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This helps account for the epidemic of homelessness and mental illness: A new kind of cheap meth

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I think this article may be outside the paywall. It’s by Sam Quinones in the Atlantic, titled “‘i Don’t Know That I Would Even Call It Meth Anymore,’” and it’s definitely worth reading. The article is adapted from Sam Quinones’s new book, The Least of Us: True Tales of America and Hope in the Time of Fentanyl and MethTwo snippets from the article:

. . . One night in 2009, in Temecula, California, partway between San Diego and L.A., a longtime user of crystal meth named Eric Barrera felt the dope change.

Barrera is a stocky ex-Marine who’d grown up in the L.A. area. The meth he had been using for several years by then made him talkative and euphoric, made his scalp tingle. But that night, he was gripped with paranoia. His girlfriend, he was sure, had a man in her apartment. No one was in the apartment, she insisted. Barrera took a kitchen knife and began stabbing a sofa, certain the man was hiding there. Then he stabbed a mattress to tatters, and finally he began stabbing the walls, looking for this man he imagined was hiding inside. “That had never happened before,” he told me when I met him years later. Barrera was hardly alone in noting a change. Gang-member friends from his old neighborhood took to calling the meth that had begun to circulate in the area around that time “weirdo dope.”

Barrera had graduated from high school in 1998 and joined the Marine Corps. He was sent to Camp Lejeune, in North Carolina, where he was among the few nonwhite Marines in the platoon. The racism, he felt, was threatening and brazen. He asked for a transfer to Camp Pendleton, in San Diego County, and was denied. Over the next year and a half, he said, it got worse. Two years into his service, he was honorably discharged.

After the September 11, 2001, terrorist attacks, Barrera was filled with remorse that he hadn’t stuck it out in the Corps. He was home now, without the heroic story he’d imagined for himself when he joined the Marines. The way he tells it, he drank and used meth to relieve his depression.

He’d sometimes stay up on meth for four or five days, and he had to make excuses for missing work. But until that point, he’d held his life together. He worked as a loan processor, then for an insurance company. He had an apartment, a souped-up Acura Integra, a lot of friends.

But as the meth changed around 2009, so did Barrera’s life. His cravings for meth continued, but paranoia and delusions began to fill his days. “Those feelings of being chatty and wanting to talk go away,” he told me. “All of a sudden you’re stuck and you’re in your head and you’re there for hours.” He said strange things to people. He couldn’t hold a job. No one tolerated him for long. His girlfriend, then his mother, then his father kicked him out, followed by a string of friends who had welcomed him because he always had drugs. When he described his hallucinations, “my friends were like, ‘I don’t care how much dope you got, you can’t stay here.’ ”

By 2012, massive quantities of meth were flowing into Southern California. That same year, 96 percent of the meth samples tested by DEA chemists were made using the P2P method. And, for the first time in more than a decade of meth use, Barrera was homeless. He slept in his car and, for a while, in abandoned houses in Bakersfield. He was hearing voices. A Veterans Affairs psychologist diagnosed him with depression and symptoms of schizophrenia.

Even many years later, when I spoke with him, Barrera didn’t know how the drug he was using had changed and spread, or why. But as a resident of Southern California, he was among the first to be affected by it. Over the next half-dozen years or so, the flood of P2P meth would spread east, immersing much of the rest of the country, too.

And, later in the article,

.. . The Louisville, Kentucky, area is one example. For years, Louisville had a paltry meth market. A pound of it sold for $14,000. Then Wiley Greenhill went to prison. Greenhill was a minor drug dealer in Detroit who had come to Louisville in 1999, attracted by Kentucky’s vibrant street market for pain pills, which were fetching five times what they sold for in Detroit.

He eventually landed at the Roederer Correctional Complex, north of Louisville, where he struck up a friendship with an inmate from California. The inmate’s father, a businessman from Southern California named Jose Prieto, had gotten into debt with the wrong people from Sinaloa. The Sinaloans told Prieto that to settle his debt, he had to sell their meth. Greenhill was given the opportunity to buy it.

By 2016 Greenhill was out of prison, and the meth began to flow. At first Prieto sent small quantities through the mail. Soon the loads reached 50 to 100 pounds a month, driven east by women Greenhill hired.

Prieto proved eager to get his product out. He fronted Greenhill hundreds of thousands of dollars’ worth of meth on the promise that he would be repaid. Tim Fritz, a DEA agent who investigated the Prieto-Greenhill ring, told me, “Jose Prieto would say, ‘Whatever you need, we got it. Whatever you buy, I’ll double it. You want 10 pounds, I’ll give you 20—pay me later.’ ”

As months passed, the Louisville meth market expanded beyond anything the region had seen before. The trade spread to southern Indiana and nearby counties in Kentucky as the number of customers grew. Other local traffickers began to import meth as well. The price of a pound of meth fell to about $1,200, less than a tenth of what it had been just a few years earlier.

At the MORE Center, a Louisville clinic set up to treat pain-pill and heroin addicts, patients started coming in on meth. Before the Prieto-Greenhill connection, only two of counselor Jennifer Grzesik’s patients were using meth. Within three years, almost 90 percent of new patients coming to the clinic had meth in their drug screen. “I don’t remember having any homeless people in my caseload before 2016,” she told me. But 20 percent of her clients now are homeless.

Greenhill and Prieto were arrested in 2018 and 2019, respectively, and are now serving lengthy federal-prison terms. They left behind a transformed market. Primed by the new supply, meth demand has exploded, in turn drawing more dealers who have found their own supply connections. The price of a pound of meth remains low. To compete, some Louisville meth dealers now offer free delivery; others offer syringes already loaded with liquid meth so users can immediately shoot up. Similar partnerships, arrangements, and retail innovations have transformed regional drug markets across the U.S. . . .

And also:

Over the past year and a half, I’ve talked with meth addicts, counselors, and cops around the country. The people I spoke with told me stories nearly identical to Eric Barrera’s: P2P-meth use was quickly causing steep deterioration in mental health. The symptoms were always similar: violent paranoia, hallucinations, conspiracy theories, isolation, massive memory loss, jumbled speech. Methamphetamine is a neurotoxin—it damages the brain no matter how it is derived. But P2P meth seems to create a higher order of cerebral catastrophe. “I don’t know that I would even call it meth anymore,” Ken Vick, the director of a drug-treatment center in Kansas City, Missouri, told me. Schizophrenia and bipolar disorder are afflictions that begin in the young. Now people in their 30s and 40s with no prior history of mental illness seemed to be going mad.

Written by Leisureguy

23 October 2021 at 3:30 pm

How do you spell “conflict of interest”? McKinsey knows. McKinsey Never Told the FDA It Was Working for Opioid Makers While Also Working for the Agency

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Ian MacDougall reports in ProPublica:

Since 2008, McKinsey & Company has regularly advised the Food and Drug Administration’s drug-regulation division, according to agency records. The consulting giant has had its hand in a range of important FDA projects, from revamping drug-approval processes to implementing new tools for monitoring the pharmaceutical industry.

During that same decade-plus span, as emerged in 2019, McKinsey counted among its clients many of the country’s biggest drug companies — not least those responsible for making, distributing and selling the opioids that have ravaged communities across the United States, such as Purdue Pharma and Johnson & Johnson. At times, McKinsey consultants helped those drugmaker clients fend off costly FDA oversight — even as McKinsey colleagues assigned to the FDA were working to bolster the agency’s regulation of the pharmaceutical market. In one instance, for example, McKinsey consultants helped Purdue and other opioid producers push the FDA to water down a proposed opioid-safety program. The opioid producer ultimately succeeded in weakening the program, even as overdose deaths mounted nationwide.

Yet McKinsey, which is famously secretive about its clientele, never disclosed its pharmaceutical company clients to the FDA, according to the agency. This year ProPublica submitted a Freedom of Information Act request to the FDA seeking records showing that McKinsey had disclosed possible conflicts of interest to the agency’s drug-regulation division as part of contracts spanning more than a decade and worth tens of millions of dollars. The agency responded recently that “after a diligent search of our files, we were unable to locate any records responsive to your request.”

Federal procurement rules require U.S. government agencies to determine whether a contractor has any conflicts of interest. If serious enough, a conflict can disqualify the contractor from working on a given project. McKinsey’s contracts with the FDA, which ProPublica obtained after filing a FOIA lawsuit, contained a standard provision obligating the firm to disclose to agency officials any possible organizational conflicts. One passage reads: “the Contractor agrees it shall make an immediate and full disclosure, in writing, to the Contracting Officer of any potential or actual organizational conflict of interest or the existence of any facts that may cause a reasonably prudent person to question the contractor’s impartiality because of the appearance or existence of bias.”

Agency officials rely on disclosure to ensure that they have the information they need to consider whether a contractor’s other business relationships risk slanting its judgment. “Contractors have the obligation to disclose potential conflicts, and then the government has an obligation to figure out how to deal with it,” said Jessica Tillipman, an assistant dean and government procurement law expert at George Washington University Law School.

Asked for comment, McKinsey did not assert that it disclosed potential conflicts to the FDA. But a spokesperson for the firm, Neil Grace, nonetheless maintained that . . .

Continue reading.

Written by Leisureguy

4 October 2021 at 6:09 pm

What role did the CIA play in the drug trade in the 1980s?

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As I mentioned in an earlier post, the Venn-diagram intersection of the circle of what the CIA does and the circle of what criminal organizations do is much larger than is comfortable (or seemly). Watch this video for an example

Written by Leisureguy

18 August 2021 at 2:59 pm

This is what billionaire “justice” looks like

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Patrick Radden Keefe, author of Empire of Pain: The Secret History of the Sackler Dynasty, writes in the NY Times:

In 2016, a small-time drug dealer in Leesburg, Va., named Darnell Washington sold a customer a batch of what he thought was heroin. It turned out to be fentanyl. The customer shared it with a friend, and the friend died from an overdose.

To combat the opioid crisis, prosecutors have begun treating overdose deaths not as accidents but as crimes, using tough statutes to charge the dealers who sold the drugs. Washington had never met the person who overdosed. But, facing a mandatory minimum prison sentence of 20 years for “distribution resulting in death,” he pleaded guilty to the lesser charge of distribution and is now serving a 15-year sentence in federal prison.

I thought about this the other day when it became clear that members of the billionaire Sackler family will most likely soon receive a sweeping grant of immunity from all litigation relating to their role in helping to precipitate the opioid crisis. Through their control of Purdue Pharma, the families of Raymond and Mortimer Sackler made a vast fortune selling OxyContin, a powerful prescription opioid painkiller that, like fentanyl, is a chemical cousin of heroin.

Though they are widely reviled for profiting from a public health crisis that has resulted in the death of half a million Americans, they have used their money and influence to play our system like a harp. It is hardly news that our society treats people like Darnell Washington with sledgehammer vengeance, and people like the Sacklers with velvet gloves.

But it’s worth asking: How did they pull this off?

For a long time, the families of Raymond and Mortimer Sackler simply evaded scrutiny, pruning their public image so that people knew about the philanthropic contributions like the Sackler Library at Oxford, but not about the source of their wealth. After the press started writing stories, in 2001, about how OxyContin had given rise to a wave of addiction, high-price spin doctors labored to keep the Sackler name out of the controversy.

As the death toll associated with OxyContin grew, Purdue continued to argue in its marketing campaign that the drug was rarely addictive. When journalists raised tough questions, the company sent its lawyers to intervene with their editors.

This “can I see your manager” approach works even with law enforcement. In 2006, federal prosecutors in Virginia were preparing to charge Purdue with felonies. They focused on three senior lieutenants who worked for the company, expecting them to flip on the Sacklers — the ultimate target, according to the lead prosecutor — when faced with potential prison time. But Purdue had enlisted two former U.S. attorneys, Rudy Giuliani and Mary Jo White. Ms. White telephoned Paul McNulty, who was then the deputy attorney general: “It’s Mary Jo White,” Mr. McNulty recalled recently. “It’s somebody who thought of herself as having access.”

The Justice Department informed the federal prosecutors in Virginia that they could not charge the executives with felonies, robbing them of their most significant point of leverage: the threat of jail. The executives did not cooperate with efforts to implicate the Sacklers; instead, they pleaded guilty to misdemeanors while maintaining that they had done nothing wrong. The company pleaded guilty to felony “misbranding” and paid a $600 million fine.

You would not be alone in detecting a whiff of La Cosa Nostra. In an expert report filed in a recent lawsuit, John C. Coffee Jr., who directs the Center on Corporate Governance at Columbia Law School, concluded that “there is little to distinguish the control the Sacklers exercised over Purdue from the control that the Godfather held over his Mafia family.” After the executives took the fall, the Sacklers voted to pay one of them $3 million. Another got $5 million. Impunity will cost you. According to court documents, a single law firm billed Purdue more than $50 million for the case.

Yet the Sacklers were unchastened. Last year, Purdue pleaded guilty to a new set of felony charges related to the marketing of OxyContin. Once again, none of the Sacklers were charged criminally; instead, they agreed to pay a relatively meager $225 million to settle a civil investigation, without any admission of wrongdoing. Astonishingly, prosecutors appear to have settled with the Sacklers without ever bothering to interview them. Asked in a deposition whether any of the Sacklers had “direct contact with the D.O.J. in connection with the investigation,” David Sackler, who served on Purdue’s board from 2012 to August 2018, replied, “I do not believe that any of them have.”

This time, no individual executives were charged even with misdemeanors. Instead, the Justice Department informed the prosecutors on the case that they wanted to deal with Purdue quickly. In October, administration officials announced that Purdue had reached an $8 billion settlement with the government. This sounded impressive — except that the company didn’t have $8 billion, because by then it had filed for bankruptcy.

How could a corporation with a product that has generated an estimated $35 billion in revenue end up filing for bankruptcy? One answer is that by the time Purdue filed for Chapter 11, in 2019, it was being sued by practically every state in the country and thousands of other claimants. But there is another, more relevant explanation.

By 2007, the Sacklers seems to have realized, as David Sackler noted, that eventually one lawsuit might “get through to the family.” They started pulling money out of Purdue and securing it in their own accounts, many of them overseas. According to an audit report, between 2008 and 2017 they took out over $10 billion. (Family members have said the transfers were proper.) Then, in 2019, with Purdue engulfed by lawsuits, the company sought protection in bankruptcy court.

It is difficult to overstate the fiendish brilliance of this move. Now, the company would be shielded from all those lawsuits while restructuring its debts. Of course, at this point some of the lawsuits had indeed broken through: More than two dozen states had filed suit against individual Sackler board members. But the Sacklers and Purdue now requested that the bankruptcy judge freeze any lawsuits against family members — even though the family had not declared bankruptcy.

American corporations can pick the jurisdiction where they file for bankruptcy and, thus, often the judge who determines their fate. Even though Purdue has never had any real business presence in White Plains, N.Y., that is where it filed its bankruptcy case. Purdue has maintained that this choice was driven by proximity to the company’s headquarters in Stamford, Conn. But it may also have been relevant that only one federal bankruptcy judge presides in White Plains — Robert Drain. In the past, Judge Drain had indicated a willingness to shield from litigation certain parties who had not even filed for bankruptcy in his court. He promptly granted the request, temporarily protecting the Sacklers from those suits.

Judge Drain is known for prizing deal making and efficiency and has tried to seal off the proceedings from the messy imperatives of justice and accountability. As an army of lawyers haggled over the carcass of Purdue, the Sacklers advocated a “global resolution,” a single, sweeping deal that would address all of the claims against the company and the family. Their offer: $4.5 billion, with no admission of wrongdoing by the family and permanent immunity from any future civil liability related to the opioid crisis.

That may seem like a lot of money, but billionaire math can be deceptive. The Sacklers proposed to pay the $4.5 billion out over nine years. Their current fortune is estimated to be at least $11 billion. Conservatively, with interest and investments, this means they can expect a 5 percent annualized rate of return on that fortune. If that’s the case, they’ll be able to pay the fine without even touching their principal. When they’re done paying in 2030, they will probably be richer than they are today.

For months, a coalition of “nonconsenting” states held out for a better deal. But Judge Drain indicated that he was inclined to permanently enjoin the states from pursuing their cases against the Sacklers. This would be essential, the judge observed, to achieve “true peace.”

On July 7, with their leverage diminishing, 15 of the nonconsenting states indicated that they would sign off on the Sacklers’ proposed deal. At a news conference, New York’s attorney general, Letitia James, said, “The battle is not over.” But clearly, it is. The company will be wound down. The Sacklers will be barred from the opioid business. They will admit no wrongdoing. They — along with their scores of lawyers, consultants and public relations advisers — will be granted permanent immunity. (In principle, they could still be criminally prosecuted, but this seems unlikely; through their representatives, members of the family have maintained that they acted “ethically and legally.”)

There is one small consolation. . .

Continue reading. There’s more, and no paywall on this article.

Written by Leisureguy

14 July 2021 at 1:27 pm

Keeping People Out of Jail [for minor crimes] Keeps People Out of Jail [by curtailing major crimes]

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David Byrne (of Talking Heads fame, and also founder of the site) writes in Reasons to Be Cheerful:

Both sides of the political fence in the U.S. agree that mass incarceration isn’t working. It is expensive, discriminatory and has serious societal consequences. Crime has, in general, been trending down for decades (even in 2020, despite public perception) while prisons just keep filling up.

Credit: NYU Brennan Center

 The partisans may disagree on the best way to lower the prison population, but the good news is they agree it has to happen. The present system is unsustainable.

One way of reducing mass incarceration is to simply start ignoring certain laws. Some 80 percent of cases filed nationally are for misdemeanors. These are the types of crimes that are often victimless, but that can mess up the life of the person prosecuted for them. A few places have addressed this in the most straightforward way possible: by not automatically prosecuting these crimes. What has happened as a result? Studies have shown that these places reduced their prison populations without putting the public at risk. Crime did not go up. In fact, in many cases, it went down. And, surprisingly, often not just for misdemeanors. 


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A seemingly radical idea

The consequences not just for the individual but for society and the economy begin well before someone is actually incarcerated. Simply being prosecuted, having a record, becomes a disadvantage for life. It can make it harder to get a jobto vote, to get a loan for an education or a mortgage for a home. Minor nonviolent infractions can leave one disadvantaged forever. They can effectively ruin a life. 

Rachael Rollins, the district attorney of Suffolk County, which includes Boston, was well aware of this when she did something that seemed radical upon being elected in 2018. The county stopped automatically prosecuting people for small crimes: minor drug possession, shoplifting, disorderly conduct and other nonviolent offenses. A study released a year later showed that this change prevented a large number of folks who were charged with these offenses from being funneled into the criminal justice system. But it also had a broader effect: violent offenses in Suffolk County went down by 64 percent, and even traffic offenses decreased by 63 percent. 

Why would declining to prosecute people for low-level crimes also reduce other types of crimes? The study, by the National Bureau of Economic Research, found that the key is keeping folks out of the criminal justice system. Doing so reduced the odds by 58 percent that these folks would engage with that system in the future. So, to be clear, this doesn’t suddenly empty out the prisons — it’s not retroactive — but it dramatically slows the flow of folks being incarcerated, which, in turn, reduces the chances that those people will commit future crimes. As the presently incarcerated end their sentences and leave, there won’t be the same flow of new prisoners coming in to replace them. It seems to me this is incredibly good news — both sides of the political divide should be happy.

I decided to call up the three authors of this study to see what they felt were the implications of their research on this policy. It turns out they were as pleasantly surprised by the results as I was. 

The authors of the study are Amanda Agan (Rutgers University), Anna Harvey (New York University) and Jennifer Doleac (Texas A&M University).

DB: Can you summarize your results for our readers?

AA: Our study found that, at least for certain defendants [mostly first time offenders], non-prosecution — not moving forward with charging an individual defendant — actually reduces the probability that that individual ends up back in the criminal justice system, and so reduces recidivism and reduces future criminal justice contact. 

We wanted to study this because there’s a potential tension: if we’re going to choose to not prosecute somebody, is this going to embolden them to go on to commit more crimes? Or is it going to kind of put them on a better path and allow them that second chance to potentially reduce their criminal justice involvement?  And we’ve found it’s the latter, that this is reducing recidivism in the future.

DB: What presently happens when these minor offenses are prosecuted?

AH: This is really important for your readers to understand: in most jurisdictions, when you’re arrested for a crime, that goes on to what is potentially a lifetime permanent criminal record maintained by the state criminal record agency, that potentially, depending on the state statutes, can show up to employers when they conduct a background check, and it can show up to law enforcement, police officers and prosecutors in the future. 

There’s really good evidence to suggest that [being prosecuted] changes people, the way you’re treated down the road, potentially, for a lifetime. What we’re studying are nonviolent misdemeanor arrests, which are, in most of the cases we study, later dismissed. What we’re finding is that defendants whose cases in which the prosecutors don’t prosecute them, they don’t receive a criminal record. And that seems to have a really beneficial effect.

DB: How did you, as the authors of the study, know for sure that it was leniency in prosecuting that had this effect? 

AA: What we were doing was a little different. We were taking advantage of the fact that in Suffolk County, the person who decides whether to charge you with a crime or not is basically randomly assigned to your case. You have no control over whether me, Jen or Anna is going to be the one that’s going to end up making a decision about whether to charge you or not. 

[For example], it turns out Jen is really lay-down-the-law. She’s really going to want to prosecute people. And Anna, Anna is super lenient, she really likes to give second chances, just kind of by nature. 

And so we’re using that luck of the draw, that some offenders happen to get Anna and others happen to get Jen. We try to understand what happens when you get Anna and you don’t get that criminal record. What is the effect on your future recidivism versus if you got that harsher prosecutor? 

DB: What kinds of offenses are we talking about?

AAThey’re all nonviolent misdemeanors like disturbing the peace, trespassing, some low-level kinds of theft or shoplifting, minor drug possession. There are also some more serious kinds of traffic or moving violations that move into the realm of criminality, rather than just citations or traffic tickets, that are going to kind of make up a majority of these nonviolent crimes that we’re talking about. 

AH: Misdemeanors are often things like driving with an expired registration, or driving with an expired license, driving with expired insurance — basically, driving without the right paperwork. Who doesn’t forget to renew stuff? 

AA:In a sense [this is] criminalizing poverty.  [Low-income folks] don’t have the time or resources to go and handle some of these problems.

As these researchers point out, once you’ve engaged with the criminal justice system it can be a slippery slope, so keeping folks out of it in the first place can have a huge knock-on effect. It prevents future crime.

AH: One of the things that we’re finding is that even though the cases that we’re studying are only these nonviolent misdemeanor offenses, when you prosecute a first-time nonviolent misdemeanor, offender, person, individual, they’re more likely to come back — not just on another non-violent misdemeanor offense, they’re more likely to come back on a violent offense and a felony offense. 


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Charm City lives up to its name

In March 2020 in Baltimore, State’s Attorney Marilyn Mosby tried a similar experiment initially prompted by the increased risk of Covid spreading in prisons. Her office would no longer prosecute a host of minor nonviolent charges: limited drug possession, prostitution, minor traffic infractions, misdemeanors and trespassing. This doesn’t mean all these things became legal, but it does mean that if you get arrested for them, you probably won’t be locked up. 

What happened? Well, no surprise, crime rates dropped suddenly. Which doesn’t mean folks stopped doing these things — only that they weren’t being prosecuted for them. But what’s interesting is that it wasn’t just those nonviolent crime rates that dropped. Violent crime dropped 20 percent too, and property crime dropped 36 percent. 39 percent fewer people overall got caught up in the criminal justice system, which is what you’d expect if some charges are not prosecuted. But, as in Suffolk County, it seems the reduction extended well beyond those nonviolent crimes. This also helps reduce discrimination, as it is mostly people of color who get caught up in the system. 

This past March, after the experiment proved to be successful, it was made permanent. When police realized these offenses were not being prosecuted they stopped arresting folks for them — for instance, there were 80 percent fewer arrests for drug possession. That allowed prosecutors to focus on violent crimes instead of these misdemeanors, which, according to some research, results in an increase in public safety. 

The cops were skeptical at first. The police commissioner expected crime to rise, but it continued to go down — even when it rose in many other big cities during the pandemic. Johns Hopkins University in Baltimore did a follow up study and found that of 1,431 folks who had charges dropped in this experiment only five ended up being arrested again, which is considered pretty incredible. 

Baltimore is now also following the example of the CAHOOTS program in Eugene, Oregon, previously written about here, by directing some calls about nonviolent incidents to the Baltimore Crisis Response, Inc., a behavioral health organization, rather than to the police. People in crisis get help from trained social workers instead of dealing with the police and risking the possibility of getting locked up. The police commissioner there has since come out in support of police not being expected to be social workers


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It’s catching on

From NBC News: . . .

Continue reading. There’s more.

Written by Leisureguy

14 July 2021 at 12:40 pm

Why Joe Biden Punched Big Pharma in the Nose Over Covid Vaccines

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Matt Stoller has a very interesting column today:

Today I’m writing about Joe Biden’s attack on vaccine monopolists. What happened is a bit technical and involves a bunch of weird international agreements on patents and IP, but the short story is that what Biden just did could be as significant as Reagan firing the air traffic controllers in 1981, or Teddy Roosevelt taking on JP Morgan in 1904 over a giant railroad combination. It’s a signal that the American order is changing.

Plus, beef prices are at record highs, so why are cattle producers going bankrupt? And why did we face meat shortages during the pandemic? I talked to South Dakota ranching advocate Bill Bullard about why our national food systems are collapsing.

Biden: We Must Vaccinate Everyone in the World

Three days ago, United States Trade Representative Katherine Tai announced that the United States supports a global waiver on intellectual property protections for Covid vaccines. There are two excellent vaccines. The first is produced by a partnership between industry giant Pfizer and the German company BioNTech, the second by multi-billion dollar start-up success story Moderna in a partnership with the National Institute of Health. Biden took the first step in a legal process to force these firms, among others, to share their technology.

The announcement sent shock waves throughout the world. French President Emanuel Macron jumped on board, director of the World Health Organization Tedros Adhanom Ghebreyesus called it a “monumental moment in the fight against Covid,” the FT’s Edward Luce said Biden had made “a brilliant move,” and political leaders globally began putting pressure on their own governments to follow suit. “Thank you, President Biden and USTR Katherine Tai,” said Lori Wallach of Global Trade Watch, a key leader in the campaign.

The pharmaceutical industry reacted with shock and anger. “In the midst of a deadly pandemic, the Biden Administration has taken an unprecedented step that will undermine our global response to the pandemic and compromise safety,” read a statement from the trade association group PhRMA. The US Biotechnology Innovation Organization pronounced “extreme disappointment” and the European Federation of Pharmaceutical Industries and Associations warned this move will lead to counterfeit vaccines.

What just happened? And what does it actually mean?

There are multiple layers to this story. I’m going to offer an explanation of how this waiver affects the global attempt to address the pandemic, the politics behind the decision, and what it means going forward. The short story is that this is an unexpected and major defeat for the pharmaceutical industry, all the more bizarre that it comes from Joe Biden, who in his career generally deferred to big business. As one Washington lobbyist told the Financial Times, “Nobody really thought Biden was going to take on the pharmaceutical lobby, [they thought] that he would be too scared. But before the financial crisis, everybody thought the financial services industry was untouchable, then that changed. This week showed that pharma companies are the new banks.”

To understand what happened, we have to start with the development of the vaccines themselves.

The Vaccine Success Story

The development of Covid vaccines is the single most successful U.S. government program since the elimination of polio. Vaccines have traditionally taken more than a decade to develop. Yet, in this case, less than a year after the virus was first genetically sequenced by Chinese scientists and posted to the web, trucks began rolling out of factories with safe and effective vaccines ready for deployment. Today, more than a billion doses have been injected into arms, and wealthier countries are seeing the pandemic recede.

In part, the global spread of pharmaceutical technology is one reason for this success. China, Russia, Europe, and the U.S. all have put out vaccines that work. Yet the best new vaccines come from the U.S. or Europe, and use a new technology called mRNA. The old way of making vaccines consisted of growing a weakened or deactivated germ, which would create an immune response by getting your body to respond to something that looked like a deadly virus. But making these kinds of viruses was cumbersome because they have to be grown, and they don’t always work well. Flu vaccines are grown in chicken eggs, for instance, and that takes a long time.

The mRNA vaccine by contrast is not a weakened germ, it is a set of instructions to your body to produce a custom-designed protein shaped like a part of the Covid virus, which your immune system then responds to. In doing so, you acquire immunity. The mRNA vaccine is programmable, meaning that it’s easy to update the vaccine to address new diseases or new variants, and because it is chemical, production scales quickly. Think of the difference between the old way of doing vaccines and mRNA as similar to printing books by woodblocks, each of which has to be carved by hand, versus using moveable type printing presses.

The mRNA technology comes from Katalin Kariko, a Hungarian immigrant who perfected the technology with fellow scientist Drew Weissman at the University of Pennsylvania. The two licensed mRNA to two small firms, BioNTech in Germany and Moderna in the United States. BioNTech spent years perfecting the technology and eventually got German government support. Meanwhile, Moderna received U.S. government funding in the 2010s from the Defense Advanced Research Projects Agency (DARPA), the same unit that helped create packet-switching technology in the 1970s.

When the pandemic hit, three things happened. First, Pfizer and BioNTech quickly agreed to work together to scale and develop their mRNA vaccine. Second, government scientists at the National Institute of Health designed a spike protein molecule and sent it to Moderna, which used it as the basis for its mRNA vaccine. Third, the U.S. government, through what was called Operation Warp Speed, created a market for vaccines, signing guaranteed-purchase agreements with a number of firms, including Pfizer/BioNTech and Moderna, to secure hundreds of millions of vaccine doses for the U.S. population.

This process worked remarkably well. The first country to have more than 50% of its population vaccinated, Israel, basically has no Covid anymore, and Covid is dropping rapidly everywhere these vaccines have been widely deployed. If we could deploy vaccines worldwide, we could effectively eradicate Covid, or at the very least, make the outbreak of new variants that can evade vaccines much less likely.

Where there’s great success, there’s great money. Pfizer is projecting it will make $26 billion in 2021 from its vaccine, and Moderna will make $18.4 billion. That’s a good thing. These firms should make large sums of money from a fantastically useful vaccine, even though the technology was publicly financed.

Still, despite this success, there’s a significant vaccine shortage. The world will need 10-12 billion to be fully vaccinated, and Moderna and Pfizer/BioNTech won’t produce that much. Pfizer/BioNTech, for instance, forecast production of 2 billion doses in 2021, and Moderna will make something on the order of a billion doses. That’s a lot, it’s just not nearly enough. Indeed, at this rate, some countries aren’t going to start significant vaccination campaigns until 2023. That’s quite dangerous, because if the pandemic keeps raging, it’s more likely that a vaccine-resistant Covid variant emerges. If that happens, such a variant will spread across the already vaccinated areas of the world.

So making sure we have a global vaccination campaign looks like a logistical challenge, but also a necessary one. That said, there’s a fly in the ointment, a ghoulish incentive at work for Pfizer, BioNTech, and Moderna.

Pfizer and the “Durability of the Franchise”

On an investor call last month, the CEO of Pfizer, Frank D’Amelio, discussed what would happen to revenue from his vaccine product as the Covid pandemic ends, what he called the “durability of the franchise.” He told analysts not to worry. People in rich countries will need annual booster shots, and that is where Pfizer will make real money.

For these annual treatments, Pfizer will be able to charge much more than it does now. The current price for a covid vaccine, D’Amelio noted, is $19.50 per dose. He told analysts of his hope Pfizer could get to a more normal price, “$150, $175 per dose,” instead of what he called “pandemic pricing.”

The ghoulish part, however, is why there will need to be annual boosters. It’s not because the vaccine strength wanes over time, though that might happen. It’s because, as D’Amelio told Wall Street, there will be new variants emerging from abroad that can evade the vaccine. And how will variants emerge abroad? Well as outbreaks occur in non-vaccinated parts of the world, new strains will naturally occur as the virus mutates. If the rest of the world gets vaccinated, however, new variants won’t arise.

What D’Amelia really wants is to be able to charge $150 for a vaccine he is now charging $19.50 for. But D’Amelio is also assuming that there won’t be a global effective vaccination campaign. And, in a narrow sense, while Pfizer’s main goal is to keep prices high, it is actually against Pfizer’s financial interest to have the rest of the world vaccinated. If the world gets vaccinated, Pfizer won’t necessarily be able to sell expensive booster shots in rich countries who can afford them. Yikes.

The corporate world, sans Pfizer, has a very strong reason not to want a vaccine-resistant variant. A new variant of Covid could force the world back into lockdown, which is expensive. The International Chamber of Commerce, hardly a bastion of lefties, put out a study asserting that not sufficiently vaccinating poor countries will cost $9.2 trillion (with wealthy countries like the U.S. bearing half the cost). Covid isn’t good business for most firms, but it’s great for Pfizer and Moderna.

So what is the holdup for global vaccination? One argument is that there isn’t . . .

Continue reading. There’s much more.

Later in the column, he discusses why beef prices are rising as cattle prices are dropping. That begins:

Beef Is Expensive. So Why Are Cattle Ranchers Going Bankrupt?During the Covid pandemic, Americans went to the supermarket and found something that hadn’t happened for decades – a meat shortage. There was plenty of cattle, but the beef wasn’t getting to the supermarket shelves.

What happened and why?

To answer this question, I asked Bill Bullard, a former cattle rancher and the current CEO of R-CALF, a cattle producer-only membership organization focused on the viability of the U.S. cattle ranching industry. “We have so skeletonized the entire live cattle and beef supply chains that it is no longer capable of withstanding a shock,” he said, “whether it be the covid pandemic or a climatic circumstance.” This shortage was a wake-up call. “The industry is incapable of meeting our national food security needs.”

Bullard is an ardent anti-monopolist, a viewpoint developed through hard-won experience dealing with a consolidated meatpacking industry. He noticed problems with our cattle markets becoming more severe in 2014. That’s when beef prices and cattle prices started to diverge. . .

Read the whole thing.

Written by Leisureguy

9 May 2021 at 5:19 pm

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?  . . .

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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. . .

Continue reading.

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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 . .

Continue reading.

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. . .

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Written by Leisureguy

26 August 2019 at 3:05 pm

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