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The $3,600 Blunt: Marijuana Goes High-End and Super Luxe

Wed, 11/15/2017 - 11:34
A new frontier for capitalizing on a redefined, more sophisticated stoner market.

When Alejandro Canto opened up his luxury cannabis retail store in Seattle earlier this year, one of the products on the shelf was a $3.6K blunt that contained 28 grams of ground high-end marijuana and 7 grams of concentrate wrapped in cannabis leaves.

A gimmick? Hardly. Canto, owner of Diego Pellicer — a swanky 3,300-square-foot retail showcase featuring imported Spanish tile, granite floors and ornate chandeliers — sees the future. And the future for marijuana includes a growing sector of the market hungry for luxury and high-end goods.

“We know the market is shifting toward a more sophisticated consumer,” Canto said. “And we want our customers to have a taste of luxury. From the moment they step inside, customers will know that the quality of our cannabis products and service is beyond anything they’ve previously experienced,” he added.

Canto is not alone in his laser focus on the premium end of the cannabis market. A growing number of cannabis entrepreneurs are hoping to establish a foothold in the luxury sector.

According to a recent study by Miner and Co. Studio, today’s cannabis consumer looks decidedly different than the traditional ‘stoner’ stereotype. According to the study, released last month, 65 percent of cannabis consumer report a household income of more than $75,000 and 84 percent hold down full-time jobs.

“Understanding this new cannabis consumer isn’t just important for these new and growing cannabis brands that market to them," said Robert Miner, president of Miner & Co. Studio. “Almost every major brand will have a portion of their customer base who are cannabis consumers.”

Most cannabis consumers do not regard their use of the product as a key identifier of who they are. The average cannabis consumer is, well, average. The lazy stoner stereotype perpetuated by media depictions is just a myth.

“While TV and movies have unquestionably played a powerful role in driving awareness and acceptance of cannabis as a normal part of our lives and culture, media is still stuck propagating the stoner stereotype such that anyone who consumes cannabis becomes the modern equivalent of Otis, the town drunk in Andy Griffith’s Mayberry – hapless, bumbling and out of it,” Miner said.

“Just as drinking a beer doesn’t mean someone is a drunk or an alcoholic – simply consuming cannabis doesn’t make him or her a zoned out stoner. Media has an opportunity to present the new cannabis consumer in a more positive light to overcome the stoner stereotype that still casts a stigma on the consumers in this vast and growing market,” he added.

While mainstream media still giggles about Cheech and Chong and jokes about the munchies, the industry will continue to keep its focus on the future. And the future is as bright as this blingy $2,190 Sweet Leaf anklet from Jacquie Aiche.

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Naked People 'Out Of Their Minds' On Drugs Seen Terrorizing Missouri Town

Wed, 11/15/2017 - 11:08
It wasn't your typical weekend in Sullivan, MO.

 

 

Naked People 'Out Of Their Minds' On Drugs Seen Terrorizing Missouri Town

A town in Sullivan, Missouri, saw bizarre behavior last weekend when four individuals were said to have wandered the streets while stripping off their clothes, barking, yelling, trespassing and showering in soda water.

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Ayahuasca Can Help Cure Depression, Alcoholism: Study

Tue, 11/14/2017 - 10:31
Use of the Amazonian concoction is associated with less problematic alcohol and drug use, and better mental health and cognitive functioning.

 

 

Ayahuasca Can Help Cure Depression, Alcoholism: Study

Ayahuasca, a psychedelic traditionally brewed in South America, has shown in a study to improve people's general sense of wellbeing and may offer a treatment for alcoholism and depression. According to the study conducted by a team from Exeter University and University College London, the Amazonian brew contains dimethyltryptamine (DMT) — a psychedelic drug illegal in the U.S. and U.K. — and could improve your sense...

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So, Is CBD Legal Or What?

Tue, 11/14/2017 - 10:03
A series of police raids in North Dakota has set the stage for a courtroom showdown regarding the legal status of CBD. So far, it's not going well. Highlights: 
  • The FDA has issued more warning letters to hemp CBD companies for making unsubstantiated medical claims.
  • A study published in the Journal of the American Medical Association indicated that 69 percent of hemp CBD products tested did not contain the amount of cannabidiol indicated on the label.
  • Sporadic police raids continue to target CBD retailers in several states.
  • A legal battle over the status of hemp-derived CBD looms in federal court.

A series of police raids in North Dakota has set the stage for a courtroom showdown regarding the legal status of cannabidiol (CBD), the non-intoxicating cannabis component with significant medical properties. Thus far, it’s not going well for purveyors of the claim that hemp-derived CBD is legal in all 50 U.S. states.

In October 2017, Northwest District Judge Robin Schmidt refused to dismiss drug trafficking charges against Falesteni Abuhamda, the owner of two North Dakota tobacco stores, which allegedly sold products containing CBD with very little or no psychoactive THC[tetrahydrocannabinol]. Abuhamda’s attorney argued that the CBD products were legal because the CBD oil was extracted from the stalk of industrial hemp.

But a forensic scientist with the state’s crime lab easily debunked this argument by stating the obvious: CBD is not found in any appreciable amount in hemp stalk. Rather it exudes from the resinous flowers and leaves of the cannabis plant. And, therefore, CBD is forbidden under the Controlled Substances Act, according to the Drug Enforcement Administration (DEA).

FDA saber-rattling

The Food and Drug Administration (FDA), which defers to the DEA on cannabis-related matters, considers CBD to be an experimental pharmaceutical undergoing evaluation. In early November, the FDA sent letters to several companies selling hemp-derived CBD products warning that they were violating the Federal Food, Drug and Cosmetic Acts.

This was the third time in recent years that the FDA has issued warnings to CBD manufacturers and retailers, which market hemp-derived CBD products as nutraceuticals or food supplements. The most recent round of FDA warning letters did not involve false statements about the source of the CBD extracts. Instead, the agency objected to unsubstantiated medical claims allegedly made by four CBD oil producers: Greenroads Health, Natural Alchemist, That’s Natural! Marketing and Consulting, and last but not least, the Stanley Brothers.

Some of these unsubstantiated claims, according to the FDA, included patient testimonials and assertions that CBD “may be effective in treating tumors from cancer” and other diseases. Thus far, however, there have been no FDA-approved clinical trials that might validate preclinical studies and anecdotal accounts of CBD’s anti-cancer properties.

Today one can easily purchase unregulated CBD products online and at some supermarkets and storefronts across the nation. For the most part, it’s a crapshoot for consumers: A new study published in the Journal of the American Medical Association disclosed that only 31 percent of 84 lab tested hemp-derived CBD products contained the amount of CBD indicated on the label. And who knows what else was in some of these products.

Sporadic raids

While CBD currently seems to be a low priority for federal law enforcement agencies, in recent months there have been sporadic local police raids against CBD retailers in several states besides North Dakota, including (but not limited to):

  • Indiana. In April 2017, Governor Eric Holcomb signed a bill allowing people with treatment-resistant epilepsy who register with the state to possess CBD products that contain less than 0.3 percent THC. Shortly thereafter, a law enforcement crackdown on CBD retailers resulted in the seizure of more than 3000 CBD products from about 60 stores throughout the Hoosier State. In August, Indiana’s Alcohol and Tobacco Commission declared a moratorium on CBD raids “unless the products clearly violate Indiana law.” Since the moratorium announcement, Indiana excise police have continued to issue citations to stores selling CBD.
  • Missouri. Vince Sanders, owner of American Shaman, a Kansas City-based wholesaler, supplied 
  • CBD products to several stores in Missouri and Kansas. He says his products are legal because they are made from industrial hemp and contain hardly any THC. But Missouri law only allows for low-THCcannabis oil to be sold by manufacturers that are licensed by the state health department, which is not the case for American Shaman.
  • Kansas. Kansas is a zero tolerance state when it comes to THC – hardly any is too much in Kansas. Eddie Smith, owner of Into The Mystic, was surprised when police officers showed up at his alternative medicine store in Mission, Kansas, in May 2017 and confiscated an array of hemp-derived CBD products. During a previous visit, an undercover cop purchased some CBD from Smith’s store. A 22-year-old U.S. Army veteran, Smith protested that he had been told “with 100 percent certainty that [CBD] is totally legal in all 50 states.”
  • Wisconsin. In May 2017, police raided several gas stations in Oshkosh, Wisconsin, which sold CBDproducts. A month later, police busted two storefronts in Franklin, Wisconsin, for retailing CBD-infused gummies that contained traces of THC. The store owners said that they had been assured by the wholesale CBD vendor that the products were legal to sell and possess. But Wisconsin lawstipulates that CBD can only be dispensed by a pharmacist or physician – not a gas station – to a patient who has been certified to possess cannabidiol for treating a specific medical condition.
  • Ohio. In August 2017, police returned 18 bottles of hemp-derived CBD to Poor Boys Smoke Shop in Marysville, Ohio, after a Union County prosecutor declined to press charges stemming from a law enforcement raid two years earlier. Medical marijuana is technically legal in Ohio, but corrupt licensing procedures have stymied patient access to cannabis and CBD-rich products.
  • Nebraska. In September 2017, Nebraska Attorney General Doug Peterson declared that CBD sales in the Cornhusker State are flat-out illegal. But under state law, the University of Nebraska Medical Center has the authority to distribute CBD to certified patients who participate in an experimental research program. CBD commerce outside of the university program is strictly forbidden. “To date no drug products containing CBD have received FDA approval,” Peterson noted.
  • Massachusetts. Two detectives visited Jay’s Smoke Shop in Taunton, MA, to inform the proprietor that it was not okay to sell CBD products at his store, even though residents in the Bay State had voted to legalize cannabis both for medical and adult use. It’s currently legal to possess and use cannabis, including CBD-rich products, in Massachusetts, but not in public or while driving a vehicle. Storefront sales won’t be authorized until 2018 at the earliest.

Complicated laws

Currently eight states plus the District of Columbia have legalized cannabis for both medical and adult use; twenty-one more states allow the therapeutic use of cannabis to some degree, but not recreational use; and 18 states have legalized CBD, but not the whole plant or cannabis products containing higher levels of THC. Only three states consider every part of the cannabis plant, including CBD, to be illegal.

Does this mean that cannabidiol is actually legal in most of the United States?

Yes, sort of … maybe.

Confusion regarding CBD’s status stems in part from the patchwork of complicated laws that vary from state to state. But the main problem is Uncle Sam’s abject refusal to acknowledge what has been known throughout the world for centuries: cannabis has significant medical value. Cannabis prohibition, a draconian, racist relic, is based on a mountain of lies, and until this anachronistic policy is terminated, attempts to sort out the legal status of CBD will be mired in contradiction and uncertainty.

Most so-called CBD-only states allow possession of very low or no-THC cannabis products, but do not allow licensed dispensaries, production facilities or home cultivation. In other words, one can possess CBD, but one can’t legally buy it or sell it. Overly restrictive laws in CBD-only states often limit the use of CBDproducts to children with treatment-resistant seizure disorders.

But even in states with legal protections for CBD users, the substance is still technically forbidden under federal law. Several bills are pending in Congress to extricate CBD from the Controlled Substances Act. Such efforts would not be necessary if CBD was federally legal.

No resin, no THC, no CBD

Undaunted, some CBD proponents believe that cannabidiol is already legal by virtue of a 2004 Ninth Circuit U.S. Appeals Court decision (Hemp Industries Association v. DEA) that struck down the DEA’s attempt to ban hemp food products. But this decision never mentioned CBD and the reasoning behind it undermines the notion that hemp stalk is a viable source of CBD. 

The Ninth Circuit rejected the DEA’s argument because hemp food products aren’t made from the resin-bearing parts of the plant – the flower tops and leaves – that contain THC and other proscribed cannabinoids.

Hemp-derived protein powder and nutritional supplements are made from hempseed, which has no resin, no THC and no CBD; thus hemp food, according to the Ninth Circuit ruling, is exempt from the Controlled Substances Act.

The DEA lacked credibility when it argued that hemp food should be banned because it comes from hempseed (which is resin-deficient). And today’s CBD hemp companies lack credibility when they try to skirt the law by arguing that their CBD comes from hemp stalk (which is resin-deficient).

The Farm Bill exception

The 2014 Farm Bill also makes no mention of CBD, but it is often cited by domestic hemp producers as the reason why CBD is federally legal. The Farm Bill defines industrial hemp as cannabis that contains 0.3 percent THC or less. Cannabis with more than 0.3 percent THC in any part of the plant is considered marijuana and is therefore illegal under federal law.

Most significantly, the Farm Bill carved out an exception to the Controlled Substances Act for industrial hemp that is cultivated under the auspices of a state-sanctioned agricultural or academic research program. (The Farm Bill doesn’t specify what constitutes “research.”) Thus far, twenty-three states have enacted laws pertaining to industrial hemp. And for the first time since World War II, industrial hemp is being grown – supposedly for research purposes –in many parts of the United States.

The Omnibus Appropriations Act of 2016 gave another boost to the fledgling domestic hemp industry by stipulating that federal funds could not be used “to prohibit the transportation, processing, sale or use of industrial hemp that is grown or cultivated in accordance with [the Farm Bill]” – in other words, neither the DEA nor state law enforcement can prevent interstate commerce involving industrial hemp.

Does this mean that CBD oil extracted from hemp grown in Kentucky or Colorado is legal to process, sell and transport across state lines, as long as it doesn’t have more than 0.3 percent THC?

The Hemp Industries Association says yes. The DEA says no.

Legal battle looming

In December 2016, the DEA issued an administrative tracking code for cannabis oil extracts, including CBDconcentrates and isolates derived from hemp biomass as well as from marijuana leaves and flower tops. This tracking code did not ban CBD because CBD has always been illegal under the 1970 Controlled Substances Act, which forbids any preparation made from cannabis resin.  All the phytocannabinoids, including CBD and THC, reside in the resinous trichomes of the cannabis plant.

The Hemp Industries Association (HIA) maintains that the DEA failed to recognize the legal distinction between marijuana and hemp, as defined by the Farm Bill, when it announced the new tracking code for cannabis oil extracts. So in January 2017, the HIA filed a judicial review petition that challenged the DEA’s administrative maneuver.

Until a federal judge weighs in, robust CBD commerce will continue in a confusing legal environment, while sports stars and celebrities sing the praises of CBD and medical patients clamor for quality cannabis oil extracts.

 

1 Even though 0.3 percent THC is an arbitrary political number with no scientific basis, it has become the current standard that much of the world uses to distinguish hemp from marijuana. The 0.3 percent legal limit for THC is based on the work of Canadian cannabis researcher Ernst Small, who wrote The Species Problem with Cannabis. In this book, Small acknowledged that there isn’t a natural dividing point at which cannabinoid content could be used to distinguish hemp from other kinds of cannabis. Nevertheless, he chose 0.3 percent THC as where to draw the line on the continuum of cannabis types.
2 The 1970 Controlled Substances Act defines “marihuana” as “all parts of the plant Cannabis sativa L. [sic], whether growing or not; the seeds thereof; the resin extracted from any part of such plant; and every compound, manufacture, salt, derivative, mixture, or preparation of such plant, its seeds or resin. Such term does not include the mature stalks of such plant, fiber produced from such stalks, oil or cake made from the seeds of such plant, any other compound, manufacture, salt, derivative, mixture, or preparation of such mature stalks (except the resin extracted therefrom), fiber, oil or cake, or the sterilized seed of such plant which is incapable of germination.”

 

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The Super Wealthy Oxycontin Family Supports School Privatization With Tactics Similar to Those That Fueled the Opioid Epidemic

Mon, 11/13/2017 - 14:21
Click here for reuse options! A fortune derived from the relentless marketing of painkillers is now being used to expand charter schools.

The notoriously secretive Sackler family, also known as the OxyContin Clan, has been the subject of much scrutiny of late, including lengthy exposés in the New Yorker and Esquire shining a harsh light on the connection between the drug that made the Sacklers wealthy and their philanthropic giving. But there is another troubling beneficiary of Sackler largesse that has escaped public scrutiny: charter schools. OxyContin heir and Purdue Pharma director Jonathan Sackler is a major funder of charters and an extensive network of pro-charter advocacy groups.

Figuring out who is funding the latest charter school-promoting front group often feels like a game of whack-a-mole. That's why reading Patrick Radden Keefe’s recent New Yorker piece, “The Family That Built an Empire of Pain,” made so much fall into place. Keefe writes, “Purdue and other pharmaceutical companies have long funded ostensibly neutral nonprofit groups that advocate for pain patients.”

The same influence techniques Purdue used to promote painkillers are now being used by Jonathan Sackler to expand charter schools.

Promotional power

The late Arthur Sackler, the eldest of three brothers who bought the company in 1952, was posthumously inducted into the Medical Advertising Hall of Fame, and cited for his achievement in “bringing the full power of advertising and promotion to pharmaceutical marketing.” Yet Allen Frances, former chair of psychiatry at Duke University School of Medicine, quoted in the New Yorker piece, highlighted the darker side of that power: “Most of the questionable practices that propelled the pharmaceutical industry into the scourge it is today can be attributed to Arthur Sackler.” As a copywriter at a medical advertising agency, Arthur Sackler devised strategies to promote drugs like Librium and Valium. Now, some of those same strategies are now being used with the aim of promoting charter schools.

Jonathan Sackler, Arthur’s nephew, is a well-known name in the education reform movement. He founded the charter school advocacy group ConnCan, progenitor of the nationwide group 50CAN, of which he is a director. He is on the Board of Directors of the Achievement First charter school network. Until recently, Sackler served on the board of the New Schools Venture Fund, which invests in charter schools and advocates for their expansion. He was also on the board of the pro-charter advocacy group Students for Education Reform.

Through his personal charity, the  Bouncer Foundation, Sackler donates to the abovementioned organizations, and an ecosystem of other charter school promoting entities, such as Families for Excellent Schools ($1,083,333 in 2014, $300,000 in 2015 according to the Foundation’s Form 990s) Northeast Charter School Network ($150,000 per year in 2013, 2014 and 2015) and $275,000 to Education Reform Now (2015) and $200,000 (2015) to the Partnership for Educational Justice, the group founded by Campbell Brown which uses “impact litigation” to go after teacher tenure laws. Earlier this year, the Partnership for Educational Justice joined 50CAN, which Sackler also funds ($300,000 in 2014 and 2015), giving him a leadership role in the controversial—and so far failing cause—of weakening worker protections for teachers via the courts.

Just as Arthur Sackler founded the weekly Medical Tribune, to promote Purdue products to the medical professional who would prescribe them, Jon Sackler helps to fund the74million.org, the “nonpartisan” education news website founded by Campbell Brown. The site, which received startup funding from Betsy DeVos, decries the fact that “the education debate is dominated by misinformation and political spin,” yet is uniformly upbeat about charter schools while remarkably devoid of anything positive to say about district schools or teachers unions.

Vertical integration

The Sackler “special sauce” is vertical integration. As far back as the early 1960’s, staffers for Tennessee Senator Estes Kefauver prepared a memo for a subcommittee he chaired that was looking into the rapidly growing pharmaceutical industry. 

“The Sackler empire is a completely integrated operation in that it can devise a new drug in its drug development enterprise, have the drug clinically tested and secure favorable reports on the drug from various hospitals with which they have connections, conceive the advertising approach and prepare the actual advertising copy with which to promote the drug, have the clinical articles as well as advertising copy published in their own medical journals, [and] prepare and plant articles in newspapers and magazines.”

This was used to great effect in promoting OxyContin. Art Van Zee MD looked at the Marketing and Promotion of OxyContin and found that in 2001 alone, the company spent over $200 million to market and promote the drug through a variety of methods. In the settlement in the US District Court of Western Virginia, the company admitted to misbranding the drug with the intent to defraud and mislead the public.

The company was lavish with branded swag for health care practitioners. According to a GAO report, these included, “OxyContin fishing hats, stuffed plush toys, coffee mugs with heat-activated messages, music compact discs, luggage tags, and pens containing a pullout conversion chart showing physicians how to  calculate the dosage to convert a patient to OxyContin from other opioid pain relievers.”

The GAO report went on to quote the DEA as saying the Purdue’s use of branded promotional items in the marketing of OxyContin was “was unprecedented among schedule II opioids, and was an indicator of Purdue's aggressive and inappropriate marketing of OxyContin.”

The description of “lavish swag” will sound familiar to anyone who has witnessed one of the no-expenses-spared charter school rallies that are a specialty of Sackler-funded organizations like Families for Excellent schools. Then there is the dizzying array of astroturf front groups all created for the purpose of demanding more charter schools. Just in Connecticut, we’ve had the Coalition for Every Child, A Better Connecticut, Fight for Fairness CT, Excel Bridgeport, and the Real Reform Now Network. All of these groups ostensibly claim to be fighting for better public schools for all children. In reality, they have been lobbying to promote charter schools, often running afoul of ethics laws in the process.

Take Families for Excellent Schools, a “grassroots” group that claims to be about parent engagement, yet was founded by major Wall Street players. In Connecticut, the group failed to register its Coalition for Every Child as a lobbying entity and report a multimillion-dollar ad buy expenditure and the costs of a rally in New Haven. 

In Massachusetts, Families for Excellent Schools-Advocacy (FESA) recently had to cough up more than $425,000 to the Massachusetts general fund as part of a legal settlement with the Office of Campaign and Political Finance, the largest civil forfeiture in the agency’s 44-year history. Massachusetts officials concluded that FESA violated the campaign finance law by receiving contributions from individuals and then contributing those funds to the Great Schools Massachusetts Ballot Question Committee, which sought to lift the cap on the number of charter schools in the state, in a manner intended to disguise the true source of the money. As part of the settlement, the group was ordered to reveal the names of its secret donors. Jonathan Sackler was one of them.

Patrick Riccards, a former CEO of ConnCan, the pro-charter group that Sackler founded in 2005, told me, “Jon went to Berkeley and in many ways fits into that idealistic mold. But at the same time it was he who made it clear to me that one of the reasons ConnCan existed was to leverage the investment in the charter community, in Achievement First, which is still the dominant charter school network in the state. [CT] The venture capital community ... has put tons of money into seeing Achievement First grow, first in Connecticut, then in New York, then in Rhode Island.”

It’s all part of the model, concluded Riccards. “While you have a public vision of great public schools for all, ConnCan’s focus was: how does the charter industry continue to grow? Every year, ConnCan’s fight was how do we increase the number of seats, and how do we increase the per pupil expenditure?”

Staggering toll

OxyContin was approved for use in treating moderate to severe pain in 1995. Purdue was determined to make the drug a hit, and funded doctors like Russell Portenoy, who said in a 1993 interview with the New York Times: "There is a growing literature showing that these drugs can be used for a long time, with few side effects and that addiction and abuse are not a problem.”

Except that the literature was based on short-term usage, not on long-acting opioids taken over extended periods of time. By 2003, Portenoy admitted to the Times that he had misgivings about how he and other pain specialists had used the research. Although he had not intended to mischaracterize it or to mislead fellow doctors, he had tried to counter claims that overplayed the risk of addiction. But if not for such mischaracterizations, the Sacklers wouldn’t be as wealthy, and America might not be suffering from a public health crisis that is costing the country an estimated $78.5 billion a year.

Even as the scope and scale of the opioid epidemic unfolds, the fortune OxyContin built continues to grow. In the case of OxyContin heir Jonathan Sackler, part of that fortune is being devoted to expanding charter schools and weakening protections for teachers in traditional public schools. Patrick Keefe’s New Yorker feature ends with a stunning statistic: “An addicted baby is now born every half hour.” He asks whether such devastation should give pause to organizations that benefit from the Sacklers' extensive philanthropy. In the case of the charter schools and education reform advocacy groups that Jonathan Sackler funds, the answer to that question should be obvious. 

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Martin Luther King, Coca-Cola, and Selective Compassion: A Black Brazilian Voyage to Atlanta

Mon, 11/13/2017 - 12:34
Click here for reuse options! We must fight for social movements that centralize minority voices.

August 14 marked 43 years since Reverend Martin Luther King Jr. received the Nobel Peace Prize for his leadership in the civil rights movement. This movement swept the United States in the 50s and 60s, calling for improvements in the lives of black Americans at a time and in a place where signs still restricted the entry of black people into bathrooms, buses, bars, restaurants, schools, and health centers. A time and a place where black Americans’ ability to vote was dependent on a complex structure of white discourses and white institutions.

And there we were, in the sixth blackest city in the United States, Atlanta, debating drug policy reform with 1,500 people from 50 countries at the Drug Policy Alliance’s International Drug Policy Reform Conference. The city is home to a black elite; it is common to see black people driving expensive cars through the city center, or catching planes from the world’s busiest international airport, or owning the establishments that we frequented at night. Atlanta was the city to elect the first black man to mayor (Maynard Jackson, in 1973) and to elect the first black female mayor of any major Southern city (Shirley Franklin, in 2001). The current mayor of Atlanta, Kasim Reed, is black.

Atlanta was also the city where Coca-Cola sold its first cup in history, in 1886, created by Atlanta pharmacist John Stith Pemberton who was searching for a drink that could alleviate the pains of his Civil War-inflicted wounds and supplant his addictive use of morphine. 

Even before Pemberton relied on the coca leaf to create Coca-Cola, Pope Leo XIII had already awarded a Vatican gold medal to a drink created by chemist Angelo Mariani in 1863 that combined the properties from the alkaloids in the coca leaf with wine. For the first half of the 19th Century, alkaloids from the coca leaf were routinely administered as anesthetics and stimulants, surprising medical professionals with their positive effects. At the time, it was inconceivable that the Andean plant would be disapproved of, let alone made illegal. Sigmund Freud recommended its therapeutic use to his patients, and produced one of his best-known works on the subject, Über Coca. The emergence of psychiatry as a profession is closely related to the dissemination of Andean alkaloids amongst the white populations in Europe and the United States. In Brazil, its consumption was part of cocktail of substances consumed by the Rio “high society” in a period known as the Belle Epoque.

The other key ingredient used in Pemberton’s formula, the kola nut, is of African origin, a fruit from the trees in the sterculiaceae family. The kola nut similarly contains alkaloids and powerful stimulating properties. These nuts were brought to Latin America by enslaved black Africans who chewed them in order to endure their painful labor. Together with cloths from the coast, black soap, and palm oil, the kola nut was one of the most common African goods in the transatlantic trade with Brazil.

Over its 125-year history, Coca-Cola – the most popular drink in the world, which boasts more consumer countries than countries in the United Nations – has left a trail of blood, fraud, embezzlement, and corruption. It affects the lives of coca and kola producers through exploitative and slave labor, is responsible for water scarcity in many black and indigenous communities, and lobbies for water management policies that cater to its own interests. In some indigenous communities in Chiapas, Mexico, the Zapatistas declared Coca-Cola-free zones for many years. Recently in Brazil, the Ministry of Labor found Coca-Cola guilty of slave labor in the state of Minas Gerais.

In Memphis, on the eve of his assassination in 1968, Dr. King and other leaders called for a boycott of Coca-Cola. They noted that – from Atlanta to Memphis, and across the entire country – despite not being its biggest consumers, black people undertook the hard labor in the production and commercialization of Coca-Cola, yet never reached prominent positions in the company. As a result of the boycott, Coca-Cola was pressured to publically state that it did not practice any form of discrimination. Nevertheless, it was ordered to pay $2 million after a lawsuit filed by the company’s workers.

When we arrived in Atlanta to discuss drug policy, we thought about how the racism spoken of by Martin Luther King Jr. and the effects of industrial capitalism on the control of black bodies by is also reflected in the war on drugs. The new role played by prisons – partially to fulfill the demands produced by and for the advance of industrial capitalism in the world – not only changed the perception of the intention of incarceration but also the perception of those who commit offenses. Prison for labor aligned with the emergence of discourses and practices that sought to consolidate the idea of the black man as “the other”, a biologically and culturally inferior race, prone to addiction and a potential agent of race degeneration.

Michelle Alexander’s speech, at the start of the Reform conference, highlighted that she was not optimistic about the recent drug policy reforms in the United States and called on us to reflect on important global and local questions surrounding the processes of reform across diverse communities. President Trump has said that he will beat the “new epidemic”, also referred to as the “opioid crisis,” of rising heroin and other opiate consumption. There have been over 120,000 deaths from overdoses in the past 24 months, double the amount of lives lost in the 19 years of the Vietnam War.

In the same election that handed Donald Trump a victory, voters in the United States approved the legalization of medical and recreational marijuana through ballot initiatives in several states. California, Nevada, Maine and Massachusetts joined Colorado, Oregon, Washington and Alaska in legalizing recreational marijuana. Medical marijuana is now legal in 29 states plus Washington DC.

It may appear paradoxical that the United States is advancing on drug policy reform at the same time as it elected conservative Donald Trump. But it is not. In fact, Michelle Alexander reminds us that what connects the victory of conservatives in the U.S. elections to the advance of marijuana regulation and the debate on use and abuse of drugs in the country is: whiteness.

Currently, the popular reaction to the opioid crisis as characterized by media campaigns has been one of compassion for the victims and appeals for care so that deaths are avoided. Public figures, including conservative members of congress, are engaged in a dispute over who can offer most to these people and their families. The conservative Republican Governor of Florida, Rick Scott, declared a state of emergency in May and allocated $54 million to prevention, treatment and rehabilitation.

In Brazil, the launch of the documentary Ilegal had wide repercussions in the main Brazilian media outlets and elicited feelings of concern and compassion for the condition of five-year old Anny, a patient from a white Brazilian family with a serious and incurable form of epilepsy, who suffered 80 epileptic attacks a week since she was born. The only remedy that worked for her was CBD, a cannabis extract. After the documentary gained attention, even the most conservative members of the Brazilian Congress supported legislative changes that allowed for the import of CBD for Anny and other families other families who could afford to pay for the medication. Unfortunately, it is mainly white Brazilian families that can afford to import these medications. Steps are now being taken to regulate medical marijuana more widely in Brazil. 

All this to say, when problems associated with drugs reach the white population, when the effects of drug abuse or the conditions of illegal sale are of concern to white people, policies change, people change, campaigns change. When the victims are white, change is initiated, money is invested, and the population is moved. However, the same treatment is not given to the population most affected by the consumption and prohibition of crack: mostly black and poor people. Brazil and the United States share this same reality.

If the majority of people involved in the sale, production and use of opioids in the United States were black, we would not be having the same conversation we are now having, as Michelle Alexander reminded us. The life of a black child does not move the country. Because compassion, financial support, and policy change is selective.

That is why the reforms that we advocate for in this country and around the world must always center on the question of race. The reconfiguration of markets and means of control, instrumentalized by legal, economic and media discourses inherited from slavery, consolidate knowledge and practices about crime and deviance, but also about care and compassion, that are deeply racialized. Just as the public health view of drug use versus the criminalization of drug use reflect opposing notions that are deeply racialized, the changes ahead will present these same conditions. Whenever the subjection of life to the power of death continues, as explained by Achille Mbembe’s necropolitics, and decisions made over who we want to care for, protect, and promote will always bring back our history of colonization.

In 1963, Pastor King said about the U.S. Emancipation Proclamation that “this momentous decree came as a great beacon light of hope to millions of Negro slaves who had been seared in the flames of withering injustice. It came as a joyous daybreak to end the long night of their captivity. But one hundred years later, the Negro still is not free.” Therefore, we must always be aware of any process of change that does not centralize our voices, offer reparations for our history, or help overcome the traumas that exist in all societies. And that our compassion is a reflection of our own humanity – broad, inclusive and true – and not only a mirror of white faces telling us for whom we should cry.

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You Won't Believe Which Middle East Theocracy Takes an Enlightened Line on Entheogens and Psychedelics!

Mon, 11/13/2017 - 10:04
Click here for reuse options! It's not exactly the Islamic Republic of Acid, but still…

In a move barely noticed in the West, more than three years ago, Iran's Grand Ayatollah Rohani issued a formal legal ruling—a fatwa—declaring that the use of entheogens and psychedelics was permissible (ḥalāl) for Shi'i Muslims for purposes of treatment and spiritual growth.

Grand Ayatollah Rohani's fatwa specified that such use should be undertaken under the direction and supervision of qualified experts, but it did not specify which psychoactive substances were meant to be included. The fatwa, however, was delivered after long discussions with petitioners about the effects of DMT, ayahuasca, haoma (or soma), LSD, psilocybin mushrooms, ibogaine, and marijuana.

Sufi mystic, Islamic scholar and psychedelic practitioner Wahid Azal explained what happened in an interview with Reality Sandwich. Another Shi'i scholar approached him about opening a dialog with the Shi'i religious establishment in an effort to get some sort of formal legal opinion about the approach to the therapeutic and spiritual use of entheogens:

To make a long story short, after well over a year and a half of back and forth discussions and correspondences between my friend (and one other individual) with the office of Grand Ayatollah Sayyed Mohammad Sadeq Hussaini Rohani in Qom, Iran; in mid-March 2014, via email, the Grand Ayatollah issued a formal legal ruling (that is, a fatwa) determining the use of entheogens and psychoactive substances to be licit and thus permissible (ḥalāl) for Shi’i Muslims provided it be under the direction and supervision of qualified experts (ahl al-ikhtiṣāṣ), and that, moreover, such plant substances as a rule do not impair the mind. In the final missive before the decision, the questioner specifically underscored the issue of the visionary component of these plants, where people have reported visions of paradise and hell, and Grand Ayatollah Rohani’s fatwa finds no objections here either.

Grand Ayatollah Rohani could have been open to mind-altering drugs because the psychedelics have a resemblance to Esfand, also known as Syrian rue (peganum harmala), which contains the psychoactive indole alkaloid harmaline, a central nervous system stimulant and MAO inhibitor used for thousands of years in the region. According to at least one Shi'i tradition, the Prophet Mohammed took esfand for 50 days.

Whatever the precise theological reasoning behind the Rohani's fatwa, with it, Iran could leapfrog Western nations when it comes to psychedelic research. Although psychedelics are seeing a research renaissance in the West, research here is limited by their criminalized legal status, as well as lack of funding. But the Islamic Republic has cleared the way. 

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Jeff Sessions Sued by 12-Year-Old Girl to Legalize Medical Marijuana Nationwide

Sun, 11/12/2017 - 07:57
The sixth-grader hasn’t had a seizure in two years.

Alexis Bortell, a 12-year-old girl who lives in Colorado, is suing Attorney General Jeff Sessions over the nation's federal prohibition of medical marijuana.

Bortell and her parents moved to the state from Texas in order to legally receive a strain of medicinal marijuana to help her battle epilepsy, KDVR reported.

"As the seizures got worse, we had to move to Colorado to get cannabis because it's illegal in Texas," Bortell said.

While her family lived in Texas, Bortell said traditional medicine did little to help the seizures she suffers from, and doctors had recommended brain surgery, KDVR reported.

One pediatrician presented her with a different option, medicinal marijuana, but it would ultimately require her to leave Texas.

After the family moved, the sixth-grader was treated with a medicinal marijuana strain titled "Haleigh's Hope." With just a single drop in the morning, and at night, Bortell hasn't suffered a seizure for a little more than two years, KDVR reported.

"I'd say it`s a lot better than brain surgery," Bortell said.

"I would like to be able to visit my grandparents without risking being taken to a foster home," Bortell said, when asked why she joined the lawsuit.

Marijuana has long been classified by the Drug Enforcement Agency as a Schedule I narcotic, placing it in the same category as ecstacy, and LSD. Marijuana is listed as more dangerous than Schedule II narcotics such as cocaine, and methamphetamine.

"How is that rationale? It's not compassionate either, but rationality? It's just outrageous," the girl's father, Dean Bortell, said. "When you look at it from a distance and you see it saving their lives, me as a father and an American, I go, what are we doing? How could you possibly look at someone who`s benefiting from this as a medicine and threaten to take it away?"

While medical marijuana has been legalized in 29 states, as well as Washington D.C., it's still federally illegal.

Along with Bortell in the lawsuit is another child, a military veteran, a marijuana advocacy group and former Denver Broncos football player Marvin Washington, KDVR reported.

While the lawsuit is certainly a long shot, it represents a larger progressive push for marijuana whether it's for recreational use or medicinal use.

Sessions has a well-known record of being opposed to marijuana in any capacity, even for medicinal purposes. His position on marijuana is starkly contrasted by public opinion, as 64 percent of Americans support the legalization of marijuana, an all-time high.

The numbers for medicinal marijuana are even higher, as 88 percent of Americans believe it should be legal.

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BUSTED: Watch LA Cops Plant Drugs in Black Suspect's Wallet—Unaware Their Body Cams Were On

Fri, 11/10/2017 - 13:11
Both officers involved in the bust refused to comment on their actions.

An investigation into what is being captured on the body cams worn by Los Angeles police has turned up evidence of officers planting drugs in a suspect’s wallet while believing their cameras were off.

According to CBS-LA, Los Angeles police are now wearing the body cams, but police officials are withholding the videos from the public. However, the station was able to acquire video of one black man being arrested for a hit and run, with the video showing something quite different from what was documented in the official police report.

The report documents the arrest of Ronald Shields, 52, in April when he was taken into custody for a hit and run. According to the police report, LAPD officer Samuel Lee stated that cocaine was found in Shields’ front left pocket

But the body cam of a fellow officer showed one officer picking up the small packet from the ground and placing it in the suspect’s wallet — before making a show of discovering it multiple times for the camera.

According Shields’ attorney, Steve Levine, officer Lee seemed stunned when he was shown the video while on the witness stand, saying the officer, “Looked dumbstruck to me. Period. He had really no answer.”

According to an expert discussing how the body cams work, the officer may not have realized that the camera was running 30 seconds before he believed he activated it.

Confronted by CBS reporter David Goldstein, both officers involved in the bust refused to comments on the discrepancy between their reports and what was shown on-camera.

Watch the video below via CBS-LA:

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Could California’s Insane Cannabis Tax Cripple the Legal Market?

Fri, 11/10/2017 - 08:56
Did someone say 45 percent sales tax?

California was the first state to legalize medical marijuana in 1996 with Proposition 215. It was a time when the wild west was full of marijuana warriors who literally laid down the law — and their lives at times. Which might help explain why California has been so resistant to full on legalization with all its taxes and regulations. Things start sounding more like Nottingham and less like Sherwood Forest when you hear the words “45 percent sales tax.”

 

Prop 215 was the perfect medical marijuana model thanks to one of its key authors, Dennis Peron, who changed the marijuana and LGBT landscapes of our nation. It was perfect in it’s numerous imperfections (hindsight) that allowed almost anyone to obtain a medical use card. But California is the world’s sixth largest economy and that means tourism. Also, full on legalization is looking better and better on the states that make it happen.

High sales taxes, however, are threatening to bring California cannabis back into the black market when they finally go all the way on January 1, 2018. “High effective tax rates on California cannabis may complicate the state’s efforts to establish legal markets” analysts Stephen Walsh and Karen Ribble said within a Fitch Ratings report on California’s pot taxes.

Rates will vary between municipalities with both state and local taxes added to the price. Growers, sellers and consumers all have their own sets of taxes with consumers paying 22.25 to 24.25 percent tax, though also reaching as high as an outrageous 45 percent — depending where one is in the state. The taxes include the state excise tax and additional state and local taxes.

The Fitch report believes that these higher taxes could send people back into a black market that’s never stopped flourishing. “California’s black markets for cannabis were well established long before its voters legalized cannabis in November 2016 and are expected to dominate post-legalization production,” read the Fitch report.

It’s all going to really come down to the consumer. Plenty of Californians and visitors are going to be pleased as punch to pay the extra taxes in order to just walk into a legal dispensary and pick up their cannabis supplies. However, those already prone to doing things under the radar? Well, we can predict one thing clearly, California’s legalized marketplace will be nothing if not dynamic.

 

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The Opioid Crisis is at Its Worst in Rural Areas: Can Telemedicine Help?

Fri, 11/10/2017 - 08:26
Technology-assisted treatment could be part of the solution.

Some of the communities hit hardest by the opioid epidemic are in rural America. However, many of those same communities lack access to comprehensive treatment.

To address the epidemic’s increasing reach, the White House declared a public health emergency on Oct. 26. The administration outlined a need to expand treatment in rural communities, most notably by making telemedicine more readily available. Telemedicine, also referred to as telehealth, aims to improve treatment access by allowing people to consult their provider remotely – for example, by using videoconferencing.

As a researcher of opioid treatment in Michigan, I’m excited to see the call for greater availability of telemedicine as a way to help rural communities. However, telemedicine has important limitations that need to be considered.

Rural struggles

Drug overdose deaths are rising in rural areas across the U.S. In 2015, the overdose death rate for rural areas surpassed the death rate for urban or suburban areas. People living in rural areas were four times more likely to die from overdoses in 2015 than they were in 1999. The opioid epidemic hit states east of the Mississippi River hardest, with the highest death rates in relatively rural states: West Virginia, New Hampshire and Kentucky.

The most scientifically supported opioid treatments combine medications – like buprenorphine, methadone or Suboxone – with behavioral therapy. These opioid treatment programs help patients stop abusing opioids and promote long-term recovery.

However, people living in rural areas face a number of barriers in accessing opioid treatment. Many rural populations have a limited number of clinics that provide opioid treatment and behavioral therapy, as well as a shortage of providers who prescribe opioid treatment medications. People living in rural areas frequently travel long distances to their opioid treatment provider. Moreover, many may feel ashamed or stigmatized if they seek out opioid treatment in their local community.

In northern Michigan, for example, roughly 400,000 residents live north of the closest clinic in Otsego County that provides both methadone and behavioral therapy. People in need of comprehensive opioid treatment in these remote areas require their own transportation and finances to support multiple hours of travel.

The shortage of providers is also an obstacle for rural communities in less remote areas of Michigan. In Lenawee County, which is situated roughly an hour from Ann Arbor and Toledo, there are approximately 100,000 citizens with access to a handful of buprenorphine treatment providers. The few rural providers in areas like this typically offer opioid treatment within small family medicine practices and have limited staff to provide behavioral therapy.

Telemedicine pros and cons

With these issues in mind, telemedicine seems like a promising way to help rural communities, and specifically, to aid in rural opioid treatment.

One study from Ontario demonstrated that the more sessions patients attended via telemedicine, the more likely they were to stay in an opioid treatment program. Patients in the study attended telemedicine sessions under a nurse’s supervision at an affiliated opioid treatment clinic. The prescribing physicians, who likely oversee other clinics from afar, were videoconferenced in from a different location. Videoconferencing helped patients better access providers to discuss medication issues, but still required patients to travel to an affiliated clinic.

The White House has yet to provide explicit details on how expanded telemedicine services will be funded. The US$57,000 released through the public health emergency isn’t enough by itself to lead to meaningful changes and needs renewal after 90 days.

The use of telemedicine for opioid treatment also presents particular challenges. Providers are required by law to see patients for initial in-person assessment before prescribing controlled medications like Suboxone.

There are exceptions to this law, including letting the patient see other clinical staff in person while videoconferencing with the prescribing physician. The emergency declaration could offer even more flexibility.

What’s more, most people need services for other problems besides opioid addiction, such as mental health problems like depression or difficulties with other drugs like cocaine. Many also lack private health insurance or financial means to pay out of pocket for telemedicine.

Despite these issues, the administration’s call to improve treatment access is a positive step for rural health.

Not just rural areas

Urban areas, too, may benefit from this technology-assisted treatment, as people living in rural and urban areas face similar obstacles.

Within my home state of Michigan, drug overdose deaths are overrepresented in urban areas. The two most densely populated counties, Wayne and Macomb, both ranked among the top counties for overdose deaths in 2014 and 2015. This risk among urban communities may be in part due to the increased availability and use of highly potent, synthetic opioids such as fentanyl.

My research on opioid treatment highlights strikingly similar treatment barriers for rural and urban patients. In a study at an urban opioid treatment clinic, we found those who live farther from the clinic were more likely to drop out sooner, potentially due to transportation-related hardships in accessing the clinic.

Urban patients have similar needs for comprehensive services to treat other mental healthand drug problems and they, too, experience financial problems and a lack of private health insurance.

Steps toward a solution

A few steps, including the advancing of telemedicine, could help save countless lives currently being lost to the opioid epidemic.

First, the administration is still considering declaring a national emergency. That would provide access to more funds, or eliminate proposed budget cuts to existing addiction treatment programs. These monies could be used to train providers interested in delivering telemedicine or used to increase the number of staff able to provide comprehensive services.

Second, we need to investigate the effectiveness of existing telemedicine approaches within rural communities, and continue developing new technology-assisted opioid treatments for rural and urban communities.

Universities, especially those located within surrounding rural communities, should develop dedicated rural health initiatives. My colleagues and I are currently conducting a study to better understand rural patients’ views on treatment access. We will also ask providers about their likelihood to use new treatments – like telemedicine or treatments delivered through mobile or internet devices – in their practice.

Last, it’s important to provide publicly funded treatment and comprehensive services to both rural and urban communities. Practically speaking, many people in need of opioid treatment are able to access treatment only using public health insurance programs like the Affordable Care Act, Medicaid and block grant programs.

Until all communities, rural or otherwise, have better access to comprehensive opioid treatment, we will continue to lose loved ones at alarming and unacceptable rates.

 

 

 

 

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The Corporate Roots of the Opioid Crisis

Fri, 11/10/2017 - 08:13
Opioid overdose claims 175 Americans each day, but powerful pharmaceutical companies continue to promote their sales.

Sitting in a small cafe in a small town in western Massachusetts, Jordan talks about his problems with opioids. He was a construction worker, but an accident at his work site sent him to a hospital and into the arms of prescription painkillers. Jordan’s doctor did not properly instruct him about the dangers of these pills, which he used to kill the pain that ran down his leg. When the prescription ran out, Jordan found he craved the pills. “I used up my savings buying them on the black market,” he told me. When his own money ran out, Jordan got involved in petty theft. He went to prison for a short stint. The lack of proper care for his addiction in the prison allowed him to spiral into more dangerous drugs, which led to his near-death. Now released, Jordan struggles to make his way in the world.

With us is Mary, another recovering addict who entered the world of prescription drugs after she had a car accident a few years ago. Her shoulders and neck hurt badly and so Mary’s doctor gave her a prescription for fentanyl, which is 50 to 100 times stronger than morphine. Mary used a fentanyl patch, which allowed the drug to slowly seep into her body through her skin. It was inevitable, Mary told me, that she became addicted to the drug. The pain went away, but the longing for the opioid continued. Mary, like Jordan, is in a de-addiction programme. It is an uphill climb, but Mary is confident. She is a bright person, whose eyes tell a story of great hope behind the fog of her addiction.

In late October, in Easthampton, Massachusetts, a small crowd gathered in public to talk about the scourge of the opioid epidemic in the area. Kaisa Clark talked about her sister Kristina, who died last year at the age of 32 from endocarditis. Kristina (Tina) was addicted, but was not given much support from the medical community. “Time and again my sister was made to feel like her life didn’t matter,” Kaisa said, her voice cracking. In her obituary, Tina’s family wrote movingly about her fight with addiction. “It was an uphill battle to acquire the necessary physical and mental health services that she required, as the stigma of substance abuse continues to plague all areas of our community.”

These are some of the two million Americans who suffer from substance abuse disorders related to prescription opioid pain relievers. The numbers are staggering. In 2016, as many as 64,000 people died in the U.S. as a result of drug overdose. In 2015, the number was 52,404 dead, which means that the number increased by 22 percent over the year. But more staggering is that over the past three years, deaths by synthetic opioids (fentanyls) increased by 540 percent from 3,000 to 20,000. Illegal drugs—such as cocaine and heroin—continue to pose a challenge, but the real threat is from prescription opioids such as fentanyls of one kind or another. Each day, 175 Americans die from opioid overdose.

National Emergency

In early November, President Donald Trump declared a national emergency against opioid abuse. “The opioid is a tremendous emergency,” he said in his characteristic style. The declaration of an emergency means that state funds should go post-haste to help stem the crisis. It is not clear, however, if this will be enough. There are indeed severe problems of inadequate funding for the treatment of addiction, and funds will be welcome. But the problem also exists at the other end—the production of the addicts. This would require a full-scale assault on the pharmaceutical industry.

Whether Trump will have the stomach to take on this powerful industry is to be seen.

In July, Dan Picard, a City Council member in the town of Middletown (Ohio), reported that the opioid epidemic had put immense pressure on the financial resources of the town. He suggested that the town adopt a “three strikes” approach to the crisis. If a person called for an ambulance because of an opioid overdose, the city would send medical care twice, administer the antidote (Narcan) and allow the person to survive. The third time, the person having an overdose would be left to die. “We need to put a fear about overdosing in Middletown,” said Picard. He was chastised for his callousness.

But Picard is not alone. Across the “rust belt,” where de-industrialization has slowly eviscerated community after community, the opioid epidemic makes its way. Matters are so grave that in West Virginia, by early March, the state ran out of money to help bury the poor. West Virginia’s Funeral Directors Association president Frederick Kitchen said that this was largely the result of drug overdose deaths. Robert Kimes of the same association said that many funeral home directors had said that the majority of those who required the indigent burial programme were young and “not financially in a great position”.

Princeton University economists Anne Case and Sir Angus Deaton looked carefully at the mortality rates for the U.S. working class and found them prone to “diseases of despair”—including drug overdose. In 2015, the Case-Deaton study found that there was a “sea of despair” that was drowning a generation of working-class Americans, with diseases such as drug addiction and alcoholism as evidence for the despair. In an updated version of the study that came out this year, Case and Deaton find that the collapse of the job market and the lack of hope amongst the working class have turned the poor towards various forms of addiction, including that of prescription drugs. Half the men who are out of the labor force, they suggest, are taking a prescription painkiller (such as an opioid).

“Although we do not see the supply of opioids as the fundamental factor,” Case and Deaton argue, “the prescription of opioids for chronic pain added fuel to the flames, making the epidemic much worse than it otherwise would have been.” Importantly, Case and Deaton point at the money. “We should note,” they suggest, “that a central beneficiary of opioids are the pharmaceutical companies that have promoted their sales.”

Social Reasons for Drug Overdose

Case and Deaton are right to point to the social reasons for the drug overdose epidemic—the despair in society as it suffers from unemployment and social collapse—but also correct to point a finger at the pharmaceutical industry. Purdue Pharma, which makes the popular drug OxyContin, made $35 billion on this drug. The family that owns Purdue Pharma, the Sacklers, has made upwards of $13 billion. They donate vast amounts of money to charity, particularly in the arts. But they have also lobbied Congress with laser-sharp intensity. Between 2006 and 2015, Purdue Pharma and others who produce opioids spent $900 million on their lobbying efforts. That is eight times the amount spent by the gun lobby. They have purchased immunity from the elite, who are loath to stand up to stem the epidemic that is hemorrhaging poor communities across the U.S.

Matters get more horrid when one looks at the entire pharmaceutical industry. It is true that the drug industry has made a fortune selling painkillers—especially opioids—to the general public. But they also make a killing from selling the antidotes for an overdose. And they have shown their colors by raising prices as the epidemic spirals out of control. The drug that Picard wanted to deny the overdose victim on their third call to the hospital is Narcan. One version of Narcan is called Evzio and is made by the pharmaceutical company Kaleo. In 2014, Kaleo sold two Evzio doses for $690, but increased the price earlier this year to $4,500. Kaleo controls about 20 percent of the antidote market. This means that it has been able to set the price for this drug across the market, including for generic naloxone, which doubled over the past year.

Neither Jordan nor Mary is able to easily face a world that seems to have turned its back on them. There are millions of others like them who live in “factory deserts,” in towns that have been utterly hollowed out by the new order of things. They have no faith in Trump’s emergency order. Some money will go towards opioid addiction, which they welcome. But that is not the crux of the matter. They point their fingers at the pharmaceutical industry and the billionaires in their society. There is money in their society, they tell me at different times, but it does not seem to be coming to them. “The rich would like us all to die or go to prison,” says Mary.

 

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Where Buying Marijuana Is Legal, But There’s Nowhere to Smoke It

Thu, 11/09/2017 - 09:02
Having a place for people in pot-legal states to indulge is the next frontier for marijuana.

This piece comes to us courtesy of Stateline. Stateline is a nonpartisan, nonprofit news service of the Pew Charitable Trusts that provides daily reporting and analysis on trends in state policy.

Las Vegas’ reputation as a place where you can indulge your vices and have a good time helps it lure some 43 million visitors a year. But tourists heading to Sin City hoping to consume newly legal cannabis have a problem: There are few places in town, other than private homes, where someone can legally light up a joint.

In Nevada and the seven other states that allow people to consume marijuana for fun, it’s typically illegal to smoke or ingest the drug in dispensaries, bars, restaurants, city parks and public streets. Hotels and landlords often ban people from using the drug on their property.

“The next frontier is: Where do people use it?” said Nevada state Sen. Tick Segerblom, a Democrat who advocated for marijuana legalization. He said that creating lounges where people can legally consume the cannabis products they buy is the logical solution.

Although lawmakers have tried, no state legislature has yet carved out rules for cannabis lounges, cafes or tasting rooms.

Policymakers in Colorado, Washington and Oregon have struggled to reconcile proposed rules with other state laws such as indoor smoking bans. Lawmakers also fear that marijuana lounges could create public health and safety problems — such as increasing drugged driving — and trigger a federal crackdown.

Some cities, including Denver and Colorado Springs, have created temporary rules for lounges. But cities run into the same legal issues as states.

Entrepreneurs are opening up marijuana lounges anyway, creating problems for law enforcement. It’s typically legal for people to get together to form a private club that permits marijuana consumption. But it can be difficult to determine what is truly a private club, and many of the pot clubs advertised online in states such as Colorado aren’t private, but are open to the public.   

The four states where ballot initiatives legalized recreational marijuana last year may have the best chance of finding a solution. Nevada allows smoking inside many bars and clubs, for instance, so pot lounge proposals raise fewer concerns about indoor air quality.

And the ballot initiatives approved in California and Maine last year open the door to legal lounges. California’s initiative says cities and counties can choose to allow smoking, vaporizing and ingesting marijuana at some retail stores and other businesses. Maine’s initiative included rules for licensed marijuana clubs.

 

A Murky Legal Area

Clean air rules, unanswered health and safety questions, and political divisions have all stalled progress on legalizing social consumption, said Andrew Freedman, a consultant who formerly served as Colorado’s director of marijuana coordination.

“It’s just a very divisive area,” he said. Even industry leaders are split on whether such lounges should be allowed.

In Oregon, the state’s ban on smoking cigarettes, e-cigarettes and other inhalants in workplaces has been a sticking point for lawmakers. A bill proposed this year to legalize pot lounges didn’t make it out of committee, derailed by concerns that it would weaken air quality rules and set a bad example. Similar criticism felled a Colorado bill that would have allowed consumption clubs to sell marijuana products and exempted them from clean indoor air requirements.

Alaska law permits people to consume marijuana at a dispensary. But for a year and a half, policymakers there have struggled to come up with rules for marijuana tasting rooms, dogged by questions about air quality, how to measure cannabis intoxication, and other issues such as whether to set purchase limits or ban happy hours.

In theory, it shouldn’t be this hard to come up with a policy solution. “The same questions that have been asked regarding public use of alcohol or smoking are the same kinds of questions that get presented when talking about cannabis,” said Colorado state Rep. Dan Pabon, a Democrat who represents part of Denver.

Policymakers ultimately have to weigh non-cannabis consumers’ right to be free of the drug against cannabis consumers’ right to use it, he said. But it’s harder to strike that balance for cannabis than for tobacco, because there’s not much research on how cannabis smoke affects bystanders. “That’s kind of keeping things at bay,” he said.

State inaction has left localities in a bind.

When the Clark County Commission, which has jurisdiction over the Las Vegas Strip, raised the marijuana lounge issue in a September meeting, they confronted a fundamental question: Does the county have legal authority to license such lounges?

The statewide ballot initiative that legalized the drug doesn’t make that explicit. Days before the commission met, lawyers for the state Legislature had found that localities have the authority to license marijuana lounges. But the Nevada attorney general hadn’t weighed in on whether pot lounges are legal — his office has since declined to do so — and Gov. Brian Sandoval, a Republican, had said marijuana lounges need to be regulated at the state level.

“I am concerned with these establishments popping up piecemeal throughout the state with differing rules and regulatory structure,” Sandoval said in a statement released to local news outlets. A fragmented system could fail to meet federal guidelines, he said.

Faced with so much uncertainty, the seven commissioners decided to table their discussion. Commissioner James Gibson suggested that they wait and see what other localities do. “I don’t see any reason why we have to be first,” he said. “But we certainly have to be right.”

How Denver Moved Forward

Denver is one of a handful of cities that have created rules for lounges, so officials around the country are watching it closely. Denver was forced to create rules for social consumption by a 2016 ballot initiative.

Initially proponents wanted to open the door to legal consumption in bars, restaurants and concert halls. But it soon became clear that that would be impossible, says University of Denver professor Sam Kamin, an expert on marijuana law.

The city’s lawyers could get around the state ban on “open and public consumption” of marijuana by defining a “public place” to be somewhere with no restrictions on public access. The ballot initiative already forbade people younger than 21 from entering a cannabis consumption area.

But other state laws and regulations left the city little room to maneuver. Colorado’s liquor licensing board bans marijuana consumption at establishments that hold a liquor license. Colorado’s Clean Indoor Air Act forbids smoking inside at almost all businesses, restricting marijuana consumption to vaping and edibles.

And under Colorado and Denver law, only licensed dispensaries can sell marijuana products. At the same time, people can’t consume marijuana at a dispensary. That meant that the city could create licenses only for “bring your own cannabis” venues.

Denver began accepting applications for social consumption licenses in July. No business or special event has yet been approved, officials say.

The biggest challenge for would-be pot lounge entrepreneurs is how to make money without selling marijuana products, said Molly Duplechian, a deputy director of policy at the Denver Office of Marijuana Policy. “They have to have something else to have a true business model.”

Emmett Reistroffer of Denver Relief Consulting, the firm that led the city ballot initiative campaign, said the biggest roadblock is the city’s zoning restrictions. Denver won’t issue licenses to businesses or events that are within 1,000 feet of schools, child care centers, alcohol and drug treatment facilities, and city recreation centers and pools — which, Reistroffer said, rules out most of the city.

Even with rules for social consumption on the books, Denver’s problems with public use are far from over. Officials still need to police illegal pot clubs, issue citations to people caught smoking joints in city streets, and monitor marijuana festivals that inspire crowds to light up in city parks.

If the state created rules for social consumption, Duplechian said, that would make Denver’s life easier.

State lawmakers will have to keep returning to the issue because Colorado has essentially legalized the sale and cultivation of marijuana while creating a black market for use, Pabon said. “I don’t think it’s an issue that’s going to go away.” 

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Backed By U.S. Anti-Drug Funds, the Mexican Military is Raping and Killing and Getting Away With It

Thu, 11/09/2017 - 08:54
A new report report details a culture of impunity and a complete lack of transparency as the Mexican military wages its war on drugs.

 

 

Mexican Military Is Raping And Torturing Civilians

Mexico's army is raping and torturing civilians in a brutal war on drugs, a new report revealed this week. ... unpunished, and the report details a culture of impunity and a complete lack of transparency as the Mexican military wages its war on drugs. “Violence has increased in the country while human rights violations ...

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The God Capsule: Can Psychedelics Prove a Biological Basis for Spirituality?

Wed, 11/08/2017 - 10:52
Click here for reuse options! A team of neuroscientists in London believes they can.

For a long time in western culture, transcendent consciousness was tightly linked with characters on the spiritual fringe: visionary prophets, ascetic sages, and ecstatic poets. Mystical states were like lightning bolts in the days before Ben Franklin’s kite—fleeting, unpredictable, and impossible to harness or measure. They were divine bolts that hit during the frenzies of ecstatic creation and desert wanderings. They were the ultimate mystery.

Then came psychedelics. In the 1950s, a small but significant coterie of researchers and artists used LSD, mescaline and psilocybin to achieve the states of consciousness described in the literature of ecstatic mysticism. It was an incredible discovery. By swallowing a pill in their living room, they could reliably reproduce the once-exotic case studies collected in books like Richard Bucke’s Cosmic Consciousness, William James’ The Varieties of Religious Experience and Aldous Huxley’s The Perennial Philosophy.

It was Huxley who famously bridged the pre- and post-psychedelic scholarship of mysticism. In 1954, he announced the dawn of the psychedelic era in the form of his erudite Mescaline trip report, The Doors of Perception. But if Huxley anticipated psychedelics’ democratization of mystical bliss, he never claimed to know how they worked. How, exactly, did they replace the ego with the infinite? His guess—that psychedelics somehow wash clean the glass “doors” of perception, “revealing the world as it is… infinite”—was based not on science, but the visionary poetry of William Blake.

Fifty years after Huxley’s death, science is beginning to understand, with some precision, how these window cleaners go about their work. By pairing the controlled mysticism induced by psychedelics with modern imaging technology, scientists are mapping the biological underpinnings of spiritual bliss, the way psychedelics helped an earlier generation of researchers map the links among the serotonin system, joy and depression.

The key finding so far involves changes to a part of the outer brain called the posterior cingulate cortex.

“Our psychedelic imaging studies show a strong association between experiences of god and a breakdown in activity linking the posterior cingulate cortex to the frontal brain regions,” says David Nutt, co-director of the Beckley-Imperial College psychedelic research program in London.

“Growing evidence suggests religious and other belief systems are inevitable products of the ways in which the brain works.”

In a forthcoming book, Nutt describes the Beckley-Imperial team’s findings that indicate mystical “out of body” states are linked to reduced blood flow in the posterior cingulate cortex, a central hub in the creation of our sense of self, or ego.

“The posterior cingulate cortex integrates inputs from the senses, especially sight, plus inner sensations such as position-sense and time, in relation to the brains predictions or inferences,” writes Nutt. “It is the master controller of ‘normal’ consciousness, so when it is switched off, another less constrained form of consciousness emerges. In analogy, if the conductor of the orchestra is removed and the individual instruments play their own way in their own time, a different sound is produced.”

When LSD and other psychedelics forcibly remove the brain’s conductor, people report losing the sense of occupying a distinct place in space and time. Commonly known as ego-dissolution, this is the defining feature of mystical states, achieved by psychedelics or other means. Just like the Victorian monks populating William James’ Varieties of Religious Experience, subjects on LSD report a sense of leaving their bodies and fusing to “become one” with a loving universe, sometimes called god for lack of a better term.

“The sense that there is more to human beings than biological processes is common to all religions, and our research suggests this has a basis in brain function,” says Nutt. “Subjects reporting ego-dissolution are significantly more likely to report a spiritual experience. Since ego-dissolution correlates to a breakdown of [specific brain regions] we can predict spirituality might come from a similar change in this brain region, which can also be triggered by meditation, fasting, and ritual singing and dancing. These insights reveal the concept of God is an emergent property of our nervous systems.”

It’s not just LSD and ritual chanting that can trigger these mystical states. Nutt points to evidence that they can be induced by brain stimulation with direct low voltage electrical currents and magnetic pulses.

“[Our theory based on LSD experiments] has recently been confirmed in a more direct manner by blocking outflow from the posterior cingulate cortex region by direct electrical stimulation,” he says. Subjects who undergo this treatment before brain surgery often report leaving their bodies, floating off as if in a dream, and experiencing long-term positive effects in terms of wellbeing and “present-ness." These reports echo the testimony of mystics from the 16th century as loudly as they do microdosers from the 21st.

There is, of course, a deep irony to this exciting front in the global psychedelic research revival. There is every reason to believe Nutt is correct to think humans have a profound and salutary evolutionary need for spirituality and mystical states, to experience the “sense of there being more to a human being than simple biological processes.”

But by mapping the neurochemistry of these states, is science not reducing them to simple biological processes? As research proceeds in Nutt’s lab—his team is currently employing MRI to study the brains of people on DMT—it is bound to add another wrinkle to the already contentious debate around religion and spirituality. Many will resist “explanations” of something so long understood as beyond the reach of reason, language and science.

Even within the psychedelic community, there is a tradition of “non-dualism” that rejects biochemical explanations of consciousness.

“The non-dualists think the brain is a receiver picking up signals flowing throughout the universe,” says Robin Carhart-Harris, Imperial-Beckley’s lead investigator. “It’s fantasy, but there’s a kind of investment in these ideas, matched with an extreme anti-authoritarianism and suspicion of scientists.”

The gatekeepers of traditional religion, meanwhile, have always feared the anti-institutional thrust of direct chemically assisted revelation. They are right to fear it, as heavy anecdotal evidence—and increasing scientific evidence—shows that a brush with mystical states is likely to encourage a broad spirituality that is humanistic and anti-authoritarian, one more likely to lead to a meditation mat than a Catholic Church.

Nutt, for one, hopes the work being done at Beckley-Imperial will become a public dialogue between neuroscience and traditional religion. In his forthcoming book on psychedelic neuroscience, Nutt takes pains to distinguish his hypothesis from the position of New Atheists like Sam Harris and Richard Dawkins, who scornfully dismiss belief in god as a delusion.

“In technical psychiatric terms, ‘delusions’ are confined to beliefs that are outside societal norms,” he writes. “Since most people believe in some form of god, it is a social norm. I suspect spirituality isn’t located in a single brain region, but rather it emerges from a network change. Brain science tells us it’s time to put transcendence and spirituality, not politics and rituals, back into the heart of religious belief. Let the brain give religion back to god.”

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California Could Decriminalize Psychedelic Mushrooms

Wed, 11/08/2017 - 09:31
An initiative to do that has been okayed for signature gathering.

 

 

California Could Decriminalize Psychedelic Mushrooms

After legalizing weed, California politicians have set their sights on a new target — psychedelic mushrooms. Mayoral Candidate Kevin Saunders filed a ballot measure in the state Attorney General’s office on Friday.

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Marijuana Edibles Provide Better Pain And Anxiety Relief Than Smoking

Wed, 11/08/2017 - 09:25
The answer to why some cannabis consumers prefer to eat their weed.

For a growing number of cannabis consumers, eating the herb is better than smoking it. That is the conclusion of a qualitative report examining customer preferences.

The study, conducted by RTI International, an independent, nonprofit research institute, provides an understanding of consumer perceptions of edible marijuana products, including why users prefer edibles to other forms of marijuana and their concerns regarding the consumption of edibles.

“Our findings suggest that some people prefer edibles to smoking marijuana because there is no smell from smoke and no secondhand smoke,” explained Sheryl C. Cates, senior research public health analyst, the RTI lead for the study. “They also liked edibles over smoking for their convenience, discreetness, longer-lasting highs, and less intense highs. Some participants said that for them, consuming edibles provided better pain and anxiety relief than smoking.”

Regarding pain relief, Jane A. Allen, RTI Research Public Health Analyst adds, “Although this study did not examine whether edibles are used as a substitute for other drugs, a growing body of research suggests that greater availability of marijuana may reduce use of pain medications, and may reduce the frequency and amount of opioid consumption.”

The study also provides insights into consumers’ concerns regarding the consumption of edible marijuana, including delayed activation time, accidental ingestion, and dosing.

“Importantly, the delayed high from edibles vs. smoking or vaping marijuana, may contribute to consumers ingesting a greater than intended amount of the drug before they feel high,” said Cates. “Informing the public on delayed activation, accidental ingestion, proper dosing and harmful effects will help consumers make better decisions and help protect public health.”

A total of 62 adults in eight focus groups, four each in Denver, Colorado and in Seattle, Washington were conducted with consumers of edibles who were at least 21 years or older and met specific study criteria.  The findings suggest that outreach campaigns on recreational marijuana should provide information on the risks and benefits of different forms of marijuana so that consumers can make informed decisions about their use.

 

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Holding Co-Users Responsible for Fatal Drug Overdoses Is Draconian and Ineffectual

Tue, 11/07/2017 - 10:38
Click here for reuse options! While overdose deaths are skyrocketing, these laws only compound the tragedy.

A new report from the Drug Policy Alliance shines a harsh spotlight on a strategy that some police, prosecutors and elected officials are embracing in response to the opioid overdose crisis—charging sellers with drug-induced homicide, which the evidence suggests is intensifying, rather than helping the problem.

The opioid overdose crisis is real enough—a record of more than 60,000 people died of drug overdoses last year, most of them from opioids—but claims that charging drug sellers with murder is an effective deterrent are unproven, according to the report, An Overdose Death Is Not Murder: Why Drug-Induced Homicide Laws Are Counterproductive and Inhumane.

Instead, such laws actually deter people not from selling drugs but from seeking life-saving medical assistance in case of overdose. That's because drug-induced homicide prosecutions typically don't target high-level kingpins, but zero in on the very people best positioned to actually save lives in the event of an overdose: family, friends and low-level drug sellers, often addicts themselves.

Like Amy Shemberger. In August 2014, she took a ride to score some heroin for herself and her boyfriend, Peter Kucinski. She snorted one bag on the way home and gave the other to Kucinski when she got home. Suffering from severe alcohol withdrawal, he needed the heroin to feel better. He snorted a $10 bag, then stopped breathing. Shemberger called 911, but it was too late. She lost her boyfriend of 18 years. Their 5-year-old son was later taken into custody by child protective services.

Two months later, Shemberger was charged with drug-induced homicide for sharing her score with her life partner. She's now serving seven years in state prison.

Amy Shemberger is not an outlier. Police and prosecutors routinely abuse their discretion by going after people best positioned to actually save the lives of overdose victims—their friends, family members, fellow drug users, and small-time drug sellers. The report offers several examples: In New Jersey, 25 of 32 drug-induced homicide prosecutions in the 2000s targeted friends of the victims who were not involved in significant drug sales. In Wisconsin, 90% of the most recent cases targeted friends or relatives of the victim. In Illinois, a study of these prosecutions found that prosecutors typically charged the last person known to be with the victim.

As with everything else in the war on drugs, it's worse if you're not white. Hampered by a felony record, when James Linder, 36, lost his job at a bakery, he resorted to selling small amounts of drugs, making enough money to get a haircut for his son and to help out his sister. But in January 2015, he sold three packets of heroin to Cody Hillier. Hillier's girlfriend, Danielle Barzyk, died of an overdose later that same day. Despite never even meeting Barzyk, Linder was charged with drug-induced homicide in her death. He was sentenced by an all-white jury in rural Illinois. Unlike Shemberger, he didn't get seven years; he got 28 years in prison.

Drug-induced homicide laws, originally passed in the depths of 1980s drug war excess, lay largely dormant until rising drug overdose numbers led police and prosecutors to revive them. Currently, 20 states (Delaware, Colorado, Florida, Illinois, Kansas, Louisiana, Michigan, Minnesota, New Hampshire, New Jersey, North Carolina, Oklahoma, Pennsylvania, Rhode Island, Tennessee, Vermont, Washington, West Virginia, Wisconsin, and Wyoming) have drug-induced homicide laws on the books. Other states without such laws also manage to charge these people with the offense of drug delivery resulting in death under various felony-murder, depraved heart, or involuntary or voluntary manslaughter laws.

"This is a wasteful, punitive policy that compounds the tragedy of an overdose by locking up even more people in the name of the failing war on drugs," said Lindsay LaSalle, senior staff attorney at the Drug Policy Alliance and author of the report. "By placing the blame for an overdose death on the single person who supplied the drugs, all the structural factors that lead to addiction and overdose are ignored, as are the solutions that could actually make a difference. While there’s no evidence in support of the effectiveness of drug-induced homicide laws, the good news is that there are proven health and harm reduction interventions that can save lives."

Those include policies and practices such as 911 Good Samaritan laws, which protect people reporting drug overdoses from arrest; expanded access to the opioid overdose reversal drug naloxone (Narcan), expanded access to opioid-assisted treatment, and expansion of harm reduction programs such as supervised drug injection sites, where users can shoot up under medical supervision and be connected with social service agencies.

There is no national database of drug-induced homicide prosecutions, so the Drug Policy Alliance report relied on media mentions of such cases to chart their spread. It found 363 articles mentioning such cases in 2011, but by 2016, that number had jumped to 1,178, a 300% increase in just five years. And this without any evidence of their effectiveness in reducing drug use or sales or preventing overdose deaths.

The resort to drug-induced homicide charges varies from state to state. Midwestern states such as Wisconsin, Ohio, Illinois, and Minnesota have been the most aggressive in prosecuting drug-induced homicides, with northeastern states Pennsylvania, New Jersey, and New York and southern states Louisiana, North Carolina, and Tennessee rapidly expanding their use of these laws. And the move remains politically popular: This year alone, elected officials in at least 13 states (Connecticut, Idaho, Illinois, Maine, Maryland, Massachusetts, New Hampshire, New York, Ohio, South Carolina, Tennessee, Virginia, and West Virginia) introduced bills to create new drug-induced homicide offenses or strengthen existing drug-induced homicide laws.

But the increased criminalization of people who use and sell drugs only exacerbates the very problem prosecutors are supposedly trying to address. It increases stigma, drives people away from needed care, and will likely result in the same racial disparities now synonymous with other drug war tactics. 

"This is no time to ratchet up enforcement responses to addiction and overdose; we can’t afford to repeat the mistakes of the past," warned LaSalle. "Overdose deaths are skyrocketing and it could be your loved one who dies from a preventable drug overdose, simply because someone was too scared to call 911."

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"Narcan Party" Hysteria Puts a Value on Drug Users' Lives

Tue, 11/07/2017 - 08:43
The real objection is that Narcan for laypeople--especially drug users--allows them to save lives without the cessation of drug use as a requirement.

While the country is obsessing over the idea of “fake news,” let’s talk about some actual fake news: Narcan parties. Increasingly, media outlets are publishing stories with attention-grabbing headlines such as Narcan Parties Becoming Disturbing Trend, Police Say and People Intentionally OD to be Revived at ‘Narcan Parties.’ The stories usually involve grave reports that the increasing availability of Narcan (naloxone), a medicine that reverses opioid overdose, is causing people to overdose on purpose because they know that Narcan can be used to save them. The reports often originate from paramedics and law enforcement responding to overdose-related 911 calls, though most harm reductionists and drug users vehemently deny the existence of so-called Narcan parties. So who is telling the truth?

As with many controversial issues, the story of “Narcan parties” starts with a truth, which then becomes distorted. Here’s what’s real: Yes, people often use drugs in groups or at parties. That’s not new. Drug use at parties has been happening long before Narcan became easily accessible. What is new is that Narcan is increasingly available to the public and used by laypeople to reverse an overdose. So when first responders arrive at the scene of an overdose they might see a party and they might see that Narcan was administered to the overdose victim, hence the term “Narcan party.”


But from there, facts get twisted.

First, some articles claim that “people are overdosing in houses or public places, knowing responders are nearby with Narcan.” I admit I have trouble keeping a straight face when I hear this. There are two things most drug users avoid at all costs: withdrawal and police. Overdosing and having first responders show up to administer Narcan summons both. Narcan blocks the effects of opioids, provoking the rapid onset of withdrawal symptoms such as pain, vomiting, diarrhea, muscle cramping, hypertension, and anxiety. That’s not an experience anyone would invite on purpose. Plus, the relationship between most illicit drug users and law enforcement isn’t exactly chummy. Neither is the relationship with many paramedics. Under the best-case overdose scenario, an opioid user could wake up in agony and possibly handcuffs. Under the worst case, they could die. So no, people aren’t overdosing on purpose because paramedics and police might be nearby with Narcan.

No one engages in risky behaviors just because first responders are a phone call away. People don’t leave their doors unlocked thinking that if someone tries to rob their home while they’re away, neighbors can call the police. People don’t light fires in their fireplaces in the winter believing that if their house goes up in flames, someone will call the fire department. People leave their doors unlocked and light fires because they believe nothing bad will happen. And in most cases, they’re right.

The same logic applies to drug use. Except in cases of suicide, people who take drugs do not think anything bad will happen. Yes, they know there is a risk of death if they overdose. Yes, they may have overdosed in the past. Yes, they may know someone who died of an overdose. But before you start thinking that drug users are irrational and deserve what they get, consider your own thought process every time you step into a car. You know car accidents are one of the leading causes of unintentional death. You may have had an accident in the past. You probably have known of someone who died in a car accident. Yet you still drive because it’s convenient and because you feel sure that nothing bad will happen—not because you feel comforted that if you do have an accident, nearby paramedics might pull you from the twisted wreckage of your car.

Because of stigma and misinformation, people inflate the risks associated with taking drugs and consider drug users more reckless than non-drug users, who also take deadly risks every day. Eliza Wheeler, Director of the DOPE Project of the Harm Reduction Coalition in Oakland, California, points out that no one claims that EpiPens cause people with nut allergies to gorge on peanuts. She explains, “The concept of ‘Narcan parties’ became distorted because drugs are involved and so everyone immediately thinks something bad must be happening. Instead of EMTs saying, ‘Hey, we responded to a call today and someone else had already saved a life with Narcan. That’s great!’ they think, ‘Oh, we responded to a call today and someone had overdosed on purpose because they had Narcan.’”

Another media claim distorted by stigma is that during “Narcan parties,” a designated person is standing by to revive people who overdose, thus allowing party-goers to engage in riskier drug use, knowing a friend will save them. This claim is false. The rumors originate from the concept of a designated driver, a person whose presence may indeed encourage some people at parties to drink more alcohol, knowing they will not have to drive home. But there is a major difference between driving someone home and giving them Narcan. As mentioned above, Narcan induces agonizing opioid withdrawal, something that opioid users avoid at all costs. Drinkers do not fear the consequences of being driven home by a sober friend after a fun night of drinking.


People are not overdosing on purpose to be revived with Narcan, although, yes, more drug users carry Narcan now and may use it if an accidental overdose occurs. But guess what? That’s a good thing!

Lee Hertel, Director of Lee’s Rig Hub, a syringe exchange program in Minneapolis, Minnesota, explains, “People who have Narcan on hand when using in groups are doing exactly what they should be doing. The golden rule of harm reduction is to never use alone and to have Narcan around if you use opiates. People who keep Narcan on them are looking out for each other and saving lives. Isn’t that the whole point of making Narcan available in the first place?”

Yes, having a life-saving antidote on hand in case of an accidental overdose is the entire point of making Narcan available to laypeople. But the controversy surrounding “Narcan parties” persists due to fears and misconceptions that drug users will take anything and misuse it. For example, the media peddles stories of drug dealers selling Narcan and dope as a package deal. In fact, many drug dealers do sell Narcan along with heroin or other opiates—but how is that any different from physicians co-prescribing Narcan with opioid pain relievers? In both cases, the goal is to prevent patients or customers from dying of an accidental overdose. But while physicians are actively encouraged to co-prescribe Narcan, when drug dealers do the same, the story is twisted to sound sinister.

I admit that as a harm reductionist, I sometimes feel a sense of fatigue that derives from constantly having to point out the obvious: Drug users make decisions based on perceived risk and reward, as we all do. It is the unique stigma against drugs and people who use them that causes drug-related decisions to be viewed as irrational and fundamentally different from the ways in which non-drug users engage in other risky behaviors every day.

I think the real pushback against the widespread availability of Narcan is not about whether it encourages riskier drug use. Empirical studies have disproven that theory time and time again. The real concern is that Narcan access for laypeople--especially drug users--allows them to save lives without the cessation of drug use as a requirement. It means we believe in saving the lives of people who might use drugs again. And again. And again. To many people, this outcome is unacceptable, so they propose policies like limits to the number of times Narcan can be administered to the same person, or forcing people into treatment after an overdose and other measures that imply that only a person who does not use drugs (or will stop immediately) deserves to be saved.

There is certainly a place for compassionate, voluntary intervention after an overdose, and evidence-based treatment options such as medication-assisted treatment should be more affordable and more available. But no one is arguing against that. The real disagreement is over whether or not drug users have the right to make their own choices about what they put in their bodies. Spreading false stories about parties where people overdose on purpose is exactly the kind of news that can whip up anger against harm reduction and create public support for punitive policies that once again show drug users that their lives are considered less valuable than those of non-drug users.

 

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3 Harmful Myths About the Opioid Epidemic

Tue, 11/07/2017 - 08:18
These myths about opioids, addiction, and people with substance use disorders persist and may even prevent people from getting treatment, say experts.

Between 2015 and 2016, drug overdose deaths went from 33,095 to 59,000, the largest annual jump ever recorded in the United States. That number is expected to continue unabated for the next several years.

Myth #1: Opioid addiction is just a psychological disorder and people who are dependent simply need better willpower.

“It’s important to define opioid addiction carefully, because the stigma is so strong. Someone who is prescribed opioid medications for pain for prolonged periods may develop tolerance, which means they need a higher dose to get pain relief. Or they may experience withdrawal symptoms when they stop taking the medication. But these are not considered cases of opioid addiction.

“Opioid addiction, or technically ‘opioid use disorder,’ is defined as loss of control over use of opioids. This means that the person continues to use opioids despite negative consequences or is unable to stop using opioids despite wanting to. This person may also have a preoccupation with using opioids, obtaining opioids, or craving for opioids. These patients may also develop tolerance or experience withdrawal when they stop using, but those symptoms by themselves do not define an opioid use disorder.

“Some people think that an opioid addiction is just psychological or a weakness of character, and that people who are addicted simply don’t have the willpower to stop. But it’s more complicated than that.

“Long-time use of opioids in an addictive way actually alters brain functioning. It causes chronic and lasting changes in the brain reward system, causing the person to feel less motivation and get less pleasure from other, naturally occurring rewards. Opioids become the primary reward and the primary focus of the person’s life, and they need more of it to activate the reward system.”<

—Richard Schottenfeld, psychiatry

Myth #2: The best way to combat an opioid addiction is without medication.

“The idea of treating opioid addiction without medication is attractive, especially because such programs can be effective for some patients with alcohol use disorder. A lot of people think that the goal of treatment for opioid use disorder is not taking any medication at all. However, the truth is that the many people in abstinence only programs for opioid use disorder will relapse.

“Research shows that medication-based treatments are the most effective treatment. Opioid use disorder is a medical condition just like depression, diabetes, or hypertension, and just like those conditions, it is most effectively treated with a combination of medication and counseling.

“There are two common medications used to treat opioid use disorder: methadone and buprenorphine. These medications help address patients’ withdrawal symptoms and block the reward or the ‘high’ that people get from using opioids. They help restore ‘normal’ brain functioning. In certain cases, other medications can help improve impulse control and treat any underlying psychiatric disorders.

“Buprenorphine and methadone are opioids agonists. This means that they bind to the same opioid receptors in the brain that opioids like oxycodone, heroin, and fentanyl do, and provide relief from withdrawal symptoms. Some people misinterpret that to mean that we’re just replacing one addiction for another. However, this is not the case.

“Most of the time, patients use opioids not to get high, but to avoid the withdrawal symptoms such as body aches, nausea, vomiting, diarrhea, cramping, muscle aches, insomnia, abdominal pain, and anxiety. Buprenorphine and methadone help patients avoid withdrawal symptoms, but don’t offer the high, which means they are less addictive. Their effects also last much longer (24-36 hours), which allows patients to get on with their day without having to think about their opioids.

“In addition, with buprenorphine and methadone, the risk of overdose is much lower for patients receiving these medications through a treatment program.”

—David A. Fiellin, internal medicine

Myth #3: It’s ok if we call people with opioid use disorder ‘addicts,’ ‘users,’ or ‘junkies.’

“The words we use to describe addiction and people with addiction are important. Negative terms such as ‘addict,’ ‘user,’ ‘junkie,’ and phrases such as ‘needs to get clean’ contribute to stigma against people with opioid use disorder and create barriers to accessing effective treatment. This can ultimately contribute to overdose.

“When we talk about people with diabetes, we don’t talk about them being ‘dirty,’ we talk about their sugars. Similarly, we should focus on measurable changes to health for people with opioid use disorders.

“Studies have shown that people who were referred to as ‘substance users’ were more likely to be considered a threat or be responsible for their condition, whereas people who were referred to as having “substance use disorder” were more likely to be seen as needing help. This is a really key component to getting people into treatment and stemming the opioid crisis.

“A person is not defined by their disease. We need to keep that in mind as doctors, media, and lay-people when thinking about the opioid crisis.”

--Jeannette Tetrault, internal medicine

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