Heroin

Making Matters Worse: DEA's Move to Restrict Opioid Prescriptions Pushed Users to the Dark Web

Heroin (STDW) - Sat, 06/16/2018 - 19:29

By the end of 2013, the country's quiet opioid addiction crisis was no longer so quiet. Opioid overdose deaths that year topped 16,000, more than four times the same statistic for 1999. That prompted a number of measures at the state and federal level to rein in opioid prescriptions, including a move by the DEA in October 2014 to tighten its policies around some of the most commonly prescribed opioids.

[image:1 align:left caption:true]The new DEA policy -- aimed at popular opioids such as Vicodin and Lortab -- imposed restrictions on doctors' prescribing and made it more difficult for patients to get refills. In one sense, the policy was a success: Prescriptions for those drugs decreased almost immediately. But new research adds to an increasing body of evidence that restricting opioid prescribing has not solved the opioid crisis but instead worsened it.

Since the DEA policy shift, opioid overdose deaths continued to grow with more than 40,000 fatal opioid overdoses in 2016. And while prescription opioid overdose deaths have slightly decreased -- there were about 14,000 that year -- overdose deaths from heroin and non-prescription synthetic opioids such as fentanyl went through the roof. Heroin and illicit synthetics accounted for nearly two-thirds of all opioid overdose deaths in 2016.

In the new study, published this week in the British Medical Journal, researchers examining the impact of the DEA policy shift found evidence that while the change indeed lowered prescribing rates for the opioids in question, it was also linked to an increase in illicit online sales of those drugs in Dark Web drug markets.

The researchers used software called DATACRYPTO to crawl encrypted Dark Web marketplaces where people can anonymously buy damned near anything, from drugs to guns to credit card numbers. DATACRYPTO harvested data on which drugs were for sale, their country of origin, and the number of customer comments on each seller's comments page. Researchers used that last figure as a proxy for how much of a drug that seller sold. They examined sales of prescription opioids, sedatives, stimulants, and steroids, as well as heroin. It was only with prescription opioids that they found a significant Dark Web sales bump.

Here's what they found: "The sale of prescription opioids through US cryptomarkets increased after the schedule change, with no statistically significant changes in sales of prescription sedatives, prescription steroids, prescription stimulants, or illicit opioids."

According to their data, prescription opioids doubled their market share of U.S. Dark Web drug sales thanks to the DEA policy change. By July 2016, opioids represented 13.7% of all drug sales in U.S. cryptomarkets, compared with a modeled estimate of 6.7% of all sales.

While the researchers were careful to not make claims of causation -- only correlation -- their conclusion speaks for itself: "The scheduling change in hydrocodone combination products coincided with a statistically significant, sustained increase in illicit trading of opioids through online US cryptomarkets. These changes were not observed for other drug groups or in other countries. A subsequent move was observed towards the purchase of more potent forms of prescription opioids, particularly oxycodone and fentanyl."

Not only is the DEA policy change linked to increased Dark Web opioid sales, it is also linked to a move toward more powerful, and thus more dangerous, opioids. The researchers noted that while fentanyl was the least purchased Dark Web opioid in the summer of 2014, it was the second most frequently purchased by the summer of 2016. Fentanyl killed as many people as prescription opioids that year.

This study -- one of the few that examines supply reduction (as opposed to demand reduction) as a means reducing drug use -- strongly suggests that supply-side interventions carry unintended consequences, especially the resort to more dangerous and more powerful substitutes. The study's authors refer to this effect as "the iron law of prohibition, whereby interventions to reduce supply, such as increased enforcement and changes to drug scheduling, lead to illicit markets dominated by higher potency products."

Perhaps better than restricting opioid prescriptions, which has deleterious impacts on the tens of millions of Americans suffering chronic pain, or other supply-side interventions, would be increased access to addiction treatment, as well as greatly expanded harm reduction measures to try to get people off opioids and keep them alive in the meantime.

Categories: Heroin

Chronicle AM: St. Louis Ends Small MJ Prosecutions, House Passes Opioid Package, More... (6/13/18)

Heroin (STDW) - Wed, 06/13/2018 - 20:26

St. Louis prosecutors will no longer go after people with less than 100 grams of marijuana, a Delaware legislator amends her legalization bill to address concerns, the House passes an opioid package, the Canadian federal government rejects some Senate marijuana amendments, and more.

[image:1 align:left]Marijuana Policy

Delaware Legalization Bill Amended. State Rep. Helene Keeley (D-Wilmington) has filed an amendment to her legalization bill, House Bill 110, aimed at addressing concerns around regulations and public safety. The amendment would more tightly regulate legal marijuana production and distribution and prohibit products that look like candy or cartoon characters. The amendment also clarifies employer protections and sets aside 10% of tax revenues to pay for drugged driving enforcement. The bill has already passed committee votes and now awaits a House floor vote.

St. Louis Ends Marijuana Prosecutions for Less Than 100 Grams. St. Louis Circuit Attorney Kim Gardner announced Tuesday that her office will stop prosecuting marijuana possession cases involving less than 3 ½ ounces (100 grams) of the weed. "Effective immediately we will no longer issue possession of marijuana cases under 100 grams as the lead charge!" Gardner wrote. Gardner said her staff would also begin reviewing and dismissing pending pot cases.

Medical Marijuana

South Carolina Voters Approve Medical Marijuana Question On Democratic Ballot. Voters in the state's Democratic primary overwhelmingly approved a non-binding question asking if they supported passing a law to allow doctors to prescribe marijuana to patients. The question passed with 81% of the vote. While medical marijuana bills have moved in the legislature, none has yet passed.

Heroin and Prescription Opioids

House Passes Package of 25 Bills Addressing Opioid Crisis. The House on Tuesday approved a package of 25 bills that nibble at the edge of the nation's opioid-related public health crisis. The bills range from addressing the disposal of opioid medications after a patient's death to encouraging overdose awareness in hospital emergency rooms to raising awareness of synthetic opioids and more. For a complete list of the bills and what they do, click on the title link.

Harm Reduction

Delaware Law Giving First Responders Immunity from Lawsuits for Administering Opioid Overdose Reversal Drug Goes into Effect. Gov. John Carney (D) on Tuesday signed into law Senate Bill 147, which provides immunity from lawsuits for public safety personnel for trying to save lives by administering Naloxone. Paramedics and police had previously been granted immunity, and laypersons also have immunity under the state's Good Samaritan law. This bill specifies that volunteer firefighters and other emergency responders will also have immunity.

International

Canadian Federal Government Rejects Some Senate Marijuana Legalization Bill Amendments. The federal government has said it accepts some 26 technical proposed amendments to the C-45 legalization bill but rejects amendments to allow provinces to bar home cultivation and prohibit producers from handing out branded merchandise. "We have looked carefully at all of the amendments that have been brought forward and today we respectfully submit to the Senate the amendments that we've accepted, and the ones that we haven't," Health Minister Ginette Petitpas Taylor told reporters Wednesday. Now, it will be up to the Senate to accept the government's position. If not, the legislative haggling could continue for some time.

Categories: Heroin

CN ON: Looking North Of The Border To Limit Heroin Deaths

Heroin (MAP) - Thu, 05/24/2018 - 07:00
New York Times, 24 May 2018 - TORONTO - An aging construction worker arrived quietly in the building's basement, took his seat alongside three other men and struck his lighter below a cooker of synthetic heroin. A woman, trained to intervene in case of an overdose, placed a mask over her face as his drug cooked and diluted beneath a jumping flame. He injected himself, grew still and then told of the loss of his wife who died alone in her room upstairs - an overdose that came just a few months before this social service nonprofit opened its doors for supervised injections.
Categories: Heroin

Chronicle AM: 2019 Ohio Init Gears Up, Fed Treatment Bill Advances, More... (5/19/18)

Heroin (STDW) - Fri, 05/18/2018 - 20:26

Michigan legalization initiative foes urge the legislature to legalize it, an Ohio legalization initiative can begin signature gathering, a federal drug treatment bill exclusively targeting opioids advances, and more.

[image:1 align:right]Marijuana Policy

Michigan Legalization Initiative Foes Urge Legislature to Pass Legalization. In a surprise move, a campaign committee formed to oppose the pending marijuana legalization initiative is now asking the legislature to preemptively pass legalization. Keep Pot Out of Neighborhoods and Schools issued a press release Thursday calling on the legislature to approve the initiative. Under state law, the legislature can just pass the initiative, or, if it rejects it or fails to act, the initiative would go before voters in November. State Republicans worry that interest in the initiative will drive turnout at the polls, worsening their chances in the election.

Ohio Legalization Initiative Cleared for Signature Gathering. The state Ballot Board on Thursday cleared a legalization initiative, the Marijuana Rights and Regulation Act, for signature gathering. Campaigners need to come up with some 305,000 valid voter signatures to qualify for the initiative. The deadline to make the November ballot is in July, but campaigners say there are instead aiming at 2019.

Medical Marijuana

House Panel Approves Medical Marijuana Protections. The House Appropriations Committee on Thursday approved an amendment from Rep. David Joyce (R-OH) to continue to protect state-legal medical marijuana programs from federal interference. The amendment is now part of the House's Commerce, Justice and Science appropriations bill. The amendment, previously known as the Rohrabacher-Blumenauer amendment, bars the expenditure of federal funds to go after state-legal medical marijuana.

Illinois Legislature Approves Medical Marijuana in Schools. The Senate on Thursday approved a bill that would allow for the use of medical marijuana in elementary and middle schools. The bill has already passed the House and now goes to the desk of Gov. Bruce Rauner (R). The bill would let parents administer marijuana-infused products, but not smoked marijuana, to their child on school grounds.

Missouri Medical Marijuana Bill Dies. A medical marijuana bill, House Bill 1554, has died in conference committee, leaving the path open for at least one medical marijuana initiative to go before the voters in November. The bill came as an amendment to a healthcare bill and would only have allowed patients with terminal illnesses to use non-smokable marijuana.

Heroin and Prescription Opioids

House Panel Advances Bill to Expand Drug Treatment, But Only for Opioids. The House Committee on Energy and Commerce on Thursday advanced a bill that would free up Medicaid dollars for spending on treatment for opioid addictions, but some lawmakers warned that the country is facing a polydrug crisis. "I'm troubled that this bill would expand treatment only to people with opioid use disorder as opposed to those with other substance use disorders like alcohol, crack-cocaine, methamphetamine," said Rep. Jan Schakowsky (D-IL). "This bill is not only blind to the reality faced by people suffering from substance use disorder but it's also discriminatory." The measure is HR 5797.

Categories: Heroin
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