Drug WarRant

If failure can be defined as something that creates the very crisis it’s intended to prevent, then a recent Brown University study of close-proximity opioid overdoses in Indianapolis confirms suspicions that little else fails like the drug war when it comes to saving lives.

The [researchers] found that within seven, 14 and 21 days, opioid-related seizures of drugs by police were significantly associated with increased overdoses within 100, 250 and 500 meters of the seizure location. Most notably, the number of fatal overdoses was two-fold higher than expected within seven days and 500 meters following an opioid-related incident in which police seized drugs.

The researchers hypothesized that the increase in overdose events was because people who use opioids will generally seek out a new supply after losing access to their previous drug supply, and that new supply will have unknown potency. In addition, in the time period between losing the familiar supply and finding a new one, people using opioids can experience diminished tolerance to drugs. Accidentally ingesting a dose beyond one’s tolerance can be fatal. […]

Congratulations are due the Brown University research team for making ‘drug war’ another definition of failure and enabling it to appear next to synonyms like breakdown, malfunction, cataclysm, crash, defeat, ruin, collapse, catastrophe, miscarriage, tragedy, frustration, and disappointment.

The US Office of Inspector General has identified questionable funding practices by DEA Administrator Anne Milgram, a former NYU law professor, federal prosecutor, and New Jersey attorney general.

Milgram is accused of diverting no-bid DEA contracts into the hands of friends or former colleagues in violations of federal regulations. These included a $400,000 data analysis contract to Jose Cordero, a $257-per-hour consulting contract to Lena Hackett, and a $1.4 million contract to a Washington, DC law firm to “review the DEA’s scandal-plagued foreign operations, a report widely criticized for giving short shrift to repeat instances of agent misconduct.”

“This report is stunningly vague in its actual evaluation of known problems at the DEA and remedies to fix them,” said Sen. Chuck Grassley, an Iowa Republican on the Senate Judiciary Committee. “This speaks to the agency’s broader effort to evade oversight. The agency has attempted to dodge my oversight inquiries but I intend to push forward.”

The external probe was announced in 2021 following reporting by The Associated Press on the crimes of José Irizarry, a disgraced former DEA agent now serving a 12-year federal prison sentence after confessing to laundering money for Colombian drug cartels and skimming millions from seizures and informants to fund an international joyride of fine dining, parties and prostitutes.

Irizarry told the AP last year that DEA agents have come to accept that there’s nothing they can do to make a dent in the flow of illegal cocaine and opioids into the United States that has driven more than 100,000 overdose deaths a year.

“The drug war is a game,” Irizarry said. “It was a very fun game that we were playing.”

Irizarry’s case got one paragraph in the external review. An ongoing federal grand jury inquiry into some of his jet-setting former DEA colleagues was mentioned in a footnote. Also, Irizarry’s lawyer told AP he offered to make his client available for an interview for the review but was never contacted. […]

A June deadline from the Biden Administration demanding that medical doctors who prescribe opioids qualify for a DEA license to do so by taking 8 hours of training has drawn critical comments from the many doctors affected:

So if I understand this correctly, the new requirement applies to DEA registrants who did not obtain the “X” waiver (as I did more than 15 years ago) or are not certified in addiction medicine. – William F Cox MD

I have to have a DEA license for my telehealth job, in which I’m not even allowed to prescribe Sudafed or Phenergan. Yet I have to spend 8 hours on this BS. – L Knight MD

Big Pharma, organized Medicine calling pain the fifth vital sign, quality measures being introduced threatening docs for not prescribing for controlling pain, local law enforcement moonlighting as security at pill mills and politicians ignoring complaints of citizens about out of state vehicles driving through their communities to pill mills the same time each week to stock up and it’s doctors’ fault we have an opioid crisis? – Steve Reznick

Incredible. Of note, 11 of the 28 “free” courses on the AMA website are actually free. – Sunset MD

Another waste of time and money. Most of the drugs that are being abused and causing fatal overdoses are illegal and are not being prescribed by anyone. – Dr. Whatnow

Makes a lot of sense for a dermatologist wasting their time taking a class on substance abuse. – BMS

State licensure has required courses for renewals. Now the MBAs and legislative committees who have no experience in the real world are making new rules. – SRB

More uncompensated time. – Dan Smith

Let’s see how many hours we can suck out of a caring MD…THE financial guys already have them on a mandatory treadmill of x patients per x minutes … God help the cancer patients, postsurgical patients, fibro patients … why is it that I feel somehow street drugs will become your grandmother’s recourse…better stock up on narcan…. – kat sheetz rn bsn

How about physicians demanding President Biden and the politicians take courses on Laws and the Constitution (just a refresher and update) to make sure they’re current with the laws and current events? This way the constituents will know they can pass laws effectively and put the dollars for these “required” courses back into the coffers of the homeless and un-and underinsured. – BarbW38

Shows you how out of touch the edict makers are. So we have to do 20-25 modules of garbage every year on Healthstream. Then more garbage to renew licenses. Now the DEA. Have to pay friends of these people to take the modules. They need to be offered “free” which means our licensing fees go to “friends and family” who get the contracts to provide this learning. Meanwhile in the trenches I dread to renew narcotics every month for cancer patients because it is so onerous and time consuming. Care is fractured and everyone and every state operates in a silo. That is the dangerous problem. – D shields

Viagra and not opioids is the winner of the unpopular drug contest when it comes to international drug smuggling, according to Kaiser Health News (KHN).

Despite evidence to the contrary, the FDA has long defended its efforts to prevent opioids from entering the country by intercepting prescription drug packages delivered through international mail….

…the agency’s own data revealed that confiscated packages did not contain significant amounts of opioids. The FDA said that just 33 packages of opioids and no fentanyl were found in the 53,000 drug shipments its investigators examined in 2022, which amounts to roughly 0.06% of the total packages searched, KHN reported.

Because the FDA has claimed that confiscating these international packages was preventing the import of opioids, pharmaceutical companies have used this claim to lobby against proposals in Washington, D.C., to allow Americans to buy their prescription drugs from countries where those drugs are cheaper, such as Canada.

The FDA often stops prescription drug shipments, even when no opioids are found, because of improper U.S. drug labeling and packaging.

The report noted that of the drugs confiscated by the FDA in 2020, the number one most common item was sildenafil, a generic form of the erectile dysfunction drug Viagra. Other common medications seized included those for asthma, diabetes, cancer, and HIV.

According to KHN, the FDA has been given millions of dollars to fight the shipment of opioids into the U.S., despite the limited evidence that these drugs are entering the country this way. […]

For decades, millions of Americans seeking to save money have bought drugs from foreign pharmacies, with most sales done online. Although the FDA says people are not allowed to bring prescription drugs into the United States except in rare cases, dozens of cities, county governments, and school districts help their employees buy drugs from abroad. […]

Neurologist Holly Elser, MD, PhD; and Keith Humphreys, PhD; Mathew V. Kiang, ScD; Swapnil Mehta, MD; Jong H. Yoon, MD; William O. Faustman, PhD; at the Department of Neurology, Hospital of the University of Pennsylvania, have debunked prohibitionist propositions familiar to many readers here at Drug WarRant which implied that smoking marijuana leads to or causes schizophrenia:

Question: Is state cannabis legalization or commercialization associated with increased rates of psychosis-related health care claims?

Exposure: State cannabis legalization policies were measured for each state and month based on law type (medical or recreational) and degree of commercialization (presence or absence of retail outlets). […]

Main Outcomes and Measures: Outcomes were rates of psychosis-related diagnoses and prescribed antipsychotics. […]

Conclusions and Relevance: In this retrospective cohort study of commercial and Medicare Advantage claims data, state medical and recreational cannabis policies were not associated with a statistically significant increase in rates of psychosis-related health outcomes. […]

Findings: In this cohort study of claims data from 63,680,589 beneficiaries from 2003 to 2017, there was no statistically significant difference in the rates of psychosis-related diagnoses or prescribed antipsychotics in states with medical or recreational cannabis policies compared with states with no such policy. […]

Meaning: The findings of this study do not support an association between state policies legalizing cannabis and psychosis-related outcomes […]

A few California police officers are undergoing withdrawal-like symptoms from the drug war due to being denied any opportunity to enforce a failed crusade against cannabis:

…a grand jury added four new criminal counts against Joseph Huffaker, including impersonating a federal officer and falsifying records in a federal investigation.

Prosecutors say Huffaker and at least one other officer posed as ATF agents during traffic stops where they illegally seized weed from drivers on the side of the highway and later falsified records to cover up the corruption.

“It’s been a long time, five years ago this month,” said Zeke Flatten [a former Texas cop], who says Huffaker and a yet unidentified second individual robbed him of three pounds of marijuana in December 2017 while impersonating ATF agents during a traffic stop along Highway 101. “I’m satisfied. I’m satisfied that they’re being held accountable.” […]

Prior to legalization, the police could steal part or all of a suspect’s marijuana supply simply by seizing it and making certain it never reached an evidence storage locker. No complaints about lost or misplaced evidence were likely to emerge from the accused. Times change, and in this case, drug enforcement crooks need to accept that weed is legal in California.