The Daily Briefing 10.12.2021

The underage vaping epidemic is being fueled by a new e-cigarette brand called Puff Bar that targets young people with products that come in fruity flavors—such as Watermelon and Lemon Ice—favored by this age group. A report in the Wall Street Journal says that Puff Bar has replaced Juul as the top-selling disposable brand among young people, with sales of more than $126 million last year. So far, Puff Bar has been able to evade FDA scrutiny by reformulating its products with synthetic nicotine, which is not under the agency’s purview. The company was founded by two 27-year-old entrepreneurs, who say they are doing everything they can to stop underage use, although a recent survey found that more than 25 percent of high-school vapers use Puff Bar. The FDA must find a way to regulate products like Puff Bar that are contributing to the teen vaping crisis.

Meanwhile, Gov. Gavin Newsom of California has signed a bill that bars opponents of needle exchange programs from using environmental laws to try to stop such services. For years, groups that want to shut down exchange sites have claimed that such programs promote drug use and homelessness. But recently they have deployed a new tactic, saying that they are a source of needle waste, which is an environmental hazard, and have closed down programs in several counties. Under the new law, lawsuits to stop needle exchange are still allowed under other grounds. The bill comes at a time when drug overdose deaths are soaring in the state, and around the country, and harm reduction programs such as needle exchanges are seen as an important component of efforts to save lives.

And finally, the marijuana legalization model used most frequently by states can lead to rampant commercialization and Big Tobacco dominating local markets, according to an article in Vox that looks at alternative ways to legalize weed. Currently, for-profit companies are growing, cultivating, and selling marijuana, expanding across state and national lines, and doing more advertising, creating a marijuana market that will look a lot like the market for alcohol. There are alternatives, the article suggests, such as allowing the government to run the supply chain and becoming a weed dealer, which means it would have greater say over public health and safety and implementing regulations to mitigate the real risk of addiction and overuse.

The Daily Briefing 10.7.2021

One of the consequences of the COVID-19 pandemic was an increase in marijuana consumption—including among pregnant women. In California, cannabis use by women in early pregnancy shot up 25 percent during the pandemic, according to a new Kaiser Permanent study of more than 100,000 pregnancies in northern California. Patients were, on average 31 years old, and were more likely to use pot if they had experienced depression, anxiety, or trauma. Although pot use during pregnancy has been linked to low birth weight and impaired neurodevelopment, such use has been creeping up over time, the study said and is consistent with the overall rise in cannabis sales in California over the time period studied, 2019-2020. The study noted that women also seek out advice from peers and online communities supportive of cannabis when choosing whether to use such products during pregnancy, which adds to the confusion, along with dispensaries that market pot as a safe and effective way to manage pregnancy symptoms.

Meanwhile, another study of marijuana found that increased use may lead to a significantly higher risk of contracting a COVID-19 breakthrough infection. The study, published in World Psychiatry, focused on fully vaccinated people with substance use disorder, a condition that involves uncontrolled dependence on substances including marijuana, alcohol, cocaine, opioids, and tobacco. Patients with cannabis use disorder had a higher risk for breakthrough infection even after they were matched for adverse socioeconomic determinants. The study speculated that the higher risk could be due to behavioral differences or the effects that the drug has on the lungs or the immune system.

And finally, California Gov. Gavin Newsome is expected to sign a novel law that would allow the state Medicaid agency to pay people not to use methamphetamines and cocaine—making it the first state to do so. The payments are part of an addiction treatment program called contingency management, which incentivizes drug users with money or gift cards to stay off drugs. Some studies—and the experience of a Veterans Administration program—suggest that such positive reinforcement works, especially for meth or cocaine addiction. As drug overdoses surge across the country, many states are seeking new approaches to treatment, and are appealing to federal authorities to make contingency management more widely available. 

The Daily Briefing 10.6.2021

Evidence revealed at the landmark opioid trial in Ohio shows that pharmacy chain employees warned about the dispensing of highly addictive prescription painkillers—but to no avail, allowing a flood of opioids to continue. The trial, which accuses the nation’s biggest pharmacy chains—including CVS, Walgreens, and Walmart—of fueling the opioid epidemic, is being closely watched as the sprawling opioid litigation plays out across the country. The documents showed that employees told superiors that the company was not verifying the legitimacy of suspicious orders and that the chains were not doing enough to reduce the growth of prescription painkillers. Laws require drugstore chains to implement strict monitoring and safety programs. But the companies claim they did nothing wrong, and instead blame doctors for writing the prescriptions and federal regulators for failing to crack down on so-called pill mills that doled out tens of millions of doses. The case is widely seen as a test to determine whether companies should be liable for the epidemic and shoulder part of the cost of responding to the crisis. Thousands of opioid lawsuits are either at trial or under a proposed settlement against not only pharmacy chains but also drug manufacturers and drug distribution companies, for their role in the epidemic.

Meanwhile, a new study released by the FDA and the CDC found that more than 2 million middle and high school students used e-cigarettes in 2021, with more than 8 in 10 of those youth using flavored e-cigarettes. Despite increased warnings and prevention programs, vaping remains extremely popular with kids, the report said, noting that 25 percent of high school students who used e-cigarettes said they vaped every day. The FDA says it is continuing to take action against companies that sell or target e-cigarettes and e-liquids to kids, including recently denying more than one million premarket applications for flavored electronic nicotine delivery systems. But obviously, the agency is not doing enough to discourage young people from using e-cigarettes and contributing to the nationwide vaping epidemic among underage users.

 And finally, California is poised to clamp down on CBD products to ensure they are accurately labeled and safe, following the explosive growth of the sector and a flow of merchandise that is mislabeled and untested. CBD, the nonpsychoactive component of marijuana, can be found in soap, food, and other wellness goods, and its use has grown significantly since Congress legalized hemp in 2018. But in the absence of federal oversight, states are stepping up efforts to regulate untested products that make unfounded claims about their efficacy and safety—often claim that CBD is a wonder drug promising relief for ailments including pain, anxiety, and depression. The regulatory bill in California, which Gov. Gavin Newsom is expected to sign, would hold manufacturers to rigorous testing and labeling guidelines.

The Daily Briefing 10.4.2021

The third phase of the sprawling, nationwide opioid litigation opens a new front this week as the trial begins in Cleveland of giant pharmacy chains accused of fueling the opioid epidemic. With lawsuits against drug makers and drug distributors either settled or at trial, this litigation takes aim at pharmacies that allowed hundreds of millions of prescription painkillers to be doled out to patients, fuelling the opioid epidemic. The case, involving two counties in Ohio, says that 10 pharmacies dispensed nearly 49 million prescription pain pills in a span of eight years—enough to provide a dozen doses to each man, woman, and child who lived there every 12 months. The mostly rural, blue-collar countries claim that CVS, Walgreens, Giant Eager, and Walmart failed to stop mass quantities of opioid drugs from reaching the black market and therefore contributed to hundreds of overdose deaths—and one of the worst public health crises in the nation’s history. Pharmacies say they were merely filling prescriptions for legal medications, but despite warnings from the Drug Enforcement Agency, they continued to dispense pills and also implemented performance metrics and quotas for their retail stores.

Meanwhile, celebrities are piling into the emerging legal marijuana market, hoping that adding their name and glamour will boost sales of the drug. The latest entry is popstar Justin Bieber, who is launching a product called Peaches—named after one of his songs—that contains a $32 pack of pre-rolled joints. When asked about why he’s getting into the business, Bieber said he wanted to help destigmatize pot, especially for those who find it helpful for their mental health. Scientists say this is a popular belief about pot that has yet to be proven in research studies, and that marijuana use may in fact worsen outcomes for people with mental health conditions.   

And finally, speaking of celebrities, actor Clint Eastwood has won a $6 million lawsuit against a company that used his image and likeness to make it appear that he was endorsing their products. The companies and online retailers concocted a fake interview with the actor and used a photo from an actual appearance in he seemed to endorse their products, which contain CBD, the non-psychoactive component of marijuana. Eastwood has no connection whatsoever with CBD, a product with few proven health benefits that is experiencing booming sales based on false marketing messages.

The Daily Briefing 9.30.2021

San Francisco is in the grips of an unprecedented drug epidemic as fentanyl floods the street-drug marketplace, intensifying the risk of addiction and leading to a staggering number of overdose deaths. While overdose deaths have surged across the country to a record 93,000 last year, fatalities linked to fentanyl have skyrocketed in San Francisco—increasing by nearly 500 percent between 2018 and 2020. Illicit fentanyl, which can be as much as 50 times more powerful than heroin, was detected in the blood of 519 of the 712 individuals who died. Last year the regional office of the DEA seized 74 kilograms of fentanyl—an amount that could kill up to 37 million people—compared with 15 kilograms in 2016. The synthetic opioid was developed in the 1960s to manage pain after surgery, but today is made illegally in China and India and is now stamped into counterfeit pills to increase the potency of drugs that look like legitimate prescription medications such as OxyContin and Xanax.

Meanwhile, the nation’s three largest drug distributors have reached a $75 million opioid settlement with the Cherokee Nation Native American Tribe in Oklahoma, to settle allegations that the companies helped fuel a public health crisis by allowing the distribution of highly addictive prescription painkillers. This settlement is separate from a proposed $26 billion deal to end thousands of lawsuits brought by states and local governments against Cardinal Health, McKesson Corpl, and AmerisourceBergen. The Cherokee Nation was the first to sue the distributors in 2017, accusing them of supplying millions of pills that caused addictions and fatal overdoses.

And finally, the Wall Street Journal reports that the legalization of marijuana around the U.S. is bringing weed into the workplace in new ways—and raising questions about boundaries and behaviors when it comes to the drug. For example, companies debate whether they should continue to test employees and job candidates for marijuana, how to talk about pot socially, and if it should be used in team-building exercises. And then there’s always the tricky issue of whether to get stoned with a client, the paper noted.

The Daily Briefing 9.29.2021

The Drug Enforcement Agency has issued its first public warning in six that a growing number of fake pills bought online through e-commerce websites—and promoted by social media sites—are laced with potentially lethal amounts of the powerful synthetic opioid fentanyl. Noting that we are in the midst of an overdose crisis—with more than 93,000 fatalities last year—the DEA said that the counterfeit pills are driving the surge in deaths. Fentanyl, even in much smaller amounts, is deadlier than street heroin, and more and more online sellers, as well as dealers, are adding the deadly drug to prescription pills. The agency said it has seized more than 9.5 million fake pills so far this year, more than the last two years combined, and that two out of every five fake pills with fentanyl contain a potentially lethal dose of the drug.

Meanwhile, a new study published in the journal Jama Psychiatry finds that methamphetamine use is surging as a major cause of high-risk addiction and overdose death, in part due to meth containing fentanyl. From 2015 to 2015, there was a 180 percent increase in the number of deaths linked to meth, from more than 5,500 a year to nearly 15, 500, according to pre-pandemic data. The researchers found Native Americans and Alaska Natives still have the highest rate of methamphetamine use disorder and have seen sharp increases in drug deaths in recent years, while Black Americans saw a tenfold increase in meth use over the same five-year period. In addition, there was increased use of needles to inject the drug, and a rapid transition from casual and recreational meth use to full-blown addiction.

And finally, the American Medical Association has issued a report showing the disparities between efforts to fight the opioid epidemic and outcomes. It noted that while there has been a 44 percent drop in opioid prescribing in the past decade, due mostly to stricter prescription monitoring, the country is still facing a worsening epidemic of drug-related overdoses and deaths. Overdoses and deaths are spiking even though physicians have increased the use of monitoring programs—more than 910 million times in 2020, according to the AMA. It also reports that although more than 106,000 physicians and other health professionals have received the required waiver allowing them to prescribe opioid withdrawal medications to treat opioid-use disorder, between 80 percent and 90 percent of people with substance use disorder receive no treatment whatsoever.

The Daily Briefing 9.27.2021

Selling marijuana on tribal lands in New York State has become a booming business for Native Americans, who are capitalizing on the slow pace of regulating the state’s newly legal marijuana industry. The New York Times reports from an upstate reservation, on the northern border with Canada, which is doing a brisk trade in pot products, drawing customers from across the region. However, the new enterprises exist in a sort of gray area, moving faster to set up dispensaries than the government in Albany can impose a regulatory body to oversee the new cannabis industry. There’s also a dispute within the tribal government, with some groups claiming the businesses are operating outside the laws of the reservation. Once again, we see that legalization is moving ahead before rules and regulations can be established to oversee and monitor the new industry.

Meanwhile, it’s no surprise that after pot sales boomed during the pandemic, employment in the sector nationwide would also post extraordinary growth. Today, more than 320,000 Americans work in the industry, a 32 percent increase from ast year, making marijuana one of the nation’s fastest-growing sectors. The industry added nearly 80,000 jobs last year, many coming from the restaurant and retail, and other service sectors, which was hit by the lockdowns. The growth of the industry has indeed been dynamic: the U.S. now has more cannabis workers than dentists, paramedics, or electrical engineers.

And finally, all that pot for sale has consequences for consumers: a new report shows that cases of marijuana over-consumption have led to an increase in cannabis-related intoxication requiring medical attention. Poison control centers have documented a dramatic increase in the number of reports involving edible cannabis, rising from 8.4 percent to 31 percent between 2017 and 2019—especially for children under 10, with these products making up 48 percent of reported cases. Such cases of intoxication in children are associated with coma, severe respiratory depression that can lead to death.  

The Daily Briefing 9.22.2021

A new study finds that there is a growing racial disparity in opioid deaths among the Black population and other racial and ethnic groups. The National Institute on Drug Abuse research analyzed data from four states—Kentucky, Ohio, Massachusetts, and New York—and found that opioid deaths among Blacks increased by 38 percent between 2018 and 2019, while rates for other groups did not rise a all. In earlier waves of the epidemic, African Americans had lower rates of overdose deaths than whites, amid heavy prescribing of prescription painkillers in white communities. Experts say the shift in populations is due in part to structural differences in healthcare, including access to effective treatment options, and data suggesting that Blacks are less likely to be prescribed opioid withdrawal medications.

Meanwhile, in an opinion piece in the Boston Globe, two psychiatrists at Beth Israel Deaconess Medical Center write that it is critical for society to recognize the opioid crisis and to understand how secrets and stigma allow it to grow. Writing in honor of National Recovery Months, the physicians urge patients battling addiction—and their families—to talk about their experiences in order to expose the truth about the disease, and help others understand the magnitude of the issue Also, they say that although progress has been made in the areas of prevention, diagnosis, and treatment, these efforts simply have not matched the breadth of the problem. And finally, they point out that addicts must overcome stigma, which is greater than other mental illnesses such as depression and anxiety and leads to silence about the opioid epidemic.

And finally, an op-ed in the Baltimore Sun looks at the growing market for legal adult-use medical marijuana, pointing out that medical cannabis is not really a medication just because states say so. Unlike medications sold in a pharmacy, which comes in plain bottles and has specific instructions on how to use it and what the side effects might be, medical marijuana is dispensed by a “budtender” who has no way to assess possible reactions or warn about potential interactions. In the end, the article notes, the patient is largely left to determine for themselves what constitutes a reasonable medication regimen and dosage that will both treat their ailments and not develop into dependency. As legalization of medical cannabis continues, amid increasingly far-reaching claims about what it does, we need more research into the effects of the drug—as well as tighter regulation of how it is sold and what it purports to do.

The Daily Briefing 9.21.2021

A new study in the journal JAMA Network Open reports troubling symptoms for many young people who are habitual users of marijuana: more and more teenagers, it says, are showing up in emergency rooms complaining of severe intestinal distress. The unusual illness—called cannabis hyperemesis syndrome—leaves them writhing, complaining of bad abdominal pain, and nausea, and they suffer from vomiting that can go on for hours. The report said there were more than 800,000 cases in Colorado between 2013 and 2019, a 29 percent increase since marijuana was legalized in the state. And more than a third of the vomiting cases were people under 25 years of age and younger. With more states legalizing marijuana, physicians say this is no longer a rare problem.

Meanwhile, marijuana legalization was supposed to end the black market for pot and provide a regulatory structure for the new industry to monitor and control the product. But guess what? California’s most-wanted pot products are ending up on the shelves of high-end dispensaries in New York City. Apparently, rule-breakers are selling untold millions of pounds of legally grown cannabis on the illicit market. And state cannabis regulators, who are fully aware of the industry’s worst kept secret, aren’t bothering to do anything about it. Under the law, this shouldn’t be happening—another example of the many promises that have been made about legalization that have not been fulfilled.

And finally, marijuana is now legal in Connecticut, but don’t think about light up a joint in a courthouse. The law does place some limits on where pot can be consumed, including public buildings, most workplaces, stores, and state parks. The judicial branch has also put in place a rule preventing possession inside a building—but because that hasn’t stopped people from lighting up, new signs are being posted that say “no cannabis allowed.”

The Daily Briefing 9.20.2021

The Justice Department is taking action to stop the Purdue Pharma opioid litigation settlement, arguing that it is wrong to grand broad legal immunity to the firm’s founding Sackler family. The controversial deal, approved earlier this month, forces the family to pay $4.5 billion in compensation, as part of an estimated $10 billion deal over the next decade, with the majority of funds going to drug abatement and treatment programs. But the settlement has been widely criticized by patients’ rights groups and others who say the family—which has reaped billions from the sale of its highly addictive OxyContin painkiller—should be shielded from further. The Justice Department said in its filing that the deal takes away the rights of those with a valid legal claim against the Sacklers. Those who support the deal, including a majority of states, say that it would provide much-needed funding for drug treatment programs.

Meanwhile, more and more college football teams that suffered financial losses during the pandemic year are throwing their moral qualms about “sin” industries out the window, and are hooking with booze and cannabis companies to gain sponsorships and the rights to sell their products. The result is a lot more alcohol for sale in stadiums and sponsorship money from the marijuana industry. Colorado, for example, became the first major university to add a cannabis company as a corporate sponsor. It’s not clear yet if pot products will be sold along with beer and hot dogs.

And finally, Maine residents are known for having an independent streak—and that’s true too when it comes to selling recreational marijuana. More than 90 percent of towns in Maine still do not allow adult-use pot sales after opting out or passing ordinances banning dispensaries, even as the industry has taken off in the state (marijuana was legalized in 2016 but sales only began in 2020). The resistance is largely due to fears about harder drugs, including opioids and methamphetamines that have ravaged many Maine communities.

The Daily Briefing 9.16.2021

As the sprawling opioid litigation draws to close promising large settlements for states, Maia Szalavitz writes in Scientific American that the windfall compensation should be used narrowly and smartly for addiction services—and not for cutting the supply of opioids. Comparing this settlement to the $246 billion tobacco agreement, in which most of the money went to state governments and not for smoking cessation programs, she says we now have an opportunity to help those struggling with substance use. Instead of focusing on prescription monitoring and other control methods, she argues, we should expand the use of medications to treat addiction and allow doctors who diagnose opioid addiction to prescribe withdrawal drugs.

Meanwhile, following the recent controversy over marijuana use at the Olympics, the World Anti-Doping Agency says it will launch a review of its ban on consuming pot with high levels of THC during competitions. Marijuana has been on the agency’s list of prohibited substances for decades, but the international body has come under pressure to revise the rule as marijuana legalization has gained momentum, and a top U.S. track star tested positive and was subsequently disqualified to participate in the Tokyo games. Substances are banned if they are deemed to enhance performance or pose a health risk to athletes. 

And finally, the CDC has issued a warning about the dangers of consuming marijuana-infused foods that contain high levels of THC, saying they could cause “adverse effects.” It issued the alert because of the increased availability of such cannabis edibles and insufficient labeling of products with both THC and CBD, the non-psychoactive component of the drug. Edibles are among the fastest-growing cannabis categories, but manufacturers have come under criticism for how they package and market such products.

The Daily Briefing 9.13.2021

The Purdue Pharma opioid litigation settlement announced last week continues to draw scrutiny as well as criticism. In an op-ed in the New York Times, Ryan Hampton, who worked on the case on behalf of victims, writes that the settlement does not provide justice for some 130,000 family members, who will receive only about $750 million of the $4.5 billion paid in by the firm’s founding Sackler family. “Purdue’s victims find themselves double victimized,” Hampton writes, noting that the amount they will receive is far less than will be paid to a handful of lawyers and consultants in the case. He also says that a controversial bankruptcy mechanism used by Purdue ended up shielding the Sacklers from ever being sued in civil court for its role in the overdose crisis.

Meanwhile, the Food and Drug Administration has finally issued its long-awaited verdict on e-cigarettes, rejecting applications for nearly 1 million products, mainly due to their potential appeal to underage teens. But the FDA did not rule on products from Juul, the most popular brand with adult smokers and many teens, saying more work needs to be done to complete the reviews. The action is part of a sweeping review by the agency to bring scientific oversight to the multibillion-dollar vaping industry after years of regulatory delays, and accusations that manufacturers are deliberately targeting young people.

And finally, Colorado legalized marijuana in 2013, promising that the system established to sell legal weed would not endanger public health. But a new report indicates that easy access to pot is hardly safe: traffic deaths where drivers tested positive for marijuana had increased by 138 percent compared to 29 percent for all Colorado traffic deaths, and that past months use of marijuana for those 12 and older increased 26 percent. And the percent of suicide incidents in which toxicology results were positive for marijuana has increased from 14 percent in 2013 to 29 percent in 2020.

The Daily Briefing 9.9.2021

As pro-pot supporters continue the push for marijuana legalization, a new international report finds that medical cannabis—which is often the prelude to recreational legalization, because of its purported health benefits—is unlikely to help most people suffering from chronic pain. The report, based on three dozen medical cannabis studies, says that although it might help some people, there’s not enough evidence for the drug to be widely recommended for those with chronic pain. In fact, researchers were quoted as saying the benefits are “quite modest,” debunking the argument that medical pot is a panacea for a variety of ills, as supporters continually claim. The guidance is important, as 36 states and Washington, D.C., have legalized medical uses of cannabis. Another problem, they noted, is that even if patients decide to try medical cannabis, there are so many products, formulations, and varieties to choose from, but no definitive information on which components are most effective at treating certain symptoms.

Meanwhile, the National Institute of Health’s 2020 Monitoring the Future Study finds that college-age adults are using marijuana more than ever before. Among college students, 44 percent reported using marijuana in 2020 compared to 38 percent in 2015. This represents the highest levels of marijuana use recorded since the 1980s. There was also a significant increase in the use of hallucinogens—including LSD and psilocybin—among college-age kids, according to the annual survey. Some good news: while pot use was thriving, college students reported significantly lower alcohol use, with 56 percent imbibing compared to 62 percent in 2019, and a decrease in binge drinking to 24 percent from 32 percent.

And finally, marijuana legalization was touted as a way to promote social equality and economic equity among populations of color who were disproportionately discriminated against during the failed war on drugs. But guess what? It isn’t working out that way. Instead of providing benefits to people of color who want to get into the cannabis industry, many Black Americans—who were four times as likely to get arrested on cannabis charges—are finding the riches out of reach. In many states, the licensing process is difficult to navigate and favors those with more access to capital, such as big weed companies.

The Daily Briefing 9.8.2021

A Wall Street Journal iinvestigation reveals that social media site TikTok serves up a continual stream of content about sex and promoting drug use—to minors. The article used a series of fake accounts linked to underage users to to examine the site’s powerful algorithms and how they quickly drive minors—among the biggest users of TikTok—to endless spools of content that often glorifies drugs and drug use. They also found that even with the site’s filters in place, videos about drugs tend to proliferate, creating what one expert called a perfect sotrm in which social media normalizes and influences the way they view drugs or other topics. With tens of thousands of videos being uploaded to the site every minute, young people are exposed to more dubious content than ever before, and it becomes extremeley difficult for moderators to screen and delete questionable content. We need stronger regulation and control of social media sites like TikTok and the content they distribute to young people.

Meanwhile, a new German study finds that e-cigarettes are a gateway to cannabis use for young people. Researchers studied students who had never used marijuana, and during that time nearly 30 percent reported using e-cigarettes at least once, and of those 17.4 percent began using marijuana. The marijuana initition rate among this group was 34.5 percent compared to 10.4 percent of those who never used e-cigarettes.

And finally, a bill pending before the California Assembly reads like a wish list of demands by the powerful cannabis industry. If approved, the bill would allow food and beverages like soda adulterated with psychoactive THC in quanitites exceeding legal cannabis edibles. It would also permit THC foods to be sold in regular food stores outside of the legal cannabis market. The expanded guidelines would also legalize hemp cigarettes and e-cigarettes, including flavored products like those the California legislature banned for tobacco in 2020.

The Daily Briefing 9.7.2021

The $4.5 billion opioid settlement with Purdue Pharma announced last week ended lengthy litigation with the OxyContin maker and secures funding over the next decade for drug abatement and treatment programs. But for many families who lost children and other loved ones in the opioid epidemic, the deal has left many families conflicted, deflated, and angry. Under the terms of the agreement, the firm’s founding Sackler family did not apologize for their role in fueling the epidemic by underplaying the addictiveness of prescription painkillers, nor will they have to give up their vast fortune to make the payouts. The family is shielded from all further opioid-related liabilities. And the families will not have an opportunity to confront the Sacklers face-to-face in court about the lives lost to opioids. Yet other families—who will receive between $3,500 and $48,000 in compensation—also realize that this was probably the best deal they could get and will avoid years of costly litigation at a time when funding for drug treatment programs is badly needed.

Meanwhile, a new study finds that adults under 45 who consume marijuana suffer from nearly double the number of heart attacks as those who do not use the drug. The study, published in the Canadian Medical Association Journal, said that whether users smoke, vape, or consume pot as an edible, there may be a significantly higher risk of having a heart attack. Researchers examined health data for more than 33,000 adults ages 18 to 44 and found that of the 17 percent who reported using cannabis, 1.3 percent later had a heart attack while only 0.8 percent of non-cannabis users reported the same. The study did not reach a conclusion about why pot has this effect, but previous research has shown it can cause an irregular heartbeat.

And finally, perhaps Amazon should have a look at this new data before it drops a requirement to test delivery drivers for marijuana use. The company says it is so short of drivers that the best way to recruit more is to advertise that they no longer screen applicants for marijuana use. This may boost applications by as much as 400 percent, as that’s the main reason why potential candidates fail, the company, which is lobbying the federal government to legalize marijuana, explains. Amazon would still test drivers for opiates and amphetamines and requires drivers to not be impaired while on the job. But if your package is late or lost, this may be the reason why.

The Daily Briefing 9.2.2021

The bankruptcy judge overseeing the Purdue Pharma opioid litigation has approved the OxyContin maker’s proposed $4.5 billion settlement, ending a years-long legal battle and opening the way for funding to flow to states for addiction treatment and compensation to victims’ families. The controversial agreement largely absolves the firm’s founding Sackler family and shields members from any liability, and as such, it will remain among the richest families in the country. In a personal note, the judge acknowledged that the settlement was “bitter” for many involved, adding that the Sacklers had never really apologized for downplaying the addictiveness of their prescription painkiller and using aggressive marketing strategies to push sales of a drug, which, along with other opioids, are linked to the deaths of more than 500,000 Americans over the past two decades.

Payments will be made to the states and the federal government over nine years, making it easier for the billionaire Sackler family to continue to make money from investments and continued sales of other Purdue drugs, although the company will be dissolved in its current form. The amount of the settlement and the long payout period has been criticized by many states, but a majority of the plaintiffs supported the plan, reasoning that it’s the best way to pay for a problem that has only worsened during the pandemic year, in which more than 93,000 died from a drug overdose. According to the agreement, more than 130,000 individuals and victims’ families will receive between $3,500 and $48,000 each, and states will receive money from a national opioid abatement trust to be distributed to local governments.

The Purdue settlement brings to a close a portion of the thousands of lawsuits against the opioid industry, including opioid manufacturers, drug distributors, and retail pharmacy chains, accused of contributing to the epidemic. A $26 billion deal is pending with the drug distributors, and other smaller settlements are also in the process of being resolved. Funding received from the litigation is welcome and will go a long way to help states and communities expand treatment and opioid-abatement programs. But it is far too little by itself when compared to the scope and scale of the massive drug crisis facing the country.

The Daily Briefing 8.31.2021

As overdose deaths due to fentanyl-laced street drugs are soaring across the country, the New York Times reports on a series of six deaths over three days along Long Island’s North Fork, a rural area about 100 miles from New York City. Police said the deaths were caused by cocaine mixed with highly lethal fentanyl, a drug more commonly mixed with heroin. The tragedy is part of a national trend, due in part to pandemic-linked drug shortages that have forced addicts to turn to substitutes like fentanyl. The dead were not hardened drug users, the article points out, but mostly recreational users seeking “a fleeting high,” that unfortunately included fentanyl, a drug so powerful that a mere speck of it can kill.

 Meanwhile, the long-running legal battle to open a safe drug injection site in Philadelphia may be decided by the Supreme Court. Hoping to clarify a series of contradictory lower court rulings, the group lobbying for the site—where users can shoot up in a safe, supervised setting—filed a petition with the Court to hear the case. Safe sites have operated for years in Europe and other countries, but are technically illegal in the U.S., and efforts to open the first American facility have failed in many cities, even as drug overdose deaths have surged due to the opioid epidemic. The latest legal move would force the Biden administration to take a stand on the issue, at a time when its drug policy appears to be shifting toward harm reduction programs including safe injection sites. Harm reduction is a critical component to save lives, but must be accompanied by drug treatment.

And finally, Colorado has unveiled a framework for distributing more than $400 million in opioid litigation settlement funds, which will go toward drug treatment and abatement programs. This could serve as a model for other states that are also in line to receive huge payouts from the opioid cases, including a share of the $26 billion settlement with drug distributors and a smaller amount from Purdue Pharma, if those agreements are eventually approved. In Colorado, most of the money will be distributed to regional health centers that are in desperate need of funding to confront the drug crisis. The plan stands in stark contrast to the way money was distributed in 1998 from tobacco companies, when funds flowed to state budgets for general purposes and not to smoking cessation initiatives.

The Daily Briefing 8.26.2021

New York Governor Kathy Hochul, in her first days in office after succeeding Andrew Cuomo, has spoken of the need to address the opioid epidemic and soaring overdose deaths. But on marijuana she has taken another approach, vowing to quickly implement the state’s stalled legal weed market without apparently addressing safety issues for the evolving cannabis industry. Legal marijuana was approved earlier this year, but Cuomo was locked in a dispute with the legislature on nominations to the cannabis regulatory board, which Hochul says she will resolve to ensure the market can get moving. So far, there’s no word from Hochul on critical issues such as amending the law to place caps on the psychoactive component THC, or extending the too-short deadline for municipalities to opt-out of allowing marijuana businesses—both critical issues to safeguard public health.

Meanwhile, pioneering legal weed state Colorado is moving to the next frontier in the marijuana market by ending its ban on public consumption of pot and allowing smoking lounges, tasing rooms, and tour busesfilled with stoned customers. Denver and Aurora would be the first cities to adopt on-site and mobile cannabis consumption, reversing a provision in the 2014 legalization law that prohibited using pot in open places. The new rules would allow pot lounges, either in brick and mortar form or on wheels. Luckily, the rules would force bus operators to put up a partition between the pot smokers and the driver, as well as install special filter systems. And the buses would not be able to stop outside schools, hospitals, or substance abuse facilities.

 And finally, a recent report finds that many hospital ERs do not address addiction, despite greater awareness of the effectiveness of addiction treatment and surging overdose deaths. ERs routinely fail to screen for substance use, offer medications to treat opioid use disorder, or connect patients to treatment or follow-up care. Now, new programs are being launched to train ER doctors, medical students, nurses, and other staff in addiction-related issues, and to help them refer patients for treatment.

The Daily Briefing 8.25.2021

Senate Majority Leader Chuck Schumer’s bill to legalize marijuana on the federal level is the wrong approach to cannabis reform, argues Kevin Sabet in the Wall Street Journal. A better way, he suggests, would be decriminalization for low-level possession and heavy regulation of the new industry to protect public health, along with a ban on the role of Big Tobacco in the emerging market. In particular, he proposes caps on the psychoactive component THC and curbs on concentrated marijuana products, as well as on any products designed to appeal to younger users. Keeping marijuana away from underage consumers is critical, he says, as use among children under 15 has increased in legal weed states including California, Nevada, and Oregon.

As such, there should be severe limits on any form of flavored or child-friendly products such as vapes and candies, as well as advertising. He also wants to stop Big Tobacco from taking a big stake in the industry, as the cigarette industry increases its investments in the new market. Overall, Sabet says we should enact measures that put public safety first—and help stop the rampant Colorado-style commercialization of the drug.

The Daily Briefing 8.24.2021

New Jersey voters overwhelmingly supported marijuana legalization in a referendum last year, with nearly 68 percent saying they wanted legal weed. But as the deadline passed this week for municipalities to opt-out of allowing cannabis businesses, more than 70 percent said “no,” passing ordinances that prohibit cultivation facilities, manufacturing, wholesale distribution, and dispensaries. Only 98 localities passed ordinances allowing pot sales, but also imposed strict zoning regulations, such as limiting them to one particular redevelopment area or zone. Others prohibited dispensaries while permitting cultivation.

The decisions were based on a number of factors. Some city officials are simply opposed to legal weed, believing the drug would adversely affect children. But many also opted out simply to buy more time as the six-month window to draw up rules for a new industry was too short. Some localities said they also lacked guidance from the state cannabis regulatory commission, which has not yet issued rules and regulations to govern the new market. Municipalities, which can opt back in at any time, were under deadline pressure because failure to pass an ordinance would mean dispensaries automatically receive conditional use in a retail zone.

Invoking opt-out clauses follows a similar pattern across the country in legal weed states, where majorities in even pro-pot states such as California and Oregon have banned sales. While legalization enjoys overall popular support, there are apparently widespread misgivings at the local level about the impact of pot on vulnerable populations, and easy access to the drug. Many municipalities, therefore, chose to forego potential tax revenues from pot sales, in order to protect public health, while reserving the right to say “yes” to marijuana in the future when more robust controls are in place.