THE DAILY BRIEFING

The addiction withdrawal medication buprenorphine is regarded by many as one of the most effective treatments for opioid addiction, but its use has until recently been limited because physicians must have a license to prescribe it. That changed in the waning days of the Trump administration, when the license rule was waived—allowing almost all physicians to give it to patients. But President Biden recently reinstated the license requirement saying the decision should be reviewed, in a move that critics say is hampering efforts to curb the opioid epidemic, according to an op-ed piece in the Wall Street Journal. The writers argue that only 7 percent of physicians are currently licensed to prescribe the drug, at a time when opioid-related overdose deaths are soaring.

Meanwhile, the powerful cannabis industry lobby is flexing its muscles in Colorado, where it shot down efforts by a state legislator to limit dangerously high potency of THC in marijuana products. The episode is a prime example of the industry’s growing clout in the state, where it is spending more and more money to influence pro-pot policies—including the limit on THC, the drug’s psychoactive compound that can reach as high as 70 in concentrates. Lobbyists have also derailed efforts to curtail advertising and marketing to kids.

And finally, speaking of lobbyists, the National Cannabis Roundtable—an influential industry group—has hired Kathleen Sebelius, the former Health and Human Services Secretary in the Obama administration, as the group’s new co-chair. She joins former House Speaker John Boehner at the organization, just as advocacy groups are gearing up for a big push to end federal-level prohibition of pot.

South Dakota voters last year approved marijuana legalization with more than 54 percent of the vote—but the state’s conservative Republican Governor Kristi Noem is now leading a legal battle to overturn the decision. The marijuana resolution was a sweeping victory for pro-pot forces, as it won in a generally conservative state and called for the simultaneous legalization of both recreational and medical cannabis. Noem opposed legalization from the get go, and is leading efforts to stop it despite voter ratification: a judge appointed by Noem has ruled that the constitutional question violated a law that restricts such measures to a single topic. Noem has said she opposes legalization because it would “hurt families” and expand the role of government. But after voters overwhelmingly approved the change she should gracefully accept defeat and focus on enacting strict rules and regulations to safeguard public health.

Meanwhile, a big acquisition is shaking up the market for pharmaceutical-grade cannabis products: GW Pharmaceuticals, the company that makes the only FDA-approved CBD medication—for a rare form of epilepsy—has been acquired for $7.2 billion by Jazz Pharmaceuticals. Analysts say it may signal the start of a merger boom in the sector as more states legalize cannabis and federal-level decriminalization of marijuana gains supporters in the Congress.

And finally, CBD sales are on the rise based on bloated marketing hype that the marijuana component is a cure-all for just about everything that ails you, but Harvard Health argues otherwise. A blog post notes there’s little conclusive scientific evidence to back such claims, and that as a biologically active compound, CBD use may have unintended negative interactions with both over-the-counter and prescription medications.

The Biden administration has begun providing details of how it will address the nation’s drug crisis, saying the priorities will be a focus on treatment, recovery and harm reduction. Regina LaBelle, who has been appointed acting director of the Office of National Drug Control Policy—which oversees and coordinates federal drug initiatives—said the government would expand the addiction workforce and launch prevention efforts, including making overdose reversal drugs more widely available. In addition, she said there is a need to improve data collection to ensure that “culturally competent” prevention programs address growing drug use and overdose among Black, Latino and Native American communities.

Other initiatives include possible use of a fentanyl test strip to detect the synthetic opioid in illicit drugs, given the rise of overdose fatalities linked to the substance. LaBelle also said President Biden endorses such harm reduction programs as syringe exchange sites for drug users. Some critics say the new administration has been slow to take on the drug epidemic as it deals with multiple crises, even as overdose deaths last year reached a record 81,000, the majority of them opioid-related. Key permanent positions such as the “drug czar” have not yet been filled (LaBelle, who was chief of staff of ONDCP in the Obama administration, is acting director), and neither has the head of the Food and Drug Administration. And there has been no word so far on Biden’s promise during the campaign to enact an ambitious $125 billion program to combat the opioid epidemic over the next decade.

Opposition is growing to President Biden’s more moderate approach to cannabis reform, as a trio of Senators vows to introduce legislation to end federal marijuana prohibition. Sens. Schumer of New York, Wyden of Oregon, and New Jersey’s Booker said in a statement they will introduce draft legislation early this year aimed at “righting the wrongs” of the war on drugs, and that includes federal-level marijuana legalization. For his part, President Biden favors allowing states to decide on their own about legalizing recreational pot rather than doing away with the federal prohibition.

Meanwhile, an op-ed by a Colorado psychiatrist who treats young people with substance use disorder says that this age group is increasingly using medical cannabis with dangerously high levels of THC. Anyone under 21, who cannot legally buy recreational pot, can get a medical card and buy such products without tracking or monitoring. Studies show that high potency THC can lead to addiction, psychosis, depression and anxiety. So as states look to Colorado on how to regulate the cannabis market, the state needs to revise its own regulations.

And finally, New Jersey voters approved marijuana legalization last year, but the law to enact the measure is in limbo over how to deal with children caught with cannabis. The proposed law says anyone under 18 would not be charged with delinquency, but opponents—including the pro-pot Governor—say they want tougher enforcement provisions for underage possession.

The cannabis industry is hoping that full Democratic control of the federal government will help push through more liberal cannabis policies—including its long sought after goal of federal-level legalization. That would add fuel to already booming pot sales—topping $20 billion last year during the pandemic—and rising values for marijuana company stocks, Politico writes. Yet despite these rosy projections by industry advocates, the reality is quite different. Washington insiders say the likelihood that Congress will make big changes to federal marijuana restrictions remains slim. That’s because Democrats have only a razor-thin majority and need 60 votes to pass most legislation. Although many progressive Democrats favor such a move, Biden did not support that policy during the campaign, preferring instead to let states decide on their own about recreational cannabis legalization. Still, Congress might be ready to pass the SAFE Banking Act—making it easier for banks to offer financial services to cannabis companies—and of course states will continue the march toward legalization.

Meanwhile, Forbes also takes up the topic of how the Biden administration will impact the cannabis industry. Despite state-level legalization in big East Coast states and reform-minded, pro-pot Democrats in Congress, don’t expect a GameStop-type boom for pot stocks anytime soon.

And finally, the New York Times looks at the newest drug on the block: nitrous oxide. The inhalant’s use and misuse seems to be on the rise—second only to cannabis use among young people in Britain—and fueled by social media, which portrays the drug as fun without mentioning possible risks. Although nitrous oxide is not associated with the dangers of opiates and marijuana, studies show it can lead to neurological complaints and death.