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Watch: Neil DeGrasse Tyson Thinks Marijuana Should Be Legal

Fri, 08/11/2017 - 20:47
Click here for reuse options! While the astrophysicist prefers reality to altered states, he doesn't believe pot should be illegal.

Neil deGrasse Tyson, the beloved astrophysicist, showed up on StarTalk's inaugural Facebook Live show to promote his book Astrophysics for People in a Hurry, but wound up discussing the legalization of marijuana.

Tom Angell, from a pro-legalization group called Marijuana Majority, asked Tyson if he agreed with the late Carl Sagan, who believed marijuana should be legal.

Tyson responded, "If you really analyze it, relative to other things that are legal, there’s no reason for it to ever have been made illegal in the system of laws."

He elaborated that alcohol is legal and a more dangerous substance than marijuana.

While pro-legalization, Tyson is not a fan of altered states on a personal level. In a 2015 Reddit AMA, Tyson wrote, “I don’t count myself among active recreational drug users. For me, the least altered state of awareness I can achieve is the one I seek, because that one is most likely to be closest to reality.”

For those who'd like to spend an hour listening to Tyson answer questions with his signature charm, the full video is embedded below.

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Opioids: An Important Treatment That Can Be Used Responsibly

Fri, 08/11/2017 - 13:20
Click here for reuse options! Don't throw the baby out with the bath water.

So it’s official. The opioid crisis is a national emergency.

The grim statistics support that conclusion. About 52,000 Americans died of a drug overdose in 2015, or a rate of 142 each day. The numbers for 2016 will almost surely be higher once the final figures are calculated.

I’m pleased that the president declared a national emergency. Although in his brief remarks yesterday he did not commit his administration to any specific policies, his declaration suggests he will support efforts to make treatment for drug addiction more widely available. This is absolutely necessary. We also need to ensure persons with mental health issues receive appropriate care. As the president’s Commission on Combatting Drug Addiction and the Opioid Crisis found, approximately 40 percent of those with a substance abuse disorder have a significant mental health problem. For these individuals, their addiction, although serious in itself, is likely a symptom of a grave underlying problem.

I’m less pleased with legislation that has now been adopted by 17 states—and may be adopted by the federal government—which places significant restrictions on a physician’s ability to prescribe opioid painkillers based on the physician’s individualized assessment of the patient’s needs. The regulations vary from state-to-state, but the trend appears to be increasingly tighter restrictions. Kentucky recently adopted a law limiting opioid prescriptions for acute pain to three days.

There’s no question that the overprescribing of opioids by ‘pill mills’—typically self-described pain clinics—was a major contributing cause of the rise in opioid addiction in the 1990s and early 2000s. How many individuals innocently became addicted because they were misinformed about the risk of addiction as opposed to those who became addicted because they consciously sought a relatively cheap high is not known and is perhaps unknowable and is, in any event immaterial, as whatever the patients’ motivation, the prescribing physicians acted unethically and, perhaps, illegally. But the fact that opioid painkillers can be, and have been, improperly prescribed should not cause us to lose sight of the fact that opioid painkillers serve a legitimate medical purpose.

Yes, many Americans have become addicted to opioids, and some of those first became addicted as a result of prescribed medication. However, many, many more Americans have used prescribed opioids responsibly. They have not become addicted. Instead, they have benefitted tremendously from the relief that opioid painkillers can provide. I know because I am one of them.

Without getting into too much personal information, I was diagnosed with psoriatic arthritis in 2010. At one point, my condition was so severe that I could hardly walk. After various therapies failed (please: I never want to hear the word “holistic” again), I was prescribed celecoxib (brand name: Celebrex). This drug was almost immediately effective. Unfortunately, over time, it began to have serious side effects. To help me deal with the pain while reducing my use of celecoxib, my physician prescribed the opioid hydrocodone. Through the judicious use of hydrocodone over the last few years—on average, about three 5 mg pills a week—I have managed to wean off celecoxib and still manage my arthritis. I have no craving to move on to stronger drugs, nor at any time have I sought to increase the number of pills prescribed.

Tens of millions of others have also managed their pain through opioids—allowing them to carry on productive lives that otherwise might not have been possible—without becoming addicts. The opioid crisis should not obscure the fact that those who become addicted as a result of using painkillers remain the exception, not the rule.

Each patient is different, of course, but that’s precisely why the recently enacted laws mandating what physicians can prescribe constitute an improper interference with the practice of medicine and the physician-patient relationship. Physicians, not politicians, should determine a patient’s treatment.

Sometimes we must sacrifice personal benefit and personal freedom for the greater good. That’s understandable. But this public policy principle does not justify imposing onerous restrictions on the use of opioids for the treatment of pain. Doing so would penalize those who use these drugs responsibly because some abuse these drugs. Such a policy has no precedent in the modern practice of medicine.

The Morning EmailWake up to the day's most important news.  

Without getting into too much personal information, I was diagnosed with psoriatic arthritis in 2010. At one point, my condition was so severe that I could hardly walk. After various therapies failed (please: I never want to hear the word “holistic” again), I was prescribed celecoxib (brand name: Celebrex). This drug was almost immediately effective. Unfortunately, over time, it began to have serious side effects. To help me deal with the pain while reducing my use of celecoxib, my physician prescribed the opioid hydrocodone. Through the judicious use of hydrocodone over the last few years—on average, about three 5 mg pills a week—I have managed to wean off celecoxib and still manage my arthritis. I have no craving to move on to stronger drugs, nor at any time have I sought to increase the number of pills prescribed.

Tens of millions of others have also managed their pain through opioids—allowing them to carry on productive lives that otherwise might not have been possible—without becoming addicts. The opioid crisis should not obscure the fact that those who become addicted as a result of using painkillers remain the exception, not the rule.

Each patient is different, of course, but that’s precisely why the recently enacted laws mandating what physicians can prescribe constitute an improper interference with the practice of medicine and the physician-patient relationship. Physicians, not politicians, should determine a patient’s treatment.

Sometimes we must sacrifice personal benefit and personal freedom for the greater good. That’s understandable. But this public policy principle does not justify imposing onerous restrictions on the use of opioids for the treatment of pain. Doing so would penalize those who use these drugs responsibly because some abuse these drugs. Such a policy has no precedent in the modern practice of medicine.

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Serious About Opioid Crisis? Then Don’t Slash Medicaid

Fri, 08/11/2017 - 10:11
Republicans are still considering making dramatic cuts in the program that would severely handicap efforts to overcome the opioid epidemic.

 

 

Serious About Opioid Crisis? Then Don’t Slash Medicaid

The opioid epidemic is a major public health crisis, devastating communities across the country. Opioids cause serious harm to the body and can lead to deadly overdoses. They also put people at risk of contracting viruses such as HIV and Hepatitis C, which cause chronic and potentially life-threatening illness and result in millions of dollars in…

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Just Say Know to Drugs: Festival and Club Pill Testing Can Make Partying Safer

Fri, 08/11/2017 - 10:01
Pill testing is increasingly becoming part of U.K. festivals and clubs. The U.S. may want to pay attention.

For the first time, people going to BoomTown this weekend will be able to find out what’s in the drugs they plan to take, by getting them tested by non-profit organisation The Loop. Front of house drugs safety testing, or Multi Agency Safety Testing (MAST), was first offered by The Loop at Secret Garden Party and Kendal Calling in 2016. This was such a success that they have been invited to provide their service at a number of festivals this year, BoomTown being the next on the calendar.

A growing number of festivals are now openly discussing a new approach to drugs, based on information and harm reduction rather than criminal justice. This shift in attitudes is coming at a very welcome time. Recent developments in the European drug market have seen an unprecedented rise in the strength of ecstasy tablets, with a number of recent reports of adverse health effects, including emergency medical treatment and fatalities, attributed to MDMA toxicity. Indeed, Office for National Statistics figures show an eightfold increase in deaths related to ecstasy in five years, rising to 63 in 2016 from an all-time low of 8 in 2010.

Without specialist drug testing services it is very difficult for drug users to know what they are taking, particularly with regard to potency and purity. Essentially, they have to rely on word of mouth and potentially inaccurate reports based on indicators such as colours or logos on tablets. These methods are unreliable and potentially life threatening. As high quality pills with a distinctive logo and colour develop a good reputation among users, other manufacturers will copy these designs to increase their profits, while changing the contents of the pill. Given that festivals and drug use go hand in hand for a number of people, services such as The Loop that offer drugs safety testing without the fear of criminal sanction would appear vital to avoid health related problems.

The importance of The Loop’s service has already been demonstrated this year, with their detection of the stimulant N-ethyl-pentylone – being missold as MDMA – which was reportedly causing medical incidents at Kendal Calling. The Loop was able to issue an alert with a description of the blue “Anonymous” pill, and this was circulated on social media by the festival and other on-site agencies so as to warn other potential users of their findings. This new approach replaces the traditional message of ‘just say no to drugs’, with timely, relevant and evidence-based advice: just say ‘know’.

The question is, therefore, do services like The Loop actually change behaviour and reduce harm? There is surprisingly little research, despite drugs safety testing being a mainstay in some European countries, such as the Netherlands, for years. A study examining whether such services do actually result in changes in behaviour was published earlier this year. Analysing data collected at music events in the USA by drugs testing company, DanceSafe, the authors found that people whose samples contained something other than MDMA were far less likely to report that they intended to use the drug as those whose samples were positive for MDMA. In other words, being told that the samples contained something unexpected resulted in people saying they would be less likely to take that drug. However, the method used by DanceSafe to test for the presence of MDMA – colorimetric reagent kits – can say only whether MDMA is likely to be present or not, and cannot determine the strength of the pills. The Loop, meanwhile, offers much more comprehensive testing, including infrared and ultraviolet spectroscopy, all conducted by PhD level chemists.

The Loop itself is also evaluating whether its services actually change people’s behaviour towards safer drug use practices, as part of an ongoing research project with Durham University. Their preliminary results are looking promising: last year one in five people handed over drugs to be disposed of after receiving their test results and the harm reduction advice they received. Moreover, this year at Kendal Calling, four in 10 reported that they now intended to use a lower dose after using the service. This is a particularly important outcome, given that the increasing rate of ecstasy-related deaths in the UK has been attributed to high strength pills leading to overdose.

Of course, drugs safety testing is not without limitations. For instance, just because the tested sample doesn’t appear to contain any harmful adulterants, there is no guarantee that all the pills in your pocket are definitely ‘clean’- pill content and strength can vary even in the same batch. Additionally no drug is completely safe, and knowing what’s in your drugs doesn’t mean you won’t experience problems. For these reasons The Loop’s test results are reported back within a structured harm reduction session – delivered by clinically experienced substance misuse practitioners – during which they draw attention to these limitations. Future research should also focus on how test results are interpreted by festivalgoers, and whether people take on board these cautions.

Initial reports from The Loop about the effectiveness of their service, along with the study from the USA are encouraging, but further quantitative research is required in the UK and Europe to conclusively say that this approach works. The Loop will continue to collate and analyse quantitative data to aid that evaluation.

At UCL we are currently running a study into the nightlife scene in partnership with a number of institutions in Europe, including the Trimbos Institute, which pioneered the use of drug testing facilities as a harm reduction tool in the Netherlands – indeed, The Loop hopes to compare their findings with the Trimbos testing database. Our study includes an online survey that is currently live, and we will follow up respondents next year using another survey. Harm reduction, including the use of testing services, forms a major component of our survey and we believe it is crucial to compare how people in the UK and elsewhere in Europe respond to these initiatives. For this reason we’d like as many people who attend festivals or who go clubbing anywhere across the UK, to complete the survey. Head to our website now if you would like to take part.

 

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Doctor's Murder Over an Opioid Prescription Leaves Indiana City With No Easy Answers

Thu, 08/10/2017 - 10:48
The killing opens a new perspective on an intractable problem.

 

 

A doctor's murder over an opioid prescription leaves an Indiana city with no easy answers

MISHAWAKA, Ind. - Dr. Todd Graham wasn't yet halfway through his workday at South Bend Orthopaedics when a new patient came into his office here complaining of chronic pain. Heeding the many warnings of health officials, he told her opioids weren't the appropriate treatment. But she was accompanied by her husband, who insisted on a prescription.…

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New Research Suggests That Medical Marijuana Can Treat Herpes

Thu, 08/10/2017 - 10:14
Cannabis oil and topicals have been known to produce impressive results on skin conditions, like eczema, psoriasis, and different kinds of abrasions.

Cannabis oil and topicals have been known to produce impressive results with skin conditions like eczema, psoriasis and different kinds of abrasions. A study conducted in 2010 tested a facial lotion that contained cannabinoids on people with postherpetic neuralgia, a pain condition similar to shingles, and the results were very surprising, demonstrating that the lotion reduced pain by 87 percent. New research suggests that several components in the cannabis plants may produce similar effects for herpes outbreaks.

Herpes is a virus that can take on many different forms, producing different sorts of ailments. There’s genital herpes, shingles, cold sores, etc. Once the virus affects someone, it remains in their bodies, making them more susceptible to developing other kinds of herpes, which might pop up when their immune system gets compromised by high stress or the influence of other diseases.

While only small researches and studies have been conducted, the results show a promising future for treating herpes with cannabis. A study from 1980 treated two groups of infected human cells with THC, one with herpes simplex 1 and the other one with herpes simplex 2. In both cases, the THC stopped the replication of the virus. These results were replicated in different researches in 1991 and 2004. Other studies found interesting results, like the possibility of THC suppressing the spread of genital herpes infections and of reducing the replication of the herpes virus in human cells that have been cultivated in vitro.

All of this information suggests a connection between herpes and cannabis. For marijuana to be considered a viable solution for the disease, the necessary research and studies need to be conducted.

 

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What Can We Learn from 1967's Summer of Love to Help Us Through Our Current Political Nightmare?

Thu, 08/10/2017 - 09:09
Click here for reuse options! Danny Goldberg discusses his new book about a magical and often misunderstood era in U.S. history.

Editor's Note: Danny Goldberg is the modern version of the Renaissance man. He has a long and colorful history as an activist, author and influential music executive. Goldberg came of age at the height of the hippie era in 1967, experiencing the powerful and haunting mix of excitement, hope, experimentation and despair. He captures it all in vibrant detail and political nuance in his newest book, In Search of the Lost Chord: 1967 and the Hippie Idea (Akashic Books). AlterNet's executive editor Don Hazen interviewed Goldberg in his offices at Gold Village Entertainment on July 12.

Don Hazen: Let’s start by addressing what lessons we can learn from 1967. In the book, 'In Search of the Lost Chord,' there is a lot about that classic split between the hippies and the radicals. And is that a Bernie/Hillary split? Is that split still with us? How do you look back 50 years and apply it today?

Danny Goldberg: Well, there are things to learn to do, and things to learn not to do, from the '60s. A major feature of the Be-In, in January 1967 that led to event of the Summer of Love, was that it was a “gathering of the tribes” to try to address that split.

There were also serious divides within the civil rights movement. Stokely Carmichael and Adam Clayton Powell sometimes mocked Martin Luther King publicly and questioned his non-violent strategy. On the other hand, when Martin King came out against the war, the NAACP board voted 60-0 to condemn him for that position because they feared pissing off President Johnson.

There were splits in the peace movement between the pacifists and non-pacifists; among those who focused on replacing LBJ with an anti-war Democrat there was bitter resentment between many of those who preferred Gene McCarthy and Bobby Kennedy supporters.

DH: And the Digger critique of Abbie Hoffman was what?He wasnot 'lefty enough'?

DG: It was that the Diggers were committed to anonymity and Abbie was the opposite of that. There's no question Abbie Hoffman was a self-promoter, but on the other hand he had the ability to popularize radical ideas in a way no one else could. The Diggers saw themselves as the conscience of all these movements.

DH: And Peter Coyote was a Digger, right?

DG: Yes, Coyote was one of the thought leaders. The Diggers organized the free concerts near Haight-Ashbury. They made and gave free meals to hundreds of people. They ran a “free store.” They came from the experimental theater world and did a lot public displays that challenged conventional thinking.

They had a mimeograph machine, and distributed circulars in the neighborhood, and when the Black Panthers started in Oakland, the Diggers lent them the machine for the first three issues of their newspaper.

But they also had a self-righteousness that judged almost everyone else in the counterculture adversely. They had a commitment to ideals that were distinct from people that were more commercially minded, so hip capitalism was one of their targets. They also had a jaundiced view of Tim Leary. They were often confrontational with radical political groups that they felt were too mired in old ideology. In some ways, they were the forerunner of the most intolerant anarchists of the Occupy period. But they also had the creativity to create some of the purest expressions of countercultural idealism.

DH: Let's step back for a second and ask you to explain how people should really understand the hippie idea, and what if any ofitcould be applied to solving the problems we are confronting today.

DG: The question I ask myself a lot, as I've been talking about the book, is: What difference does something that happened 50 years ago matter? Other than nostalgia (which I don't think is a completely bad thing) the relevance depends on the extent that there are values that are not driven by the 24-hour news cycle or by who's president, but endure from generation to generation, basic concepts about what it is to be a human being. To me, the hippie idea was a spiritual movement at its core, even though the word hippie and the external symbols like tie dye or long hair or hip language like "groovy" or "far out" or "cool, man," soon became passé.

DH: Don’t forget the peace sign.

DG: Yes, the peace sign, too—all of these things were quickly drained of meaning because of commercialization, the media magnifying glass, predators, etc. I understand why the punk generation that came along 10 or 15 years later had contempt for it, because they weren't reacting to the experience I had; they were reacting to the cartoon version of it. I'm sure if I were of that generation, I would have been a punk also, because it was all about trying to seek integrity, authenticity, and meaning.

But to me, the hippie moment was a critique of materialism. Ayn Rand's philosophy was just as pernicious in the '60s as it is today, or maybe the way to say it's just as pernicious today as it was then.

DH: Is there any model of a counterculture theme or anti-materialistic vision that's applicable today, anything like 'back to the land'? Because the country is so split. The differences are just enormous. Even the way of thinking.

DG: The thing I keep hoping is that the meeting place is spirituality, because I do think that most people who identify as Christians are sincere about it. Even though many of the right-wing American leaders who exploit them seem quite removed from the spirit of the Sermon on the Mount, Pope Francis is a compelling and powerful moral and spiritual voice who, to me, evokes counterculture values as much as he does Catholic tradition. Some of the attitudes of conservative evangelicals are primarily tribal. But I think that the words of Jesus Christ are so powerful that they can have unintended effects; the idea of loving thy neighbor as thyself is essentially the same as hippie idea.

In researching 1967, one thing that blew my mind was reading some of the speeches of Martin Luther King and Bobby Kennedy, neither of whom, as far as I know, ever took LSD. They both wore suits and had short hair and didn't identify as hippies in any way.

DH: No dashikis for Martin Luther King.

DG: And no love beads for Bobby Kennedy... But they came to the same meeting place in terms of the ideal that there's more to life than just money. Kennedy gave this great speech about how the gross national product measures everything except the things that are most important in life. And King, in sermon after sermon, talked about the inner world, of man as a spirit and as a soul. Of course he coupled this with an ethical code which required activism in an immoral world.

So it is my hope is that there is a critical mass of people who see themselves as being in different tribes, but who in their souls share some values that could create some kind of a moral clarity in the country.

The other big thing, I think, in terms of changing the politics of the country now, is to focus on young people, because that's also a similarity with the '60s. You've got this gigantic generation, the biggest generation since the Baby Boom generation, and more progressive. Those of us who were against the war were never a majority until way later when the whole country turned against the war by the mid-'70s. But the proportion of younger people who voted for Bernie, the proportion of younger people who vote Democrat, is very, very high.

DH: Let's go back to the spiritual theme. The heroes of your book are really Ram Dass and Allen Ginsberg. I'm interested in how you think that Allen Ginsberg and Ram Dass were able to carry that message, and whether it's succeeded in beginning inside the culture, or the culture just went all materialist.

DG: I think it's a mixed bag. One of the things about being older is knowing that I have more life behind me than in front of me, and it's quite clear that the odds of all the problems of America or the Western world being solved in my lifetime is extremely low. The rapid success of the civil rights movement on certain issues and the explosive spread of hip images and rock and roll, I created a set of expectations regarding timing that were not realistic. But the fact that everything's not perfect or close to perfect doesn't mean that all the efforts to advance the species are a failure; it means that history is to be looked at in terms of hundreds or thousands of years, not just one generation.

In terms of the individual lives, I think Ram Dass is exemplary. He's been committed to service. The money from Be Here Now went to his foundation that he and Wavy Gravy among others set up that has helped cure blindness in millions of people in third-world countries.

DH: I read a review of your book on the Be Here Now network. I never knew that existed.

DG: It's a podcast network that is a spin-off that is associated with the foundation that is built up around Ram Dass and run by Raghu Markus. I do a podcast on it called Rock and Roles.

DH: Let's talk about the riots, and segue from Martin Luther King to Detroit and to Newark and what a huge impact the uprisings had on the black community. We do not seem to have made much progress on race in this country. The riots of 1967 seem to have been a product of somewhat raised expectations from civil rights and the poverty program. Today, the black community has very little expectations. That might be a reason why white males are dying at a much higher rate than blacks and Latinomen,because their reality is more accepted.

DG: The scale dwarfs anything that's happened since. In Detroit there were 43 dead, 1,189 injured, over 7,200 arrests, and more than 2,000 buildings destroyed. And much havoc in other cities as well.

Not everyone called them riots—they were called rebellions, revolts. They were usually triggered by police violence. But the tinder box of frustration, poverty, oppression was so great, and the raised expectations were followed by only marginal improvement especially in the North where the problems was “de facto” segregation that wasn’t fixed by the civil rights bill. Before he was killed, King had become a much more radical and complicated thinker as the years went by and he saw the complexity of the legacy of racism.

DH: What else from the ’60s is applicable in the Trump era?

DG: Number one, ease up on tribalism on our side.

DH: Yeah, well, tribalism's natural for corruption. And also for loyalty and protection.

DG: True. It's incredibly seductive, because it feels good. It's why people join gangs.

DH: Nepotism is one of the most powerful forces in the world. Taking care of your own, your family. Everyone protects their family, or else they're thought of as having bad character.

DG: Taking care of your own family isn’t the problem. Doing it in a way that hurts other people's families is what is immoral. The Mafia will claim you have no choice. The Mafia is the ultimate Ayn Rand entity.

DH: So, 1967 is the year that you picked, but '68, '69 and '70 also were huge years for me: 1969 was Woodstock, of course. 1970 was Kent State and Cambodia and the biggest student rebellion ever. It seems to me that the reverberations of 1967 just kept rolling along in different ways. And ofcoursethere's Altamont versus Woodstock.

DG: Well, I think it's about the balance, and that's the conceit of the title, In Search of the Lost Chord, that there were these different notes and relationship to them, and it's about the balance of the energies. Things got darker in '68 with the assassinations of King and Kennedy. Another inflection point was the decline of Haight-Ashbury. There was a community in '65 and '66 and the beginning of '67, it was a model of an alternative lifestyle that couldn't survive the glare of the media. The media definitely killed it. There was actually a formal ceremony in Haight-Ashbury called Death of the Hippie in October ’67. And the drugs got worse very quickly.

DH: The brown acid.

DG: Yes, some of the LSD sold by less than idealistic dealers was mixed with speed. Pure speed, then as now, brought out the worst in people. Heroin, then as now, destroyed lives. So even though shards of countercultural idealism cropped up in places well into the '70s, the peak was already in the rearview mirror. Even the purest kind of LSD had limits in its value to people.

I'm someone who is very happy with my memories of LSD trips. I've never had a bad trip, thank god, but it became like seeing the same movie too many times. It's been decades and I have no plans to take it again.

DH: Yeah, it doesn't tell you how to figure things out.

DG: Yeah, at the end of the book, I quote Peter Coyote saying that LSD is like a helicopter that takes you to the top of the mountain, but then it brings you back down again, so if you actually want to live on the top of the mountain, it's a lifetime of work to get up there, not a helicopter ride.

DH: But the hippie period triggered a lot of things such as the back-to-the-land movement and the Grateful Dead, right?

DG: Absolutely. There are still reverberations from that period that continue to this day. Environmentalism had antecedents with people like Thoreau, but its explosion as a mass movement was the direct outgrowth of hippie culture. Many of the creators of a lot of the internet in the ’90s, including Steve Jobs, took psychedelics. On the political side, there is a direct line from the civil rights and anti-war movements to feminism, the gay rights movement, CodePink, Occupy Wall Street, and many aspects of the Sanders campaign.

In the spiritual realm, in 1967, Richard Alpert, the fired Harvard professor who was Tim Leary’s protégé in popularizing LSD, went to India, met his guru Neem Karoli Baba, was renamed Ram Dass, wrote the book Be Here Now, a major catalyst of the New Age movement. And in 1967 the Beatles, who were the most famous musicians in the world, were introduced to meditation, which overnight went from being a word known primarily in monasteries and theology departments to being part of the language of pop culture.

DH: Maharishi Mahesh Yogi, right?

DG: Yeah, the Maharishi was the first one that became a public figure when they visited him, but almost immediately afterwards, George Harrison and John Lennon became interested in the so-called Hare Krishna guru, Swami Bhaktivedanta.

And all this opened up a wellspring of a zillion different spiritual paths explored by people in the mass culture, some of the bogus but some real. The I Chingwent from selling a couple of thousand copies a year to 50,000-100,000 a year, and was quoted in numerous rock lyrics. A lot of younger people were relieved that you don't have to choose between the religion you were born into or purely secular materialism. There were lanes you could go down to try to integrate the idea of identifying yourself as a spirit without having to be enmeshed in the hierarchy of rules and structures that seemed irrelevant to a modern life. Some people found transcendence in mainstream religions, but a lot of us didn’t find it there.

DH: Is there something that you want the world to know about this book that you're not getting out there?

DG: Well, the main thing about the book is its complexity. There were so many things happening all at the same time. It's a mosaic of a couple hundred pieces, and there were another couple of thousand that I couldn't deal with because I didn't have the time or the wisdom to do it. I feel guilty dumbing it down sometimes.

DH: Somebody in the book said that New York was always two years later, but you said by '67 it had caught up. Is that really true?

DG: Ken Kesey said that to Tom Wolfe in The Electric Kool-Aid Acid Test.

There was this sense of you had this magical thing that no one else had. When it was the province of universities and psychiatrists and people that were authorized to experiment with it, it was very limited. But once it was illegal in late 1966, it became easy to get. High school in New York kids couldn't get acid in 1964, but could in '67.

DH: They had no Summer of Love in New York.

DG: I don't know, man. It was nice to be young there then. That's the year I graduated from high school.

There was a Be-In in Easter of '67. There were these things that Bob Fass would organize, this Fly-In and sweeping up streets on the Lower East Side. It was a bit darker than the Bay Area, but we had the peace and love thing going too for a minute.

DH: I was both a hippie and a radical and most of my hippie friends were not so political, and most of my radical friends had disdain for drugs. And then there was, within SDS, the progressive labor faction, the ones that cut their hair off and went to the factories and worked.

DG: But there were people who struggled to bridge the divide. Abbie Hoffman, Jerry Rubin and Paul Krassner—all had dual citizenship.

DH: Abbie Hoffman was one of our best political strategists. I traveled to Nicaragua with him and then I spent some time with him in Zihuatanejo. But I saw his dark side, too, which obviously led to his death. He was amazing. He was a manic depressive, yeah. And when he was manic, there was just no one, no one, who could compete with him as a speaker, as a thinker, a strategist, a performer.

DG: I think he's a little underrated by history because the depression became more part of the story. Hoffman and Jerry Rubin and of course Jimi Hendrix, Janis Joplin, Brian Jones and Jim Morrison had tragically premature deaths. On the other hand, the people I dedicated the book to—Paul Krassner, Wavy Gravy and Ram Dass—didn't self-destruct, and continued to live righteous lives with real consistency about who they said they were as younger people, as did Bob Dylan and Joan Baez and Peter Coyote and many others who are not famous, but who are worthy role models.

So overall, it certainly is a mixed bag. I have a romantic view of it, but hopefully not a delusional view of it.

DH: Well, that's a good way to stop: A romantic but not delusional view.

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It Took Just One Distorted Study for the Media to Freak Out Over Health Risks and Marijuana

Thu, 08/10/2017 - 06:59
Click here for reuse options! Fear spreads far too easily when it comes to cannabis.

A new, widely reported study claims that marijuana poses significantly greater risks to cardiovascular health, particularly with regard to hypertension, than does cigarette smoking.

Don’t believe the hype. A careful review of the study’s methods gives reason to pause.

Authors of the study used a “retrospective study” design. Rather than identifying current marijuana consumers and comparing their health to non-users, researchers instead identified subjects who previously acknowledged having “ever used” cannabis in a 2005-2006 nutritional survey (the National Health and Nutrition Examination Survey). Those participants who fessed up to having engaged in past pot use were then automatically classified by the study’s researchers as current users of the drug, despite the fact that no evidence exists to corroborate this claim.

Even more problematically, to calculate the estimated duration of each subject’s marijuana use, researchers simply subtracted the age participants first reported trying pot from their current age. (For example, if one acknowledged having tried cannabis at age 20 and is now 40 years old, the study’s investigators classified this person as a 20-year-long “marijuana user.”)

Making the presumption that someone who has "ever used" marijuana will continue to use pot for the rest of his life is simply absurd. As noted by Gallup and others, while an estimated one-half of all adults acknowledge having tried cannabis—typically during young adulthood—most of these individuals do not continue to consume it long-term, particularly after age 30. (Gallup reports that only about one in eight Americans define themselves as current users of marijuana.)

While the authors acknowledged this serious limitation in their press release (“[T]here were limitations to the way marijuana use was estimated,” they wrote. “For example, it cannot be certain that participants used marijuana continuously since they first tried it”), they opined that such unconventional methodology was necessary because there exists an “absence” of longitudinal data assessing the long-term use of cannabis and cardiovascular health.

This assertion, however, is false. Notably, a pair of longitudinal trials have been published in recent months explicitly addressing marijuana use and heart health. Data published last year in the Journal of the American Medical Association reported on the relationship between marijuana use over a 20-year duration and overall health in a cohort of 1,037 individuals. “We found no association between cannabis and cardiovascular risks [e.g., high blood pressure, higher cholesterol],” the authors wrote. "In general, our findings showed that cannabis use over 20 years was unrelated to health problems early in mid-life.”

More recently, an international team of researchers writing in the American Journal of Public Health assessed cumulative cannabis use and cardiovascular risk in a cohort of over 5,000 subjects over a period of more than two decades. Authors reported, "Compared with no marijuana use, cumulative lifetime and recent marijuana use showed no association with incident CVD (cardiovascular disease), stroke or transient ischemic attacks, coronary heart disease, or CVD mortality." Their findings are similar to those of several other well-controlled studies (here, here and here) finding that cannabis exposure does not appear to be independently linked with significant cardiovascular risk in otherwise healthy subjects.

By contrast, cigarette smoke exposure is a well-established contributor to adverse cardiovascular outcomes. For instance, smoking tobacco cigarettes has been estimated to increase stroke risk by as much as 600 percent.

That said, the authors’ findings that cannabis may influence vascular function is hardly a novel one. It is well established that cannabinoids, both exogenous and endogenous, can influence blood pressure. Both hypotension and hypertension have been reported following cannabinoid administration, though tolerance to these physiological effects appears to develop rather quickly. Nonetheless, such effects can lead to various potentially problematic outcomes such as tachycardia, particularly in more naïve subjects, and possibly on occasion may stimulate even more severe effects in those susceptible to adverse cardiovascular events. Therefore, it is reasonable to advise that potential high-risk populations ought to refrain from cannabis inhalation because of these concerns. But sensational claims that cannabis poses a greater risk to heart health than cigarettes are simply not evidence based and should not be taken seriously at this time.  

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The Rich Have Mostly Stopped Smoking Cigarettes—So They Are Mainly Killing Stressed-Out Poor and Working-Class People

Thu, 08/10/2017 - 01:51
Click here for reuse options! Cigarettes have caused a health epidemic that disproportionately affects the rural poor.

Long gone are the days when cigarette smokers frequented restaurants and other public spaces; when people smoked freely undeterred by threats of cancer; when nearly everyone, regardless of income or geography, took part in the social ritual of lighting up. From 1965—when the Surgeon General first released its report on the negative effect smoking has on health—to 2017, the number of Americans who smoke declined from 41.9 percent to 15 percent. However, despite the relative progress over the fifty year fight against tobacco use, it is still affecting over 43.8 million people, many of whom are poor or live in rural areas.

Cigarettes still kill nearly half a million people in the United States each year, according to the Center for Disease Control and Prevention. That number is 15 times the number of deaths related to the opioid crisis.

While the rich have given up their cigarettes, among Americans without a highschool diploma the smoking rate remains more than 40 percent. 18 to 20 percent more people living in rural areas acquire lung cancer compared with their city-dwelling counterparts. And researchers agree that the economically disenfranchised die more from cigarettes than any other group of Americans.

Debbie Seals, a 60 year old grandmother who worked with Girl Scouts of the USA but now volunteers teaching classes for the American Lung Association, has had first hand experience with the way class influences smoking. In her hometown of Martinsville, VA cigarettes are everywhere—strip malls, gas stations, advertisements, convenience stores, in people’s cars, on the street—a stark difference, she notes, from the wealthier parts of the state.

Like much of Appalachia, Martinsville has suffered culturally and economically following the decline of the once booming textile mills and furniture factories. All children in elementary and middle school automatically qualify for free and reduced-price meals because so many families face extreme poverty.

As a volunteer running clinics to help people quit smoking, Seales has noticed how the blighted circumstances her students inhabit influence their tobacco addiction. “People down here smoked because of the stress in their life,” she told the Washington Post. “They smoke because of money problems, family problems. It’s the one thing they have control over. The one thing that makes them feel better. And you want them to give that up? It’s the toughest thing in the world.”

For example, Victoria Cassell, one of Seale’s former students who attended her seven-week program every year for four years, has had difficulty quitting because of other struggles in her life. Her sister died, her husband began to have heart problems, and her daughter and grandson moved back home. Deciding to quit forced her to have lunch alone at the factory where she works because all of her other co-workers smoke. After three days without a cigarette, an argument with a coworker made her desperate for tobacco. She went to a friend and bummed a cigarette.

A study by Christine Sheffer at the City College of New York found that, compared with poor people, those with a high socioeconomic status were 55 percent more likely to quit smoking after three months and 2.5 times more likely to quit after six months.

In the study, more than 2,700 smokers were given nicotine patches and cognitive-behavioral therapy. The number of attempts was the same regardless of socioeconomic status but wealthier people had a greater success rate.

Researchers agree that community-based tobacco treatment programs like the one Seale leads can reduce the role socioeconomics plays in smoking, but it does nothing to change poverty related factors like stress, coping resources, and psychological issues, exposure to other smokers, and treatment resources. An article in the Huffington Post concluded that “the poorer the smoker, the poorer the treatment resources.”

With smoking mostly eradicated in well-off communities, much of America’s upper and middle classes view tobacco use as an obsolete epidemic. “If you’re educated and live in a well-off area, the smoking problem we’re talking about these days is now largely invisible to you,” Matthew L. Myers, president of the Campaign for Tobacco-Free Kids, explained to the Washington Post. “In some places, you can go days without bumping into a smoker. So you start to hear the question, why push more resources into this? Meanwhile the need is getting even greater, because the people left smoking are the ones who can least afford to.”

Funding for advocacy groups trying to eliminate smoking is dropping rapidly. Many experts claim that this may be one of the reasons that smoking rates, which declined exponentially for years, have stagnated. Under former Mayor Michael Bloomberg, New York City launched major programs to discourage smoking—establishing higher cigarette taxes, banning smoking in bars and restaurants, and enforcing restrictions on outdoor smoking—so that by 2010 the city’s smoking rate was at an all time low of 14 percent. However, by 2014, the rate had climbed up to 16 percent. Officials suspect that the anti-smoking cutbacks of 50 percent in those four years caused the rate to slide.

“The thing that makes tobacco different from other public health epidemics is that if you suddenly decide the problem is solved and you’re going to walk away from it, unlike polio, there’s an extremely powerful industry spending billions of dollars [that’s] going to fill that void very quickly,” Dave Dobbins, chief operating officer of the Truth Initiative explained.

Without necessary legislation and proper funding allocated to groups fighting tobacco, the industry has continued to soar. Over the past 10 years, since 2007, profit margins have gone up 77 percent. Every time a federal or state tax increases on cigarettes, the tobacco companies raise the prices. So when taxes go up, so do profit margins.

Like all small markets, tobacco companies face very little competition. Since the mid-nineties when politicians and awareness groups began to crack down on smoking with federal regulations, the industry consolidated into two companies: Altria and Reynold’s American. In 2009, the FDA attained regulatory control over tobacco, making it harder for new players to enter the market. Thus they continue to grow, even as the number of smokers in the United States stagnates or declines.

In an interview with NPR, Wall Street Journal reporter Jennifer Maloney explained that the industry is not dying anytime soon. “The industry believes that for the foreseeable future they’ll be handle to generate a good amount of revenue from cigarettes. But they know that this won’t last forever, so they are using this money to develop new alternative products such as e-cigarettes on the hopes that one day, as Americans shift from smoking cigarettes to other products. They’ll be ready to deliver those products”.

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Can Medical Marijuana Help Alcoholics Stop Drinking For Good?

Wed, 08/09/2017 - 11:13
The substitution effect: More people are making the switch to marijuana.

Could cannabis be a helping hand to alcoholics? If possible, it could be a watershed moment for themany as 33 million Americans who struggle with alcohol use disorder. Alcohol is the most commonly used addictive drug in the United States. The Centers for Disease Control estimate that approximately 88,000 Americans die as a result of excessive alcohol use each year. 

Researchers are paying attention to an economics principle and how it may be relevant regarding people and drug choice. When prices rise or people have less income they naturally substitute more expensive items for less expensive ones. Economists call that the “substitution effect.” Could people exhibit the same behavior when choosing an intoxicant? Would they choose one that is less dangerous just as they choose a product that is less expensive?

It’s not a pipe dream. Afterall, Medicare records have shown that in states with medical marijuana, prescription medicine use is down significantly. Additionally, death from opiate overdose is down by 25 percent in states with medical marijuana.

Studies have shown the same substitution happens in the relationship between alcohol and marijuana. One Canadian study surveyed over 400 medical marijuana patients and found that over 41% substituted cannabis for alcohol. The three reasons they gave were less withdrawal, fewer side-effects, and better symptom management.

In another study, of 350 medical marijuana patients in California, 40 percent said they had substituted cannabis for alcohol. Ironically, nearly half of those “reported using cannabis to relieve pain that they suffered as a result of an alcohol related injury.“ 

Alcoholics Anonymous and thousands of private treatment centers nationwide that believe true sobriety is the answer may argue that encouraging cannabis to someone with alcohol use disorder is just offering a new vice and potentially a new danger to their lives. Afterall, nearly 9 percent of cannabis users may develop substance use disorder.

However, not all people will connect with the religiosity of AA or be able to afford the cost of 28 days off of work and “drying out” in a treatment facility. Maybe this will be an invaluable option for those who don’t connect well with other approaches.

While not perfect, marijuana isn’t known to cause or contribute to liver disease, heart disease, stroke, sleep disorders, depression and a whole host of other problems associated with heavy drinking. Some people who have had the opportunity to compare the two different user experiences understand, cannabis is 100 times safer than alcohol.

It may be simple economics that help make the decision. 

 

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Trump Wants to Fight the Opioid Crisis With More Drug War

Tue, 08/08/2017 - 23:21
At "major briefing" on epidemic, president says "strong law enforcement is absolutely vital to having a drug-free society," but there's no emergency.

At an event Donald Trump had billed as a “major briefing” on the opioid crisis gripping America, the president on Tuesday stressed that “strong, strong law enforcement” was vital and rebuffed an official call to declare a national emergency.

Some had expected Trump to to declare such an emergency after his opioids commission force described this move in recent days as the “first and more urgent recommendation”.

Instead, Trump’s prepared remarks focused on enforcement stopping the international influx of illicit drugs and alluded to the Mexican border.

“We’re also working with law enforcement officers to protect innocent citizens from drug dealers that poison our communities,” Trump said. “Strong law enforcement is absolutely vital to having a drug-free society.

“We’re also very, very tough on the southern border where much of this comes in, and we’re talking to China, where certain forms of manmade drug comes in and it is bad,” he said. The president was presumably referring to fentanyl, a synthetic opioid. The drug was nearly unheard of on the illegal market in the United States until recently.

The rate of drug overdose deaths quadrupled between 1999 and 2014 according to the Centers for Disease Control and Prevention, fueled largely by widely available prescription painkillers marketed as having a low risk for addiction. The overdose death toll in 2016 is believed to have topped 59,000, more than peak deaths from car crash deaths, HIV or firearms.

A surge in painkiller prescriptions has created a parallel rise in abuse and overdose. In 2014, 2 million Americans were believed to be addicted to prescription painkillers, with Vicodin and Oxycontin among the leading opioids involved in an overdose. Three out of four heroin users previously used prescription opioids. Heroin is now predominantly supplied by Mexican cartels.

Trump emphasized the administration’s efforts to stop the flow of drugs over the Mexican-American border, but did not mention pharmaceutical companies. Several state and local jurisdictions have sued pharmaceutical companies for the way companies marketed opioids.

“We’re being very, very strong on our southern border – and I would say the likes of which this country certainly has never seen that kind of strength,” said Trump.

Trump’s remarks were made at his Bedminster, New Jersey, golf resort alongside the first lady, Melania Trump. The president has been on a 17-day “working vacation” in the state.

The US health secretary, Tom Price, who has in the past questioned the value of science-based opioid treatment, said the federal government is “working together on a comprehensive strategy”, which would be presented to the president in the “near future”.

Price was repeatedly asked later by reporters why the president was not declaring a national emergency. Price said: “The president certainly believes that it is, that we will treat it as an emergency – and it is an emergency. When you have the capacity of Yankee Stadium or Dodger Stadium dying every single year in this nation, that’s a crisis that has to be given incredible attention, and the president is giving it that attention.”

Later, Price added: “Most national emergencies that have been declared in the area of public health emergency have been focused on a specific area, a time-limited problem – either an infectious disease or a specific threat to public health. The two most recent that come to mind are the Zika outbreak and Hurricane Sandy. So we believe that at this point, the resources that we need or the focus that we need to bring to bear to the opioid crisis, at this point, can be addressed without the declaration of an emergency – although all things are on the table for the president.”

To date, the largest health-related proposals from Trump and congressional Republicans have been to gut Medicaid, a government-run health program for the poor, and “let Obamacare fail”. Both would have undercut Americans’ ability to seek treatment for opioid addiction. Republican efforts to reform healthcare failed in July.

 

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Trump Still Won't Declare a National Emergency to Address the Opioid Crisis

Tue, 08/08/2017 - 18:56
Click here for reuse options! His own bipartisan commission has recommended as much, but the president can't be bothered.

Secretary of Health and Human Services Tom Price announced Tuesday that President Donald Trump has no "immediate" plans to declare a state of emergency amid the growing national opioid crisis, despite the recommendation of a bipartisan commission.

"Our citizens are dying," the bipartisan commission wrote in its report to the president. 

New Jersey's Republican governor Chris Christie headed the commission, which also asked the Trump administration to waive a federal rule that's preventing poor and disabled people from accessing health care related to opioid addiction.

"We say to the president, you must declare an emergency," Christie said on CNN last week, likely hoping that the TV-obsessed president would see the clip.

Instead, the country was treated to Price parsing the word "emergency."

"The president certainly believes that we will treat it as an emergency—and it is an emergency," Price said.

Opioid deaths have more than quadrupled since 1999, and there is no end in sight to the expanding crisis. Numbers for the last year aren't yet available, but they're expected to be the worst on record.

Making "America great again" won't bring much comfort to the communities that are losing their children to drug overdoses.

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Drug War Civil Disobedience: In One City, an Unsanctioned Safe Injection Site Has Been Operating for Three Years

Tue, 08/08/2017 - 10:32
In a move that harkens back to the days of illegal needle exchanges, a social service agency isn't waiting for permission to save lives.

For nearly three years, in an undisclosed US city, a social service agency has quietly been inviting people to inject illegal drugs at a clandestine site, without the government’s approval.

More than 100 people have injected drugs at the site, according to data released Tuesday about the 2,754 injections. This data provides the first glimpse of what it would look like if the US decided to follow 10 other countries and open supervised injection facilities.

Researchers said two people’s lives were saved because they overdosed at the site, where staff had immediate access to the opioid reversal drug naloxone, and 90% of people who used there said they would have injected in a public restroom, street, park or parking lot if the site had not been available.

“With half a million people dying of overdose since 2000 in the US, we have a huge problem,” Alex Kral, an epidemiologist from RTI International, a nonprofit research group, told the Guardian. “We’ve been trying to do many things about that, but clearly not enough is being done.”

The secret site is modeled after legal facilities in countries including CanadaDenmark and France, where users can take drugs in a safe space with clean supplies. These facilities have been found to provide safety for users as well as communities where used needles can litter the streets, parks and public restrooms.

Kral and Peter Davidson, a medical sociologist at the University of California, provided a rare glimpse into the US facility in an American Journal of Preventative Medicine commentary published Tuesday. For two years, the facility has given an anonymous survey to its clients, who are overwhelmingly male (91.3%), white (80%) and homeless (80.5%).

There are limits to what the facility can offer, and what the data can reveal, because the site is not sanctioned, but the survey responses showed that in the previous 30 days, 25% of the users had witnessed an overdose outside the site and 67.45% had disposed of a syringe in a public place.

Supervised injection sites have long been controversial, but the scale of the opioid addiction crisis in the US – which sees 91 people die from overdoses each day – appears to be shifting attitudes.

Last week the new US surgeon general, Jerome Adams, said supervised injection facilities should be explored as a tool in responding to the addiction crisis. And in June the American Medical Association, the largest body of physicians in the US, endorsed a resolution calling for pilot supervised injection programs.

But in 2014 these facilities were still far from becoming a reality, so the underground injection site was created. “The staff didn’t want to wait around for it to be sanctioned,” Kral said.

The secret site has two rooms, one with five injection stations and the other for post-injection monitoring. It is open four to six hours a day, five days a week and is available by invitation only.

Users spend between 10 and 20 minutes in the room, which is always staffed by at least one person who has been trained in overdose prevention, resuscitation, use of naloxone and injection technique.

The site’s existence, an act of public health civil disobedience, is a throwback to unsanctioned needle exchange sites that appeared during the HIV/Aids crisis. In Canada, where supervised injection sites exist, activists have also created “pop-up” injection tents to respond to the opioid crisis.

Kral said he did not know about any other unsanctioned facilities in the US.

Soon, however, legal facilities could open in Seattle and San Francisco. There are also efforts under way to bring these facilities to other US cities, if lawmakers deem them safe and effective.

New York City approved $100,000 to study how an injection facility would impact the city; Seattle voted to open a site and San Francisco launched a taskforce to study the spaces after research found the city could save $3.5m annually with one 13-booth supervised injection facility. A similar study published in May found Baltimore could save $6m in medical costs if it built one supervised injection facility.

Kral said the unsanctioned facility’s data could help make the case for these sites: “This has been open for almost for three years and the sky has not fallen.”

 

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How Big Pharma Is Making America's Opioid Crisis So Much Worse

Tue, 08/08/2017 - 10:19
Why does a 30-day supply of the addiction treatment drug suboxone cost $500?

“A crippling problem.” “A total epidemic.” “A problem like nobody understands.” These are the words President Trump used to describe the opioid epidemic ravaging the country during a White House listening session in March.

The percentage of people in the U.S. dying of drug overdoses has effectively quadrupled since 1999, and drug overdoses now rank as the leading cause of death for Americans under 50.

Drugs do exist to reverse opioid overdoses or treat long-term opioid addiction. But while opioids have become easier and easier to obtain through illicit markets and sellers on the dark web, a drug that could save countless lives has become increasingly out of reach.

Consider the addiction treatment drug, Suboxone. Patents and other exclusivities on the basic version of Suboxone expired some time ago, yet the price remains sky-high, and access problems persist. Oral film strips now cost over US$500 for a 30-day supply; even simple tablets cost a whopping $600 for a 30-day supply. The cost alone puts the medication out of reach for many.

I study the pharmaceutical industry, and I see how drug companies are able to play games that keep competition out and prices high. Lack of access to addiction treatment drugs like Suboxone can be traced, in part, to the soaring prices, access problems and anti-competitive conduct that has become business as usual in the pharmaceutical industry across the board.

Patent incentives

Pharmaceutical companies have brought tremendous advances in medicine. I believe they should be adequately compensated for the enormous amount of time and resources needed to develop a new drug. Our intellectual property system is designed to do just that, rewarding companies that bring new drugs to market with a competition-free period – 20 years from the patent application date – during which they can recoup their profits.

After this defined period, generic versions of the drug are supposed to appear on pharmacy shelves, bringing down prices to levels that can be borne more easily by consumers and the health care market generally.

Brand-name companies, however, engage in myriad games to make sure theirs is the only version of the drug on pharmacy shelves, long after generics should have joined the ranks.

Martin Shkreli, the infamous pharmaceutical industry CEO responsible for hiking the cost of his company’s lifesaving drug from $13.50 to $750 overnight, once tweeted that “Every time a drug goes generic, I grieve.”

And it is not just a case of a few bad apples. Complex schemes to hold off generic competition are widespread throughout the pharmaceutical industry, as I have found in my research.

The games pharma plays, sort of like Monopoly®

Legislators on both sides of the aisle have decried sky-high drug prices, but it can be hard to pin down the specific behavior to address. Pharmaceutical game-playing has grown over the decades into a multi-headed monster, with a new tactic popping up as soon as the old one is cut off. My colleague and I set out to clearly identify and expose these various games in our book, “Drug Wars: How Big Pharma Raises Prices and Keeps Generics Off the Market.

One game we analyzed involved the filing of petitions at the Food and Drug Administration (FDA) that raise unfounded or frivolous concerns in an effort to delay generic competitors.

Some of the petitions were just stunning to us. For example, some petitions soberly ask the FDA to require, well, what it already requires, such as ensuring that the generic drug product is stable and has an appropriate shelf life. Other petitions tie the application up in knots for reasons that are hard, even for the FDA, to discuss with a straight face.

For example, the company that manufactures the blood pressure medicine Plendil filed a petition asking the FDA to delay approval of generics by citing concerns over how different types of oranges in orange juice might affect absorption of the medication and demanding additional information on the juice used in the clinical trials.

Although 80 percent of these petitions are eventually denied, it takes time and resources for the FDA to review each petition.

Citing concerns over citizen petition games, Congress recently required the FDA to respond to such petitions within five months, but a five-month delay for a blockbuster drug can be worth hundreds of millions of dollars. (The Federal Trade Commission recently filed an antitrust suitagainst Shire ViroPharma for attempts to hold off competition related to its gastrointestinal drug Vancocin, a campaign that included 24 filings related to a single petition.) Congress also gave the FDA the ability to summarily deny petitions when appropriate, a power that the FDA has failed to use even once.

By parsing through 12 years of FDA data, we found that out of all citizen petitions filed, the percentage of petitions with the possibility of delaying generic entry doubled since 2003, rising from 10 percent to 20 percent. Thus, in some years, one in five petitions filed at the FDA on any topic, including tobacco, food and dietary supplements, had the potential to delay generic competition.

Moreover, we found that 40 percent of such petitions were filed a year or less before the FDA approved the generic, indicating that companies are using these petitions as a last-ditch effort to hold off competition.

There are plenty of other games to play, as well. For example, generic applicants need samples of the brand-name drug to show the FDA that their version is equivalent; some brand-name companies flatly refused to sell samples to generic companies.

Another common tactic involves making tiny modifications to the dosage or formulation of a drug just as the original patents are about to expire. This strategy, known as “product hopping,” allows the drug company to obtain a brand-new set of patents on their “new and improved” version of the drug.

Even if the patents are overturned – and studies show that generics convince courts to overturn the majority of patents they challenge – the process again takes time.

Much of the attention is focused on patents, but the 13 regulatory exclusivities that the FDA doles out also help create competition-free zones. These offer months or even years of additional protection, by taking steps such as carrying out pediatric studies or developing drugs for rare diseases termed “orphan drugs.” Drug companies have stretched these systems to the point at which the costs to society far outweigh the benefits.

string out games that obstruct and delay competition, one after another. As I noted when testifying before Congress about such strategies, “A billion here, a billion there; that adds up to real money.”

In 2015, 80 percent of the profit growth of the 20 largest drug companies resulted from price hikes. And drugs are vastly more expensive in the U.S. than abroad. (The liver failure drug Syprine, for example, sells for less than $400 a year in many countries; in the U.S., the average list price is US$300,000. Gilead’s hepatitis C drug, Sovaldi, reportedly sells for the equivalent of $1,000 abroad – in the U.S., it sells for $84,000.)

The industry can do this, in part, because unlike the demand for other goods, the demand for pharmaceuticals is highly inelastic. Consumers will continue to pay for the drugs that can save their lives, even if it breaks the bank.

The impact on addiction treatment

Nowhere is the pain of these games more troubling than in the market for opioid addiction medicine.

In September, I testified before a House Judiciary Subcommittee at a hearing about the state of competition in the markets for addiction medicine, noting that, while “Open and vigorous competition is the backbone of U.S. markets…we are not seeing that in the market for addiction medicine.”

Pharmaceutical companies often argue that high profits are needed to fund development of new drugs, some of which don’t make it to market.

“The competitive market is structured to take maximum advantage of savings from brand competition,” testified Anne McDonald Pritchett, vice president, policy and research for the Pharmaceutical Research and Manufacturers of America.

However, open and vigorous competition is certainly not what the manufacturer behind the addiction treatment drug Suboxone had in mind when it combined several games to fight off generics appearing on the horizon. These games included product hopping (shifting the market to a new form of the drug just as the exclusivity expires so pharmacists cannot fill the prescription with a generic), refusing to cooperate with generic companies on safety plans, and petitioning the FDA to impose safety measures on generic versions that were never required for the brand-name version.

The opioid addiction epidemic is a complex problem, and there are no simple answers. One thing, however, is certain. The U.S. system should not reward companies for blocking generic competition. When we do that, the American public pays the price.

 

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My Grandmother Is a Drug Addict—and I Blame Big Pharma

Tue, 08/08/2017 - 10:09
As Appalachia slowly rots from the inside, drug company execs and shareholders are making billions.

My grandmother is a drug addict.

She still refuses to admit it even though most everyone around her knows that her dependence on opioid painkillers drives nearly every part of her life. At first glance, she might look like a typical little gray-haired lady, but she lies, she cons, and she uses others in ways most of us couldn't fathom just to get the money to buy more Vicodin.

At this point, most all her family is estranged, and I am not certain she really cares. For her, the only priority is the pills. It has been this way for at least 20 years, and I’m not sure if the drug abuse made her selfish and hateful, or if she was that way before the drugs. I suspect the former. I want to believe the former. I probably need to believe the former. 

As much as I would like to help her, the hard truth is that it has proven nearly impossible for any of us who are related to her to try to help her without being pulled into miserable situations ourselves. I don’t know what the answer is because I know that even as hateful and selfish as she is, she didn’t choose to be a drug addict. Circumstances beyond her control dealt her a life so terrible that she came to think of drugs as the only solution. As much as I want to be angry at her, I know in my heart that she is suffering in ways I cannot begin to understand. And frankly, I consider myself blessed, lucky, whatever you want to call it, that I cannot understand myself what she is going through.

While it might seem rare, or even a bit of a novelty, for an elderly lady to be a drug addict, it really isn’t that unusual in Appalachia. Addicts come in all ages here in the mountains. They come from rich families and from poor families. Addiction in Appalachia is not limited by race or by education level. It afflicts the Baptists and the Methodists and the Pentecostals and the agnostics. If you live in Appalachia, you almost certainly know someone who is, or was, an addict. In fact, you most likely know someone who died as a result of their addiction.

While addiction reaches both the rich and the poor in Appalachia, the stark reality is that addiction thrives in these mountains in large part because of poverty. The poverty came first. The drug addiction came later, often as a desperate response. The poor are disproportionally destroyed by addiction. They have the least access to treatment options, and they are more likely to escape addiction through death than through recovery. Most remain addicted all their lives, and their lives are usually cut tragically short. 

Over the past few years, the opioid epidemic that is plaguing rural America has finally begun to get a bit of national attention. The evening news shows have run a few specials, and some documentary filmmakers have made important films about the crisis.

Today, prescription opioids have largely taken the place of heroin, methamphetamine, and crack cocaine in bringing heartache and desperation to Appalachia. These opioids don't come across the southern border or from a clandestine lab or even from a trailer park chemist. They come from multi-national corporations. They are prescribed by physicians, and purchased and dispensed, at least initially, from licensed pharmacies. The most popular form is called Oxycodone. You might know it by one of its brand names: OxyContin, Roxycodone, or Percocet. A closely-related drug, hydrocodone, is sold under brand names including Vicodin, Lorcet, and Norco. In much of Appalachia, these drugs, all of which are opioids, are household names.

While many Americans encounter these drugs only while recovering from a surgical procedure, OxyContin and other prescription opioids are responsible for thousands of deaths per year in Appalachia. According for the Centers for Disease Control, more than 1,000 people per day seek treatment in US emergency rooms because they have misused prescription opioids. In 2014, the most recent year for which statistics are available, over 2,000,000 people in the United States either abused or were dependent on prescription opioids.

It all sounds so clinical and official, really, when we talk about “prescription opioids” and data compiled by the CDC. The reality, however, is that many people who abuse opioids in Appalachia buy them illegally, and getting a fix isn’t cheap. In many parts of Appalachia, especially in eastern Kentucky and in West Virginia, a sort of illicit economy has developed around the widespread abuse of opioids. While the pills are manufactured by multi-national companies, prescribed by health practitioners, and dispensed by pharmacies, those to whom they are prescribed often sell them illegally. In most parts of Appalachia, street-level dealers, some of whom are addicts themselves and sell pills to support their habits, are able to get more than a dollar per milligram for the pills. A 30 milligram OxyContin, for example, will usually fetch $30. For addicts in advanced stages of addiction, a single 30mg pill is barely enough to stave off withdrawal symptoms. It takes substantially more than that for them to get high. 

Those who buy these prescription opioids illegally rarely take them in the ways intended by the manufacturers. While some addicts simply take the pills orally, many eventually end up crushing the pills and snorting them, or worse, shooting them up intravenously. It is a mind-boggling journey, from the tightly controlled manufacturing laboratory of a major pharmaceutical manufacturer to the vein of an addict in central Appalachia, via what might be a secondhand needle. No matter how the OxyContin gets to its final destination, however, its initial sale is still added into the black side of the manufacturer’s balance sheet. As Appalachia is slowly rotted from the inside by this dangerous poison, drug company executives and shareholders are making billions.

I have always wondered: do they know? Do they care? When Mark Timney, CEO of Purdue Pharma, the maker of OxyContin, sees his direct payroll deposit hit his bank account, does he think about the hundreds of people who die every year because of his product? Does Timney think about the moral implications of running a company that makes a product that has destroyed lives and homes and towns? I suspect that Timney doesn’t think about the unfortunate and hopelessly addicted end-users of his products any more than the CEO of Raytheon thinks about the collateral damage on the receiving end of the Tomahawk Missiles his company manufactures. Perhaps the world would be a better place if these aloof and isolated executives were forced to step outside their bubbles and see the gut-wrenching destruction their products cause.

If Timney had to walk through the alley behind Cumberland Avenue in Middlesboro, Kentucky and see the dirty needles lining the gutter, he might be forced to consider his moral obligations to folks other than his board or Purdue's stockholders. If he had to ride along with police officers who have to remove malnourished babies from the homes of parents who have died from OxyContin overdoses, perhaps he would understand the full implications of what he willfully does for a living. He has a choice. Those who become addicted to his product are deprived of choices by the chemistry Purdue Pharma has worked so hard to perfect. 

For those of us who have seen opioids destroy families and communities and lives, it isn't much of a stretch to equate the CEO of a big pharma corporation with the CEO of a weapons maker. In the parts of Appalachia most destroyed by prescription opiates, it sure feels like a war is happening around us even if there are few gunshots and no bombs. I have lived in a community where OxyContin has drained away hope and life and dignity. I have served as foreperson of a grand jury that indicted hundreds of drug traffickers who served as middlemen between Purdue Pharma and addicts. I have witnessed the hopeless desperation of drug addicts, including members of my own family, who would do anything – anything – for another pill.

In so many parts of Appalachia, prescription opioids are as much a part of the landscape as the mountains that surround us. I lived in Middlesboro, Kentucky, for seven years of my adult life. Even having grown up around a grandmother who has for years been on a slow march toward the grave via Vicodin, I was stunned by how much a part of the local culture prescription opioids were in eastern Kentucky.

I moved to Middlesboro in 2004, just as the meth epidemic was beginning to be addressed with tougher restrictions on the sale of precursor ingredients. As meth ebbed, OxyContin became the drug of choice.

In those days, it was easy to get. Local drug traffickers would pack busses and vans full of people from the hollers and hills. They’d head down I-75 to Florida where unscrupulous health practitioners would, with a wink and a nod, diagnose patients they’d never see again with chronic pain and give them a prescription for whatever opioid cocktail they’d like. Upon request, they would even throw in prescriptions for the popular sedative Xanax for good measure. The scripts could be conveniently filled by the on-premises pharmacy. The addicts would hop back on the bus and head back to Kentucky. They’d give half their pills to the drug dealer who organized the trip, as payment for the ride and the office visit charges, and keep half for themselves.

At the time, Florida lacked a statewide tracking system for prescription drugs. The same addicts could make weekly trips to different parts of Florida for month-long supplies of pills. They could have a dozen active prescriptions for OxyContin or other powerful opiates, and absent a statewide tracking system, no one in any official capacity would catch the duplication. On more than one occasion, authorities in Kentucky caught drug traffickers with thousands of high-powered opiate painkillers in just-filled prescription bottles and were not even able to arrest them. Even though consuming just a fraction of the total number of pills prescribed per day would have killed the drug traffickers, every single pill was lawfully prescribed to the person in possession of the pills, so law enforcement in Kentucky couldn’t charge them because they had not technically broken the law. The officers knew the pills would be on the streets in hours and in the veins of addicts minutes after they were sold, but the officers had no recourse.

By 2010, the problem had become so severe that some elected officials from Kentucky were lobbying their counterparts in Florida to adopt a computerized prescription drug-tracking database. However, Florida governor Rick Scott fought against the implementation of such a system citing privacy concerns and opposed funding it even though the Florida legislature approved it. Scott even went so far as to turn down a $1,000,000 contribution from Purdue Pharma to fund the database. Finally, in 2011, after pressure from members of Congress and the Obama administration, Scott relented and approved a database.

Even with tightened restrictions on opioid prescriptions and better monitoring databases, the problems persist in much of Appalachia. The solutions, it seems, are slow in coming. I have written previously that lawmakers often turn a blind eye while their contributors systematically exploit the poor for profit. I note that while payday lenders and rent-to-own retailers have plenty of money for lobbyists and political contributions, the poor often can’t even get their congressional representatives to pick up the phone. The result is that lawmakers often tailor their rhetoric to put the blame on the drug addicts themselves rather than the companies that supply the drugs. Even the prescription tracking databases focus on finding patients breaking the law rather than on addressing the root sources of the pills. These politicians talk a whole lot about the importance of eliminating drugs from their communities, but they rarely mention the companies that created the products to begin with and spent millions of marketing dollars getting them into the hands of the people who became addicted to them.

Congress could get high-powered opiates off the streets in short order if they had the guts to do it. I might be jaded or naïve, but it seems like it would be straightforward to stop the abuse of powerful narcotics made by legitimate manufacturers. They operate from clean state-of-the-art facilities and skyscrapers, not from makeshift labs hidden in trailer parks or South American jungles. Perhaps because of the legitimacy of their businesses, the companies that make opioids seem to have more political and social cover even though their products destroy communities in the same way that meth and heroin do.

With prescription drugs, most politicians are clearly in the corner of drug companies despite their lofty rhetoric. In the healthcare debates unfolding around the United States now, many point out that drug prices in the US are substantially higher than in other developed nations. Congress, it seems, is hesitant to clamp down on drug manufacturers, and perhaps it is for good reason. In the same way that many in Congress are not willing to regulate prescription prices, they are also often unwilling to consider dramatic changes in public policy that would put a dent in the legal opioid business because such solutions would hurt the bottom lines of their corporate donors. 

It’s no wonder that elected representatives, even those with constituents dying every day from opioid overdoses, might think twice before taking action to cut off the flow of OxyContin to Appalachia. Big Pharma spends a lot of money to buy influence both in Congress and in state legislatures. Cartel leaders who smuggle crack or heroin can’t pay congressional representatives to turn a blind eye, but through campaign contributions and lobbyists, pharmaceutical companies can.

In North Carolina, Kentucky, Tennessee, and West Virginia, the states whose mountainous regions make up the core of the Appalachian territory most hurt by opioids, pharmaceutical manufacturers have given nearly $2,000,000 in political contributions to federal-level elected officials over the past decade. From 1986 to present, these drug companies have given over five million dollars to state-level officials and candidates for state legislative seats. $7,000,000 has flowed directly from drug companies to elected officials while thousands of dead bodies are left in the wake of OxyContin.

Incidentally, opioid abuse is not the only pharmaceutical problem that desperately needs to be addressed by these lawmakers. While many in Appalachia are dying of overdoses, many others can’t afford to treat their diabetes or heart conditions or cancer. For an investment of a few million dollars, these pharmaceutical companies are able to make a mint selling deadly drugs to addicts who die because of them, and a second mint selling overpriced drugs to those who will die without them.

While not all that money that flows to politicians comes from manufacturers of OxyContin or other opioid pankillers, the companies that sell addictive opioids do in fact spend a great deal of money to influence lawmakers at the state and federal levels. Over the past 16 years, Purdue Pharma, the maker of OxyContin, has doled out approximately $2 million in political contributions. One of Purdue’s favorite recipients is Senator Richard Burr of North Carolina, who represents a number of Appalachian counties, including my own. They have given Senator Burr thousands of dollars in campaign contributions even though hundreds of his constituents have died from the products Purdue sells. In fact, during the 2016 election cycle, Burr received half of the $20,000 Purdue gave to federal candidates. I wonder if Senator Burr thought about his constituents who die from OxyContin overdoses when his campaign committee got a $10,000 check from Purdue Pharma last year. 

 

 

Opioids are big business in the states that make up Appalachia. In TN, KY, NC, and WV, a stunningly high number of opioids are prescribed. The CDC reports the number of opioid prescriptions per 100 residents. In the entire United States, there are almost 83 opioid prescriptions per 100 residents. In NC, the number is 97 per 100. In KY, there are 128 opioid scripts per 100 residents. The numbers are even higher in WV (138/100) and in TN (143/100). If you live in Kentucky, there are enough opioid prescriptions in your community, on average, for every person you know, yourself included, to have at least one. Judging by the numbers, many people have more than one.

When I quipped earlier that OxyContin was a household name in parts of Appalachia, I meant it quite literally. In parts of the region, statistically, every household has a member with a prescription for some form of opioid painkiller. 

While OxyContin gets the most attention, it is in many ways a catchall term to describe many other deadly high-powered opiates. There are five major opioid manufacturers: Purdue Pharma, Johnson & Johnson Janssen, Insys, Mylan, and Depomed. These five manufacturers are currently under investigation by the United States Senate. Senator Claire McCaskill, a Democrat from Missouri, initiated the investigation. McCaskill has proven to be one of the few voices in Congress willing to go beyond rhetoric and take direct action to hold opioid manufacturers accountable. In announcing the investigation, McCaskill cited the ways prescription opioids have destroyed communities she represents. Her goal is to determine whether or not the five companies under investigation knowingly contributed to the opioid crisis.

It is wholly proper to call the problem a crisis. Between 1999 and 2014, sales of prescription opioids quadrupled in the United States even though data indicates that the amount of reported pain did not increase accordingly. The drug manufacturers were incredibly successful in pitching their opioid painkillers as a magic solution to chronic pain, and we now know that these drug companies often misled physicians about the addictive properties of the drugs. People who face crippling pain every day do need access to effective treatments. Those treatments should not come at the expense of their sobriety or their lives, and drug companies should be completely honest both with prescribers and with patients about the addictiveness of their drugs. 

 

As sales of drugs like OxyContin have skyrocketed, so, too, have opioid overdose deaths. Between 2014 and 2015, the core Appalachian states all saw double-digit increases in opioid overdose deaths. In West Virginia, opioid overdose deaths increased by seventeen percent. In Kentucky, the increase was twenty-one percent. These stark statistics are a clear indication that the region is facing an imminent threat. Something must be done, and putting an end to this crisis involves a plan more robust and recovery-oriented than the so-called war on drugs that the government, at all levels, has been blundering for decades. It will take more than militarized police and regional task forces and tough sentences to solve the problem. Only a holistic approach stands any chance at all of succeeding. 

As we consider potential solutions to the crisis that continues to unfold in our communities, it is essential that we understand just how complicated the problems are. It is easy to blame the addicts themselves. I know many people who take that approach, and I once thought I understood where they come from. In fact, I once held the opinion myself that addicts simply needed to make better decisions and stop using drugs.

As I watched members of my own immediate family succumb to addiction, I began to realize just how firm a grasp opioids have on those who are addicted to them. Those who are addicted to Vicodin or OxyContin or hydrocodone or fentanyl cannot simply wake up one morning and decide to stop taking the drugs. Even if they are able to overcome the immense mental hold the drugs have on them, there are physical consequences when one stops taking opioids.

Though I rarely speak to her and have not seen her in a number of years, I remember times when my grandmother was unable to get the pills she needed to feed her addiction. Within hours of taking her last pill, she would begin to suffer physically from withdrawal symptoms. The physical withdrawal symptoms made it even more urgent that she find a way to get more pills. When there was nothing of value left to pawn for cash, she would resort to begging anyone who would listen. 

Those who take fast-acting opiates – those not designed to be time-released – can experience muscle aches, anxiety, fever, and sweats within just six hours when they run out of pills. Those who go three days without a fix experience nausea, stomach cramps, and diarrhea, among other symptoms. These severe withdrawal symptoms can last for over a week. Usually, just one dose of the opioid from which they are withdrawing can curb the symptoms.

For many addicts, their addictions become a process of maintenance rather than pursuit of a high. As they build up tolerance to the drugs, they are forced to take more and more to get high. Building up a high tolerance for opioids makes addicts more susceptible to overdoses. In many instances, addicts who are arrested and go through detoxification in jail or in a rehabilitation facility return home upon release and immediately begin looking for pills. Sometimes, they will take a dose equal to what they would have taken to get high before their detoxification. However, detoxing often lowers their tolerance, and they are no longer able to tolerate the same amount of drugs they were able to just weeks before. The result, in many instances, is an accidental overdose.

So often, those of us who have never been addicts ourselves react by shaming those who struggle with addiction. We hesitate to speak aloud the realities that most others already know when those close to us are addicts. That shame extends for addicts even to death. Rather than being candid when our loved ones die of overdoses, we try to pretend they met a different fate. Rarely does one see an obituary that lists drug overdose as the cause of death. We don't talk about it because we are ashamed to. 

Perhaps if we were more candid both with ourselves and with our neighbors, we might begin to understand that we have more in common than we realize. One of the most important parts of recovery, I think, is community. Addicts need to know that they are accepted and loved, not that they are shamed or outcast. Those of us whose family members struggle with addiction need to know that many of our neighbors are struggling in the same ways, too.

We must stop blaming addicts for being addicted. So many cultural, economic, and mental health realities that are far beyond the control of addicts conspire to prevent them from a neat recovery no matter how dedicated they are to healing. Perhaps the most important part of recovery apart from a supportive community and access to proper mental and physical healthcare is hope. In so many parts of Appalachia, there’s little to give addicts hope. In fact, it’s that desperation – that hopelessness – that often leads them to drugs in the first place. As we continue to think through how we should react to this crisis, we have to look deeper than the drugs or the addiction.

Getting pharmaceutical companies out of the community-killing business is a lofty goal. Perhaps we start by demanding that our elected representatives stand up to drug companies instead of just talking tough then taking campaign contributions from big pharma when they think we aren't looking. Some will argue that when prescription opiates go away, addicts will turn back to heroin or meth to feed their addictions. They are likely right. However, it seems disingenuous at best that we use such a terrible excuse to avoid holding multi-national corporations accountable for peddling poison to vulnerable communities. 

We must understand that the addiction plaguing our mountains is simply a reaction to a much deeper set of problems. Addicts are usually driven to drugs because they think getting high or dying are the only ways to escape the hopelessness and misery they face every day of their lives. Until we get serious about addressing the systemic poverty in our region, at its roots, our family members and our neighbors stand little chance of beating the cycle of intergenerational addiction. They need hope, and hope comes from being valued as humans. America at large has little use for white trash, and we tend to put drug addicts squarely into this category. Only when we think of our addicted neighbors as neighbors and not throwaway humans will we start to truly understand what we need to do to put our communities back together. 

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Why Are So Many Pot Shops in Poor Neighborhoods?

Mon, 08/07/2017 - 22:47
Click here for reuse options! It's not a plot to keep the people down.

Recreational marijuana retail sales outlets are disproportionately located in poor neighborhoods. That's what the industry journal Marijuana Business Daily found when it recently analyzed their distribution in two of the first major cities to host legal pot shops.

In Seattle, the Daily found that 40 percent of pot shops were in zip codes where the average income was in the bottom 25th percentile. In Denver, the trend was even more pronounced, with nearly 45 percent of the stores located in the poorest neighborhoods.

Those zip codes account for 26 percent of the population in Seattle and 27 percent in Denver, so it's not that retailers are simply going where the people are. And there's no evidence it's some nefarious plot to target poor residents for stupefaction.

So what's behind the trend? According to the Daily, part of the answer is the initial reluctance by property owners to get involved with a business still federally illegal. And landlords with properties in middle- or upper-class neighborhoods could appeal to more upscale tenants outside the marijuana business, leaving tenant-hungry property owners in poorer areas more amendable to filling vacancies even with more potential risky businesses.

“That’s where the retail space was available,” pot entrepreneur and Dank dispensary owner Greg Gamet told the Daily. “Landlords had a hard time renting properties in these areas previously… they’re more apt to rent these when there’s no renters.”

And poorer areas were cheaper and easier to do business in. Where times are tough, the flame of NIMBYism flickers less brightly. Low-income neighborhoods generally didn't protest the arrival of pot shops, which meant jobs and economic development, and they didn't place as many regulatory hurdles as the more well-off areas.

Low-income neighborhoods also mean lower rents. And lower rents meant higher profit margins compared to pot shops in tonier parts of town, a critical factor in consolidating one's position in the early days of the highly competitive legal weed business.

But the phenomenon of pot stores being overrepresented in poor neighborhoods may prove ephemeral, in part because of the very economic success of the shop-keepers and in part because the stigma around marijuana is eroding and the revenue flows are enticing, even for hard-eyed businessmen with valuable real estate assets.

"Moving forward," the Daily predicts, "major cities in markets that legalized recreational marijuana after Colorado and Washington state—like Boston and Portland, Oregon—are less likely to see clusters of retail marijuana stores in low-income neighborhoods."

For better or worse.

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Crime Task Force Report Leaves Sessions Without Ammo in His War on Weed

Mon, 08/07/2017 - 10:26
His own hand-picked task force found no change needed for marijuana enforcement.

One of Jeff Sessions’ pet projects is bringing back reefer madness. As he’s publicly likened marijuana to heroin, he certainly isn’t a fan of the herb. He also put together the Task Force on Crime Reduction and Public Safety, a think tank of prosecutors and federal law enforcement agents to study the effect of cannabis on the population. It was to be your standard witch hunt, however, according to the AP, the results were “tepid” at best.

The full findings haven’t been made public, but the bits that made it to the AP make a very good case for Sessions’ to not release the findings. It seems there’s no news inside their papers, and in this case, no news is good news for the cannabis community. It seems clear that the cherry picked task force took their jobs seriously. There were recommendations to continue studies and to basically keep things status quo for the time being.

Theoretically, this means there is no plan of action for Sessions’ to take down legal and/or medical marijuana and that states continue to rely on their voters to make decisions regarding the plant.

The findings we have access to are neither complete nor final, but no matter what the final documents say, Sessions’ does not need to heed the task force’s recommendations. So we may not be in the clear yet, but the odds lean in our favor. If we were a betting rag, we’d say Sessions is going to table this and get on with other more pressing White House issues.

Activists and proponents for the plant immediately celebrated the news out of the AP, which expounded, “Threats of a federal crackdown have united liberals, who object to the human costs of a war on pot, and some conservatives, who see it as a states’ rights issue. Some advocates and members of Congress had feared the task force’s recommendations would give Sessions the green light to begin dismantling what has become a sophisticated, multimillion-dollar pot industry that helps fund schools, educational programs and law enforcement.”

It sounds to us that cannabis is doing more good than harm, but we already knew that. There have been no recorded deaths by cannabis and it is known as a highly medicinal herb on top of being a source of nutrition. In any case, the found findings point toward an immediate future where pot is left alone and states have the ability to make their own choices and enforce them accordingly.

 

 

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DEA Pushes 20 Percent Reduction in Opioid Manufacturing

Mon, 08/07/2017 - 10:19
The agency says demand is dropping for opioid pain relievers because of increased awareness about addiction, thus the decrease.

(CN) – The U.S. Drug Enforcement Administration on Friday proposed a 20 percent reduction in opioid narcotic manufacturing next year.

The DEA said it is proposing to reduce more commonly prescribed opioid painkillers, including oxycodone, hydrocodone, oxymorphone, hydromorphone, morphine, codeine, meperidine and fentanyl. The agency said demand for these medicines has dropped, as awareness has increased of the dangers of opioid addiction.

“Physicians, pharmacists and patients must recognize the inherent risks of these powerful medications, especially for long-term use,” acting DEA administrator Chuck Rosenberg said. “More states are mandating use of prescription drug monitoring programs, and that has prompted a decrease in opioid prescriptions.”

The DEA and its federal partners have increased efforts in the last several years to educate practitioners, pharmacists, manufacturers, and the public about the dangers associated with the misuse of opioid medications and the importance of properly prescribing, the DEA said. Last year, the U.S. Centers for Disease Control and Prevention issued guidelines on opioid use to health care practitioners recommending a reduction in prescribing opioid medications for chronic pain, the DEA said.

The DEA may initiate quotas on the manufacturing of controlled substances. The quota system was intended to reduce or eliminate diversion from legitimate channels of trade by controlling the quantities of the basic ingredients needed for the manufacture of controlled substances, the DEA said.

The purpose of quotas, the DEA said, is to provide an adequate supply for legitimate medical use of schedule I and schedule II controlled substances, which have a high potential for abuse, while limiting the amounts available to prevent diversion.

DEA must balance the production of what is needed for legitimate use against making too much of these potentially harmful substances, the agency said. DEA establishes quotas for more than 250 controlled substances annually.

In setting its quotas, the DEA considers data from the U.S. Food and Drug Administration; estimates of retail consumption based on prescriptions dispensed; manufacturers’ forecasts and other data.

 

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DPA Study: New York City Remains the World's Marijuana Arrest Capital, and It's Still Mainly Black and Brown People Getting Popped

Mon, 08/07/2017 - 06:42
Click here for reuse options! In a bid to defend thousands of racially biased pot arrests, de Blasio attacks drug reformers.

Last month, the Drug Policy Alliance released a report noting that marijuana arrests under New York City Mayor Bill de Blasio continue to be marked by shocking racial disparities, much as they were under his predecessors, Rudy Giuliani and Michael Bloomberg. Stung by the criticism, de Blasio is fighting back, but his response so far has consisted of attacking DPA as "legalizers" and comparing apples to oranges.

The DPA report, Unjust and Unconstitutional: 60,000 Jim Crow Marijuana Arrests in Mayor de Blasio’s New York,noted that while pot possession arrests are down under de Blasio from the numbers achieved under Giuliani (more than 40,000 arrests in 2001) or Bloomberg (more than 50,000 arrests in 2011), NYPD still arrested more than 18,000 people for pot possession last year, and a whopping 86% of them were black or brown, maintaining the racial disparities so apparent in earlier administrations.

That's "a far cry from the mayor's pledge to rein in NYPD's targeting of people of color," charged DPA New York State director Kassandra Frederique in the report. That de Blasio had managed to bring pot arrests down to an average of only 20,000 a year during his tenure shouldn't be portrayed as progress, argued Frederique, instead describing it as "slower injustice, but slower injustice is still injustice delivered."

De Blasio struck back Friday, releasing a statement calling the DPA report "misleading" and attacking DPA as "a group committed to legalization." De Blasio's statement emphasized that marijuana arrests had dropped significantly under his administration—something DPA never disputed—but failed to address the claim of continuing racial disparities in arrests. Instead, it merely noted that because pot arrests were down overall, arrests of people of color for pot were down, too.

But the takeaway sentence in de Blasio's statement inadvertently makes DPA's case:

As a result of this new policy, arrests for marijuana possession are down 37% — from almost 29,000 in 2013 to approximately 18,000 in 2016. This has translated into approximately 9,600 fewer arrests of black and Latino New Yorkers for marijuana possession in 2016 as compared to 2013.

In other words, a reduction of less than 11,000 total pot arrests between the two years resulted in about 9,600 people of color not being arrested. De Blasio's own data and arguments show that the city's minorities clearly take the brunt of marijuana law enforcement, his wriggling notwithstanding.  

And now, DPA is returning fire at de Blasio.

"Mayor de Blasio is not disputing the data published in our report, he is trying to spin his poor record to look as though he has made some progress," Frederique said in a Friday press release. "In reality, New York City was the marijuana arrest capital of the world under Bloomberg and still holds that dubious title under de Blasio today. The 18,000 arrests in 2016 alone and outrageous racial disparities are a disgrace to the city and a blight on the mayor’s record. The unjust and racially targeted arrests are devastating black and Latino communities across the city."

Frederique also applied some political ju-jitsu to de Blasio's "legalizer" attack.

"The mayor’s efforts to discredit the report and the Drug Policy Alliance by calling us legalizers, is a desperate attempt to distract the public from the facts of his abysmal record. Our report is based on data from the New York State Division of Criminal Justice Services. Rather than attack his critics, the mayor should attack the problem of racially-targeted arrests," she said. "For the record, the Drug Policy Alliance is committed to marijuana legalization to increase access for patients and end targeted policing in communities of color. And we’re not alone; nearly 60% of Americans also support legalization."

Instead of attacking critics, the mayor should fix the problem, Frederique added.

"It’s time for the mayor to get out of the spin cycle and back to work," she prescribed. "The mayor must end the biased policing practices that have ruined the lives of so many young black and Latino New Yorkers now."

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Blowing Up the Big Marijuana IQ Myth—The Science Points to Zero Effect on Your Smarts

Sun, 08/06/2017 - 11:47
Click here for reuse options! Debunking one of the oldest theories about cannabis.

“Marijuana makes people retarded, especially when they’re young.” So claimed conservative commentator Ann Coulter while speaking at Politicon last week. 

But while such inflammatory claims by culture warriors like Coulter are to be expected – and may readily be dismissed – the notion that smoking pot will have lasting negative impacts on intelligence is a longstanding one, and a claim that is all too often made by those on both sides of the political spectrum. Yet the latest science finds little to no factual basis for this contention.

Longitudinal data just recently published online in the journal Addiction reports that pot smoking is not independently associated with adverse effects on the developing brain. A team of investigators from the United States and the United Kingdom evaluated whether marijuana use is directly associated with changes over time in neuropsychological performance in a nationally representative cohort of adolescent twins. Authors reported that “family background factors,” but not the use of cannabis negatively impacted adolescents’ cognitive performance.

They wrote: “[W]e found that youth who used cannabis … had lower IQ at age 18, but there was little evidence that cannabis use was associated with IQ decline from age 12 to 18. Moreover, although cannabis use was associated with lower IQ and poorer executive functions at age 18, these associations were generally not apparent within pairs of twins from the same family, suggesting that family background factors explain why adolescents who use cannabis perform worse on IQ and executive function tests.”

Investigators concluded, “Short-term cannabis use in adolescence does not appear to cause IQ decline or impair executive functions, even when cannabis use reaches the level of dependence.”

They’re not alone in their conclusions. In 2016, researchers at the University of California, Los Angeles and the University of Minnesota performed a similar longitudinal analysis regarding marijuana’s potential impact on intelligence quotient in a separate cohort of adolescent twins. They reported no dose-response relationship between pot exposure and IQ decline at age 20, and observed no significant differences in performance among those who used marijuana and their non-using twins. 

Investigators concluded: “In the largest longitudinal examination of marijuana use and IQ change, … we find little evidence to suggest that adolescent marijuana use has a direct effect on intellectual decline. … [T]he lack of a dose–response relationship, and an absence of meaningful differences between discordant siblings lead us to conclude that the deficits observed in marijuana users are attributable to confounding factors that influence both substance initiation and IQ rather than a neurotoxic effect of marijuana.”

The UCLA findings mimicked those of separate longitudinal data published earlier that year in the Journal of Psychopharmacology. Investigators in that study assessed IQ and educational performance in a cohort of 2,235 adolescent twins. They too reported that after adjusting for potential confounds (such as the use of tobacco and alcohol), teens who used cannabis “did not differ from never-users on either IQ or educational performance.”

Florida State researchers similarly examined the issue earlier this year. Writing in the journal Drug and Alcohol Dependence, they reported on the impact of marijuana exposure on intelligence scores in subjects over a 14-year period (ages 12 to 26). They concluded, “[O]ur findings did not reveal a significant association between cumulative marijuana use and changes in intelligence scores.”

Nonetheless, political opponents of cannabis policy reform continue to opine that pot smoking “reduces IQ by 6-8 points.” This claim is derived from a widely publicized 2012 New Zealand study published in The Proceedings of the National Academy of Sciences. It reported that the persistent use of cannabis from early adolescence to adulthood was associated with slightly lower IQ by age 38. 

However, a followup review of the data published later in the same journal suggested that the observed changes were the result of investigators’ failure to properly control for confounding variables, primarily the socioeconomic differences between users and non-users, and were not unduly influenced by subjects’ cannabis use history.

A later paper by the lead investigator of the New Zealand study similarly reported that the presence of confounders makes it difficult to impossible to attribute changes in teens’ academic performance on pot use alone, finding that the effects of persistent adolescent cannabis use on academic performance are “non-significant after controlling for persistent alcohol and tobacco use.”

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