Tag: opioid epidemic

Drug Busts Are Linked to More Overdoses and Deaths

As the Drug Enforcement Administration (DEA) celebrates its 50th birthday, new research highlights how counterproductive its mission is. Published in the American Journal of Public Health, the research links drug busts to a spike in overdoses in nearby areas.

The cross-university team of researchers started out with this hypothesis: “Law enforcement efforts to disrupt local drug markets by seizing opioids or stimulants are associated with increased spatiotemporal clustering of overdose events in the surrounding geographic area.”

To test this hypothesis, they looked at data from Marion County, Indiana, on drug seizures and overdoses—including fatal overdoses, emergency medical calls for nonfatal overdoses, and naloxone administration—in 2020 and 2021. Marion County is the largest county in Indiana and contains the state capital, Indianapolis.

They found a significant association between “opioid-related law enforcement drug seizures” and an increase in drug overdoses in surrounding areas (that is, within 100, 250, and 500 meters). This association held at one week, two weeks, and three weeks from the drug bust data.

“For example, the expected number of fatal overdoses within 500 meters and 21 days of opioid-related drug seizures ranged from 18.0 to 22.7 per 100 drug seizures, so the observed rate of 23.6 was higher than expected,” the paper states.

Stimulant-related drug seizures were also associated with an increase in drug overdoses, albeit to a lesser extent than with opioid-related drug seizures. The significant association here only held “at a distance of 100 meters within 7 days,” and was stronger for nonfatal overdoses.

During the two-year study period, there were 2,110 opioid-related and 3,039 stimulant-related seizures—an average of seven per day. There were 1,171 overdose deaths recorded during that period (an average of 1.6 per day) and 12,590 nonfatal overdoses (an average of 17.2 per day).

“Supply-side enforcement interventions and drug policies should be further explored to determine whether they exacerbate an ongoing overdose epidemic and negatively affect the nation’s life expectancy,” the researchers suggest.

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They Followed Doctors’ Orders. Then Their Children Were Taken Away.

One morning in the summer of 2020, Jade Dass woke up and vomited. She assumed she was hung over; she’d been depressed lately and sometimes self-medicated with too much wine. But then a woman in her online counseling group suggested that she might be pregnant. Dass looked in the mirror and realized she was probably right.

At 26, Dass had spent the previous 10 months in recovery from an opioid addiction. Her boyfriend of three years, Ryne Bieniasz, was in recovery, too. Since getting out of rehab in 2019, they had been trying to re-establish their lives, but they had trouble finding work and a place to live. Eventually they made their way to a remote horse farm east of Phoenix, doing odd jobs in exchange for housing. They didn’t have a car or close friends or much in the way of family support. Even so, Dass longed to be a mother; she thought she would be good at it.

To help with her recovery, Dass had been taking Suboxone, a medication that binds to the receptors in the brain that crave opioids, preventing withdrawal without creating a high. She was concerned that it might affect the developing fetus, but a health care provider, she says, assured her that she should continue taking it. The advice seemed counterintuitive; pregnant women are routinely urged to abstain from alcohol, tobacco, even ibuprofen. So Dass did her own research. Everyone from the American College of Obstetricians and Gynecologists to the Centers for Disease Control and Prevention said the same thing. Pregnant women with opioid addiction should be encouraged to take doctor-prescribed synthetic opioids such as buprenorphine, the main component of Suboxone, or methadone, which has been used to treat heroin and other addictions for almost six decades. Weaning off these medications could trigger withdrawal and contractions that could result in a miscarriage, premature birth or cause a person to relapse.

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Bombing Mexican Cartels Won’t Stop Fentanyl

Americans continue to overdose on illicit fentanyl despite increased seizures of the drug coming north from Mexico. Several prominent Republicans are suggesting that the U.S. respond with wartime tools such as airstrikes and troop deployments. But combining the war on drugs with the war on terror is a surefire recipe for costly engagement abroad and little progress in reducing fentanyl-related harm at home.

During his presidency, The New York Times reported last year, Donald Trump expressed interest in using missiles to attack Mexican drug cartels and destroy their labs. Reps. Mike Waltz (R–Fla.) and Dan Crenshaw (R–Texas) helped revive that idea in January, when they introduced a joint resolution that would authorize the president to “use all necessary and appropriate force” against “foreign nations, foreign organizations, or foreign persons” involved in fentanyl production or trafficking.

Sen. Lindsey Graham (R–S.C.) argues that the military should “go after these organizations wherever they exist.” Several GOP presidential hopefuls, including former United Nations Ambassador Nikki Haley and entrepreneur Vivek Ramaswamy, have echoed that sentiment.

There is little reason to believe these strikes would be as precise or effective as proponents claim. “Even a campaign of air strikes against cartels could easily escalate,” says Benjamin H. Friedman, policy director at Defense Priorities. “Cartels could retaliate,” he notes, and “strikes are bound to fail to affect fentanyl shipments, let alone meaningfully damage cartels.”

Mexico hawks like Waltz say the U.S. has “done this before,” citing Plan Colombia, a Clinton-era counternarcotics and counterterrorism initiative. But “claiming that Plan Colombia was a success is just plain false,” says Javier Osorio, a professor of political science at the University of Arizona whose research focuses on criminal violence in Latin America.

When the Revolutionary Armed Forces of Colombia (FARC) “demobilized after the peace agreement in 2016,” Osorio says, coca cultivation “skyrocketed.” He notes that “it’s even higher than before the U.S. started conducting aerial eradications” of coca fields. A similar counternarcotics program in Mexico, the Mérida Initiative, has been “a total disaster,” Osorio says: It has not stopped drug trafficking, and years after the initiative began, Mexico’s top law enforcement official was still “in bed” with the Sinaloa cartel.

The war on drugs has helped turn Latin America into the most violent region in the world, leading to increased black market activity and corruption. “If airstrikes miraculously kill off a cartel, another will fill the gap,” Friedman says, “likely with considerable violence between criminals as the market shifts.” According to Osorio, “There’s always going to be someone willing to kill and die for supplying drugs when there’s such a huge market.”

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Kentucky’s Risky Million-Dollar Bet to Fight the Opioid Crisis With Psychedelics

On the steps of the state capitol building in Frankfort on May 31, the Kentucky Opioid Abatement Advisory Commission (KYOAAC) announced the launch of a new state-funded program that would aim to help stem the damage and destruction wrought by the ongoing opioid crisis that has devastated the lives of millions and led to the deaths of hundreds of thousands. But the new initiative wasn’t simply to throw more money and resources into tried-and-true public health programs.

Instead, the commission announced it was going to explore allocating tens of millions of dollars toward studying and promoting the use of the controversial, plant-based hallucinogen ibogaine in psychedelic-assisted therapy to combat the opioid crisis, as well as treat a host of other mental health issues. The goal is to make Kentucky the first state in the nation to pursue a clinical program around ibogaine—currently legal only in Mexico and New Zealand.

“This administration recognizes that the opioid epidemic is one of the most tragic and visible symptoms of spiritual affliction which pervades our society,” Bryan Hubbard, chairman and executive director of KYOCC, told The Daily Beast. “We must do better. We must explore every possible avenue which holds the potential for improvement.”

The news was lauded by advocates of psychedelic-assisted therapy, an increasingly popular form of mental health treatment.

“With yesterday’s announcement, Kentucky is taking a bold leadership role to addressing the opioid epidemic,” Jesse MacLachalan, state policy and advocacy coordinator for Reason For Hope, a psychedelic therapy advocacy nonprofit, told The Daily Beast. “This is a prudent and measured approach to explore innovative solutions to the greatest addiction crisis our country has experienced in its history. We applaud the Bluegrass State for the example they are setting for states across the country.”

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L.A. County Gives Crack Pipes to Homeless to Prevent Fentanyl Deaths

Los Angeles County has begun distributing pipes used for smoking crack, methamphetamine, and opioids to the homeless population, hoping to discourage them from overdosing by injecting themselves with fentanyl.

The Los Angeles Times reported on the grim phenomenon Tuesday, which has divided homeless advocates:

By a line of ragged RVs slung along 78th Street in South Los Angeles, a seven-member team passes out glass pipes used for smoking opioids, crack and methamphetamine.

Part of the front line of Los Angeles County’s offensive against the deadly fentanyl epidemic, the group hands out other supplies: clean needles, sanitary wipes, fentanyl test strips and naloxone, medication that can reverse an overdose.

…

Fentanyl, which is laced in everything from weed to heroin and meth, was present in more than half of the nearly 1,500 overdose deaths of homeless people in 2020-21. In response, Los Angeles County this year increased its harm reduction budget from $5.4 million to $31.5 million. Most of the money covers staffing and programs; officials said that only a fraction of county funds — no state or federal money— goes to pipes.

Some believe that the pipes merely facilitate addiction; others argue that they slow the rate of drug intake.

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DRUG WAR TACTICS WON’T STOP XYLAZINE DEATHS

Over the past six months, national and local media have flooded the news cycle with stories about the “horrors” of xylazine, a non-opioid animal tranquilizer increasingly found mixed with fentanyl, sometimes to deadly effect. Outlets including the New York Times and CNN have trafficked in graphic portrayals of xylazine use, even calling it “the zombie drug,” a term advocates say fuels stigma and punitive measures against people who use drugs.

Indeed, amid this wave of sensationalized coverage and broader concerns that xylazine is driving up overdose rates nationwide, lawmakers have responded by rushing to criminalize possession of the drug. But critics fear the current push against xylazine is repeating the cycle that led to its rise.

Four states, Florida, West Virginia, Ohio, and Pennsylvania, have already added xylazine to their lists of controlled substances. Proposed legislation in the U.S. House of Representatives and Senate would criminalize some xylazine possession at the federal level and increase funding for law enforcement to “crack down on its spread,” in the words of one of the bill’s sponsors.

This official response to xylazine mirrors tactics that have been used for decades in campaigns against emerging “drugs of concern.”

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The Republican Primary Consensus for Sending the Military Into Mexico

When Sen. Tim Scott (R–S.C.), a comparatively affable chap in the context of contemporary GOP politics, announced his 2024 presidential bid on Monday, the speech was predictably full of the upbeat, anecdotal, ain’t-America-grand stuff that Scott, like generations of Republicans before him, has made central to his political career.

Then things suddenly turned dark.

“When I am president, the drug cartels using Chinese labs and Mexican factories to kill Americans will cease to exist,” Scott vowed. “I will freeze their assets, I will build the wall, and I will allow the world’s greatest military to fight these terrorists. Because that’s exactly what they are.”

Scott’s bellicosity was no mere bolt from the blue. As Reason has been documenting for six years now, Republicans, even while otherwise souring on U.S interventionism abroad, have increasingly concluded that the alarming spike in domestic fentanyl overdoses would best be treated by sending the military into Mexico.

Donald Trump first floated the idea, while he was president, of designating drug cartels as terrorist organizations—thereby allowing for extraterritorial prosecutions, enhanced investigative powers, and increased penalties for domestic drug-related crimes—in March 2019, but held off after the government of Mexico repeatedly objected on grounds of sovereignty while making uncooperative noises about transnational migration policy.

But the appetite for corralling cartels into the otherwise-unpopular war on terror was only beginning to rumble in the conservative belly. Trump himself in the summer of 2020 twice asked then–Defense Secretary Mark Esper whether “we could just shoot some Patriot missiles and take out the labs, quietly,” according to Esper’s 2022 memoir. Notable MAGA politicians Sen. J.D. Vance (R–Ohio) and Rep. Marjorie Taylor Greene (R–Ga.) have both suggested violent interdiction south of the border, as have a bevy of more traditional hawks. There are a handful of escalatory bills bouncing around Congress.

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Helping veterans, battling opioid addiction driving magic mushroom legislation progress

Forty lawmakers, 36 Democrats and 4 Republicans, have co-sponsored a bill aiming to allow for the medical use of psilocybin and a psilocybin therapy grant program, which is currently sitting at the committee level of the Assembly, with its Senate version also in committee. The Assembly bill, A03581, was introduced by Democrat Pat Burke in February. There has been other legislation introduced regarding the hallucinogen as well, with Linda Rosenthal’s version legalizing the adult possession and use of hallucinogens like it.

Research has shown that psilocybin, an organic psychedelic compound, can benefit people with cluster headaches, depression, anxiety, irritable bowel syndrome, ADHD and obsessive compulsive disorder, but it’s getting the most universal traction because of its impact on those suffering from PTSD.

“Psilocybin doesn’t have the huge appeal that marijuana had,” Democrat Assemblyman Phil Steck, who is the Assembly’s Chairman of the Alcoholism and Drug Abuse Committee, says. “But, there are definitely people who make a strong case for the proposition that it helps with PTSD. Certainly we want to do everything that we can to help people that are coming back from war, and if psilocybin has proven to do that, then it should be legal for that purpose.”

Johns Hopkins University has conducted several studies on psilocybin, saying it has substantial antidepressant effects, but needs to be administered under carefully controlled conditions through trained clinicians and therapists.

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Prohibition Gave Us Xylazine in Fentanyl. The Solution, Drug Warriors Say, Is More Prohibition.

The emergence of the animal tranquilizer xylazine as a fentanyl adulterant, like the emergence of fentanyl as a heroin booster and substitute, has prompted law enforcement officials to agitate for new legal restrictions and criminal penalties. That response is fundamentally misguided, because the threat it aims to address is a familiar consequence of prohibition, which creates a black market in which drug composition is highly variable and unpredictable. Instead of recognizing their complicity in maintaining and magnifying that hazard, drug warriors always think the answer is more of the same.

Xylazine was first identified as a fentanyl adulterant in 2006, and today it is especially common in Puerto Rico, Philadelphia, Maryland, and Connecticut. In Philadelphia between 2010 and 2015, according to a 2021 BMJ article, xylazine was detected in less than 2 percent of drug-related deaths involving heroin and/or fentanyl. Its prevalence in such cases had risen to 31 percent by 2019. According to a 2022 Cureus report, “up to 78%” of illicit fentanyl sold in Puerto Rico and Philadelphia contains xylazine. In 2022, the Drug Enforcement Administration (DEA) reports, xylazine was detected in 23 percent of fentanyl powder and 7 percent of fentanyl pills analyzed by its laboratories.

Xylazine is a sedative, analgesic, and muscle relaxant that is not approved for use in humans but is commonly used by veterinarians. It is chemically similar to phenothiazines, tricyclic antidepressants, and clonidine. But like fentanyl and other opioids, xylazine depresses respiration, so combining it with narcotics can increase the risk of a fatal reaction. Unlike a fentanyl overdose, a xylazine overdose cannot be reversed by the opioid antagonist naloxone.

Xylazine also seems to increase the risk of potentially serious skin infections and ulcers that have always been a hazard of unsanitary injection practices. According to a 2022 article in Dermatology World Insights and Inquiries, “the presumed mechanism” is “the direct vasoconstricting effect on local blood vessels and resultant decreased skin perfusion,” which impairs healing.

Why is xylazine showing up in fentanyl? For the same reasons fentanyl started showing up in heroin. As a 2014 literature review in Forensic Science International notes, “illicit drugs, such as cocaine and heroin, are often adulterated with other agents to increase bulk and enhance or mimic the illicit drug’s effects.” Because xylazine and heroin have “some similar pharmacologic effects,” the authors say, “synergistic effects may occur in humans when xylazine is use as an adulterant of heroin.”

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GOP embraces a new foreign policy: Bomb Mexico to stop fentanyl

A growing number of prominent Republicans are rallying around the idea that to solve the fentanyl crisis, America must bomb it away.

In recent weeks, Donald Trump has discussed sending “special forces” and using “cyber warfare” to target cartel leaders if he’s reelected president and, per Rolling Stone, asked for “battle plans” to strike Mexico. Reps. Dan Crenshaw (R-Texas) and Mike Waltz (R-Fla.) introduced a bill seeking authorization for the use of military force to “put us at war with the cartels.” Sen. Tom Cotton (R-Ark.) said he is open to sending U.S. troops into Mexico to target drug lords even without that nation’s permission. And lawmakers in both chambers have filed legislation to label some cartels as foreign terrorist organizations, a move supported by GOP presidential aspirants.

“We need to start thinking about these groups more like ISIS than we do the mafia,” Waltz, a former Green Beret, said in a short interview.

Not all Republican leaders are behind this approach. John Bolton, Trump’s third national security adviser who’s weighing his own presidential run, said unilateral military operations “are not going to solve the problem.” And House Foreign Affairs Committee Chair Mike McCaul (R-Texas), for example, is “still evaluating” the AUMF proposal “but has concerns about the immigration implications and the bilateral relationship with Mexico,” per a Republican staff member on the panel.

But the eagerness of some Republicans to openly legislate or embrace the use of the military in Mexico suggests that the idea is taking firmer root inside the party. And it illustrates the ways in which frustration with immigration, drug overdose deaths and antipathy towards China are defining the GOP’s larger foreign policy.

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