THE DAILY BRIEFING

As more states legalize marijuana, pot entrepreneurs are becoming ever more innovative. Take the global beverage giants—especially beer brewers—who are eying a potentially lucrative multibillion-dollar market for weed-based drinks. There are already many pot-infused products, including seltzers, teas, colas, and cocktails, but the beverage sector is only a small part of the $20 billion legal weed marketplace. Now the industry sees potential in a wider range of marijuana drinks, mainly because they have negligible calories, you don’t have to smoke or inhale them, and there’s no risk of a hangover—at least, that’s what the marketing strategy will be. As the beverage makers ponder how to get more drinkers high, they’re also recalibrating the THC component to a lower level, as most cannabis beverages have traditionally packed a wallop—not exactly what the casual customer may be expecting as they get behind the wheel of their car.

Such concerns are apparently not bothering officials in Modesto, California, a city with some 200,000 residents in the state’s Central Valley. In what is believed to be the first sanctioned citywide cannabis tourism program, Modesto is promoting its pot dispensaries as a tourism draw, hoping to increase revenue as drivers make a stop in the town, which is midway between San Francisco and Los Angeles. The message would be, take a break, get gas, and something to eat, pop into the weed shop, and then back on the road. Currently, about 40 percent of the customer base at the city’s roughly two-dozen dispensaries is from out of town, so this gimmick may actually work. No word however about the risk of driving while drugged after fuelling up and getting high in Modesto.

And finally, The Guardian newspaper investigates whether medical cannabis is really a magic bullet for many maladies or if it’s too soon to make any definitive conclusions. While research suggests that extracts from the plant can be effective n treating pain, anxiety, and epilepsy, experts still preach caution around recreational use. The article notes that medical pot is still a contentious field due to fragmented data collection based mainly on the experiences of recreational users and that THC has been linked with an increased risk of psychosis and schizophrenia. There’s only one cannabis-based drug approved by the FDA—for a rare form of epilepsy—but advocates for medical marijuana and CBD often make unfounded claims about its effectiveness in treating a wide range of illnesses and disorders.

Overdose deaths are surging in Canada, as they are in the U.S., and the province of British Columbia is responding with a controversial strategy to give out highly addictive opioids to those struggling with substance abuse. The program includes distributing tablets of powerful fentanyl, with the hope that such drugs obtained from pharmacies and clinics are safer alternatives to street drugs, which increasingly are laced with lethal amounts of opioids and tranquilizers. Many say that the plan is an ineffective half-measure, as it does not include access to any form of drug treatment or a requirement that an addict must enroll in treatment. More than five people die every day from a drug overdose in the province, and while this approach may reduce fatalities at first, it won’t, in the long run, help substance users on the road to recovery.

Meanwhile, states are eager to get their hands on a portion of the proposed $26 billion opioid settlement and this may eventually lead to competing interests vying for a share of the money. If the deal is approved, the money would be shared among some 40 states that brought lawsuits against three big drug distributers and the opioid maker Johnson & Johnson. The settlement arrangement does include guidelines for how the money should be spent on addiction and treatment services, but legislatures could still squabble with governors and counties over priorities such as abatement programs. To get ahead of the process, Tennesse has established a special council to allocate funding, while New York set up a “lockbox” for money to ensure it goes to addiction services. Still, public health officials are still concerned about how exactly the states will allocate their dollars, and which programs will be funded.

And finally, the judge overseeing the opioid trial underway in West Virginia –part of the sprawling opioid litigation involving thousands of lawsuits—will have to answer a critical question: was it “reckless” for drug distributors to ship 81 million doses of a highly addictive opioid to one small Rust Belt city? And if so, can the deaths and addiction that followed be described as a public nuisance? The ruling, expected in a month, could shape precedents concerning corporate accountability for the opioid epidemic, in which more than 500,000 Americans have died. The West Virginia trial is taking place as more than 40 states are deciding whether to accept a proposed $26 billion settlement for a portion of the opioid cases, in which big drug distributors and opioid maker Johnson & Johnson are accused of contributing to the opioid epidemic. 

A majority of creditors seeking compensation from Purdue Pharma for its role in the opioid epidemic have agreed to a $4.5 billion settlement with the OxyContin maker, clearing the way for the deal to be approved. More than 120,000 creditors—including cities, states, tribes, and families and caregivers of children born addicted to opioids—are seeking payment from Purdue, which is ready to settle but will not admit responsibility for contributing to the opioid epidemic. The company will pay out the money over nine years to fund addiction treatment and prevention programs and exit the opioid market. Many states at first objected to the deal but then extracted further concessions from the firm, including the release of millions of documents related to the case and its painkiller business.

Meanwhile, the opposition is growing to another proposed opioid settlement between the states and the country’s largest drug distributors and opioid maker Johnson & Johnson. Washington State and West Virginia, as well as the city of Philadelphia, say the $26 billion settlement is too little and the payout timeframe of nearly two decades too long, faced as they are with a growing drug crisis and surge in overdose deaths today. They also want the companies, which underplayed the addictive nature of opioids and failed to control their distribution, to be held accountable. If a majority of states back out of the deal, it could reduce the total amount of compensation or scuttle the settlement altogether.

And finally, the World Health Organization has warned for the first time about the dangers of e-cigarettes, describing vaping as an emerging health threat. In a new report, the WHO said that nearly 85 countries do not have safeguards to protect against the rising popularity of vaping; only 32 countries have banned e-cigarettes, and 79 have adopted at least one measure—such as health warnings on the packaging—to curb sales. The report concluded that e-cigarettes are harmful and must be better regulated. In the U.S., there is an epidemic of youth vaping, which has prompted the Food and Drug Administration to consider stricter regulation of the industry.

The recent successes of the marijuana legalization movement can be attributed to many factors—including, as it turns out the financial support of a boatload of billionaires, from conservative political activist Charles Koch to Jeff Bezos and Elon Musk, who are on the front lines of the cannabis revolution. For his part, Koch told Forbes he supports legal pot because prohibition is a basic infringement on personal freedom, as well as a destructive policy that adds to America’s mass-incarceration problem. That’s why the devout libertarian is spending a fortune to help end federal marijuana prohibition.

Before they write some more checks, however, perhaps the deep-pocketed businessmen should take a look at this new study that found an increase in overdoses among children who ingest marijuana edibles. The number of children under 12 who have ingested edibles at home jumped from 132 in 2015 to almost 2,500 last year, according to the Association of Poison Control Centers, and those requiring medical attention jumped astronomically, too. This parallels the legalization of marijuana in many states. One reason for the rise, doctors say, is that the packaging for these substances looks very attractive to kids.

And finally, an analysis of the most popular vaping-related TikTok videos on a single day last year showed that nearly two-thirds portrayed potentially dangerous e-cigarettes in a positive light. The videos promoted vape use, joked about e-cigarette use, and showed tricks to do with a vape pen, all at a time when vaping has reached epidemic levels among young people. Collectively, the videos were viewed more than 1.5 billion times. Although other social media platforms have taken steps to ban such content, TikTok remains a ready source for positive messaging about vaping despite the risks posed by e-cigarettes.

President Biden has spoken out forcefully for establishing mandatory drug treatment for addicts—and keeping those struggling with substance abuse out of prisons and jails altogether. Addressing a town hall meeting in Ohio, one of the epicenters of the opioid epidemic, the president also advocated for post-incarceration services including housing and job training, in addition to drug treatment. The statement suggests that Biden will pursue this controversial approach as he gears up his drug policy team at the White House to confront a drug overdose epidemic that last year killed a record 93,000 Americans. Oregon has already decriminalized hard drugs in favor of paying a small fine and entering voluntary treatment, but the program has so far not been successful.

Meanwhile, in the wake of the proposed $26 billion opioid settlement announced this week between states and major players in the opioid industry, public health officials and advocacy organizations are pushing for state governments to sign on to a set of principles for how the money should be used. Instead of flowing to a state’s general fund, they want the money set aside in a dedicated fund for addiction services. They fear a repeat of the $206 billion tobacco settlement of 1998, in which most of the money was siphoned off to balance state budgets and never used for smoking cessation and abatement programs. The opioid settlement does contain provisions for using the money for addiction services, but it’s not clear if it enforceable. Some states, including New York, have already passed laws guaranteeing the money will be used for that purpose.

And finally, there may be another settlement in the opioid litigation on the horizon: fifteen states that had previously blocked a bankruptcy plan by OxyContin maker Purdue Pharma have now abandoned the fight, opening the way to a final agreement. The bankruptcy would allow the $4.2 billion settlement to go forward, but absolve the company’s billionaire founding Sackler family of any responsibility and shield it from any further liabilities. Thousands of other opioid cases are still pending against opioid manufacturers and pharmacy chains.

Senator Chuck Schumer has finally unveiled long-awaited legislation to end the federal-level prohibition of marijuana, reflecting a milestone in shifting public opinion about pot and efforts to end the decades-long war on drugs. The draft bill would remove cannabis from the Controlled Substances Act and begin regulating and taxing it under federal authority rather than the current situation in which states that have legalized the drug control sales, taxes, and usage. The bill also calls for expunging previous marijuana-related arrests and programs to help communities affected by cannabis prohibition. Winning passage of the bill, however, isn’t likely, as the measure faces significant opposition from both and moderate Democrats, and President Biden has not endorsed it.

Not surprisingly, the Schumer proposal received a frosty reception from across the board—including the cannabis industry. The bill’s authors even admitted that there are no standards to measure drugged driving or the impact of pot on fetal health. Critics such as Smart Approaches to Marijuana said it did not contain a cap on potency, limits on advertising, and a ban on flavored products that would be attractive to children. The union representing cannabis workers said it lacked support for creating good-paying jobs in the industry. Schumer no doubt believes that by simply introducing the legislation he will curry favor with progressives in his next reelection bid.

And finally, while the federal government can’t find a way forward, municipalities in newly legal pot states New York, New Jersey, and Connecticut are scrambling to figure out whether to allow marijuana dispensaries in their neighborhoods. Debate is heating up as localities debate the potential risks—including traffic fatalities and underage use—and the purported financial benefits for communities. Many have already said no, but others are putting out the welcome mat, believing that additional tax revenues and new jobs and businesses outweigh the possible pitfalls. The article points out that a majority of municipalities in Colorado have opted out of commercial sales, but fails to mention the same "not in our backyard" trend in California, Oregon, and Michigan, reflecting a grassroots opposition to rampant marijuana commercialization.

After years of legal wrangling, a tentative agreement has been reached to settle thousands of opioid lawsuits for an estimated $26 billion—with the money destined for addiction treatment and prevention services. The deal must still be approved by the 40 states and dozens of municipalities that brought the lawsuits against drug distributors Cardinal Health, AmeriSourceBergen and McKesson, and opioid maker Johnson & Johnson.  In a separate agreement, drug distributors would give $1.1 billion to New York State to end a trial currently underway there.

Yet thousands of other cases are still outstanding against opioid makers and pharmacy chains for their role in the epidemic, in which more than 500,000 Americans died over the past two decades from drug overdose, mostly opioids. Experts say however that the settlement provides an incentive for these companies to avoid trial without having to admit responsibility and be shielded from further litigation.

The settlement money is badly needed at a time when overdose are surging—to a record 93,000 last year—and treatment providers were forced to curtail services due to funding cutbacks. Money will be distributed to the states based on a formula including population an overdose deaths, with a provision that funds be used solely for addiction services, and not to balance state budgets. Some states, including New York, have passed a law stipulating that all funds be used to address the drug crisis.

If approved, the settlement is a major step forward to hold accountable the companies responsible for so many deaths and misery and a tragic drug crisis. But it does not end the opioid epidemic. Instead, it should be part of a comprehensive strategy that requires leadership, massive funding and a commitment to expanding drug treatment.

Drug overdose deaths rose nearly 30 percent in 2020 to a record 93,000, according to preliminary estimates by the CDC—the largest single-year increase ever as fatalities surged for opioid, meth, and fentanyl-related deaths across the country. Deaths rose in every state but two, with pronounced increases in the South and West and among Black and Hispanic populations. The data showed that fatalities had accelerated pre-pandemic and grew even more pronounced during lockdowns, social distancing, and the closing of drug treatment facilities. The national rise in deaths—which now exceed car crashes, gun violence or the AIDS epidemic—came as fentanyl became more entrenched in the drug supply, replacing heroin and finding its way into meth. What can the Biden administration do?

The Washington Post points out that the president has a number of ideas and strategies at his disposal, including expanding drug treatment, medication-assisted programs, and residential services, as well as harm reduction, boosting drug interdictions, and more education and prevention initiatives. But he may also consider some novel approaches, such as complete decriminalization of hard drugs, as Oregon has done. Treatment and access to anti-addiction medications are critical to this response; just 18 percent of people with substance use disorder receive such drugs and less than 10 percent of facilities nationwide offer residential treatment.

And finally, one thing that President Biden has done is to finally nominate a new “drug czar” to head the White House Office of National Drug Policy Control to oversee and help coordinate national drug policies. Biden tapped former West Virginia Health Commissioner Dr. Rahul Gupta for the job—a good choice for his experience dealing with the opioid epidemic in his state. Gupta would be the first physician to take the post, which was created in 1982. However, Biden is not expected to reverse President Obama’s decision to demote the office from a cabinet-level position, thereby denying Gupta a more prominent platform to advocate for drug policies during a national crisis.

Juul Labs was once the high-flying, market dominating company that fueled a global e-cigarette boom—and with it a teenage nicotine epidemic. Today, the company is under siege amid thousands of lawsuits accusing it of marketing to underage users, potential government regulations, and widespread health concerns about its vaping products. The biggest threat to staying in business is an upcoming FDA ruling on whether Juul’s devices and nicotine pods have enough public health benefit to continue selling them in the U.S. Major health organizations have asked the agency to reject the application, fearing it would lay the groundwork for the company to expand its reach once again.

Meanwhile, there is continuing debate over the decision by the World Anti-Doping Agency to disqualify American track star Sha’Carri Richardson from the upcoming Tokyo Olympics after she tested positive for marijuana. The drug is on the list of the agency’s prohibited substances, because it can be performance enhancing, and negatively effect hand-eye coordination, concentration and endurance, according to the agency. Some say the rules should be changed to allow athletes to consume cannabis products, as they are now legal in many states and countries.

And finally, pundits are speculating that the Sha’Carri Richardson pot scandal may be mellowing President Biden’s views on marijuana. Commenting on the suspension, Biden praised the athlete on the way she responded to the decision, but said “rules are rules.” Then he seemed to leave the door open to change, adding, “whether [the rules] should remain that way is a different issue.” Biden has been more cautious about marijuana legalization than many fellow Democrats and has not endorsed lifting the federal prohibition on pot, while saying states should be able to go their own way.

With the support of the Biden administration, Congress has for the first time allocated funding for harm-reduction services, prompting renewed debate about this controversial approach to help substance users. Harm reduction programs can include overdose prevention, distribution of clean syringes, and so-called safe consumption sites with healthcare professionals on hand to provide assistance if needed. Such facilities can save lives and prevent the spread of disease, and they also offer information about drug treatment and referral services. But they usually do not but do not require patients to enter treatment, a flaw that makes them less effective than they could be to assist more individuals struggling with substance abuse to get clean.

Meanwhile, nearly five months into Oregon’s initiative to decriminalize hard drugs and expand treatment, the first results are discouraging. Under the law, anyone caught with heroin or other illicit substances receives a citation (akin to a parking ticket) and $100 fine, which is waived if the individual agrees to get a health screening through an addiction recovery hotline. So far, just 29 people have called the hotline, as there is no mandatory treatment.

And finally, Johnson & Johnson has agreed pay New York State $230 million to resolve an opioid lawsuit against the drug company, one of thousands of such cases that are pending against opioid makers, drug distributors and pharmacy chains for their role in the opioid epidemic. The New York deal came on the eve of a jury trial in the state, and may boost efforts to reach a master settlement similar to the $206 billion agreement in the 1990s against tobacco companies.