emily Green   February 1, 2024

  Mila Priest, 8, focuses on computer playing the PAX Good Behavior Game during class at Fern Hill Elementary School in Forest Grove, OR, Nov. 9, 2023.
Holly Pearce, 18, deploys a strategy at the West Linn High School club fair. If prospective members join her in-school club, she tells them, they need do little more than show up while receiving free food and an honors cord for their gown at graduation. What she doesn’t lead with is that it’s a drug and alcohol prevention club.

“The free food,” she said “that’s what gets people there in the first place.”

Once students are in the door, she said, it’s her mom, Pam, who gets them to stay.

Pam Pearce has been in recovery for 28 years. During lunchtime club meetings, she often shares her personal story with club members, she said, and she tells it to them straight.

She grew up nearby in Lake Oswego and attended the University of Southern California. The photos she displays of smiling youths from her high school and college years look much like the club members she shares the photos with.

“The only honors I had was biggest partier and best dressed,” she said. “And I like to say it because the end of the story is: that almost killed me.”The point is to dispel the myth that addiction only affects “other” people. It can be anyone, she said, and it can be the teens in the club or one of their friends.

A concerned parent pushing for prevention, Pam Pearce is part of an emerging trend in Oregon, where, according to federal data, at least 354 youths have died from drug overdoses since the start of 2018 as fentanyl has spread through the drug supply.

Oregon schools enjoy wide autonomy in what they teach, and that includes their substance use prevention strategies. A recent six-month investigation into prevention in Oregon classrooms from The Lund Report found that many schools rely on little more than a chapter in a health textbook to get the job of prevention done.

The state provides little support or accountability when it comes to in-school prevention, records and interviews show. So in districts where more robust prevention is happening, it’s often parents and individual teachers who drive it.

Mother of lost son becomes activist

In Oregon City, Michele Stroh began pushing for prevention after she lost her son, Keaton Stroh, 25, to a fentanyl-laced pill in July 2020.

“I didn’t know about fake pills; I didn’t know about any of that. And I got angry,” Stroh said. “So I ran for the Oregon City School Board.”

She wanted the district to be more proactive in the fentanyl crisis, she said. So she recruited speakers to talk at assemblies at all the Oregon City School District high schools, middle schools and charter schools. She organized a parent education night, and her efforts resulted in the overdose reversing drug Narcan being placed in all the schools, sports facilities and school buses.

“We were the first school district in Clackamas County to have a Narcan policy,” she said.

She’s approached other districts but found them to be more hesitant.

“I think it helps, the fact that the district knows me, and the teachers know me — and they knew my son,” Stroh said.

 

Jon and Jennifer Epstein were also pushed into action after losing their son Cal Epstein, 18, to a fentanyl-laced counterfeit pill in December 2020. They began advocating for fentanyl education and awareness in the Beaverton School District, where their sons attended school and Jon Epstein had taught for 10 years. The district worked with them to create a program called “Fake and Fatal,” which teaches youths about the dangers of fentanyl and counterfeit pills. Since then, at the Epsteins’ urging, Oregon legislators passed a bill to take fentanyl education statewide, and Oregon’s congressional delegation has introduced national legislation.

While some parents, such as Pearce in West Linn, had to investigate to figure out what prevention is happening at their kids’ schools, The Lund Report created a data portal that makes that information easily accessible for the first time — including what top prevention scientists say about the efficacy of programs in use at each district.

Pearce’s club at West Linn High School has grown to nearly 200 student members. The teens also advise their community prevention coalition, which Pearce — known for her advocacy — was recruited to lead. And they visit middle schools to talk to younger kids about what to expect in high school.

What teens say

The Lund Report recently sat down with some teenagers who participate in the prevention club. They said the club creates a safe space where kids can talk honestly about drugs — or go to when they don’t want to be around teens who are using.

“My view immediately changed as I set foot in this club,” said the club’s president, Jonathan Garcia, 17. “I listened to Pam in that first meeting, and I was just like, ‘Oh, my God — what have I been taught?’ It was like, number one, I haven’t been taught anything compared to what I just learned, and I’ve been taught all the wrong things.”

The club discusses topics like why a person might turn to drugs and alcohol in the first place. Some of the teens said it was the first time they learned about addiction’s root causes.

“Nothing was sugar coated,” said Aidan Sauer, 15. “Everything was just to the point.”

Growing the club at her daughter’s high school is just one way Pearce promotes prevention in the West Linn-Wilsonville school district, where all three of her kids were students.

She sends teachers information about prevention-related tools and lessons. And she lobbied her district until it agreed to participate in the state’s Student Health Survey. The survey asks students in the sixth, eighth and 11th grades about their substance use and well-being. Pearce said she “was on a mission” after she found out her local district didn’t administer the free survey.

“It also allows young people to share with you what’s happening in their environment. Like — how else are they going to tell you what’s happening?” she said.

Starting this year, every Oregon school is required to take part in the survey for the first time. Prevention scientists say the data can help districts to understand whether or not their prevention efforts are working. Many prevention programs, including clubs like the one at West Linn High School, aren’t well-researched. Others might not work in every setting and for every group of kids, so tracking the outcomes is important, experts say.

In 2020, Pearce also co-founded the first high school in Oregon for students in recovery from addiction, located in Lake Oswego.

Teaching kids self-regulation in Washington County

A prevention program called the PAX Good Behavior Game doesn’t teach kids anything about drugs and alcohol, but prevention scientists at Oregon Research Institute and Washington State University’s IMPACT Research lab contend it’s one of the best evidence-backed approaches to substance use prevention at the elementary school level.

Today, the program is in wide use across Washington County, and its successful implementation there can be traced to the efforts of a former third grade teacher at Joseph Gale Elementary School and a concerned mother who happens to work for the county.

On a foggy morning this past November, third graders in a second-floor classroom at Fern Hill Elementary in Forest Grove focused intently — and quietly — on their arithmetic. With a handful of unfamiliar adults watching the lesson, there were plenty of distractions that day. But the 8- and 9-year olds seemed un-bothered as they completed math problems on their Chromebooks.

Helping them focus was the PAX Good Behavior Game, also known as PAX. It’s a program that gives teachers a menu of techniques for helping kids self-regulate and practice self control.

At the core of the system is a game, and in some studies, playing that game in elementary school reduced substance use and other problems among students years later.

The teacher sets a length of time the game will be played, and if kids are able to stay on task, they’re rewarded a goofy dance or some other non-material prize when the time is up. While the clock was ticking, third grade teacher Kayla Davidson walked around the classroom observing the students work. If someone got up or lost focus, she would give their table — not the individual student — what’s called a “spleem,” which is basically a negative point. At the end of the game, tables had the opportunity to explain collectively how they might avoid getting a spleem next time.

Before PAX, Davidson said she was more reactive in her approach to disruptive behavior. She might call a student’s parent or call out a child for their behavior in front of the class. “That could really be hurtful and harmful to the student, if they’re just being called out for bad behavior constantly,” she said.

“A lot of them are bringing things with them. It could be things like hunger or worrying about which parent they’re going with today,” Davidson said. The game gives the kids “a space and a strategy” for not having to worry about those things so they can focus on their work, she added.

Third graders in Davidson’s classroom told The Lund Report that, for the most part, they really like playing the game. For 8-year-old Aubrey Stone, “the best part about it is that you’re growing your brain.”

About 13 years ago, Kirstina Meinecke brought PAX to the Forest Grove School District when she got a job as a third grade teacher there. She had learned how to use the game when teaching in Washington on the Yakima Indian Reservation. Other teachers took interest, and it began to spread. Today, PAX is incorporated into every elementary school classroom in the Forest Grove district, and into teachers’ ways of conducting their classrooms. Meinecke’s job with the district now is primarily to provide teachers with PAX training and ongoing support as a coach.

In Oregon, parents and teachers catalyze drug prevention in schools

Forest Grove is one of four districts in Washington County that uses the PAX Good Behavior Game. While PAX was spreading there, a public health program supervisor at Washington County, Rebecca Collett, started working to spread the program into other county schools. She’d noticed a need for better classroom management while volunteering at her son’s school in the Tigard-Tualatin district.

Collett remembers asking, “Why are we doing so many programs, when there’s one evidence-based program that prevents suicide, prevents drug and alcohol use, prevents dysregulation in the classroom, prevents all this?”

Since then, the county has helped school districts fund the implementation of the PAX Good Behavior Game through a mix of county, state and federal funds. The county has trained nearly 800 teachers at 51 schools on how to use PAX since 2014.

“Once it started working, we didn’t have to sell it,” Collett said. “The teachers started sharing how well it was working in their classroom, how much healthier they were, how much easier classroom behaviors were, and management.”

The county estimated it saves $83 for every $1 spent, and the cost is about $13 per student.

Tools for parents

Pearce encourages other concerned parents to take action if they want to see better prevention programs in their kids’ schools.

“People talk, but they don’t act,” she said. “We need to stop talking, and we need to start doing.”

She said parents should start by reaching out to their county health departments to see if there is a local prevention specialist or prevention coalition they can connect with, and they should attend school board meetings, ask questions and advocate. They can even start a club like the one she leads, she said.

Parents also can share evidence-based practices and materials with their districts and teachers they know, she added.

Figuring out what prevention programs are supported by validated research can be tricky, but there are several online registries that parents and community groups can use to learn more about programs. The online database published by The Lund Report used expert ratings from these clearinghouses to rate districts’ programs.

Source: https://www.thelundreport.org/content/oregon-parents-and-teachers-catalyze-drug-prevention-schools?

TogetherWeCan_InternationalOverdoseAwarenessLogo

Perhaps we’re finally turning a corner when it comes to lowering overdose deaths. While the number of people dying as a result of an overdose remains frighteningly high, a new report signals modest progress in efforts to reduce fatalities.

Updated figures from the Centers for Disease Control and Prevention (CDC) found fatal drug overdoses fell 2.4% from 2022 to 2023. The toll from the overdose crisis reached 108,317 lives last year, according to data the CDC posted Aug. 4. While that’s lower than the 111,029 overdose deaths in 2022, it still represents a massive number of preventable deaths, and there’s yet more we can do to ensure that fatalities continue to decline.

That is one of the goals of International Overdose Awareness Day, observed on August 31.

In recognition of the day, the National Council has created an informative new video to help people understand how to administer naloxone. Naloxone (often known by the brand name Narcan) is a medication that reverses opioid overdoses. It is quite literally a lifesaver.

The lower number of overdose fatalities in 2023 may be related to the Food and Drug Administration’s March 2023 decision to make naloxone available over the counter, a decision we applauded. But having naloxone available doesn’t mean everyone who may need it has access to the drug. And it doesn’t mean that everyone knows how to administer naloxone.

Let’s hope the modest drop in overdose fatalities last year was an early indication that we’re finally flattening the curve of overdose deaths.

That’s exactly why we made this video.

Everyone should carry naloxone, especially those who work with the public — whether as a teacher, ambulance driver, librarian, coach or in some other capacity.

The Substance Abuse and Mental Health Services Administration (SAMHSA) continues to promote naloxone distribution through state opioid response (SOR) grants. Naloxone distribution and saturation planning is a federal-state partnership (of sorts) to optimize naloxone distribution.

States are required to create distribution and saturation plans as part of their SOR grant; every state is required to make one. The purpose is for states to meaningfully plan and coordinate their naloxone distribution based on data and input from impacted community partners so they optimize reach, including focusing distribution efforts to those most likely to experience and/or witness an overdose.

Substance use isn’t going away anytime soon. July’s release of the 2023 National Survey on Drug Use and Health provides important new data about substance use challenges and the nature of substance use among people of all ages. For instance:

Among people aged 12 or older in 2023, 70.5 million people (24.9%) had used illicit drugs in the past year, up from 70.3 million people in 2022 and 61.2 million in 2021.

In 2023, 48.5 million people 12 or older (17.1%) had a substance use disorder in the past year, down slightly from 48.7 million in 2022.

In 2023, 8.9 million people 12 and older (3.1%) used opioids in a non-prescribed way in the past year, compared to 8.9 million in 2022 and 9.4 million in 2021.

This data shows us that no one is immune from a substance use challenge.

We can’t turn our backs on people with a substance use disorder or ignore the tragic consequences of substances, whether they’re considered illicit or socially acceptable, like alcohol. To support people with a substance use disorder or their loved ones, the Start With Hope project also recently published many new resources, including:

The Start With Hope project was started in November 2023 by The Ad Council, in partnership with the CDC, the National Council and Shatterproof to deliver a message of hope to those living with substance use disorders as well as those at risk of developing one.

Let’s hope the modest drop in overdose fatalities last year was an early indication that we’re finally flattening the curve of overdose deaths. When it comes to lives lost, we can’t be satisfied with modest improvements. Let’s ensure continued progress by spreading the word about lifesaving resources.

Check out our new video, and let us know what you’re doing in your communities to reduce overdose deaths and provide resources to those with a substance use disorder.

We can and will learn from one another on how to best support people and communities.

Author

Charles Ingoglia, MSW
(he/him/his) President and CEO
National Council for Mental Wellbeing
 
Source:  https://www.thenationalcouncil.org/lowering-overdose-deaths-naxolone-how-to/
Published: Sep. 1, 2024

Aug. 31 is known as International Awareness Day the department wanted to spread awareness about the crisis of drug overdoses.

During this event, people gathered at the city hall and lit candles to remember lost lives or loved ones.

The South Carolina Department of Alcohol and other Drug Abuse Services states the number of overdoses has been increasing for the past 10 years.

Organizations and community members came together to learn more about how to spot an overdose and the importance of Narcan nasal sprays.

Thomas Young, a Charleston County support specialist, said his overdose was a wake-up call to get the help he needed.

“I was basically dead on arrival and it took six Narcan to get me awake,” Young said.

There have been between 100-120 incidents regarding overdoses with 20 of those fatal within the first six months of this year according to the North Charleston Police Department.

In 2022 alone, there were 437 opioid-related deaths in the Lowcountry and over 1,800 throughout the whole state, according to the South Carolina Department of Health and Environmental Control.

Opioid prevention coordinator Shelbey Joffrion said she thinks substance abuse disorder is important for people to know and how it touches to have someone by them during difficult times.

“I just think it’s important that everyone knows the substance abuse disorder touches everyone,” Joffrion said. “I have not met anyone who says they have not had their friend or family in their circle. It touches all of us.”

Young explains he never thought it be sober ever again and how it takes a team to overcome a drug addiction.

“I never I never thought I’d be sober, ever,” Young said. “It’s basically a miracle that I’m sober because I was a glorified drug user for many years. Nobody can really get clean by themselves, no matter how much they try. We kind of need everybody in this together.”

Click this link for more information regarding the South Carolina Department of Alcohol and other Drug Abuse Services.

Source: https://www.live5news.com/2024/09/01/north-charleston-hosts-first-overdose-awareness-day-event/

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
(Spectrum News/Vania Patino)

By Los Angeles

LOS ANGELES — Facing peer pressure can be hard, but teens at the Boys and Girls Club in Monterey Park are learning to say no to drugs and alcohol together.

 


What You Need To Know

    • The Boys and Girls Club in Monterey Park offers a drug and alcohol prevention program for youth called Brent’s Club
    • Participants are drug tested at random every week and rewarded through activities, trips and scholarships for saying no to drugs
    • Earlier this year, a group of students traveled to Washington D.C to participate at the Boys & Girls Clubs of America’s Summit for America’s Youth
    • The students were able to speak with elected officials about the need for continued funding toward drug prevention resources

 

Victoria Perez is one of the high school students who chooses to spend her afternoons at the Brent’s Club chapter offered at the Boys and Girls Club.

“I thought maybe it would just be lessons of drug and alcohol awareness, but it just it’s so much bigger than that,” Perez said.

Perez and the other participants soon realized they were not just gaining knowledge about the dangers of drugs, but were also being rewarded for actively taking those lessons into their daily decision making.

The program takes their commitment to staying drug free serious, and it’s why every week participants are drug tested at random.

So far, director of the Brent’s Club, Angel Silva, says they have not had any test results come back positive.

The deal is that those who remain drug free are rewarded through field trips, activities and also become eligible for a full four-year scholarship or partial renewable scholarships.

“Like our Maui trip that we do every summer, where we go, and we do a service project on the island of Maui,” Silva said.

The approach was designed by the Brent Shapiro Foundation, which was created by Brent’s parents after losing their son to addiction. The hope was to prevent this from happening to any other families and help reduce the risks of falling into substance abuse among youth.

This year, some participants created the TLC or Think, Lead, Create Change mental health project to advocate for continued funding toward drug use prevention, treatment and recovery resources.

Perez was one of the participants and, along with her team, was able to attend the Boys & Girls Clubs of America’s Summit for America’s Youth in Washington, D.C.

This was the first time flying for many of the participants and the first time at D.C. for all the students.

It’s experiences like those that Silva says these students would otherwise not have access to without the program.

Perez says it took a lot of preparing and researching to create the project, but was all worth it when they were able to present it to elected officials and share why this cause means so much to them.

“It was such an amazing opportunity, especially for advocating for not just alcohol and drug abuse, but for mental health and how those things merge together,” Perez said.

The advocacy and awareness the students are helping create comes as a time when fentanyl continues to be the most common cause of accidental drug overdose deaths in Los Angeles County.

“We were learning and teaching at the same time very much, because we thought we knew everything about fentanyl, but it decided to change the whole game,” Silva said.

Although, it can be tough to keep up, he says the ever-changing substance landscape makes their efforts that much more important.

Something Perez’s mother, Monica Vargas, agrees with and why she says the program has given her a peace of mind although the idea was jarring at first.

“It was a little shocking because where I come from, I’m a first generation, so we tend to come sometimes from very close or conservative families. So we think out of sight, out of mind. We don’t talk about it,” Vargas said.

However, she knew it was important for parents to communicate with their children, and this program was the perfect way to do it.

“If those additional incentives help, especially with so much pressure out there for these teens, by all means, I’m all for it. I’m 100% for it,” Vargas said.

Along with the incentives, Silva says the students have also become each other’s support system, which itself is a way to reduce the risk of substance abuse among youth.

“That’s the great part. You know, it’s not just within the clubhouse, they all go to the same school, and they hold each other accountable,” Silva said.

Source: https://spectrumnews1.com/ca/southern-california/health/2024/09/02/teens–drug-and-alcohol-prevention-

Methods: We recruited 58 MA-dependent young adult females from a compulsory isolation drug rehabilitation center in Sichuan Province and randomly divided them into an MBRP group (n = 29) and a control group (n = 29) according to their degree of psychological craving. The MBRP group received 2 hours of MBRP training twice a week for 4 weeks, alongside routine treatment at the drug rehabilitation center. Meanwhile, the control group solely received routine treatment at the drug rehabilitation center without any additional interventions. The assessment was conducted before and immediately after the intervention, with the Compulsive Drug Use Scale (OCDUS) used to assess craving and the Five-Factor Mindfulness Scale (FFMQ) used to assess trait mindfulness. Also, a “mental feedback monitoring balance” instrument was used to assess concentration and relaxation during some training sessions. This randomized trial was conducted to evaluate the effectiveness of decreasing psychological craving and increasing trait mindfulness.

Results: At baseline, there were no significant differences in total or dimension scores for FFMQ or OCDUS between the two groups (all P > 0.05). After the intervention, the repeated measures ANOVA showed a significant time main effect on changes in observing, non-judging, and non-reacting scores (all P < 0.05), and a significant interaction effect between time and group on both FFMQ total score and OCDUS score (P < 0.01 or P < 0.05). Mental feedback monitoring indicated significant improvement in concentration and relaxation after breath meditation exercises (P < 0.05 or P < 0.001). Additionally, the MBRP group showed improved relaxation during the body scan exercise (P < 0.01).

Conclusion: MBRP training can improve the trait mindfulness of MA addicts and reduce psychological cravings effectively.

The full article can be accessed via the source link below:

Source: https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1339517/full

Published Lisbon  16.09.2024

The Croatian national focal point and the European Union Drugs Agency (EUDA) are organising today the latest Reitox Academy on evidence-based prevention. The academy will cover the principles of science-based prevention, feature examples of quality prevention programmes across Europe and discuss models for improving national prevention interventions.

Experts from different countries will present examples of good practice in prevention interventions in diverse settings, including: school (Estonia, Spain, Brazil); family (Estonia) and community (Croatia, Germany) (1).

The event will round off with a session on lessons learned in applying evidence-based prevention programmes and implementing quality standards in the EU. An expert from Bosnia and Herzegovina will share experience from a non-EU country in a final panel discussion.

September 16, 2024

Prevention typically consists of methods or activities that seek to reduce or deter specific or predictable problems. It protects individual well-being and promotes desired behaviors.

Education is a key element of prevention. To understand how to contribute to the prevention of substance use disorders, all individuals need to know two important facts:

Substance use disorders are diseases. They are progressive, chronic, and fatal. They are classified as primary diseases, meaning they are caused by something else, such as an emotional problem or poor choices. Substance use disorders are medical conditions of the brain.

Substance use disorders are treatable. Just as heart disease or diabetes can be treated, so can substance use disorders. In addition to medication, effective treatments usually involve therapy and connecting to community support.

Sharing these facts helps remove stigma around substance use and makes people more comfortable talking about it. This opens up opportunities to:

  • Increase collaboration among state agencies, community organizations, and special populations
  • Develop culturally appropriate strategies and implement plans to reduce risks and increase protective factors across the state and in specific communities
  • Expand citizen participation in community activity

The most promising way to reduce alcohol and drug problems is to use a comprehensive, multi-faceted approach to prevention. There are evidence-based tools that organizations and communities can use to guide these efforts. For example, organizations that adopt a Strategic Prevention Framework and develop logic models are more likely to achieve positive outcomes.

Experts Dedicated to Building Healthy Communities

The RAAD campaign is coordinated by DAABHS (rhymes with “abs”). That’s our abbreviated way of saying the Arkansas Department of Human Services Division of Aging, Adult and Behavioral Health Services the Substance Abuse Prevention team.

The DAABHS team is passionate about uniting individuals and communities in prevention efforts. Each member of the team contributes unique skills and energy to advance the RAAD mission.

They are receptive to questions and ideas and can connect you to existing programs or provide guidance to help you launch new prevention initiatives in your area.

Source: https://humanservices.arkansas.gov/divisions-shared-services/shared-services/office-of-substance-abuse-and-mental-health/prevention-ar/

UC expert joins WVXU’s Cincinnati Edition roundtable discussion

Featured photo at top of an officer speaking with children at school. Photo/SDI Productions/iStock.

The Kentucky Opioid Abatement Advisory Commission recently announced a new three-year drug prevention initiative, funded by grants from the state’s opioid settlement fund for prevention, enforcement, treatment and recovery efforts.

The University of Cincinnati’s LaTrice Montgomery joined WVXU’s Cincinnati Edition to discuss youth drug prevention programs and what research says about the most effective approaches.

The popular DARE (Drug Abuse Resistance Education) program that began in the 1980s originally featured a uniformed officer speaking to kids in a lecture style on how to “just say no” to drugs.

“As we now know, that lecture style doesn’t always resonate with youth,” said Montgomery, PhD, adjunct associate professor in the Department of Psychiatry and Behavioral Neuroscience in UC’s College of Medicine and a licensed clinical psychologist. “So we’ve learned it needs to be much more interactive and include not only drug resistance skills but social and emotional skills.”

As research has progressed, Montgomery said DARE is still around but features a different approach that includes the REAL (Refuse, Explain, Avoid and Leave) method.

Chris Evans, executive director of the Kentucky Opioid Abatement Advisory Commission, told WVXU their team is using a research-based approach to tailor their programs to what will be most effective.

“It’s really designed to encourage young people to make positive life choices and help build up their resilience,” he said. “What this program does is really shine a light again on those strengths of kids and finding a way for them to identify and strengthen what’s going on with them. And we’ve seen the studies have indicated that is a better approach to dealing with kids nowadays in terms of getting them to be educated and to listen and to make positive choices in this space.”

Source: https://www.uc.edu/news/articles/2024/09/are-teen-just-say-no-campaigns-effective.html

Rocky Herron, a former DEA agent, interacting with students after
his drug prevention presentation. (Photo: Business Wire)

CARLSBAD, Calif., October 01, 2024–(BUSINESS WIRE)–In response to the growing crisis of synthetic drugs like fentanyl and methamphetamine, Hopeful Life is proud to announce a vital new initiative in the fight against youth substance abuse. As our nation continues to grapple with the devastating rise of synthetic drugs, there remains a critical gap in educating our youth about the dangers of substance abuse before they make life-altering, or even life-ending, decisions.

Young lives are at risk, and many of them are not fully aware of the dangers. Tragically, drug prevention education is still not a national priority, and our hardest-hit communities often lack the resources to address this crisis head-on. Without proper education, substance abuse continues to destroy futures. This must change. We have partnered with Rocky Herron, a former DEA agent with 31 years of experience, to bring his life-saving drug prevention education directly to schools and communities across the country.

This partnership marks a new chapter for Hopeful Life, as we formally introduce Rocky’s powerful presentations, I Choose My Future, into our comprehensive approach to combating substance abuse. Rocky has successfully engaged over 250,000 youth in 17 countries, transforming the way students think about drugs and their long-term impact. His emotionally charged presentations go beyond raising awareness—they inspire change. Rocky’s presentations connect with students on a personal level, showing them the real-world consequences of drug abuse. His message empowers them to make choices that protect their health and future. As one student shared, “students often comment that they have been told many times that drugs are ‘bad’ but I Choose My Future made them understand why.”

Rocky’s presentations don’t just raise awareness—they change lives. In a recent survey of students in Montana, 64.6% of respondents reported knowing someone personally affected by drug use. After attending Rocky’s presentation, 79.8% of students expressed deeper concern about drug use in their communities, and a remarkable 90.1% felt more comfortable seeking help for themselves or others, a profound shift in understanding and behavior (Rocky Herron Survey Results).

Rocky’s message cuts through the statistics and connects with students on a personal level. They don’t just hear about drug dangers, they see the real-world consequences and are empowered to make choices that shape their futures. As one student shared, “This presentation gave me even more reason to stay away from drugs”​ (Survey).

For adults, Rocky’s presentations provide valuable insights into the connection between substance abuse and mental health, equipping parents and educators with the tools they need to support their children. His sessions cover urgent topics such as fentanyl, synthetic drugs, and vaping, offering practical prevention and intervention strategies.

Hopeful Life believes in creating sustainable, community-wide impact. Our mission is to enhance individual, organizational, and community health through cutting-edge insights and solutions powered by the latest advances in science, technology, and policymaking. We provide comprehensive analytics that measure substance abuse trends and identify correlations at both local and national levels, ensuring our efforts are data-driven and effective. By partnering with Rocky Herron, we amplify his life-changing message where it is needed most, providing critical support to expand his outreach to more schools, more communities, and more at-risk youth.

We don’t just support Rocky’s efforts—we make sure they reach the students who need them most. Through our multidisciplinary approach, we help communities access the life-saving knowledge they need to prevent substance abuse and create lasting change.

The stakes are high. Our youth deserve a chance at a drug-free future, and with your support, Hopeful Life can continue bringing essential education to schools and communities. Every donation helps us reach more students and potentially save lives.

Through our partnership with Rocky Herron, Hopeful Life is expanding its reach to provide more students with the knowledge and tools they need to make informed decisions. Our mission is to enhance community health through education, science, and data-driven solutions. By introducing Rocky’s program, we’re bringing a proven, life-saving message to the forefront of our fight against substance abuse.

Together, we can combat the drug abuse crisis and empower the next generation to make better choices. Please consider donating to Hopeful Life today to support our life-changing mission.

Source: https://finance.yahoo.com/news/hopeful-life-introduces-life-changing-012400527.html?

In October, SAMHSA celebrates Substance Use Prevention Month — an opportunity for the prevention field and prevention partners to highlight the importance and impact of prevention. And given the substance use and overdose challenges facing our country, prevention has never been more important. This month, each of us can inspire action by sharing how prevention is improving lives in communities across our nation.

As part of the Biden-Harris Administration and the U.S. Department of Health and Human Services’ Overdose Prevention Strategy, along with SAMHSA’s Strategic Plan, our prevention efforts aim to prevent substance use in the first place, prevent the progression of substance use to a substance use disorder, and prevent and reduce harms associated with use. Our grantees across the country are doing just that every day. Here are just a few quick stories of our grantees in action.

Pueblo of Zuni – Zuni Tribal Prevention Project
Zuni, New Mexico
(Strategic Prevention Framework-Partnerships for Success grant awardee, FY 2020)

In 2021, Pueblo of Zuni (Zuni Tribal Prevention Project) developed a Family Wellness Kit program to strengthen family communication during the COVID-19 pandemic. Family bondingparent-child communication, and cultural identity (PDF | 818 KB) are protective factors against substance use and other youth risk behaviors.

The kits included culturally relevant family cohesion activities, and a new type of kit was distributed monthly (over 18 months) with:

  • Four activities (one for siblings; one for grandparents; one for the entire family; and one for siblings, grandparents, or family).
  • One activity guide with instructions.
  • Activity supplies.
  • One debrief guide with discussion prompts.
  • One parent/caregiver skill development guide on active listening, validation, effective communication, family engagement, positive discipline, and setting boundaries.

Staff follow-up every three months to check-in with the families: 72 activities had been developed, and 85 percent of 102 registered families completed the program. Families appreciated the integration of Zuni culture in the kits and enjoyed completing the activities together. They also reported spending more quality time together, growing closer, and communicating more.

A participant described the benefit as, “…being together as a family and just having more conversations; we even show more affection, like giving hugs and saying, ‘I love you.’” Families also said that they continued using the activities and created more family routines such as family nights and putting away cell phones during family times like dinner.

Connecticut Department of Mental Health and Addiction Services, Prevention and Health Promotion Division – Know Ur Vape
(Substance Use Prevention, Treatment, and Recovery Services Block Grant recipient)

In 2022, the Connecticut Department of Mental Health and Addiction Services (DMHAS) Prevention and Health Promotion Division partnered with Connecticut Clearinghouse and Connecticut’s Tobacco Enforcement division to develop a vaping prevention campaign.

Launched in 2023, Know Ur Vape leverages the power of social media influencers and the social media trend of “unboxing” videos to reach youth and young adults. The campaign seeks to prevent vaping initiation among teens and young adults and encourage quitting among those who vape.

Each video starts out in a familiar way, then features a surprising plot twist, and concludes with a health message and a resource. Each influencer receives one of three themed boxes: sports, beauty, or mystery. As they open the box and interact with the contents, their reactions indicate excitement, confusion, concern, and then displeasure. The videos demonstrate the negative effects of vaping, including its addictive and disruptive nature, impairment to athletic performance, and harmful effects on skin and physical appearance.

Influencers include University of Connecticut athletes. As part of the campaign, television personality Nia Moore sat down with Megan Albanese of Southington STEPS coalition on Instagram Live to discuss her negative experiences with vaping.

In the campaign’s first three months, the videos were viewed 177,656 times on social media, with 18,905 likes and 776 comments. On TikTok, the videos received 113,904 views and on Instagram, one post received 24,600 views. The campaign was featured on the Drug Enforcement Administration’s Just Think Twice website and the CADCA website.

West Virginia Departments of Health and Human Services – Overdose Prevention and Response
(First Responders – Comprehensive Addiction and Recovery Act grant awardee, FY 2022)

The Police and Peers Initiative in the Fayette, Kanawha, Monongalia, Nicholas, and Preston counties of West Virginia places Peer Recovery Support Specialists (PRSS) with law enforcement to enhance care for people in crisis. The initiative established partnerships with local Quick Response Teams, Law Enforcement Assisted Diversion teams, and others in the community.

PRSS provide opioid reversal, case management, and motivational interviewing services; linkage to addiction treatment, social services, support programs; and customized action plans based on the individual’s self-identified needs. This enhances quality of care and services and reduces the burden on law enforcement officers (who can then focus on public safety).

Since 2022, the program has linked 120 people to treatment and 110 to psychosocial support services (housing, clothing, basic needs, employment, etc.) as well as distributed 262 naloxone kits and 780 fentanyl test strips.

Early in the initiative, a Fayette County Sheriff’s Deputy contacted a PRSS about an overdose incident. The PRSS met with the individual, who chose to enroll in an outpatient Medication for Opioid Use Disorder program. This person has now sustained over eight months of recovery, gained employment, reinstated their driver’s license, and bought a vehicle.

During an Oak Hill Police Department callout, a PRSS de-escalated a disturbance. The peer connected three people to treatment — all of whom completed treatment — and one person was reunited with their children while maintaining recovery.

With the Kingwood Police Department (starting in April 2024), PRSS activities include collaborating with the municipal court, training the fire department on naloxone administration, participating in ride-alongs, attending coalition meetings, and developing a street outreach plan.

Prairie Band Potawatomi Nation – Walking in 2 Worlds
Mayetta, Kansas
(Tribal Behavioral Health grant awardee)

Prairie Band Potawatomi Nation hosted a two-day workshop to help human services professionals support the Native Two-Spirit, lesbian, gay, bisexual, transgender, queer (2SLGBTQ) population. The “Walking in 2 Worlds” event educated professionals and community members about the struggles and complexities of 2SLGBTQ adults and youth across Indian Country.

Issues for these individuals include isolation; homelessness; job insecurity; racism; stigma; and increased risks of substance use, substance use disorders, overdose, violence, suicide, and human trafficking victimization. Many cases of violence and human trafficking go unreported, due to multiple (and intersecting) barriers faced by this population, and a lack of supportive services tailored to address their unique needs.

The workshop benefitted from speakers who shared personal stories, documentary films, and technical assistance from SAMHSA’s Native Connections training and technical assistance.

Resources to Tell Your Prevention Story

Prevention has never been more important. As a nation, we continue to face significant substance use and mental health challenges, especially among youth and young adults. Prevention works and helps us get ahead of these challenges so that youth, families, and communities can thrive.

Prevention Month is a key opportunity to elevate the national conversation and showcase prevention’s positive effects on communities across the country. Here are ideas and resources for you to tell your prevention story.

To Tell Your Story During Prevention Month:

  • Download the Substance Use Prevention Month toolkit — which includes social media messages, graphics, email signature graphic, virtual meeting background, and resources.
  • Share your #MyPreventionStory on social media.

To Get Involved Year-round:

To Put Prevention Science into Practice:

In determining which grantees to highlight for this blog, SAMHSA’s Center for Substance Abuse Prevention staff (including government project officers) looked across CSAP’s prevention portfolio to identify grantees that represent the scope of our prevention portfolio and would reflect: diversity in population served or population of focus (e.g., age, ethnicity, sexual orientation, social context of family or individual), geographic diversity of the programs (e.g., rural, urban, and regions), outcome of focus (e.g., upstream prevention or preventing a downstream outcome such as overdose), and diversity in prevention strategies implemented (e.g. social media and public messaging, naloxone distribution and training, individual programs, family programs).

Source: https://www.samhsa.gov/blog/substance-use-prevention-month-telling-prevention-story

Overview

In recent years, police forces in England and Wales have worked more closely with health, education and other local partners to address social issues, such as drug use, youth violence and people in mental health crisis.[1] This aims to ensure that vulnerable people are supported by the most appropriate professional, and that certain complex social issues are not automatically met with a criminal justice response.

These initiatives are sometimes referred to as public health approaches to policing.[2] They can include interventions aimed at preventing offending altogether (for example, early years school-based programmes), as well as ones covering offenders or people coming into contact with the police.[3]

In 2018, organisations representing public health bodies, health services, voluntary organisations and police forces signed an agreement to work more closely together to prevent crime and protect the most vulnerable people in England.[4] Public Health Scotland and Police Scotland announced a formal collaboration in 2021.[5] In 2019, Public Health England and the College of Policing published a discussion paper on public health approaches to policing,[6] and the Association of Police and Crime Commissioners issued guidance in 2023 to support implementation of such approaches.3

Research has found that cooperation between police and health services can help to improve social outcomes. For example:

  • a 2017 study in the USA suggested that health services and police forces have worked effectively together to improve police responses to mental health-related encounters[7]
  • research in 2017 highlighted international examples of how formal collaboration between criminal justice and public health agencies helped to reduce youth violence[8]
  • a 2022 study found that nurses and police officers could develop collaborative teamwork practices in police custody suites in England[9] [10]

There are examples of police forces working with health partners and other agencies to improve responses to vulnerable people in England and Wales:

  • Under drug diversion schemes, police refer people caught in possession of small quantities to voluntary sector treatment services, rather than prosecute for a possession offence. As of 2024, diversion schemes were operating in Thames Valley,[11] West Midlands,[12] and Durham police force areas.[13] The College of Policing and the University of Kent have received funding to evaluate these schemes, which is expected to be completed in 2025.[14]
  • The Right Care, Right Person model aims to reduce the deployment of police to incidents related to mental health and concern for welfare, and instead ensure that people receive support from the most appropriate health or social care professional. Humberside Police developed the model, which includes training for police staff and partnership agreements between police, health and social services.[15] From 2023, police forces nationally were beginning to adopt it, with support from the National Police Chiefs’ Council and the College of Policing.[16]
  • Violence Reduction Units (VRUs) bring together police, local government, health and education professionals, community groups and other stakeholders to provide a joint response to serious violence, including knife crime. The London Mayor’s Office for Policing and Crime established the first VRU in England and Wales in 2019. It states that it takes a public health approach to violence prevention,[17] including deploying youth workers in hospitals and police custody suites.[18] Between 2019 and 2022, the government funded 20 VRUs across England and Wales.[19] In 2019, the government provided funding for the Youth Endowment Fund, which funds and evaluates programmes in England and Wales that aim to prevent children and young people from becoming involved in violence.[20]

Since 2020, Scotland has seen increasing use of diversion from prosecution schemes.[21] In October 2024, the UK’s first official consumption facility for illegal drugs, including heroin and cocaine, was opened in Glasgow.[22]

Challenges and opportunities

In 2023, HM Inspectorate of Constabulary and Fire & Rescue Services noted how police forces were often the “service of last resort” doing the work of other public services, especially with regards to mental ill health.[23] For some vulnerable people, police custody may provide their only space for healthcare interventions.10 Both police forces and voluntary organisations suggest that, at a time when police capacity is under pressure, public health approaches can reduce the amount of time police officers spend dealing with people with complex health needs, who may be referred to other health, care or support services.[24],[25] However, this can also lead to demand and capacity pressures being displaced onto these services.

For example, drug diversion schemes may increase the demand on local drug treatment services, which themselves are facing significant pressures. In her independent review of drugs for the government in 2021, Dame Carol Black raised significant concerns about the capacity and resourcing of drug treatment services in England, and the impact of funding reductions.[26] The Criminal Justice Alliance has called for increased funding for local drug services, to accommodate people being diverted away from the criminal justice system.[27]

The government’s 10-year drug strategy (2021) committed to invest £533 million into local authority commissioned substance misuse treatment services in England from 2022/23 to 2024/25, as part of its aim to “rebuild local authority commissioned substance misuse treatment services in England”.[28] In 2023, the Home Affairs Committee called for all police forces in England and Wales to adopt drug diversion schemes.[29] It also expressed concern about the long-term sustainability and security of funding for the drug treatment and recovery sector.26

Similar pressures in mental health services have led to concerns about the safety of the national rollout of Right Care, Right Person. In November 2023, the Health and Social Care Committee identified urgent questions around the available funding for health services, and the lack of evaluation, in the rollout of the scheme[30] The Royal College of Psychiatrists and the Royal College of Nurses agreed that people with mental illness should be seen as quickly as possible by a mental health professional.[31],[32] However, they and other health, local government, and mental health charities, have expressed several concerns about the programme. These include: the speed and consistency of implementation, lack of funding, the potential for gaps in provision, and increased welfare risks.[33],[34],[35],[36]

Key uncertainties/unknowns

Outside the UK, some public health approaches have involved a significant shift away from enforcing drug possession for personal use through the criminal justice system.[37] For example:

  • Portugal decriminalised possession of drugs for personal use in 2001 and instead refers drug users to support and treatment.[38] Analysis of these measures from researchers and policy experts suggests decriminalisation led to reductions in problematic use, drug-related harms and criminal justice overcrowding.38,[39]
  • In the USA, Oregon trialled a policy in 2020 making drug possession a fineable offence.[40]
  • In Canada, British Columbia trialled an approach in 2023 that decriminalised possession of small amounts of certain drugs for personal use in specific non-public locations.[41]

Citing international examples, some drug policy experts have called on the government to go further in its adoption of a public health approach to drug use.37 The Home Affairs Committee stated in 2023 that the government’s drug strategy should have adopted a broader public health approach, and called for responsibility for misuse of drugs to be jointly owned by the Home Office and Department of Health and Social Care.26 In 2019, the Health and Social Care Committee recommended the government shift responsibility for drugs policy from the Home Office to the Department of Health and Social Care, and for the government to “look closely” at the Portugal model for decriminalisation of drug possession for personal use.[42]

However, Portugal’s approach has also faced criticism. For example, a research review in 2021 highlighted continued social and political resistance to some of the measures 20 years after being introduced.[43] A 2023 editorial in the Lancet highlighted how a recent rise in the use of illicit drugs in Portugal had led to renewed criticism of the policy.[44] More recently, some states in North America have reversed decriminalisation policies, reportedly due to adverse consequences of drug decriminalisation.33,[45][46]

This points to a mixed evidence base internationally for a fully public health approach to drug use. However, it may be difficult to compare international examples, given the different models of decriminalisation that have been adopted, and in a variety of social, economic, political and legal systems.[47]

Key questions for Parliament

  • Should the government do more to support the implementation of public health approaches to policing across England and Wales, considering both the police, and health, care and other local services?
  • Should the police continue to implement the Right Care, Right Person model? Do mental health services have sufficient resource and capacity to bridge the gap?
  • Should drug diversion schemes be rolled out across England and Wales? Do drug treatment services have sufficient capacity and resource to respond to increased demand on services?
  • Should the government go further in taking a public health approach to drugs by decriminalising drug possession for personal use?
  • How effective have government measures to reduce youth violence been?
  • What international comparisons are useful for implementation of public health approaches to policing?

 

Source: DOI: https://doi.org/10.58248/HS62

by Perkins and Ranalli, ETR. Aug 28, 2024

ABOUT THE EXPERTS

Laura Perkins, MLS (she/her/hers) is a Product Editor at ETR and has over 20 years of experience in editorial content and health literacy.

Lauren Ranalli, MPH (she/her/hers) is the Director of Communications and Public Affairs at ETR and has over 20 years of experience in public health and adolescent health services.

Source: https://www.physiciansweekly.com/addressing-prescription-drug-misuse-among-adolescents/

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

Abstract

Background

Youth in disadvantaged socio-economic circumstances in South Africa face significant risks to their physical and mental well-being due to exposure to harmful behaviours. More than 50% of the global disease burden is attributed to non-communicable diseases linked to such behaviours. While interventions have been initiated to address these risks, the limited reduction in risky behaviour necessitates closer examination and the exploration of more targeted or innovative approaches for effective mitigation.

Objectives

To explore existing health risk behaviour prevention/intervention programmes targeting youth, focusing on decreasing risky behaviour engagement and to discuss the success of the intervention used.

Methods

Three electronic databases were searched from 2009 until November 2023. Studies specifically reported using an intervention programme in youth or adolescents aged 9 to 19 were included. Data extracted included age, grade, sample size, targeted risky behaviour, and outcome.

Results

A total of 1072 articles were screened across three major databases, and of the nine included studies, n = 7 yielded mild to moderate intervention success results. The use of incentives yielded unsuccessful results. The most successful intervention strategy identified was school-based intervention programmes targeting multiple risky behaviours.

Conclusion

School interventions combining counselling, electronic screening, and personalized feedback effectively modified behaviour, while incentive-based programs had minimal impact. This underscores the importance of targeted interventions to discourage risky behaviour among young people.

Clinical implications

Effective intervention and prevention programs targeting health risk behaviours in youth are essential in safeguarding their mental and physical well-being. A clear link between risky behaviour engagement and the potential development of non-communicable diseases or trauma should be emphasised.
The full article can be accessed by clicking on the Source link below:
Source: https://www.springermedizin.de/health-risk-behaviour-prevention-intervention-programmes-targete/27472880
Dr. Robert DuPont (NIDA, USA) shifted the paradigm from demonization to treatment of users.

Key points

  • In the 1970s, people addicted to opioids were demonized, considered hopeless. Some still believe this.
  • Setting high standards and following addicted patients for five years helps doctors know what treatments work.
  • Prevention is key to success in substance abuse, and it’s important to encourage non-use among teens.
In the United States, people addicted to opioids were once demonized as hopelessly bad, and treatment was virtually nonexistent. No one may have done more to change both matters than psychiatrist Robert DuPont, M.D, who, in 1969, during an unexplained surge in crime in the nation’s capital, was working with prisoners in the District of Columbia Department of Corrections. DuPont decided to test incoming inmates for drugs and was shocked to learn that nearly half (45%) were addicted to heroin. Desperate for heroin, they turned to crime for money.

At the behest of the district’s mayor, DuPont developed a D.C.-based clinic, the Narcotics Treatment Administration. It treated more than 15,000 heroin addicts over the next three years, and the D.C. crime rate plummeted by 50%, in a direct correlation.

Helping Medical Professionals Do Better

Robert L. “Bob” DuPont, born in 1936, graduated from Emory University and Harvard Medical School and completed his psychiatric training at the National Institutes of Health. He became the first director of the newly-created National Institute on Drug Abuse (NIDA), where he created a first-of-its-kind comprehensive training program for doctors, nurses, and counselors working in addiction treatment programs. Drug overdose deaths began declining, from from 6,413 to 2,492 by 1980.

In 1978, DuPont left government service to create the Institute for Behavior and Health (IBH), a think tank focusing on drug policy. Dupont has published more than 400 journal articles and 15 books, most recently Chemical Slavery: Understanding Addictions and Stopping the Drug Epidemic (2018).

The IBH conducted the first national study of doctors dependent on drugs and alcohol, their treatment, and five-year outcomes. “Physicians are given a comprehensive assessment by a team of professionals and get treatment for comorbidities, but the focus is on their addictions. They typically attend a month or more of residential treatment and, as outpatients, are monitored for five years with random drug and alcohol testing. If they miss a scheduled test or test positive for any drug, including alcohol, they are taken out of their practice again, assessed, and sent back to treatment.”

DuPont points out that many doctors who entered the program were initially resentful because they didn’t think there was anything wrong with them—typical of individuals with substance use disorder from all walks of life. Yet, most physicians greatly value their medical license, and the overwhelming majority cooperated because participation and success meant they could continue to practice medicine.

His study of nearly 1,000 drug-addicted physicians closely monitored for five years showed what is possible for the rest of the population. Seventy-eight percent never tested positive for drugs or alcohol, an excellent record. In addition, of those who did have a positive or missed drug test, nearly two-thirds never had a second positive test.

A follow-up study of physicians who successfully completed treatment and monitoring contracts five or more years ago showed that more than 95% were still in recovery. Physicians rated the treatment they had received as important to their recovery but said the most valued part of their care was involvement in the 12 steps.

Lessons Learned About Substance Abuse

DuPont says many people don’t realize that it’s rarely just one drug abused by most problematic substance users. And that is particularly true of individuals who die from drug overdoses, in whom two or more drugs are often identified post-mortem.

He also notes that many drugs used today are not in their natural forms but instead are ultra-potent synthetics, like fentanyl. In 2022, about 111,000 people died, and in 2023, about 108,300 people died of drug overdose. .

Early diagnosis and treatment is key

The earlier patients are diagnosed and treated, the better their chances of achieving and sustaining recovery, says DuPont. Many people can stop using substances for some period. However, the real problem is not drug withdrawal, as many people believe, but, instead, the repeated relapses. Yet he has known many individuals with seemingly hopeless drug or alcohol issues who emerged sober and productive. He largely credits organizations like Alcoholics Anonymous and Narcotics Anonymous.

Prevention is best

Whenever possible, prevention of drug use is best, particularly among young people. Not only is adolescence a time when most addictions begin, it’s also a time when the brain is uniquely vulnerable..

DuPont now focuses on youth substance-use prevention: no alcohol, nicotine, marijuana/THC, or other drugs by those under age 21. He notes that the percentage of 12th graders who report never using in their lifetime has increased from around 26% in 2018 to 32% in 2023. The trend is also evident in younger students. DuPont emphasizes, “This trend is key to reversing decades of pain, suffering, and addictions.“

At age 88, Robert DuPont, M.D., advocates for treatment research, long-term treatment with outcome reporting, mental health treatment parity (as important as physical health), and prevention. Recovery, he insists, is possible.

About the Author

Mark S. Gold, M.D., is a pioneering researcher, professor, and chairman of psychiatry at Yale, the University of Florida, and Washington University in St Louis. His theories have changed the field, stimulated additional research, and led to new understanding and treatments for opioid use disorders, cocaine use disorders, overeating, smoking, and depression.

Source: https://www.psychologytoday.com/gb/blog/addiction-outlook/202408/a-front-row-change-agent-of-the-drug-epidemic
Bethesda, Maryland  / Monday, August 19, 2024

The National Institutes of Health (NIH) has launched a programme that will support Native American communities to lead public health research to address overdose, substance use, and pain, including related factors such as mental health and wellness. Despite the inherent strengths in Tribal communities, and driven in part by social determinants of health, Native American communities face unique health disparities related to the opioid crisis. For instance, in recent years, overdose death rates have been highest among American Indian and Alaska Native people. Research prioritized by Native communities is essential for enhancing effective, culturally grounded public health interventions and promoting positive health outcomes.

“Elevating the knowledge, expertise, and inherent strengths of Native people in research is crucial for creating sustainable solutions that can effectively promote public health and health equity,” said Nora D. Volkow, M.D., director of NIH’s National Institute on Drug Abuse (NIDA). “As we look for ways to best respond to the overdose crisis across the country, it is crucial to recognize that Native American communities have the best perspective for developing prevention and therapeutic interventions consistent with their traditions and needs. This programme will facilitate research that is led by Native American communities, for Native American communities.”

Totaling approximately $268 million over seven years, pending the availability of funds, the Native Collective Research Effort to Enhance Wellness (N CREW) Programme will support research projects that are led directly by Tribes and organizations that serve Native American communities, and was established in direct response to priorities identified by Tribes and Native American communities.

Many Tribal Nations have developed and continue to develop innovative approaches and systems of care for community members with substance use and pain disorders. During NIH Tribal Consultations in 2018 and 2022, Tribal leaders categorized the opioid overdose crisis as one of their highest priority issues and called for research and support to respond. They shared that Native communities must lead the science and highlighted the need for research capacity building, useful real-time data, and approaches that rely on Indigenous Knowledge and community strengths to meet the needs of Native people.

The N CREW Programme focuses on: Supporting research prioritized by Native communities, including research elevating and integrating Indigenous Knowledge and culture; Enhancing capacity for research led by Tribes and Native American Serving Organizations by developing and providing novel, accessible, and culturally grounded technical assistance and training, resources, and tools; Improving access to, and quality of, data on substance use, pain, and related factors to maximize the potential for use of these data in local decision-making.

“Native American communities have been treating pain in their communities for centuries, and this programme will uplift that knowledge to support research that is built around cultural strengths and priorities,” said Walter Koroshetz, M.D., director of NIH’s National Institute of Neurological Disorders and Stroke (NINDS). “These projects will further our collective understanding of key programmes and initiatives that can effectively improve chronic pain management for Native American and other communities.”

The first phase of the programme will support projects to plan, develop, and pilot community-driven research and/or data improvement projects to address substance use and pain. In this phase, NIH will also support the development of a Native Research Resource Network to provide comprehensive training, resources, and real-time support to N CREW participants.

The second phase of the program, anticipated to begin in fall 2026, will build on the work conducted in the initial phase of the program to further capacity building efforts and implement community-driven research and/or data improvements projects. Additional activities that support the overarching goals of the N CREW Programme may also be identified as the program develops.

The N CREW Programme is led by the NIH’s NIDA, NINDS, and National Center for Advancing Translational Sciences (NCATS), with participation from numerous other NIH Institutes, Centers, and Offices. The N CREW Program is funded through the NIH Helping to End Addiction Long-term Initiative (or NIH HEAL Initiative), which is jointly managed by NIDA and NINDS. For the purposes of the N CREW Programme, Native Americans include American Indians, Alaska Natives, and Native Hawaiians. Projects will be awarded on a rolling basis and publicly listed.

This new programme is part of work to advance the Biden/Harris Administration’s Unity Agenda and the HHS Overdose Prevention Strategy.

Source: https://www.pharmabiz.com/NewsDetails.aspx?aid=171961&sid=2

Tricia Otto’s son, Calvin, will forever be 29 years old. That’s because he lost his life to fentanyl poisoning at age 29 in April of last year.

“He was funny. He had an amazing sense of humor. He was thoughtful. He was kind. He always worried about how other people were feeling. Um, he struggled with addiction for about 14 years, but he fought really hard against that,” Tricia Otto explains. “He always talked about wanting to be a fireman … And instead of fighting fires, my son spent his time fighting demons.”

In 2023 alone, there were over 1, 200 drug overdose deaths from fentanyl in Colorado.

That’s according to the Common Sense Institute. That equates to roughly three deaths per day on average. This upcoming Wednesday, August 21st, is National Fentanyl Prevention and Awareness Day. It was started by the nonprofit Facing Fentanyl. They’re organizing a takeover of Times Square in New York City this week.

Here in Colorado, there will be a Candlelight Vigil at the Denver City and County Building this Wednesday at 7 p. m. (flyer posted below).

Tricia Otto, in addition to being Calvin’s mom, is the Drug-Induced Homicide Foundation Colorado Chapter State Representative. She joined KGNU’s Jackie Sedley to discuss how important it is to talk about fentanyl poisoning, to use language that takes blame off of those with substance use disorder, and to hold those who sell illicit substances accountable.

“Referring fentanyl poisoning as an accidental overdose diminishes the calculated greed and disregard for human life that led to this tragic, tragic passing,” Otto says. “Those struggling with substance abuse disorder are targeted and exploited by drug dealers and others who stand to profit from their vulnerability. Calling it an accident ignores the deliberate actions of those that prey on the addicted, pushing dangerous substances for their own gain. This is not an unfortunate mishap. It’s a calculated act of malice that leads to the death and devastates families.”

Source: https://kgnu.org/fentanyl-overdose-prevention-awareness-triciaotto-calvinotto/

by Zachary Pottle |- Addiction Center

Remaining Sober In College

With August underway, many college students will be heading back to campuses across the country for another school year. For many, college is an exciting experience where young adults can learn, make friends, grow into their own, and of course attend the occasional party. However, for some students, returning to campus can present a host of challenges, especially those in recovery who may be worried about maintaining their sobriety.

It’s no secret college students experiment with substances. Now more than ever, college campuses are filled with drugs and alcohol. According to the 2023 National Survey on Drug Use and Health (NSDUH), 45.3% of male and 48.5% of female full-time college students ages 18 to 22 drank alcohol in the past month. Additionally, roughly 40% of both male and female college students said they had tried an illicit substance within the past year; with the most common being marijuanacocainehallucinogens, and prescription drugs.

If you’re a student dealing with addiction, you might worry about being pressured to use drugs, attend parties where alcohol is prevalent, or spend time with people who engage in substance use. However, college doesn’t have to be overwhelming. By taking proactive steps to avoid substance use temptations, you can still enjoy your college experience.

Tips For Staying Sober On Campus

For students who are entering back into the college space after receiving treatment or in the earlier stages of recovery, campuses can be a stressful environment. Learning how to guard your sobriety while in environments ripe with drug and alcohol use can be hard, but fortunately many colleges have resources available to help keep you sober and engaged with your peers.

Avoid Popular “Party” Spots

While it likely goes without saying, avoiding places where drugs and alcohol are likely to be present is one of the best ways to stay sober in college. Many colleges have places that are synonymous with these types of activities; like popular local bars, fraternity or sorority houses, and other similar spaces. If you know that exposure to drugs or alcohol may trigger cravings or put your sobriety at risk, avoiding these spaces is key.

However, avoiding these places doesn’t mean that you have to have a “boring” college experience. For every bar or nightclub there’s an equal amount of spaces where social gatherings happen free of drugs and alcohol. Libraries, activity centers, sports facilities, and other places on campus are all great for avoiding triggers while also being a part of campus life.

Join A Club Or Campus Organization

While Greek life organizations are often associated with drug and alcohol use, many are involved in campus life and hold fundraisers, events, and other activities for all students on campus. Joining a fraternity or sorority can also be a great way to meet and connect with others, especially groups that focus on campus life and academic performance.

Many colleges also have a plethora of clubs and organizations for students to join. These include groups like student government, intramural sports, arts clubs, cultural clubs, and community service groups. Joining a group is a great way to stay involved with campus life while remaining sober.

Start An Exercise Routine

One of the most beneficial things you can do for your health is to exercise. Exercise can be especially helpful for those struggling with cravings or mental health conditions like anxiety or depression, both of which can be common for young adults struggling with their sobriety. Research shows that people who exercise regularly have better mental health and emotional wellbeing, and lower rates of mental illness.

Exercise doesn’t have to be strenuous or take a long time. Studies show low or moderate intensity exercise is enough to make a difference in terms of your mood and thinking patterns. The Centers for Disease Control and Prevention (CDC) recommends young adults aged 18-25 engage in 150 minutes of moderate-intensity physical activity a week. This can also be 75 minutes of vigorous-intensity or an equivalent combination of moderate- and vigorous-intensity physical activity. For additional benefits, the CDC recommends an extra two days of muscle-strengthening each week.

Utilize Campus Resources

Safeguarding your sobriety can be difficult, especially when your mental health is lacking. Without proper mental health care, depression, anxiety, stress or other mental health concerns can lead even the strongest of those in recovery into relapse. As our understanding of the importance of mental health has increased over the years, so too has our access to mental health care across the country.

Many colleges, especially larger state-sponsored schools with large student bodies, have counseling and other psychological services free of charge for enrolled students. Colleges that offer these types of services typically do so either online or in-person, and usually operate on a scheduling basis. If you’re unsure about whether or not your college offers counseling services, contact your admissions office or campus resource center to find out more.

Additional Resources For College Students In Recovery

While counseling services and campus organizations can both be beneficial to students in recovery, the reality is that many people experience relapses. Studies show that between 40 to 60 percent of individuals in treatment for substance abuse will relapse. It’s important to remember; however, that a relapse is not a sign of failure. Rather, relapses are a part of the recovery process.

Relapses can be a slight “bump in the road” for some, while for others relapses may require a bit of extra help to get them back on track. Treating chronic diseases requires changing long-established behaviors, and relapse doesn’t signify failure. When someone in recovery from addiction relapses, it’s a sign that they should consult their doctor to restart treatment, adjust it, or explore other options.

For students who may need extra resources, services like outpatient rehab may be a viable option to help keep you in school while also addressing relapse concerns. Outpatient programs provide young adults with the flexibility to receive treatment for part of the day while returning to campus each night. These programs vary, including day programs, intensive outpatient programs (IOP), and continued care. An addiction specialist can help determine which option best suits your needs.

Finding Help

Addiction is often seen by many as a lifelong disease; one that requires constant dedication, mindfulness, and strength. You should never be ashamed of needing support, regardless of how much or how frequent it is. If you’re struggling to stay sober, reaching out for help is always better than sacrificing your hard-earned sobriety. For additional resources and support, contact a treatment provider today to learn about your options.

Source: https://www.addictioncenter.com/community/stay-sober-college/

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/

12 Aug 2024

Substance abuse disorders are on the rise among young people. The American Addiction Center reports one in seven young adults are affected. Crisis coach Scott Silverman and youth drug prevention educator Rocky Herron joined the CBS 8 Morning Show with details.

Source: https://www.youtube.com/watch?v=K6BYoWOnAG8

One of the most pressing issues for businesses in states where marijuana use is legal is determining employee impairment before taking any adverse action. Unlike alcohol, where a simple breathalyzer test can gauge impairment, marijuana’s effects vary significantly based on consumption method, strain, and user tolerance.

Studies have shown that THC—the psychoactive compound in cannabis—and its metabolites can linger in the body long after the “high” has worn off. Recognizing this, many states have enacted laws requiring employers to prove impairment, not just the presence of THC. Traditional drug tests like urinalysis, oral fluid tests, hair tests, and even emerging breath THC tests only indicate prior use, not current impairment.

This means that zero-tolerance policies based solely on the detection of THC metabolites are no longer viable in many states. Instead, employers must place more focus on assessing fitness for duty through reasonable suspicion training for supervisors and consider adopting impairment detection technology.

Given that measuring THC levels cannot be the sole indicator of impairment, new tools have emerged to detect impairment from drug and alcohol use. Advanced impairment detection technologies offer more accurate insights into an employee’s current state of impairment. These devices measure psychological and/or physical indicators, allowing employers to make informed decisions about workplace safety. Leading solutions are portable, scientifically defensible, and provide results within minutes.

However, these technologies alone are not enough. Supervisors play a crucial role in identifying and documenting impairment. Proper training in recognizing the signs of impairment and documenting these observations is essential. Supervisors must be equipped to take appropriate action based on their assessments, ensuring that safety and performance standards are upheld. We here at NDWA can help provide trainings for your supervisors – find out more here.

Employees must understand that they are not exempt from workplace safety regulations regardless of their state’s marijuana laws. Being under the influence at work can endanger themselves and their colleagues, and impact work quality and efficiency. It is the responsibility of employees to ensure their marijuana use doesn’t impair their fitness for duty. They must arrive at work sober and ready to perform.

Advanced impairment detection technology is promising, but isn’t a singular solution. By training supervisors to document regular behavior and performance, businesses can maintain safe and productive work environments.

 

Source:  NATIONAL DRUG-FREE WORKPLACE ALLIANCE

Effort aims to elevate Indigenous knowledge and culture in research, to respond to the overdose crisis and address related health disparities

The National Institutes of Health (NIH) has launched a program that will support Native American communities to lead public health research to address overdose, substance use, and pain, including related factors such as mental health and wellness. Despite the inherent strengths in Tribal communities, and driven in part by social determinants of health, Native American communities face unique health disparities related to the opioid crisis. For instance, in recent years, overdose death rates have been highest among American Indian and Alaska Native people. Research prioritized by Native communities is essential for enhancing effective, culturally grounded public health interventions and promoting positive health outcomes.

“Elevating the knowledge, expertise, and inherent strengths of Native people in research is crucial for creating sustainable solutions that can effectively promote public health and health equity,” said Nora D. Volkow, M.D., director of NIH’s National Institute on Drug Abuse (NIDA). “As we look for ways to best respond to the overdose crisis across the country, it is crucial to recognize that Native American communities have the best perspective for developing prevention and therapeutic interventions consistent with their traditions and needs. This program will facilitate research that is led by Native American communities, for Native American communities.”

Totaling approximately $268 million over seven years, pending the availability of funds, the Native Collective Research Effort to Enhance Wellness (N CREW) Program will support research projects that are led directly by Tribes and organizations that serve Native American communities, and was established in direct response to priorities identified by Tribes and Native American communities.

Many Tribal Nations have developed and continue to develop innovative approaches and systems of care for community members with substance use and pain disorders. During NIH Tribal Consultations in 2018 and 2022, Tribal leaders categorized the opioid overdose crisis as one of their highest priority issues and called for research and support to respond. They shared that Native communities must lead the science and highlighted the need for research capacity building, useful real-time data, and approaches that rely on Indigenous Knowledge and community strengths to meet the needs of Native people.

The N CREW Program focuses on:

  1. Supporting research prioritized by Native communities, including research elevating and integrating Indigenous Knowledge and culture
  2. Enhancing capacity for research led by Tribes and Native American Serving Organizations by developing and providing novel, accessible, and culturally grounded technical assistance and training, resources, and tools
  3. Improving access to, and quality of, data on substance use, pain, and related factors to maximize the potential for use of these data in local decision-making.

“Native American communities have been treating pain in their communities for centuries, and this program will uplift that knowledge to support research that is built around cultural strengths and priorities,” said Walter Koroshetz, M.D., director of NIH’s National Institute of Neurological Disorders and Stroke (NINDS). “These projects will further our collective understanding of key programs and initiatives that can effectively improve chronic pain management for Native American and other communities.”

The first phase of the program will support projects to plan, develop, and pilot community-driven research and/or data improvement projects to address substance use and pain. In this phase, NIH will also support the development of a Native Research Resource Network to provide comprehensive training, resources, and real-time support to N CREW participants.

The second phase of the program, anticipated to begin in fall 2026, will build on the work conducted in the initial phase of the program to further capacity building efforts and implement community-driven research and/or data improvements projects. Additional activities that support the overarching goals of the N CREW Program may also be identified as the program develops.

The N CREW Program is led by the NIH’s NIDA, NINDS, and National Center for Advancing Translational Sciences (NCATS), with participation from numerous other NIH Institutes, Centers, and Offices. The N CREW Program is funded through the NIH Helping to End Addiction Long-term Initiative (or NIH HEAL Initiative), which is jointly managed by NIDA and NINDS. For the purposes of the N CREW Program, Native Americans include American Indians, Alaska Natives, and Native Hawaiians. Projects will be awarded on a rolling basis and publicly listed.

This new program is part of work to advance the President’s Unity Agenda and the HHS Overdose Prevention Strategy.

Source:  https://nida.nih.gov/news-events/news-releases/2024/08/nih-launches-program-to-advance-research-led-by-native-american-communities-on-substance-use-and-pain

Dr. David R. Holtgrave, Ph.D., Joins the Department of Health as Senior Policy Advisor to the Commissioner to Enhance the Department’s Mission to End the Opioid Epidemic

ALBANY, N.Y. (August 15, 2024) – The New York State Department of Health is pleased to welcome nation-leading public health, prevention and substance use policy expert Dr. David R. Holtgrave, Ph.D., to the executive leadership team as Senior Policy Advisor to the Commissioner. Dr. Holtgrave joins the State Health Department with more than 35 years of public health experience, including serving in the White House Office of National Drug Control Policy from 2022-2024.

“Dr. Holtgrave is a national leader in drug prevention programs and a public health expert who comes to the State Health Department to help our fight against the overdose epidemic,” State Health Commissioner Dr. James McDonald said. “I’m thrilled to welcome Dr. Holtgrave to the executive leadership team, as we continue to rebuild the Department and hire experienced, compassionate public health experts.”

Dr. Holtgrave joins the Department with decades of experience addressing urgent public health issues, demonstrated by his development of an evidence-based national response plan to confront the emerging challenge of fentanyl combined with xylazine in the illegal drug supply, his rapid research to inform COVID-19 clinical decision making and his transitional work in addressing HIV-related health inequities in the U.S.

At the Department of Health, Dr. Holtgrave is charged with a range of activities all with the common theme of translating data into the best possible public health programs and policies for the residents of New York. In particular, he will focus on facilitating the substance use work in the Department to ensure that it is as coordinated, evidence-based and impactful as possible.

“I am honored and humbled by Commissioner McDonald’s invitation to join in the impactful work being done at the Department of Health,” Senior Policy Advisor to the Commissioner Dr. David Holtgrave said. “As the Department is committed to improving the health and well-being of all New Yorkers and building health equity across the State, I am delighted to be able to serve on this incredible team.”

Prior to his service in the White House Office of National Drug Control Policy, Dr. Holtgrave served as the Dean of the University at Albany School of Public Health and worked in close partnership with the New York State Department of Health.

From 2005 to 2018, he was the Chair of the Department of Health, Behavior, and Society at the Johns Hopkins Bloomberg School of Public Health, and served as a member and then Vice-Chair of the Presidential Advisory Council on HIV/AIDS (PACHA). His experience includes service as the Director of the Division of HIV/AIDS Prevention – Intervention Research & Support at the U.S. Federal Centers for Disease Control and Prevention (CDC); and as Professor and then Vice-Chair of the Department of Behavioral Sciences and Health Education at the Emory University Rollins School of Public Health.

A first-generation college student, Dr. Holtgrave earned his Ph.D. in 1988 from the University of Illinois at Urbana/Champaign in Quantitative Psychology and immediately thereafter held a post-doctoral research fellowship in the Interdisciplinary Programs in Health at the Harvard T.H. Chan School of Public Health.

Source: https://www.health.ny.gov/press/releases/2024/2024-08-15_executive_leadership.htm

School-based interventions hold the potential to save lives, researchers say.

Charlotte WaddellChristine SchwartzJen Barican and Nicole Catherine 16 Aug 2024The ConversationCharlotte Waddell is a professor emerita of health sciences at Simon Fraser University, where Christine Schwartz is an adjunct professor and Nicole L.A. Catherine is a professor. Jen Barican is a senior research manager at SFU. This article was originally published by the Conversation.

Successful drug prevention programs delivered to middle-school students taught skills such as resisting peer pressure, managing stress and cultivating positive friendships. Illustration via Shutterstock.

Can a program for Grade 7 students help end the opioid crisis? The answer is yes, according to compelling research findings on school-based primary prevention interventions.

To address this crisis, many of Canada’s responses to the opioid crisis still focus downstream on adults, after problems have started or become entrenched.

In contrast, primary prevention operates upstream in childhood — before most young people start engaging in substance use, misuse or experimentation.

As researchers concerned with helping children avoid opioid misuse, we conducted a systematic review of prevention programs designed for this purpose.

Interventions that could save lives

The program Strengthening Families significantly reduced prescription opioid misuse among young people in Iowa and Pennsylvania, with benefits lasting up to 14 years after the program ended.

The impact was also large, reducing misuse by 65 per cent.

Project PATHS, the other successful program, which was delivered in Hong Kong, significantly reduced heroin use with benefits lasting up to two years later. And each time these programs prevented a young person from misusing opioids, they potentially saved a life.

Beyond intervening early, both of these successful programs shared other similarities. Children learned enduring skills such as resisting peer pressure, managing stress and cultivating positive friendships.

Teaching multiple skills that children could apply throughout their development likely played a role in the programs’ long-term success — and likely contributed to other positive outcomes including reducing cannabis and ecstasy use.

Both program evaluations also highlighted the ability to reach very large numbers of children, using school delivery. These numbers were about 12,000 for Strengthening Families and about 8,000 for Project PATHS.

These numbers suggest that new Canadian school-based prevention efforts could potentially reach thousands of young people. With such a substantial population impact, these programs hold great promise to reduce many harms associated with the opioid crisis — including not only deaths but also criminal activity and distress for individuals misusing opioids and their families.

These two school-based programs have another significant feature adding to their appeal for delivery in Canada. Training for facilitators is very brief — only two days for Strengthening Families and three days for Project PATHS.

The short training time also helps reduce delivery costs, further increasing the appeal for policymakers and school administrators.

In Canada, we need such programs. And evaluations

Yet program benefits do not always translate between countries. So Canadian evaluations would be an important component to accompany implementation of either or both programs.

PreVenture, a school-based program developed by a clinical psychologist and researcher at the University of Montreal, is a good example of expanding both prevention and evaluation efforts.

Researchers from across Canada are currently assessing whether this program can avert opioid use with youth in British Columbia, Ontario and Nova Scotia — building on its success with decreasing alcohol problems as well as the number of drugs that youth used in an RCT in the United Kingdom.

If successful, PreVenture could also be expanded so that fewer Canadian children experience the devastating effects of the opioid crisis.

Research has highlighted important gains that Canadians can achieve by investing in school-based prevention programs.

To realize these benefits, however, leadership is needed at the provincial and territorial levels given that schools fall within these jurisdictions.

Yet the federal government can also take strong leadership, for example, encouraging these types of primary prevention efforts across the country — as they have done with previous important child health problems.

Prevention needs to be central to the approach

The federal government has committed more than a billion dollars since 2017 to address the toxic drug problem — paralleled by provincial and territorial funding.

But a policy shift towards meaningful prevention also requires tackling the realities of current Canadian health spending priorities. While last November, the federal government called for proposals for “projects aimed at helping prevent and decrease substance use-related harms among young people,” such efforts need to be backed by rigorous evaluation methods such as RCTs.

And the programs we describe above have RCT support — suggesting that these are a place to start.

Devastation from the opioid crisis is obviously continuing. Efforts to respond to the acute crisis must therefore also continue — including ensuring access to effective treatments for all in need and curtailing the supply of toxic substances.

But primary prevention also needs to be central in the public health responses, given that continuing increases in treatment spending have not been enough and will likely never be enough on their own. Primary prevention is a crucial but underused component of a comprehensive public health approach.

Most importantly, new primary prevention efforts can increase the chances of more young people experiencing the healthy development that they deserve, in turn precluding much suffering and many costs later in life — while meeting the collective duty of care that all Canadians share for all children.The Conversation

Source: https://www.thetyee.ca/Analysis/2024/08/16/Programs-Youth-Toxic-Drug-Deaths/

August 4, 2024

Lifestyle changes—including eating fruits, vegetables, and whole grains—can help patients, especially those with diabetes or hypertension, improve outcomes.

Robert Ostfeld, MD, ScM, director of preventive cardiology at Montefiore Health System and professor of medicine at Albert Einstein College of Medicine in New York sat down with Drug Topics ahead of the American Society for Preventive Cardiology Congress on CVD Prevention to discuss the role that dietary patterns and nutrition decisions play in living a healthful lifestyle.

Drug Topics: What specific nutrients or dietary patterns have been shown to benefit patients with hypertension and diabetes, and how can this information be incorporated into patient counseling?

Robert Ostfeld, MD, ScM: That’s a very important question. A healthful diet, of course, can very positively impact cardiometabolic health—including blood pressure, diabetes, [and] lipids—and cardiovascular health and overall health in general.

Reassuringly, there is broad [alignment] in terms of what defines a healthful dietary pattern. For example, multiple medical societies—like the American Heart Association, the American College of Cardiology, the American Society for Preventive Cardiology, the Canadian Cardiovascular Society, the European Society of Cardiology—are all broadly aligned; consuming more plant-based nutrition, less ultra-processed foods, less red and processed meats, is helpful both cardiometabolically and [for] cardiovascular health overall.

Unfortunately, that recommendation hasn’t necessarily percolated down well, at least into the US. There was an interesting recent analysis where from the NHANES database—the National Health and Nutrition Examination Survey database—published in 2021, where they looked at a little over 11,000 people…where they used 5 elements to define diet. One element was consuming at least 4 and a half servings of fruits and vegetables a day, at least 3 servings of whole grains each day, low sugar or sweetened beverage consumption, low salt consumption, and 2 servings of fatty fish each week. If you had 0 or 1 of those, then they felt you had a poor diet; 2 or 3 an intermediate [diet], and 4 or 5, an ideal dietary pattern. About 75% of the US has a poor, 0 to 1 of those [elements] dietary pattern; 25% [have] intermediate, and 0.7% of the US has an ideal dietary pattern.

READ MORE: Food Is Medicine: Pharmacists Can Advance Policies for Healthier Communities

There’s a huge gap between where we are and where we could. You could ask, “Does it even really matter?” Of course it does. In this study, they modeled if everyone adopted an ideal dietary pattern—so 4 or 5 of those 5 elements—for 1 year, what would happen? Well, it was estimated that cardiovascular event rates would fall by about 42%. The gap matters. There’s randomized prospective cohort data that eating a healthful dietary pattern, more plant based [and] aligned with American College of Cardiology and American Heart Association recommendations, can also be helpful for high blood pressure, particularly the DASH [Dietary Approaches to Stop Hypertension] dietary pattern for high cholesterol, the dietary portfolio pattern, which is a high fiber plant based diet, and also, similar recommendations broadly for diabetes.

What I should reinforce is, it’s not really that there’s 1 diet for high blood pressure, high cholesterol, and diabetes. They’re really broadly aligned that consuming more healthful, plant-based foods—fruits, vegetables, whole grains, beans, lentils—less ultra-processed foods and less red and processed meats, is helpful for all of the above: cardiovascular health and cardiometabolic health.

Drug Topics: How can patients be supported in overcoming common barriers to healthy eating, such as budget constraints and limited access to nutritious foods, in the management of hypertension and diabetes?

Ostfeld: Helping the individual patient in the office embrace a more healthful diet can be a challenge. Society does not make…it easy for the healthy choice to be the easy choice. And behavior change, getting someone to change how they eat, how they live, can be very, very difficult. These are big hurdles that we face.

As an individual practitioner, it can be overwhelming to overcome some of these things; at least we can try and start. As an individual [health care provider], you’ll have your team around you who can support you and reinforce your message. Nurses, support staff, and registered dietitians can be incredibly helpful to reinforce and educate about this topic.

In the clinic specifically, I will try to find a specific reason that the patient may be interested in living more healthfully. Maybe they want to lose weight or improve their skin complexion, maybe they want to lower their blood pressure, lower their cholesterol, come off a medication… Whatever the case may be, I try to highlight how consistently eating more healthfully can address that particular issue. I will give them some very specific steps—some simple specific steps, because everyone’s busy and there’s so much information to take in—that they can hopefully do when they get home to live more healthily. I have a handout that I give them that I try to keep very simple.

Sometimes in clinic, because we’re all so busy, I’ll just say, “Let’s just start with 222.” [That’s] 2 servings of green leafy vegetables a day, 2 servings of fruit each day, 2 servings of other vegetables each day: 222. I’ll do that a little bit weirdly, deliberately, so they’ll remember it. Then when they go home, depending on where they live, there may be more or [fewer] access or cost issues. [I’ll explain that] for ease, [they] could cook in bulk; we certainly don’t have to buy, you know, organic green juices. You can get frozen vegetables, frozen fruits, big sacks of potatoes, oatmeal, and beans, and those things can be much less expensive and more doable.

Another way to help patients adopt a more healthful lifestyle is—there may be the hurdle of costs here—but there are services that can deliver meals, healthful meals, to patients; they may be able to access registered dieticians, and of course there are multiple online resources that are free for patients. The Physicians Committee for Responsible Medicine has a 21-day kickstart for more plant-based nutrition should, the [health care provider] feel that that’s appropriate for the patient. There are a variety of resources that people can have access to; some may cost a little bit more, but some are also free. The American College of Lifestyle Medicine also has multiple online resources.

Source: https://www.drugtopics.com/view/q-a-examining-the-key-drivers-of-a-healthful-lifestyle

This page is part of the European Drug Report 2024, the EMCDDA’s annual overview of the drug situation in Europe.

Evolving drug problems pose a broader set of challenges for harm reduction

The use of illicit drugs is a recognised contributor to the global burden of disease. Interventions designed to reduce this burden include prevention activities, intended to reduce or slow the rate at which drug use may be initiated, and the offer of treatment to those who have developed drug problems. A complementary set of approaches goes under the general heading of harm reduction. Here the emphasis is on working non-judgementally with people who use drugs in order to reduce the risks associated with behaviours that are mostly associated with adverse health outcomes, and more generally to promote health and well-being. Probably the best known of these is the provision of sterile injecting equipment to people who inject drugs, with the aim of reducing the risk of contracting an infectious disease. Over time these sorts of approaches appear to have contributed to the relatively low rate, by international standards, of new HIV infections now associated with injecting drug use in Europe. Over the last decade, as patterns of drug use have changed and the characteristics of those who use drugs have also evolved, to some extent, harm reduction interventions have also needed to adapt to address a broader set of health outcomes and risk behaviours. Prominent among these are reducing the risk of drug overdose and addressing the often-considerable and complex health and social problems faced by people who use drugs in more marginalised and socially excluded populations.

A spectrum of responses is needed to reduce changing drug-related harms

Chronic and acute health problems are associated with the use of illicit drugs, and these can be compounded by factors such as the properties of the substances, the route of administration, individual vulnerability and the social context in which drugs are consumed. Chronic problems include dependence and drug-related infectious disease, while there is a range of acute harms, of which drug overdose is perhaps the best documented. Although relatively rare at the population level, the use of opioids still accounts for much of the morbidity and mortality associated with drug use. Injecting drug use also increases risks. Correspondingly, working with opioid users and those who inject drugs has been historically an important target for harm reduction interventions and also the area where service delivery models are most developed and evaluated.

Reflecting this, some harm reduction services have become increasingly integrated into the mainstream of healthcare provision for people who use drugs in Europe over the last three decades. Initially, the focus was on expanding access to opioid agonist treatment and needle and syringe programmes as a part of the response to high-risk drug use, primarily targeting injecting use of heroin and the HIV/AIDS epidemic. Recent joint EMCDDA-ECDC guidance on the prevention and control of infectious diseases among people who inject drugs recommends providing opioid agonist treatment to prevent hepatitis C and HIV, as well as to reduce injecting risk behaviours and injecting frequency, in both the community and prison settings. The guidelines also recommend the provision of sterile injecting equipment alongside opioid agonist treatment to maximise the coverage and effectiveness of the interventions among people who inject opioids.

 

To access the full report, please click on the link below:

Source: https://www.euda.europa.eu/publications/european-drug-report/2024/harm-reduction_en

The European Drug Report 2024: Trends and Developments presents the EMCDDA’s latest analysis of the drug situation in Europe. Focusing on illicit drug use, related harms and drug supply, the report provides a comprehensive set of national data across these themes, as well as on specialist drug treatment and key harm reduction interventions.

This report is based on information provided to the EMCDDA by the EU Member States, the candidate country Türkiye, and Norway, in an annual reporting process.

The purpose of the current report is to provide an overview and summary of the European drug situation up to the end of 2023. All grouping, aggregates and labels therefore reflect the situation based on the available data in 2023 in respect to the composition of the European Union and the countries participating in EMCDDA reporting exercises. However, not all data will cover the full period. Due to the time needed to compile and submit data, many of the annual national data sets included here are from the reference year January to December 2022. Analysis of trends is based only on those countries providing sufficient data to describe changes over the period specified. The reader should also be aware that monitoring patterns and trends in a hidden and stigmatised behaviour such as drug use is both practically and methodologically challenging. For this reason, multiple sources of data are used for the purposes of analysis in this report. Although considerable improvements can be noted, both nationally and in respect to what is possible to achieve in a European-level analysis, the methodological difficulties in this area must be acknowledged. Caution is therefore required in interpretation, in particular when countries are compared on any single measure. Caveats relating to the data are to be found in the online Statistical Bulletin 2024, which contains detailed information on methodology, qualifications on analysis and comments on the limitations in the information set available. Information is also available there on the methods and data used for European-level estimates, where interpolation may be used.

Content

The drug situation in Europe up to 2024

This page draws on the latest data available to provide an overview of the current situation and emerging drug issues affecting Europe, with a focus on the year up to the end of 2023. The analysis presented here highlights some developments that may have important implications for drug policy and practitioners in Europe.
Understanding Europe’s drug situation in 2024 – key developments

Drug supply, production and precursors

Analysis of the supply-related indicators for commonly used illicit drugs in the European Union suggests that availability remains high across all substance types. On this page, you can find an overview of drug supply in Europe based on the latest data, supported by the latest time trends in drug seizures and drug law offences, together with 2022 data on drug production and precursor seizures.
Drug supply, production and precursors – the current situation in Europe 

Cannabis

Cannabis remains by far the most commonly consumed illicit drug in Europe. On this page, you can find the latest analysis of the drug situation for cannabis in Europe, including prevalence of use, treatment demand, seizures, price and purity, harms and more.
Cannabis – the current situation in Europe 

Cocaine

Cocaine is, after cannabis, the second most commonly used illicit drug in Europe, although prevalence levels and patterns of use differ considerably between countries. On this page, you can find the latest analysis of the drug situation for cocaine in Europe, including prevalence of use, treatment demand, seizures, price and purity, harms and more.
Cocaine – the current situation in Europe 

Synthetic stimulants

Amphetamine, methamphetamine and, more recently, synthetic cathinones are all synthetic central nervous system stimulants available on the drug market in Europe. On this page, you can find the latest analysis of the drug situation for synthetic stimulants in Europe, including prevalence of use, treatment demand, seizures, price and purity, harms and more
Synthetic stimulants – the current situation in Europe 

MDMA

MDMA is a synthetic drug chemically related to the amphetamines, but with somewhat different effects. In Europe, MDMA use has generally been associated with episodic patterns of consumption in the context of nightlife and entertainment settings. On this page, you can find the latest analysis of the drug situation for MDMA in Europe, including prevalence of use, seizures, price and purity and more.
MDMA – the current situation in Europe 

Heroin and other opioids

Heroin remains Europe’s most commonly used illicit opioid and is responsible for a large share of the health burden attributed to illicit drug consumption. Europe’s opioid problem, however, continues to evolve in ways that are likely to have important implications for how we address issues in this area. On this page, you can find the latest analysis of the drug situation for heroin and other opioids in Europe, including prevalence of use, treatment demand, seizures, price and purity, harms and more.
Heroin and other opioids – the current situation in Europe 

New psychoactive substances

The market for new psychoactive substances is characterised by the large number of substances that have emerged, with new ones being detected each year. On this page, you can find an overview of the drug situation for new psychoactive substances in Europe, supported by information from the EU Early Warning System on seizures and substances detected for the first time in Europe. New substances covered include synthetic and semi-synthetic cannabinoids, synthetic cathinones, new synthetic opioids and nitazenes.
New psychoactive substances – the current situation in Europe 

Other drugs

Alongside the more well-known substances available on illicit drug markets, a number of other substances with hallucinogenic, anaesthetic, dissociative or depressant properties are used in Europe: these include LSD, hallucinogenic mushrooms, ketamine, GHB and nitrous oxide. On this page, you can find the latest analysis of the situation regarding these substances in Europe, including seizures, prevalence and patterns of use, treatment entry, harms and more.
Other drugs – the current situation in Europe 

Injecting drug use

Despite a continued decline in injecting drug use over the past decade in the European Union, this behaviour is still responsible for a disproportionate level of both acute and chronic health harms associated with the consumption of illicit drugs. On this page, you can find the latest analysis of injecting drug use in Europe, including key data on prevalence at national level and among clients entering specialist treatment, as well as insights from studies on syringe residue analysis and more.
Injecting drug use – the current situation in Europe 

Drug-related infectious diseases

People who inject drugs are at risk of contracting infections through the sharing of drug use paraphernalia. On this page, you can find the latest analysis of drug-related infectious diseases in Europe, including key data on infections with HIV and hepatitis B and C viruses.
Drug-related infectious diseases – the current situation in Europe 

Drug-induced deaths

Estimating the mortality attributable to drug use is critical for understanding the public health impact of drug use and how this may be changing over time. On this page, you can find the latest analysis of drug-induced deaths in Europe, including key data on overdose deaths, substances implicated and more.
Drug-induced deaths – the current situation in Europe 

Opioid agonist treatment

Opioid users represent the largest group undergoing specialised drug treatment, mainly in the form of opioid agonist treatment. On this page, you can find the latest analysis of the provision of opioid agonist treatment in Europe, including key data on coverage, the number of people in treatment, pathways to treatment and more.
Opioid agonist treatment – the current situation in Europe 

Harm reduction

Harm reduction encompasses interventions, programmes and policies that seek to reduce the health, social and economic harms of drug use to individuals, communities and societies. On this page, you can find the latest analysis of harm reduction interventions in Europe, including key data on opioid agonist treatment, naloxone programmes, drug consumption rooms and more.
Harm reduction – the current situation in Europe 

PDF version of full report

The European Drug Report 2024 was designed as a digital-first product, structured by modules, and optimised for online reading. Within each chapter, you may download a PDF version of the page. We are also making available here  a PDF version of the full report (all modules and annex tables combined). Please note that some errors may have occurred during the transformation process and that it is possible that this version does not contain all corrections made since the report was first published (please check the last updated date).

Download full PDF version of the European Drug Report 2024 (16 MB, last updated 14.06.2024)

Source: https://www.euda.europa.eu/publications/european-drug-report/2024_en

How can modern psychedelic research and traditional approaches integrate to address substance use disorders and mental health challenges?

A recent study published in the Journal of Studies on Alcohol and Drugs discusses the history and current state of psychedelic research for the treatment of substance abuse disorders (SUDs).

Psychedelics

Psychedelics are consciousness-altering drugs, some of which include lysergic acid diethylamide (LSD), dimethyltryptamine (DMT), psilocybin, and mescaline. Methylenedioxymethamphetamine (MDMA) and ketamine are also considered psychedelics; however, these drugs have different mechanisms of action.

Although psychedelics have been exploited for centuries to induce altered states of consciousness, their use, as opposed to their abuse, has largely been unexplored in modern medicine. In fact, several studies have indicated the potential utility of psychedelics for individuals who have mental illness due to traumatic experiences, false beliefs, and unhealthy behavioral patterns, such as posttraumatic stress disorder (PTSD) and depression.

The recent coronavirus disease 2019 (COVID-19) pandemic led to global changes in the use of methamphetamine, alcohol, and cannabis, as well as a significant increase in opioid overdoses in the United States. Thus, another promising application of psychedelics is their potential use for treating SUDs.

However, restrictive policies, poor funding, lack of equitable and diverse recruitment and access, as well as the multiplicity of small-scale psychedelic research programs have prevented researchers from effectively investigating the effects of psychedelics in the treatment of SUDs.

Overview

Over the past seven decades, researchers have become increasingly interested in examining the potential use of psychedelics in traditional medicine. Despite federal policies banning recreational drug use, researchers have elucidated some of the biological effects of psychedelics on the central nervous system (CNS) and their potential role in the treatment of SUDs. Nevertheless, there remains a lack of well-controlled multi-center trials and systematic reviews in this area.

As researchers continue to examine the pharmacological potential of these drugs, it is crucial to address their addiction and abuse potential, the legalization of recreational drugs, and the attempts of pharmaceutical companies to introduce high-selling psychedelics as therapies for mental illness.

History and current use of psychedelics

Psychedelics like ayahuasca, Peyote, and psilocybin-containing mushrooms have been used throughout history by traditional healers and indigenous communities for both spiritual and health purposes. By recognizing these contributions, researchers can benefit from the potential benefits of traditional usage patterns while investigating the use of these drugs for treating SUDs and other mental health disorders.

For example, a hybridized SUD therapy program in Peru utilizes ayahuasca to treat alcohol and drug use. At one year following treatment, reduced depression and anxiety, higher quality of life, and reduced severity of addiction have been reported.

One notable contribution is the acknowledgment that key experiences of treatment participants might provide more insight than the search for putative “active ingredients” of interventions as complex as psychedelic-assisted treatment.”

Purging in psychedelic treatment

Psychedelic use, specifically ayahuasca use, is closely linked to vomiting as a means of purging the body. This is reported to have spiritual, Amazonian, and clinical benefits.

Conclusions

The optimal approach to psychedelic-assisted treatment involves mutual respect for and recognition of the value of both traditional and modern applications. Thus, mixed-methods research is crucial, as traditional approaches may help identify a better therapeutic agent or program than traditional approaches to identifying and isolating active ingredients.

However, it is essential to evaluate and quantify the success rates of traditional approaches to psychedelic use, as well as elucidate the biological mechanisms that may contribute to their therapeutic effects. Researchers must recognize and credit traditional history and practices throughout these efforts to protect these cultures from being exploited, ignored, and suppressed by pharmaceutical industries.

The rush to patent processes in psychedelic treatments of addiction and other psychiatric conditions reflects the enormous greed of private commercial entities to benefit financially from vulnerable patients in need of effective therapies.

Thus, regulatory control of psychedelic therapies is vital to establish rigorous research standards that can lead to the generation of sufficient evidence in this area. Without this type of overview, private corporate interests may seek to exploit governmental support for crucial research needed to address these mental health issues.

Source:  https://www.news-medical.net/news/20240828/Psychedelics-A-new-hope-for-substance-abuse-treatment.aspx

 

Mothers of children who died via fentanyl poisoning champion NC’s new death-by-distribution law and continue to advocate for awareness

BY GALE MELCHER   The CityBeat 

JULY 20TH, 2024

On a billboard off of Battleground Avenue in Greensboro, 20 smiling faces flash grins through the screen — smiles that will forever be contained in pictures and their families’ memories. All 20 people pictured on the billboard passed away after taking drugs they didn’t know were laced with fentanyl, a synthetic opioid drug that is being mass-produced and added to other illicit drugs to increase their potency. This often results in death — in North Carolina, 183 deaths occurred this March.

Next to the faces a message reads: “Hidden in so-called ‘recreational’ drugs, fentanyl steals families.”

On July 6 around noon, families gathered around Elizabeth’s Pizza facing the billboard to remember their loved ones and raise awareness about the dangers of illicit drugs.

Deborah Peeden lost her granddaughter Ashley in October 2021 and shared her story with TCB last year.

In 2023, the Drug Enforcement Administration seized more than 80 million fentanyl-laced fake pills. This year, that number has reached more than 28.1 million and is still climbing. Additionally, seven out of 10 pills seized by the DEA contain lethal doses of fentanyl.

 

Deborah Peeden stands next to an image of her granddaughter, Ashley, who thought

she was doing cocaine with friends when she died from fentanyl poisoning at age 23.

(Photo by Gale Melcher)

In an interview, Peeden said that she felt it was important to put the billboard up to highlight the memory of locals lost to fentanyl. For the past two years, Peeden has paid for a billboard in memory of Ashley. Peeden is now an ambassador for Facing Fentanyl, a campaign that provides prevention education and opioid-reversal kits to schools.

“Some days I’m good, and other days it just hits out of the blue,” Peeden said. “She’s on my mind 24/7 every single minute of every single day. She’s got her birthday coming up on August 1.”

Peeden explained that when dates like birthdays come around, she “can feel that tsunami wave coming.”

“You feel like you’re drowning,” she said.

On July 6, TCB spoke with other mothers who have lost their children to fentanyl poisoning;  TCB is not publishing their names as their childrens’ cases are still active. Many of the families have connected via support groups and bonded over their losses. One mother tugged at the layers of colorful bracelets on her wrist before finding the name of Thomas Lamb etched into a plastic bracelet. Thomas died from fentanyl poisoning in September 2022. She’s friends with Thomas’s mother, Amy Lamb, who still celebrates his birthday every year with his friends and family.

 

A bracelet etched with the name of Thomas Lamb. In September 2022, Thomas, age 18,

purchased a pill to help him sleep; he thought it was Xanax. It was fentanyl.

(Photo by Gale Melcher)

A small child bobbed through the crowd, stopping to point at their loved one’s face on the billboard and shout out their name. Some of the families are hopeful that they will be able to see some form of justice through North Carolina’s death-by-distribution law, passed in 2019 and recently updated on Dec. 1.

The older version of the law stated that a person is guilty of death by distribution if all of the following requirements are met: the person unlawfully sold at least one controlled substance such as an opioid, cocaine or methamphetamine, that the substance they sold caused the death of the user and that the person who sold the drug did not act with malice. The crime was a Class C felony, which usually results in a 5-12 year prison sentence with a maximum sentence of 19 years.

The updated version of the law removes the malice requirement or proof that the drug was sold. Under the new law, perpetrators can be charged with a Class C felony if they simply distribute a drug such as methamphetamine, fentanyl or cocaine that leads to a victim’s death. If the perpetrator did act with malice, they could be charged with a Class B2 felony.

In an email to TCB, the Greensboro Police Department’s Public Information Coordinator Patrick DeSota explained that in response to the updated law, the police department “instituted internal procedural changes in [their] response to suspected overdose deaths” in an effort to further these types of investigations. DeSota added that they have implemented screening questions specific to suspected overdose investigations.

Peeden was a vocal critic of GPD and the way they handled Ashley’s case, and said she’s “glad” the law has been updated.

“I’m hoping that that will make a big difference,” Peeden said. “With Ashley’s case, they just never did anything with hers. Nothing more than a police report.”

 

Posters warn of the dangers of fentanyl.

(Photo by Gale Melcher)

Still, communications specialist for Guilford County Sheriff’s Office Bria Evans wrote that the change in law “does not directly affect [their] investigative procedures” but that it does “make it easier for [them] to criminally charge individuals” because they no longer have to “prove the actual ‘sell’ of the substance.”

Another anonymous mother TCB spoke to said that she hopes the updated law will send “shockwaves” to drug dealers, reverberating the message that selling drugs could have serious consequences.

One silver lining is that NC deaths from fentanyl appear to be declining according to data collected by the state Department of Health and Human Services. Since December, which totaled 264 deaths, monthly deaths have dropped to 220 in January, 207 in February and 183 in March. And awareness of the drug is key, Peeden explained.

“It can happen to anybody’s child, and if you don’t think it can happen to you, think again,” Peeden said.

And while Peeden and the other families have been advocating for their loved ones for years, the pain “doesn’t get easier,” she said.

“I’ve had someone tell me ‘Debbie, you’ve done enough, just stop, you’ve done enough, you need to quit.’ I’m like no, I can’t quit,” Peeden said. “We’ve got too many kids out there who don’t know, we have too many parents out there that don’t know, and we want to try to save the lives of other kids so that these parents go through the nightmare that we’re going through.”

 

Thomas Lamb, who died in September 2022 from fentanyl poisoning,

will forever be 18 to his family and friends.

(Photo by Gale Melcher)

 

Source: Gale Melcher, Citybeat Reporter (She/They) gale@triad-city-beat.com

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

Key topics

 

Overdose prevention services should be offered through HIV care

National Institute on Drug Abuse Director Nora Volkow explains the need to leverage the successes of HIV care to prevent overdose deaths. HIV and substance use are inextricably linked. An analysis of the New York City HIV surveillance registry found that in 2017, rates of overdose deaths for people with HIV were more than double overall overdose death rates for the city, but that 98% of those who died of overdose had been linked to HIV care after their HIV diagnosis and that more than three-quarters had been retained in care. This highlights an overlooked opportunity to save lives. Drug overdose claims more lives of people with HIV than HIV-related illness. Volkow says 81% of people who received an HIV diagnosis in 2019 in the U.S. were linked to HIV care within a month, 66% received care and 50% were retained in care. It is sometimes hard to reach people who use drugs with substance use treatment or harm reduction, but when people with HIV seek and receive treatment for HIV, it presents a promising opportunity to deliver addiction services. Delivering naloxone and overdose education in HIV care settings is a relatively easy way to prevent overdose deaths.

 

Hemp legalization opened the door to intoxicating products

Lawmakers who backed hemp legalization in the 2018 Farm Bill expected the plant to be used for textiles and nonintoxicating supplements. They did not realize that, with some chemistry, hemp can get you high. People anywhere in the U.S. can use hemp-derived THC without breaking federal law. Hemp and marijuana are varieties of the same plant species. Marijuana is defined by its high content of delta-9 THC. Hemp contains very little delta-9 THC but can contain a large amount of CBD, a cannabinoid that does not get you high. The Controlled Substances Act explicitly outlawed both hemp and marijuana. The Farm Bill defines hemp in a way that allows the plant and products made with it as long as they contain less than 0.3% delta-9 THC, making it seemingly legal to convert CBD into delta-8 THC as long as the process started with a plant that contained less than 0.3% delta-9 THC. The Farm Bill also appears to authorize the creation of hemp-based delta-9 THC products as long as the total delta-9 content is 0.3% or less of the product’s dry weight. The hemp-derived cannabinoid industry is now worth billions of dollars, and hemp-derived intoxicants are available at vape shops and gas stations, but they are not regulated.

 

Federal news

 

Expanded access to methadone is needed

National Institute on Drug Abuse Director Nora Volkow highlights the need to expand access to methadone. Only a fraction of people who could benefit from medications for opioid use disorder receive them, due to a combination of structural and attitudinal barriers. In 2023, the federal government eliminated the waiver requirement for buprenorphine. This year, it changed methadone regulations to make permanent the increased take-home doses of methadone established during the COVID emergency, along with other provisions aimed to broaden access. Changes implemented during COVID have not been associated with adverse outcomes, and patients reported significant benefits. Recent trials of models of methadone dispensing in settings other than methadone clinics have not supported concerns that making methadone more widely available will lead to harms. Data suggest that counseling is not essential for reducing overdoses or retaining patients in care, though it can be beneficial for some. It will also be critical to pursue other ways that methadone can safely be made more available to a wider range of patients.

 

CDC defends overdose prevention work before House committee

Several top Centers for Disease Control and Prevention (CDC) officials testified before the House Energy and Commerce Committee to defend their agency’s programs. The hearing comes after House Republicans passed a budget that would cut CDC funding by 22%. Republicans claimed the agency has failed to fulfill its responsibilities and lost the public’s trust. Republicans accused the CDC of straying from its core mission of keeping the public healthy and said the agency is spending too much time on programs some GOP lawmakers deemed unnecessary or duplicative. The CDC program directors pushed back, citing work they deemed critical to public health. They emphasized three areas of focus – improving readiness and response to disease outbreaks, improving mental health and supporting young families. Allison Arwady, director of the National Center for Injury Prevention and Control, which would be eliminated under the proposed funding bill, spoke about why the center’s work on overdose prevention is necessary.

Source: CDC Defense (Politico); CDC fields GOP criticism at E&C hearing (Politico)

 

Task force releases recommendations to protect youth from social media harms

The federal Kids Online Health and Safety Task Force released a report with recommendations and best practices for safer social media and online platform use for youth. The report provides a summary of the risks and benefits of social media on the health, safety and privacy of young people; best practices for parents and caregivers; recommended practices for industry; a research agenda; and suggested future work, including for the federal government. In collaboration with the Task Force, the Center of Excellence on Social Media and Youth Mental Health is launching a variety of new web content, including best practices resources; age-based handouts for parents that pediatricians and others can distribute at well-check visits; new clinical case examples for pediatricians and other clinicians demonstrating how to integrate conversations about media use into health consultations with teens; and expanded content for teens. The report outlines 10 recommended practices for online service providers.

 

FDA allows sale of tobacco-flavored Vuse e-cigarettes

The Food and Drug Administration (FDA) authorized sales of certain tobacco-flavored Vuse Alto e-cigarette products from R.J. Reynolds. Vuse is the top-selling e-cigarette brand in the country, comprising more than 40% of the market. The marketing authorization applies to six tobacco-flavored pods, which are sealed, prefilled and nonrefillable. Last year, the FDA banned the sale of Vuse Alto menthol and fruit-flavored e-cigarettes, citing increasing popularity among kids.

 

State and local news

 

Montana plans to install harm reduction vending machines

Montana health officials are considering a new strategy to make naloxone more accessible. Drawing on a pool of behavioral health funds set aside by lawmakers in 2023, health officials have proposed installing two dozen naloxone and fentanyl test strip vending machines around the state at behavioral health drop-in centers and service locations for homeless people. The $400,000 plan to build, stock and maintain 24 vending machines for a year has not yet been approved by the governor. Different versions of the harm reduction vending machine model are being tried in at least 33 states, becoming increasingly popular especially in places with hard-to-reach populations. Some local public health groups in Montana have already begun using vending machines to distribute free naloxone, drug testing strips and other supplies, using public grants or private philanthropy, but these would be the first vending machines in Montana being directly funded by the state.

 

Iowa providing $13 million to expand addiction treatment and recovery housing

Iowa Governor Reynolds announced that the state’s opioid treatment and recovery providers can begin applying for $13 million in grants to expand or improve facilities or develop sober living housing options. The funding opportunities were announced in May as part of a larger $17.5 million investment to help address the opioid crisis. The $10 million Iowa Opioid Treatment and Recovery Infrastructure Grant will assist opioid treatment and recovery providers with physical infrastructure and capacity building. The Iowa Recovery Housing Fund includes $3 million for grants for nonprofit organizations to develop sober recovery housing. The grants leverage federal American Rescue Plan Act funds. An additional $1.5 million will be used for programs focused on prevention, including a $1 million education initiative for health care providers to support opioid-alternative pain management and $500,000 for a comprehensive multimedia opioid overdose prevention campaign. The remaining $3 million will support the completion of a residential addiction treatment center for adolescents.

 

LAPPA releases model state laws to minimize harms of incarceration

The Legislative Analysis and Public Policy Association released two pieces of model state legislation. The first would require a state department of health and human services to apply for a Medicaid Reentry Section 1115 demonstration waiver to allow a state Medicaid program to cover pre-release services for Medicaid-eligible incarcerated individuals for up to 90 days prior to release and to require the department to conduct comprehensive monitoring and evaluation of the demonstration if the waiver is approved. The second is focused on reducing collateral consequences of conviction. It would establish a process for the identification, collection and publication of collateral consequences that impact individuals convicted of crimes; establish a process by which an individual can obtain a certificate of relief from certain collateral consequences before records are eligible to be sealed or expunged; establish mechanisms for the automatic sealing and expungement, as well as a process for petitioning; prohibit certain entities from inquiring into an individual’s criminal history; etc.

 

Other news in addiction policy

 

Mobile treatment vans can help expand methadone access

Some public health experts hope that mobile treatment programs will help increase access to methadone. Addiction experts say methadone is particularly important as the strength of street fentanyl has lessened the effectiveness of other medications and approaches for some. The mobile vans were approved by the federal government in 2021, lifting a moratorium on their use that had been in place since 2007. Their goal is to reach some of the millions of Americans with opioid use disorder that methadone clinics cannot. While the vans make treatment more accessible, the cost and ongoing restrictions limit the number of people that they can help, as well. Constructing and outfitting a methadone van costs about $375,000. They have to replicate the high-security environments of clinics, with a security guard, 360-degree cameras and a safe for the medication. There are now 42 vans registered nationally, though not all are operational yet.

 

Source: https://drugfree.org/drug-and-alcohol-news/policy-news-roundup-july-25-2024/

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

July 29, 2024

This blog was also published in the American Society of Addiction Medicine (ASAM) Weekly on July 24, 2024.

Over the past several years, the increasing prevalence of fentanyl in the drug supply has created an unprecedented overdose death rate and other devastating consequences. People with an opioid use disorder (OUD) urgently need treatment not just to protect them from overdosing but also to help them achieve recovery, but highly effective medications like buprenorphine and methadone remain underused. Amid this crisis, it is critical that methadone, in particular, be made more accessible, as it may hold unique clinical advantages in the age of fentanyl.

Growing evidence suggests that methadone is as safe and effective as buprenorphine for patients who use fentanyl. In a 2020 naturalistic follow-up study, 53% of patients admitted to methadone treatment who tested positive for fentanyl at intake were still in treatment a year later, compared to 47% for patients who tested negative. Almost all (99%) of those retained in treatment achieved remission. An earlier study similarly found that 89% of patients who tested positive for fentanyl at methadone treatment intake and who remained in treatment at 6 months achieved abstinence.

Methadone may even be preferable for patients considered to be at high risk for leaving OUD treatment and overdosing on fentanyl. Comparative effectiveness evidence is emerging which shows that people with OUD in British Columbia given buprenorphine/naloxone when initiating treatment were 60% more likely to discontinue treatment than those who received methadone (1). More research is needed on optimal methadone dosing in patients with high opioid tolerance due to use of fentanyl, as well as on induction protocols for these patients. It is possible that escalation to a therapeutic dose may need to be more rapid.

It remains the case that only a fraction of people who could benefit from medication treatment for OUD (MOUD) receive it, due to a combination of structural and attitudinal barriers. A study using data from the National Survey on Drug Use and Health (NSDUH) from 2019—that is, pre-pandemic—found that only slightly more than a quarter (27.8%) of people who needed OUD treatment in the past year had received medication to treat their disorder. But a year into the pandemic, in 2021, the proportion had dropped to just 1 in 5.

Efforts have been made to expand access to MOUD. For instance, in 2021, the U.S. Department of Health and Human Services (HHS) advanced the most comprehensive Overdose Prevention Strategy to date. Under this strategy, in 2023, HHS eliminated the X-waiver requirement for buprenorphine. But in the fentanyl era, expanded access to methadone too is essential, although there are even greater attitudinal and structural barriers to overcome with this medication. People in methadone treatment, who must regularly visit an opioid treatment program (OTP), face stigma from their community and from providers. People in rural areas may have difficulty accessing or sticking with methadone treatment if they live far from an OTP.

SAMHSA’s changes to 42 CFR Part 8 (“Medications for the Treatment of Opioid Use Disorder”) on January 30, 2024 were another positive step taken under the HHS Overdose Prevention Strategy. The new rule makes permanent the increased take-home doses of methadone established in March 2020 during the COVID pandemic, along with other provisions aimed to broaden access like the ability to initiate methadone treatment via telehealth. Studies show that telehealth is associated with increased likelihood of receiving MOUD and that take-home doses increase treatment retention.

Those changes that were implemented during the COVID pandemic have not been associated with adverse outcomes. An analysis of CDC overdose death data from January 2019 to August 2021 found that the percentage of overdose deaths involving methadone relative to all drug overdose deaths declined from 4.5% to 3.2% in that period. Expanded methadone access also was not associated with significant changes in urine drug test results, emergency department visits, or increases in overdose deaths involving methadone. An analysis of reports to poison control centres found a small increase in intentional methadone exposures in the year following the loosening of federal methadone regulations, but no significant increases in exposure severity, hospitalizations, or deaths.

Patients themselves reported significant benefits from increased take-home methadone and other COVID-19 protocols. Patients at one California OTP in a small qualitative study reported increased autonomy and treatment engagement. Patients at three rural OTPs in Oregon reported increased self-efficacy, strengthened recovery, and reduced interpersonal conflict.

The U.S. still restricts methadone prescribing and dispensing more than most other countries, but worries over methadone’s safety and concerns about diversion have made some physicians and policymakers hesitant about policy changes that would further lower the guardrails around this medication. Methadone treatment, whether for OUD or pain, is not without risks. Some studies have found elevated rates of overdose during the induction and stabilization phase of maintenance treatment, potentially due to starting at too high a dose, escalating too rapidly, or drug interactions.

Although greatly increased prescribing of methadone to treat pain two decades ago was associated with diversion and a rise in methadone overdoses, overdoses declined after 2006, along with methadone’s use as an analgesic, even as its use for OUD increased. Most methadone overdoses are associated with diversion and, less often, prescription for chronic pain; currently, 70 percent of methadone overdoses involve other opioids (like fentanyl) or benzodiazepines.

Recent trials of models of methadone dispensing in pharmacies and models of care based in other settings than OTPs have not supported concerns that making methadone more widely available will lead to harms like overdose. In two feasibility studies, stably maintained patients from OTPs in Baltimore, Maryland and Raleigh, North Carolina who received their methadone from a local pharmacy found this model to be highly satisfactory, with no positive urine screens, adverse events, or safety issues. An older pilot study in New Mexico found that prescribing methadone in a doctor’s office and dispensing in a community pharmacy, as well as methadone treatment delivered by social workers, produced better outcomes than standard care in an OTP for a sample of stably maintained female methadone patients.

Critics of expanded access to methadone outside OTPs sometimes argue that the medication should not be offered without accompanying behavioural treatment. Data suggest that counselling is not essential. In wait-list studies, methadone treatment was effective at reducing opioid use on its own, and patients stayed in treatment. However, counselling may have benefits or even be indispensable for some patients to help them improve their psychosocial functioning and reduce other drug use. How to personalize the intensity and the level of support needed is a question that requires further investigation.

Over the past two decades, the opioid crisis has accelerated the integration of addiction care in the U.S. with mainstream medicine. Yet methadone, the oldest and still one of the most effective medications in our OUD treatment toolkit, remains siloed. In the current era of powerful synthetic opioids like fentanyl dominating the statistics on drug addiction and overdose, it is time to make this effective medication more accessible to all who could benefit. The recent rules making permanent the COVID-19 provisions are an essential step in the right direction, but it will be critical to pursue other ways that methadone can safely be made more available to a wider range of patients with OUD. Although more research would be of value, the initial evidence suggests that providing methadone outside of OTPs is feasible, acceptable, and leads to good outcomes.

Source: https://nida.nih.gov/about-nida/noras-blog/2024/07/to-address-the-fentanyl-crisis-greater-access-to-methadone-is-needed

Cannabis or more commonly known as marijuana, is one of the most frequently used drugs in the United States. In 2022, marijuana became more popular than alcohol as the preferred daily drug of use among Americans. In the same year, it was found that 30 out of every 100 high school age students reported using the drug within the past 12 months, and 3 of every 50 reported using it daily.

Marijuana is often perceived as harmless, which has influenced its increased use by a factor of 15 within the past three decades, but this substance can have severe physical and mental health effects.

This blog will share the heart-wrenching stories of Brant Clark and Shane Robinson, as told by their families, along with a recent article by Alton Northup editor-in-chief of KentWired. Their lives were tragically cut short by marijuana induced psychosis.

Brant Clark

Ann Clark shares the heartbreaking story of her 17-year-old son, Brant, who experienced cannabis-induced psychosis leading to his tragic suicide. She recounts his rapid descent into hopelessness and the devastating impact on their family to raise awareness about the dangers of marijuana use on mental health.

Ann Clark shares the heartbreaking story of her 17-year-old son, Brant, who experienced cannabis-induced psychosis leading to his tragic suicide. She recounts his rapid descent into hopelessness and the devastating impact on their family to raise awareness about the dangers of marijuana use on mental health.

Brant Clark (pictured) was a happy and bright 17-year-old who reported using marijuana socially. However, during his last high school winter break, after smoking marijuana at a party with friends, he experienced a psychotic break believed to have been triggered by smoking a large amount of potent marijuana.

After the party Brent expressed to his mother his feelings of “emptiness and hopelessness”, and deep regret, lamenting his decision to smoke marijuana. Within two days of the onset of symptoms, Brant was admitted to the ER and psychiatric care unit. Tragically, three weeks later, he ended his own life, leaving behind a note revealing his intense mental anguish and regret.

Brant’s doctor diagnosed him with Cannabis-Induced Psychosis, a condition where marijuana use leads to severe mental disturbances. Brant’s case highlights how this condition can manifest suddenly and with tragic consequences. Ann, Brant’s mother, recalls the happiness her son brought to her life, and the pain that lingers after his loss.

 Shane Robinson

In 2009, Lori Robinson’s son faced a similar fate. Shane, a vibrant 23-year-old, turned to marijuana for pain relief after a knee injury. Despite his parents’ concerns, Shane believed that the drug was a safe alternative to pain medication. However, Shane’s behavior changed drastically. He began to experience hallucinations and delusions. After being hospitalized several times and a prolonged struggle with mental health, Shane took his own life at the age of 25.

Lori, Shane’s mother, shared that the psychologists who treated her son questioned marijuana’s role in Shane’s mental illness, but neither Shane nor Brant had any prior history of mental illness, and their symptoms rapidly emerged after using marijuana.

Cannabis-Induced Psychosis would finally be added as a recognized mental health diagnosis in the year of 2013.

 

Medical and Scientific Insights

Although research still has a long way to go and should continue to examine how mental health disorders are affected by marijuana use independently, it should also focus on understanding the physiological mechanisms, as well as the effects of increased potency and contaminants in marijuana. The progress that has been made is enough to encourage the continuation of this field of research. Recent studies have shown strong associations between cannabis use disorder (CUD) and psychotic episodes. One study showed that 5 out of every 6 teenagers who sought help for a psychotic episode had used marijuana and that they were 11 times more likely to experience psychotic episodes compared to non-users of the drug. Another study showed a 30% increase in schizophrenia cases among men aged 21-30 were associated with CUD.

Dr. David Streem from the Cleveland Clinic shared with the editor of KentWired that he has observed a dramatic increase in psychosis cases over the past decade, which aligns with the increase in marijuana potency from less than 10% in the 90s to 30% or more today.

Advocating for Prevention

Ann Clark and Lori Robinson have become advocates, raising awareness about the dangers of cannabis-induced psychosis. Despite facing skepticism and opposition, they courageously continue to share their son’s stories to educate others about the potential risks of marijuana use.

As marijuana becomes widely legalized, Ann believes that “it only gives our young people a lower perception of harm, and a false sense of security and safety”. However, increased levels of THC and the building body of evidence linking marijuana to mental health conditions, call for greater public health education and regulations.

The tragic stories of Brant and Shane underscore the urgent need for awareness about cannabis-induced psychosis as the use of marijuana becomes more prevalent among younger populations.

Source: https://kentwired.com/120770/news/cannabis-induced-psychosis-cost-their-sons-their-lives-more-could-be-next/

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

Press Release: Ambassador Linda Thomas-Greenfield Launches Alliance to Prevent Drug Harms in Collaboration with United Nations and Tech Industry

Today, Ambassador Linda Thomas-Greenfield, Representative of the United States to the United Nations, launched the Alliance to Prevent Drug Harms (Prevent Alliance), alongside representatives from the United Nations and the tech industry, including Meta, Snap Inc., and X Corp.

“Two out of every five Americans know someone who has died of an opioid overdose…in every corner of the world…we’re seeing a rapid rise in synthetic drug use, dependence, and overdose death,” said the Ambassador. “This is an international crisis…we’ve seen the criminal groups that produce these drugs adapt quickly.”

That adaptation includes the use of technology platforms, including social media, to promote the illicit use of non-medical synthetic drugs.

“This alliance between the United States, the United Nations, and our partners in the private sector, holds immense potential to make a meaningful difference. To disrupt this crisis, both here in the United States and all across the globe, and adapt with the same agility, the same resourcefulness, of those we’re up against. This is a good step, but we all know much more needs to be done to address this problem.” Ambassador Thomas-Greenfield continued.

The Prevent Alliance, a public-private partnership effort, is committed to ending the use of online platforms to aid the flow of illicit substances. Through a framework for cross-industry cooperation, the Prevent Alliance will work to disrupt the availability of synthetic drugs online, promote drug-prevention content across platforms, and enables cross-sector communication establishing the best evidence-based practices for drug-prevention campaigns.

The alliance builds upon the work of the Global Coalition to Address Synthetic Drug Threats, a multilateral effort to combat the threats posed by synthetic drugs launched by Secretary Blinken last year, and the U.S.-led adoption of new controls targeting the synthetic drug manufacturing process at the UN Commission on Narcotic Drugs earlier this year.

Maggie Nardi, the Deputy Assistant Secretary of State of the Bureau for International Narcotics and Law Enforcement Affairs (INL), said, “Governments alone cannot shield people from the dangers of synthetic drug misuse; we must forge stronger alliances with public health, civil society, affected communities, academics, and industry to combat their illicit manufacture, distribution, and promotion.”

Under the Biden Administration, the United States is dedicating more resources to tackle the demand for drugs, including more resources for public awareness, health interventions and services to prevent and reduce the implications of drug use, as well as measures to prevent, detect, and stop the illicit manufacturing and trafficking of drugs. These efforts include support for the UN Office on Drugs and Crime (UNODC) and Commission on Narcotic Drugs, as well as U.S. leadership in rallying countries around the Global Coalition to Address Synthetic Drug Threats.

“Evidence-based prevention is key to respond to the drug use situation globally, especially in a rapidly digitalized world. Social media nowadays carries an important influence on the individual. To harness this influence positively, science can help,” said Delphine Schantz, director of UNODC’s New York office. “UNODC together with WHO reflected on that science through the International Standards on Drug Use Prevention. This science aims at creating a healthy and safe environment for children and youth, fostering resilient generations against drugs and any risky social and health behaviors. Working through this science, social media could be one of those added layers of prevention.”

“Families and communities around the world are struggling with the opioid crisis,” said Nell McCarthy, Vice President of Trust and Safety at Meta. “From governments to the private sector, and health care systems to civil society organizations, we must all do our part to combat this crisis, which is why Meta is proud to be part of the Prevent Alliance.”

Source: https://usun.usmission.gov/ambassador-linda-thomas-greenfield-launches-alliance-to-prevent-drug-harms-in-collaboration-with-united-nations-and-tech-industry/ July 2024

More than 178 000 people died from excessive alcohol use in the US during 2020 to 2021, surpassing deaths from the overdose epidemic.1 Excessive drinking is now the leading cause of preventable death in the US.1 Alcohol use disorder (AUD) most commonly begins during adolescence, although rarely is it identified and treated at this age.2 We urgently need interventions that allow us to better identify those young people at risk of developing AUD and alcohol-related complications later in adulthood. In their study of alcohol use among youths with a chronic medical condition (CMC), Weitzman et al3 describe a novel approach for alcohol prevention in a population of youths with medical vulnerability. Youths with a CMC are particularly susceptible to the effects of alcohol and warrant particular attention. Although the rate of alcohol use among these youths is similar to that of their peers, youths with a CMC have higher rates of progression to heavy alcohol use and AUD.4 Weitzman et al3 found that high-risk alcohol use occurred in more than 1 of 10 youths (aged 14-18 years) with a CMC seen in the specialty clinics included in their study. These youths also have an increased risk of treatment nonadherence and potential medication reactions with alcohol as a result of the underlying disease, worsening the potential effects of high-risk alcohol exposure in this population.4

Given these disparities, Weitzman et al3 designed a randomized clinical trial aimed at evaluating the effects of the Take Good Care (TGC) alcohol use prevention intervention over 12 months among youths with a CMC. In the specialty clinic setting, youths in the intervention group received a brief, personalized intervention consisting of a self-administered slide deck on an electronic tablet. Slides were disease tailored, and they included specific effects of alcohol use on disease processes, treatment safety, and efficacy as well as motivational information on health-protecting decisions and behaviors. Although there was no change among youths reporting no or minimal (low-risk) alcohol use, there was a 40% relative reduction in self-reported frequency of alcohol use among those receiving the TGC intervention who reported high-risk alcohol use at baseline compared with those who received treatment as usual.

The study by Weitzman et al3 highlights the potential importance of brief interventions in changing youth behavior, particularly among a group of youths who are medically vulnerable. Although a shocking 11.5% of youths with a CMC in this study reported high-risk alcohol use at baseline, nationally only a quarter of pediatricians report using validated screening tools to assess alcohol use among adolescents and only 11% of pediatricians correctly use the Screening, Brief Intervention, and Referral to Treatment (SBIRT) tool recommended by the American Academy of Pediatrics.5 Despite growing evidence supporting the benefit of SBIRT for pediatric populations, barriers to implementation include insufficient time and need for clinician training5; both of these barriers are ameliorated with the use of the self-administered, electronic intervention described by Weitzman et al.3 This study adds to the growing database highlighting the effectiveness of SBIRT in identifying and intervening in instances of substance use among youths. It presents a tool easily adopted by clinicians, with an impact on those youths at greatest risk of developing problematic alcohol use.

Considering the prevalence of alcohol use among youths with CMCs, an important aspect of the study by Weitzman et al3 is its low-touch intervention that can be easily adapted and implemented in a variety of clinical settings. Weitzman et al3 show the value of even simple, low-touch interventions in changing youth behavior. From the patient perspective, the use of an electronic tablet enhances privacy when answering questions and allows for flexibility in time spent on each piece of content. From the clinician perspective, the use of an electronic tablet requires minimal additional effort or training, standardizes the content provided, and allows for intervention completion outside of face-to-face appointment time. Yet despite its simplicity, the low-touch TGC intervention has been shown to exert a substantial effect on adolescent behavior. At 12 months, the reduction in alcohol use frequency among youths with a CMC and high-risk alcohol use represents not only a meaningful behavioral change but also an enduring one.

In contrast with traditional fear-based messages around alcohol prevention, Weitzman et al3 demonstrate the impact of a strengths-based model that engages the normal adolescent quest for independence and the examination of choice in larger contexts. The TGC intervention educated youths with a CMC on disease-specific processes, treatments, and effects of alcohol, thereby encouraging reflection around alcohol-related choices. In presenting this information for youths to consider, the intervention relayed respect for patients’ ability to engage in their own health care and health behaviors. Additionally, disease-tailored content paired with motivational information on health-protecting behaviors encouraged patients’ sense of autonomy and independence. The statistically significant effects of this approach suggest that personalized intervention resonates with youths with CMCs and is an effective tool for behavioral change. Furthermore, this delivery model allows for content to be tailored based on disease or other aspects of youths’ lived experience. Content adjusted to the needs of specific subpopulations of youths creates interventions that they connect with and are thus most greatly affected by, in both depth and longevity of impact.

Finally, key to the study by Weitzman et al3 is the intervention location; utilization of the specialty care setting for an alcohol use prevention intervention is novel and effective. Many youths with a CMC receive the majority of their care in the specialty care setting and, accordingly, often develop stronger therapeutic relationships with their specialty care physician than their primary care physician. In 41.3% of visits to their specialists, youths with a CMC present for routine preventative care,6 yet specialists screen for substance use at alarmingly low rates compared with their primary care counterparts (self-reported 8% vs 38%, respectively).7 Interventions within the specialty clinic space allow for greater potential to reach more youths with CMCs at critical moments in their health journeys, thereby curbing heavy alcohol use, its associated medication nonadherence, and potential interaction with medications. By doing so, this method of intervention may decrease disease-associated complications and mortality in addition to alcohol-associated complications and mortality among youths with CMCs, and by extension, the adults that they become. The TGC intervention and its broader application represent an exciting new paradigm for future practice.

Source: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2820973 July 2024

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

International Day against Drug Abuse and Illicit Trafficking on June 26:

June 23, 2024 1:05 am

By Resolution 42/112 of 7 December 1987, the General Assembly decided to observe June 26 as the International Day against Drug Abuse and Illicit Trafficking as an expression of its determination to strengthen action and cooperation to achieve the goal of an international society free of drug abuse. No country has been spared of the drug menace, though some countries have been disproportionately affected. While most countries nab and rehabilitate drug users, the big-time dealers and smugglers often go scot free, leading to a vicious cycle.

Supported each year by individuals, communities, and various organisations all over the world, this global observance aims to raise awareness of the major problem that illicit drugs represent to society.

Challenges

The global drug problem presents a multifaceted challenge that touches the lives of millions worldwide. From individuals struggling with substance use and associated disorders to communities grappling with the consequences of drug trafficking and organised crime, the impact of drugs is far-reaching and complex. Central to addressing this challenge is the imperative to adopt a scientific evidence-based approach that prioritises prevention and treatment.

The International Day against Drug Abuse and Illicit Trafficking, or World Drug Day, is marked to strengthen action and cooperation in achieving a world free of drug abuse. This year’s (2024) World Drug Day campaign recognises that effective drug policies must be rooted in science, research, respect for human rights, compassion, and a deep understanding of the social, economic, and health implications of drug use.

Together, all should be determined to combat the global drug problem, guided by the principles of science, compassion, and solidarity.

Continued record illicit drug supply and increasingly agile trafficking networks are compounding intersecting global crises and challenging health services and law enforcement responses, according to the World Drug Report 2023 launched by the UN Office on Drugs and Crime (UNODC). This year’s report will be launched next week.

New data put the global estimate of people who inject drugs in 2021 at 13.2 million, 18 percent higher than previously estimated. Globally, over 296 million people used drugs in 2021, an increase of 23 percent over the previous decade. The number of people who suffer from drug use disorders, meanwhile, has skyrocketed to 39.5 million, a 45 percent increase over 10 years.

Latest findings

The World Drug Report also highlights how social and economic inequalities drive – and are driven by – drug challenges; the environmental devastation and human rights abuses caused by illicit drug economies; and the rising dominance of synthetic drugs.

The demand for treating drug-related disorders, including mental conditions, remains largely unmet, according to the report. Only one in five people suffering from drug-related disorders was in treatment for drug use in 2021, with widening disparities in access to treatment across regions and countries.

Youth are the most vulnerable to using (or rather abusing) drugs and are also more severely affected by substance use disorder in several regions. In Africa, 70 percent of people in treatment are under the age of 35.

Public health, prevention, and access to treatment services must be prioritised worldwide, the report argues, or drug challenges will leave more people behind.

The report underscores the need for law enforcement responses to keep pace with agile criminal business models and the proliferation of cheap synthetic drugs that are easy to bring to market. Criminals producing methamphetamine – the world’s dominant illegally manufactured synthetic drug – evade law enforcement and regulatory responses through new synthesis routes, bases of operation, and non-controlled precursors.

Fentanyl has drastically altered the opioid market in North America with dire consequences. In 2021, the majority of the approximately 90,000 opioid related overdose deaths in North America involved illegally manufactured fentanyls.

Local situation

In Sri Lanka, the single most significant drug problem is the trafficking of heroin for local consumption. Sri Lanka serves as a transshipment hub for heroin trafficked into the country mainly from South Asian and West Asian locations. It is estimated that there are about 45,000 regular users of heroin and about 600,000 users of cannabis in the country. The recent Yukthiya operation netted a large number of addicts and pushers. Moreover, several drug lords who were hiding abroad have been brought down and produced before courts.

In fact, the nexus between organised crime and drug trafficking is rather well-known. Central and South American drug cartels are best known for extreme violence. In Sri Lanka too, most of the motorcycle killings (turf wars) have been attributed to rivalry between different drug dealing gangs. Underworld factions, sometimes, led by leaders living in exile in the Middle East, depend mainly on the drug business for their survival. Even prison and law enforcement officers have been caught dealing with or assisting notorious drug barons who are behind bars.

It is vital to nab the “big fish” who control the flow of drugs into the country and their distribution within the country. All drug addicts must be rehabilitated, instead of being sent to prison. This, after all, is one reason for the overcrowding of prisons. Another factor is that otherwise innocent drug users come into contact with hardened criminals inside the prison and could take to crime.

Our Security Forces must be equipped with the latest surveillance devices including long range drones to detect any incoming vessels smuggling drugs. This is important because the Navy and the Coastguard cannot cover the entire Exclusive Economic Zone. However, even amidst equipment and manpower issues, the Sri Lanka Navy has been successful in busting several drug smuggling rings that operate in and around Sri Lanka.

Enforcing the law against drug trafficking is important, but in keeping with this year’s World Drug Day theme, prevention is even more essential. This should begin from home or school, with students being warned on the dangers posed by illicit drugs of all types (this does not mean that legally available drugs such as tobacco are any better). Even some legal OTC pharmaceuticals can be abused if taken in abnormal quantities.

Drug trafficking is a complex global problem that demands global solutions with the active participation of all countries. That is essential to save the future generations from this scourge.

Source: https://www.sundayobserver.lk/2024/06/23/impact/25805/focus-on-preventing-drug-abuse/

 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/

Simantik Dowerah – First Post India June 26, 2024

Social stigma and low awareness about available treatment options significantly impact treatment-seeking behaviours, professor at the Department of Psychiatry at NIMHANS Bangalore, Dr Prabhat Chand tells Firstpost
(File) Students take part in an awareness march to mark the International Day against Drug Abuse and Illicit Trafficking, in Patna. PTI

The International Day Against Drug Abuse and Illicit Trafficking, observed every year on 26 June, serves as a global reminder of the urgent need to combat the menace of drug abuse and illicit trafficking. This day aims to raise awareness about the severe impact of drug addiction on individuals, families and communities worldwide. It also emphasises the importance of prevention, treatment and rehabilitation efforts to address this complex issue.

Governments, organisations and individuals come together on this day to advocate for policies and actions that promote a drug-free world, supporting those affected by addiction and working towards sustainable development and peace. The day calls for solidarity and collective action to safeguard public health and build healthier, safer societies for all.

On the occasion of the International Day Against Drug Abuse and Illicit Trafficking, Firstpost interviewed Dr Prabhat Chand, professor at the Department of Psychiatry, Centre for Addiction Medicine & NIMHANS Digital Academy VKN ECHO, Bangalore to gain insights into drug abuse trends in India and its broader societal implications.

How grave is drug abuse in India and how have their usage patterns changed over time?

Drug abuse in India is a significant public health challenge affecting diverse populations across the nation. The most abused substances after alcohol are cannabis and opioids. According to national surveys, the prevalence of cannabis users is 3.1 crore and about 72 Lakh are problem users. The opioid use increased significantly from 0.7 per cent to 2.1 per cent (i.e., 2.3 crore) during the same period. Other substances such as sedatives (1.08 per cent), inhalants (0.7 per cent), cocaine (0.10 per cent), amphetamines (0.18 per cent), and hallucinogens (0.12 per cent) also contribute significantly to the drug abuse landscape. The International Day Against Drug Abuse and Illicit Trafficking on June 26th, 2024, with the theme ‘The evidence is clear: invest in prevention,’ underscores the urgency of this issue.

How do socio-economic factors influence vulnerability to substance abuse in India? What are the demographics mostly affected and at high risk?

Socio-economic factors such as peer influence, societal pressures, difficult childhood and lack of access to supportive environments significantly influence vulnerability to substance abuse in India. The demographics mostly affected and at high risk include young male adults aged 18-25, people from low socio-economic backgrounds and those with lower educational attainment. Over the years, the age of onset for first substance use has been decreasing consistently.

What are the primary challenges in accessing addiction treatment facilities across different tiers of cities in India?

Access to treatment facilities varies significantly across different regions and city tiers. The treatment gap for addictive disorders is as high as 75 per cent, as per various national surveys. It means 75 out of 100 people with addictive disorders do not have access to care. The challenge is twofold – 1. Accessibility of care 2. Quality of care. For example, for opioid use disorder, Opioid against treatment (OAT) is evidence-based care across the world. But in India, the supply of OAT is available in very few places. That means people have to travel far to access the care. It is well known that addiction is a chronic brain condition and needs good aftercare. These are compounded by strong social stigma and low awareness. This emphasises the need for significant investments to enhance treatment options and optimise resource allocation based on national survey evidence.

How does stigma impact treatment-seeking behaviours in rural areas compared to urban centres?

Social stigma and low awareness about available treatment options significantly impact treatment-seeking behaviours. This leads people with addictive disorders to seek treatment at the later stage of the addiction cycle. Also, the studies show that more than 50 per cent of patients likely have comorbid psychiatric disorders, which also makes care more challenging. Bridging this gap requires tailored health service information campaigns to inform users and the general population about the available treatment services.

What strategies are recommended to bridge the treatment gaps between urban and rural areas, especially in smaller pockets and villages?

To bridge the treatment gaps – 1. Increase access to care 2. Making knowledge the effective interventions to the health care providers 3. Early identification by physicians, nurses or healthcare providers 4. Identification of high-risk youth and provider of holistic support 5. Integrate common substance use along with routine care like hypertension or diabetes.

Integrated care models and effective coordination between drug supply control and entities focused on demand reduction and harm reduction are crucial. Additionally, targeted outreach and education programmes can help prevent substance abuse and identify people in need of treatment at an earlier stage.

Why is it crucial to address gender disparities in treatment-seeking behaviours?

Addressing gender disparities in treatment-seeking behaviours is crucial because men predominantly access services compared to women. Tailored health service information campaigns are necessary to engage women and marginalised communities effectively, ensuring equitable access to treatment and support services. By promoting inclusivity in treatment access, India can foster a supportive societal framework that empowers people affected by substance abuse.

How can integrated care models improve outcomes for people with co-occurring substance abuse and mental health disorders?

Integrated care models can improve outcomes by providing comprehensive services that address both substance abuse and co-occurring mental health disorders. This necessitates significant investments to enhance treatment options and ensure effective coordination between drug supply control, demand reduction, and harm reduction entities. Such models are essential for addressing the multifaceted nature of substance abuse and its associated mental health issues.

What role do government policies, healthcare providers, NGOs and communities play in tackling the drug abuse crisis in India and how can collaboration be enhanced to achieve better outcomes?

Government policies, healthcare providers, NGOs and communities play a crucial role in tackling the drug abuse crisis in India. Collaboration among these entities can be enhanced by fostering coordination between drug supply control and demand reduction efforts, expanding treatment accessibility, promoting inclusivity in treatment access, and implementing targeted outreach and education programmes. By prioritising evidence-based strategies and fostering a supportive societal framework, India can empower people affected by substance abuse to reclaim their lives and contribute meaningfully to society. Sustained efforts in prevention, treatment infrastructure expansion and effective policy formulation are essential to achieving better outcomes and paving the way towards a healthier, drug-free future for Indian citizens.

Healthcare providers like doctors can use the ‘Addiction Rx mobile app’ as a guidance tool for screening, assessment and intervention in addictive disorders. This app is developed as a part of the standard treatment guidelines by the Ministry of Health and Family Welfare DDAP Addiction Rx app: iOS and Android.

The doctors, counsellors and nurses can discuss the cases and enrol in certificate courses at the NIMHANS Digital Academy ECHO weekly tele-platform to learn best practices.

Source: https://www.firstpost.com/india/international-day-against-drug-abuse-a-significant-public-health-challenge-affecting-india-13786238.html

Published: Jun 28, 2024, 7:02 PM

It seems as if every community, big or small, has been impacted by the problems associated with substance use and drug overdose. Within these communities, these problems extend into the family unit, with people becoming addicted and dying because of drugs.

However, community drug education and prevention programs can be a first line of defense. There is hope for the younger generations as they have more access to prevention and education resources to help them make informed decisions. In addition, more information is available for parents to equip them with the tools to help their kids understand the dangers and risks associated with drugs and alcohol.

Locally, the Kansas Prevention Collaborative partners with several different states and educational institutions and provides agencies. Substance misuse prevention focuses on underage drinking, marijuana use, and other substances.

Additionally, they offer the “It Matters” campaign, which focuses on the power of perception to help youth and young adults avoid substance misuse. The behavioral health services and programs in the state are provided by the Kansas Department for Aging and Disability Services, which includes treatment, recovery, and prevention.

Prevention and education information is valuable, especially during Fourth of July celebrations. Binge drinking around Independence Day is typical, and it is known as one of the heaviest drinking holidays of the year. In social settings, it becomes easy to consume too much alcohol and experiment with illicit drugs that are potentially laced with opioids.

According to drug abuse statistics, an average of 156 people die from opioid overdose in one year in Kansas. Opioids are a factor in 45.2% of all overdose deaths in the state. The Kansas Department of Health and Environment reported the rate of drug overdose deaths in the state of Kansas almost tripled within the last year few years. Drug education and prevention can help.

Parents play an essential role when providing drug education. They can take the initiative to create an inclusive and supportive environment with their children. This can equip them with the tools they need to make knowledgeable decisions surrounding alcohol and drug use.

Teens and adults all use drugs and alcohol for different reasons. Much of their use is linked to peer pressure, whether from peers, in a social setting, or in the case of someone they look up to who they see drinking or using drugs.

Stress is also a common factor, and alcohol or drugs seem like an easy escape from the problems of life.

Additionally, environment and family history are contributing factors. Children, for example, who grow up in households with heavy drinking and recreational drug use are more likely to experiment with drugs.

Any parents wondering what to do should consider starting the conversation about alcohol and drug use early. It is also essential to be calm, loving, and supportive. Seek out specialized resources, such as those offered by county or non-profit organizations providing prevention and education.

Additionally, parents want to focus on making it safe for their children to tell them anything and never end the conversation, keeping it going regardless of age.

Local drug education resources are here to help with the goal of helping people of all ages make knowledgeable decisions about drugs and alcohol.

Jody Boulay is a mother of two with a passion for helping others. She currently works as a Community Outreach Coordinator for DRS to help spread awareness of the dangers of drugs and alcohol.

Source: https://www.gbtribune.com/opinion/local-drug-education-and-prevention-programs-are-here-help/

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

COVID-19 pandemic and increasingly dangerous drug supply among factors that may have contributed to diminished impact of intervention

A data-driven intervention that engaged communities to rapidly deploy evidence-based practices to reduce opioid-related overdose deaths – such as increasing naloxone distribution and enhancing access to medication for opioid use disorder – did not result in a statistically significant reduction in opioid-related overdose death rates during the evaluation period, according to results from the National Institutes of Health’s HEALing (Helping to End Addiction Long-Term) Communities Study. Researchers identified the COVID-19 pandemic and increased prevalence of fentanyl in the illicit drug market – including in mixtures with cocaine and methamphetamine – as factors that likely weakened the impact of the intervention on reducing opioid-related overdose deaths.

The findings were published in the New England Journal of Medicine and presented at the College on Problems of Drug Dependence (CPDD) meeting on Sunday, June 16, 2024. Launched in 2019, the HEALing Communities Study is the largest addiction prevention and treatment implementation study ever conducted and took place in 67 communities in Kentucky, Massachusetts, New York, and Ohio – four states that have been hard hit by the opioid crisis.

Despite facing unforeseen challenges, the HEALing Communities Study successfully engaged communities to select and implement hundreds of evidence-based strategies over the course of the intervention, demonstrating how leveraging community partnerships and using data to inform public health decisions can effectively support the uptake of evidence-based strategies at the local level.

“This study brought researchers, providers, and communities together to break down barriers and promote the use of evidence-based strategies that we know are effective, including medications for opioid use disorder and naloxone,” said NIDA director, Nora D. Volkow, M.D. “Yet, particularly in the era of fentanyl and its increased mixture with psychostimulant drugs, it’s clear we need to continue developing new tools and approaches for addressing the overdose crisis. Ongoing analyses of the rich data from this study will be critical to guiding our efforts in the future.”

NIH launched the HEALing Communities Study, a four-year, multisite research study to test a set of evidence-based interventions for reducing overdose deaths across health care, justice, and behavioral health settings. Over 100,000 people are now dying annually of a drug overdose, with over 75% of those deaths involving an opioid. Numerous evidence-based practices have been proven to prevent or reverse opioid overdose, but these strategies are gravely underused due to a number of barriers.

As part of the intervention, researchers collaborated with community coalitions to implement evidence-based practices for reducing opioid overdose deaths from the Opioid-Overdose Reduction Continuum of Care Approach. These evidence-based practices focus on increasing opioid education and naloxone distribution, enhancing access to medication for opioid use disorder, and safer opioid prescribing and dispensing. The intervention also included a series of communication campaigns to help reduce stigma and increase the demand for evidence-based practices.

Communities were randomly assigned to either receive the intervention (between January 2020 and June 2022) or to the control group (which received the intervention between July 2022 and December 2023). To test the effectiveness of the intervention on reducing opioid-related overdose deaths, researchers compared the rate of overdose deaths between the communities that received the intervention immediately with those that did not during the period of July 2021 and June 2022.

Between January 2020 and June 2022, intervention communities successfully implemented 615 evidence-based practice strategies (254 related to overdose education and naloxone distribution, 256 related to medications for opioid use disorder, and 105 related to prescription opioid safety).

Despite the success in deploying evidence-based interventions in participating communities, between July 2021 and June 2022, there was not a statistically significant difference in the overall rate of opioid-involved overdose deaths between the communities receiving the intervention and those that did not, (47.2 opioid-related overdose deaths per 100,000 people in the intervention group, versus 51.7 in the control). The study team is also examining data on the impact of the intervention on total overdose deaths and examining specific drug combinations, such as stimulants and opioids, and on non-fatal opioid overdoses, among other study outcomes.

“The implementation of evidence-based interventions is critical to addressing the evolving overdose crisis,” said Miriam E. Delphin-Rittmon, Ph.D., HHS Assistant Secretary for Mental Health and Substance Use and the leader of SAMHSA. “This study recognizes there is no quick fix to reduce opioid overdose deaths. Saving lives requires ongoing commitment to evidence-based strategies. The HEALing Communities Study facilitated the implementation of 615 evidence-based practice strategies, with the potential to yield lifesaving results in coming years.”

The authors highlight three specific factors that likely weakened the impact of the intervention on reducing opioid-related overdose deaths. First, the intervention launched two months before the COVID-19 shutdown which severely disrupted the ability to work with health care, behavioral health, and criminal legal systems in implementing evidence-based practices. Indeed, due in large part to the emergence of the COVID-19, only 235 of the 615 strategies (38%) were implemented before the comparison period began in July 2021.

Second, after communities selected which evidence-based practices they wanted to implement, they only had 10 months to implement them before the comparison period began. The authors note that this was not enough time to robustly recruit necessary staff, change clinical practice workflows, or develop new collaborations across agencies and organizations. They note more time to implement these strategies, and more time between implementation and measuring results, may be needed to observe the full impact of the intervention.

Lastly, significant changes in the illicit drug market could have impacted the effectiveness of the intervention. Fentanyl increasingly permeated the illicit drug supply, and was increasingly mixed or used in combination with stimulant drugs like methamphetamine and cocaine, or in counterfeit pills made to look like prescription medications. The increasing use of fentanyl, as well as xylazine, over the study period posed new challenges for treatment of opioid use disorder and opioid-related overdose.

“Even in the face of a global pandemic and worsening overdose crisis, the HEALing Communities Study was able to support the implementation of hundreds of strategies that we know save lives,” said Redonna Chandler, Ph.D., director of the HEALing Communities Study at NIDA. “This is an incredible feat for implementation science, and shows that when we provide communities with an infrastructure to make data-driven decisions, they are able to effectively implement evidence-based practices based on their unique needs.”

The HEALing Communities Study was supported and carried out in partnership between the National Institute of Health’s National Institute on Drug Abuse (NIDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) through the NIH HEAL Initiative.

Source: https://nida.nih.gov/news-events/news-releases/2024/06/nih-funded-intervention-did-not-impact-opioid-related-overdose-death-rates-over-evaluation-period

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

WHYY (PBS) 14th June 2024

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/

Original Investigation – Substance Use and Addiction
July 17, 2024

Melinda Campopiano von Klimo, MD1Laura Nolan, BA1Michelle Corbin, MBA2et alLisa Farinelli, PhD, MBA, RN, CCRP, OHCC2Jarratt D. Pytell, MD3Caty Simon4,5,6Stephanie T. Weiss, MD, PhD2Wilson M. Compton, MD, MPE2

JAMA Netw Open. 2024;7(7):e2420837. doi:10.1001/jamanetworkopen.2024.20837
Key Points

Question  What reasons do physicians give for not addressing substance use and addiction in their clinical practice?

Findings  In this systematic review of 283 articles, the institutional environment (81.2% of articles) was the most common reason given for physicians not intervening in addiction, followed by lack of skill (73.9%), cognitive capacity (73.5%), and knowledge (71.9%).

Meaning  These findings suggest effort should be directed at creating institutional environments that facilitate delivery of evidence-based addiction care while improving access to both education and training opportunities for physicians to practice necessary skills.

Abstract

Importance  The overdose epidemic continues in the US, with 107 941 overdose deaths in 2022 and countless lives affected by the addiction crisis. Although widespread efforts to train and support physicians to implement medications and other evidence-based substance use disorder interventions have been ongoing, adoption of these evidence-based practices (EBPs) by physicians remains low.

Objective  To describe physician-reported reasons for reluctance to address substance use and addiction in their clinical practices using screening, treatment, harm reduction, or recovery support interventions.

Data Sources  A literature search of PubMed, Embase, Scopus, medRxiv, and SSRN Medical Research Network was conducted and returned articles published from January 1, 1960, through October 5, 2021.

Study Selection  Publications that included physicians, discussed substance use interventions, and presented data on reasons for reluctance to intervene in addiction were included.

Data Extraction and Synthesis  Two reviewers (L.N., M.C., L.F., J.P., C.S., and S.W.) independently reviewed each publication; a third reviewer resolved discordant votes (M.C. and W.C.). This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines and the theoretical domains framework was used to systematically extract reluctance reasons.

Main Outcomes and Measures  The primary outcome was reasons for physician reluctance to address substance use disorder. The association of reasons for reluctance with practice setting and drug type was also measured. Reasons and other variables were determined according to predefined criteria.

Results  A total of 183 of 9308 returned studies reporting data collected from 66 732 physicians were included. Most studies reported survey data. Alcohol, nicotine, and opioids were the most often studied substances; screening and treatment were the most often studied interventions. The most common reluctance reasons were lack of institutional support (173 of 213 articles [81.2%]), knowledge (174 of 242 articles [71.9%]), skill (170 of 230 articles [73.9%]), and cognitive capacity (136 of 185 articles [73.5%]). Reimbursement concerns were also noted. Bivariate analysis revealed associations between these reasons and physician specialty, intervention type, and drug.

Conclusions and Relevance  In this systematic review of reasons for physician reluctance to intervene in addiction, the most common reasons were lack of institutional support, knowledge, skill, and cognitive capacity. Targeting these reasons with education and training, policy development, and program implementation may improve adoption by physicians of EBPs for substance use and addiction care. Future studies of physician-reported reasons for reluctance to adopt EBPs may be improved through use of a theoretical framework and improved adherence to and reporting of survey development best practices; development of a validated survey instrument may further improve study results.

Introduction
NDPA WEBSITE:  Note – In the interests of relative brevity, the References have been omitted from this published version.

Overdose is a leading cause of injury-related death in the US,1 with 107 941 such deaths occurring in 20222 and annual deaths due to alcohol exceeding 140 000 from 2015 to 2019.3 The more than 46.3 million people in the US with a past-year substance use disorder4 and a nationwide economic impact of alcohol misuse and illicit drug use that tops $442 billion5 further evidences the magnitude of this crisis.

A variety of safe and effective evidence-based practices (EBPs) to identify, reduce the morbidity and mortality of, and treat substance use disorders exist. Examples include screening, brief intervention, and referral to treatment,610 as well as behavioral therapies and pharmacotherapies for nicotine, alcohol, and opioid use disorders.1113 Furthermore, harm reduction approaches (eg, naloxone training and coprescribing, drug checking and testing, and syringe service programs) offer significant individual and public health benefits for people who use drugs and for those who do not have abstinence-based treatment goals.1416

Clinician adoption of EBPs is necessary; however, screening for substance use disorders remains low,7 creating missed opportunities to intervene in harmful substance use or recognize and discuss potential progression to a severe disorder. Treatment capacity is inadequate to meet demand,17 with only 6.3% of people with a past-year substance use disorder receiving treatment in the US in 2021.4 Our goal is to summarize published data on physician-described barriers to adoption of EBPs for addiction in clinical practice and recommend actions to address them.

Methods
Data Sources and Searches

This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines. The search strategy was developed iteratively with a National Library of Medicine informationist specializing in systematic reviews. We applied this strategy on October 4, 2021, to PubMed, Embase, and Scopus and on October 5, 2021, to medRxiv and SSRN Medical Research Network. In addition, a gray literature search of relevant government and nongovernment websites was conducted on October 5, 2021. We found no previous similar systematic reviews. The systematic review protocol was registered in PROSPERO (CRD42022286208) and accepted on January 14, 2022.

Study Selection

A 12-person team used Covidence to apply exclusion criteria first to the title and abstract of each study then to the full text of studies not already excluded. Two people (L.N., M.C., L.F., J.P., C.S., and S.W.) reviewed each study in both rounds. Discordant opinions were resolved by a third reviewer (M.C. and W.C.). To be included, the study had to present data on: (1) physicians at any practice level; (2) any substance use intervention(s) (Box); and (3) physician reasons for reluctance to intervene in addiction. Studies not in English, letters, editorials, narrative reviews, and commentaries were excluded. Data collection on reasons for reluctance were systemized using the theoretical domains framework (TDF),18,19 a comprehensive approach for identifying behavioral determinants and for assessing implementation problems (eg, clinicians’ behavior) to inform intervention development. The team created a data extraction template with 10 reluctance reason categories (Box). We did not formally assess risk of bias in included studies because few used experimental or controlled study designs. Due to patterns observed during data extraction, the team approved the ad hoc collection of data on factors (eg, using a theoretical framework, obtaining target audience input in survey design, and piloting surveys) that could affect the internal validity of individual studies or precision of results. We conducted a limited exploration of facilitators because we observed that many included studies provided at least some data on possible facilitators of intervention in addiction.

Definitions of Intervention Type and Reluctance Reasons

Intervention type and definition
  • Harm reduction: syringe services, overdose prevention, naloxone, or drug user health.

  • Screening and assessment: screening, assessment of positive screening, or diagnosis.

  • Treatment: brief intervention, medication management, or behavioral services.

  • Recovery support: care coordination, care integration, or relapse prevention.

Reason and definitiona
  • Knowledge: beliefs about having the necessary knowledge, awareness, or understanding, including knowledge of condition or scientific rationale, procedural knowledge, or knowledge of task environment.

  • Institutional environment: beliefs about support from institution or employer, including material resources, organizational culture, competing demands.

  • Skills: beliefs about having the necessary skills, ability, or proficiency to deliver the intervention.

  • Cognitive capacity: beliefs about the cognitive capacity to manage a level of expected complexity of care, possibly related to cognitive overload and mental fatigue.

  • Expectation of benefit: beliefs about the likelihood of the patient benefiting or the course of the disease being altered due to the intervention.

  • Social influences: beliefs about public or community acceptance or support for the intervention, including willingness to allocate or develop needed resources.

  • Emotion: feelings of fear, dislike, worry, negative judgement, worthiness of patient population.

  • Relationship: concern about harming or losing the patient-physician relationship by causing offense, provoking avoidance, or other negative consequence.

  • Reinforcement: beliefs about the adequacy of reimbursement, professional rewards, and other positive reinforcement.

  • Professional role/identity: beliefs about professional role, boundaries, and group identity, excluding the intervention.

a Reasons are derived from the theoretical domains framework, a comprehensive approach for identifying behavioral determinants and assessing implementation problems (eg, clinicians’ behavior) to inform intervention development.

 

Data Analysis

We conducted a series of quantitative analyses using SPSS, version 27 (IBM). Analyses were selected based on their purpose; independent variable; dependent variable; and statistical requirements, including measurement levels. We examined reasons for reluctance by specialty, intervention, drug type, and year and common combinations of reasons for reluctance using bivariate analysis and cross-tabulation. We conducted a regression analysis of reasons for reluctance by year. Statistical significance was considered a 2-sided P value less than .05. The exploratory analyses of ad hoc study quality data were not part of the planned analysis and are descriptive only. We used Atlas.ti version 24 (Atlas.ti) to conduct thematic analysis to examine facilitators using the following themes: knowledge and skills, intrapersonal and interpersonal factors, infrastructure, and regulation reform.

Results
Study Characteristics

Our search yielded 9308 studies published between January 1, 1960, and October 5, 2021, with 1280 remaining after removal of duplicates and 552 assessed for eligibility (eFigure 1 in Supplement 1). Of 283 studies20302 included (eTable 1 in Supplement 1), 97.30% were published in 2000 or later (Table 1). The number of studies increased over time. For example, 4 studies89,156,184,236were published in 2000 and 2133,48,49,66,68,75,77,79,93,107,108,113,139,142,148,240,251,255,302,306,313 in 2021, with a high of 31 8,27,47,50,52,54,69,74,92,100,114,121,146,147,161,165,174,182,191,193,199,204,206,209,221,247,263,270,275,287,300 in 2020 (eTable 2, eTable 3, eTable 4, eTable 5, and eFigure 2 in Supplement 1). Together, the included studies describe the views of 66 732 physicians who largely practiced general practice, internal medicine, or family medicine primarily in an office setting in the US. Most studies reported survey-based research results. Of the 4 general categories of addiction interventions (Table 2), treatment was most often addressed, followed by screening and assessment, with harm reduction and recovery support least discussed. Some studies addressed more than 1 intervention. Alcohol (86 studies20,21,23,25,26,29,31,34,36,38,41,44,51,53,54,57,59,60,62,6972,81,82,86,88,89,94,95,103,105,111,113,117,119,123127,131,132,138,141,150,153,155,158,160,162,164,168,170,171,173,176,191193,196201,204,205,210,219,235,237,248,250,254,256,258,271,281,283,285,291,294,296,299,300), nicotine (30 studies28,40,48,49,52,61,73,85,97,109,118,129,134,140,142,149,179,188,190,212,218,223,231,249,252,265,270,286,288,298), and opioids (104 studies30,32,33,35,37,42,46,47,50,55,56,58,64,66,7480,83,84,87,9092,98100,104,106108,110,112,114,115,121,122,130,133,135,137,139,143,144,146148,151,152,154,156,163,165,167,172,174,180,182,184,186,189,202,203,206,207,213216,221,222,225228,238240,242245,247,251,253,255,257,259,262,269,272,275,277,280,282,284,287,290,292,293,302) were most often studied alone. Among studies reporting on multiple drugs (44 studies22,39,43,45,63,65,67,68,93,96,101,102,116,120,136,145,166,181,183,185,194,195,208,209,217,220,230,232234,241,246,260,263,264,267,268,273,274,278,279,289,295,297), alcohol was included most often (38 studies45,63,65,67,68,93,96,101,102,116,120,136,145,166,181,183,194,195,208,209,217,230,232234,241,246,260,264,267,268,273,274,278,279,289,295,297). Other substances were often reported as “other” or merely “drugs.” Cross-tabulations of each reason for reluctance with each of the most common specialties, interventions, and drugs produced no significant results; consequently, no P values are reported (Table 2). While this systematic review is of physician reluctance, 110 studies20,2325,28,30,31,33,34,39,42,44,47,48,50,52,54,57,59,63,64,6670,87,88,90,92,93,95,99,101,103107,109,111113,116,120,122,123,126,129,134,136,138,139,143,146,147,151,156,157,159,162,166,167,169,173,174,177,178,183,186,189,190,192,194,195,199201,203,205,206,209,211,217,221,225,229,235,236,243245,251,257,260,261,266,269,270,275,277,280,283,286,287,290,291,297,299,302 mentioned possible facilitators of physician engagement.

Physician Reluctance

Most studies did not gather or report data on all reasons. When queried, institutional environment (173 of 213 articles [81.2%]20,22,2527,3033,35,37,38,4044,46,47,4951,5464,66,68,7478,80,8284,86,87,8993,95,97,99,100,104,106110,112114,116,117,121124,126,127,129,134139,143,144,146148,150,151,153155,157159,161165,167,169176,179,180,182,183,185,186,189,192,195,198,199,201204,206,207,209,211,216221,223,226,228230,232234,236,238,239,241243,245,247,251,252,257261,263265,268,269,271,272,275,277,280,284,287,290,291,293,295,299,301,302) was the most common reason, followed by lack of skill (170 of 230 articles [73.9%]2022,2433,35,3739,4749,51,5355,58,59,61,6368,75,76,78,8082,84,85,88,89,9193,95,97100,102107,109114,116121,123125,130132,134,136,138,139,142,143,145,147,149,150,152,154,159161,167,168,172174,176,178,180,182,183,186,188,190,191,193,194,197202,204,206211,213,214,216,218221,224226,229,231,233,235,236,238,241,242,246,247,249,256,259,264266,268,269,271,273,274,276279,281283,285287,290295,297,298,301,302), cognitive capacity (136 of 185 articles [73.5%]22,25,26,30,32,34,37,40,41,4749,52,55,5861,6366,68,69,71,74,75,77,78,80,82,85,8791,93,95,97,100,101,104107,109114,116,117,119,120,122126,129,134136,138,139,142,146151,154156,159162,167,172,174,180,181,185187,190192,196199,205,206,209,211,213,214,216,217,219,225,229232,235,237,239,241243,254,256,260,264,265,268270,272,275,277,283,286,287,290292,299,301,302), and knowledge (174 of 242 articles [71.9%]2022,2533,36,37,39,42,43,49,5359,61,62,6466,6870,73,76,78,81,82,84,85,9193,95,97100,102107,109,110,113,114,116121,126,128,130,131,136,138,139,141143,147,149152,154,155,157,159161,163,166168,170174,176180,182186,188,190194,197204,206210,212215,219,221,224,226,236238,241,242,244,246,247,251,252,256258,264,266269,271,273,274,276281,283288,292295,297302); and social influences (121 of 184 articles [65.8%]26,27,3032,41,42,46,47,49,51,57,58,60,62,63,68,71,77,79,80,82,83,88,90,92,95,99,101,102,106110,112114,118,121124,126,127,129,134138,146,147,151,153,155,157159,161,165,167,169,170,176,177,180,182,185,189,195,197208,210212,216,217,219,221,223,227,228,233235,238,242,245,247,249,254,255,257,260,261,264,266,268,269,282,283,286,287,289,291,296298,301,302) (Table 2). We conducted bivariate analyses of reasons for reluctance and specialty, drug type, intervention, and time (Table 2; eFigure 3 in Supplement 1). Too few studies of recovery support existed to conduct a bivariate analysis with reasons for reluctance. Analysis of combinations of the top 4 reasons for reluctance found the most often paired reluctance reasons were knowledge and skill (135 of 221 articles [61.1%]2022,2533,37,39,49,5355,58,59,61,6466,68,76,78,81,82,84,85,9193,95,97100,102107,109,110,113,114,116121,130,131,136,138,139,142,143,147,149,150,152,154,159161,167,168,172174,176,178,180,182,183,186,188,190,191,193,194,197202,204,206210,213,214,219,221,224,226,236,238,241,242,246,247,256,264,266,268,269,271,273,274,276279,281,283,285287,292295,297,298,301,302), followed by cognitive capacity and institutional environment (99 of 165 articles [60.0%]22,25,26,30,32,37,40,41,47,49,55,5861,63,64,66,68,74,75,77,78,80,82,87,8991,93,95,97,100,104,106,107,109,110,112114,116,117,122124,126,129,134136,138,139,146148,150,151,154,155,159,161,162,167,172,174,180,185,186,192,198,199,206,209,211,216,217,219,229,230,232,239,241243,260,264,265,268,269,272,275,277,287,290,291,299,301,302) (Table 3). Institutional environment appeared in combination with other reasons more often than any other reason (7 of 12 pairings). Reasons not in our data extraction template were described in a few studies, including lack of demand (13 articles87,92,112,122,143,167,171,214,216,232,257,280,292), cost to the patient (8 articles58,69,148,155,171,174,288,292), and patient refusal (6 articles61,146,170,174,182,206). Analysis of the trend over time for each reason for reluctance revealed a significant increase in identification of social influence (F1,20 = 4.91; P = .04) and relationship (F1,20 = 4.54; P = .046) (eFigure 3 in Supplement 1). We extracted exemplar text from included studies for the top 4 reasons for reluctance (Table 4), discussed in the following section.

Institutional Environment

Reasons for reluctance related to the institutional environment included lack of trained staff66,154,167,182,186,207,242,260 or resources to train staff,59,92,221 acceptance of addiction interventions by staff107,259 or leadership,57,80,155,169,175,261,275 and clinician backup.54,56,64,75,76,90 Regulatory and liability concerns were frequently reported,32,35,50,75,76,87,90,99,107,163,165,167,174,245,259,261 as were record-keeping or confidentiality concerns207,259,275 and staff time required for prior authorizations.92 Often mentioned were also cost to the patient or lack of insurance coverage,148,155,170,171,173,174,182 along with medication unavailability at pharmacies95,144,148,170 and the absence of population-specific patient education materials.260,291 Less frequently cited but noteworthy reasons for reluctance include contractual limitations,291 nonexistent or unimplemented treatment algorithms,99,287 mental health programs not accepting patients with addiction,264 addiction treatment programs rejecting patients deemed insufficiently ready to change or having difficulty matching the level of care needed,229 and difficulty obtaining records from addiction treatment programs.107 Reimbursement can be viewed as a component of institutional environment. In the TDF, reimbursement is 1 part of reinforcement as a reason for reluctance (Box). While reinforcement was 1 of the 2 least often identified reasons for reluctance, data specific to reimbursement was extracted because it is a perennial point of concern in adopting evidence-based interventions for addiction. Physician reimbursement was viewed as insufficient to cover both the staff time necessary to intervene in addiction and the expense of additional staff training.174,207,277 Medicaid reimbursement was specifically highlighted as inadequate.186 In some cases, physicians perceived the reimbursement to be inadequate but were not certain of the reimbursed amount.56

Lack of Knowledge

In studies identifying lack of knowledge as a reason for reluctance, knowledge was more deficient for treatment than for screening or diagnosis and for drug use more than for alcohol or tobacco use.20,65,70,93,99,102,117,152,194,221,252,273 Physicians were unfamiliar with the evidence for substance use disorders as biomedical conditions,119,138,199,257 harm reduction strategies,58,154 and screening for risky substance use.59,161 Some physicians lacked awareness of the extent of substance use by their patients.256

Lack of Skill

Physicians reported lacking skills to conduct interventions effective enough to produce behavior change, including counseling21,38,51,59,117,291 and brief intervention.93,209,229 They also described a lack of skill needed to initiate or manage treatment,92,152,221,273 especially for substance use disorders other than alcohol or tobacco.63,194 In some studies, they equated their lack of skill with lack of experience with observing or delivering a substance use disorder intervention under supervision.22,75,91,238,256 Inabilities to assemble or demonstrate naloxone administration devices58,277 or to deliver appropriate training in its use to patients99 were also noted.

Lack of Cognitive Capacity

Lack of cognitive capacity was not often characterized beyond a general sense of overwhelm with clinical tasks (eg, “just too busy”)64,291 and the need to prioritize patients’ competing needs.58,107,109,268 In some cases, physicians perceived intervening in addiction as too time-consuming, both during the appointment and for monitoring,69,87,90,93,287 or that addiction treatment demand would be too great.66,75,91 Even delegating screening to other clinical team members was viewed as diverting time from the physician visit229; available tools were considered time-consuming.260 Some physicians expected meeting the care needs of patients with addiction to be too time-consuming.

Facilitators

We analyzed 4 main themes related to facilitators. First, physicians need the knowledge and skills to intervene; they need adequate education and training in areas like managing pharmacology. Second, intrapersonal and interpersonal factors exist that facilitate physician intervention. Intrapersonal factors include physician characteristics (eg, work experience, confidence, and practice type) and motivation (eg, desire to improve patient outcomes, reimbursement, and understanding addiction as within their scope of practice). Interpersonal factors include the physician-patient relationship, specifically the patient characteristics that may compel the physician to intervene (eg, the patient is receptive to help). Third, an infrastructure is needed that supports physician interventions and includes institutional changes at the practice level to implement protocols to standardize care (eg, screening and improved technology). An environment that fosters collaboration with other professionals or entities (eg, multidisciplinary teams and referral systems) and offers resources that would support the intervention (eg, materials or tools for use with patients, follow-up care, or treatment facilities) is also essential. Finally, regulation reforms (eg, eliminating prior authorization requirements, expanding substance use disorder insurance coverage, and simplifying laws and policies governing prescribing and medication distribution to patients) would facilitate physician intervention.

Discussion

The number and growth of publications meeting inclusion criteria for this systematic review demonstrates increasing interest in the perceived and actual barriers to physician engagement with addiction in clinical practice. The significant increase in social influence and relationship as reasons for reluctance over time may indicate increased awareness of stigma and associated social harms. Regarding intervention types, the availability of effective alcohol use disorder and opioid use disorder pharmacotherapies likely accounts for the literature’s focus on those therapies, corresponding with efforts to increase access to medications for opioid use disorder and to promote the adoption of screening, brief intervention, and referral to treatment practices. As the evidence base for a wider array of harm reduction strategies grows, it will be important to understand and address physicians’ perceived and actual barriers to their acceptance and adoption of those strategies. Information is limited on the adoption of recovery support interventions by physicians, a finding that also merits investigation.

That institutional environment is associated with physician reluctance to intervene may not surprise practicing clinicians. The pairing of institutional environment and cognitive capacity may signify the cost in time physicians expend overcoming institutional barriers to EBP for addiction (eg, inefficient workflows and communication and coordination of care across silos). The association of institutional environment with treatment and opioids may reflect the push to increase buprenorphine access despite regulatory impediments and health systems being unprepared for this responsibility.

Strategies to reduce physician reluctance related to institutional environment include greater commitment by health systems to make essential workflow and staffing changes, the breaking down of barriers between addiction services and both medical and mental health care, and commitment by insurers to provide reimbursement that covers the actual cost of providing addiction interventions. The analysis of facilitators supports a specific need for protocols to adequately intervene with patients with either at-risk substance use or substance use disorders. Institutional environment changes (eg, investing in staffing and staff training, implementing standard practices or protocols, and conducting addiction-specific quality assurance) could also facilitate intervention.

Lack of knowledge and skill are top reasons for reluctance, both separately and combined. It is unclear whether survey respondents understood knowledge and skill as the researchers intended because these terms were rarely defined in the studies. Only a few studies allowed for future replication by including objective measures of knowledge or skill (eg, counting successfully delivered services and interviewing patients).

True lack of knowledge and skill can be understood in several ways, including as a manifestation of the volume of information practicing clinicians are required to possess, acquire, and update. For example, physicians need updated information on dosing, pharmacology, and overall efficacy of interventions and medications. This challenge is made harder if interventions (eg, screening practices, initiating pharmacotherapy) are insufficiently adapted for different practice settings. Delivering these interventions effectively, efficiently, and in a nonstigmatizing manner requires skill mastery. Physicians, like other clinicians, acquire their skills by observing and then practicing under supervision. Medical education and postgraduate training have only recently begun to prepare physicians for these tasks.303,304

Ongoing training is critical for physicians to acquire and apply advanced skills in the care of this patient population,305307 but few opportunities exist to observe and be observed practicing new skills once required medical training is complete. The analysis of facilitators suggests skill training should focus on brief intervention (eg, screening or assessment) and on communication with patients. Trainings accessible to physicians (eg, free or incentivized, hands-on, or delivered in clinical settings) and delivered by specialized trainers and/or mentors would facilitate the growth of a pool of experts to intervene in substance use. Physicians who expand their knowledge and skills should be eligible for continuing medical education credits and increased compensation.

Other reasons for reluctance (eg, negative social influences, negative emotions toward people who use drugs, and fear of harming the relationship with the patient by discussing substance use) could each be viewed as manifestations of stigma associated with substance use disorder and its treatment. Lack of demand may also reflect stigma if it is a manifestation of unwillingness on the part of patients to seek help due to fear of social, legal, and moral judgement or a presumption by the physician that there is no addiction in their community.

These reasons may diminish if effective public and professional education, in particular those developed and led by patient groups or by people who use drugs,308312 are delivered to counter stigma.313 The analysis of facilitators suggests the following may be helpful: educational materials for patients and families, community outreach, and public health campaigns promoting nonstigmatizing language.

Reducing stigma will not be enough to address fear of harming the patient relationship, especially for physicians who care for minors and other populations that may be subject to punitive consequences of addiction. These physicians must consider additional confidentiality requirements, and their fear of harming the patient by triggering negative social and legal consequences may be more of a deterrent than previously considered. Interpersonal aspects of the patient-physician relationship and how they create reluctance or facilitate intervention are not well understood, although the analysis of facilitators shows that physicians may be motivated to intervene in substance use disorders when they have an established relationship with the patient, the patient is receptive to help, and/or the desire to improve patient outcomes is strong. Future research should examine unintended impacts of increased physician intervention in addiction like strain on the physician-patient relationship, less opportunity to meet other health care needs, and stigmatizing interactions with other health care clinicians due to the substance use disorder diagnosis being more widely documented.

Limitations

This study has limitations. Inconsistent use of terms across included studies increased the complexity and interpretation of this analysis, but analysis of a sample this size can still inform research and policy. Studies were often developed without the benefit of a theoretical framework. Survey development lacked or failed to report participation of the audience of focus and/or was not piloted, raising concerns about the validity and applicability of results. During the years this systematic review covered, new medications and formulations became available, making comparison across decades challenging. The unregulated drug market also evolved, resulting in changes to illicit substances, methods of using them, and the regulatory environment in which clinicians address substance use. This review was limited to physicians, some of whom may have participated in more than 1 survey or focus group in the included studies. Although the results are relevant to the practice environment of many clinicians, including those specializing in addiction, they do not reflect the unique challenges that may be encountered by specific disciplines. Although we collected and described data about facilitators, the original search was not designed specifically to retrieve publications about facilitators of intervention in addiction.

Conclusions

These data suggest that policy, regulatory, or accreditation changes are needed to systematically address institutional barriers, as well as increases to physician reimbursement and opportunities for clinically relevant training that provides both skill development and knowledge gain. Another systematic review of facilitators and reluctance among other clinical disciplines may refine the recommendations presented here. Future studies of clinician reluctance to adopt EBPs for addiction need to be of higher quality. They, at a minimum, should employ a theoretical framework and adhere to survey development best practices or use a validated survey instrument.

Article Information

Accepted for Publication: May 7, 2024.

Published: July 17, 2024. doi:10.1001/jamanetworkopen.2024.20837

Source: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821497

By Killian Meara

For National Fentanyl Awareness Day, Drug Topics talked with Scott H. Silverman about how public health leaders can address the fentanyl crisis and the best ways to educate the public on the dangers of fentanyl use.

The opioid epidemic in the United States stretches back to the 1990s, when the synthetic opioid oxycodone hydrochloride was first introduced as a medication to treat moderate to severe pain and chronic pain. Since then, opioid overdose deaths in the country have skyrocketed, with data from the CDC showing there were over 109000 in 2022, with nearly 70% due to synthetic opioids.1

The primary driver behind the rise in synthetic opioid-related overdose deaths is fentanyl. Used to treat complex pain conditions and pain related to surgery, fentanyl is 50 times stronger than heroin and 100 times stronger than morphine.2 That means even a small dose of the synthetic opioid can be potentially lethal for people who have no tolerance.

According to some research, while fentanyl use is now widespread, a majority of users do not intend to use it.This is largely because its introduction into other illicit substances has become pervasive. The synthetic opioid has been found in heroin, cocaine, methamphetamines, opioid analgesics, amphetamines, and benzodiazepines.3 Because of the increased threat of overdose fentanyl poses, it is critical to bring awareness to the drug and to implement harm reduction services to mitigate risk.

National Fentanyl Awareness Day, held annually on May 7, aims to educate the public about the dangers of fentanyl use. This year, Drug Topics talked with Scott H. Silverman, a crisis coach, behavioral health consultant, and team lead for the substance abuse recovery program Confidential Recovery, about how public health leaders can address the fentanyl crisis, challenges in accessing treatment and support, and the best ways to educate the public on the dangers of fentanyl use.

Drug Topics: What do you believe are the most important priorities for policymakers, healthcare providers, and community leaders to address in the fentanyl crisis?

Scott H. Silverman:The most important priority for the fentanyl crisis is to make it as important as the COVID-19 pandemic. If we don’t, the morbidity rate will continue to grow and the fentanyl distributors will see that the US doesn’t really care, so they will continue to target us.

Real-time data is crucial to make changes. For example, the medical examiners should be communicating on a national level to share what percentage of the overdoses are solely from fentanyl or fentanyl-laced drugs. We need real-time demographics because we can’t wait 18 months to find out the statistics and what happened in 2022. We must find out as quickly as possible to address this crisis head-on. It must be made a priority by federal, state and local governments, because they are the only ones that can help put a stop to this. Overall, data-driven information in a time-sensitive manner is going to be critical.

Drug Topics: From your perspective, what are the most pressing challenges in accessing effective treatment and support services for individuals struggling with opioid addiction?

Silverman: I don’t believe the insurance industry understands what they’ve got in front of them. It’s a benefit-driven industry, and the industry needs to take a good look at themselves and figure out how they are going to really help people. We’ve seen the current President reduce the cost of pharmaceuticals and pharmaceutical companies are still doing fine, so they know how to create systemic change, but it needs to become a priority.

Drug Topics: How can communities, organizations, and individuals work together to prevent opioid-related overdoses and deaths?

Silverman: Education and prevention. Right now, the big conversation is around [naloxone (Narcan)], the drug that reverses overdoses. The issue is we are giving a lot of people that drug after they overdose, but how do we work hard to educate and incentivize people who are making a conscious decision to not put something in their body? That’s going to require a ton of education and a ton of prevention, which social media could really help make the change that’s needed for young people specifically. Kids are getting iPhones and iPads now in the single-digit ages, so why not make social media a learning opportunity to educate and save lives?

Drug Topics: What do you think are the most effective ways to educate the public about the dangers of fentanyl misuse?

Silverman: Common sense messaging is the most effective way to educate the public. Using simple messages like, “one pill can kill,” can really make a difference. The DEA came up with that phrase knowing that it’s a poison and the people that make it don’t care if their consumer dies. The government is trying to tell people about this issue, but the real question for consumers is,“Are you listening and are you seeking the knowledge?” So, how do we incentivize and find creative ways to reach them? This commonsense messaging doesn’t need to be wrapped into your dinner napkin every night, but it should be a part of the discussion every week with the family. The education aspect really comes with family discussion.

Drug Topics: Looking ahead, what do you hope to see in terms of progress and awareness surrounding fentanyl misuse and overdose prevention?

Silverman: I hope the morbidity rate declines. I would love to stop going to funerals and we shouldn’t say, “That’s sad, but it’s somebody else’s kid.” The data shows that 42% of adults in the country know somebody or know of somebody who died of an overdose. There’s no other disease that has that high of a morbidity rate that people know about. If it’s that high of a morbidity rate, why aren’t we doing more? Whatever that’s defined as and putting more strength at the border, although we have multiple borders, you can ship these drugs over in a parachute, float it in with a drone, bring it in through the mail and you can even make it now. There’s a lot of money around it too, a lot of young people are buying these materials on the dark web and making it themselves.

Source:  https://www.drugtopics.com/view/fentanyl-education-prevention-key-to-ending-crisis-in-us

 

 

The initiative aims to reduce substance use-related harms among young people across Canada through the Icelandic Prevention Model, with support and expertise from Planet Youth.͏ ͏ ͏

 

No community in Canada has been left untouched by the substance use-related harms and the toxic illegal drug supply and overdose crisis. Efforts to prevent substance use, especially among youth, are critical, and by strengthening communities and environment of youth, they will be at lesser risk of initiating substance use.

 

On June 26, the Honorable Ya’ara Saks, Minister of Mental Health and Addictions and Associate Minister of Health, announced the Canadian government’s support for the Youth Substance Use Prevention Program (YSUPP). The event took place in Glace Bay, Novia Scotia in the Undercurrent youth center which provides leisure activities for the youth in the area. The initiative aims to reduce substance use-related harms among young people across Canada through the implementation of the Icelandic Prevention Model (IPM), with support and expertise from Planet Youth.

 

The initial stage of this initiative will secure funding for seven projects in British Columbia, Saskatchewan, Ontario, and Nova Scotia. Which will be added to the already started seven Planet Youth initiatives in other parts of Canada. These projects will focus on the Canadian adaptation and implementation of the Icelandic Prevention Model and its collaborative approach to preventing substance use harms among youth. With Planet Youth’s guidance, the IPM emphasizes a community-driven strategy to address the root causes of substance use.

 

These projects will engage diverse communities and sectors, including First Nations, schools, service providers, community leaders, and young people with lived and living experience. Their participation will be crucial in evaluating the IPM within the Canadian context, ensuring that the model is effectively tailored to meet the unique needs of Canadian youth.

 

Additionally, Renison University College, affiliated with the University of Waterloo, will receive funding to establish a new Knowledge Development and Exchange Hub for Youth Substance Use Prevention. Planet Youth experts will train the Hub to provide guidance and training on the IPM’s implementation in Canada. The Hub will lead a pan-Canadian youth substance use prevention community of practice, facilitating the sharing of information and best practices among various projects.

 

Preventing and reducing youth substance use through YSUPP is a key component of the Canadian Drugs and Substances Strategy. The Canadian government is committed to continuing this critical work in collaboration with all levels of government, partners, Indigenous communities, stakeholders, and local organizations. These efforts aim to reduce substance use-related harms, ensure comprehensive support for those in need, and ultimately, save lives.

 

Source: Public Health Canada

 

Links:

EHF Address: Planet Youth ehf. Lagmúla 6, 108, Reykjavik, Iceland.

By Jody Boulay on Friday, July 5, 2024

It seems as all communities have been impacted by the problems associated with substance use and drug overdose. These problems extend into the family unit, with people becoming addicted and dying because of drugs. However, community drug education and prevention programs can be a first line of defense.

There is hope for the younger generations as they have more access to prevention and education resources to help them make informed decisions. In addition, more information is available for parents to equip them with the tools to help their kids understand the dangers and risks associated with drugs and alcohol.

Locally, Osceola County offers many addiction recovery resources, such as House of Freedom, Turning Point Counseling, and Park Place Behavioral Health in Kissimmee, as well as a substance abuse hotline in English (407-870-8282) and Spanish (407-240-1181).

Most importantly, amid the growing opioid epidemic, there is significant attention placed on preventing opioid overdose. In June, the Florida Department of Health in Osceola County hosted an event to help raise awareness about the dangers of overdosing called Revive Awareness Day, where free naloxone was available. (Residents can also find naloxone by calling the Osceola Department of Health at 407-343-2000.)

Drug education and prevention programs in Florida have made a significant impact, especially among youth. In addition to the long-term decline in alcohol and cigarette use, Florida students have also reported long-term reductions in the use of illicit drugs other than marijuana. However, while alcohol use is down, highrisk drinking behavior is still common.

Prevention and education information is valuable, especially during Fourth of July celebrations. Binge drinking around Independence Day is typical, and it is known as one of the heaviest drinking holidays of the year. In social settings, it becomes easy to consume too much alcohol.

Parents play an essential role when providing drug education. They can take the initiative to create an inclusive and supportive environment with their children. This can equip them with the tools they need to make knowledgeable decisions surrounding alcohol and drug use.

Teens and adults all use drugs and alcohol for different reasons—peer pressure, whether from peers, in a social setting, or in the case of someone they look up to who they see drinking or using drugs. Stress is also a common factor, and alcohol or drugs seem like an easy escape from the problems of life.

Additionally, environment and family history are contributing factors. Children who grow up in households with heavy drinking and recreational drug use are more likely to experiment with drugs.

Any parents wondering what to do should consider starting the conversation about alcohol and drug use early. It is also essential to be calm, loving, and supportive. Seek out specialized resources, such as those offered by county or non-profit organizations providing prevention and education. Parents want to focus on making it safe for their children to tell them anything and never end the conversation, keeping it going regardless of age.

Local drug education resources are here to help with the goal of helping people of all ages make knowledgeable decisions about drugs and alcohol.

Jody Boulay, a mother of two with a passion for helping others, works as a Community Outreach Coordinator for DRS to help spread awareness of the dangers of drugs and alcohol.

 

Source: https://www.aroundosceola.com/opinion/support-local-drug-education-and-prevention-programs

Teams from Boyle Street Community Services had been assigned to walk around the Stanley Milner Library, downtown malls and pedways and the LRT system. Their duties focused on responding to drug poisonings but they also helped educate business owners, pick up needles and refer people to services.

The city funded the first phase of the pilot, which began in the spring of 2022, then extended its funding in December 2023, but Jen Flaman, deputy city manager of community services, told city council in a May 27 memo that there were no administrative funds available to extend it further.

The memo said the city submitted a funding request to the provincial government but was unsuccessful and has applied to a Health Canada program but has not heard back.

The pilot cost $3.3 million, and included funding for a data analyst at Boyle Street.

Marliss Taylor, who is Boyle Street’s director of Streetworks and health services and oversaw the pilot, said it was a success.

She said the teams responded to more than 440 drug poisonings, distributed more than 20,000 naloxone kits, disposed of more than 7,000 sharp objects, and referred 2,500 people to detox or supervised consumption services.

“We absolutely were able to save some lives and I think that’s critically important,” Taylor said.

‘It never gets easier,’ says overdose prevention nurse, Tabatha Plesuk, a nurse based at the Stanley Milner Library in Edmonton. She said the teams also helped security guards and demonstrated friendly, respectful ways of interacting with vulnerable people in public places.

EMS responses to opioid-related events surged in Edmonton in recent years and a record 1,867 people died in Alberta because of opioid poisoning last year.

Though the rate of drug poisoning deaths in the province has slowed since 2023, Taylor said the number of overdoses in Edmonton is still high. According to the province’s substance use surveillance data, there were 148 drug poisoning deaths in the city between January and March of this year.

Taylor said she is worried about what could happen if the overdose prevention teams stop running.

“What we don’t want is for people to be injured or die of an unintentional drug overdose in spaces where people are not sure how to react,” she said.

In an emailed statement, Michelle Steele, a city spokesperson, said the teams were funded as a response to the worsening drug poisoning crisis in 2022 “with the recognition that the funding was not permanent.”

The city memo said funding ended on June 30 and the team’s services would be closing, but Taylor said the teams are still working for now.

She said Boyle Street is seeking other funding sources, with help from nearby businesses and organizations.

Madeleine Cummings

Madeleine Cummings is a reporter with CBC Edmonton. She covers local news for CBC Edmonton’s web, radio and TV platforms. You can reach her at madeleine.cummings@cbc.ca.

Source: https://www.cbc.ca/news/canada/edmonton/edmonton-stops-funding-drug-overdose-prevention-pilot-1.7254667

According to the World Health Organisation, substance abuse claims the lives of over 500,000 people annually, with a staggering 35 million people worldwide suffering from drug use disorders.

Perhaps the most heart breaking aspect of this crisis is its impact on the youth.

The United Nations Office on Drugs and Crime reports that approximately 5.6 per cent of the global population aged 15-64 has used drugs at least once in the past year, with the highest prevalence among those aged 18-25.

Today the impact of drug use manifests in the society in several ways including such violent crimes as kidnapping, assassination, armed robbery and insurgency.

One of the states where this is rampant is Katsina where wanton destruction of lives and herds, kidnapping, raping and invasion of communities by criminal elements is now almost the order of the day.

“We must get to the root of the problem, and the root of the problem is drug abuse by the teeming youths in the state. We know that these inhumane acts cannot be committed without the influence of drugs“, worried Gov. Dikko Radda said during a visit to NDLEA chairman, retired Brig-Gen Buba Marwa.

He has support from Ajentekebia Harry, Country Director of Logistics Nigeria, Continent Afrique, and NGO.

“Many of the criminal and terrorist activities you see today in Nigeria are drug induced. These drugs have the capacity to simulate unholy acts that can plunge the nation into chaos,” he said.

The consequences of substance abuse among youth are far-reaching, affecting academic performance, mental health, and future prospects.

According to the National Institute on Drug Abuse, U.S. teenagers who use drugs are at an increased risk of developing addiction later in life, as well as experiencing cognitive impairments and mental health issues

In the face of these staggering statistics, the role of good parenting emerges as a beacon of hope and a powerful catalyst for change. Numerous studies have demonstrated the protective influence of strong family bonds, open communication, and positive role modeling in preventing substance abuse among youth.

The Substance Abuse and Mental Health Services Administration, reports that children with involved parents are up to 50 per cent less likely to engage in substance abuse.

Furthermore, a study by the National Centre on Addiction and Substance Abuse found that teenagers who frequently have family dinners are 33 per cent less likely to use drugs, alcohol, or tobacco.

By fostering a nurturing environment, instilling resilience, and providing guidance, good parents can equip their children with the tools to navigate the challenges of life without resorting to substance abuse.

While the role of good parenting is undeniably crucial, addressing the pervasive issue of substance abuse requires a multifaceted approach that involves collaboration among families, communities, and policymakers.

By empowering families, strengthening community support systems, and implementing effective policies, we can forge a path towards a drug-free society – one where the next generation can thrive, unencumbered by the devastating consequences of substance abuse.

The Federal Government says it recognises the role of civil society organisations in combating drug abuse among young people.

Consequently, it is prepared to partner with Vanguard Against Drug Abuse (VGADA), to raise awareness against drug abuse.

It is also prepared to rehabilitate and provide skills for youths affected by substance abuse.

Ayodele Olawande, Minister of State for Youth Development, made the pledge in Abuja when he received Hope Omeiza, Executive Director of VGADA detox centre.

“There is also need to enlighten the parents, especially the mothers at the grassroots, so as to help educate children and youths on drug abuse and illicit trafficking,” he said.

He said that the ministry had been to 19 states and many local government areas to campaign against dangers of drugs, substance abuse and illicit trafficking.

“From our experience, we have two different types of young people today – the formal and the informal. The formal people know and are aware of the dangers of these drugs, but the informal are at the grassroots level.

“We are not engaging the informal people and that is why illicit drug use has been spreading widely to the towns, the villages, and to the grassroots. This is the reason you’ll see me in every community engaging with the stakeholders, the women especially.

“We believe that everything begins from the home; with the mothers talking to their children, it will help curtail the menace to the barest minimum,” he said.

Drawing example from Adamawa, the National Drug and Law Enforcement Agency (NDLEA) paints a grim picture of the drug situation in Nigeria, especially as it affects the youth population.

State Commander of NDLEA, Samson Agboalu, says it has arrested no fewer than 454 suspected illicit drug traffickers/peddlers from June 2023 till date.

Agboalu said the figure reflected a 9.38 per cent decrease from the 501 arrests made in the previous year. While those arrested decreased in Adamawa, drug seizures significantly rose, with a total of 4,732.128 kilogrammes of hard drugs confiscated.

”This is a 75 per cent increase from the 1,164.750 kg seized between June 2022 and June 2023.

“These seizures include a range of substances such as Cannabis Sativa, Methamphetamine (ice), Cocaine, Tramadol, Exol-5, Diazepam tablets, Codeine-based syrup, Rohypnol tablets, and Pentazocine injections.

The curve of conviction of drug offenders has witnessed an upward curve as prosecution efforts and forfeitures from June 2023 till date saw 148 individuals being convicted.

This is a major increase from 115 convictions recorded between June 2022 and June 2023.

“The highest sentences handed down were between10 and five years’ imprisonment, with the least six months.

“Monetary forfeiture recorded an increase, with the sum of N851, 153 forfeited to the Federal Government and deposited into the Treasury Single Account (TSA), compared to N729,480 in the previous year”, he said.

The NDLEA commander called for the adoption of preventive measures as a strategic approach in addressing drug abuse in the state.

While the civil society organisations and relevant government agencies battle drug abuse among youths, many stakeholder believe that winning the war would be a mirage without tackling it from the foundation of the society, the family.

On Feb. 12. NDLEA organised training on Drug Prevention Treatment and Care, DPTC, for spouses of state governors in Abuja.

The event offered the First Lady, Oluremi Tinubu to air her voice on what parents should do to stem drug abuse in the society.

“As mothers, we understand the profound impact that drug abuse can have on our children’s lives. Therefore, it is incumbent upon us to protect, nurture, and guide them towards a future free from the shackles of addiction’’, she said.

The First Lady’s position on the important role of parenting in curbing drug abuse among young people is re-echoed by a medical expert, Taiwo Malomo.

“As parents, especially as mothers, as a matter of urgency, we must rise up to tackle this menace“, says Malomo, a Principal Medical Office, ’’Surgical Emergency Department, University of Abuja Teaching Hospital, Gwagwalada.

Similarly, Dotun Ajiboye, a psycho-socialist, advises parents and guardians to consult a mental health professional immediately they noticed substance use in a child, to save them from drug addiction.

“It is very important for every parent and guardian to know the root cause of substance abuse in their children.

“Parents should give godly guide on how to avoid or live above these triggers,” Ajiboye said in a media report.

Source: https://businessday.ng/features/article/good-parenting-as-catalyst-for-drug-free-society/

 

Mary Brett – in memoriam

Mary Brett, Former biology teacher (30 years at Dr Challoner’s Grammar School for boys, Amersham, Buckinghamshire. UK), Trustee of CanSS (Cannabis Skunk Sense), Member of PandA (Centre for Policy Studies) and former Vice President of Eurad. With regret, it is noted that Mary has recently died, in 2024, after a long illness – her expert contribution to the field of drug prevention and education is to be celebrated, and remembered for the quality of her work throughout.

The paper reproduced here below  is but one example of Mary’s expert contributions to the field.

Executive Summary

Prevention is the policy of this Government but harm-reduction organisations are being consulted for information and evidence—the Advisory Council on Misuse of Drugs (ACMD), Drugscope and the John Moores University Liverpool.

Information on cannabis from these sources is out-of-date, misleading, inaccurate, has huge omissions and is sometimes wrong. It does not stand comparison with current scientific evidence.

Children do not want to take drugs. They want reliable information to be able to refuse them.

Tips on safer usage and “informed choice” have no place in the classroom.

Prevention works.

  1. Current information about drugs being given to this government comes mainly, if not entirely, from harm-reduction organisations. I find this astonishing. The policy of this Coalition Government is prevention.
  2. I had long suspected, and had it confirmed by BBC’s Mark Easton’s blog 20 January 2011, that “Existing members of the council (ACMD) are avowed “harm-reductionists”. Drugscope, a drugs information charity paid for entirely by the taxpayer, has always had a harm reduction policy. We find statements like, “prevention strategies are not able to prevent experimental use” and “harm minimisation reflects the reality that many young people use both legal and illegal substances”. And the John Moores University in Liverpool has been at the forefront of the harm reduction movement since the eighties. Pat O’Hare, President of the International Harm Reduction Association (IHRA), said: “As founder of the first IHRA conference, which took place in Liverpool in 1990, it gives me a great sense of pride to see it coming “home” after being held all over the world in the intervening 20 years”.
  3. FRANK is the official government website providing information to the public, especially children 11–15. I have learned that the information for the recently re-launched FRANK website came from The John Moores University. A member of the FRANK team, Dr Mark Prunty was involved in a commissioned report, “Summary of Health Harms of Drugs” published in August 2011.
  4. Harm reduction has its place in the treatment of addiction, eg reducing the dose till abstinence is attained. But no place in the classroom where well over 90% of children have no intention of ever taking drugs. Harm reduction can and does sometimes act as a green light.
  5. This government says it wants to stop young people from ever starting to use drugs, but that’s not the aim of harm reductionists. They assume children will take drugs anyway, so give them “tips” on taking them more safely, and offer them “informed choice”. And for some reason I have never understood, they always downplay the harmful effects of cannabis—information is vague, inadequate, misleading, out-of-date and sometimes completely wrong.
  6. Brains are not fully developed till the 20s, the risk-taking part developing before the inhibitory area. Children from seven upwards are simply incapable of making the right decision. They need to be protected, not abandoned to make critical life choices. Only 30–40% will ever try drugs—a world away from regular use. What other illegal activities do we invite them to choose—pilfering, graffiti-spraying? Harm reduction advocates are so wrong. Children don’t actually want to take drugs. They want sound, reliable and full information to help them refuse drugs from peer group users who are pressuring them. I know—they’ve told me. Harm reduction policies are tantamount to condoning drug use.
  7. Prevention works. The prevention campaign in USA 1979–1991 saw illicit drug users drop from 23 to 14 million. Cannabis and cocaine use halved. Over 70% abstained from cannabis use because of concern over physical and/or psychological harm (P.R.I.D.E. survey USA 1983). In Sweden, 2010 “last month use” of cannabis was 0.5% (ages15 to 64), European average—3.7%.
  8. Overall, drug use may have fallen in the last 10 years but the last BCS reported that there had been a 1% increase in the “last year” use of cannabis among 16 to 24 year olds in the UK. This amounts to around 55,000 people—no room for complacency.
  9. At a meeting of the FRANK team, Dr Mark Prunty, asked me to send my large scientific report on cannabis (“Cannabis—A general view of its harmful effects”, written for The Social Justice Policy Group, in 2006, fully endorsed by eminent scientists, and regularly updated), and all new research papers that I received. He also had the two books I have written (“Drug Prevention Education” and “Drugs—it’s just not worth it”1). I wasted my time. Why is there no scientific researcher on the FRANK team or at least temporarily co-opted?
  10. One of the John Moore’s staff members, Dr Russell Newcombe helped to pioneer the harm-reduction movement in Merseyside from the mid-1980s and was Senior Researcher for Lifeline Publications & Research (Manchester, 2005–10). Lifeline literature on drugs, used in some schools, is hugely harm reduction based. Several leaflets and DVDs on “How to inject” are freely advertised on the Internet and can be easily accessed, as are needles, by children. Children are scared of injecting—now they needn’t worry!
  11. The last paragraph in Lifeline’s Big Blue Book of Cannabis says, “If we look at our crystal ball at the world of tomorrow what can we expect to see? More medical uses for cannabis; stronger types of weed appearing on the streets; more laws; more fiendish ways of catching users and the same old hysterical reactions to people smoking a plant”—That says it all!
  12. My analysis of the cannabis information in the “Summary of Health Harms of Drugs” pages 31–33 follows:
  13. “No cases of fatal overdose have been reported”. Isn’t it the same with tobacco? “No confirmed cases of human death”. “Stoned” drivers kill themselves/others. Cancers recorded, especially head and neck at young age (Donald 1993, Zang 1999). Serotonin, “happiness” neurotransmitter depleted (Gobbi 2009) causing depression—can lead to suicides (Fugelstad (Sweden) 1995). Violence from psychosis or during withdrawal, murders documented in the press and coroners’ reports. Teenagers have had strokes and died after bingeing (Geller 2004).
  14. Strength: No figures are given for Tetrahydrocannabinol (THC) content. Skunk now averages 16.2% but can range up to 46% THC, old herbal 1–2%, Hash 5.9% (Home Office Report 2008). No warning that skunk occupies 80% of the UK market, hash 20%. FRANK says that skunk is 2–4 times stronger than old herbal cannabis—wrong! They mislead the public by comparing it with hash. The enlightened Dutch, who know about drugs, have now banned any skunk with a THC content over 15%, equating it with cocaine and heroin. The vast bulk of our young users are smoking what amounts to a class “A” drug!
  15. 50% of THC will remain in cells for a week, 10% for a month. The John Moores report makes no mention of its persistence. Numerous studies show the adverse effects of this on academic results (Grade D student four times more likely to use cannabis than one with A grades, USA 2002) and personality. Users become inflexible, can’t plan their days, can’t find words or solve problems, development stalls, they remain childish. At the same time they feel lonely, miserable and misunderstood (Lundqvist 1995).
  16. Psychosis: Not reported is that anyone (with/without family history) taking cannabis can develop psychosis if they take enough THC (Morrison, Robin Murray team 2009). D’Souza (2007) had also shown this. Cannabis increases dopamine (pleasure neurotransmitter) in the brain. Excess dopamine is found in brains of schizophrenics. The first paper linking psychosis and cannabis was published in 1845! The report says: “Health effects of increases in the potency of cannabis products are not clear”. Skunk users have been found to be seven times more likely to develop psychosis than hash users ( Di Forte, Murray’s team 2009).
  17. No mention of absence of Cannabidiol (CBD) (anti-psychotic) in skunk, so psychotic THC is not counteracted! Old herbal cannabis had equal amounts CBD and THC. (McGuire 2008 and 2009, Morgan (2010), Demirakca (2011) etc. Dependence risks and psychotic symptoms are blamed on bingeing—regular use is enough! It is suggested that psychotic or schizophrenic patients may be self-medicating negative symptoms—disproved in several papers (Degenhardt 2007, Van Os 2005).
  18. They say that likelihood of progressing to other drugs is more to do with personality, lifestyle and accessibility than a gateway effect. Swedish research (Hurd 2006, Ellgren 2007) on animals finds THC primes the brain for use of others, and Fergusson (2006 and 2008) in a 25 year NZ study from birth found cannabis to be the single most significant factor for progressing.
  19. It is claimed that there is “no conclusive evidence that cannabis causes lung cancer” We don’t have conclusive proof for cigarettes and lung cancer! “Evidence for the effects on the immune system is limited”—over 60 references in my report! No warning that people should not drive within 24 hours of consumption (Leirer 1991).
  20. Children born to cannabis-using mothers may have “mild developmental problems”. Fried has followed child development since 1987. He has found cognitive impairment, behaviour and attention problems, babies twice as likely to use the drug at adolescence. Goldschmidt (2002) found delinquent behaviour, Bluhm (2006) warned of an increased risk of neuroblastoma, a childhood cancer.
  21. Now several recent papers demonstrate structural brain damage eg Welch (September 2011) loss of volume in thalamus, Solowij 2011 smaller cerebellum white matter volume, Ashtari (2011) loss in hippocampus volume, (Yucel 2008, Rais 2008).
  22. I have cited only a few references, there are well over 600 in my report.
  23. At least one piece of information in FRANK’s magic mushroom (Psilocybe—Liberty Caps) section is not in the Moore’s report, so where did it come from? The extremely poisonous familiar red/white spotted fungus, the Fly Agaric, is included. This is serious—it should not be there. Its inclusion is even more alarming as the amount used (1–5g) and the fact that it should not be eaten raw are given—blatant harm reduction advice! A child could die!
  24. New posters from FRANK:

www.homeoffice.gov.uk/publications/alcohol-drugs/drugs/frank/coke-poster

www.homeoffice.gov.uk/publications/alcohol-drugs/drugs/frank/meow-poster

www.homeoffice.gov.uk/publications/alcohol-drugs/drugs/frank/skunk-poster

My pupils would have used words like: pathetic, patronising, trite, useless and positively encouraging drug use—and so would I.

  1. I repeat—children don’t want to take drugs. They want a sound education and good grades, free from hassle and the pressure to take drugs.
  2. Drugscope’s cannabis information updated 2011 is even less reliable than FRANK’s. They continue to deny that cannabis can cause physical addiction, say “There are suggestions that the drug can in rare cases trigger psychosis, a factor that led to the government in 2009 to reclassify cannabis” (Drugscope disagreed with the reclassification), state that the strength of skunk is 12–14% THC when in 2008 it averaged 16.2%, and completely ignore all the Swedish and New Zealand evidence for the “Gateway Theory”. Professor Murray’s 2009 papers are not mentioned, and in a reply to me, the writer of Drugscope’s literature, seemed to think it was the THC that caused cancers, not the smoke.
  3. In 2006, Professor David Nutt said that LSD and Ecstasy probably shouldn’t be class A. In May 2008 I attended an open meeting of the ACMD at which a presentation (by Pentag) on ecstasy was given—a meta-analysis commissioned by the ACMD. I was concerned about their conclusions so contacted the foremost ecstasy researcher in Britain, Professor Andrew Parrott of Swansea University.
  4. Incredibly Professor Parrott knew nothing about the proposed down-grading of ecstasy by the ACMD until I alerted him. He was leaving for Australia to Chair an International Conference on Ecstasy and sent me his numerous publications. I passed them to the ACMD. When he returned, having missed the evidence—gathering meeting in September, I alerted him to the open meeting in November. He had to send three e-mails before they answered and allowed his presentation to go ahead. He was given a mere 20 minutes.

In an open letter to the ACMD on November 13 he wrote:

  1. 29. I cannot believe that I have spent the past 14 years undertaking numerous scientific studies into Ecstasy/MDMA in humans, then for the ACMD to propose downgrading MDMA without a full and very detailed consideration of the extensive scientific evidence on its damaging effects. My research has been published in numerous top quality journals, and can be accessed via my Swansea University web-page.
  2. Professor Nutt, who was Chairing the ACMD meeting on November 25 2008 for the first time was severely criticized by Professor Parrott. He said that Nutt made numerous factual errors, eg that there were zero dangers from injection of MDMA. Parrott said it was probably safer to inject heroin. Nutt said that ecstasy was not addictive, involved no interpersonal violence, was not responsible for road deaths, did not cause liver cirrhosis or damage the heart. Scientific work demonstrates that users show compulsive and escalating use, midweek aggression, that driving under its influence is extremely dangerous, that it is hepatotoxic—liver transplants have been needed in young people under 30, and profound cardiovascular effects. Professor Nutt did not defend himself in our presence. Nor to my knowledge has he since!
  3. Answers from Anne Milton, Minister for Public Health given to Parliamentary Questions from Charles Walker MP, October 2011 include:
  4. The Medical Research Council (MRC), funded by The Department of Business, Innovation and Skills, is supporting Professor Glyn Lewis in his research on adolescence and psychosis and Professor Val Curran’s research into the vulnerability of people to the harmful effects of cannabis.
  5. Professor Lewis, widely quoted on the Web by Peter Reynolds (CLEAR—Cannabis Law Reform) said that, “there is no certainty of a causal relationship between cannabis use and psychosis”, and announced that the risk of psychosis from cannabis use is at worst 0.013% and perhaps as little as 0.0030%. Professor Curran is a member of Professor Nutt’s Independent Scientific Committee on Drugs (ISCD).
  6. I find it incredible that there is essential sound accurate up-to-date scientific information about the effects of cannabis available in scientific journals and publicised in the press and the public is not being made aware of it by FRANK, the official Government website. Why has FRANK not been taken to task?
  7. While the harm reduction lobby are being consulted, persisting with their own agendas, and the preventionists supporting the Government’s New Strategy not listened to, nothing will change.
  8. Prevention is better than cure. Prevention is what every parent wants for their children. Prevention is common sense and it works.
  9. Meanwhile, while we wait for common sense to prevail, some children will become psychotic, addicted, move on to other drugs, drop out of education or even die. And the parents I work with will be left picking up the pieces.

January 2012

Source: Home Affairs  or visit http://www.parliament.uk/business/committees/committees-a-z/commons-select/home-affairs-committee/publications/

By Grace Deng – Journalist, Washington State Standard –

Washington tribal leaders are looking at an overseas model to combat the rise in opioid use among teens.

It’s called the Icelandic Prevention Model, and it’s helped slash alcohol use among Icelandic 15- and 16-year-olds from 77% to 35% in 20 years.

“There’s no other model in the world that has that kind of turnaround in the community,” said Nick Lewis, councilmember of the Lummi Nation and chairman of the Northwest Portland Area Indian Health Board.

Washington has dubbed its effort the “Washington Tribal Prevention System” and the Health Care Authority, along with five tribes, will partner with Planet Youth, a non-profit bringing the Icelandic Prevention Model to other places.

The model involves re-thinking how to discourage drug use by placing responsibility on the community, rather than the individual. Instead of asking kids to “just say no,” the Icelandic Prevention Model calls on the adults in a child’s life to create an environment without drugs and alcohol, said Margrét Lilja Guðmundsdóttir, chief knowledge officer at Planet Youth.

“The child should never be responsible for the situation in the community,” Guðmundsdóttir said.

The Washington Tribal Prevention System officially kicked off its ten-year pilot program with the ceremonial signing of contracts on Feb. 14. The five tribal governments participating are Jamestown S’Klallam Tribe, Lummi Nation, Tulalip Tribes, Swinomish Indian Tribal Community and Colville Tribes.

In Washington, American Indian and Alaska Native residents have the highest rate of death from opioid overdoses, far outpacing other races and ethnicities, according to state Department of Health data. 

“Our stories might be different,” Lewis said. “But if they can turn things around, we can too.”

The first two years, the Health Care Authority officials said, are just administrative planning, which will cost $2 million to $3 million a year. Gov. Jay Inslee has called for $1 million for the project in his supplemental budget proposal this year, and the rest of the money would come from federal grants.

Whether lawmakers will provide the $1 million Inslee requested or some other amount for the program will become clearer in the days ahead as the Legislature irons out budget legislation.

When the program moves out of the planning phase – scheduled to happen in its third year – costs are expected to go up dramatically. But Aren Sparck, tribal affairs administrator for the Health Care Authority, said he’s optimistic about finding funding from both private and public entities because of how much interest there is in the model.

Sparck also said the program could be adopted by other tribes and communities. “I think this is going to be a test for the entire state,” he said.

What exactly is the Icelandic model?

In Iceland, youth, parents, schools, the government and other community members work in tandem to create an environment that discourages drug use.

For example, the country has free after-school activities funded by the government. Kids are bussed directly to those activities. Youth councils help shape what activities happen, so teens are actually interested. It’s about making drug-use prevention a lifestyle, said Loni Greninger, tribal vice chair at Jamestown.

Last year, Health Care Authority officials and several tribal delegations visited Iceland to see the model for themselves. Sparck said he was skeptical at first — but when he saw the model in person, “jaws were on the floor.” The way Iceland has managed to make its model just a part of daily life, Sparck said, is exactly what he wants to see in Washington.

“I was talking to some of the youth and asking them, ‘What’s it like to be in the world’s most successful prevention model? And they asked us, ‘What’s the Icelandic Prevention Model?’” Sparck said.

Sparck said one of the things he learned about was a large dance party that young people in Iceland helped plan. Students invited one of the well-known DJs in Europe and policed each other, ensuring there were no drugs and alcohol at the event.

“What we saw was empowering the youth to make their decisions together. So they own this, and they’re a part of it and invested in it,” Sparck said.

Putting trust in youth to help create an alcohol and drug-free environment is also a big part of the model, officials said.

“A child wants a healthy environment,” Lewis said. “A child wants to grow up and be healthy. You never hear a child say ‘I want to grow up and be a drug addict.’”

The tribal model

The Icelandic Prevention Model relies on cultural practices within Iceland. Planet Youth works with its partners to translate the model into their own cultures, Guðmundsdóttir said.

While this is the first time Planet Youth has worked with tribal governments, Guðmundsdóttir and tribal leaders said Iceland and Washington’s tribes share a lot of values in common — namely the belief that it takes a community to raise a child.

“You’re literally wrapping your arms around these kids in everything prevention and wellness,” Greninger said about Iceland’s model.

“That’s what we tribes aspire to do,” she said. “But when you are working with separate entities, we all have our own visions and missions and agendas, we’re all busy every single day. It’s hard to line up all of that.”

Planet Youth — and efforts to implement Iceland’s model in other places — are relatively new, and it took Iceland decades to get where it is now. But there’s already research suggesting Iceland’s model is transferable.

“It’s not a quick fix,” Guðmundsdóttir said. “It’s a never-ending story. You will always have new kids, new parents, new kinds of substances.”

“It’s not a one-year project. It’s a long-term way of thinking,” she added.

When Lummi Nation policymakers presented the Iceland Prevention Model to Lewis, he said he recognized it as just another name for what his tribe is already doing, but without the resources they need to implement it at the level Iceland has.

According to Lewis, it’s often difficult to get funding for tribal drug treatment practices because they aren’t always considered evidence-based — and it’s almost impossible to gather enough proof that a tribal practice works because tribal populations are so small.

The Icelandic Prevention Model, to Lewis, proves that what tribes have already been trying to do works when it’s fully resourced. He hopes using Iceland’s model will help raise the funding needed and remove the silos between different efforts in Washington.

“If we’re going to break this cycle, we need to go back to creating healthy environments and get back to the values that bring people together,” Lewis said.

Source: https://www.anacortesnow.com/news/health/5285-washington-tribes-look-to-iceland-for-help-getting-teens-off-drugs

MURRAY, Ky. — Around 200 people gathered Tuesday in Wrather Hall on the campus of Murray State University for a roundtable discussion about the drug epidemic locally and across the country.

The event was sponsored by the School of Nursing and Health Professions, and featured speakers from the law enforcement, legal, political, and healthcare communities

Jim Carroll is the former director of the White House Office of National Drug Control Policy — informally known as the U.S. Drug Czar — and said the three biggest factors in dealing with the drug epidemic locally and nationally is enforcement, treatment, and prevention.

“It’s the only way to really tackle this issue is one, reducing the availability of drugs in our community, recognizing that there are people who are suffering from addiction and that recovery is possible that if we can get them in to help, that they can recover,” Carroll said. “It’s important to do all three; it’s possible to reduce the number of fatalities.”

Carroll said the issue is getting worse, with the number of fentanyl deaths going up 50% in the last four years, up to around 115,000 from around 70,000 in 2019.

Uttam Dhillon is the former acting director of the Drug Enforcement Agency, and said that the reason the drug epidemic has become such a serious issue is because of the crisis at the southern border.

“The two biggest cartels are the Sinaloa cartel and the…CJNG, and they fight for territory and the ability to bring precursor chemicals in from China to make methamphetamine and fentanyl, and then transport those drugs into the United States,” Dhillon said. “The battle between the cartels is actually escalated and they are now actually using landmines in Mexico… so this is a brutal war in Mexico between the cartels.”

Dhillon said the reason the stakes are so high in Mexico is because the demand for illicit drugs in the United States is so large.

“Basically every state in the union has activity from the drug cartels in Mexico in them, and that’s really important to understand, because that’s why we are being flooded by drugs,” Dhillon said. “We never declared Mexico a narco state during the Trump Administration, but as I stand here today, I would say in my opinion, Mexico is a narco state.”

In terms of dealing with the nation’s drug epidemic, Dhillon said we first have to start by enforcing the law, which in part begins at the southern border.

Increased enforcement at the border, however, does not fully solve America’s drug epidemic. That is where the panel said local partners in prevention and recovery come in.

Kaitlyn Krolikowski is the director of administrative services at the Purchase District Health Department and said that prevention and treatment is about more than keeping people out of jail.

In January and February, there have been four overdoses in west Kentucky, according to the McCracken County coroner.

“Dead people don’t recover,” Krolikowski said. “We are here to help people recover and to help our community.  For our community to prosper, we need healthy community members and the way that we’re going to get that is by offering them treatment, saving lives, and giving them the resources that they need to be members of our community that we’re proud of.”

While many members of the audience were police officers, non-nursing students, and community leaders, the event was designed to help give clinicians more context about the world they will practice in after graduation.

Dina Byers is the dean of the School of Nursing and Health Professions at MSU, and said that its important to hear what is going on at the national, state, and local level when it comes to illicit drugs.

“It was important that they hear what’s going on,” Byers said. “And that was the purpose of this event was to provide a collaborative effort, a collaborative panel discussion around many topics today.”

If you or someone you know is struggling with addiction, you can call the police without fear of being arrested, or call your local health department to get resources that can help saves lives.

“We know that the ‘Just Say No’ campaign doesn’t work. It’s based in pure risks, and that doesn’t resonate with teens,” said developmental psychologist Bonnie Halpern-Felsher, PhD, a professor of pediatrics and founder and executive director of several substance use prevention and intervention curriculums at Stanford University. “There are real and perceived benefits to using drugs, as well as risks, such as coping with stress or liking the ‘high.’ If we only talk about the negatives, we lose our credibility.”

Partially because of the lessons learned from D.A.R.E., many communities are taking a different approach to addressing youth substance use. They’re also responding to very real changes in the drug landscape. Aside from vaping, adolescent use of illicit substances has dropped substantially over the past few decades, but more teens are overdosing than ever—largely because of contamination of the drug supply with fentanyl, as well as the availability of stronger substances (Most reported substance use among adolescents held steady in 2022, National Institute on Drug Abuse).

“The goal is to impress upon youth that far and away the healthiest choice is not to put these substances in your body, while at the same time acknowledging that some kids are still going to try them,” said Aaron Weiner, PhD, ABPP, a licensed clinical psychologist based in Lake Forest, Illinois, and immediate past-president of APA’s Division 50 (Society of Addiction Psychology). “If that’s the case, we want to help them avoid the worst consequences.”

While that approach, which incorporates principles of harm reduction, is not universally accepted, evidence is growing for its ability to protect youth from accidental overdoses and other consequences of substance use, including addiction, justice involvement, and problems at school. Psychologists have been a key part of the effort to create, test, and administer developmentally appropriate, evidence-based programs that approach prevention in a holistic, nonstigmatizing way.

“Drugs cannot be this taboo thing that young people can’t ask about anymore,” said Nina Christie, PhD, a postdoctoral research fellow in the Center on Alcohol, Substance Use, and Addictions at the University of New Mexico. “That’s just a recipe for young people dying, and we can’t continue to allow that.”

Changes in drug use

In 2022, about 1 in 3 high school seniors, 1 in 5 sophomores, and 1 in 10 eighth graders reported using an illicit substance in the past year, according to the National Institute on Drug Abuse’s (NIDA) annual survey (Monitoring the Future: National Survey Results on Drug Use, 1975–2022: Secondary School Students, NIDA, 2023 [PDF, 7.78MB]). Those numbers were down significantly from prepandemic levels and essentially at their lowest point in decades.

Substance use during adolescence is particularly dangerous because psychoactive substances, including nicotine, cannabis, and alcohol, can interfere with healthy brain development (Winters, K. C., & Arria, A., Prevention Research, Vol. 18, No. 2, 2011). Young people who use substances early and frequently also face a higher risk of developing a substance use disorder in adulthood (McCabe, S. E., et al., JAMA Network Open, Vol. 5, No. 4, 2022). Kids who avoid regular substance use are more likely to succeed in school and to avoid problems with the juvenile justice system (Public policy statement on prevention, American Society of Addiction Medicine, 2023).

“The longer we can get kids to go without using substances regularly, the better their chances of having an optimal life trajectory,” Weiner said.

The drugs young people are using—and the way they’re using them—have also changed, and psychologists say this needs to inform educational efforts around substance use. Alcohol and cocaine are less popular than they were in the 1990s; use of cannabis and hallucinogens, which are now more salient and easier to obtain, were higher than ever among young adults in 2021 (Marijuana and hallucinogen use among young adults reached all-time high in 2021, NIDA).

“Gen Z is drinking less alcohol than previous generations, but they seem to be increasingly interested in psychedelics and cannabis,” Christie said. “Those substances have kind of replaced alcohol as the cool thing to be doing.”

Young people are also seeing and sharing content about substance use on social media, with a rise in posts and influencers promoting vaping on TikTok and other platforms (Vassey, J., et al., Nicotine & Tobacco Research, 2023). Research suggests that adolescents and young adults who see tobacco or nicotine content on social media are more likely to later start using it (Donaldson, S. I., et al., JAMA Pediatrics, Vol. 176, No. 9, 2022).

A more holistic view

Concern for youth well-being is what drove the well-intentioned, but ultimately ineffective, “mad rush for abstinence,” as Robert Schwebel, PhD, calls it. Though that approach has been unsuccessful in many settings, a large number of communities still employ it, said Schwebel, a clinical psychologist who created the Seven Challenges Program for treating substance use in youth.

But increasingly, those working to prevent and treat youth substance use are taking a different approach—one that aligns with principles Schwebel helped popularize through Seven Challenges.

A key tenet of modern prevention and treatment programs is empowering youth to make their own decisions around substance use in a developmentally appropriate way. Adolescents are exploring their identities (including how they personally relate to drugs), learning how to weigh the consequences of their actions, and preparing for adulthood, which involves making choices about their future. The Seven Challenges Program, for example, uses supportive journaling exercises, combined with counseling, to help young people practice informed decision-making around substance use with those processes in mind.

“You can insist until you’re blue in the face, but that’s not going to make people abstinent. They ultimately have to make their own decisions,” Schwebel said.

Today’s prevention efforts also tend to be more holistic than their predecessors, accounting for the ways drug use relates to other addictive behaviors, such as gaming and gambling, or risky choices, such as fighting, drag racing, and having unprotected sex. Risk factors for substance use—which include trauma, adverse childhood experiences, parental history of substance misuse, and personality factors such as impulsivity and sensation seeking—overlap with many of those behaviors, so it often makes sense to address them collectively.

[Related: Psychologists are innovating to tackle substance use]

“We’ve become more sophisticated in understanding the biopsychosocial determinants of alcohol and drug use and moving beyond this idea that it’s a disease and the only solution is medication,” said James Murphy, PhD, a professor of psychology at the University of Memphis who studies addictive behaviors and how to intervene.

Modern prevention programs also acknowledge that young people use substances to serve a purpose—typically either social or emotional in nature—and if adults expect them not to use, they should help teens learn to fulfill those needs in a different way, Weiner said.

“Youth are generally using substances to gain friends, avoid losing them, or to cope with emotional problems that they’re having,” he said. “Effective prevention efforts need to offer healthy alternatives for achieving those goals.”

Just say “know”

At times, the tenets of harm reduction and substance use prevention seem inherently misaligned. Harm reduction, born out of a response to the AIDS crisis, prioritizes bodily autonomy and meeting people where they are without judgment. For some harm reductionists, actively encouraging teens against using drugs could violate the principle of respecting autonomy, Weiner said.

On the other hand, traditional prevention advocates may feel that teaching adolescents how to use fentanyl test strips or encouraging them not to use drugs alone undermines the idea that they can choose not to use substances. But Weiner says both approaches can be part of the solution.

“It doesn’t have to be either prevention or harm reduction, and we lose really important tools when we say it has to be one or the other,” he said.

In adults, harm reduction approaches save lives, prevent disease transmission, and help people connect with substance use treatment (Harm Reduction, NIDA, 2022). Early evidence shows similar interventions can help adolescents improve their knowledge and decision-making around drug use (Fischer, N. R., Substance Abuse Treatment, Prevention, and Policy, Vol. 17, 2022). Teens are enthusiastic about these programs, which experts often call “Just Say Know” to contrast them with the traditional “Just Say No” approach. In one pilot study, 94% of students said a “Just Say Know” program provided helpful information and 92% said it might influence their approach to substance use (Meredith, L. R., et al., The American Journal of Drug and Alcohol Abuse, Vol. 47, No. 1, 2021).

“Obviously, it’s the healthiest thing if we remove substance use from kids’ lives while their brains are developing. At the same time, my preference is that we do something that will have a positive impact on these kids’ health and behaviors,” said Nora Charles, PhD, an associate professor and head of the Youth Substance Use and Risky Behavior Lab at the University of Southern Mississippi. “If the way to do that is to encourage more sensible and careful engagement with illicit substances, that is still better than not addressing the problem.”

One thing not to do is to overly normalize drug use or to imply that it is widespread, Weiner said. Data show that it’s not accurate to say that most teens have used drugs in the past year or that drugs are “just a part of high school life.” In fact, students tend to overestimate how many of their peers use substances (Dumas, T. M., et al., Addictive Behaviors, Vol. 90, 2019Helms, S. W., et al., Developmental Psychology, Vol. 50, No. 12, 2014).

A way to incorporate both harm reduction and traditional prevention is to customize solutions to the needs of various communities. For example, in 2022, five Alabama high school students overdosed on a substance laced with fentanyl, suggesting that harm reduction strategies could save lives in that community. Other schools with less reported substance use might benefit more from a primary prevention-style program.

At Stanford, Halpern-Felsher’s Research and Education to Empower Adolescents and Young Adults to Choose Health (REACH) Lab has developed a series of free, evidence-based programs through community-based participatory research that can help populations with different needs. The REACH Lab offers activity-based prevention, intervention, and cessation programs for elementary, middle, and high school students, including curricula on alcohol, vaping, cannabis, fentanyl, and other drugs (Current Problems in Pediatric and Adolescent Health Care, Vol. 52, No. 6, 2022). They’re also working on custom curricula for high-risk groups, including sexual and gender minorities.

The REACH Lab programs, including the comprehensive Safety First curriculum, incorporate honest discussion about the risks and benefits of using substances. For example: Drugs are one way to cope with stress, but exercise, sleep, and eating well can also help. Because many young people care about the environment, one lesson explores how cannabis and tobacco production causes environmental harm.

The programs also dispel myths about how many adolescents are using substances and help them practice skills, such as how to decline an offer to use drugs in a way that resonates with them. They learn about the developing brain in a positive way—whereas teens were long told they can’t make good decisions, Safety First empowers them to choose to protect their brains and bodies by making healthy choices across the board.

“Teens can make good decisions,” Halpern-Felsher said. “The equation is just different because they care more about certain things—peers, relationships—compared to adults.”

Motivating young people

Because substance use and mental health are so intertwined, some programs can do prevention successfully with very little drug-focused content. In one of the PreVenture Program’s workshops for teens, only half a page in a 35-page workbook explicitly mentions substances.

“That’s what’s fascinating about the evidence base for PreVenture,” said clinical psychologist Patricia Conrod, PhD, a professor of psychiatry at the University of Montreal who developed the program. “You can have quite a dramatic effect on young people’s substance use without even talking about it.”

PreVenture offers a series of 90-minute workshops that apply cognitive behavioral insights upstream (addressing the root causes of a potential issue rather than waiting for symptoms to emerge) to help young people explore their personality traits and develop healthy coping strategies to achieve their long-term goals.

Adolescents high in impulsivity, hopelessness, thrill-seeking, or anxiety sensitivity face higher risks of mental health difficulties and substance use, so the personalized material helps them practice healthy coping based on their personality type. For example, the PreVenture workshop that targets anxiety sensitivity helps young people learn to challenge cognitive distortions that can cause stress, then ties that skill back to their own goals.

The intervention can be customized to the needs of a given community (in one trial, drag racing outstripped substance use as the most problematic thrill-seeking behavior). In several randomized controlled trials of PreVenture, adolescents who completed the program started using substances later than peers who did not receive the intervention and faced fewer alcohol-related harms (Newton, N. C., et al., JAMA Network Open, Vol. 5, No. 11, 2022). The program has also been shown to reduce the likelihood that adolescents will experiment with illicit substances, which relates to the current overdose crisis in North America, Conrod said (Archives of General Psychiatry, Vol. 67, No. 1, 2010).

“People shouldn’t shy away from a targeted approach like this,” Conrod said. “Young people report that having the words and skills to manage their traits is actually helpful, and the research shows that at behavioral level, it really does protect them.”

As young people leave secondary school and enter college or adult life, about 30% will binge drink, 8% will engage in heavy alcohol use, and 20% will use illicit drugs (Alcohol and Young Adults Ages 18 to 24, National Institute on Alcohol Abuse and Alcoholism, 2023SAMHSA announces national survey on drug use and health (NSDUH) results detailing mental illness and substance use levels in 2021). But young people are very unlikely to seek help, even if those activities cause them distress, Murphy said. For that reason, brief interventions that leverage motivational interviewing and can be delivered in a school, work, or medical setting can make a big difference.

In an intervention Murphy and his colleagues are testing, young adults complete a questionnaire about how often they drink or use drugs, how much money they spend on substances, and negative things that have happened as a result of those choices (getting into an argument or having a hangover, for example).

In an hour-long counseling session, they then have a nonjudgmental conversation about their substance use, where the counselor gently amplifies any statements the young person makes about negative outcomes or a desire to change their behavior. Participants also see charts that quantify how much money and time they spend on substances, including recovering from being intoxicated, and how that stacks up against other things they value, such as exercise, family time, and hobbies.

“For many young people, when they look at what they allocate to drinking and drug use, relative to these other things that they view as much more important, it’s often very motivating,” Murphy said.

A meta-analysis of brief alcohol interventions shows that they can reduce the average amount participants drink for at least 6 months (Mun, E.Y., et al., Prevention Science, Vol. 24, No. 8, 2023). Even a small reduction in alcohol use can be life-altering, Murphy said. The fourth or fifth drink on a night out, for example, could be the one that leads to negative consequences—so reducing intake to just three drinks may make a big difference for young people.

Conrod and her colleagues have also adapted the PreVenture Program for university students; they are currently testing its efficacy in a randomized trial across multiple institutions.

Christie is also focused on the young adult population. As a policy intern with Students for Sensible Drug Policy, she created a handbook of evidence-based policies that college campuses can use to reduce harm among students but still remain compliant with federal law. For example, the Drug Free Schools and Communities Act mandates that higher education institutions formally state that illegal drug use is not allowed on campus but does not bar universities from taking an educational or harm reduction-based approach if students violate that policy.

“One low-hanging fruit is for universities to implement a Good Samaritan policy, where students can call for help during a medical emergency and won’t get in trouble, even if illegal substance use is underway,” she said.

Ultimately, taking a step back to keep the larger goals in focus—as well as staying dedicated to prevention and intervention approaches backed by science—is what will help keep young people healthy and safe, Weiner said.

“What everyone can agree on is that we want kids to have the best life they can,” he said. “If we can start there, what tools do we have available to help?”

 

Posted 

Being a father is not easy; it takes sacrifice, which means playing an essential role in a child’s life by being there for them and loving them unconditionally.

Every father knows they need to provide abundant love and support. A father is always there for their children, offering guidance, support, and education. The greatest joy, of course, for any father is seeing their children thrive, do well in life, and be healthy.

Yet things happen in life, and kids and teens experiment with risks while testing their limits and boundaries, such as trying drugs or alcohol. Fathers have a responsibility to speak to their kids about drugs and alcohol and help them understand the risks and consequences.

Fortunately, drug education and prevention campaigns have proven relatively effective in Illinois, but more should be done. According to drug abuse statistics, Teenagers in Illinois are 4.29% more likely to have used drugs in the last month than the average American teen. Roughly 8.69% of the 12 to 17-year-olds surveyed reported using drugs in the previous month, with marijuana being the most widely used substance.

Illegal drugs today are more readily available than ever before. According to the DEA, drug traffickers have turned smartphones into a one-stop shop to market, sell, buy, and deliver deadly fake prescription pills and other drugs. Amid this ever-changing age of social media influence, kids, teens, and young adults are easily influenced.

Drug traffickers advertise on social media platforms like Instagram, Snapchat, TikTok, Twitter, YouTube, and Facebook. The posts are promptly posted and removed with code words and emojis used to market and sell illicit drugs. Unfortunately, digital media provides an increased opportunity for both marketing and social transmission of risk products and behaviors.

Fathers are responsible for protecting and preparing our children for the world. Drug education is essential. Take the time to speak to your kids about the dangers of illicit substances, how to avoid and manage peer pressure, and what to look for. Be prepared to share personal experiences and help them understand that some choices have consequences.

Along with bearing this responsibility, fathers must not neglect their well-being and mental health. Raising children can be a lot; there are many challenges along the way, and the pressure of being a good influence can get the best of us. We may second guess our choices and decisions and stress over the small things.

All of this makes it vital not to ignore our mental health; children, especially younger kids, mimic what they see. How we cope with frustration, anger, sadness, or isolation impacts our children in several ways.

Our actions have consequences. Children see how we handle every situation, and while no father is perfect, we must be conscious of the fact they are impressionable when they are young. They look up to us, mimic our actions, and see when we are doing well in life mentally.

The key for fathers caring for children is to take the time to care for themselves. However, if you are struggling, contact 988 Suicide and Crisis Lifeline. Taking care of your mental health is the same as taking care of your physical health; it is an integral part of your well-being and contributes to you being the best father you can be.

Nickolaus Hayes is a healthcare professional in the field of substance use and addiction recovery and is part of the editorial team at DRS. His primary focus is spreading awareness by educating individuals on the topics surrounding substance use.

Source: https://rochellenews-leader.com/stories/every-father-should-speak-to-their-kids-about-drugs-and-alcohol,57623

Teens who use cannabis have a significantly higher risk of developing a psychotic disorder compared to those who don’t, according to a study published in the journal Psychological Medicine Wednesday, the latest research linking the drug to mental health disorders among young adults.  Other research has linked the drug to mental health disorders in young adults.

KEY FACTS

Teens aged 12 to 19 who used cannabis had an 11 times higher risk of developing a psychotic disorder compared to teens not using cannabis, according to an analysis of health data for 11,000 teens and young adults aged 12 to 24.

The study did not find an association between cannabis use and psychotic disorders in people aged 20 to 33.
The data—pulled from the annual Canadian Community Health Survey from 2009 to 2012—looked into hospitalizations, emergency room visits and outpatient visits, and researchers followed up with the participants for additional visits to the doctor, the emergency room or other hospitalizations in the nine years after the survey.

Among the teens who visited the emergency room or were hospitalized for psychotic disorders, about 5 in 6 reported using cannabis previously, researchers said.

Teens who use cannabis might be at a higher risk of developing psychotic disorders because the drug disrupts the endocannabinoid system, which helps regulate bodily functions like sleep or mood, resulting in symptoms like hallucinations, according to the study.

Though there is a strong yet age-dependent association between cannabis use and psychotic disorders, researchers noted it’s hard to say whether there is a direct link, as it’s possible the teens were self-medicating with cannabis to treat symptoms of psychotic disorders before they were clinically diagnosed.

BIG NUMBER

29%. That’s the percentage of high school seniors in the U.S. who reported using cannabis over the previous year, according to the annual Monitoring the Future Survey in 2023, which reports drug and alcohol use among adolescent students.

KEY BACKGROUND

Other studies in recent years have linked psychotic disorders in young adults to cannabis. In a study published last year, researchers found young men who used cannabis have an increased risk of developing schizophrenia compared to young women. A year earlier, researchers found there was “considerable evidence” linking cannabis use and depression among adolescents. The study also suggested the link was caused by a disruption of the endocannabinoid system. In 2018, researchers called for additional drug prevention programs targeting cannabis use in teens, after data indicated cannabis use could result in increased anxiety.

TANGENT

Last week, the Justice Department moved to reclassify marijuana—listed as a Schedule I drug like heroin, LSD and ecstasy—as a Schedule III drug under the federal Controlled Substances Act. The designation, if approved, recognizes marijuana as having potential medical benefits, which could allow for future studies on the drug’s potential benefits. The proposal still requires approval from the Drug Enforcement Administration.

Source: https://www.forbes.com/sites/tylerroush/2024/05/22/teens-using-cannabis-are-at-higher-risk-of-psychosis-study-suggests/

May 18, 2024

First, the good news: According to the U.S. Centers for Disease Control and Prevention, the number of fatal overdoses in the U.S. decreased last year — down 3% from 2022.

Now, the not so great news: That’s still 107,500 people who died at the hands of a decades-long substance abuse epidemic; and those same CDC researchers say the last time there was such a decrease, the number of fatal overdoses increased dramatically in the following year.

Further, Brandon Marshall, a Brown University researcher who studies overdose trends, offered some less-than-comforting reasons for the decrease that have little to do with winning the fight against this monster.

Shifts in the drug supply and use habits (smoking or mixing with other drugs rather than injecting, for example) could be one reason for the change. Another is simply that the epidemic has killed so many people already there are fewer to die.

That doesn’t mean prevention and recovery support efforts are not vital. And it does not mean there is any less need to support the families of those who have lost loved ones to this plague.

The Journal of the American Medical Association — Psychiatry, reported earlier this month that more than 321,000 U.S. children lost a parent to fatal drug overdose from 2011 to 2021.

“These children need support,” and are at a higher risk of mental health and drug use disorders themselves, said Dr. Nora Volkow, director of the National Institute on Drug Abuse. “It’s not just a loss of a person. It’s also the implications that loss has for the family left behind.”

Meanwhile, the fact that so many experts are reluctant to be optimistic about a small decrease could mean they understand something continues to fuel this epidemic. Yes, there is as much supply as demanded. That is one part of the problem. But the other is understanding what drives so many into the arms of this beast. How do we provide people the economic, mental health and social hope and support to break cycles? How do we encourage them to embrace a bright future, rather than being unable to see past a bleak present they can hardly bear?

“My hope is 2023 is the beginning of a turning point,” said Dr. Daniel Ciccarone of the University of California, San Francisco.

Imagine the possibilities if we all took a comprehensive, informed, compassionate approach to actually making that happen.

Source:  https://www.journal-news.net/journal-news/imagine-the-possibilities/article_330d84dc-7bbb-557f-ab5d-2eff8bd12fc5.html

Revitalizing anti-corruption efforts

Supporting anti-corruption efforts in Hong Kong was a major focus during Ms. Waly’s mission. In a speech delivered at the 8th Symposium of the Independent Commission Against Corruption (ICAC) of Hong Kong on the occasion of the Commission’s 50th anniversary, Ms. Waly said that “In this era of uncertainty, as crises rage and threats simmer, we need to re-think and revitalize anti-corruption efforts,” adding that “corruption underpins many of the biggest challenges facing humanity today.”

In her remarks, Ms. Waly outlined four key priorities that UNODC considers essential to pave a new path for anti-corruption efforts, namely to 1) future-proof responses to corruption by leveraging the positive role of technology and unleashing the potential of youth; 2) unlock the full potential of international and regional anti-corruption frameworks, and to streamline cross border cooperation; 3) addressing gaps in capacities through partnerships; and 4) better understand corruption and its trends, through robust measurement, research, and analysis.

“Corruption is undermining everything we fight for, and empowering everything we fight against,” she said. “As we stand at this historic crossroads of challenges and opportunities, we need to seize every chance […] to innovate in the face of growing corruption challenges, together.”

On the sidelines of the Symposium, Ms. Waly signed a Memorandum of Understanding with ICAC Commissioner Woo Ying-ming to solidify their partnership and expand joint technical assistance to advance anti-corruption efforts in Asia.

Ms. Waly also met with the Chief Executive of Hong Kong, Mr. John KC Lee, to discuss the importance of coordinated regional action in the fight against organized crime.

Ms. Waly later visited the Hong Kong Jockey Club (HKJC) where she met its Executive Director of Racing and the Secretary General of the Asian Racing Federation (ARF).

Illegal betting in sports has become a global problem, helping to drive corruption and money-laundering in sports. By running the ARF and Anti-Illegal Betting and Related Financial Crime Council, HKJC is working to address issues like illegal betting and financial crimes that affect the integrity of sports and racing.

Ms. Waly invited the HKJC and ARF to support UNODC’s GlobE4Sport initiative, which will be launched this year. The initiative will create a global network which will support anti-corruption efforts in sport through the informal sharing of information between criminal justice authorities and sports organizations.

Ms. Waly also visited Hong Kong customs facilities, where she was briefed by Commissioner Louise Ho Pui-shan on the equipment and measures used by law enforcement to inspect cargo shipments and tackle trafficking in drugs and wildlife.

Supporting compassionate rehabilitation

With fewer than 20 per cent of people with drug use disorders in treatment globally, UNODC is committed to supporting non-stigmatizing and people-centred health and social services to people who use drugs, as reflected by Ms. Waly’s visit to the Association of Rehabilitation of Drug Abusers of Macau (ARTM).

ARTM is a civil society organization offering voluntary, evidence-based prevention, treatment and harm reduction services to affected communities in Macau, China. Civil society organizations (CSOs) play a vital role in tackling drug related issues, including by combating stigma and delivering essential services to affected communities.

During the visit, Ms. Waly met with people in rehabilitation for drug use and learned about the work of ARTM in providing new life skills, such as painting, baking and ceramics classes, as well as treatment for women and classes for children.

ARTM was itself founded by a former user of drugs, Augusto Nogueira, whose experience helps the organization provide compassionate and inclusive rehabilitation. Augusto says that his main struggle when he was using drugs was not being able to identify a solution for his problem.

“My addiction was stronger than my will to stop using,” he said.

After undergoing his own challenging rehabilitation process, Augusto had ideas on how to professionalize the existing prevention and treatment activities in Macau. With the goal of providing evidence-based, personalized approaches to drug treatment and rehabilitation services, he founded ARTM in 2000.

ARTM belongs to the Asia-Pacific Civil Society Working Group on Drugs, supported by UNODC. Convened by the Vienna NGO Committee on Drugs (VNGOC), the Working Group aims to strengthen civil society action on drug related matters and the implementation of joint international commitments in the Asia-Pacific region.

ARTM also works to bring the voices of civil society to the international stage, including by presenting civil society recommendations on how best to implement drug policies at the Commission on Narcotic Drugs.

During her visit, Ms. Waly acknowledged the call from grassroot civil society organizations like ARTM for greater investment in evidence-based prevention, including through the implementation of the CHAMPS initiative. Ms. Waly praised ARTM’s cooperation with UNODC, including by delivering a training workshop on UNODC’s family-based prevention programme, Strong Families.

Ms. Waly also met with the Secretary of Security of Macau to discuss how Macau’s experience can help inform regional responses in tackling organized crime, illegal online gambling, and drug trafficking.

Source: https://www.unodc.org/unodc/en/frontpage/2024/May/unodc-executive-director-highlights-anti-corruption–fight-against-organized-crime–and-drug-prevention-on-visit-to-hong-kong-and-macau–china.html

 

 

 

 

April 24, 2024

 

Introductory remarks (shown in italic) added by NDPA (UK) on 19 May 2024:

 

The presentation below is from notable Australian specialists in the field of drug prevention, submitted to the Australian Government. The essence of the presentation is that: “The Australian community deserve a clear picture of all persons whose Mental Health has come to the attention of the police, hospitals and the community.”

 

Although this presentation is addressed to the Australian Government,  Drug Free Australia strongly feel that this information should inform and guide governments worldwide.

 

<<<<<<<<<<<<<<<<<<<<<DFA>>>>>>>>>>>>>>>>>>>>>>

 

When cannabis genotoxicity effects are added to cannabis neurotoxicity effects the argument against the widespread use of cannabis for everything becomes very robust indeed.

 

The drug prevention taskforce outlines below our real concerns regarding the Stabbing rampage at Sydney.  It does appear that here in Australia our State and Federal Medical Department has been testing toxic factors using blood and not using the much better hair test.

 

Most of the cannabis (80-90%) is excreted within 5 days as hydroxylated and carboxylated metabolites. See attached (Chemistry and Toxicology of cannabis).

 

Because 90% of THC is gone in 80 minutes from blood. Please demand hair testing of the subject for marijuana use (blood test may not be positive due to rapid clearance).  This is very indicative of cannabis induced psychosis most of the cannabis (80-90%) is excreted within 5 days as hydroxylated and carboxylated metabolites . There are eighteen acidic metabolites as per Goulle JP, Saussereau E, Lacroix C. [Delta-9-tetrahydrocannabinol pharmacokinetics]. Ann Pharm Fr 2008; 66: 232-244. Studies attached.

 

Drug Free Australia is seeking to bring urgent attention to Australian whether Federal or State, regarding extremely important research relating to Mental Health and cannabis use.  It appears that Australian public policies have moved from concern for the health and wellbeing of society – by improving and promoting good health – to pushing unnecessary drug use for profiteers while charging the tab to society-at-large.  DFA believes that it is time for governments worldwide to promote research and media publicity which avoids the cherry-picked faux studies used by those wanting to legalise cannabis.  Rather, the focus should be on its serious harms to mental and physical health particularly related to early use.

 

TOP 15 RISKS OF MARIJUANA ON HEALTH   https://iasic1.org. The Drug Free Australian paper (MENTAL HEALTH AND CANNABIS USE) see attached.  (A Panel Study of the Effect of Cannabis Use on Mental Health, Depression and Suicide in the 50 States)see attached.

 

EXCLUSIVE: Regular cannabis use in people’s mid-20s can cause permanent damage to the brain development and legalizing the drug has WRONGLY presented it as harmless, drug safety expert Dr Nora Volkow, director of the National Institute on Drug Abuse, warned cannabis use among young adults was a ‘concern’. She called for ‘urgent’ research into the potential health risks of the drug. Several papers have suggested regular use could be damaging mental development and affecting users’ social life

But these often also include people regularly using alcohol and tobacco, making it difficult to deduce whether cannabis is behind the changes. About 48million Americans use cannabis annually, a number that is rising. https://www.dailymail.co.uk/health/article-11138001/Taking-cannabis-mid-20s-damages-cognitive-development-NIH-expert-warns.html

 

1.Prohibition has worked globally for more than 100 years since the UN Drug Conventions began. These have kept illicit drug use down to 5% use worldwide, whereas legalised tobacco and alcohol have much higher rates.

 

  1. Legalising and decriminalizing substances inevitably gives a green light for use (as we have seen with increased use of cannabis in parts of the United States where it has been made legal.

 

  1. Global illicit drug industries are responsible for an enormous amount of environmental destruction

(Illegal Marijuana growers poison forests-these people fight back) https://www.nationalgeographic.com/environment/article/illegal-marijuana-growing-threatens-california-national-forests (Green But Not Green: How Pot Farms Trash the Environment) http://www.slate.com/articles/news_and_politics/uc_breakthroughs_2014/2014/04/green_but_not_green_how_pot_farms_trash_the_environment.html

 

 

RECOMMENDATIONS THAT CAN HELP PREVENT THE AUSTRALIAN “LOST GENERATION DYING”

 

All Australian Governments and community leaders need to take this evidence regarding Mental Health very seriously.  The issue of cannabis-caused violence needs to be addressed. For example, the Australian Government must consider organising several Mental Health teams working 24/7 to evaluate the mental health and wellbeing of those involved in animal cruelty, road rage, spousal abuse and child fatalities. These teams should have the authority to place these individuals into detox and rehabilitation centres for three to twelve months according to their progress. They will also need to be constantly reminded that they are very important to the Australian community’s future.  Here in Queensland, we have one centre available. .and a third that could be built. They could be equipped at minimum cost and run with existing staff for this mental health program.

 

The Australian National Drug Strategy 2017-2026 identifies cannabis as a priority substance for action, noting 20% of Australian drug and alcohol treatment services are provided to people identifying cannabis as their principal drug of concern. DFA believes that the number is higher for those under 25 years of age.

 

Herschel Baker

International Liaison Director,

Queensland Director

Drug Free Australia

M: 0412988835 

Prevent. Don’t Promote Drug Use

drugfreeaust@drugfree.org.au

drugfree@org.au

Joy Butler

President

WCTU

http://www.dfk.com.au/index.html

 

Links to view the articles related to the above presentation:

First click on the link, then click on the image that appears

 

May 17, 2024
Rumpel Senior Legal Research Fellow
Paul is a Senior Legal Research Fellow in the Meese Center for Legal and Judicial Studies at The Heritage Foundation.

 SUMMARY

Novel Psychoactive Substances multiply the difficulties involved in protecting ourselves and our families, friends, and neighbors from falling victim to illicit drug use. Ingenious chemists have used the Internet to research the chemical structure of existing psychoactive substances and use their skills to escape a strict reading of the controlled substances schedules. The result is to make extraordinarily difficult our long-standing strategy of relying primarily on an aggressive, supply-side, law enforcement–focused approach to reducing the availability of dangerous drugs. We can—and should—pursue each worthwhile option to combat this even though we know that we cannot immunize society against the pernicious effects of all NPSs, change hearts bent on evil, or save everyone who succumbs to drug abuse.

KEY TAKEAWAYS

Novel Psychoactive Substances (NPSs) multiply the difficulties involved in protecting our-selves and our families, friends, and neighbors from illicit drug use.

NPSs like fentanyl and their illegitimate offspring like the nitazenes have brought an end to the era of drug experimentation.

We can—and should—pursue every worthwhile option to combat this scourge even though we know that we cannot save everyone who succumbs to drug abuse.

 

Source: https://www.heritage.org/crime-and-justice/report/twenty-first-century-illicit-drugs-and-their-discontents-the-challenges

 

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