President Biden’s Unity Agenda, unveiled in his first State of the Union Address, included a pledge to combat the opioid epidemic and help those struggling with drug addiction. While no new programs or initiatives were outlined, he called for increased funding for prevention, treatment, harm reduction, and recovery. In particular, he suggested getting rid of outdated rules that stop doctors from prescribing treatments for opioid use disorder, and for law enforcement to stop the flow of illicit drugs by working with state and local officials to go after traffickers. He reached out to those suffering from drug addiction, telling them “know you are not alone,” and he celebrated the 23 million Americans who are in recovery. No new programs or initiatives were outlined, such as a proposal in 2020 by then-candidate Biden to launch a $125 billion effort of the next decade to fight the opioid epidemic.
The Daily Briefing 03.01.2022
Psychedelics are emerging as a promising new field of research for possible benefits to treat conditions such as depression and PTSD, but studies have mostly focused on full doses of powerful drugs such as psilocybin. Now, however, the concept of micro-dosing psychedelics has become popular, with many claiming that small amounts enhance feelings of attention and cognition, well-being and relief from anxiety. Yet as more and more consumers dabble with these drugs, scientists are warning them to be careful, as evidence is still limited about their effect, and there’s no proof they help people—or if there’s any positive impact at all. Much of early research has been anecdotal, consisting of enthusiastic survey responses from users, but these have been small studies that did not compare a microdose to a placebo. The studies are therefore tied to users’ expectations and not reliable, so caution is required when using psychedelics, especially when it comes to sourcing and accurate dosing. There is a growing movement to decriminalize such drugs—but we should first conduct clinical trials to ascertain whether widespread use of psychedelics, in full or microdoses, poses a public health risk.
Meanwhile, although more than two in three Americans support legalizing marijuana, and a majority of states have legalized the sale of either recreational or medical cannabis (or both), federal-level legalizationstill appears to be far off. Although Democrats currently control Congress and the White House—which pro-pot groups believed would usher in a new era of cannabis reform—the Biden administration has been slow to move on the issue. And with midterm elections coming up, and the Democrats portrayed as soft on crime relaxing marijuana laws is not a priority. Also, some moderate Democrats say they want to see more research before legalizing at a time when rates of abuse of other drugs have risen, along with a surge in overdose in opioid-related deaths. President Biden has essentially avoided the issue, having previously supported allowing states to legalize on their own but not addressing marijuana’s status as a controlled substance.
And finally, the lack of federal legalization isn’t stopping the growth of marijuana sales—especially for cannabis-infused beverages, which are regarded among enthusiasts as a less invasive way to consume the drug. A report in Forbes notes that while the flower market share is declining in both the U.S. and Canada, the beverage category is one of the new product categories that saw positive market share growth, up 45 percent last year. As the rapid commercialization of cannabis follows legalization, expect more innovative marijuana products to go on sale—hopefully with oversight from government agencies.
The Daily Briefing 02.28.2022
Two cases involving doctors who were prolific prescribers of prescription opioid painkillers, and are currently in prison on charges related to pill mills, are going to the Supreme Court. The doctors doled out hundreds of thousands of prescriptions for quick-release fentanyl drugs for common ailments such as neck aches, and back and joint pain, disregarding guidelines stating that the drugs were approved for severe pain in cancer patients. They’re doing up to 20 years time in federal prison and paying millions of dollars in fines, and their assets have been seized. Now lawyers want the convictions overturned, arguing that the criminal standard the physicians faced was applied inconsistently among federal circuit courts. Experts say there’s little chance the doctors would be set free, but the court’s decision may impact the latitude medical professionals can take in prescribing potentially addictive painkillers and other addictive medications. It also raises questions about how well-meaning doctors might also be negligent, and where this stands in criminal law, with some saying they were acting as drug dealers. The opioid epidemic started with the overprescribing of these drugs, but even after strict prescription monitoring was introduced, the rate of overdose deaths has skyrocketed to record levels.
The Daily Briefing 02.25.2022
Three of the nation’s largest drug distributors have agreed to go ahead with a nearly $20 billion settlement of the majority of opioid lawsuits filed by state and local governments, bringing to an end a years-long legal battle over their role in the opioid epidemic. The three companies—AmerisourceBergen, Cardinal Health, and McKesson—will pay out the money over the course of 18 years to communities affected by the abuse of prescription painkillers. The deal covers about 90 percent of the lawsuits against the companies and comes as thousands of other cases against drug manufacturers and pharmacy chains are also headed toward some form of settlement. Under the agreement, the money must be spent on social services to address the harms of opioid addiction, such as treatment programs, education, prevention, addiction programs for the homeless, or for opioid-addicted babies. The settlement payouts provide a huge opportunity to address the addiction and overdose crisis and the staggering rise of fatalities to more than 100,000 annually.
Meanwhile, New York Magazine reports from the nation’s first supervised syringe sites in New York City, part of an effort to introduce harm reduction programs as the overdose fatality rate soars, both in the city and across the country. So far, the sites have saved more than 100 lives, by providing substance users with a safe setting for intravenous drug use, including clean needles, medical personnel, and fentanyl test strips. However, the sites do not provide drug treatment; instead, they hand out information about treatment and can refer a patient if they voluntarily want to try rehab. While such sites save lives, the lack of focus on treatment means they don’t really change lives, as the user will return to a life of drug use. If cities are experiencing high rates of drug overdose deaths and are looking to New York as a model, to be most effective and better serve their patients they should include a bridge to treatment as part of the harm reduction effort.
And finally, a new poll shows that while most parents do not know much about the cannabis-derivative CBD, the non-psychoactive component of the drug, they would be open to giving it to their kids under certain conditions. An overwhelming majority said they would consider CBD for treating anxiety, sleep problems, ADHD, and even autism, although there is only one FDA-approved product that contains CBD, and that’s for children with a rare form of epilepsy. The parents, however, would also like to know more about possible side effects and have the drug regulated by the FDA and prescribed by a doctor. CBD is widely marketed as a cure-all for any number of ailments—from insomnia to PTSD and stress—despite the fact that there is little scientific evidence that it is safe and effective for any of these ailments. The FDA is considering new rules and regulations for CBD sales, in response to the wave of false marketing claims by companies that sell the product.
The Daily Briefing 02.21.2022
Nearly 300 Americans die every day from a drug overdose, but instead of confronting this tragic public health crisis politicians from both parties are spreading misinformation about the goal of harm reduction programs—thereby endangering the Biden administration’s addiction policy. The latest fracas erupted after a conservative newspaper alleged that federal funds would be used to distribute “crack pipes” as part of safe smoking kits, which contain clean syringes, fentanyl testing strips, as well as sterile pipes to encourage addicts to switch from intravenous drug use to smoking, as that is considered a safer option. Yet instead of applauding this science-backed approach to help those struggling with substance use, politicians accused the administration of handing out "crack pipes" to Black communities—a racist trope in itself going back to the crack epidemic. There’s no evidence whatsoever that Biden wanted to do any such thing; no matter, this led to frenzied media activity and the introduction of legislation to curb the distribution of the kits, and the first federally-financed harm reduction programs. Harm reduction by itself is not a panacea for addiction or the overdose crisis, but it is a critical step to save lives, and ideally, engage patients in drug treatment programs.
Meanwhile, the Sackler family says it’s offering another $1 billion to sweeten the deal to end sprawling opioid litigation against Purdue Pharma, bringing the total to about $6 billion. But there’s a catch: the billionaire family members still insist that the settlement include a provision to shield them from any further civil liabilities—a demand that has already been rejected by 8 states and the District of Columbia (more than 30 states have said ok to the offer). It’s not clear if the extra $1 billion will help persuade the holdouts to settle, leaving the litigation in limbo, while at the same time, other opioid cases against drug distributors and pharmacy chains head toward a conclusion. While this settlement money—to be doled out over more than a decade—is badly needed by states and local authorities to pay for drug treatment and prevention programs, and to compensate victims’ families, it should not be a substitute for a massive increase in federal funding that can help people right now and reduce overdose deaths.
And finally, although there’s no scientific evidence showing that medical marijuana is effective to treat opioid addiction—that isn’t stopping a number of cannabis companies in Pennsylvania from saying it does and promoting pot as a substitute for opioid withdrawal medications. An investigation revealed that the companies use a wide range of misleading tactics, cherry-pick data, misrepresent only parts of studies, and make broad claims without citing scientific research. Most alarmingly, they suggest that medical pot can be a viable substitute for buprenorphine, one of three FDA-approved drugs to treat opioid use disorder, which health experts say can be dangerous for patients. If states are going to legalize marijuana, they must closely monitor and push back against false marketing claims that may be detrimental to consumers.
The Daily Briefing 02.17.2022
Lawmakers have asked the Department of Justice to explore whether criminal charges should be brought against members of the Sackler family who control Purdue Pharma, opening a possible new front in sprawling nationwide opioid litigation. The senators made their move as a potential $4.5 billion settlement between the Sackler family and prosecutors in some 3,000 lawsuits hangs in the balance. That settlement initially included a provision shielding the family from further liabilities, a clause that angered victims’ families and was recently rejected by a judge. In pressing their action, the senators noted that the Sacklers directed and oversaw operations and marketing that falsely claimed its premier product, OxyConton, was non-addictive, which fueled the opioid addiction and overdose crisis. Whether the Justice Department will take up the matter isn’t clear, nor is how this would impact other billion-dollar settlements.
Meanwhile, Pew Trusts has released an in-depth look at the addiction crisis, and how the states should address it. First, they must expand their treatment offerings and remove unnecessary regulations so that more people can access life-saving treatment for opioid use disorder. Although medication is the most effective treatment for OUD, only a fraction (just 18 percent) of the 1.6 million people with OUD receive medication. Pew also calls for more flexible approaches to treatment—such as mobile methadone treatment, to make access easier— and to provide integrated medical and mental health care.
And finally, one of the hallmarks of marijuana legalization laws approved by states is the opt-out provision, allowing municipalities to ban cannabis businesses in their neighborhoods. Although polls show that a majority of Americans generally favor legalization, in most legal states a majority of localities have nevertheless opted out and said no to dispensaries as well as on-site consumption lounges, fearing an uptick in drug use and a negative impact on vulnerable populations, such as young people. Now, however, the powerful cannabis lobby in California appears to be mounting a campaign to rescind the opt-out provision, arguing that this has led to a growth in the illicit market for pot. Citing a “disappointment gap" between what legalization promised and today’s still booming black market, an industry lobbyist says that today there are fewer licensed retail outlets in the state than there were before cannabis reform. Not a very compelling reason to take away the right of communities to say they don’t want pot stores in their backyard.
The Daily Briefing 02.16.2022
The death in 2019 of 27-year old Los Angeles Angels baseball player Tyler Skaggs from an opioid overdose raised serious questions about drug use in Major League Baseball. Now, the trial of a communications executive accused of supplying drugs to the player (he has denied the charges) is revealing the possible extent of drug-taking in the majors. According to trial testimony, four other players have come forward to say they too used opioids while playing for the Angels, pointing to the prevalence of drugs inside the game. This is putting increased scrutiny on the Angels for failing to recognize what was happening in the clubhouse and the league’s efforts to address opioid addiction in its ranks. Players began mandatory opioid testing only in 2020, decades after the opioid epidemic was sweeping the country, and now kills more than 100,000 Americans a year. Given the extent of the opioid problem across the country, experts say it was inevitable that opoid use was more widespread than previously known. Baseball players and other professional athletes could be particularly susceptible to opioid addiction, as they must frequently deal with pain and the pressure to perform in spite of it.
The Daily Briefing 02.15.2022
With more than 100,000 American deaths from a drug overdose over the past 12 months, the New York Times looks at the root causes behind this tragic crisis, noting that the U.S. is the only developed nation in the world dealing with a comparable problem. It blames the crisis on the easy availability of prescription painkillers over the past decades, followed by the wave of heroin use after prescription monitoring was put in place, and the current situation in which the powerful synthetic opioid fentanyl is fueling the surge in overdose fatalities. Compounding the problem, the Times observes, is that Americans have insufficient access to both mental health and drug treatment. A better treatment network would have mitigated the damage—but the U.S. has never had such a system. Over time, the lack of leadership and resources to confront addiction and overdose has led us to the current public health crisis, in which we have effectively made it easier to get high than to get help, the article notes.
Meanwhile, Forbes reports that tech giant Apple has quietly swung its support and corporate muscle behind cannabis reform—joining Amazon and other companies in efforts to open a federally legal, commercial cannabis industry across the U.S. For years, large tech companies such as Facebook and Google didn’t get involved in marijuana policy, but that changed over the summer when Apple, without much fanfare, changed its policy to allow apps handling the sales and delivery of both medical and recreational cannabis in legal marijuana states. Not surprising that corporate America is backing legal pot, as more and more states adopt legalization. But they should also be lobbying for tough rules and regulations governing this booming market, in order to protect vulnerable populations such as young people.
And finally, many people who consume marijuana say it helps them stave off nausea during pregnancy and treatment for cancer. But new studies show that for some daily, long-term pot users the effect is the opposite: nearly uncontrollable vomiting. The condition, known as cannabinoid hyperemesis syndrome, is receiving more attention with the growing use of marijuana in legal states. Those with the syndrome can suffer bouts of vomiting so severe that they may need to be hospitalized along with dehydration, weight loss, and life-threatening electrolyte disorders—shattering the image of the drug as a largely benign substance.
The Daily Briefing 02.14.2022
More than 300 Americans die every day from a drug overdose, but instead of focusing on this public health crisis Republicans and right-wing media have been whipped into a frenzy over government grants to supply people with safe smoking kits, among other harm reduction measures. According to the misinformation campaign, the smoking kits—along with overdose reversal medication, fentanyl test strips, and infectious disease testing supplies—are allegedly aimed at handing out crack pipes to the Black community. While this is patently false, and based on racist tropes perpetuated during the crack era which disproportionately impacted Black people, Fox News, and Republican politicians, are claiming that Biden wants more “Black people to smoke more crack and meth.” In fact, safe smoking supplies, distributed through harm reduction programs, is an evidence-based practice that helps people who inject drugs to switch to smoking, which is considered a less risky mode of consumption. Other benefits include reduction of injection-related harm and risks such as infection and blood-borne disease transmission, as well as reduced risk of overdose, as inhalation involves lower doses of the drug. At a time when more than 100,000 Americans have died of a drug overdose in the past 12 months, spreading lies about giving crack pipes to Blacks diverts us from the critical task of confronting the tragic addiction and overdose crisis.
The Daily Briefing 02.11.2022
As the nation grapples with addiction and opioid-fueled overdose epidemic, the federal government has proposed new guidelines for prescribing opioid painkillers in the first comprehensive revision of the rules since 2016. The CDC proposalremoves a previously recommended ceiling on doses for chronic pain patients, while also urging physicians to first turn to “nonopioid therapies” such as over-the-counter ones like ibuprofen as well as physical therapy, massage, and acupuncture. The guidelines—which do not apply to patients suffering pain from cancer, sickle cell, or end-of-life palliative care—remove lower dosing levels that many chronic pain patients felt were unfair, but which led to a large reduction in prescriptions as part of efforts to curb the opioid epidemic. The CDC wants doctors to have more flexibility on dosing, while clearly stating the potential risks of prescribing highly addictive opioids.
Meanwhile, the Supreme Court will address a related issue when it takes up the case of two doctors convicted of unlawfully dispensing opioid painkillers. The question before the court is, what threshold do physicians have to cross—and what sort of intent do they need to have—for prescribing to be considered a crime? Doctors are free to prescribe controlled substances such as opioids, but can also be criminally liable if they prescribe the medication in dangerous ways. Health officials are grappling with these questions in the wake of the opioid epidemic, which was fuelled by massive overprescribing of prescription painkillers.
And finally, the American Heart Associationsays that despite the perception that marijuana is harmless, there’s a growing body of evidence challenging that belief, and there are many unanswered questions about its impact on brain health. At a time when both recreational and medical marijuana is more available due to legalization, current research suggests that actively using the drug can impact verbal memory, driving ability, cognitive functions in children, as well as clot-caused stroke.
The Daily Briefing 02.09.2022
Drug overdose deaths are surging across the U.S., driven by the powerful synthetic opioid fentanyl. But fatalities are also increasing due to a combination of opioids and stimulants such as cocaine and methamphetamines—and when looked at along racial lines, the number was even more dramatic among Black Americans, according to new research from NYU Langone. While overdose fatalities from opioids and stimulants rose across all racial groups and across the country, Black Americans died at three times the rate as non-Hispanic White people—particularly in eastern states. Investigators found that the rate of Black overdose deaths climbed by 575 percent, compared to 184 percent for White people. The report blamed a lack of access to healthcare and substance use disorder treatment services as the main cause of the increase.
Meanwhile, a report released by a congressional commission estimated that the opioid epidemic costs the U.S. roughly $1 trillion annually, up from $700 billion just a few years ago. The estimate is based on the fact that overdose fatalities have more than doubled in recent years, from about 44,000 in 2013 to more than 100,000 last year—and now outpace deaths from firearms, suicide, homicide, or car crashes. The report recommends expanding mental health services and access to treatment for those suffering from addiction.
And finally, the same report named Mexico as the main source of deadly fentanyl in the U.S., and warned that if policies are not changed to address the challenges of the addiction and overdose crisis, more lives will be lost. Last year, fentanyl accounted for nearly two-thirds of the more than 100,000 overdose deaths, as the powerful synthetic drug was taken directly by addicts or mixed by dealers into other drugs unbeknownst to users. While China had previously been the dominant source of fentanyl, Mexico is now the primary supplier, with the drug produced cheaply there and easily transported over the border.
The DailY Briefing 02.08.2022
A bipartisan congressional commission is urging the Biden administration to adopt a strong leadership role to fight the nationwide addiction and overdose epidemic, as part of a new multi-pronged strategy. With overdose fatalities at record levels—more than 100,000 over the past year alone—the commission’s report says the anti-drug effort requires Cabinet-level leadership, including reinstating the White House “drug czar” and the Office of National Drug Control Policy to a cabinet post in order to direct a far-reaching federal effort. The strategy should include law enforcement as well as expanding evidence-based treatment and establishing pathways for addicts to re-enter society and rebuild their lives. The Rosenthal Center has long advocated such measures, including reinstating the ONDCP and drug czar positions to the cabinet to oversee and coordinate sprawling state and federal programs. Whether President Biden eventually will act on these recommendations is uncertain, as he has so far shown little interest in significantly expanding the government’s role in fighting addiction, boosting funding, or reforming the structures that are currently in place to confront the addiction and overdose crises.
At the same time, what the Biden administration has spoken out about is the importance of advancing harm reduction programs, which have received much media attention recently with the opening last year in New York City of the country’s first safe injection sites, otherwise known as overdose prevention centers. This happened after a long legal battle with federal authorities, but now it appears that the Justice Department is signaling a change in policy that would allow these types of facilities to flourish. The Department says it is currently evaluating such sites and looking into what appropriate guardrails would be needed to safeguard public health—a drastic change in tone after vigorously fighting harm reduction programs in the past. Safe sites have existed for decades in Canada and Europe, and while these facilities are critical to saving lives they fail when it comes to engaging substance users and encouraging them to enter treatment. If safe sites are to expand on a national level we need to ensure they not only reduce harm but also become a bridge to life-changing treatment
The Daily Briefing 02.02.2022
Opioid litigation settlements are coming at a rapid pace, with the latest deal valued at $590 million dollars between more than 400 Native American tribes and opioid maker Johnson & Johnson, and three of the nation’s largest drug distributors. Native American communities, which were hard hit by the opioid crisis, accused the companies of fueling the crisis, causing tribal governments to spend millions of dollars in healthcare, social services, and other costs. The deal follows a separate $26 billion settlement last year between the same companies and state and local governments, which were among some 3,300 lawsuits blaming the wholesalers for failing to monitor shipments and J& of downplaying the risk of highly-addictive opioids.
As part of the settlement, the wholesalers — McKesson, AmerisourceBergen, and Cardinal Health— will pay nearly $440 million over seven years, while the Janssen unit at Johnson & Johnson agreed to $150 million over two years. This is a significantly faster timetable than in previous settlements with states and local governments. By contrast, the drug manufacturer will pay thousands of local governments and states $5 billion over nine years, with the distributors paying $21 billion over 18 years. The money will go to tribal governments for education, prevention, and treatment programs that have been sorely lacking within the Indian health service.
Native Americans suffered the highest per capita rate of opioid overdoses, the highest drug overdose death rates in 2015, and the largest percentage increase in the number of deaths over time from 1999 to 2015 compared to other racial and ethnic groups, according to federal government data and statements made at a congressional hearing. Even as settlements are made, the addiction and overdose crisis continues, with more than 100,000 Americans dying of an overdose in the 12-month period ending this April. While the settlement money is welcome, and will eventually help slow the rate of fatalities, we also need massive government funding now to confront this ongoing public health crisis.
The Daily Briefing 02.01.2022
One of the many myths of marijuana legalization was that it would end the black market for pot and the illegal drug trade—at least, that’s what pro-cannabis supporters have promised. But that’s not what has happened: some of the states with the largest legal markets are dealing with rampant illegal production. So much so that legal states such as Oregon and California are still furnishing the majority of America’s illegal weed, and the black market is booming across the country, according to a report in Politico. In California, most of the state continues to purchases pot from unlicensed sources. What is happening in the woods of southern Oregon—which has become a center for illegal cannabis grow farms, as well as drug cartels—is one of the most confounding paradoxes of legalization. Illegal farms scare local residents, scar the landscape, and attract criminal activity. Some say it’s an economic problem, due to high taxes on legal weed, but critics argue that legalization has created greater demand, thereby attracting more sellers, both legal and illegal.
Meanwhile, the opioid addiction and overdose epidemic continues unabated, with Washington, D.C. reporting a 46 percent increase in 2020 from the previous year. Recently, there were 10 overdoses in the District in a matter of hours—three of them fatal. Before the pandemic, Mayor Muriel Bowser promised to cut the number of opioid deaths in half, but now such fatalities outpace homicides. Health officials say that two years ago, most of the cases in D.C. were 18 to 26 years old, but today that has shifted to 46 to 55-year olds, many of them with medical conditions that make an overdose harder to survive.
And finally, the Sackler family, founders of opioid maker Purdue Pharma, are said to be near an agreement upping their share of a settlement to resolve years-long opioid litigation. Reports say the Sacklers might boost their more than $4 billion offer in order to overcome objections from 8 states who opposed the deal because it shielded the family from further legal liability. Recently, a judge agreed with this claim, noting that members of the Sackler family had not individually filed for bankruptcy protection. Billions of dollars in settlement money are currently in the pipeline from the sprawling litigation against opioid manufacturers, drug distributors, and retail pharmacies, with the money going toward drug prevention, education, and treatment programs.
The Daily Briefing 01.31.2021
With drug overdoses at an all-time high in the U.S., a new study sheds light on the path many patients take from their first opioid prescription to a fatal overdose. A study of more than 236,000 adults identified several factors that people had in common: they were more likely to be men, over 75, insured by Medicaid or Medicare, and have substance use disorder or depression and underlying medical conditions. In addition, they were at higher risk if they were first prescribed oxycodone or tramadol, and fill their prescriptions at three or more pharmacies. Flagging these factors, the study noted, might help doctors see which patients are most likely to be harmed when given these drugs.
Meanwhile, a recent analysis of previous research on the impact of cannabis on young people’s cognition finds that many of the known learning and memory difficulties—such as slowed processing speed, and difficulties in focusing—could linger for weeks. Verbal learning, retention, and recall were especially affected for longer periods when the person was no longer high. There’s also a suggestion that cannabis use in teen and young adult years, when the brain is especially vulnerable, may have lasting residual effects, such as poor academic and job performance.
And finally, despite such findings of the impact of pot on teens, the cannabis industry continues to flout rules and regulations intended to curb marketing to this age group. In fact, many recreational marijuana companies market their product in a way that specifically appeals to children and teens, and is also easily viewed by people of all ages on social media platforms, according to a new study. It found content designed to appeal to youth culture—with young models or recognizable characters—or budget limitations, such as promotions and discounts, despite current regulations. Many pot companies generate dozens of social media posts per day, and there is currently no system in place to monitor them and enforce rules. As more and more pro-pot groups tout safety precautions in the push for legalization, such studies point to the industry’s flagrant disregard for the health of consumers—especially vulnerable populations including young people.
The Daily Briefing 01.28.2022
More than 1,500 municipalities across New York State decided at the end of 2021 whether to opt-out of allowing marijuana businesses, with about half of all cities, towns, an villages banning dispensaries and 57 percent saying ‘no’ to on-site consumption lounges. Although pro-pot groups like to point out that an overwhelming majority of Americans favor legalization, there is still much debate when it comes to opening neighborhood cannabis businesses. In New York, many of these local discussions led to fractious board meetings, strident social media posts, and political challenges from citizens and interested groups, reflecting the depth of divided opinions about cannabis reform. Those who want to opt out cite the following reasons: state regulations are not yet complete, a fear of encouraging drug use, especially for young people; changing the character of a town; and finally, worries about drugged driving. Supporters point out the economic benefits of job creation and tax revenue. As legalization is likely to move forward in a slew of states this year, this debate is far from over.
Meanwhile, concerns about drugged driving in the age of legal weed is not an overreaction, at least according to yet another study about the impact of marijuana on driving. The research, published in JAMA Psychiatry, showed that regular cannabis users may be driving more impaired and for longer than they may think. Worse driving performance is evident for several hours post smoking in many users, according to the study. What’s more, the consistent and frequent use of cannabis negatively affects cognitive function and reduces driving ability. Those in the study who had smoked THC, the psychoactive component of pot, showed reduce driving performance including being more likely to leave their lane, and this persisted even after three hours, in which they showed lingering signs of impaired driving ability.
And finally, in addition to avoiding drugged driving, you may also want to avoid marijuana when pregnant, as yet another study makes very clear. Published in JAMA Open Network, the analysis found that people who smoke marijuana during pregnancy are at a higher risk for having low birth weight babies and preterm delivery, among other complications, compared to those not exposed to the drug. The drug takers are also more likely to require admission to neonatal intensive care units due to birth complications. This latest report adds to a growing body of evidence underscoring the risks and dangers of marijuana during pregnancy, and the potential harm it may cause to your baby.
The Daily Briefing 01.26.2022
In or out? That was the question for more than 1,500 municipalities across New York State under its new marijuana law, which asked localities to decide whether to allow cannabis businesses in their areas. With the final count in, the State Office of Cannabis Management says that 34 percent of all municipalities have said no to both dispensaries and on-site consumption lounges, including 10 percent of all cities with a total population of almost 120,000. Although polls show that Americans overwhelmingly favor marijuana legalization, legal states including Colorado, California, and Washington have seen large numbers of local governments opt-out, citing reasons such as the potential for negative impact on vulnerable young people and the danger of drugged driving. In New York, any municipality that has initially said no can opt back in at any time.
Meanwhile, the American Lung Association warns in its annual tobacco report that while adult smoking rates have fallen from 22 percent in 2003 to 14 percent in 2019, vaping and flavored cigarettes products threaten to turn back the progress made in reducing tobacco use. The organization notes that high school smoking rates have dropped significantly since 2002, but that more than 2 million high school and middle school students said they use e-cigarettes in 2020. The report says that companies are exploiting loopholes in regulations by introducing products with synthetic nicotine, some of them flavored, that have become the most popular e-cigarette products among teens. The Association has called on the Food & Drug Administration to regulate synthetic nicotine as a drug.
And finally, the movement to decriminalize possession of hard drugs is growing across the U.S., with states including Massachusetts, Vermont, and possibly California considering following the lead of Oregon, the first state to do so. In an opinion piece in the New York Times, Maia Szalavitz writes that these states are coming around to the conclusion that it is impossible to treat addiction as a disease and a crime simultaneously. Noting that 80 percent of prisons and jails offer medications to treat substance use, she says the lack of treatment while incarcerated deters people from seeking further help. However, it’s still too early to evaluate the effectiveness of Oregon’s approach, which includes a significant expansion of treatment availability that has not yet happened. So far, however, very few of those who have been cited for possession make a required follow-up call to get the required treatment evaluation.
The Daily Briefing 01.25.2022
America’s longest war is the war on drugs—and we lost. That’s the focus of a thoughtful essay in the Wall Street Journal, looking at the losses over the past half-century: untold lives and billions of dollars spent on both law enforcement and the military. Since President Nixon’s declaration of war in 1971, drug use has soared in the U.S., drugs are more potent than ever, and the power of criminal narcotics gangs has exploded. Accidental overdoses kill more than 100,000 Americans a year, and the powerful synthetic opioid fentanyl has now killed far more people than all U.S. conflicts since World War Two combined. We declared war on drugs—and drugs won. The way forward, the article suggests, is to focus less on law enforcement and decriminalization and more on a health-based approach, with special attention to medication-assisted treatment.
Meanwhile, New York State’s cannabis control board has quietly revised regulations so that a licensed practitioner can certify a patient for medical weed for any condition they believe the drug can treat—rather than from a list of approved conditions. This change will vastly expand the market for medical marijuana and also pose risks to patients. Not that the list of conditions made much sense anyway: doctors could, for example, certify pot for those suffering from Alzheimer’s disease, although patients-rights groups warn that there’s no scientific evidence showing that cannabis is an effective treatment, and might even be dangerous. Now, a doctor can simply say they believe pot will help with whatever is ailing a patient and issue a medical cannabis card, without any clinical data to back that up. So much for science and best medical practices.
And finally, the recent social media frenzy surrounding a study purportedly showing that cannabis can stop COVID is yet another example of how the hype and promise of pot products far outweigh the reality. The researchers stressed that the early-stage study was not definitive, and would require clinical trials and that consumers should not turn to untested pot products in hopes that it might protect them from the coronavirus. These facts, however, did not stop widespread media attention and speculation that smoking a joint would keep you safe from the disease.
The Daily Briefing 01.24.2022
With the nation experiencing a record number of drug overdoses, former U.S. Rep. Patrick J. Kennedy has taken the Biden administration to task for not doing enough to confront the overdose and addiction crises—and has called on the president to announce a “coordinated federal strategy to address it. Reviewing the first year of Biden’s presidency in a commentary in The Hill, Kennedy fault the administration for describing the small incremental changes as progress, and urges the administration to invoke every power of the executive branch to reverse the trend of fatal overdoses. A new strategy should focus on several areas: widen the availability of overdose response resources; shut down illicit fentanyl mills; provide insurance parity for mental health and substance use, and increase access to medication-assisted treatment (MAT). Finally, Kennedy says Biden should show leadership at the federal level to guide policies and programs for state and local governments.
Meanwhile, NPR looks at new studies that add to a growing body of evidence confirming that drug treatment works—and that most people who experience alcohol and drug addiction not only survive but eventually recover and go on to live full and healthy lives. Studies show that life after addiction is not only possible, it’s the norm: Roughly 22.3 million Americans—or more than 9 percent of adults—living in recovery after some form of substance use disorder. Unfortunately, most Americans only see the destructive side of addiction, rather than those who make it through rehab to rebuild their lives. Both available data and live experience contradict a widespread misperception that substance use disorder is a permanent and often fatal affliction, when in fact people who use hare drugs for long periods do typically recover.
And finally, AARP reports there has been an alarming increase in fatal overdoses among older adults, with nearly 80,000 Americans age 55 and older dying due to an opioid overdose between 1999 and 2019. During this time, the number of those in this age group who had died spiked from just over 500 to more than 10,000. The surge in fatalities was due to a number of factors, including an increase in the number of opioids used to treat chronic medical conditions—such as arthritis and cancer, among others—most commonly diagnosed in this demographic, as well as a lack of screening for substance misuse among older adults.
The Daily Briefing 01.20.2022
A series of new studies and reports contributes to a growing body of evidence about the potential risks and dangers of marijuana and its derivative products containing CBD, the non-psychoactive component of the drug. In many cases, the findings contradict the claims of the marijuana legalization movement and the booming CBD industry. In one study published in JAMA Psychiatry, researchers looking into the “substantial and alarming” increase in suicide attempts in the U.S. over the past decade found that the largest increases were among women, young adults, and those who regularly use substances such as alcohol or cannabis. As more and more states legalize marijuana, pro-pot groups continue to falsely assert that pot is a mostly benign substance.
Meanwhile, the problem of drugged drivingwas addressed in a Canadian study looking at the prevalence of psychoactive THC in drivers who were moderately injured in traffic accidents. The result: the number had more than doubled since cannabis legalization in the country, which bolsters existing data showing an increase in driving-while-drugged traffic accidents in legal pot states and underscoring concerns that legalization is likely to lead to more injuries and death. Currently, there are no devices available to accurately measure the presence and level of marijuana and THC in the body.
Finally, as the market for CBD products continues to grow amid little or no government or industry regulation, a studyshows that consumer CBD products vary greatly in formulation, purity, and label accuracy—with beverages being particularly inconsistent. Many of these products also contain THC. Overall, the products—often touted as a panacea for stress, insomnia, pain, and other conditions, without scientific backing—show inconsistent labeling and vary in their label claims, thereby exposing patients and consumers to risks such as side effects, interactions, and failed drug tests. It’s time for federal agencies and public health organizations to finally crackdown on the CBD industry’s dubious claims and dangerous marketing.