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8 Really Ridiculous Marijuana Strain Names

Mon, 10/23/2017 - 12:10
Click here for reuse options! Does the very name of your marijuana strain bring a smile to your face? It should.

Once upon a time, back in the days of yore, pot was pot. It was green, full of stems and seeds, and usually available as compacted bricks of weed from Mexico. It didn't have fancy names.

But about a half century ago, as marijuana seeped into the popular consciousness, there were some break-out branding efforts. You didn't want just any Mexican weed—you wanted the fabled "Meshmecan" (a garbled rendition of the name of the Mexican state of Michoacan), or better yet, Acapulco Gold.

And then there was Maui Wowie. And Thai Stick. And Colombian Red Bud. All of these strain names were rooted in place, seeking to make exoticism—as well as high THC content—a selling point.

But today, in the age of creeping marijuana legalization, the number of strains has exploded, the linkage with locales has largely vanished, and marketing-savvy pot entrepreneurs seeking a niche for their products have gone on a serious branding binge. Many strain names are linked to properties of the plants they identify ("Blue Dream," "Purple Urkle," "Sour Diesel"), others are named for their powerful properties ("AK 47,"  Alaskan Thunderf**k"), and some for celebrities (Willie Nelson's "Willie's Reserve," the Bob Marley family's "Marley Natural").

And some are just downright strange and funny. Here are 8 of the funniest marijuana strain names (in no particular order), with a tip of the hat to Civilized.

1. Purple Monkey Balls

It can be amusing to watch your friends' faces when you tell them what they're smoking.

2. Dopium

References to other drugs are not unusual, with the implication being that the weed is so strong it's like, well, opium, in this case. Another strain name in this category is "Green Crack." Some people find these funny; others, usually in the industry, worry about linking benign buds to harder drugs.

3. Zombie Killer OG

May not actually help you kill zombies in real life, but will undoubtedly make the undead easier to kill on your video screen.

4. Crouching Tiger Hidden Alien

Huh?

5. Girl Scout Cookies

Probably the only strain name you can talk about buying in front of your parents. The Girl Scouts probably aren't so amused, though.

6. Bob Saget OG

Saget is best known as the family-friendly dad in the sit-com Full Houseand currently has a gig as the host of America's Funniest Home Videos. What makes this name so funny is that Saget is actually an obscenely foul-mouthed and bodily function-oriented comic, as evidenced by Saget's version of the classic dirty joke The Aristocrats.

7. Barack O Bubba

Humorless Democratic Party partisans are not amused, but the rest of us can get a chuckle out of this one.

8. Charlie Sheen

Not sure I want to smoke this. Can't afford all the hookers and cocaine. 

 

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Top 10 Imaginary Drugs in Fiction

Mon, 10/23/2017 - 10:47
From the strange potion in Alice’s Adventures in Wonderland to Don DeLillo’s death fear cure, these are some of the most potent hits in literature.

Science-fiction writers are always looking for ways to bring about change, whether in society, in the nature of the physical world or in the human mind. And making up new drugs is a powerful way of inducing alteration on all these levels. 

In my own work I’ve invented drugs such as Vurt, Metaphorazine, Lucidity, Wave, Haze and many more. My latest novel A Man of Shadows sees people enjoying a concoction called kia, shortened from chiaroscuro, a time-altering drug created from a flower that blossoms only at dusk.

Fictional drugs are miniature rocket ships: they take characters to places unknown and strange. The practice of drug invention goes back to the ancient Greeks (MolyLethe) and Shakespeare (Oberon’s love potion). Here are some modern examples from the pharmacopoeia of dangerous delights.

1. Soma (Brave New World by Aldous Huxley)
Soma is used to calm and pacify, suspending people in a state of permanent bliss. The World State of Huxley’s dystopian novel issues the drug as a means of control, to quell rebellious feelings. This is a drug used as a political metaphor, a form of mass entertainment taken to its ultimate level, a replacement for religion. In contrast, Huxley’s own mescaline-induced journey through the “doors of perception” gave him a glimpse of the mystery of pure being. From which we can only conclude that he kept the best drugs for himself.

2. Melange (Dune by Frank Herbert)

The most famous drug in science fiction – and one of the most powerful – melange or “spice” is found on the desert planet of Arrakis, produced and guarded by giant sandworms. In small doses it brings on a perfect high and increases sensual awareness of the world around you. In large amounts it enables the user to travel through the folds of space. Wow. This property makes it highly desirable, and entire empires rise and fall in the struggle to control its procurement and distribution. This is drug as merchandise, and as a gateway to the stars.

3. Substance D (A Scanner Darkly by Philip K Dick)
Dick is perhaps the most prolific of the drug inventors. He used it as plot generator, a source of transformative energy – and a way to both escape reality and experience it more fully. He certainly put in the research in his own life, spending whole weeks off his head. Still, the books were written. Substance D is a psychoactive; it produces an initial euphoria, which is great until the user finds out what the D stands for: Despair, Desertion, Dumbness, and in its final incarnation, Death. Here lies the dark realism at the heart of Dick’s visionary craziness.

4. Slug (The Final Circle of Paradise by Arkady and Boris Strugatsky)
I was thinking of including William Gibson’s “cyberspace” in this list, because it acts very much like a drug on the human psyche, but I have to be strict. And anyway, the Strugatsky brothers probably got there first, back in 1965. Slug transports the user into an artificially generated world far more intense than reality. People long to return there, and many of them die on repeat trips, their brains overloaded. The novel’s Russian title translates as “Predatory Things of Our Times”, which pretty much sums it up.

5. Black Meat (Naked Lunch by William S Burroughs)
Anyone suffering from chilopodophobia (fear of centipedes) please look away now. Black meat is made from the ground flesh of a specimen that can reach six feet long. This is the most disgusting of all the fictional drugs. It causes extreme nausea in users as well as more delicious feelings, and is highly addictive. Fearlessly writing from the centre of his being, Burroughs transforms his own heroin addiction into a new kind of narrative, where even language crumbles into new shapes.

6. Moloko Plus (A Clockwork Orange by Anthony Burgess)
Burgess reinvents the hooligan and sets him loose in a twisted version of 60s England. Alex and his gang of droogs hang out at the Korova bar and drink their Moloko Plus, a milk-based drink laced with a choice of other ingredients, hence the plus. Add-ons include barbiturates, opiates and synthetic mescaline. Alex likens this to drinking milk “with knives in it”, something to sharpen you up. The perfect aperitif to a nice little spot of ultraviolence.

7. “Drink Me” (Alice’s Adventures in Wonderland by Lewis Carroll)
Or as the dealers call it: Lysergic Alice Diethylamide. This is probably most readers’ first introduction to the concept of substances that can change the way you think, the way you act, and even the shape of your body. Without the precise usage of both Drink Me and Eat Me, our heroine would never have gained entrance to the magic garden through the tiny door. It’s all there, waiting to be unravelled. And then there’s the “acid flashback” effect: just a few years later, Alice is glimpsing shapes in the mirror …

8. Dylar (White Noise by Don DeLillo)
This may be the ultimate drug of escape, for the simple fact that it removes the human fear of death. Soon people are desperate to find black-market supplies of the still experimental substance. Philosophical questions abound. If we have no sense of our own mortality, can we still call ourselves human? Would religion have a place, would art be created in anything like the same quantities? And then there are the side effects, which consist mainly of losing the ability to “distinguish words from things”. The very mention of the phrase “speeding bullet” is enough to cause a user to dive to the floor for cover. Now that’s scary.

9. Weirdcore (The Destructives by Matthew de Abaitua)
A downer for the soul, weirdcore sends the user to a lower level of sapience, below the “standard” setting. After consuming a coil of this stuff, the addict feels shallower, less emotional, more like an object: they might think of their skin for instance as a sentient tabletop. This is a good thing, apparently. Shallowness is intoxicating. Mind you, the hangover is fierce, bringing with it feelings of unshakeable dread. That will be reality slapping you in the face. Use with caution.

10. The Pan-Galactic Gargle Blaster (The Hitchhiker’s Guide to the Galaxy by Douglas Adams)
What better way to extend our bookish bender than a glass of this lively cocktail invented by Zaphod Beeblebrox, ex-President of the Universe. Ingredients include Santraginean seawater, Fallian marsh gas and the dissolved tooth of an Algolian Suntiger. The effect of the drink has been likened to “having your brains smashed out by a slice of lemon, wrapped round a large gold brick”. Lovely. Make mine a double.

• A Man of Shadows by Jeff Noon is published in paperback by Angry Robot, priced £8.99. It is available from the Guardian Bookshop for £7.64.

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Who Profits From the Opioid Crisis? Meet the Secretive Sackler Family Making Billions From OxyContin

Fri, 10/20/2017 - 13:55
They downplayed the risks of addiction and exploited doctors’ confusion over the drug’s strength.

This week, President Donald Trump’s nominee for drug czar, Republican Congressmember Tom Marino, had to withdraw from consideration after a Washington Post/”60 Minutes” investigation found he led a drug industry-backed effort to pass a law that weakened the U.S. Drug Enforcement Administration’s ability to crack down on addictive opioids. Meanwhile, calls are growing to look at the major pharmaceutical companies that have fueled the opioid crisis. A new investigation by Esquire magazine reveals how the secretive Sackler family, owners of the company that invented OxyContin, downplayed the risks of addiction and exploited doctors’ confusion over the drug’s strength. We speak with Christopher Glazek, the Esquire reporter behind the story.

Transcript

This is a rush transcript. Copy may not be in its final form.

NERMEEN SHAIKH: We turn now to look at America’s staggering opioid epidemic, the secretive family making billions from the crisis, and how Congress undermined efforts to restrict the flow of pain pills that have led to tens of thousands of deaths. President Trump’s Commission on Combating Drug Addiction and the Opioid Crisis has said, quote, “America is enduring a death toll equal to September 11th every three weeks.”

But this week, his nominee for drug czar, Republican Congressmember Tom Marino, had to withdraw from consideration, after a Washington Post/60 Minutes investigation found he led a drug industry-backed effort to pass a law that weakened the U.S. Drug Enforcement Administration’s ability to crack down on addictive opioids and keep them off the black market. The Ensuring Patient Access and Effective Drug Enforcement Act passed in 2016. It made it nearly impossible for the Drug Enforcement Administration to intervene in cases where large, suspicious shipments of opioids are delivered to pharmacies bound for the black market. The drug industry lobbied heavily to win passage of the bill, contributing $1.5 million to its 23 congressional co-sponsors. Marino alone accepted nearly $100,000 in campaign cash from the industry.

This is Joe Rannazzisi, who ran the DEA’s Office of Diversion Control, which regulates and investigates the pharmaceutical industry, speaking to 60 Minutes about the measure.

JOE RANNAZZISI: If I was going to write a book about how to harm the United States with pharmaceuticals, the only thing I could think of that would immediately harm is to take the authority away from the investigative agency that is trying to enforce the Controlled Substances Act and the regulations implemented under the act. And that’s what this bill did.

BILL WHITAKER: The bill, introduced in the House by Pennsylvania Congressman Tom Marino and Congresswoman Marsha Blackburn of Tennessee, was promoted as a way to ensure that patients had access to the pain medication they needed.

AMY GOODMAN: Congressman Marino has said he’s proud of his work on the 2016 law, which passed without opposition in the House and Senate, was signed by President Obama.

Meanwhile, calls are growing to look at the major pharmaceutical companies who fueled the opioid crisis. A new investigation by Esquire magazine reveals how the Sackler family, owners of the company that invented OxyContin, downplayed the risks of the drug’s addiction and exploited doctors’ confusion over the drug’s strength. The piece in Esquire is headlined “The Secretive Family Making Billions from the Opioid Crisis.” It begins, “You’re aware America is under siege, fighting an opioid crisis that has exploded into a public-health emergency. You’ve heard of OxyContin, the pain medication to which countless patients have become addicted. But do you know that the company that makes Oxy and reaps the billions of dollars in profits it generates is owned by one family?”

For more, we’re joined by Christopher Glazek, the reporter behind the investigation.

Christopher, welcome to Democracy Now!

CHRISTOPHER GLAZEK: Thank you.

AMY GOODMAN: So, the name Sackler is famous in the art world, because it’s hard to go into a museum where you don’t see an atrium named, whether we’re talking about the museum—the Metropolitan Museum, the Tate in London—I mean, all over. Why don’t you explain how we know the name, and how we don’t know the name when it comes to OxyContin, and how significant OxyContin is when it comes to the opioid epidemic?

CHRISTOPHER GLAZEK: Yeah, well, the Sackler family is very interesting, because, in some ways, it’s extremely public, and then, in other ways, it’s extremely private. So, you’ll see their name on university campuses. Almost every Ivy League school has an institute or a museum named for the Sacklers. As you mentioned, there’s—

AMY GOODMAN: Like where, in universities?

CHRISTOPHER GLAZEK: Oh, like at Yale, at Tufts, at Columbia, at NYU, at Cornell, at King’s College London, at Edinburgh, at Sussex. I mean, the list really goes on and on and on. And in the museum world, too. I mean, there’s named rooms or wings for the Sacklers at the Guggenheim, at the Louvre, at the Tate, at the Met. You know, so people know the Sackler name. But the Sacklers themselves are rarely interviewed. They basically never give interviews. They’re rarely seen in public. And almost nobody in the world, in the art world or in the world of higher education, understands that the major source of their fortune is OxyContin. And one reason for that is that the Sacklers never put their name on their company, never put their name on their product.

So, you know, as you mentioned, I mean, the reason I wanted to do the piece, we have an opioid crisis in this country, and more than 200,000 people have died from prescription drugs since OxyContin was released in 1996, and w have an accountability crisis also. You know, we tend to think of big social problems, like drug epidemics, as the product of these large, impersonal forces that are hard to understand. And there’s some truth to that. But that can also distract from the fact that a lot of social problems also have their origins in actions taken by individuals. So, that was something I wanted to shine a light on.

NERMEEN SHAIKH: Well, how did you learn, come to learn, of the Sacklers’ involvement in this?

CHRISTOPHER GLAZEK: Well, it’s very interesting. So, you know, I had read quite a bit about Purdue Pharma, which had manufactured OxyContin and which, in 2007, had to plead guilty to criminal charges for what was called criminally misbranding a prescription drug. And they had to pay a huge fine, and three of their top executives went down. And there had been a ton of writing about that, but almost no writing about the fact that the company was actually 100 percent owned by one family, and that family filled more than half of the board seats and actually supplied top executives for the company.

You know, one thing that kind of emerged is that when they signed onto this huge settlement, which got a ton of press in 2007, it seemed like the top leaders of the company took the fall, because the CEO at the time had to plead guilty to a misdemeanor. But he wasn’t the CEO during the period covered by the settlement or during the crucial period of OxyContin’s promotion and marketing. During that period, the top executive was actually a member of the Sackler family who owned the company. And yet the Sackler name appeared nowhere in the guilty plea. It was like a hundred pages. It appeared all over this other document that was attached, which was a nonprosecution agreement. And so, basically, the government said, “We’re not going to prosecute any of these 200 entities related to the Sackler family.”

AMY GOODMAN: So, Christopher Glazek, tell us the story of the Sackler family, their rise, the rise of OxyContin. Go back decades.

CHRISTOPHER GLAZEK: Sure. So, the Sacklers were basically three brothers from Brooklyn who were—came from a Jewish immigrant family. And they got their start, really—I mean, the eldest brother, Arthur Sackler—in medical advertising. So he was a really important pioneer in the field of medical, and specifically pharmaceutical, advertising. He was one of the first people ever inducted into the Medical Advertising Hall of Fame, actually.

So, basically, when he came on the scene in the '40s, there really wasn't much pharmaceutical advertising. There were these door-to-door salesmen. They were called “detail men,” and they would basically try to push their drugs on doctors. What Arthur realized is that you could use print advertising to reach a much larger number of doctors more efficiently. And he was actually the first person to convince the Journal of American Medicine to insert a color brochure advertising a particular drug, which, at that time, was an antibiotic—and then actually got involved in this big scandal about overprescription of antibiotics, you know, another public health problem. His big, huge first influx of cash came with Valium, because he was the one who designed the marketing campaign for Roche, which was the manufacturer, and he made Valium the most widely prescribed drug in America.

AMY GOODMAN: What was his trick there?

CHRISTOPHER GLAZEK: So the trick, basically, was that, you know, Valium—there was another drug that had already been on the market that was the same as Valium. It was called Librium. I mean, almost indistinguishable. And so it was like this big question: Well, how are we going to market this one? Librium had been marketed pretty narrowly for a specific anxiety function. His idea was to take Valium, a new drug with a new name, and market it for every kind of problem. And so he kind of—they played with this concept called “psychic tension,” which was purported to be the source of indigestion, of depression, of sleep problems, of restless leg syndrome. And so—

AMY GOODMAN: It was the word before “stress.”

CHRISTOPHER GLAZEK: Yes, right. It was kind of like what we now think of maybe as stress. You know, so he was, in this way, able to vastly expand the range of potential patients and indications, and, in that way, made the first $100 million drug.

NERMEEN SHAIKH: And what kind of use did Valium have versus Librium?

CHRISTOPHER GLAZEK: So, I mean, it was used by people who were suffering kind of what are called “somatic problems,” so different kind of physical manifestations which may or may not have their root in something related to anxiety. Valium was just narrowly targeted—or, sorry, Librium was narrowly targeted to people who had like a specific kind of anxiety issue, which at that time was not quite the thing that it is today.

NERMEEN SHAIKH: So Valium was prescribed much, much more than Librium—

CHRISTOPHER GLAZEK: Yes.

NERMEEN SHAIKH: —or Librium.

CHRISTOPHER GLAZEK: Yeah, way, way, way more. And it became, actually, the most prescribed medication of all time, you know, at that time.

AMY GOODMAN: And so, move on from there.

CHRISTOPHER GLAZEK: Right. So, Arthur also became a huge art collector, kind of established the family’s foothold in the art world. And throughout his entire life, he had actually passed on jobs and businesses to his younger brothers. So he was involved in the purchase of this really tiny pharmaceutical company in 1952 which was called Purdue Pharma, which was on its last legs. It had basically been a kind of patent medicine peddler. It had this drink called Gray’s Glycerin Tonic, which was—you know, in the patent medicine era, it was also marketed for all kinds of purposes—if you have a headache, if you have sex problems, if you have whatever problem. So, they bought this kind of shell, financially troubled shell.

And for years and years, Purdue Pharma didn’t really—wasn’t a major player in the pharmaceutical world. It had one really good product, which was Betadine, which it acquired in the ’60s, which was a disinfectant. And they kind of had this great fortune of acquiring the rights to Betadine just as the Vietnam War was amping up. So the government had bought huge quantities of Betadine to treat wounded soldiers. But still, you know, a midget in the pharma scene.

Then they got into the pain business, and that’s when the real money started flowing in. And they developed—you know, so the kind of company lore is that there was a doctor in London—because some of the family members moved to London—and who was associated with the hospice movement. And they said, “You have a time-release asthma pill that isn’t really selling very much. What if you made a time-release morphine pill?” And they said, “You know, we have these hospice patients who have these IVs, and it’s hard to give them enough pain medication to sleep through the night.” And so, he said, you know, “A time-release morphine pill could really be transformational.” So they made this, and it came out in the United States in 1984 as MS-Contint, which is kind of the predecessor of OxyContin. And it was targeted exclusively at the cancer market. And really, it was an amazing drug. It helped cancer patients sleep through the night without needing to redose. And, you know, addiction didn’t matter if you’re a terminal cancer patient.

There was a problem with MS-Contin: Its patent was going to expire in the '90s, and the company didn't have anything to replace, and that was really the company’s, you know, golden goose. So, basically, younger relatives of Arthur’s at the company, other executives at the company were brainstorming: What can we do about MS-Contin having its patent expire? And they said, “Well, what if we created a new time-release pain pill, but we don’t use morphine, we use another derivative of the poppy plant, oxycodone, and we create a time-release oxycodone pill, and instead of marketing it to cancer patients, we market it to 30 million back pain patients, we market it to people with menstrual problems, we market it to people with toothaches? So, what if we take this powerful drug that we know works for this one purpose, but then kind of give it to everybody?” And that was the billion-dollar idea, the $14 billion idea, that gave the Sacklers what is likely the largest fortune in pharmaceutical history.

NERMEEN SHAIKH: Well, I mean, one of the problems with the term—I mean, I realized, myself, when I was reading your piece, that there’s a lot of confusion between oxycodeine, oxycodone and the OxyContin. So, could you explain what that distinction is and whether the name itself was chosen so that precisely this confusion could be created?

CHRISTOPHER GLAZEK: Exactly. So, you know, I talked to employees at the company, you know, and there’s some reference to this also in some internal company documents. OxyContin and MS-Contin—one’s morphine, one’s oxycodone—they’re basically the same. They’re kind of—like Librium and Valium, they’re virtually indistinguishable. But morphine had a stigma, which is that people thought if you’re on morphine, that means you’re dying. And ordinary doctors, general practitioners, family practitioners, they weren’t going to prescribe morphine. Like that sounded like some really serious stuff. Oxycodone, though, had a very different brand, because it was in Percocet and Percodan. And so, thousands of doctors, you know, ordinary doctors, general practitioners, would prescribe Percocet for injuries. And so they were familiar with it, and they were comfortable with it. But Percocet has a very small dose of oxycodone in it.

As you allude to, there was another confusion: People thought that “oxycodone” sounded like “codeine.” And codeine is another weak opioid. Doesn’t sound like morphine. Morphine sounds strong. So, they were basically playing on this misconception that doctors had, and they acknowledged this when they had to plead guilty, that doctors thought that oxycodone was weak, even though it’s actually more powerful than morphine.

AMY GOODMAN: So let’s turn to a joint investigation between 60 Minutes and The Washington Post on the opioid crisis. This is Joe Rannazzisi, who ran the DEA’s Office of Diversion Control, which regulates and investigates the pharmaceutical industry, speaking with CBS correspondent Bill Whitaker.

JOE RANNAZZISI: That’s out of control. What they want to do is do what they want to do and not worry about what the law is. And if they don’t follow the law in drug supply, people die. That’s just it. People die. … This is an industry that allowed millions and millions of drugs to go into bad pharmacies and doctors’ offices, that distributed them out to people who had no legitimate need for those drugs.

BILL WHITAKER: Who are these distributors?

JOE RANNAZZISI: The three largest distributors are Cardinal Health, McKesson and AmerisourceBergen. They control probably 85 or 90 percent of the drugs going downstream.

BILL WHITAKER: You know the implication of what you’re saying, that these big companies knew that they were pumping drugs into American communities that were killing people.

JOE RANNAZZISI: That’s not an implication, that’s a fact. That’s exactly what they did.

AMY GOODMAN: Whistleblower Joe Rannazzisi, speaking with CBS correspondent Bill Whitaker. In another part of the interview, he talks about pain clinics.

JOE RANNAZZISI: Pain clinics, overnight, popping up off an entrance ramp or an exit ramp on an interstate. Then, all of a sudden, there’s a pain clinic there.

BILL WHITAKER: Had you ever seen anything like that before?

JOE RANNAZZISI: Never. In fact, it was my opinion that this made the whole crack epidemic look like nothing. These weren’t kids slinging crack on the corner. These were professionals who were doing it. They were just drug dealers in lab coats.

BILL WHITAKER: You know what a chilling picture that paints?

JOE RANNAZZISI: I do, because I watched them get arrested, and I was the one who approved the cases.

AMY GOODMAN: So, that is Joe Rannazzisi, who ran the Drug Enforcement Administration, the DEA’s Office of Diversion Control, which regulates and investigates the pharmaceutical industry, speaking with CBS correspondent Bill Whitaker. Of course, he became a whistleblower. Christopher Glazek, talk about the significance of what this man said.

CHRISTOPHER GLAZEK: Well, you know, the opioid epidemic has many different actors in different parts of the chain. And this investigation focused on the distributors, who are basically the people who carry the opioid pills from the manufacturer and give it to specific pharmacies. And there’s been a lot of litigation focused on them. Some thought that, you know, they knew, that they had had reason to know, that certain pharmacies maybe were involved in diversion. And they have this ongoing struggle with the DEA about what’s appropriate to seize and under what circumstances.

In my view, what you want to do when you look at the opioid crisis is look at where the real profits are. And it’s actually not with the distributors. It’s really with the manufacturers. And, you know, people kind of think they’re following the money. And McKesson and Cardinal are these huge, giant companies. But you really want to follow the margin, because that’s going to tell you who’s controlling a market and who’s kind of like a minor toll taker. And the fact is that the manufacturer, Purdue Pharma, which really created this market, created all this business for Cardinal and McKesson, etc., they had much more detailed information about where pills were going. They knew down to the prescription level, you know, what doctors were prescribing what. The distributors didn’t know that. The distributors—all distributors knew was about pharmacies. So they really are just one part of this giant chain. But Purdue had the aerial vision of the entire thing. And they—

AMY GOODMAN: Where is Purdue based?

CHRISTOPHER GLAZEK: It’s based in Stamford, Connecticut.

AMY GOODMAN: Mm-hmm.

CHRISTOPHER GLAZEK: Yeah.

NERMEEN SHAIKH: Well, one of the things that you point out in the piece is that part of the money, the money that the Sacklers made from Purdue and selling OxyContin, in a foundation they have called the Richard and Beth Sackler Foundation—could you talk about where they chose to donate some of that, the money from that foundation?

CHRISTOPHER GLAZEK: For sure. You know, we live in a billionaire democracy, and billionaires exert tremendous control not only over business, but also over the arts and higher education and over politics. And, you know, different members of the Sackler family have very different political leanings. Richard Sackler, who was the top executive during the time that OxyContin was mainly promoted, has given money to a variety of anti-Muslim groups. He’s actually given money to several groups designated hate groups by the Southern Poverty Law Center. He’s also given money to this organization called True the Vote, which was the original source for Trump’s claim that 3 million illegal immigrants voted in the election. You know, if you go what appears to be his Facebook page or his YouTube page, he seems to have some affection for Geert Wilders in the Netherlands and kind of Brexit types, so a lot of kind of—he also seems to be a gold bug, very concerned about inflation and things like that. Other members of the Sackler family are not right-leaning. Some are them are quite left-leaning, actually. But Richard’s foundation, you know, and the money that came from OxyContin has gone to a number of causes that raise some eyebrows.

AMY GOODMAN: So, what is happening with OxyContin now? Talk about the number of deaths a day. Talk about the bill that passed last year and was signed off on by the president—not by President Trump, but by President Obama—that now has led to Congressman Marino, who was the choice to be the drug czar, having to withdraw, under Trump.

CHRISTOPHER GLAZEK: Right. So, basically, what that legislation did is it hampered the ability of the DEA to seize suspicious shipments. And, you know, I actually—it’s quite a complex issue. Whether it really is the most important aspect of the opioid crisis is something that one could debate. It does seem pretty galling, though, that Trump nominated Marino, who was so involved in this legislation, to be the drug czar. Like you don’t want the fox guarding the chicken coop. So, that did seem pretty outrageous, and it’s a great thing that that has been exposed and brought to light.

But the key point about the opioid crisis is that what triggers addiction—you know, people talk a lot about diversion, the black market, drug dealers. That’s part of it. It’s kind of a small part. Most people become addicted to OxyContin by just taking it as prescribed. So, really, it’s the number of prescriptions, who is driving the prescriptions, and the total volume of opioid that’s circulating through the market.

NERMEEN SHAIKH: Well, one of the—you cite a piece, an L.A. Times investigative piece, which concludes that the American market for OxyContin is actually diminishing.

CHRISTOPHER GLAZEK: Yes.

NERMEEN SHAIKH: So could you explain why that is, and then how this drug is now being marketed, quite successfully, abroad?

CHRISTOPHER GLAZEK: Yes, exactly. So, you know, OxyContin has run into a lot of regulatory problems in the United States and a lot of bad press. And, you know, kind of borrowing from the Big Tobacco playbook, it’s like when you run into problems in your home market and you’ve got all these lawsuits, maybe it’s time now to go abroad. And that seems to be what the Sackler family is doing. They have all these international companies that are related to Purdue which sell pain products abroad.

And, you know, the CDC, in this country, actually issued this warning last year, basically saying that we’re not sure that opioids are good for long-term pain at all, that maybe opioid use is not an effective treatment for chronic pain, because it changes your pain threshold and, over time, it becomes less and less effective. So, I mean, this was like a really—you know, a kind of death blow for the chronic pain market here. But now you have the company going abroad, kind of reprising all of its greatest hits from the ’90s. They released a study in Colombia saying that we believe that more than 40 percent of the population suffers from chronic pain.

AMY GOODMAN: In May, a dozen members of Congress sent a bipartisan letter to the World Health Organization that warned the Sackler-owned drug companies were preparing to flood foreign countries with legal narcotics. The letter mentions the Sacklers by name, notes they own Purdue Pharma, and reads, quote, “Purdue began the opioid crisis that has devastated American communities. … Today, Mundipharma is using many of the same deceptive and reckless practices to sell OxyContin abroad.” Mundipharma, owned by the Sacklers. And the L.A. Timesreporting the company circulated a press release in Colombia that suggested 47 percent of the population suffered from chronic pain. Your final comment on all of this, Christopher Glazek, and where it goes now?

CHRISTOPHER GLAZEK: Well, the big question is complicity, and it’s a really tricky question. You know, is Tufts University complicit in the opioid epidemic because they’ve taken huge amounts of money from the Sacklers? You know, is a third-generation Sackler heir, who maybe is a documentary filmmaker or restaurateur—do they have some burden or complicity to address here? And I think that’s a complicated question. But the solution to complexity is not secrecy. And what we’ve seen again and again is that people who have taken Sackler money, and the Sacklers themselves, have concealed their connection to OxyContin. And that cannot be the solution to the problem.

AMY GOODMAN: We’re going to leave it there, Christopher Glazek, journalist, editor, whose new exposé was just published in Esquire—we will link to it—”The Secretive Family Making Billions from the Opioid Crisis.”

This is Democracy Now! When we come back, we go across the pond to London to talk about what’s happening south of us in Guantánamo. Stay with us.

 

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This Is How Legal Cannabis Is Improving Public Health

Fri, 10/20/2017 - 11:49
Click here for reuse options! Cannabis has a significant positive impact on some of America's deadliest bad habits.

Legal cannabis access is associated with numerous favorable public health outcomes. Here are just a few of them.

FEWER OPIOID DEATHS

Changes in the legal status of cannabis is associated with significant reductions in opioid-related mortality. Data published in 2014 in JAMA Internal Medicine reports that medical cannabis regulation is associated with year-over-year declines in overall opioid-related mortality, including heroin overdose deaths. Specifically, medicalization states experienced a 20 percent decrease in opioid deaths as compared to non-medicalized states within one year. This decrease climbed to 33 percent by year six. Other studies have separately linked the establishment of both dispensaries and adult use retailers with reductions in opioid deaths. Traffic fatalities involving opioid-positive drivers has also fallen in states that have implemented medical marijuana laws.

FEWER OPIOID-RELATED HOSPITALIZATIONS

Cannabis medicalization is associated with a reduction in opioid-related hospitalizations. According to a 2017 study in the journal Drug and Alcohol Dependence, “medical marijuana policies [are] significantly associated with reduced opioid pain reliever-related hospitalizations.” Specifically, legal medical cannabis states experienced a 23 percent drop in hospitalizations due to opioid dependence and a 13 percent decline in hospitalizations due to overdose.

LESS PRESCRIPTION DRUG USE

Patients in states where marijuana is legal use far fewer prescription drugs than do those in jurisdictions where cannabis remains prohibited. According to a pair of recent studies published in the journal Health Affairs, the passage of medical cannabis regulations results in a significant drop in Medicare and Medicaid-related prescription drug spending. Separate studies find that many registered medical cannabis patients taper their use of pharmaceuticals. For instance, a 2017 University of New Mexico study reported that state registrants often reduced or even eliminated their prescription drug intake over time, while non-registrants with similar medical conditions did not. A study assessing state-qualified patients in Illinois concluded that many subjects consumed cannabis “intentionally to taper off prescription medications.” A 2017 analysis of Canadian-registered cannabis patients reported that a majority of subjects self-reported substituting marijuana for prescription drugs, particularly opioids, benzodiazepines, and anti-depressants. A separate review of over 1,500 state-qualified patients in New England similarly determined that patients typically used medical cannabis as a replacement for opioids, anti-anxiety drugs, and sleep aids.

LESS ALCOHOL USE

Market research indicates that many adults are choosing legal pot over booze. For example, 2017 survey data from self-identified cannabis consumers in California reports that one-third of millennials have switched from beer to marijuana. Twenty percent of Gen X-ers and eight percent of boomers similarly acknowledged substituting weed in place of booze. A 2016 market analysis by the Cowan & Company research firm similarly determined that beer sales by major distributors – such as Anheuser-Bush and MillerCoors – have “collectively underperformed” in Colorado, Oregon, and Washington in the years immediately following adult use legalization.

Some medical cannabis patients also report curbing their alcohol intake. A 2017 study published in the Journal of Psychopharmacology reported that 42 percent of medical marijuana patients surveyed reported reducing their alcohol consumption following admission into their state’s medicinal cannabis program. A 2015 review of 473 Canadian patients similarly reported that just over half of respondents substituted marijuana for alcohol.

This reported shift from booze to pot may be linked with increased traffic safety. According to a 2016 study in the American Journal of Public Health, the enactment of medical cannabis laws “are associated with reductions in traffic fatalities, particularly pronounced among those aged 25 to 44 years.” Researchers attributed this decline to be the result of fewer people driving under the influence of alcohol. A 2011 white paper published by the Institute for the Study of Labor similar reported that medical cannabis legalization in Colorado coincided with a nearly nine percent decrease in traffic fatalities, most likely to due to its impact on alcohol consumption."

FEWER DRUG TREATMENT ADMISSIONS

The opening of medical cannabis dispensaries is correlated with an immediate decrease in narcotic-related admissions to drug treatment facilities. That is the finding of a just-published research paper by a University of Georgia economics professor which concludes, “dispensary openings experience a 20 percentage point relative decrease in painkiller treatment admissions over the first two years of dispensary operations.” A 2016 Castlight Health study of over one-million subjects similarly reported medical cannabis access was associated with far lower prevalence of opioid abuse and doctor shopping.

LESS OBESITY

Changes in marijuana’s legal status is associated with an annual reduction in obesity-related medical costs. Writing in 2015 in the journal Health Economics, San Diego State University researchers reported, "[T]he enforcement of MMLs (medical marijuana laws) is associated with a 2% to 6% decline in the probability of obesity. ... Our estimates suggest that MMLs induce a $58 to $115 per-person annual reduction in obesity-related medical costs." Separate studies comparing subjects with a history of cannabis use versus controls consistently report that consumers are less likely to be obese, to suffer from diabetes, and are at a decreased risk of being diagnosed with metabolic syndrome.  

 

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10 Marijuana-Themed Halloween Costumes for the Pot Person in Your Life

Fri, 10/20/2017 - 10:03
Click here for reuse options! What better way to show one's pot pride than dressing up like a dang fool?

The clock is ticking toward trick or treat night, and millions of Americans are going through the annual ritual of trying to figure out what to do for a Halloween costume. Donald Trump and Kim Jung-un masks are sure to be big this year, and we might see some neo-Nazi clowns, but for the (semi) conscious cannabis consumer, there are other choices. 

Wanna let your weed flag fly? You've got options, baby. Here are 10 costumes designed to let the world know how you really feel.

1. Creepy Marijuana Mask. You might want to offer your buddies some weed with a high CBD-to-THC ratio to fend off panic reactions after looking at this guy.

2. Nurse Anita Reefer. Scantily clad women pushing weed are the bane of the socially conscious marijuana industry, which doesn't want to alienate half the population, but pop culture doesn't care.

3. Bag of Weed. Yep, this is pretty self-explanatory.

 

 

4. Ganja Mon. Why the reference to Jamaica, I don't know. No self-respecting Rastafarian would ever let himself get caught in this thing. 

 

5. Pot Head. Say no more.

 

6. Joint Venture Business Suit. Nothing says "executive material" like a bunch of pot leaves on your suit.

 

7.  Marijuana Bumble Bee. Get buzzed. Get it?

 

8. Rasta Imposta Joint Man. Again, our apologies to Jamaica. 

 

 

9. Marijuana Chef.For when your regular chef's apron and cap aren't silly enough. 

 

10. Marijuana Pirate. Why not?

 

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The Addict in All of Us: Dr. Gabor Maté on the Problem We All Live With

Fri, 10/20/2017 - 09:36
"Addiction is an attempt to solve a life problem. Only secondarily does it begin to act like a disease."

Over the past several decades, popular attitudes toward addiction have undergone a radical destigmatization. Many attribute the beginning of this shift to former first lady Betty Ford and her decision to go public about her addiction to alcohol and opiates soon after leaving the White House. She hadn’t been a public nuisance or a barfly. She’d never driven drunk, she said, or stashed bottles so she could drink secretly when she was alone. But by openly addressing her problems and becoming an outspoken advocate for rehabilitation through the Betty Ford Clinic (now the Betty Ford Center), she helped change the face of addiction. Perceptions of addicts as out-of-control gutter drunks and junkies were replaced by images of glamorous celebrities like Liza Minelli, Mary Tyler Moore, and Elizabeth Taylor as they checked in and out of Betty Ford.

While Ford’s clinic was opening, a counseling educator named Patrick Carnes was finishing Out of the Shadows, a book that proposed compulsive sexual activity was a form of addiction and popularized the notion that someone could be addicted to something other than substances. Carnes’s concept of sex addiction made a splash in the popular psyche and among many mental health professionals, and it spawned treatments that were influenced by 12-step programs all around the country. In the decades that have followed, the addiction label has ballooned in common usage to include a list of behaviors such as overeating, gambling, shopping, kleptomania, and internet overuse and gaming.

The concept of overdoing a behavior to the point of addiction has resonated with the general public, even as many mental health professionals have cringed at the implications. When the DSM-5 included gambling disorder under a new addiction heading that extended the moniker to behaviors, Allen Francis, chair of the DSM-IV, objected strongly and advised clinicians to reject the diagnostic change, writing in The Huffington Post that “If taken beyond its narrowest usage, ‘behavioral addiction’ would expand the definition of mental disorder to its breaking point and would threaten to erase the concept of normality.”

Today, as the debate over the wisdom of extending our notions of what constitutes addiction continues, one of the most eloquent and influential spokespeople for that broader conception is a haunting- looking, charismatic Canadian physician named Gabor Maté. As much social critic as clinician, Maté is the author of In the Realm of Hungry Ghosts, a bestseller about addictions. His TED talk on “The Power of Addiction and the Addiction of Power” has had almost 700,000 views. He insists that addictive patterns of behavior are rooted in the alienation and emotional suffering that are inseparable from Western capitalist cultures, which, by favoring striving and acquiring over noticing and caring for one another, end up shortchanging—and too often traumatizing—children and families. He argues that the more stressful our early years, the likelier we are to become addicts later as a substitute for the nurture and connection we never received.

With his mop of wayward curls, heavily hooded eyes, and the Mick Jagger-ish concavity of his thin frame, Maté is a striking figure on the workshop circuit as he challenges his audience to ask not what’s wrong with addiction, but what’s right with it. What is the addict getting from it that makes his addiction worth the price he pays? Why is the ameliorative quality of a behavior or a high so necessary for so many? If addicts can find peace and control only when they’re using, what agonizing discomfort must they feel when they’re not?

Much of what Maté knows about addiction he learned doctoring to the hardcore drug addicts of Vancouver’s Downtown Eastside, which has one of highest concentrations of active drug users in North America. His former employer, the Portland Hotel Society (PHS), is known for its controversially permissive treatment, which helps addicts get by while they’re actively using by providing food, shelter, and healthcare. PHS’s most radical service is a clinic called InSite, which goes a step beyond clean needle exchanges and helps IV drug users shoot up safely. It dispenses crack pipes for a quarter in its vending machines to reduce the spread of disease.

Part of Maté’s appeal is his willingness to talk about his own addictive tendencies and his view that most of us fit somewhere along the addiction spectrum. He’s vocal about being a workaholic: who is he if not a doctor and an author and an in-demand public speaker? he asks. For years, he freely talked about his inability to control the urge to go on shopping sprees for classical music CDs, referring to it as an addiction that “wears dainty white gloves.” He openly places himself on an addiction continuum where he believes compulsive shoppers and crack fiends can both be located. Be it a need to score horse tranquilizers in a scummy alley, or escape by melding into the glorious fantasy world of an online video game, or, in Maté’s case, plunking down cash for a set of obscure violin concertos, the denial, the craving, the temporary pleasure, the fallout—it’s all there.

Classical music thrills him, he says, but it’s not the listening to it that he’s addicted to: it’s the momentary thrill he gets from buying and possessing it. As with any addict, it’s the release he’s after: that adrenaline push when the drug is within reach (as he approaches the door to the music store) and the brief endorphin flight of freedom when he’s found and paid for what he wants. But, he confesses, he’s barely left the store before he’s fixating again on his next buy.

When he was most deeply in the throes of this addiction, Maté sometimes spent thousands of dollars in a week on music that he never listened to. At one point, he left a mother in the middle of active labor to go on a shopping spree. Seeking an answer to his bondage to this kind of behavior, he attended AA meetings in Vancouver, becoming an addict among addicts, and sometimes being recognized.

Although the shopping addiction has receded, Maté still struggles with his workaholism. He’s clear that his addictions have failed him, as they fail all the addicts he knows, but he recognizes that the trauma of his childhood enhances his enslavement to them. Born to a Jewish family in Nazi-occupied Budapest, he lived in a household filled with fear. His father was forced to labor with the brutally abused Jewish battalions in Hungary. His maternal grandparents died in Auschwitz. An aunt disappeared.

Some treatment professionals have publicly disagreed with Maté’s pronouncements about the inevitable connections between addiction and trauma, including his statement that while “every traumatized child doesn’t grow into an addict, every addict has been a traumatized child.” And they take his disagreement with the current biomedical model of addiction, and his flat-out rejection of a genetic component, as ill-informed and potentially dangerous. He counters that focusing on a disease model makes it too easy to ignore the thorny societal and familial issues that underlie the power of addiction.

Whether he’s right about the devastating effects of early trauma, or has gone so far into his cultural critique that he’s lost sight of distinguishing differences among addictions and other kinds of disorders, he clearly has a gift for articulating the suffering and desperation of people caught in the grip of deep inner compulsions, no matter how innocent seeming or how darkly self-destructive they may be. His work forces us to look closely at the sense of emptiness and the failed search for meaning that characterize our hyperstimulating times.

In the interview that follows, Maté explores the meaning of addictions and how he’s tried to come to terms with the inner demons in his own life.

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PSYCHOTHERAPY NETWORKER: Let’s start off by talking about your view of addiction. You’ve written that “any passion can become an addiction.” What do you mean by that?

GABOR MATÉ: Addiction is a complex psychophysiological process, but it has a few key components. I’d say that an addiction manifests in any behavior that a person finds temporary pleasure or relief in and therefore craves, suffers negative consequences from, and has trouble giving up. So there’s craving, relief and pleasure in the short term, and negative outcomes in the long term, along with an inability to give it up. That’s what an addiction is. Note that this definition says nothing about substances. While addiction is often to substances, it could be to anything—to religion, to sex, to gambling, to shopping, to eating, to the internet, to relationships, to work, even to extreme sports. The issue with the addiction is not the external activity, but the internal relationship to it. Thus one person’s passion is another’s addiction.

PN: Okay, but the whole subject of addictions is shrouded in a certain amount of controversy these days. What do you think is the most common misconception about addictions?

MATÉ: Well, there are a number of things that people often don’t get. Many believe addictions are either a choice or some inherited disease. It’s neither. An addiction always serves a purpose in people’s lives: it gives comfort, a distraction from pain, a soothing of stress. If you look closely, you’ll always find that the addiction serves a valid purpose. Of course, it doesn’t serve this purpose effectively, but it serves a valid purpose.

PN: Lots of people believe that the term addiction has become too loosely applied. So what’s the difference between saying “I have an addiction” and “I have bad habits that give me short-term satisfaction, but don’t really serve me in the long term?”

MATÉ: The term addiction comes from a Latin word for a form of being enslaved. So if it has negative consequences, if you’ve lost control over it, if you crave it, if it serves a purpose in your life that you don’t otherwise know how to meet, you’ve got an addiction.

PN: Some people are critical of the term addiction because they believe it medicalizes and pathologizes behavior in a way that’s not helpful.

MATÉ: I don’t medicalize addiction. In fact, I’m saying the opposite of what the American Society of Addiction Medicine asserts in defining addiction as a primary brain disorder. In my view, an addiction is an attempt to solve a life problem, usually one involving emotional pain or stress. It arises out of an unresolved life problem that the individual has no positive solution for. Only secondarily does it begin to act like a disease.

PN: What’s lost by just thinking of addictions as bad habits?

MATÉ: It falls short of a full understanding of addiction. Let’s say a person has a bad habit of picking his nose in public. That’s a bad habit, right? Frequently scratching one’s genitals while giving a public talk would be regarded as a bad habit. But neither of these things is an addiction because nobody craves doing them, nor do they particularly get pleasure from them. They’re compulsive behaviors, perhaps, but if there’s no craving involved and no inability to give it up, there’s no addiction. Some bad habits aren’t addictions. But, for example, if somebody can’t stop having affairs, despite the negative consequences, that’s not just a bad habit.

PN: The notion of trauma is closely tied into your conception of addiction. Why is that?

MATÉ: If you start with the idea that addiction isn’t a primary disease, but an attempt to solve a problem, then you soon come to the question: how did the problem arise? If you say your addiction soothes your emotional pain, then the question arises of where the pain comes from. If the addiction gives you a sense of comfort, how did your discomfort arise? If your addiction gives you a sense of control or power, why do you lack control, agency, and power in your life? If it’s because you lack a meaningful sense of self, well, how did that happen? What happened to you? From there, we have to go to your childhood because that’s where the origins of emotional pain or loss of self or lack of agency most often lie. It’s just a logical, step-by-step inquiry. What’s the problem you’re trying to resolve? And then, how did you develop that problem? And then, what happened to you in childhood that you have this problem?

PN: Some people have challenged your belief that addiction is inevitably connected to trauma. Looking at the research, they say that most addicts weren’t traumatized, and most traumatized people don’t become addicts.

MATÉ: Then they’re not looking at the research. The largest population study concluded that nearly two-thirds of drug-injection use can be tied to abuse and traumatic childhood events. And that’s according to a relatively narrow definition of trauma. I never said that everybody who’s traumatized becomes addicted. But I do say that everybody who becomes addicted was traumatized. It’s an important distinction. Addiction isn’t the only outcome of trauma. If you look at the Adverse Childhood Experiences Study, it clearly shows that the more trauma there is, the greater the risk for addiction, exponentially so. Of course, there are traumatized people who don’t become addicts. You know what happens to them? They develop depression or anxiety, or they develop autoimmune disease, or any number of other outcomes. Or if they’re fortunate enough and get enough support in life to overcome the trauma, then they might not develop anything at all.

When I give my talks across the world, it’s not unusual to have somebody stand up and say, “Well, you know, I had a perfectly happy childhood, and I became an addict.” It usually takes me three minutes of a conversation with a person like that to locate trauma in their history by simply asking a few basic questions.

PN: What are they?

MATÉ: Sometimes I ask if either parent drank and I hear, “Yeah, my dad was an alcoholic.” At that point, the whole audience gasps because everybody in the room gets that you can’t have a happy childhood with a father who’s an alcoholic. But the person can’t see that because they dealt with the pain of it all by dissociating and scattering their attention. Maybe they developed ADD or some other problem on the dissociative spectrum. They shut down their emotions, and now they’re no longer in touch with the pain that they would’ve experienced as a child. That’s an obvious one. Less obviously, I might ask about being bullied. And when a person says, “Yeah, I was bullied as a kid”—or just sometimes felt scared, or alone, or in emotional distress as a child—I ask to whom they spoke about such feelings. The answer is almost uniformly “nobody.” And that in itself is traumatic to a sensitive child.

So trauma can be understood in the sense of the Adverse Childhood Experiences criteria: emotional abuse, physical abuse, sexual abuse, a parent dying, a parent being jailed, a parent being mentally ill, violence in the family, neglect, a divorce. Or it can be understood in the sense of relational trauma. That means you don’t have to be hit or physically abused. If the parents were stressed or distressed or distracted—if their own trauma got in the way of their attuning with the child—that’s enough to create the lack of sense of self in the child. Or it’s enough to interfere with the development of a healthy sense of self, and with normal brain development itself. This point must be emphasized: the physiology of the brain develops in interaction with the environment, the most important aspect of which, to cite a seminal article from the Center on the Developing Child at Harvard University, is the mutual responsiveness of adult–child relationships.

PN: Recently, more and more attention is being devoted to expanding our conception of addiction to include behavioral addictions. What’s the difference between substance and behavioral addictions?

MATÉ: First, let’s look at what’s similar. The pattern of compulsive engagement in the behavior that one craves, finds temporary pleasure or relief in, but suffers negative consequences from—that’s similar across all addictions. Also, many of the behaviors around both kinds of addiction, such as denial, are similar. So workaholics will deny the effect of workaholism in their own life or the lives of their family members. There will often be subterfuge and dishonesty about the addiction. The sex addict isn’t going to be publicly talking about his addiction, or even acknowledging it. Shame is the common undercurrent in addiction, whatever the object of the addiction may be.

The other thing that’s common among all addictions has to do with brain circuits. I can’t overemphasize this. It doesn’t matter if you look at the brain of a fervent shopper or a cocaine addict: the same incentive and motivation circuits are activated, and the same brain chemicals are being secreted. In the case of the shopper or the gambler or the sexaholic, it’s dopamine. If the sexaholic was only after sex, the solution would be simple: marry another sexaholic. You could have all the sex that you wanted whenever you wanted it. But what is it really about? It’s about the hunt, the search, the excitement of the chase. And that has to do with the brain’s incentive and motivation circuitry, the nucleus accumbens and its projections to the cortex, and the availability of dopamine, which is also what cocaine and crystal meth and nicotine and caffeine elevate.

So what I’m saying is that on a biochemical and brain circuitry level, there’s no difference between behavioral and substance addictions—or more accurately, only a quantitative difference, not qualitative. It all has to do with the brain’s pleasure-reward centers, pain-relief circuitry, incentive-motivation circuitry, and impulse-regulation circuits. You know that it’s not good for you, but you can’t stop yourself. That’s the same thing in all addictions.

Finally, there’s the matter of poor stress regulation. When you ask people who have some addictive behavior, like gambling or sex or shopping, what induced them to go back to the behavior after having given it up for a while, they usually say something stressful happened—which means that their own stress-regulation circuitry isn’t fully developed. They have to try to regulate it externally. And that, too, is an artifact of childhood circumstances: these crucial circuits didn’t develop properly for lack of the right conditions.

PN: What’s the distinction between having addictions and OCD?

MATÉ: The person with OCD is compelled to perform some behavior, but finds it unpleasant to have to engage in it. It’s not egosyntonic. The person doesn’t like it. There’s no pleasure in it and no craving for it.

PN: And does their brain look different than the brain of an addicted person?

MATÉ: To really answer that, I’d have to look over the research more. But I suspect that, while there may be certain similarities, the pleasure-reward centers aren’t activated in the person with OCD. I think OCD is also rooted in trauma, a different manifestation of it than addiction, but rooted in it nonetheless.

In any case, the difference between the substance addict and the so-called process or behavior addict is that the substance addict relies on an external substance to create that change in the state of their brain, and the process addict can do so just through the behavior.

PN: In your books, you’re very disclosing about your own behavioral addiction to buying classical music, what you call the “dainty white gloves form” of behavioral addiction. Could you talk a little bit about that?

MATÉ: First of all, I appreciate you seeing the distinction. I wasn’t addicted to classical music; I was addicted to shopping for classical music. I love classical music; it’s one of my passions. But if I just loved classical music, then I could just buy it and stay home listening to it. I wouldn’t have to keep running back to the store to get more and more and more. It’s the shopping that gave me that dopamine hit I was looking for. And then, when I wasn’t doing it, I was craving acquiring it. You can love classical music without being addicted to shopping for classical music. So it’s the acquisition that was really the addiction—the process of the hunt, the chase, the thrill.

PN: How did that particular addiction take root in your life?

MATÉ: Interestingly enough, it began during a therapy seminar I was attending as a participant. They were playing some of Bach’s solo violin sonatas, which I wasn’t familiar with and loved listening to. And somebody said, “There’s a classical record store just a few blocks away from here.” I walked down to that store, and I was hooked. I started buying records, and then I had to keep going back over and over again. Then CDs came out, so I had to exchange all my records for CDs. I was lost for years. One week, I spent $8,000 on recordings. Obviously, there’s a reason why the music meant so much to me. What was I looking for? I was looking for spiritual meaning, for aesthetic beauty, for depth, for a sense of completion. These were all qualities lacking in my life. So that’s what I sought to receive through the music.

PN: A striking quality of your writing is how self-disclosing you are. Is that something that comes easily to you?

MATÉ: Once we get that there’s nothing personal about these patterns, self-disclosure is perfectly natural. As Eckhart Tolle says, the ego isn’t personal. Neither are the emotional and behavioral manifestations of trauma. So I’m not ashamed of anything I write about in my personal life. Sometimes people say, “How can you compare your addiction and yourself to the heroin-addicted, HIV-ridden, downtrodden people you’re working with?” But when I talk to my clients about my own addictive patterns, they just laugh and shake their heads and say, “Doc, I get it. You’re just like the rest of us.” They don’t balk and say, “How can you possibly make that comparison?” They realize that I get their experience. The differences between us are obvious. It’s the similarities that are interesting.

PN: In your latest book, you revealed that you still had an addiction to buying classical music. Is that still true?

MATÉ: No, I don’t do it compulsively any more. I’ve been to my favorite classical music store maybe twice this year. I bought just one or two discs each time, and haven’t gone back to get more. I do notice that when I’m down or stressed or something, my tendency to start thinking about it arises. But I’d definitely say that I don’t have an addictive relationship to the purchase of music anymore.

PN: What finally enabled you to overcome your addiction?

MATÉ: I finally got that I have all this beautiful music at home that could keep me busy for a long, long time. I got really tired of myself being that person who was that much in slavery to a habit. I think I developed a degree of disgust for that helpless need. I understood where it stemmed from, but it’d become more of a bane than a benefit.

Having said that, I still haven’t resolved the issue of workaholism in my life. In fact, I’m having to deal with that right now, because it’s creating issues in my personal life that I have to confront. Who am I if I’m not out there speaking, or doing therapy with people, or teaching or leading seminars, or even contemplating another book? Just who am I, period? And that question is at the core of dealing with addictions. Who are you, really? Who are you when you’re not in that state? To be totally honest, I haven’t resolved the issue of addiction in my life in general. So it could be that I just displaced it more into work.

PN: Clearly in your own life, you haven’t found any magical solutions to the problem of addictions. But looking at the wider field, what do we understand today about addiction treatment that we didn’t 10 or 20 years ago?

MATÉ: I’d say, in my own life, I’ve found more than a few solutions. What I’m dealing with now is acquiring presence on a higher level and anticipating broader possibilities than before. At the same time, you’re quite right. I know of no magic solutions. The work continues.

All we know about the advances in addiction treatment arises out of our understanding of trauma. People often think that trauma is the bad things that happen to someone: trauma is that you were sexually abused, or that you were beaten, or your parents abandoned you, or died, or something like that. But trauma is the internal impact, which is fundamentally a disconnection from the self and from our bodies and our gut feelings. And the trauma is the discomfort, the inability to be in the present moment because the present moment is too painful.

If, as I argue, addiction is rooted in trauma, then the treatment of addiction has to aim beyond just stopping the behavior. That’s where the addiction treatment falls down so miserably. Too often it’s all aimed at behavioral regulation or behavior reform, with the thought that if people stop the behavior, then they’re going to be okay. No, they’re not—and they won’t be fully okay until they deal with the fundamental issues. So the treatment has to aim at nothing less than the restoration of the individual to themselves and to their capacity to be with the present moment, whether the present moment is pleasant or not. That’s what’s too often missing from addiction treatment.

PN: Is there any evidence that our treatment approaches today are that much more effective in resolving addictions than they once were?

MATÉ: No. Our failure rate, the relapse rate, is miserable. The problem is that most addiction treatment programs don’t have a trauma-informed perspective—meaning that, for the most part, the research evidence they rely on is based on false assumptions. When it comes to trauma work, for example, if you take the specific example of EMDR, there are pretty good results showing that it helps resolve traumatic imprints, not in everybody, but in a lot of people. But much research ignores trauma. In any case, there’s no one-size-fits-all method, but any method worth its salt needs to be trauma-informed. And the basis for success in any method—whether it involves talk therapies, somatic work, EMDR, EFT, behavioral modification, anything—must be the quality, the compassionate underpinning, of the therapeutic relationship, or what’s aptly called the therapeutic alliance.

PN: What advice do you have for therapists trying to help people change their relationship with their digital devices?

MATÉ: What a lot of what people use the internet for is really about meeting their attachment needs. So on Facebook, what do people seek? They have “friends,” they “like” each other. These are attachment dynamics. And addiction in general is rooted in disturbed attachments in the first place. So whether people are using the internet to escape their emptiness, boredom, loneliness, emotional pain, lack of meaning, or lack of connection with others, of course there’s going to be internet addiction. It’s not new; it’s just a new outlet for the same dynamic.

The reality is that instead of the internet connecting people, which it could do, it often isolates them even more. So once more, we have to ask: what does the compulsive digital activity do for you? What about it satisfies you in the moment? And how do you lose that sense of excitement with life itself, that sense of connection, that the device (falsely) promises you? From what and why do you need to distract yourself? In short, what trauma are you wanting to soothe or escape from?

 

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Vietnam and the War on Drugs: What We Forget, We Repeat

Fri, 10/20/2017 - 09:25
History has shown the anti-war protesters to be on the right side of the argument.

I just finished watching the 18-hour documentary series by Ken Burns and Lynn Novice on the Vietnam War. To call it an epic masterpiece is an understatement–to call it a definitive documentary on one of the most complex events in U.S. history is to commit the common sin of oversimplification. Nonetheless, I found the series extremely affecting–as a person who came of age and political consciousness during the era covered, it was a reminder of how much my worldview and life path was a response to all that was happening then.  What I will say, is that of all the documentaries I have watched on the Vietnam War era, this one was the most personal, the most human, the most balanced (despite an obvious U.S. bias) and the most accurate in providing historical facts.

When all is said and done, one is left with the ultimate futility of armed combat–aka WAR. The incredible loss of life, permanent injuries to individuals, families, and communities; the decimation of the physical environment and natural resources–just never seems worth it in the end. And I must add that the thing that pains me the most is the realization that in every war of the 20th century and continuing into the 21st century, civilian deaths outnumber military deaths by almost 10 to 1. In a war where the principal measure of success was body count, soldiers were incentivized to see every Vietnamese as a potential enemy and every dead one as an indicator of success.  As poignantly noted by the journalist, Joe Galloway, the Vietnam War "turned honorable men into liars" who felt compelled to dehumanize people so that they could kill them. As explained by Marine veteran, John Musgrave, he "wasn’t killing people, he was killing ‘gooks’. This was Racism 101: the necessity of turning people into objects to retain your sanity when you have children fighting wars."

In between my tears, I began reflecting on the parallels between the Vietnam War and the War on Drugs (which ironically was initiated just as the Vietnam War was ending). The initial U.S. involvement in Vietnam was in support of French desire to maintain it's colonial power in Vietnam. After the French army was defeated, the U.S. betrayed its agreement with Ho Chi Minh to hold democratic elections in favor of supporting the corrupt despot Diem. The U.S. public was deceived into believing Ho Chi Minh was not a nationalist seeking independence for his country, but instead solely a communist and implacable foe of America. The tens of thousands of men and women who volunteered to serve in Vietnam believed they were engaged in a fight against communism in support of freedom and democracy. Similarly, the U.S. public was deceived into believing that drug abuse was the country's biggest public safety threat and that a 'war on drugs' was the best approach, because after all, the U.S. always wins...but in declaring a ‘war on drugs’ the government was declaring war on its own citizens in much the same way the Vietnam War seemed to require the U.S. military to destroy villages in order to save them.

Yet the Vietnam War was not winnable, in much the same way as the war on drugs is not winnable. As President Lyndon Baines Johnson admitted to an aide in 1965, “there ain’t no daylight in Vietnam." Yet he couldn't admit mistakes in judgment or defeat in battle, so he and his administration engaged in a campaign of deliberate public deception. As noted in the Burns/Novick documentary, the CIA broke down the motivation behind the government's continued involvement in Vietnam: 70 percent to avoid humiliation; 20 percent to contain communism; 10 percent to help Vietnamese. I estimate much the same could be said about the federal government's motivation to retain what are admittedly disastrous drug policies, even with respect to marijuana: 70 percent to avoid humiliation (can't admit they were wrong); 20 percent to reduce drug-related crime; 10 percent to help people struggling with addiction.

The most striking parallel between the two wars is the disastrous results of the adoption of the wrong set of metrics for success. As noted by one of the Vietnam War commentators: "when you can't count what's important, you make what you can count important." In Vietnam, the principal metric was body count–how many of the enemy were killed and/or wounded in any given action, with the goal of reaching what was termed the "crossover point" where the number killed was higher than the enemy's ability to replace them. In the drug war the primary metrics are arrests and/or drugs seized, motivating police to make every arrestee a drug user and/or seller and incentivizing them to rack up large numbers of arrests by targeting vulnerable people indiscriminately or by misrepresentation–aka "juking the numbers" of arrests. In the theater of war–especially guerrilla warfare–soldiers are taught that anyone can be an enemy–any age or gender.  Consequently, in Vietnam everyone was suspect until proved otherwise.  Failure to assist in the search for the enemy made you the enemy, much the same way that drug conspiracy laws work today.  Mothers, daughters, grandmothers, and cousins were routinely arrested, tortured and sometimes killed as co-conspirators in a war they just wanted to avoid. The routine destruction of entire villages and the livelihood derived within was considered collateral damage of the war, much the same way we view as collateral damage police looting under the guise of "civil asset forfeiture laws" and denial of basic civil rights–including the right to employment–to persons convicted of drug offenses. Today entire families may find themselves targeted by prosecutors who've been instructed by this administration to aggressively use drug conspiracy laws to win convictions and impose maximum terms of imprisonment.

The intense focus on increasing the body count and/or "kill ratio," led some soldiers to engage in atrocities and wanton acts of violence that cast a shadow on all U.S. military personnel in much the same way that the money and violence endemic with the drug trade has provided cover for bad police to hide corruption and shelter brutality against the people they're charged with protecting. In both cases, the lack of accountability for such behavior led to widespread community disdain and distrust.

Finally, the parallels in the government's response to dissent are alarming. The anti-war movement grew out of the civil rights movement. Many of the students that had traveled south to participate in the civil rights struggle began to see the relationship between racial justice and pacifism–opposing unjust wars. Many civil rights activists also understood that the cost of the ongoing Vietnam conflict threatened to undermine the government's ability to wage the domestic "war on poverty." As opposition to the war grew, the anti-war movement was increasingly demonized along with the press. LBJ claimed journalist Morley Safer had ‘defaced the American flag and given support to the enemy” when he reported accurately what was happening with the war.  Safer’s interviews with soldiers revealed their routine dehumanization of the Vietnamese people similar to the dehumanization of black men, women, and children we've witnessed by some current members of law enforcement. Johnson referred to Safer’s employer–CBS–as the Communist Broadcasting System–sound familiar? 

The Vietnam War era saw the increasing militarization of local police in response to dissent by protesters. The scenes of clashes between police and anti-war protesters outside the Democratic convention in Chicago in August, 1968 evoked recent memories of Ferguson and Baltimore. Then, as now, these clashes generate public fear and dismay over the level of anger and violence expressed and for revealing just how deep our divides are. The political divide over the Vietnam War and racial justice led directly to the election of Richard Nixon, who promised to restore "law and order" on behalf of the "silent majority" of Americans not represented by the protestors and counterculture who he defined as the “real Americans." Despite Nixon's election and promises, the war and the protests continued. Hardliners saw the protestors as subversive dissidents that had to be suppressed with maximum force–and called in the national guard. This often just inflamed emotions on both sides, most tragically on the campus of Kent State in Ohio, where four students were killed when national guardsmen opened fire on unarmed students when they refused to disperse. The level of political polarization over the war is revealed by the fact that despite the deaths of unarmed students, polls showed the majority of Americans supported the actions of police and believed the killings justified.  Middle America accepted the narrative that anti-war protesters were unpatriotic, dishonoring the country's history and legacy–ungrateful for the benefits the U.S. had given them. After all, if you're proud to be an American, you should be willing to die for the honor—"America, love it or leave it" was their rallying cry.  Many draft-eligible men responded by leaving for Canada and other parts unknown.

One of the more important aspects of the Burns/Novick Vietnam documentary is that it gave voice and honor to all sides. I cried for the young Americans that needlessly died in the war and I cried for the young Vietnamese that needlessly died in the war. I understood and appreciated the courage it took to go and fight for your country in some far off land on behalf of a principle that you believed in and I understood and appreciated the courage it took to protest your country's involvement in war on behalf of a principle you believed in. Ideally, the mark of a free society is the ability to accommodate and honor both points of view. Today, we’re engaged in a societal debate about the legitimacy of the “war on drugs." Attorney General Sessions seems to believe the major problem with the ‘war on drugs’ is that we’ve haven’t fought it hard enough. In that he resembles Gen. Westmoreland, who remained convinced the Vietnam War could be won if we committed more troops, more firepower and increased the kill ratio. Like Westmoreland, Sessions wants more drug arrests and convictions, more drug offenders imprisoned for even longer periods of time. Others believe this is a failed strategy, that we can never arrest our way out of the problem and attempting to do so causes needless harm to individuals, families, and communities.

Ultimately, history has shown the anti-war protesters to be on the right side of the argument. There was a point where the movement shifted from one protesting U.S. involvement in Vietnam to a movement committed to ending U.S. involvement in the Vietnam War. I wonder if we've reached that point in the movement against the 'war on drugs'. Are we committed to more than protesting what's wrong with the drug war–pointing out all the harm it is doing to individuals and communities? Are we committed to ending drug prohibition? If so, what does that movement look like? What are its tactics and measures of success? More importantly, like those who fought to end the Vietnam War–what price are we willing to pay to win?

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Trump's Opioid Emergency Promise Was News to the Officials Who Have to Make It Happen

Fri, 10/20/2017 - 08:00
The president's latest announcement caught his administration completely off guard.

It’s a fire drill in the Trump administration after Donald Trump promised on Monday that “next week” he’d make an emergency declaration on the opioid crisis. His advisers and the agencies that would have to make an emergency response happen were not and are not ready to do that, and go figure—it’s just not that easy:

Emergency declarations are typically used to respond to isolated events such as hurricanes and floods, or disease outbreaks. Using one to combat a nationwide epidemic with no obvious end point might require unprecedented resources and raises numerous legal and other questions, said one senior White House official. [...]

Multiple sources in and out of relevant federal agencies said that key leaders on the opioid issue had not been asked to draw up strategies and tactics.

A senior FDA official said she did not know who was in charge of the emergency declaration efforts and described the effort as “such a mess.”

Let’s repeat that: “Key leaders on the opioid issue had not been asked to draw up strategies and tactics.” That’s perfect.

To make it all a little more complicated, there’s no health and human services head since Tom Price resigned in disgrace, there’s no Drug Enforcement Association head since the last person acting in that role resigned over Trump’s lack of respect for the law, Trump’s back to square one in picking an Office of Drug Control Policy leader since his first one had to withdraw over his sponsorship of a law making it harder for the DEA to combat the opioid crisis, and a Department of Homeland Security chief to replace now-White House chief of staff John Kelly has not yet been confirmed.

All of this is probably moot, though, because the fact that Donald Trump said he’d be making an emergency declaration does not actually mean Donald Trump intends to make an emergency declaration. It means he thought that would get him some approval and good press in the moment he said it and didn’t think beyond that. So most likely he’ll end up declaring something with the word emergency in it that doesn’t commit many resources or involve a real plan, but Trump will get to sign something in front of cameras (if he remembers to do the signing part) and say he’s taking action, and that’ll be good enough to keep him happy, even if it does nothing to keep people from dying of overdoses.

 

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I Bought Legal Cannabis For The First Time And This Is What Happened

Thu, 10/19/2017 - 10:35
Seventeen years in the making.

The first time I blazed up was a fun day that I’ll never forget. It in true New Jersey fashion, one party brings the weed, the other brings a Dutchmaster and the change from paying for it with a 20 dollar bill. We rolled more cannabis than I would probably smoke over the next year into a super fat blunt and got ludicrously high. Whoever said you don’t get high your first time was lying. We cackled and cavorted and ate pizza and talked about dumb shit, the best pressure valve we could deploy in our strict and uptight suburban town, and we were 13 years old.

Now, at 30, I have been partaking of cannabis on and off for that entire length of time. There were six years of total abstinence, a few years of Saturday-only smoking, and even some bingey times, but now I consider cannabis a normal part of my life despite the draconian dimension that remains on most of the East Coast, where I live. Despite having many medically sound reasons to use cannabis, I’ve never once bought cannabis legally in this time, and saying so plainly is the truth that provides context to reality, as only severe illness is eligible in the New York State medical cannabis program.

One fine morning, I woke up in Seattle, where it’s not only legal to purchase cannabis in many forms, but completely run-of-the-mill for some time. Though being basically no big deal to most people, just walking inside to the clean, well stocked and attractive aisles at Uncle Ike’s Capitol Hill was a mindfuck to the core. I knew they existed, I knew I could go there, and now I have.

The first thing a cannabis lover in exile notices is the collective smell of the dozens of strains and all of their terpenous glory mingling together into a potent haze of scent. You can’t smell it when you’re standing on the corner, but the second you open the door is wraps you in a loving, safe, green cloud, and is probably why no one is carrying even a whiff of bad attitude inside.

Not only impressed by sheer selection, I found the whole legal commerce part most overwhelming, but in a good way. I felt cared for in a genuine customer service way by the wonderful woman behind the counter. She knew her strains, knew the threads of related strains for different effects but similar taste profile, and was patient, kind, and budget conscious. It was like being in Sephora and having someone not only know the products well, but the ingredients, differences in prices and brands, and all without looking up a thing and being pleasant as hell.

Aside from a brilliant service experience, the weed itself was so much better than New York’s ridiculousness that it was worth a chuckle, or maybe a tear. Getting the best requires money, time, and privilege in New York, where as in Washington it’s just a matter of popping in a shop, no different than a bottle of wine, which consequently is also a limited purchase in New York State.

Being that I’ve imbibed in cannabis for almost half of my life, I still can’t wrap my brain around the difference in quality, marketing, packaging, selection, convenience, and basically any and all ways it could be simpler and more a part of everyday life in Washington. The only major barrier is that it’s not possible to smoke it in public legally, which puts a strange twist on things.

It’s no wonder so many people come to legal states to be weed tourists, or simply leave prohibition states altogether. Cannabis prohibition is no longer just looking dumb and dated but sinister and freedom hating. Buying weed legally for the first time was a blessing and a promise of what I hope the future holds for not just the East Coast or all of America, but the whole world.

 

 

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Trump, Sessions Crime Policies 'Risk Igniting a New Drug War,' Eric Holder Charges

Thu, 10/19/2017 - 10:24
The GOP appears to be marching resolutely backwards on commonsense drug reforms and other criminal justice policies.

 

 

Eric Holder Says Trump's Crime Policy Is Dangerous

Former Attorney General Eric Holder, whose tenure was embroiled in controversy, had some strong words this week for the Trump administration's position on key issues involving the criminal justice system. ... around the country who had gathered in Washington, D.C., according to The Hill. Holder said it was "unwise" for Sessions, who once called marijuana "only slightly less awful" than heroin, to push ...

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Want to Cut Crime? Hand Out Psychedelics

Wed, 10/18/2017 - 23:48
Click here for reuse options! We could use a little peace, love and understanding.

New research suggests that psychedelic use is associated with a lesser likelihood of criminal behavior. The finding opens the door to further research on the use of classical psychedelics such as psilocybin (magic mushrooms), LSD and mescaline (peyote), in treatments aimed at reducing such behavior.

The research was done by a team of investigators at the University of Alabama at Birmingham led by Peter Hendricks, associate professor in of the Department of Health Behavior in the UAB School of Public Health. The results were published online last month by the Journal of Psychopharmacology

"These findings, coupled with both older and emerging bodies of evidence, make a case that classic psychedelics may provide enduring benefits for criminal justice populations," said Hendricks. "They certainly suggest that clinical research with classic psychedelics in forensic settings should be considered." 

The study used data compiled in 13 years' worth of the National Survey on Drug Use and Health to analyze the relationship between psychedelic use and criminal behavior among the 480,000 adult respondents. Respondents were asked about their past use of a number of psychedelics, including ayahuasca, DMT, LSD, mescaline, and psilocybin mushrooms and about their criminal histories.

Researchers found that having ever used a psychedelic was associated with a 22% decrease in the odds of being arrested for a property crime and an 18% decrease for violent crime within the past year. Use of psilocybin (magic mushrooms) in particular was linked to a decreased likelihood of either property or violent crimes.  

"These findings are consistent with a growing body of research suggesting classic psychedelics confer enduring psychological and prosocial benefits," Hendricks said. "Classic psychedelics can produce primary mystical experiences — also known as primary religious experiences or peak experiences — and have been used for millennia across cultures with therapeutic intention."

The findings contribute to an ever more compelling rationale for the initiation of clinical research with classic psychedelics, including psilocybin, in forensic settings, Hendricks said.     

"The development of innovative and effective interventions to prevent criminal behavior is an obvious priority," he said. "Our findings suggest the protective effects of classic psychedelic use are attributable to genuine reductions in antisocial behavior rather than reflecting improved evasion of arrest. Simply put, the positive effects associated with classic psychedelic use appear to be reliable. Given the costs of criminal behavior, the potential represented by this treatment paradigm is significant."

 

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Making Way for Psychedelics: 5 Paths Going Forward

Wed, 10/18/2017 - 13:47
Click here for reuse options! Psychedelics have been criminalized in the U.S. for half a century. Maybe there's a better way.

Psychedelics, hidden for decades in the shadows, are back in the light. Research studies at universities like UCLA and NYU have ushered in a new era not seen since the 1950s and '60s, when psychedelics were a common psychotherapy tool for psychiatrists like Humphry Osmond, who gave psychonaut Aldous Huxley, author of The Doors of Perception, a dose of mescaline in 1953.

Since psychedelics were officially declared illegal in 1967, marijuana, a Schedule I substance along with psychedelics, is legal in some form in 29 states and the District of Columbia. The federal legality of psychedelics hasn’t changed, but societal perception and use has.

The microdosing trend has been driven by the Silicon Valley crowd in particular, who have reported that psychedelics spike creativity and productivity and reduce depression and anxiety.

Recently, the Multidisciplinary Association for Psychedelic Studies (MAPS) received the green light to commence a Phase III FDA approval process to study MDMA for PTSD treatment for veterans, and more Americans are going to far-flung sites to take part in shamanic rituals using ayahuasca, ibogaine and peyote.

With all this psychedelic momentum, should psychedelics be legalized? Here are some possibilities.

1. Albert Hofmann’s method

Albert Hofmann was the first person to synthesize LSD for Switzerland’s Sandoz Pharmaceutical in 1938. Hofmann also experienced the first LSD trip when he accidentally ingested some LSD and took a notorious bicycle ride on April 19, 1943. Hofmann believed that psychedelics have benefits and that people should be able to access them, though he felt the drugs should be subject to controls and taken under the supervision of a psychiatrist.

2. The religious way

In the case of O Centro Espírita Beneficente União do Vegetal, a Christian Spiritist sect, the government found that their use of ayahuasca, a sacramental tea containing the psychedelic DMT, was protected under the First Amendment. The government had to concede that applying the Controlled Substances Act to ayahuasca would be a burden on religious freedom.

In 1996, Congress passed the Religious Freedom Restoration Act, ensuring that Native Americans could use peyote as part of their religious practice. Though likely the road less traveled, the burden is on the government to prove a psychedelic is not for religious use.

3. Medical road

Medicinal cannabis markets have boomed since California was the first to legalize medical marijuana in 1996. A medicinal system is likely the easiest route to follow since it’s a recognizable structure, more palatable to mainstream consumers and a simpler model to convince lawmakers. This is the route MAPS seems to be following, as evidenced by its close work with the FDA. But this approach also produces a unique set of challenges, especially cost, time and establishing regulations.

4. Fully legal

This method is probably the most politically difficult because it relies on two government agencies, the Food and Drug Administration and the Drug Enforcement Administration. Trump’s chosen FDA commissioner, Scott Gottlieb, has called for deregulation to cut costs and expedite drug reviews, though it’s unknown whether that would apply to psychedelic policy.

The DEA could be tricky because it’s overseen by anti-drug crusader Attorney General Jeff Sessions. Some of his recent drug policy moves are ordering his staff to enforce mandatory minimums for drug offenders and asking Congress for permission to prosecute medical marijuana providers. Given Sessions’ obstinate views on cannabis, psychedelics would probably be held to the same hard line.

5. Prohibition path

This is the road we currently travel, where people are driven to the darkest corners of the internet to get "legal" psychedelics, find themselves on the streets looking to buy or interact with strange dealers. Others find themselves without protections from bad players trying to make a buck. Especially vulnerable are those in the nightlife and party scene, where MDMA is frequently tainted with fentanyl, a potentially lethal synthetic opioid.

Many experts say that psychedelics defy all regulatory categories and shouldn’t be subject to drug policy at all. Psychedelics, meaning “mind manifesting,” need a category all to themselves.

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Fire, Brimstone, and Dioxin: Toxic Smoke from Wine Country Wildfires Threatens Cannabis Crop and Public Health

Wed, 10/18/2017 - 11:35
Heavy smoke has blanketed the skies in the nine-county San Francisco Bay Area, poisoning the air to an unprecedented degree. Highlights: 
  • Smoke from major fires will contaminate crops in Northern California’s prime cannabis-growing region.
  • Cannabis, a bioaccumulator, will uptake heavy metals from the soil that have deposited on the ground.
  • Analytical labs should test cannabis products for an array of fire-related heavy metals, aromatic hydrocarbons, and dioxins, even those that are not mandated by regulations.

 

The October firestorms raging in Northern California have incinerated nearly a quarter million acres and displaced more than 100,000 residents. Heavy smoke has blanketed the skies in the nine-county San Francisco Bay Area, poisoning the air to an unprecedented degree and prompting air quality alerts and health advisories throughout the region.

“We have never recorded higher levels of air pollution in the Bay Area,” said air district spokeswoman Kristine Roselius.

While a limited number of deaths have been reported thus far, the public health impacts of this disaster will be felt for many months to come. This is not a typical wildfire; in Santa Rosa, flames have melted gas pipes, power lines, even a cellphone tower. The blaze has scorched thousands of homes and cars, releasing metals into the air. Rubber, fibreglass, paint, and electrical equipment burn to uncommon and highly dangerous toxins, such as dioxins and other biphenyl compounds.

Poisons contained in the smoke will slowly fall from the air and be absorbed by plants and the watershed, contaminating agricultural crops, including those in the Emerald Triangle, America’s cannabis breadbasket. The timing couldn’t have been worse for cannabis farmers as these fires came at the start of harvest season. Cannabis producers and consumers need to be cautious about the chemicals that could accumulate.

There are three common ways that toxins and carcinogens in smoke can be removed from the atmosphere:

  • Volatile chemicals like formaldehyde and carbon monoxide will dissipate by reacting with trace gasses in the air, perturbing the concentration of ozone and other gasses. When carbon monoxide reacts with oxygen radicals, for example, it converts to carbon dioxide.
  • Hardier chemicals may be removed from the sky by wet deposition, whereby rain pulls pollution out of the atmosphere. But that requires precipitation. And if it rains, highly toxic run-off will pollute the watershed.
  • Other chemicals will simply fall from the sky and deposit onto plants, soil, and other solid surfaces. These compounds include benzene, polycyclic aromatic hydrocarbons, and dioxins. The chemicals that settle on cannabis or nearby water and soil can be absorbed by the plant and passed on to the consumer. Cannabis, a bioaccumulator, will uptake heavy metals from the soil that have deposited on the ground.

While these toxins can pose serious health hazards, it is important not to exaggerate harms. Cannabis smoke (even from untainted, organically grown cannabis) also contains carcinogens, but smoking marijuana does not increase the risk of oral and lung cancers—possibly because THC, CBD, and other plant cannabinoids exert a direct anti-tumor action against oral and lung cancer.

Another factor that may mitigate harm from inhaled cannabis smoke is the inhibition of a group of enzymes called CYP1A. Polycyclic aromatic hydrocarbons become more carcinogenic when metabolized by CYP1A enzymes in the body: By inhibiting CYP1A in the lungs, cannabinoids could reduce the activation of these carcinogens.

In cannabis smoke, roughly 0.5% of the plant material converts to polycyclic aromatic hydrocarbons. That is 5000 parts per million by weight (ppm). Carcinogenicity of aromatic hydrocarbons is usually discussed at concentrations on the order of 10 ppm.1 It remains to be seen if toxins deposited by the fires will be greater than the concentrations normally found in cannabis smoke. If not, then this cannabis is likely safe to consume (though it may require a warning under prop 65). To reduce further toxicity, it would be best for people to avoid smoking cannabis tainted by the wildfires: vaporization and ingestion are alternatives.

But consumers should also be aware that extraction processes (including butane, ethanol, and CO2) may concentrate these unwanted chemicals, though this is not precisely known. Cannabis producers and consumers should make sure, if possible, that any lab tests apply to the final product, not just the plant material that was used for extraction.

Accurate testing is paramount. Unfortunately, some cannabis labs have a record of providing results before they have validated their methods and can be certain that their numbers are correct. (Validation involves spiking precise amounts of contaminants into clean cannabis samples to ensure that accurate results are obtained.)

Several fire-generated toxins that may be deposited on cannabis crops—including benzene and toluene—are on the list of regulated solvents that California labs will likely have to quantify in cannabis products as of 2018. In preparation for the upcoming regulations, analytical labs may have already validated methods for detecting these compounds.

But other, less common toxins, such as benzopyrenes and polychlorinated dibenzo dioxins (PCDDs; sometimes simply called dioxins), are not included in the new regulations. Dioxins are particularly important: they are formed when chlorinated plastics burn, such as PVC pipes. One kind of dioxin, which is called TCDD, disrupts endocrine, immune, and reproductive systems as well as fetal development. It is also a carcinogen at larger concentrations. (TCDD was also a contaminant in Agent Orange, a chemical weapon created by Monsanto and used in the Vietnam war.)2

Whether mandated by state regulations or not, cannabis labs should also test for these compounds.3 Thus far, however, cannabis labs have not validated testing procedures for these compounds.

Another concern: helicopters and planes have been dumping tons of fire retardant in an effort to contain the fires. The fire retardant used, another Monsanto-designed product called Phos-Chek, may also have adverse health consequences. One of the main constituents of Phos-Chek is ammonium salt. Ammonium is a fertilizer: If absorbed through the plant, it is unlikely to be toxic, but smoking or vaporizing ammonium stuck on cannabis resin should be avoided.4

Project CBD hopes that some lab in California will validate methods and offer tests to detect the major contaminants that result from the wildfires. We expect these will include benzene, toluene, benzopyrenes, and heavy metals, as well as some dioxins and polychlorinated biphenyls.

Adrian Devitt-Lee, a Project CBD contributing writer, is a senior research associate with CannaCraft.

Footnotes:
  1. Parts per million is a unit that can cause some confusion. It can mean concentration by weight (ppmw) or by volume (ppmv). When discussing cannabis and lab tests, parts per million is measured in weight: ppmw means microgram of contaminant per gram of cannabis. (A microgram, written µg, is one millionth of a gram.) But when talking about safety data, especially for inhaled compounds, parts per million is usually micrograms of contaminant per liter of air. This makes it much easier to determine the concentration of contaminants in a person’s lung. Since an adult human’s lungs contain about 4-6 liters and a joint weighs about half a gram, ppmv is roughly 10 times larger than ppmw. In other words, the lab test for a contaminant should be no more than 10 times larger than the safety parameter for inhaling that contaminant. This is a rule of thumb, not a definitive statement. See the report in footnote 4 for more information on safety data.
  2. TCDD is pervasive in the environment. It can be found at low concentrations in milk and meat, with beef being the worst offender. This is partly because dioxins are extremely durable compounds—the half life of TCDD is close to 10 years. The average human body has roughly 1-5 parts per trillion dioxin in their fat tissue (that is, 1-5 picograms of dioxin per gram of fat). These levels have been declining greatly since the 1970s.
  3. This list is not finalized. The proposed regulations were repealed after the public comment period by the trailer bill, the bill that merged recreation and medical cannabis regulations. The new regulations have not yet been released.
  4. Inhaling ammonia in cannabis at concentrations below 100 ppm is likely safe. 100 ppm means 100 µg ammonia per g cannabis product. The number is based on the equation described Appendix A of this report by Project CBD. Using the terminology from that document, the STEL for ammonia is 27 µg/L. It is reasonable to assume that children use less than 0.25 grams of cannabis and that adults use less than 1 gram of cannabis in a 15 minute period. This increases the estimates in the document by a factor of four.
Sources

 

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Amid Controversy Over Anthem Protests, NFL Endorses Drug Sentencing Reform

Wed, 10/18/2017 - 00:03
Click here for reuse options! Will the move appease the players and get Trump off the league's case?

Caught between players who insist on exercising their right to call out racial injustice in a manner of their choice, and a scapegoating president who demands the league stifle what he deems unpatriotic protest, the National Football League has reacted in a surprising and progressive way: In a Monday letter to leading senators, the NFL endorsed a federal sentencing bill aimed at reducing the number of drug offenders.

The bipartisan Sentencing Reform and Corrections Act of 2017 (S. 1917) was rolled out earlier this month by such Senate heavy hitters as Judiciary Committee Chair Chuck Grassley (R-IA), ranking Democratic member Dianne Feinstein (D-CA), minority whip Dick Durbin (D-IL), Lindsey Graham (R-SC), and Patrick Leahy (D-VT), among others.

"We are writing to offer the National Football League's full support for the Sentencing Reform and Corrections Act of 2017 (S. 1917)," said Commissioner Roger Goodell and Seattle Seahawks owner Doug Baldwin, Jr. in the letter. "We want to add our voice to the broad and bipartisan coalition of business leaders, law enforcement officials, veterans groups, civil rights organizations, conservative thought leaders, and faith-based organizations that have been working for five years to enact the changes called for in this comprehensive legislation."

The subject of years of negotiation in the Senate, the bill would reduce mandatory minimum sentences for some drug offenders, give judges greater discretion to sentence below federal sentencing guidelines, reform sentencing enhancements around weapons possession (to allow departures from mandatory minimums if the weapon wasn't used or brandished), make Fair Sentencing Act of 2012 reforms retroactive, and create programs to reduce recidivism.

As compromise legislation, the bill isn't all reform. It also includes provisions creating new mandatory minimum sentences—for interstate domestic violence and providing weapons to terrorists—and harshly punishing the sale of heroin cut with fentanyl. Still, overall, the bill would be a big step toward reducing the federal prison population overall and the federal drug prisoner population in particular.

More than two-thirds of NFL players are black. Just like the rest of us, they understand that pro football isn't the only place blacks are overrepresented: As the numbingly familiar refrain goes, African Americans make up only 13% of the population and use drugs at roughly the same rate as other groups, yet they constitute 40% of all prisoners and a whopping 72% of federal drug prisoners.

Racial justice issues have been bubbling up in the NFL since former San Francisco 49ers quarterback Colin Kaepernick took a knee during the national anthem last season, to protest racial injustice and police killings of black men. The issue reached a fever pitch when President Trump used the widespread anthem protests to throw red meat to his base this season. The NFL has been desperately searching for a way to get over the anthem controversy and back to the business of pro football. Endorsing federal sentencing reform could be a way to do that, but it leaves the league trying to appease players on one hand, while giving props to the cops on the other.

"Football and community are the twin pillars of the NFL," Goodell and Baldwin said. "Over the last two seasons, one particular issue that has come to the forefront for our players and our teams is the issue of justice for all."

For the NFL, they wrote, the challenge is to ensure "that every American has equal rights and equal protection under the law, while simultaneously ensuring that all law enforcement personnel have the proper resources, tools, and training and are treated with honor and respect."

For the team owners, however, the challenge is whether this move will quell the controversy, get the players back to concentrating on football and get President Trump back to concentrating on something—anything!—other than the NFL. 

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Trump Drug Czar Nominee Withdraws After Damning Report He Blocked DEA Action Against Big Pharma Pill Sellers

Tue, 10/17/2017 - 10:25
Tom, we hardly knew ye.

Rep. Tom Marino (R-PA), who was President Donald Trump’s choice to serve as his administration’s drug czar, has withdrawn his name from consideration after a damning 60 Minutes report about his role in weakening the Drug Enforcement Administration’s oversight of opioids in the United States.

“Rep. Tom Marino has informed me that he is withdrawing his name from consideration as drug czar,” Trump wrote on Twitter Tuesday morning. “Tom is a fine man and a great Congressman!”Twitter Ads info and privacy60 Minutes report from this past weekend revealed that Marino and Rep. Marsha Blackburn (R-TN) introduced a bill that weakened the FDA’s ability to restrict pharmaceutical companies’ distribution of prescription opioids.

Although the bill was originally promoted as “a way to ensure that patients had access to the pain medication they needed,” the investigation found that “what the bill really did was strip the agency of its ability to immediately freeze suspicious shipments of prescription narcotics to keep drugs off U.S. streets.”

Trump said on Monday that he would reexamine Marino’s nomination in the wake of the report.

 

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How Marijuana Can Help Opioid Addictions

Mon, 10/16/2017 - 13:03
"We are really excited about the potential," one researcher says.

Feeling a bit anxious and stressed these days? Read this. Researchers in Canada and the U.S. have found more evidence that marijuana can likely benefit people suffering from opioid addiction, depression, social anxiety and PTSD

“This is a substance that has potential use for mental health,” according to Zach Walsh, an associate professor of psychology at the University of British Columbia. “We should be looking at it in the same way [as other drugs] and be holding it up to the same standard.” 

The study also provides hope that marijuana may also be a benefit for those battling substance abuse.

“Research suggests that people may be using cannabis as an exit drug to reduce the use of substances that are potentially more harmful, such as opioid pain medication,” Walsh, the study’s lead investigator.

“We are really excited about the potential substitution effect,” Walsh, said. “If people use cannabis as a replacement for opioid medications, or to get off of opioids or cut back, we could see some pretty dramatic public health benefits. The level of opioid overdoses is so high right now.”

This is not the first report to suggest this.  A RAND study last year found that states with medical marijuana have lower rates of opioid overdose and abuse. Another study this year in Health Affairs found that medical professionals are less prone to prescribe prescription opioids in states that allow marijuana.

The research is unclear as to why this is happening. Some researchers theorize that cannabis acts as a replacement for opioid painkillers. And other medical professionals believe marijuana magnifies the effects of opioids, leading users to take lower doses for the same level of relief.

According to Neuroscience News, Walsh and his team systematically reviewed all studies of medical cannabis and mental health, as well as reviews on non-medical cannabis use – making the review one of the most comprehensive reports to date on the effects of medical cannabis on mental health.

“In reviewing the limited evidence on medical cannabis, it appears that patients and others who have advocated for cannabis as a tool for harm reduction and mental health have some valid points,” Walsh said.

 

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‘Dead Serious’ Pennsylvania GOP Mayoral Candidate Determined to Enact ‘Narco Bunnies’ Plan to Sniff Out Drugs

Mon, 10/16/2017 - 12:48
You can't make this stuff up.

While many police departments employ K-9 units that are used to sniff out explosives and drugs, one Republican mayoral candidate wants to see bunnies do the work.

It all began when the Amherst, New York police proposed drug-sniffing bunnies as part of an April Fool’s joke on their Facebook, The Philadelphia Inquirer reported. During a Phoenixville, Pennsylvania mayoral forum, GOP nominee Dave Gautreau actually proposed that if he was elected to the Mayor’s office he would find drug-sniffing bunnies for the police department.

Despite snickers, he wasn’t kidding and doubled down.

“I was dead serious,” he said. “I would not make a joke about a rabbit if I did not believe it to be true.”

Voters aren’t sure what to think of the proposal, so they hopped on the internet to sniff around for some examples. That’s when they found the joke the local fuzz in Amherst posted for April Fool's Day. The narco-rabbit even earned a fake article on a satire page called People of Lancaster.

Gautreau’s campaign slogan is “Vote for Goat” and has a website that features a cartoon goat. His candidacy was conceived during a party with friends last year. He said that he would also like the borough to have K-9 officers as well to help the drug problem, but suspected the expenses would be larger. Bunnies, by contrast, are much more cost-effective, a friend told him at the party. The friend went on to cite the Lancaster bunny, but neglected to mention it was a joke.

Gautreau swears that he called the Lancaster police department or the city offices—he couldn’t remember. The woman he spoke to, whose name he also doesn’t recall, told him that Lancaster did use the narco-sniffing bunnies as part of their team to fight the drug war.

The woman “sounded convincing,” he told The Inquirer. “I should have Googled it then, but I didn’t.”

The Lancaster City Bureau of Police doubts anyone confirmed the narco-sniffing bunnies.

“I can assure you we do not use any type of rabbits in our law enforcement activities, nor do we have plans to,” Lt. Bill Hickey said.

Voters are mocking Gautreau for the policy since the proposal.

 

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Trump's Drug Czar Is Protecting Big Pharma's Opioid Epidemic

Mon, 10/16/2017 - 11:43
Click here for reuse options! Tom Marino wants to jail pot smokers, yet has a soft spot for the nation's biggest drug pushers.

Update: Tom Marino has since withdrawn from consideration for drug czar following the Washington Post/60 Minutes report. 

President Trump's nominee to head the White House Office of National Drug Control Policy (ONDCP, the drug czar's office) appears more concerned with helping Big Pharma sell tons of opioid pain pills than helping the DEA battle the crisis that saw more than 60,000 Americans die of drug overdoses last year.

That's according to a major investigative report from the Washington Post and CBS News' 60 Minutes Sunday. The report identified Trump's pick, Pennsylvania Republican Rep. Tom Marino, as the primary architect of a bill passed last year that made it harder for DEA agents to go after opioid pain pill manufacturers who in recent years have dumped unprecedented amounts of the addictive drugs on the market.

The bill, the Ensuring Patient Access and Effective Drug Enforcement Act, made it more difficult for the DEA to immediately stop shipments of opioids to or from companies suspected of dealing excessive amounts of the powerful pain-relieving medications. Marino championed it at the behest of a pharmaceutical industry-funded group, the Healthcare Distribution Management Association, which argued that the DEA was too heavy-handed in going after pharmacy and drug companies over what it described as minor paperwork errors.

According to the report, companies including CVS, Rite Aid and McKesson spent more than $100 million pushing the bill. It passed a complacent and compliant Congress last year only after Marino spent years trying to get it through.

"The drug industry, the manufacturers, wholesalers, distributors and chain drugstores, have an influence over Congress that has never been seen before," former DEA official Joseph Rannazzisi told the Washington Post. "I mean, to get Congress to pass a bill to protect their interests in the height of an opioid epidemic just shows me how much influence they have."

Marino and the industry portrayed the bill as a means of protecting legitimate patient access to the drugs—what happens to chronic pain patients in the midst of a crackdown on opioid prescribing is a real issue—but DEA chief administrative law judge John Mulrooney disagreed.

"At a time when, by all accounts, opioid abuse, addiction and deaths were increasing markedly" the new law "imposed a dramatic diminution of the agency’s authority," he wrote in a draft article the Marquette Law Review editorial board provided to the Washington Post.

Marino, who Trump nominated last month for the drug czar post, is on record supporting the increased criminalization of drug use, which would run counter to efforts to treat it as a public health issue, as well as opposing both medical marijuana and marijuana legalization. But he's got a soft spot for the nation's biggest drug pushers—and that could jeopardize his nomination.

"This is a very serious question," said Senate Minority Leader Charles Schumer (D-NY)). "I’m going to meet with Mr. Marino. And I hope to ask him about this because it’s very troubling," he told the New York Daily News.

West Virginia Sen. Joe Manchin (D), whose state has been the epicenter of the opioid crisis, said Monday he didn't need to meet with Marino. Instead, Manchin called on the White House to pull Marino's nomination. He was "horrified" by the report, he told the Washington Post, adding that "there's no way that in having the title of drug czar you'll be taken seriously or effectively by anyone in West Virginia and the communities that have been affected by this knowing that you were involved in something that had this type of effect."

On Monday, Trump acknowledged the report in response to questions from reporters. "He was a very early supporter of mine from the great state of Pennsylvania. He’s a great guy, I did see the report, we're going to look into the report," he said when asked whether he still supports Marino as drug czar.

If Trump doesn't withdraw the nomination, Marino is guaranteed to face a rocky confirmation fight in the Senate—a man who wants to jail pot smokers, but paves the way for Big Pharma to earn billions from addictive prescription drugs deserves some tough scrutiny on the Hill. 

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The VA Fueled the National Opioid Crisis, Killing Vets

Fri, 10/13/2017 - 14:47
Veterans have been needlessly suffering for years, and it's only getting worse under the Trump administration.

Close Late one summer night in 2014, Kevin Keller broke into his best friend’s home. Keller was a U.S. Navy vet wracked with constant pain, and because his right arm had been crippled by a stroke, he had to use his left hand to scrawl a note of apology to his buddy: “Marty, Sorry I broke…

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Big Pharma Plays Every Dirty Trick in the Book to Transform Teens and Adults Into Opioid-Zombified Addicts

Thu, 10/12/2017 - 06:14
Click here for reuse options! The U.S. prescription drug industry has opened a new frontier in public havoc, creating a national emergency that claims 90 lives per day.

This article originally appeared on the blog of the Institute for New Economic Thinking.

Over a 40-year career, Philadelphia attorney Daniel Berger has obtained millions in settlements for investors and consumers hurt by a rogues’ gallery of corporate wrongdoers from Exxon to R.J. Reynolds Tobacco. But when it comes to what America’s prescription drug makers have done to drive one of the ghastliest addiction crises in the country’s history, he confesses amazement.

“I used to think that there was nothing more reprehensible than what the tobacco industry did in suppressing what it knew about the adverse effects of an addictive and dangerous product,” says Berger. “But I was wrong. The drug makers are worse than Big Tobacco.”

The U.S. prescription drug industry has opened a new frontier in public havoc, manipulating markets and deceptively marketing opioid drugs that are known to addict and even kill. It’s a national emergency that claims 90 lives per day. Berger lays much of the blame at the feet of companies that have played every dirty trick imaginable to convince doctors to overprescribe medication that can transform both teens and adults into zombified junkies.

So how have they gotten away with it?

A Market for Lies

The prescription drug industry is a strange beast, born of perverse thinking about markets and economics, explains Berger. In a normal market, you shop around to find the best price and quality on something you want or need—a toaster, a new car. Businesses then compete to supply what you’re looking for. You’ve got choices: If the price is too high, you refuse to buy, or you wait until the market offers something better. It’s the supposed beauty of supply and demand.

But the prescription drug “market” operates nothing like that. Drug makers game the patent and regulatory systems to create monopolies over every single one of their products. Berger explains that when drug makers get patent approval for brand-name drugs, the patents create market exclusivity for those drugs, which protects them from competition from other brand drugs that treat the same condition as well as from generics. The manufacturers can now exploit their monopoly positions created by the patents by marketing their drugs for conditions for which they never got regulatory approval —and this dramatically increases sales. They can also charge very high prices because when you’re in pain or dying, you’ll pay virtually anything.

Using all these tricks, opioid manufacturers have been able to exploit the public and have created a whole new generation of desperate addicts. They monopolize their products and then, as Berger puts it, “market the hell out of them for unapproved and dangerous uses.”

Opioids are a drug class that includes opium derivatives like heroin (introduced by German drug maker Bayer in 1898), synthetics like fentanyl, and prescription painkillers like oxycodone (brand name: OxyContin). A number of factors are aggravating the addiction crisis: There has been a movement in medicine to treat pain more aggressively, while at the same time wide-ranging economic distress has generated a desire to escape a dismal reality. But a key driving force is doctors who have been wooed by Pharma marketing reps overprescribing for chronic pain.

“For the first time since the years after heroin was invented,” writes investigative journalist Sam Quinones in Dreamland: The True Tale of America's Opiate Epidemic, “the root of the scourge was not some street gang or drug mafia but doctors and drug companies.”

Doctors were once reluctant to write prescriptions for opioids. The U.S. drug regulator, the Food and Drug Administration, would only approve such drugs for severe cases like cancer patients in chronic agony or certain people in short-term pain after, say, an operation. But representatives of Connecticut-based drug maker Purdue, which released OxyContin in 1996, along with other companies, began to flood doctors’ offices with reports asserting that using the drug for off-label purposes was harmless. Often the targets were primary care physicians with little training in addiction. Have a chronic arthritis case? Give your patient OxyContin. Tell folks to take it every day, for weeks, even years, to treat just about any kind of chronic pain. The upshot was dependence, typically not because people were getting high for fun, but because they were using a legal drug in precisely the way the doctor ordered.

Purdue and others whisked doctors to stylish retreats to push them to prescribe drugs for uses not approved by U.S. regulators—a marketing strategy banned by federal law. They even created fake grassroots organizations to make it seem as though patients were demanding more prescriptions. Pharmaceutical companies like to dodge responsibility for the opioid crisis by blaming dishonest distributors and pointing out that they’re not the ones prescribing or handing out drugs to patients. True enough: They don’t need to, because they’ve done their work hooking you long before the drug is in your hands.

“The marketing is not only fraudulent; it’s incredibly elaborate,” says Berger. “Fake scientific studies promote the lie that opioids are better than other medications for pain. They’ve gone to just about any length. Bribery, you name it. It’s outrageous.”

OxyContin is so addictive it can create physical dependency in a matter of weeks. As drug makers and doctors who began to dole out pills by the handful in pain clinics learned, addicts do not behave like ordinary consumers: They don’t “choose” to buy or to wait until next week. They need their drug right away and will do anything to get it because if they don’t they will suffer excruciating symptoms.

A Los Angeles Times report shows that among the lies Purdue spread about OxyContin was that one pill subdued pain for 12 hours. Except that for many patients it wears off much sooner, exposing them to unbearable pain and withdrawal. Purdue knew this, but feared lower sales if it admitted the truth. So sales reps advised doctors to just give stronger doses, which increased the addiction risk. As the money from hooked patients piled up, so did the bodies.

In 2007, Purdue pleaded guilty in federal court in Virginia to misleading doctors and patients about OxyContin’s safety and paid a $600 million fine. But that sum was hardly an annoyance. From 1995 to 2015, Purdue made $35 billion from OxyContin sales alone. The Sacklers, who own the company, is now one of the richest families in America, as revealed by this triumphant Forbes spread. They know that lax regulation keeps the heat off, and that even litigation and criminal prosecutions can do little to stop them. Berger says that until such legal programs are massive in scale and scope, companies will go on with business as usual.

“We have to have injunctive relief [a court order to stop a behavior] that bans the marketing to doctors of opioids completely for unapproved uses, as well as an expansion of the FDA and DEA to specifically target the drugs,” says Berger. His law firm, Berger & Montague, is involved in the effort to seek relief for the city of Philadelphia, which has seen above-average opioid prescribing and suffered the highest rates of fatal drug overdoses in the state last year.

Even though prescriptions have been slightly reduced across the country since 2012, Philadelphia is finding out what happens to many people hooked on opioids when they can’t get a prescription or find the price too high: They turn to heroin. Fatal overdoses of heroin, oxycodone’s close cousin, have been skyrocketing since 2007 across the country.

'Landscapes of Despair'

The opium poppy has been part of human history since at least 3,400 BCE, when it was cultivated in Mesopotamia as the “joy plant.” Derivatives such as laudanum and morphine offered more convenient, and people wrongly believed, safer ways to get the plant’s benefits. Bayer originally touted heroin as a non-addictive substitute for morphine (even for children) until it was outlawed in the U.S. in 1925. Rendering it illegal did not stop it from destroying the lives of many of America’s most celebrated artists, from Billie Holiday to Philip Seymour Hoffman. Drug overdoses now kill more people than gun homicides and car crashes combined. In 2015, nearly two-thirds of all overdoses had one thing in common: opioids. 

Syracuse University’s Shannon Monnat, a sociologist focused on rural issues and an INET grantee, has been studying the epidemic and how it impacts various populations. Her research reveals that the rise in drug-induced deaths has been especially sharp among middle-aged people (45-55), with prescription opioid overdoses increasingly impacting both middle-aged and older populations. Heroin, whose sedating and euphoric effects are very similar to prescription narcotics, looks to be the culprit in more young adult overdoses.

Monnat considers how the opioid crisis points to bigger societal problems impacting the economy, educational institutions, the health care system, political systems, and communities. Her work centers on investigating the characteristics of what she calls “landscapes of despair”—places where people are hurting economically and socially, like Appalachia, the industrial Midwest and parts of New England. She points out that persistent disadvantage and long-term poverty are clearly connected to the opioid crisis, noting that many of the areas most impacted were once robust centers of manufacturing before jobs moved to other countries.

Opioid addiction seems to thrive in downwardly mobile small cities in rural areas—but not all of them. “What’s fascinating is that some of these areas have very high mortality rates from drug overdose, like Appalachia,” say Monnat. “But others, like the Southern 'Black Belt' [a region that stretches across Alabama and Mississippi], have not seen such rises.”

Originally named for its rich, dark, soil, which attracted cotton planters in the 19th century, the Black Belt has a high population of African Americans. The area has a history of unremitting poverty, low incomes, high unemployment, and high mortality. Yet despite many hardships, which are linked to the legacy of slavery, Monnat says that the region is also distinct for its “very tight-knit communities, strong kinship networks, and other networks where people can find emotional support.” It seems that when people have somewhere to turn in hard times, they may build up immunity to an epidemic like the opioid scourge.

Ironically, another factor that may have protected these communities, discussed by Quinones in Dreamland, is prejudice: The low-profile heroin dealers originating from Mexico’s west coast who are associated with the current opioid scourge prefer to target white communities. They also avoid big cities where large cartels are already established. So small, predominately white towns are their sweet spot.

Appalachia is known for kinship networks, but it also has a legacy of isolation and an outlaw tradition associated with the history of moonshining and bootlegging which can feed into today’s underground selling and distribution of opioid drugs. In this region, much of the struggling white working-class has seen economic distress with little hope of relief from America’s political system. Democrats often openly disdain the people they call rednecks and hillbillies, while concentrating on identity politics rather than economic distress. Republicans promote policies of free trade and deregulation that cast the region further into destitution.

Monnat has found that counties with large numbers of people employed in physical labor—especially physical occupations with higher disability rates—have higher drug fatalities. These are places where coal miners work in backbreaking positions and military veterans suffer the pain of injuries. Drug companies have besieged these areas with aggressive marketing of pain pills. “In Appalachia, you’d see mining companies with physicians on staff prescribing opioids to keep people in pain working,” she says. “That was happening before OxyContin, but companies like Purdue targeted these communities to push OxyContin as a safer alternative to other pain medications.”

The National Institutes of Health report that the opioid epidemic, which started as a regional crisis, is now a national crisis, decimating communities and even helping to reshape the American political landscape. Monnat finds a relationship between the landscapes of despair and the 2016 presidential election. Voting patterns show that areas in which President Trump did better than expected, like Pennsylvania and Ohio, were also places where opioid overdoses and deaths from alcohol and suicide occurred at high rates over the past decade.

During his campaign, Trump expressed concern for people in regions like Appalachia and flung stinging barbs at the politicians who had failed them. These voters supported him in high numbers, yet his policies will likely give more power to the pharmaceutical companies that have turned their suffering into stock windfalls.

Profit Trumps People

Trump the campaigner shook his fist at Big Pharma for “getting away with murder”—one of those statements that occasionally drops from his lips with atomic accuracy. But Trump the president has done an about-face. As journalist David Dayen pointed out, a draft of an executive order on drug prices (which never materialized) called for deregulation of the FDA and favors to industry. It was written by a pharmaceutical lobbyist.

In March, President Trump issued an executive order creating a commission to study drug addiction and the opioid epidemic. The commission, headed by New Jersey Governor Chris Christie, has so far released recommendations that locate the overprescribing problem “in doctor’s offices and hospitals in every state in our nation,” while making nary a mention of pharmaceutical marketing departments. The panel suggests insufficient remedies like new treatment facilities and educating schoolchildren on the dangers of opioids, along with ineffective ideas like more funds to Homeland Security. Regulation of Big Pharma? Nope.

The federal government did announce it would team up with drug makers to research and generate non-opioid pain medications and additional medication-assisted treatment options. Among the participants? Purdue.

Economist William Lazonick of the University of Massachusetts Lowell and an INET grantee, agrees with Berger that the way the pharmaceutical industry operates amounts to a catastrophe for the public. “It’s crazy that each and every drug is not treated like a regulated monopoly,” he says. “Taxpayers fund much of the research that goes into creating these drugs through the NIH and other public research facilities. Moreover, the companies are gifted with a monopoly through patents which last two decades.”

Lazonick notes that Big Pharma claims it needs high profits to keep inventing new drugs, but the industry spends more of its profits buying back its own stock than increasing investment in R&D on new drugs. Executives running drug companies are incentivized to make profits any way they can because they are rewarded by high stock prices. Lazonick explains that they stoke those stock prices by gouging patients or lying about the safety of products—whatever it takes.

He observes that for the past several decades America has undergone a devastating experiment based on the philosophy of economist Milton Friedman, who claimed that the only social responsibility of a company is to make a profit. Untimely deaths from tobacco-related illnesses, auto safety failures, and now, harmful opioid drugs, prove that the experiment is a tragic failure.

Lazonick sees the need for nothing less than a new structure of corporate governance that ensures the ethical responsibly of drug makers to do what they are supposed to do: create high-quality, low-cost products that are safe. The current structure, based on the misguided idea that companies should be run for the sole purpose of enriching shareholders, is particularly perverse when it comes to products that are potentially fatal. The problem with this model is that when shareholders are the only people who matter, the rest of us suffer.

Since taxpayers support pharmaceutical companies by funding public research and many other things they require to do business, Lazonick says it is only fair and logical that someone representing the public sits on their boards. Berger adds that companies should be required to make drugs widely available at affordable prices in return for their use of publicly funded basic research at no cost whatsoever.

America, for the time being, stands out among nations in letting pharmaceutical companies run amok to inflate drug prices, advertise and market drugs without proper regulation, and use taxpayer resources while exposing them to egregious harm. “The only thing America’s drug companies are competitive about,” says Lazonick, “is getting people addicted.”

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