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A Clean, Well-Lit Place to Smoke Rocks: North America's First Supervised Inhalation Site Opens

Alternet - Tue, 03/06/2018 - 00:16
It's not just about allowing someone to use drugs more safely—it’s about building a trusting relationship with users.

In response to the opioid crisis, Canada has been rapidly opening supervised injection sites, safe spaces allowing for injection drug users to consume narcotics like heroin under medical supervision.

But ARCHES, a recently opened facility in Lethbridge, Alberta, Canada comes with a twist—it's the first supervised inhalationsite in North America, allowing drug users to combust and inhale narcotics, such as meth or crack cocaine, under the supervision of trained medical staff.

On the surface, supervised consumption sites (SCS) sound more harmful than helpful: we're letting people use dangerous, addictive drugs? What the…?

But these sites have existed around the globe for at least three decades, with more than 100 facilities in more than 66 cities. The research on them shows that they greatly reduce the spread of disease such as HIV and hepatitis C, prevent fatal overdose and connect drug users with addiction treatment and health services. Many link people with job training, counseling or housing services.

In other words, consumption sites are an important harm reduction strategy in the fight against the overdose crisis. Bottom line: they save lives.

Injection cubicles at ARCHES. (The Fix)

There’s been a major push for supervised consumption in the United States, from Philadelphiato Denver to San Francisco, but so far, these initiatives have all but stagnated. One or two may launch this summer, but the Trump Administration has threatened any that open with legal action.

Meanwhile, in Canada, consumption sites are opening at a staggering rate—at least 17 are fully operational plus around a dozen more with pending applications. The earliest SCS is Insite in Vancouver, which opened in 2003. They’ve monitored more than 3.6 million clients as they’ve injected drugs, never once experiencing a death. In fact, to the best of anyone’s knowledge, there’s never been a death at any supervised consumption site.

But ARCHES, which opened on February 28th, is the first site in North America to offer all four modes of drug ingestion: oral, nasal, injection and inhalation. To understand why this distinction is significant, it’s important to keep the overdose crisis in context.

It’s actually polydrug use, not opioids, that are causing the most fatalities. Whether it’s due to heroin contaminated with fentanyl or mixing stimulants with depressants—known as “speedballing”—a one-strategy-fits-all approach won’t help every type of drug user.

“People are dying from all modes of consumption. It’s not the method that’s killing them, it’s the drug,” Stacey Bourque, ARCHES’ Executive Director, says in a phone call. “How come they shouldn’t have a safe place to have medical supervision when they’re just using it in a different method? And in a method that we would probably promote over injection, because there are less other unintended health consequences of use with smoking than there is with injection.”

That isn’t to say smoking drugs is entirely safe—there are still many risks, especially when drug users are in a hurry. A 2006 study published in BMC Public Health found rushed crack cocaine users had a higher prevalence of burns and inhaled metallic crack pipe filter screens. A decade later, a paper published in the same journal with a few of the same authors illustrated these potential risks are easily mediated by supervised consumption.

According to Bourque, methamphetamine injection is more prevalent in her community than opioid injection. “So if we have the opportunity to move people from injecting to inhalation, then that’s another opportunity for us to reduce harm,” she says. “Which is the purpose of our existence.”

Supervised inhalation sites are not uncommon in Europe, where they exist in The Netherlands, Switzerland, Spain, Denmark and elsewhere. Some just provide an outdoor area for smoking, while others, like ARCHES, provide sealed rooms with high-tech ventilation systems.

To meet Alberta Health’s regulations, the consumption rooms at ARCHES are negative pressure rooms so when the doors open, nothing escapes, Bourque explains. The mechanical systems are specially engineered to turn the air over 15 times an hour inside the two inhalation rooms, compared to the six times an hour it changes over in the six injection spaces.

Then there’s the built-in emergency switch that nurses, police or EMS can flip in case they need to enter the room. It immediately closes the damper and dumps the air so it becomes breathable. Finally, there’s an uninterruptible power supply system, just in case of a power failure. The ventilation system for the whole building cost about $50,000 Canadian.

In other words, these inhalation rooms aren’t outfitted with the kind of cooking exhaust fans you’ll find in your kitchen.

“I sat down with a mechanical engineer and described to him what I thought we need in a site like this to be able to keep everybody safe,” Bourque says. “We’re never actually without ventilation, so we’re not putting anyone at risk at any point.”

Another aspect of the overdose crisis is that while opioids get the most attention in mainstream media, methamphetamine and stimulant use are rising in the shadows. In Oregon, twice the number of overdose deaths are attributed to meth compared to heroin. It’s just as prevalent in places such as New Hampshire, Montana, Oklahoma and South Dakota.

Canada is no different. Meth use has been described as a “tidal wave” in Winnipeg, while in Alberta, the amount of young people seeking treatment for meth use has doubled since 2012. In Saskatchewan, the number of people admitted to drug treatment programs for meth rose 200 percent between 2015 and 2016. Fentanyl seizures in Canada have experienced a drop while meth seizures jumped approximately 100 percent in two years.

So why aren’t inhalation sites more popular? Dr. Taeko Frost, western regional director at the Harm Reduction Coalition, believes supervised injection is more palatable for the public than inhalation because the emphasis is on disease containment and keeping needles off the streets, rather than safer consumption.

“People get really stuck—pun not intended—on the syringe issue,” she says. “What this movement is really about is restoring dignity and respect and creating space for people that doesn't exist because of our housing crisis, because of policing practices, because of our failed war on drugs and drug policy.”

Frost also emphasizes the racial justice aspect of this situation.

“Depending on where you are, there may be differences between populations of people who use stimulants and people who inject drugs that may also unintentionally cut out and further perpetuate health disparities among people of color,” Frost says. “We need to be really adamant about and support safe consumption services for that reason, so that we are not further creating health disparities and discrimination by type of drug and route of administration.”

Insite has been trying to offer inhalation services for years, but the process hasn’t been easy. In order to protect staff and other clients, there would need to be costly renovations and there is no timeline for this to occur.

“Like most municipalities, Vancouver must abide by regulations protecting workers and others from secondhand smoke and there is no quick fix to this,” Carrie Stefanson, Insite’s public affairs leader, said in an email. But she doesn’t believe the route of administration has much to do with their policies—they do allow snorting drugs, for example. “Our health policies are guided by science, not public sentiment,” she says.

If something does go wrong at a SCS, there are trained medical staff on hand to immediately assist a drug user who has overdosed. In the case of an opioid overdose, breathing becomes so slow that the person suffocates. They can be revived using naloxone (Narcan), an opioid receptor antagonist that “kicks” drugs like heroin out of the brain, allowing normal breathing to resume. But for stimulants like crack cocaine and meth, there is no such antidote.

“Unfortunately, there is no silver bullet for stimulant overdoses (frequently called ‘overamping’) like in the case of opioids and naloxone,” explains Kat Humphries, the programs director at the Harm Reduction Action Center in Colorado. “But there are plenty of things you can do to help someone overamping.”

Humphries says if someone is overheating from stimulants, you should encourage them to stay still and avoid any agitated or overly-pronounced movement. Then help them cool down with ice packs, misting or fanning techniques and give them water or a drink with electrolytes. You can also place cool, wet cloths under the armpits, on back of knees, or on the forehead.

“Other signs and symptoms vary depending on the cause. You may witness anything from dehydration to hyperthermia to a severe heat stroke or heart attack,” Humphries explains. “In many cases, the person may become confused and potentially hostile, and may present as intoxicated. As the person’s heart attempts to push enough oxygen out to their whole body, their heart rate and breathing will increase. It’s important to call 911 when you feel uncomfortable managing a stimulant overdose, because it can turn deadly quickly.”

Supervised consumption sites aren’t just about allowing someone to use drugs more safely—it’s about building a trusting relationship with users, humanizing them and encouraging them to seek treatment when they’re ready. But many critics of these types of programs label it “enabling.”

“The only thing we enable is breathing,” Bourque says. “I’ve heard a lot of the healthcare professionals say, ‘We’re supposed to preserve health, we’re not supposed to help them or make it worse.’ But at the end of the day, this is healthcare. Rarely do we have somebody come in just for drug use. They always see the nurse or the counselor or the housing team. It’s never just one thing. But in order for them to access those services, you have to have a relationship built. Calling it ‘enabling someone’ is just such garbage. You can’t enable something that’s already happening.”



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UK is world's largest producer of legal cannabis - Sky News

Google - Cannabis - Mon, 03/05/2018 - 19:55

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A drug reform group slams the Government for "maintaining cannabis has no medical uses" while allowing its export abroad. 07:49, UK, Tuesday 06 March 2018. DALY CITY, CA - APRIL 18: Leaves of a mature marijuana plant are seenin. Image: The UK was the ...

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Editorial: Marijuana, casino to impact Valley job market - GazetteNET

Google - Cannabis - Mon, 03/05/2018 - 18:07


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The newly legal recreational marijuana industry in Massachusetts and the opening of the MGM Springfield resort casino later this year are sure to have an impact on the Pioneer Valley economy. While it will take awhile to determine their long-term ...

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Judge satisfied officer knew difference between skunks and marijuana -

Google - Cannabis - Mon, 03/05/2018 - 17:18

Judge satisfied officer knew difference between skunks and marijuana
A Niagara man who challenged the validity of a search warrant, claiming the odour coming from his property was due to skunks and not a $1.25-million marijuana grow op, will return to court this spring for sentencing. Niagara Regional Police executed a ...

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CALL FOR ENTRIES: Nominate the rising stars of marijuana's investment scene - Business Insider

Google - Cannabis - Mon, 03/05/2018 - 16:21

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CALL FOR ENTRIES: Nominate the rising stars of marijuana's investment scene
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Delta recreational marijuana production on grand scale - Delta-Optimist

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Police remove shopping cart full of marijuana plant trimmings -

Google - Cannabis - Mon, 03/05/2018 - 14:50

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How does resolving cannabis problems differ from problems with alcohol or other drugs? - Science Daily

Google - Cannabis - Mon, 03/05/2018 - 14:42

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The Drug Test-Free Workplace: 7 Occupations That Don't Require You to Pee in a Bottle to Get Hired

Alternet - Mon, 03/05/2018 - 13:43
Click here for reuse options! If you're not interested in pre-employment drug testing, go here.

Widespread workplace drug testing—a uniquely American phenomenon—has generated controversy ever since Ronald Reagan pushed hard for it back in the 1980s. On the one hand, opponents see it as an invasion of workers' privacy protections; on the other, advocates believe it is the best means of preventing injuries that might occur when a worker is intoxicated.

Although workplace drug testing was rare prior to Reagan, 56% of all employers now require pre-employment drug tests, according to Statistic Brain. Some of this is mandated by law: Truck drivers, airline pilots and some other public transport positions face federal drug-testing requirements. But much pre-employment drug testing and random, suspicionless drug testing is not required by law; it is instead the employers' choice.

High levels of drug testing are to be found in industries such as health care, heavy manufacturing and construction, where being impaired on the job can lead to loss of life or limb or endanger the health and well-being of others. But drug testing is also popular in industries with no such apparent risk, such as retail. Whether that guy at the camera counter at Walmart smoked a joint over the weekend probably has no discernible impact on public safety.

Speaking of smoking joints, marijuana is by far the most commonly used illicit drug (though it's now legal in nine states). Positive workplace drug tests for marijuana are on the rise, reflecting broader popular acceptance of the drug, which is also leading some companies to quit testing for pot. In a low unemployment economy, employers may be increasingly reluctant to lose potential workers over a positive test for marijuana.

And some potential workers are reluctant to seek employment at places that are going to subject them to drug testing. Fortunately for them, there are some economic sectors where facing a pre-employment or random at-work drug test is not a real risk—in fact, it's a rarity. But most of these jobs require a university degree. Like so many things in America, drug testing is a class thing.

That said, if you want to work in a field where you don't have to worry about peeing in a bottle to get or keep a job, here, thanks to Insider Monkey, are some options.

1. Management Positions

These relatively well-paying professional gigs tend to have drug testing levels approaching absolute zero. On the high end, if you can call it that, were general managers (1.8%) and project managers (1.6%), but office managers, business managers, and retail managers all came in under 1%, with event managers besting them all at a minuscule 0.01%. Average pay for these positions ranged from the mid-40s for retail and office managers to more than $70,000 for project managers. Ironically, the administrative assistant position, which can be an excellent entry-level job for people seeking careers as managers, is more likely to be subject to drug testing than any managerial position. Still, it's only 1.9% of administrative assistants.

2. Personal Services

You're not going to get rich in these jobs, but you're not likely to get drug tested, either. Because of the transient nature of jobs in these careers or because many people in these fields are self-employed, gig economy workers just don't get that drug test scrutiny. Cosmetologists, hairstylists and fitness trainers all face testing less than 1% of the time, while pet groomers and massage therapists come in under 3%. These jobs have median pay ranging from around $25,000 to $30,000.

3. Information Technology

These are the fields that are stereotypically the domain of the nerdy stoner. You wouldn't expect employers in the industry to turn down a budding genius because he gets high at home, and you would be right. Only 3% of web designers and IT consultants face the empty cup, and fewer than 3% of Java developers and front-end developers do. While not quite as drug testing-free as cosmetologists or pet groomers, IT workers make a lot more money. On the low end, web designers are pulling in a median $48,000, while pay is around $70,000 for the other positions listed.

4. Marketing

Those bright, shiny people trying to make us buy stuff are also largely exempt from drug testing, especially on the bottom rungs. Only 0.3% of marketing assistants are subject to pre-employment drug screens, and only 3.8% of marketing coordinators. The former positions average $36,000 a year, while the latter average $41,500.

5. Real Estate, Insurance and Financial Services

These white-collar jobs are all unlikely to see drug testing requirements. Fewer than 3% of loan processors and insurance agents face the prospect of peeing in a cup to win a job, while a minuscule 0.5% of real estate agents do. Real estate agents are also the highest paid in this group, averaging $47,000, while both loan processors and insurance agents come in at under $40,000.

6. Bartender

People whose job it is to mix and sell legal psychoactive substances are very unlikely to be tested for illegal ones. With only 3.2% of employers demanding pre-employment drug tests, bartenders are the least likely of restaurant and bar workers to be tested. Chefs face testing at a rate of 6.2%, while 4% of hostesses are likely to face it. The median salary for bartenders is $29,240.

7. Creative White Collar

Neither graphic designers nor copywriters are likely to face a pre-employment drug test. A big reason is that many of these are freelance gigs: No boss = no drug test. But even when working for employers, drug testing is unlikely in these fields. Copywriters came in at 3.2%, while graphic designers were at 3.9%.

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Is Marijuana Legalization Tied To An Increase In Pedestrian Deaths?

Alternet - Mon, 03/05/2018 - 11:27
States where the adult use of marijuana was legalized had an uptick in pedestrian traffic deaths last year, according to a new study.

More pedestrians were killed in traffic accidents in 2017 than in any year since 1990, and researchers believe that the legalization of marijuana for adult use may have something to do with the rise in fatalities. 

According to a study released this week by the Governors Highway Safety Association, states that legalized marijuana for adult use (or "recreational marijuana") saw a 16.4% increase in pedestrian traffic deaths in the first half of 2017, compared to 2016. All other states—those that did not legalize—saw a 5.8% decrease in pedestrian deaths. 

Although the connection was not causal, the correlation was enough to catch the attention of Richard Retting, a traffic safety engineer at Sam Schwartz Consulting and author of the study.

“We are not making a definitive, cause-and-effect link to marijuana,” Retting told The New York Times, calling the data “a marker for concern.”

He said that researchers will continue to monitor for links between traffic deaths and marijuana legalization. “It may be a canary in a coal mine, an early indicator to address,” Retting said. 

Researchers couldn’t say whether the data might indicate more marijuana use by drivers, pedestrians or both. 

Alaska, Colorado, Maine, Massachusetts, Nevada, Oregon, Washington and the District of Columbia all legalized marijuana between 2012 and 2016, the time period that the researchers looked at.

Maine and Alaska, which have small populations, had such few fatalities that it was hard to connect increases with marijuana legalization. Massachusetts was the only legal marijuana state that saw fewer deaths in 2017—though the difference was only by one. 

Other states, including Colorado, saw a more significant percentage increase, although the numbers remained relatively low. There, 37 people were killed in pedestrian accidents in the first half of 2017, an increase of 12% over the previous year. 

Jason Levine, executive director at the Center for Auto Safety, said that while the connection will be interesting to monitor, it is too soon to draw any conclusions about a possible link between marijuana legalization and pedestrian deaths. 

“I’d be cautious about drawing a direct link to any potential cause,” he said. “But it’s certainly worth trying to figure out why those numbers are what they are.”

Russ Rader, a spokesman for the Insurance Institute for Highway Safety, said that overall insurance claims are 3% higher in states that have legalized marijuana for adult use. 

While researchers will continue to monitor the connection between marijuana policy and pedestrian fatalities, they are also looking at rising smartphone use among drivers as another factor. 


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