The war on drugs expands into new territories

Good article by the wonderful Maia Szalavitz in the New York Times: The War on Drugs Has a Warning for Post-Roe America

Under Roe, most obstetricians and gynecologists didn’t face this level of legal peril. But this isn’t the first time America has criminalized aspects of medicine. Physicians who prescribe controlled substances like opioids carry a similar burden. They can face decades in prison if prosecutors target them for overprescribing. Although there are cases of bad actors who prescribed opioids for profit, even legitimate physicians may fear being targeted by law enforcement, and research shows that the threat of legal action has a broad chilling effect on the way doctors provide care. The war on drugs shows that when medicine is criminalized and politicized, harm to patients and doctors increases, while the activities that the laws are intended to curb continue or even increase.[…]

Terrified of legal action, some physicians are already taking extreme measures to protect themselves from abortion prosecutions, such as ending women’s prescriptions for an immune disorder treatment, methotrexate, because if they get pregnant, it can cause miscarriage.

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17 Responses to The war on drugs expands into new territories

  1. Servetus says:

    It’s not only doctors who are legally driven to prioritize their careers over their patients’ healthcare as it’s been with cannabinoids, opioids, and the drug war.

    People will now want to read the fine print in their new health insurance contract that may be depriving them of the optimum medical care they need, something that’s happened before with contraceptives. Hospital staff with a moral agenda will add to the confusion of where to find legally available health care that includes abortifacients. Staffing conflicts in hospitals will intensify. Catholicism could finally succeed in taking condoms off the market.

    The Justices already know they’re about to receive a flurry of litigations for their decision. It’s always useful to look at the probability of future legal problems with the Roe v Wade reversal. And Dodd v United States gives new meaning to the idea of legal confusion.

    Given a very small group seriously ignorant of the life sciences comprising boundary value problems or sophisms concerning abortion, how will the Supreme Six rule on cases like these? Suppose for whatever reason a police raid on a location causes a woman to go into severe shock and suffer a miscarriage. Can police now be charged with a crime like manslaughter or 2nd degree murder? Can or will they be immune from being sued? Good luck on finding a solution.

  2. Servetus says:

    The15th World Congress on Polyphenols (AKA cannabinoids) is set to convene at “ADEIT ‘Fundación Universitat’, Valencia, Spain, & Online.” On September 30 it will address cannabinoids:

    “It is very important for our scientific committee to talk about the credibility of cannabis research and their medical applications. We will highlight the chemistry and pharmacology of cannabinoids, the analysis of cannabinoids, the influence of mitochondria, the application of cannabinoids as anticancer…”…

    AAAS Public Science News Release: Medical cannabis, cannabinoids and derivatives will be highlighted during the 15th World Congress on Polyphenols. Applications 2022 this September.

  3. Servetus says:

    Psychedelics use in the US now stands at 5.5 million adults per year and is on the rise according to an NIDA funded report that recommends preventive strategies for what’s being called a health risk involving “unsupervised hallucinogen use”:

    18-AUG-2022 — …According to author Livne, “Given the recent media coverage showing that an increasing number of adults may be reporting positive effects of ‘microdosing’ and expecting therapeutic benefits of hallucinogens without negative effects, our findings merit a comprehensive examination of time trends and motives for hallucinogen frequency and quantity of use.”

    “In light of popular media reports of a forthcoming ‘psychedelic revolution’ with commercialization and marketing that may further reduce public perception of any risk, researchers, clinicians and policymakers should increase their attention to the rising rates of unsupervised hallucinogen use among the general public,” observes Hasin. “Our results highlight such use as a growing public health concern and suggest that the increasing risk of potentially unsupervised hallucinogen use warrants preventive strategies”

    Co-authors are Dvora Shmulewitz, Department of Psychiatry, Columbia University Irving Medical Center, and Claire Walsh, New York State Psychiatric Institute.

    The study was supported by the National Institute on Drug Abuse (T32DA031099). […]

    AAAS Public Science News Release: New study estimates over 5.5 million U.S. adults use hallucinogens —
    Past 12-month LSD use rate increased from 0.9 percent in 2002 to 4 percent in 2019

    Wiley Online Library — Adolescent and adult time trends in US hallucinogen use, 2002–19: any use, and use of ecstasy, LSD and PCP

    • NorCalNative says:

      Exactly the kind of fear mongering one would expect from a journal called “Addiction.” According to the link, age 12-to-17 use of psychedelics is down, as is all use of PCP and Ecstasy.

      News Flash! Actual microdosing of psychedelics needs supervision about as much as one needs supervision to chew and/or drink a glass of water. Very large doses of psychedelics like psilocybin for depression or end-of-life anxiety are probably best handled in a clinical setting, IF, that individual is naive or lacks knowledgable support from a trusted friend.

      Folks who make a living in the addiction field need a strong authoritarian Preznit who wants to execute dealers. If their hero doesn’t show up soon Americans will continue to chip away at their Schedule I game.

      In the spirt of rebellion, this article made me consume a piece of psilocybin about one-quarter the size of the nail on my pinky.

  4. Servetus says:

    Another pillar supporting cannabis consumer stereotypes has fallen. Researchers at the University of Cambridge debunked the stereotypical myth of the unengaged and lazy stoner:

    1-SEP-2022 – Adult and adolescent cannabis users are no more likely than non-users to lack motivation or be unable to enjoy life’s pleasure, new research has shown, suggesting there is no scientific basis for the stereotype often portrayed in the media.

    Cannabis users also show no difference in motivation for rewards, pleasure taken from rewards, or the brain’s response when seeking rewards, compared to non-users. […]

    The researchers found no difference between users and non-users or between age groups on either the physical effort task or the real reward pleasure task, confirming evidence from other studies that found no, or very little, difference.

    Skumlien added: “We’re so used to seeing ‘lazy stoners’ on our screens that we don’t stop to ask whether they’re an accurate representation of cannabis users. Our work implies that this is in itself a lazy stereotype, and that people who use cannabis are no more likely to lack motivation or be lazier than people who don’t.

    “Unfair assumptions can be stigmatising and could get in the way of messages around harm reduction. We need to be honest and frank about what are and are not the harmful consequences of drug use.” […]

    AAAS Public Science News Release: Cannabis users no less likely to be motivated or able to enjoy life’s pleasure

    The International Journal of Neuropsychopharmacology Anhedonia, apathy, pleasure, and effort-based decision-making in adult and adolescent cannabis users and controls

    Martine Skumlien, MRes, Claire Mokrysz, PhD, Tom P Freeman, PhD, Vincent Valton, PhD, Matthew B Wall, PhD, Michael Bloomfield, PhD, Rachel Lees, MSc, Anna Borissova, MBBS, Kat Petrilli, MRes, Manuela Giugliano, MSc, Denisa Clisu, MSci, Christelle Langley, PhD, Barbara J Sahakian, PhD DSc, H Valerie Curran, PhD, Will Lawn, PhD.

  5. Servetus says:

    The University of Exeter has many good things to say about internet forums designed for those recovering from opioid use disorder:

    6-SEP-2022 – Active participation in internet forums has the potential to provide life-changing social benefits and wellbeing for people who are in remission from opioid use disorder. […].

    “Whether it is addiction to prescription drugs such as painkillers, illicitly manufactured synthetic opioids such as fentanyl, or opiates including heroine, the human cost is profound.

    “The provision of therapy and recovery support groups is an important step in addressing this issue, but there can barriers to accessing these services such as a lack of funding, stigma, and personal circumstances. This research highlights the impact that online groups, such as forums on popular platforms like Reddit can have. The results suggest that they may provide a lifeline for those who are in remission from opioid use disorder.” […]

    AAAS Public Science News Release: Research reveals potentially life-changing impact of internet forums on those in remission from opioid use disorder

    Journal of Medical Internet Research: Effects of Substance Use, Recovery, and Non–Drug-Related Online Community Participation on the Risk of a Use Episode During Remission From Opioid Use Disorder: Longitudinal Observational Study.

    Elahe Naserianhanzaei, PhD; Miriam Koschate-Reis, PhD.

  6. Servetus says:

    Australian cocaine is plagued by low quality products:

    30-AUG-22 — A high proportion of cocaine samples in Australia have been found to contain no trace of the drug, suggesting that supply from Latin America is a long way from meeting market demand in the country.

    Researchers from the Australian National University (ANU) in Canberra found that 40 percent of the cocaine samples submitted to the city’s CanTEST Health and Drug Checking Service since mid-July contained “no cocaine at all,” according to an August 25 press release. In those samples that did contain cocaine, purity levels were at an average of just 27 percent.

    The supposed cocaine was cut or replaced with sugar, talc, or dimethyl sulfone, the latter often being used to cut methamphetamine, reported the Guardian. […]

  7. Servetus says:

    DEA agents are investigating a medical clinic whose physicians were allegedly being pressured to over prescribe Adderall, a stimulant used to treat ADHD:

    16-SEP-22 — U.S. Drug Enforcement Administration agents have questioned people about telehealth company Done Global Inc.’s practices for prescribing controlled substances, according to documents reviewed by The Wall Street Journal and people familiar with the inquiries.

    The inquiries in recent weeks suggest ongoing and potentially widening interest from federal authorities in online mental-health companies such as Done that during the Covid-19 pandemic have been prescribing stimulants like Adderall for treatment of attention-deficit hyperactivity disorder—drugs the U.S. government classifies as controlled substances in the same category as OxyContin. […]

    The [WSJ] Journal first reported in March that some of Done’s clinicians felt they were pressured to prescribe stimulants and that a 2021 internal company report written by Done’s then-chief medical officer said that “multiple Done providers have specifically expressed a perception of pressure to diagnose ADHD and prescribe stimulants.” […]

  8. Servetus says:

    For those dog owners whose pet is suffering from osteoarthritis a remedy may be found in cannabis oil and Boswellia serrata:

    Long-term effects of a diet supplement containing Cannabis sativa oil and Boswellia serrata in dogs with osteoarthritis following physiotherapy treatments: a randomised, placebo-controlled and double-blind clinical trial

    Valeria Gabriele, Donal Bisanzio, Antonella Riva, Giorgia Meineri ORCID Icon, Raffaella Adami & Elisa Martello ORCID Icon

  9. Servetus says:

    A new therapy based on cannabinoid biochemistry proves effective and with no adverse side effects to countering amyopathic dermatomyositis:

    AAAS Public Science News Release: Lenabasum, a cannabinoid receptor agonist, is an effective and safe treatment for amyopathic dermatomyositis: According to a phase 2 clinical trial published in the Journal of Investigative Dermatology, this well-tolerated medication offers the first oral therapeutic option specifically for the skin-only form of this autoimmune condition

    Journal of Investigative Dermatology: Safety and Efficacy of Lenabasum, a Cannabinoid Receptor Type 2 Agonist, in Patients with Dermatomyositis with Refractory Skin Disease: A Randomized Clinical Trial

    Victoria P. Werth, Emily Hejazi, Sandra M. Pena, Jessica Haber, Majid Zeidi, Nithin Reddy, Joyce Okawa, Rui Feng, Muhammad M. Bashir, Kirubel Gebre, Arvin S. Jadoo, Josef Symon, S. Concha, Nancy Dgetluck, Scott Constantine, Barbara White.

  10. Servetus says:

    New use is discovered for leftover hemp products normally disposed of after extraction of CBD:

    CORVALLIS, Ore. – An Oregon State University study found that spent hemp biomass – the main byproduct of the cannabinoid (CBD) extraction process of hemp – can be included in lamb diets without any major detrimental effects to the health of the animals or their meat quality.

    The findings are significant because the hemp byproducts, known as spent hemp biomass, currently have little to no economic value for the hemp industry, the researchers said.

    Spent hemp biomass also has not been legalized as feed for livestock by the Food and Drug Administration due to the potential presence of THC and its potential impacts on animal health, so this finding is one step forward to getting that approval.

    “To our knowledge, our study is the first to evaluate the effects of feeding spent hemp biomass to livestock,” said Serkan Ates, an associate professor in Oregon State’s College of Agricultural Sciences. […]

    AAAS Public Science News Release: Hemp byproducts are good alternative feed for lambs, Oregon State study finds

    Journal of Animal Science: Assessment of spent hemp biomass as a potential ingredient in ruminant diet: Nutritional quality and effect on performance, meat and carcass quality, and hematological parameters in finishing lambs

    Nathan B Parker, Massimo Bionaz, Hunter R Ford, Agung Irawan, Erminio Trevisi, Serkan Ates.

  11. Servetus says:

    Cannabis succeeds as a pain reliever for replacing opioids:

    27-SEP-2022 — Medical cannabis could be an important alternative to opioids when managing pain, a new study of thousands of patients concludes.

    The research, published in the peer-reviewed journal Substance Use and Misuse, found that people reported being in less pain and could function better physically and socially, after using medical cannabis.

    It also found that the majority of those who had been taking oxycodone, codeine and other opioids to treat their pain were able to stop or reduce them via using medical cannabis. […]

    AAAS Public Science News Release: Could greater prescription of medical cannabis be a solution to the opioid crisis? In new study, opioid use seen to reduce or stop altogether, following prescription of medical cannabis

    Substance Use & Misuse: Medical Cannabis Patients Report Improvements in Health Functioning and Reductions in Opiate Use

    Carolyn E. Pritchett, Heather Flynn, Yuxia Wang & James E. Polston.

  12. NorCalNative says:

    Cannabis succeeds as a pain reliever for replacing opiates…

    No argument here, but it’s complicated. Cannabis has analgesic properties but it’s not in the class with opiates. I used cannabis to replace Morphine in 2013, on my own, before the health care field starting dumping most opiate patients so I know it’s a doable thing. My docs would have removed the opiates, I just beat them to the punch.

    However, despite my medical knowledge and stable access to cannabis products there are times when I wish I could purchase opiates because cannabis doesn’t always control or manage pain from osteoarthritis and neuropathy. It would have happened already , but I’m too damn scared of fentanyl-laced street drugs.

    In truth, the best analgesic is cannabis and opiates combined. Just cuz inattentive docs didn’t manage their opiate patients and allowed them to sell or give their medicine away isn’t a good reason for discontinuing appropriate opiate prescribing. Drug testing and pill counting are useful (invasive) tools to keep opiates from becoming street drugs. I know, I was piss tested many times. I didn’t like it but I understood why docs would do it.

    Transdermal patches, RSO, concentrates, tinctures, and flower in that order is my medical list. Suffering is the flip side of the “pain” coin, and that’s where cannabis shines. It’s not pain until it reaches the brain. That makes pain an emotional experience. Same level of pain, but LESS suffering with weed is a BFD. It’s said that laughter is the best medicine and its all about the mental distraction. Cannabis serves to help distract the mind from pain and allows better functioning.

    Interesting that the best pain relief found in nature produces euphoria. Euphoric distraction matters to patients in pain. It’s a quality-of-life thing.

    OT. I use to follow former? couch mate DdC on twitter and another internet forum where he posted. His twitter account was last used on March 21 of this year and his other thing (tapa-something) went silent as well. Hope he’s okay.

  13. Servetus says:

    Opioid receptors react to daylight hours in strange ways:

    7-OCT-2022 — In a new study conducted at the Turku PET Centre, Finland, researchers observed that shorter daylight hours impact the opioid receptor signalling in the brown fat of animals. When the amount of light diminishes, the opioid receptor levels increase. The observation was done in rats living in an artificial environment imitating seasonal daylight changes.

    “In the study, we observed that the number of mu-opioid receptors in brown fat was dependent on the length of daylight the rat was exposed to. This complements our previous findings that day length modulates opioid receptor levels in the brain emotional circuits in humans and rats,” says Senior Researcher Lihua Sun from the Turku PET Centre of the University of Turku.

    He states that the opioid receptor activity of brown fat and brain are two separate phenomena. However, they share the same goal of helping a mammal, a person or an animal, adapt both physiologically and also emotionally to the change of seasons.

    “Opioid receptor levels in the brain and brown fat might be interconnected, for example strengthening each other’s activity, but more research is needed to confirm this,” Sun emphasises. […]

    AAAS Public News Release: Daylight hours impact opioid receptor levels in brown fat

    European Journal of Nuclear Medicine and Molecular Imaging: [11C]carfentanil PET imaging for studying the peripheral opioid system in vivo: effect of photoperiod on mu-opioid receptor availability in brown adipose tissue

  14. Servetus says:

    Researchers in Australia will select children as participants to determine the medical effects of medicinal cannabis in children under palliative care:

    12 OCT 2022 — A Murdoch Children’s Research Institute pilot study will explore the use of medicinal cannabis to reduce symptoms in children and adolescents who are undergoing palliative care for non-cancerous conditions. […]

    The project, led by Murdoch Children’s Associate Professor Daryl Efron, will be the first in the world to investigate the feasibility and acceptability of a medicinal cannabis clinical trial into easing the symptoms of children undergoing palliative care for non-oncological conditions.

    The study will involve 10 participants, aged six months to 21 years, who are receiving care in the Victorian Paediatric Palliative Care Program, and have symptoms that are affecting their quality of life. Recruitment for the trial will start later this year. […]

    Associate Professor Efron said paediatric patients undergoing palliative care experience a range of debilitating symptoms that have a significant impact on well-being and quality of life including pain, irritability, gastrointestinal symptoms, seizures, spasticity and dystonia.

    “These symptoms are difficult to control with currently prescribed medications, most of which cause significant side-effects,” he said.

    Murdoch’s Children’s Research Institute: Medicinal cannabis study into easing symptoms of children in palliative care

  15. Servetus says:

    A Big Pharma product designed to identify those who might have a genetic propensity to develop opioid use disorder has been shot down by an FDA advisory committee:

    An FDA advisory committee on Thursday voted strongly against AvertD, a prescription genetic risk assessment tool for opioid use disorder (OUD).

    In an 11-2 decision, the Clinical Chemistry and Clinical Toxicology Devices Advisory Committee said the probable benefits of the AvertD device did not outweigh its probable risks, taking into account risks and benefits of currently available alternative forms of detecting OUD risk.

    AvertD detects the presence of 15 single nucleotide polymorphisms (SNPs) to help identify people who may have an increased risk of OUD. It’s intended to be used in combination with clinical evaluations and patient assessments when oral prescription opioids are being considered to treat acute pain. […]

    “We have no idea what the prescribing patterns would be after the test was implemented,” Gordon pointed out. “We have no patient-level outcomes. We have no assessment of both providers and patients of how they would approach receiving results of this test. And I think that’s a really important point because I’m really worried about the false positives.”

    “I believe 100% of the risk associated with this test is with false positives and false negatives — both people being untreated or poorly treated because somehow it came back as a positive result, or being given inappropriate treatment because it said negative,” observed Timothy Ness, MD, PhD, of the University of Alabama at Birmingham, who also voted no.

    For some panelists, the demographic makeup and sample selection of the study helped sway their decision. “I have a lot of concerns about the demographic population that was sampled in the testing, that it’s not reflective of the population that would actually be treated out there,” noted Sherif Zaafran, MD, president of the Texas Medical Board, who voted no. […]

    MedPage Today: Thumbs Down for Genetic Test for Opioid Use Disorder, FDA Advisors Say — False positives, false negatives remain a concern

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