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Can Drug Checking Help Solve the Overdose Crisis?

Tue, 08/29/2017 - 14:43
Click here for reuse options! It's a crucial and potentially life-saving harm reduction intervention already well known in nightlife settings.

The opioid overdose crisis is a multi-layered and complex problem, and one that won’t be solved by any single solution. In addition to efforts that support naloxone and syringe access, as well as expansion of on-demand treatment, a new tool that deserves more attention is emerging: drug checking.

Drug checking,” or testing a substance in order to provide information about contents and purity, is a crucial and potentially life-saving harm reduction intervention already well known in nightlife and festival settings.  But until very recently, those trying to keep people who use heroin and other opioids safe didn’t consider it one of their top tools. That may be starting to change.

The main reason why? Fentanyl.

Fentanyl has changed the landscape of opioid, and particularly heroin, use. Although approved and used as a pain-reliever in many settings, when produced illicitly, this highly potent whitish powder can be cut into heroin (as long as it’s also powder form and not tar) or even added to counterfeit pills made to look like Oxycontin and other prescription opioids. And because it takes far less fentanyl than it does heroin or other opioid to trigger an overdose, it has caused deaths to surge in several areas all over the U.S. and Canada.

The proliferation of fentanyl has pushed those in the opioid-using community to think far more urgently about how they might test a substance. But it hasn’t been easy – fentanyl doesn’t show up on reagent drug tests, the most common drug checking method available to the public, and those used most often by people in nightlife or festival settings.

They say necessity is the mother of invention: it was the Canadian supervised injection facility, Insite that first began experimenting with repurposing fentanyl test strips designed for urine testing and instead using them to test heroin before use. The idea has since spread to syringe exchanges and drop-in centers in the U.S. 

The worry has crossed over between communities. The western Canadian festival Shambhala, known for its long-running onsite drug checking, recently found alarming results showing fentanyl in substances they checked at their event. Reflecting this growing concern that fentanyl could show up in any substance, the festival-oriented harm reduction organization DanceSafe is now selling these test strips as well as reagent kits on their website.

Questions remain about the efficacy of the fentanyl test strips, how realistic it is to expect heroin and other opioid users to use them, and what resources exist to support expanded distribution of the strips in any case. Despite these questions, the underlying promise of drug checking’s role in reversing the overdose crisis is growing clearer to both the opioid and nightlife harm reduction communities.

Interested in hearing more about this issue? The conversation will continue at DPA’s Reform Conference in Atlanta this year, on a roundtable sessionChecking Out Drug Checking: Can It Solve the Overdose Crisis? to be held on Friday, October 13 from 4:30 – 6 p.m.

If you haven’t yet, consider joining other reformers from around the world at this meeting. Early bird registration ends on Friday, September 8.

And if you can’t join, keep in mind that although drug checking won’t solve the overdose crisis on its own, we should be loudly advocating for everything that has a chance of helping reduce the number of these tragic and often preventable deaths.

This piece first appeared on the Drug Policy Alliance Blog

 

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The FDA Says MDMA is a ‘Breakthrough’ Drug for PTSD Patients

Tue, 08/29/2017 - 12:38
It's not quite ready for a therapist near you, but the FDA move means clinical trials will be put on a fast track.

 

The FDA says MDMA is a ‘breakthrough’ drug for PTSD patients

It's a big step forward for a controversial treatment. 'Molly' tablets often don't contain much MDMA, because they're packed with fillers. The purest way to get MDMA is in crystal form. Depositphotos Ecstasy doesn’t sound like something you do in a doctor’s office. But the Food and Drug Administration wants that to change. The FDA just…

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How the War on Drugs Fueled the Fentanyl Crisis

Tue, 08/29/2017 - 12:23
The campaign to cut off heroin supplies has encouraged the growth of labs producing the opioid. We need to instead embrace a public health approach.

A staggering 59,000 people died of drug overdose in 2016 according to a recent New York Times analysis. Annual overdose deaths in the US have already surpassed those inflicted by Aids at its peak.

Sparked by big pharma’s criminal mismarketing of opioid painkillers, the overdose epidemic rages to new heights with the increasing street presence of illicitly manufactured fentanyl, a fully synthetic opioid 100 times more potent than heroin. Without an immediate massive investment in harm reduction and treatment, this toll will only worsen, even if the specter of carfentanil, a synthetic opioid 100 times more powerful than fentanyl, is held at bay.

As a medical student I have seen addiction wreak havoc on my patients’ lives even when it does not kill them. One of the first surgeries I assisted was for a patient whose heroin addiction had, for years, interfered with his diabetes care. Diabetes impairs healing and so when my patient ignored a misplaced snip from a toenail clipper it spiraled into a festering foot sore and then a spreading bone infection. We had to amputate at the knee to save his life.

Before medical school, I had an even closer look at addiction while, as an ethnographic researcher, I lived for more than four years on an open-air heroin selling corner in Philadelphia interviewing dealers, users and their families.

Over those years, even before the growing presence of fentanyl, dozens of people died of overdoses in the garbage-filled train tracks immediately adjacent to my block. Now those tracks have turned into a veritable mass grave as the body count in Philadelphia continues its precipitous rise, as it does across the country.

Sadly, a month ago, Paul Yabor, a friend and committed harm reduction and HIV/Aids activist, added his life to the tragic count. He was found face down among hundreds of discarded syringes, next to the same tracks that we had so many times walked by together. Struggling for decades with addiction, Paul faced historically unprecedented risk in his last relapse because of the fentanyl increasingly flooding the streets.

But there is no mystery to why fentanyl is taking over. It is the direct consequence of market pressures produced by the war on drugs. Eradication efforts targeting acres of South American poppy fields aiming to cut off the heroin supply have instead encouraged the growth of fentanyl-producing labs with much smaller footprints in China and Mexico.

A few grams of fentanyl can earn smugglers the same money as kilograms of heroin. Drugs have become stronger and more frequently synthetic because they are easier to smuggle and easier to produce. Imperfect dilutions of these ultra-concentrated synthetic opioids for street consumption lead to dramatic variability in the potency of each dose driving the grim statistics.

This is a pattern that we have seen before. It is sometimes referred to as the “iron law of prohibition” – more interdiction, stronger drugs. In the 1920s alcohol prohibition drove down the consumption of relatively weak beer and drove up the consumption of stronger wine and spirits.

In the 1980s, energetic marijuana interdiction led to a repurposing of trafficking routes towards less bulky and more lucrative cocaine. Even before widespread fentanyl, the potency of street heroin had already been steadily increasing. Each pyrrhic victory of the war on drugs has left us with stronger and more harmful drugs.

A tragic irony of Paul’s death is that he was in the middle of advocating for a supervised injection facility in the neighborhood to replace the filthy, dangerous spaces where hundreds of doses of heroin are injected daily.

Supervised injection facilities are an evidence-based way to keep people alive by allowing them to inject drugs under medical supervision during this uniquely dangerous time to struggle with addiction. There are already more than 100 of these facilities in 66 cities across nine countries including Canada. None of these countries is facing the scale of the crisis that we in the US face and yet they rightly eschew moralizing for the sake of public health. A facility like this in the US would start saving lives the day it opens.

While pursuing necessary emergency measures, like supervised injection facilities, we need to also make every investment to achieve treatment on demand. Currently, only 10% of those in need of addiction treatment receive it. Buprenorphine and methadone are two evidence-based options for opioid agonist therapy that have repeatedly been shown to reduce death and support recovery and yet we drag our feet in matching access to need.

A crisis of this magnitude demands an energetic, open and scientifically-grounded consideration of every available tool at our disposal and the political will to follow where the science leads. The moralizing punitive logic of the war on drugs helped lead us into this crisis. Only a public health approach can lead us out.

 

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America's Lucrative New Weed Industry Should Compensate the Black Victims of the County's War on Drugs

Mon, 08/28/2017 - 10:45
It was state-sponsored racial terrorism, so reparations should be paid from the profits of the newly legal – and mostly white-owned – cannabis economy

America has long been high on its own endless supply of hypocrisy. The “land of the free” has the largest prison population in the world; the “home of the brave” has elected a coward to the White House. The United States, it has become clear, is still a divided country with different rules for its different coloured citizens. And, arguably, nowhere are those double standards more bluntly black and white than when it comes to the corporatisation of cannabis.

In recent years, the US establishment has gone from piously advising people to Just Say No to drugs, to saying “yes, please” to profiting from pot. To date, eight states have legalised recreational cannabis. Some colleges, such as the University of Denver, have introduced Business of Marijuana courses into their curriculums. Hordes of bright, mainly white, young things have launched lucrative cannabis startups and there’s an interminable stream of trend pieces in the US media about everything from cannabis-kale to how “bud bars” are the fashionable new fixtureat white weddings.

Blue-chip companies are also benefiting from the green rush: Scotts Miracle-Gro, a lawn-care company, saw its shares rise 31% last year, after buying up lots of companies that provide supplies for hydroponics, the favoured method of cultivating cannabis. Guess how many people of colour are on the Scotts leadership team? None.

So while legal marijuana money has started pouring into the US economy, there’s ample evidence that it’s largely white people profiting. A Buzzfeed investigationlast year, for example, estimated only about 1% of the storefront marijuana dispensaries in the US are owned by black people.\The racial inequities in the new marijuana economy are particularly egregious considering the US’s decades-long war on drugs, which disproportionately punished African Americans for petty drug crimes. A 2013 report from the American Civil Liberties Union (ACLU) found black people are almost four times more likely to be arrested for marijuana possession than white people, despite similar usage rates. The war on drugs has always been sanitised shorthand for: The War on Non-White People, With a Particular Emphasis on Black People.

The US’s racist approach to marijuana – both past and present – is hardly news. But what do we do about it? Well, I’ve got an idea: reparations. Every business now exploiting the legalisation of marijuana should forfeit at least 50% of their pot-based profits to a fund that gives reparations to people whose lives were destroyed by the US’s discriminatory war on drugs.

If this sounds fanciful, it shouldn’t. There is a longstanding debate in the US aboutwhether the government should compensate African Americans for the legacy of slavery – and the war on drugs is very much part of that legacy. Indeed, slavery was never entirely abolished in the US, it simply evolved, as white America found less overt ways to beat down its black population. Slavery 2.0 was the Jim Crow laws, that segregated and disenfranchised black people from around 1890 to the early 1950s. Slavery 3.0 took the form of what has been described as the “new Jim Crow”: the mass incarceration of black people. In her highly influential 2010 book, The New Jim Crow, legal scholar Michelle Alexander explains that “rather than rely on race, we use our criminal justice system to label people of colour ‘criminals’ and then engage in all the practices we supposedly left behind … employment discrimination, housing discrimination, denial of the right to vote, denial of educational opportunity … are suddenly legal ... We have not ended racial caste in America; we have merely redesigned it.”

There has been a lot of pushback against the idea of reparations for slavery. In a poll conducted last year, 81% of white people opposed the idea. Arguments against reparations for slavery tend to focus on the fact that slavery is a long time past. A National Review article entitled The Case Against Reparations argues, for example, that: “The people to whom reparations were owed are long dead; our duty is to the living, and to generations yet to come, and their interests are best served by liberty and prosperity, not by moral theatre.”

You can’t argue any of these counterpoints when it comes to the case for marijuana reparations, however. Many of the people whose lives were ruined by disproportionally harsh punishment for petty drug crimes are still alive and suffering the consequences. What’s more, it’s hard to talk about moral theatre when you’re taking money from people who are currently profiting from drugs and giving it to people who were incarcerated for attempting to profit from drugs.

Reparations only seem to be contentious when the people receiving money aren’t white. In 2015, for example, a bill signed by Barack Obama established the US Victims of State Sponsored Terrorism Fund. This uncontroversial fund seizes assets from terrorist financiers and uses the money to compensate US victims of terrorism by state sponsors of terrorism. Much of the money for the fund has come from French bank BNP Paribas, which was fined $9bn in 2014 for violating US sanctions against Iran, Cuba and Sudan. Earlier this year the criminal division announced that more than $800m (£621m) had been paid out from the fund to individuals such as the Iran hostages held from 1979 to 1981.

The US’s war against drugs, I don’t think it’s any exaggeration to say, was state-sponsored racial terrorism. The only reason it’s not widely recognised as such, and there isn’t a compensation fund, is because racism is one hell of a drug.

 

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The Opioid Epidemic is Finally a National Emergency -- Eight Years Too Late

Mon, 08/28/2017 - 09:48
Addiction scientists know what needs to be done to turn the tide. Politicians should ask them.

“It has been many long, hard, agonizing battles for the last few years and you fought like a warrior every step of the way. Addiction, however, won the war. To the person who doesn’t understand addiction, she is just another statistic who chose to make a bad decision.”

Despite working nearly two decades as an addiction scientist, I cannot read Kelsey Grace Endicott’s mother’s eulogy without crying. The opioid epidemic has turned those who lost their lives to addiction into statistics, while leaving their families in sorrow.

Overdose deaths in the U.S. have tripled since 2000, with 52,404 deaths in 2015 as the highest ever recorded. While the Centers for Disease Control and Prevention (CDC) has yet to release official statistics for 2016, early estimates put the number of deaths at as many as 65,000.

On August 10, President Trump declared the opioid epidemic a national emergency. Nearly a decade into this epidemic, this national emergency was declared at least eight years too late. Policymakers have missed opportunities to implement strategies scientifically demonstrated to reduce overdose deaths and help people recover.

Declaring a national emergency is important, but it’s not clear what steps the administration will take or how much funding will be committed to these strategies. We have proven prevention and treatment services that we need to significantly expand, and we need the money to do this.

The right treatments

Declaring the opioid epidemic a national emergency expands the availability of federal funding; frees up public health workers to address the issue; and makes it possible to remove regulatory barriers to lifesaving medications.

In a speech on May 11, Attorney General Jeff Sessions suggested that tools like “Just Say No” and Drug Abuse Resistance Education (DARE) can help fight the opioid epidemic.

However, addiction science has repeatedly proven that such drug prevention programs are ineffective. Some would argue that we are biologically wired to try new things, so education alone is not sufficient to prevent repeated drug use.

Prevention efforts are part of the solution, but we need more immediate solutions for people already ensnared by addiction. Naloxone, known by the brand name Narcan, is usually the only thing that can prevent death when someone has overdosed on opioids. Science has unequivocally demonstrated that naloxone can reverse an opioid overdose, if administered in time and in an adequate dose.

When patients with opioid use disorders are treated with FDA-approved medications like methadone and buprenorphine, they not only reduce their use of opioids but they are also less likely to overdose. When these drugs are used to treat addiction, they are referred to as medication-assisted treatment. Medication-assisted treatment helps many people, particularly early in recovery, when otherwise their brains seem to focus only on using more drugs. In fact, a National Institute on Drug Abuse study found that only about 7 percent of patients can stop using opioids without buprenorphine.

We need drugs like naloxone and buprenorphine to prevent deaths and help people recover from addiction. In the past few years, state governments have taken significant steps to remove regulatory barriers and expand community access to naloxone.

But policies are infrequently aligned with addiction science. In 2015, only 11 percent of people who needed addiction treatment received it. There are not enough medication-assisted treatment treatment slots available: A recent study estimated that the U.S. was short 1.3 million treatment slots for medication-assisted treatment in 2012. Demand has only increased since then.

There is an entrenched belief that people choose to use drugs and that this choice reflects a moral failing. Even the director of the U.S. Department of Health and Human Resources – which cites medication-assisted treatment as part of its strategy – has been quoted saying: “If we’re just substituting one opioid for another, we’re not moving the dial much.”

Moving too slowly

Early on, everyone believed that the epidemic was fueled by widely available prescription pain relievers. Books like “American Pain” by John Temple described “drug tourists” routinely traveling from states like Kentucky and West Virginia to Florida, where millions of prescription pills were dispensed at “pill mills.”

Such overprescribing and doctor-shopping did contribute to the current epidemic. States have been successful at dispensing fewer prescription opioids, but this doesn’t help the nearly 2.6 million Americans already addicted, or the 329,000 who report currently using heroin.

And, since 2014, it has become clear that the epidemic is no longer just about prescription opioids. In addition, heroin is frequently mixed or substituted with powerful synthetic opioids like fentanyl or carfentanil. They require far more of the overdose reversal drug naloxone than is routinely dispensed in communities.

Meanwhile, in poor and rural areas, community resources for public services are being exhausted by the costs of the epidemic.

Areas that have been disproportionately impacted by the epidemic, like West Virginia, have woefully inadequate access to harm-reduction services like syringe exchange programs and specialty addiction treatment. A clinic at our university that dispenses buprenorphine has more than 600 people on its waiting list. We will soon open a second clinic that will help reduce but not eliminate the waiting list.

A bill passed by President Obama, the 21st Century Cures Act, is making approximately US$1 billion in funding available to help states combat the opioid epidemic. But, as Dr. Keith Humphreys at Stanford University has said: This is not enough. We likely need 50 times that, as Ohio spent $1 billion in 2016 on the opioid epidemic.

Fighting back

It can be hard to grasp the devastation of the opioid epidemic. As the President’s Commission on Combating Drug Addiction and the Opioid Crisis has described it, in the scale of deaths, it’s like the September 11 terrorist attacks happening every three weeks. A national emergency would have been declared 10 years ago if such a disaster occurred every three weeks. And it can be even harder to imagine the emotional turmoil and the depth of sorrow felt by the families who’ve lost their daughters, sons, brothers, sisters, mothers and fathers.

I think it’s fair to say that we all want a simple solution – something that we can wrap our arms around. Something that can be done in one legislative session. But that has not worked and it will not work, just as declaring a national emergency is not enough.

Addiction scientists know what needs to be done to turn the tide. While we may not understand every aspect of the epidemic and certainly need more research to understand these deaths of despair, we are eager to collaborate with communities to find empirically informed solutions, such as medication-assisted treatment. The President’s Commission on Combating Drug Addiction and the Opioid Crisis consists of four politicians and one addiction scientist. It might help to start by asking an expert, rather than politicians, what should be done.

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California Could Become the First State to Legalize Magic Mushrooms

Sat, 08/26/2017 - 12:49
Click here for reuse options! A voter initiative to do just that has been filed with state officials.

It could be up to California voters to make the state the first in the nation to allow for the use and sale of psilocybin, the mind-altering component of magic mushrooms.

On Friday, Kevin Saunders, a candidate for mayor in the Monterey County town of Marina, filed the California Psilocybin Legalization Initiative with the state attorney general's office. The initiative would exempt people 21 and over from state criminal penalties for using, possessing, cultivating, transporting, and selling psilocybin.

Filing an initiative is just the first step. The measure must be submitted for public comment for 30 days and then given a circulating title and summary by the attorney general's office before it is approved for signature gathering. If and when it is approved, campaigners then have to gather some 365,880 valid voter signatures to be placed on the November 2018 ballot.

Saunders told the Los Angeles Times that psilocybin helped him get over an addiction to heroin a decade ago. "I think we're seeing something that could literally heal our brothers and sisters," he said. "We're talking about real cutting-edge stuff."

Using the initiative process, California became the first state in the nation to legalize medical marijuana in 1996. And while it wasn't the first state to legalize marijuana via the initiative process—Colorado and Washington led the way in 2012—the state legalized recreational marijuana via an initiative last year.

The initiative and referendum process has been criticized as inflexible, circumventing planning, and relying on an uninformed electorate, and it is also open to criticism as a tool for corporate interests. But it has proven invaluable for advancing the cause of drug reform in the face of state legislatures resistant to change.

All eight states that pioneered pot legalization did it through the initiative process. No state has yet legalized marijuana through the legislative process. And the pioneering medical marijuana states all did it through the initiative process as well. After California approved it in 1996, it was five years before Hawaii became the first state to okay it legislatively.

California is now poised to once again break down the walls of prohibition—this time with natural psychedelics.

 

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I Toke Thee to Be My Wife: Inside a Cannabis Wedding in California

Sat, 08/26/2017 - 12:15
From a pot sommelier to cannabis buds in the bouquets, Zak Walton and Dani Geen’s ceremony was not Carmel’s typical nuptials.

It was a picture postcard California beach wedding. The bride wore white. The Pacific Ocean lapped at the altar. The violinist played Elvis Presley’s Can’t Help Falling in Love.

Then, upon being declared husband and wife, Zak Walton and Dani Geen inclined their heads, puckered their lips, closed their eyes and took long, deep puffs of potent cannabis.

A table by the altar had all the accoutrements: pots of cannabis concentrate, a torch lighter to heat it up, and glass vessels known as rigs, through which they inhaled the vapour.

The family and friends sat before them minded not a bit. This, after all, was a weed wedding and most of them had also ingested.

Melissa Cunningham, the wedding planner, said: “The psychic effect you get from it is very calming. Dani and Zak want to be on the same spectrum going into their matrimony.”

Everybody seemed to be on the same spectrum during the ceremony on Thursday at Stewart’s Cove, a bucolic beach near Carmel, south of San Francisco.

Walton, 30, savouring his first minutes of married life with a joint alongside bridesmaids and groomsmen, all smoking, said: “I’m feeling good. Nice and relaxed, medicated.”

What had he consumed so far? “I had some dabs at the hotel, a joint, some edibles. Not too much, not too little,” he said.

It was all legal: the cannabis buds in the bouquet and floral arrangements, the goody bags with joints and cannabis vapes, the cannabis-infused munchies (“handcrafted to melt in your mind”) and the dab bar at the reception in nearby Monterey, where a pot sommelier in a three-piece suit offered guests different ways to get lightly, blissfully stoned.

California voters approved recreational marijuana last November, a landmark victory in the fight for legalisation that has paved the way for the largest commercial pot market in the US.

Activists and entrepreneurs have found ways to “weedify” multiple products and services, including weddings.

It was news to the catering guys setting up chairs on the beach before the ceremony. “A cannabis wedding, really?” said one, astonished. “Is it, like, a thing?” asked another.

To evangelists, it’s the future.

Philip Wolf, the co-founder of the Cannabis Wedding Expo, which showcases industry products and services, said: “Down the road, people won’t call it a cannabis wedding, because bud bars will be normalised. Smoking creates a bonding aspect. People did it in ancient times. It enhances conversations.”

Luna Stower, 33, a friend of the bride, said cannabis soothed nerves and made couples more romantic. Stower, the wedding officiant and sales director for a cannabis distribution company, had benefited from munching toffee hours earlier made by a company called Mind Tricks. “It’s very relaxing. An aphrodisiac and a euphoric sedative that lasts a very long time. It has organic sugar so it’s a quality high,” she said.

The high did not addle Stower’s brain. She led the ceremony fluidly, without notes, and made a quip about the the couple loving and honouring each other “till dab do you part”. Dabbing is the term for heating a dose of concentrate on a hot surface and inhaling it through glass.

Cannabis brought the Oakland-based couple together because they started out as smoking buddies, said Walton, who works on cars. “One thing led to another and here we are 12 years later,” he added.

He uses the herb to ease backache and Geen, 31, uses it for fibromyalgia, tumours and other conditions. “Cannabis has been my medicine and my saviour,” she said. Not to mention her employer: she works for Harborside Health Center, a medical cannabis dispensary.

She wanted her wedding to show that cannabis could be classy – integrated into decor and menus, with the reception hosted at Monterey’s Victorian-era Perry House – and safe, with controls to keep it away from children.

Geen laughed off the stereotype of zonked stoners, saying certain strains of pot sharpened concentration. “I’m going to remember my night better than someone who has had a lot of alcohol,” she said.

Steve DeAngelo, her boss and guest, agreed, citing Carl Sagan, Steve Jobs, Bill Clinton and Barack Obama as evidence that weed did not engender low functionality.

The drug also did wonders for intimacy, he said. “It opens you to more sensual experiences. It allows men, especially young men, to match their sexual rhythm to a woman’s rhythm,” DeAngelo added.

Geen reckoned that about 60 of the 70 guests were using cannabis.

Some were exultant, like David Nevitt, 34, who dabbed, munched, vaped and toked. “We’re at a weeding! Usually at weddings you have to be discreet, do it in the car park. Doing it here right in front of everybody, it feels revolutionary,” he said.

Others were grateful. Holly Alberti, 34, said: “I’ve taken several concentrated dabs and I could use some more. The ride over was quite stressful, we got lost.”

And some, including a pair of college professors, were coy, saying they might partake. They declined to give their names lest Google for ever link them to pot.

The groom’s mother, Aurea Walton, 55, was one of the few to opt out. “I’m Catholic,” she said. “So no, I won’t partake.” Then she smiled. “Unless it’s by mistake.”

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Don't Believe the Hype: Fentanyl-Laced Marijuana Is a Dangerous Myth

Fri, 08/25/2017 - 12:27
Click here for reuse options! Cops and politicians have been raising the alarm about a problem that doesn't exist.

Fentanyl is serious business. The synthetic opioid is 50 times stronger than heroin and is linked to huge numbers of opioid overdose deaths. It may be mixed with heroin or other powder drugs, producing a more potent high than users expect, and the results are too often fatal.

So it's not surprising that claims fentanyl has shown up in marijuana causes alarm bells to ring. But there's not a scintilla of evidence for it, and the claims are doubly damaging. Scaring pot smokers away from a substance that has no overdose potential is not a good thing, and neither is raising fears about opiated weed when weed may actually help people suffering from opioid addiction.

Still, like a vampire, the myth of marijuana laced with the deadly opioid fentanyl refuses to die. It first went nationwide in June, thanks to an Ohio U.S. senator's press conference, and while a VICE debunking at the time should have driven a stake through its heart, it has risen again this month, most recently thanks to a local prosecutor in Tennessee.

"There are some marijuana dealers that will tell their clients that I have no doubt there is fentanyl in it and some of the more addictive folks, especially folks that also use other drugs, will get that marijuana laced with fentanyl in hopes of getting a better high," District 24 Attorney General Matthew Stowe told a credulous WKRN-TV  in an interview last week. "The bottom line is, anyone, anywhere could mix fentanyl and marijuana and there’s no way of knowing it until it’s too late."

But wait, there's more: "Marijuana laced with fentanyl can be extremely deadly and to anyone who touches it, taste it, smokes it [or] anything else of that nature," Stowe claimed. "If it’s laced with fentanyl, marijuana can be the deadliest drug there is."

Marijuana laced with fentanyl would be deadly—if such a thing existed. There is no evidence it does.

There are a couple of reasons such a concoction is unlikely. First, fentanyl is typically a white powder, and unlike drugs such as heroin or even cocaine, which are also powders, marijuana is green plant material. Buds adulterated with white powder would look like buds adulterated with white powder.

Secondly, no one seems to know if smoking fentanyl in weed would even work. Chemist Kirk Maxey, who helps law enforcement agencies like the DEA test suspected synthetic opioids, told VICE he doesn't know if it's scientifically possible. 

"Documenting the pipe chemistry of fentanyl in leaf material would be a research paper," he said. "And I don't think it's been done yet."

Still, such obvious objections haven't stopped the spread of the myth, which may have originated in a February Facebook post from the Painesville Township Fire Department in northeast Ohio. That post, which quickly went viral, reported that three men had reported overdosing after smoking "marijuana laced with an unknown opiate." It was picked up by a local ABC TV affiliate, which reported "three separate incidents, but all with the same result—overdoses from opiate-laced marijuana."

The story wasn't true. As Cleveland.com reported shortly afterward, toxicology results showed that "the three people who claimed they had overdosed on marijuana laced with an unknown opiate actually used crack cocaine and other drugs."

The media hubbub died down, but the seed was planted, growing through the spring in the fertile soil of an Ohio gripped by a deadly opioid epidemic and filled with officials willing to fertilize it with healthy doses of manure. In June, it blossomed.

"Marijuana laced with fentanyl: police warn of another potentially dangerous drug mixture," News 5 Cleveland reported on June 14. There weren't any actual cases of the pot/fentanyl mixture showing up, but "police said the warning was necessary to alert people, especially parents, to the potential risk."

And politicians. Five days later, Ohio U.S. Senator Rob Portman (R) held a Cincinnati press conference on the opioid crisis with Hamilton County coroner Lakshmi Sammarco, whose reported remarks helped give the myth new life. 

"We have seen fentanyl mixed with cocaine," said Sammarco. "We have also seen fentanyl mixed with marijuana."

The comment rocketed around the web, raising alarm and the specter of innocent pot smokers felled by deadly adulterants, but there was less to it than meets the eye. When, unlike other media outlets that simply ran with the story, VICE actually reached out to Sammarco, the story fell apart.

Sammarco said her quote had been misinterpreted and that her office hadn't actually seen any fentanyl-laced weed. Sammarco told VICE that Sen. Portman had mentioned to her that it had been spotted in northeast Ohio—apparently based on that erroneous News 5 Cleveland report.

When VICE contacted Portman's office about the origin of the fentanyl-in-weed story, spokesman Kevin Smith replied only "I don't have anything on that" before hanging up the phone.

Despite the baselessness of the claim, it was back again this month. Police and health officials in London, Ontario, sent out warnings after people who claimed to have only smoked pot came back positive for opioids on urine drug tests, without ever considering the possibility that those people weren't telling the truth.

Canadian Federal Health Minister Jane Philpott had to step in to put a stop to the nonsense: "We have confirmed this with chiefs of police [and] law enforcement officials across this country—there is zero documented evidence that ever in this country cannabis has been found laced with fentanyl," she told the London Free Press. "It’s very important that we make sure that that message is clear."

That didn't stop police in Yarmouth, Massachusetts, from generating a similar story just days later. It was another case of a man who overdosed on opioids claiming only to have smoked pot. Police there said they "believe that is possible that the marijuana was laced with fentanyl, which police are starting to see more and more across the country."

Except they're actually not. That first batch of fentanyl-laced marijuana has yet to be discovered. But that hasn't stopped prosecutor Stowe any more than it's stopped the other cops, politicians and hand-wringing public health officials from propagating the misinformation. This is Reefer Madness for the 21st century.

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How Marijuana Can Disrupt Leukemia Cells

Fri, 08/25/2017 - 10:51
New scientific research shows that marijuana's cannabinoids have the ability to “target and switch off pathways” that allow cancers to grow.

Leukemia is the blanket term for the four different types of cancer found in bone marrow and blood cells. There are roughly 200,000 U.S. cases per year and typically found in adults over the age of 55, but also found in children under the age of 15.

While chemotherapy and other treatments are available, a recent study not only proves that that cannabinoids are anticancer agents, but that there are six different cannabinoids (the chemical compounds found in cannabis plant) that have anticancer effects on leukemia cells specifically.

·         Related Story: Here’s Why Cannabis Can Have a Huge Impact on Leukemia Patients

 

Dr. Wai Lui an oncologist and his team of researchers at the Department of Oncology at St. George’s, University London discovered that these cannabinoids were able to interfere and disrupt the development of cancerous cells. They also noted that in certain cases, when using specific dosage patterns, these six cannabinoids have the ability to destroy cancer cells on their own.

So What Does This Mean?

Let’s break this down. Dr. Liu and his team tested these six pure cannabinoids–cannabidiol (CBD), cannabidiolic acid (CBDA), cannabigerol (CBG), cannabigerolic acid (CBGA), cannabigevarin (CBGV), and cannabigevaric acid (CBGVA)–on lab-grown leukemia cells. They were tested individually as well as collectively in select groups.

·         Related Story: What You Need To Know About Medical Marijuana And Leukemia

 

They found that each of the six cannabinoid examined presented anti-cancer properties as effective as those seen in THC. Most importantly, they noted that these effects were even more powerful when the cannabinoids were grouped together.

Dr. Lui’s research also revealed that these six cannabinoids had the ability to “target and switch off pathways” that allow cancers to grow.

This entire report is good news for patients, because it shows that cannabinoid in its purest form has the ability to fight leukemia cells. Plus, the cannabidiol is the non-psychoactive compound found in marijuana, so there’s no high.

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Is Law School an 'Adderall Nation'?

Fri, 08/25/2017 - 10:24
The pep pills are law students' little helpers.

 

I have never been prescribed Adderall, tried it illegally, or had any desire to try it. Back in my baby boomer, Pitt Law days, before I discovered the evil white powder cocaine, I relied on hot coffee, “Vivarin,” and “NoDoz” for those law school pre-exam all-nighters on the rare occasions I studied. Once cocaine became part…

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Hiding Opioid Addiction Treatment in Plain Sight

Thu, 08/24/2017 - 13:36
Click here for reuse options! We should be reducing the stigma attached to addiction, not hiding drugs that could save lives.

On my way to meet a friend, I walked through the Grand Central subway station and found myself confronted by a massive advertising campaign. Giant faces taking up much of the wall stared at me―black, white and Hispanic, all between 20 and 40 years old, looking serious and healthy. Big signs asked “What is Vivitrol?” and said “Ask your healthcare provider,” adding “There’s another option.”

But they never said what Vivitrol is for,  at least not until a final panel crowded with text revealed the condition.

As an internist who sees patients in an opioid treatment program, what strikes me about this ad campaign is that it barely mentions the problem the drug is used to treat. Its goals are to put the name of the drug into the minds of the public, and to suggest that Vivitrol is another (and presumably better) treatment option. Better than what? And what does it do, anyway?

Here’s what commuters in a hurry would miss: Vivitrol is a drug used to treat opioid addiction.

That’s what makes this campaign so fascinating—and distressing. The invisibility of the problem of opioid addiction reflects our society’s ongoing stigmatization of addiction and treatment for it. The ad panels with concrete information about Vivitrol―what it’s used for, side effects, appropriate and inappropriate patients―are few and far between, and written in a font far smaller than that used in the other panels.

Opioid addiction has created a national crisis. An estimated 142 people die from opioid overdoses every day in our country. In 2016, more than 1,300 people died of such overdoses in New York City alone, a huge increase from the 630 opioid-overdose deaths recorded in 2015. The White House panel commissioned to study the problem has recommended declaring a national emergency in response to the epidemic.

Despite all the publicity about recent celebrity deaths due to opioids, people with opioid addiction are reluctant to disclose their condition, even to family, close friends and doctors. They fear judgment from all those who see addiction as a sign of weakness or a personality defect, rather than the disease my colleagues and I see every day.

Examining Treatment Options

Of course, I already know what Vivitrol is, what it’s used for and what the other treatment options are. For more than 10 years I have prescribed methadone and buprenorphine to my patients, nearly all of whom suffer from opioid addiction and its many complications. I have seen methadone and buprenorphine allow people to regain control of their health and lives, find jobs and homes, repair relationships and return to their faith communities.

I don’t recall ever seeing an ad for methadone or buprenorphine outside a medical journal.

At this point there is a paucity of data to support the efficacy of Vivitrol. It appears to work better than no treatment, but that’s pretty much all we can say about it. There has not been a study that compares it to methadone or buprenorphine. Because patients must completely abstain from any opioid use for at least three days before starting Vivitrol, getting them to start the medication can be challenging. And they are more likely to leave treatment than patients on methadone or buprenorphine. Since opioid addiction is a chronic disease requiring lifelong monitoring and treatment, patients who are not being treated are likely to relapse. Methadone and buprenorphine work well; we know this from dozens of studies done over several decades. But although the evidence supports their use, these drugs are no longer under patent protection and are not profitable enough to merit significant advertising campaigns.

I have never treated a patient with Vivitrol, and out of the hundreds of patients I have seen over the years, only two have ever asked me about it. For many of my patients, most of whom are mature adults with decades-long histories of addiction, Vivitrol may never be a good option.

When the drug was first approved in 2010 to treat opioid addiction, I was extremely dubious about its utility. Early studies of oral naltrexone (the generic name for Vivitrol) did not support its use as an effective treatment for opioid addiction. My experience treating patients with methadone and buprenorphine successfully made naltrexone seem like a poor choice when better treatments were available. Since then a lot has changed, including my opinion about Vivitrol. The injectable formulation of Vivitrol improves rates of compliance with the treatment and therefore its effectiveness.

The opioid crisis has exploded in our nation, and the typical course of opioid addiction has changed. People are starting opioid use at younger ages and becoming addicted more quickly, and their lives are unraveling faster. Vivitrol may work better in people with shorter histories of addiction. We need all the treatment options we can get for patients with different histories, needs and levels of support at home. What remains largely unchanged, however, is the stigma of opioid addiction and addiction treatment.

Bias Versus Effectiveness

Methadone and buprenorphine are often disregarded as treatments that allow for “real” recovery because they are opioid agonists―medications that activate the same receptors as those activated by abused opioids. However, when used to treat opioid addiction, methadone and buprenorphine do not provide the euphoric high caused by heroin and other abused opioids. Opioid agonist drugs keep people with opioid addiction from feeling physical and psychological withdrawal and craving opioids. They are able to stabilize their often chaotic lives and focus on goals other than their next oxycodone pill or bag of heroin.

If this is not real recovery, I don’t know what is.

Still, I look forward to learning more about Vivitrol, and how best to use it to help my patients, from clinical studies—not advertising.

Also, I wish there were greater efforts to spread the word about treatments that we know help people suffering from opioid addiction. To their credit, many local health departments (including our own New York City Department of Health and Mental Hygiene) have pushed the opioid crisis into the public eye with public service announcements about overdose prevention. I look forward to seeing more public health efforts to throw some light on opioid addiction treatment and the many paths to recovery, including methadone and buprenorphine.

We need to show the public that recovery from opioid addiction is possible and to reduce the stigma attached to addiction and treatment, and expose patients to all of the effective medications we use to treat this terrible and growing problem.

 

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'Disjointed': The Marijuana Sitcom Made for Killjoys Who Don't Smoke Pot

Thu, 08/24/2017 - 10:40
There are probably decent arguments for why you may want to watch this sitcom, but... we forgot them. Heh. Heh.

Sometimes smoking pot can make a person feel stuck — as in, the body can’t move, or be moved to move. Such a state goes well with the “Netflix and chill” ethos because if you’re locked inside it, odds are you have nothing better to do. Or even if you do, you’re not going to do it. Weed is hilarious like that.

Such a haze may also lead to heady musings, such as the notion that “bad” and “failure” can be mutually exclusive terms when it comes to television. Most of us know terrible television when we see it. But for reasons unknown, or the reason specified above, we keep on watching. Weed has a tendency to make failure bearable.

Then there are puzzles like Netflix’s “Disjointed,” premiering Friday. Created by David Javerbaum, formerly a writer for “The Daily Show with Jon Stewart,” and network comedy generator Chuck Lorre, “Disjointed” blunts its potential by tracing the linework of an established and well-traversed comedic niche with the same broad strokes Lorre employs in shows like “Two and a Half Men” and “Mike & Molly.”

Marijuana still isn’t legal for recreational use in most states, but pot is mainstream enough for the average viewer to know how mundane and widespread cannabis use is. Countless series have featured characters who smoke, and recent shows such as HBO’s “High Maintenance” depict users that hail from a variety of social strata leading normal productive lives.

There exists a poignant subplot in “Disjointed” involving the dispensary’s security guard Carter (Tone Bell), a veteran haunted by a frightening tour in the Middle East that left crippling scars in his psyche. Through Carter’s story, the show takes creative departures from the standard sitcom format using beautiful, haunting animated sequences, allowing viewers to gain a sense of his troubled interior state. These inventive visual soliloquies hint at a capacity for originality that could have made “Disjointed” a distinct entry into this subset of the comedy genre.

“Disjointed” also has characters hallucinating conversations with people who aren’t actually there and uninspired weed-centric fake commercials (though one insurance commercial spoof is legitimately funny). Above all, it asks us to connect to the crunchy owner of the shop where all the blazing takes place, a woman just wants to get people high, man, without the bummer of responsible business ownership.

In these ways and others, “Disjointed” huffs down every cliché about marijuana and the degenerates who use it, blowing them back in our faces with such knee-slappers as “stoners love a good sh*t joke.” It’s as if Javerbaum and Lorre wrote this alleged comedy for people who harbor disdain for cannabis culture, perhaps with the notion that what they’ll see will change their minds. This presumes people will want to watch the Netflix comedy for more than a few minutes and, you know, binge this thing.

If that happens, thank the show’s star Kathy Bates.

Bates can sell just about anything to Middle America, even a second-rate multi-camera laugh-in filmed before a live studio audience. “Disjointed” marks the award winning actress’ second go at helming a series after starring in NBC “Harry’s Law,” although she previously worked with Lorre on a “Two and a Half Men” guest star gig.

Here she plays dispensary owner Ruth Feldman, an old-school hippie who hangs charms in her hair and dedicated her life to legalization before opening Ruth’s Alternative Caring in Los Angeles. Ruth spends her days consistently, proudly and stubbornly getting high, talking about being high and shirking off the duties of entrepreneurship because, guess what? She’d rather be high.

Consistent with Lorre’s network comedy style, most of the action takes place within Ruth’s consumer space, her office and the dispensary’s grow room in back. Her staff of “budtenders” includes Pete (Dougie Baldwin), the resident botanist who speaks to his plants in an Australian accent for reasons unknown (other than the fact the actor who plays him is an Aussie). Then there’s Jenny (Elizabeth Ho), who introduces herself as the shop’s “tokin’ Asian” — allowing a pause for laughs — and Olivia (Elizabeth Alderfer), the obligatory cute white girl, a Lorre comedy staple.

Aaron Moten plays Ruth’s biracial son Travis, and he chafes at his mother’s lack of motivation even as he takes steps to give Ruth’s Alternative Caring a web presence. Ruth, meanwhile, is disappointed in Travis because he went to business school.

Travis sees the growth potential of his mother’s business, recognizing that the mainstreaming of cannabis and the spread of legalization places her on the edge of a pot boom. In essence, he’s the actual brains of this outfit. But Ruth is a soft, old school lefty radical who doesn’t want to become The Man, or the Wo-Man, and just wants to give people her “healp.” Did we mention that she’s stoned all the time?

Notice how tightly the simplistic comedy formula that made “Two and a Half Men” a gigantic hit is rolled into “Disjointed”: A misbehaving central character is joined at the hip to a straitlaced, exasperated awkward sidekick. Together they’re surrounded by gentle buffoons. Toss them dialogue that sets up obvious punchlines and leaves spaces for gales of cued-up laughter and blam, you’ve got enough bland content for 20, half-hour episodes.

“Disjointed” is a stoner comedy for people who don’t get stoned, written by people who I suspect either haven’t been high for a very long time, have never gotten high, or thought that they were smoking weed that one time but were actually inhaling burnt oregano laced with bath salts. Like a lonely, virginal mathlete who wants to befriend the burners in his dorm, the show’s humor is enthusiastic, harmless and not as convincing in its familiarity with the subject matter as it wants us to think it is.

It also proves that creating a winning pot comedy requires its own potent strain of expertise, including knowing how to balance sophomoric humor, honest insight and ludicrous situations to achieve euphoric effects. “Disjointed” never hits such heights, and that leads a person to have renewed appreciation for the series and films that do.

You would have to be very, very high — as in, melting into the couch — to dedicate 10 hours of your life to this show. But even that might not help, since that state tends to make time stretch out. No amount of green can make this experience palatable.

 

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Judge Nixes Indiana’s Civil Forfeiture of Vehicles

Thu, 08/24/2017 - 10:06
A state law that allowed police to keep seized cars for months without a hearing has been blocked.

INDIANAPOLIS (CN) — Though Attorney General Jeff Sessions is increasing use of civil forfeiture to seize money and property from people not convicted of a crime, a federal judge ruled that Indiana’s law on seizure and forfeiture of vehicles is unconstitutional because it violates due process.

“We plan to develop policies to increase forfeitures,” Sessions said on July 17. “No criminal should be allowed to keep the proceeds of their crime.”

Civil forfeitures, however, allow the government to take money and property from people who have not been convicted of a crime, or even charged with one.

In the Indiana case, Indianapolis police arrested Leroy Washington in September 2016 and charged him with selling marijuana. They towed his car and held it for forfeiture.

In November that year, Washington demanded the return of his car and filed a federal class action against the police, the mayor and the county prosecutor. He challenged the constitutionality of the Indiana law that allows police to seize and hold a vehicle for three to six months without a hearing or judicial oversight.

Indianapolis officials argued that “the Constitution does not require any procedure prior to the actual forfeiture proceeding.”

But on Aug. 18, Chief U.S. District Judge Jane Magnus-Stinson granted Washington summary judgment, finding that the Indiana law violates the Due Process Clause of the Fifth and 14thAmendments, and enjoined the state from enforcing it.

Washington has regained possession of his car, but Magnus-Stinson found him a proper representative of the class because he “has continued to diligently pursue this case.”

She certified the class and ruled that the case is not moot due to Washington’s reclamation of the vehicle.

“Defendants have not indicated any intention to cease enforcement of the statute, and defendants do not dispute that 169 vehicles have been seized for forfeiture between Nov. 2, 2016 and Feb. 13, 2017,” Magnus-Stinson wrote.

She noted that the statute does not allow the vehicle owner to claim the property via replevin.

“It is evident to this court that a three- to six-month deprivation is a lengthy one, and could cause significant hardship to the individual whose vehicle is seized,” the judge wrote.

She added that the lack of an interim remedy, such as retrieval of the vehicle after posting bond, “particularly burdens individuals who lack the financial resources to secure another vehicle during the pendency of proceedings, or who are unable to access reliable public transportation.”

Magnus-Stinson stated that “robust procedural safeguards” are important due to the government’s “direct pecuniary interest” in the result of forfeiture proceedings.

“The property may be sold in a public sale, with the proceeds divided, pursuant to the statute, between the seizing law enforcement agency and the common school fund,” she ruled.

In granting a permanent injunction, Magnus-Stinson said, “this court will not attempt a constitutional rewrite of the statute.”

 

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Major Evidence Teens Don't Consume More Marijuana Where It Is Sold Legally

Wed, 08/23/2017 - 14:29
With less risk of criminal justice involvement, it turns out the kids are alright.

“But what about the kids?”

Most of us drug policy reformers have been asked this question (or one like it) by a well-meaning adult concerned that marijuana legalization sends the ‘wrong message’ to our youth. And we get it- people worry that legalization could lead young people to start using marijuana at an earlier age or make it more socially acceptable for them to use.

study published on August 17 with data out of Colorado adds to the growing body of literature which could allay some of these fears. The researchers were curious about whether the onset of retail marijuana sales in Colorado in 2014 had an impact on adolescent use, attitudes towards marijuana, and access to marijuana. They analyzed responses from over 20,000 public middle and high school students who completed the Healthy Kids Colorado Survey (HKCS) and compared their 2013 responses to their 2014 responses in order to detect any possible changes.

So what did they find?  There was no sudden increase in reported rates of marijuana use after retail sales began in 2014. Rates remained essentially the same as 2013. The portion of adolescents who thought that smoking marijuana was harmful also did not change. The majority of the sample (over 60%) continued to believe it was wrong for young people to use marijuana. And, although slightly more students said they could ‘easily’ get access to marijuana in 2014, the researchers found that having a marijuana store within two miles of the school could not explain this increase in perceived access. Interestingly, this study’s results diverge from research in the areas of alcohol and tobacco, which has long suggested that stores which sell these products close to schools are associated with increased use among students. It didn’t appear to be the case for marijuana in Colorado in 2014.

As the country continues to weigh the benefits and risks of marijuana legalization, studies such as these tracking the impact on adolescent attitudes and behaviors are critical. We know that prohibition has been harmful to youth, particularly young people of color. With less risk of criminal justice involvement and no increase in rates of youth, for now anyway, it seems that the kids are alright indeed.

This piece first appeared on the Drug Policy Alliance blog

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Native American Tribes Eye Lucrative Marijuana Market

Wed, 08/23/2017 - 11:00
Tribes have some competitive advantages--no federal taxes--but uncertainty is holding them back.

 

 

Native American Tribes Eye Lucrative Marijuana Market

An increasing number of Native American tribes are looking to the marijuana business to break the poverty on reservations, but they are treading quietly over uncertainties in federal policy, which could shift under President Donald Trump. Cannabis is big business in states that have legalized its medical or recreational use. Arcview, a California cannabis investor network,…

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Emerging Drug Threats and the Whack-a-Mole Theory

Wed, 08/23/2017 - 10:38
With overdose deaths at record highs, doubling down on failed policies may not be the brightest idea.

Every quarter, the federal agency tasked with surveilling American citizens, countering drug smuggling and enforcing the Controlled Substances Act, releases a report detailing their most unique narcotic seizures. The Drug Enforcement Administration's Emerging Threat Reports can be seen as a snapshot of the rising tide of synthetic drugs in the United States—but critics say these reports are too focused on supply and not enough on demand.

Melvin Patterson, a spokesperson for the DEA, says their Special Testing and Research Laboratory discovers new psychoactive substances (NPS) on a “probably weekly” basis.

“Sometimes it’s more lethal, sometimes it’s less lethal,” Patterson told The Fix in a phone call. “[The reports are] a good source of information to get your thumb on the pulse of what’s happening.” 

Records only date back to the first quarter of 2016, but last year’s annual analysis offered some stunning statistics, including 1,299 identifications of fentanyl, fentanyl analogues and other new opioids, accounting for 68 percent of total IDs. Of the 15 distinct fentanyl analogues discovered, 60 percent were identified for the first time.

The DEA has also been discovering more synthetic cannabinoids, drugs similar to cannabis molecules, and cathinones, a class of stimulants sometimes generically referred to as “bath salts.” Also contained in the report are a smattering of hallucinogens and tryptamines, as well as 43 unconfirmed substances.

However, for the general public, these Emerging Threat Reports may be hard to interpret. The PDFs are generally short—only a page or two—and other than categorizing chemicals by class, they don’t describe much beyond that, including the pharmacology of the drug or potential side effects.

Most people probably haven’t heard of substances like dibutylone or etizolam, so they may just see their names as a jumble of alphabet soup.  Even if grandma has heard of “zombie-like” mass overdoses caused by something like AMB-FUBINACA, a synthetic cannabinoid, what is she supposed to do with this info?

Michael Collins, Deputy Director of the Drug Policy Alliance, says these reports use misleading metrics by focusing on seizures. “What does it mean if there are more seizures of fentanyl?” he asked in a phone call. “Does it mean there is less fentanyl on the street or does it mean there is more fentanyl coming in? Does it mean that we’re getting all the fentanyl that’s coming in [or] does it mean we’re getting not enough? It’s just not really clear.”

“The metric that should be used is, are we reducing overdose deaths?” Collins adds.  “By that metric, law enforcement and the DEA are failing.”

Indeed, fatal synthetic drug overdoses are at an all-time high in the U.S., especially from opioids. Death tolls from synthetic opioids (not including methadone) jumped 72.2% between 2014 and 2015 alone.

The vast majority of these substances appear to come from China and India, where loose regulations and cheap labor allow for massive distribution of psychoactive chemicals or their precursors. Even Mexican drug traffickers are getting their fentanyl and methamphetamine from Asian labs.

Patterson says DEA discoveries of new psychoactive substances—that is, chemicals previously unheard of in black markets that could pose a health threat—are on the decline, while synthetic drug use in general continues to rise. He attributes the downturn to pressure put on China to control 116 substances, including 39 synthetic cannabinoids, in September 2015.

“Up until that point, each week we were just seeing more and more and more—that’s where everybody came up with the Whac-A-Mole Theory,” Patterson explains. “Because you know, you prosecute one thing or you just get something controlled and then—boom!—another drug or psychoactive substance would pop up, and it would be chemically just a little different.”

The Whac-A-Mole Theory is a term used by many to describe the way clandestine drug labs have kept ahead of law enforcement by slightly tweaking psychoactive molecules into drugs that aren’t yet scheduled. As soon as one drug is made illegal, another similar chemical appears on black or gray markets.

In January 2017, DEA Administrator Chuck Rosenberg visited China to persuade authorities into banning four fentanyl analogues, including the elephant tranquilizer carfentanil. But Patterson says Americans probably won’t see the effects of this ban until December or early next year. He also adds that the Federal Analogue Act, passed in 1986, has helped drive a recent wave of prosecutions in the nation, which has driven down the variety—but not necessarily the volume—of drug busts.

But despite all this regulation and seizure, drug use and overdose deaths don’t show any signs of stopping—with at least 52,000 overdose casualties, last year was the worst on record. The next decade is projected to be even more deadly.

“There’s all this energy and resources into cutting off the supply of drugs, [but if] there’s one thing that history has shown us is that focus on the supply side is wrong-headed,” Collins says. “Every penny that goes to law enforcement, goes to the DEA, goes toward seizures, is money taken away from things that do work, like treatment and harm reduction.”

Collins says he would rather see funding spent on getting naloxone into the hands of drug users, expanding medication-assisted treatment such as buprenorphine and methadone, and even safe-injection facilities. In some corners of the world, these approaches have corresponded with dramatic decreases in drug abuse.

“One of the frustrating things about the current opioid epidemic is it’s an all-hands-on-deck moment,” Collins explains. “[But] the rhetoric around it is, ‘We’ve got to try every option, put every option on the table.’ And so often what states and the federal government are doing is basically doubling down on some of the policies that we know don’t work.”

 

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AlterNet Is Leading the Fight for Drug Reform: Will You Help?

Wed, 08/23/2017 - 10:23
Click here for reuse options! Every dollar counts.

As a subscriber to AlterNet's drugs newsletter, you know that independent media is a key ingredient for social change when it comes to reform. Whether the issue is legalization or ending mass incarceration, the journey starts with educating people, changing minds, inspiring people to become activists, and breaking through social taboos, racist mind-sets and powerful government agencies and business interests that stand in the way of progress. And media needs to be there every step of the way as reforms and changes begin to happen. 

AlterNet has been a media leader for almost two decades on drug reform issues. Can you make a generous contribution to support our work?

Every day, we push back against the massive onslaught of corporate propaganda that dominates the airwaves. With unique, original reporting, in-depth analysis and editorials, and a curated mix of the best content from select publishers and grassroots organizations around the globe, AlterNet is recognized as one of the best on this issue. 

We are a great bang for your buck. But we simply can't do it without your supportCan you help?

In solidarity,

Phil Smith, AlterNet Drugs Editor

 

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German Police Seize Thousands of Donald Trump Shaped Ecstasy Tablets

Tue, 08/22/2017 - 10:59
Click here for reuse options! The pills would have gone for an estimated street value of around $45,000.

German police have caught a whiff of the party drug ‘making America great again.’ On Tuesday, the Polizeiinspektion Osnabrueck seized 5,000 ecstasy tablets shaped like the head of President Donald Trump. 

The pills, which are marketed with the slogan “Trump makes partying great again,” were found after police pulled over an Austrian 51-year-old man and his 17-year-old son in their rental car in Lower Saxony, a state in northwest Germany.

The pills have an estimated wholesale value of $12,900 and a street value of $45,900. Police also found a large (unspecified) amount of cash.

Photo Credit: Polizeiinspektion Osnabrück

Last month, AlterNet reported that Donald Trump themed Ecstasy tablets were making the rounds on the dark web, an online unregulated market for purchasing illegal goods and services. This is the first known large-scale seizure regarding the American-themed drug.

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The Essential Guide for the First-Time Cannabis Tourist

Tue, 08/22/2017 - 10:57
For those who don’t live in a state where cannabis is legal, states with legalized cannabis have become a vacation destination.

As more states legalize recreational cannabis, the number of those trying this plant for the first time or resume a habit they gave up after college continues to grow. For those who don’t live in a state where cannabis is legal, traveling to a state with legalized cannabis has become a destination vacation.

·         Related Story: Federal Laws Must Change For A Sustainable Future In Cannabis

Here’s a list of suggestions for first-time cannabis tourists looking to try recreational cannabis.

Do Your Pre-Trip Research

Before booking your trip, review the rules governing cannabis in the state where you will be visiting. These laws will clue you in regarding the basics of how much cannabis you can buy, as well as where you can consume cannabis. Check out Kush Tourism for listings of cannabis tours and cannabis friendly lodgings if you want an in-depth cannabis experience.

Pick Your Dispensary

Download the Leafly app for a handy guide of recommended dispensaries nearest to your location. This site also contains strain reviews and other information that can be valuable to have at your fingertips when on the go.

Bring Your ID and Cash

Be sure to bring along some form of government issued identification. No one under 21 will be permitted to enter a recreational dispensary. Everyone will be checked at the door regardless of how old they may look. Also, leave the pets at home as only service animals will be allowed to go inside. As this is still a cash only business be sure to bring along enough cash for your purchases. Most dispensaries have an ATM on site but it’s better to be safe than sorry.

Give Yourself Time

This isn’t like going into a 7-11. At a quality dispensary, the budtenders give each customer personalized attention, and the lines can get a bit long at times.

Honesty is the Best Policy

There’s no stigma to being a newbie cannabis user or only smoked bad weed during your college haze. Budtenders are used to dealing with first-time cannabis users, and enjoy helping someone have the best experience possible. So let them know you’re new to the current cannabis scene, and ask them for their recommendations for first time users.

Be Mindful of Your Money

It’s incredibly easy to get carried away and walk out with a lot of expensive paraphernalia that you may never use after your trip. A pre-rolled joint is the cheapest option to consume cannabis. For those who don’t like smoking, another inexpensive option is a disposable vape pen that comes fully loaded and ready to use. However, do not skimp out by buying bad weed, as poor quality cannabis will not produce the desired effects you may be seeking.

Follow The Law

Be mindful that cannabis cannot be consumed legally in public, and that hotels, restaurants, and bars do not allow smoking of any kind. Also, Federal law prohibits transporting cannabis across state lines or flying with recreational cannabis. A qualified budtender will not give you recommendations regarding how you can circumvent the laws pertaining to recreational cannabis. So don’t ask. Edibles, vape pens, and topicals are ways one can consume cannabis in a discrete manner that won’t draw attention like smoking.

Start Small

Take a short hit from a vape pen or pre-rolled joint. Then sit back and chill for 15 minutes. Then take another hit if you want a stronger sensation. Repeat this process until you have the effect you’re seeking. If you are taking edibles, start with a small 5mg dose. Wait half an hour, and then take another 5mg if you want a stronger hit.

Set the Mood

Clear the schedule so you don’t have to be somewhere within a limited time frame. You don’t know how your body will respond. Even if you don’t go to sleep, you’re liable to be too mellow and relaxed to get behind the wheel.

Have an Emergency Kit on Hand

 

·         Related Story: Here’s The Scoop On Medical Marijuana For Autism Treatment

Before consuming any cannabis have some water or other non-alcoholic beverages readily available as cannabis often produces dry mouth. Also, have some munchies around as certain strains of cannabis can make one hungry. Include pistachios in your munchie mix, as they can come in handy should one consume too much cannabis.

 

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"Tsunami" of Cocaine May Be Headed For The U.S.

Tue, 08/22/2017 - 10:32
As cocaine makes its way into the country in record amounts, use of the drug is on the rise for the first time in a decade.

Last weekend U.S. authorities seized four tons of cocaine from the Pacific Ocean, a small part of a so-called tidal wave of cocaine headed for the country.

"I talk about it as really an approaching tsunami of cocaine getting ready to hit the global market,” Coast Guard Adm. Christopher Tomney, the director of Joint Interagency Task Force South, told CBS News

While U.S. authorities report that Colombia has been producing more cocaine than during the peak of the Medellín and Cali cartels, they're able to seize only a fraction of the shipments that they know are bound for American consumers. 

Tomney says that agents are able to stop “very little” of the shipments they know about. “Three out of every four events that we have awareness of, we have no asset to go after,” he said. "They're getting through. We need more ships. We need more aircraft is the bottom line.”

Investing in more ships and other vehicles to intercept drugs makes good financial sense, said Capt. Mark Fedor, who runs the Coast Guard Cutter James. “Our last patrol, we were able to bring 16 tons of cocaine back," he said. "It was worth about $420 million. Nearly enough to pay for this ship. And that was just in about a 45-day period.”

In 2016 the Coast Guard seized a record amount of cocaine: 416,600 pounds, worth more than $5.6 billion. However, those on the front lines say this is a drop in the bucket compared to the actual amount of drugs being sent to the country. 

"It's very frustrating for the men and women of this task force knowing we could be doing so much more," Tomney said. "But it really comes down to a series of choices…How much do we want to make this a priority?"

The amount of the drug coming into the country is having a real effect on cocaine-loving Americans. Cocaine use is on the rise for the first time in 10 years, increasing 26% between 2014 and 2015, according to the Office of National Drug Control Policy (ONDCP). This has resulted in a 54% increase in cocaine overdose deaths between 2012 and 2015. 

Most recently, there's been a rise in reports of drug users taking cocaine alongside fentanyl, a powerful opioid. That combination was present in 37% of overdose deaths in New York City last year. The same trend had been reported in New Haven, Connecticut and Cleveland, Ohio. 

“There is a mountain of cocaine, much of it is likely headed our way,” Justin Miller, intelligence chief for the DEA’s Miami field division, said earlier this year. “But we are already seeing these drug combinations, and cocaine deaths are already going up significantly."

 

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