Tag: drugs
Several Justices Seem Dismayed at the Idea That Doctors Can Be Accidentally Guilty of Drug Trafficking
Equasy – An overlooked addiction with implications for the current debate on drug harms
“So what was her addiction – what is equasy? It is an addiction that produces the release of adrenaline and endorphins and
which is used by many millions of people in the UK including
children and young people. The harmful consequences are well
established – about 10 people a year die of it and many more
suffer permanent neurological damage as had my patient. It has
been estimated that there is a serious adverse event every 350
exposures and these are unpredictable, though more likely in
experienced users who take more risks with equasy. It is also
associated with over 100 road traffic accidents per year – often
with deaths. Equasy leads to gatherings of users that often are
associated with these groups engaging in violent conduct.
Dependence, as defined by the need to continue to use, has
been accepted by the courts in divorce settlements. Based on
these harms, it seems likely that the ACMD would recommend
control under the MDAct perhaps as a class A drug given it
appears more harmful than ecstasy (See Table 1).
Have you worked out what equasy is yet? It stands for
Equine Addiction Syndrome, a condition characterised by gaining pleasure from horses and being prepared to countenance the
consequences especially the harms from falling off/under the
horse. I suspect most people will be surprised that riding is
such a dangerous activity. The data are quite startling – people
die and are permanently damaged from falling – with neck and
spine fracture leading to permanent spinal injury (Silver and
Parry, 1991; Silver 2002). Head injury is four times more com-
mon though often less obvious and is the usual cause of death.
In the USA, approximately 11,500 cases of traumatic head
injury a year are due to riding (Thomas, et al., 2006), and we
can presume a proportionate number in the UK. Personality
change, reduced motor function and even early onset
Parkinson’s disease are well recognised especially in rural clinical practices where horse riding is very common. In some shire counties, it has been estimated that riding causes more head
injury than road traffic accidents. Violence is historically inti-mately associated with equasy – especially those who gather
together in hunting groups; initially, this was interspecies aggression but latterly has become specific person to person violence
between the pro and anti-hunt lobby groups.”
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“So why are harmful sporting activities allowed, whereas relatively less harmful drugs are not? I believe this reflects a societal
approach which does not adequately balance the relative risks of
drugs against their harms. It is also a failure to understand the
motivations of, particularly younger people, who take drugs and
their assessment of the perceived risks compared with other
activities. The general public, especially the younger generation,
are disillusioned with the lack of balanced political debate about
drugs. This lack of rational debate can undermine the trust in
government in relation to drug misuse and thereby undermining
the government’s message in public information campaigns.”
The war on drugs puts a target on China
“The bulk of the illegal synthetic opioids that reach the U.S. are sourced in China by Mexico’s Sinaloa and Jalisco New Generation cartels. They buy from legitimate and illicit Chinese suppliers through “purchases made on the open market, smuggling chemicals hidden in legitimate commercial shipments,” the 2020 DEA National Drug Threat Assessment noted.
Successful bilateral cooperation in combating the fentanyl flow peaked in May 2019 when Xi responded to U.S. pressure by making all forms of fentanyl subject to production controls and anti-trafficking measures. That prompted a drastic reduction in direct shipments of fentanyl and related compounds from China.
But Mexican cartels and their Chinese suppliers quickly pivoted to the export and processing of unregulated chemicals that can be processed into synthetic opioids. The Chinese government moved to block that trade in June by adding six fentanyl precursor chemicals to the list of substances requiring government approval. Chinese suppliers responded by marketing the unregulated raw materials for precursors.
“Drug trafficking organizations adapted to the PRC’s [regulatory controls] of all fentanyl-related substances, and now appear to have increased the purchase of fentanyl precursors from the PRC to manufacture fentanyl in Mexico, indicating a pronounced shift in how fentanyl is trafficked into the United States,” a State Department spokesperson told POLITICO.
The response from Chinese chemical producers and exporters underscores the challenges of regulatory fixes that don’t keep up with the ability of the industry to skirt those laws.
“[Chinese suppliers] are acting like water, they’re just finding the gaps and cracks in the law,” said Bryce Pardo, drug policy researcher at RAND Corp. “They have gone on to [synthetic opioid component chemicals] that are used in all sorts of other medications and other commercial applications that can never be controlled because it would be way too burdensome for industry and genuine consumption purposes to control these other kinds of chemicals.”
On the Hill, China’s role as a drug chemical supplier for illicit synthetic opioids has become a political lightning rod, particularly for lawmakers from states such as Ohio that are suffering soaring increases in synthetic opioid-related overdose deaths.”
Feds Pledge $30 Million To Fund Drug Harm Reduction Programs
“The money for the program was included in the American Rescue Plan—passed back in March—a massive $1.9 trillion spending bill that was sold as a COVID-19 response but contained very little that had to do with the epidemic. The bill set aside $4 billion for use for drug addiction programs and mental health treatment.”
South Dakota’s Governor Succeeds in Blocking Voter-Approved Marijuana Legalization
“South Dakota voters made history last November by simultaneously approving ballot initiatives aimed at legalizing recreational and medical use of marijuana. The success of the broader initiative, Amendment A, was especially striking because it prevailed by an eight-point margin in a state that is mostly Republican and largely conservative. But thanks to a legal challenge backed by Republican Gov. Kristi Noem, Amendment A was almost immediately tied up in litigation, and last Wednesday the South Dakota Supreme Court definitively overturned it, ruling that the measure violated the “single subject” rule for constitutional amendments.”
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“State legislators proved more willing to set aside their personal views on marijuana in deference to the policy preferred by voters. “In my mind, [legalization is] inevitable because we’ve already seen the support from the public,” Senate Majority Leader Gary Cammack said after Klinger’s decision. “I didn’t vote for recreational marijuana, but my constituents did,” added Greg Jamison, another Republican senator. “Rarely do we get a chance to enact a law and not for sure know what our constituents think of that. Here we know.”
In response to such comments from members of her own party, Noem threatened to veto any legalization bill the legislature might decide to pass. Noem later suggested she might be open to decriminalizing low-level marijuana possession. Possessing two ounces or less is currently a misdemeanor punishable by up to a year in jail and a maximum $2,000 fine.”
Cops Thought Sand From Her Stress Ball Was Cocaine. She Spent Nearly 6 Months in Jail.
“Add stress balls to the list of innocuous items that have landed innocent citizens in jail due to shoddy police work and unreliable drug field tests.
The U.S. Court of Appeals for the 11th Circuit ruled last week that two Atlanta police officers are not entitled to qualified immunity from a civil lawsuit brought against them by Ju’zema Goldring for malicious prosecution. Goldring says the officers falsely accused her of jaywalking and cocaine trafficking, based on a field test of a powdery substance inside a stress ball she had in her purse.
Goldring spent nearly six months in the Fulton County jail because she couldn’t afford bail and told local news outlet NBC 46 that she was occasionally put in solitary confinement. What’s more, she was left in jail for four months after a crime lab concluded that the mysterious powder was sand, not cocaine.
According to the 11th Circuit’s opinion, Atlanta police officers Vladimir Henry and Juan Restrepo stopped Goldring on October 10, 2015, for allegedly jaywalking. Goldring claims she wasn’t jaywalking. In any case, the officers took Goldring to the police station and proceeded to cut open a stress ball they found in her purse and test the powdery substance inside using a Nark II field test for drugs.
As Reason reported earlier this year, such drug field test kits are manufactured by several different companies and are used by police departments and prison systems across the country. The test kits use instant color reactions to indicate the presence of certain compounds found in illegal drugs, but those same compounds are also found in dozens of known licit substances. And although the tests are fairly simple to use, they’re still prone to user error and misinterpretation.”
Two Courts Debunk Widely Accepted Opioid Myths
“Since 2014, state and local governments have filed thousands of lawsuits against pharmaceutical companies they blame for causing the “opioid crisis” by exaggerating the benefits and minimizing the risks of prescription pain medication. The theory underlying these cases is pretty straightforward: Drug manufacturers lied, and people died.
Two recent rulings—one by a California judge, the other by the Oklahoma Supreme Court—show how misleading this widely accepted narrative is. Both decisions recognize that undertreatment of pain is a real problem and that bona fide patients rarely become addicted to prescription opioids, let alone die as a result.”
Senate rules could undercut Democrats’ prescription drug plan
“Democrats have a multi-pronged strategy for addressing drug prices in the Build Back Better Act. First, they would allow Medicare to negotiate with pharmaceutical manufacturers on the prices of a certain number of prescription drugs, something they have been promising to do for years. But Democrats also want to limit drug companies’ ability to hike the prices of their medications for everyone — regardless of what kind of health insurance they have — in the future.
To do that, Congress has proposed requiring drugmakers to pay rebates for any price increases, in either the Medicare health program or the commercial health plans that cover 180 million Americans.
But, as Politico reported this week, the plan to apply the inflation-indexed rebates to the commercial market could be in trouble.
Senate Republicans — at the urging of the drug industry — plan to challenge whether the rebates for commercial health plans are permissible in a bill passed through the budget reconciliation process.”
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“the Byrd Rule requires that all the provisions in a budget reconciliation bill directly change federal spending or revenue.
Republicans will argue that the purpose of the provision is to control drug prices for the private plans, full stop, and that does not have anything to do with federal spending or revenue — at least not directly.
The Democratic counterargument would be that applying these rebates to commercial plans would have a serious, more than incidental, effect on the federal budget. The federal government subsidizes almost all private insurance plans in one way or another, and so lower or higher costs for those plans could have major implications and lower costs for private health plans could also mean higher wages for workers, who would then pay more in taxes.
Who wins is likely ultimately a decision for the Senate parliamentarian.”
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“what would happen if the parliamentarian determines rebates covering commercial plans cannot be allowed under the Byrd Rule?
The big fear, voiced by advocates of the Democrats’ plan, is that drug companies would extract higher prices from the commercial market in order to make up for the revenue they would lose from Medicare once that program’s new price controls take effect.
According to several experts, that appears unlikely. Loren Adler, associate director of the USC-Brookings Schaeffer Initiative for Health Policy, covered why in a lengthy analysis published in September.
“Fundamentally, for this to occur, it would have to be the case that drug companies are benevolently choosing not to profit-maximize at present,” Adler told me this week, “which I find rather difficult to believe.””
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“Under the current plan, drugmakers would pay a rebate based on their sales volume in both the Medicare and commercial markets. In that scenario, there would be little reason to raise list prices faster than inflation, because you are paying the penalty based on the entire market.
But if those rebates can’t include the commercial market, the penalty will be based on the Medicare market only — making it a smaller price to pay if a company does decide to hike the list price of a drug at a rate higher than inflation.”
How Mitch McConnell Accidentally Created An Unregulated THC Market
“Mitch McConnell didn’t know what he was doing when he passed the 2018 Farm Bill. The bill included his provision that legalized industrial hemp, a form of cannabis that can be made into a wide variety of products including cannabidiol, a non-intoxicating cannabis compound commonly called CBD. That part was intentional — the law quickly launched a multi-billion dollar industry that put the once-obscure CBD compound into lattes, seltzers and hundreds of CVS stores across the country.
But after three years it appears one of the law’s biggest impacts was entirely unintentional: It accidentally created a booming market for synthetic THC, marijuana’s primary intoxicant.
The same type of CBD that’s for sale at CVS is now being synthetically converted into THC and packaged into vape cartridges and gummy bears. Thanks to a loophole in the 2018 Farm Bill, these drugs are marketed as a “legal high” and sold online and in states where marijuana remains illegal.
But chemists warn that these drugs can contain hazardous solvents, acids and unknown compounds. When FiveThirtyEight legally purchased hemp-derived THC products for testing, we found illegal levels of THC and a variety of mystery compounds that could not be identified. There are no federal safety testing requirements for these products, and while hemp companies occasionally publish test results, some brands have been caught using fake test documents.”
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“The hemp industry has quickly moved past selling just Delta-8-THC and is now offering an increasingly long list of synthetic cannabinoids that they can ship directly to your door.”
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“McConnell has spent years fighting for hemp legalization and, in particular, the legalization of CBD in an effort to appease his home state’s farmers. He made hemp legalization a campaign issue in 2013 and, when the Drug Enforcement Agency blocked Kentucky’s farmers from growing CBD-rich hemp under an earlier pilot program, the senator publicly fought the agency until the DEA backed down.
When it came to writing the 2018 law, McConnell apparently didn’t want to take any chances with the DEA. His provision permanently removed hemp from the Controlled Substance Act”
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“The five professional chemists we spoke to for this piece were all particularly concerned by the sale of synthetic cannabinoids like Delta-8-THC-O acetate, which are both synthetically made and synthetically designed (unlike Delta-8-THC, which can be found naturally in cannabis). These types of synthetic cannabinoids were first invented by the pharmaceutical industry and can react with our internal cannabinoid receptors in unnaturally strong ways.”