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Many Psychedelics Share This Common Trait — And It Will Literally Change The Way You Think

Wed, 06/20/2018 - 10:24
This helps explain why they are increasingly seen as a valuable treatment for psychiatric disorders such as depression, anxiety, and addiction.

New research suggests that different classes of psychedelic drugs all share the tendency to promote the growth of new brain cells, especially the kind that reach out and forge connections with other brain cells. This finding could help explain both the mind-expanding properties of the drugs and the mechanisms by which they appear to act as valuable treatments for a broad range of psychiatric disorders.

Earlier research had identified the dissociative anesthetic ketamine as promoting growth in key brain cells (as well as being a fast-acting and effective treatment for depression), but this new research finds similar effects in amphetamine-based psychedelics such as DOI (2,5-dimethoxy-4-iodoamphetamine), ergoline psychedelics (such as LSD), and tryptamines (such as DMT).

Using experiments in cell culture and with animals, researchers led by Dr. David Olson of the University of California at Davis found that various classes of hallucinogenic drugs acted on the structure and function of cortical neurons using the same mechanisms as ketamine. The findings could point to new treatment approaches for depression, anxiety, PTSD, and addiction, the researchers wrote last Tuesday in the peer-reviewed journal Cell Reports.

“The state-of-the-art, prototypical, fast-acting antidepressant is ketamine—a compound that promotes neural plasticity and repairs circuits involved in mood and anxiety disorders,” Olson told MedPage Today. “Our work demonstrates that psychedelics produce comparable effects on neuronal structure and function, providing a potential explanation for why MDMA, psilocybin, and ayahuasca seem to have antidepressant and anxiolytic effects in the clinic.”

Using test tubes, as well as rats and fruit fly larvae, the researchers found that all of these classes of psychedelics increased “neural plasticity,” the ability to create new connections among brain cells. The drugs all excited the growth of dendritic spines and axons, the cerebral hangers-on that brain cells use to reach out and create connections, or synapses, with other brain cells.

That’s the opposite of what happens with depression, anxiety, PTSD, and addiction. The current theory is that these disorders may occur when neurites retract, not allowing brain cells to connect at synapses.

“One of the hallmarks of depression is that the neurites in the prefrontal cortex—a key brain region that regulates emotion, mood, and anxiety—those neurites tend to shrivel up,” Olson said in a statement.

Olson’s research found that the neural plasticity effect found with ketamine was also “remarkably potent” with even very small doses of LSD, which could help explain the popularity of “microdosing” among people seeking happier and more creative lives. Chemical compounds that mimicked psilocybin and MDMA also increased neural plasticity on the same level as ketamine, and that could mean new opportunities for researchers working with psychiatric disorders.

The studies also showed that the effect outlasted the action of the drugs. In rats, for example, psilocybin produced results that lasted for hours after the drug had left the body. Similarly, rats given a single dose of DMT not only saw an increase in dendritic spines similar to ketamine but saw that effect last for 24 hours when the drug itself had been eliminated within one hour.

This is potentially very good news for researchers working on treatments for anxiety, depression, and addiction, which all seem to act on the same brain circuits.

“Prior to this study, there was only one player in town and that was ketamine. This opens up some new doors,” Olson said. “As the diversity of chemical structures capable of producing ketamine-like plasticity effects continues to grow, so does my hope that we will find a safe and effective fast-acting treatment for depression,” he said.

This article was produced by Drug Reporter, a project of the Independent Media Institute.

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The Power and Promise of Psychedelics: Michael Pollan Show Us How to Change Our Minds

Mon, 06/18/2018 - 23:05
The acclaimed foodie author serves up a heaping platter of mind-bending science and history.

Can psychedelic drugs improve our lives? Michael Pollan thinks so, and he makes a pretty persuasive case in his latest book, How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence.

This is good stuff. Pollan elegantly blends science, medicine, memoir, travel writing and history in a dazzlingly authoritative dive into his subject matter. If you want to read only one book on psychedelics, make it this one.

The subject is something of a departure for Pollan, who has risen to prominence as the consummate foodie, authoring such well-known tomes as The Omnivore’s Dilemma, Food Rules, and In Defense of Food. But it’s not entirely surprising: In his 2001 The Botany of Desire, Pollan delved into the world psychoactive substance to examine the mutually beneficial relationship between humans and marijuana. (He also described our relationship with apples, tulips, and potatoes.)

In his current effort, Pollan dives into the science of psychedelics, going deep into brain chemistry and the actual mechanisms by which these drugs alter consciousness. Basically, the science suggests, psychedelics damp down the brain’s default mode network, the cerebral mechanism that allows us to maintain normal consciousness. When the default mode network is weakened, new neural pathways open up, brain parts that don’t usually communicate with each other start talking, and the going gets weird.

And that opens the door not only for trippy imagery, but also for spiritual epiphanies or, less grandly, coming to terms with oneself and one’s issues. As Pollan reviews the current research taking place in this psychedelic revival, he encounters terminal cancer patients whose closely guided trips help them grapple with their own mortality, spiritual seekers finding enlightenment, and drug users who find themselves able to break noxious addictions.

He also tries psychedelics himself—something he hadn’t done before—taking LSD, magic mushrooms, and toad venom containing DMT. His description of his experiences is vivid and compelling, and he tries his best to express those ineffable “truths” the psychedelic experience offers. Describing the subjective reality of an acid trip is a difficult feat, and Pollan does better than most.

And speaking of magic mushrooms, who knew that the term was coined by a Time/Life publicist in the 1950s? I didn’t. But that was indeed the case as Life editors were putting together the groundbreaking tale of Gordon Wasson’s experience eating psilocybe cubensis with Mexican shaman Maria Sabina.

Pollan’s book is full of such delicious little tidbits of psychedelic lore and history, including an account of the Stoned Ape hypothesis, favored by some mycophiles, which argues that hominids ingesting magic mushrooms led to the development of human consciousness.

But it also tells the tale of psychedelics as never before, revealing a “secret history” of lost research on psychedelics in the 1950s and 1960s, where thousands of subjects ingested them in more than a thousand scientific experiments. Some of the results were impressive—LSD appeared to help curb alcoholism, as well as helping people come to terms with mental disorders or terminal illnesses—but that body of research was largely forgotten as the federal government and scientific establishment led a severe crackdown once Tim Leary and the hippies got ahold of acid.

Naturally, Leary remains the central figure of the 1960s psychedelic scene—and a highly contentious one—but one of Pollan’s biggest contributions is showing how psychedelics were busily leaking out of the lab and into the culture at large in ways that had nothing to do with Leary. Hollywood actors and other elites were taking LSD in therapeutic sessions, spreading the word and participating in group sessions that in some cases seemed more like acid parties than therapeutic encounters.

Still, once Leary shed his researcher’s objectivity to become a messianic acid missionary with his slogan of “tune in, turn on, and drop out,” and undertook a mission to cure not sick people but the culture itself, it was game over for the first wave of psychedelic research:

“The fact that by their very nature or the way that first generation of researchers happened to construct the experience, psychedelics introduced something deeply subversive to the West that the various establishments had little choice but to repulse. LSD truly was an acid, dissolving almost everything with which in came into contact, beginning with the hierarchies of the mind (the superego, ego, and unconscious) and going from there to society’s various structures of authority and then to lines of every imaginable kind, between patient and therapist, research and recreation, sickness and health, self and other, subject and object, the spiritual and the material. If all such lines are manifestations of the Apollonian strain in Western civilization, the impulse that erects distinctions, dualities, and hierarchies, and defends them, the psychedelics represented the ungovernable Dionysian force that blithely washes all those lines away.”

For the past half-century, psychedelics have been making a slow, but now rapidly accelerating recovery from the repression sparked by Leary’s proselytizing and the specter of a psychedelicized America. Again, Pollan shines with his explication of the mind-blowing research taking place and the possibilities being opened up. If there was any question that psychedelics are enjoying a scientific and medical renaissance, Pollan puts that to bed.

Yet, in awe of the power of psychedelics, Pollan stops short of calling for their legalization. Instead, he seems to want every trip to be guided, every journey to have a destination. Has he been captured by the very scientists and researchers whose stories he tells? He writes about the spiritual and the psychological, religion and science, and “shamans in white lab coats,” but he doesn’t want to talk about recreational use of the drugs.

But the psychedelics are here, and they are being used just for fun. The molecule is in our midst and the fungus is among us. Neither is going away nor are they staying in the lab.

How to Change Your Mind is a major addition to the literature on psychedelics. Reading it will blow your mind. Do it now.

This article was produced by the Drug Reporter, a project of the Independent Media Institute.

 

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The DEA's Move to Restrict Opioid Prescriptions Had an Unforeseen Consequence—It Pushed Users to the Dark Web

Sat, 06/16/2018 - 11:55
Meet the "iron law of prohibition."

By the end of 2013, the country's quiet opioid addiction crisis was no longer so quiet. Opioid overdose deaths that year topped 16,000, more than four times the same statistic for 1999. That prompted a number of measures at the state and federal level to rein in opioid prescriptions, including a move by the DEA in October 2014 to tighten its policies around some of the most commonly prescribed opioids.

The new DEA policy—aimed at popular opioids such as Vicodin and Lortab—imposed restrictions on doctors' prescribing and made it more difficult for patients to get refills. In one sense, the policy was a success: Prescriptions for those drugs decreased almost immediately. But new research adds to an increasing body of evidence that restricting opioid prescribing has not solved the opioid crisis but instead worsened it.

Since the DEA policy shift, opioid overdose deaths continued to grow with more than 40,000 fatal opioid overdoses in 2016. And while prescription opioid overdose deaths have slightly decreased—there were about 14,000 that year—overdose deaths from heroin and non-prescription synthetic opioids such as fentanyl went through the roof. Heroin and illicit synthetics accounted for nearly two-thirds of all opioid overdose deaths in 2016.

In the new study, published this week in the British Medical Journal, researchers examining the impact of the DEA policy shift found evidence that while the change indeed lowered prescribing rates for the opioids in question, it was also linked to an increase in illicit online sales of those drugs in Dark Web drug markets.

The researchers used software called DATACRYPTO to crawl encrypted Dark Web marketplaces where people can anonymously buy damned near anything, from drugs to guns to credit card numbers. DATACRYPTO harvested data on which drugs were for sale, their country of origin, and the number of customer comments on each seller's comments page. Researchers used that last figure as a proxy for how much of a drug that seller sold. They examined sales of prescription opioids, sedatives, stimulants, and steroids, as well as heroin. It was only with prescription opioids that they found a significant Dark Web sales bump.

Here's what they found: "The sale of prescription opioids through US cryptomarkets increased after the schedule change, with no statistically significant changes in sales of prescription sedatives, prescription steroids, prescription stimulants, or illicit opioids."

According to their data, prescription opioids doubled their market share of U.S. Dark Web drug sales thanks to the DEA policy change. By July 2016, opioids represented 13.7% of all drug sales in U.S. cryptomarkets, compared with a modeled estimate of 6.7% of all sales.

While the researchers were careful to not make claims of causation—only correlation—their conclusion speaks for itself: "The scheduling change in hydrocodone combination products coincided with a statistically significant, sustained increase in illicit trading of opioids through online US cryptomarkets. These changes were not observed for other drug groups or in other countries. A subsequent move was observed towards the purchase of more potent forms of prescription opioids, particularly oxycodone and fentanyl."

Not only is the DEA policy change linked to increased Dark Web opioid sales, it is also linked to a move toward more powerful, and thus more dangerous, opioids. The researchers noted that while fentanyl was the least purchased Dark Web opioid in the summer of 2014, it was the second most frequently purchased by the summer of 2016. Fentanyl killed as many people as prescription opioids that year.

This study—one of the few that examines supply reduction (as opposed to demand reduction) as a means reducing drug use—strongly suggests that supply-side interventions carry unintended consequences, especially the resort to more dangerous and more powerful substitutes.  The study's authors refer to this effect as "the iron law of prohibition, whereby interventions to reduce supply, such as increased enforcement and changes to drug scheduling, lead to illicit markets dominated by higher potency products."

Perhaps better than restricting opioid prescriptions, which has deleterious impacts on the tens of millions of Americans suffering chronic pain, or other supply-side interventions, would be increased access to addiction treatment, as well as greatly expanded harm reduction measures to try to get people off opioids and keep them alive in the meantime.

This article was produced by the Drug Reporter, a project of the Independent Media Institute.

 

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Meet the Man Sentenced to 13 Years for Two Marijuana Joints

Fri, 06/15/2018 - 08:18
Bernard Noble shares his heartbreaking story—one that is all too common thanks to the war on drugs.

This podcast was originally published on Drugs and Stuff, a podcast from the Drug Policy Alliance.

We were lucky to talk with Bernard Noble, who recently came home after serving more than 7 years in a Louisiana prison. Bernard was finally granted parole after being sentenced to 13 years for allegedly possessing two joints of marijuana. You’ll hear all about this grave injustice directly from the man whose case drew national attention as an example of extremely harsh drug sentences in the United States, and how an entire family is tragically affected when a parent is sent to prison.

We were also joined by DPA's Anthony Papa, who became the first person in New York State history to receive both clemency (from Gov. George Pataki 1997) and a pardon (from Gov. Andrew Cuomo 2016) after he was unfairly sentenced to 15-to-life for a first-time, nonviolent drug offense under New York’s draconian Rockefeller Drug Laws. This discussion between two men who served a number of years behind bars because of the war on drugs is powerful and, at times, heart-breaking.

If you want to support Bernard, you can give here: https://www.youcaring.com/bernardnoble-1182699

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Expanding Medicare to Everyone Is the Only Way We Can Fully Protect It

Wed, 06/13/2018 - 07:37
Our health care system is incredibly inefficient.

Medicare is under attack. The only way to fully protect it is to expand it to everyone.

Today’s Republican politicians have made no secret of their desire to end Medicare as we know it. For years, they have supported raising Medicare’s age of eligibility from age 65 to age 67 and transforming it from a guaranteed benefit program into one in which the government gives you an inadequate “voucher” for private health insurance. The well-respected Center on Budget and Policy Priorities has explained that the Republican proposals “would shift substantial costs to Medicare beneficiaries and… leave many 65- and 66-year olds without any health coverage at all.”

This anti-Medicare battle is one that conservatives have been waging since its enactment. Like Social Security, which they argued at the time of its passage was “socialism,” opponents in 1965 accused Medicare of being “socialized” medicine and claimed it would put the government between you and your doctor.

Social Security and Medicare have now stood the test of time. That means it’s harder for opponents to scare you about “socialism” and government “interference.” Instead, they claim that the issue is affordability, and that they are simply trying to “save” Social Security and Medicare. But these programs don’t need saving. They are both solutions, not problems. The fight is about ideology and values, as well as whether to protect the profits of powerful political donors.

Those who oppose Medicare are against government-sponsored insurance. They want to keep for-profit corporate middle men involved in delivering our health care. But that is what is truly unaffordable, as well as morally bankrupt.

Our health care system is incredibly inefficient. Just look at the drug prices we pay. They are the highest in the world.

The following graph, prepared by the non-partisan Congressional Budget Office, projects the nation’s health care costs over 75 years, assuming that future costs rise at their historical rate.

If we keep going as we have been, our health care costs will eventually consume 99 percent of GDP. Obviously, that is impossible. We cannot spend all of our collective wealth on health care and leave nothing for food, housing, and other necessities! Rising health care costs overall are what is unsustainable, not Medicare.

While Medicare and Medicaid are much more efficient than private sector insurance, they cannot keep their costs in check when overall health care costs are rising so rapidly. This is particularly true when Donald Trump and the other Republicans hamstring Medicare by prohibiting it from negotiating for lower drug prices and implementing other cost-saving measures. It is overall costs, private as well as public, that must be addressed.

By ending Medicare and substituting vouchers so that seniors and people with disabilities must fend for themselves against private insurance companies, what Republicans aim to do is to shift costs away from the government and onto the shoulders of seniors, people with disabilities, and low-income families. That will make the government balance sheet look better, but it will cause all of our health care costs to go up.

If Republicans are successful in raising Medicare’s initial age of eligibility from 65 to 67, for example, that action alone would reduce the federal government’s balance sheet by $5.7 billion—but it would cost individuals, employers, and states $11.4 billion! And that’s only in the first year.

Ending Medicare—or simply continuing to constrain it, so that it can’t even negotiate for lower drug prices—will enrich corporations but bury the rest of us. It will allow Republicans to cut taxes even more for their billionaire donors and spend more on military contractors, while more and more of us will have to choose between health care and food.

That is no solution. Market-based provision of health care using for-profit corporations is vastly inferior to universal, government-sponsored health insurance, which is the most effective and efficient way to cover everyone. Insurance is most cost-efficient and reliable when the risks can be spread across as broad a population as possible and when no one can purchase the insurance only when personal risk factors increase—a practice known as adverse selection.

Only the national government has the power and ability to establish a nationwide, universal risk pool, which makes adverse selection impossible. And when the federal government administers the insurance, overhead is minimized. Instead of high-paid CEOs, hardworking civil servants are in charge. And other costs, like advertising and marketing, are unnecessary. Moreover, the government is not seeking a profit for shareholders. Consequently, the government can provide health care less expensively and more efficiently for everyone.

For these reasons, every other industrialized country provides universal health care coverage, spends far less as a percentage of GDP, and produces better outcomes. But we don’t have to look to other countries to see the advantages.

Given the greater efficiency of government-sponsored wage and health insurance, it is not surprising that Social Security and Medicare are so cost effective. More than 99 cents of every dollar Social Security spends is paid in benefits. Less than a penny goes to administration. These are much lower administrative costs than can be found under Social Security’s private sector counterparts.

Similarly, Medicare covers seniors and people with disabilities, people who, on average, have the worst health and the most expensive medical conditions, requiring the largest numbers of doctor and hospital visits. Accordingly, they have the largest number of health care claims. Yet, Medicare is significantly more efficient than private health insurance.

According to the most recent Trustees Report, Medicare spends just 1.1 penny of every dollar on administrative costs. The rest is paid in benefits. In contrast the administrative costs of private health insurance average around 11 to 17 percent. In some cases, they can run as high as 30 percent.

Medicare’s per capita administrative costs are substantially lower than those in the private sector. And that is without universal coverage, which would allow even greater efficiencies and even lower prices.

It is noteworthy that if the United States had the same per capita health care cost as any other industrialized country, our nation would project long-term federal budget surpluses for the foreseeable future. (The Center for Economic and Policy Research has an online calculator that allows you to pick any of those other countries and see the effect on the U.S. budget.)

Unless we extend Medicare to everyone, costs will rise, giving Republicans the excuse that they want to cut or, worse, privatize Medicare. By replacing for-profit insurance corporations with Medicare for All, we will lower Medicare’s per capita costs and dramatically reduce how much our nation spends on health care. This will free up resources to provide better benefits and still have money left over for other pressing federal needs.

Medicare for All is extremely wise policy. Its efficiency will make adding dental, hearing, vision, and other important treatments much more affordable. Unlike cutting Medicare, which would shift costs to seniors and people with disabilities, expanding Medicare would reduce the costs all of us pay.

So why isn’t Medicare for All the law of the land yet? Big Pharma and other powerful donors know that it would reduce their profits. Therefore, they have resisted this sensible solution for a century. They fight against Medicare for All so that their profits can grow even larger at the expense of the rest of us.

Including everyone in Medicare will protect the program politically. Instead of politicians and their corporate donors playing the young against the old, they will instead have to bow to the will of all of us. Expanding Medicare will finally force politicians to improve Medicare, eliminating lifetime caps and making other reforms that should have been enacted long ago. If they refuse, we can vote them out of office in favor of elected officials who listen to the people.

Medicare for All will be better for seniors, better for people with disabilities and better for all of us. It will make guaranteed, high quality health care a right, not a privilege. But to win against the powerful special interests and their political lackeys, we must all stand together and make sure our voices are heard and our votes counted.

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Mind Molding Psychedelic Drugs Could Treat Depression and Other Mental Illnesses

Wed, 06/13/2018 - 07:02
Psychedelic drugs have inspired great songs and works of art. But they may also have potential for treating disease like depression and PTSD by helping to regrow damaged regions of the brain.

It seems that psychedelics do more than simply alter perception. According to the latest research from my colleagues and me, they change the structures of neurons themselves.

My research group has been studying the effects of psychedelics on neuronal structure and function, and we found that these compounds cause neurons to grow. A lot. Many of these compounds are well-known and include lysergic acid diethylamide (LSD), psilocin (from magic mushrooms), N,N-dimethyltryptamine (DMT, from ayahuasca) and 3,4-methylenedioxymethamphetamine (MDMA, aka ecstasy).

These are among the most powerful drugs known to affect brain function, and our research shows that they can alter the structure of the brain as well. Changes in neuronal structure are important because they can impact how the brain is wired, and consequently, how we feel, think and behave.

Prior to our study, there were relatively few compounds known to have such drastic and rapid effects on neuronal structure. One of those compounds was ketamine – a dissociative anesthetic and quite possibly the best fast-acting antidepressant that we have available to us at the moment.

If you think of a neuron like a tree, then its dendrites would be the large branches, and its dendritic spines – which receive signals from other neurons – would be the small branches. Some of these small branches might have leaves, or synapses in the case of a neuron. In fact, neuroscientists often use terms like “arbor” and “pruning” much like a horticulturist would. When we grew neurons in a dish – which is not unlike growing a plant in a pot – and fed them psychedelic compounds, the neurons sprouted more dendritic branches, grew more dendritic spines, and formed more connections with neighboring neurons.

Rethinking depression

Thanks to studies on ketamine, slow-acting antidepressants and chronic stress models of depression, scientists now know that depression is not simply the result of a “chemical imbalance,” as pharmaceutical companies like to suggest. It is far more complicated and involves structural changes in key neural circuits that regulate emotion, anxiety, memory and reward.

One of the hallmarks of depression is the atrophy of neurons in the prefrontal cortex – a region of the brain that controls anxiety and regulates mood among other things. Basically, these branches and spines shrivel up, disconnecting from other neurons in the brain. One hypothesis for why ketamine is so effective is because it can rapidly regrow the arbors and spines of these critical neurons.

Like ketamine, psychedelics have shown promise in the clinic for treating neuropsychiatric diseases. The DMT-containing herbal tea known as ayahuasca produces fast-acting antidepressant effects within a day, psilocybin eases the anxiety of terminally ill cancer patients and MDMA can reduce fear in those suffering from post-traumatic stress disorder (PTSD). Our recent papers suggest the intriguing possibility that psychedelic compounds and ketamine might share a common therapeutic mechanism.

Psychedelics vs. psychoplastogens

Strictly speaking, a psychedelic is a “mind-manifesting” drug – a definition that’s open to interpretation. They tend to produce perceptual distortions or hallucinations by activating 5-HT2A receptors. Our research group has found that compounds typically regarded as psychedelics, like LSD and DMT, as well as those that are sometimes called psychedelics, like MDMA, and those that are not usually called psychedelics, like ketamine, are all capable of profoundly impacting neuronal structure.

Our group has coined the term “psychoplastogen” to refer to such compounds, and we believe that these molecules may hold the key to treating a wide variety of brain diseases.

Our studies on neurons grown in dishes, as well as experiments performed using fruit flies and rodents, have demonstrated that several psychoplastogens, including psychedelics and ketamine, encourage neurons to grow more branches and spines. It seems that all of these compounds work by activating mTOR – a key protein involved in cell growth.

The biochemical machinery that regulates mTOR activity is intricate. As we tease apart how psychedelics and other psychoplastogens turn on mTOR signaling, we might be able to engineer compounds that only produce the therapeutic effects on neuronal growth while bypassing pathways that lead to undesired hallucinations.

This figure shows the effects of three psychedelics and one control (VEH) on cortical neurons. These neurons were treated for 24 hours before being visualized using super-resolution microscopy. The colors represent proteins found in specific locations of the neuron. Orange protrusions from the purple dendrite indicate dendritic spines. Ly et al., CC BY-ND

The field has known for some time now that psychedelics can produce lasting positive effects on brain function, and it’s possible that these long-lasting changes result from the psychoplastogenic effects of these drugs. If true, this would suggest that psychoplastogens might be used to repair circuits that are damaged in mood and anxiety disorders.

Panacea or poison?

Many diseases, such as depression and anxiety disorders, are characterized by atrophy of dendritic branches and spines. Therefore, compounds capable of rapidly promoting dendritic growth, like psychedelics, have broad therapeutic potential. The number of papers demonstrating that psychedelics can produce therapeutic effects continues to grow every year.

However, we should temper our enthusiasm because we do not yet know all of the risks associated with using these drugs. For example, it’s possible that promoting neuronal growth during development could have negative consequences by interfering with the normal processes by which neural circuits are refined. We just don’t know, yet.

Similarly, it is unclear what effects psychoplastogens will have on the aging brain. It’s important to keep in mind that excessive mTOR activation is also associated with a number of diseases including autism spectrum disorder (ASD) and Alzheimer’s disease.

To me, it’s obvious that we need to understand how these powerful compounds affect the brain, in both positive and negative ways, if we hope to fully comprehend the fundamental laws governing how the nervous system works and how to fix it when it doesn’t.

David E. Olson, Assistant Professor, Department of Chemistry; Department of Biochemistry & Molecular Medicine; Center for Neuroscience, University of California, Davis

This article was originally published on The Conversation. Read the original article.

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New Federal Bill Would Protect States’ Experiments With Legal Marijuana

Tue, 06/12/2018 - 09:39
And the president says he will “probably” support it.

A bipartisan group of legislators introduced a bill Thursday in both houses of Congress that would protect state marijuana legalization, medical marijuana, and decriminalization laws from federal interference. On Friday morning, President Trump said he would “probably” support the bill.

Under the measure, the Strengthening the Tenth Amendment Through Entrusting States Act (STATES Act), the Controlled Substances Act (CSA) provisions federally criminalizing marijuana would no longer apply to anyone acting in compliance with state, territorial, or tribal laws allowing marijuana activities.

The bill would also clarify that marijuana business transactions done in compliance with state laws are not drug trafficking and that money made in state-legal marijuana operations is not the proceeds of an unlawful transaction. This provision would provide breathing room for financial institutions to provide services to the industry and give state-legal pot businesses the ability to claim standard business deductions at tax time.

The bill additionally removes industrial hemp from the list of controlled substances under the CSA.

It also retains criminal provisions of the CSA that bar the endangerment of life while manufacturing marijuana and the employment of people under 18 in drug operations. And it prohibits the distribution of marijuana at transportation safety facilities, such as truck stops and rest areas.

The bill is a direct response to Attorney General Jeff Sessions’ avowedly aggressive approach to marijuana. The Obama administration dealt with state-legal marijuana by largely getting out of the way, but under Sessions, the Justice Department has rescinded Obama-era guidance to federal prosecutors that limited law enforcement efforts. A feared crackdown has not materialized, but the Justice Department’s posture has created legal and business uncertainty, threatened public health and safety, and undermined state regulatory regimes.

At a Thursday news conference announcing the bill, Senate co-sponsor Sen. Cory Gardner (R-CO), who earlier worked with President Trump to ease fears of a federal marijuana crackdown, said he had been in contact with Trump on the measure.

“I have talked to the president about this bill,” Gardner said. “In previous conversations he talked about the need to solve this conflict. He talked about his support for a states’ rights approach during the campaign. Not putting words in the mouth of the White House, but I think this will be an opportunity for us to fulfill what is that federalism approach.”

On Friday, as he prepared to head to Canada for the G7 summit, Trump told reporters he backs Gardner and is considering supporting the bill.

“I know exactly what he’s doing,” Trump said. “We’re looking at it. But I probably will end up supporting that.”

Despite the president’s remarks, the bill is unlikely to pass this session. Republican congressional leaders have proven loath to move on marijuana reform bills, and even Trump’s support is unlikely to sway key conservatives who are more aligned with Attorney General Sessions than President Trump on marijuana policy.

Still, filing the bill allows its sponsors to stake out positions at the cutting edge of marijuana reform. Sen. Gardner is a Republican seeking to defend his seat this year in a state that legalized marijuana who has sparred with the Justice Department over the issue, while Senate co-sponsor Elizabeth Warren (D-MA), representing a state where legal marijuana sales are set to begin this summer, is considered a leading Democratic presidential contender.

“In 2012, Coloradans legalized marijuana at the ballot box and the state created an apparatus to regulate the legal marijuana industry. But because of the one-size-fits-all federal prohibition, state decisions like this put Colorado and other states at odds with the federal government,” said Gardner. “The federal government is closing its eyes and plugging its ears while 46 states have acted. The bipartisan STATES Act fixes this problem once and for all by taking a states’ rights approach to the legal marijuana question. The bipartisan, commonsense bill ensures the federal government will respect the will of the voters—whether that is legalization or prohibition—and not interfere in any state’s legal marijuana industry.”

“Outdated federal marijuana laws have perpetuated our broken criminal justice system, created barriers to research, and hindered economic development,” said Warren. “States like Massachusetts have put a lot of work into implementing common-sense marijuana regulations—and they have the right to enforce their own marijuana policies. The federal government needs to get out of the business of outlawing marijuana.”

House sponsor Earl Blumenauer (D-OR) doesn’t need to burnish his marijuana reform credentials—he is a co-founder of the Congressional Cannabis Caucus—while House sponsor David Joyce (R-OH) is defending his seat in battleground Ohio, where medical marijuana sales are slated to begin this fall.

“For too long the senseless prohibition of marijuana has devastated communities, disproportionately impacting poor Americans and communities of color. Not to mention, it’s also wasted resources and stifled critical medical research,” said Blumenauer. “It’s past time to put the power back in the hands of the people. Congress must right this wrong.”

“We should trust the people of the states, like Ohio, who have voted to implement responsible common-sense regulations and requirements for the use, production, and sale of cannabis,” said Joyce. “If the people of these states have decided to provide help for those veterans and others suffering from pain and other health issues, we should allow them access without government interference.”

The legislation is backed not only by the usual suspects, such as the ACLU, Drug Policy Alliance, Marijuana Policy Project, National Cannabis Industry Association, and NORML, but also by the National Conference of State Legislatures. Also supporting the bipartisan effort are conservative groups, such as Americans for Prosperity, Americans for Tax Reform, and the Institute for Liberty, as well as banking groups including the Cooperative Credit Union Association, the Massachusetts Bankers Association, the Maine Credit Union League, and the Mountain West Credit Union Association.

Other marijuana reform bills have been introduced in this Congress, too, but like this one, they are likely doomed by Republican recalcitrance. Still, if the Democrats manage to take control of the House and/or the Senate in November, we could start to see some real progress made. Support for marijuana legalization has gone past the tipping point; now it’s just inertia and intransigence blocking progress.

 Related Stories
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Arkansas Police Wrongfully Arrest Addicted Mom For Murder After Preterm Birth

Sun, 06/10/2018 - 06:24
Based on her statements to medical professionals, her medical records, and the evidence in the motel room, they arrested her for second degree murder and "introduction of a controlled substance into the body of another".

Angela Miller, 23, probably wishes she'd never entered the land of God, guns, and apparently Gilead-inspired small town cops.

But for whatever reason she found herself pregnant in Arkansas -- where we're having to fight for access to medical abortion, leaving only one functioning abortion provider in the state.  

After she'd allegedly injected methamphetamine in a motel in Benton, a small town near the intersections of two interstates, she went into early labor on Tuesday, June 5th.  She was only 24 weeks along.  She had someone at the motel call 911 for her, and her baby lived briefly after its too-early birth under the care of medical professionals at Saline Memorial Hospital.  Sadly, at 24 weeks, it's a coin-toss in the best of times as to whether the baby will survive.  She lost the toss, and her child.

You might think that was enough of a nightmare, but it was only the beginning.

See, Angela was from a state that criminalized assaults against pregnant women, not assaults against fetuses.  She probably hadn't heard of the many women in red states arrested for poor pregnancy outcomes.  She probably felt safe being honest with the physicians trying to save her child about her drug use.

She wasn't in Oregon anymore, though.

Instead, the doctors felt compelled (as mandated reporters) to report anything that could possibly have been considered child abuse or neglect.  With this child having died after taking a breath (therefore not a stillbirth), the local police felt compelled to investigate and thought they could make a case, since the child had died a "person" even if what they claimed caused the death occurred before delivery.  They used 911 records from her call for help to go to the motel she was staying at, where they found paraphernalia for injecting methamphetamine -- their final piece of evidence, and compelling enough apparently for many locals interviewed.

Based on her statements to medical professionals, her medical records, and the evidence in the motel room, they arrested her for second degree murder and "introduction of a controlled substance into the body of another".   As soon as she was considered stable enough to release from the hospital -- Thursday, June 7 -- the proud cops took her to the Saline County Detention Center.  They triumphantly posted a media release about the arrest, even.  Mighty proud folks!

Fortunately, the Saline County Deputy Prosecuting Attorney schooled them for their errors in Angela's bail hearing today.  No, you still can't charge a pregnant woman for a crime committed against her own unborn fetus, even if the child lives a short time after birth.  Nor can you apply a law that was clearly designed to address drug-facilitated sexual assault to a pregnant woman for actions while she was still pregnant.  

The only remaining charges Angela faces, at least at this time, are for the drugs themselves.  Her bond has been set at $5,000, and while the prosecutor said they would continue to see what laws on the books applied, the charges based on ignorant police attempts to use laws designed to protect women against her at one of the worst times in her life have been dismissed.

But how many others will go through a similar experience after being honest with their physicians?

The solution to maternal substance abuse is not found in laws that scare women away from doctors when they need them the most, or laws that discourage them from full and frank disclosure.  I personally wonder if her arrest for the drugs isn't actually "fruit of the poisonous tree", if warrants were properly obtained, etc, but hope that if only convicted of a small drug offense she can still get the treatment she needs.  

Now part of that treatment is going to be for the trauma of thinking she might not get out of prison for decades, though.  Even if she is lucky in comparison to many that her overcharging was addressed quickly.  

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State’s Rights Bill on Marijuana Threatens to Divide Trump Administration

Fri, 06/08/2018 - 08:00
Several marijuana proposals are floating around Congress, including sweeping bills embraced by leading Democrats that would end federal prohibition for good and decriminalize marijuana nationwide.

Lawmakers have introduced bipartisan legislation that would end federal marijuana prohibition in states that have legalized cannabis products for medical and recreational use. President Trump has previously indicated that he would support such a bill, setting the stage for a potential showdown with the Justice Department and one of his least favorite employees: Attorney General Jeff Sessions.

Unveiled on Thursday by members of Congress from states that have legalized weed, the legislation takes a “state’s rights” approach to marijuana favored by many Republicans and even Trump, although the president is known to change his mind. The bill, known as the STATES Act, would not legalize marijuana nationally. Instead, it allows US states, territories and tribal governments to develop their own marijuana regulations without fear of federal interference, as long as the regulations meet certain guidelines.

Sessions, a seasoned drug warrior who hates marijuana, has rescinded an Obama-era memo that generally protected legal marijuana businesses from federal raids, and asked lawmakers to ditch a longstanding policy that has prevented federal law enforcement from interfering with the medical marijuana industry.

Sessions’s hard-line approach to marijuana has put him at odds with members of his own party, and as the midterms approach, polls show that 70 percent of voters oppose the enforcement of federal prohibition in legalized states, so the legislation could very well find its way to the president’s desk. The top Republican sponsoring the bill, Sen. Cory Gardner of Colorado, is chairman of the National Republican Senatorial Committee (NRSC) charged with winning elections and strengthening the GOP’s majority in the Senate.

Earlier this year, Gardner retaliated against Sessions’s attacks on legal weed by threatening to block Justice Department nominations in the Senate. This won him a phone call with the president, who reportedly promised to support legislation protecting states that have legalized marijuana from federal crackdowns. During his campaign for office, Trump repeatedly said the legalization question should be left up to the states.

“The bipartisan, commonsense bill ensures the federal government will respect the will of the voters — whether that is legalization or prohibition — and not interfere in any states’ legal marijuana industry,” Gardner said in a statement.

Justin Strekal, political director of the National Organization for the Reform of Marijuana Laws, said the bill introduced this week falls within the parameters of what Trump told Gardner he would support during their discussion in April. By signaling early support for such legislation, Trump has gone “way further” toward supporting major marijuana reform than any previous president.

“Given that this bill is being co-led by Sen. Gardner, who is the head of the NRSC, it is a sign that it is time for the Republican-led Senate to address this issue and move the legislation forward,” Strekal said in an email to Truthout.

Trump may choose to stay silent on the bill for the time being, but if it advances through Congress, he will be forced to take a position. Coming out in favor of the bill could further sour his already troubled relationship with Sessions, who left the president fuming last year when he recused himself from the federal probe into the Trump campaign’s ties to Russia, despite Trump’s orders.

The bill would effectively set the minimum legal age for using marijuana at 21 nationwide.

The bill would exempt states that have legalized marijuana from the section of the Controlled Substances Act that prohibits cannabis use and lists the drug as a dangerous substance with no medical value. This would protect both businesses and individual users, as long as they follow state rules around marijuana use and distribution. State and federal law enforcement could still target black market marijuana operations.

The legislation would also clarify that financial transactions with legal marijuana businesses do not constitute drug trafficking. For years, major banks and other financial institutions have refused to open accounts for legal marijuana growers and retailers due to federal prohibition, forcing entrepreneurs to do business with large amounts of cash.

The STATES Act requires state marijuana regulations to meet certain stipulations, including rules prohibiting marijuana businesses from hiring employees under the age of 18 and selling marijuana in highway rest areas and truck stops. The bill would also effectively set the minimum legal age for using marijuana at 21 nationwide.

It would also amend the statute to recognize that industrial hemp is not the same as marijuana, which would benefit the growing industry behind a crop used to make food, medicine, textiles and other products.

Several marijuana proposals are floating around Congress, including sweeping bills embraced by leading Democrats that would end federal prohibition for good and decriminalize marijuana nationwide. However, with Republicans in control of Congress and Trump in the White House, legislation that leaves marijuana legalization up to the states has the best chance of gaining traction — and furthering the divide between the president and his attorney general.

 

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NYT Food Columnist Michael Pollan Talks Psychedelics, Science and Mental Health

Thu, 06/07/2018 - 16:20
Click here for reuse options! A discussion about the state of psychedelic drugs and a skeptical culture.

Longtime Michael Pollan fans will find How To Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence is a different book from his past work - mostly. Although in the past, Pollan wrote about food and agriculture, his love of nature carries through to his new book, especially in one section when he forages for magic mushrooms with mushroom expert Paul Stamets. As in past books, he uses an engaging, first-person style of telling a story by introducing readers to the people he meets along the way who teach him about various topics. Unlike previous books, instead of teaching him about food and agriculture, the characters you'll meet in this book teach about psychedelic drugs. Specifically: LSD, psilocybin (the psychedelic compound in magic mushrooms), ayahuasca, and the dried and smoked venom of a toad that Pollan and others refer to as "the toad."

The new book is divided into distinct parts (six, instead of four this time). Pollan reviews the history of psychedelics: how they were discovered, researched for various medical uses, popularized as a part of the counterculture, criminalized and abandoned scientifically, and how they are now coming back within science and medicine in what he calls a renaissance. He reviews the current science of psychedelics: how they affect the brain, how they might be used in medicine to treat addiction, depression, and the fear of death faced by terminal cancer patients, and how they might improve the lives of "healthy normals" too. And, in a chapter titled "Travelogue" (since he went on several trips), he tries the drugs himself and writes about his experiences.

Pollan distinguishes psychedelics from "drugs of abuse" - opioids, meth, or even tobacco, each of which are toxic and addicting. Comparatively, psychedelics are fairly safe (Pollan even got the green light to try them from his cardiologist). That is not to say he endorses unlimited use of psychedelics. With only one exception, Pollan takes his trips with the help of guides. Although the guides are "underground" (not acting legally), they are trained specialists who screen out anyone who cannot safely take psychedelics, prepare each client for a safe trip, stay with them during the trip to ensure safety, and then help them debrief and process what happened afterward.

One of the most interesting themes of the book concerns the tension between psychedelics and science. For one thing, in the 1950s and 1960s, scientists had been doing promising psychedelic research in many areas (such as treating alcohol addiction) when the backlash against psychedelics led to the drugs becoming illegal and all of the research shelved and - for many - forgotten. We often view science as objective truth, but in this case, social and cultural factors led scientists to abandon research even as it was producing hopeful results.

Testing the effects of psychedelics using the normal protocols for testing other drugs is difficult to impossible. (He writes about the 1962 Good Friday Experiment in which ten divinity students received psilocybin while another ten received a placebo: "Telling them apart was not difficult, rendering the double blind a somewhat hollow conceit: those on the placebo sat sedately in their pews while others lay down or wandered about the chapel, muttering things like "God is everywhere" and "Oh, the Glory!")

Even more difficult for the current method of testing the effectiveness of drugs to handle are the importance of set and setting: "Set is the mind-set or expectation one brings to the experience, and setting is the environment in which it takes place." Both are crucial factors in influencing the trip one takes and how it affects them. On one hand, researchers can provide a set and setting to prime participants to have good trips that will maximize the benefits they gain. On the other hand, doing so introduces variables and bias in a way that many scientists would find unacceptable.

However, it appears that psychedelics do provide medical benefits for many when used carefully and with the care of a trained therapist or guide. Should we disregard psychedelics unless we can measure them using our current scientific paradigm? Or can we find a way to harness their benefits in a responsible way even though set and setting introduce variables that cannot be perfectly controlled?

I spoke to Pollan by phone and he answered a few questions about his new book.

JR: You always write yourself into your books, but the information you revealed about yourself in this book felt more personal. Why did you choose to open up more about yourself in this book and how do you feel about having done so?

MP: You're right in your observation. It is a much more personal book and it definitely exposes more of myself than previous books and in general I've used the first person as a narrative tool as much as anything, a place to stand to look at a story. But in this case, if you're having psychedelic experiences, they bring up lots of material. You can't make sense of it on the page without explaining who you are. The molecules lower your defenses and so when your defenses are lowered, you're more exposed. If you are going to be true to the experience you are having, you're going to reveal more about yourself.

And I also made a decision early on I was going to refuse to be embarrassed by what I wrote and that if I really wanted to be honest about the experience I had to put aside how it made me look and what I might be revealing about myself. The experiences are hard enough to write about as it is and then if you're also trying to spin them to hide yourself or make yourself look better than you are, you're not going to provide a very satisfying account to the reader. So it's not like I'm on a new confessional jag as a writer but it was really part and parcel of the experience. I just don't know how you would describe them without - it's not the molecule that's creating the experience, it's you. The molecule is amplifying mental processes that are already at work and if you want to describe those mental processes, well, they are you. Or me.

JR: I love that when we got a picture into your mind, you're still thinking about plants. On that note, there was one part of this book felt very familiar to me when you went looking for Psilocybin mushrooms with Paul Stamets. I felt like, while this is a different sort of book, it's still Michael Pollan. Inoticed,you seem to have given mushrooms the Botany of Desire treatment, speculating why they evolved psychoactive compounds.

MP: Even though they are not exactly a domesticated creature, I always think about the other species' point of view too. And I have since Botany of Desire. I actually think of that chapter as the Botany of Desire-ish chapter of this book because I really am trying to get inside the mushroom's head or whatever it is.

JR: Cap?

MP: Yeah, cap, right. And since I said that, there's been some interesting new research on what's in it for the mushroom and why they have this chemical. There was a really cool study that came out that found that this gene to produce psilocybin has spread amongst several different kinds of mushrooms. It's not a single evolutionary path. It's been kind of horizontally transferred because of its usefulness. And the authors hypothesize that the mushroom's competing with arthropods for a food source. For decaying plant matter and animal feces and things like that. And the chemical helps the mushroom prevail in that competition presumably by discombobulating the insects so they don't feed as efficiently.

JR: Interesting.

MP: Yeah, really interesting. So that would suggest it is a defense chemical of a certain kind that - I guess I do say this in the book - that it makes more sense to confuse the predator than to kill it because if you kill it, you'll select for resistance whereas if you confuse it, it will just go like, "What was I doing here? Where was that cow patty?" And it will just kind of lose interest. And also, psychedelics do diminish appetite. I was never hungry during my trips. So we're still in the realm of speculation but it is very interesting to think about why this chemical would be preserved in natural selection because it fits so well into the serotonin receptor.

JR: You comment kind of repeatedly throughout the book about the ineffability of the psychedelic experience. When you were interviewing the other people who have already taken psychedelics, had you already tried them? Were you already speaking their language?

MP: Especially in the chapter on the renaissance, I hadn't tried them yet. I hadn't tried them yet. And so I listened carefully and worked very hard to convey their experiences as best I could and the variety of the experiences and the intensity. But I didn't speak their language yet.

I kind of get it more, because when people describe this, you sort of imagine an uncontrollable hallucination when someone says, "I traveled into my body and looked at my cancer, or my fear." But it isn't quite like that. It's sort of more like a waking dream or a particularly intense daydream. You can turn it off. You can move. You can decide to go somewhere else.

Hallucination isn't exactly the right word for it. I don't know what is the right word for it. Someone called it an intrapsychic movie and that's sort of close. But it's not completely out of your control in the way a schizophrenic's hallucination would be. You know you're not really inside your body but you've kind of gone there imaginatively. So those accounts make more sense to me now than they did before.

JR: I'm curious what it was like for you to try to describe the indescribable and, I'm just imagining your perspective having listened to others describe it when you couldn't relate, and then you could relate, and trying to describe your own, and how that changed your perspective and what the challenges are to write a book that is based on this experience that can't be described.

MP: Well, it's not that it can't be described. It's difficult to describe. Anything can be described - it's how close do you get to the reality of the experience and that's the challenge. You can describe it poorly, or partially, or sketchily.

I found a few approaches. I did approach that chapter - the Travelogue chapter - with a great deal of trepidation. Like, how am I going to do this? How am I going to keep this interesting? You know, you don't like hearing about other people's dreams. There's nothing more boring than that. And they are sort of like dreams, although they have a lot more coherence, I think.

I found that two things were helpful. One was writing about the experience sort of the way a memoirist writes about childhood. When you read a good memoir of childhood or any earlier phase of someone's life, they toggle back and forth between their adult perspective and the child's perspective. And it really is in the tension between those two, or the space between those two perspectives that the writing acquires a certain force and credibility. If you were just in the child's perspective, you would learn a lot less than you would when you toggle back and forth and the adult weighs in and then the child weighs in. It's the same person, but there's a switch back and forth in perspective.

So I sort of did the same thing and that was to be inside the experience as the person who is tripping, who is believing everything and seeing all of these crazy things and then stepping outside to kind of frankly acknowledge how crazy it sounds, how implausible it is. There's a little riff in the book where I talk about - on the LSD trip - these powerful feelings I had of love. I well understood how thin they sounded but they were so powerful and I just talked about it. I kind of broke the fourth wall, like an actor turning to the audience, and I felt that was the best way to deal with it. To just be really frank and say it feels like this, but I know it reads like this. And that was one helpful technique. It's obviously for the reader to judge if this all works, but that was helpful to me.

The other was when I was experiencing things that were so far beyond the usual conventions of narrative such as the toad trip where not only have I lost a sense of self, character to write about, but I've lost a sense of time and a sense of place, because material reality was obliterated too. Time was obliterated. How do you write a story without those three ingredients? You really need those three ingredients.

So I resort to metaphor. Metaphor is really how - it's how poets deal with the ineffable. You get the right metaphor and it crystallizes a whole complex of emotion and insight if you choose it well. So I just kind of threw a couple metaphors at the wall. One was being blown up in a thermonuclear blast and being in the middle of one of those houses they erected in the Bikini Atoll and then blew up so they could see the force of the nuclear explosion. Another was being strapped to a rocket and feeling the G-forces mount as you climb through the atmosphere completely unprotected. And then the third was let's go back to before the Big Bang - not that any of us remember this - but from what we know from the cosmology, there was no time and there was no matter, there was just pure energy and that's what it felt like. And I said, it was a little like that. And so we can use metaphor to go places we really can't go descriptively. And I don't know if those are brilliant or original metaphors, but they helped. They helped.

It turned out to be a really enjoyable thing to write. I just loved the challenge of it. As someone who usually works as a journalist in this tight little box of checkable facts, here I was describing a purely imaginary world and that was very liberating.

JR: I'll bet. As an aside, this is something I relate to. As I am healing from PTSD, I'll have these incredibly profound experiences, and I can describeit,like you said, but I can't convey how profound it feels, the magnitude of it. And it sounds crazy. But it feels real. I'll come off of it and I'll want to tell somebody that something big happened, but there are no words. So I related to what you wrote because I've had that experience.

MP: I think that's it. The amplitude, the intensity of the experience. You can describe it but it's kind of cloaked in this emotional power that is very hard to get across.

JR: How did your body feel when your ego had entirely dissolved while on your trip?

MP: There is a bodily sensation. The sensation of merging. Very soft. You feel kind of unbounded. Like your skin is permeable. Everything is permeable. It starts as kind of a heady experience but it did have a physical component, and it was very pleasant.

JR: A running theme throughout this book is the difficulty science has in measuring the effects or benefits of psychedelic drugs. Do you think we should continue to seek ways to study psychedelics using the current scientific paradigm that calls for double-blinded studies under controlled conditions by researchers who are unbiased outsiders, or do you think perhaps psychedelics have something to teach us about how we need to change science?

MP: Psychedelics really are a challenge. It is very hard to blind these studies, although they have had some success. Roland Griffiths talks about how he can fool not just his volunteers but his guides, his therapists, I forget what the percentage is, where they mistook the placebo session for a psychedelic session. It's really hard to do. I think it's worth trying.

There is a value in double blind studies if only a rhetorical value in that they persuade the FDA and the regulators so if you are going to try to - if you want to move these medicines to approval by the FDA you have to play by the rules you have. But you need to recognize the limitations. And when they talked to the FDA about this, the FDA was not troubled by the whole problem, interestingly enough. They had a pretty broad attitude about it, but I think they respected the efforts to try.

There's so many elements. One is reducing the number of variables. What do you do with the music? There's this weird variable. You're playing Bach, you're playing Pat Metheny, and then there is of course the attitude of the therapist which has a profound effect on the experience.

You know maybe the challenge is to stop calling it psychedelic therapy and acknowledge it really is a package that you're testing. And I don't know if the FDA will have a pathway for that but you have really a psychedelic-assisted type of therapy. And some of the papers used that term but I noticed when they are doing the official drug trial papers they just say "psychedelic therapy" because of the FDA tests drugs, they don't test a whole therapeutic package that involves talk therapy and pharmacology.

I think academically it's really interesting the questions it raises about the conventions we have for testing drugs, which we should realize are historical artifacts. We didn't start testing drugs that way until 1962 and there may be better ways to do it that need to be developed and applied for things like psychedelics. I'm not sure. But it certainly makes you think about the whole regime as not necessarily inevitable or the only way to do it.

JR: It seems like, as with any type of psychotherapy, there's an interaction between the patient and the therapist, or the patient and the music even. Even if you gave everybody the same music, not everybody likes the same music.

MP: That's right. And what if you don't like the music that you're hearing? It affected my experience. So that's a weird variable but it seems to be very important to the success of the session.

JR: I noticed at one point you wrote they were trying psychedelics in very sterile, hospital-like conditions and...

MP: And it got bad results. People freaked out. There are little odd things that kind of prime you for a spiritual experience in America. They give you the pill in a chalice instead of a little paper cup. And there's a Buddha in the room and a ceramic mushroom, and so the rooms are priming a spiritual experience. I don't think it's an accident that the American researchers hear a lot more about mystical experiences from their volunteers than the English do. They do hear about ego dissolution, and those two things may actually be the same but with different labels. That's what I suspect. But there's no question that the orientation of the researchers is affecting the results they are getting. And that's why I think that going to phrase 3 which will be much bigger trials conducted by people somewhat less invested in the outcome, the results might be not as good.

JR: Most ofpsychedelicuse you describe is done in the care of a therapist or guide of some sort. However, many Americans take psychedelics on their own, without such precautions. I've got a question, but I'd like to give you the context first. First of all, where I live, a native plant produces psychoactive compounds that were traditionally used by Native Americans when men came of age.

MP: What is it called?

JR: Datura wrightii. Some people have died taking it. Second, I told my therapist that I am reading your book and joked that, because I made my own sourdough starter and baked bread and made cheese after reading Cooked, I'd probably end up taking drugs after reading this one.

MP: [Laughs] How did she react?

JR: She told me, "Please do not do that. That would interfere with what we are trying to do here." I did not ask why. It's possible she's just not open to drugs because they are drugs.

MP: There are a lot of people like that in psychiatry. They are very troubled by psychedelics because the symptoms present as psychosis and that's what they are trained to see. There was a Letter to the Editor in the New York Times on Sunday in response to an article I wrote two weeks ago about guides, and then I describe one of my own experiences from the book, and the psychiatrist who is on the faculty at UPenn writes this letter saying people should not use these drugs, they result in psychotic episodes such as the one I had had. So this guy was willing to diagnose my trip as a psychotic episode from a distance of 3000 miles and he was wrong.

And they've been wrong all through this history. They originally thought that the drugs induced psychosis, they called them psychotomimetics as a result. But it never occurs to them that maybe their diagnostic criteria have a problem.

JR: He just violated the Goldwater rule.  

MP: I know! I know! That was the other thing. I was tempted to write him back. They are so persnickety about that, and there he was. But it was more revealing of him than me so it was interesting.

JR: I am curious if you heard of any circumstances or cases in which somebody should not do this, or a reason they should not do it. If you have a therapist or a guide vetting you and making sure you have a safe trip, did you hear of any pitfalls that would lead someone to be a bad candidate for taking psychedelics?

MP: One of the things you want from a guide is for them to screen you, to make sure you're not at risk either because of some other drug you're taking or because you are at risk for schizophrenia or you have family history. Even the underground guides take a medical history and ask you lots of questions and ask you what meds you're on. And that kind of care I think is really important.

There are people who should not take these drugs. They are definitely not for everyone. If you are at risk for schizophrenia, you will get screened out of any of the university trials.  And it's interesting, many of the guides reject people. Someone comes to them, they think they have a serious mental illness, and they don't want to work with them because of the risk.

So I think that is a very important issue, and it's one of the values of having a guide. How are you going to make that judgment about yourself? I guess some people can make that judgment, you know, I've got a brother who is schizophrenic or maybe I shouldn't mess around with these drugs. But it's hard to generalize. I've been saying this in my interviews, but then I got this very moving letter from a woman who did have psychosis of some kind and had found psychedelics very helpful. So there are some people, I am sure, who were helped, but you don't recommend people who are in that extreme state to roll the mental dice. And you are rolling the mental dice with a psychedelic. There are psychological risks.

JR: Toward the end of the book, you comment briefly on the inadequacies of the mental health care system. And you kind of give some ways in which psychedelics could help and also some reasons why maybe our system won't let them in. Where do you see psychedelics as fitting in mental health care?

MP: Well, a lot of it depends on the receptivity of the community of therapists and doctors. I think that they are becoming more receptive than they were just a few years ago. When NYU first started studying cancer patients [using psychedelics to help terminal cancer patients cope with fear of death], the oncologists would not refer people to them. The oncologists were really negative about the whole thing. They thought it represented giving up and just kind of accepting that you'd failed to successfully treat a cancer. They see every death as a personal defeat. It's kind of the mindset. But now, I was just at this training program for psychedelic guides, there were three or four oncologists there who want to add psychedelic therapy to their oncology practice. So I think that it's moving quickly right now.

Although somebody just sent me a study, a survey of psychiatrists. And they were still very skeptical of psychedelic therapy. They all agree there should be more research but they were more skeptical. So I think it will take a little while, but it's happening.

And I'm meeting many psychiatrists and MDs at my events. They seem very open-minded. Of course they are a self-selecting group to come to my events. But the strongest criticism I hear is "we need more research," and I agree with that. We need more research. So I think if psychiatry and mental health practitioners more generally embrace this, it will be because the science proves that it's a valuable medicine, and they definitely need new tools. They have so little innovation since the SSRIs antidepressants and there's a general recognition that they are not working as well as they used to, and there's many people that they don't help. If only out of desperation, they should be taking a look at this. And I think that they will.

You know, many of the psychiatric drugs that are commonly prescribed are far more toxic than LSD or psilocybin. The side effects - I'm not talking about SSRIs, although they have their own side effects that people don't like - I'm talking about the antipsychotics - the Stelazine and Thorazine and those drugs. Really serious side effects. The toxicity of psychiatric medicines is really serious, and that you would not deign to study a drug that has essentially little or no toxicity is kind of remarkable.

JR: You talk a bit about not just using psychedelics to treat sick people, but giving them to so-called "healthy normals" too. Do you think there's a benefit to that?

MP: I think that there is. You know, "the betterment of well people" as Bob Jesse put it in the book. I mean, look, I got benefit from it. And I'm fairly healthy, fairly normal - I don't want to overstate the case.

It appears that psychedelics are helpful for depression, addiction, anxiety, obsession. We all have those illnesses to one degree or another in that we're all stuck in habits of thought that don't serve us well. Especially as we get older, we get more and more ossified and the idea of something that could lubricate cognition - or "shake the snowglobe" - could be useful for lots of people.

In the same way that garden-variety neurotics go to receive benefits from going to therapy, those folks would stand the benefit from psychedelic therapy possibly. You don't have to have a diagnosis of a serious mental illness to get psychotherapy. It benefits people who are sad, it benefits people who are confused about life decisions or have problems of various kinds or suffer from grief. Grief is not a mental illness, but people seek therapy for that. So, in that whole universe of people seeking help, many of them, it would be a shame if it were not somehow made available to them. I don't know how we'd do that exactly. There's a lot of work to be done figuring out how to incorporate these medicines in the culture if indeed they prove out - when they go into the next stage of trail. But I think it's something we need to address and work on.

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Oklahoma Expected to Become Latest Medical Marijuana State by Month’s End

Wed, 06/06/2018 - 11:48
A voter initiative is on the June 26 ballot and the polls are looking good.

One of the reddest of red states is set to go green later this month. Voters in Oklahoma will go to the polls on June 26 to decide whether to support the Question 778 medical marijuana initiative, and all indications are that it will win.

The state’s Sooner Poll showed support for the initiative at 57.5 percent last month. That’s down slightly from January when the same poll had support at 61 percent, but still enough to pull off a victory at the polls later this month, especially given the limited organized opposition to it so far.

One opposition group, Oklahomans Against 788, has a Facebook page, but according to state campaign finance reports, has only collected a paltry $755—and from only two donors. The two political action committees supporting the initiative, Oklahomans for Health and Yes on 778, on the other hand, have raised more than $31,000 and have more than $9,000 in the bank for media buys this month. (Oklahoma isn’t a huge media market.)

Newly emerging opposition from conservative religious figures is probably too late to make a difference, but a group calling itself Oklahoma Faith Leaders, whose head is a former consultant to Oklahoma Republican U.S. Senator James Lankford, enlisted Lankford to issue a press release last week warning that the initiative would be “harmful to the social fabric of Oklahoma.”

Lankford went on to blame outside agitators with hidden agendas: “This state question is being sold to Oklahomans as a compassionate medical marijuana bill by outside groups that actually want access to recreational marijuana,” Lankford added. “Most of us have seen first-hand the damage done to families and our communities from recreational marijuana use.”

It’s unclear just what “damage done” Lankford was referring to, but the initiative does not legalize recreational marijuana, and if any “outside groups” are involved, it is certainly not evident from the campaign finance reports.

Instead of sending Oklahoma on the path to perdition, passing the initiative would bring the state up to speed with most of the rest of the country. Currently, 30 states and the District of Columbia allow medical marijuana, while another 15 states have laws allowing the use of CBD cannabis oil for medicinal purposes.

The Oklahoma initiative is a full-fledged medical marijuana measure, which would allow patients to grow their own medicine; create a system of licensed dispensaries, cultivation, and processing facilities; set taxes at a relatively low 7 percent; and bar localities from using zoning laws to block dispensaries (although they wouldn’t be allowed within 1,000 feet of a school).

It’s the culmination of a long, arduous effort to legalize medical marijuana in the Sooner state. For years, the Republican-dominated state legislature has refused to move on the issue, instead grudgingly approving only clinical trials of CBD cannabis oil for minors suffering from epilepsy in 2015. The following year the legislature removed the age cap and expanded the trials to include other diseases and conditions. But it has refused to go any further, including this year, when a much more limited medical marijuana bill, Senate Bill 1120, died in March for lack of support.

The initiative itself has faced a similarly arduous path. Originally aimed at the November 2016 ballot, the measure successfully gathered the required signatures in the summer of 2016, and they were verified in September 2016. But the date of signature submission, a rewrite of the ballot title required by state officials, and the court battle that followed meant the measure didn’t make the 2016 ballot. The Oklahoma Supreme Court ruled in favor of Oklahomans for Health in March 2017, and Gov. Mary Fallin (R) nine months later proclaimed that the initiative would appear on the June 2018 primary election ballot.

That’s the first time since 2005 that an Oklahoma governor selected a date different from the general election for an initiative. Now, despite it being an off-year primary election, Oklahomans will finally have a chance to join the ranks of the medical marijuana states. But they’re going to have to actually go out and vote to make it happen.

 

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Did Michael Pollan Kill God? Inside the NYT Food Columnist's Exploration of Magic Mushrooms

Tue, 06/05/2018 - 04:58
From Pollan’s new book “How to Change Your Mind” — currently on top of the New York Times best-seller list — it looks like he got what he was after.

Michael Pollan had enlightenment envy.

Unlike most patients in clinical trials of psilocybin, when Pollan ate a magic mushroom, he wasn’t terrified by a terminal illness, he wasn’t suffering from alcoholism or depression and he hadn’t been diagnosed with a personality disorder.

But he “envied the radical new perspectives” of the people in psychedelic therapy whom he interviewed, and he found the idea of “shaking the snow globe” of his mental life appealing. “I also wasn’t sure I’d ever had a spiritual experience,” he said, and in late middle age, he felt “time was growing short.”

From Pollan’s new book “How to Change Your Mind” — currently on top of the New York Times best-seller list — it looks like he got what he was after.

But Pollan’s account of his journey contests the value or necessity of millennia of spiritual struggles, ages of religious insights and even, most radically, belief in the existence of God.

His lyric depiction of his “egoless, nondual state of consciousness,” of the “obliteration” of the very category of “personal,” of his “I” who was nevertheless not his self, and who was “unbounded by any body” and had “no desires of any kind,” reminded me of William James’s case studies in “The Varieties of Religious Experience.” Mystical experiences, James wrote, qualify, as “states of knowledge. They are states of insight into depths of truth unplumbed by the discursive intellect. They are illuminations, revelations, full of significance and importance.”

But if a single psilocybin trip could rewire Pollan’s brain, or ours, in the way that Buddhist monks take lifetimes to achieve, are the years we spend wrestling with faith, or ragging ourselves for being lousy meditators, just a waste of time?

Did Pollan really eat his way to a spiritual experience, or was it just a chemical experience — is there even a difference? If ’shrooms open doors to the depths of ineffable truths, does it really matter if God is dead or not?

By the time I hit middle age, I’d worked out my answer to “Is God dead?” without benefit of psychedelics. I got there in stages, like Kübler-Ross’s five stages of dealing with death, only instead of denial, anger, bargaining, depression and acceptance, for me it was faith, reason, nihilism, mysticism and omg-we’ve-run-out-of-diapers.

I grew up in the same Newark neighborhood that Philip Roth did, though a generation later. Orthodoxy failed me when I asked my mother, who kept a kosher home, why it was OK for us to eat spare ribs at Ming’s on Sunday nights, and she explained that God was not troubled when our kind of Jews, the Jews of the Weequahic section, made common sense accommodations to modern life. Except, of course, when it came to dating shiksas, which carried a mandatory sentence of “he’s dead to me.”

Through the loophole of reasonableness that she opened, I drove a truck bearing I❤SCIENCE license plates. Culturally, I couldn’t have been more Jewish, but theologically, I became the Voltaire of Schuyler Avenue. Like 12-year-old Ozzie Freedman in Roth’s “The Conversion of the Jews,” the 12-year-old me challenged God’s power, questioned God’s morality, even disputed God’s existence. By the time I went off to college, it was to become a molecular biologist – to learn the scientific method and master the evidence for the secular materialist account of life.

But I also learned in college that ruthless doubt, once unleashed, can lay waste to more than childhood faith. It can reduce love to libido, altruism to evolution, justice to privilege, science to politics, taste to class, virtue to tribe, merit to luck, skepticism to cynicism and meaning to myth. I know that there are happy atheists, but it was to the dead end of dread that relentless rationality led me. It also led me to leave J.D. Watson’s lab and seek out new mentors: Fyodor Dostoevsky, Friedrich Nietzsche and Samuel Beckett.

What rescued me from nihilism was finding God everywhere, except in religion. That’s what I suspect a rising number of Americans mean when they tell pollsters that they’re “spiritual but not religious.” For me, it was meditation that set me on that path. I took it up as an adult, to stop grinding my teeth, but meditation took me to a kind of DIY mysticism. My toolkit has ranged from Rumi to Ken Wilber, from Huxley’s perennial philosophy to Heschel’s radical amazement, from mindfulness to gratitude — to being dumbstruck with awe at nature, at art, at my newborn babies’ fingers curled around mine, at Katz’s pastrami, at the starry sublime.

Still, I’m not much of a mystic – I bet I spend more time sleepwalking than mindfully experiencing the moment. But quotidian reality, if we remember to notice it, can be a portal to enlightenment. “I had developed a set of fairly dependable mental algorithms for navigating whatever life threw at me,” Pollan says about his daily routine, “and while these are undeniably useful tools for coping with everyday life and getting things done, they leave little space for surprise or wonder or change.” Pollan needed a drug, and a rupture from ordinary reality, to experience transcendence. But my experience is that reality itself can disclose the divine. If you pay attention, everything — not just sunsets, but laundry, too — can be surprising, even startling. Everything can be an occasion for wonderment; everything can prompt the ultimate question, “Why is there anything at all?”

Psilocybin is a turbocharged route to finding enchantment in everyday life. More than a thousand published papers attest to its safety when administered in appropriate settings. I have no problem with Pollan or anyone else taking a short cut to illumination. In fact, according to a Johns Hopkins study in a recent Journal of Psychopharmacology, the drug works best when it’s combined with the kind of slowpoke old-school stuff I’ve turned to, like meditation, progressive muscle relaxation and mindful breathing. Psilocybin, the Hopkins study says, brought about the largest, most significant, and most enduring positive changes in “interpersonal closeness, gratitude, life meaning/purpose, forgiveness, death transcendence, daily spiritual experiences, religious faith and coping” when subjects also meditated, had a mindfulness practice, kept a journal and “engaged in activities they personally judged to facilitate spiritual growth (e.g. being in nature, contemplative movement, artwork or service activities).”

William James, shaking the snow globe more than a century before Michael Pollan, also tried a chemical on himself — nitrous oxide. He called the “metaphysical revelation” that came to him when high on laughing gas “a reconciliation.” This was how he explained it: “It is as if the opposites of the world, whose contradictoriness and conflict make all our difficulties and troubles, were melted into unity.” Every religion, every mystic tradition, contains that vision of the world. You can reach it with fasting, with sitting, with prayer; you can find it in a fungus; you can see it in a grain of sand, and hold infinity in the palm of your hand.

“Melted into unity”: What a heartening prospect. Whether it’s a struggle or a thrill ride, the seeker’s path to purpose is the world’s path to peace. If God isn’t dead, She won’t care how you get there.

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Medicine Residue Is Everywhere in Our Rivers and Lakes—and Fish Are Behaving Strangely

Mon, 06/04/2018 - 23:30
We have a new major environmental problem on our hands.

For all the well-documented sources of environmental pollution—think chemical manufacturers, energy plants, mining operations and agricultural processes—there’s another major source of contamination that continues to get short shrift by those charged with protecting the nation’s waterways and the public’s health: Pharmaceuticals and personal care products.

“Across the board, we don’t have our heads around this problem,” said Emma Rosi, senior scientist at the Cary Institute of Ecosystem Studies. And considering America’s voracious appetite for pharmaceuticals—there were 3.7 billion drugs ordered or provided through physician visits alone in 2015—the scope of the problem is unsurprisingly staggering.

Chemical compounds found in pharmaceutical and personal care products are showing up ubiquitously in the nation’s rivers, lakes, groundwater and drinking water—even remote regions of national parks. Up to 80 percent of streams in the U.S. alone are contaminated with chemicals, including pharmaceuticals, according to the U.S. Geological Survey (USGS). What’s more, the sheer volume of different persistent compounds found in the environment vastly complicates the regulation and remediation of them.

“These are potent compounds, that’s why we use them,” Rosi added. “But if they don’t get broken down and they enter the environment, they are just as potent to the organisms there.”

So, how are these chemicals finding their way out into the nation’s waterways? The primary culprit is human waste—urine and feces—that makes its way to wastewater treatment plants unequipped to filter out all the various contaminants in the water. But it’s not just human waste that’s a problem.

A recent study found levels of certain pharmaceuticals “substantially higher” in plants that received wastewater from drug manufacturing facilities compared to those that didn’t. The study—which looked at 120 different drugs and pharmaceutical degrades—concluded that these facilities are an “important, national-scale source of pharmaceuticals to the environment.”

Some unwanted drugs are flushed down the toilet or tossed into the trash. Hospital waste is another avenue. But while we know how and where pharmaceutical wastes are getting into the environment, we don’t yet know the full extent of the problem in terms of their myriad impacts on delicate ecosystems.

“There’s insignificant research to understand the scope of this issue,” said Rosi. “And I would argue that there’s not enough research funding for scientists to really understand the influence of these compounds.”

Even so, what we know is that some of these chemical compounds can profoundly affect aquatic life. Rosi breaks it down three ways—the first is related to their endocrine disrupting properties.

In a study of fish at 19 different National Wildlife Refuges, for example, scientists from the USGS and the U.S. Fish and Wildlife Service found that between 60 to 100 percent of the fish studied were intersex, meaning they had female egg cells growing on their testes. The scientists linked this phenomenon to elevated levels of estrogen in the water. But estrogen-like chemicals aren’t the only culprit.

A study conducted by researchers at the University of Wisconsin-Milwaukee suggests that higher levels of metformin—a commonly prescribed diabetes drug—causes the development of intersex testes in male fathead minnows, reduces their size and affects their ability to reproduce.

Pharmaceuticals are also a driver of environmental change, said Rosi. The presence of antidepressants in the nation’s waterways, for example, can disrupt and alter fish behavior, including breeding patterns. The presence of cimetidine, a commonly used antacid and antihistamine, has the potential to negatively impact the health of freshwater invertebrates and bacterial biofilm, another study suggests. Levels of cimetidine are on the rise in the nation’s streams and rivers.

The third way pertains to their potential impact on human health. “There’s a lot of concern about antibiotic resistance,” said Tia-Marie Scott, a physical scientist with the USGS.

There are more than 250 million antibiotic prescriptions written in the U.S. each year. But because the human body cannot metabolize antibiotics fully, and because wastewater treatments plants don’t filter them out, experts fear that the release of these drugs into the environment is contributing to the development and spread of antibiotic-resistant bacteria, which is estimated to be responsible for at least 23,000 deaths in the U.S. every year. And it’s not just human waste that’s a problem; agriculture is another major contributor of antibiotic releases.

“This is a whole can of worms that we’re only just able to start getting an understanding of,” Scott said.

Just how big is the problem?

Studies conducted in the U.S. illustrate how pharmaceutical compounds and chemicals found in personal care products are present throughout the nation’s rivers, lakes, groundwater and drinking water in alarming rates.

A 2011 Government Accountability Office (GAO) report about their impacts in drinking water comprises a number of studies, including one by the USGS that found 53 of 74 testing locations had one or more pharmaceuticals in the water. In 2010, an Environmental Protection Agency (EPA)-funded analysis of 48 research publications found 54 active pharmaceutical ingredients and 10 metabolites that been detected in treated drinking water.

The Great Lakes have come under scrutiny, too. In a University of Wisconsin-Milwaukee study of Lake Michigan, 32 pharmaceuticals and personal care products were detected in the water, and another 30 were detected in the lake’s sediment. But it’s not just waterways situated near more urbanized areas that are vulnerable to contamination. Pharmaceutical compounds have even made it to isolated regions of the U.S.—including a number of National Parks in Northern Colorado, for example.

“That really gets at how we’re seeing concentrations that are detectable at our most pristine environments,” said Scott. Nor is this a problem confined to the continental U.S. Europe has been researching the problem in its waterways for quite a number of years, while the Alaskan Department of Environmental Conservation's Fish Monitoring Program keeps tabs on the presence of pharmaceuticals in the state’s fish populations. “This problem occurs pretty much everywhere,” Scott said.

How to tackle the problem

The decades-old National Environmental Policy Act gives Food and Drug Administration (FDA) administrators “mechanisms” to stop persistent pharmaceutical compounds from entering the environment, said Scott Graham, director of the Public Engagement and Science Communication Laboratory at the University of Wisconsin-Milwaukee.

The problem, said Graham, is that the FDA relies on pharmaceutical companies to conduct their own research into the environmental toll of their products, and this research is then presented to “environmental safety teams” at the agency—teams that are often overworked and understaffed. This leads to evaluations being conducted by FDA personnel who are “ill-qualified to make accurate judgments” on the drug’s potential environmental impact, he added. 

“[Drugs] end up getting approved because we have the pharmaceutical companies doing the wrong kind of science which is then being evaluated by the wrong kind of evaluator,” Graham said, who calls 2016 FDA environmental guidelines regarding drugs with estrogenic, androgenic, or thyroid activity a “weak” step forward.

The sheer scope of the problem is too vast for one agency to tackle alone. Rather, Graham advocates for a multi-pronged approach between different federal agencies. But with that in mind, EPA officials also admit in the 2011 GAO report that there is “no formal mechanism, such as a long-term strategy or formal agreement, to manage and sustain these collaborative efforts.”

Just take the staggering amount of waste produced in the U.S. Some 32 billion gallons of wastewater flows through 700,000 miles of underground pipes daily. But wastewater treatment plants don’t have the technology to remove all pharmaceuticals during the treatment process—nor are they mandated to. That, and the nation’s sewage infrastructure is old and deteriorating. So much so, it’s estimated that 900 billion gallons of sewage are released each year into waterways through infrastructure leaks and sewage overflows.

According to the USGS’s Tia-Marie Scott, while some wastewater treatment plants are stepping up to the plate, there are no affordable “one size fits all engineering solutions” to tackle the vast variety of different compounds in the environment. Which leads to the EPA’s stance on this issue. No pharmaceuticals are currently on the EPA’s Primary Drinking Water Regulations.

“And I’m not even sure that’s a practical approach, because there are tens of thousands of emerging contaminants we’re identifying in our wastewater that could be of concern,” said Scott. “And the way our regulations are updated to accommodate new compounds, it doesn’t happen in a fast enough manner to deal with how many different chemicals are being used year after year, even day after day.”

There is a “green pharmacy” movement, pushing for the design of new drugs that biodegrade easily in the environment. But experts caution that the reason pharmaceuticals are so effective is that they’re designed to break down under very specific conditions. That’s why some argue that there also needs to be a cultural shift in the way Americans consume pharmaceuticals and personal care products.

“There are lots of things that we use in our everyday lives that we can reduce a little bit,” said Rosi. “Because if people understand that what they’re using and washing down their drains are ending up at their local rivers, streams, lakes, they might think twice. It doesn’t just go away.”

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Is Trump Using His Pardon Powers the Right Way?

Fri, 06/01/2018 - 13:33
Trump prefers to pardon prominent public figures, but what about people in the lower tax brackets?

President Trump and the use of presidential pardons is all over the news. Earlier this week the President met with Kim Kardashian to discuss the case of Alice Marie Johnson, a grandmother who has spent more than 20 years behind bars on a drug charge.

And yesterday he used his power to pardon to grant relief to Dinesh D’Souza, who was convicted of campaign finance violations and has never spent a day in prison. Some critics have said this was a signal to his lawyer Michael Cohen, who is under investigation for the same crime, to be quiet and not help in the investigation of the president. Trump has said he also might grant relief to former Gov. Rod R. Blagojevich who was sentenced to 14 years and Martha Stewart who spent five months in prison for lying to government investigators about stocks. Trump described their cases as “really unfair”.

For the most part, President Trump has ignored the pending 10,000 or so applications for pardon relief from regular prisoners and has focused on granting pardons to prominent public figures whose cases aligned with his politics.

Kardashian was emotionally moved when she saw a Twitter post about a 63-year-old grandmother who was serving a life sentence for drugs without parole. In 1997, Alice Marie Johnson was found guilty of cocaine conspiracy and money laundering in Tennessee. She was sentenced to life without parole for leading a multi-million dollar drug ring that dealt tons of cocaine from 1991 to 1994. U.S. District Judge Julia Gibbons called the 41-year-old Memphis woman the quintessential entrepreneur. According to the Tennessean, a newspaper in Nashville, during Johnson’s trial evidence was presented that showed an operation with Texas-based Columbian drug dealers and their Memphis connections trading cocaine for millions.

Now 21 years later, the 62-year-old grandmother has turned her life around and has gathered the support of many high-profile influencers, including Kardashian, Ivanka Trump, and Jared Kushner who set up a meeting with President Trump on Tuesday. 

As the first person to receive clemency and a pardon in New York, I applaud Kardashian for helping to support clemency for Ms. Johnson. On the other hand, I have great sadness for the hundreds of thousands of people who are rotting away in state and federal prisons because of the drug war.

The war on drugs has created thousands of cases similar to Alice Johnson due to its severe sentencing structure. And the majority of those cases do not have the superstar support and media coverage which is dearly needed when advocating for release via pardon power. To balance the scales of justice to those who do not possess the ability to create a successful campaign as Ms. Johnson we need to address the war on drugs’ draconian sentencing to prevent giving life sentences without parole to non-kingpins.

I was sentenced to 15-to-life in 1985 for a first time nonviolent drug crime when I passed an envelope containing four ounces of cocaine in exchange for $500. I was a mule in a sting operation and spent the best years of my life in a 6x9 foot cage until Gov. Pataki granted me executive clemency via the support of many movie stars. 

There are many nonviolent federal drug offenders like Alice who have spent a tremendous amount of time in prison and have exhausted all of their legal remedies. They are ready to return home.

President Trump should step up and give these people a second chance in the name of justice.

This piece first appeared on the Drug Policy Alliance Blog.

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You’ll Never Believe Which Country Just Enacted Massive, Meaningful Drug Reform

Wed, 05/30/2018 - 14:27
It’s a move that will save thousands of lives.

For years, Iran has been one of the world’s leading executioners of drug offenders, with hundreds of people hung from the gallows annually for drug smuggling and trafficking. But in a remarkable turnabout, that is no longer the case.

After the Iranian parliament amended the country’s drug laws in November 2017, drug executions have all but halted, according to a new report from Iran Human Rights (IHR). The non-profit group found that only one person had been executed for a drug offense this year in Iran, compared to 112 during the same period last year and nearly 500 for all of 2017.

That’s a 99 percent reduction in the resort to the death penalty for drugs in the Islamic Republic.

The changes to Iran’s drug laws didn’t remove the death penalty from the books—it remains one of 33 countries, including the United States, that mete out the ultimate punishment for drug offenses—but it dramatically raised the quantities of drugs needed to merit the death penalty.

Under the old law, being caught with a little more than an ounce (30 grams) of drugs such as cocaine or heroin could bring a death sentence. Now, it takes nearly 4 1/2 pounds (2 kilograms). Similarly, for plant-based drugs such as cannabis and opium, the death penalty threshold has increased ten-fold, from 5 kilograms (11 pounds) to 50 kilograms (110 pounds).

The death penalty can also be imposed for certain other drug offenses where quantity is not the issue, for example, the use of a minor in a drug trafficking operations, carrying or using firearms while committing drug-related crimes, having a prior death penalty or prison sentence longer than 15 years, or being the “leader” of a drug trafficking group.

The one man executed for drug offenses in Iran this year, identified as Kiomars Nosuhi, was convicted of being a “leader” of a drug trafficking group.

Bordering Afghanistan, the world’s primary supplier of raw opium and heroin, Iran has for decades waged war on drug smugglers, with thousands of police and soldiers killed in the struggle. While opium smoking was a traditional Iranian pastime, the country now has one of the world’s highest addiction rates, with heroin largely replacing opium. In recognition of that reality, in the past decade, Iranian officials have switched from harsh punishments of drug users to emphasizing drug treatment and harm reduction. The end of the reflexive resort to the death penalty for drugs marks another step in the country’s march toward a more progressive policy response.

While human rights groups applaud the dramatic decline in drug executions, they continue to express concern over the way the Iranian judicial system responds to drugs.

“We welcome the significant reduction in the use of the death penalty and hope that this trend will continue towards complete abolition,” said IHR spokesperson Mahmood Amiry-Moghaddam. “However, we have several serious concerns regarding the process of implementation of the new amendment, including bribery in the judicial system, insufficient capacity to handle a large number of cases, and lack of a monitoring organ overlooking the process.”

And then there are the tens of thousands of drug offenders filling Iran’s prisons. The country has more than 250,000 people behind bars, 50 percent to 70 percent for drug offenses. The Islamic Republic may not be running the gallows at full tilt anymore for drugs, but incarceration remains a key element of Iranian drug policy. Still, Iran has taken an important step forward.

 

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Ambien Maker Shames Roseanne Barr for Blaming Her Bigoted Rant on its Drug: ‘Racism is Not a Known Side Effect’

Wed, 05/30/2018 - 07:33
Sanofi threw shade at the former sitcom star after she claimed she was "Ambien tweeting" when she attacked former Barack Obama adviser Valerie Jarrett.

Sanofi, the pharmaceutical company behind Ambien, has put out a statement knocking Roseanne Barr for seemingly blaming its drugs for her racist tirade this week.

“People of all races, religions and nationalities work at Sanofi every day to improve the lives of people around the world,” the company said in an official announcement. “While all pharmaceutical treatments have side effects, racism is not a known side effect of any Sanofi medication.”

One day after her hit ABC sitcom got cancelled in the wake of her racist attacks on former Obama White House aide Valerie Jarrett, Barr took to Twitter to say that “it was 2 in the morning and I was Ambien tweeting” when she decided to compare Jarrett’s appearance to that of an ape.

People of all races, religions and nationalities work at Sanofi every day to improve the lives of people around the world. While all pharmaceutical treatments have side effects, racism is not a known side effect of any Sanofi medication.

— Sanofi US (@SanofiUS) May 30, 2018

 

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How the Media Portrays Black and White Drug Users Differently

Mon, 05/28/2018 - 07:14
NYT’s sympathetic coverage of white moms struggling with opioids contrasts with its hysteria over “crack babies”

On Mother’s day, New York Times Magazine published a cover story titled “Children of the Opioid Epidemic.” The photo on the cover of the magazine was the image of a young white mother holding a cherub-like infant dressed in pink stockings and lace. The mother is on her knees, gently kissing her daughter’s neck, her face is obscured. The image goes to great lengths to protect the mother and the child – they are both innocent victims of an opioid epidemic. The article begins with the story of Alicia, the setup immediately renders Alicia’s humanity. She struggled with drugs and alcohol from a young age, her family had bouts with both substance misuse and mental illness, her mother acting as the glue held the family together in the suburbs of Rhode Island. We learn of Alicia’s dreams and her struggles before ever learning of her addiction to Percocet medication. Even as Alicia’s use bloomed, the writer recognized Alicia’s need to use the drugs as a coping tool, to calm her anxieties, to quiet the voices that drove her toward self-sabotage.  Alicia’s drug use didn’t diminish her humanity; it made it more salient, more immutable.


The lives of the women profiled in the story are complex and the writer makes great effort to mute her judgments and witness the mothers nurturing their children. Because of this thoughtful observing, the women are shown in their wholeness. But the writer also uses descriptors that highlight the whiteness of her subjects. She highlights Alicia’s blond hair, a flaxen-haired child, and another’s hazel eyes. In a way, this is as much a story about the redemptive power of whiteness as it is about opioid use.


The New York Times, like many major publications that have reported on the opioid epidemic, has a history of covering societal drug use.  Often, publications reference the differential response to the opioid epidemic and the way that race has influenced political response. Coverage of the opioid epidemic alludes to the “cultural overreaction” to the “crack baby” and the panic over crack use in general. Less often do publications take responsibility for the role they played in influencing the way people respond to drug users. Observers who immediately and rightfully took issue with the Times' portrayal of the children of the opioid epidemic took to social media to voice their discontent.

Those who took issue with coverage did it out of frustration; their memories are not short. They recall the dehumanization of black women and their children, who did not benefit from the gentle words of a famed novelist.  It is apt that the light shone on the New York Times, a publication that proffered racist and sensationalized journalism depicting black people as sex-crazed cocaine addicts and black children born to mothers who used cocaine as broken and irredeemable.  It is not hyperbolic to claim that the New York Times had a role in the creation of the modern war on drugs, one it now deems to be a failure.


The New York Times and other major national publications fanned the flames of the drug war, and have now pivoted their coverage to protect white victims and whiteness. Telling stories in a way that allows people to exist beyond their drug use is not the issue; it should be standard practice. What is surprising is that the New York Times and other publications have not done the work of looking through the archives to see the harm they have caused historically and presently – especially the harm done to black mothers.

Beginning in the late '80s, the New York Times began to publish exposes on children born to mothers who used cocaine. The Times liberally used the moniker “Crack Babies” and “Drug Babies” to describe newborns, therefore associating them with a criminalized substance, creating the narrative of a generation of diseased children. On Mother’s Day in 1989, the Times published an article decrying the fact that Mother’s Day this year will be spent thinking about babies tethered to tubes in the intensive care units who will eventually be turned over to foster care, instead of thinking of fancy strollers and bassinets. Journalists followed these children of this era to school to monitor their development and to witness the children born of the collective fears of white America. When the hysteria had quieted and research proved that the physical, mental and emotional tolls of neonatal exposure to cocaine were significantly exaggerated, journalists placed blame on the research, not the media institutions that profited from the pain of black mothers.


Presently, black women are still feeling the toll of the stories told about them and their pain. Black children remain overrepresented in the child welfare system. Black women and their children are more likely to be tested for drugs without their consent. When their children are taken away by child protective services, they are made to jump through countless hoops to regain custody of their children and if they are unable to meet the demands of the family court they are told to just figure it out.


Black motherhood is a high-risk endeavor and little empathy is given to those who fall short of societal expectations. The New York Times and other major media publications are not totally responsible for the systemic racism that leaves black motherhood at the societal fringe, but they are crucial part of the mechanism.  I don’t know how the media can atone for their actions in shaping the narratives of the drug war, but acknowledging the harm they caused is a start.

Next Mother’s Day, we should tell the stories of black mothers whose pain goes unacknowledged.

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What 'Roseanne' Gets Wrong About Opioid Addiction

Mon, 05/28/2018 - 07:08
The depiction of opioid addiction on “Roseanne” isn’t doing public health practitioners any favors

The new "Roseanne" series has been getting much acclaim, but the way the show addresses opioid addiction will not help the Connor family or any of the millions of families watching across the country. Roseanne’s use of painkillers to address her ongoing knee pain spirals out of control and results in the type of crisis facing many U.S. families today. The episodes (thankfully) do not attempt the stereotypical Hollywood-style resolution in 30 minutes, neither do they propose the type of approach that would allow the title character to get the help she needs.

What did the Connor family get wrong?

First, we see Roseanne’s husband Dan (John Goodman) respond emotionally (understandably) to his wife’s behavior. Driven by a physiological condition, an addicted person’s behavior often leads him or her to act in certain ways, causing friends and family members to behave in ways that are not only inconsistent with getting a person help, but also potentially harmful. The Conner family expends lots of energy in trying to figure out who has been using the missing opioid pills—when the answer is right in front of them all along. Rather than looking for a treatment option for his wife, Dan resorts to serving as a dispensary and doling out one pill every six to eight hours, not knowing that Roseanne has stashed a private supply of her own in her icepack. Dan’s well-meaning but misguided effort could easily have tragic results if the pills he provides to his wife are combined with those that she has hidden for herself. Obituaries and death certificates tragically contain the phrase “accidental overdose” due to situations just like this one.

Second, with this disease/disorder, people often try what has been referred to as "self-treatment," rather than seeking out appropriate care. We see things like parents grounding their kids, children flushing their parents’ cigarettes or alcohol (or other drugs), etc. The point here is that people need to seek help for a substance use disorder from professional providers—not try to handle the problem themselves through a show of force or discipline. Imagine if we tried that approach with diabetes or high cholesterol. For example, a parent I heard speak recently who had served on a non-profit board of an addiction treatment agency, shared that when he learned of his child’s heroin addiction his first step was not to help his child get help, but to purchase $1,000 worth of drug testing kits to try to impose abstinence.

Finally, there are major issues with a healthcare system when people have to figure out how to get the $3,000 deductible noted in the show that would have been required to allow Roseanne to have the knee operation she needs. One generation down, Roseanne’s daughter is pressured to take a less-than-desirable job to qualify for health insurance. Desperation may be a tremendous motivator, but should it be the driving force in an individual’s choice of employment simply because health benefits are offered?

What is needed to get an addicted person help?

The first thing is a complete revamping of how we view addiction. It is not a moral issue, although those who are addicted may indeed do “immoral” things. It is not a character flaw, although people in recovery do work on improving themselves. It is not something we can address solely through tougher laws, although appropriate laws are clearly needed.

It is a public health problem. We need accessible, affordable, evidence-based treatment for those with a substance use disorder. If each community in this country had treatment on demand, people like Roseanne’s character could access the care they need, when they need it. Instead, we are plagued with no bed availability, waiting lists, arbitrary and discriminatory policies against medication-assisted treatment, and other roadblocks to care that simply do not exist for more “mainstream” maladies.

There are two important components to address this critical problem: access to care and an adequate delivery system. Access is largely a financial issue, as the Roseanne episodes clearly show. Whether it be a single payer system, expanded Medicaid, or some other structure, people must be able to get the help they need without having to wait needlessly or figure out how to get the money to afford treatment. The current delivery system is flawed in that services at varied levels of care (outpatient, residential, medication-assisted) are not available in all communities. Enhanced access would drive the creation of more treatment options and provide the services that are so crucial to finding our way out of the current crisis.

Ironically, one of the ads aired during the final episode of "Roseanne" was a promo for an upcoming show titled The Last Days of Michael Jackson. Stigma around addiction is alive and well—preventing individuals and families from responding to a physiological problem (addiction) in the way they would for any other such issue. Who knows if the King of Pop would still be with us if we had a more enlightened view of addiction and its treatment?

As we wait for the next season of "Roseanne," let’s hope that the Conner family will consult with trained professionals to inform how they deal with their matriarch. What a great example it would be if she were to enter into a structured treatment regimen, manage her opioid withdrawal with appropriate oversight, and enter into recovery. America deserves that, and Roseanne would join the millions of people in successful, stable recovery.

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Why Are California’s Legal Marijuana Sales So Low?

Fri, 05/25/2018 - 11:23
The path away from the black market is hitting some serious bumps.

California is on track to generate $1.9 billion in legal marijuana sales this year, according tonew data from a financial analysis firm tracking the market. That’s a lot of weed, but it’s only half the amount the same firm earlier estimated the state would rake in.

The estimates are from New Frontier Data, which crunches cannabis industry numbers, and are based on tax revenues from pot sales, which so far have fallen dramatically short of projections. According to New Frontier, the state collected $33.6 million in pot taxes between January 1 and March 31, which makes it extremely unlikely that tax revenues will meet original expectations of hitting $175 million in the first half of the year.

New Frontier had earlier estimated that the state would see $3.8 billion in marijuana sales this year, and this latest estimate slashes that number by a whopping 50 percent. The company also slashed its projections for the size of the legal industry by 2025. Instead of the $6.7 billion in sales it earlier estimated, it now says it thinks sales will only hit $4.7 billion, a hefty one-third reduction.

That’s bad news not only for state tax revenues, but also for an industry that is supposed to be coming in out of the cold. What happened? New Frontier has an idea.

“It is quite clear that the new adult use regulations have made it more difficult than anticipated for the legal market to get established and for consumers to transition to from the illicit market. Given the number of local government bans on cannabis businesses, we are not seeing the same kind of conversion rates that we have seen in other legal markets,” said Giadha Aguirre De Carcer, New Frontier Data founder and CEO.

State and local licensing fees for marijuana businesses can range from$5,000 to $120,000 per year, depending on the type and scope of the business. And complying with regulatory mandates, such as those around zoning, water usage, and lab testing, costs even more.

It’s not just onerous—and expensive—regulation for those who want state licenses to grow, distribute, and sell marijuana that is the problem. There’s also a serious lack of buy-in by a good portion of the state’s cities and counties, and that means that a big hunk of the state has no access to local legal marijuana.

“If there’s (no governmental support) locally, then there’s no option for a state license, and that’s why most people are being shut out at this point in time,” California Cannabis Industry Association executive directorLindsay Robinson told the Marijuana Business Daily. “The process gave local authorities an option to kind of sit on their hands, and that’s the biggest barrier that we’re seeing.”

According to CCIA spokeswoman Amy Jenkins, only about a third of the state’s 540 local governmental entities have approved commercial marijuana activity. Lack of legal access is “forcing consumers to turn to the illicit market,”she told the Los Angeles Times this week.

Or return to it. Or stay in it, if they never left. Humboldt State University economics professor Erick Eschkerpegged the size of the state’s pot market—legal and illegal—at about $7.8 billion. Of that, about $2.3 billion came from the medical marijuana market, leaving about $5.5 billion for legal, gray market, and black market pot sales. If the legal market is only accounting for $1.9 billion in sales, that suggests that gray and black market sales are still about twice the size of legal sales. These consumers don’t get hit with stiff sales and excise taxes, and if they can still get it from the guy down the street, why pay those high, state-legal prices?

If California wants to eliminate the black market in marijuana, it’s got a whole lot of work to do. And no matter what steps the state takes to deal with its internal black market, there’s still the export black market to the non-legal states in the rest of the U.S. Ultimately, the only way to end the black market is to legalize it nationwide, but we’re not quite there yet. In the meantime, California’s transition to a legal marijuana regime is facing some unhappy realities.

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Here Are Four Ways Fentanyl Could Radically Disrupt the Global Drug Trade

Tue, 05/22/2018 - 11:56
It's not just wreaking havoc on the streets of American cities.

The synthetic opioid fentanyl isn't just killing American drug users by the thousands; its emergence also signals a shift in the decades-old contours of the global drug trade, with ramifications not only for traditional drug-producing countries and drug trafficking networks but also for U.S. foreign policy. 

Synthesized from chemicals—not from papaver somniferum, the opium poppy—fentanyl is about 50 times stronger than heroin and is severely implicated in the country's drug overdose crisis, accounting for almost 20,000 deaths in 2016

Illicit fentanyl is typically mixed with other opiates, such as heroin, resulting in much stronger doses of opioids that users expect, thus leading to opioid overdoses. But it is also increasingly also showing up in non-opiate drugs, resulting in fentanyl overdose deaths among unsuspecting methamphetamine and cocaine users

But the havoc super-potent fentanyl is wreaking among drug users pales in comparison with the dramatic changes it could prompt in the global illicit drug production industry. As academic researchers Vanda Felbab-Brown, Jonathan Caulkins, and Keith Humphreys write in the current issue of Foreign Affairs, fentanyl's rise has the potential to cause disruption and innovation in black markets. 

Here are four ways fentanyl alters the illegal drug production and distribution status quo: 

1. It doesn't require an agricultural base. Virtually all of the other opioids on the black market, from heroin to morphine, oxycodone, and hydrocodone, require land to grow poppies on. And they require land that is outside the effective control of the state. Non-state actors who can control such areas, whether it’s the Taliban in Afghanistan or the drug cartels in southern and western Mexico, reap the profits and power of that control. With the ascent of lab-produced fentanyl made out of chemicals, traditional opiate producers should see their profits and their influence undermined.   

2. It doesn't require a large workforce. Traditional opium production requires a large seasonal workforce of people to plant and tend the poppies, score the pods and scrape off the leaking opium, and then process and package the raw opium. Other workers will get jobs processing raw opium into heroin. All of those jobs bring money into the hands of poor agricultural families and political capital to the traffickers, whether it’s the Taliban in Afghanistan or the cartels in Mexico. With fewer job opportunities to offer up, the traffickers lose clout. 

3. It doesn't require an elaborate smuggling infrastructure. Because fentanyl is so potent, small amounts of the drug can contain huge numbers of doses, and that means it doesn't require transportation networks of trucks, planes, and boats to get an agricultural crop from the valleys of Afghanistan or the mountains of Mexico to consumers in the U.S. Fentanyl is so potent, medicinal doses are measured in micrograms, and packages of it worth hundreds of thousands of dollars can fit inside a Priority Mail envelope. With smuggling fentanyl as easy as dropping a package in the mail, international drug smuggling organizations now have competition they never had before. 

4. All of this can change the dynamics of U.S. foreign policy. If plant-based opiates lose market share to synthetics in the future, this can both weaken insurgencies (Afghanistan) and criminal networks (Mexico). Ever since the U.S. invasion of Afghanistan in 2001, drug warriors have been constrained in their efforts to go after the Afghan opium crops because of fears it would drive poppy-dependent peasants into the hands of the Taliban. If opium production becomes relatively less important vis-à-vis fentanyl production, that constraint on an aggressive U.S. response to Afghan opium production is weakened. Similarly, in Mexico, to the degree that fentanyl displaces peasants and processors and weakens the link between drug cartels and rural populations, it increases the ability of the Mexican government and its American backers to crack down even harder on the cartels. 

Under drug prohibition, there is a strong impetus to come up with more pure, more potent, and more compact products. Fentanyl is the ultimate expression of that imperative, and its arrival is changing the contours of the global drug industry—and who knows how it will play out?

 

 

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