from the better-solutions dept.
The Free Thought Project reports via AlterNet
There's one thing that appears to be saving more lives during the opioid epidemic than anything else--medical cannabis. While government touts meaningless attempts at addressing the problem--paying lip service to the people while protecting Big Pharma's profits and filling jails--people are saving themselves by turning to an ancient plant.
Yet another scientific study has confirmed that medical cannabis access reduces harm from opioid abuse among the population. A recent study published in the Drug and Alcohol Dependency journal found that states with legal medical cannabis experience fewer hospitalizations related to opioids.
"Medical marijuana legalization was associated with 23% and 13% reductions in hospitalizations related to opioid dependence or abuse and [opioid pain reliever] OPR overdose, respectively; lagged effects were observed after policy implementation."
Researchers from the University of California analyzed hospital administrative records for the period of 1997 to 2014. The author reported:
"This study demonstrated significant reductions on OPR- (opioid pain reliever) related hospitalizations associated with the implementation of medical marijuana policies. ... We found reductions in OPR-related hospitalizations immediately after the year of policy implementation as well as delayed reductions in the third post-policy year."
The data also show that cannabis-related hospitalizations did not increase after legalization, contrary to what prohibitionists would have you believe.
Since this time last year, Ohio, Florida, North Dakota, and Arkansas legalized medical cannabis, Illinois decriminalized it, and California, Nevada, Maine and Massachusetts legalized recreational cannabis. An attempt to legalize recreational cannabis in Arizona narrowly failed.
29 U.S. states and the District of Columbia have legalized cannabis for medical use, although restrictions vary widely from state to state.
Germany's medical cannabis law was approved in January and came into effect in March. Poland has also legalized medical cannabis, and Georgia's Supreme Court has ruled that imprisonment for possession of small amounts of cannabis is unconstitutional.
🍁 Cannada: Not So Fast 🍁
Last week, Canadian Prime Minister Justin Trudeau unveiled (archive) legislation (archive) that would make Canada the first major Western country to legalize recreational cannabis (the only country to legalize it to date is Uruguay, although implementation has taken years), dealing a serious blow to the crumbling United Nations Single Convention on Narcotic Drugs. However, the Liberal Party of Canada intends to wait more than a year to act on its campaign promise, during which time Canadians can still face prosecution for possession of the drug:
True to form, this government has written down a series of talking points, in this case, trying to make it sound like it's cracking down on pot rather than legalizing it. And Justin Trudeau's ministers are sticking to the messaging from party central like a child reciting Dr. Seuss.
Not once in that As It Happens interview did [Justice Minister Jody] Wilson-Raybould explain why the government intends to keep on criminalizing Canadians so unfairly (see the Liberal party's website statement) for another year. Instead, literally every second time she opened her mouth, she re-spouted the line about "strictly regulating and restricting access." Off asked eight questions. Four times, Wilson-Raybould robotically reverted to the same phrase.
Meanwhile, Public Safety Minister Ralph Goodale, a parliamentary lifer who mastered the art of repetitive dronetalk sometime back in the last millennium, was out peddling more or less the same line, but with an added warning: Not only will the government continue to criminalize Canadians for what it considers a trifling offence, enforcement will be vigorous. "Existing laws prohibiting possession and use of cannabis remain in place, and they need to be respected," Goodale declared. "This must be an orderly transition. It is not a free-for-all." Why the government cannot simply decide to invoke prosecutorial and police discretion, and cease enforcing the cannabis laws it considers unjust, was not explained. Why that would necessarily be a "free for all" also went unexplained.
The Liberal Party of Canada has taken pains to remind everyone that the Conservative Party will "do everything they can to stop real change and protect a failed status quo". Unfortunately, they did not get the memo that "marijuana" is a term with racist origins.
Make like a tree and legalize it, Cannadia... Cannibinoidia.
President Trump and Attorney General Jeff Sessions
Backtrack to April 20th, 2016. Bernie Sanders still seemingly had a shot at becoming the President of the United States. Sanders, as well as Hillary Clinton (though begrudgingly), supported decriminalization of cannabis, medical use, and the continuation of states making decisions about recreational use. The #2 Republican candidate Ted Cruz also had a "let the states sort it out" stance.
One contender stood out, and he went on to become the @POTUS to #MAGA. The widely predicted "third term" was prevented, and that outcome may greatly affect a burgeoning semi-legal cannabis industry. One recent casualty are Amsterdam-style "cannabis clubs" (think: brewpubs). Colorado's legislature has backed off on a bill that would have allowed on-site consumption of cannabis at dispensaries due to the uncertain future of federal enforcement of cannabis prohibition.
Trump's position on cannabis has been ill-defined, although he supports medical use and has indicated that states should handle the issue. But the same can't be said of his Attorney General, former Senator Jeff Sessions. Here are some quotes about the drug from Mr. Sessions:
We need grown-ups in charge in Washington to say marijuana is not the kind of thing that ought to be legalized, it ought not to be minimized, that it's in fact a very real danger.
I think one of [President Obama's] great failures, it's obvious to me, is his lax treatment in comments on marijuana... It reverses 20 years almost of hostility to drugs that began really when Nancy Reagan started 'Just Say No.
You can't have the President of the United States of America talking about marijuana like it is no different than taking a drink... It is different... It is already causing a disturbance in the states that have made it legal.
Good people don't smoke marijuana.
Cannabis advocates are becoming increasingly paranoid about the federal government's stance towards the states (and a certain District) that have legalized cannabis. And this is following an Obama administration that was criticized for conducting raids in states with legalization. It is too early to tell how the Trump administration will choose to deal with cannabis, but there are signs that harsher policies and greater enforcement could be coming:
On Wednesday, [April 5th,] Jeff Sessions directed Justice Department lawyers to evaluate marijuana enforcement policy and send him recommendations. And some state officials are worried. This week the governors of Alaska, Colorado, Oregon and Washington wrote the attorney general. They asked Sessions and the new Treasury secretary to consult with them before making any changes to regulations or enforcement.
At the White House, press secretary Sean Spicer said recently that the president is sympathetic to people who use marijuana for medical reasons. He pointed out that Congress has acted to bar the Justice Department from using federal money to interfere in state medical cannabis programs. But Spicer took a harsh view of recreational marijuana. "When you see something like the opioid addiction crisis blossoming in so many states around this country, the last thing we need to be doing is encouraging people. There is still a federal law we need to abide by," Spicer said.
Really, Spicer? Recreational cannabis use shouldn't be encouraged during an opioid addiction crisis? Read on.
Politics nexus unavailable for comment.
The Opioid Crisis Drags On (it's relevant)
Heroin use has become more dangerous as dealers have increasingly added other substances that massively increase potency without affecting the size of a dose significantly. Carfentanil, which is used as an elephant tranquilizer, has led to hundreds of deaths over very short timespans. It is impossible for the average user to predict the potency and potential danger of street heroin. While there have been international responses to these compounds, new chemical analogues are being created all the time:
Chinese labs producing the synthetic opiates play hide-and-seek with authorities. On their websites, they list fake addresses in derelict shopping centers or shuttered factories, and use third-party sales agents to conduct transactions that are hard to trace. The drugs themselves are easy to find with a Google search and to buy with a few mouse clicks. A recent check found more than a dozen Chinese sites advertising fentanyl, carfentanil, and other derivatives, often labeled as "research chemicals," for sale through direct mail shipments to the United States. On one website, carfentanil goes for $361 for 50 grams: tens of thousands of lethal doses.
The cat-and-mouse game extends to chemistry, as the makers tinker with fentanyl itself. Minor modifications like adding an oxygen atom or shifting a methyl group can be enough to create whole new entities that are no longer on the list of sanctioned compounds. Carfentanil itself was, until recently, unregulated in China.
2016 saw the addition of kratom to Schedule I of the Controlled Substances Act in the U.S. Advocates for the tree leaf drug, which was formerly classified as a supplement, believe that its painkiller effects and low risk factors make it a useful replacement for the oft-deadly opioids that millions of Americans are addicted to. Kratom users have treated their pain and opioid withdrawal symptoms using the formerly "legal high". The DEA has refused to acknowledge this application and points out the "skyrocketing" number of calls to the Poison Control Center regarding kratom in recent years. One skeptic of kratom, Dr. Josh Bloom of the American Council on Science and Health, has looked at the same evidence and concluded that the trail of bodies left by substances like fentanyl and the scarce number of deaths (perhaps wrongly) attributed to kratom make it clear that the substance is the better "poison". He also notes that:
The number of calls to poison control centers is not reliable for determining how many poisonings actually occurred. It is a crude approximation at best.
Much like kratom, medical cannabis has been touted as a solution to the opioid crisis. States with legalized medical cannabis have seen a reduction in reported instances of opioid dependence [DOI: 10.1016/j.drugalcdep.2017.01.006] [DX] So it is puzzling that White House Press Secretary Sean Spicer would use opioids as a bludgeon against cannabis legalization while AG Sessions expresses astonishment over the suggestion of using cannabis as a "cure" for the opioid crisis.
Bonus: Here's a video (2m14s) of a woman getting administered Narcan/naloxone. Here's an alternate video (2m39s) in which a man who overdosed on heroin is able to sit up in about a minute after being administered naloxone.
⚚ The Slow March for Science ⚕
While the Drug Enforcement Agency has refused to reclassify cannabis from its current Schedule I status, citing the supposedly rigorous conclusions reached by the Food and Drug Administration, it will allow more than one institution to grow cannabis for research purposes, ending the monopoly held by the University of Mississippi. However, the Schedule I status of cannabis remains an impediment to further research:
[...] DEA's decision not to reschedule marijuana presents a Catch-22. By ruling that there is not enough evidence of "currently accepted medical use"—a key distinction between the highly restrictive Schedule I classification and the less restrictive Schedule II—the administration essentially makes it harder to gather such evidence.
"They're setting a standard that can't be met," says David Bradford, a health economist at the University of Georgia, Athens. "That level of proof is never going to be forthcoming in the current environment because it requires doing a really extensive clinical trial series, and given that a pharmaceutical company can't patent whole plant marijuana, it's in no company's interest to do that."
Schedule I status presents obstacles for clinical researchers because of restrictions on how the drugs must be stored and handled, Bradford says. Perhaps more significant, that listing may evoke skittishness at funding agencies and on the institutional review boards that must sign off on research involving human subjects.
"It doesn't resemble cannabis. It doesn't smell like cannabis," Sisley told PBS NewsHour last week.
Jake Browne, a cannabis critic for the Denver Post's Cannabist marijuana news site, agrees. "That is, flat out, not a usable form of cannabis," he said. Browne should know: He's reviewed dozens of strains professionally and is running a sophisticated marijuana growing competition called the Grow-Off.
"In two decades of smoking weed, I've never seen anything that looks like that," Browne said. "People typically smoke the flower of the plant, but here you can clearly see stems and leaves in there as well, parts that should be discarded. Inhaling that would be like eating an apple, including the seeds inside it and the branch it grew on."
Research on cannabinoids and psychedelics is proceeding, slowly. One study published yesterday (74 years after the first LSD trip) came to an astounding conclusion: Psychedelics can induce a "heightened state of consciousness":
Healthy volunteers who received LSD, ketamine or psilocybin, a compound found in magic mushrooms, were found to have more random brain activity than normal while under the influence, according to a study into the effects of the drugs. The shift in brain activity accompanied a host of peculiar sensations that the participants said ranged from floating and finding inner peace, to distortions in time and a conviction that the self was disintegrating.
[...] What we find is that under each of these psychedelic compounds, this specific measure of global conscious level goes up, so it moves in the other direction. The neural activity becomes more unpredictable," said Anil Seth, a professor of neuroscience at the University of Sussex. "Until now, we've only ever seen decreases compared to the baseline of the normal waking state."
Increased spontaneous MEG signal diversity for psychoactive doses of ketamine, LSD and psilocybin (open, DOI: 10.1038/srep46421) (DX)
♯ Ending on High Notes ♯
And now to scrape the bottom of the barrel:
- Americans Don't Care If Their Parents Know They Smoke Weed, Survey Says
- California Today: At Newspapers, Covering Pot Like Wine (archive)
- Nation's first public needle vending machine for drug users debuts in Las Vegas
- GRiZ Won the Celebrity Weed Game Without Selling Out
- Secret A.T.F. Account Paid for $21,000 Nascar Suite and Las Vegas Trip (archive)
- Legal Marijuana Ends at Airport Security, Even if It's Rarely Stopped (archive)
- Anti-Heroin Video From a Florida Sheriff Appalls Critics but Impresses Constituents (archive)
The Food and Drug Administration approved a powerful new opioid Friday, despite strong criticism and accusations that it bypassed its own advisory process to do it.
The new drug, Dsuvia, is a tablet that goes under the tongue. It is designed for use in the battlefield and in other emergency situations to treat intense, acute pain.
Known generically as sufentanil, it's a new formulation of a drug currently given intravenously. Critics say it will be incredibly easy for health workers to pocket and divert the drug to the illicit drug market and because it is so small and concentrated, it will likely kill people who overdose on it.
"This is a dangerous, reckless move," said Dr. Sidney Wolfe senior adviser of Public Citizen's Health Research Group. He questions whether there's need for yet another synthetic opioid when the U.S. is in the throes of an opioid overdose crisis.
Sufentanil is described as 5 to 10 times more potent than fentanyl and 500 times as potent as morphine. Carfentanil is 100 times more potent than fentanyl, but is only approved for the veterinary use of tranquilizing large animals. Sufentanil is the strongest opioid painkiller available for use in humans.
Cannabis and kratom? Exercise caution!
Opioid Addiction is Big Business
Heroin, Fentanyl? Meh: Carfentanil is the Latest Killer Opioid
Study: Legal Weed Far Better Than Drug War at Stopping Opioid Overdose Epidemic
President Trump Declares the Opioid Crisis a National Emergency
Study Finds Stark Increase in Opioid-Related Admissions, Deaths in Nation's ICUs
FDA Blocks More Imports of Kratom, Warns Against Use as a Treatment for Opioid Withdrawal
Opioid Commission Drops the Ball, Demonizes Cannabis
U.S. Life Expectancy Continues to Decline Due to Opioid Crisis
FDA Labels Kratom an Opioid
Two More Studies Link Access to Cannabis to Lower Use of Opioids
"Synthetic Opioids" Now Kill More People than Prescription Opioids in the U.S.
U.S. Opioid Deaths May be Plateauing
For their study, published Tuesday in the American Journal of Psychiatry, [Yasmin] Hurd and her colleagues looked at 42 adults who had a recent history of heroin use and were not using methadone or buprenorphine.
Recruited from social services groups, halfway houses and treatment centers, the participants had used heroin for an average of 13 years, and most had gone less than a month without using. They had to abstain from any heroin use for the entire trial period.
The participants were divided into three groups: one group given 800 milligrams of CBD, another 400 milligrams of CBD and another a placebo. All the participants were dosed once daily for three consecutive days and followed over the next two weeks.
During those two weeks, over the course of several sessions, the participants were shown images or videos of nature scenes as well as images of drug use and heroin-related paraphernalia, like syringes and packets of powder that resembled heroin. They were then asked to rate their craving for heroin and their levels of anxiety.
A week after the last administration of CBD, those who had been given CBD had a two- to three-fold reduction in cravings relative to the placebo group. Hurd said the difference between the two CBD groups was insignificant. The research team also measured heart rate and cortisol, the "stress hormone," and found that the levels in those who got CBD were significantly lower than those who hadn't received the drug
Cannabidiol for the Reduction of Cue-Induced Craving and Anxiety in Drug-Abstinent Individuals With Heroin Use Disorder: A Double-Blind Randomized Placebo-Controlled Trial (DOI: 10.1176/appi.ajp.2019.18101191) (DX)
Related: Study Finds That Legalized Medical Cannabis Led to a Decline in Medicare Prescriptions
Study: Legal Weed Far Better Than Drug War at Stopping Opioid Overdose Epidemic
Opioid Commission Drops the Ball, Demonizes Cannabis
Two More Studies Link Access to Cannabis to Lower Use of Opioids
Experts have proposed using medical marijuana to help Americans struggling with opioid addiction. Now, two studies suggest that there is merit to that strategy.
The studies, published Monday in the journal JAMA Internal Medicine [open, DOI: 10.1001/jamainternmed.2018.0266] [DX], compared opioid prescription patterns in states that have enacted medical cannabis laws with those that have not. One of the studies looked at opioid prescriptions covered by Medicare Part D between 2010 and 2015, while the other looked at opioid prescriptions covered by Medicaid between 2011 and 2016.
The researchers found that states that allow the use of cannabis for medical purposes had 2.21 million fewer daily doses of opioids prescribed per year under Medicare Part D, compared with those states without medical cannabis laws. Opioid prescriptions under Medicaid also dropped by 5.88% in states with medical cannabis laws compared with states without such laws, according to the studies.
"This study adds one more brick in the wall in the argument that cannabis clearly has medical applications," said David Bradford, professor of public administration and policy at the University of Georgia and a lead author of the Medicare study. "And for pain patients in particular, our work adds to the argument that cannabis can be effective."
Also at the Washington Post.
Association of Medical and Adult-Use Marijuana Laws With Opioid Prescribing for Medicaid Enrollees (open, DOI: 10.1001/jamainternmed.2018.1007) (DX)