The Daily Briefing 2.17.2021

New York Governor Andrew Cuomo, under pressure to water down his marijuana legalization proposal, has revised the bill to allow delivery services and lower the criminal penalties for selling pot to a minor. As he tries to appease critics who claimed that the original version contained too many restrictions, Cuomo would permit delivery operations for consumers who can’t make it to a dispensary, while at the same time, maintaining a community opt-out provision to bar cannabis deliveries. Perhaps more troubling, Cuomo caved on penalties for selling weed to anyone under age 21, reducing the charge from a felony to a misdemeanor, saying the change would accelerate criminal justice reform. It’s not clear, however, if this will be enough to win passage—his third attempt to do so—at a time when neighboring states, including New Jersey, are moving ahead with legalization.

Meanwhile, another supposed benefit of legalization is to promote entrepreneurship in the cannabis industry for communities of color that were harmed during the failed “war on drugs.” Yet a new study in Nevada found that it’s not working out that way: marijuana business owners and board members are disproportionately white and male, while the industry workforce is more equitably spread among the state’s demographic groups.

And finally, the debate over whether to make it easier for physicians to prescribe the addiction-withdrawal medication buprenorphine is continuing, with some addiction treatment providers saying they favor maintaining the current licensing arrangement. They argue that the regulation—overturned by former President Trump, but then reinstated by President Biden as it undergoes review—ensures quality treatment, protects patients, and is also likely to reduce illegal reselling of pills. Currently, less than 7 percent of physicians are licensed to prescribe the medication; loosening the rule would widen that to almost all doctors. Less than 20 percent of the 1.8 million Americans with opioid use disorder receive any addiction medications.

The Daily Briefing 2.16.2021

New CDC data confirms that the U.S. is facing a drug crisis of unprecedented proportions, as overdose fatalities surge to the highest level ever recorded in a single year—more than 81,000 deaths in the 12-month period ending last June. The 20 percent increase reflects the overlapping health crises of COVID-19 and a pre-existing opioid epidemic, which have strained cash-strapped healthcare systems and addiction treatment providers that have been forced to curtail services. Public health officials are heavily focused on combating the coronavirus, while substance abuse has largely fallen off the radar, at a time when the isolation, stress and economic upheaval of the pandemic—all triggers for addiction and relapse—are increasing.

Meanwhile, just as Oregon enacts its groundbreaking law to decriminalize low-level drug possession to focus instead on treatment, lawmakers in neighboring Washington State are moving in the same direction. A similar bill has been introduced in the legislature, but apparently without any provision to mandate treatment—a fatal flaw also enshrined in the Oregon measure.

And finally, for the first time there is hard evidence that marijuana legalization can lead to an increase in driving while high. Officials in Colorado say a new tracking system shows that 47 percent of drivers are testing positive for marijuana followed by amphetamines and cocaine, and there has been a subsequent 48 percent uptick in DUI arrests involving pot in the last year. What’s more, the number of marijuana-impaired drivers involved in deadly crashes has risen every year between 2017 and 2019— a tragic fact that states pushing to legalize pot should consider.

The Daily Briefing 2.10.2021

The addiction withdrawal medication buprenorphine is regarded by many as one of the most effective treatments for opioid addiction, but its use has until recently been limited because physicians must have a license to prescribe it. That changed in the waning days of the Trump administration, when the license rule was waived—allowing almost all physicians to give it to patients. But President Biden recently reinstated the license requirement saying the decision should be reviewed, in a move that critics say is hampering efforts to curb the opioid epidemic, according to an op-ed piece in the Wall Street Journal. The writers argue that only 7 percent of physicians are currently licensed to prescribe the drug, at a time when opioid-related overdose deaths are soaring.

Meanwhile, the powerful cannabis industry lobby is flexing its muscles in Colorado, where it shot down efforts by a state legislator to limit dangerously high potency of THC in marijuana products. The episode is a prime example of the industry’s growing clout in the state, where it is spending more and more money to influence pro-pot policies—including the limit on THC, the drug’s psychoactive compound that can reach as high as 70 in concentrates. Lobbyists have also derailed efforts to curtail advertising and marketing to kids.

And finally, speaking of lobbyists, the National Cannabis Roundtable—an influential industry group—has hired Kathleen Sebelius, the former Health and Human Services Secretary in the Obama administration, as the group’s new co-chair. She joins former House Speaker John Boehner at the organization, just as advocacy groups are gearing up for a big push to end federal-level prohibition of pot.

The Daily Briefing 2.9.2021

South Dakota voters last year approved marijuana legalization with more than 54 percent of the vote—but the state’s conservative Republican Governor Kristi Noem is now leading a legal battle to overturn the decision. The marijuana resolution was a sweeping victory for pro-pot forces, as it won in a generally conservative state and called for the simultaneous legalization of both recreational and medical cannabis. Noem opposed legalization from the get go, and is leading efforts to stop it despite voter ratification: a judge appointed by Noem has ruled that the constitutional question violated a law that restricts such measures to a single topic. Noem has said she opposes legalization because it would “hurt families” and expand the role of government. But after voters overwhelmingly approved the change she should gracefully accept defeat and focus on enacting strict rules and regulations to safeguard public health.

Meanwhile, a big acquisition is shaking up the market for pharmaceutical-grade cannabis products: GW Pharmaceuticals, the company that makes the only FDA-approved CBD medication—for a rare form of epilepsy—has been acquired for $7.2 billion by Jazz Pharmaceuticals. Analysts say it may signal the start of a merger boom in the sector as more states legalize cannabis and federal-level decriminalization of marijuana gains supporters in the Congress.

And finally, CBD sales are on the rise based on bloated marketing hype that the marijuana component is a cure-all for just about everything that ails you, but Harvard Health argues otherwise. A blog post notes there’s little conclusive scientific evidence to back such claims, and that as a biologically active compound, CBD use may have unintended negative interactions with both over-the-counter and prescription medications.

The Daily Briefing 2.5.2021

The Biden administration has begun providing details of how it will address the nation’s drug crisis, saying the priorities will be a focus on treatment, recovery and harm reduction. Regina LaBelle, who has been appointed acting director of the Office of National Drug Control Policy—which oversees and coordinates federal drug initiatives—said the government would expand the addiction workforce and launch prevention efforts, including making overdose reversal drugs more widely available. In addition, she said there is a need to improve data collection to ensure that “culturally competent” prevention programs address growing drug use and overdose among Black, Latino and Native American communities.

Other initiatives include possible use of a fentanyl test strip to detect the synthetic opioid in illicit drugs, given the rise of overdose fatalities linked to the substance. LaBelle also said President Biden endorses such harm reduction programs as syringe exchange sites for drug users. Some critics say the new administration has been slow to take on the drug epidemic as it deals with multiple crises, even as overdose deaths last year reached a record 81,000, the majority of them opioid-related. Key permanent positions such as the “drug czar” have not yet been filled (LaBelle, who was chief of staff of ONDCP in the Obama administration, is acting director), and neither has the head of the Food and Drug Administration. And there has been no word so far on Biden’s promise during the campaign to enact an ambitious $125 billion program to combat the opioid epidemic over the next decade.

The Daily Briefing 2.2.2021

Opposition is growing to President Biden’s more moderate approach to cannabis reform, as a trio of Senators vows to introduce legislation to end federal marijuana prohibition. Sens. Schumer of New York, Wyden of Oregon, and New Jersey’s Booker said in a statement they will introduce draft legislation early this year aimed at “righting the wrongs” of the war on drugs, and that includes federal-level marijuana legalization. For his part, President Biden favors allowing states to decide on their own about legalizing recreational pot rather than doing away with the federal prohibition.

Meanwhile, an op-ed by a Colorado psychiatrist who treats young people with substance use disorder says that this age group is increasingly using medical cannabis with dangerously high levels of THC. Anyone under 21, who cannot legally buy recreational pot, can get a medical card and buy such products without tracking or monitoring. Studies show that high potency THC can lead to addiction, psychosis, depression and anxiety. So as states look to Colorado on how to regulate the cannabis market, the state needs to revise its own regulations.

And finally, New Jersey voters approved marijuana legalization last year, but the law to enact the measure is in limbo over how to deal with children caught with cannabis. The proposed law says anyone under 18 would not be charged with delinquency, but opponents—including the pro-pot Governor—say they want tougher enforcement provisions for underage possession.

The Daily Briefing 2.1.2021

The cannabis industry is hoping that full Democratic control of the federal government will help push through more liberal cannabis policies—including its long sought after goal of federal-level legalization. That would add fuel to already booming pot sales—topping $20 billion last year during the pandemic—and rising values for marijuana company stocks, Politico writes. Yet despite these rosy projections by industry advocates, the reality is quite different. Washington insiders say the likelihood that Congress will make big changes to federal marijuana restrictions remains slim. That’s because Democrats have only a razor-thin majority and need 60 votes to pass most legislation. Although many progressive Democrats favor such a move, Biden did not support that policy during the campaign, preferring instead to let states decide on their own about recreational cannabis legalization. Still, Congress might be ready to pass the SAFE Banking Act—making it easier for banks to offer financial services to cannabis companies—and of course states will continue the march toward legalization.

Meanwhile, Forbes also takes up the topic of how the Biden administration will impact the cannabis industry. Despite state-level legalization in big East Coast states and reform-minded, pro-pot Democrats in Congress, don’t expect a GameStop-type boom for pot stocks anytime soon.

And finally, the New York Times looks at the newest drug on the block: nitrous oxide. The inhalant’s use and misuse seems to be on the rise—second only to cannabis use among young people in Britain—and fueled by social media, which portrays the drug as fun without mentioning possible risks. Although nitrous oxide is not associated with the dangers of opiates and marijuana, studies show it can lead to neurological complaints and death.



The Daily Briefing 1.29.2021

The Biden administration is facing growing criticism about its slow response to the nation’s drug crisis. With more than 200 Americans dying every day from drug overdose, urgent action is required. But so far Biden has yet to appoint people to lead key federal agencies tackling the drug epidemic. And he has put on hold a last minute Trump rule change to allow more doctors to prescribe an addiction-withdrawal medication that many say could save lives with immediate effect. During the campaign, Biden made a firm commitment to combating the opioid epidemic, including a $125 billion program over the next decade. Obviously, the president is tackling a series of major crises—and hopefully he will soon turn his attention to the drug epidemic.

Meanwhile, the Wall Street Journal reports that the consulting firm McKinsey, which aggressively advised opioid manufacturers on how to boost sales—and therefore contributed to the opioid epidemic—is in settlement talks with states attorneys general to avoid civil lawsuits. The potential deal could be worth hundreds of millions of dollars, and follows the release of court filings detailing its recommendations to Purdue Pharma at a time when the country was reeling from opioid addiction and deaths. Last month McKinsey acknowledged the “terrible impact” of opioid misuse and addiction on millions of families.

And finally, the New Yorker points out that the cannabis boom in the United States is not exactly environmentally friendly. In fact, large-scale indoor grow sites suck up huge amounts of electricity, and that means “efforts to reduce the carbon footprint are going down the drain because of indoor-grow greed.”

The Daily Briefing 1.28.2021

A new study in the British Medical Journal sheds some light on the hotly debated issue of whether marijuana legalization has an impact on the opioid epidemic, but it also raises new questions. Researchers found an “association” between a higher number of cannabis stores in counties and a lower mortality rate from opioid use. The authors point out, however, that they cannot find any cause-and-effect between stores and deaths. Supporters of legalization argue that easier access to pot—purportedly a benign drug—is preferable to opioid use. But a strongly worded editorial accompanying the study warns that marijuana cannot be regarded as a remedy to the opioid crisis until a robust evidence base is available.

Meanwhile, there’s new research concerning another contentious debate—about CBD products and claims about its effectiveness for a range of maladies This study in the journal Addiction shows that CBD, the non-psychoactive component of marijuana, did not have any benefits for individuals with cocaine addiction. In fact, it did not lower participants’ cravings for cocaine, or their risk for relapse. There is only one FDA-approved drug with CBD, for a rare form of epilepsy, but that hasn’t stopped marketers from pushing CBD as a panacea for everything from anxiety to cancer and even COVID-19, as well as substance use disorder.

And finally, cigarette sales in the United States are soaring due in part to the pandemic lockdown, but e-cigarette use has nosedived due to health concerns, according to new data from Marlboro maker Altria Group. E-cigarette sales were booming before the pandemic, but the outbreak of vaping-related illnesses and deaths have caused smokers to return to conventional cigarettes.

The Daily Briefing 1.26.2021

President Biden is reportedly going to rescind a last minute rule change by the outgoing Trump administration that would have allowed more physicians to prescribe an opioid-treatment drug. Some say the move was long overdue, as it would have let doctors prescribe the drug without special training or a license—and therefore expand use of the medication as part of addiction withdrawal treatment. Biden has expressed support for the new regulation, but legal experts say that the Department of Health and Human Services lacks the authority to issue such guidelines because the requirements are mandated by Congress. There are also clinical concerns about the drug, buprenorphine, as the opioid epidemic has been fuelled by overprescribing and therefore requires additional safeguards.

Meanwhile, a New York Times analysis of the marijuana market in Canada two years after legalization shows that many of the promises made at the time have not been met. For example, the for-profit industry continues to struggle while the black market thrives; Indigenous communities feel their needs are being ignored; and the injustices that came from criminalizing pot have yet to be fully remedied.

And finally, the Washington Post takes up a similar theme, looking at whether the emerging cannabis market in the United States is an agent of social justice—as many supporters of legalization claim—or just another big business. Kevin Sabet, president of Smart Approaches to Marijuana, tells the Times that cannabis companies have failed to deliver for communities of color, noting that disproportionate arrests and steady incarceration rates persist in legal states.



The Daily Briefing 1.25.2021

Overdose fatalities have been surging all year as the COVID-19 pandemic bore down on the country, and now it’s official: the CDC says that a record 81,230 Americans died last year from May 2019 to May 2020—the highest number of drug deaths ever recorded in a12-month span. Deaths increased in 46 states—and by more than 25 percent in 25 of those states. By any measure, the numbers are staggering, with fentanyl-related deaths increasing by 38 percent nationwide (and 98 percent in 10 western states). And deaths tied to cocaine use, often involving co-use with fentanyl or heroin, rising 26 percent. The CDC notes that the death rate accelerated as the pandemic disrupted daily life and led to isolation and depression and economic distress, including those with substance use disorder.

Meanwhile, Wall Street is optimistic that cannabis companies will bounce back this year as states move ahead with marijuana legalization and a Democratic-controlled Congress could mean federal-level legal changes. Pot sales exploded during the pandemic, and analysts say the uptick is likely to continue. Still, moves to decriminalize marijuana on the federal level might not muster enough votes due to the Democrats’ slim majority and opposition from President Biden.

And finally, former President Trump’s last-minute pardons and commutations included the major drug dealer Jonathan Braun, who was convicted and sentenced to 10 years in prison for running a large-scale marijuana smuggling ring. Braun is not out of the woods yet, the New York Times points out as he faces other civil and criminal investigations on unrelated matters.

The Daily Briefing 1.21.2021

President Biden is turning his attention drug policy, appointing Regina LaBelle as acting head of the White House Office of National Drug Control Policy, ONDCP, which coordinates the federal response to addiction policy. LaBelle, a former chief of staff at ONDCP in the Obama administration, will be in charge as the search for a permanent chief of the agency continues. Among the names mentioned for the position are former Rep. Patrick Kennedy; Rahul Gupta, chief medical officer of the March of Dimes, and former president of the American Medical Association, Patrice Harris. Still no word yet on whether Biden will reinstate the drug czar to a cabinet-level position, giving it more prominence and clout.

Meanwhile, New York Governor Andrew Cuomo has revealed more details of his proposed marijuana legalization plan, which includes a community opt-out provision that is supported by the Rosenthal Center. Under the proposal for local control, individual municipalities with populations of 100,000 or more will have the option to say no to marijuana businesses. The proposed bill also rules out licenses for home delivery services and on-site consumption at dispensaries.

And finally, Massachusetts Governor Charlie Baker has signed a law establishing a state trust fund to administer any monies received from opioid litigation settlements. The funds would be used to mitigate the impacts of the opioid epidemic and expand access to opioid use disorder prevention, intervention and recovery options. Settlement talks are continuing in thousands of lawsuits brought against the opioid industry, drug distributors and pharmacy chains for their role in the opioid crisis.

The Daily Briefing 1.20.2021

During his long political career, President Biden made a name for himself as a fighter in the decades long “war on drugs.” But has he takes office amid an ongoing opioid epidemic, soaring overdose fatalities and a rush by states to legalize marijuana, expect to see a slow retreat from his past policies. Concerning cannabis, Biden has adopted a moderate stance compared to the progressive wing of the Democratic Party, in which he supports decriminalization and medical marijuana—and letting states decide on recreational—but does not endorse full, federal-level legalization. Biden is likely to come under pressure to do so, now that the Democrats control the Senate and many governors are pushing for legalization to help raise revenues to fill budget shortfalls.

Perhaps the biggest change from previous policies, however, is Biden’s compassion for those struggling with drug addiction, and his commitment to expanding drug treatment instead of incarcerating low-level drug users. He is expected to propose a comprehensive $125 billion program over the next decade to address the opioid epidemic—a significant boost to current funding and the first major federal effort of this size and scope since the epidemic started more than two decades ago. Hopefully Biden can win approval of this desperately needed legislation, even as Congress grapples with the corona virus pandemic and a crippling economic downturn.

The Daily Briefing 1.19.2021

New Yorker writer Masha Gessen tells the harrowing story of her son’s opioid addiction, comparing her experience with recently released documents of the Sackler family complaining about their damaged reputation due to the opioid epidemic. Gessen recounts the start of her son’s addiction after an accident, and his subsequent attempted overdose, as well as his struggle to get clean and how drugs eventually destroyed their relationship. At the same time, the Sacklers—founders of opioid maker Purdue Pharma—were upset about how they were treated in the media and discussed what to do about it to salvage the family name. Gessen ends by saying that she feels luckier than many moms involved in anti-Sackler protests—at least her son is still alive.

And finally, analysts say the market for food and beverage products infused with CBD—the non-psychoactive component of marijuana—might boom this year. So expect to see products such as Ben & Jerry’s ice cream with CBD, but only if federal regulatory agencies can finally issue guidelines on the additive. So far, the FDA has frequently called out companies for illegally using CBD in foods and drugs and making outrageous claims that it can cure everything from acne to Alzheimer’s and even cancer and COVID. The industry is growing rapidly based on this misinformation and misleading marketing, as consumers purchase CBD products believing they are safe and effective. Currently, there is mostly anecdotal evidence about its impact, and little if any scientific research showing that it does what producers claim. It’s time for the FDA and other agencies to crackdown on CBD products to protect public health.

The Daily Briefing 1.15.2021

In its last days, the Trump administration announces a major shift in addiction medicine policy, giving doctors dramatically more flexibility to prescribe the popular addiction medication buprenorhphine. The change will allow almost all physicians to prescribe the drug—without undergoing a training program and receiving a special waiver—thereby significantly increasing access to the medication, which reduces addiction cravings as part of drug treatment. The decision comes as drug overdose deaths have soared to record levels, due in part to the COVID-19 pandemic and the reduction of services by financially-strapped treatment providers. As of now, only 66,000 physicians and another 25,000 prescribers such as NPs or Pas have the waiver. More than 2 million Americans are estimated to be in need of treatment for opioid use disorder, but only a fraction of them obtain services.

Meanwhile, put Virginia on the list of states urging fast-track marijuana legalization. Governor Ralph Northam has unveiled legislation to legalize recreational weed within two years, as part of a bill that includes a 21 percent sales tax and a licensing program to enable people harmed by the disparate enforcement of marijuana laws to set up a business in the new market for the drug.

And finally, a marijuana activist group in Washington, D.C., where cannabis is legal, says it will launch a program to award those who get a COVID vaccine with a bag of pot. Organizers say the “Joints for Jabs” effort is aimed at encouraging vaccinations—and also publicizing campaigns to legalize cannabis nationwide.


 




The Daily Briefing 1.14.2021

The long legal battle to open a controversial safe injection site in Philadelphia is facing yet another setback after a federal appeals court ruled that such a facility would be illegal. Supporters of the project had won a lower court ruling allowing the project to go ahead, but had also faced resistance from local residents who didn’t want the facility in their neighborhood. This would have been the first safe site in the United States, providing a place for drug users to shoot up in a supervised setting. Other cities are also considering opening safe sites as the rate of drug overdose soars, although such facilities are mainly aimed at harm reduction rather than engaging patients in treatment.

Meanwhile, STAT reports on a possible breakthrough to find the first treatment for methamphetamine use disorder, a very serious illness with often-fatal consequences. A new study finds that a combination of two existing drugs—including opioid medication Vivitrol and a smoking cessation antidepressant—shows promise to help people cut use. Nearly 20,000 deaths were attributable to meth in the 12-month period ending June 2020, up from 6,7000 in 2016.

And finally, the density of marijuana shops in a specific area leads to higher consumption of cannabis by young people, a RAND survey has concluded. Looking at young adults in Los Angeles County a year before legalization and then afterwards, the study shows that the presence of more shops within a 4 mile area was associated with heavier use and more symptoms of cannabis use disorder. Such data should be considered by states as they legalize marijuana and establish regulations to control the market and safeguard public health.