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The Future of Weed: 12 Bold Predictions for the Next Decade of Consumer Cannabis

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As more states legalize marijuana, the Federal government must at some point reconsider its classification as a Schedule 1 drug:

Schedule I drugs, substances, or chemicals are defined as drugs with no currently accepted medical use and a high potential for abuse. Some examples of Schedule I drugs are:

heroin, lysergic acid diethylamide (LSD), marijuana (cannabis), 3,4-methylenedioxymethamphetamine (ecstasy), methaqualone, and peyote

LSD, ecstasy, and peyote all have potential use in psychotherapy, and marijuana clearly has medical use and not nearly so high a potential for abuse as alcohol, which is not on the schedule at all despite its clear and obvious dangers associated with addiction and death. (See, for example, this report from today: “Bowling Green student dies after drinking ‘copious’ alcohol at a frat event under investigation for hazing.”) There are no recorded deaths from marijuana.

In Inside Hook Eli London takes a look at where the cannabis business might go:

So what’s the deal with weed?

It’s sort of legal, but also not really. It’s a plant … or at least a flower that’s derived from one. Back when it mostly grew out of the ground, it was demonized by Nixon’s DEA as a gateway drug; now that it’s taxable and grown in hulking, byzantine greenhouses, it’s seen as a path to redemption from the opioid epidemic and a road to riches for investors and entrepreneurs.

The sales of legal cannabis are projected to reach somewhere in the realm of $35 billion within the next five years. The actual economic impact of that market could hit $130 billion in that same timeframe. Marijuana startups are cropping up like they were being founded in hydroponic soil and bathed in UV light. Dozens of cannabis companies (mostly based in Canada, since it’s not federally legal in the US) are already available for trading in American markets. Marijuana is fully legal in 15 states (as well as DC) and at least somewhat legal in all but three states.

The green wave is coming. My inbox flows over with PR pitches from upstart marijuana companies and thinkpieces about the industry every week. In my financial news consumption, I hear about cannabis stocks on a near daily basis. In my political reading, I’m constantly reminded of the state-vs.-federal debate that underpins policy and legalization. And in keeping up with social-justice issues, I’m constantly reminded of the ugly and devastating impact marijuana and the war on drugs has had on Black and brown communities across the country.

But rather than try to summarize all these things and write a dreadfully underqualified synopsis of where the industry is heading over the next decade, I figured it would be better to talk to experts – founders, investors, lobbyists, organizers and more – from across the cannabis landscape to get their thoughts directly. I asked them broad questions about what the next decade of consumer cannabis will look like, and from their answers, I was able to parse together 12 predictions for what the next 10 years hold.

This is not an exhaustive or definitive list; it is a compendium of common themes and predictions I saw from speaking with a sizable amount of industry professionals. It is by no means gospel, but it is — we hope — a document that will give you thoughtful insight into a nascent sector of the American economy that is only destined to keep growing. That’s what plants do, after all.

Getting Stoned Out of Your Gourd Will No Longer Be the Goal

Microdosing cannabis will become the preferred performance, productivity and wellness tool across many professions, including pro sports. Microdoses of cannabis become commercially available in settings where consumers face triggers for stress or anxiety, e.g., airports and airplanes, dental offices, etc.” – David Cookson, Founder, Sula

“There’s a misconception about what a large swath of the market wants out of a cannabis experience. While there’s a legacy community of consumers who want to get very high or for whom a high THC percentage is simply the norm, there’s a much larger existing and nascent consumer demo that is looking for a more moderate and functional high. Just as not everyone wants to be drunk when they drink, not everyone wants to be blasted when they’re high.” – David Weiner, Co-Founder, Gossamer

“Microdosed products will not only become more popular, they will be the norm. Products with a mild dose of THC are the most appealing to mainstream consumers that are open to cannabis but have not tried or have not tried recently. It is these products, like our Cann Social Tonics with 2mg THC, that will bring in waves of new consumers to the industry. They care about feeling in control, having consistent experiences that are turnkey, energizing and social. Watch out for more and more microdose THC products across all product categories.” – Jake Bullock, Co-Founder, Cann

We Will Stop Thinking about Weed in Terms of Indica or Sativa

“As more research is funded, we see the supremacy of the Indica/Sativa dichotomy being challenged. Research suggests that looking at cannabis strictly through this framework might not serve our understanding in the way it is marketed to us.” – Max Spohler, Co-Founder, Artet  

“Classification of ‘strains’ as indica, sativa or hybrid as well as creatively named hybrids/strains will be largely replaced by a scientifically supported classification system that more accurately correlates to evidence-based ‘effects’ and indications for cannabis compounds.” – Cookson

THC and CBD Are Only Part of the Equation

“Consumers will continue to become more knowledgeable about the benefits of cannabis and its various compounds beyond just THC and CBD, including terpenes and cannabinoids like CBN and CBG. They will also understand how cannabis can fit into their daily routines along with other supplements and health products.” – Jim Baudino, Partner, Sands Lane Holdings

“[There will be an increase in] awareness of minor cannabinoids and terpenes. We’ve only scratched the surface of understanding this plant’s full potential. Right now many consumers only know THC and CBD, and many buy weed solely on how high the THC percentage is. However, terpenes impact the high more than many consumers realize, so I think those will be more in the spotlight in coming years.” – Kate Miller, Co-Founder and CEO, Miss Grass

“More conversations [will revolve] around the impact of various cannabinoids (outside of the THC and CBD conversations that currently dominate). The cannabis plant in so rich and versatile, and up until now we primarily focus on two, while there are well over 100 to consider. – Nidhi Lucky Handa, Founder, Leune . . .

Continue reading. There’s much more.

Written by LeisureGuy

9 March 2021 at 3:03 pm

How One of the Reddest States Became the Nation’s Hottest Weed Market

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Paul Demco has a lengthy and interesting article in Politico:

WELLSTON, Oklahoma—One day in the early fall of 2018, while scrutinizing the finances of his thriving Colorado garden supply business, Chip Baker noticed a curious development: transportation costs had spiked fivefold. The surge, he quickly determined, was due to huge shipments of cultivation supplies—potting soil, grow lights, dehumidifiers, fertilizer, water filters—to Oklahoma.

Baker, who has been growing weed since he was 13 in Georgia, has cultivated crops in some of the world’s most notorious marijuana hotspots, from the forests of Northern California’s Emerald Triangle to the lake region of Switzerland to the mountains of Colorado. Oklahoma was not exactly on his radar. So one weekend in October, Baker and his wife Jessica decided to take a drive to see where all their products were ending up.

Voters in the staunchly conservative state had just four months earlier authorized a medical marijuana program and sales were just beginning. The Bakers immediately saw the potential for the fledgling market. With no limits on marijuana business licenses, scant restrictions on who can obtain a medical card, and cheap land, energy and building materials, they believed Oklahoma could become a free-market weed utopia and they wanted in.

Within two weeks, they found a house to rent in Broken Bow and by February had secured a lease on an empty Oklahoma City strip mall. Eventually they purchased a 110-acre plot of land down a red dirt road about 40 miles northeast of Oklahoma City that had previously been a breeding ground for fighting cocks and started growing high-grade strains of cannabis with names like Purple Punch, Cookies and Cream and Miracle Alien.

“This is exactly like Humboldt County was in the late 90s,” Baker says, as a trio of workers chop down marijuana plants that survived a recent ice storm. “The effect this is going to have on the cannabis nation is going to be incredible.”

Oklahoma is now the biggest medical marijuana market in the country on a per capita basis. More than 360,000 Oklahomans—nearly 10 percent of the state’s population—have acquired medical marijuana cards over the last two years. By comparison, New Mexico has the country’s second most popular program, with about 5 percent of state residents obtaining medical cards. Last month, sales since 2018 surpassed $1 billion.

To meet that demand, Oklahoma has  . . .

Continue reading. There’s much, much more.

One thing that struck me was how elected representatives worked hard to frustrate and foil the will of the public they claim to represent. In fact, the attitude of officials seems to have been in many cases outright hostile to the public and to the public interest. From later in the article:

No one embodies the transformation of Oklahoma from drug war battlefield to marijuana mecca better than Robert Cox.

Cox opened the Friendly Market in downtown Norman in October 2014. The 67-year-old grandfather of seven was nearing retirement and wanted to upgrade the image of the stereotypical seedy head shop. Eight years earlier, Cox had rediscovered a love of marijuana after a 29-year hiatus from using the drug. “It was like a transformational awakening,” he says.

But from the outset, Cox was warned by the Norman police that if he sold anything that they deemed to be drug paraphernalia—including glass pipes—they would come after him. At first, he heeded their warnings and stopped selling smoking devices. But after seeking legal advice, Cox decided to fight.

In December 2015, barely three months after sales resumed, the police twice raided The Friendly Market. Cox and the store’s manager, Stephen Holman, a member of the Norman City Council, were each hit with 13 criminal charges, including one felony count of “obtaining proceeds of drug activity.” Two other workers were each charged with one misdemeanor count. In addition, the cops seized most of the shop’s merchandise, forcing The Friendly Market to shut down.

Cox refused to back down. Over the course of two years, they fought the charges, culminating in a six-day jury trial for Cox and Holman. Ultimately, the owner and employees prevailed every criminal charge.

But even after they triumphed in court, the local authorities refused to return The Friendly Market’s merchandise, continuing to claim it was illegal drug paraphernalia. The case went all the way to the Oklahoma Supreme Court, with Cox once again prevailing. The store’s seized merchandise was finally returned, and Cox reopened for business in October 2017.

“We all smiled for weeks,” Cox recalls. “We were ecstatic.”

A year later, medical marijuana sales began in Oklahoma. . .

Written by LeisureGuy

27 November 2020 at 9:01 am

Rigorous Study Backs A Psychedelic Treatment For Major Depression

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Jon Hamilton has an intriguing article for NPR:

The substance that makes some mushrooms “magic” also appears to help people with major depressive disorder.

A study of 27 people found that a treatment featuring the hallucinogen psilocybin worked better than the usual antidepressant medications, a team reported Wednesday in the journal JAMA Psychiatry.

“The effect was more than four times greater,” says Alan Davis, an author of the study and a faculty member at both Johns Hopkins University and Ohio State University.

The study comes after earlier research offered hints that psilocybin might work against depression and after a study by researchers at Johns Hopkins found that it could ease depression and anxiety in patients who had life-threatening cancer.

The study of cancer patients “led us to consider whether or not this treatment might be effective for people in the general depression community,” Davis says.

In the new study, patients received two doses of psilocybin on different days and also received about 11 hours of psychotherapy. The drug was administered in a supervised yet homey setting designed to put participants at ease, Davis says.

“They have a blindfold on, they have headphones on, listening to music,” he says. “And we really encourage them to go inward and to kind of experience whatever is going to come up with the psilocybin.”

Half the participants began treatment immediately. The rest were put on a waitlist so they could serve as a comparison group until their own treatment began eight weeks later.

“There was a significant reduction in depression in the immediate-treatment group compared to those in the waitlist,” Davis says. And patients responded much faster than with typical antidepressants.

“The effect happened within one day after the first session and sustained at that reduced level through the second psilocybin session all the way up to the one-month follow-up,” he says.

The study is notable for its scientific rigor, says Dr. Charles F. Reynolds III, distinguished professor emeritus of psychiatry at the University of Pittsburgh’s School of Medicine and the author of an editorial that accompanied the research.

“It offers, I think, a good deal of promise as a feasible approach to treating particularly chronic forms of depression,” Reynolds says. Even so, the results still might be skewed because patients were told they were going to get the drug.

“Some of the rapid improvement that we saw could have been related to expectancy effects on the part of the participants,” he says.

The study comes less than two years after the Food and Drug Administration approved the anesthetic and party drug ketamine for depression. And the emergence of treatments like ketamine and psilocybin may signal a new era in treatment, Reynolds says.

“Certainly that’s  . . .

Continue reading.

Written by LeisureGuy

8 November 2020 at 10:48 am

Hidden criteria that cause an approach that works to be rejected: Drug treatment division

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Abby Goodnough reports in the NY Times:

Steven Kelty had been addicted to crack cocaine for 32 years when he tried a different kind of treatment last year, one so basic in concept that he was skeptical.

He would come to a clinic twice a week to provide a urine sample, and if it was free of drugs, he would get to draw a slip of paper out of a fishbowl. Half contained encouraging messages — typically, “Good job!” — but the other half were vouchers for prizes worth between $1 and $100.

“I’ve been to a lot of rehabs, and there were no incentives except for the idea of being clean after you finished,” said Mr. Kelty, 61, of Winfield, Pa. “Some of us need something to motivate us — even if it’s a small thing — to live a better life.”

The treatment is called contingency management, because the rewards are contingent on staying abstinent. A number of clinical trials have found it highly effective in getting people addicted to stimulants like cocaine and methamphetamine to stay in treatment and to stop using the drugs. But outside the research arena and the Department of Veterans Affairs, where Mr. Kelty is a patient, it is nearly impossible to find programs that offer such treatment — even as overdose deaths involving meth, in particular, have soared. There were more than 16,500 such deaths last year, according to preliminary data, more than twice as many as in 2016.

Early data suggests that overdoses have increased even more during the coronavirus pandemic, which has forced most treatment programs to move online.

Researchers say that one of the biggest obstacles to contingency management is a moral objection to the idea of rewarding someone for staying off drugs. That is one reason publicly funded programs like Medicaid, which provides health coverage for the poor, do not cover the treatment.

Some treatment providers are also wary of giving prizes that they say patients could sell or trade for drugs. Greg Delaney, a pastor and the outreach coordinator at Woodhaven, a residential treatment center in Ohio, said, “Until you’re at the point where you can say, ‘I can make a good decision with this $50,’ it’s counterproductive.”

Two medications used to treat opioid addiction, methadone and buprenorphine, have often been viewed with similar suspicion because they are opioids themselves, even though there is abundant research showing they substantially reduce the risk of death and help people stay in treatment. But the federal government has started aggressively promoting such treatment for opioid addiction, and has heavily invested in expanding access to it.

As of yet, there are no medicines proven to suppress the intense cravings that come with addiction to meth and cocaine. Instead, there are a raft of behavioral interventions, some of which have very little evidence of effectiveness.

“The most common treatment is to do whatever the hell you feel like,” said Michael McDonell, an associate professor at Washington State University who has conducted a number of studies on contingency management. “We had two statewide meetings about meth recently, and at one, a colleague said, ‘Why aren’t we just doing contingency management? Why would we spend all this money on interventions that won’t work?’”

The fact that no public or private insurer will pay for contingency management, except in a few pilot programs, is a major challenge to expanding it; the biggest obstacle is that offering motivational rewards to patients has been interpreted as violating the federal anti-kickback statute. A group of treatment experts recently asked the Department of Health and Human Services to waive the statute for two years as it pertains to contingency management, but the agency refused, saying programs that provide rewards need to be evaluated on a case-by-case basis.

Congress recently told states that they could start spending federal “opioid response” grants on treatment for stimulant addiction, but the agency that distributes the grants allows only $75 per patient, per year to be spent on contingency management — far less than what research has found effective.

“The biggest question is . . .

Continue reading.

The refusal to support a program that works because one has moral objections (to things that work?) seems to me to be itself morally objectionable (not to mention short-sighted if not outright stupid).

Written by LeisureGuy

27 October 2020 at 8:58 pm

What if a Pill Can Change Your Politics or Religious Beliefs?

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I’ve been interested in trying psilocybin for years, but properly supervised. Maybe I’ll get the chance yet. Eddie Jacobs writes in Scientific American:

How would you feel about a new therapy for your chronic pain, which—although far more effective than any available alternative—might also change your religious beliefs? Or a treatment for lymphoma that brings one in three patients into remission, but also made them more likely to vote for your least preferred political party?

These seem like idle hypothetical questions about impossible side effects. After all, this is not how medicine works. But a new mental health treatment, set to be licensed next year, poses just this sort of problem. Psychotherapy assisted by psilocybin, the psychedelic compound in “magic mushrooms,” seems to be remarkably effective in treating a wide range of psychopathologies, but also causes a raft of unusual nonclinical changes not seen elsewhere in medicine.

Although its precise therapeutic mechanisms remain unclear, clinically relevant doses of psilocybin can induce powerful mystical experiences more commonly associated with extended periods of fasting, prayer or meditation. Arguably, then, it is unsurprising that it can generate long-lasting changes in patients: studies report increased prosociality and aesthetic appreciation, plus robust shifts in personalityvalues and attitudes to life, even leading some atheists to find God. What’s more, these experiences appear to be a feature, rather than a bug, of psilocybin-assisted psychotherapy, with the intensity of the mystical experience correlating with the extent of clinical benefit.

These are undoubtedly interesting findings, but should any of it matter? However unusual a treatment’s consequences, shouldn’t we prioritize the preferences of an informed, consenting patient? Yes, I understand that this might change me in strange ways. But my depression is debilitating. I will roll that dice. Putting aside the matter of how well-informed one could really be about such radical transformations, political realities make things more complicated, with the case of psilocybin— currently a Schedule 1, highly illicit drug—showing vividly how values, politics and social narratives can influence the development of biomedical science.

The taboo of the illicit is not an insuperable obstacle. The Multidisciplinary Association for Psychedelic Studies (MAPS), an organization that advocates for “careful uses” of psychedelics, has gone an impressive way in rehabilitating MDMA (i.e., ecstasy) into a legitimate medicine. MAPS’s masterstroke was to focus on demonstrating its potential for treating PTSD. By articulating how MDMA-assisted therapy could help veterans, support for whom enjoys a rare level of bipartisan agreement, MAPS have attracted supporters from across the political spectrum, receiving positive coverage from MSNBC and Fox News alike.

Advocates of psilocybin-assisted therapy tout it as the solution to the burgeoning mental health crisis. But, like MDMA, psilocybin is far from a culturally neutral drug, carrying both the shame of Schedule 1 status and a checkered social history. It too may need to build the kind of politically heterogeneous coalition of supporters that MDMA-assisted therapy enjoys.

But to generate a breadth of appeal, one challenge stands out: psilocybin seems to make people more liberal. Scientific reports associating psychedelic use and liberal values stretch back as far as 1971, and although these findings have been replicated more recently, a noncausal explanation is readily available. Those with conservative attitudes tend to look more disapprovingly on illicit drug use, making them less likely than liberals to try a psychedelic drug in the first place.

However, emerging evidence suggests the relationship could be causal, with clinically administered psilocybin actively shifting political values, just as it shifts many other nonclinical characteristics. Notably, one study of psilocybin for treatment-resistant depression reported that the treatment decreased authoritarian political views in patients. That clinical trial also detected another effect that had previously been reported in healthy participants: psilocybin use leads to increases in the personality domain of openness, itself a predictor of liberal values. . . .

Perhaps psilocybin removes learned stereotypes and allows the mind to see reality for what it is, and reality has a well-known liberal aspect (one reasons conservatives are so strongly opposed to education).

Continue reading.

Written by LeisureGuy

15 October 2020 at 3:01 pm

An example of systemic racism

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Spencer Critchley posted on Facebook:

The end of Breonna Taylor’s life is a perfect example of how systemic racism works.

I don’t know if any of the police officers involved is a racist — and because of systemic racism, that’s almost beside the point.

And although I disagree, I can see how the case might be made, under the existing laws, that her shooting was a legally justified accident — and because of systemic racism, that too is almost beside the point.

Systemic racism means the racism is in the way systems are designed. It’s there because of our history of racism, or because of assumptions that are the living legacy of that history.

Systemic racism means that it’s almost impossible that what happened to Breonna Taylor would ever happen to someone like me. This remains true even if you assume the worst about her — remembering that assuming the worst about her is at the heart of the problem — and if you transfer those worst assumptions to me.

If someone close to me were suspected of dealing drugs, the police would not break down my door in the middle of the night. If *I* were suspected of dealing drugs, the police would not break down my door in the middle of the night. And if somehow they did, and I fired at them, I would get the benefit of the doubt.

Systemic racism starts with assumptions about how and why we pass and enforce drug laws. If people of my race and class use drugs, it’s just harmless recreation — “Hey, let’s celebrate 4/20!” Or it’s a minor vice — “Yeah, we may have done a little blow.” Or at worst, it’s a health problem — “Good for him, he got himself into rehab.” And whatever legal trouble someone like me gets into can be made a lot less serious by an expensive lawyer.

Take class out of it, and the difference remains. Look at how the meth epidemic in rural America is seen as cause for concern, while drug abuse in inner cities is seen as moral failure.

Look at those two phrases: a “meth epidemic” is a disease afflicting a community. “Drug abuse” is your own damn fault.

Think of how often you hear about “black on black crime.” You know what? By far most white crime is white on white. It’s because criminals prey on their own communities. And our communities, after all this time, are segregated.

Even with perfectly unbiased police, prosecutors, and judges, systemic racism would remain. It would remain embedded in the laws we expect those people to enforce. It would remain embedded in the economic choices that produce so much poverty, which is the surest predictor of crime and other social problems, independent of any racial or individual characteristics. And it would remain embedded in our failure to support alternatives to enforcement. I’ve never met a police officer who wanted to be sent to deal with domestic strife or mental health crises. But we keep sending them.

We don’t have to believe all law enforcement officers are racist (or any more racist than anyone else is) to see that there is systemic racism in the way our society enforces law.
Through my work I’ve gotten to know cops who are among the least racist people I’ve ever met. I don’t know many other people who would unhesitatingly risk their lives for strangers with whom they may have nothing in common. These cops do that all the time.

Some cops fall far short of that standard. But this isn’t a “bad apples” problem. Our real problem is not caused, and will not be solved, by individual police officers.

It will be solved, or not, by all of us. And that starts with something that couldn’t be more simple, although for some reason we find it hard: seeing that every one of us is a human being, and precious.

To be handled with care.

I will add that his Facebook posts are well worth reading. Minor personal note: He lives in Monterey, where I lived until a few years ago.

Written by LeisureGuy

25 September 2020 at 10:15 am

Contaminants Found in 90% of Herbal Supplements Tested

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The FDA does not jurisdiction over herbal supplements as it does over drugs, so it cannot act to ensure purity or validity of claims of efficacy. Thus the decision by Congress is to use the honor system, with corporations on their honor to ensure that their products are pure, safe, and efficacious. That works pretty much as one would expect. Dr. Michael Greger blogs:

The majority of dietary supplement facilities tested were found noncompliant with good manufacturing practices guidelines.

“The U.S. public is not well protected” by current dietary supplement recommendations, an issue I explore in my video Dangers of Dietary Supplement Deregulation. Sometimes, there is too little of whatever’s supposed to be in the bottle, and other times, there’s too much, as I discussed in my video Black Raspberry Supplements Put to the Test. In one case, as you can see at 0:20 in my video, hundreds of people suffered from acute selenium toxicity, thanks to an “employee error at one of the ingredient suppliers.” Months later, many continued to suffer. Had the company been following good manufacturing practices, such as testing their ingredients, this may not have happened. In 2007, the FDA urged companies to adhere to such guidelines, but seven years later, the majority of dietary supplement facilities remained noncompliant with current good manufacturing practices guidelines.

What are the consequences of this ineffective regulation of dietary supplements? Fifty-thousand Americans are harmed every year. Of course, prescription drugs don’t just harm; they actually kill 100,000 Americans every year—and that’s just in hospitals. Drugs prescribed by doctors outside of hospital settings may kill another 200,000 people every year, but that doesn’t make it any less tragic for the thousands sickened by supplements.

Sometimes the supplements may contain drugs. Not only does a substantial proportion of dietary supplements have quality problems, the “FDA has identified hundreds of dietary supplements…that have been adulterated with prescription medications” or, even worse, designer drugs that haven’t been tested—like tweaked Viagra compounds. About half of the most serious drug recalls in the U.S. aren’t for drugs but for supplements, yet two-thirds or recalled supplements were still found on store shelves six months later.

There is also inadvertent contamination with potentially hazardous contaminants, such as heavy metals and pesticides in 90 percent of herbal supplements tested, as you can see at 2:09 in my video. Mycotoxins, potentially carcinogenic fungal toxins like aflatoxin, were found in 96 percent of herbal supplements. Milk thistle supplements were the worst, with most having more than a dozen different mycotoxins. It’s thought that since the plant is harvested specifically when it’s wet, it can get moldy easily. Many people take milk thistle to support their livers yet may end up getting exposed to immunotoxic, genotoxic, and hepatotoxic—meaning liver toxic—contaminants. How is this even legal? In fact, it wasn’t legal until 1994 with the passage of the Dietary Supplement Health and Education Act. Prior to that, supplements were regulated like food additives so you had to show they were safe before they were brought to market—but not anymore. Most people are unaware that supplements no longer have to be approved by the government or that supplement ads don’t have to be vetted. “This misunderstanding may provide some patients with a false sense of security regarding the safety and efficacy of these products.”

This deregulation led to an explosion in dietary supplements from around 4,000 when the law went into effect to more than 90,000 different supplements now on the market, each of which is all presumed innocent until proven guilty, presumed safe until a supplement hurts enough people. “In other words, consumers must suffer harm…before the FDA begins the slow process toward restricting [a] product from the market.” Take ephedra, for example. Hundreds of poison control center complaints started back in 1999, increasing to thousands and including reports of strokes, seizures, and deaths. Yet the FDA didn’t pull it off store shelves for seven years, thanks to millions of dollars from the industry spent on lobbying.

What did the companies have to say for themselves?  . . .

Continue reading.

Written by LeisureGuy

4 June 2020 at 1:20 pm

Kansas sheriff finally pays up for stupid and botched raid

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I remember this from when it happened and now — seven years later — the sheriff’s department is finally giving up. Kansas.

Jacob Sullum reports at Reason:

The Leawood, Kansas, couple whose home was raided in 2012 after sheriff’s deputies claimed that loose tea found in their trash was marijuana will receive $150,000 for their trouble under a settlement agreement with the Johnson County Sheriff’s Office. The settlement—which caps seven years of litigation, including two trips to the U.S. Court of Appeals for the 10th Circuit—falls far short of the $7 million that Adlynn and Robert Harte originally sought. But it represents an implicit acknowledgment that the Hartes and their children suffered an outrageous invasion of their privacy and dignity in the service of a comically inept publicity stunt.

Here are some of the absurd facts that emerged as the couple’s case was making its way through the courts:

  • The family was targeted because Robert Harte bought supplies at a hydroponic gardening store in Kansas City. Harte was planning to grow vegetables with his son as a science project. But to Sgt. James Wingo of the Missouri State Highway Patrol, who was staking out the store, he looked like a cannabis kingpin.
  • Wingo passed his hot tip to the Johnson County Sheriff’s Office, which sat on the information for eight months. Deputies did not start investigating the Hartes until early April 2012, a couple of weeks before they planned to conduct a bunch of pot raids on April 20, the unofficial stoner holiday.
  • The deputies never conducted a background investigation, which would have revealed not only that the Hartes had clean criminal records but that they were both former CIA employees with the highest level of security clearance.
  • Desperate to justify a raid that had already been planned, deputies rummaged through the Hartes’ garbage on three occasions. The first time around, Deputies Edward Blake and Mark Burns found “a small amount of wet, green vegetation,” which they deemed innocuous.
  • During his second inspection of the Hartes’ trash, Burns found the same leaves, which he suddenly decided looked like “wet marijuana plant material.” A drug field test supposedly confirmed the presence of THC.
  • When Burns dove into the family’s refuse a third time, just three days before the big 4/20 event, he found more leaves, which again supposedly tested positive for THC.
  • The “wet marijuana plant material” was actually loose tea that Adlynn Harte favored. Burns later confessed that he had never seen loose tea before but thought, based on his training and experience, that it looked like marijuana leaves.
  • A lab technician consulted after the raid disagreed, saying the leaves found in the Hartes’ trash didn’t “appear to be marijuana” to the unaided eye and didn’t “look anything like marijuana leaves or stems” under a microscope.
  • Field tests for drugs are notoriously unreliable. As 10th Circuit Judge Carlos Lucero noted after considering this case in 2017, one study “found a 70% false positive rate using this field test, with positive results obtained from substances including vanilla, peppermint, ginger, eucalyptus, cinnamon leaf, basil, thyme, lemon grass, lavender, organic oregano, organic spearmint, organic clove, patchouli, ginseng, a strip of newspaper, and even air.”
  • The label on the test kit used by Burns warns that its results “are only presumptive in nature” and should be confirmed by laboratory analysis. Yet then-Sheriff Frank Denning, who authorized the search of the Hartes’ home without laboratory confirmation of the field test results, claimed he had never heard such tests could generate false positives, despite four decades in law enforcement and despite the warning on the label.
  • The visit to the hydroponic store and the tea in the trash were the sole basis for the search warrant.
  • On the day of the raid, 10th Circuit Judge Joel Carson noted in a 2019 opinion, “Bob opened the front door” shortly before 7:30 a.m., “and the deputies flooded in the foyer. Bob ended up on the ground with an assault rifle pointed at or near him. The deputies ordered Addie and the couple’s two young children to sit cross-legged against a wall. A deputy eventually allowed the family to move to the living room couch where an armed deputy kept watch over them.”
  • It soon became clear that Johnson County’s Keystone Cops had screwed up. “After searching the home for about fifteen to twenty minutes,” Carson wrote, “the deputies found the hydroponic tomato garden that was readily visible from the exterior of the home through a front-facing basement window. And after ninety minutes of extensive searching, a couple of the deputies claimed to smell the ‘faint odor of marijuana’ at various places in the residence. A drug-detection dog showed up, but did not alert the officers to any other areas of the house requiring further searches. The dog’s handler also did not smell marijuana.”
  • The deputies found no marijuana or any other evidence of illegal activity, even after searching the house “from stem to stern.” But the same deputies who did not know the difference between tea and marijuana also did not realize there could be a legal explanation for the purchase of hydroponic gardening equipment. Blake “testified that up to that point in time, he had never seen a layout of a hydroponic-grow operation similar to Plaintiffs’ that was not being used to grow marijuana.”

Lucero summed up the situation well three years ago. “The  . . .

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Written by LeisureGuy

12 May 2020 at 8:28 am

Walmart Was Almost Charged Criminally Over Opioids. Trump Appointees Killed the Indictment.

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Jesse Eisinger and James Bandler report in ProPublica:

On a Tuesday just before Halloween in 2018, a group of federal prosecutors and agents from Texas arrived in Washington. For almost two years, they’d been investigating the opioid dispensing practices of Walmart, the largest company in the world. They had amassed what they viewed as highly damning evidence only to face a major obstacle: top Trump appointees at the Department of Justice.

The prosecution team had come to Washington to try to save its case. Joe Brown, the U.S. attorney for the Eastern District of Texas, led the group, which included Heather Rattan, an over-20-year veteran of the office who had spent much of her career prosecuting members of drug cartels.

They first went to the Drug Enforcement Administration’s headquarters to meet the acting administrator, Uttam Dhillon. There Rattan laid out the evidence. Opioids dispensed by Walmart pharmacies in Texas had killed customers who had overdosed. The pharmacists who dispensed those opioids had told the company they didn’t want to fill the prescriptions because they were coming from doctors who were running pill mills. They pleaded for help and guidance from Walmart’s corporate office.

Investigators had obtained records of similar cries for help from Walmart pharmacists all over the country: from Maine, North Carolina, Kansas and Washington, and other states. They reported hundreds of thousands of suspicious or inappropriate opioid prescriptions. One Walmart employee warned about a Florida doctor who had a “list of patients from Kentucky that have been visiting pharmacies in all of central Wisconsin recently.” That doctor had sent patients to Walmarts in more than 30 other states.

In response to these alarms, Walmart compliance officials did not take corporate-wide action to halt the flow of opioids. Instead, they repeatedly admonished pharmacists that they could not cut off any doctor entirely. They could only evaluate each prescription on an individual basis. And they went further. An opioid compliance manager told an executive in an email, gathered during the inquiry and viewed by ProPublica, that Walmart’s focus should be on “driving sales.”

After they finished their presentation, Dhillon sat back in his chair and exclaimed, “Jesus Christ,” according to five people familiar with the investigation. “Why aren’t we talking about this as a criminal case?”

That’s precisely what had occurred seven months earlier: Rattan had informed Walmart that she was preparing to indict the corporation for violating the Controlled Substances Act. Indictments of Fortune 500 companies are unheard of, let alone of one with $500 billion in annual revenue and over 2 million employees. But Rattan, with support from her boss Brown, believed the evidence justified such an unprecedented step.

Before the Texas prosecutors could file their case, however, Walmart escalated concerns to high-ranking officials at the DOJ, who then intervened. Brown was ordered to stand down. On Aug. 31, 2018, Trump officials officially informed Walmart that the DOJ would decline to prosecute the company, according to a letter from Walmart’s lawyer that lays out the chronology of the case.

But the Texas prosecutors hadn’t given up. Now, two months later, they still thought they had a chance to bring the then-deputy attorney general, Rod Rosenstein, and other top officials around. After the first presentation at the DEA offices that day, the Texas group — now accompanied by the DEA’s Dhillon — caravanned over to the DOJ.

They filed into a big, bright conference room, where they were received by Rosenstein and a collection of political appointees and career staff. Rattan and her team were given a half-hour to make their presentation. She explained that dispensing opioids without a legitimate medical purpose is legally akin to dealing heroin. Criminal law says if a person or entity is willfully blind or deliberately ignorant, they are as liable as if they had acted intentionally. Once Walmart’s headquarters knew its pharmacists were raising alarms about suspicious prescriptions, but the compliance department continued to allow — even push — them to fill them, well, that made the company guilty, the Texas prosecutors contended.

This was not a question of a few rogue employees, Rattan explained. Walmart had a national problem. Worse, the prosecutors contended, the company was a repeat offender. Walmart had agreed to a settlement with the DEA seven years earlier in which it had promised to improve its controls over the abuse of opioid prescriptions. Still the problems persisted. That’s why the prosecutors believed they needed to pursue the extraordinary path of a criminal prosecution. As they concluded, Brown was emphatic, telling Rosenstein: “We have to act.”

A fine would not be a sufficient deterrent, the DEA’s Dhillon added, since Walmart “has more money than it knows what to do with.”

“Not that there’s anything wrong with that,” Rosenstein responded, according to five people familiar with the investigation. “We are all capitalists here.”

Rosenstein’s quip brought the prosecutorial team up short. They weren’t pursuing Walmart because it was profitable but because, in their view, the company had put its customers at deadly risk. . .

Continue reading. There’s much more — and it’s disgusting.

Written by LeisureGuy

25 March 2020 at 3:27 pm

A Communist LSD Trip: The Story of Czechoslovak Acid

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From Prezkroj, an article by Aleksander Kaczorowski:

The history of Czechoslovak LSD is one of the greatest phenomena of the second half of the 20th century. How come for almost a quarter of a century, in a communist state, thousands of people, including many popular artists such as Karel Gott, were able to use psychedelic drugs entirely legally?

Why was 1960s Czechoslovakia the leading manufacturer and exporter of LSD? And why could psychiatrists there, under the guardianship of the secret police and military intelligence, experiment freely with this substance long after it had been banned all over the world?

The most unbelievable thing about this story is that it originated long before the era of Flower Power, the counterculture movement and the 1968 Prague Spring, in a past as distant and gloomy as possible: during the first years of communist rule in Eastern Europe.

In the autumn of 1952 – at the exact moment when the paranoically suspicious USSR leader Joseph Stalin unleashed a purge among the Kremlin doctors, accusing them of conspiring to assassinate him and other leaders – several young psychiatrists in Prague ingested for the first time a mysterious substance that had been sent from a laboratory in Basel. This is how the Czechoslovak adventure with LSD began.

The substance arrived in Prague in an entirely legal way. A standard shipment from the pharmaceutical company Sandoz was sent to Dr Jiří Roubíček, an associate professor at the Faculty of Psychiatry at the Medical University of Prague. It contained ampoules with an oily, transparent substance described as ‘lysergic acid diethylamide’, a substance first synthesized in 1938 by the Swiss scientist Albert Hofmann. Initially considered useless, LSD attracted the attention of the company owners after Hoffman accidentally tested its effects on himself on 19th April 1943. Four years later, the first study summarizing the results of LSD tests involving healthy volunteers and patients in psychiatric hospitals was released. The article was attached to the parcel that landed on Roubíček’s desk.

Doctors in their patients’ shoes

Roubíček was a well-regarded researcher of phenomena related to brainwave activity, and the author of pioneering research on the application of encephalography methods in psychiatry. He regularly received various parcels from the Swiss company, but this one was particularly interesting. The description stated that the mysterious substance evoked hallucinations characteristic of mental illnesses. After a series of tests on animals, Roubíček decided to administer the substance to a group of healthy volunteers and explore how LSD would affect the human brain.

The initial experiments were carried out at a psychiatric hospital in Prague’s Bohnice district. The participants were given minimal doses – doctors already knew that just one gram of the substance would be sufficient to induce hallucinations in 10,000 people. Each volunteer drank a glass of water mixed with the hallucinogen and was locked in a padded room equipped with a one-way mirror.

The doctors then began testing the substance on themselves. “I was one of the first people in Czechoslovakia who took LSD,” the eminent psychiatrist Professor Jan Srnec recalled 60 years later. “It was something unbelievable. First of all, it was extraordinary that such a small dose could cause a complete disintegration of the psyche. Second, LSD had an entirely different effect on different people. In my case, it was a state of pure euphoria, elation.”

Thanks to LSD, psychiatrists were able to put themselves in their patients’ shoes. They could experience, in a controlled environment, the conditions faced by people with incurable mental illnesses. Many orthopaedists have shared the experience of a patient with a broken arm or leg. But how can someone relate to the condition of a person with severe schizophrenic delusions if they themselves do not experience any mental health issues? How can a psychiatrist help such a patient? LSD was the door through which Czechoslovak doctors entered the world of delusions and psychoses, and they left it wide open for those willing to explore.

The first to take advantage of this opportunity were artists, especially painters and graphic designers. Roubíček had acquaintances in the circles of artistic bohemia. So, he came up with the idea to invite some of them to take part in the experiment. In return, they were to express through visual means what other volunteers could only talk about.

The effect surpassed all expectations. The artistic depictions of hallucinations and visions were extremely suggestive, and news of the extraordinary substance quickly spread among non-conformist Czechoslovak artists.

One of them was Vladimír Boudník, the creator of an innovative graphic technique known as ‘explosionism’. Since the mid-1950s, the legendary Gentle Barbarian – the eponymous character of Bohumil Hrabal’s 1973 novel – had been creating prints using filings randomly scattered on industrial sheet metal and imprinted in the graphic press. In this way, he obtained extraordinary visual effects reminiscent of drug-induced visions. Besides LSD administered under the supervision of psychiatrists from Bohnice, Boudník did not take any other drugs or hallucinogenic substances.

As a result, there were so many people keen to participate in the experiments that Roubíček and his colleagues decided to train a group of assistants. . .

Continue reading. There’s much more.

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Written by LeisureGuy

29 January 2020 at 2:21 pm

Cannabinoids remove plaque-forming Alzheimer’s proteins from brain cells

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The Salk Institute for Biological Studies reports:

Salk Institute scientists have found preliminary evidence that tetrahydrocannabinol (THC) and other compounds found in marijuana can promote the cellular removal of amyloid beta, a toxic protein associated with Alzheimer’s disease.

While these exploratory studies were conducted in neurons grown in the laboratory, they may offer insight into the role of inflammation in Alzheimer’s disease and could provide clues to developing novel therapeutics for the disorder.

“Although other studies have offered evidence that cannabinoids might be neuroprotective against the symptoms of Alzheimer’s, we believe our study is the first to demonstrate that cannabinoids affect both inflammation and amyloid beta accumulation in nerve cells,” says Salk Professor David Schubert, the senior author of the paper.

Alzheimer’s disease is a progressive brain disorder that leads to memory loss and can seriously impair a person’s ability to carry out daily tasks. It affects more than five million Americans according to the National Institutes of Health, and is a leading cause of death. It is also the most common cause of dementia and its incidence is expected to triple during the next 50 years.

It has long been known that amyloid beta accumulates within the nerve cells of the aging brain well before the appearance of Alzheimer’s disease symptoms and plaques. Amyloid beta is a major component of the plaque deposits that are a hallmark of the disease. But the precise role of amyloid beta and the plaques it forms in the disease process remains unclear.

In a manuscript published in June 2016’s Aging and Mechanisms of Disease, the Salk team studied nerve cells altered to produce high levels of amyloid beta to mimic aspects of Alzheimer’s disease.

The researchers found that high levels of amyloid beta were associated with cellular inflammation and higher rates of neuron death. They demonstrated that exposing the cells to THC reduced amyloid beta protein levels and eliminated the inflammatory response from the nerve cells caused by the protein, thereby allowing the nerve cells to survive.

“Inflammation within the brain is a major component of the damage associated with Alzheimer’s disease, but it has always been assumed that this response was coming from immune-like cells in the brain, not the nerve cells themselves,” says Antonio Currais, a postdoctoral researcher in Schubert’s laboratory and first author of the paper. “When we were able to identify the molecular basis of the inflammatory response to amyloid beta, it became clear that THC-like compounds that the nerve cells make themselves may be involved in protecting the cells from dying.”

Brain cells have switches known as receptors that can be activated by endocannabinoids, a class of lipid molecules made by the body that are used for intercellular signaling in the brain. The psychoactive effects of marijuana are caused by THC, a molecule similar in activity to endocannabinoids that can activate the same receptors. Physical activity results in the production of endocannabinoids and some studies have shown that exercise may slow the progression of Alzheimer’s disease.

Schubert emphasized that his team’s findings were conducted in exploratory laboratory models, and that the use of THC-like compounds as a therapy would need to be tested in clinical trials. . .

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25 January 2020 at 6:52 pm

Inside Purdue Pharma’s Media Playbook: How It Planted the Opioid “Anti-Story”

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David Armstrong reports in ProPublica about how wealthy drug dealers get away with it.

In 2004, Purdue Pharma was facing a threat to sales of its blockbuster opioid painkiller OxyContin, which were approaching $2 billion a year. With abuse of the drug on the rise, prosecutors were bringing criminal charges against some doctors for prescribing massive amounts of OxyContin.

That October, an essay ran across the top of The New York Times’ health section under the headline “Doctors Behind Bars: Treating Pain is Now Risky Business.” Its author, Sally Satel, a psychiatrist, argued that law enforcement was overzealous, and that some patients needed large doses of opioids to relieve pain. She described an unnamed colleague who had run a pain service at a university medical center and had a patient who could only get out of bed by taking “staggering” levels of oxycodone, the active ingredient in OxyContin. She also cited a study published in a medical journal showing that OxyContin is rarely the only drug found in autopsies of oxycodone-related deaths.

“When you scratch the surface of someone who is addicted to painkillers, you usually find a seasoned drug abuser with a previous habit involving pills, alcohol, heroin or cocaine,” Satel wrote. “Contrary to media portrayals, the typical OxyContin addict does not start out as a pain patient who fell unwittingly into a drug habit.”

The Times identified Satel as “a resident scholar at the American Enterprise Institute and an unpaid advisory board member for the Substance Abuse and Mental Health Services Administration.” But readers weren’t told about her involvement, and the American Enterprise Institute’s, with Purdue.

Among the connections revealed by emails and documents obtained by ProPublica: Purdue donated $50,000 annually to the institute, which is commonly known as AEI, from 2003 through this year, plus contributions for special events, for a total of more than $800,000. The unnamed doctor in Satel’s article was an employee of Purdue, according to an unpublished draft of the story. The study Satel cited was funded by Purdue and written by Purdue employees and consultants. And, a month before the piece was published, Satel sent a draft to Burt Rosen, Purdue’s Washington lobbyist and vice president of federal policy and legislative affairs, asking him if it “seems imbalanced.”

On the day of publication, Jason Bertsch, AEI’s vice president of development, alerted Rosen to “Sally’s very good piece.”

“Great piece,” Rosen responded.


Purdue’s hidden relationships with Satel and AEI illustrate how the company and its public relations consultants aggressively countered criticism that its prized painkiller helped cause the opioid epidemic. Since 1999, more than 200,000 people have died from overdoses related to prescription opioids. For almost two decades, and continuing as recently as a piece published last year in Slate, Satel has pushed back against restrictions on opioid prescribing in more than a dozen articles and radio and television appearances, without disclosing any connections to Purdue, according to a ProPublica review. Over the same period, Purdue was represented by Dezenhall Resources, a PR firm known for its pugnacious defense of beleaguered corporations. Purdue was paying Dezenhall this summer, and still owes it money, according to bankruptcy filings.

Purdue funded think tanks tapped by the media for expert commentary, facilitated publication of sympathetic articles in leading outlets where its role wasn’t disclosed, and deterred or challenged negative coverage, according to the documents and emails. Its efforts to influence public perception of the opioid crisis provide an inside look at how corporations blunt criticism of alleged wrongdoing. Purdue’s tactics are reminiscent of the oil and gas industry, which has been accused of promoting misleading science that downplays its impact on climate change, and of big tobacco, which sought to undermine evidence that nicotine is addictive and secondhand smoke is dangerous.

Media spinning was just one prong of Purdue’s strategy to fend off limits on opioid prescribing. It contested hundreds of lawsuits, winning dismissals or settling the cases with a provision that documents remain secret. The company paid leading doctors in the pain field to assure patients that OxyContin was safe. It also funded groups, like the American Pain Foundation, that described themselves as advocates for pain patients. Several of those groups minimized the risk of addiction and fought against efforts to curb opioid use for chronic pain patients.

Purdue’s campaign may have helped thwart more vigorous regulation of opioid prescribing, especially in the decade after the first widespread reports of OxyContin abuse and addiction began appearing in 2001. It may also have succeeded in delaying the eventual reckoning for Purdue and the billionaire Sackler family that owns the company. Although Purdue pleaded guilty in 2007 to a federal charge of understating the risk of addiction, and agreed to pay $600 million in fines and penalties, the Sacklers’ role in the opioid epidemic didn’t receive widespread coverage for another decade. As backlash against the family swelled, the company filed for Chapter 11 bankruptcy in September.

“Efforts to reverse the epidemic have had to counter widespread narratives that opioids are generally safe and that it is people who abuse them that are the problem,” said Caleb Alexander, co-director of the Center for Drug Safety and Effectiveness at the Johns Hopkins Bloomberg School of Public Health, who has served as a paid expert witness in litigation alleging that Purdue’s marketing of OxyContin misled doctors and the public. “These are very important narratives, and they have become the lens through which people view and understand the epidemic. They have proven to be potent means of hampering interventions to reduce the continued oversupply of opioids.”

Satel, in an email to ProPublica, said that she reached her conclusions independently. “I do not accept payment from industry for my work (articles, presentations, etc),” she wrote. “And I am open to meeting with anyone if they have a potentially interesting topic to tell me about. If I decide I am intrigued, I do my own research.”

As for Purdue’s funding of AEI, Satel said in an interview that she “had no idea” that the company was paying her employer and that she walls herself off from information regarding institute funders. “I never want to know,” she said. She didn’t disclose that the study she referred to was also funded by Purdue, she said, because “I cite peer-reviewed papers by title as they appear in the journal of publication.”

The sharing of drafts before publication with subjects of stories or other interested parties is prohibited or discouraged by many media outlets. Satel said she didn’t remember sharing the draft with Rosen and it was not her usual practice. “That’s very atypical,” she said. However, Satel shared a draft of another story with Purdue officials in 2016, according to emails she sent. In that case, Satel said, she was checking facts.

Satel said she didn’t remember why the doctor with a patient on high doses of painkillers wasn’t named in the Times story. The draft she sent to Purdue identified him as Sidney Schnoll, then the company’s executive medical director, who defended OxyContin at public meetings and in media stories. In an interview, Schnoll described Satel as an old friend and said her description of his patient was accurate. He left Purdue in 2005 and now works for a consulting company that has Purdue as a client, he said.

Purdue, in a statement, said it has . .

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Written by LeisureGuy

19 November 2019 at 4:45 pm

Jeff Bezos Mocks France

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Matt Stoller writes in Big:

Those of you who have read BIG for awhile know that I pay a lot of attention to foreign enforcers. I wrote up how the Russians are actually effective at protecting competition in search, whereas the EU is not. I’m also intrigued by Rod Sims in Australia, who is likely to take significant action.

My favorite enforcer in Europe is the German head of their cartel office, Andreas Mundt. Mundt has been the most aggressive antitrust enforcer in the world when it comes to Facebook. In February, his office attacked the core of its targeted advertising program, ruling “that the company stop automatically sharing data among the services it owns, like Instagram and WhatsApp, or websites that use its “like” and “share” buttons.”

This ruling wasn’t just about privacy. Data is a key input in advertising, so preventing Facebook from using data to undermine its competitors who sell advertising would have a big impact on the market. Mundt is also a fighter. A German court just ruledagainst Mundt using the rationale that Facebook’s collection of data isn’t a competition problem. And Mundt is appealing.

Mundt, however, is on the leading edge of enforcement. Many European officials are, like center-left Americans in the antitrust bar, still libertarian-leaning, though sort of embarrassed about it. The most recent example of European unwilling to confront power happened last month when the French decided to impose a tax on big techinstead of restructuring market power directly. The tax applies to companies with revenue of higher than 750 million euros and 25 million euros in France.

So what did Jeff Bezos do? His response is almost comical.

Virginie Lemaire recently opened her email to an unsettling message from Amazon: fees for sellers like her in France will be increasing by 3%.

Lemaire, a single mother of two, started her jewelry company Perle d’un jour in 2011. Trained as an artisan jeweler, she makes handmade custom pieces like necklaces, bracelets and rings.

The French small business owner started selling her products on Amazon two years ago and now generates one-fifth of her sales from the e-commerce giant’s marketplace.

So it was an unwelcome surprise when she found out Amazon would be raising seller fees for her and thousands of other small and medium-sized French businesses starting in October. The reason the company cited was simple: a 3% digital tax passed by the French government in July.

Yup, Amazon just passed the tax along to French businesses. That’s monopoly power, baby. Bezos can simply impose private taxes, pretty much at willThe idea of taxing monopolies, instead of breaking them up, is coming from those who like centralized power but are uncomfortable with American control of it.

Another example of this philosophy is the just leaked documents of plans to create a $100 billion European sovereign wealth fund to build European competitors to American and Chinese big tech.

The officials identify Google, Apple, Facebook, Amazon, Microsoft, Baidu, Alibaba and Tencent among the companies Europe needs to rival. “Europe has no such companies,” their document notes.

Europeans are embarrassed they don’t have large tech companies, instead of recognizing the leverage this gives them. Financing competitors to monopolists isn’t likely to work, and it will also violate trade commitments. And conceptually it’s problematic because it mis-frames the problem as Europeans not being innovative enough to compete. But Europeans are just as innovative as anyone else. The problem is that European markets, like markets dominated everyone by big tech, are monopolized by centralized institutions.

This philosophy also misframes leverage. Europe is not some weak set of feckless states who must bow before Google or Amazon. These are countries with sovereign power, and Amazon and Google need European markets a hell of a lot more than these countries need Amazon and Google. Europe should just break these guys up, as Mundt is effectively doing with Facebook.

The reason these officials do not want to break up big tech monopolies is that they don’t fear concentrated power, they just believe that only European leaders should be able to concentrate it. Similarly, some on the left in the U.S. just do not care that Google and Facebook have monopolized advertising, thinking as they do that advertising is a dirty business. They prefer publicly financed media, a sort of ‘we like centralized power but the people in charge have to be nice people.’ This preference for centralized power goes all the way back to Teddy Roosevelt and the New Nationalists, so the debate isn’t new.

Jeff Bezos’s almost casual ability to ward off France’s digital tax shows, however, that the philosophy of ‘concentrate power but in nice peoples’ hands’ is conceptually flawed. The only way to deal with big tech is by going at their monopoly power directly. Doing so will requires more enforcers within the European regulatory apparatus adopting Mundit’s creativity and aggressiveness, and more importantly, his philosophy that concentrations of private power are intrinsically a threat to liberty.

One of the key officials who has to change her mind is Margareth Vestager, the head of the European Competition Authority (though for how much longer it’s not clear). Vestager is somewhat assertive and gets big fines from Google, but on a conceptual level she basically accepts the thinking of big tech lobbyists. This attitude came out when she was asked about Elizabeth Warren’s plan to break up big tech. She said she opposes it, and explained why. . .

Continue reading.

Written by LeisureGuy

27 August 2019 at 10:11 am

Seattle Has Figured Out How to End the War on Drugs

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The War on Drugs, let us remember, is thanks to Richard Nixon, infamous crooked president, who rejected the findings of his own expert commission on the problem figuring that, since he was president, he knew a lot more than a group of people who had seriously studied the issues for years. (Sound familiar?) Nicholas Kristof writes in the NY Times:

On gritty streets where heroin, fentanyl and meth stride like Death Eaters, where for decades both drugs and the war on drugs have wrecked lives, the city of Seattle is pioneering a bold approach to narcotics that should be a model for America.

Anyone caught here with a small amount of drugs — even heroin — isn’t typically prosecuted. Instead, that person is steered toward social services to get help.

This model is becoming the consensus preference among public health experts in the U.S. and abroad. Still, it shocks many Americans to see no criminal penalty for using drugs illegally, so it takes courage and vision to adopt this approach: a partial retreat in the war on drugs coupled with a stepped-up campaign against addiction.

The war on drugs has been one of America’s most grievous mistakes, resulting in as many citizens with arrest records as with college diplomas. At last count, an American was arrested for drug possession every 25 seconds, yet the mass incarceration this leads to has not turned the tide on narcotics.

The number of opioid users has surged, and more Americans now die each year from overdoses than perished in the Vietnam, Afghan and Iraq wars combined. And that doesn’t account for the way drug addiction has ripped apart families and stunted children’s futures. More than two million children in America live with a parent suffering from an illicit-drug dependency.

So Seattle is undertaking what feels like the beginning of a historic course correction, with other cities discussing how to follow. This could be far more consequential than the legalization of pot: By some estimates, nearly half of Americans have a family member or close friend enmeshed in addiction, and if the experiment in Seattle succeeds, we’ll have a chance to rescue America from our own failed policies.

In effect, Seattle is decriminalizing the use of hard drugs. It is relying less on the criminal justice toolbox to deal with hard drugs and more on the public health toolbox.

Decriminalization is unfolding here in part because of Dan Satterberg, the prosecuting attorney for King County, which includes Seattle. It’s also arguably underway because of what happened to his little sister, Shelley Kay Satterberg.

At the age of 14, Shelley ran away from home because her parents wouldn’t let her go to a concert on a school night. It was a rebellion that proved devastating. She was away for several months, was gang-raped by two men, was introduced to hard drugs and began to self-medicate with those drugs to deal with the trauma of rape.

As Dan Satterberg rose through the ranks of prosecutors, Shelley Satterberg wrestled with addiction. She was never arrested or jailed (middle-class drug users often avoid police attention, which focuses on marginalized people who use or sell in public).

Dan told me that he was angry at Shelley — angry that she had made terrible choices, angry that she had hurt their parents. But over time he also concluded that his own approach of prosecuting drug users accomplished little, except that it isolated them from the family and friends who offered the best support system to escape addiction.

In 2015, Dan took Shelley to Navos, a nonprofit that provides mental health and addiction services, and she was able to stop using street drugs and gradually put her life back in order. Dan saw that treatment made a huge difference in Shelley’s life and became a believer.

Yet it wasn’t enough. Shelley died of a urinary tract infection last year at age 51, a consequence of previous drug and alcohol abuse.

“It gave me some insight about what works better than jail,” Dan Satterberg told me. “What Shelley needed was not a jail cell and not a judge wagging a finger at her, but she needed some support.”

Seattle’s first crucial step came in 2011 when Satterberg and others started a program called LEAD, short for Law Enforcement Assisted Diversion. The idea is that instead of simply arresting drug users for narcotics or prostitution, police officers watch for those who are nonviolent and want help, and divert them to social service programs and intensive case management.

Almost immediately, this was a huge success. A 2017 peer-reviewed study found that drug users assigned to LEAD were 58 percentless likely to be rearrested, compared with a control group. Participants were also almost twice as likely to have housing as they had been before entering LEAD, and 46 percent more likely to be employed or getting job training.

LEAD isn’t cheap — it costs about $350 per month per participant to provide case managers. But it is cheaper than jail, courts and costs associated with homelessness. As a result, this approach has spread rapidly around the country, with 59 localities now offering LEAD initiatives or rolling them out.

Chian Jennings, 45, who had struggled with drugs for years, living in the streets and financing her habit by selling sex and by stealing, was smoking crack when a policeman stopped her.

“It was probably the best thing that happened to me,” Jennings told me. “It saved my life.” Instead of locking her up, the police officer handed her over to social workers at LEAD.

Through LEAD, Jennings got medical care, clothing and housing. She also gained confidence in herself, people who cared for her and the idea that life could get better. “They’re some of the most caring people I’ve ever met,” she said of the counselors. “Whether you come in high or not, they always treat you with respect.” Now, she said, “I work to make them proud of me.”

Jennings remains a work in progress. She says she still sometimes uses cocaine, but less over time, and she adds that she’s no longer stealing. If she had been held in jail, she said, “it would have pissed me off, and I would have gotten high when I got out. I’d still be homeless, stealing for food and drug money.”

Prison, she says, just makes people more miserable and more dependent on drugs when they are released. “This bit about ‘I learned my lesson’ — no, it doesn’t work that way,” she said. “People are hurting inside. That’s why they’re using in the first place.”

The war on drugs began in 1971 out of a legitimate alarm about narcotics both in the United States and among U.S. troops in Vietnam. But the “war” approach locked up enormous numbers of people and devastated the family structure. Drug laws discriminated against African-Americans (possession of crack cocaine, disproportionately used by blacks, drew far harsher sentences than possession of the same quantity of powdered cocaine, more likely to be used by whites).

Yet locking up endless waves of users has had little deterrent effect, and overdose deaths have surged. The White House has estimated that the economic cost of the opioid crisis in the United States exceeds $500 billion a year, equivalent to about $4,000 per household. And that doesn’t even include cocaine, meth and other drug use.

While the U.S. doubled down on the criminal justice approach to drugs, Portugal took the opposite avenue, decriminalizing possession of all drugs in 2001. It was a gamble, but it succeeded. As I’ve reported, Portugal’s overdose deaths plunged. The upshot is that drug mortality rates in the United States are now about 50 times higher than in Portugal. . .

Continue reading.

Written by LeisureGuy

26 August 2019 at 3:05 pm

The Opioid Crisis Is About More Than Corporate Greed

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Zachary Siegel reports in the New Republic:

“Just like Doritos keep eating. We’ll make more.”

“It’s like people are addicted to these things or something. Oh, wait, people are…”

These lines are from emails sent between opioid manufacturers and distributors, recently pried loose by attorneys general suing Big Pharma for its role in fueling a massive wave of overdose deaths. Similar to the damning internal memos revealing that Big Tobacco knew that cigarettes indeed caused cancer, these emails appear to show that Big Pharma knew that a significant share of their product was landing in the street, feeding addiction. And yet they kept shipping out obscene quantities to rural towns across America, creating even more demand.

Nearly every step of the pharmaceutical supply chain is implicated in the soaring death rate. According to the Centers for Disease Control and Prevention, prescription opioids killed 218,000 people from 1999 to 2017. Many of the companies—from Johnson & Johnson to obscure distributors like Cardinal Health—are listed as defendants in hundreds of lawsuits filed by nearly every state in the country. The government thinks these corporations should pay up and treat the addiction their products caused. But the companies claim to have been acting legally and in compliance with federal regulators like the Drug Enforcement Administration (DEA). Was it all, technically, legal?

What the opioid crisis illustrates is not that there are a few bad apples in the pharmaceutical industry, but that the country’s entire health care system is driven by profit at the expense of public health and safety. Drug manufacturers, pharmacy chains, drug distributors, and insurance companies got rich while people, especially people lower down the income ladder, suffered—and the DEA, through neglect or incompetence or a mix of both, watched it all happen.


While there are significant similarities between Big Pharma and Big Tobacco, there is also a key difference that makes today’s story of corporate malfeasance even worse: namely, that the supply chain for tobacco is much simpler than opioids, which are, theoretically, tightly controlled substances that pass through a dizzying array of actors and regulators.

First, a doctor must write a prescription, which must be filled at a pharmacy, and is likely paid for by an insurance company. Depending on the needs of their customers, pharmacies place orders for these drugs (customers, it turns out, need a lot of them). Shipping companies then go between the pharmacy and the drug manufacturers. Overseeing this entire system is the DEA, which sets the quota for how many opioids a company is allowed to manufacture, and tracks where those pills go.

While politicians are making hay out of Big Pharma’s wanton greed and recklessness, far less attention has been paid to the DEA. Attorneys general suing Big Pharma recently unearthed a database that both the corporations and the government—each for their own self-interested reasons—fought to keep sealed, called the Automation of Reports and Consolidated Orders System (ARCOS). Mammoth in size and granular in detail, ARCOS tracks the shipments of every single controlled substance, from the company that manufactured it, to the company that shipped it, to the pharmacy that received it. It is the world atlas for how the opioid crisis began.

All told, from 2006 to 2012, roughly 76 billion oxycodone and hydrocodone pills criss-crossed America, according to a Washington Post analysis. While many of these pills went to legitimate patients, millions more were showered on troubled communities with a voracious thirst for pain relief. While drug manufacturers produced more and more opioids (approved by the DEA), and distributors shipped those pills to pharmacies all over the country (tracked by the DEA), drug companies saw record profits—and America’s overdose death rate soared off the charts.

“I think this [database] brings home what we all knew,” says Corey Davis, an attorney and public health expert at the Network for Public Health Law. “This wasn’t just incompetence on the part of the DEA and the Department of Justice, it was knowing and intentional failure to do what most people think is their jobs.”

What is the DEA’s job, exactly? Its first task, and the one most associated with the agency, is the Sicario-esque disruption of illicit flows of drugs coming into the U.S. from abroad, like intercepting speedboats filled with cocaine. Its other major responsibility is controlling licit pharmaceuticals. “The whole goal of the prescription system is to make sure that patients are getting their medications, and that medications are not going to those who aren’t patients,” which is called “diversion,” says Bryce Pardo, a drug policy researcher at the RAND Corporation. “That’s the whole point of the system, which was invented a hundred years ago. Clearly, the system broke. The system failed.”

Pardo points out, in the DEA’s defense, the story of a so-called DEA whistle-blower blaming a pharma-backed piece of legislation passed by Congress in 2016, which prevented agents from stopping suspicious shipments of opioids, and stunted investigations into the very corporations that are now being villainized and sued. Just as DEA agents were working their way up the pharmaceutical supply chain, much as they would in a case against any transnational crime organization, Congress hamstrung their enforcement efforts.

Or so the story goes—but that’s not the whole of it. “These companies, often times acting legally, were asking for preclearance from the DEA to go about their business,” says Leo Beletsky, a professor of law and health sciences at Northeastern University (where I’m currently a journalism fellow). “Now, the DEA is saying their hands were tied when, in fact, their hands were not tied. They were completely asleep at the wheel. And by the time the DEA began constricting the [prescription] supply and targeting certain doctors and distributors, it was too late.”


In drug policy scholarship, there is a concept called the “balloon hypothesis.” When one end of a balloon gets squeezed, the air inside, rather than disappearing, rushes to fill the other end of the balloon. The balloon hypothesis is used to describe, often critically, America’s drug enforcement strategy. If cocaine production in Colombia is stamped out, production will shift to, say, Peru. If the Dark Web’s Silk Road gets shut down, a new Dark Web market pops up. The air has to go somewhere.

The balloon hypothesis also applies to the ever-shifting demand for drugs. “Over a period of 20 years, the DEA provided the green light to a 39-fold increase in the oxycodone quota and a 12-fold increase in the hydrocodone quota, even as our opioid epidemic unfolded,” Senator Dick Durbin wrote in a letter to the editor to The Washington Post. 

In other words, the prescription balloon expanded, under the DEA’s watch, big time. But starting in 2011, the prescription market finally began to shrink after Purdue Pharma reformulated its blockbuster drug OxyContin with so-called abuse deterrent technology, and pill mills serving the black market were shut down. The supply was squeezed. The air still had to go somewhere, and it rushed to deadlier opioids like heroin spiked with illicit fentanyl. With enforcement focused on prescription opioids, the overdose crisis got worse.

Dan Ciccarone, a physician-researcher at the University of California, San Francisco who studies heroin use, says the crisis unfolded in three waves:  . . .

Continue reading. There’s much more, including some pertinent observations on reducing demand (which ultimately is the only solution).

The Four Ordinary People Who Took On Big Pharma

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Beth Macy writes in the NY Times:

In the beginning, there were just four: the Godfather from Philly, the Army sergeant from Georgia, the professor from California and the feisty mom from Florida.

It was the early 2000s, and they usually talked over old-school computer message boards. Occasionally they gathered in person, carrying posters of their children and middle-aged spouses — all dead from OxyContin overdoses.

Today we know just how dangerous this drug is. Purdue Pharma, the company that made OxyContin, the first extended-release opioid to be widely prescribed, may finally be held to account. Some 200,000 people have died from overdosing on prescription opioids, and around 2,000 lawsuits attempting to make opioid makers and distributors pay for the damage unleashed by careless overprescribing are wending their way through the courts. But experts predict it will take more than $100 billion to turn the crisis around, and it’s hard to feel optimistic when you know the story of how long and hard these four labored in obscurity before anyone listened to them.

The four called themselves RAPP, short for Relatives Against Purdue Pharma, and they testified at hearings, lent support at whistle-blower trials and marched outside pharmaceutical-funded physician meetings at fancy resorts. They were outgunned at every pass — by a pharma-funded phalanx of lawyers and by doctors who had become paid spokesmen for the company. One resort even turned a sprinkler on them. But they picked up new members by the week.

Their leader was Ed Bisch, an I.T. worker from Philadelphia who’d lost his 18-year-old son, Eddie, in 2001. They called him the Godfather because he’d brought them together in the first place, via his website, OxyKills, shortly after Eddie’s death.

Mr. Bisch had wanted to believe Purdue’s excuses at first. He was persuaded, even, to change the name of his message board to OxyAbuseKills, after the company approached him about softening his tone, then gave him a $10,000 grant to put toward his education efforts. “They kept blaming it on the ‘abusers,’ but finally I said, ‘Look, at least 50 percent of my emails are from relatives of peoplewho are patients who are either dead or addicted,’” Mr. Bisch recalled. “It took me a while to realize how evil this company was.”

Barbara Van Rooyan, a professor of counseling at Folsom Lake College in California until she retired in 2012, told Mr. Bisch recently that finding his website “saved my life and gave me hope that the grief could be used for some good.” Her 24-year-old son, Patrick, died after taking OxyContin at a Fourth of July party in 2004. “It’s kind of like a muscle relaxant, and it’s F.D.A.-approved, so it’s safe,” the friend told Patrick.

The following year, with support from RAPP, Ms. Van Rooyan petitioned the Food and Drug Administration to recall OxyContin until it could be reformulated to make it harder for abusers to crush or dissolve the pills for a more intense high; she also wanted the drug restricted to end-of-life care and to treatment of cancer and other severe pain. It took eight years before the F.D.A. responded by noting that Purdue had voluntarily reformulated the drug in 2010 (so that point was moot), and her restriction petition was denied.

By 2007, RAPP numbered in the hundreds. That August scores of them converged in the rain outside a tiny federal courthouse in Abingdon, Va., because they wanted “to look evil in the face,” as the Florida mother, Lee Nuss, put it. Three of Purdue’s top executives had flown in to be sentenced on misdemeanor misbranding charges. Purdue’s parent company pleaded guilty to a felony misbranding charge, admitting that for six years it had fraudulently marketed OxyContin as being less prone to abuse and having fewer narcotic side effects than competing drugs.

All four of the original members of RAPP spoke at the hearing. They knew one another so well by then that they car-pooled to Abingdon and doubled up in hotel rooms to save money. One of them, Ed Vanicky, had fed evidence to the Virginia prosecutors — including a now-infamous cassette tape of a public-relations conference in which a Purdue spokesman brushed off the problems of OxyContin in Appalachia by saying, “The fact is, these rural areas have had problems with prescription drug abuse since the Civil War.” (In other words, the hillbillies, not Purdue’s drug, were defective.)

Mr. Vanicky was an Army sergeant in 2000 when he found his 44-year-old wife, Mary Jo, in bed dead after taking OxyContin for a herniated disc. He had just returned home from a yearlong posting in Korea and had never even heard the word OxyContin until the coroner who performed his wife’s autopsy inquired about it.

As she stepped down from the Abingdon witness stand, the Florida mother, Ms. Nuss, brandished a small brass urn containing some of the ashes of her son, Randall, who was 18 when he overdosed on OxyContin. There was a metal detector in the courthouse, and her friends still can’t figure out how she managed to sneak in that urn.

In the end, the company was forced to pay some $634 million in fines. A pittance, compared to the billions it had earned on the drug.

That fine is still the largest paid by Purdue to date, and it would do nothing to slow the epidemic. Not a single executive went to jail, and none of the settlement money went to treatment. OxyContin sales surged in its aftermath, topping $2 billion in 2008.

When Purdue finally reformulated OxyContin to make it abuse-resistant, the pill-addicted switched to heroin and, later, fentanyl to keep their dopesickness at bay. Within another decade, nearly 400,000 people would be deadMore than 2.6 million Americans are now addicted.

Today, the group’s prescience is clear. But they are sad, and they are tired. They still believe the company’s owners, the Sackler family, and executives should go to jail. But more than anything, they want the judges overseeing the lawsuits to make sure Purdue and the family use their riches to guarantee Americans access to treatment.

Recent news of the company’s misdeeds — like the allegation from New York’s attorney general, Letitia James, that Sackler family members moved hundreds of millions of dollars into private or offshore accounts, paying themselves when they knew the company was already insolvent or close to it — only confirms what the four have long believed.

In March, Oklahoma settled its case against Purdue and the Sacklers for $270 million — in part because the company was contemplating filing bankruptcy, and the state feared bankruptcy claims would insulate it from paying restitution. That meant all the documents in the case would remain sealed — a fate RAPP laments because it allows the company to hide its tactics from public scrutiny, occluding the dangers of the drug. “I have been saying for years that sealing the lawsuits let them get away with murder,” Mr. Bisch said.

This summer Vanity Fair published a rare interview with David Sackler, grandson of one of the three brothers who founded Purdue Pharma, who said his family had suffered “endless castigation,” including the taunting of his 4-year-old at nursery school. With a tone-deafness reserved for people who can afford to surround themselves with sycophants, he told the writer Bethany McLean, “Look at all the good Purdue has done.”

Mr. Vanicky read the article and told me, “I bet it sucks to be a Sackler these days.” He has personally called the offices of many attorneys general to thank them for filing suit against the Sacklers and Purdue.

Now 72,  . . .

Continue reading.

Written by LeisureGuy

21 July 2019 at 3:27 pm

It’s bad when the government lies to the public: Most Heroin Addicts Didn’t Start By Being Prescribed Pain Pills, Despite Drug Czar’s Claims

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Philip Smith reports in Drug War Chronicles:

As part of its campaign to stem opioid addiction and overdoses, the White House Office of National Drug Control Policy (ONDCP — the drug czar’s office) has launched an education campaign called The Truth About Opioids, but some of the material it is presenting has more than a whiff of spin to it — and could imperil the ability of pain patients to get the relief they need.

The web site declares in big, bold letters that “80% of heroin users started with a prescription painkiller,” and highlights the words “80%,” “heroin,” “started,” and “prescription” in lurid purple. The graphic suggests that heroin users were prescribed opioids, developed a habit, and then went on to junk, with the further implication that a way to reduce heroin addiction is to tighten and reduce the prescribing of opioids.

The web site then asks readers if they are “shocked,” “ah-ha,” “outraged,” or “fired up” by the information. It is only if readers scroll down the page that they are informed that the basis for the statistic is a 2013 study of “Heroin use and heroin use risk behaviors among nonmedical users of prescription opioid pain relievers.” (Emphasis added.)

That’s right, even though the graphic shouts out that people prescribed opioids then went on to become heroin addicts, the science it uses to back its claim is about recreational pain pill users. That’s deceptive.

Misleading claims about prescribing opioids and the potential for opioid addiction are, of course, nothing new. Twenty years ago, PurduePharma infamously claimed that the risk of addiction from OxyContin was so low as to be negligible, a marketing tactic that helped kick into overdrive the pain pill phase of the current wave of opioid use.

But the drug czar’s office, with its misleading suggestion that being prescribed opioids leads to heroin addiction, tips the pendulum too far in the other direction. There are real world consequences to using such faulty information. The Drug Enforcement Administration cited that 80% figure last year when it ordered steep decreases in the supply of prescription opioids, and it claimed in the Federal Register that patients got addicted “after first obtaining these drugs from their health care providers.”

“The 80% statistic is misleading and encourages faulty assumptions about the overdose crisis and medical care,” Pain News Network columnist Roger Chriss argued in a column last year.

And now, a new study from researchers at Penn State University published in the Journal of Addictive Studies bolsters that claim. Concentrating on southwestern Pennsylvania, an area with high levels of addiction, the researchers conducted surveys and in-depth interviews with drug users to determine their drug using histories. The sample size was small, with 125 people surveyed and 30 interviewed, but the results were illuminating.

The researchers found that two out of three of those interviewed got their first prescription opioids not from a doctor’s prescription, but either bought or stole it from a family member or friend. Another 7 percent bought their drugs from a stranger or a dealer. And only one out of four (26 percent) began with opioid medications prescribed by a doctor.

“What emerged from our study — and really emerged because we decided to do these qualitative interviews in addition to a survey component — was a pretty different narrative than the national one. There’s a lot about that narrative that I think is an overly simplistic way of thinking about this,” said lead author Ashton Verdery, PhD, an assistant professor of sociology, demography and social data analytics at Penn State.

“We found that most people initiated through a pattern of recreational use because of people around them. They got them from either siblings, friends or romantic partners,” he continued. “Participants repeatedly reported having a peer or caregiver in their childhood who had a substance use problem. Stories from childhood of witnessing one of these people selling, preparing, or using drugs were very common. Being exposed to others’ substance use at an early age was often cited as a turning point for OMI (opioid misuse) and of drug use in general.”

Among study participants, recreational drug use — or polysubstance abuse, in public health speak — was common, Verdery noted, and usually began not with prescription opioids but with drugs such as alcohol, marijuana, cocaine, methamphetamine, and prescription sedatives and stimulants.

“It is important to note that interviewees universally reported initiating OMI only after previously starting their substance use career with another drug (e.g., alcohol, marijuana, cocaine). Opioids were never the first drug used, suggesting that OMI is likely associated with being further along in one’s drug using career,” he added.

Researchers studying opioid addiction need to be aware of the role other substances play in the process, Verdery said. Understanding how opioid addiction is intertwined with other drug use is necessary to figure out the correct steps to take to prevent addiction before it takes hold. . .

Continue reading.

Written by LeisureGuy

21 June 2019 at 10:23 am

The War on Cocaine Only Strengthens Drug Cartels, Study Finds

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Philip Smith reports in Drug War Chronicles:

If you’ve spent nearly a half-century and $250 billion trying to stop the flow of cocaine into the US and the white powder is now cheaper and more plentiful than ever, maybe it’s time to rethink. That’s the implicit lesson lurking behind a new study on the impact of drug interdiction efforts on drug trafficking organizations.

Interdiction is the supply side approach to reducing drug use. Rather than reducing demand through education, prevention, and treatment, interdiction seeks to reduce the supply of drugs available domestically by blocking them en route to the US or at the border.

Published in the Proceedings of the National Academy of Sciences and conducted by scientists from a half-dozen American universities, the study relied on a computer model called NarcoLogic that shows how drug traffickers respond to interdiction strategies and tactics. More sophisticated than previous attempts to simulate the drug trade, NarcoLogic models local- and network-level trafficking dynamics at the same time.

“Our team consists of researchers who worked in different parts of Central America during the 2000s and witnessed a massive surge of drugs into the region that coincided with a reinvigoration of the war on drugs,” David Wrathall of Oregon State University’s College of Earth, Ocean and Atmospheric Sciences said in a press release announcing the research results. “We asked ourselves: did drug interdiction push drug traffickers into these places?”

The short answer is yes, and that has implications that go far beyond drug policy. The Central American migrants who are at the center of the current “border crisis” are fleeing not only poverty but also high levels of violence generated by the movement of Mexican drug trafficking groups into the region a decade ago as they faced increasing interdiction efforts at home and from US authorities.

In fact, although it is not addressed in this new research, it was earlier interdiction efforts aimed at Colombian cocaine trafficking groups in the 1980s that led directly to the transformation of formerly small-scale Mexican cross-border smuggling organizations into the Frankenstein’s monster of drug prohibition that the cartels are today. With the Colombians under intense pressure, Mexican traffickers rose to the occasion and have been making billions of dollars a year ever since.

This despite five decades of US interdiction efforts with an average annual expenditure of $5 billion. Instead of curbing the flow of cocaine into the United States, all that has been accomplished is making the drug trafficking operations more widespread and harder to eradicate. Putting pressure on one route or location simply leads traffickers to scatter and regroup. This is the “balloon effect,” where suppressing traffic or production in one area prompts it to pop up elsewhere, and the “cockroach effect,” where traffickers simply decentralize their operations.

“Between 1996 and 2017, the Western Hemisphere transit zone grew from 2 million to 7 million square miles, making it more difficult and costly for law enforcement to track and disrupt trafficking networks,” Wrathall said. “But as trafficking spread, it triggered a host of smuggling-related collateral damages: violence, corruption, proliferation of weapons, and extensive and rapid environmental destruction.”

And for all that effort, the impact on cocaine price and availability has been negligible — or even perverse.

“Wholesale cocaine prices in the United States have actually dropped significantly since 1980, deaths from cocaine overdose are rising, and counterdrug forces intercept cocaine shipments at a low rate. More cocaine entered the United States in 2015 than in any other year,” Wrathall said. “And one thing people who support interdiction and those who don’t can agree on is that change is needed. This model can help determine what that change should look like.”

The main takeaway from the study is not that drug trafficking became more widespread and resilient because of ineffective interdiction efforts, but because of interdiction itself. The policy aimed at suppressing the drug trade has only made it stronger and wealthier. . .

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Written by LeisureGuy

11 April 2019 at 9:27 am

Portugal’s Path to Breaking Drug Addiction

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Rob Waters has a very interesting article in Craftsmanship magazine. It begins:

For the past 50 years, Italy, Portugal and the United States have taken radically different approaches to drug enforcement and to the epidemics of drug use and addiction that have afflicted each country. One, the U.S., has emphasized punishment. It leads the world in incarcerating people—and at burying them after drug overdoses. Another, Portugal, has decriminalized drugs and created a model for effective drug treatment. Italy, meanwhile, has veered wildly between these two poles, never settling on a clear approach.

This is the story of how Portugal has dealt with its drug problems and largely succeeded, while the U.S. and Italy, despite pockets of success—like the San Patrignano rehabilitation community in northern Italy described in another article in this issue—have mostly failed.

For all three countries, the modern epidemic of hardcore drugs began with a dramatic rise in the use of heroin. In the U.S., heroin use surged during the Vietnam War, as American soldiers experimented with Southeast Asian heroin and many became addicted. When they came home, drug syndicates saw a market and filled it, putting large quantities of heroin onto the streets of U.S. cities.

Heroin came to Italy in the mid-1970s and its use grew rapidly, striking all social classes. By the late 1980s, Milan alone had an estimated 100,000 heroin users, according to a 1989 article in the New York Times, which noted that in 1988,  809 Italians died of overdoses.

At its peak in the late 1990s, Portugal had one of the highest rates of heroin addiction and fatal overdoses in the world. About one percent of Portugese people were using heroin and one person a day was dying of an overdose—in a country of just 10 million. Then Portugal changed course and took a radical step, eliminating criminal penalties for drug use and possession and making a commitment to provide treatment to all who want it. Today, Portugal has arguably the world’s most enlightened set of drug policies.

As in the U.S., Portugal’s heroin experience began with war. Throughout the 1960s and early 1970s, Portugal deployed hundreds of thousands of soldiers to suppress uprisings in the country’s African colonies. Like the Americans’ experience in Vietnam, these soldiers were exposed to marijuana and other drugs. Then, in 1974, a military coup struck Portugal, followed by a peaceful popular uprising (the “Carnation Revolution”). Almost overnight, decades of rule by a right-wing dictatorship were brought to an end.

A young doctor named João Goulão was then working in the Algarve area of southern Portugal. He had a front-row seat to what happened next.

“Suddenly almost a million soldiers and settlers came back to the mainland, bringing literally tons of cannabis, and there was an explosion of experimentation,” Goulão, who now runs the country’s drug agency, told me in a recent interview. Portugal at the time was going through an extraordinary upheaval, creating a new government and new laws. Young people and returning soldiers savored their new freedom by experimenting with drugs as marijuana, heroin, cocaine and LSD flooded in. “We were completely naïve about drugs,” says Goulão, “and completely unprepared to deal with it.”

FROM BAD TO WORSE

In a flash, Portugal went from having one of the lowest rates of drug use among European countries to having perhaps the highest. The biggest problem was heroin.

“Heroin spread very fast and among all social groups,” says Goulão. “It was not something that happened only among marginalized people and minorities, or in ghettoes. Suddenly everybody knew someone who had problems with drugs.”

As heroin use grew, so did overdoses. Doctors and public health professionals throughout the country began setting up treatment programs. After his daughter died of an overdose, the Minister of Justice set up treatment centers in three large cities. Private programs popped up as well, but Goulão says most were of poor quality and many ripped off the patients and families who came to them for help.

These efforts amounted to Band-Aids, not a concerted national policy. The number of providers and treatment programs kept growing but heroin use grew even faster. The sharing of needles also spread AIDS, adding to the death toll. With drug possession and sales seen as crimes, the prison population soared. And since drugs circulated widely within prisons, it had little effect on the underlying problem.

“People could spend two or three years in jail and come back worse than when they went there,” says Goulão. “The situation was getting worse every day.”

STEP ONE: DECRIMINALIZATION

In 1998, Portugal Prime Minister António Guterres, (now secretary-general of the United Nations) convened a group of nine experts—judges, psychologists and health professionals including Goulão—to develop a national strategy for addressing the crisis. The group visited other European countries, interviewed professionals and researched different approaches. In the end, they concluded they could do relatively little to address the supply of drugs—but could do a lot to address the demand.

The committee developed a set of concrete proposals focused largely on “prevention, treatment, harm reduction, and the reintegration of people,” Goulão says. “All of it was based in the idea that we were dealing with a health and social condition rather than a criminal one.”

The committee’s most radical proposal was to eliminate criminal penalties for the use and possession of drugs. Government leaders accepted the proposal but it also required the approval of Parliament. So Goulão and his colleagues took their case to the public and spent the next year presenting their plan in dozens of forums and discussions.

Their proposal was opposed by right-wing parties and Goulão remembers their arguments: “Portugal will become a paradise for drug addicts and drug users from all over the world. We will have planes coming to Lisbon every day with people to use drugs. Our children will start using drugs at early ages.”

But support from the public and, surprisingly, from the Catholic Church carried the day—in 2001, Parliament passed the sweeping changes. “Using drugs in Portugal was no longer a crime,” Goulão says.

STEP TWO: MULTIPLE OPTIONS FOR TREATMENT

Today, some 40 programs in Portugal provide detoxification and long-term treatment, with 1600 beds in residential treatment programs known as “therapeutic communities,” Goulão says. Most are run by nonprofit agencies, under contract with the government. They employ a variety of treatment approaches, but all must provide  . . .

Continue reading.

Written by LeisureGuy

29 March 2019 at 4:58 pm

A belief in meritocracy is not only false: it’s bad for you

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Clifton Mark, who writes about political theory, psychology, and other lifestyle-related topics and lives in Toronto, Ontario, writes in Aeon:

‘We are true to our creed when a little girl born into the bleakest poverty knows that she has the same chance to succeed as anybody else …’ Barack Obama, inaugural address, 2013

‘We must create a level playing field for American companies and workers.’ Donald Trump, inaugural address, 2017

Meritocracy has become a leading social ideal. Politicians across the ideological spectrum continually return to the theme that the rewards of life – money, power, jobs, university admission – should be distributed according to skill and effort. The most common metaphor is the ‘even playing field’ upon which players can rise to the position that fits their merit. Conceptually and morally, meritocracy is presented as the opposite of systems such as hereditary aristocracy, in which one’s social position is determined by the lottery of birth. Under meritocracy, wealth and advantage are merit’s rightful compensation, not the fortuitous windfall of external events.

Most people don’t just think the world should be run meritocratically, they think it is meritocratic. In the UK, 84 per cent of respondents to the 2009 British Social Attitudes survey stated that hard work is either ‘essential’ or ‘very important’ when it comes to getting ahead, and in 2016 the Brookings Institute found that 69 per cent of Americans believe that people are rewarded for intelligence and skill. Respondents in both countries believe that external factors, such as luck and coming from a wealthy family, are much less important. While these ideas are most pronounced in these two countries, they are popular across the globe.

Although widely held, the belief that merit rather than luck determines success or failure in the world is demonstrably false. This is not least because merit itself is, in large part, the result of luck. Talent and the capacity for determined effort, sometimes called ‘grit’, depend a great deal on one’s genetic endowments and upbringing.

This is to say nothing of the fortuitous circumstances that figure into every success story. In his book Success and Luck (2016), the US economist Robert Frank recounts the long-shots and coincidences that led to Bill Gates’s stellar rise as Microsoft’s founder, as well as to Frank’s own success as an academic. Luck intervenes by granting people merit, and again by furnishing circumstances in which merit can translate into success. This is not to deny the industry and talent of successful people. However, it does demonstrate that the link between merit and outcome is tenuous and indirect at best.

According to Frank, this is especially true where the success in question is great, and where the context in which it is achieved is competitive. There are certainly programmers nearly as skilful as Gates who nonetheless failed to become the richest person on Earth. In competitive contexts, many have merit, but few succeed. What separates the two is luck.

In addition to being false, a growing body of research in psychology and neuroscience suggests that believing in meritocracy makes people more selfish, less self-critical and even more prone to acting in discriminatory ways. Meritocracy is not only wrong; it’s bad.

The ‘ultimatum game’ is an experiment, common in psychological labs, in which one player (the proposer) is given a sum of money and told to propose a division between him and another player (the responder), who may accept the offer or reject it. If the responder rejects the offer, neither player gets anything. The experiment has been replicated thousands of times, and usually the proposer offers a relatively even split. If the amount to be shared is $100, most offers fall between $40-$50.

One variation on this game shows that believing one is more skilled leads to more selfish behaviour. In research at Beijing Normal University, participants played a fake game of skill before making offers in the ultimatum game. Players who were (falsely) led to believe they had ‘won’ claimed more for themselves than those who did not play the skill game. Other studies confirm this finding. The economists Aldo Rustichini at the University of Minnesota and Alexander Vostroknutov at Maastricht University in the Netherlands found that subjects who first engaged in a game of skill were much less likely to support the redistribution of prizes than those who engaged in games of chance. Just having the idea of skill in mind makes people more tolerant of unequal outcomes. While this was found to be true of all participants, the effect was much more pronounced among the ‘winners’.

By contrast, research on gratitude indicates that remembering the role of luck increases generosity. Frank cites a study in which simply asking subjects to recall the external factors (luck, help from others) that had contributed to their successes in life made them much more likely to give to charity than those who were asked to remember the internal factors (effort, skill).

Perhaps more disturbing, simply holding meritocracy as a value seems to promote discriminatory behaviour. The management scholar Emilio Castilla at the Massachusetts Institute of Technology and the sociologist Stephen Benard at Indiana University studied attempts to implement meritocratic practices, such as performance-based compensation in private companies. They found that, in companies that explicitly held meritocracy as a core value, managers assigned greater rewards to male employees over female employees with identical performance evaluations. This preference disappeared where meritocracy was not explicitly adopted as a value.

This is surprising because impartiality is the core of meritocracy’s moral appeal. The ‘even playing field’ is intended to avoid unfair inequalities based on gender, race and the like. Yet Castilla and Benard found that, ironically, attempts to implement meritocracy leads to just the kinds of inequalities that it aims to eliminate. They suggest that this ‘paradox of meritocracy’ occurs because explicitly adopting meritocracy as a value convinces subjects of their own moral bona fides. Satisfied that they are just, they become less inclined to examine their own behaviour for signs of prejudice.

Meritocracy is a false and not very salutary belief. As with any ideology, part of its draw is that it justifies the status quo, explaining why people belong where they happen to be in the social order. It is a well-established psychological principle that people prefer to believe that the world is just.

However, in addition to legitimation, meritocracy also offers flattery.  . .

Continue reading.

Written by LeisureGuy

14 March 2019 at 7:09 pm

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