Tobacco use at any age is unsafe, as it is the leading cause of preventable disease, disability, and death among adults in the U.S. Youth use of tobacco is especially dangerous because nearly all tobacco use begins during youth and young adulthood. It is therefore disturbing that the latest data from the National Youth Tobacco Survey finds that 1 in 9 middle and high school students currently use tobacco products—more than 3 million in total—and that e-cigarettes are the most popular product overall for the ninth year in a row. Among those reporting tobacco use, more than 18 percent suffered from severe psychological distress and 27 percent had low academic achievement. Although cigarette smoking among U.S. youths has been steadily declining during the past 2 decades, the introduction of e-cigarettes has led to a vaping epidemic among this age group, mainly due to the sale of flavored vaping products that target youth. In response to the youth vaping crisis, in 2020 the FDA declared a nationwide ban on many flavored e-cigarette products. But this only applies to specific types of devices, such as cartridges or pre-filled pods, allowing teens to access other devices including nicotine vapes with disposable pods sold under the brand Puff Bars. As such, more stringent bans have been enacted on the state level. Last week, for example, Californians overwhelmingly voted to uphold a law banning all flavored tobacco products in the state, making it the largest state so far to prohibit such products after Rhode Island, New Jersey, and Massachusetts. We need the FDA to show leadership in the fight against youth vaping, with a ban on all flavored devices, broader education programs, better oversight of marketing, and a crackdown on underage access to these products.
COLORADO SET TO APPROVE PSILOCYBIN LEGALIZATION DESPITE WARNINGS THE MOVE OUTPACES SCIENCE
Colorado has long been at the forefront of progressive drug policy reform, agreeing to legalize marijuana a decade ago while the city of Denver decriminalized psilocybin mushrooms in 2019. Now, an initiative on the midterm ballot to decriminalize psilocybin statewide and also allow the establishment of state-licensed “healing centers” that offer treatment appears to head for victory. Unlike the legal cannabis market, there won’t be dispensaries handing out psilocybin in Colorado. Rather, the state will certify “facilitators” who will administer the drug at "healing centers" or existing healthcare facilities. It’s not exactly clear how all of this will work, as Oregon is the only other state to have taken a similar step, and the regulated market is not yet operating. The yes vote comes amid a flurry of promising studies showing that psychedelics have the potential to help in the treatment of conditions such as depression, anxiety, PTSD, and even tobacco and drug addiction. However, opponents including the American Psychiatric Association argued that the measure was outpacing science, noting a lack of any approved therapies that use psychedelic mushrooms and scant scientific evidence that the proposition is good public policy. Much more research and clinical trials are needed to establish whether psychedelics are beneficial in a clinical setting, but once again legalization and decriminalization are moving too fast—and making these potentially dangerous drugs more widely available without safe regulations and oversight.
VOTERS APPROVE LEGAL WEED IN TWO MORE STATES, CALIFORNIA BANS FLAVORED VAPING AND COLORADO'S BALLOT MEASURE TO DECRIMINALIZE PSYCHEDELICS IS STILL TOO CLOSE TO CALL
In midterm elections, there was little policy debate over the addiction and overdose crisis that last year killed more than 108,000 Americans, but voters were asked to decide on a number of ballot measures concerning marijuana legalization, flavored tobacco and vaping products, and legalizing psychedelics. On marijuana legalization, voters in Maryland and Missouri said yes to decriminalization, while Arkansas, and North and South Dakota rejected ballot measures. The latest results were not unexpected, as the “no” states lean conservative while “yes” votes were favored in more liberal Maryland. Currently, 19 states plus the District of Columbia already allow adult-use pot, and 40 states have legalized medical cannabis. Now, the newly legal pot states must work out the details of a regulatory structure for the new market, including rules governing marketing, packaging, THC levels in powerful marijuana products, and local opt-out provisions to ban dispensaries. Only two states—Vermont and Connecticut—have implemented dosing caps on THC, the psychoactive component of marijuana, which is linked to psychotic episodes. Meanwhile, Californians overwhelmingly approved a sweeping ban on all flavored tobacco products, including vapes, which are targeted at young people and fueling a vaping epidemic in this age group. Although further legal action might delay implementation, along with pending federal rules by the FDA, this would make California the biggest state so far to ban flavored products, a move seen as a rebuke to the tobacco and vaping industries which lobbied heavily against it. And in Colorado, a ballot measure to legalize the possession of a variety of certain psychedelics is still too close to call. The city of Denver has already legalized magic mushrooms but this initiative would be statewide and also includes the creation of so-called psilocybin “healing centers" opposed by psychiatrists and other mental health professionals.
POLITICIANS USE MIDTERMS TO RALLY SUPPORT FOR STIFFER DRUG PENALTIES—NOT MORE FUNDING FOR DRUG TREATMENT
In tomorrow’s midterm elections, voters will decide on a number of drug-related initiatives, including marijuana legalization in 5 states and a slew of cannabis-related questions elsewhere concerning local control over allowing dispensaries. At the same time, the opioid epidemic—and in particular, the synthetic opioid fentanylthat is fueling record overdose deaths—is the focus of attention, mostly from Republican congressional candidates. However, even though fatalities are soaring, they’re not focusing on the addiction and overdose crises and expanding treatment options. Rather, they are highlighting the influx of fentanyl into the U.S., using it to bolster their argument about law enforcement, crime, and border security. They have pledged to stop traffickers from bringing the drug n the country (mainly from Mexico), impose stiffer penalties, and provide more funding for law enforcement while attacking Democrats for supporting drug decriminalization and softer penalties for nonviolent drug offenses. Some Democrats are in this camp as well, including Rep. Tim Ryan of Ohio, who is running for Senate and introduced a bill earlier this year classifying fentanyl as a “weapon of mass destruction.” While drug interdiction is critical to help stop the flow of the deadly opioid into the country, playing politics with addiction policy is misguided. We need a comprehensive approach to stopping the overdose epidemic, with more resources to expand a wide range of treatment options and make treatment accessible to all who want it.
MARIJUANA BALLOT MEASURES ON THE LOCAL LEVEL TEST THE STRENGTH OF THE LEGALIZATION MOVEMENT
Five states will vote in the upcoming midterms on initiatives to legalize recreational marijuana, but attention is also focused on a slew of local-level ballot measures in dozens of municipalities across the country that would either expand or restrict the availability of the drug. The number of measures that voters will decide on reflects the nation’s evolving attitudes toward marijuana, the Pew Trust points out, with a majority of Americans saying they favor legalization. Currently, 19 states plus the District of Columbia already allow adult-use pot, and 40 states have legalized medical cannabis. If the five new states—Arkansas, Maryland, Missouri, and the Dakotas—approve legalization, nearly half of all states will allow a marijuana industry. But it’s the ballot measures in other states that tell the story of the legalization movement and the continuing skepticism about moving in this direction. In Colorado, for example, a legal state, voters in the city of Colorado Springs will decide whether 100 medical cannabis dispensaries will be allowed to expand to selling recreational weed, in part to offset the city’s ban on recreational sales after it opted out of allowing retail sales within the city limits. In Rhode Island, which legalized pot earlier this year, communities will decide whether to ban local dispensaries, while in Michigan, they will be asked whether to overturn such a ban. The measures suggest that there is still wariness on the local level about legalizing marijuana and increasing access to it, and the dangers that it poses to vulnerable young people and communities, as well as increasing traffic accidents due to driving under the influence.
NEW STUDY DAMPENS INITIAL EXPECTATIONS ABOUT PSYCHEDELIC TREATMENTS FOR DEPRESSION
The ongoing hype about the benefit of using psychedelics such as psilocybin to treat mental health conditions like depression has been tested in a recent study—and found to be not as “dazzlingly powerful” as had been suggested in previous research. The new study shows that the drug was indeed effective to reduce or eliminate symptoms in the short term in more than one-third of patients with treatment-resistant depression, but this was not as long-lasting as seen in earlier trials. While the results warrant further research, doctors say they are also sobering, in that the overall response rate of 37 percent was lower than in previous trials and also in another trial comparing psilocybin with more commonly used SSRI antidepressant medications for major depressive disorder. In addition, most participants in the new trial also experienced adverse events, such as headaches and nausea, while 5 percent had severe adverse events, such as suicidal ideation and self-injury. One issue concerning the psilocybin trial as is the difficulty of finding a convincing placebo, and because it is given alongside intensive therapy, it’s hard to differentiate between the presence of the therapist and the psychedelic experience. Much more research is needed into psychedelics before they will be ready for mainstream clinical practice, and like all such drugs, they should not be considered a panacea.
PHARMACY CHAINS REACH TENTATIVE $10 BILLION DEAL TO SETTLE OPIOID LAWSUITS
Another settlement deal has been reached in long-running nationwide opioid litigation, with two of the nation’s largest pharmacy chains—CVS and Walgreens—agreeing to a $10 billion tentative deal to end thousands of lawsuits brought by states, municipal, and tribal governments. If the deals are finalized, they would represent payouts from an arm of the pharmaceutical industry that was most resistant to settling, as most of the major opioid manufacturers and drug distribution companies have already reached agreements on payouts for their contribution to the opioid crisis. The pharmacy retailers had chosen instead to test their defense in court, while also reaching separate settlements in West Virginia and New York. But recent court decisions have gone against claims they were not liable in any way for turning a blind eye to the diversion of prescription opioids and ignoring red flags that the drugs were fueling addiction and overdoses across the country. As part of the deal, each company will pay $5 billion over 10 years for CVS, and 15 years for Walgreens, while not admitting to any wrongdoing for an epidemic that has claimed more than 500,000 American lives over the past decade. (Walmart, which was also part of the longstanding claims against pharmacies, is said to have reached a $3.1 billion settlement). The money will go to governments for social services related to opioid addiction, including education and prevention programs, but not to individuals or families impacted by the epidemic. With billions of dollars now being made available from the lawsuits, states are starting to use the money in different ways: Rhode Island, for example, is funding supervised injection sites. But as the final settlements come into focus, we need a clear and comprehensive blueprint for using these resources in the most effective way.
GROWING USE OF MIND-ALTERING ANESTHETIC KETAMINE TO TREAT DEPRESSION DRAWS CONCERNS
A growing number of startup companies are getting into the business of prescribing ketamine, an FDA-approved mind-altering anesthetic drug, to patients for mental health conditions such as depression, suicidal thoughts, and PTSD, for which it is not authorized. Increasingly, psychiatrists are voicing concerns about the practice, saying that prescribing the drug off-label and sometimes at very high doses poses, for use at home, considerable risks. Ketamine should only be used in hospitals with medical supervision for its intended purpose—anesthesia. Some studies suggest that ketamine can alleviate some symptoms of depression when other treatments have failed, but there is little data on the drug’s effectiveness for anxiety and PTSD, and no evidence of the impact of its long-term use. The companies sell ketamine in tablets and lozenges online, making use of relaxed, pandemic-era rules on prescriptions, based on a questionnaire and virtual evaluation. But physicians warn that taking ketamine at home and without proper medical supervision increases the risks of patients falling and hurting themselves. The drug, which is also popular with party goers, can be addictive and increase the risk of complications including stroke or heart attack at higher doses. With growing interest in ketamine and other mind-altering substances such as psychedelics, it’s essential to closely monitor prescribing and use, as research has not yet established clear guidelines on dosages, side effects, and best practices.
THERE'S NO CONCLUSIVE EVIDENCE THAT MARIJUANA EASES PAIN
Pro-pot advocates routinely claim that marijuana is good for treating pain. Like so many other myths, this is not supported by scientific evidence. And a new study finds that marijuana might actually increase the pain people experience after surgery, as well as their consumption of opioids to cope with it. The study of some 35,000 patients undergoing elective surgery showed that those who used pot within 30 days after surgery experienced 14 percent more pain n the first 24 hours and consumed 7 percent more opioids. While some studies have shown that marijuana can help treat neuropathic pain—a type of chronic pain caused by damaged nerves—more research is needed to know whether it’s more effective than other options. Meanwhile, the International Association for the Study of Pain has said that there wasn’t enough high-quality research to endorse cannabis use for pain. This hasn’t stopped the cannabis industry from continually touting the drug’s purported pain-relieving properties, ever since California’s 1996 decision to legalize medical marijuana. Around 10 percent of consumers turn to pot products to ease pains—the fourth most-cited reason after relaxing, relieving stress, and improving sleep. Pain research is inherently difficult because of the subjectivity of pain, and medical experts caution that such claims are mostly anecdotal and highly individual, and influenced by marijuana marketing.
A NEW STUDY SHOWS MARIJUANA USE INCREASES A-FIB RISK
It has long been known that drugs such as methamphetamines, cocaine, and opiates can directly affect the heart and cause abnormal rhythms such as a-fib. A new study adds marijuana to this list, finding that the drug can increase the risk by 35 percent. This debunks the common perception that cannabis may be healthy because it’s natural, or that the drug is essentially benign for most users when it is not, and may, in fact, have adverse consequences that could substantially impact users' lives. A-fib reduces the quality of life and increases the risk of stroke, heart failure, kidney disease, and dementia. Although it does not prove that marijuana causes a-fib, it does provide strong evidence of correlation—enough so that the report urges users to consider cessation to see if it has a meaningful effect on arrhythmia. By comparison, meth increased a-fib risk by 86 percent, cocaine rose by 61 percent, and opiates, by 74 percent. The report concluded that these drugs can have dramatic effects on the link between the nervous system and the heart.
INVESTORS RUSH TO PATENT PSYCHEDELIC THERAPIES, JEOPARDIZING RESEARCH IN THE EVOLVING FIELD
Research into the possible benefits of using psychedelic-related therapy to treat depression, PTSD, and substance abuse, as well as other mental health conditions, is growing at a rapid pace. Not surprisingly, cash-rich investors are pouring into the field with great expectations, even though studies about the impact of psychedelics such as psilocybin, LSD, and Ecstasy are only in their early, but promising stages and the drugs are still illegal on the federal level (although that is changing as many cities and states consider legalization). Many of the corporate newcomers to psychedelics are vying for a financial edge through a blizzard of patent claims, the New York Times reports. One seeks a monopoly on nearly all methods of delivering the drug to patients, while another asserts that its treatment rooms were unique because they feature “muted” colors and cozy furniture. The claims have alarmed many scientists and patient advocates, who warn that a corporate takeover of the fledgling sector could make the new therapies prohibitively expensive, or fail to place enough emphasis on the psychotherapy component of treatment, which is critical. While it’s possible that hallucinogens could eventually revolutionize the treatment of many conditions, for-profit companies are moving much faster than the science. There have been a number of promising studies in the field, and the National Institutes of Health has begun funding research, but the money rush could take nascent psychedelic therapy into potentially troubling directions.
YOUNG NEW YORK CITY PROFESSIONALS ARE OVERDOSING ON FENTANYL-LACED COCAINE
High-achieving young professionals in New York City have long been attracted to using cocaine, but now the drug, brought to their homes by a DoorDash-type delivery service, is killing them. The Wall Street Journal looks at three of these young professionals—a lawyer, a Wall Street trader, and a social worker—who all died on the same day from an overdose after using cocaine laced with fentanyl, a powerful legal opioid prescribed for cancer patients and others with severe pain. More and more, traffickers mix it into drugs sold throughout the illicit market. The drug, up to 50 times more potent than heroin, is showing up in heroin and cocaine and pills stamped out to look like oxycodone or Adderall and other prescription medications, but which contain a lethal dose that is driving the surge in overdose fatalities nationwide. . Dealers cut it into cocaine to be more potent and addictive and to draw new users, who don’t suspect their stash is contaminated, or know that a tiny amount of fentanyl can kill unseasoned users. The professionals depicted in the article are just starting what would likely have been successful careers, but their casual cocaine use ends in tragedy. The drug costs around $200 and is delivered by couriers who service customers across Manhattan, according to phone texts. Of the nearly 1,000 cocaine-related deaths in New York in 2020, some 80 percent involved fentanyl, while the delivery service appears to operate relatively unhindered. While education and prevention campaigns are important to warn about the dangers of fentanyl-contaminated drugs, it’s time for law enforcement to crack down on such operations.
HOSPITALS REPORT DRAMATIC RISE IN MARIJUANA-RELATED PSYCHOSIS CASES
The corporate-backed marijuana industry has convinced most Americans that marijuana is essentially benign, using that myth to drive the legalization of recreational pot in 19 states and the District of Columbia. Five more states will vote on legalization in this year’s midterms, at a time when business interests including tobacco and food and drinks companies are investing in cannabis products and distribution and fueling sales in legal states. Yet even as the legalization movement continues to gain strength, there is a growing body of evidence that pot is anything but harmless. In a recent story in the New York Post, emergency room doctors in San Diego report a dramatic rise in cannabis-related cases every day, with the most common symptom being psychosis. Studies have routinely linked marijuana products with high levels of THC—the psychoactive ingredient of the drug—and now doctors say the number of patients experiencing psychosis is increasing, by up to 24 percent in one Colorado study, in the five years following the legalization of pot in the state a decade ago. This parallels the rise of high-potency pot with up to 90 percent THC in products such as edibles, compared to 25 percent in the strongest marijuana flower. Even a moderate dose of THC can cause psychotic symptoms in many individuals while prompting paranoia in others. As more and more states legalize the drug, we have to tell the truth about its potential risks and dangers and convince lawmakers to draft legislation that includes tough rules and regulations to safeguard public health.
BIDEN ANNOUNCES PLAN TO EXPAND ACCESS TO ADDICTION-FIGHTING MEDICATIONS TO PREGNANT WOMEN
The Biden administration has taken a decisive step to combat cases of opioid use disorder (OUD) and surging overdoses among pregnant women, unveiling a plan to significantly expand access to medications that reduce withdrawal cravings. The program will focus on making drugs such as buprenorphine and methadone more widely available, as a way to reduce dependency and save lives, at a time when overdoses nationwide are at a record high of more than 108,000 annually. While these drugs are not a cure-all for addiction, they can be part of medication-assisted treatment (MAT) that combines medications and behavioral therapy and has proven to be both safe and effective for many individuals. OUD among pregnant women has quadrupled in recent years and is associated with low birth weight, preterm labor, and miscarriage. Pregnant women are more likely to die of an overdose than the average woman of childbearing age. Yet pregnant women were 17 percent less likely to be accepted for opioid treatment than women who did not mention a pregnancy to a treatment provider, according to a recent study. Under the Biden plan, judges will be trained to incorporate opioid replacement drugs into sentencing for pregnant women, as part of a court-mandated treatment plan. Further, addiction experts will focus on improving access to medication in communities with the highest rate of addiction, such as American Indians and Alaska Natives. This is a bold and important step by the Biden administration to make addiction treatment more readily available to those who need it most and integrate such care into the criminal justice system.
YOU NO LONGER NEED TO SEE A DOCTOR TO GET MEDICAL POT IN WASHINGTON, D.C.
Until recently, residents of Washington, D.C. had to get a doctor’s recommendation and a medical marijuana card to legally purchase weed. Health conditions that would qualify for a card included cancer, glaucoma, Parkinson’s disease, and Alzheimer’s disease, as well as chronic intractable pain. Now, however, under new laws approved by the city council, adult residents, as well as tourists, can now “self-certify” their need for medical cannabiswithout ever seeing a doctor. As expected, pot sales surged in July after the first ruling, which bypasses any kind of medical exam and makes a mockery of the concept of “medical marijuana” because any adult can prescribe it. The government says the goal is to create a more patient-centric medical marijuana program and draw more patients into the legal marketplace as well as “protect patients”—although it’s not clear how they will be protected if they can self-diagnose such serious medical conditions. Medical marijuana is now legal in 37 states, having been adopted much earlier than recreational cannabis on the premise that it provides certain medical benefits, although evidence of this is more anecdotal than scientific. However, with more and more states legalizing recreational pot—now legal in 19 states and the District—the line between recreational and medical is fast disappearing, as it becomes clear that medical weed was the wedge to drive more radical cannabis reform. Why even call it medical pot if there's no real connection to medicine? With this in mind, we need stronger laws and regulations to control the commercialization of both recreational and medical cannabis and safeguard public health.
FIVE MORE STATES TO VOTE ON RECREATIONAL MARIJUANA LEGALIZATION IN MIDTERMS
It was only a decade ago when recreational marijuana was illegal nationwide. But after cannabis advocates won the approval of legalizing recreational cannabis in Colorado and Washington, the movement has grown into a sprawling, multi-billion dollar industry backed by corporate interests and focused on increasing sales rather than ensuring public safety. Today, recreational cannabis is now legal in 19 states, two territories, and Washington, D.C., while medical marijuana is legal in 37 states, three territories, and the District. In the upcoming midterm elections, voters in five, mostly conservative states—including Arkansas, and North and South Dakota—will face ballot initiatives to legalize recreational pot, and if approved, would make the drug legal in nearly half of all states. This has taken place amid rapidly shifting attitudes about marijuana: two-thirds of Americans say they want recreational pot legalized in their state as well as on the federal level, where it remains an illegal Schedule 1 drug, similar to heroin. On a local level, however, Americans are wary about allowing pot stores in their neighborhoods. Even in pro-pot states such as Oregon and Colorado, a majority of municipalities have opted out of allowing dispensaries due to concerns about its impact on vulnerable young people and driving while under the influence (a recent Gallup poll found that young Americans are smoking cannabis at the highest rate ever). As voters go to the polls, they should carefully consider the implications of legalizing marijuana, as well as the details in initiatives when it comes to commercialization and safeguarding public health.
DOCTORS FIND TELEHEALTH A VIABLE TREATMENT OPTION FOR ADDICTION
Pandemic lockdowns significantly disrupted access to drug treatment for many struggling with substance abuse, exacerbating the already low levels of access and underuse of effective medication for opioid use disorder. In response, government agencies eased restrictions on security, licensing, prescribing, and reimbursement to allow for greater access via telehealth. For example, practitioners were no longer required to conduct an in-person examination to prescribe withdrawal medications; many insurers picked up payment costs, and location restrictions were lifted in many rural areas. These measures improved access to OUD medications and services, as more and more physicians began to take advantage of telehealth to treat addiction. A new survey of about 1,000 doctors finds that loosening telehealth regulations had a positive impact, with a majority saying it was more effective than expected and a viable treatment option. An overwhelming majority also favor making the changes permanent, as telehealth helps patients who have a prohibitive commute to a medical facility, high childcare arrangement costs, or inflexible employment, all of which may lead to medication delays that resulting debilitating withdrawal symptoms. These findings are critical at a time when overdose fatalities are soaring, and up to 90 percent of individuals with an OUD do not receive treatment of any kind, and of those who do about two-thirds do not receive safe and effective medications. Telehealth is not a panacea for addiction but can contribute to expanding access to treatment for many people.
COLORADO VOTERS TO DECIDE WHETHER TO MAKE PSYCHEDELICS MORE WIDELY AVAILABLE
A decade ago, Colorado passed the nation’s first marijuana legalization measure, ushering in a new and untested market for adult-use cannabis products. Now, voters in the upcoming midterms will decide whether the state will decriminalize and allow easier access to psychedelics—in particular, psilocybin and psilocin, the hallucinogenic compounds found in certain strains of mushrooms. These powerful substances would not be sold in retail dispensaries, as is the case with pot, but rather be made available to anyone over 21 in state-sponsored and regulated settings, and supervised by a trained facilitator. Personal use would be decriminalized, allowing anyone to grow, share, and gift these substances but not be allowed to sell them directly. The vote comes amid growing interest in psychedelics to potentially treat mental health conditions such as depression, anxiety, PTSD, and even drug addiction. In fact, supporters argue that decriminalization and establishing state-run treatment facilities would expand opportunities for addressing those with mental health disorders. Yet asking voters to decide on such a critical issue that impacts public health is risky. Although recent studies suggest that psilocybin and similar substances might be effective in clinical settings, the FDA has not approved their use. Moreover, the American Psychiatric Association says there is “currently inadequate scientific evidence for endorsing the use of psychedelics to treat any psychiatric disorder” outside of approved studies. Critics also say that the bill, if approved, would make it easier for young people to access psychedelics and consume them in a non-supervised setting, rather than as part of what's known as psychedelic-assisted therapy. Psychedelics certainly have the potential to be beneficial to patients but require much more study and clinical trials—as well as regulation and guidelines for use—so that voters genuinely know what the repercussions might be.
HOW YOUR LOCAL PHARMACY CHAIN CONTRIBUTED TO THE OPIOID EPIDEMIC
The opioid epidemic and subsequent litigation have focused largely on manufacturers such as Purdue Pharma and wholesalers like McKesson that enabled the flow of highly addictive prescription painkillers that have killed hundreds of thousands of Americans. Yet giant retail pharmacy chains CVS, Walgreens, and Walmart were also involved—and to a greater extent than was previously known, according to a review of litigation documents and trial testimony by STAT News. The documents, from cases against the pharmacy chains, show they were eager to keep filling opioid prescriptions and reaping the profits rather than ensure the health of their customers. They had weak and disorganized prescription control systems and executives often resisted improved monitoring. In one case, two CVS locations in Orlando, Flordia, knowingly filled dozens of prescriptions from a doctor whose license had been revoked amid allegations of illegal prescribing. This all took place amid an accelerating drug crisis in which opioids—mostly prescription painkillers like OxyContin, dispensed by the pharmacies—played a big part, as such drugs eventually led to thousands of cases of addiction and overdoses. Many of the documents revealed glaring gaps in the ability of pharmacies to track the powerful drugs changing hands at their counters. And even if a local pharmacy tried to alert higher-ups about the need for more scrutiny, and more controls on suspect physicians, they were routinely rebuffed. The documents also showed the inability of pharmacies to stem suspicious or fraudulent prescriptions. Like the manufacturers and distributors, pharmacies have also recently settled many of the lawsuits: CVS, for instance, agreed to pay $567 million and Walmart $650 million, although legal battles continue as the chains fight the allegations. The settlement money will go toward education, prevention, and treatment programs for those struggling with substance use, but the litigation is a reminder of the greed that fueled the opioid epidemic that the nation is still grappling with.
DON'T CONFUSE POT DECRIMINALIZATION WITH ITS POTENTIAL DANGERS
Reactions to President Biden’s surprise pot pardon last week for people convicted of simple marijuana possession as a federal crime continue to roll in, with some analysts arguing that it might help the Democrats in upcoming midterms while others noting that there are, in fact, are no prisoners currently in federal prisons for pot crimes. In the Washington Post, health columnist Dr. Leana S. Wren takes up an equally important topic: while decriminalization is long overdue as part of criminal justice reform, and misplaced drug policies, it should not be regarded as a signal that marijuana is safe for everyone or that recreational use—especially among youths—should be normalized. She deconstructs the dominant narrative about marijuana—that it s essentially harmless—detailing its genuine dangers, from addiction (cannabis use disorder) to its impact on cognitive ability, memory, motivation, and learning, as well as much research linking it to schizophrenia, depression, anxiety, and psychosis in some people. In the column, she quotes Nora Volkow, director of the National Institute on Drug Abuse, as saying that marijuana is not a benign drug," especially for children and adolescents. Volkow says that if legalization goes ahead, we should also be thinking about a public health structure to provide treatment for people who have harmful patterns of marijuana consumption. Dr. Wren concludes by noting that none of these observations, as well as a growing body of evidence debunking the myth of harmless pot, contradict Biden’s pardon or efforts to decriminalize the drug. Along with criminal justice reform, we need more robust education and prevention programs and more robust regulatory control to protect vulnerable young people.