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Why Marijuana Fans Should Not See Approval for Epilepsy Drug As a Win for Weed

Fri, 04/20/2018 - 07:24
Healing, but no high?

A Food and Drug Administration panel recommended approval of a drug made of cannabidiol on April 19 to treat two types of epilepsy. The FDA is expected to decide in June whether to accept the panel’s 13-0 recommendation to approve Epidiolex, which would would become the first drug made of cannabidiol, a compound in the cannabis plant, to gain approval from the FDA.

While the panel’s unanimous decision is not binding, the action will no doubt heighten public debate about the use of cannabidiol, medical marijuana, medical cannabis and hemp oil. Should cannabidiol, or CBD, or marijuana be legalized for medical purposes? What is the evidence that these products are beneficial? Are these products safe to use?

Those who support the use of marijuana for recreational or medicinal purposes might have found the timing of the panel’s ruling interesting. National Weed Day is April 20.

But weed is not cannabidiol, even though both come from cannabis.

As a professor of pharmacy with a special interest in epilepsy, I find it important that CBD may be a new option for the treatment of epilepsy. This new use has led me to carefully study published literature on CBD and discuss it as an option with patients who have epilepsy. Additionally, I have been involved with the American Epilepsy Society’s ongoing review of CBD as a possible treatment for epilepsy. From this perspective, I believe that CBD may offer benefits for patients with some types of epilepsy and possibly other disorders.

The cannabis plant produces hundreds of different compounds, many of which have differing effects in the body. Tetrahydrocannabinol, or THC, is the substance that is most known for its psychoactive effects, or the “high” associated with marijuana.

However, there are many other substances from the cannabis plant that also produce effects in the body. Many of these differ from THC in that they are not psychoactive – and they do not produce a “high.” Cannabidiol, or CBD, is one of those substances.

Cannabidiol is a complex molecule that is produced by the cannabis plant. Cannabis has been proposed for centuries as a medicinal plant. Only recently has CBD been studied scientifically for various disorders.

Compared to THC, CBD works at different receptors in the brain and other parts of the body. In this way, CBD is very different from THC and may offer new mechanisms of treatment. For this reason, CBD has received a great amount of attention as a possible treatment for many different disorders.

CBD has been proposed as a cure or treatment for many disorders and diseases, including epilepsy, chronic pain, anxiety, multiple sclerosis, amyotropic lateral sclerosis (ALS or Lou Gehrig’s disease) and insomnia. Some of these uses are based on science, but others are proposed by advocates of CBD and medical marijuana. Several anecdotal reports, case reports, case series and small studies have reported on CBD for many of these disorders. Information from these reports is conflicting. Case reports, case series and small studies are considered insufficient evidence to prove or disprove the safety and efficacy of a drug or treatment. This is because these studies are usually unable to distinguish between the effect of a drug and a placebo effect, or the patient thinking the drug is working when it really is not providing benefit.

However, there are two well-designed, large studies that indicate CBD is effective in two different epilepsy syndromes. In these studies, about 40 percent of patients taking CBD had a significant reduction in specific types of seizures.

Epilepsy is the only disorder where there is solid scientific evidence demonstrating that CBD is safe and effective. This does not mean that CBD will not work for other disorders, but epilepsy is the only one where we have clear, well-documented evidence that CBD helps.

Results from these studies show that CBD does have side effects. The most common ones are drowsiness, nausea, intestinal cramping, bloating and diarrhea. More serious side effects can occur. In one of the studies in epilepsy, about 10 percent of patients taking CBD had an increase in laboratory tests of liver function. These tests commonly indicate damage to the liver. About 2-3 percent of patients taking CBD had to discontinue it due to large increases in certain liver enzymes in laboratory tests, showing possible liver damage.

We are also learning about drug interactions that occur with CBD. In these studies, CBD slowed the metabolism of several drugs that are commonly given to individuals with epilepsy. The interactions between CBD and other drugs patients were taking caused side effects. It is unclear if these side effects were due to CBD, the other drugs, or a combination. Doses of the other drugs were reduced, due to the interactions.

The mechanism for these interactions indicate that there are likely several other interactions between CBD and other common medications. Cannabidiol needs to be used cautiously in combination with other medications.

Issues beyond effectiveness.

There are several other factors to consider in regards to CBD. Cannabidiol does not dissolve well in water. For this reason, oral products of CBD are made with an oil, often some type of vegetable oil. It is important that the right oil is used.

Also, less than 20 percent of an oral dose of CBD is absorbed. This makes it difficult to produce a CBD product where CBD is reliably and consistently absorbed.

An FDA study of unregulated CBD products available on the market shows these products are frequently contaminated with things like pesticides, herbicides, fungus or bacteria. Additionally, the FDA found that over 50 percent of CBD products may not contain the amount of CBD on the label. This is especially true in states where CBD products are not regulated by the state. In 17 states where there is regulation, there is much better control on product quality and purity.

Finally, there are two pharmaceutical-grade CBD products that have been studied for production by a pharmaceutical company. One is Epidiolex, approved by the FDAD panel on April 19, and the other is still being studied. Epidiolex would be approved only for use in two types of epilepsy, Dravet syndrome and Lennox-Gastaut syndrome.

So far, the evidence is that CBD is safe and effective for specific epilepsy syndromes. There is insufficient scientific evidence to indicate that it is effective or ineffective for other disorders. Information from well-designed studies do indicate that CBD causes important side effects and drug interactions that must be considered. Individuals who wish to use CBD should be managed and monitored by health care professionals familiar with its use.

Timothy Welty, Professor of Pharmacy Practice, Drake University

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

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Here Are 13 Transformational Bills in Congress That Could Change America as We Know It

Thu, 04/19/2018 - 20:30
Americans often miss the crucial issues that are also "on the ballot" in congressional elections.

Editor's note: As of April 2018, there are three special elections for U.S. House seats and two special elections for U.S. Senate seats upcoming in 2018. Click here for a full list. Also, as of April, 68 state legislative special elections have been scheduled or held in 23 states. Click here for an updated list.

We are so focused on political parties, and also on the personalities of candidates, that we almost always ignore some of the really important, and sometimes transformational things that are also “on the ballot” in congressional elections. 

And when there is a Special Election in the middle of a Congressional Session, this is even more the case, as brand-new lawmakers can change the dynamic on Capitol Hill, helping to sway the outcome of numerous bills awaiting votes in Congress.

So, here are just a few of the bills that currently exist and are waiting to be voted on (or not) that a Congresswoman Debbie Lesko or a Congresswoman Hiral Tipirneni—currently in a battle to fill the seat left vacant by incumbent Rep. Trent Franks (R-Ariz.)—will be able to co-sponsor and vote for. Or not.

Arizona's 8th District voters aren't the only American voters who have a say in who's getting a seat in the 115th Congress. Voters in Ohio's 12th and Michigan's 13th are also tasked with filling vacancies in upcoming special elections. Also, voters from Minnesota and Mississippi will vote to fill vacant Senate seats.

The following bills have the power of enacting transformational change across the nation on issues that should concern everyone.

  1. The Clean Energy for America Act: To incentivize additional renewable energy and more renewable energy jobs, potentially helping to turn Arizona into a solar power "powerhouse."
  2. The Paycheck Fairness Act: To ensure that women receive equal pay for equal work. The bill already has 199 sponsors and co-sponsors and only needs 19 more supporters to have enough votes to pass the House. Will any of the candidates seeking congressional seats this year be that 200th vote?
  3. The Citizen Sovereignty Act: To help reduce the influence of big money lobbyists in Washington. The bill will be introduced on April 25, the day after the April 24th special elections.
  4. The Safe and Affordable Prescription Drug Importation Act: To allow Americans to purchase prescription drugs from Canada at lower rates than available in the United States and “The SPIKE Act” to prevent large spikes in the cost of currently available drugs.
  5. The Save Net Neutrality Act: To return net neutrality as the law in the U.S.
  6. The Fair Representation Act: To end political gerrymandering, the practice of states choosing political districts for political benefit.
  7. The Student Loan Fairness Act: To allow college students to benefit from the same interest rates as big banks do.
  8. The Marijuana Justice Act: To eliminate federal penalties for the possession or use of marijuana for recreational purposes.
  9. The Dog and Cat Meat Trade Prohibition Act: One of many bills that affect animals that almost never receive public attention, this would overrule laws in many states allowing for the killing of dogs and cats and help NGOs end the Yulin Dog Meat Festival (currently stuck in committee).
  10. The PAST Act: Also stuck in Congress, this would outlaw the torture of Tennessee Walker horses, reversing a law that animal rights advocates consider to be one of the cruelest in American history. 
  11. The Dream Act: To cancel the removal and grant lawful permanent resident status on a conditional basis to an alien who is inadmissible or deportable.
  12. The Medicare for All Act: To expand Medicare to all ages and allow every American to receive medical services from the government if they so desired.
  13. The Background Check Expansion Act: To create comprehensive background checks for gun purchases. 

Also, in March of 2017, Congress passed H.J.Res 69 to allow hunters in Alaska to shoot baby bears and their parents hibernating in their dens, overturning a key Obama-era animal rights law. Will Lesko or Tiperneni—or other candidates seeking congressional seats this year in Ohio and Michigan—support a bill to overturn this cruel resolution if they are elected?

Legislators legislate. That is their responsibility. Their main job is to sponsor or co-sponsor and vote for pieces of legislation that will solve the challenges of the American people and move our country forward.

If you are eligible to vote for candidates seeking a legislative seat, ask them specifically whether they will co-sponsor and vote for bills that you care about.

And, then, it is your responsibility to go to the polls and "hire" a proxy who will go to Washington and vote for these bills.  

So, let's move beyond political parties and talk about—and hold our political candidates responsible for—voting for the specific things that matter to us, our families, animals and the environment, and the direction of our country.

Tell your elected lawmakers in Washington how they should vote on these important bills. Click here to contact your representative. Click here to contact your senator. 

 

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WATCH: Chuck Schumer Is Ready to Legalize Marijuana

Thu, 04/19/2018 - 20:28
The Senate minority leader's proposal would send federal pot prohibition up in smoke.

The Senate's highest-ranking Democrat is letting his freak flag fly. In a Thursday night interview with VICE News, Minority Leader Chuck Schumer (D-NY) announced he is crafting legislation that would result in the effective end of federal marijuana prohibition.

Schumer has previously supported medical marijuana and allowing states the right to experiment with legalization, but this would be a radical shift in federal drug policy.

The New York senator isn't the first high-profile Democrat to embrace marijuana legalization—2020 presidential contenders Sens. Cory Booker (D-NJ), Kirsten Gillibrand (D-NY), and Bernie Sanders (I-VT) are all on board—but he is the Senate minority leader. He could be the Senate majority leader next year (a longshot) or in 2021, and having a friendly majority leader means a legalization bill actually moves in the Senate.  

"Ultimately, it’s the right thing to do. Freedom," he told VICE News' Shawna Thomas. "If smoking marijuana doesn’t hurt anybody else, why shouldn’t we allow people to do it and not make it criminal?" Schumer said.

The legislation should be unveiled within the next week and has four main points:

1. Remove (or deschedule) marijuana from the Controlled Substances Act, ending federal marijuana prohibition and leaving pot laws up to the states.

2. Provide assistance to encourage minority and woman-owned marijuana businesses.

3. Provide funding for research on marijuana's effects, especially on driving impairment.

4. Maintain federal authority to regulate marijuana advertising like alcohol and tobacco.

Not only does Schumer now support leaving it to the states, he supports legalizing it in his own state.

"My personal view is legalization is just fine," he said. "The best thing to do is let each state decide on its own."

Marijuana could be a winning issue for Democrats this November and in 2020. The latest Gallup poll had support for legalization at a record high 64%. But Schumer said legalizing pot wasn't about politics.

"I’m doing it because I think it’s the right thing to do. I’ve seen too many people’s lives ruined by the criminalization," he said. "If we benefit, so be it. But that’s not my motivation."

He even told Thomas that while he had never smoked weed before, he might give it a try. "Maybe, I’m a little old, but who knows?"

Watch the interview:

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What's the Vibe?: 10 Music Festivals and the Drugs That Define Them

Thu, 04/19/2018 - 19:24
Who's doing what at which festival?

From SXSW to Burning Man to the Electric Daisy Carnival, festivals are known not only for their musical styles, but also for the drug-taking habits of the people that attend them. Blissfully dancing acid heads, ecstatic rollers, and drunken mud pit wallowers weave in and out of the massive crowds. They're part of the scenery at what is, after all, a massive party scene.

But who's doing which drugs at what festivals? Thanks to the good folks at TickPick.com, an online ticket marketplace, we now have an inkling. They surveyed more than a thousand festival-goers, and the result is their Most Used Festival Drugs. It's not a definitive study, but it is a fun point of departure for exploring the festival drug scene.

The first finding worth noting is that despite their reputations as drug-drenched bacchanals, most people at music festival aren't using illegal drugs. America's favorite drug—alcohol—is also the favorite of the festival scene, with three-quarters reporting having imbibed, twice as many as reported toking up. Fewer than 40% overall reported smoking pot, and when it comes to other drugs, the numbers shrink even further.

MDMA/Ecstasy/Molly came in third at 13%, but none of the other drugs listed—LSD, magic mushrooms, cocaine, opiates, DMT, other—came in as high as 9%.

While they all featured heavy alcohol and marijuana use, each music festival has its own personality, and its own drug habits. For instance, Lone Star state concertgoers at SXSW and the Austin City Limits Festival were the least likely to pick up a joint—27.1% and 24.2% respectively. Austin may be the pot-friendliest city in Texas, but it's still Texas.

The electronic dance music (EDM) festivals, are, unsurprisingly, Ecstasy hotbeds. Miami's Ultra festival came in at 17.7% for Ecstasy, while at the Electric Daisy Carnival in Las Vegas, more than one out of four attendees (26.4%) were rolling to those 130 beats per minute. Both festivals also scored high for cocaine use, with Ultra at 10.6% and the Carnival at 9.9%.

Cocaine didn't even make the top five list at Burning Man, that massive gathering each September in the Nevada desert. No, Burning Man is for tripping brains. More than one out of three Burners were on psychedelics, either mushrooms (19.2%) or LSD (16.0%). Burning Man also ranked high for Ecstasy use at 17.9%. What else are you going to do at Black Rock?

Below is the chart of the top drugs at each festival. Pick your music and pick your poison:

 

 

 

 

 

 

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This Popular Recreational Drug Can Rapidly Treat Depression and Reduce Suicidal Thoughts: New Study

Mon, 04/16/2018 - 08:54
The scientists found that those who had taken it reported significantly decreased suicidal thoughts and reduced depressive symptoms at four hours and 24 hours after administration.

Ketamine is best known for being a popular recreational drug and a powerful medical anesthetic, but an increasing body of research is showing that the compound may also be effective in treating psychiatric disorders, such as depression.

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Trump Cuts the Legs Out from Under Sessions' War on Weed

Sun, 04/15/2018 - 19:57
The president made some very encouraging remarks, but will he follow through?

President Trump last week signaled a dramatic turnaround in administration marijuana policy, telling Colorado Republican Sen. Cory Gardner that the Justice Department would not go after state-legal marijuana in Colorado and that he would support moves to address the contradiction between legal marijuana states and federal pot prohibition.

That puts Trump in line with his own campaign statements that marijuana should be a states' rights issue, but at odds with Attorney General Jeff Sessions, who has been a staunch opponent of marijuana legalization and who has explicitly told federal prosecutors they are free to go after the legal marijuana industry. Sessions, who is much abused by Trump for failing to protect him from the Mueller investigation, now finds himself on the outs on pot policy, too.

And Trump didn't even bother to tell Sessions he was about to cut the legs out from under him, an almost unprecedented slight from a president to his attorney general.

Gardner, a Republican up for reelection in a pot-friendly state, had placed a hold on Justice Department nominees since Sessions rescinded the Obama-era policy in January and announced the apparent policy shift with a Friday afternoon press release after a phone call with Trump earlier in the week.

"Since the campaign, President Trump has consistently supported states’ rights to decide for themselves how best to approach marijuana," Gardner said. "Late Wednesday, I received a commitment from the President that the Department of Justice’s rescission of the Cole memo [Obama-era guidance] will not impact Colorado’s legal marijuana industry. Furthermore, President Trump has assured me that he will support a federalism-based legislative solution to fix this states’ rights issue once and for all."

Gardner said Trump's comments had convinced him to remove his remaining holds on Justice Department nominees, and that he would continue to work on a bipartisan legislative solution to pass Congress so Trump can "deliver on his campaign position."

"The president did speak with Sen. Gardner yesterday and again today," White House Press Secretary Sarah Sanders told reporters Friday. She said "the president is a firm believer" in states' rights and confirmed Gardner's account of the assurances he received from the president was accurate.

While Trump is notorious for seat-of-the-pants policy shifts and for lack of follow-through on policy pronouncements, some activist groups were quick to laud the apparent shift.

"Sen. Gardner has done a great service for his constituents by standing up for federalism regarding marijuana policy," said Don Murphy, director of conservative outreach for the Marijuana Policy Project. "Everyone who knew about President Trump’s statements on this issue during the campaign was hoping he would uphold those values and support states’ abilities to enact laws regulating marijuana for medical or adult use while in office. This news should make states more comfortable implementing their legalization programs. It should also serve as a rallying cry for lawmakers to pass comprehensive legislation that leaves marijuana policy to the states permanently."

Congress renewed spending restrictions that prevent federal interference in state medical marijuana in March, but no such protections exist for states that have regulated marijuana for adults. Trump’s statements suggest that the same policy will apply to both medical and adult use providers, but the Dept. of Justice could still legally pursue cases against state-legal adult use operations if federal prosecutors choose to do so.

"With the support of the President, the American public, and mounting evidence that regulating marijuana similarly to alcohol is much preferable to prohibition, there is no reason for Congress to delay any longer," continued Murphy. "There are several pieces of marijuana policy legislation being considered right now, and every one of them should get hearings immediately."

But Washington state Attorney General Bob Ferguson was more cautious. As the head law enforcement officer in a legal marijuana state, Ferguson is adopting a wait-and-see position.

"I understand President Trump has offered his support for states to have the right to regulate marijuana and for legislation to enshrine this right in law," he said in a Friday statement. "I am cautiously optimistic that the president appears to have heard the will of the people on this issue. But this president has demonstrated a willingness to go back on his word. Until there is a formal agreement protecting Washington’s well-regulated marijuana industry, I will continue to stand ready to defend it."

Given this president, that is probably the prudent position.

 

 

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Oklahoma's Revolution Didn't End with Teacher Strikes—It's Going Much Further

Fri, 04/13/2018 - 13:23
Oklahoma is gearing up for changes across the state in the 2018 midterm.

Oklahoma is in the midst of a revolution, with rolling teacher strikes statewide. Teachers have taken over the state capitol building, pressuring legislators to give them—and their fellow school employees—a raise. At the time of this writing, more state agencies, from Corrections to Mental Health to Transportation, are joining the teachers in their fight, and are getting louder about their budget shortfalls, too. While the Oklahoma Education Association (OEA—the primary teacher’s membership organization) recently announced the strike is over, the teachers continue to strike and walk out, and, according to a leader of the teacher’s strike, are seeking a new union that will actually represent their interests.

Meanwhile, legislators are seeking ways to punish the striking teachers, and have accused the teachers of bussing in protesters, and local police call the teachers “terrorists." 

In other words, the current state of unrest in Oklahoma is far from over, and state workers are far from being done protesting.

Adding fuel to the fire is the 2018 gubernatorial election. The state primaries, along with a popular medical marijuana ballot question, are June 26. (The state currently has some of the toughest marijuana laws in the nation, with 55 people still serving life sentences for non-violent drug crimes, including marijuana offenses.)

There is a rallying cry rumbling in the state to replace every single elected official this year.

Meanwhile, the mainstream media continues to miss the mark on what’s happening on the ground locally. The state’s demographics betray the media’s portrayal of Oklahoma as Republican red and lily white: Most registered voters in Oklahoma are registered Democrat or are unaffiliated. Bernie won the primary easily, and got more votes in the primary than Trump did. A third of Oklahomans are African Americans, Native Americans, Latinos, and those of mixed race.

And still, the demographics of Oklahoma are changing: In Guymon, a small town in the Oklahoma panhandle, just north of the Texas border and hours from the nearest shopping mall, 37 languages are spoken in the public school system of just 3,000 students. Here, a teacher assistant’s full-time salary starts at just over $12,000 a year.

The news has been teeming with tales of teachers selling their plasma or working five jobs to make ends meet, yet the truth is it’s state workers who are impoverished, across the spectrum. While the poverty rate in the U.S. has fallen over the last 10 years, the poverty rate in Oklahoma has steadily risen

And that’s only scratching the surface of the reasons for Oklahoma’s revolution. What’s boiling underneath is the knowledge that the state should be exceedingly wealthy: Fossil fuels are kings here, and oil, gas, and coal are sucked from the earth, from the rural countryside to the state capitol building in Oklahoma City. Decades of sweetheart deals have left the state paying those industries more than those industries pay the state.

Fossil fuel industries have been polluting with impunity for as long as they’ve been mining or pumping the resources, leaving entire towns, like Bokoshe and Dover, poisoned. Former state attorney general and current EPA director Scott Pruitt eliminated the environmental unit of the OK-AG’s office. Add in a slurry of corruption, cutbacks, and incompetence, and the state’s biggest environmental offenders are free to continue to poison Oklahoma’s citizens, air, land, and waterways. 

The bottom line of what’s happening here is that people are sick and tired of politics as usual—the good ’ol boy system, they say, must end. 

But many are skeptical of both parties. Even most of the Democrats in Oklahoma are considered “Dixiecrats,” and in the primaries, the Democratic Party favorite is former state attorney general Drew Edmondson, who oversaw the death penalty execution of dozens of Oklahomans.

Meanwhile, Connie Johnson, the Our Revolution candidate, is the African-American former state senator who started the state’s Our Revolution chapter. Johnson is in a strong position, but seems to currently be out-fundraised by Edmondson.

With replacing every elected official becoming a rallying cry, it’ll be interesting to see who gets voted in to state offices—and how many continue business as usual—and how the revolution impacts the rest of the country.

 

 

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DOJ Report Finds That DEA Contracts Actually Gouge Taxpayers and Benefit Ex-Agents

Fri, 04/13/2018 - 10:06
It's relatively small potatoes for the scandal-plagued drug-fighting agency, but it's part of a long pattern of institutional abuse and misbehavior.

In a report released Thursday, the Justice Department's Office of the Inspector General (OIG) found that the Drug Enforcement Administration (DEA) granted contracts to former employees that cost more than half a million dollars more than if those employees would have been paid had they still been working for the agency.

The questionable contracts were used in the agency's Asset Forfeiture Program. The program contracted with Maximus Inc., a government employment agency, to provide workers to tally cash and other assets seized in drug busts that could be sold to generate revenue. The report found that DEA paid Maximus $85 million between 2013 and 2017 under 12 separate contracts.

Although Maximus was the main contractor, contract workers for the program were actually selected by DEA supervisors, and 40% of them were former DEA employees. Those ex-employees had an average of 22 years with the agency, and more than 90% of them reported to the same office they had worked for before they left the agency.

And they got paid substantially more as private contractors than they did as government workers. Two of those workers took in $485,386 more than they would have with their government salaries as senior DEA investigators. They got their positions even though they didn't have masters degrees, which were required for the positions, and even though the DEA didn't officially waive that requirement.

DEA also unlawfully paid local travel costs for contractors who worked away from the main job site. The report said such reimbursement is prohibited for contractors, but did not say how much the travel expenses cost the agency.

"We found that the DEA is highly involved in the process of selecting task order workers, many of whom were former DEA employees and we believe the [Justice Management Division] needs to assess the contracting agency’s role to ensure it is appropriate and to safeguard the integrity of the contract personnel selection process," the report said.

While the OIG didn't find evidence the DEA violated ethics rules in choosing the contract workers, "there is room for improvement," a DEA spokesman said.

While the DEA's hiring practices in this case appear to demonstrate favoritism toward ex-employees at the expense of taxpayers and suggest that "the swamp" extends into the bowels of the anti-drug bureaucracy, this is really rather small potatoes for the scandal-plagued agency.

Just two years ago, another OIG report found that DEA had spent more than $235 million between 2010 and 2015 to pay confidential informants even though "DEA did not adequately oversee payments to its sources," which included snitches who had previously been deactivated because they had been caught committing other crimes or perjuring themselves on the stand in drug cases in which they were involved.

A 2015 report from the Drug Policy Alliance outlines numerous other DEA scandals, ranging from deaths at the hands of DEA agents in the U.S. to a massacre of innocents in Honduras to collusion with the Sinaloa Cartel that allowed it to smuggle billions of dollars' worth of drugs into the U.S. in return for information about rival cartels to its role in helping the National Security Agency spy on the phone calls of Americans. And that's just scratching the surface.

Ripping off the taxpayers for a few hundred thousand dollars with shady contractor deals seems like small potatoes for the $2 billion-a-year drug-fighting agency, but it is part and parcel of a pattern of institutional arrogance and misconduct that goes back decades. Maybe it's time to get rid of the DEA.

 

 

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Colorado House OKs Bill to Let School Nurses Administer Medical Marijuana

Fri, 04/13/2018 - 08:51
It's another step toward the normalization of cannabis as medicine.

DENVER (CN) – A bill that would allow school nurses to administer medical marijuana to students passed the Colorado House 47-17 on Thursday.

The bill is sponsored by state Sen. Irene Aguilar, a Democrat, and Republican state Rep. Dylan Roberts.

Medical marijuana is one of few issues that enjoys bipartisan support, according to a recent Pew Research poll that found 6 in 10 Americans support its use. Whether to allow cannabis into the classroom, however, has been a subject of debate.

“I was pleased that it passed. Most school nurses knew it would be passed so they came to me yesterday,” Aguilar said.

Currently, nurses administer medication according to doctors’ orders, and voiced concern that the same standard be maintained for medical marijuana.

Patty Rojec, president-elect of the Colorado Association of School Nurses, is concerned that without direction from the state board of nursing and physicians, school nurses may be put in a gray area forced to choose between families’ wishes and the direction of the medical community.

“There is no precedent for that, nurses don’t get to choose,” Rojec said. “We’re afraid this bill puts us in a difficult position. Our scope of practice needs to change if this bill is to work. Physicians’ scope of practice needs to change.”

In Colorado, doctors may recommend patients use medical marijuana, but they do not write a prescription for it.

Many marijuana advocates consider this bill another step toward making its use a normal part of life.

“As the novelty of medical cannabis wears off, it is to be expected that further legal and regulatory changes such as this will be proposed with the goal of treating cannabis in a manner that is similar to other conventional medical treatments,” said Paul Armentano, deputy director for cannabis advocacy group NORML.

Cannabis is currently banned by federal law as a Schedule I substance, meaning the U.S. Drug Enforcement Agency considers it highly addictive and of no medical value.

But medical marijuana has become an increasingly popular way to address a variety of symptoms from pain to insomnia and is used to treat epilepsy and cancer.

To date, 28 states have approved some kind of medical marijuana program and eight have legalized the substance for recreational use.

Colorado’s bill builds on Jack’s Law, which allowed for primary caregivers to bring medical marijuana to students at school. Fifteen-year-old Jack Splitt suffered from dystonia, which causes agonizing and involuntary muscles contractions. Before his untimely death, Splitt and his mother Stacey Linn were strong advocates for patients’ right to use medical cannabis.

Parents with children who are taking medical marijuana for debilitating health conditions already have enough to worry about without making an extra trip to the school, noted Aguilar. This bill provides protection to school nurses who are allowed to give children prescribed medication.

“Too many people, when they think of medical marijuana, they think of children smoking it, and it is usually administered in the form of CBD oil,” Aguilar noted.

Smoking marijuana on school property, on buses or at events remains prohibited, as does students’ possession of it.

The bill heads next to the state Senate for approval.

The U.S. Department of Justice declined to comment on the matter.

 

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This Profession Smokes the Most Weed -- See Where Yours Ranks

Fri, 04/13/2018 - 06:06
U.S. Centers for Disease Control and Prevention ranked Colorado occupations by how much their workers use marijuana.

So apparently people who work in media smoke a lot of weed... Cough. Puff. No comment. But we're not the profession most likely to light up. A recent study by the U.S. Centers for Disease Control and Prevention ranked Colorado occupations by how much their workers use marijuana, which was legalized in the state in 2012 and became available for purchase two years later.

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How Big Pharma Deceives You About Drug Safety

Fri, 04/13/2018 - 04:17
Since at least as far back as the mid-1970s, Health Canada has not fined a single drug company for the way that it promotes prescription drugs.

The recent decision of a Saskatchewan judge to reject the proposed settlement between the provinces and Purdue Pharma, the maker of OxyContin, should raise serious questions.

Purdue introduced the prescription drug OxyContin in 1996 and marketed it as safer and less addictive than other opioids. This is now seen by many as the beginning of the opioid crisis in Canada. The settlement in question was meant to compensate patients who were victims of the opioid epidemic and the provinces for some of their additional health-care costs in dealing with the epidemic.

The decision should raise questions not just about how Purdue marketed OxyContin, but also about how Health Canada regulates — or more accurately does not regulate — the promotion of prescription drugs in Canada.

Since at least as far back as the mid-1970s, Health Canada has not fined a single drug company for the way that it promotes prescription drugs.

A reporter for the Toronto Star asked Health Canada why it had never prosecuted drug companies for illegally marketing drugs in Canada despite the same companies being fined for doing so in the United States.

The response from Health Canada was that it “has not been made aware of any specific similar issue in Canada and has not received complaints concerning these companies promoting off-label uses of their products in Canada.”

Regulation by industry

In theory, the Food and Drugs Act and its regulations give Health Canada the ability to directly regulate promotion.

In practice, the agency has turned over the day-to-day regulation of promotion to a combination of industry, as represented by its lobbying arm Innovative Medicines Canada (IMC), and an independent external group with strong industry representation, the Pharmaceutical Advertising Advisory Board (PAAB).

The PAAB is governed by a 14-person board, with representatives from five organizations that directly benefit from drug advertising: IMC, BioteCanada, Association of Medical Advertising Agencies, Canadian Association of Medical Publishers and Consumer Health Products Canada.

Its Code of Advertising Acceptance is deeply flawed.

This code requires a “fair balance of risk to benefit” but there is no specific requirement that equal space in the ads be devoted to harms and benefits, and there is no provision for the font size used to describe benefits and harms to be equal in size.

The generic name does not have to be used each time that the brand name is given, despite evidence that use of the generic name leads to better prescribing.

The most serious penalty that the PAAB can impose where “information may cause inappropriate product use or constitutes an imminent and/or significant health hazard” is that the head of the organization may require letters of correction, published notices or the immediate withdrawal of the advertisement.

‘Drug abuse is not a problem…’

One example of how Purdue misled Canadian doctors about OxyContin was an ad that appeared in Canadian Family Physician in 2000.

The ad featured the World Health Organization “pain ladder” — a guideline for administering the right drug in the right dose at the right time for cancer pain relief — that Purdue had adapted. New drugs were added to the ladder as part of the adaptation, one of which was oxycodone, the generic name for OxyContin, and there was no mention that the original pain ladder was only for people with cancer.

The same ad also had the statement that, “drug abuse is not a problem in patients with pain for whom the opioid is appropriately indicated.”

The provenance for that quote can be traced back to a five-sentence letter in the New England Journal of Medicine in January 1980.

The patients referred to in the letter suffered from acute pain, not chronic pain, were in hospital, not outpatients, and there was no long-term follow-up.

The ad had been approved by the PAAB.

Health Canada an advisor

The Oct. 18, 2016, issue of the Canadian Medical Association Journal had an ad for another opioid, Targin, also made by Purdue.

The ad prominently featured the statement: “Demonstrated reduced drug liking relative to oxycodone, when administered intranasally or intravenously.” Drug liking refers to the risk that a drug will be abused because of its addictive potential.

Below this statement, in barely visible print, was the acknowledgement that “the likely clinical significance of these results has not yet been established.”

The ability of companies to insert claims where the clinical significance is unknown is allowed by the PAAB code. How much reduction in liking was observed was not stated.

Intranasal and intravenous administration was tested because those are routes likely to be used by recreational drug users. Targin is only available in an oral formulation, but there was nothing in the ad about potential for abuse by people who had been legitimately prescribed this dosage form.

Buried deep in the fine print was the warning about “addiction, abuse and misuse.” This ad was also approved by the PAAB.

In 2012, OxyContin was replaced by OxyNeo, a new formulation that couldn’t be crushed and injected. The following year Purdue spent more than $3 million promoting OxyNeo, took out 143 pages of advertising in Canadian medical journals and its sales representatives made 17,000 office visits to doctors.

When the PAAB was subjected to public criticism in an academic forum, the organizers of the forum, of whom I was one, were asked to send an apology to all of the audience members, an apology that would be first reviewed by the organization’s lawyer.

Health Canada presumably approves of how the PAAB operates since it acts as an adviser to the organization.

No information on drug harms

Despite the visibility of journal ads, the amount spent on them is dwarfed by the amount spent on visits by sales representatives. In 2016, pharmaceutical companies in Canada spent $12.5 million on ads versus more than $400 million on sales reps.

The actions of these men and women are regulated through the Code of Ethical Practices of IMC. The code states that: “Members must provide full and factual information on products, without misrepresentation or exaggeration. Statements must be accurate and complete. They should not be misleading, either directly or by implication.”

This claim was tested in 2009-2010 in a project lead by Dr. Barbara Mintzes, then a faculty member in population and public health at the University of British Columbia, that I was involved in.

We asked general practitioners in Vancouver and Montreal who saw sales representatives to fill out questionnaires after each visit to record what they heard.

Claims about benefits of drugs were made twice as often as the harms from those drugs were discussed.

There was no oral or written information about harms between 36 to 40 per cent of the time.

Contraindications to use of the drug were mentioned about 15 per cent of the time. And for serious adverse side effects it was even worse — the sales reps talked about them only five to six per cent of the time.

Penalties are lunch money

The validity of complaints about code violations is decided by the Industry Practices Review Committee (IPRC). The permanent members of the IPRC are two company representatives, two external health-care professionals all appointed by the IMC Board of Directors, a representative appointed by the IMC president and IMC’s general counsel.

The maximum financial penalty after a fourth violation in a 12-month period is $100,000. After the third violation, the chief executive officer of the company is required to appear before the R&D Board of Directors to provide a detailed explanation of the violations and a comprehensive written action plan to ensure remediation.

When companies are spending upwards of $14 million promoting a single product, $100,000 is lunch money.

The way in which companies promote their products should be no surprise; they are in the business of making a profit for their shareholders.

What is surprising is that Health Canada condones their marketing practices. It’s time for that to change.

Joel Lexchin, Professor Emeritus of Health Policy and Management, York University and Associate Professor of Family and Community Medicine, University of Toronto

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

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Prisons Are Making the Addiction Crisis Worse—Inmates Need Institutional Support to Prevent Recidivism and Relapse

Thu, 04/12/2018 - 12:12
Former inmates lack the tools to survive and succeed once they're released.

Keith Whiteman was first locked up in 1995, at age 20. Three years in prison, five months out—then he offended again. Another two years in prison, seven months out. Three more times he returned, spending years behind bars and then a few months free. Each time he committed yet another offense (or several), all a byproduct of his addiction to drugs. “A recidivating machine,” Keith described himself to me.

Overall, Keith had 40 felony convictions, six felony imprisonments, and many more stints in jail. Each cycle came at a cost, both to him and to society. During 15 years in the custody of the Washington State Department of Corrections, Keith took advantage of every “treatment” program the DOC had to offer. Yet while you could lock him up a countless number of times, for longer and longer sentences, it wasn’t until he was released into a web of support that he was able to break the cycle of imprisonment: going in with a drug addiction, coming out with a drug addiction, and reoffending.



In 2008, though, something changed: Just before his release, Keith connected with the Post-Prison Education Program, and we delivered. We stood with Keith and his family as he strived to build a life worth living. The Post-Prison Education Program facilitated and encouraged his entry into and success in college; provided housing, groceries, transportation, and additional basic needs; and, importantly, mentored Keith intensively. For the first time, Keith said, people cared about him who weren’t related to him, who owed him nothing. Buoyed by hope, he was able to overcome addiction, earn a college degree, launch a career in human services, and father his son with consistency and dignity.

Dr. Gabor Mate’s words come closer than any I’ve ever heard or read that adequately explain the power of addiction: “people jeopardize their lives for the sake of making the moment livable. Nothing sways them from the habit—not illness, not the sacrifice of love and relationship, not the loss of all earthly goods, not the crushing of their dignity, not the fear of dying. The drive is that relentless.”

“Prison wasn’t the solution,” Keith said in an interview for Brave New Films’ new film about addiction and incarceration, Sentencing Reform: Drug Addiction. "It never is, and it never will be."

Noted criminal justice analyst David Lovell, who spent years as a research professor at the University of Washington, once argued that the Department of Corrections (DOC) is incapable of successfully addressing recidivism, readmission, overdoses, and suicides. “Probation and community corrections officers can’t really manage cases, at least not by themselves, in a way that responds in a timely fashion,” Lovell wrote. To help high-risk prisoners in their time of need, “you need to be available and trusted. That’s not a reasonable expectation for DOC employees,” by virtue of their enforcement role. “Many of them do their very best,” he wrote.  But what corrections officers in the community do—supervise ex-offenders and refer them to programs—does not “take the place of a genuine relationship between the ex-prisoner and his or her real community of support.”

If what Americans really want is sheer hateful vindictiveness and punishment with no intent of rehabilitation, they should by all means continue on the course set by presidents Nixon, Reagan, Clinton, Bush, and now Trump: Build more prisons, increase sentences, call for the death penalty for drug dealers, and continue to throw away taxpayers’ dollars at a rate of as much as $504 billion per year. Continue to be blindingly, inexpressibly ignorant, while failing to improve community safety even one whit.


However, if our country wants to help pull people out of addiction and into productive, healthy, and hopeful lives, they should listen to what Eldon Vail, former secretary of the Washington State Department of Corrections, proposed to me years ago: Commit, in the state legislature, to reducing the prison population, starting with long-term prisoners. Release people only into programs with a proven track record that are centered in evidence-based principles and include treatment, job training, education, and/or employment. The programs should handle all the casework; probation officers, he said, should be there for enforcement only. Dedicate half the savings from a reduced prison population to the programs supporting former prisoners on the outside.

Such an approach would save taxpayer dollars, Vail said, in the short and long term, and would enhance community safety. What’s more, when people who have long suffered from addiction leave prison and land in a well-knit safety net, they can build lives worth living for themselves, their families, and our communities. Just ask Keith Whiteman.

Watch Sentencing Reform: Drug Addiction by Brave New Films below.

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Is It Possible to Be Physically Addicted to Marijuana?

Thu, 04/12/2018 - 11:45
Unlike Sunday morning, it’s not easy.

Much of the discussion of cannabis addiction falls under the purview of psychology, where self-reported feelings and more-or-less arbitrary clinical definitions tend to dominate. Obviously, there are psychological drivers for marijuana use, which are well known to include feelings of existential dread in the face of a long, sober evening and a growing sense of dissatisfaction with basic-cable reruns of Hart to Hart. But what about the un-spinnable physical truth of the body? Are there biochemical aspects to those addicted to marijuana?

This is not at all well studied in human beings, but there are some intriguing observations from animal testing.

One way for scientists to simulate kicking cannabis cold turkey is to administer cannabinoid receptor antagonists. These are a substances that shut down the CB1 and CB2 receptors that are stimulated by the active ingredients in marijuana. If they are knocked out, it doesn’t matter how much cannabis you take in, you will not feel it.

When, in clinical settings, rats that have been turned into major pot-heads are administered cannabinoid receptor antagonists, they exhibit a variety of symptoms unseen in ordinary cannabis withdrawal. These include wet-dog shakes (a real clinical term); compulsive grooming, itching and face scratching; spasms; and moon-walking (not a real clinical term). Some of these symptoms are also characteristic of opioid withdrawal. Dogs in similar trials exhibit similar, though less colorful, symptoms.

A possible explanation for the startling effects of “precipitated cannabis withdrawal” is found in the unusual chemical structure of THC, which, unlike other intoxicants, is readily stored in the body’s fat cells. Unlike lab rats, people in the real world who quit marijuana still have functioning cannabinoid receptors. Thus for weeks, or even longer, after stopping cannabis, a former user will still be metabolizing tiny amounts of THC as it is burned up along with body fat. It’s not enough for a high, but it might be just enough to ease the worst biochemical aspects of withdrawal.

In other words, the body might have its own inbuilt cannabis rehab program. If it weren’t for this, quitting marijuana might feel a lot more like kicking heroin.

 

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The Clampdown on Visiting Loved Ones in Prisons and Jails Isn't Helping Anyone

Wed, 04/11/2018 - 18:23
Click here for reuse options! In-person visits are beneficial to prison safety and recidivism rates and are crucial to those behind bars.

Evie Litwok felt the necessity of visitors when she served time in the Federal Correctional Institute in Tallahassee, Florida. While she was in solitary, visits were cut down to one hour per week, and prisoners were both forbidden physical contact and shackled during visitation. When a woman housed with Litwok found that her husband was unable to afford the trip across state lines for a mere hour, she bashed her head against the cement wall until it was bloody. “Those who survived the best were women who had contact with family,” said Litwok.

Giovanni Reid, who grew up in Pennsylvania prisons, told AlterNet what it meant to have visitors during his 26 years behind bars, beginning when he was 16. He said, “Visitors are absolutely necessary. They connect you to something more meaningful in your life.”

Likewise, Karter Reed, who served 20 years in Massachusetts prisons, credits part of his successful transformation to the 70 visitors who drove miles to support him. “I learned how to be a responsible male adult role model in prison visiting rooms with my nieces and nephews,” he said when he testified at a Department of Correction (DOC) 2016 public hearing. He was there along with many advocates to protest the rollout of new visiting procedures in Massachusetts state prisons that limit the number of visitors per prisoner and insist on a pre-approved visitor list. Reed’s 23 cousins, all of whom came to visit him, would have been out of luck.

“First Day Out.” Photo courtesy of Karter Reed (center L, white T-shirt).

So, here’s the conundrum. In-person visits have a positive impact on prison safety and are crucial to those behind bars. Furthermore, research says that visitation is one of the most important keys for prisoner re-entry and that it significantly reduces recidivism, i.e., the return rate to prison. Why, then, are we seeing more repressive restrictions, and, importantly, shutting the door to real visits as institutions try to replace them with video visitation?

Is It Really All About the Drugs?

Department of Correction officials across the country will tell you it’s all about preventing contraband.

Christopher M. Fallon, assistant deputy commissioner of communications at the Massachusetts DOC, said in a telephone interview that K2, or synthetic marijuana, and the narcotic Suboxone are brought in on Listerine breath strips. “The inmates were paying people to bring in drugs, muling in the drugs,” he added, attempting to explain why Massachusetts has increased surveillance. The state also has canines at facilities, sniffing visitors for drugs when they pass through security.

To “crack down on contraband during visitations,” Maryland prisons recently banned hugging and kissing. In New Hampshire, in addition to limiting physical contact, per WMUR, board games with prisoner’s children are now banned at state institutions, and “vending machines have been removed because they were used to hide drug transfers,” said prison officials.

Prisoners are currently strip-searched after every visit in many states, in large part to check for smuggled-in drugs. But perhaps the most egregious practice, as of July 2017, is that in Florida, strip searches of visitors are now allowed. According to the Florida Times-Union, “Visitors who set off metal detectors must consent to unclothed searches of their person and their vehicles, or forfeit visitation privileges.” This means that in “2,350 searches of visitors… at 16 facilities,” hundreds of strip searches took place, which the women described as “degrading.” The Times-Union’s analysis determined that “more than 97 percent of nearly 200 searches in a three-month span were conducted on females.”

So far no lawsuits have been filed against Florida’s DOC that AlterNet could uncover, but the Times-Union reported that Amy Fettig, deputy director of the American Civil Liberties Union’s National Prison Project, decried the practice of strip searching visitors and said it was certainly “unnecessary.” James Pingeon, an attorney at Prisoner Legal Services in Massachusetts (PLS), said in an interview that “PLS is concerned about whether the new [MA] visiting policies comport with the law because they seem to be an exaggerated and unreasonable response to the problem of smuggling drugs into the prison.” In 2015, New Hampshire “tried to stop Suboxone coming through prison mail by banning greeting cards, drawings and colored paper.” The American Civil Liberties Union is battling the state over the policy, which they say particularly hurts children.

Research has shown that drugs are a problem in prisons. But according to the non-profit Pew Charitable Trusts, correction officers have a large part to play in this, as well. They cite some big drug busts across the U.S. involving prison staff. Also, there were mixed results in the reduction of drugs and violence inside prisons when California recently piloted a program to curb contraband costing $15.3 million.

Video Visitation

Prison activists counter corrections with their own ideas about why in-person visits have become so repressive. Lois Ahrens, founder and director of the Real Cost of Prisons Project, who has communicated with thousands of prisoners from every state across the country, calls it “extreme control.” In a phone interview, Ahrens said, “All of this is a way of trying to dissuade people from being actual visitors, in order to push the idea of video-calling. The ability to have real contact, to sit near each other, eat something together, can’t be replaced by video, which costs more money and is much more surveilled.”

Wanda Bertram, communications strategist for the non-profit Prison Policy Initiative (PPI), said in a series of email communications and on the phone that video visitation is now in more than 35 states. A kind of low-quality Skype for prisoners, PPI reported in 2015 that video visitation can cost up to $1.50 per minute.

Photo via The Daily Dot (originally photo from Convict Soap Box).

Bertram explained that “at least 130 jails across the U.S. have implemented video calling and also banned in-person visits…. This doesn't count the number of facilities that have cut back on in-person visits without banning them outright.” She added that such communication might make surveillance easier, but “when you introduce technology that allows people to visit with loved ones remotely, it opens up opportunities for facilities to take advantage of families.”

In Knoxville, Tennessee, according to a report from the grassroots organization Face to Face Knox, “The replacement of family visits with video calls has resulted in more violence, no drop in the rate of reported contraband, and higher levels of disciplinary infractions, putting more demand on staff.”

Is Legislation the Wave of the Future?

Several states, said Bertram, including Illinois, Texas and California, have passed laws to forbid video-visitation from being the sole way families can communicate with their loved ones. Massachusetts and New Jersey are also trying to pass such legislation.

Brian Dolinar, program director at Urbana Champaign Independent Media Center, who was part of the battle to fight off the video-visitation only policy in Illinois, says that corrections discourages in-person visits with a hostile visiting environment far from prisoners’ homes. He continued, “By increasing video visitations, prisons can make the in-contact visit so repressive that it’s unappealing and therefore they push people onto video systems.”

Facts are clear. Over and over, studies show that bans on in-person visits “make jail more dangerous, do nothing to stop the flow of contraband, and strip money from the pockets of families.” But it may take more litigation and law after law in state after state to keep prison visits intact.







 

 

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The Grades Are In: Best And Worst States For Marijuana Patients

Tue, 04/10/2018 - 10:08
Seven states receive a B+ and 16 states (mostly from the South) flunk.

In a comprehensive, 187-page report on the status of access for medical marijuana patients in the US, seven states received a grade of B+, the highest score given this year.

California, Hawaii, Illinois, Michigan, Nevada, Ohio and Oregon were recognized as the best states for patients. California, Michigan and Illinois were repeat winners from last year.

The report, “Medical Marijuana Access in the United States,” was released by Americans For Safe Access, a 15-year-old organization whose mission is to “ensure safe and legal access to cannabis for therapeutic use and research.”

No state was given an “A” grade and 16 states received “F” grades, 10 of those states from the South. All states that received a failing grade limit their medical cannabis program to cannabidiol, an extract of the marijuana plant.

Five states — Idaho, Nebraska, Kansas and South Dakota — did not even qualify for a grade since they do not have medical marijuana laws.

The categories states are graded on include:

  • Patient Rights and Civil Protection
  • Access to Medicine
  • Ease of Navigation
  • Functionality
  • Consumer Safety and Provider Requirements

“We want lawmakers to use this report to see that there are gaps in their medical cannabis programs. Even programs that have been around for decades like California still have room for improvement,“ said Steph Sherer, Executive Director for Americans for Safe Access. “Research has shown us that there can be as much as a 40% decrease in opioid overdose deaths in states with medical cannabis dispensaries. States with effective medical cannabis programs can save lives, and this report lays out the steps to increase program effectiveness.”

The report reviewed existing laws and regulations, and laws passed in between January 1, 2017 and December 31, 2017.  This year’s report, unlike previous versions, urges states to improve their programs to use medical cannabis as a tool to fight the opioid crisis.

You can read the entire 187-page report here.

 

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Trump Launches a New Drug War, Targeting the Opioid Crisis -- But Who's the Real Enemy?

Tue, 04/10/2018 - 09:50
Trump and Jeff Sessions want to execute low-level dealers and crack down on legal marijuana. But Big Pharma is safe

In a characteristically incoherent speech last month, President Donald Trump displayed all the signs of a wannabe despot while outlining his plan to combat the opioid crisis, hich included the controversial call to execute drug dealers. “If we don't get tough on the drug dealers we are wasting our time, and that toughness includes the death penalty,” declared the president, who praised other countries where drug dealers are put to death, such as China, Singapore and the Philippines. “You take a look at some of these countries where they don’t play games. They don’t have a drug problem.”

This, of course, isn’t the first time Trump has heaped praise on the authoritarian policies of other countries or expressed his admiration for foreign dictators, whom he seems to respect a great deal more than the democratically elected leaders of America’s closest allies. On the issue of drugs, Trump has displayed a particular fondness for Philippine President Rodrigo Duterte, who is notorious for ordering extrajudicial killings of drug suspects, and who was overheard telling unemployed citizens to “kill all the drug addicts” last year.

Besides advocating the death penalty for drug dealers, the president couldn’t resist sprinkling some xenophobic rhetoric into his crazed speech, blaming Mexico and illegal immigrants for fueling the opioid epidemic. “Ninety percent of the heroin in America comes from our southern border, where, eventually, the Democrats will agree with us and we’ll build the wall to keep the damn drugs out,” declared Trump, failing to mention that the vast majority of those who misuse opioids — 11.5 of the 11.8 million opioid misusers in 2016, according to the Substance Abuse and Mental Health Services Administration — were misusing prescription opioids, not illegal drugs like heroin.

The president’s tough guy act clearly shows that under the guise of getting “tough,” the Trump administration is preparing to double down on the war on drugs, which has ruined countless lives — disproportionately those of people of color and the poor — over the past several decades, while failing to reduce drug addiction. In fact, the evidence shows that the criminalization of drugs actually increases levels of addiction, while decriminalization has the opposite effect. Trump’s authoritarian approach to the opioid epidemic will no doubt please many of his supporters, but five decades of disastrous drug war policies show that it is an approach destined to fail miserably and exacerbate America’s drug problem.

While Trump’s plan is supposedly about getting tough on those who fueled the opioid crisis, in reality it is about getting tough on the victims of the drug war and opioid epidemic. Case in point: The Trump administration appears to be in the process of escalating the war on marijuana, which could potentially help opioid addicts get clean (and serve as an alternative for pain relief).

Though more than six in 10 Americans now favor legalizing cannabis, back in January the Trump administration took a major step toward cracking down on legal marijuana. The Justice Department rescinded an Obama-era policy that had discouraged the federal government from enforcing marijuana laws in states like Washington, Oregon, Alaska and Nevada, where the drug is now legal. Attorney General Jeff Sessions, who once said that “good people don’t smoke marijuana” (and joked in the 1980s that he thought the Ku Klux Klan was “OK until I found out they smoked pot”), is a lifelong drug warrior who is leading the administration’s efforts to revamp the war on drugs.

Marijuana isn’t the only plant that the administration has in its sights. In February, the U.S. Food and Drug Administration, which is led by Scott Gottlieb — a physician with deep ties to the pharmaceutical industry — declared that the popular herbal supplement kratom, which is indigenous to Southeast Asia and has been reported to help many opiate addicts get clean, was itself a dangerous opioid that has been associated with 44 deaths.

This comes more than a year after the DEA attempted to temporarily classify the plant as a Schedule 1 drug, before backing off after a major backlash. Responding to the FDA’s claims, nine leading scientists wrote a rebuttal letter, asserting that “available science is clear that kratom, although having effects on opioid receptors in the brain, is distinct from classical opioids (e.g. morphine, heroin, oxycodone, etc.) in its chemistry, biological effects,” and “does not appear to produce the highly addictive euphoria or lethal respiratory depressing effects of classical opioids.”

 

The last point is important, as kratom appears to be a much safer alternative to the opioids that cause respiratory depression (which can often lead to death). The FDA’s claim that the herb has been associated with 44 deaths is, at best, highly misleading. Almost all the reported deaths involved other substances or medical issues, and only one incident appears to have involved just kratom (though there is no information about the actual cause of death). Indeed, the evidence suggests that kratom, which is related to the coffee plant, is much like marijuana in the sense that it isn’t dangerous when taken in high doses (anecdotal reports indicate that ingesting too much kratom simply leads to throwing it up).

Both marijuana and kratom have the potential to help combat the opioid epidemic by providing safer substitutes for deadly opioids like fentanyl and OxyContin. Yet rather than being open-minded about these promising alternatives, the Trump administration is readying for a crackdown on both. Pharmaceutical companies (along with private prisons) will no doubt cheer this effort on, as these natural alternatives are bad for business.

Evidence shows, for example, that in the states where marijuana has been legalized or approved for medical use, the number of prescriptions for painkillers and other classes of drugs has fallen dramatically. From a business perspective, then, it was perfectly reasonable when one of the top fentanyl producers, Insys Therapeutics, donated $500,000 to Arizonans for Responsible Drug Policy in 2016 to defeat a measure to legalize marijuana in the state. Its efforts were successful.

The same company has been in the news again this year, but for different reasons. Around the same time Trump was calling for the execution of drug dealers and a wall on the southern border, multiple doctors were indicted in New York for taking part in a kickback scheme with Insys. According to authorities, Insys bribed doctors to increase the number of new patients taking their fentanyl spray product, Subsys, whether they truly needed it or not. (The spray was intended for cancer patients.)

Several months earlier the billionaire founder of Insys, John Kapoor, had been indicted for leading this conspiracy to bribe doctors (Kapoor has pleaded not guilty). Considering that fentanyl caused more deaths in 2016 than heroin, one wonders whether President Trump would also advocate the death penalty for a pharmaceutical billionaire like Kapoor -- or, better yet, for members of the Sackler family, who fueled the opioid crisis and made billions of dollars off their deadly drug OxyContin.

One suspects that the president doesn’t hold respectable billionaires who donate lavishly to his political party to the same standard as low-level dealers. Like so many things in American society, the war on drugs is and always has been fundamentally racist and classist, and since it was declared a half-century ago, people of color and poor people have borne the brunt of its devastating effects. While black people and Latinos use and sell drugs at similar rates as white people, for example, the former groups make up 57 percent of the people incarcerated in state prisons for drug offenses.

In America, wealth not only grants one instant respectability, but often exempts one in practice from the laws everyone else is expected to follow. This was evident after the financial crisis, when a grand total of zero Wall Street executives were prosecuted for the massive fraud their banks had engaged in. By contrast, a report from the Prison Policy Initiative reveals just how much poverty has been criminalized in America, finding that “incarcerated people had a median annual income of $19,185 prior to their incarceration, which is 41% less than non-incarcerated people of similar ages.”

In a recent column for the New York Times, Chris Hayes attempted to explain why this is, arguing that the “law and order” rhetoric Trump has so effectively employed since he launched his presidential campaign is more about the “preservation of a certain social order” than the “rule of law.” In this worldview, “crime is not defined by a specific offense,” but “by who commits it.”

“The history of the United States,” Hayes writes, “is the story of a struggle between the desire to establish certain universal rights and the countervailing desire to preserve a particular social order.”

The president is a reactionary, and thus his administration is not only committed to preserving the social order, but reversing any progress that has been made in the modern era — whether that means cracking down on legal marijuana, revamping the war on drugs or boosting the private prison industry. While poor people and minorities will continue to suffer under these policies, one can be sure that the super-rich folks who occupy the White House will continue to adhere to their own set of laws.

 

 

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Pot and Hops: A Family Reunion

Mon, 04/09/2018 - 08:35
New beer brews with cannabis terpenes -- and hops oil extracts fortified with THC

Once upon a time, cannabis and humulus (hops) were the same plant.

About 27 million years ago, cannabis and hops diverged from their common ancestor and evolved as separate botanical species.

Today, cannabis and humulus are identified as distinct species within the same plant family Cannabaceae. One can see a family resemblance in the jagged-edged leaves emblematic of both plants.

Family ties are also evident in the fact that cannabis seeds and pollen look the same as humulus seeds and pollen. These similarities make it difficult to distinguish between the fossilized remnants of both plants.

So how did scientists figure out when cannabis became cannabis, a unique species of its own?

Niche theory

Dr. John McPartland addressed this question when he spoke at the 2016 meeting of the International Cannabinoid Research Society in Poland. He used “niche theory” to ascertain whether a carbon-dated pollen sample was indicative of cannabis or its humulus cousin.

Niche theory involves identifying a plant remnant based on other botanicals found in proximity. Cannabis prefers uplifted, flood-disturbed, alluvial soil and appears in a pollen assemblage dominated by high grassland flora, cereal grains, Artemisia, and flowering plants of the Goosefoot family. When remnants of these plants are present, cannabis rather than hops is likely among them.

Humulus, by comparison, colonizes a wetter ecological niche, flourishing in the vicinity of poplars and willows, for example. When remnants of these plants are found with cannabis/humulus seed or pollen, hops is the likely suspect.

Based on chloroplast DNA sequences and radiocarbon dating, McPartland suggests that cannabis emerged as a distinct botanical species 27.8 million years ago, and its area of origin was the Tibetan Plateau.

Therapeutic attributes

As well as their shared physical characteristics (leaf, seed, pollen), cannabis and hops are similar in other ways. Some of the same components, including terpenes and other phytonutrients, are found in the female inflorescences of both species.

Cannabis has a rich history as a medicine going back to prehistoric times, and so does hops. Long before they became a bittering agent in the brewing industry, hop flower tops were used in traditional Eurasian cultures to treat restlessness and sleep disturbances. Ditto for cannabis flower tops.

In addition to their calming, sleep-inducing qualities, hops and cannabis share other significant therapeutic attributes. Both herbs have potent antibacterial and anti-cancer properties, according to recent scientific research.

Xanthohumol is one of several phenolic compounds in hops that have noteworthy medical potential. This “prenylated flavonoid” was shown to be a “’broad-spectrum’ cancer chemopreventive agent” in a 2004 preclinical study at Oregon State University, which recommended further investigation into its “potential for application in cancer prevention programs.” Subsequent research in Belgium found that xanthohumol “effectively inhibits proliferation of prostate cancer.”

Chinese scientists reported that xanthohumol is effective against HIV infection and suggested that it might serve as “an interesting lead compound” for developing “a novel therapeutic agent” for HIV. 

Another flavonoid, 8-prenylnaringenin, found in hop flowertops is a potent phytoestrogen that could be useful as a dietary supplement for treating post-menopausal hot flashes. This flavonoid compound also has anti-diabetic potential, according to a 2018 report by German and Italian scientists.

Beer & Bud

What goes around, comes around. Eons ago cannabis and hops were the same plant, and now they are being reunited by several West Coast beer-makers who are spiking their brew with THC or CBDor other cannabis components.

In the summer of 2017, Lagunitas, the craft beer exemplar, partnered with CannaCraft, a California-based cannabis oil producer, and introduced a limited edition of “Supercritical,” an ale brewed with terpenes (but no THC or CBD) extracted from two popular cannabis varietals, Girl Scout Cookie and Blue Dream.

For an encore, CannaCraft is producing a couple of different THC-infused vape oil blends combined with terpenes extracted from hops. The dominant terpenes in “Stereoterpical” and “Hop Cannon” – the newest psychoactive additions to the AbsoluteXtracts vape cartridge product line – are also present in various cannabis cultivars.

The terpene profiles of these THC-fortified hop oil blends include memory-enhancing pinene with its woody aroma; anxiety-reducing limonene with its citrus flavor; relaxing linalool with lavender notes; humulene, an appetite-suppressing sedative; and anti-inflammatory beta-caryophyllene, a bitter, all-star phytonutrient.

So smell the mystery, and sleep well. If you can’t smoke your beer, you might try vaping it.

Project CBD director Martin A. Lee is the author of Smoke Signals: A Social History of Marijuana – Medical, Recreational and Scientific. He consults for CannaCraft and several other cannabis businesses. Patrick Anderson provided research assistance for this article.

Sources:

·  Delmulle L, Bellahcène A, Dhooge W, Comhaire F, Roelens F, et al. Anti-proliferative properties of prenylated flavonoids from hops (Humulus lupulus L) in human prostate cancer cell lines. Phytomedicine. 2006 Nov;13(9-10):732-4. PubMed PMID: 16678392.

·  Magalhães PJ, Carvalho DO, Cruz JM, Guido LF, Barros AA. Fundamentals and health benefits of xanthohumol, a natural product derived from hops and beer. Nat Prod Commun. 2009 May;4(5):591-610. PubMed PMID: 19445313.

·  Seliger JM, Misuri L, Maser E, Hintzpeter J. The hop-derived compounds xanthohumol, isoxanthohumol and 8-prenylnaringenin are tight-binding inhibitors of human aldo-keto reductases 1B1 and 1B10. J Enzyme Inhib Med Chem. 2018 Dec;33(1):607-614. PubMed PMID: 29532688.

·  Stevens JF, Page JE. Xanthohumol and related prenylflavonoids from hops and beer: to your good health!. Phytochemistry. 2004 May;65(10):1317-30. PubMed PMID: 15231405.

·  Wang Q, Ding ZH, Liu JK, Zheng YT. Xanthohumol, a novel anti-HIV-1 agent purified from Hops Humulus lupulus. Antiviral Res. 2004 Dec;64(3):189-94. PubMed PMID: 15550272. 

·  Yuan Y, Qiu X, Nikolić D, Chen SN, Huang K, et al. Inhibition of human cytochrome P450 enzymes by hops (Humulus lupulus) and hop prenylphenols. Eur J Pharm Sci. 2014 Mar 12;53:55-61. PubMed PMID: 24342125; NIHMSID: NIHMS549835; PubMed Central PMCID: PMC3987852.

·  Zanoli P, Zavatti M. Pharmacognostic and pharmacological profile of Humulus lupulus L. J Ethnopharmacol. 2008 Mar 28;116(3):383-96. PubMed PMID: 18308492.

 

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4 Ways Using Even Legal Marijuana Makes You a Second-Class Citizen

Sat, 04/07/2018 - 13:45
Click here for reuse options! Legalizing weed is only half the battle.

Marijuana is now legal in nine states constituting about one-fifth of the U.S. population, and medical marijuana is recognized in a total of 29 states. That means people in those states can possess and use marijuana without fear of criminal prosecutions (if they have a doctor's recommendation in the medical marijuana-only states).

But even in legal marijuana states, pot smokers face restrictions that in effect turn them into second-class citizens, unable to do things non-drug users or users of legally sanctioned drugs, such as alcohol, can do, or somehow punished for doing them. While legalizing marijuana is a giant breakthrough, as long as marijuana users face stigma, discrimination, and worse over their choice of substances, the job is only half-done.

Here are four ways even legal marijuana users get screwed.

1. Employment Rights

You may be able to smoke pot legally, but it can still cost you your job. Even in legal marijuana states, legalization laws generally are careful not to intrude on the rights of employers to conduct drug testing for pot and to fire people who test positive—even if they're not high or impaired at work.

Legal cases in California, Colorado, Montana, and Washington have all upheld the right of employers to fire or refuse to hire workers who test positive for marijuana even if they have a medical marijuana recommendation. But the law is rapidly evolving, and a recent case from Connecticut, a nursing home that refused to hire a medical marijuana patient after he tested positive for THC was ordered to reinstate the job offer.

A thriving economy and growing social acceptance of marijuana may also bring some solace to pot smokers. As Bloomberg noted just last month, we are now seeing a "slow decline in pre-employment drug screening," with some major employers abandoning the practice in the face of a tight job market. That trend, unsurprisingly, is being led by companies in the marijuana legal states. In Colorado, for instance, the percentage of employers using pre-employment drug tests declined from 77 percent in 2016 to 66 percent last year.

But still, if you smoked a joint on Friday night, Walmart still doesn't think you're fit to stock its shelves on Monday morning.

2. Gun Rights

If you smoke pot, you can't legally purchase or own a gun. As more states move toward legalization, the Bureau of Alcohol, Tobacco & Firearms (ATF) has clarified its Form 4473, the federal Firearms Transaction Record that purchaser must fill out to buy a gun: "Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance?" the form asks.

And just so you stoners get it, ATF has added the following language: "Warning: The use or possession of marijuana remains unlawful under Federal law regardless of whether it has been legalized or decriminalized for medicinal or recreational purposes in the state where you reside."

That means pot smokers who want to legally purchase a weapon have to lie on Form 4473. And that's a federal crime. (Unlikely to be caught and prosecuted, but still.)

In August 2016, a federal appeals court upheld the ban on gun sales to medical marijuana patients. The 9th U.S. Circuit Court of Appeals in San Francisco ruled that the federal government's ban on gun sales to medical marijuana cardholders does not violate the Second Amendment. The decision came in the case of a Nevada woman turned away from a gun shop after obtaining a medical marijuana card. The ruling sets precedent for all nine states in the circuit, including California, Oregon, and Washington.

There have been proactive efforts by law enforcement in a handful of states to, for example, order registered medical marijuana patients to turn in their guns, but those have so far been aborted in the face of loud opposition. In Pennsylvania, the state Health Department is no longer providing the names of patients to law enforcement after newspapers there reported the patients would not be able to buy firearms; in Illinois, regulators removed a rule that would have barred legal gun owners from becoming patients; and in Hawaii, police had to walk back a plan to force patients to hand in their guns.

Still, as long as the federal government maintains marijuana prohibition and as long as ATF considers marijuana a controlled substance, pot smokers' gun rights are at risk. And the NRA doesn't seem to care.

3. Parental Rights

In both medical marijuana states and full-blown legal pot states, parents have lost custody of their children over their marijuana use. Part of the problem is that marijuana remains federally illegal, turning the pot-using parent into a criminal in the eyes of courts of child protective services workers. Another part of the problem is discrimination and subjectivity about what constitutes "the best interest of the child." If a child protective bureaucracy or even an individual caseworker harbors anti-marijuana sentiments, even non-problematic recreational use of pot can be used to take children from the home or deny custody to the offending parent.

Marijuana use is especially likely to pop up in divorces where custody of the child or children is contested. If your spouse griped about your pot-smoking while you were married, be prepared for him or her to try to use it against you in a nasty divorce case. Divorce attorneys warn parents facing this prospect to quit smoking pot now, well ahead of any court dates and court-ordered drug tests.

That's another way pot-smoking parents get hammered. Courts may demand onerous drug testing for months or year or require that visits with children be supervised.

Medical marijuana support groups report hundreds of cases of parents losing custody of their kids, some merely for having registered as medical marijuana patients. But there are small signs of positive change on the horizon: California's Prop 64, for instance, includes a provision saying courts can no longer rescind or restrict a parent's custodial rights solely because they have a medical marijuana recommendation.

That's a start, but we still have a long way to go before pot-smoking parents can rest easy.

4. Housing Rights

You can be kicked out of your home for using marijuana if you are poor and live in HUD, Section 8, or other federally subsidized housing. Under a 1999 HUD Memorandum Regarding Medical Marijuana in Public Housing still in effect, any activity relating to controlled substances, including even medical marijuana, can get you evicted.

And it doesn't have to be just you. If you live in federally subsidized housing and your grandson gets caught smoking a joint in the parking lot, you can find yourself tossed out on the street.

Even people who don't live in federally subsidized housing face problems, especially if they live in rental housing. Landlords can prohibit tenants from using marijuana, and rental apartment industry associations typically counsel their members that "banning the use or possession of marijuana on site does not violate any landlord/tenant or fair housing laws, even when marijuana has been legalized by local ordinance or state statute." Nor, they argue, is allowing the use or cultivation of medical marijuana a "reasonable accommodation" required by law, even if it is medically recommended.

Marijuana is increasingly legal and accepted, but the progress is uneven and the battle to be treated like normal citizens remains unfinished.

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If You Want to Kill Drug Dealers, Start With Big Pharma

Sat, 04/07/2018 - 08:37
Large corporations are the true authors of the opioid crisis.

At a recent rally in New Hampshire, Donald Trump called for the death penalty for drug traffickers as part of a plan to combat the opioid epidemic in the United States. At a Pennsylvania rally a few weeks earlier, he called for the same.

Now his administration is taking steps toward making this proposal a reality. Attorney General Jeff Sessions issued a memo on March 21 asking prosecutors to pursue capital punishment for drug traffickers — a power he has thanks to legislation passed under President Bill Clinton.

Time and again, these punitive policies have proven ineffective at curbing drug deaths. That’s partly because amping up the risk factor for traffickers makes the trade all that more lucrative, encouraging more trafficking, not less.

But it’s also because these policies don’t address the true criminals of the opioid crisis: Big Pharma.

If Trump really wanted to help, he’d put the noose around drug-making and selling giants like Purdue Pharma, McKesson, Insys Therapeutics, Cardinal Health, AmerisourceBergen, and others.

The president knows this, in a way. These companies “contribute massive amounts of money to political people,” he said at a press conference in October 2017 — even calling out Mitch McConnell, who was standing beside him, for taking that money. Pharmaceutical manufacturers were “getting away with murder,” Trump complained in the same speech.

For once, he’s wasn’t wrong.

The pharmaceutical industry spends more than any other industry on influencing politicians, with two lobbyists for every member of Congress. Nine out of ten House members and all but three senators have taken campaign contributions from Big Pharma.

It’s not just politicians they shell out for.

Opioid pioneer Purdue Pharma, the creator of OxyContin, bankrolled a campaign to change the prescription habits of doctors who were wary of the substance’s addictive properties, going so far as to send doctors on all-expense-paid trips to pain-management seminars. The family that started it all is worth some $13 billion today.

From 2008 to 2012, AmerisourceBergen distributed 118 million opioid pills to West Virginia alone. That’s about 65 pills per resident. In that same time frame, 1,728 people in the state suffered opioid overdoses.

McKesson — the fifth largest company in the U.S., with profits over $192 billion — contributed 5.8 million pills to just one West Virginia pharmacy.

Meanwhile, five companies contributed more than $9 million to interest groups for things like promoting their painkillers for chronic pain and lobbying to defeat state limits on prescribing opioids.

These companies don’t stop at promoting opioids. They also spend big on stopping legislation that would actually help curb opioid use.

Insys Therapeutics, a company whose founder was indicted for allegedly bribing doctors to write prescriptions for fentanyl (a substance 50 times stronger than heroin), spent $500,000 to stop marijuana legalization in Arizona in 2016.

In response, cities and states from New York City to Ohio are suing pharmaceutical companies for their role in the deaths of tens of thousands of Americans every year. It’s time for the federal government to get behind them.

Of course, going after these companies isn’t going to eliminate opioid abuse on its own. That will take combating the root social and economic causes that lead to so many deaths of despair.

But it’s clear who the real profiteers of the opioid epidemic are. If Trump wanted to get real about curbing incentives for selling opioids, he’d turn away from street dealers and target the real opioid-producing industry.

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Rollin' With the Dragon: Opioids Are Gaining Popularity in the Club Scene

Fri, 04/06/2018 - 14:34
Click here for reuse options! The electronic dance music scene is most commonly associated with Molly, but there's a new kid in town.

The club kids have found a new high. According to a new study from electronic dance music (EDM) drug use watcher Joseph Palamar, opioids are becoming increasingly popular among people in the throbbing beat scene. Nearly 10 percent of them reported using opioids in the past year, a rate 2.5 times the national average, and 5 percent reported using them in the past month.

Oxycontin was the most commonly used opioid in the EDM scene, followed by Vicodin, Percocet, codeine, and Purple Drank (also known as Sizzurp or Leans), which also contains codeine.

In the study, researchers surveyed nearly 1,000 fans (ages 18-40) as they were about to enter EDM parties at nightclubs and festivals in New York City. Attendees were asked about their nonmedical use of 18 different opioids, from prescription pain pills to black market heroin and fentanyl.

The EDM scene has long been known for drug use, but the researchers warn that the turn to opioids is a dangerous trend that should not be ignored.

"We've always known that electronic dance music party attendees are at high risk for use of club drugs such as ecstasy or Molly, but we wanted to know the extent of opioid use in this population," said Palamar, the study's lead author and an associate professor of population health at NYU School of Medicine. 

The most popular prescription opioid reported in this scene was Oxycontin, which, like many prescription opioids, is used to relieve pain, but also produces euphoric effects, inducing relaxation and happiness. Following close behind were Vicodin, Percocet, codeine, and Purple Drank. About 15 percent of opioid users reported snorting them, while 11 percent reported injecting them, both forms of ingestion more likely to result in dependence.

People who had already used opioids reported a much higher propensity for using them again than did people who had never used them. Among previous users, nearly three-quarters (73.4 percent) said they would do them again, while only about 6 percent of non-users said they would try them if offered.

"This population of experienced drug users needs to be reached to prevent initiation and continued use, which can lead to riskier and more frequent use, dependence, and deleterious outcomes such as overdose—particularly if opioids are combined with other drugs," Palamar warned. "Many individuals in this population are experienced with drugs such as ecstasy, but due to their experience with various drugs, they may underestimate the addictive potential of opioids, which are typically not used as 'club drugs,'" Palamar added.

The study comes as the U.S. finds itself in the midst of an opioid crisis where nearly two million people are dependent and more than a hundred are dying of overdoses every day.

"The population in general needs better education about opioids," said Palamar. "Taking opioid pills is much different from taking ecstasy and it needs to be understood that opioids are not party drugs."

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