Skip to Content

Alternet

Syndicate content AlterNet.org: Drugs
Updated: 12 hours 44 min ago

Trump’s New Drug Pricing Plan is Just Another 'Nonsensical' Scam Designed to Blame Foreigners

Sun, 05/13/2018 - 23:10
Click here for reuse options! He calls it “American patients first,” and takes aim at what he calls “foreign freeloading.”

Trump promised to rein in drug prices. It was his only sensible campaign promise.

But the plan he announced Friday does little but add another battering ram to his ongoing economic war against America’s allies.

He calls it “American patients first,” and takes aim at what he calls “foreign freeloading.” The plan will pressure foreign countries to relax their drug price controls.

America’s trading partners “need to pay more because they’re using socialist price controls, market access controls, to get unfair pricing,” said Alex Azar, Trump’s Secretary of Health and Human Services, who, perhaps not incidentally, was a former top executive at the drug maker Eli Lilly and Company.

By this tortured logic, if other nations allow drug companies to charge whatever they want, U.S. drug companies will then lower prices in the United States.

This is nonsensical. It would just mean more profits for U.S. drug companies. (Revealingly, the stock prices of U.S. pharmaceutical companies rose after Trump announced his plan.) 

While it’s true that Americans spend far moreon medications per person than do citizens in any other rich country – even though Americans are no healthier – that’s not because other nations freeload on American drug companies’ research.

Big Pharma in America spends more on advertising and marketing than it does on research – often tens of millions to promote a single drug.

The U.S. government supplies much of the research Big Pharma relies on through the National Institutes of Health. This is a form of corporate welfare that no other industry receives. 

American drug companies also spend hundreds of millions lobbying the government. Last year alone, their lobbying tab came to $171.5 million, according to the Center for Responsive Politics.

That’s more than oil and gas, insurance, or any other American industry. It’s more than the formidable lobbying expenditures of America’s military contractors. Big Pharma spends tens of millions more on campaign expenditures.

They spend so much on politics in order to avoid price controls, as exist in most other nations, and other government attempts to constrain their formidable profits.

For example, in 2003, Big Pharma got a U.S. law prohibiting the government from using its considerable bargaining clout under Medicare and Medicaid to negotiate lower drug prices. Other nations with big healthcare plans routinely negotiate lower drug prices.

During his campaign Trump promised to reverse this law. But the plan he revealed Friday doesn’t touch it. Trump’s plan seeks only to make it easier for private health insurers to negotiate better deals for Medicare beneficiaries.  

In reality, private health insurers don’t have anywhere near the clout of Medicare and Medicaid – which was the whole point of Big Pharma’s getting Congress to ban such negotiations in the first place.

In the last few years, U.S. drug companies have also blocked Americans from getting low-cost prescription drug from Canada, using the absurd argument that Americans can’t rely on the safety of drugs coming from our northern neighbor – whose standards are at least as high as ours.

Trump’s new plan doesn’t change this, either.  

To put all this another way, when Americans buy drugs in the United States, they really buy a package of advertising, marketing, and political influence-peddling. Consumers in other nations don’t pay these costs. Which explains a big part of why drug prices are lower abroad. Trump’s so-called plan to lower drug prices disregards this reality.

Trump’s plan nibbles at the monopoly power of U.S. pharmaceutical companies, but doesn’t deal with the central fact that their patents are supposed to run only twenty years but they’ve developed a host of strategies to keep patents going beyond then.

One is to make often insignificant changes in their patented drugs that are enough to trigger new patents and thereby prevent pharmacists from substituting cheaper generic versions.

Before its patent expired on Namenda, its widely used drug to treat Alzheimer’s, Forest Labs announced it would stop selling the existing tablet form of in favor of new extended-release capsules called Namenda XR. Even though Namenda XR was just a reformulated version of the tablet, the introduction prevented generic versions from being introduced.  

Other nations don’t allow drug patents to be extended on such flimsy grounds. Trump’s plan doesn’t touch this ploy.

Another tactic used by U.S. drug companies has been to sue generics to prevent them from selling their cheaper versions, then settle the cases by paying the generics to delay introducing those cheaper versions.

Such “pay-for-delay” agreements are illegal in other nations, but antitrust enforcement hasn’t laid a finger on them in America – and Trump doesn’t mention them although they cost Americans an estimated $3.5 billiona year.

Even after their patents have expired, U.S. drug companies continue to aggressively advertise their brands so patients will ask their doctors for them instead of the generic versions. Many doctors comply.

Other nations don’t allow direct advertising of prescription drugs – another reason why prices are lower there and higher here. Trump’s plan is silent on this, too. (Trump suggests drug advertisers should be required to post the prices of their drugs, which they’re already expert at obscuring.)

If Trump were serious about lowering drug prices he’d have to take on the U.S. drug manufacturers.

But Trump doesn’t want to take on Big Pharma. As has been typical for him, rather than confronting the moneyed interests in America he chooses mainly to blame foreigners. 

 

Click here for reuse options!
Categories: News Feeds

Enjoy Rudy Giuliani's Screw-Ups as Trump's Lawyer, But He's Still Horrible on Marijuana

Thu, 05/10/2018 - 14:49
While the man may be a buffoon, his views on drugs and crime are no laughing matter.

Who isn't enjoying Rudy Giuliani's performance as an endearingly bumbling personal attorney for President Trump? After all, in the few days he has been in the position, he's managed to come up with multiple stories about the president, his porn stars, and his fixers, none of which reflect favorably on Team Trump. He's unintentionally been doing his incompetent best to help implode the Trump White House, and for that, he deserves our thanks.

But although Giuliani's zany antics are entertaining and—one hopes—damaging even further the credibility-challenged president, let's take a moment to remember what a true reactionary the former New York City mayor really is, especially when it comes to drugs and crime.

Giuliani made his political bones as a federal prosecutor and grandstanded his record of drug prosecutions into a successful mayoral bid in 1993, becoming the first Republican mayor of the liberal metropolis in 20 years. Under his leadership, New York City became the marijuana possession arrest capital of the world.

Under his predecessors, Democrats Ed Koch and David Dinkins, small-time pot busts had numbered in the hundreds or low thousands each year, but under Giuliani, those busts went through the roof. The city hit 10,000 pot possession arrests in 1996, nearly 20,000 in 1997, and more than 30,000 in 1998 and 1999, before peaking at more than 50,000 in 2000. They declined slightly in 2001, Giuliani's last year in office, as the NYPD found other things to worry about after the September 11 attacks that year.

Then and to this day, the vast majority of people arrested for small-time pot possession were non-white. Minorities accounted for more than 80% of pot busts then, and even now, while pot possession arrests are way down (under 20,000 a year under Bill de Blasio), black and brown people accounted for 86% of those busts in 2017.

In an especially cruel twist, Giuliani's and the NYPD's mass marijuana arrest campaign came years after the state actually decriminalized the possession of small amounts of pot. What would typically happen is that the cops would roust someone, demand that he empty his pockets, and then arrest him for public possession of marijuana, which was not decriminalized. To make his campaign work, Giuliani had to subvert the spirit of the decriminalization law. He had no problem doing so.

The "tough on crime" mayor's campaign of pot possession arrests was part of a broader anti-crime offensive that went under the rubric "broken windows." That strategy emphasizes going after visible signs of criminality, even if the crimes are minor, as a means of increasing order and thus improving quality of life. That meant going after trivial offenses, such as pot possession, public urination, or public drinking and locking up large numbers of offenders, again, most of them non-white.

Another part of Giuliani's anti-crime, anti-drug strategy was "stop and frisk," the NYPD's aggressive targeting of primarily young people of color for suspicionless stops and searches. Giuliani and then Police Commissioner William Bratton pioneered the strategy, stopping about 90,000 people in his last year in office. The practice ballooned under his successor, Mayor Michael Bloomberg, peaking at 685,000 stop and frisks in 2011. Some 88% of those subject to the abusive practice were totally innocent, and 87% of them were black and brown.

It took a federal court to end the practice, with District Court Judge Shira Scheindlin ruling it unconstitutional in 2013. By last year, Giuliani's stop and frisk legacy was on its last legs, with only 10,000 such stops reported in the city. Again, though, 90% of them were aimed at black and brown people, even though two-thirds of those stopped were innocent of any crime.

Giuliani has been out of office since 2002, but the intervening years show no sign he has brought his views on marijuana or policing into the 21st century. When running one of his failed presidential campaigns in 2007, he refused to endorse the use of medical marijuana, claiming it was a stalking horse for legalization—and that people would be better off with pain medications!

"I believe the effort to try and make marijuana available for medical uses is really a way to legalize it. There's no reason for it," he said at a New Hampshire town hall. "You can accomplish everything you want to accomplish with things other than marijuana, probably better. There are pain medications much superior to marijuana," he said. "We'd be much better off telling people the truth. Marijuana adds nothing to the array of legal medications and prescription medications that are available for pain relief."

Years after that, Giuliani remained immune to the facts and science about marijuana. In 2014, in the early stages of yet another failed presidential campaign, he drew on his prosecutorial expertise to explain why he opposed legalizing marijuana.

 "It can deteriorate your brain. I used to be a narcotics prosecutor," he said.

Giuliani hasn't been talking about marijuana much lately, but his stances are increasingly out of step even with the Republican Party. Former House Speaker John Boehner, for instance, has dramatically switched course on marijuana legalization, and Giuliani's new boss, the titular head of the party, has signaled that he won't go after marijuana in states where it is legal.

But Trump's words notwithstanding, both Giuliani, his own personal lawyer, and Jeff Sessions, his man at the Justice Department, are still old-school pot prohibitionists. Rudy may be doing the rest of us some favors with his stumbling efforts to defend the president from himself, but his malign position on pot remains bad news indeed.

 

 

Categories: News Feeds

Illinois Cop's Warning: If You Legalize Weed, We'll Have to Kill Our Drug Dogs

Tue, 05/08/2018 - 11:14
The stench of desperation is in the air.

As the state legislature ponders a bill that could make Illinois the 10th state to legalize marijuana, law enforcement is getting nervous. Old anti-marijuana shibboleths have lost their potency, but the Macon County Sheriff's Office has a brand new reason not to free the weed: They will have to kill their drug dogs.

As the Daily Pantagraph reported in an article about what happens to marijuana-sniffing drug dogs in states where it is legal, the dogs typically are trained to detect a number of drugs and it is difficult to retrain them not to alert on marijuana. Other states that have legalized it have either retired their pot-sensitive dogs, tried to retrain them, or used them to search for large, illicit amounts of marijuana.

But Chad Larner, training director of the K-9 Training Academy in Macon County, scoffed at the notion of retraining, saying it would be "extreme abuse" to try to do so, and "Larner said a number of dogs would likely have to be euthanized."

That claim is a ridiculous "red herring," Illinois NORML executive director Dan Linn told the Pantagraph. "The idea that legalizing for adults to have an ounce on them will equal ... all these dogs being euthanized, that seems kind of ridiculous and hyperbolic,” he said.

Other Illinois drug dog cops contacted by the Pantagraph largely agreed with Linn.  They said retired drug dogs "typically live with their handlers" and they "dismissed the idea that any would be euthanized because of retirement." 

The Macon County sheriff doesn't go as far as his drug dog trainer, but he is a staunch opponent of marijuana legalization because…drug dogs.

"The biggest thing for law enforcement is, you're going to have to replace all of your dogs,” said Macon County Sheriff Howard Buffett. "So to me, it’s a giant step forward for drug dealers, and it’s a giant step backwards for law enforcements and the residents of the community."

Sheriff Buffett isn't just any sheriff. He's the son of Omaha billionaire investor Warren Buffett, and he's used his family wealth both to finance law enforcement spending in the county and to basically buy his way into the sheriff's office. Earlier this year, he announced that his Howard G. Buffett Foundation was donating $1.4 million to the county to pay for everything from new records systems to new guns and ballistic vests.  He was appointed to his position by retiring Sheriff Thomas Schneider last September and will serve until a new sheriff is elected in November.

Buffett also financed drug dogs across the state. His foundation paid $2.2 million in 2016 to support drug dog units in 33 Illinois counties. No wonder he and his employees are doing the 2018 version of the classic National Lampoon cover:

 

 

 Related Stories
Categories: News Feeds

NYC Mayor de Blasio Endorses Safe Injection Sites Plan—Despite DEA Claiming They're Illegal

Thu, 05/03/2018 - 17:17
The city joins a handful of other major localities in the country by pushing for safe injection sites.

Just a day after close to a hundred community activists, reform advocates, and local elected officials took to the streets outside New York City's City Hall Wednesday to demand that Mayor Bill de Blasio (D) move on a long-delayed feasibility study on safe injection sites, the mayor has moved.

On Thursday evening, the mayor's office announced de Blasio's support for a plan to open four of the sites, which the office refers to as Overdose Prevention Centers, a year from now, after a period of consultation with stakeholders.

"After a rigorous review of similar efforts across the world, and after careful consideration of public health and safety expert views, we believe overdose prevention centers will save lives and get more New Yorkers into the treatment they need to beat this deadly addiction," de Blasio said in a statement.

Safe injection sites (SISs)—or safe injection facilities or supervised injection facilities or supervised consumption sites or overdose prevention centers—allow drug users to inject (or sometimes inhale) their own drugs under medical supervision. They typically also have a social services component that aims to assist drug users in finding drug treatment and other services.

Operating in around 90 cities in Europe, Australia, and Canada, they are a proven harm reduction intervention. Numerous peer-reviewed scientific studies have shown they reduce public disorder; increase access to treatment, reduce the risk of HIV, Hep C, and bacterial infections; reduce drug overdose deaths; and reduce medical costs thanks to a reduction in disease and overdose, while at the same time increasing access to cost-saving preventive health care. What SISs don't do, the studies have found, is increase crime, injection drug use, or the initiation of new drug users.

Yet no such sites operate in the United States. Pushes are underway in several cities, including Philadelphia, San Francisco, and Seattle, but all have faced challenges ranging from moralism and NIMBYism to the fact that they would appear to violate federal law. Just this week, DEA spokesman Melvin Patterson said they violate the Controlled Substances Act and are "subject to being prosecuted." Given the proclivities of the Trump administration, that is probably not a threat to be taken lightly.

Still, the cities are willing to push on the issue, the American Medical Association has endorsed the notion, and legislatures in a number of states are pondering bills to allow them. And now, with the country's largest city coming on board, momentum for the sites is only growing stronger.

In New York City, where the SIF NYC Campaign, a coalition of dozens of community, drug reform, public health, medical, and religious groups, has been pressuring the administration to act for months, the mayor's announcement was greeted with relief.

"Mayor de Blasio’s embrace of safer consumption spaces is a critical step forward in preventing overdose deaths in New York City. We know that safer consumption spaces are an evidence-based solution that can help dramatically in saving lives, reducing criminalization, and improving public health," said Kassandra Frederique, New York state director at the Drug Policy Alliance. "New York can and must be a leader now in saving lives by opening safer consumption spaces swiftly."

That will take some political acumen in dealing with city district attorneys and the state Health Department, which answers to Gov. Andrew Cuomo, with whom de Blasio's relations are strained at best. It will also take some political fortitude in taking on the Sessions Justice Department and the DEA.

De Blasio's announcement marks the successful culmination of the campaign to bring the city on board with safe injection sites as a harm reduction and overdose prevention measure, but it's just the beginning of the fight to actually get them up and running.

 

 

 Related Stories
Categories: News Feeds

Legal Marijuana Runs Right Over Maine's Obstructionist Tea Party Governor

Thu, 05/03/2018 - 14:00
The legislature voted to override the veto.

Paul LePage, Maine's irascible Tea Party Republican governor, is no friend of marijuana. He opposed the state's successful 2016 marijuana legalization initiative, and, once it won, vetoed the legislature's bill to implement the will of the voters. That was last year.

That left the state with pot possession and personal cultivation legal, but no way to buy or sell legal marijuana. This year, the legislature once again passed a bill to implement the initiative's taxed and regulated sales provisions, LD 1719. It even incorporated some of LePage's previous criticisms, resulting in a bill more restrictive than what voters approved.

Again, LePage vetoed the bill. But this time, the legislature had had enough. On Wednesday, the House voted 109-39 and the Senate voted 28-6 to override LePage's veto, poking a thumb in the governor's eye and setting the state on a path to the legal sale and production of recreational marijuana some 18 months after voters approved it.

The bill creates the rules for licensing and regulating marijuana producers, processors, and retail establishments and sets the tax rates for adult-use marijuana. But as a sop to LePage and other foes, it does not allow for social use, meaning buyers will be limited to using it at home (if the landlord agrees), and lawmakers also halved the number of plants people can grow, from six to three.

While the bill doesn't cap the number of cultivation licenses or the amount of weed that can be grown in the state, creating fears that a glut of pot will drive out all but the most deep-pocketed growers, it does contain a provision granting business licenses only to Maine residents for the first three years.

Pot shops aren't going to pop up overnight, either. Now that the bill has become law, state regulators will have to develop rules and regulations for the industry, which in turn will have to be approved by the legislature. It may be the spring of 2019 before Mainers can finally walk into a shop and buy their legal weed.

Still, the veto override is a major step on Maine's path to legal taxed and regulated marijuana sales.

"After a long and unnecessary delay, the decision by Maine voters to regulate marijuana for adults will finally be respected," said Matthew Schweich, executive director of the Marijuana Policy Project and campaign director for the 2016 Maine legalization ballot initiative campaign. "While this bill is imperfect, its overall effect is implementation of the legalization policy that Maine voters approved at the ballot box a year and a half ago."

Maine was one of four states where voters passed legalization initiatives in 2016, and it will be the last of the four to get sales up and running. California and Nevada have already implemented their programs, and Massachusetts should see retail sales begin next month.

"With his veto overridden, the governor should cease his obstructionist tactics so that Maine does not fall further behind Massachusetts in establishing a system for legal and regulated marijuana sales," Schweich added.

Nine states and the District of Columbia have so far legalized marijuana for adults. While at least 20 states will or have considered legalization bills this year, the most likely prospect for the next legal marijuana state is Michigan, where voters will have their say in November. In the meantime, Maine will be busy getting its pot shop regulations ship-shape and waving goodbye to Gov. LePage in the rearview mirror.

 Related Stories
Categories: News Feeds

The Feds Can Indict Marijuana Users for Buying Guns Even in States Where Pot Is Legalized

Tue, 05/01/2018 - 13:25
Just one way using even legal marijuana makes you a second-class citizen.

Less than a month ago, AlterNet published "4 Ways Using Even Legal Marijuana Makes You a Second-Class Citizen," which enumerated some of the reasons marijuana legalization by itself is not sufficient to guarantee the rights of pot smokers. One of those reasons was the inability of marijuana users to own or purchase guns.

Under federal law, enforced by the Bureau of Alcohol, Tobacco & Firearms (ATF), all gun purchasers must fill out Form 4473, which asks: "Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance?" the form asks.

Last year, and just to make sure stoners got the message, 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."

The article noted that pot smokers who want to legally purchase a weapon would have to lie on Form 4473, but that they were unlikely to be caught and prosecuted.

That has changed. The U.S. attorney in Maine has now indicted two men on federal firearms charges for allegedly lying about their marijuana use on the gun purchase form.

Donald Henderson, 33, of Winthrop, was indicted for alleged false statements while buying a pistol from a local gun shop in February 2017 and again while purchasing another pistol the following month. The indictment alleges he checked the box saying he was not a marijuana user when he in fact was.

And Richard Quattrone, 48, of Augusta, was also indicted for lying on a federal firearms license in March 2017. The indictment says he purchased a pistol from the same local gun shop as Henderson and checked the box saying he was not a user of marijuana or controlled substances when he was in fact "an unlawful user of marijuana."

The federal prosecutors in Maine are on firm legal ground—the law is quite clear—but the question now becomes whether a political backlash can rein them in. That's what happened when law enforcement officials in some states tried to order registered medical marijuana patients to turn in their guns. 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.

The Jeff Sessions Justice Department, where ATF resides, is unlikely to be as swayed by angry public opinion as state officials in legal marijuana states, and that suggests that people who use marijuana need to really think twice before filling out that Form 4473. If they tell the truth, they will be barred from purchasing a gun; if they lie, they could be charged with a federal criminal offense and sent to prison.

If you're a pot smoker and really, really want to buy a gun, you may want to stick to gun shows and private purchases, but you are still potentially liable for federal prosecution if you get caught with it and the local U.S. attorney wants to score a coup.

This is one more reason marijuana legalization is only half the battle.

 

 

 Related Stories
Categories: News Feeds

The Deadliest Drug in America At the Heart of Trump's VA Nominee Scandal

Tue, 05/01/2018 - 02:18
For the first time in a while, pundits and politicians were talking about the drug that kills more people than any other each year in the U.S.

I’m talking about alcohol, which upstaged opioid abuse in news coverage recently, but only after Rear Adm. Ronny L. Jackson withdrew his name for consideration to head Veterans Affairs, in part because of allegations that he has abused alcohol. Jackson has denied any problem with alcohol.

This provides an opportune time to discuss the seriousness of alcohol abuse.

Alcohol contributes to 88,000 deaths in the U.S. each year, more than double the number of people, 42,000, killed by heroin and opioid prescription drug overdose in 2016. Excessive drinking accounted for one in 10 deaths among working-age adults.

In addition, more than 66.7 million Americans reported binge drinking in the past month in 2015, according to a report by the surgeon general.

As someone who has studied alcohol use disorder for over 15 years and who has treated thousands of patients who have it, I think it’s a major, yet often poorly understood, public health problem.

A social lubricant

Alcohol can be a quick and easy way to get into the spirit of a celebration. And it feels good. After two glasses of wine, the brain is activated through complex neurobiochemical processes that naturally release dopamine, a neurotransmitter of great importance.

When the dopamine molecule locks on to its receptor located on the surface of a neuron, or basic brain cell, a “buzz” occurs. It is often desirably anticipated before the second glass is empty.There are those, however, who drink right past the buzz into intoxication and, often, into trouble. For them, the brain starts releasing the same enjoyable dopamine, no different than what happens in the casual drinker’s, but it doesn’t stop there. A compulsion to binge drink can result.

Binge drinking, defined as drinking five or more drinks for men and four for women on the same occasion on at least one day in the past 30 days, is a medical condition that victimizes the comparative malfunction of the pleasure circuits in the brain.

The three stages of addiction

The alcohol addiction process involves a three-stage cycle: binge-intoxication, withdrawal-negative affect, and preoccupation-anticipation.

It begins in the neurons, the basic type of brain cell. The brain has an estimated 86 billion of these cells, which communicate through chemical messengers called neurotransmitters.

Neurons can organize in clusters and form networks in order to perform specific functions such as thinking, learning, emotions and memory. The addiction cycle disrupts the normal function of some of these networks in three areas of the brain – the basal ganglia, the extended amygdala and the prefrontal cortex.

The disruptions do several things that contribute to continued drinking. They enable drinking-associated triggers, or cues, which lead to seeking alcohol. They also reduce the sensitivity of the brain systems, causing a diminished experience of pleasure or reward, and heighten activation of brain stress systems. Last, they reduce function of brain executive control systems, the part of the brain that typically helps make decisions and regulate one’s actions, emotions and impulses.

These networks are critical for human survival. Unfortunately for the binge drinker, they become “hijacked,” and the bingeing continues even after the harmful effects have begun.

Because binge drinkers’ brains feel intense pleasure from alcohol, there is a powerful motivation to binge drink again and again. What may begin as social binge drinking at parties for recreation can cause progressive neuro-adaptive changes in brain structure and function. The brain is no longer well enough to function normally. Continued partying can transition into a chronic and uncontrollable daily pattern of alcohol use. These maladaptive neurological changes can persist long after the alcohol use stops.

Your brain on alcohol

During the binge-intoxication stage, the basal ganglia rewards the drinker with pleasurable effects, releasing dopamine, the neurotransmitter responsible for the rewarding effects of alcohol and creating the desire for more.

With continued bingeing, the “habit circuity” is repeatedly activated in another part of the basal ganglia called the dorsal striatum. It contributes to the compulsive seeking of more alcohol. This explains the craving that is triggered when a binge drinker is driving by a favorite bar and can’t resist pulling in, even after a promise to go directly home after work.

During the withdrawal-negative affect stage, there is a break from drinking. Because the reward circuit has a diminished ability to deliver a dopamine reward, there is far less pleasure with natural, safe experiences such as food and sex, compared to alcohol.

During abstinence from alcohol, stress neurotransmitters such as corticotropin-releasing factor and dynorphin are released. These powerful neurochemicals cause negative emotional states associated with alcohol withdrawal. This drives the drinker back to alcohol to gain relief and attempt to reestablish the rewards of intoxication.

After a period of abstinence from alcohol, which may last only hours, the drinker enters the preoccupation-anticipation stage. This involves the prefrontal cortex, where executive decisions are made about whether or not to override the strong urges to drink. This part of the brain functions with a “go system” and “stop system.”

When the go circuits stimulate the habit-response system of the dorsal striatum, the drinker becomes impulsive and seeks a drink, perhaps even subconsciously. The stop system can inhibit the activity of the go system and is important especially in preventing relapse.

Brain imaging studies show that binge drinking can disrupt the function in both the go and stop circuits. This interferes with proper decision-making and behavioral inhibition. The drinker is both impulsive and compulsive.

An illness that can be treated

Scientific evidence shows that this disorder can be treated.

The FDA has approved three medications for treatment that should be offered whenever appropriate. There is well-supported scientific evidence that behavioral therapies can be effective treatment. This includes recovery support services, such as Alcoholics Anonymous.

Most importantly, it is important to know that alcohol use disorder is a brain disorder causing a chronic illness. It is no different from diabetes, asthma or hypertension. When comprehensive, continuing care is provided, the recovery results improve, and the binge drinker has the hope of remaining sober as long as lifelong treatment and maintenance of sobriety become a dedicated lifestyle choice.

Jamie Smolen, Associate Professor of Medicine, University of Florida

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

Categories: News Feeds

New York Times Feature Seriously Ponders Whether We Should Let People Addicted to Drugs Die

Mon, 04/30/2018 - 10:10
The piece asks how many "second chances" are deserved.

Over the weekend, as the journalism world fiercely debated whether it’s OK to make fun of Sarah Huckabee Sanders, the New York Times—without stirring much controversy—asked if doctors should let people die if they’re addicted to drugs.

“Injecting Drugs Can Ruin a Heart. How Many Second Chances Should a User Get?” the headline of a large feature piece wonders. The article details the frustrations doctors face dealing with the fallout from the opioid crisis. That includes having patients doing drugs in the hospital, a phenomenon one doctor likens to “trying to do a liver transplant on someone who’s drinking a fifth of vodka on the stretcher.”

People who inject drugs are susceptible to blood infections, which can lead to endocarditis, a catastrophic condition that requires a surgeon to patch a heart back together with one or more artificial valves. The procedures are expensive, and doctors or hospitals are not happy to do them on repeat for people who continue to do drugs. So the piece seems to ask, in all earnestness, whether it makes sense to deny people with a deadly condition treatment if they seem likely to relapse.

The piece centers around 28- year-old Jerika Whitefield, a Tennessee mother who lands in the hospital half-dead from endocarditis after injecting meth. “Her whispered appeal to a skeptical nurse: “Please don’t let me die. I promise, I won’t ever do it again.”’ The article goes on to explain that doctors tell her this would be the last time they would operate on her if she keeps shooting up. Her step-father recalls that one doctor admitted he would not try very hard to save her life. “He said once someone’s been shooting up, you go through all this money and surgery and they go right back to shooting up again, so it’s not worth it,” Mr. Mignogna recalled. “I was just dumbfounded,” the article notes.

Whitefield gets a redemption narrative. She appears to have stopped doing illegal drugs, even as she continues to suffer from the serious health complications of endocarditis and the anxiety of being treated like a pariah by the medical establishment. Others, who are nameless in the piece, aren’t as lucky.

“A little over a year ago, [Dr. Pollard] replaced a heart valve in a 25-year-old man who had injected drugs, only to see him return a few months later. Now two valves, including the new one, were badly infected, and his urine tested positive for illicit drugs. Dr. Pollard declined to operate a second time, and the patient died at a hospice. It was one of the hardest things I’ve ever had to do,” he said.

It’s not entirely clear if the doctor opted out of operating on the 25-year-old man because he thought he was too sick to make it through the procedure, or if he chose to let him die because he assumed he’d keep doing drugs. It’s also not clear if Jerika Whitefield’s doctors really meant to follow through on their threat not to operate on her in the future or if the warning was a tactic to scare her straight. But the idea that medical professionals should refuse to treat a patient who fails to curb their addiction is highly questionable.

Dr. Jana Burson runs a MAT (medically assisted treatment) clinic in Wilkes County, North Carolina, where she administers buprenorphine and methadone to over 500 patients. She sees the struggles people go through to kick their addictions and she doesn’t think medical professionals should treat people battling addiction any differently than other patients.

“I think it’s a horrible idea,” Dr. Burson tells Raw Story. “Same as refusing to prescribe insulin for a diabetic who may not follow her diet. I don’t think we want to start down that road. Could we refuse to treat emphysema in patients who are still smoking? Where would it end?”

Widney Brown, Managing Director at the Drug Policy Alliance, points out how irrational it is to deny people treatment as some sort of tough love approach to addiction, when there policies that work to help people.

“The simplest point is that if we had comprehensive harm reduction practices for people who inject drugs—like sterile needle exchanges and safe consumption sites—they wouldn’t be getting heart infections. With harm reduction, you reduce the risk of complications.”

Also, why single out people who use drugs? “People engage in risky behavior all the time. Everytime you get in a car, you put on a seat belt and have an air bag (which is harm reduction) because driving is risky. Yet we stigmatize drug use as the kind of risk where we don’t want to allow people access to what can reduce harm. We’re more into stigmatizing this group of people rather than help them figure out how to not have bad health outcomes as a result of drug use.”

Brown, who previously worked for the medical ethics organization Physicians for Human Rights in conflict zones like Afghanistan and Syria, says physicians shouldn’t be arbiters of morality.  “They’re there to heal. At a minimum do no harm, at a maximum help people live in the best way. They’re not the ones who should be deciding that this person is not worthy of medical treatment because of what they do.” In war zones, doctors are ethically bound to treat people based on need, not based on whose side they’re on, Brown says. “If an enemy is shot up, they’re compelled to treat the person who needs it most, not based on whether they’re a good or bad person.”

America’s war on drugs continues to rely on judgmental, punitive approaches, rather than public health strategies—with poor outcomes.  “So you drive people underground, and you’ve got them using drugs in the most dangerous way—at the same time you’re not funding treatment. In that context of doing nothing to ensure people are making good choices about drugs—whether to do them in a safer way or to quit—and then we decide not to save this person’s life because they do drugs?”

 Related Stories
Categories: News Feeds

Big Pharma, Big Oil and Big Banks' Ongoing Assault on Us Meets the Definition of 'Terrorism'

Sun, 04/29/2018 - 23:13
Click here for reuse options! The terror they inflict on Americans is very real. Various definitions of terrorism have been proposed in recent years, by organizations such as the FBI, the State DepartmentHomeland Security, and the ACLU. Some common threads persist throughout the definitions: violence, injury or death, intimidation, intentionality, multiple targets, political motivation. All the criteria are met by pharmaceutical and oil and financial companies. They have all injured and intimidated the American public, and caused people to die, with intentionality shown by their refusal to acknowledge evidence of their misdeeds, and political motives clear in their lobbying efforts, where among all U.S. industries Big Pharma is #1, Big Oil is #5, and Securities/Investment #8. 

The terror inflicted on Americans is real, and is documented by the facts to follow. 


Big Pharma: Qualifying for Trump's Call for Capital Punishment for Drug Dealers 

In a Time Magazine article a young man named Chad Colwell says "I got prescribed painkillers, Percocet and Oxycontin, and then it just kind of took off from there." Time adds: "Prescriptions gave way to cheaper, stronger alternatives. Why scrounge for a $50 pill of Percocet when a tab of heroin can be had for $5?" About 75% of heroin addicts used prescription opioids before turning to heroin. 

Any questions about Big Pharma's role in violence and death in America have been answered by the Centers for Disease Control and the American Journal of Public Health. Any doubts about Big Pharma's intentions to intimidate the public have been put to rest by the many occasions of outrageous price gouging. And any uncertainty about political pressure is removed by its #1 lobbying ranking

As for malicious intentions, Bernie Sanders noted, "We know that pharmaceutical companies lied about the addictive impacts of opioids they manufactured." Purdue Pharma knew all about the devastating addictive effects of its painkiller Oxycontin, and even pleaded guilty in 2007 to misleading regulators, doctors, and patients about the drug’s risk. Now Purdue and other drug companies are facing a lawsuitfor "deceptively marketing opioids" and ignoring the misuse of their drugs. 

No jail for the opioid pushers, though, just slap-on-the-wrist fines that can be made up with a few price increases. But partly as a result of Pharma-related violence, Americans are suffering "deaths of despair"-- death by drugs, alcohol and suicide. Suicide is at its highest level in 30 years


Big Oil: Decades of Terror 

Any doubts about the ecological terror caused by fossil fuel companies have been dispelled by the World Health Organization, the American Lung Association, the United Nations, the Pentagon, cooperating governments, and independent research groups, all of whom agree that human-induced climate change is killing people. 

The oil industry's intentionality and political motives have been demonstrated by their refusal to admit the known truth, starting with Exxon, which has covered up its own climate research for 40 years, and continuing through multi-million dollar lobbying efforts by Amoco, the US Chamber of Commerce, General Motors, Koch Industries, and other corporations in their effort to dismantle the Kyoto Protocol against global warming. 


Big Banks: Leaving Suicidal Former Homeowners Behind 

Any doubts about the violence stemming from the 2008 mortgage crisis have been resolved by studies of recession-caused suicides. Both the British Journal of Psychiatry and the National Institutes of Healthfound definite links between the recession and the rate of suicides. 

As with Big Pharma and Big Oil, intentionality and political motives are evident in the banking industry's lobbying efforts on behalf of deregulation -- leading to the same conditions that threatened American homeowners in 2008. There has also been a surge in the number of non-bank lenders, who are less subject to regulation. 

Making it all worse are private developers, who make most of their profits by building fancy homes for the rich. And by avoiding affordable housing. Since the recession, Blackstone and other private equity firms -- with government subsidies -- have been buying up foreclosed houses, holding them till prices appreciate, and in the interim renting them back at exorbitant prices. 

This is leaving more and more Americans out in the cold -- literally. A head of household in the U.S. needs to make $21.21 an hour to afford a two-bedroom apartment at HUD standards, much more than the $16.38 they actually earn. Since the recession, the situation has continually worsened. From 2010 to 2016 the number of housing units priced for very low-income families plummeted 60 percent. 

Here's the big picture: Since the 1980s there's been a massive redistribution of wealth from middle-class housing to the investment portfolios of people with an average net worth of $75 million. It's not hard to understand the "deaths of despair" caused by the terror inflicted on people losing their homes.   Click here for reuse options!
Categories: News Feeds