The Daily Briefing 04.15.2022

For years the Food and Drug Administration has been in a running battle with the e-cigarette industry over rules and regulations of the now booming vaping sector, especially with teens. Now, Congress has finally given the federal agency the legal authority to close the largest loophole in the industry: cracking down on companies that use synthetic rather than plant-based nicotine, including those in fruit- and candy-flavored products popular among young people. The law targets companies like Puff Bar that had switched their recipes to lab-made nicotine to avoid FDA control. Synthetic nicotine will now be subject to the same sales restrictions as nicotine products, allowing the FDA to stop companies from targeting kids, at a time when vaping among middle and high school students has reached epidemic proportions. After launching in 2019, Puff Bar became the most popular e-cigarette among teenagers, with flavors such as blueberry, strawberry banana, and mango—a typical marketing tactic that is particularly sinister when it is applied to highly addictive e-cigarettes. Meanwhile, the FDA continues to exert control of the vaping industry, reviewing applications for a vast array of vaping devices that are seeking market approval—and rejecting more than one million so far for their potential appeal to teenagers.

The Daily Briefing 04.13.2022

More troubling news as the addiction and overdose epidemic continues to spiral out of control: a new study finds that the rate of fatal teen overdoses in the U.S. nearly doubled in 2020 after staying flat for a decade. The report, published in JAMA Network, showed that fatalities are spiking not because of a surge in drug use among 14- to-18-year olds, but rather because of the supply of increasingly deadly drugs such as fentanyl, which is also driving the overall death toll to more than 100,000 annually—a grim record. In fact, the survey showed that fewer teens are actually experimenting with drugs, including during the pandemic despite lockdowns and isolation, and other factors that increase stress. What is killing teens now is drugs such as Xanax or marijuana that are diverted from the legal supply and contaminated with fentanyl by drug dealers, and consumed unawares by young people. In 2020, 954 adolescents fatally overdosed, a rate of 4.5 per 100,000; for the first six months of 2021, the rate rose another 20 percent to 5.5 percent. The new study also noted that the highest adolescent mortality rate was among American Indian or Alaska Native teens; as of 2020, this group had the highest overall overdose mortality rate—some 30 percent higher than white people. To protect young people, we need a nationwide education, prevention, and awareness campaign warning of the dangers of drug use—and especially, contaminated legal drugs laced with powerful fentanyl.

The Daily Briefing 04.12.2022

As more and more states legalize both recreational and medical marijuana, sales in the U.S. are expected to top $33 billion by the end of this year, a 32 percent increase over last year. And if the market continues to grow as expected, sales could exceed $52 billion by 2026. In the latest state to open its market—New Jersey—the first licenses have been awarded to medical-marijuana stores. As weed becomes more widely available, concerns are also growing about the risks of driving while high on pot. Is it more dangerous than driving while drunk? The New York Times answers this question by saying that getting behind the wheel after smoking a joint poses distinctive risks. Research shows that THC, the psychoactive component of cannabis, impairs a number of behaviors related to driving, including the ability to weave between lanes, and delays response times in general. Psychoactive effects can also make cannabis dangerous, such as the paranoia that some people experience while high could induce a panic attack while on the road. Weed can muddle perceptions of safety, and also create an altered sense of time and the sludgy sense that everything around you is moving slower than it actually is. What’s more, unlike alcohol, where there’s a definite quantity that constitutes a single drink, marijuana has no agreed-upon dosage. It's tricky for pot users to predict how exactly they’ll be impaired, especially with edibles, which take longer to be absorbed into your system. Debates over legalization often focus on the driving-while-high issue, with many critics voicing concerns that law enforcement has no way to measure how impaired a driver might be, even as traffic accidents have increased in legal states. But that isn’t stopping the powerful cannabis industry from pushing for legalization and lax regulations and oversight of sales.

The Daily Briefing 04.11.2022

The House has passed a bill to legalize marijuana on the federal level, but Democratic backers of the measure face a tough uphill climb to win approval in the Senate. The bill—which would remove marijuana from the federal controlled substances list—faces staunch opposition from Republicans, as well as a few Democratic Senators, including Joe Manchin of West Virginia and Jeanne Shaheen of New Hampshire. Both senators have voiced concerns about legalizing recreational cannabis (Manchin is supportive of legal medical marijuana) given the substance abuse crisis in the country, and the lack of comprehensive data on how people are affected by pot. The uncertainty comes as more and more states legalize marijuana on their own and establish cannabis markets. Polls show broad support for legalization, although in many legal states municipalities have invoked the opt-out clause to ban retail cannabis sales and on-site consumption lounges, indicating a grassroots reluctance to sanction commercial cannabis sales. The Democratic House bill, knowns as the MORE Act, would not only remove marijuana from the controlled substances list but also expunge certain marijuana-related convictions, and impose a tax on marijuana sales to help communities disproportionately impacted by the nation’s war on drugs. While legislators argue over how to move the bill forward, there’s unfortunately little discussion of how to regulate and monitor the marijuana market and impose restrictions to protect public health and safety on a federal level.

The Daily Briefing 04.07.2022

The federal Drug Enforcement Agency has sent a letter to law enforcement officials across the country warning of a nationwide spike in fentanyl-related mass-overdose events. The DEA raised the alarm following a surge of nearly 30 fatalities in at least seven cities in recent months, as drug traffickers continue to push fentanyl and mix the powerful synthetic opioid with other illicit drugs. Mass-overdose events—defined as three or more overdoses occurring close in time and at the same location—have taken place in cities including Austin, Texas, Omaha, and Washington, D.C. The usual scenario, the agency says, is when drug dealers sell their product as “cocaine,” when it contains fentanyl, or when they sell pills designed to appear nearly identical to legitimate prescriptions but are actually fake pills containing pills—a frightening trend where many victims are dying after unknowingly ingesting fentanyl. The warning comes as fentanyl poisoning fuels the nationwide opioid epidemic that last year killed more than 100,000 Americans. In response, the DEA says it is working to trace mass-overdose events back to the local drug trafficking organization and international cartels responsible for the surging domestic supply of the drug.

The Daily Briefing 04.06.2022

As fentanyl-related overdose fatalities surge across the country, to more than 100,000 annually, efforts are underway to both reduce the availability of the drug and increase penalties for those with sell it or mix it with other drugs—one of the main causes of overdose deaths, as users consume the product unaware that it is contaminated. One way to reduce accidental overdoses is to make fentanyl test strips—which can detect the drug’s presence—more widely available; strips are currently used at safe syringe sites and other harm reduction facilities, and sometimes at concert venues where drugs are being taken. Lawmakers in some states also want to hand down harsher sentences for those caught dealing fentanyl or contaminating other drugs with it, although much of the fentanyl coming into the U.S. is from China or comes over the border from Mexico. Since last year, at least half a dozen states have enacted laws to legalize fentanyl strips and a dozen others are considering them.

 Meanwhile, as New York State gears up to implement a marijuana legalization law passed last year, a government website called Cannabis Conversations has been launched to inform consumers about this new market—and the potential dangers of cannabis. It bluntly says that there can be real health risks and impacts, especially if you are pregnant, and can be addictive and lead to cannabis use disorder (up to 3 in 10 people who use pot develop this condition.) The site tells consumers that certain cannabis compounds like THC, the drug's psychoactive ingredient, can affect the developing brain in young people, with possible effects such as difficulty thinking and solving problems, memory and learning issues, reduced coordination, difficulty maintaining attention, and problems with school and social life. At least the government is being honest about the risks, but with all these downsides and potential health hazards, it’s a wonder that legalization happened at all.

 And finally, The New York Times looks into another myth about marijuana —that it can improve your sex life—and casts some doubts about taking the drug as an aphrodisiac. According to the paper, the research so far on the subject is so thin that it’s hard to say with certainty whether cannabis will increase or decrease desire or improve your sex life. It adds that anecdotal evidence suggests that the right dose and delivery method can make a positive difference with some people by enhancing the senses, but also warns that it could inhibit desire.

The Daily Briefing 04.04.2022

Psychedelic drugs are becoming mainstream, with calls for their legalization and more research into their impact and possible use in the treatment of certain mental health conditions such as depression anxiety, and PTSD. Now, scientists are focusing on psilocybin, the active ingredient in psychedelic mushrooms, as a promising treatment for drug and alcohol addiction, as well as tobacco, according to limited early studies. One of the reasons addictions are so hard to treat is that most are more than chemical dependency, with people suffering cravings long after short-term withdrawals have waned, as their brains often divert them back to the familiar territory of their addiction. Some experts say psilocybin addresses this psychological need. Still, it’s uncertain how effective using psilocybin to treat addiction is in the long term and whether some individuals are more likely to benefit than others. Some study participants had troubling experiences during their trips, and experts say that people should not be taking the drug outside of legitimate research studies or without medical supervision, so we should move ahead with caution to evaluate the potential of psychedelics.

Meanwhile, the House has passed a far-reaching bill to legalize marijuana on the federal level, but there is no clear pathway for the legislation to be approved in the Senate. It’s the second go-around in less than two years for the House on the measure, which was approved largely along party lines, with Democrats in favor and Republicans largely against. Known as the MORE Act, it would have decriminalized cannabis, scrapped some old marijuana-related convictions, and allowed states to make their own decisions about marijuana markets—which they are already doing anyway. The bill faltered mainly on the issue of whether the government should provide financial incentives to individuals and communities who were the most harshly impacted by the war on drugs; Republicans, for the most part, say no, while Democrats cast the MORE Act as a criminal-justice initiative. There’s little chance the bill would gather enough support to pass the Senate, and if the Republicans make gains in the midterm elections, the future of the legislation would be further in doubt. Currently, 18 states plus the District of Columbia have, on their own, legalized marijuana, and established robust commercial markets for both recreational and medical cannabis. 

And finally, new data indicates that post-surgery opioid prescribing for kids has plummeted over the past few years, in the wake of research linking opioids to such harms as respiratory depression, and the risk of continued opioid use, when non-opioid painkillers work just as well. Once routinely ordered for children to relieve moderate pain after outpatient surgery from tonsillectomies or knee arthroscopy, prescriptions written for teens declined to 48 percent from 78 percent between 2014 and 2017, and for preschoolers to 12 percent from 30 percent, based on a study of more than 124,000 patients.

The daily Briefing 04.02.2022

While some states are considering capping the potency levels in pot products, due to adverse health outcomes, Oregon is moving in the opposite direction—increasing levels to nearly twice as strong as those allowed under previous limits. The new cannabis rules allow licensed shops to sell edibles containing up to 100mg of THC, the psychoactive component of marijuana, per serving. For its part, a bill being considered in Colorado would more strictly regulate high-potency marijuana and limit how much pot a consumer could purchase in a day, following studies showing negative physical and mental health effects. Oregon doesn’t apparently care about such things, although the state’s Liquor and Cannabis Commission did warn that with higher potency products “consumers must know their limits,” and choose products that have the desired effect but not unwanted side effects. It’s not clear if product labels will be changed to reflect that warning to help guide consumers to the right edible. Stronger edibles could mean more cases of cannabis overconsumption, the agency said, as recent data showed that of the 386 cannabis-related calls to Oregon Poison Control in 2019, 34 percent were the result of edible consumption, and nearly half of the calls required further medical attention. We need more oversight, stronger regulations, and stricter caps on THC levels in order to protect public health.

The Daily Briefing 03.31.2022

The sprawling nationwide opioid litigation continues to move toward a conclusion, with a settlement agreement announced in Florida in which CVS Health will pay $484 million to settle opioid-related claims by the state—the first pharmacy chain to do so. Compensation will be paid out over 18 years and includes no admission of wrongdoing by the drug retailer. CVS and other pharmacy chains face hundreds of lawsuits involving the opioid crisis, in which the company has argued that they had tried to stop pills from being illegally diverted and followed procedures to comply with federal and state regulations. In the Florida case, Wallgreens did not reach an agreement and will go to trial in April; at the same time, lawsuits against drugmakers Teva and Allergan also reached settlements for $170 million and $134 million, respectively. Many of the thousands of lawsuits have been settled, or are nearing agreement, including a $6 billion deal with OxyContin-maker Purdue Pharma for its role in the crisis. More than 600,000 Americans have died of a drug overdose over the past two decades, a majority of them opioid-related.

And finally, one year after New York State legalized marijuana, a new Siena College poll finds that a majority of voters oppose ensuring that those with previous marijuana convictions, or their family members, get first dibs on cannabis retail licenses—a major component of the legislation. Strong majorities of Republicans, independents, voters outside New York City, and white voters give it a strong thumbs down, while Latino and Black voters approve. Giving preference to those with marijuana convictions is an attempt to redress wrongs that occurred during the failed war on drugs, in which a disproportionate number of drug arrests were in communities of color. As New York finally rolls out its legalization framework, which includes financial support for those most impacted by drug convictions, it also appears to be trying to avoid pitfalls encountered in other states that have seen designated “social equity” applicants struggle with issues like lack of capital or competition from deep-pocketed corporations.

The Daily Briefing 03.30.2022

Marijuana legalization and shifting cultural attitudes surrounding cannabis use are driving up positive marijuana tests among U.S. workers. According to a report by drug-testing lab Quest Diagnostics, nearly 4 percent of screenings for marijuana came back positive last year, an increase of more than 8 percent from 2020. That figure is up 50 percent from 2017, as the number of states that have legalized recreational cannabis grew from to 18 from eight, plus the District of Columbia. At the same time, the evolving legal landscape and ongoing labor shortage have compelled many employers to stop testing for marijuana altogether, and in some states, they are barred from factoring test results into hiring decisions. Overall, Quest reported that the proportion of U.S. workers who were positive for various drugs rose to 4.6 percent, the highest level since 2001. With legalization moving ahead, it’s important to lay down clear rules, regulations, and standards concerning marijuana use on the job to ensure workplace safety.

Meanwhile, if you’re wondering why marijuana sales have been soaring over the past two years—blame the COVID-19 pandemic, according to a report in the Guardian newspaper. Among the many shake-ups in the social order, the paper explains was the creation of a new cohort of pandemic-era stoners, not only due to the lockdowns but also the de-stigmatization of the drug and ongoing legalization. Legal marijuana sales increased by 120 percent in 2020 and 61 percent in 2021, with one report noting that Americans bought $18 billion worth of cannabis during the first coronavirus year.

And finally, a new study in the American Journal of Psychiatr found that long-term cannabis users show deficits in cognition and small hippocampal volume by midlife. Results showed that long-term cannabis users’ IQ declined from childhood to midlife, with resultant poorer learning and processing speed relative to their childhood IQ, as well as memory and attention problems, that could not be explained by habitual use of tobacco, alcohol, or other illicit drugs.

The Daily Briefing 03.24.2022

Medical marijuana is legal in 36 states and its use has soared in popularity with easier availability and aggressive marketing touting the drug as a panacea for myriad health conditions, although there's scant scientific evidence to support those claims. Now, a new study from Massachusetts General Hospital, looking at users with medical marijuana cards, finds that pot use does not improve the symptoms of people suffering from anxiety, pain, and depression—as many medical marijuana makers promise—and may also lead to the onset of cannabis use disorder (CU), a condition of frequent marijuana use that impairs psychological, physical, or social functioning. According to the study, people seeking cannabis to treat symptoms of anxiety and depression were at the greatest risk of CUD, with symptoms such as difficulty overcoming drug tolerance. Overall, the research revealed that there can be negative consequences to using cannabis for medical purposes. As such, there is a need for stronger safeguards over the dispensing and use of medical cannabis, as well as better guidance to patients around a system that currently allows them to choose their own products, decide their own dosing, and often receive no professional follow-up care.

The Daily Briefing 03.22.2022

Big Tech aims to help those struggling with substance use, as startups in the new field of addiction tech attract investment and look for ways to aid in drug treatment and rehab. Dozens of addiction telemedicine startups already exist, offering consultations with a physician to obtain addiction medications, and many provide virtual rehab with digital cognitive behavior treatment through connected devices, peer support, and coaching, and even include mail-in urine tests to monitor compliance with sobriety. With more than 100,000 overdose doses during the past 12 months, it’s not surprising that Silicon Valley is turning its attention to addiction and overdose to gain a foothold in a potential $40 billion market for addiction-related products and treatment. But many experts say that while these may be helpful to some patients, flashy technology is not geared to expanding treatment options for the less privileged, and will never be able to reach those in the throes of addiction who are often on the wrong side of the digital divide and face issues such as lack of housing and low incomes.

Meanwhile, overdoses are spiking nationwide among the incarcerated, with drug deaths in Tennessee, for example, jumping more than eightfold in prisons in just the past two years. Nearly half were from the highly potent synthetic opioid fentanyl, which is circulating widely in correctional institutions. Until recently, fatal overdoses in Tennesse prisons were rare, but in the last two years at least 68 people have died from drugs in both state-run and for-profit facilities. Unfortunately, one of the most proven therapies for addiction, medication-assisted treatment (MAT), is nearly impossible to access in Tennesee prisons, with only five people in custody receiving MAT among 20,000 individuals in prison.

And finally, as the use of psychedelic drugs becomes more mainstream, fueling the growth of a retreat industry offering expensive treatments with hallucinogens, scientists say that the venom of a toad used in such therapies is putting the species at risk of population collapse. In a sign of the unintended consequences of the psychedelic resurgence, there is concern that the scramble to use the secretions of the Sonoran desert toads could lead to poaching, over-harvesting, and illegal trafficking. When the toad is threatened, it excretes toxins strong enough to kill a full-grown dog; a substance in those toxins can be dried into crystals and smoked in a pipe, producing an intense psychedelic experience. Like all such substances, these are powerful drugs with the potential to treat disorders such as depression and PTSD, but caution is advised as we are only just starting to research their full impact and whether they are safe and effective as a treatment.

The Daily Briefing 03.17.2022

The use of telehealth services grew rapidly during the COVID-19 pandemic, helping patients access care remotely during lockdowns and social distancing regulations. But as the pandemic eased, the use of telehealth has declined for outpatient care—except for mental health and substance use disorders. Data gathered from some 126 million patients found that mental health and substance use services by telehealth have remained elevated and continue to grow as a share of all telehealth visits, especially for rural residents who find it difficult to access medical services. At its pandemic peak, telehealth represented 40 percent of mental health and substance use outpatient visits; as in-person care returned, telehealth visits dropped off overall but remained at 36 percent for mental health and substance use. This reflects the potential of telehealth to increase access to drug treatment, and although this should not replace in-person care, it can help many individuals receive critical services.

The Daily Briefing 03.15.2022

Marijuana legalization was supposed to usher in a new era of cannabis retailing—making pot widely available for medical and recreational use, and a tool to advance social equity and help communities disproportionately impacted by the war on drugs. Well, things are not going exactly as planned. In California, for example, an early adopter of equity licenses to spur minority-owned businesses, entrepreneurs say they are facing a high rate of theft, vandalism, racism, and high taxes, which are eating into profits and making it hard to remain open. Some states legalized cannabis largely to stop cannabis-related arrests and ensure that those same communities can profit from the legalized industry. Fact is, as the New York Times reports, many of these entrepreneurs are struggling while the largely white-dominated industry is making a fortune. They say that thefts are on the rise, often by well-organized gangs, and that police often fail to respond, while high state taxes and difficulty obtaining financing add to their woes. As big players, including tobacco companies, have swooped in to take a large stake in the industry, we have seen rampant commercialization that often flouts state laws on advertising and marketing—including billboards along highways in California—and ads targeted to underage consumers.

Meanwhile, New York State is trying to get around some of these problems by making giving priority for retail marijuana licenses to those who have been convicted of a marijuana-related offense. Gov. Kathy Hochul has said that early business owners in the state’s projected billion-dollar marijuana industry will be those most affected by the nation’s decades-long failed war on drugs. They will also have access to stockpiles of the drug grown by local farmers to stock shelves, and storefronts leased by the state—all part of a $200 million effort by Albany to advance racial equity in the new industry.

The Daily Briefing 03.14.2022

Fatal overdose fatalities are soaring among the Black population, fueled by fentanyl and exacerbated by lack of treatment options and poor access to healthcare. New data from researchers at UCLA showed that through 2020, the rate of drug deaths among Black people eclipsed the rate in the white population for the first time since 1999. There were more than 15,000 overdoses in 2020 among Blacks, more than double the number from four years earlier, at a time when overdoses are soaring across the country to more than 100,000 over the past year. Researchers said the findings demonstrate the need to close gaps in access to drug treatment for opioid use disorder and harm-reduction services for Black communities, and that ending routine incarceration of drug users could help prevent fatal overdoses among people after they leave prison.

Meanwhile, Florida police have confirmed that several West Point cadets were among six young men who overdosed this week on what was believed to be cocaine laced with fentanyl while on spring break. There were no fatalities, but two of the cadets were in critical condition in hospital and on ventilators.

And finally, marijuana is almost legal in New York State—the law was passed last year, but regulations have not yet been worked out—yet that hasn’t stopped unlicensed vendors from setting up shops in New York City selling all manner of products, without any control or oversight. In Washington Square Park, for example, an open-air market has emerged, where sellers chat up buyers “as if welcoming visitors with canapés,” the New York Times reported. With sales now in a grey area, police and parks officials sometimes issue a summons for illegal vending, but largely ignore the new market.

The Daily Briefing 03.11.2022

As the sprawling, nationwide opioid lawsuits come to an end with massive settlement payouts going to local and state governments, the families who had lost loved ones to addiction and overdose have been heard for the first time. As part of the deal to end litigation against Purdue Pharma and its billionaire founding Sackler family, an extraordinary hearing took place that for the first time allowed victims’ families to confront three members of the family to express their pain and range and how they suffered. More than 600,000 Americans died from a drug overdose over the past two decades, many after becoming addicted to prescription painkillers such as those sold by Purdue and aggressively marketed as non-addictive. Speakers held up photos of the dead and hurled invectives at the Sacklers, cursed them for their greed, and called them cruel, callous, and murderers as the Sackler family watched and listened impassively on Zoom, not saying a word (by agreement, one family member was allowed to have the camera turned on). The Sacklers will pay nearly $6 billion over 18 years to settle thousands of cases against Purdue, but have never admitted responsibility for contributing to the opioid crisis, and are shielded from further civil lawsuits. The majority of money from all the cases—which include other drug manufacturers, as well as drug distributors and pharmacy chains—will go toward drug prevention and treatment programs, but the Purdue settlement also includes compensation for individual victims and parents of children born with neonatal abstinence syndrome, ranging from $3,000 to $48,000. As this sad chapter in American public health comes to an end, it’s time to focus on an addiction and overdose epidemic that is still raging—and requires our immediate attention.

The Daily Briefing 03.10.2022

Starting in 2023, Oregon will be the first state with widely legalized psychedelic drugs, and although the law didn’t approve psychedelic therapy, there’s already a burgeoning network of businesses, pharmaceutical companies, and nonprofits trying to get a foothold in what could become a booming industry. These include shops selling the drugs, training for psychedelic therapy, and operating clinics where the drugs would be used. This comes as the psychedelic legalization movement gains ground as a way to treat psychiatric conditions such as depression, and win FDA approval of drugs and treatment methods. While psychedelics have shown some promise in early research, it’s still not clear what effect they might have on patients, what controls are necessary, and how they should be used in mental health or clinical settings. Generally considered safe, psychedelics such as magic mushrooms also come with risks. They can be emotionally destabilizing, potentially exacerbate psychosis for people with pre-existing conditions, and create feelings of susceptibility. As more states consider legalizing these powerful drugs, we must ask serious questions about how to make them safe and accessible at scale—particularly for vulnerable populations.

One company that is backing psychedelic legalization is, unusually, the liquid soap maker Dr. Bronner’s, which has become one of the biggest financial contributors to the movement to win mainstream acceptance of these drugs. Since 2015, Dr. Bronner’s Magic Soaps has donated more than $23 million to drug advocacy and research organizations, following on from its hefty contributions toward cannabis legalization.

The Daily Briefing 03.09.2022

Two years ago a Food and Drug Administration crackdown had virtually wiped out the use of flavored e-cigarettes that had become a teenage favorite and fueled a vaping epidemic among young people. But the ever-inventive vaping industry managed to come back by swapping out one of the product’s key ingredients—tobacco-derived plants—and instead use synthetic nicotine, made in a lab, thereby circumventing FDA monitoring and oversight. The result: sales of highly addictive, disposable, flavored e-cigarettes are soaring, raising concerns about another teen vaping crisis and a new generation addicted to nicotine. Overall, sales of disposable devices filled with candy flavors and synthetic nicotine nationwide grew from nonexistent in 2020 to take up shelf space in two-thirds of U.S. vape shops, with sales of disposable fruit- and candy-flavored devices increasing by 290 percent to 56.5 million a month by the end of 2021.

Meanwhile, lawmakers are within striking are of closing the legal loophole that allows such companies to escape FDA oversight of vaping products containing synthetic nicotine. A draft bill would give the agency explicit authority to regulate such products, posing a challenge to vaping companies that switched to synthetic nicotine to defy the agency’s earlier crackdown on flavored e-cigarettes. The bill, if signed, would be a major win for tobacco control advocates who have urged the FDA to do more to regulate synthetics, despite its lack of authority. The FDA also made e-cigarette companies, including then-market leader Juul, apply for authorization to remain in the market, thereby limiting the number of products for sale.

The Daily Briefing 03.08.2022

The expanding legalization of recreational marijuana has led to wider availability of cannabis edibles—so much so that the pot-laced, candy-like products have replaced vaping as the stealth way for teens to get high, especially at school. Although legalization supporters promised safeguards to protect vulnerable populations, such as young people, the cannabis industry is failing to monitor and stop underage use. In Colorado, for example, which, like most states, has an age limit for the sale of cannabis products—21 for recreational use, 18 with a medical marijuana card—it is fairly easy for high schools students to get them from older siblings and friends, according to doctors and school officials, who say they are finding edibles more often on school premises.

Edibles are popular because, unlike joints and even vape pens, with their puffs of smoke and distinctive smell, they are almost impossible to spot, and can look just like regular candy and cookies. They are also more likely to lead to overconsumption: one small cookie or gummy can contain multiple oses of THC, the psychoactive component of marijuana. And since edibles take an hour or more to kick in, impatient kids can easily ingest too much.

Also concerning is that kids view edibles as less dangerous than smoking or vaping because they are not inhaled, and they, therefore, underestimate the potential for harm. But they are dangerous, with one candy bar or cookie packing about 10 doses of THC, five times the standard unit of 5 milligrams. There is a growing body of evidence confirming the negative impact of THC on the developing brain, and its links to poor performance in school and deficits in attention and memory. But this apparently means little to the booming cannabis industry, which still markets marijuana as an essentially harmless product. It’s time for states, which are leading the legalization charge, to implement stronger measures to control underage use and to protect young people.

The Daily Briefing 03.03.2022

After years-long litigation, members of the billionaire Sackler family and their company, Purdue Pharma, have reached a nearly $6 billion deal to settle thousands of lawsuits against the company for its role in the opioid epidemic. Under the agreement, the Sacklers won immunity from further civil prosecution—one of the final sticking points—but not from possible criminal liability. The family agreed to add $1 billion to the settlement, and also to issue a so-called apology statement in which it expressed “regret” that its drug OxyContin “unexpectedly” became part of an opioid crisis. Family members have never acknowledged wrongdoing or any personal responsibility for the public health crisis, which has killed more than 600,000 Americans over the past two decades.

If approved by a bankruptcy court judge, the deal brings to an end a series of sprawling and contentious legal battles in which pharmaceutical companies such as Purdue were blamed for fueling the crisis by falsely marketing their highly addictive prescription painkillers as safe. The last hurdle for eight holdout states was accepting the additional $1 billion, as well as the Sacklers agreeing to their demand for a hearing that would allow people who suffered from addiction to OxyContin to describe what they endured, with at least one member of the Sackler family present. Also, the Sackler name—long associated with philanthropy—would have to be removed from cultural and other institutions if asked to do so.

The holdout states will receive a bigger portion of the settlement payout, which will go toward drug treatment, education, and prevention programs, as well as smaller payments to more than 100,000 individual victims. The Sacklers did win more time to distribute the extra money—now to be doled out over 18 years—with the remainder coming over the next 9 years. Experts say the states eventually agreed to the conditions of the deal because they didn’t want to fight another lengthy legal battle, and with the addiction and overdose crisis raging, they need the money sooner rather than later. But others believe the Sacklers are getting off easy, without any accountability for their actions and the pain and deaths they have caused. Still, with other opioid lawsuits also being settled for billions of dollars—including those against drug distributors and pharmacy chains—there will now be significant funding available to fight the epidemic and help those struggling with drug abuse.