Vaccines to prevent fentanyl, heroin overdose close to human trials

Researchers are expected to begin human clinical trials in early 2024 to test the safety and efficacy of vaccines to prevent heroin and fentanyl overdoses. While there is still a way to go, if approved, the vaccines could revolutionize the treatment of opioid addiction and reduce the number of deaths resulting from overdose.

Opioids – especially synthetic opioids – are the main driver of drug-related overdose deaths. The availability of drugs like heroin and fentanyl continues to feed the problem of opioid dependence and places users at risk of death. They’re also difficult drugs to quit.

Drug use and associated overdoses not only burden the loved ones of the person who died, but they also inflict an economic burden. In 2017, the costs for opioid use disorder and fatal opioid overdose in the US were estimated to be US$1.02 trillion.

While the streets are unlikely to ever be clear of drugs like heroin and fentanyl – and, even if they were, they’d probably be replaced by other, equally damaging drugs – researchers at the University of Montana (UM) are close to trialing the next best thing in tackling the opioid epidemic: vaccines to prevent fentanyl and heroin overdose and aid in treating opioid dependence.

The development of the vaccines began with Marco Pravetoni, a professor of psychiatry and behavioral sciences at the University of Washington, who, along with his research team, has been working on vaccines against opioids for more than 10 years.

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Federal Lawmakers Are Preparing To Reintroduce Legislation To Regulate Kratom Amid Pushback To FDA-Proposed Ban

As federal lawmakers prepare to reintroduce a bill to regulate kratom, a former Trump administration drug czar stressed the need to beat back “misinformation” from the Food and Drug Administration (FDA), which has attempted to ban the substance in the U.S. and abroad.

Members of the American Kratom Association (AKA) said during a webinar Tuesday that they expect federal legislation to regulate the drug “will be filed shortly” in Congress and could be taken up later this session.

The text of the forthcoming bill “will be word-for-word the same” as congressional legislation introduced last session, said Mac Haddow, a senior fellow at AKA. The title, however, will be updated to the Kratom Consumer Protection Act, a nod to model legislation that AKA has been lobbying for at the state and federal levels.

Sponsors will include, on the Senate side, Sens. Mike Lee (R-UT) and Cory Booker (D-NJ), who also sponsored last session’s bill, the Federal Clarity for Kratom Consumers Act. In the House, lead sponsors will be Reps. Mark Pocan (D-WI) and Jack Bergman (R-MI). Pocan sponsored last year’s bill in the House, while Bergman is a new addition.

The forthcoming legislation’s bipartisan sponsorship in each chamber—specifically pairing a “very liberal” elected official with a “very conservative” one—is designed to highlight “that this is not a partisan issue,” Haddow said. “This is about good policy.”

If the bill becomes law, it would require FDA to take further steps to evaluate the health and safety of kratom and would also prohibit the agency from regulating kratom products in a way that’s more restrictive than regulations for food or dietary supplements.

Neither chamber took action on the proposal last session, but AKA expects more traction—and more sponsors—on this year’s bill.

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U.S. Citizens Were 89% of Convicted Fentanyl Traffickers in 2022

Fentanyl overdoses tragically caused tens of thousands of preventable deaths last year. Many politicians who want to end U.S. asylum law claim that immigrants crossing the border illegally are responsible. An NPR‐​Ipsos poll found that 39 percent of Americans and 60 percent of Republicans believe, “Most of the fentanyl entering the U.S. is smuggled in by unauthorized migrants crossing the border illegally.” A more accurate summary is that fentanyl is overwhelmingly smuggled by U.S. citizens, almost entirely for U.S. citizen consumers.

Here are the facts:

  • Fentanyl smuggling is ultimately funded by U.S. consumers who pay for illicit opioids: nearly 99 percent of whom are U.S. citizens.
  • In 2022, U.S. citizens were 89 percent of convicted fentanyl drug traffickers—12 times greater than convictions of illegal immigrants for the same offense.
  • In 2023, 93 percent of fentanyl seizures occurred at legal crossing points or interior vehicle checkpoints, not on illegal migration routes, so U.S. citizens (who are subject to less scrutiny) when crossing legally are the best smugglers.
  • The location of smuggling makes sense because hard drugs at ports of entry are at least 96 percent less likely to be stopped than people crossing illegally between them.
  • At most, just 0.009 percent of the people arrested by Border Patrol for crossing illegally possessed any fentanyl whatsoever.
  • Each individual busted for fentanyl by Border Patrol possessed, on average, half as much fentanyl as each person busted at ports of entry in 2023 (10 versus 20 pounds).
  • The government exacerbated the problem by banning most legal cross‐​border traffic in 2020 and 2021, accelerating a switch to fentanyl (the easiest‐​to‐​conceal drug).
  • During the travel restrictions, fentanyl seizures at ports quadrupled from fiscal year 2019 to 2021. Fentanyl went from a third of combined heroin and fentanyl seizures to over 90 percent.
  • Annual deaths from fentanyl nearly doubled from 2019 to 2021 after the government banned most travel (and asylum).

It is monstrous that tens of thousands of people are dying unnecessarily every year from fentanyl. But banning asylum and limiting travel backfired. Reducing deaths requires figuring out the cause, not jumping to blame a group that is not responsible. Instead of attacking immigrants, policymakers should focus on effective solutions that help people at risk of a fentanyl overdose.

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A Netflix Drama Reinforces Pernicious Misconceptions About Pain Treatment

Former New York Times reporter Barry Meier, whose book about OxyContin is the main basis for the Netflix drama Painkilleracknowledges that the drug is “valuable for treating severe pain caused by cancer or chronic health issues.” The problem, he says, was that OxyContin’s manufacturer, Purdue Pharma, “could only make billions from it by lying, by saying it was good for everyday, common pain.”

Netflix’s six-part miniseries highlights that second point, vividly portraying Purdue Pharma’s reckless marketing of OxyContin. But it dismisses the caveat: that there are legitimate medical uses for this drug and other prescription opioids, which can make life bearable for patients who otherwise would suffer from excruciating pain.

Like the 2022 Hulu drama Dopesick, Painkiller embraces an indiscriminate aversion to opioids. The same attitude has inspired ham-handed restrictions on pain medication, which have helped drive drug-related deaths to record levels while leaving millions of patients to suffer needlessly.

Although Meier’s take on opioids is more nuanced than the one presented by this adaptation of his book, he shares with the screenwriters a desire to pin a complex, long-running social problem on a single villain. That much is clear from the subtitle of his book: “An Empire of Deceit and the Origin of America’s Opioid Epidemic.”

As Meier’s former employer frequently puts it, OxyContin is “widely blamed” for “igniting the opioid crisis.” But is it rightly blamed?

OxyContin, which was introduced in 1996, is an extended-release version of oxycodone, a semisynthetic opioid that had long been available in products such as Percocet and Percodan. OxyContin contained a larger dose of oxycodone, which was supposed to be gradually released over a 12-hour period, such that a patient could obtain steady pain relief by taking two pills a day.

That safeguard, according to labeling approved by the Food and Drug Administration, was “believed” to reduce the drug’s abuse potential. As it turned out, the original design could be readily defeated by crushing the tablets and snorting the powder.

According to federal survey data, however, nonmedical use of prescription pain relievers rose for 11 consecutive years before OxyContin was introduced. And regardless of how appealing it may have been to drug users, OxyContin never accounted for a very large share of the opioid analgesic market.

During litigation, Purdue presented data indicating that OxyContin accounted for just 3.3 percent of pain pills sold in the United States from 2006 through 2012. After adjusting for potency, ProPublica calculated that the product’s “real” market share was more like 16 percent.

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Ohio’s Local Health Departments Join Marijuana Legalization Opposition Campaign Ahead Of November Vote

An association representing Ohio’s 112 local health departments is opposing a marijuana legalization ballot measure set to go to voters in November, claiming the policy change would only contribute to drug-related problems in the state.

“Making marijuana more accessible through legal recreational use and retail sales hurts Ohio, creates serious new risks for children’s health and makes our workplaces and highways less safe,” the Ohio Association of Health Commissioners warned in a statement Tuesday. “With Ohio’s rates of opiate abuse and overdoses still among the highest in the country, we need to be helping Ohio find solutions to addiction, not facilitating it or the interests of an industry that profits from it.”

Ohio’s secretary of state’s office announced last week that advocates for the legalization measure turned in enough signatures to qualify for the ballot, which prompted statements of support—and opposition—from stakeholders across the state. The health commissioners join the Ohio Children’s Hospital Association and Adolescent Health Association, as well as law enforcement and some business groups, in advocating against the change.

Many of the new opposition group‘s claims treat as settled science issues that other say demand further investigation. For example, a recent federal research from the U.S. Centers for Disease Control and Prevention (CDC) found that teen marijuana use has actually been in decline since legal retailers began opening. And a number of studies have associated cannabis use and legalization with reductions in the use of unregulated opioidsprescription drugs and other regulated substances.

Ohio currently ranks seventh among all U.S. states in terms of drug overdose death rates, after West Virginia, Tennessee, Louisiana, Kentucky, Delaware and New Mexico.

The campaign backing the measure, the Coalition to Regulate Marijuana Like Alcohol, told Marijuana Moment on Tuesday that it’s “confident that Ohioans, just like voters in the states that have come before us, will see through these tired, debunked talking points.”

“Ohio’s current system of prohibition does not work,” said campaign spokesman Tom Haren. “We know that there is an adult-use market in Ohio today. It is called the illicit market. It is completely unregulated, products are not tested and products are not taxed. Also, drug dealers in the illicit market are happy to sell to children without ever checking for ID. This is a reality that is bad for the health of Ohioans.”

In states that have legalized, Haren added, “We know that usage among minors and adolescents does not change. We know that regulation does not adversely affect the workforce, and we also know that it is a boon for state tax revenue.” The measure’s 10 percent proposed tax, for example, “will generate more than $100 million every year to fund substance abuse and addiction treatment.”

In fact the state could see between $257 million and more than $400 million annually in tax revenue through legalization, according to a recent analysis from Ohio State University researchers.

Voters, for their part, appear to be leaning in favor of legalization. A USA TODAY Network/Suffolk University poll published in July found that about 59 percent of Ohioans supported legalizing the possession and sale of cannabis for adults 21 and older. Just 35 percent were opposed.

Republicans officials in Ohio remain divided on the issue. Gov. Mike DeWine said last week that he believes “it would be a real mistake for us to have recreational marijuana,” adding that he visited Colorado following its move to legalize in 2012 and saw what he argued is an “unmitigated disaster.”

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Study Shows Marijuana Is ‘Significantly Associated’ With Reduced Use Of Unregulated Opioids

A new federally funded study has found that marijuana is “significantly” associated with reduced opioid cravings for people using them without a prescription, suggesting that expanding access to legal cannabis could provide more people with a safer substitute.

Researchers at the British Columbia Centre on Substance Use and UCLA surveyed 205 people who use cannabis and opioids without a prescription from December 2019 to November 2021, aiming to test the theory that marijuana represents an effective harm reduction tool amid the overdose crisis.

The study, published in the International Journal of Drug Policy, found that 58 percent of participants reported that their motivation to use marijuana was to reduce opioid cravings. And a multivariable analysis showed that cannabis use “was significantly associated with self-reported reductions in opioid use.”

The researchers said that, to their knowledge, this represents the first study of its kind to specifically investigate “outcomes of intentional cannabis use to manage opioid cravings” among those who are using painkillers that they may be getting from the illicit market, which comes with a risk of obtaining contaminated products.

“These findings indicate that cannabis use to manage opioid cravings is a prevalent motivation for cannabis use among [people who use unregulated opioids] and is associated with self-assessed reductions in opioid use during periods of cannabis use,” the study authors wrote. “Increasing the accessibility of cannabis products for therapeutic use may be a useful supplementary strategy to mitigate exposure to unregulated opioids and associated harm during the ongoing drug toxicity crisis.”

The U.S. National Institutes of Health (NIH) and Canadian Institutes of Health Research (CIHR) provided funding for the study. One of the seven study authors disclosed that he has professorship backed by the cannabis company Canopy Growth to research marijuana science at the University of British Columbia.

This is one of the latest pieces of research in a large pool of scientific literature suggesting that marijuana can serve as a substitute for both legal and illegal substances and prescription drugs.

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Texas A&M suspended professor accused of criticizing Lt. Gov. Dan Patrick in lecture

Joy Alonzo, a respected opioid expert, was in a panic.

The Texas A&M University professor had just returned home from giving a routine lecture on the opioid crisis at the University of Texas Medical Branch in March when she learned a student had accused her of disparaging Lt. Gov. Dan Patrick during the talk.

In the few hours it took to drive from Galveston, the complaint had made its way to her supervisors, and Alonzo’s job was suddenly at risk.

“I am in a ton of trouble. Please call me!” she wrote to Chandler Self, the UTMB professor who invited her to speak.

Alonzo was right to be afraid. Not only were her supervisors involved, but so was Chancellor John Sharp, a former state comptroller who now holds the highest-ranking position in the Texas A&M University System, which includes 11 public universities and 153,000 students. And Sharp was communicating directly with the lieutenant governor’s office about the incident, promising swift action.

Less than two hours after the lecture ended, Patrick’s chief of staff had sent Sharp a link to Alonzo’s professional bio.

Shortly after, Sharp sent a text directly to the lieutenant governor: “Joy Alonzo has been placed on administrative leave pending investigation re firing her. shud [sic] be finished by end of week.”

The text message was signed “jsharp.”

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Thanks for nothing, DEA. Fifty years later, drugs are deadlier and more abundant than ever

As of this week, the United States has “enjoyed” half a century under the thumb of the Drug Enforcement Administration (DEA), a wing of the Department of Justice established in 1973 by former President Richard Nixon. Instead of truly addressing the deepening drug problem in the U.S., the DEA has worsened public health outcomes related to drug use, promoted racially stigmatizing policies, stomped on civil liberties and burned stacks of cash in a vain effort to control the uncontrollable.

There’s no denying the drug situation in the U.S. is dire. Approximately 1 million people have died of overdoses since 1999, many of these deaths driven by powerful opioids like illicit fentanyl and its many analogs. Nonetheless, polydrug use — the mixing of multiple substances — is a far more lethal combination than any drug on its own, as well as the true underbelly of this drug crisis disaster.

Despite decades of increased funding, more seizures and more policing, the DEA cannot seem to make a dent in this crisis. The body count from overdoses continues to rise, and there’s no end to the flow of drugs into the U.S.

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Portland’s Multnomah County to give fentanyl users tin foil, straws, pipes to smoke drug

The county covering most of Portland, Oregon will be distributing tin foil and straws to fentanyl users in the city. 

According to a local report, the Multnomah County Health Department will be distributing the drug paraphernalia along with glass pipes for smoking meth and crack as well. Along with those, “snorting kits” will also be made available. 

The Oregon Legislature passed a bill that decriminalizes the distribution of drug paraphernalia if the materials are for harm reduction purposes.

It has not been signed into law by the governor of Oregon yet, however, residents of Portland have reportedly become frustrated about the situation with regards to drug use. Many reports have shown an increase in fentanyl overdoses as well as a growing number of residents wanting to bring back criminal penalties for the open use of drugs. 

Spokesman Sarah Dean, of Multnomah County, confirmed with Willamette Week that the policy to distribute the “smoking supplies” is new. Dean said that the rise of fentanyl being smoked instead of injected has decreased the demand for “harm reduction” services related to overdoses. 

Dean said handing users smoking supplies discourages them from injecting the drug, which is also a vector for disease. She stated, “Several decades of research have also shown that providing supplies for safer drug use does not increase illegal drug use.”

The amount of fentanyl in the county, according to Dean herself, has risen substantially. A policy that was going to criminalize and limit the use of fentanyl itself was dropped after being introduced by Mayor Ted Wheeler of Portland just recently. 

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Florida Bans Medical Marijuana in All State-Licensed Rehabs and Sober Living Houses

Last week, Florida legislators passed a law that will narrow the state’s medical marijuana eligibility. While the change might seem marginal, it’s a step in the wrong direction.

Florida Gov. Ron DeSantis, a leading contender in the 2024 Republican presidential primary, signed S.B. 210 into law. The bill pertains to substance abuse treatment programs licensed by the state, like rehabs or sober living residences. It adds language to Florida law that beginning in 2024, licensed treatment facilities must enforce “a prohibition on the premises against alcohol, marijuana, illegal drugs,” and prescription medications not prescribed to the person taking them. The text further clarifies that it “includes marijuana that has been certified by a qualified physician for medical use.”

Medical marijuana use in an addiction treatment or sober living facility is controversial. Cleveland House, a South Florida sober house, states on its website that if one resident is smoking pot, it could negatively impact another resident’s recovery. But studies increasingly suggest that marijuana can help alleviate symptoms of opioid addiction. Men’s Tribal House, a sober living facility in Utah, actively incorporates medical marijuana use into the recovery plans of half its residents.

In 2016, more than 70 percent of Florida’s voters chose to expand the state’s medical marijuana program. Under previous state law, only patients with “cancer or a physical medical condition that chronically produces seizures or severe and persistent muscle spasms” qualified, and only for doses low in THC, the principal psychoactive component in cannabis. The 2016 ballot measure, later passed into law as S.B. 8, expanded eligibility to include a variety of conditions like Crohn’s disease, post-traumatic stress disorder, and anything that caused “chronic nonmalignant pain.”

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