BEGINNING in the late 1990s, pharmaceutical companies selling high-dose opioids seized upon a notion, based on flimsy scientific evidence, that regardless of the length of treatment, patients would not become addicted to opioids. It has proved to be one of the biggest mistakes in modern medicine. An epidemic of prescription drug abuse has swept across the country as a result, and one of the latest victims, according to The New York Times, may have been Prince. The paper reported that he had developed a problem with prescription painkillers, and that just before his death, friends sought urgent medical help from a California doctor who specializes in treating people addicted to pain medication. Whether pain pills played a role in his death won't be known until the results of an autopsy are released. [continues 669 words]
MARIJUANA advocates are teaming up with Madison Avenue to try to make pot palatable to mainstream Americans - and to the advertisers that want to reach them. High Times, the 42-year-old must-have magazine for the cannabis enthusiast, has collaborated with Sparks & Honey, an Omnicom advertising agency, on a report meant to prompt big-picture thinking in the marijuana industry. The paper, "Rebranding Marijuana," was released April 20, the unofficial pot holiday. "Through the slow legal and regulatory processes," the report noted, "marijuana is opening up opportunities across a variety of industries, most of which have nothing to do with yesterday's stoner weed." [continues 795 words]
The article, "On track for 570 opiate deaths in 2016, Erie County steps up response," in the April 6 Buffalo News in part focused on the shortage of health care providers who can prescribe medication assisted treatment for opiate use disorders. It noted the small number of physicians who are certified to prescribe buprenorphine ( trade names: Suboxone, subutex and Zubsolv). Even when certified, physicians can prescribe to only 100 clients at a time. Unfortunately, although nurse practitioners ( NPs) and physician assistants ( PAs) provide medical care to millions of people daily, and are an integral part of health care, a federal law created in 2000 prohibits NPs/ PAs from prescribing buprenorphine to treat addictions. Buprenorphine is a schedule III controlled substance, which when utilized as prescribed does not induce a "high" and has less risk for overdose than do other prescription opioids and heroin. Ironically, NPs and PAs can prescribe buprenorphine for pain management. [continues 276 words]
To the Editor: Re "Northeast Opiate Crisis Stalls Marijuana Legalization" (news article, April 20): Marijuana access is associated with reduced incidences of opioid abuse and mortality. According to a 2015 National Bureau of Economic Research study, "States permitting medical marijuana dispensaries experience a relative decrease in both opioid addictions and opioid overdose deaths compared to states that do not." Separate studies also find that cannabis is associated with better treatment outcomes in opioid-dependent subjects. Writing this year in the journal Drug and Alcohol Dependence, researchers at Columbia University reported a "beneficial effect of marijuana smoking on treatment retention." [continues 87 words]
To the Editor: Re "Rethink the Global War on Drugs" (editorial, April 25): While the 2016 Special Session of the General Assembly on the World Drug Problem had its limitations, and while the shift from prohibition and criminalization to a public health perspective has been subtler than many would have liked, the debate has opened the door to broader discussions about drug law reform in preparation for 2019, the date set for the next major review. The issues are complex and challenges remain, but this is a step in the right direction. [continues 171 words]
The science on marijuana is settled. The assertions that continue to be made linking marijuana use to serious drug addiction by officials like Michele Leonhart, the former administrator of the Drug Enforcement Administration, are contradicted by facts. But since the science is settled, the question we should be unpacking is why do some people persist in promoting messages known to be false, as was done by Gov. Chris Christie of New Jersey during his failed bid for president? Why are we still not discussing the evidence: that the real gateways to addiction are poverty, trauma, mental health problems and the effects of criminalization and stigma? [continues 173 words]
While opioid pain relievers offer critical benefits to certain patients, such as those with cancer-related pain, the rise of opioid prescriptions has had devastating public health consequences. The C.D.C. recently urged physicians to be very cautious in prescribing these drugs. Meanwhile, access to medical marijuana has expanded rapidly - 24 states and D.C. have legalized its broad medical use - and chronic or severe pain is the most common condition reported among those using it. On it's face, this might seem to mirror the rise in prescription opioid use. [continues 251 words]
It should come as no surprise that the vast majority of heroin users have used marijuana (and many other drugs) not only long before they used heroin but while they are using heroin. Like nearly all people with substance abuse problems, most heroin users initiated their drug use early in their teens, usually beginning with alcohol and marijuana. There is ample evidence that early initiation of drug use primes the brain for enhanced later responses to other drugs. These facts underscore the need for effective prevention to reduce adolescent use of alcohol, tobacco and marijuana in order to turn back the heroin and opioid epidemic and to reduce burdens addiction in this country. [continues 238 words]
The gateway theory can be summarized as an ounce of truth embedded in a pound of bull. Yes, most people who use heroin and cocaine used marijuana and alcohol and tobacco for that matter first. But the vast majority of people who use marijuana never progress to using other illicit drugs, or even to becoming regular marijuana consumers. That's why the National Academy of Sciences' Institute of Medicine says "there is no conclusive evidence that the drug effects of marijuana are causally linked to the subsequent abuse of other illicit drugs." The principal connection between marijuana and other illicit drugs mostly involves the nature of the market, not the nature of the high. In The Netherlands, where the marijuana market has been quasi-legal and regulated for decades, marijuana use is less prevalent than in the United States, and those who do consume marijuana are less likely to use other illicit drugs. [continues 196 words]
To the Editor: Re "Outrageous Sentences for Marijuana" (editorial, April 14): Whether or not the Supreme Court rules that draconian mandatory sentences for marijuana use are constitutional, they are an ineffective, harmful and extremely costly policy approach to substance use. Marijuana use should be treated as a public health problem, not a crime. Incarcerating people for using marijuana serves neither the individual's nor the public's interest. Having a criminal record for marijuana use is damaging to people's livelihoods and life opportunities, particularly for youths. [continues 96 words]
The Erie County Legislature has to be congratulated for looking to solve the current opioid crisis. However, its solution to create an addiction hotline falls short of addressing the problem. An addiction hotline does not equate to saving lives. Anyone can do an Internet search or look in the phone book to find contact information about drug rehab programs in Erie County. What will the hotline accomplish? The hotline will refer callers to programs that have waiting lists for inpatient services and to outpatient clinics. However, if you don't have insurance or the ability to pay for these services, you have wasted your time, not to mention $300,000 of county taxpayer dollars. [continues 132 words]
At the urging of Mexico, Guatemala and Colombia, world leaders met at the United Nations in a special session last week to discuss saner ways to fight the drug trade. They did not get very far toward a shift in approach. Nonetheless, there was a consensus that investing in health care, addiction treatment and alternatives to incarceration would do more to end the drug trade than relying primarily on prohibition and criminalization. "A war that has been fought for more than 40 years has not been won," President Juan Manuel Santos of Colombia said in an interview. "When you do something for 40 years and it doesn't work, you need to change it." [continues 366 words]
UNITED NATIONS (AP) - Jamaica defended its decriminalization of possession of small amounts of marijuana. Iran said it seized 620 tons of different types of drugs last year and is helping protect the world from "the evils of addiction." Cuba opposed the legalization of drugs or declaring them harmless. The first U.N. General Assembly special session to address global drug policy in nearly 20 years heard major differences on the approach to drug use on its second day Wednesday. On the liberalization side, Canada's Health Minister Jane Philpott announced that the government would introduce legislation to legalize marijuana next spring. [continues 509 words]
FOR THE first time in 20 years, the UN has convened a special session on "the world drug problem" amid fierce international debate about whether drug users should primarily be punished or rehabilitated. The UN General Assembly Special Session on drugs, which started yesterday and is scheduled to run until tomorrow, was called after Mexico, Colombia and Guatemala appealed to the body to revise the global approach to illegal drugs. After two decades - and a trillion or so dollars later - the "war-on-drugs" approach of criminalising drug users has dismally failed to prevent the distribution and use of illegal drugs. [continues 824 words]
NEW YORK - Afghanistan has called for more international support for its efforts in fighting the drug problem as the anti-narcotics war is "beyond the limits of any single government". Slamat Azimi, the minister of counter narcotics of Afghanistan, made the statement at the Special Session of the UN General Assembly on the World Drug Problem here. "It is obvious that fighting drugs and narcotics is beyond the limits of any single government; therefore, there is a need for extensive help from the international community. [continues 174 words]
NEW YORK - The UN General Assembly is rethinking the global strategy in the war on narcotics for the first time in two decades as activists, UN officials and world leaders cited an international trend towards more liberal drug laws. Despite agreement to deal with the global drug problem, there are deep divisions among the 193 member states. Some favour a shift towards decriminalisation and a greater focus on reducing the harm caused by narcotics abuse and the war on drugs. A number of Latin American leaders say the aggressive war on drugs has failed, having killed or destroyed thousands of lives worldwide. They say there is an irreversible trend towards legalising "soft drugs" such as dagga. Mexican President Enrique Pena Nieto said his country would soon increase the amount of dagga Mexicans are allowed for personal use and legalise daggaa for medical purposes. [continues 239 words]
NEW YORK - India has voiced its concern over "the growing nexus of drug trafficking and terrorist networks", saying that "we have to continue and toughen our collective fight against these evils". Indian finance minister Arun Jaitley was addressing the Special Session of the UN General Assembly on the World Drug Problem here. "The growing nexus of drug trafficking and terrorist networks endangers peace, security and stability across regions," he said. "We have to continue and toughen our collective fight against these evils." [continues 146 words]
Consumers Number About 246 Million, With the U.S. Leading the Way and Cannabis the Top Narcotic. As leaders from around the world gather in New York for what many are calling the most important summit on illegal drugs in two decades, one thing is clear: The world has a serious drug problem. Worldwide, about 246 million people use illicit drugs, and 1 in 10 of these users suffer from disorders related to drug use. Of the estimated 12 million people who inject drugs, at least 1.6 million are also living with HIV, while slightly more than half suffer from hepatitis C. Each year, 200,000 people suffer drug-related deaths, such as overdoses. [continues 785 words]
UNITED NATIONS - The first U.N. special session to address global drug policy in nearly 20 years bristled with tension Tuesday over the use of the death penalty for drug-related offenses, as countries wrestled over whether to emphasize criminalization and punishment or health and human rights. The outcome document adopted by member states included no criticism of the death penalty, saying only that countries should ensure that punishments are "proportionate" with the crimes. "Disproportional penalties create vicious cycles of marginalization and further crime," Mexican President Enrique Pena Nieto told the gathering. He also called for the decriminalization of marijuana for medical and scientific purposes and said the international community's responses to drug issues are "frankly, insufficient." [continues 103 words]
UNITED NATIONS (AP) - The first U.N. special session to address global drug policy in nearly 20 years bristled with tension Tuesday over the use of the death penalty for drug-related offenses. The outcome document adopted by member states included no criticism of the death penalty, saying only that countries should ensure that punishments are "proportionate" with the crimes. "Disproportional penalties ... create vicious cycles of marginalization and further crime," Mexican President Enrique Pena Nieto told the gathering. He also called for the decriminalization of marijuana for medical and scientific purposes and said the international community's response to drug issues is "frankly, insufficient." [continues 140 words]
UNITED NATIONS (AP) - The first U.N. special session to address global drug policy in nearly 20 years bristled with tension Tuesday over the use of the death penalty for drug-related offenses, as countries wrestled over whether to emphasize criminalization and punishment or health and human rights. The outcome document adopted by member states included no criticism of the death penalty, saying only that countries should ensure that punishments are "proportionate" with the crimes. "Disproportional penalties ... create vicious cycles of marginalization and further crime," Mexican President Enrique Pena Nieto told the gathering. He also called for the decriminalization of marijuana for medical and scientific purposes and said the international community's responses to drug issues is "frankly, insufficient." [continues 165 words]
Managing Social Norms Is As Important As Rewriting the Rules of Cannabis Consumption in Canada, Conference Hears As the Trudeau government prepares to draw up legislation that would legalize marijuana for recreational use, leading policy experts in the United States have some pointed advice for Canada: Rules are important, but cultivating unwritten social standards around how people use the drug are just as crucial. In states such as Colorado and Washington, where prohibition of cannabis has been lifted, lawmakers have seen recreational marijuana use soar. While that has pumped welcome tax dollars into government coffers, it has also led to problems with public consumption, overuse and intoxicated driving. [continues 704 words]
UNITED NATIONS - Canada has promised to legalize marijuana. Mexico's highest court has allowed some citizens to grow cannabis for personal use. Colombia has reversed its decades-long policy of aerial spraying against coca, the raw ingredient in cocaine. Even in the United States, once the chief architect of the global war on drugs, four states permit recreational marijuana sales. Other states have pro-legalization ballot measures pending. And a heroin epidemic has prompted the mayor of at least one city to propose establishing a supervised injection clinic. [continues 888 words]
A U. N. Special Session Will Examine the Effects of the Hard- Line Approach and Will Study Alternatives. At what is being billed as the most significant high-level gathering on global drug policy in two decades, the stage will be set for world leaders to discuss what would have once been unthinkable - reversing course in the war on drugs. The United Nations General Assembly Special Session on the World Drug Problem, which begins Tuesday in New York, will bring together government, human rights and health leaders to discuss whether the hard-line tactics of combating drug trafficking and money laundering have failed. [continues 800 words]
Santa Barbara, Calif. - I'M 74 years old, and I have smoked marijuana almost every day since dinosaurs roamed the earth in the early '70s. When my awareness is heightened, I'm on my game - the best I can be at thinking creatively, making decisions, focusing on my work, seeing the big picture ... and caregiving. For 20 years my wife, Anne, has struggled gallantly against the physical, cognitive, emotional and spiritual depredations of Parkinson's disease. For the first 15, I took care of her myself. Now I have lots of help. Either way, enjoying a hit or two on the pipe every couple of hours has granted me tens of thousands of sweet clemencies that keep me from burning out as a caregiver. [continues 804 words]
WHEN Attorney General Loretta Lynch decided late last year that the Justice Department would end the federal civil-asset forfeiture program, criminal-justice reform advocates proclaimed it a "significant deal." But late last month, less than four months later, the Obama administration reversed itself and reinstated the Asset Forfeiture Fund's Orwellian "equitable sharing" program. That's a shame, particularly when the only supporters of the policy are the law-enforcement agencies that directly benefit from it. Indeed, the federal program's combined annual revenue has grown more than 1,000 percent in the last 15 years, filling the coffers of federal, state and local police departments. [continues 577 words]
Lee Carroll Brooker, a 75-year-old disabled veteran suffering from chronic pain, was arrested in July 2011 for growing three dozen marijuana plants for his own medicinal use behind his son's house in Dothan, Ala., where he lived. For this crime, Mr. Brooker was given a life sentence with no possibility of release. Alabama law mandates that anyone with certain prior felony convictions be sentenced to life without parole for possessing more than 1 kilogram, or 2.2 pounds, of marijuana, regardless of intent to sell. Mr. Brooker had been convicted of armed robberies in Florida two decades earlier, for which he served 10 years. The marijuana plants collected at his son's house - including unusable parts like vines and stalks - weighed 2.8 pounds. [continues 468 words]
We at the Erie County Board of Health feel compelled to bring more attention and awareness to the imminent public health epidemic currently upon us. Opioids - both prescription drugs and drugs of abuse, such as heroin and fentanyl - are killing residents at an unprecedented rate. Opiate addiction is affecting residents of all ages and from all walks of life; the disease does not discriminate and has no socioeconomic boundaries. In 2014, 127 residents' deaths were attributed to opioids of all types. As of March 28, there have been 219 deaths attributed to opioids in 2015, and there is still a backlog of bodies waiting to have the cause of death cleared through results of toxicology screens. [continues 176 words]
Howard Marks, an Oxford-educated drug trafficker who at his peak in the 1970s controlled a substantial fraction of the world's hashish and marijuana trade, and who became a best-selling author after his release from an American prison, died on Sunday. He was 70. His death, from colorectal cancer, which he disclosed last year, was confirmed by Robin Harvie, publisher for nonfiction at Pan Macmillan, which released Mr. Marks's final book, "Mr. Smiley: My Last Pill and Testament," in September. No other details were provided. [continues 735 words]
If there's a feeder system for developing future opioid addiction, it includes narcotic treatment for back pain without medical justification. More than 80 percent of adults will experience lower back pain at some point in their lives, according to a Univera Healthcare review of upstate New York population data. Among the report's findings is that medical professionals often focus on treating the pain, rather than addressing quality of life or ability to function. The result is that prescription painkillers, including opiates, are widely prescribed, despite medical evidence that they rarely hasten recovery and carry with them the substantial risk for long-term abuse. [continues 320 words]
The practice of medicine and the humane treatment of patients would take giant steps backward if policy solutions to the opioid addiction "crisis" did not guarantee that people who need opioids for pain relief will still be able to access these critically important medications in sufficient amounts without additional hardship. We raise this issue because already some doctors have said they will avoid prescribing these medications in response to new laws and rules. There is reason to be concerned that the response to this latest drug crisis will involve policy mistakes. After all, that's the history of the entire war on drugs. It was recently reported that John Ehrlichman, a top aide to President Richard Nixon, admitted that Nixon initiated the "war on drugs" in the early 1970s as a political maneuver to use law enforcement to arrest and imprison hippies, protesters and African-Americans. Since then, literally $1 trillion has been spent on this ill-conceived failed "war" that has ruined countless lives, causing so much more harm than good. [continues 85 words]
When it comes to the epidemic of African-Americans dying at the hands of police, people who are asked to consider the issue often get stuck on whether the person in question had it coming. What was he or she doing at the time? Running away? Resisting arrest? And if so, doesn't that prove he or she was guilty of something? And from there, it's a short hop to the conclusion that if only this person had been doing the right things - staying off the streets, keeping out of trouble, not hanging around with the wrong people or doing exactly as the police demanded at the moment of a heated encounter - tragedy could have been averted. Yeah, right. In a perfect world, mothers and fathers living in low-income communities with crumbling schools and few employment opportunities would heroically manage to raise children who were able to stay away from trouble with alcohol, drugs or gang-type behavior even though these things are all around them. [continues 510 words]
This letter was intended as a response to the Feb. 9 News article about 23 people dying from opiate abuse in 11 days. Shortly after taking pen to paper, news surrounding and involving the opioid epidemic became a daily topic in the media. I commend The News for being a leader in exposing this epidemic, and devoting the time and attention that the issue so desperately needs. How addiction is viewed plays largely in how successful we will be at overcoming this epidemic. There is a stigma attached to addicts, even to those who obtain treatment. While we may be slowly moving away from our "shaming and blaming" of people who suffer from addiction, public views are not changing fast enough. We must remember that addiction is a disease, affecting people of all races, socioeconomic status and geographic locations. [continues 114 words]
Devolution is when the federal government relinquishes responsibility, intentionally or unintentionally, for something it was previously responsible for to local governments. An example of this can be seen in the way the heroin and opioid epidemic is being addressed in Erie County. Gridlock in Congress prevents meaningful federal action, despite the efforts of our elected leaders. They include Sen. Charles Schumer's role in the Comprehensive Addiction and Recovery Act, which would provide communities additional funding for prevention efforts, and Rep. Brian Higgins' introduction of the Recovery Enhancement for Addiction Treatment Act, which would allow physicians to dispense maintenance medications to more patients. [continues 305 words]
The 55-year-old crack addict counted his change outside a Harlem liquor store. He had just over a dollar, leaving him 35 cents short of the cheapest mini-bottle. The 21-year-old heroin addict sat in a McDonald's on the Lower East Side, wondering when his grandmother would next wire him money. He was homeless, had 84 cents in his pocket and was living out of two canvas bags. Each was approached by someone who asked the addict for help buying drugs. Using the stranger's money, each addict went to see a nearby dealer, returned with drugs, handed them over and was promptly arrested on felony drug-dealing charges. The people who had asked for drugs were undercover narcotics officers with the New York Police Department. [continues 1442 words]
How a Shift in Health-Care Delivery and Big Pharma's Hunger for Profits Have Driven the Opioid Epidemic I was walking past, and happened to see him behind the partially drawn curtain. There he was, lying on the gurney, head back, mouth gaping. White, 25, covered in tattoos, not breathing, his lips a fine pale blue. We ran into the room. The nurse pushed Narcan, a drug that reverses opiates. And 30 seconds later he woke up as if a switch had been flipped. Narcan is like magic; it literally raises people from the dead. [continues 1658 words]
To the Editor: Re "A Strong Response to the Opioid Scourge" (editorial, March 17): The Centers for Disease Control and Prevention has done a disservice to people living with intractable chronic pain with its latest one-sided recommendations for reducing opiate overuse - recommendations that you praise. I worked in a drug treatment facility and have seen the ravages of addiction, and I know the risks of opiate use. When I suffered multiple severe injuries from a fall, I tried every treatment I could find to reduce my suffering without narcotics. None came close to reducing it to a tolerable level. Grudgingly, I came to the conclusion that pain medicines were going to have to be part of my comprehensive approach to pain management. [continues 70 words]
To the Editor: Re "Obama Takes Crusade Against Opioids on Road" (news article, March 30): While I was heartened to see that, finally, the administration is stepping up to face the dire epidemic of drug overdose deaths in America, I cannot help but wonder why it took so long. My 22-year-old son is part of the grim 2014 statistic: 28,648 drug deaths from opioids. He died from an accidental heroin overdose in September 2014. His story echoes a familiar tale of the progression from easily accessible prescription painkillers to heroin. And, like many others, he was a sweet, handsome and intelligent young man whose life, dreams and soul were ripped away by the disease of addiction. He was also part of a treatment process that criminalized him - in and out of treatment programs, finally receiving medication for his addiction but unsupervised. [continues 89 words]
To the Editor: Re "Heroin Yields Ground to Fentanyl, Its More Potent Killer Cousin" (front page, March 26): The influx of fentanyl as an additive to heroin and as a free-standing active killer is a scary reminder that the drug epidemic must be addressed from the demand side as well as the supply. Supply-side strategies that rely on law enforcement, opioid prescription restrictions and international cooperation are necessary but not sufficient to reduce and reverse our national scourge of substance use disorder. [continues 155 words]
To the Editor: Re "Town's Anti-Drug Plan: Safe Site to Use Heroin" (front page, March 23), about a proposal by the mayor of Ithaca, N.Y., to establish the first site in the United States where people could legally inject heroin: Supervised injection facilities, or SIFs, are a longstanding public health tool in several countries and are rapidly gaining support elsewhere, including in the United States. Advocates like me understand why people have questions about something that at first pass looks as if it enables destructive behavior. [continues 117 words]
Patients and Doctors Discuss the Management of Drugs That Can Be Helpful or Harmful. To the Editor: Re "A Strong Response to the Opioid Scourge" (editorial, March 17): There are longtime users of low-dose opioids, like me, who never require an increase in dose and who find that this medication provides quality of life. How? By addressing chronic pain, sleep disorders and associated depression. The alternatives proposed by the Centers for Disease Control and Prevention, like aspirin and ibuprofen, can cause long-term damage to body organs and short-term stomach pain. For many of us, spare use of a low-dose opioid is the very best alternative. [continues 79 words]
Patients and Doctors Discuss the Management of Drugs That Can Be Helpful or Harmful. To the Editor: Re "New Standards for Painkillers Aim to Stem Overdose Deaths" (front page, March 16): The Centers for Disease Control and Prevention has been doing a commendable job monitoring and controlling the prescription opioid drug overdose epidemic. But other federal government agencies can and should do more to address this public health crisis. Specifically, the Drug Enforcement Administration should increase its crackdown on physicians running pill mills, and Congress should open an investigation into the role of the Food and Drug Administration in this completely man-made epidemic and hold hearings on the marketing approaches and other business practices of pharmaceutical companies that may have contributed to the skyrocketing increase in opioid drug prescriptions. New York The writer is a professor of epidemiology and director of the Center for Injury Epidemiology and Prevention at Columbia University. [end]
Patients and Doctors Discuss the Management of Drugs That Can Be Helpful or Harmful. To the Editor: The proper treatment of pain disorders by physicians should not be directed by the fear of lawsuits or pressure by insurance payers but rather by sound guidelines developed by organizations like the American Academy of Pain Medicine. The news media has readily noted a "prescription drug epidemic," but overdoses mainly result from drug diversion and misuse rather than from taking an opioid as prescribed. Epidemiological data has reported up to 16,500 deaths a year from the aspirin-ibuprofen family of medicines, which can cause ulcers, kidney failure and liver inflammation, none of which occur with opioids. [continues 68 words]
Patients and Doctors Discuss the Management of Drugs That Can Be Helpful or Harmful. To the Editor: Re "States Push to Curb Painkiller Overuse" (Business Day, March 12): As an orthopedic surgeon in Massachusetts, I applaud the efforts of my state to limit patients' excessive opioid use. Every year in this country, more than 70 million post-surgical patients receive opioids, and research shows that one in 15 will go on to long-term use, indicating that the surgical setting has become an inadvertent gateway to the overall societal epidemic. [continues 129 words]
Patients and Doctors Discuss the Management of Drugs That Can Be Helpful or Harmful. To the Editor: The number of deaths directly attributable to opioids far exceeds the incidence of fatalities associated with several other epidemics that we have experienced in this country in past years. More than a half of 460 autopsies I performed last year for coroners in southwest Pennsylvania were drug related, and a substantial percentage were people who got started on powerful analgesics prescribed by their physicians. [continues 51 words]
Patients and Doctors Discuss the Management of Drugs That Can Be Helpful or Harmful. To the Editor: For many people with chronic pain, opioid painkillers are a lifeline. The new guidelines from the Centers for Disease Control and Prevention, while perhaps reasonable as a first approach, are unrealistic for patients who have done well (sometimes for years) on carefully monitored opioid doses under continuing medical care. As The Times has reported, these longtime patients must now be subjected to humiliating "pain contracts" and random drug tests. [continues 127 words]
The Supreme Court has handed the marijuana-legalization movement an important victory. Two states - Nebraska and Oklahoma - sought to invalidate the landmark Colorado measure known as Amendment 64, which legalized recreational marijuana in that state. But the challenge fell flat when the Court announced last week that it wouldn't hear their case. That means the Colorado law will remain in effect - and more states can opt to legalize also. No one can deny the gathering momentum behind the legalization movement. Since 2012, four states have approved referenda that essentially legalize marijuana for recreational purposes: [continues 571 words]
ITHACA, N.Y. - Even Svante L. Myrick, the mayor of this city, thought the proposal sounded a little crazy, though it was put forth by a committee he had appointed. The plan called for establishing a site where people could legally shoot heroin - something that does not exist anywhere in the United States. "Heroin is bad, and injecting heroin is bad, so how could supervised heroin injection be a good thing?" Mr. Myrick, a Democrat, said. But he also knew he had to do something drastic to confront the scourge of heroin in his city in central New York. So he was willing to take a chance and embrace the radical notion, knowing well that it would provoke a backlash. [continues 1204 words]
Inside New York
