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Tag: Opioids

  • Consulting firm McKinsey agrees to $78 million settlement with insurers over opioids

    Consulting firm McKinsey agrees to $78 million settlement with insurers over opioids

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    Consulting firm McKinsey and Co. has agreed to pay $78 million to settle claims from insurers and health care funds that its work with drug companies helped fuel an opioid addiction crisis.

    The agreement was revealed late Friday in documents filed in federal court in San Francisco. The settlement must still be approved by a judge.

    Under the agreement, McKinsey would establish a fund to reimburse insurers, private benefit plans and others for some or all of their prescription opioid costs.

    The insurers argued that McKinsey worked with Purdue Pharma – the maker of OxyContin – to create and employ aggressive marketing and sales tactics to overcome doctors’ reservations about the highly addictive drugs. Insurers said that forced them to pay for prescription opioids rather than safer, non-addictive and lower-cost drugs, including over-the-counter pain medication. They also had to pay for the opioid addiction treatment that followed.

    From 1999 to 2021, nearly 280,000 people in the U.S. died from overdoses of prescription opioids, according to the U.S. Centers for Disease Control. Insurers argued that McKinsey worked with Purdue Pharma even after the extent of the opioid crisis was apparent.

    The settlement is the latest in a years-long effort to hold McKinsey accountable for its role in the opioid epidemic. In February 2021, the company agreed to pay nearly $600 million to U.S. states, the District of Columbia and five U.S. territories. In September, the company announced a separate, $230 million settlement agreement with school districts and local governments.


    Supreme Court weighs legal shield for Sackler family

    02:20

    Asked for comment Saturday, McKinsey referred to a statement the company released in September.

    “As we have stated previously, we continue to believe that our past work was lawful and deny allegations to the contrary,” the company said, adding that it reached a settlement to avoid protracted litigation.

    McKinsey said it stopped advising clients on any opioid-related business in 2019.

    Similar settlements have led to nearly $50 billion being paid out to state and local governments. The payments come from nearly a dozen companies, including CVS and RiteAid, that were sued for their role in fueling the overdose epidemic.  

    Advocates say the influx of money presents a unique opportunity for the U.S. to fund treatment solutions for substance use disorders, but a KFF Health News investigation found that much of the money has sat untouched. 

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  • Mexico raids and closes 31 pharmacies in Ensenada that were selling fentanyl-laced pills

    Mexico raids and closes 31 pharmacies in Ensenada that were selling fentanyl-laced pills

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    MEXICO CITY — Mexican authorities said Friday they have raided and closed 31 pharmacies in Baja California’s coastal city of Ensenada, after they were detected selling fake or fentanyl-laced pills.

    Marines and health inspection authorities seized 4,681 boxes of medications that may have been offered for sale without proper safeguards, may have been faked and may contain fentanyl.

    “This measure was taken due to the irregular sales of medications contaminated with fentanyl, which represents a serious public health risk,” the Navy said in a press statement.

    Mexico’s health authorities are conducting tests on the seized merchandise. Ensenada is located about 60 miles (100 kms) south of the border city of Tijuana.

    The announcement represents one of the first times Mexican authorities have acknowledged what U.S. researchers pointed out almost a year ago: that Mexican pharmacies were offering controlled medications like Oxycodone, Xanax or Adderall, but the pills were often fentanyl-laced fakes.

    Authorities inspected a total of 53 pharmacies, and found the suspected fakes in 31 of them. They slapped temporary suspension signs on the doors of those businesses.

    Sales of the pills are apparently aimed at tourists.

    In August, Mexico shuttered 23 pharmacies at Caribbean coast resorts after authorities inspected 55 drug stores in a four-day raid that targeted establishments in Cancun, Playa del Carmen and Tulum.

    The Navy said the pharmacies usually offered the pills only to tourists, advertised them and even offered home-delivery services for them.

    The Navy did not say whether the pills seized in August contained fentanyl, but said it found outdated medications and some for which there was no record of the supplier, as well as blank or unsigned prescription forms.

    In March, the U.S. State Department issued a travel warning about sales of such pills, and the practice appears to be widespread.

    In February, the University of California, Los Angeles, announced that researchers there had found that 68% of the 40 Mexican pharmacies visited in four northern Mexico cities sold Oxycodone, Xanax or Adderall, and that 27% of those pharmacies were selling fake pills.

    UCLA said the study, published in January, found that “brick and mortar pharmacies in Northern Mexican tourist towns are selling counterfeit pills containing fentanyl, heroin, and methamphetamine. These pills are sold mainly to U.S. tourists, and are often passed off as controlled substances such as Oxycodone, Percocet, and Adderall.”

    “These counterfeit pills represent a serious overdose risk to buyers who think they are getting a known quantity of a weaker drug,” Chelsea Shover, assistant professor-in-residence of medicine at the David Geffen School of Medicine at UCLA, said in February.

    The U.S. State Department travel warning in March said the counterfeit pills being sold at pharmacies in Mexico “may contain deadly doses of fentanyl.”

    Fentanyl is a synthetic opioid far more powerful than morphine, and it has been blamed for about 70,000 overdose deaths per year in the United States. Mexican cartels produce it from precursor chemicals smuggled in from China, and then often press it into pills designed to look like other medications.

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    Follow AP’s coverage of Latin America and the Caribbean at https://apnews.com/hub/latin-america

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  • OxyContin maker bankruptcy deal goes before the Supreme Court on Monday, with billions at stake

    OxyContin maker bankruptcy deal goes before the Supreme Court on Monday, with billions at stake

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    WASHINGTON — The Supreme Court is hearing arguments over a nationwide settlement with OxyContin maker Purdue Pharma that would shield members of the Sackler family who own the company from civil lawsuits over the toll of opioids.

    The agreement hammered out with state and local governments and victims would provide billions of dollars to combat the opioid epidemic. The Sacklers would contribute up to $6 billion and give up ownership, and the company would emerge from bankruptcy as a different entity, with its profits used for treatment and prevention.

    But the justices put the settlement on hold during the summer, in response to objections from the Biden administration. Arguments take place Monday.

    The issue for the justices is whether the legal shield that bankruptcy provides can be extended to people such as the Sacklers, who have not declared bankruptcy themselves. Lower courts have issued conflicting decisions over that issue, which also has implications for other major product liability lawsuits settled through the bankruptcy system.

    The U.S. Bankruptcy Trustee, an arm of the Justice Department, contends that the bankruptcy law does not permit protecting the Sackler family from being sued by people who are not part of the settlement. During the Trump administration, the government supported the settlement.

    Proponents of the plan said third-party releases are sometimes necessary to forge an agreement, and federal law imposes no prohibition against them.

    Lawyers for more than 60,000 victims who support the settlement called it “a watershed moment in the opioid crisis,” while recognizing that “no amount of money could fully compensate” victims for the damage caused by the misleading marketing of OxyContin.

    A lawyer for a victim who opposes the settlement calls the provision dealing with the Sacklers “special protection for billionaires.”

    OxyContin first hit the market in 1996, and Purdue Pharma’s aggressive marketing of the powerful prescription painkiller is often cited as a catalyst of the nationwide opioid epidemic, persuading doctors to prescribe painkillers with less regard for addiction dangers.

    The drug and the Stamford, Connecticut-based company became synonymous with the crisis, even though the majority of pills being prescribed and used were generic drugs. Opioid-related overdose deaths have continued to climb, hitting 80,000 in recent years. Most of those are from fentanyl and other synthetic drugs.

    The Purdue Pharma settlement would be among the largest reached by drug companies, wholesalers and pharmacies to resolve epidemic-related lawsuits filed by state, local and Native American tribal governments and others. Those settlements have totaled more than $50 billion.

    But it would be one of only two so far that include direct payments to victims from a $750 million pool. Payouts are expected to range from about $3,500 to $48,000.

    Sackler family members no longer are on the company’s board and they have not received payouts from it since before Purdue Pharma entered bankruptcy. In the decade before that, though, they were paid more than $10 billion, about half of which family members said went to pay taxes.

    A decision in Harrington v. Purdue Pharma, 22-859, is expected by early summer.

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  • New Study Suggests Cannabis Does Not Help Opioid Use Disorder | High Times

    New Study Suggests Cannabis Does Not Help Opioid Use Disorder | High Times

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    A long-term study on opioid addiction and cannabis use found little to no evidence that using cannabis can help addicts reduce or stop their long-term intake of illicit opioids. 

    The study, published in the American Journal of Psychiatry, was led by researchers at the University of Sydney and followed over 600 heroin addicts for up to 20 years, monitoring their cannabis and heroin intake at regular intervals to try and associate a relationship, positive or negative, between the two. 

    “The Australian Treatment Outcome Study (ATOS) recruited 615 people with heroin dependence in 2001 and 2002 and reinterviewed them at 3, 12, 24, and 36 months as well as 11 and 18–20 years after baseline,” the study said. “Heroin and cannabis use were assessed at each time point using the Opiate Treatment Index. A random-intercept cross-lagged panel model analysis was conducted to identify within-person relationships between cannabis use and heroin use at subsequent follow-ups.”

    The results of the study did not find cannabis to be a statistically significant factor in reducing or ceasing a person’s opioid use, despite anecdotal evidence from addicts who claim the plant helps them use less opioids or stop using them altogether. The lead author of the study credited these misconceptions to the way previous studies were conducted, in that they only followed addicts for a short time and did not examine long-term impacts.

    “Our investigation shows that cannabis use remains common among this population, but it may not be an effective long term strategy for reducing opioid use ,” says lead author Dr. Jack Wilson, from The Matilda Centre for Research in Mental Health and Substance Use, at the University of Sydney.

    “There are claims that cannabis may help decrease opioid use or help people with opioid use disorders keep up with treatment. But it’s crucial to note those studies examine short-term impact, and focus on treatment of chronic pain and pain management, rather than levels of opioid use in other contexts.”

    The study actually found data that indicated cannabis use may lead to further opioid use, particularly around the two-three year period of the study. 

    “After accounting for a range of demographic variables, other substance use, and mental and physical health measures, an increase in cannabis use 24 months after baseline was significantly associated with an increase in heroin use at 36 months,” the study said. 

    That said, the study did not go so far as to make a claim that cannabis use may increase heroin use, it merely mentioned the data. Rather, the results section of the study indicated that there simply was not a significant enough relationship in the data to draw any conclusive conclusions, if you will. 

    “Although there was some evidence of a significant relationship between cannabis and heroin use at earlier follow-ups, this was sparse and inconsistent across time points. Overall, there was insufficient evidence to suggest a unidirectional or bidirectional relationship between the use of these substances,” the study said. 

    Dr. Wilson indicated in a press release from the University of Sydney that based on previous available research there does not appear to be a one-size-fits-all solution to opiate addiction, a sentiment which was further reinforced by the results of this long-term study. 

    “Opioid use disorders are complex and unlikely to be resolved by a single treatment,” Dr Wilson said. “The best way to support them is evidence-based holistic approaches that look at the bigger picture, and include physical, psychological, and pharmacotherapy therapies.”

    Previous studies have found somewhat contradictory results compared to this one but as aforementioned, none of those studies were conducted for anywhere near as long. For instance, a study conducted through the University of Connecticut found evidence that cannabis users required less opioids while recovering from a particular major neck surgery. However, the study lasted less than a year and did include data on any possible adverse outcomes that may have occurred after the study, context which is important due to the nature of addicts to sometimes stumble into opiate addiction after having them prescribed for pain.

    Additionally, a 2022 study published in Substance Use and Misuse found that around four out of five patients who were prescribed opioids self-reported in a survey that they were able to reduce or cease their opiate intake using medical cannabis. However, this study was based on one survey and did not follow anyone long-term. That said, there have been several other studies that found similar, positive results. In general, the issue of cannabis as a potential replacement for opioids appears to be a mixed bag until more research is conducted. 

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    Patrick Maravelias

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  • Study: MMJ, Opioids Comparable in Treating Pain––Weed Carries More ‘Holistic’ Relief | High Times

    Study: MMJ, Opioids Comparable in Treating Pain––Weed Carries More ‘Holistic’ Relief | High Times

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    There has been plenty of recent research affirming that medical cannabis is indeed a suitable alternative to opioids, with many users finding they are able to reduce or eliminate opioid use entirely after maintaining a medical cannabis regimen. Now, one study is taking a closer look at the specific holistic effects that both medical cannabis and opioids provide to get more insight on the efficacy of each substance as it pertains to chronic pain management.

    The recent study, “The holistic effects of medical cannabis compared to opioids on pain experience in Finnish patients with chronic pain,” was conducted by a team of researchers from Åbo Akademi University, who looked into the effects of medical cannabis and opioids for chronic pain treatment.

    Published in the Journal of Cannabis Research, the study aimed to take a closer look at how effective medical cannabis is compared to traditional opioids in treating chronic pain, as cannabis use for symptom management has become increasingly more common in recent years. Results suggested that opioids and cannabis are both “equally efficacious” at mitigating pain intensity in patients with chronic pain, while cannabis offered more “holistic” relief in improving sleep, focus and emotional wellbeing

    Comparing Opioids and Medical Cannabis for Pain Relief

    To investigate the efficacy of both substances, researchers had subjects complete retrospective surveys to measure the positive and negative phenomenological effects of both cannabis and opioids. 

    The sample included 201 chronic pain patients, with 40 who used medical cannabis and 161 who used opioids to treat pain. Each group had some crossover, with about 45% of medical cannabis patients reporting the use of opioids to treat pain and about 4.3% of opioid users having used medical cannabis.

    Participants were asked to evaluate statements detailing positive and negative effects of their medications, with researchers comparing scores from the two groups.

    While neither opioids nor medical cannabis are first-line treatments for chronic pain, researchers noted that both are commonly used when other treatments cannot provide sufficient relief. Recreational users of cannabis or opioids or people who used either substance to treat conditions other than chronic pain were also “explicitly asked not to partake in the study.”

    The analysis revealed three experience factors: negative side effects, positive holistic effects and positive emotional effects. The medical cannabis group received higher scores than the opioid group in the positive emotional effects and holistic positive effects, with no difference in negative effects.

    Chronic Pain Treatment: Medical Cannabis More Beneficial Than Opioids?

    Ultimately, researchers concluded from the self-ported data that, while both medical cannabis and opioids were “perceived to be equally efficacious in reducing pain intensity,” medical cannabis positively affects broader factors related to pain, like emotion, functionality and an overall sense of wellbeing.

    “Both MC and opioids were perceived to reduce pain intensity equally well. The group differences support the hypothesis that the effects of [medical cannabis] on pain are more holistic than those of opioids,” authors state. The study also notes that the strongest difference between the two groups — which were more commonly reported in the medical cannabis group — were deeper relaxation, better sleep, improved mood and the ability to feel pain without reacting to it.

    “In sum, the results lend support to the notion that the psychoactive effects of MC are relevant to its therapeutic effect on pain, in line with suggestions in previous literature,” authors said. However, they noted that their use of “psychoactive” isn’t in reference to something producing an altered state of consciousness or distorting perception, but “instead something that holistically alters consciousness to a more positive direction, or towards ‘normality.’”

    Researchers also said that there were no indications of medical cannabis distorting cognitive processes. Instead, it was perceived to improve memory, focus and clarity of thought.

    “The results of the present study underline that the psychoactive effects of [medical cannabis] can be therapeutically positive and have beneficial effects on mood and functioning,” authors conclude. “However, this conclusion would require more robust testing, ideally in randomized controlled trials.”

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    Keegan Williams

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  • Mexico’s arrest of cartel security boss was likely personal

    Mexico’s arrest of cartel security boss was likely personal

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    MEXICO CITY — The U.S. government thanked Mexico for arresting a hyper violent alleged Sinaloa cartel security chief, but according to details released Friday, the detention may have been highly personal for the Mexican army.

    Defense Secretary Luis Cresencio Sandoval said Nestor Isidro Pérez Salas, who was arrested Wednesday, had ordered a 2019 attack on an unguarded apartment complex where soldiers’ families lived.

    “He was the one who ordered the attack … against our dependents, our families,” Sandoval said.

    The Oct. 17, 2019 attack was a result of a humiliating failed effort to capture Sinaloa cartel leader Ovidio Guzman, one of the sons of imprisoned drug lord Joaquin “El Chapo” Guzman. Pérez Salas served as head of security for Guzman and his brothers, who are collectively known as the “Chapitos.”

    Soldiers caught Guzman but later were ordered to release him to avoid bloodshed.

    In order to pressure the army to release Guzman, cartel gunmen had surrounded the army families’ housing complex in Culiacan, the capital of Sinaloa, and sprayed it with gunfire. They took one soldier hostage, burst into four apartments looking for more potential hostages, and tossed in two hand grenades that failed to explode.

    The army had apparently relied on an unwritten rule that soldiers’ wives and children were not to be targeted. “It was an area that was not even guarded,” Sandoval said.

    In January, when soldiers finally managed to detain Ovidio Guzman, Pérez Salas also allegedly participated in setting off violence that left 30 people dead, including 10 military personnel.

    The army was forced to use Black Hawk helicopter gunships against the cartel’s truck-mounted .50-caliber machine guns. Cartel gunmen hit two military aircraft, forcing them to land, and sent gunmen to the city’s airport, where military and civilian aircraft were hit by gunfire.

    Sandoval revealed Friday that there had been a special operation that day to get Pérez Salas, but it failed.

    The army continued to follow his movements, and later tried to detain him a second time, but “he was able to escape,” Sandoval said.

    The third time was a charm; video posted on social media showed that Pérez Salas was surrounded but managed to climb onto the roof of a house before he was caught Wednesday.

    The U.S. Drug Enforcement Administration had posted a $3 million reward for the capture of Pérez Salas, though it was unclear if that will be distributed to the army and National Guard forces that caught him this week.

    President Joe Biden issued a statement Thursday praising the arrest. U.S. prosecutors have asked that Pérez Salas be extradited — as his boss Ovidio Guzman was in September — to face U.S. drug charges.

    “These arrests are testament to the commitment between the United States and Mexico to secure our communities against violence, counter the cartels, and end the scourge of illicit fentanyl that is hurting so many families,” Biden wrote.

    But it appears Pérez Salas’s arrest was personal for the Mexican army.

    “He was also responsible for a series of attacks against military personnel that caused a significant number of casualties,” Sandoval said.

    Pérez Salas is wanted on U.S. charges of conspiracy to import and distribute fentanyl in the United States. But he also allegedly left a trail of killings and torture of police and civilians.

    An indictment in the Southern District of New York says Pérez Salas allegedly participated in the torture of a Mexican federal agent in 2017. It said he and others tortured the man for two hours, inserting a corkscrew into his muscles, ripping it out and placing hot chiles in the wounds.

    According to the indictment, the Ninis — the gang of gunmen led by Pérez Salas and Jorge Figueroa Benitez — carried out other gruesome acts of violence as well.

    The Ninis would take captured rivals to ranches owned by the Chapitos for execution, it said.

    “While many of these victims were shot, others were fed, dead or alive, to tigers” belonging to the Chapitos, “who raised and kept tigers as pets,” according to the indictment.

    And while the Sinaloa cartel does some lab testing on its products, the Ninis conducted more grisly human testing on kidnapped rivals or addicts who are injected until they overdosed.

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    Follow AP’s coverage of Latin America and the Caribbean at https://apnews.com/hub/latin-america

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  • OxyContin maker’s settlement plan divides victims of opioid crisis. Now it’s up to the Supreme Court

    OxyContin maker’s settlement plan divides victims of opioid crisis. Now it’s up to the Supreme Court

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    WASHINGTON — The agreement by the maker of OxyContin to settle thousands of lawsuits over the harm done by opioids could help combat the overdose epidemic that the painkiller helped spark. But that does not mean all the victims are satisfied.

    In exchange for giving up ownership of drug manufacturer Purdue Pharma and for contributing up to $6 billion to fight the crisis, members of the wealthy Sackler family would be exempt from any civil lawsuits. At the same time, they could potentially keep billions of dollars from their profits on OxyContin sales.

    The Supreme Court is set to hear arguments Dec. 4 over whether the agreement, part of the resolution of Purdue Pharma’s bankruptcy, violates federal law.

    The issue for the justices is whether the legal shield that bankruptcy provides can be extended to people such as the Sacklers, who have not declared bankruptcy themselves. The legal question has resulted in conflicting lower court decisions. It also has implications for other major product liability lawsuits settled through the bankruptcy system.

    But the agreement, even with billions of dollars set aside for opioid abatement and treatment programs, also poses a moral conundrum that has divided people who lost loved ones or lost years of their own lives to opioids.

    Ellen Isaacs’ 33-year-old son, Ryan Wroblewski, died in Florida in 2018, about 17 years after he was first prescribed OxyContin for a back injury. When she first heard about a potential settlement that would include some money for people like her, she signed up. But she has changed her mind.

    Money might not bring closure, she said. And by allowing the deal, it could lead to more problems.

    “Anybody in the future would be able to do the exact same thing that the Sacklers are now able to do,” she said in an interview.

    Her lawyer, Mike Quinn, put it this way in a court filing: “The Sackler releases are special protection for billionaires.”

    Lynn Wencus, of Wrentham, Massachusetts, also lost a 33-year-old son, Jeff, to overdose in 2017.

    She initially opposed the deal with Purdue Pharma but has come around. Even though she does not expect a payout, she wants the settlement to be finalized in hopes it would help her stop thinking about Purdue Pharma and Sackler family members, whom she blames for the opioid crisis.

    “I feel like I can’t really move on while this is all hanging out in the court,” Wencus said.

    Purdue Pharma’s aggressive marketing of OxyContin, a powerful prescription painkiller that hit the market in 1996, is often cited as a catalyst of a nationwide opioid epidemic, persuading doctors to prescribe painkillers with less regard for addiction dangers.

    The company pleaded guilty to misbranding the drug in 2007 and paid more than $600 million in fines and penalties.

    The drug and the Stamford, Connecticut-based company became synonymous with the crisis, even though the majority of pills being prescribed and used were generic drugs. Opioid-related overdose deaths have continued to climb, hitting 80,000 in recent years. That’s partly because people with substance abuse disorder found pills harder to get and turned to heroin and, more recently, fentanyl, an even more potent synthetic opioid.

    Drug companies, wholesalers and pharmacies have agreed to pay a total of more than $50 billion to settle lawsuits filed by state, local and Native American tribal governments and others that claimed the companies’ marketing, sales and monitoring practices spurred the epidemic. The Purdue Pharma settlement would be among the largest. It’s also one of only two so far with provisions for victims of the crisis to be compensated directly, with payouts from a $750 million pool expected to range from about $3,500 to $48,000.

    Lawyers for more than 60,000 victims who support the settlement called it “a watershed moment in the opioid crisis,” while recognizing that “no amount of money could fully compensate” victims for the damage caused by the misleading marketing of OxyContin.

    In the fallout, parts of the Sackler family story has been told in multiple books and documentaries and in fictionalized versions in the streaming series “Dopesick” and “Painkiller.”

    Museums and universities around the world have removed the family’s name from galleries and buildings.

    Family members have remained mostly out of the public eye, and they have stepped off the board of their company and have not received payouts from it since before the company entered bankruptcy. But in the decade before that, they were paid more than $10 billion, about half of which family members said went to pay taxes.

    Some testified in a 2021 bankruptcy hearing, telling a judge that the family would not contribute to the proposed legal settlement without being shielded from lawsuits.

    Two family members appeared by video and one listened by audio to a 2022 court hearing in which more than two dozen people impacted by opioids told their stories publicly. One told them: “You poisoned our lives and had the audacity to blame us for dying.”

    Purdue Pharma reached the deal with the governments suing it — including with some states that initially rejected the plan.

    But the U.S. Bankruptcy Trustee, an arm of the Justice Department responsible for promoting the integrity of the bankruptcy system, has objected to the legal protections for Sackler family members. Attorney General Merrick Garland also has criticized the plan.

    The opposition marked an about-face for the Justice Department, which supported the settlement during the presidency of Donald Trump, a Republican. The department and Purdue Pharma forged a plea bargain in a criminal and civil case. The deal included $8.3 billion in penalties and forfeitures, but the company would pay the federal government only $225 million so long as it executed the settlement plan.

    A federal trial court judge in 2021 ruled the settlement should not be allowed. This year, a federal appeals panel ruled the other way in a unanimous decision in which one judge still expressed major concerns about the deal. The Supreme Court quickly agreed to take the case, at the urging of the administration of President Joe Biden, a Democrat.

    Purdue Pharma’s is not the first bankruptcy to include this sort of third-party release, even when not everyone in the case agrees to it. It was specifically allowed by Congress in 1994 for asbestos cases.

    They have been used elsewhere, too, including in settlements of sexual abuse claims against the Boy Scouts of America, where groups like regional Boy Scout councils and churches that sponsor troops helped pay, and against Catholic dioceses, where parishes and schools contributed cash.

    Proponents of Purdue Pharma’s settlement plan often assert that federal law does not prohibit third-party releases and that they can be necessary to create a settlement that parties will agree to.

    “Third-party releases are a recurring feature of bankruptcy practice,” lawyers for one branch of the Sackler family said in a court filing, “and not because anyone is trying to do the released third parties a favor.”

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    Mulvihill reported from Cherry Hill, New Jersey.

    ___

    This story has been corrected to show that the appeals court ruling was unanimous, not 2-1.

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  • FDA warns about Neptune’s Fix supplements after reports of seizures and hospitalizations

    FDA warns about Neptune’s Fix supplements after reports of seizures and hospitalizations

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    The Food and Drug Administration is warning consumers not to use or purchase any products from the supplement brand called Neptune’s Fix after receiving multiple reports of severe reactions, including seizures and hospitalizations. The FDA says it is testing samples for illegal and harmful ingredients.

    Neptune’s Fix supplements purport to contain tianeptine, an opioid alternative prescribed as an antidepressant in some Latin American, Asian and European countries. Tianeptine is not approved for use in the U.S.

    The FDA has previously warned about this “potentially dangerous” substance, which the agency says has been linked to addiction and deadly overdoses.  

    Bottles of Neptune's Fix, which the FDA is investigating for illegal substances
    The FDA is warning consumers to not purchase or use Neptune’s Fix products, or any other product with tianeptine, which is not approved in the U.S.

    FDA


    Now authorities worry other substances may also be mixed into these products, which are being sold illegally online and in retailers like gas stations and vape or smoke shops. 

    News of the FDA’s testing comes less than a month after health officials in New Jersey warned they had identified a cluster of poisonings linked to tianeptine products including Neptune’s Fix.

    More than half of the patients suffered seizures after ingesting the products, the state’s health department said. Some required hospitalization. Others showed up at hospitals with a variety of other serious symptoms, including hallucinations and vomiting.

    It is unclear which states have reported issues with Neptune’s Fix to FDA or how long the agency’s testing of the products will take. 

    An FDA spokesperson did not immediately respond to a request for comment.

    “Gas station heroin”

    Authorities have moved to crack down on other tianeptine supplements in recent years, after the CDC reported in 2018 that poison control centers had been fielding a growing number of calls over tianeptine abuse and withdrawal from use of the drug.

    Nicknamed “gas station heroin” due to its wide availability in convenience stores and other small retailers, several states have taken steps to curb sales of the drug. Other brands of tianeptine the FDA has previously warned about include Za Za and Tianna Red. 

    Florida’s attorney general announced an emergency rule in September to designate tianeptine as a Schedule I controlled substance in the state, after moves to tighten restrictions on the drug in Alabama, Georgia, Indiana, Kentucky, Michigan, Mississippi, Ohio and Tennessee.

    Federal prosecutors have also gone after companies for smuggling and selling tianeptine products in the U.S.

    Emergency rooms have reported surges in reports of users struggling over withdrawal from the drug in recent years, including after efforts to pull the product from store shelves.

    Unlike typical antidepressants, the drug works by binding to the body’s mu opioid receptors, causing effects that mimic opioid toxicity and withdrawal. Similar to other opioids, naloxone has been used to manage tianeptine overdoses. 

    “We were having to put a lot of people in the intensive care units (ICUs) because the withdrawal symptoms were so bad and often included delirium requiring high doses of sedating medications,” Dr. William Rushton, head of the University of Alabama’s Medical Toxicology program, said in a post by the university.

    Alexander Tin

    Alexander Tin is a digital reporter for CBS News based in the Washington, D.C. bureau. He covers the Biden administration’s public health agencies, including the federal response to infectious disease outbreaks like COVID-19.

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  • Oregon’s first-in-the-nation drug decriminalization law faces growing pushback amid fentanyl crisis

    Oregon’s first-in-the-nation drug decriminalization law faces growing pushback amid fentanyl crisis

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    PORTLAND, Ore. — Oregon’s first-in-the-nation law that decriminalized the possession of small amounts of heroin, cocaine and other illicit drugs in favor of an emphasis on addiction treatment is facing strong headwinds in the progressive state after an explosion of public drug use fueled by the proliferation of fentanyl and a surge in deaths from opioids, including those of children.

    “The inability for people to live their day-to-day life without encountering open-air drug use is so pressing on urban folks’ minds,” said John Horvick, vice president of polling firm DHM Research. “That has very much changed people’s perspective about what they think Measure 110 is.”

    When the law was approved by 58% of Oregon voters three years ago, supporters championed Measure 110 as a revolutionary approach that would transform addiction by minimizing penalties for drug use and investing instead in recovery.

    But even top Democratic lawmakers who backed the law, which will likely dominate the upcoming legislative session, say they’re now open to revisiting it after the biggest increase in synthetic opioid deaths among states that have reported their numbers.

    The cycle of addiction and homelessness spurred by fentanyl is most visible in Portland, where it’s not unusual to see people shooting up in broad daylight on busy city streets.

    “Everything’s on the table,” said Democratic state Sen. Kate Lieber, co-chair of a new joint legislative committee created to tackle addiction. “We have got to do something to make sure that we have safer streets and that we’re saving lives.”

    Measure 110 directed the state’s cannabis tax revenue toward drug addiction treatment services while decriminalizing the possession of so-called “personal use” amounts of illicit drugs. Possession of under a gram of heroin, for example, is only subject to a ticket and a maximum fine of $100.

    Those caught with small amounts of drugs can have the citation dismissed by calling a 24-hour hotline to complete an addiction screening within 45 days, but those who don’t do a screening are not penalized for failing to pay the fine. In the first year after the law took effect in February 2021, only 1% of people who received citations for possession sought help via the hotline, state auditors found.

    Critics of the law say this doesn’t create an incentive to seek treatment.

    Republican lawmakers have urged Democratic Gov. Tina Kotek to call a special session to address the issue before the Legislature reconvenes in February. They have proposed harsher sanctions for possession and other drug-related offenses, such as mandatory treatment and easing restrictions on placing people under the influence on holds in facilities such as hospitals if they pose a danger to themselves or others.

    “Treatment should be a requirement, not a suggestion,” a group of Republican state representatives said in a letter to Kotek.

    Law enforcement officials who have testified before the new legislative committee on addiction have proposed reestablishing drug possession as a class A misdemeanor, which is punishable by up to a year in jail or a $6,250 fine.

    “We don’t believe a return to incarceration is the answer, but restoring a (class A) misdemeanor for possession with diversion opportunities is critically important,” Jason Edmiston, chief of police in the small, rural city of Hermiston in northeast Oregon, told the committee.

    However, data shows decades of criminalizing possession hasn’t deterred people from using drugs. In 2022, nearly 25 million Americans, roughly 8% of the population, reported using illicit drugs other than marijuana in the previous year, according to the annual National Survey on Drug Use and Health.

    Some lawmakers have suggested focusing on criminalizing public drug use rather than possession. Alex Kreit, assistant professor of law at Northern Kentucky University and director of its Center on Addiction Law and Policy, said such an approach could help curb visible drug use on city streets but wouldn’t address what’s largely seen as the root cause: homelessness.

    “There are states that don’t have decriminalization that have these same difficult problems with public health and public order and just quality-of-life issues related to large-scale homeless populations in downtown areas,” he said, mentioning California as an example.

    Backers of Oregon’s approach say decriminalization isn’t necessarily to blame, as many other states with stricter drug laws have also reported increases in fentanyl deaths.

    But estimates from the U.S. Centers for Disease Control and Prevention show, among the states reporting data, Oregon had the highest increase in synthetic opioid overdose fatalities when comparing 2019 and the 12-month period ending June 30, a 13-fold surge from 84 deaths to more than 1,100.

    Among the next highest was neighboring Washington state, which saw its estimated synthetic opioid overdose deaths increase seven-fold when comparing those same time periods, CDC data shows.

    Nationally, overdose deaths involving synthetic opioids such as fentanyl roughly doubled over that time span. Roughly two-thirds of all deadly overdoses in the U.S. in the 12 months ending June 30 involved synthetic opioids, federal data shows.

    Supporters of Oregon’s law say it was confronted by a perfect storm of broader forces, including the COVID-19 pandemic, a mental health workforce shortage and the fentanyl crisis, which didn’t reach fever pitch until after the law took effect in early 2021.

    A group of Oregon lawmakers recently traveled to Portugal, which decriminalized the personal possession of drugs in 2001, to learn more about its policy. State Rep. Lily Morgan, the only Republican legislator on the trip, said Portugal’s approach was interesting but couldn’t necessarily be applied to Oregon.

    “The biggest glaring difference is they’re still not dealing with fentanyl and meth,” she said, noting the country also has universal health care.

    Despite public perception, the law has made some progress by directing $265 million dollars of cannabis tax revenue toward standing up the state’s new addiction treatment infrastructure.

    The law also created what are known as Behavioral Health Resource Networks in every county, which provide care regardless of the ability to pay. The networks have ensured about 7,000 people entered treatment from January to March of this year, doubling from nearly 3,500 people from July through September 2022, state data shows.

    The law’s funding also has been key for providers of mental health and addiction services because it has “created a sustainable, predictable funding home for services that never had that before,” said Heather Jefferis, executive director of Oregon Council for Behavioral Health, which represents such providers.

    Horvick, the pollster, said public support for expanding treatment remains high despite pushback against the law.

    “It would be a mistake to overturn 110 right now because I think that would make us go backwards,” Lieber, the Democratic state senator, said. “Just repealing it will not solve our problem. Even if we didn’t have 110, we would still be having significant issues.”

    ___

    Associated Press writer Geoff Mulvihill contributed from Philadelphia.

    ___

    Claire Rush is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues.

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  • Election workers report receiving suspicious packages, some containing fentanyl, while workers process ballots

    Election workers report receiving suspicious packages, some containing fentanyl, while workers process ballots

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    Four county elections offices in Washington state were evacuated Wednesday after they received envelopes containing suspicious powders — including two that field-tested positive for fentanyl — while workers were processing ballots from Tuesday’s election.

    The elections offices were located in King County — home of Seattle — as well as Skagit, Spokane and Pierce counties, the Secretary of State’s Office said in emailed news release. Local, state and federal agents were investigating, and no one was injured, officials said.

    Renton police detective Robert Onishi confirmed that an envelope received by workers at a King County elections office field-tested positive for fentanyl, while Spokane Police Department spokesperson Julie Humphreys said in a news release that fentanyl was found in an envelope at the Spokane County Elections Office. 

    The envelope received by the Pierce County elections office in Tacoma contained baking soda, Tacoma police spokesperson William Muse told The Seattle Times.

    Similar incidents were reported in other states, with the FBI’s Atlanta Bureau saying that it, and other law enforcement partners, had 
    “responded to multiple incidents involving suspicious letters sent to ballot counting centers nationwide.” The office did not say what other states had received such letters, or provide information about where in Georgia the suspicious envelopes had been received.

    Georgia Secretary of State Brad Raffensperger confirmed Fulton County had been targeted. “Our No. 1 priority is secure elections and protecting the men and women who secure our elections,” Raffensperger said in response to the reported threats. 

    The Department of Justice said it was “aware of the reports” and that the FBI and U.S. Postal Inspection Service were investigating the reports. USPIS declined to comment further. 

    A message inside the envelope said “something to the effect of stopping the election,” Muse said. “There was no candidate that was identified. There was no religious-affiliated group identified. There was no political issue identified. It was just that vague statement.”

    Voters in Washington state cast their ballots by mail. Tuesday’s elections concerned local and county races and measures, including a question on renter protections in Tacoma, a tight mayor’s race in Spokane and close city council races in Seattle.

    Secretary of State Steve Hobbs called the incidents “acts of terrorism to threaten our elections.”

    “These incidents underscore the critical need for stronger protections for all election workers,” he said.

    Halei Watkins, communications manager for King County Elections, told The Seattle Times the envelope opened by staffers in Renton on Wednesday morning was not a ballot. By 3 p.m., King County had returned to counting and was planning to meet its original 4 p.m. deadline to post results, but the update would be “significantly smaller” than what is usually posted on the day after an election, Watkins said.

    Patrick Bell, a spokesperson for Spokane County Elections, said workers were sent home after the envelope was found mid-morning and no further votes would be counted Wednesday.

    The FBI warned that all people should exercise care in handling mail, especially from senders they don’t recognize. Toxicology and public health experts have previously told CBS News that just touching or being near fentanyl won’t cause an overdose.

    The Secretary of State’s Office noted that elections officials in two counties — King and Okanogan — received suspicious substances in envelopes during the August primary. In the case of King County, the envelope contained trace amounts of fentanyl, while in Okanogan the substance was determined to be unharmful on testing by the United States Postal Inspection Service.

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  • East Boston man arrested after police find 240 grams of fentanyl in home – The Cannabist

    East Boston man arrested after police find 240 grams of fentanyl in home – The Cannabist

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    An East Boston man is facing a slew of drug charges after police found a stockpile of fentanyl, cocaine, marijuana, psychedelic mushrooms and thousands of dollars in his home, Suffolk DA Kevin Hayden announced Sunday.

    “Fentanyl is a death drug, plain and simple,” Hayden said in a release. “The amount seized here — 240 grams of fentanyl, plus sizeable quantities of other drugs — represents a tremendous amount of potential human devastation.”

    After months of investigating, police executed a search warrant for the apartment of Robert Ciampi, 63, on Orleans Street in East Boston on Nov. 1, according to the release.

    Read the rest of this story on BostonHerald.com.

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    The Cannabist Network

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  • Ohio Voters Go For Legal Marijuana

    Ohio Voters Go For Legal Marijuana

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    Joining 23 other states who are reaping in more tax revenue, less illegal drug market and more help for the medically fragile, Ohio voters go for legal marijuana.   For the first time, 52% of Americans live in a legal cannabis state.  And Pew Research says 90% of citizens believe cannabis should be legal in some form.

    According to BDSA, a leading cannabis data analyst firm “despite having only a few years of legal sales under its belt, the Ohio cannabis market has exhibited strong early growth that indicates continued expansion for the future. BDSA projects that Ohio will launch adult-use cannabis in 2025, contributing an estimated $300 million in that year alone.”

    RELATED: California or New York, Which Has The Biggest Marijuana Mess

    Like alcohol, marijuana is popular for with a majority, but unlike alcohol, it has clear medical benefits including a clear alternative pain relief solution from opioids. It has also shown clear promise with PTSD. With 7.5% of Ohio being veterans or their family, this is positive health news.

    “Marijuana is no longer a controversial issue,” said Tom Haren, spokesman for the Coalition to Regulate Marijuana Like Alcohol. “Ohioans demonstrated this by passing State Issue 2 in a landslide. Ohioans are being extremely clear on the future they want for our state: adult-use marijuana legal and regulated.”

    As a citizen-initiated statute, the law is subject to change. The GOP Legislature, who opposed the popular move, are able to make changes to the law, or repeal it. It will be interesting to see if elected officials listen to the voting public or prefer to move Ohio to a nanny state like Florida.

    Ohio Republican leaders who failed to convince Ohioans that legal marijuana will endanger children, increase traffic accidents and create headaches for employers trying to hire. Senate President Matt Huffman, R-Lima, and House Speaker Jason Stephens, R-Kitts Hill, have indicated the Legislature will look at the new law and make changes.

    RELATED: How Does Marijuana Affect My Sleep And Dreams?

    As with some states, there is still a a hard road ahead, but it looks like, mid-term, voters will get what they requested.

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    Terry Hacienda

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  • People Are Choosing Marijuana Over Sleep Aids

    People Are Choosing Marijuana Over Sleep Aids

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    Cannabis has been used for pain relief and to promote sleep for thousands of years. Over the past several decades, a therapeutic role for cannabis in mainstream medicine has increasingly emerged.  Research into the benefits of cannabis for sleep has shown some progess with many people report using cannabis as a sleep aid.  Yes, people are choosing marijuana over sleep aids because they tend to work better with less side effects.

    A study demonstrates this way of thinking is not at all uncommon, showing less people are purchasing over the counter sleep medications when they have access to legal marijuana.

    The study, published in the journal Complementary Therapies in Medicine, was conducted by researchers from the University of New Mexico and California State Polytechnic University. These scientists looked into retail data collected from the Nielsen company in order to understand how legal marijuana in Colorado affected the sales of over the counter sleep medications. Nearly 600 stores (587) were analyzed, and recreational dispensaries from different counties were also sampled.

    RELATED: How Using Marijuana Can Effect Your Sleep Patterns

    “For the first time, we show a statistically significant negative association between recreational access to cannabis and OTC sleep aid sales, suggesting that at least some recreational purchasers are using cannabis for therapeutic rather than recreational purposes,” says the study.

    Photo by Mayara Klingner/EyeEm/Getty Images

    The study explains even if there’s no clinical evidence that supports marijuana as a sleep aid, people are still taking matters into their own hands, causing a significant reduction in the use of over the counter sleep medications.

    “Our results are consistent with evidence that legal access to medical cannabis is associated with reductions in Scheduled II-V prescription medications (e.g., opioids and sedatives), many of which may be used in part as sleep aids,” say the authors.

    RELATED: How Does Marijuana Affect My Sleep And Dreams?

    While changes such as this one mean that marijuana is a trusted alternative medicine from a variety of users, the fact that there isn’t enough science to back up these claims means that the people responsible need to catch up. The more that marijuana is embraced, the bigger risks the general population will be willing to take. This isn’t a problem with over the counter sleep medications, which aren’t all that serious, but it might become an issue with other types of conditions.

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    Maria Loreto

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  • As billions roll in to fight opioid epidemic, one county shows how recovery can work

    As billions roll in to fight opioid epidemic, one county shows how recovery can work

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    FINDLAY, Ohio — Communities ravaged by America’s opioid epidemic are starting to get their share of a $50 billion pie from legal settlements.

    Most of that money comes with a requirement that it be used to address the overdose crisis and prevent more deaths.

    But how?

    It could mean that places look more like the area around Findlay. Here, conservative Hancock County has built a comprehensive system focused on both treatment and recovery.

    “People recover in a community,” said Precia Stuby, the official who heads the county’s addiction and mental health efforts. “We have to build recovery-oriented communities that support individuals.”

    It was 2007 when Stuby began hearing from officials about prescription opioids being misused. That was about the same time Jesse Johnson, then 14, was prescribed the painkiller Percocet.

    The Findlay native was pregnant when she needed stents put into her kidneys as treatment for infections and kidney stones. After seven months on the opioid medication, she gave birth to a healthy daughter. Then she underwent an operation to remove the stents. The prescriptions stopped and she became sick from withdrawal.

    “I remember not even being able to hold my daughter,” said Johnson, now 31. “It just hurt.”

    Alcohol, marijuana and, a few years later, cocaine and opioids from the black market helped Johnson ease the pain.

    By then, county officials were seeing the area’s fatal opioid overdose toll tick up. The recovery system then included only some outpatient services and Alcoholics Anonymous.

    From 1999 through 2020, 131 deaths in the county were attributed to opioids. Across the country, it was more than 500,000. The county’s opioid-linked death rate over that period paralleled the nation’s as the crisis moved from pain pills to heroin to even more potent fentanyl.

    But the county took a path that many places did not.

    Officials created a plan with the help of the federally funded Addiction Technology Transfer Center that stressed recovery and built upon a local recognition that “this is our family, our friends, our brothers, our sisters,” Stuby said.

    The settlement funds from drugmakers, wholesalers and pharmacies will not be enough for every harm reduction, treatment, recovery and prevention program that might be needed to fight the nation’s opioid epidemic.

    But it could be enough to jumpstart major changes to the efforts.

    The county’s approach, which echoes experts’ recommendations for use of the settlement money, is that people with the right support can recover from addiction.

    Since its implementation began a decade ago, Hancock County has brought in more than $19 million in grants, largely from the federal government. Other funding comes from a county tax levy and the state. Health insurance helps pay for treatment.

    Among the steps Hancock County has taken:

      1. Like hundreds of communities, it’s launched a drug court where people can avoid jail if they work on recovery.

      2. The University of Findlay began offering classes on addiction. They can lead to an entry-level certificate for work in the field.

      3. It’s added three recovery homes and a community center where people can attend 12-step meetings, play video games or learn to crochet — and a similar place for teens.

      4. The county launched a needle exchange, providing supplies to reduce needle sharing and the risk of HIV and hepatitis C. These are policy staples in larger cities, but less common in smaller ones.

      5. At the Family Resource Center, the quick response team identifies and reaches out to overdose survivors and people with substance use disorder who are being released from jail or prison.

      6. The county deployed outreach workers to help people who survive overdoses, those who are incarcerated and others navigate the recovery system.

    There’s evidence that the efforts are helping. After 28 overdose deaths from all drugs last year, Hancock County has three confirmed overdose deaths and five suspected ones so far in 2023.

    “It’s not just about how to get people off of opioids, but how do we keep them in remission and increase their stable recovery?” said John F. Kelly, of Harvard Medical School. His research has shown that recovery support services — such as housing, community centers and peer coaching — can help.

    It’s worked for Johnson.

    After she was released from a hospital following an overdose when she was 27, a peer support worker tracked her down in Findlay’s homeless shelter.

    Now 31, she’s still in recovery, has two of her children living with her and regularly sees two others who live with her stepfather.

    Earlier this year, she started a peer support job with the Family Resource Center, the same organization that employed the worker who was so instrumental in her own early recovery.

    “It’s something that I’ve always wanted to do,” she said, “because I wanted to be that person that reached out to me and then found me at one of the worst times in my life and pulled me together somehow.”

    ___

    Johnson reported from Washington state. AP video journalist Patrick Orsagos also contributed to this article.

    ___

    The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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  • Access to CBD Leads to Decrease in Opioid Prescriptions, Study Shows | High Times

    Access to CBD Leads to Decrease in Opioid Prescriptions, Study Shows | High Times

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    A recent report published in the Southern Economic Journal on Oct. 26 found evidence that legal access to CBD has helped lead to a decrease in opioid prescriptions.

    A study called “CBD as a cure-all? The impacts of state-level legalization of prescription cannabidiol (CBD) on opioid prescriptions,” was authored by economists associated with South Carolina-based Wofford College, and California State University Bakersfield. “We find that the ability to purchase CBD legally leads to 6.6% to 8.1% fewer opioid prescriptions,” the authors stated.

    Researchers make it clear that it wasn’t just CBD legalization that led to opioid prescription reduction, but that of legal access to CBD products. “In general, we find that state level legalization of CBD products only leads to a statistically significant reduction in opioid prescriptions when states also allow for open and legal dispensaries, suggesting that adequate supply-side access is necessary to realize the potential benefits of legalization,” authors wrote.

    The report stated that stores selling CBD help decrease opioid prescriptions by 3.5% just two years after legalization goes into effect. It’s not the same for every state though, as this statistic varied for states with stricter regulations on CBD sales, including the requirement that people provide their ID or submit their personal info to a registry. “…(i) state legalization of prescription CBD alone does not reduce opioid usage; (ii) regulations limited purchasing, such as ID laws, negate nearly all of the benefits of demand-side legalization; and (iii) supply-side access, either via interstate purchasing or legal and open dispensaries, are vital in using pain-management substances to fully combat the opioid epidemic.”

    “Our paper provides important preliminary evidence that CBD may in fact reduce opioid prescription rates,” the authors said. “While CBD products may not necessarily be the cure-all they are marketed as, they do appear to be net substitutes for opioids.”

    The authors examined individual state laws and regulations specifically focused on CBD, such as Iowa, Tennessee, and Texas, between 2010-2019. During that window, there was a significant shift in CBD as an accepted and mainstream product. “Although the fastest growing segment of the CBD market is over-the-counter [OTC] usage, the vast majority of states that have established industrial hemp programs did not do so until 2016, meaning that OTC CBD products were largely unavailable until later in our study period.”

    They also examined Centers for Disease Control and Prevention (CDC) data for opioid prescriptions on a county level, but noted that it suggests “…that further research on the impacts of CBD is warranted.”

    The 2018 Farm Bill transformed the hemp industry in the U.S. Prior to the passage of the bill though, access was more limited. As time passed, states such as Tennessee decided to permit legal importation of CBD products from outside the state in 2016.

    The authors explained that while opioid prescriptions were reduced in those CBD-only states, the states that also allowed medical marijuana laws (MMLs) and/or recreational marijuana laws (RMLs) still made more of an impact on opioid prescription reduction. “Compared to states with no legal usage of marijuana, those who have adopted MMLs or RMLs prescribe fewer opioids per 100 population. However, these areas tend to be healthier and have more doctors, suggesting it is possible difference in opioid usage rates are not due to the presence of legal marijuana.”

    A state with a variety of CBD-only dispensaries appears to lead to the most significant drops in opioid prescriptions though. “Importantly, we see that [states with] CBD laws have lower opioid prescribing rates than states with no laws, though still higher than in states with MMLs or RMLs,” However, when we look at states that have allowed CBD dispensaries, we see that opioid prescribing rates are lower than those found in states with MMLs or RMLs, even with similar objective health measures (obesity and diabetes) to states with CBD laws.”

    Medical cannabis states experienced a 35% decrease in opioid prescriptions, but states that have not yet legalized still saw a decrease of 33%.

    Researchers concluded that their study is just a glimpse into the positive benefits of CBD and its effect on opioid prescriptions. “While further work is needed to understand the degree to which our results are generalizable to the over-the-counter market for CBD, our results suggest policy makers should consider the costs of regulation and carefully balance the tradeoffs between ensuring the quality of and restricting access to CBD,” authors said in their conclusion.

    In 2020, a former Drug Enforcement Administration (DEA) agent, Anthony Armour, who tried to swap opioids with CBD was fired from his position. Most recently in September 2023, the DEA defended its decision to fire the individual. “Mr. Armour argues that he ‘displayed negligence or poor decision-making,’ and DEA properly held him accountable for his poor decisions when they resulted in a verified positive drug test. DEA lost trust in Mr. Armour and properly removed him.”

    Separately, the DEA is currently considering recommendations from the Department of Health and Human Services. It’s uncertain if the agency will move forward to reschedule cannabis into a less restrictive category that shows medical value of the plant.

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    Nicole Potter

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  • Surprising Number Uses Marijuana To Not Get High

    Surprising Number Uses Marijuana To Not Get High

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    With Canada fully legal, 24 states in the US for recreational and 40 with medical, marijuana has gone mainstream.  A full 90% of people believe it should be legal in some form.  Is cannabis like alcohol and there for a good time, or are people truly using it for something else? The data say a surprising number uses marijuana to not get high, but to manage something medical.

    Part of the reason this number is significant is research has shown cannabis is no where near as addictive as opioids. North America is facing an unprecedented opioid crisis leaving cities big and small in a turmoil about what to do.

    According to a report from High Yield Insights, a Chicago-based consumer behavior research firm the numbers are intriguing.  States where recreational use has been legalized, nearly half (44 percent) of cannabis consumers are using cannabis for medical purposes, including for pain relief (69 percent) and sleep assistance (65 percent), and to manage anxiety (54 percent).

    In another study published in Psychopharmacology, the numbers are lower but significant. In  US legal–recreational states (34%) than US illegal states (23%), US legal–medical only states (25%), and Canada (25%). The most common physical health reasons include use to manage pain (53%), sleep (46%), headaches/migraines (35%), appetite (22%), and nausea/vomiting (21%). For mental health reasons, the most common were for anxiety (52%), depression (40%), and PTSD/trauma (17%). There were 11% who reported using cannabis for managing other drug or alcohol use and 4% for psychosis.

    Photo by Keenan Constance via Unsplash

    High Yield Insights shared medical marijuana patients are twice as likely to check CBD levels when they purchase cannabis, with 47 percent verifying CBD concentrations versus 25 percent of recreational users. Medical users also seek out more convenient and discrete ways to consume, such as edibles, topicals, oils and tinctures. Notably, medical users are twice as likely as recreational consumers to use topicals (22 percent vs 11 percent) and over three times as likely to use tinctures (17 percent vs 5 percent).

    Related: Cannabis Consumers Wean Off Of Booze, Over-The-Counter Drugs

    “The industry generally understands that the adult use consumer differs significantly from the medical user. We saw an opportunity to quantify this customer segment’s behaviors and preferences in a way to yield deeper understanding and reveal untapped market opportunities,” said Mike Luce, co-founder of High Yield Insights and a veteran in consumer and market research.

    “Flower will always play a significant role, but medical users are seeking solutions that feel familiar and accessible. With edibles, we’re seeing a demand for low- dose, fast-onset options that meet users’ needs for discretion and convenience. CBD-focused companies also have an opportunity for growth if aligned with medical cannabis users’ interest in what today are niche product forms,” Luce added.

    Several studies have demonstrated medical marijuana helps reduce the opioid dosage for patients undergoing treatment for non-cancer pain. More research can be done to legal the patients benefits.

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    Sarah Johns

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  • San Francisco Is Ready To Enforce the Harshest Punishments for Fentanyl Dealers

    San Francisco Is Ready To Enforce the Harshest Punishments for Fentanyl Dealers

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    Fentanyl abuse has become a huge problem in the country and politicians are trying to come up with different ways to deal with the crisis that is taking so many lives. So many people know someone who has been personally affected by the opioid crisis. Now, the city of San Francisco is taking steps to crack down on drug dealers. California is not really seen as “tough on crime” considering the state’s liberal leanings. San Francisco especially is certainly not considered tough on this issue. However, a new task force in the city seeks to empower law enforcement when it comes to opioid cases. Law enforcement will now be able to investigate fatal overdoses from the powerful drug as homicides, allowing prosecutors to charge dealers with actual murder. This was confirmed by California Governor Gavin Newsom via press release.

    Treating overdoses like homicides will allow the task force to treat these cases like they would any other homicide case, in terms of gathering evidence and processing intelligence. The main opioid they will be targeting is fentanyl, which is highly addictive and very deadly. To make up this force, the city will include individuals from San Francisco’s police department, the district attorney’s office, the California National Guard, and the California Highway Patrol. This will need to be a coordinated effort to really track and tackle this epidemic. I have watched many shows that document the impact drugs have on the lives of everyday people. I also watch some shows from the enforcement personnel’s perspective, following police officers and others as they seek to weed out the roots of the problem. The opioid problem is extremely complex, so I am interested to see if San Francisco’s task force will be effective.

    According to data from CNN, San Francisco has had 619 “unintentional drug overdoses” this year, as of September. This year’s death rate is on pace to surpass 2022’s rate of 647. San Francisco Mayor London Breed supports the task force, saying that the sale of fentanyl needs to be treated more severely. The idea behind the harsher new sentencing is the hope that it will deter dealers from selling the drug. But not everyone is a fan of the new force and their approach.

    Tracy McCray, who is president of the San Francisco Police Officers Association, said that this opioid crisis has “squeezed the life out of our city.” McCray thinks the police are missing way too many officers and that they can’t effectively respond to calls. They believe that this should be the main focus. Mano Raju, who is the public defender for San Francisco, thinks this is just another part of the failed war on drugs. Raju wants more resources funneled towards public health strategies that are based on evidence. He thinks that punitive approaches have failed over and over. And in addition to being ineffective, the war on drugs has long discriminated against people of color, especially Black people.

    This is clearly a tough divide, as people are searching for solutions that are humane and effective. Politically, I can see this being a net positive for Democrats. The blue city of San Francisco, and California as a whole, have been painted as a drug cesspool by right-wing media (despite having lower crime rates than several red states). Newsom said, “The opioid crisis has claimed too many, and fentanyl traffickers must be held accountable including, as appropriate, for murder.” He went on to add, “This task force is fighting for those affected by this crisis – for victims and loved ones who deserve peace.” Newsom is seen by pundits as having greater political aspirations, which are evident in his recent moderate decisions. It appears that he may be trying to solidify his toughness on this issue as he contemplates his political future. Public health policies mixed with legal changes can bring a holistic approach to a very complex issue. I am not sure what will end up working, but I hope something starts to turn the tide. 

    (featured image: Andrew Lichtenstein/Corbis via Getty Images)

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    Autumn Alston

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  • Movie Review: ‘Pain Hustlers’ tells a sadly familiar story with a kitchen-sink style

    Movie Review: ‘Pain Hustlers’ tells a sadly familiar story with a kitchen-sink style

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    The wife of a man who nearly died of an opioid overdose comes bursting into the office of the sleazy doctor who prescribed it, wrongly, in exchange for personal gain. She slugs the doctor, in her agony.

    The scene comes deep into the new Netflix film “Pain Hustlers,” and it feels bracingly real and tragic.

    If only the rest of the movie, the latest in a string of opioid-themed films, felt the same. Instead, despite a high-powered cast featuring a reliably solid Emily Blunt, an expertly low-life Chris Evans and the gifted Catherine O’Hara, the film tries too hard to be something it isn’t, or shouldn’t be: slick and breezy and too clever for its own good, filled with mockumentary interviews, wild montages, and other tricks used to more disciplined effect in more accomplished films.

    Not that Blunt isn’t an effective presence here as Liza Drake, a struggling, single Florida mom who works at a strip club but wants to move up in life — to be treated with respect, and to support her ailing teen daughter and her flighty mother. Indeed, Blunt carries the film with her intelligent and likable presence.

    But that speaks precisely to the other big problem with the film, which is directed by “Harry Potter” vet David Yates and inspired by the article and book by Evan Hughes, telling the real-life tale of an opioid startup that intentionally mis-marketed a fentanyl spray meant for severe cancer pain. Here, the bare bones are the same, but Yates and screenwriter Wells Tower invent their own corrupt company and their own characters.

    And the filmmakers seem determined to make their protagonist likable. In giving Liza a fairly ironclad excuse for her actions — her sweet, plucky daughter needs costly brain surgery — they take an easy way out. Not to mention that through most of the film, Liza believes (unbelievably, really, given her smarts) that she’s merely helping patients get the right drug. Wouldn’t it have been more interesting to see Blunt play a character who knew exactly what she was doing?

    Instead, Liza claims at the start, looking back: “I did it for the right reasons.” And here’s sales rep Pete, her unscrupulous colleague: “This was 2011. Strictly speaking, we were not part of the opioid crisis.” Evans, leaning into the sleaze, is fun to watch throughout, though the filmmakers care oddly little about his backstory.

    Then there’s Jackie, Liza’s mom, wacky but also steely, and, in the hands of a wonderful comic actor like O’Hara, vivid in everything she does. Lest you think Mom doesn’t approve of Liza’s slippery new career, heck, she joins her at the company, and even makes moves on the boss — but we’re getting ahead of ourselves.

    When we first meet Liza, she’s living in her sister’s garage. At the strip club, she meets Pete, who, mid-flirtation, suggests she come work for him, promising $100k in commissions in one year.

    Liza’s daughter, Phoebe (Chloe Coleman, in a lovely performance) gets in trouble at high school, engaging in what one might call, um, arson. We also learn she suffers from epilepsy. She requires a stable environment, the doctor says. And then Liza and daughter get kicked out of the garage and move into a cheap motel, eating instant noodles. Liza reconsiders that job offer.

    Outfitted with a fake resume — Pete, with a quick edit, gives her a biochem degree — Liza gets hired by Zanna, the company run by eccentric billionaire doctor Jack Neel (Andy Garcia, efficiently creepy) and proves a quick study. Against all odds, she finds a doctor (Brian D’Arcy James, playing against type as a sleazeball pain doc in need of a hair transplant) to write a prescription for Lonafen, a sublingual fentanyl spray. Soon she’s corralled him into a “speakers program” designed to bribe more doctors.

    Moving quickly from sundresses to color-blocked power ensembles, Liza starts raking in commissions, and she and Pete hire a team of hungry salespeople. Pete likens what they’re doing to driving a few miles over the speed limit — technically illegal, but everybody does it. Meanwhile, Liza’s suddenly able to afford a condo fit for a king, buy Mom a car, and enroll Phoebe in private school.

    Zanna, named for Neel’s own late wife, goes public, and is the industry’s new kid on the block. The company’s celebratory slogan, shouted at decadent parties: “We Own Cancer!”

    But things start getting uncomfortable. Neel, increasingly paranoid, rejects Liza’s proposed compliance plan. Then, he decides the best way to improve flat sales is to market Lonafen off-label — for any kind of pain, even headaches.

    Liza is aghast — Pete, not so much — but her daughter’s condition worsens, and Medicaid won’t cover the operation. She needs cash. Then, patients start overdosing. The look one man’s widow gives a weeping Liza, wordless, is chilling.

    The pace picks up as the law starts bearing down. But ultimately, “Pain Hustlers” feels like a retreading of the same ground covered in other recent works, bringing nothing especially new to the table and, in splitting the stylistic difference between slick/breezy and poignant/authentic, succeeding fully at neither.

    “Pain Hustlers,” a Netflix release that begins streaming Friday, has been rated R by the Motion Picture Association “for language throughout, some sexual content, nudity and drug use.” Running time: 122 minutes. Two stars out of four.

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  • Rite Aid files for bankruptcy amid opioid-related lawsuits and falling sales

    Rite Aid files for bankruptcy amid opioid-related lawsuits and falling sales

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    Philadelphia — Major U.S. pharmacy chain Rite Aid said Sunday that it has filed for bankruptcy and obtained $3.45 billion in fresh financing as it carries out a restructuring plan while coping with falling sales and opioid-related lawsuits.

    In 2022, Rite Aid settled for up to $30 million to resolve lawsuits alleging pharmacies contributed to an oversupply of prescription opioids. It said it had reached an agreement with its creditors on a financial restructuring plan to cut its debt and position itself for future growth and that the bankruptcy filing was part of that process.

    The plan will “significantly reduce the company’s debt” while helping to “resolve litigation claims in an equitable manner,” Rite Aid said.

    In March, the Justice Department filed a complaint against Rite Aid, alleging it knowingly filled hundreds of thousands of unlawful prescriptions for controlled substances from May 2014-June 2019. It also accused pharmacists and the company of ignoring “red flags” indicating the prescriptions were illegal.

    The Justice Department acted after three whistleblowers who had worked at Rite Aid pharmacies filed a complaint.

    Jeffrey Stein, who heads a financial advisory firm, was appointed Rite Aid’s CEO as of Sunday, replacing Elizabeth Burr, who was interim CEO and remains on Rite Aid’s board.

    Earlier this month, Rite Aid notified the New York Stock Exchange that it was not in compliance with listing standards. During a grace period, the company’s stock continues to be listed and traded.

    The bankruptcy filing in New Jersey and noncompliance with listing standards would not affect the company’s business operations or its U.S. Securities and Exchange Commission reporting requirements, it said.

    Rite Aid said it was arranging for payment of wages and other costs as usual, though some “underperforming” stores among its more than 2,100 pharmacies in 17 states will be closed.

    It earlier reported that its revenue fell to $5.7 billion in the fiscal quarter that ended June 3, down from $6.0 billion a year earlier, logging a net loss of $306.7 million.

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  • Kilogram of fentanyl found in NYC day care center where 1-year-old boy died of apparent overdose

    Kilogram of fentanyl found in NYC day care center where 1-year-old boy died of apparent overdose

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    NEW YORK — A taped package containing several thousand dollars worth of fentanyl was discovered inside the New York City day care center where a 1-year-old child died of an opioid overdose last week, according to a court filing.

    The owner of the day care center, however, maintained she had no knowledge of the presence of the highly-potent opioid, which sickened three other young children, including an 8-month-old girl who tested positive for fentanyl use.

    Grei Mendez, a 36-year-old who operated the Divino Niño day care inside a Bronx apartment, pleaded not guilty on Sunday to murder charges in the death of Nicholas Dominici. A man who rented a room inside the Bronx apartment, Carlisto Acevedo Brito, 41, is awaiting arraignment on the same set of charges.

    Police said they recovered approximately one kilogram of fentanyl, along with a press device used to combine the drug with other narcotics, inside the closet of a hallway connected to the apartment. A second press was located inside the adjoining room occupied by Brito, according to a criminal complaint.

    An attorney for Mendez, Andres Aranda, said his client lived above the day care center and rented out a room to Brito, her husband’s cousin, for $200 per month.

    “Apparently when the day care was not open, people came in and out of the apartment,” Aranda said.

    Friday was a “normal day” inside the day care center, with Mendez bringing the children upstairs, reading and cooking for them, then putting them to sleep, he said. But when Dominici didn’t wake up from his nap, she became terrified, calling 911 and shouting for neighbors, her lawyer said.

    Mendez, who also works as a home health aide, was sent to Rikers Island without bail following an arraignment Sunday night. Brito is due to appear in court on Monday afternoon. A message left with Brito’s attorney wasn’t immediately returned.

    The day care facility opened in January of this year. It passed both of its inspections, authorities said, including a surprise visit made by inspectors earlier this month.

    When emergency personnel arrived at the apartment on Friday afternoon, they discovered Dominici, as well an 8-month-old girl and a 2-year-old boy, showing signs of opioid intoxication. Medics administered Narcan, an overdose-reversing drug, to all three, helping to counter the symptoms of the 8-month-old and 2-year-old.

    Dominici was pronounced dead at a hospital in the Bronx later that day.

    A fourth child who had attended the day care was taken to a hospital by her mother after showing signs of opioid exposure, including shortness of breath and unresponsiveness.

    It remains unclear how the children may have been exposed to the drugs. Dominici’s cause and manner of death are pending further study, according to the city’s medical examiner’s office.

    Fentanyl, a synthetic opioid that is up to 50 times stronger than heroin, has become a primary driver of soaring overdose deaths both nationally and in New York City. Illegally-made fentanyl is often added to other drugs, including heroin, cocaine and methamphetamine, to increase its potency.

    Unintentional drug overdoses among children are also on the rise, with opioids the most common substance contributing to fatal poisoning of kids.

    In the overwhelming majority of cases, children were found to have orally ingested the substance, rather than touching or inhaling it in the air, according to a 2019 study published in the Journal of Pediatrics.

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