Treatment

Chronicle AM: South Africa Legalizes Pot Possession, Senate Passes Opioid Bill, More... (9/18/18)

Treatment (STDW) - Tue, 09/18/2018 - 20:34

South Africa just became the first country on the continent to legalize marijuana possession, New Jersey wants to be the next state to legalize marijuana, the Senate passes a limited opioid bill, and more.

[image:1 align:left caption:true]Marijuana Policy

Maryland Poll Has Strong Support for Marijuana Legalization. A new Goucher Poll has support for marijuana legalization at 62%. Only 33% were opposed. The poll also had majority support for a $15 an hour minimum wage, the Affordable Care Act, and single-payer health care, and 71% disapproving of President Trump. Expect the legislature to try again to pass legalization next year.

New Jersey Legalization Bill Almost Ready. A bill to tax and regulate legal marijuana commerce is "98% done," one of the state's leading marijuana advocates said Monday. Scott Rudder, head of the New Jersey CannaBusiness Association, said the remaining issue is whether to impose a 25% retail tax right away or to start with a lower tax rate that goes up over time. Gov. Phil Murphy (D) also expressed optimism about prospects for a bill. "I continue to believe it’s this year," Murphy said. "Doing it is important but doing it right is more important and that’s going to be key." Legislative leaders have vowed to get a bill to Murphy's desk by the end of the month, but the clock is ticking.

Medical Marijuana

Louisiana Lifts Limits on Number of Patients for Whom Each Doctor Can Recommend Medical Marijuana. The state Board of Medical Examiners on Monday got rid of a rule that limited the number of patients to whom doctors can recommend medical marijuana. The board also agreed to remove a restriction that would have required patients to see their doctor every 90 days in order to renew their order for medical cannabis.

Heroin and Prescription Opioids

Senate Passes Opioid Bill. The Senate on Monday approved legislation aimed at addressing the opioid crisis. The Opioid Crisis Response Act of 2018 (S.2680) The bill includes provisions increasing scrutiny of incoming international mail, eases the way for the National Institutes of Health to speed research on non-addictive pain relievers, allows the Food and Drug Administration to require pharmaceutical companies to package smaller quantities of opioids, and creates new federal grants for treatment, training emergency workers, and research on prevention. Funding for the anticipated spending will have to be provided in separate spending bills. The House passed its own opioid bill earlier this year. Now, congressional leaders will have to hammer out a compromise in conference committee.

Drug Policy Expert Says Senate Bill is Not Enough. While the opioid bill referenced above authorizes $500 million a year in grants states will have to compete over, the amount is well below the massive outlay of funds used to combat the AIDS crisis in the 1990s, and the Congressional Budget Office found that the bill would be revenue-neutral. That irked Stanford psychiatry professor and former Obama drug policy advisor Keith Humphreys. "How much money was Congress willing to spend on the worst opioid epidemic in US history? None," he said. "Given that there was no consensus in Congress in favor of a really big investment such as we employed for AIDS, the two sides did the next best thing, which was agree on many second-tier policies that were smaller bore," Humphreys said. "There are good things in the bill that will save lives, but it will not be transformational."

International

South Africa High Court Legalizes Marijuana Possession. In a case brought by three marijuana users who argued marijuana prohibition "intrudes unjustifiably into their private spheres," the country's Constitutional Court on Tuesday ruled that the private possession, cultivation, and consumption of marijuana is legal. >"It will not be a criminal offense for an adult person to use or be in possession of cannabis in private for his or her personal consumption," Deputy Chief Justice Raymond Zondo wrote in his ruling. It will, however, remain illegal to use cannabis in public and to sell and supply it. The ruling did not set allowable quantities, with the court saying parliament had two years to come up with a new law that reflected the ruling. Thousands of predominantly poor and black South Africans are arrested for marijuana offenses each year.

Categories: Treatment

Chronicle AM: No MedMJ for Vets This Year, Senate Takes Up Opioid Package, More.... (9/11/18)

Treatment (STDW) - Tue, 09/11/2018 - 20:14

A congressional conference committee has killed medical marijuana for veterans, the Senate is set to take up a package of opioid bills, the West African Commission on Drugs releases a model law for drug decriminalization, and more.

[image:1 align:left caption:true]Marijuana Policy

California Governor Vetoes Mandatory Minimum Penalties for Pot Shops That Sell to Minors. Gov. Jerry Brown (D) on Monday vetoed a bill that set mandatory minimum penalties for marijuana shops caught selling weed to minors. The bill would have imposed mandatory 15-day license suspensions for a first offense, 25-day suspensions for a second, and revocation for a third offense. But "this bill is not necessary," Brown said. "The bureau already has the authority to revoke, suspend, and assess fines if a licensee sells to a minor."

Medical Marijuana

Congress Removes Military Veteran Medical Marijuana Provision from Funding Bill. A conference committee working on final details for the Veterans Affairs appropriations bill has decided not to include a provision allowing VA doctors to recommend medical marijuana to veterans. The Senate bill included the provision, but the House version did not. Two years ago, both houses passed VA spending bills that included versions of the provision, but that, too, was excised in conference committee.

Heroin and Prescription Opioids

Senate Expected to Vote on Opioid Legislation This Week. Senate leaders announced late last week they had reached an agreement to bring a package of bills aimed at the opioid crisis to a Senate floor vote this week. The Senate will consider a substitute amendment to the opioids package that passed the House in June. Progress had stalled over Democratic concerns that a grant program would benefit only one addiction advocacy group. That has now changed. There remains a divergence between the House and Senate packages regarding requirements for Medicaid to cover treatment at more inpatient facilities and loosening privacy protections for medical records for substance abuse patients.

Sentencing Policy

Ohio Governor Candidates Clash Over Drug Possession Defelonization Initiative. Buckeye State voters will have a chance to vote to defelonize drug possession in November with the Issue 1 constitutional amendment initiative. The amendment would also bar any jail time for a first or second offense within 24 months. Mike DeWine, the Republican candidate for governor, opposes it, saying it "takes vital tools away from judges." Democratic candidate for governor Richard Cordray, however, supports it, saying its passage would "set the way toward a policy of being smart on crime in the future, smart on how we use taxpayers' dollars, smart on how we build people's potential to be productive citizens in our society."

International

Expert Group Publish Blueprint for West Africa Drug Decriminalization. The West Africa Commission on Drugs has published a "model law" for decriminalizing drug possession and reducing related harms in West Africa. The commission is currently chaired by former Nigerian President Olusegun Obasanjo, who said on Tuesday: "West Africa faces three dangers from drugs: organized crime, corruption, and harms to people who use drugs. Our current laws increase those harms rather than help,"

This article was prepared by StoptheDrugWar.org's 501(c)(4) lobbying nonprofit, the Drug Reform Coordination Network, which also pays the cost of maintaining this website. DRCNet Foundation takes no positions on candidates for public office, in compliance with section 501(c)(3) of the Internal Revenue Code, and does not pay for reporting that could be interpreted or misinterpreted as doing so.)

Categories: Treatment

Chronicle AM: NYC Overdose Action March, US Sentencing Commission Sets Priorities, More... (8/31/18)

Treatment (STDW) - Fri, 08/31/2018 - 20:43

The police chief in Oklahoma City wants pot busts downgraded, the US Sentencing Commission sets policy priorities for the next 18 months, marchers demand New York Gov. Andrew Cuomo take action on the state's overdose crisis, and more.

[image:1 align:right caption:true]Marijuana Policy

Oklahoma City Police Chief Wants to Quit Arresting Pot Possessors. Police Chief Bill Citty is calling for adjusting city ordinances so that police officers will not have to jail people caught with small amounts of marijuana. He is backing a move to reduce the penalty for possession from a $1,200 fine and up to six months in jail to just a $400 fine. "Right now, we're taking all possessions of marijuana, and it would be a Class B offense and it would actually, they would be arrested," said Citty. "We've been arresting every single one of them. This would stop that practice. By lowering it to $400, this allows us to basically take it out of that court of record trial and we're able to assign citations for the possession of marijuana. Now, that will be if they don't have a state permit or license that allows them to have it for medical use." The proposed ordinance will be up for discussion on September 11 and again on September 28.

Utah Governor Calls for Federal Rescheduling of Marijuana. As voters in the state prepare to give a thumbs up or thumbs down to a medical marijuana initiative in November, Gov. Gary Herbert (R) is calling on Congress to reschedule it. "I'd like to see the federal government get out of the way," he said on Thursday during his monthly news conference. "We ought to call upon our congressional delegation (to) take it off the Schedule I list. Let's do the studies, let's do the clinical trials. Are they not paying attention in Washington? Evidently not," he said.

Wisconsin Voters Will Have a Chance to Weigh in on Legalizing Marijuana. Voters in 16 counties and two cities will have a chance to vote on non-binding advisory referenda for or against legalizing marijuana for either medicinal or recreational purposes. The referenda are on local ballots scattered across the state, from Milwaukee and Dane to LaCrosse and Langlade counties, as well as the cities of Racine and Waukesha.

Harm Reduction

New York Activists March from City Morgue to Governor's Office to Call for Action on Overdose Crisis. Activists and family members who have lost loved ones to overdose marched through Manhattan on International Overdose Awareness Day to demand Gov. Cuomo (D) take action on the overdose crisis. Amid the seventh straight year of increased overdose deaths in NYC -- 2017 being the deadliest year on record -- the community brought pictures and stories of their loved ones to Governor Cuomo's Manhattan office and demanded he takes action with evidence-based public health interventions to end the crisis.

Sentencing

Sentencing Commission Finalizes 2018-2019 Priorities. In a notice printed in the Federal Register Thursday, the US Sentencing Commission laid out is policy priorities for the remainder of 2018 and into 2019. The priorities include reexamining sentencing guidelines in the wake of the Booker decision, implementing its 2016 recommendations on sentencing enhancements to focus on actual violent offenders, and continuing its efforts to implement reforms in mandatory minimum sentencing, among others.

Categories: Treatment

The Opioid Crisis Could Cost a Half Million Lives in the Next Decade

Treatment (STDW) - Wed, 08/29/2018 - 18:35

The most recent data from the Centers for Disease Control and Prevention, released in mid-August, showed a record 72,000 drug overdose deaths last year, with 49,000 related to heroin, fentanyl and prescription opioids. According to the authors of a study released last week in the American Journal of Public Health, that could be the new normal.

[image:1 align:right]The study, by Stanford researchers Allison Pitt, Keith Humphreys, and Margaret Brandeau, attempts to assess the number of opioid-related deaths we could expect to see over the next decade, as well as the impact of different policy responses on reducing the death toll.

The researchers said there are steps that can be taken to reduce the death toll, but also that some seemingly simple solutions, such as cracking down on opioid prescribing for chronic pain, could actually increase the toll. And even those policies that could cut the opioid death rate are likely to do so only marginally.

Using a mathematical model, the researchers estimate that some 510,000 people will die over the next decade because of opioid use. The number includes not only drug overdoses but also other opioid-related deaths, such as HIV infections caused by shared needles.

Even including the non-overdose deaths, the number is staggering. Last year was the worst year ever for opioid-related overdose deaths, but this research suggests we are going to see year after year of similar numbers.

Making the overdose reversal drug naloxone more widely available could cut opioid-related deaths by 21,200 over the next decade, allowing greater access to medication-assisted therapies with drugs such as buprenorphine and methadone would save another 12,500 lives, and reducing opioid prescribing for acute pain would prevent another 8,000 deaths, the researchers said. But those three policy moves combined would shave less than 10 percent off the overall death toll.

"No single policy is likely to substantially reduce deaths over 5 to 10 years," the researchers wrote.

While harm reduction interventions such as those above would save lives, some aspects of tightening opioid prescribing would actually increase opioid-related deaths by as much as the tens of thousands -- because they increase heroin deaths more than they cut painkiller deaths. Moves such as reducing prescribing for chronic pain, up-scheduling pain relievers to further restrict their prescribing, and prescription drug monitoring programs all tend to push existing prescription opioid users into the illicit heroin and fentanyl markers all end up contributing to net increases in opioid deaths over the 10-year period, the researchers found.

On the other hand, other interventions on the prescribing front, such as reducing acute prescribing for acute pain (pain that may be signficant but is short-term), reducing prescribing for transitional pain, reformulating drugs to make them less susceptible to misuse, and opioid disposal programs, appear to prevent more deaths than they cause.

Ultimately, reducing the opioid death toll includes reducing the size of the opioid-using population, the researchers say. That implies making addiction treatment more available for those currently using and preventing the initiation of a new generation of opioid users. Restrictions on prescribing, while possibly driving some current users to dangerous illicit markets, can have a long-term impact by reducing the number of people who develop a dependence on opioids.

Whether that's a tolerable tradeoff for those pain patients who don't get the relief they need from other medications -- or for patients and others who end up dying from street heroin but might have lived despite their prescription opioid use -- is a different question.

By all appearances, when it comes to the loss of life around opioids, it looks like a pretty sad decade ahead of us.

This article was produced by Drug Reporter, a project of the Independent Media Institute.

Categories: Treatment

Chronicle AM: NY Gov Signs Opioid Bill, VT Dems Want Full MJ Legalization, More... (8/27/18)

Treatment (STDW) - Mon, 08/27/2018 - 21:22

An Arizona prosecutor gets challenged for trying to profit off small-time pot offenders, Oregon regulators slash the daily purchase amounts for medical marijuana patients, a Louisiana prisoner featured in the Chronicle years ago gets a break, and more.

[image:1 align:left caption:true]Marijuana Policy

Arizona County Attorney Sued Over Drug Court Diversion Program for Smalltime Marijuana Offenders. The Civil Rights Corps, a Washington, DC-based advocacy group, and a local law firm have sued Maricopa County (Phoenix) Attorney Bill Montgomery. They allege that he and the county drug court diversion program are preying on and profiting off people charged with minor pot possession offenses. Under the state's harsh laws, possession of even small amounts is a felony, but first- and second-time offenders are eligible for a diversion program. The problem is the diversion program has a $1,000 fee, and those who cannot pay the entire fee linger in the program, paying $15 to $20 fees for drug testing as often as several times a week and face being tried as felons if they fail to complete the program. "The complaint explains that the marijuana diversion program operated by TASC Inc. and the Maricopa County Attorney's Office represents a two-tiered legal system," Civil Rights Corps Attorney Dami Animashaun said in a statement. "Wealthy people buy their way off diversion quickly, while poor people risk being expelled from the program and prosecuted for a felony solely because they cannot afford to pay."

Vermont Democrats Call for Taxed, Regulated Legal Marijuana Sales. Vermont has already legalized the personal possession and home cultivation of marijuana, and now the state's Democratic Party has formally endorsed expanding legalization to include taxed and regulated legal marijuana sales. "We believe that marijuana should be legal, taxed and regulated in the interests of consumer and public health, and economic opportunity," reads a platform plank adopted by delegates at the Vermont Democratic Party's platform convention on Sunday.

Medical Marijuana

Oregon Regulators Slash Daily Purchase Limit for Patients. In a bid to reduce leakage into the black market, the Oregon Liquor Control Commission last Thursday dramatically reduced the amount of medical marijuana patients can purchase each day. Medical cardholders may now buy only one ounce a day, not the 24 ounces that had been the limit. The emergency change is in effect until December 27.

Illinois Governor Signs Hemp Bill. Gov. Bruce Rauner (R) on Saturday signed a bill legalizing industrial hemp, the Illinois Hemp Act. "Legalizing the farming of industrial hemp just makes good sense," Rauner said in a statement. "Roughly 38 states -- including our neighbors in Wisconsin, Kentucky, Indiana, Missouri and Tennessee -- have allowed or are considering allowing cultivation of this crop for commercial, research or pilot programs. Our farmers should have this option as well." The state Department of Agriculture will issue licenses to farmers who want to grow it, and regulators will establish rules for THC-level testing of industrial hemp crops.

Heroin and Prescription Opioids

New York Governor Signs Legislation To Expand Use Of Rehabilitation And Diversion Services To Combat Heroin And Opioid Epidemic. Governor Andrew Cuomo (D) last Friday signed legislation (A.10403/S.8760) to help in the fight against the heroin and opioid epidemic by diverting substance-dependent individuals who are involved in the criminal justice system. This legislation provides another form of support to prosecutors and law enforcement officers as they seek treatment and counseling for people who are addicted to opioids. These diversion models include law enforcement assisted diversion, known as LEAD, and other programs treating substance abuse and addiction. The legislation expands the allowable use of funding from seized or forfeited assets by law enforcement and the Office of Alcoholism and Substance Abuse."We must use every tool at our disposal to combat this nation's opioid epidemic and the underlying issues that lead people to commit crime, and this legislation makes available additional funding to help New Yorkers in need," Governor Cuomo said. "By helping New Yorkers turn their lives around, this program helps strengthen communities, increase public safety and break the vicious cycle of recidivism once and for all."

Sentencing

One Louisiana Man Gets a Sentence Cut. A Louisiana man sentenced to life in prison for marijuana possession as a habitual offender has received a sentence reduction that will allow him to go free in a matter of weeks. Jody Butler's case was covered by the Chronicle's Clarence Walker back in 2013, but it took until now for justice to be done. New Orleans Parish District Attorney, who made a career of imposing long sentences on small-time drug offenders, raised no objection to a sentence reduction in Butler's case, the latest in which he has backpedaled away from his earlier, harsher stance.

Categories: Treatment

Psychedelics Are Showing Real Promise for Treating Mental Disorders

Treatment (STDW) - Wed, 08/15/2018 - 21:50

Research presented at the American Psychological Association's annual meeting in San Francisco last weekend is illuminating the rapid advance of psychedelic science. New findings are adding to a growing mountain of evidence that psychedelics could be effective at treating a range of psychological problems, including post-traumatic stress disorder (PTSD), depression, and social anxiety.

[image:1 align:left]The research could be laying the groundwork for legal prescribing of psychedelics including MMDA (ecstasy), ayahuasca, LSD, and psilocybin (magic mushrooms). But that's a way down the road: All of these drugs are currently illegal, classified as Schedule I under the Controlled Substances Act. (The two plants that combine to make ayahuasca are not illegal, but DMT, the mind-altering ingredient in ayahuasca, is.)

Researchers began studying psychedelics for their potential healing benefits after the discovery of LSD in 1943, but that research came to a screaming halt in the 1960s, when psychedelics were criminalized in the wake of their widespread adoption by the counterculture. Recent years, however, have seen an efflorescence of interest in the therapeutic benefits of the substances -- and it's starting to pay off.

"Combined with psychotherapy, some psychedelic drugs like MDMA, psilocybin, and ayahuasca may improve symptoms of anxiety, depression and post-traumatic stress disorder," said Cristina L. Magalhaes, Ph.D., of Alliant International University Los Angeles, and co-chair of a symposium on psychedelics and psychotherapy. "More research and discussion are needed to understand the possible benefits of these drugs, and psychologists can help navigate the clinical, ethical and cultural issues related to their use."

In one study, researchers questioned 159 participants about their spirituality, their relationship with their own emotion, and their use of hallucinogens. Laurentian University's Adele Lafrance, Ph.D., reported that psychedelic use correlated with higher levels of spirituality, which were associated with fewer symptoms of anxiety and depression and improved emotional stability.

"This study reinforces the need for the psychological field to consider a larger role for spirituality in the context of mainstream treatment because spiritual growth and a connection to something greater than the self can be fostered," said Lafrance.

An ayahuasca study found similar results. That study suggested the drug could help relieve addiction and depression, as well as helping people cope with trauma.

"We found that ayahuasca also fostered an increase in generosity, spiritual connection, and altruism," said Clancy Cavnar, Ph.D., with the NĂșcleo de Estudos Interdisciplinares sobre Psicoativos (Nucleus of Interdisciplinary Psychoactive Studies).

Another study, led by Alicia Danforth, Ph.D., of the Los Angeles Biomedical Research Institute at the Harbor-UCLA Medical Center, found that a combination of psychotherapy and MMDA could treat social anxiety in adults on the autism spectrum. In that study, 12 participants with moderate to severe social anxiety twice given doses of MMDA and treated with psychotherapy, and they showed significant, long-lasting reductions in anxiety.

"Social anxiety is prevalent in autistic adults and few treatment options have been shown to be effective," said Danforth. "The positive effects of using MDMA and therapy lasted months, or even years, for most of the research volunteers."

Yet another study examined the use of psilocybin in reducing stress and anxiety in people suffering from terminal cancer. In that study, 13 subjects were given psilocybin in conjunction with psychotherapy. Researchers found that the experience helped subjects grapple with their feelings about death and develop new understandings of dying.

"Participants made spiritual or religious interpretations of their experience and the psilocybin treatment helped facilitate a reconnection to life, greater mindfulness and presence and gave them more confidence when faced with cancer recurrence," said Gabby Agin-Liebes, a doctoral candidate in psychology at Palo Alto University, who conducted the research.

After a decades-long lacuna, psychedelic science is back. How long that will take to translate into psychedelics becoming legally available by prescription remains to be seen, but the groundwork is being laid right now.

Categories: Treatment

Saying Goodbye to Mr. Methadone: Dr. Bob Newman Dead at Age 80

Treatment (STDW) - Wed, 08/15/2018 - 21:29

Dr. Robert Newman died earlier this month after being struck by an automobile earlier this summer. He was 80 years old.

[image:1 align:left caption:true]If any one man can be credited with carving out a space for the use of methadone as a treatment for heroin addiction, he is that man. Working as a New York City public health doctor in the 1960s, he was given the task of ensuring that heroin addicts who wanted treatment could get treatment with methadone. His boss, city health department head Gordon Chase, told him he would be known as "Mr. Methadone."

While he did not achieve the goal of providing treatment to everyone who wanted it, Newman oversaw the rapid expansion of the city's fledgling methadone program in the early 1970s. The number of patients on methadone went from a handful to more than 10,000 in two years, and 35,000 by 1975.

And he stood up for those patients. When the NYPD wanted Newman to turn over patients' methadone records, he refused. Instead, he took to the courts to defend his patients' right to privacy -- and he won.

After that, he devoted his career to advocating for evidence-based treatment, traveling the country and the world and picking up a second moniker, "the methadone pope," as he advanced harm reduction ideas decades before they became popularized.

He faced opposition from abstinence and 12-step proponents, as well as from elected officials like New York City Mayor Rudy Giuliani, who in 1998 tried to shut down the city's methadone program on the moralistic grounds that it merely substituted one addiction for another. The diplomatic Newman didn't challenge Giuliani head on but instead used interviews to make his case that methadone treatment allowed addicts to lead productive lives.

Newman also advocated for a humane approach toward addicted mothers and pregnant women, supporting groups such as National Advocates for Pregnant Women in their fight against the demonization and criminalization of those women. He was a drug policy reformer who served for decades on the board of the Drug Policy Foundation and then its successor the Drug Policy Alliance.

As this century's opioid epidemic deepened, Newman was cautiously optimistic that the work he had begun decades earlier would help further destigmatize addiction. "I'm hoping that pragmatism will win out," he said. "As more and more Congresspeople, people in the general community and physicians have children who develop a problem with prescription drug use and can't get treatment for it, I think it will make people more receptive to opening doors to treatment."

Newman was not only an influential physician in addiction issues, he was a giant in the hospital world as a whole. He served as President of Beth Israel Medical Center in New York, and then of the entity that acquired Beth Israel along with other facilities -- and then of the entity that acquired that entity. But one could still talk him at a drug policy conference, or send him an email, and you'd get an email back.

Dr. Robert Newman's contribution to an enlightened approach to addiction cannot be overstated. He will be missed, but his legacy lives on.

(Read Bob Newman's 1998 interview with this newsletter here.)

Categories: Treatment

Chronicle AM: PA Gov Says State Not Ready for Legal Pot, New FDA Guidelines on MATS, More... (8/9/18)

Treatment (STDW) - Thu, 08/09/2018 - 19:37

The FDA has issued new draft guidance aimed at expanding the use of medication-assisted treatments (MATs) for opioid addiction, Pennsylvania's governor says the state isn't ready for legal weed, the Oklahoma medical marijuana fight isn't over yet, and more.

[image:1 align:left caption:true]Marijuana Policy

Pennsylvania Governor Says State Not Ready for Marijuana Legalization. Gov. Tom Wolf (D) said during a radio interview on Tuesday that he doesn't think the state is ready to legalize marijuana. "There are, what, six states that have legalized recreational marijuana in the United States," Wolf said. (The actual number is nine.). "I don't think the citizens of Pennsylvania are ready for it, and so the answer I would say is no… I don't think Pennsylvania's actually ready for recreational marijuana." The position puts Wolf at odds with two neighboring Democratic governors, Phil Murphy of New Jersey, who is strongly pushing legalization, and Andrew Cuomo of New York, who just signed off on the notion.

Los Angeles Won't Vote on Raising Pot Tax in November. The city council has reversed a decision to place a 1% marijuana tax increase on the November ballot. The city estimated it would raise approximately $30 million per year from the tax increase, but faced immediate blowback from industry groups who said pot taxes were already too high and are driving consumers to the black market.

Medical Marijuana

Oklahoma Agencies Still Have "Concerns" Over Legal Medical Marijuana. Interim health commissioner Tom Bates told lawmakers Wednesday that the Health Board still has concerns about how medical marijuana will be implemented and that a special session of the legislature may be needed to see the program properly implemented. The board wants lawmakers to amend the law so that, among other changes, commercial grows are indoor only, patient home grows are prohibited or require a special license, smokable marijuana is prohibited, THC levels are limited to 12% or less, a pharmacist is required on-site at dispensaries, and that a list of qualifying conditions for patients be created. Some of the changes are among those recommended in the Health Board's first try at setting interim rules, which were retracted in the face of loud public opposition. Any effort to re-adopt them is certain to lead to renewed clamor.

Heroin and Prescription Opioids

FDA Seeks to Expand Use of Medication-Assisted Therapies for Addiction. The Food & Drug Administration (FDA) on Monday released new draft guidance aimed at promoting the creation and more widespread use of medication-assisted therapies (MATs) for opioid use disorder. The guidance adjusts how FDA evaluates new treatments for opioid addiction. Instead of only determining whether a treatment lowers opioid use, the agency will now assess whether the medication could help lower overdose rates and limit the spread of infectious disease. "We must consider new ways to gauge success beyond simply whether a patient in recovery has stopped using opioids, such as reducing relapse overdoses and infectious disease transmission," said Scott Gottlieb, FDA commissioner.

Categories: Treatment

Does Microdosing Psychedelics Really Improve Your Life?

Treatment (STDW) - Mon, 08/06/2018 - 21:12

Microdosing psychedelics has been a thing for awhile now. It is the practice of ingesting drugs such as LSD or psilocybin (the stuff that puts the magic in magic mushrooms) in amounts too small to create a psychedelic experience in a bid to improve focus and creativity, boost mood, or quell anxiety.

[image:1 align:left caption:true]Microdosing has developed a laudatory literature -- see Ayelet Waldman's 2017 A Really Good Day: How Microdosing Made a Mega Difference in My Mood, My Marriage, and My Life and Michael Pollan's 2018 How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence -- but next to no serious scientific study.

Until now. In findings first presented at the June Beyond Psychedelics conference in Prague (and to be published as three separate research papers later this year), University of Toronto researchers offered fascinating insights into the how, why, and results of using small amounts of psychedelics for therapeutic effects.

In a research announcement, cognitive neuroscientist and study coauthor Thomas Anderson said his interest in the topic was sparked when reviewed the scientific literature and found plenty of anecdotal reports but a lack of scientific research on the practice.

"There's currently a renaissance going on in psychedelic research with pilot trials and promising studies of full-dose MDMA (ecstasy) use for post-traumatic stress disorder and of psilocybin use within healthy populations or to treat depression and end-of-life anxiety," said Anderson. "There hasn't been the same research focus on microdosing. We didn't have answers to the most basic epidemiological questions -- who is doing this and what are they doing?"

Anderson and a team of researchers decided to do something no one had done before: ask the users themselves about their experiences. The researchers identified microdosing communities on Reddit and other social media forums and sent them an anonymous online survey asking about the quantity and frequency of their psychedelic use, reasons for microdosing, effect on mood, focus and creativity, and the benefits and drawbacks of the practice. The survey generated 1.390 initial responses, with 909 respondents answering all questions. Two-thirds of the respondents were either current or past microdosers.

"We wanted to ensure the results produced a good basis for future psychedelic science," Anderson said.

What they found was that microdosers reported positive effects, including improved focus and productivity, better connection with others, and reductions in migraines. Quantitatively, microdosers scored lower than non-microdosers on scales measuring negative emotionality and dysfunctional attitude.

Microdosers did report some drawbacks to the practice, but those were related more to the illegal status of psychedelics than to the practice itself.

"The most prevalently reported drawback was not an outcome of microdosing, but instead dealt with illegality, stigma and substance unreliability," says Anderson. "Users engage in black market criminalized activities to obtain psychedelics. If you're buying what your dealer says is LSD, it could very well be something else."

The survey did help clarify the frequency of microdosing -- most respondents reported using every three days, while a smaller group did it once a week -- and just what constituted a microdose.

"Typical doses aren't well established," said Anderson. "We think it's about 10 mcg or one-tenth of an LSD tab, or 0.2 grams of dried mushrooms. Those amounts are close to what participants reported in our data."

But accurate dosing was another problem area: "With microdoses, there should be no 'trip' and no hallucinations. The idea is to enhance something about one's daily activities, but it can be very difficult to divide a ½-cm square of LSD blotting paper into 10 equal doses. The LSD might not be evenly distributed on the square and a microdoser could accidentally 'trip' by taking too much or not taking enough," Anderson said.

"The goal of the study was to create a foundation that could support future work in this area, so I'm really excited about what these results can offer future research," he explained. "The benefits and drawbacks data will help ensure we can ask meaningful questions about what participants are reporting. Our future research will involve running lab-based, randomized-control trials where psychedelics are administered in controlled environments. This will help us to better characterize the therapeutic and cognitive-enhancing effects of psychedelics in very small doses."

Eventually, the science will catch up to the practice. In the meantime, microdosers are going to microdose. Anderson has a scholarly caution for them: "We wouldn't suggest that people microdose, but if they are going to, they should use Erlich reagent (a drug testing solution) to ensure they are not getting something other than LSD."

This article was produced by Drug Reporter, a project of the Independent Media Institute.

Categories: Treatment

US PA: A 'Game-Changer' For Pa. Medical Marijuana Flower Goes On Sale

Treatment (MAP) - Fri, 07/27/2018 - 07:00
Philadelphia Daily News, 27 Jul 2018 - NEXT WEEK Medical marijuana dispensaries in Pennsylvania are bracing for a surge in new customers when vaporizable "flower" -- the most popular and recognizable form of cannabis -- goes on sale on Wednesday, Aug. 1.
Categories: Treatment

US Editorial: Only Congress Can Keep Jeff Sessions' Reefer Madness In

Treatment (MAP) - Fri, 07/27/2018 - 07:00
Baltimore Sun, 27 Jul 2018 - Atty. Gen. Jeff Sessions' decision to withdraw an Obama-era directive discouraging the enforcement of federal marijuana laws in states that have legalized pot shouldn't surprise anyone familiar with Sessions' views on drug laws. The attorney general has every right to enforce federal drug laws as vigorously as he sees fit. But just because he can doesn't mean he should. The truth is that resuming the discredited war on marijuana would be neither a smart step nor welcome policy, and just the threat of it is a reminder of the shortsightedness of the federal government's approach to drugs.
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US: Editorial: Repeal Prohibition, Again

Treatment (MAP) - Fri, 07/27/2018 - 07:00
New York Times, 27 Jul 2018 - The federal government should follow the growing movement in the states and repeal the ban on marijuana for both medical and recreational use. It took 13 years for the United States to come to its senses and end Prohibition, 13 years in which people kept drinking, otherwise law-abiding citizens became criminals and crime syndicates arose and flourished. It has been more than 40 years since Congress passed the current ban on marijuana, inflictingA great harm on society just to prohibit a substance far less dangerous than alcohol.
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US: Public Faith In Marijuana Outpaces Medical Research, Study Finds

Treatment (MAP) - Wed, 07/25/2018 - 07:00
Philadelphia Daily News, 25 Jul 2018 - Despite limited evidence, Americans have an increasingly positive view of the health benefits of marijuana. Nearly two-thirds believe pot can reduce pain, while close to half say it improves symptoms of anxiety, depression, epilepsy, and multiple sclerosis, according to a new online survey of 9,003 adults. Pennsylvania and New Jersey are among the 30 states, along with the District of Columbia, Guam, and Puerto Rico, that have legalized medical marijuana. But scientists say hard data on the health effects of pot -- both positive and negative -- are largely missing. Because marijuana is considered an illicit drug by the federal government, research has been scant, though there are efforts underway in Pennsylvania and nationally to remedy that.
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US NJ: Editorial: Like Jersey City, Murphy's AG Takes The High Ground

Treatment (MAP) - Wed, 07/25/2018 - 07:00
Bridgeton News, 25 Jul 2018 - Jersey City's mayor is planting himself at the forefront of a national movement to stop destroying people's lives for having a little marijuana. Steven Fulop is firmly on the right side of this issue, and Gov. Phil Murphy's attorney general, Gurbir Grewal, is not fighting him on it -- once again demonstrating that he is not just concerned with law and order, but justice.
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US NJ: Report: New Jersey Puts Temporary Hold On Marijuana Cases

Treatment (MAP) - Tue, 07/24/2018 - 07:00
Morning Call, 24 Jul 2018 - New Jersey's attorney general has announced an immediate adjournment of all marijuana cases in municipal courts statewide until at least September. The decision was included in a letter state Attorney General Gurbir Grewal sent Tuesday to municipal prosecutors in the state. It asked them to seek an adjournment until September 4 -- or later -- of any matter "involving a marijuana-related offense pending in municipal court," a move that will allow the attorney general's office time to develop "appropriate guidance" for prosecutors.
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US PA: Pa. report: Legalizing Marijuana Could Generate $580 Million

Treatment (MAP) - Thu, 07/19/2018 - 07:00
Philadelphia Daily News, 19 Jul 2018 - STATE TAX REVENUES Legalizing marijuana for adult recreational use in Pennsylvania could generate more than $580 million in tax revenue for the state, said Auditor General Eugene DePasquale in a report issued Thursday morning.
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US: Marijuana Bills Increasingly Focus On Social Justice

Treatment (MAP) - Thu, 07/19/2018 - 07:00
Philadelphia Daily News, 19 Jul 2018 - State lawmakers and advocates pushing to legalize marijuana this year aren't just touting legalization as a way to raise tax revenue and regulate an underground pot market. They're also talking about fixing a broken criminal justice system and reinvesting in poor and minority communities that have been battered by decades of the government's war on drugs. The focus on justice and equity has sharpened over time, longtime pot advocates say, as it's become clear that such issues should be addressed and that doing so won't alienate voters -- most of whom, polls consistently show, support legal marijuana. Civil rights groups also have raised their voices in legalization discussions.
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US: Oped: The CDC Director's Deeply Personal Reason For Fighting

Treatment (MAP) - Wed, 07/18/2018 - 07:00
Baltimore Sun, 18 Jul 2018 - HIS SON NEARLY DIED OF AN OVERDOSE One of the nation's top public-health officials has explained why the fight against the opioid epidemic is so personal to him. At a conference in New Orleans, Centers for Disease Control and Prevention Director Robert Redfield Jr. opened up about his family's experience with opioids, saying that one of his adult children nearly died of an overdose of cocaine mixed with fentanyl, a potent synthetic opioid that is 30 to 50 times stronger than heroin, according to the Associated Press.
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