THE DAILY BRIEFING

Marijuana use is increasing dramatically among older adults, leading doctors to voice concerns about the safety of the drug for those over 65. One study estimates that cannabis consumption in this demographic has jumped 75 percent from 2015 to 2018, and accelerated even further during the COVID-19 pandemic. Analysts say contributing factors include lockdown stress, legalization and a backlash against opioids. And as is true with so many debates about legalization, the policy is moving way ahead of the science: physicians warn that the data is still very unclear about the safety of medical marijuana, and whether or not they actually help medically. While some studies show that pot can alleviate nausea from chemotherapy and certain types of chronic pain, the impact is usually modest.

Meanwhile, as lawmakers in New York State hash out a new marijuana legalization bill, the New York Daily News has published an editorial urging the legislature to include a ban all driving while under the influence of pot. It notes that every state that has legalized marijuana had seen an increase in impaired driving, along with more crashes, injuries and fatalities. Another reason: there are no reliable tests for drug-related DUI as we have for alcohol, making it hard for law enforcement to control.

And finally, there are conflicting rulings from the White House about marijuana policy and hiring staff. At first, the Biden administration signaled that past pot use wouldn’t necessarily disqualify a person from employment, a reversal from previous presidents. Now, it seems that 5 staff members have been let go for using pot in the past—highlighting how murky the guidelines are. For example, some staff members that did consume marijuana are being allowed to stay on, after signing a pledge not to use while working for the government and submit to random drug testing. The conflict reflects confusion about broader marijuana policy, as progressives try to secure support from President Biden for more far reaching cannabis reform, while he favors a moderate approach in line with existing science.

Who will President Biden pick to be the nation’s “drug czar”? Speculation is growing he’ll tap former West Virginia health commissioner Rahul Gupta for the job, which coordinates national drug policy. Gupta, now a top official at the advocacy group March of Dimes, won praise for tackling opioid overdose in the state, and is backed by influential West Virginia Sen. Joe Manchin. But Gupta was also criticized during his tenure for shutting down a needle exchange program aimed at reducing the transmission of HIV/AIDS. The drug czar post may be brought back to a cabinet-level position, an appropriate move at a time when drug overdose fatalities have reached a record level and Biden is promising a robust response to the opioid epidemic.

Meanwhile, concern is growing over the growing number of overdose deaths among Latinos. Although CDC does not classify deaths by race, data has recently emerged about higher rates among certain groups, including Blacks and Latinos. In Maryland, for example, deaths last year related to opioid use among Latinos increased 27.3 percent among Latinos, compared to 13 percent for non-Hispanic whites. Latino adults have experienced more depression and suicidal thoughts than other groups during the pandemic, according to a CDC report, and there is a shortage of bilingual behavioral health professionals.

And finally, New Jersey lawmakers are still haggling over the state’s new marijuana legalization law. Potential amendments include provisions on workplace rules and underage use, which now allows law enforcement to notify parents—but only after a second or third offense. Critics say this unfairly binds the hands of police and leaves parents in the dark about drug use.  

Victims of the opioid epidemic may be able to claim up to $48,000 in compensation from Purdue Pharma, the maker of highly addictive OxyContin, according to an analysis of the company’s latest bankruptcy proposal. Under the terms of the offer, aimed at settling nationwide opioid litigation, covered injuries include overdose deaths, addiction and babies born with neonatal abstinence syndrome, caused by exposure to opioids in the womb. Payouts would depend on the severity of an individual’s injury or addiction, and come from a $750 million trust established by Purdue, which is facing more than 100,000 personal-injury lawsuits related to the firm’s flagship prescription painkiller. If approved by a bankruptcy court, the firm will also set up trusts to fund opioid abatement and treatment programs.

Meanwhile, New York State lawmakers are inching toward agreement on a marijuana legalization bill, but are stuck on how to address impaired driving under the influence of pot. There’s no roadside test for marijuana or THC, making law enforcement difficult. The impasse came about after legislators acknowledged a significant increase in traffic accidents and fatalities in legal marijuana states.

And finally, as legislators in Albany hash out the legalization measure, they should be aware of a new survey that finds broad support overall for legalization in New York—but also resistance to allowing pot shops in neighborhoods. While 61 percent of New Yorkers favor legalization, 52 percent of New York City residents would chose an opt-out close banning marijuana sales where they live. This disconnect mirrors trends in other legal states—including California, Colorado and Oregon—where a majority of localities don’t want a marijuana retail presence in their backyard.

Purdue Pharma, the maker of OxyContin, has made a new offer to settle nationwide opioid litigation, increasing its contribution and guaranteeing that funding will go toward helping individuals and communities devastated by the opioid epidemic. In a filing to bankruptcy court, Purdue upped its offer to $4.2 billion over a decade—from around $3 billion—mostly from members of the firm’s founding Sackler family, who would relinquish control of the company. And it proposed setting up trust funds to handle distribution of the money to victims, hospitals and Native American organizations, rather than going into the general coffers of state and local governments. Purdue is not out of the woods yet, as a bankruptcy court and tens of thousands of parties to the litigation must approve the settlement proposal.

Meanwhile, Kevin Sabet writes in the New York Post that the $1.9 trillion COVID relief package will deliver $100 billion to New York State to shore up its budget shortfall—thereby eliminating one of the main arguments that Big Post uses to push for marijuana legalization. Legalization would also fail to create an “equitable” industry, wipe out the illicit market, and keep the drug away from young people, Sabet writes.

And finally, legal weed is also under debate in Rhode Island, where lawmakers are discussing two major questions: how much revenue will be generated from legalization, and would this have to go toward the increased costs associated with addiction that legalization is expected to cause? Unlike other legal states, Rhode Island is considering these issues before it moves ahead with allowing easier access to weed.

Drug overdose deaths soared last year in the U.S. during the COVID-19 pandemic, and evidence now suggests that Black Americans may have suffered the heaviest toll. Although the CDC doesn’t track drug deaths by race, researchers at the University of Pennsylvania say data collected in Philadelphia show that overdoses climbed more than 50 percent among the city’s Black residents, while among whites fatalities remained flat and in some months even declined. Analysts say that people of color and poor Americans generally face a harder time accessing addiction treatment and are less likely to be given addiction withdrawal medications as part of treatment.

Meanwhile, officials in Maine are also concerned about the state’s staggering increase in drug overdoses last year to a record 502—a nearly 30 percent increase over the previous year. Maine was just getting a handle on the addiction crisis when the pandemic hit, bringing isolation and depression and cutting many people off from treatment, while their struggles were obscured by efforts to contain the virus. Across the country, drug-related overdoses spiked in 2020 to more than 83,000 during the 12-month period ending in June, the highest level ever recorded in a year.

And finally, Mexico is about to legalize marijuana, a landmark policy change that would make the country the world’s largest market for the drug—but don’t expect a “green” profit wave to materialize anytime soon. Analysts say a majority of Mexicans oppose legalization, and there’s relatively low domestic demand compared to Canada, another legal country. And if Mexican drug cartels expect to make money by exporting marijuana, they will face competition from the 13 states in the U.S. that allow legal sales of the drug.

President Biden has promised an all-out assault on the nation’s opioid crisis, with significant resources to be allocated for harm reduction, law enforcement and significantly expanding drug treatment. But so far, says the editorial board of Bloomberg, there’s been little forthcoming from the White House. More than 500,000 Americans have died from drug overdose since 1999, and illicit illegal fentanyl is fueled a spike in fatalities last year record high of more than 80,000. As cash-strapped states cut back on resources for addiction treatment, Bloomberg urges President Biden and Congress to take action to bring the crisis under control.

Meanwhile, Mexico is set to legalize marijuana, making it the largest legal cannabis market in the world. Yet the move to legalize in Mexico is going ahead despite widespread public opposition, and doubts that the move would deter the rising level of drug cartel violence, as pro-pot groups claim.

And finally, while many states are considering curbs on marijuana products with dangerously high levels of intoxicating THC—due its impact on public health— Alaska might go in the other direction and increase the amount of the psychoactive compound allowed in edible pot. Under pressure from the cannabis industry, the state’s marijuana control board is studying doubling the amount of THC from its current level, the most restrictive in the country. Opponents in Alaska argue that the more potent pot used today has already led to an increase in calls to poison control centers and traffic crashes and fatalities.

A movement is growing in several states to enact legislation that limits high levels of intoxicating THC in marijuana products, after new scientific research showed the substance is associated with cases of psychosis and cognitive impairment in young people. Colorado is considering such curbs for all adult-use marijuana, while Florida is looking at medical marijuana, with sponsors of a bill saying high-potency pot s being abused by doctors and patients as well as recreational users. Any measures to limit easier access to marijuana face strong opposition from the cannabis industry, which argues that any regulation will lead us back to the days of Reefer Madness.

Meanwhile, more news on THC: a new study finds that the psychoactive component of pot persists in breast milk when mothers used marijuana during pregnancy—and even after successfully abstaining. The report, in JAMA Pediatrics, called for early marijuana abstention to limit the effects of THC on fetal brain development.

And finally, a hard-hitting op-ed in the online Connecticut Mirror calls out Gov. Ned Lamont of Connecticut for pursuing fast track marijuana legalization, saying there’s “only talk of money” and no debate about “poisoning our children and adolescents.” The article also questions the notion that legalization will help communities of color through new business opportunities, asserting that it will also get their children hooked on marijuana.

The market for legal medical marijuana in the United States is booming, with 36 states and the District of Columbia having legalized the drug for a range of illnesses. Yet so far there is little scientific evidence to demonstrate that medical marijuana has any of the purported benefits that producers claim. What’s more, the product remains largely unregulated and anything but safe, according to a new book summarized in the New York Times. In fact, most of the same health concerns raised decades ago about using medical marijuana therapeutically remain unresolved, even as the potency of pot—and its intoxicating THC component—have dramatically increased. For example, proponents say medical pot can be an effective treatment for everything from pain to glaucoma and multiple sclerosis, but no scientific studies or randomized control trials have shown this to be true.

Meanwhile, the Federal Trade Commission has finally started a long awaited law enforcement crackdown to stop the deceptive marketing of CBD products that contain the non-psychoactive component of marijuana. It has settled with six companies over their unsupported health claims that CBD can treat or prevent cancer, AIDS, heart disease and Alzheimer’s, among other diseases. The FTC says the action—creatively called CBDeceit—will send a clear message to the CBD industry.

And finally, former congressman Patrick Kennedy, who many believe is a top contender to be President Biden’s Drug Czar, has spoken out against growing opposition to his possible nomination from pro-pot lobbyists. Kennedy, who is in recovery, said the country is facing a trade-off between commercializing an addictive product and “paying the price down the road” with all the people who will suffer from addiction.

Congress is following up the case of four drug industry giants who have reached a combined $26 billion settlement for their role in the opioid epidemic, and now plan to recoup more than $1 billion for legal costs. Lawmakers have expressed concern about a possible misuse of a tax provision intended to help companies struggling during the COVID-19 pandemic—not to provide a cash refund to firms that contributed to a nationwide drug crisis. And they have asked the companies—Johnson & Johnson, AmeriSourceBergen, McKesson and Cardinal Health—to commit to not using the tax loophole.

Meanwhile, Long Island prosecutors have taken the unusual step of indicting a former doctor for murdering five of his patients whose deaths were opioid-related after he prescribed prescription painkillers for them. It is the first time in New York that a doctor has been charged under the legal theory that “depraved indifference” led to the patients’ deaths. Other states and communities ravaged by the opioid epidemic have brought similar cases, but there have been few convictions as the burden of proof is high.

And finally, a new study shows teens that misuse opioids are more likely to exhibit suicidal behaviors. About one of every three high school students that misused prescription opioids had attempted suicide, according to a study in Pediatrics. Misuse could stem from relieving physical pain from a medical procedure, curiosity, socializing or succumbing to peer pressure.

The U.S. cannabis industry had a banner year in 2020, as COVID-19 lockdowns and related anxiety (along with boredom, no doubt) drove sales to a record $17.5 billion—a 46 percent increase from 2019, according to cannabis sales platform RDSA. Also fueling sales: weed dispensaries were deemed “essential businesses” in many states amid stay-at-home orders, and new adult-use marijuana markets opened in Illinois and Arizona. Cannabis delivery companies also made a killing—with customer use up 25 percent—as they were well positioned to capitalize on the pandemic. Still, legal pot hasn’t yet wiped out the illicit market—as pro-pot groups claim—estimated to be worth more than $100 billion each year. And there’s no mention, of course, of the increased costs for aw enforcement, healthcare and addiction treatment services.

Meanwhile, Virginia’s recently approved marijuana legalization law is being criticized for severely limited the ability of municipalities to opt out of allowing dispensaries. It would give localities only one year (2022) to hold a prohibition referendum before the law goes into effect in 2024, without further recourse. In Vermont, the legalization law takes a different approach: it requires towns to opt in through a public vote if they want pot shops. So far only about 10 percent of Vermont municipalities have put the matter up for a vote since legalization in 2020. Despite opinion polls showing strong public support for legalization, local opposition remains strong: only 40 percent of Colorado counties allow sales, and 25 percent in California.