The Daily Briefing 9.29.2020
The Daily Briefing 9.25.2020
The movement to legalize marijuana in the United States had high hopes as the year began, as efforts progressed in state legislatures and on the ground to collect signatures for ballot initiatives. But the COVID-19 pandemic and social distancing regulations helped slow the momentum. Still, a number of states—including Arizona, New Jersey and Montana—will have cannabis policy votes on Election Day this November. Voters in those states will decide on adult-use marijuana, while in South Dakota the issue is medical marijuana. And in Vermont, the legislature is nearing a final vote on legalization.
Pro-pot forces continue to tout surveys showing broad public support for legalization, but the 2020 Rosenthal Cannabis Study found that a growing number of Americans are increasingly concerned about the risks and dangers of easier access to pot—and even support a moratorium on further legalization.
Meanwhile, in New Zealand, a similar debate is taking place over a referendum to legalize marijuana—which, if passed, would make the country the third after Canada and Uruguay to legalize cannabis. Supporters there say it would end the black market for pot and curb convictions, which are disproportionally higher among marginalized Maori communities; critics argue that will encourage marijuana use.
And finally, overdose deaths related to substance abuse have spiked in Maryland, the latest state to report a rise in fatalities linked to the COVID-19 pandemic. Overdoses related to methamphetamines more than doubled in the first half of 2020 compared to the same period last year, while opioid deaths climbed 9.4 percent, and fentanyl was involved with more than 90 percent of the cases.
The Daily Briefing 9.24.2020
As more and more women consume marijuana during pregnancy, a new study adds to a growing body of evidence that such behavior can be detrimental to child development. A new study published in JAMA Psychiatry finds that pot use during pregnancy is linked to psychotic-like behaviors, anxiety, depression and more attention, social and sleep problems, as well as weaker cognitive abilities.
The comprehensive study, with nearly 12,000 participants, was the largest long-term study of brain development and child health in the United States. And it comes as cannabis use among pregnant women ages 12 to 44 more than doubled between 2002 and 20017. THC—the psychoactive component of marijuana—enters the fetal brain through the mother’s bloodstream, and once there can impact the baby’s brain development.
Prior studies have shown that consuming marijuana during pregnancy is associated with low birth weight, impulsivity and other behavioral issues in children, according to the CDC. With more states considering legalizing marijuana, we need strong regulations and safeguards—as well as education programs—to curb pot use while pregnant.
And finally, the FDA is upgrading warning labels for a class of psychoactive drugs known as benzodiazepines—often prescribed for anxiety, insomnia and panic disorders—saying they are widely misused and can be addictive and cause withdrawal reactions. The drugs are often prescribed for long periods of time and are often misused with other substances such as alcohol or prescription opiods. In 2019, an estimated 92 million benzodiazepine prescriptions were dispensed in the U.S., with more than half of patients taking them for two months or longer.
The Daily Briefing 9.23.2020
Opioid trafficking on the so-called “dark web” has long been a source of illicit drugs fueling the opioid epidemic. But a recent raid by the Justice Department has hopefully put a dent in such operations. In a global crackdown, law enforcement officials arrested 179 people in the U.S. and Europe, and seized more than $6.5 million in cash and 500 kilograms of drugs—including heroin and other opioids, cocaine and the powerful synthetic opioid fentanyl, which has caused a spike in overdose fatalities in the United States. The dark web is part of the Internet within an encrypted network and accessible only through specialized tools, making it difficult to stop the illegal drug trade that has flourished online.
Meanwhile, as Florida begins the sale of marijuana edibles, the state’s Poison Information Center has warned parents about an increase in fake marijuana edibles and candies that have sent many children to the hospital. The center said the number of poisoning cases tripled in 2019, as it is difficult to tell the difference between fake pot products and the real thing—all the more reason for every state to establish strict rules and regulations on the sale of marijuana products if the drug is legalized.
The Daily Briefing 9.22.2020
One of the biggest benefits of the Affordable Care Act and its Medicaid expansion provision has been increased access to addiction treatment, as the measure requires insurance companies to cover substance abuse services—but this would be eliminated if the Supreme Court, backed by the Trump administration, strikes down the law. The New York Times points out that roughly 800,000 Americans with opioid addiction became eligible for treatment through the ACA, at a time when the opioid epidemic was spreading to all corners of the country.
Also in jeopardy if the ACA is overturned would be state spending on addiction medications covered by Medicaid, which more than doubled from 2013 to 2017 and are an essential component of treatment for many individuals. Overall, eliminating the ACA would be a severe blow to addiction treatment and to treatment providers just as the drug overdose rate has climbed back to record levels.
Meanwhile, a new study shows that people with substance use disorder—especially involving opioids—are at a significantly higher risk for contracting COVID-19 and are more likely to develop a serious case of the virus and die. Both social and biological factors play into the risk: opioids depress the respiratory system, and users are more likely to contract the virus while seeking drugs or if they are homeless or in jail or prison.
And finally, two years after Canada legalized weed, the Canadian Automobile Association is launching a public service ad campaign warning young people against driving while high. This follows revelations in a recent survey that 20 percent of Canadians aged 18-24 get behind the wheel after using marijuana. The ads will focus on cannabis edibles, which can stay in your system for up to 12 hours.
The Daily Briefing 9.21.2020
The growing regulatory backlash against vaping and rising public health concerns about e-cigarettes are not deterring one of China’s biggest companies in the sector, Relx, from trying to enter the U.S market. Relx, which controls an estimated 70 percent of the Chinese market, is seeking FDA approval to sell its products at a time when vaping is coming under closer scrutiny amid a teen nicotine epidemic, and its links to respiratory illnesses and deaths as well as COVID-19.
Meanwhile, a coalition of pro-marijuana advocacy groups has unveiled a plan to legalize interstate cannabis commerce, which is currently banned under federal law. The group is pushing governors of legal and soon-to-be-legal states to set up such an arrangement—which must be sanctioned by Congress—saying that increased commerce would create jobs and help revitalize the pandemic-hit economy. As more and more states look to cannabis reform for an badly needed economic boost, we urge states to closely consider the extra costs of marijuana legalization and its negative impact on public health.
And finally, the New York Times publishes a story about how a mother with a family history of addiction successfully kept her daughter off opioid painkillers following surgery. Her fears were well founded, as 5 percent of patients age 13 to 21 reported “persistent” post-surgery opiate use, according to a 2018 study.
The Daily Briefing 9.18.2020
The number of high school student regularly using e-cigarettes dropped significantly over the past year after several years of soaring use—the result of public health warnings about e-cigarette risks and vaping-related illnesses, and a ban on sales of flavored products popular with young people.
Yet the data also reveals a disturbing trend: sales of disposable flavored vapes soared more than 1,000 percent to 26.5 percent of high school students, compared to 2.4 percent a year earlier, as teens rushed to buy this type of mint fruit and mint-flavored e-cigarette. The overall decline in teen vaping is encouraging news, but the FDA decision to exclude disposable products is a missed opportunity that the agency must address.
Meanwhile, House Democrats have delayed voting on a measure to decriminalize marijuana at the federal level—the first bill of its kind to reach the House—after criticism from moderates who want the caucus to focus on corona virus relief. Nearly 70 percent of Americans favor legalizing marijuana, but the 2020 Rosenthal Cannabis Study found growing concerns about the risks and dangers of legal weed as well as support for a moratorium on further legalization until further research can be done.
And finally, a new study looking at the impact or warning labels on cannabis packages in the U.S. and Canada shows they do communicate risks to consumers—more so for impaired driving than psychotic episodes, which were considered less believable. Overall, warning labels on cannabis products can educate consumers about impact and potential harm, the report concluded.
The Daily Briefing 9.17.2020
Marijuana messaging is getting caught up in election year politics as Democrats and Republicans fight over cannabis and criminal justice reform and pandemic relief. Republicans falsely claim the Democrats are prioritizing a bill to remove federal penalties for marijuana and expunge arrest records over a corona virus aid package, and that in turn has led to other allegations that moderate Democrats back efforts to “defund the police,” which they don’t.
Lost in the back and forth is any serious discussion about the risks of marijuana legalization, and how to strike a balance between decriminalization, wider access to the drug, and criminal justice reform. The Biden/Harris ticket favors decriminalization and letting states decide on legalizing recreational cannabis, while the Trump team has not yet announced any clear policies.
Meanwhile, the New York Times is touting the purported benefits of marijuana and CBD, the non-psychoactive component of pot, in products backed by the design diva Martha Stewart. In the article, Stewart praises both marijuana and her CBD drops as a “societal good”—without providing any scientific evidence or warnings to consumers about the potential dangers of these largely unregulated products.
And finally, Playboy is launching its own line of CBD products “to enhance intimacy and boost sexual wellness”—without any evidence they do any such thing. As the market for marijuana and CBD expands—along with increasingly outlandish claims about efficacy—it’s time for the FDA and other authorities to more actively oversee and regulate these products to protect public health.
The Daily Briefing 9.16.2020
Efforts to reduce vaping among teens have reduced e-cigarette use, but the latest data on college-age adults points in another direction: vaping marijuana and nicotine among this age group rose sharply in the last three years. The percentage of college students who vaped marijuana nearly tripled to 14 percent, while the percentage who vaped nicotine jumped from 6 percent in 2017 to 22 percent in 2019, according to a study by the National Institutes of Health.
The report also revealed a high prevalence of marijuana use among college-age adults, while cigarette smoking and opioid misuse continued a downward trend. Recently, a report found that vaping among middle school and high school students fell dramatically in 2020 from a previous record high.
Meanwhile, Democratic vice presidential candidate Kamala Harris has defended her party’s platform on cannabis reform—which calls for decriminalization of marijuana, but not nationwide legalization—saying it is not simply “half-step incrementalism.” Speaking at a town hall meeting, Harris said the reforms—including expunging pot convictions—would help end disparities in the justice system for white people and people of color. The Biden/Harris policy on pot has come under fire from progressives who support full legalization of the drug.
And finally, police in Pasadena, California are investigating a spate of seven drug overdoses over a 24-hour period in which 3 individuals died, to see if they are related to the same drug. Opioid-related overdoses are relatively uncommon in the city, while fatalities are spiking across the country.
The Daily Briefing 9.15.2020
After a long legal battle, New York State has won court permission to collect $200 million from the makers of opioid painkillers to pay for costs related to the opioid epidemic. The ruling, by a federal appeals court, ends a dispute between the state and pharmaceutical firms seeking to block a law allowing the state to collect the tax. The costs of opioid addiction in the state reached $200 million in 2017—more than twice what it was in 2011—and drug overdoses and fatalities are rising again due in part to the isolation and stress of the COVID-19 pandemic.
Paying for addiction has become a critical issue in many states, including New York, which now have huge budget shortfalls as a result of corona virus-related economic losses. New York Governor Andrew Cuomo, for example, has ordered cuts in funding for drug treatment to help overcome the budget gap. While $200 million is merely a drop in the bucket of what is needed to combat the opioid crisis, it would help treatment providers to continue offering full services to patients.
The ruling is separate from ongoing opioid litigation, in which states, counties and the federal government are suing opioid makers, drug distributors and pharmacy chains for their alleged role in fueling the epidemic. A master settlement of thousands of those lawsuits could yield a substantial sum to be used for addiction treatment and compensating communities hard hit by the opioid crisis.
The Daily Briefing 9.14.2020
A panel of FDA experts has concluded there’s little evidence that a revamped version of the highly addictive opioiod painkiller OxyContin—designed to discourage drug abuse—actually resulted in fewer overdoses or deaths. The drug, introduced by Purdue Pharma a decade ago, was said to be a harder-to-crush update of the firm’s best-selling, and highly addictive opioid that helped fuel the nation’s opioid epidemic. But the FDA now says the pills can still be misused by simply swallowing them, which remains the most frequent route among those with opioid addiction.
Meanwhile, in other FDA news, the agency has issued warning letters to 17 website operators for illegally selling unapproved and misbranded opioids that lack a prescription as well as adequate directions for use. As part of its crackdown on illegal opioid sales, the FDA warned consumers that the drugs have significant risks of addiction, abuse and misuse and can lead to overdose and death.
And finally, New Mexico Governor Michelle Lujan Grisham has joined the parade of state leaders pushing for fast-track legalization of recreational marijuana—in her case, arguing that expected tax revenues should be used to fund Medicaid amid a corona virus-related budget shortfall. Grisham claims the state would rake in some $100 million annually—but critics point out that this includes existing medical pot revenue and estimates of a “mature” cannabis market in the future. She also fails to point out the increased costs the state would incur from easier access to the drug—including law enforcement, health care and hospitalization, and addiction treatment.
The Daily Briefing: 9.10.2020
The COVID-19 pandemic has introduced new challenges for those who care for pregnant women with a history of substance use disorder. An article in STAT points out that corona virus-related stress, economic distress, and isolation are significant risk factors for relapse, and for women facing a difficult time in the months after giving birth it can be especially trying without proper resources.
Yet closures of facilities and the advent of telehealth treatment make essential social connections and personal contact that can ease tensions, much more challenging to obtain. A number of organizations are addressing this problem, and more must be done to facilitate the support systems and access to treatment for pregnant women struggling with substance abuse.
Meanwhile, the Guardian publishes an opinion piece from New Hampshire Senator Maggie Hassan, demanding to know more about the 2006 Justice Department decision not to prosecute Purdue Pharma for its alleged role in fueling the opioid epidemic. According to newly released documents, the Justice Department was about to indict the opioid maker for mail and wire fraud, money laundering and conspiracy in pushing opioids, but then let the company off with a slap on the wrist after intense lobbying from, among others, Rudy Giuliani. Hassan wants to know why the more serious charges were dropped—allowing Purdue to continue selling opioids in huge quantities and therefore contributing to the epidemic and the deaths of thousands from overdose.
The Daily Briefing 9.9.2020
There’s encouraging news concerning the epidemic of youth vaping: preliminary data shows a significant decline in use after the FDA and many states banned the sale of most flavored e-cigarettes. About 20 percent of high school students said they used e-cigarettes in the past 30 days, compared to 27.5 percent a year ago, based on a survey by the FDA and CDC that was conducted between January and March this year.
The decline also coincided with the raising of the legal purchase age for tobacco products to 21, and the outbreak of vaping-related respiratory illnesses that sickened thousands and led to hospitalizations and death. The data, while still early, clearly indicates a link between restricting the sale of flavored vaping products that are popular with teens and young adults and lower rates of use—which should spur the FDA to make the temporary ban on flavored vapes permanent and take further steps to curb youth vaping.
Meanwhile, seven people have died in California after police raided an illegal pot-growing operation—and also found 1,000 pounds of marijuana. Legalization supporters claim that a legal market for pot is better than an illegal one, yet despite legal recreational pot in California since 2016 the illicit market is still thriving—especially in rural areas.
And finally, the Wall Street Journal does a deep dive into statistics about opioid overdose deaths during the corona virus pandemic, finding that counties across the country are reporting rising fatalities. Social-distancing limitations are complicating treatment for people who struggle with addiction and the organizations that provide services to them, along with disruptions in health care and economic dislocation, the paper reports.
The Daily Briefing 9.8.2020
Since the start of the COVID-19 pandemic, experts have warned that the corona virus—a respiratory pathogen—most likely capitalizes on the scarred lungs of smokers and vapers, increasing the ability of the virus to spread from person to person. Now, researchers are homing in on ways the virus can infiltrate the lungs and spark some of COVID’s worst symptoms. One study, for example, showed that vaping can more than double a person’s risk of severe corona virus symptoms, while young adults are five times more likely to receive a corona virus diagnosis.
Researchers are especially concerned about additives to e-cigarettes such as heavy metals and vitamin E acetate, in addition to the damage caused by vaping nicotine and THC, the psychoactive component of marijuana—all the more reason for federal authorities to accelerate the crackdown on potentially harmful and addictive vaping and e-cigarettes.
Meanwhile, voters in six states—five of which lean conservative and rural—will decide on ballot measures in November concerning marijuana legalization—sending a message from the Heartland about cannabis reform. Since Colorado legalized pot in 2014, 10 other states have done the same, but most of them are coastal and lean left. In November, states such as Alaska, Maine, Nebraska and Nevada will have their say on both recreational and medical marijuana initiatives, against the backdrop of the COVID-19 pandemic, in which pot sales have boomed.
And finally, the Marshall Project features a story about a heroin addict who entered treatment through a drug court—only to find out that she would be denied her withdrawal medications. The results were disastrous: Within in 24 hours of release, she relapsed and subsequently landed back in jail, lost her job and resigned herself to a life of drug addiction. Drug courts can be effective to help substance abusers enter treatment—but the treatment must offer a full range of options that includes medications to reduce cravings, if warranted, as well as followup care after release.
The Daily Briefing 9.3.2020
Efforts to combat the teen nicotine and vaping epidemic took a big step forward, as California banned all retail sales of flavored tobacco products—including e-cigarettes—to reduce the lure of teens and tweens to vaping. Children have become one of the largest markets of flavored tobacco products, with adolescents and young adults and teens under age 25 comprising 60 percent of e-cigarette sales. The law restricts the sale of all flavored tobacco products including menthol, which was excluded from a partial FDA ban enacted last year that critics say does little to tackle an increase in youth tobacco use.
Across the country, eight states have issued emergency rules to temporarily ban the sale of flavored e-cigarettes, which are especially appealing to minors and associated with vaping-related injuries and death, as well as substance abuse. Unfortunately, the California ban does not include online sales—a loophole that should be closed by both state and federal regulators.
Meanwhile, the embattled e-cigarette maker Juul, under scrutiny for helping fuel the teen nicotine epidemic, is cutting more workers and considering withdrawing from the European and Asian markets—a remarkable retreat for a once fast-growing company that singlehandedly powered the e-cigarette surge by targeting younger consumers.
And finally, a new study finds that three-quarters of participants in an inpatient addiction program came into the hospital using more than one substance, including meth. This suggests that to overcome the opioid epidemic, a single focus on opioids may do more harm than good if doctors overlook the complexity of each individual’s actual substance abuse, the report concludes.
The Daily Briefing 9.2.2020
Tobacco imagery and cigarette smoking depicted on television is on the increase and leading young viewers to try e-cigarettes, according to a first-of-its-kind study published in Preventive Medicine. The study found that young viewers with the highest exposure to TV tobacco depictions are three times as likely to start vaping as those who don’t.
Although the images mostly show conventional cigarettes, teens and young adults are turning to e-cigarettes—which contain nicotine or marijuana— and are the dominant form of nicotine use among young people. More than 27 percent of high school students said they vaped in 2019, up from 11.7 percent in 2017, while traditional cigarette smoking levels have dropped to 5.4 percent of high school students. The dominant images depicted in the top shows for young people include a character puffing on a cigarette and a power wall of convenience-store brands, but vaping images are also increasing.
Meanwhile, marijuana use among Baby Boomers—especially men—is on the rise in both states that have legalized cannabis as well as those that haven’t. A report in the Annals of Internal Medicine said men ages 60 to 64 had the highest rates of marijuana use between 2016 and 2018, and use nearly doubled among men ages 65 to 69. The increase is attributed to changing perceptions about pot and easier availability, as well as proliferating claims about purported medical benefits for pain, anxiety and sleep problems. Still, young adults ages 18 to 25 remain the biggest users of the drug, with nearly 39 percent reporting use in 2018.
The Daily Briefing 9.1.2020
Drug overdose deaths are soaring in many cities, with San Francisco the latest to report a staggering increase in fatalities in 2019 due largely to the COVID-19 pandemic. Public health officials reported a 70 percent surge in deaths to 441 individuals, or more than one per day for an entire year, compared to 258 overdoses in 2018. They also warned that this year will likely be even worse, as the pandemic isolates more people, social services are disrupted, and there are higher barriers to receiving health care and drug treatment. The report said more than half of the deaths in San Francisco were due to the powerful synthetic opioid fentanyl, which has also fueled fatalities in other cities, and that fewer people were admitted to residential substance abuse treatment.
Meanwhile, Oregon and Illinois report booming marijuana sales, which started during the pandemic and are continuing to break records. The surge is encouraging governors of other states—including Pennsylvania, New Jersey, New York and New Mexico— to consider fast tracking marijuana legalization to raise tax revenues.
And finally, the American Lung Association is launching a nationwide media awareness campaign to end the youth vaping epidemic. With one in 4 high school students reporting trying e-cigarettes, the ALA will broadcast public service messages to help parents of preteens and teens to talk about the effect of vaping on lungs. It will also feature an initiative aimed at equipping schools with resources to combat teen vaping.
The Daily Briefing 8.31.2020
An article in the New York Times explores the worrying trend of individuals who seek treatment with a powerful hallucinogenic drug at so-called “psychedelic ceremonies” in Costa Rica, and elsewhere. The drug being used at these unregulated retreats, ayahuasca, contains the vomit-inducing hallucinogen DMT, which can trigger psychotic episodes. Many of the individuals—including military veterans suffering from PTSD—are seeking an alternative to antidepressants and other widely prescribed pharmaceuticals, and pay up to $7,000 a week at treatment centers for the drug therapy.
While researchers are increasingly looking into the potential of psychedelics to treat mental health disorders, psychiatrists are concerned that this type of psychedelic-assisted healing is risky, especially in an uncontrolled setting in remote locations. In extreme cases, people have tried to commit suicide while high on psychedelics or experienced psychotic episodes that require hospitalization.
What’s more, scammers and charlatans might try to advantage of people in a vulnerable position. There is growing buzz about the treatment from celebrities and influencers, and it is gaining attention as a challenge to conventional mental health care. Yet while many say the treatment has helped them overcome depression and trauma, it can pose a danger when administered by unlicensed practitioners.
The Daily Briefing 8.28.2020
Research on the potential harms of cannabis account for roughly half of the $1.5 billion spend over the past decade @science
"Funding for research exploring medical cannabis treatments is also growing."
Legalizing recreational marijuana to raise revenue to offset state budget shortfalls is getting pushback in Florida @sunsentinel
"The idea isn't popular in the conservative Florida legislature and Governor DeSantis opposes full legalization."
Could legalizing recreational marijuana help solve Florida’s COVID-19 budget shortfall?
After outpatient knee surgery, 70 percent of patients receive opioid painkillers—often at strengths that could lead to overdoses and death.
"The links are alarming considering links between first-time opioid users and high-dose prescriptions."
Excessive, high-dose opioids commonly prescribed after knee surgery, Penn study finds