Lone Candle
Champion of Truth
“Bianca Clayborne and Deonte Williams were driving through rural Tennessee with their five young children when they were pulled over. When police found 5 grams of marijuana in the car, Williams was arrested and the five children were seized by local child protective services. One month later, the couple is still fighting to regain custody of their children.”
“Despite the Chinese Communist Party’s strict stance on drugs, the triads — which run global crime networks distributing chemicals needed to manufacture methamphetamine and fentanyl, among other potentially dangerous substances — often curry favor with the CCP by functioning as extralegal enforcers for the government, Felbab-Brown said. The CCP in turn often allows them to continue their operations, though it does not control them.”
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“Roughly 75 percent of the $100 billion cannabis market in the U.S. remains illegal, and roughly two thirds of that illicit weed is grown domestically”
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“In California, the Department of Cannabis Control says Chinese triads have been nominally involved in illegal cannabis production for decades, but that there’s been a recent increase in the number of actors and money that may have originated in China. The DCC also said that some — but not all — of the Chinese-funded grows they’ve encountered are operated by Chinese triads.”
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““This notion that you now have Chinese actual funding for illicit cannabis, it’s definitely new, and it cuts directly across the interests of Mexican drug trafficking groups,” said Felbab-Brown. “It’s interesting to see whether it continues growing, [and] how that’s going to affect relations between the Mexicans and the Chinese [criminal groups].””
“During the early stages of the COVID pandemic, the Drug Enforcement Administration (DEA) temporarily lifted restrictions on doctors’ ability to write prescriptions for controlled drugs via telehealth. However, the agency is poised to bring telehealth under regulation again, bringing back strict limits on how and when doctors can prescribe certain drugs.
DEA officials announced the proposed regulations on Friday. The rules would render most controlled drugs ineligible for prescription via telemedicine appointment—severely restricting patients’ ability to obtain drugs without an in-person examination.”
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“However, the proposal contains several carve-outs. Under the policy, Schedule III-V controlled medications can still be prescribed via telemedicine. But patients would be limited to a 30-day supply, after which the patient would be required to have an in-person visit in order to get a refill. The same exception applies to buprenorphine, a drug used to treat opioid substance abuse. Further, under the proposed rule, patients can get indefinite prescriptions for controlled substances via telehealth but only if they are referred to a telehealth physician after receiving an in-person examination by another doctor.”
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“Officials justified the regulations by citing concerns over the risk of overprescription of controlled drugs. While administration officials did mention the benefits that telehealth services bring to rural Americans, there is little consideration of how these services are equally important to many who rely on controlled drugs—and the increased risk that desperate patients will turn to significantly more dangerous drugs to alleviate their symptoms.
“As a health policy lawyer w. chronic pain & ADHD, I cannot overstate how unnecessary & cruel this policy is given what visits look like in person v. Telehealth,” wrote health policy lawyer Madeline T. Morcelle on Twitter. “Or how deadly this could be for those who struggle to get to [appointments] due to disability or transport/geographic barriers.””
“There are few better emblems of the failures of the US system of medical care than its inability to consistently provide insulin to Americans who need it.
The drug was discovered 100 years ago, and it provides essential and ongoing treatment for millions of people living with diabetes, one of the most common chronic diseases in the country. And yet one in six Americans with diabetes who use insulin say they ration their supply because of the cost. Some people end up spending nearly half of their disposable income on a medicine they must take to stay alive.
Though insulin generally costs less than $10 per dose to produce, some versions of the drug have a list price above $200. This is in part because, in the US, a warped market has allowed three companies to dominate the insulin business.”
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“With California leading the way, a handful of states are considering trying to disrupt the market for essential medications, starting with insulin. The plan would be to manufacture and sell insulin themselves for a price that is roughly equivalent to the cost of production.”
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“Medicare, the federal health insurance program for seniors, is about to institute a $35 per month cap on insulin costs for its beneficiaries, a provision of the Inflation Reduction Act that Democrats passed last year. But, because of the Senate’s arcane rules, they could not establish the same cap for private insurance, which covers more than half of Americans.”
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“The main mechanism the US has for bringing down prescription drug prices is allowing generic drugs to compete with brand-name versions. When a company develops a new drug, it gets a period of exclusivity, 10 years or more, in which it is the only one able to make or sell that drug. But after that exclusivity period has passed, other companies can make a carbon copy and sell it at a lower price. Studies find that once several generic competitors come on the market, prices drop significantly.
But pharma companies are savvy about finding ways to extend their monopolies, with insulin and other drugs, by making minor tweaks to the chemical compound and asking for a patent extension. In the case of insulin, the companies can also modify the delivery device to protect their market share. Each product is meant to be used with specific, company-designed injectors. Though the patents on the artificial insulin developed in the 1990s have started expiring, these companies continue to hold and extend monopolies on either their devices or other chemical compounds, making it harder for generic competitors to enter the market.
Other federal regulations have added to the challenge. The FDA began to treat insulin as a biologic drug in 2020 — meaning it is made with living materials instead of combining chemicals like conventional pharmaceuticals — which comes with a different set of standards for generic versions, which are known as biosimilars, as well as manufacturing challenges given the precise conditions these products must be made in. Biosimilars can cost up to $250 million to produce and take up to eight years to bring to the market, versus a one-year investment of as little as $1 million for conventional generics. And unless the FDA recognizes a new generic insulin as interchangeable with the products already on the market, health insurers might not want to cover it and doctors may not be willing to prescribe it.
To add one more layer of difficulty, the current manufacturers can always decide to drop their prices to crowd out new generic competitors, given the gap between the retail price and the $10 cost of production. The first biosimilar drugs have come onto the market in the past few years, but only one of them has been deemed interchangeable with the brand-name version; ultimately, in late 2021, it was priced at only $20 less than the brand-name insulin it was competing with. More competition is needed to meaningfully depress prices.”
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“If manufacturing a cheap generic insulin proves viable for California, the consequences could be enormous and stretch far beyond insulin. California would provide proof of concept, and a fledging public marketplace for public pharmaceutical production could potentially emerge.”
“Colorado set a new precedent for drug policy reform in November, when its voters approved a ballot initiative that decriminalizes a wide range of conduct related to consuming five natural psychedelics.
Proposition 122 also authorizes state-licensed “healing centers” where adults 21 or older can obtain and use psychedelics. It represents the broadest loosening of legal restrictions on psychedelics the United States has ever seen.”
“Previously, all drugs in development were required to undergo animal studies before being tested in human trials. Now, drug companies will still have the option to start testing experimental drugs on animals, but they won’t have to.
This doesn’t mean that drug companies will start going straight to testing drug toxicity on humans, but that they may rely on alternative methods to animal testing. Language in the Federal Food, Drug, and Cosmetic Act now states that tests may “include animal tests, or non-animal or human biology-based tests methods, such as cell-based assays, micro physiological systems, or bioprinted or computer models.”
These days, “there are a slew of other methods that drugmakers employ to assess new medications and treatments, such as computer modeling and ‘organs on a chip,’ thumb-sized microchips that can mimic how organs’ function are affected by pharmaceuticals,” notes NPR.”
“Humphreys thinks the root of “San Francisco’s drug crisis” is “a libertarian, individualistic culture” that since the 19th century has attracted people who yearn “to be free of traditional constraints back East, to reinvent themselves, to escape the small-mindedness of small towns and to find themselves.” While that culture “underlies the city’s entrepreneurialism, artistic energy and tolerance for diversity in all forms,” he says, it “has a downside when it comes to addiction, which thrives in such a cultural milieu.” San Francisco “has long been one of the booziest cities in the country,” he writes, and “heavy use of substances has always been part of how San Francisco defines freedom and the good life.”
Conflating “heavy use of substances” with libertarianism is more than a little strange. Libertarianism focuses on the proper role of government; it does not tell people how they should conduct their private lives, except insofar as their actions impinge on the rights of others.”
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“The actual cause of ever-escalating drug deaths, he avers, is “the libertarian assumption that given freedom and tolerance, everyone will rationally and productively pursue their self-interest,” which “cannot explain why a starving person would, for example, forgo food in exchange for fentanyl or cocaine.”
The assumption that Humphreys describes as “libertarian” is plainly at odds with reality. But libertarianism does not assume that people never make mistakes, never develop bad habits, or never engage in behavior they ultimately regret. It simply argues, for moral and pragmatic reasons, that the possibility of error is not enough to justify using force, which should be reserved for conduct that violates other people’s rights.
Humphreys suggests that decisions regarding psychoactive drugs are a special case because those substances negate the ability to choose. As I explain in Saying Yes, this belief is a tenet of voodoo pharmacology, which posits that drugs take control of people and compel them to act against their own interests.
Survey data, which show that people can and generally do use both legal and illegal drugs without developing life-disrupting habits, contradict that theory. Observational and laboratory research confirms that the way people react to drugs is not pharmacologically determined but highly contingent on the circumstances and incentives they face, as psychologists such as Stanton Peele, Bruce Alexander, and Carl Hart have been pointing out for many years.”
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“”Portugal is in no way a libertarian country,” Humphreys writes. “Rather, it’s a cohesive, communal society in which drug use is culturally frowned upon rather than celebrated as a sign of freedom. When drug-addicted people commit crimes in Portugal, they are sent to a ‘dissuasion committee’ that can apply penalties to those who refuse to seek and stay in addiction treatment. Informally, this is backed up by pressure from family and community for addicted individuals to enter recovery.”
Humphreys is right that Portugal’s approach is not libertarian. While “dissuading” drug users is preferable to arresting, prosecuting, and incarcerating them, it shows little respect for individual autonomy. Humphreys is comfortable with that because he thinks individual autonomy is meaningless in the context of drug use. Hence he thinks San Francisco should “use court authority to mandate addiction treatment more broadly than it currently does.””
“Life expectancy in the United States dropped last year to its lowest since 1996, extending a downward trend that began in 2020, according to new data from the Centers for Disease Control and Prevention.
The latest figures from the CDC, which leave expected U.S. lifespans well below those in other large, wealthy nations, reflect the federal and local governments’ ongoing struggle to meet the demands of concurrent public health crises.
The Covid-19 pandemic has had “a domino effect,” said Nora Volkow, director of the National Institute on Drug Abuse, by “exacerbating the already very severe problem that we have in overdose deaths.”
The two crises, the Covid-19 pandemic and rising drug addiction and overdoses, are “a wake-up call” for government, added Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “It clearly is what’s cutting into the health of our communities, unlike almost anything we’ve seen before.””
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“The ongoing politicization of the U.S. Covid response has negatively impacted many Americans’ decisions about vaccination and other mitigation measures. Roughly 14 percent of Americans and 36 percent of people 65 and over have received the latest booster, according to the CDC.
At the same time, Volkow believes the pandemic drove social changes that made people more vulnerable to taking drugs as a way of escaping. The pandemic also made it harder to get help. “Resources that were able to support people in the past were no longer available,” she said.”
“The initiative that legalized magic mushroom businesses allows cities and counties to ban them via ballot initiative. Local governments also retain the power to craft “time, place, and manner” regulations over psilocybin businesses.
This past election, 25 of Oregon’s 36 counties voted to ban psilocybin businesses, including four that voted to legalize psilocybin in 2020. Only two counties that put the questions to voters, Deschutes and Jackson counties, kept these businesses legal.
And this week, those two counties will consider new land use regulations that could severely restrict where newly legal “psilocybin service centers” can set up shop.”
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“When marijuana was legalized in Oregon, it went through a similar journey. Voters approved a relatively liberal legalization ballot initiative. The legislature followed this up with more constricting regulations. Then a long list of local governments opted not to allow marijuana businesses. Those that did often imposed zoning regulations that made a lot of prime real estate off-limits to the new industry.
Given that history, it’s perhaps unsurprising that local governments would want to tightly regulate legalized psychedelics facilities—given how novel and new they are.
Subjecting new industries to heavy regulation is nevertheless a great way to strangle them in the crib. A business as weird as legalized shrooms requires a lot of experimentation. And we shouldn’t trust county commissions to design the perfect trip.”