The Daily Briefing 5.13.2021

After years of slow and steady decline, drug overdose deaths last year in Massachusetts increased 5 percent, as the stress and isolation of the COVID-19 pandemic took its tool and treatment providers curtailed services. Even more troubling, overdose fatalities surged 69 percent among Black men, while the rate among Hispanic men remained the highest. The setback reflects broader trends across the country, and a spike in nationwide drug-related deaths to a record 90,000—a nearly 30 percent increase over the year before. The easing of pandemic restrictions isn’t expected to impact the death rate, with overdoses already rising two percent in Massachusetts in the first quarter of 2021.

Meanwhile, at the first opioid trial taking place in West Virginia, the prosecution presented evidence showing that the big three drug distributors facing charges flooded one county in the state with 109.8 million doses of prescription opiates between 2006 and 2014, or about 122 per person annually, mostly to Veterans Affairs clinics. The distributors—along with opioid manufacturers and retail pharmacies—are facing thousands of lawsuits alleging that their actions fueled the nationwide opioid epidemic.

And finally, recent Hollywood films are looking at the experience of grief by families dealing with addiction. But according to the New York Times Magazine, they often get it wrong. The films portray the struggle addicts face, but reduces a complex illness into something like a sports movie or boxing match, with a clear winner and loser and a goal to conquer. But, as the writer points out, addiction does not follow a defined dramatic arc. It is a repetitive, years-long process of trial and error, sometimes ending with a cathartic breakthrough and recovery.

The Daily Briefing 5.11.2021

The nationwide opioid epidemic is the subject of a new HBO documentary, Crime of the Century, which explores the roots of the crisis, the role of the opioid maker Purdue Pharma, and the heartbreaking human toll it has taken over the past two decades. The film is a timely reminder of how Purdue bribed its way into billions of dollars of profit while leaving death and destruction behind. With overdose fatalities surging last year to a record 90,000, the majority opioid-related, we see the origins of the national tragedy and how Purdue deceived doctors and patients into believing that OxyContin was not addictive, and pushed the product to every corner of the country even as the death toll soared.

Meanwhile, as nationwide opioid litigation against Purdue and other companies continues, 24 states are trying to block a proposed $4.2 billion bankruptcy settlement with the firm, saying it would provide immunity from prosecution for the founding Sackler family. Calling the deal unprecedented, unethical and unjust, opponents argue that it would shield the family from further scrutiny and enable it to avoid liability for the deaths of hundreds of thousands of Americans.

And finally, an editorial in the Washington Post urges the Biden administration to turn its attention to the opioid epidemic, noting that it is getting worse due to the isolation and hardships brought on by COVID-19. And as the Rosenthal Center has urged, the paper says Biden should make good on a campaign promise to commit $125 billion over the next decade to combat this national crisis.

The Daily Briefing 5.10.2021

Psychedelics drugs such as psilocybin and MDMA are on the cusp of becoming mainstream treatment options in psychiatry, according to the New York Times. After years of demonization and criminalization, such drugs are attracting attention from researchers, universities, therapists and lawmakers—and of course Wall Street—which sees a potential booming market. This will have profound implications for psychiatry, as classic psychedelics including LSD have shown early potential to treat conditions such as depression and PTSD. But amid the drive to commercialize and legalize the drugs, many worry that more research is needed on possible side effects, as well as stringent oversight and regulations if such treatments become more available.

Meanwhile, the Wall Street Journalreports that millions of dollars are flowing to “platoons” of cannabis lobbyists, banks and new marijuana trade organizations in an attempt to shape the future of the industry. As more states legalize pot—there are now 17, plus the District of Columbia—and Congress considers loosening federal-level laws and banking restrictions, the lobbyists are influencing the ground rules for this emerging market. They include corporations, union advocates, personal-use supporters and social-justice activists, reflecting the industry’s widening base even as some of the groups have differing goals.

And finally, conservative states are lining up to legalize medical marijuana. Such bills are pending in Republican-controlled legislatures in North Carolina, Alabama and Kansas for the first time, even though clinical studies have yet to establish that medical pot is indeed effective for many conditions supporters claim it helps.

The Daily Briefing 5.6.2021

With drug overdose deaths soaring in Colorado, a new program has been launched to supply at-risk patients with the overdose reversal medication naloxone when they are discharged from hospitals. Hospitals in the Colorado Naloxone Project will distribute the drug to patients who were admitted for overdose, rather than prescribing the drug when they leave, because only 5 percent of those individuals eventually fill those prescriptions. The initiative comes as a “third wave” of the opioid epidemic hits Colorado, driven by an alarming surge in fentanyl illegally produced in Mexico and trafficked to the U.S., which pushed the death rate up 524 percent between 2018 and 2020.

Meanwhile, the FDA has approved a new high dose version of naloxone, which is double the potency of current versions. Experts and patient advocates say the higher dosage, to be sold over the counter in pharmacies, is needed because lower-dose versions sometimes must be given multiple times to keep the patient alive until medical help arrives.

And finally, it looks like the East End of Long Island may be emerging as a bastion of anti-marijuana forces. Since New York legalized the drug last month, many towns and villages in the area say they want to ban pot sales using the law’s opt-out provision. With a state-imposed deadline of December 31, debate is growing about whether to allow dispensaries to operate, with supporters of a ban arguing that easier access to weed would adversely effect the health of communities and make the roads less safe due to impaired driving. Even with a ban, however, the state has sanctioned home-delivery services, which would be allowed to operate despite the opt-out provision.

The Daily Briefing 5.4.2021

As more and more states legalize marijuana, cannabis companies are coming under pressure to limit the strength of their products amid growing concerns about the public health consequences. The steadily rising levels of THC—the intoxicating component of pot—in such products has led to an alarming spike in cases of psychotic episodes among young people, and can impair brain development, studies show. Lawmakers in legal marijuana states including Colorado and Washington are now calling for limits on THC and closer scrutiny of marijuana businesses and what they sell. Supporters say this will protect consumers, especially kids and young adults. But the $20 billion cannabis industry is vehemently fighting back any attempt to impose THC curbs, even as marijuana concentrates often have potency levels of up to 80 percent or more (Vermont is the only state with such limits, while New York has a higher tax).

Meanwhile, New York City cab drivers will no longer be tested for cannabis, now that the state has legalized marijuana. It’s still illegal to drive while high, but the lack of a testing requirement means any driver can smoke weed and get behind the wheel.

And finally, a new study shows promising results for using psychedelic drugs such as MDMA to treat PTSD. The illegal drug, known as Ecstasy, was shown to bring relief to those suffering from PTSD when paired with talk therapy. Mental health experts say the research could pave the way for further studies into the potential of MDMA and similar drugs to treat a wide range of conditions—including substance abuse, depression and social anxiety in autistic adults.

The Daily Briefing 5.3.2021

For decades, West Virginia has been ground zero for the opioid epidemic, as the opioid industry flooded the state with tens of millions of prescription painkillers that fueled overdose deaths and devastated families and communities. Now, the first federal trial among thousands of lawsuits in nationwide opioid litigation gets underway in Huntington County, West Virginia, which will test various legal theories that underpin the cases—and possibly lay the groundwork for settlements in other jurisdictions. The trial will see three of the country’s largest drug distributors—McKesson, AmerisourceBergen, and Cardinal Health—accused of allowing pills to flood into pharmacies largely unchecked. One county, for example, received more than 81 million prescription painkillers, or 91 pills per person per year.

As a result, the state had the highest per-capital death rate from opioid overdoses in 2018, and 5 percent of West Virginia babies are born to mothers using opioids. The companies say there were too many steps between them and the opioid user to be held legally responsible for misuse, addiction and deaths. Over the past two decades, more than 400,000 Americans have died of opioid-related drug overdose, and millions more became addicted, setting the stage for the wave of lawsuits that also accuse opioid manufacturers and retail pharmacies of being responsible for the crisis. The West Virginia case goes ahead even as settlement talks continue in other jurisdictions with drug distributors, and opioid makers including Purdue Pharma, amid disputes between the companies and states’ attorneys general over the terms of the deal.

The Daily Briefing 4.30.2021

Canada legalized marijuana in 2018 amid much fanfare and projections of a booming market for weed—but the reality has been quite different. In fact, most of those sunny forecasts have failed to materialize, with many companies reporting staggering losses and going under. Analysts blame the poor performance on the country’s tightly regulated distribution system—sales are mostly through government-runs stores—along with a ban on weed advertising and marketing, unlike in legalized states in the U.S., where promoting pot is an essential part of the business to influence consumers.

Meanwhile, Wall Street financiers are high on startups looking into the potential of psychedelics to treat mental illnesses. Until recently, this sector barely existed. But today, venture funding is flowing into companies banking on psychedelic medicines to treat conditions such as depression, anxiety and addiction. While a growing body of research illustrates the possibilities of psychedelics, obstacles include worries about the mind-altering side effects of such drugs.

And finally, a new study finds that long-haul COVID survivors are at risk from a separate epidemic of opioid addiction, given the high rates of painkillers being prescribed to these patients. The study, at Veterans Health facilities, showed an alarmingly high rate of opioid use among COVID survivors with lingering symptoms, and warned about the frequent use of opioids for coronavirus patients.

The Daily Briefing 4.28.2021

The Daily Briefing 4.26.2021

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Drug overdose deaths in San Francisco surged last year to 713, more than twice as many as died from the coronavirus epidemic, prompting city officials and addiction professionals to re-evaluate drug policies. In a follow-up story about the grim new statistic, the New York Times speaks with an activist who says that expanding drug treatment is critical to combat the epidemic, as harm-reduction initiatives, while important, have not stopped the rising death toll. “It’s not just enough to hand out clean needles,” said Thomas Wolf, referring to harm reduction policies, which he says cross the line into enabling drug use. Such easy access to drugs, at a time when deadly fentanyl is flooding the city, makes it impossible for addicts to “get clean and stay clean,” he believes. Overdoses last year across the country spiked to nearly 90,000, but San Francisco, which champions harm-reduction, had more overdoses per capita than any other major city on the West Coast.

Meanwhile, the trial has begun in California against four opioid drug makers, in the latest round of lawsuits against the industry that is accused of fueling the opioid epidemic. Between 1997 and 2017, the industry flooded California with more than 20 billion doses of prescription opioids. The California lawsuits—part of more than 3,000 cases in nationwide opioid litigation—and may eventually prompt other defendants to reach settlements.

And finally, talk show host Ellen DeGeneres has come under fire after admitting that she downed three cans of a cannabis-infused drink and then got behind the wheel of her car. Social media critics blasted DeGeneres for potentially driving under the influence of drugs, as the drinks contained intoxicating THC, which has been blamed for a growing number of fatal traffic accidents.

The Daily Briefing 4.22.2021

Now that New York has legalized marijuana, cities and towns across the state are debating whether to opt out of allowing cannabis sales, as the law allows them to do. The Wall Street Journal reports on a number of suburban municipalities on the eastern end of Long Island that are weighing the potential benefits of tax revenue and jobs against the impact of pot businesses and an increase in drugged driving. Some localities, including the Town of Hempstead in Nassau County, have already said no to cannabis businesses. A recent poll indicated that a majority of residents of New York City approve of opting out, as communities in many legalized states have already done, despite surveys showing general support for marijuana legalization.

Meanwhile, more and more Democratic politicians are embracing legalization, seeing it as a unity issue for the party. They believe that supporting easier access to weed—as a way to advance social equity and criminal-justice reform—will appeal to the party’s younger and more progressive base. The outlier political figure on legalization, however, is President Biden, who favors decriminalization and letting states go their own way on recreational and medical marijuana use.

And finally, there’s growing debate concerning what to about high levels of intoxicating THC in cannabis products: to reduce consumption and protect public health, some advocate taxing pot with more potent THC, while others say it’s best to establish and impose set limits. It’s good we’re finally discussing public health and cannabis reform, but pushback from the cannabis industry will likely scuttle any effort to place caps on THC levels, as happened recently in Colorado.

The Daily Briefing 4.21.2021

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Senate Majority leader Chuck Schumer is making a big effort to end federal-level marijuana prohibition, but his biggest problem to win passage may be Democratic senators—not generally more conservative Republican members. The latest to signal their disapproval are senators Shaheen of New Hampshire, and Tester of Montana. Shaheen, for her part, noted that research shows legalization of cannabis leads to more drug use, adding that we’re in the middle of a deadly opioid epidemic. A few other senators are also on the fence, and Schumer can’t afford any dropouts in his own party to get this through. Even if it did pass, the White House is still noncommittal about whether President Biden would sign the legislation.

Meanwhile, the Biden administration is considering banning menthol cigarettes and also lowering the nicotine in all cigarettes sold to levels at which they are no longer addictive. A menthol ban aims to curb smoking initiative among young people, while lowering nicotine would push smokers to alternatives including e-cigarettes, which can be equally addictive, especially among younger consumers.

And finally, a new study shows how e-cigarette companies are still pursuing youthful users by embedding product placements in popular music videos, which remains legal. The study found that those exposed to e-cigarette imagery were more likely to vape—and that some of these videos were viewed more than one billion times. Vaping use is surging among young people and is a public health concern.

The Daily Briefing 4.15.2021

President Biden is coming under growing pressure to take decisive action on national drug crises, as the overdose death toll surged to nearly 88,000 in 2020—a record number and a 29 percent increase over the year before—erasing modest progress over the past few years. Biden, who promised to combat the opioid epidemic during the campaign, has been slow to commit resources to a rigorous anti-drug effort and to fill out his drug policy staff, including the “drug czar” to oversee and coordinate policies and programs. In a letter to the White House, dozens of organizations in the addiction field—including Treatment Communities of America—called on the administration to “act with urgency” on the ongoing addiction crisis. This includes expanding access to the life-saving withdrawal medication buprenorphine, which currently requires that physicians have special training to prescribe it.

The president must also commit more funding to drug treatment, as the American Rescue Plan allocates only $1.5 billion for this purpose—compared to the $125 billion over the next decade Biden had proposed. New CDC data confirms that the epidemic, once found largely among white Americans in rural and suburban areas, now impacts Blacks disproportionately. What’s more, dealers are lacing non-opioids such as meth and cocaine with opioids—including fentanyl and heroin—thereby significantly increasing the risk of overdose.

The Daily Briefing 4.14.2021

Fishing is tough, physically grueling work and therefore highly prone to injury, so it’s not surprising that people working in the fishing industry have significantly higher rates of opioid-involved overdose deaths. Around two in five of the 60,000 fishing workers in the U.S. have experienced either an opioid-related overdose or a substance-related accident or injury on the job. To cope, they often combine prescription painkillers, alcohol and other substances, increasing the risks of addiction and deaths. Now, help is available through organizations offering counseling, harm reduction services and overdose reversal medications.

Meanwhile, the New York Times publishes a moving account of how the opioid epidemic ravaged a small town in Pennsylvania. The writer, Shawn McCreesh, calls himself a member of Generation Opioid, noting that by the time he graduated high school a decade ago “opiates were everywhere,” followed by waves if addiction and death “that threatened to swallow families whole.”

And finally, an opinion piece by an addiction psychiatrist in USA Today, about the George Floyd murder trial, says it is unsurprising that Floyd’s substance use would be used to vilify him by the defense. “Our society has long viewed addiction as a moral failing,” especially among people of color. Yet Floyd was among the 2.4 million Americans struggling with opioid addiction, the majority of whom do not receive treatment.

The Daily Briefing 4.13.2021

Preliminary analysis of CDC data on drug overdose deaths estimates that fatalities may exceed 90,000 in 2020, up from nearly 71,000 the year before—the largest annual increase in two decades. Health officials had been tracking a surge in overdoses due to the COVID-19 pandemic, but the latest figures point to even greater losses due to the stress, isolation and economic downturn caused by the corona virus. But as the death toll mounts, there’s little word from the Biden administration on what it intends to do. The president has yet to appoint a “drug czar” to oversee and coordinate national drug policy, and a recent statement outlining drug policy priorities did not include any new funding beyond the $4 billion allocated in the American Rescue Plan. Clearly, we need federal action now to confront this national drug crisis.

Meanwhile, New Mexico became the latest state to legalize marijuana—but with a distinct difference: unlike in other legalized states, the law does not allow municipalities to opt out of allowing pot dispensaries. The opt-provision has become an important tool for localities opposed to legalization to say they don’t want pot shops in their neighborhood. But unfortunately, even this measure of local control has been eliminated.

And finally, the CEO of Uber is also thinking about getting into the pot business, He told CNBC the company would like to start home-delivery services once federal-level prohibition of marijuana is lifted.

The Daily Briefing 4.9.2021

A Colorado lawyer who helped draft the state’s marijuana legalization proposition now says he has profound regrets about the law, writing that the industry is dominated by corporate greed and crony capitalism and lacks proper safeguards to protect children. In an editorial, Robert Corry complained that pot lobbyists spread the lie that regulations on limiting the potency of THC—the psychoactive component of pot—would destroy marijuana businesses. As such, the industry “threw a tantrum” against even modest steps to regulate such products to make Colorado safer, especially for young people—a reaction that clashes with the industry’s cleverly cultivated image of hip social responsibility, Corry says.

Meanwhile, as New Yorkers get used to the idea of being a legalized pot state, local officials are already gearing up to invoke an opt-out provision in the law allowing them to ban retail dispensaries. Local leaders say they believe marijuana is a gateway drug and don’t want it in their neighborhoods, even if it means losing out on a share of tax revenues, as they would under the opt-out rules.

And finally, a new book explores the role of Purdue Pharma’s founding Sackler family in fueling the ongoing opioid epidemic. Empire of Pain,by New Yorker writer Patrick Radden Keefe, looks at how the family became a decisive force in the tragedy, after introducing the powerful, highly addictive painkiller OxyContin and marketing the drug as safe and effective—all the while making a name for itself in the world of philanthropy.

The Daily Briefing 4.7.2021

The national opioid epidemic and the struggle by many people to overcome addiction are in the spotlight in the George Floyd murder trial in Minneapolis. Testimony offered by Mr. Floyd’s girlfriend, Courteney Ross, provided a glimpse into how opioid addiction often begins with seeking relief from chronic pain, and can spiral into addiction and periods of recovery and relapse. Lawyers for the Floyd family said this testimony was important to raise awareness about substance use and how people should be treated with dignity, respect, and support rather than brutality.

Meanwhile, what do the rapper Snoop Dogg and the rightwing billionaire Charles Koch have in common? Not much, perhaps, except their support for marijuana legalization. The two have come together in the new Cannabis Freedom Alliance, a group that joins the Koch brothers’ political advocacy with the rapper and a libertarian think tank along with marijuana businesses to support legalization efforts. While cannabis reform has mostly involved left-leaning organizations, the Alliance aims to garner Republican backing at a time when many lawmakers in Congress are pushing to end federal-level marijuana prohibition.

And finally, the CBD craze apparently knows now bounds as companies bring to market CBD-infused clothing. They claim that socks, yoga pants and gloves saturated with CBD oils can ease stress, anxiety, and pain—although there is no evidence proving that the marijuana component is an effective treatment.

The Daily Briefing 4.5.2021

New York last week legalized adult-use recreational marijuana and now it’s New Mexico’s turn to ease access to legal weed. Gov. Michelle Lujan Grisham said she would sign the bill passed by the state legislature, which had been called in to special session to pass the legalization measure. Much like other states that have legalized pot, the governor hailed the social-justice implications of legalization as well as purported benefits such as job and tax revenue creation—without mentioning the possible risks to public health that other states have already experienced. The state expects to get about $20 million annually but only 2023 when the market is fully established.

Meanwhile, a new study finds that the dangerous mix of cocaine and opioids are increasingly responsible for the surge in drug overdose deaths, which at 88,000 over a 12-month period are at a record high. The study showed that more than 75 percent of cocaine-related overdose fatalities also involved one or more opioids in 2019. At the same time, opioid deaths linked to meth and fentanyl use are also on the rise.

And finally, the Hollywood Reporter writers that Michael Sackler, an heir to the Sackler family fortune from OxyContin maker Purdue Pharma, is trying to cultivate a new image by becoming an ethically-responsible investor. In the article, Sackler asserts that he is innocent of involvement with the family firm and its aggressive marketing of prescription painkillers that contributed to the opioid epidemic. But it also points out that this next generation Sackler did in fact play an integral role in the family’s crisis-management efforts as it came under pressure in lawsuits and in the media to take responsibility for its actions and pay compensation to victims.

The Daily Briefing 4.2.2021

With drug overdose fatalities at a new record high—88,000 for the 12-month period ending August 2020—the Biden administration has finally announced its drug policy priorities, focusing on expanding treatment, harm reduction and education and prevention programs aimed at youth substance abuse. Noting that the addiction crisis has taken too great a toll on Americans and their families, the White House and Office of National Drug Policy Control (ONDCP) said the priorities are part of a “bold” effort to reduce overdoses and save lives, and are founded on evidence-based practices and ensuring racial equity. T

he statement also calls for reducing the supply of illicit substances, and advocates for “recovery-ready” workplaces—employment programs for people in recovery—and expanding the addiction workforce. While describing the implementation of these policies as “urgent,” the statement does not include any mention of significant new funding, aside from the $4 billion included in the American Rescue Plan earmarked for the Substance Abuse and Mental Health Agency.

There was no word about a $125 billion program over the next decade to combat the opioid epidemic, promised by Biden during the campaign. Also no mention of who will be the nation’s “drug czar” running ONDCP (there is now an acting director) and whether this position will be brought back to the cabinet to give it more clout. And surprisingly, the policy priorities ignore marijuana legalization and cannabis reform at a time when states are moving quickly to legalize the drug amid concerns about public health and safety.

The Daily Briefing 3.31.2021

It’s a done deal: New York Governor Andrew Cuomo signs a law legalizing adult-use recreational marijuana, making the state the 15th to sanction easier access to weed. Legalization is touted as a way to boost state tax revenues and help communities disproportionately harmed by the failed war on drugs. But with lax rules and regulations on use—including home-delivery services, on-site consumption, and lenient penalties for drugged DUI—the law poses a threat to public health and safety especially in light of new findings that marijuana is as addictive for adolescents and teens as prescription opioids. But that apparently doesn’t figure into the political equation.

Meanwhile, Senate Majority Leader Senator Chuck Schumer is preparing legislation to end federal-level prohibition of pot, in what would be the biggest overhaul of drug policy in decades. The bill being drafted by the New York Senator goes beyond decriminalization by removing pot from the list of controlled substances and enables the feds to tax and regulate it (and of course win support from progressives for the Senator’s next reelection bid).

And finally, is President Biden waging a one-man war against weed by cracking down on White House hires that have used the drug? A story in Politico says more staff have been let go under the edict that had been previously known, and that other federal agencies and departments are also scrutinizing past drug use. The battle over marijuana is a simmering point of contention between Biden and the left-wing of the party that regards his moderate position as “outmoded and antiquated.”

The Daily Briefing 3.29.2021

State governors in New York, New Mexico and Virginia want marijuana legalization—and they want it now. In the rush to commercialize cannabis, New York’s legislature is set to quickly approve a bill tabled just last week. Virginia’s governor has pushed forward the date for legalization to July—years ahead of the original schedule. And New Mexico lawmakers have been called into special session to consider a legalization bill. The politicians falsely claim that easier access to weed will quickly solve a host of problems, from social inequality to criminal justice reform, and pandemic-related budget shortfalls.

But they fail to recognize the potential risks and dangers to public health, as were revealed in a new study that suggests that adolescents and teenagers may be particularly vulnerable to the intoxicating effects of marijuana and prescription drugs. Many people who used such drugs at an early age went on to develop a substance use disorder, indicated that experimentation had spiraled into addiction. The research expands on early findings that marijuana use by teens can impair learning and cognitive development.

And finally, as an opioid litigation settlement takes shape, Dr. Marvin D. Seppala writes in an opinion piece in STATnews that the windfall is urgently needed now—and should be directed to expanding access to drug treatment and for a wider range of addictions, not just those directly related to the opioid epidemic.