The action is now moving beyond America. With over two-fifths of the world overweight or obese, demand for glp-1 drugs is voracious. Pharma companies are racing to make them work as pills, which would be cheaper to produce than jabs, and to reduce their side-effects. Generic versions for older GLP-1 agonists are entering the market. Semaglutide is to come off patent in Brazil, China and India in 2026; eight such drugs are in the works in China. That is just as well. As incomes in the developing world have risen and life has become more sedentary, people’s waistlines are catching up with those in the West.

Curbing obesity would be consequential. Yet glp-1 drugs promise to do much more. Overweight patients on semaglutide have been found to suffer fewer heart attacks and strokes; the benefits, astonishingly, seem to be largely independent of how much weight is lost. Tirzepatide improves sleep apnoea. Trials show that glp-1 agonists reduce chronic kidney disease in diabetics; and there are signs they may lessen brain shrinkage and cognitive decline in Alzheimer’s. Studies of health records suggest that they may help with addictions, too; people already on glp-1 drugs in America were less likely to overdose on opioids or abuse cannabis or alcohol. Researchers are even talking, in hushed tones, of their anti-ageing effects.

How can one class of drug do so much? As our briefing explains this week, not only do the drugs act in the gut, but they also bind to receptors all over the body and in the brain. 

Read it all.

I’ve been saying this for quite some time: GLP-1 agonists are miracle “everything drugs”! it’s likely there’ll be more of these types of drugs soon

“It’s not just obesity. Drugs like Ozempic will change the world
As they become cheaper, they promise to improve billions of lives” pic.twitter.com/61tc17dKRE

— Derya Unutmaz, MD (@DeryaTR_) October 24, 2024

Mexico’s new President Claudia Sheinbaum is using her first 100 days in office to try to lower homicides and loosen the grip of organized crime groups that control swaths of the country, extort businesses, smuggle drugs and kill with impunity.

Among Sheinbaum’s top efforts to “pacify the country” will be a push to slash killings in the country’s 10 deadliest cities, including Tijuana and Ciudad Juárez on the U.S. border, according to a presentation of the strategy seen by The Wall Street Journal. She is also planning new efforts to combat the smuggling of the deadly drug fentanyl, which kills tens of thousands of Americans a year, the presentation says. 

In a graphic display of the violence that Sheinbaum must deal with, the mayor of Chilpancingo, the capital of Guerrero, one of Mexico’s most violent states, was assassinated Sunday, officials said. The newly elected mayor, Alejandro Arcos, was the second Chilpancingo official to be killed in the last three days, the probable victim of one of two violent gangs that control the city. “It is a state totally dominated by organized crime,” said Eduardo Guerrero, a Mexico City security expert. “It’s a jungle. What the criminals are saying to authorities is: We rule here.” 

Read it all.

Inside Mexico’s New Plan to Take On Cartel Violence https://t.co/KTlyIIZqZK

— Alicia A. Caldwell (@aacaldwellLA) October 7, 2024

As marijuana legalization has accelerated across the country, doctors are contending with the effects of an explosion in the use of the drug and its intensity. A $33 billion industry has taken root, turning out an ever-expanding range of cannabis products so intoxicating they bear little resemblance to the marijuana available a generation ago. Tens of millions of Americans use the drug, for medical or recreational purposes — most of them without problems.

But with more people consuming more potent cannabis more often, a growing number, mostly chronic users, are enduring serious health consequences.

The accumulating harm is broader and more severe than previously reported. And gaps in state regulations, limited public health messaging and federal restraints on research have left many consumers, government officials and even medical practitioners in the dark about such outcomes.

Again and again, The New York Times found dangerous misconceptions.

Many users believe, for instance, that people cannot become addicted to cannabis. But millions do.

Read it all.

NYT: As America’s Marijuana Use Grows, So Do the Harms – The drug, legal in much of the country, is widely seen as nonaddictive and safe. For some users, these assumptions are dangerously wrong. https://t.co/yi8TpMPjvV

— Aaron M. Renn 🇺🇸 (@aaron_renn) October 5, 2024

The illicit fentanyl that kills tens of thousands of Americans a year is largely produced from Chinese chemicals cooked up in clandestine Mexican laboratories, according to U.S. authorities. This requires drug traffickers to transport the necessary chemicals halfway around the world. But cartels have found a clever way to smuggle these chemicals from China to Mexico – by first importing them into the United States.

Master carton shipping has become an indispensable way for delivery companies to move vast quantities of merchandise around the world quickly. It’s legal, it’s practical, and in the era of e-commerce, it’s key to our everyday lives, whether we realize it or not.

Still, the practice makes it a snap for traffickers to sneak fentanyl chemicals into the country, hidden in small boxes packed inside other boxes. On top of that, a little-known U.S. trade regulation has made this smuggling easier still.

The de minimis rule exempts low-value parcels from taxes, duties and stringent customs reporting rules. It’s meant to keep U.S. Customs and Border Protection from wasting time and effort when the cost of collecting tariffs on cheap imports exceeds the revenue gained.

Read it all.

A tweak in a trade rule fueled America’s online shopping habits. It also helped Mexican narcos smuggle vital fentanyl-making chemicals from China Here’s how: https://t.co/ahkIC9QfdB by @draz_DJ @gottesdiener @kristinacooke @SEisenhammer via @specialreports pic.twitter.com/aXnl1Yfpkw

— Reuters Investigates (@specialreports) October 1, 2024

Firms that manage drug benefits, which promise to keep a lid on high drug costs, instead steer patients away from less expensive medicines and overcharge for cancer therapies, Federal Trade Commission investigators found.

The FTC, in a report released Tuesday, detailed a number of actions that it said large pharmacy-benefit managers use to boost their profits and increase the spending of the health plans and employers that hired them to control costs. The actions can also lead to higher outlays for patients at the pharmacy counter, the agency said.

The findings follow a two-year investigation into the firms, known as PBMs, and calls from some lawmakers to rein in the firms’ business practices.

FTC Chair Lina Khan said the agency planned further scrutiny of big PBMs with the goal of making healthcare affordable. “Dominant pharmacy-benefit managers can hike the cost of drugs—including overcharging patients for cancer drugs,” she said. 

Read it all.

PBMs are a paradigmatic example of how a middleman meant to reduce costs and enhance efficiency becomes so bloated and powerful that it adds to costs and reduces efficiency. Great to see FTC addressing this issue!https://t.co/q0s3VC638W

— Kate Judge (@ProfKateJudge) July 9, 2024

An artificial intelligence (AI) model that speaks the language of proteins — one of the largest yet developed for biology — has been used to create new fluorescent molecules.

The proof-of-principle demonstration was announced this month by EvolutionaryScale in New York City, alongside US$142 million in new funding to apply its model to drug development, sustainability and other pursuits. The company, launched by scientists who previously worked at tech giant Meta, is the latest entrant in an increasingly crowded field that is applying cutting-edge machine-learning models trained on language and images to biological data.

“We want to build tools that can make biology programmable,” says Alex Rives, the company’s chief scientist, who was part of Meta’s efforts to apply AI to biological data.

Read it all.

“We want to build tools that can make biology programmable”
Ex-Meta scientists debut gigantic AI protein design model https://t.co/RJnpoLmVGJ

— Magdalena Skipper (@Magda_Skipper) July 8, 2024

Overdose deaths in the United States declined slightly last year, the first decrease in five years, according to preliminary federal data released Wednesday.

The rare good news in the decades-old addiction crisis was attributable mostly to a drop in deaths from synthetic opioids, chiefly fentanyl, said researchers at the National Center for Health Statistics, who compiled the numbers.

But the full portrait of the death toll from street drugs remains grim. Even as opioid deaths fell, deaths from stimulants such as cocaine and methamphetamine rose. And some states, including Oregon and Washington, continued to experience sharp rises in overall overdose fatalities.

Drug overdoses overall in 2023 were estimated at 107,543, down from 111,029 in 2022, a 3 percent drop. Opioid deaths fell 3.7 percent while deaths from cocaine rose 5 percent and deaths from meth rose 2 percent.

Read it all (emphasis mine).

U.S. drug overdose deaths dropped slightly in 2023, the first annual decrease in drug overdose deaths since 2018.

But the overall number of deaths is still extremely high. https://t.co/ptdF17zxED

— The Hill (@thehill) May 16, 2024

Its opponents have been vocal, with many arguing the bill creates a likely pipeline to a recreational marijuana program in the Palmetto State.

Law enforcement turned out to staunchly oppose the bill, as they have done in the past, at an earlier meeting of the ad hoc committee April 23. The most vocal opponent was SLED Chief Mark Keel.

“This bill does not follow that tradition of the medical model, which is why, in my opinion, it is not about medicine. This bill is about legalizing marijuana in South Carolina,” Keel said. “Once we go down that road, we’re not going to be able to claw it back.”

The Greenville County sheriff and chiefs of police from Myrtle Beach, West Columbia and Chapin echoed his concerns.

Read it all.

South Carolina House snuffs out medical marijuana again. Now what? https://t.co/5URTfLcyXr

— The Post and Courier (@postandcourier) May 1, 2024

First the cartel cut its teeth with drug trafficking. Then avocados, real estate and construction companies. Now, a Mexican criminal group known for its brutality is moving in on seniors and their timeshares.

The operation is relatively simple. Cartel employees posing as sales representatives call up timeshare owners, offering to buy their investments back for generous sums. They then demand upfront fees for anything from listing advertisements to paying government fines. The representatives persuade their victims to wire large amounts of money to Mexico — sometimes as much as hundreds of thousands of dollars — and then they disappear.

The scheme has netted the cartel, Jalisco New Generation, hundreds of millions of dollars over the past decade, according to U.S. officials who were not authorized to speak publicly, via dozens of call centers in Mexico that relentlessly target American and Canadian timeshare owners. They even bribe employees at Mexican resorts to leak guest information, the U.S. officials say.

Read it all.

“Over 5 years, American timeshare owners were bilked out of $288 million. The real number is most likely $350 million, as about 20% never register a complaint.”

A Mexican Drug Cartel’s New Target? Seniors and Their Timeshares https://t.co/DAKwfJwE37

— Dan Beucke (@DanBeucke) March 21, 2024

“The challenge we are having is a lack of interest by federal prosecutors to charge illicit marijuana cases,” said Ray Donovan, the former chief of operations of the Drug Enforcement Administration. “They don’t realize all the implications. Marijuana causes so much crime at the local level, gun violence in particular. The same groups selling thousands of pounds of marijuana are also laundering millions of dollars of fentanyl money. It’s not just one-dimensional.”

The expansion into the cannabis market is propelling the rise of Chinese organized crime as a global powerhouse, current and former national security officials say. During the past decade, Chinese mafias became the dominant money launderers for Latin American cartels dealing narcotics including fentanyl, which has killed hundreds of thousands of Americans. The huge revenue stream from marijuana fuels that laundering apparatus, which is “the most extensive network of underground banking in the world,” said a former senior DEA official, Donald Im.

“The profits from the marijuana trade allow the Chinese organized criminal networks to expand their underground global banking system for cartels and other criminal organizations,” said Im, who was an architect of the DEA’s fight against Chinese organized crime.

U.S. law enforcement struggles to respond to this multifaceted threat. State and federal agencies suffer from a lack of personnel who know Chinese language and culture well enough to investigate complex cases, infiltrate networks or translate intercepts, current and former officials say. A federal shift of priorities to counterterrorism after 2001 meant resources dedicated to Chinese organized crime dwindled — while the power of the underworld grew.

And the shadow of the Chinese state hovers over it all….

Read it all.

Officials estimate the value of the illegal marijuana market grown in Oklahoma at somewhere between $18 billion and $44 billion a year.

Investigators have found links to foreign mafias and say that more than 80% of the groups are of Chinese origin. https://t.co/A4WKYfaCet

— ProPublica (@propublica) March 16, 2024

The death certificate for Ryan Bagwell, a 19-year-old from Mission, Texas, states that he died from a fentanyl overdose.

His mother, Sandra Bagwell, says that is wrong.

On an April night in 2022, he swallowed one pill from a bottle of Percocet, a prescription painkiller that he and a friend bought earlier that day at a Mexican pharmacy just over the border. The next morning, his mother found him dead in his bedroom.

A federal law enforcement lab found that none of the pills from the bottle tested positive for Percocet. But they all tested positive for lethal quantities of fentanyl.

“Ryan was poisoned,” Mrs. Bagwell, an elementary-school reading specialist, said.

Read it all.

Overdose or Poisoning? A New Debate Over What to Call a Drug Death.: Grieving families want official records and popular discourse to move away from reflexive use of “overdose,” which they believe blames victims for their deaths. https://t.co/EE9BNjgr23

— Sophia Devetzi (@SophiaDevetzi) March 11, 2024

As the saying goes, dogs, and pets in general, have long been viewed as man’s best friend. But pet pharmaceuticals haven’t always matched that, and often a tick or flea collar was the lone preventive medicine many pets saw, outside of necessary vet visits.

But Peck said she has seen a shift in mentality from pet owners, as well as a shift in the pharmaceutical pipeline, that is bringing animal medicine more in line with human medicine.

“Newer generations see their pets very differently than previous generations,” Peck said. “Fifty, sixty years ago, your dog was in the backyard; now it has moved into your house, often your bed and sometimes replaced your children — your dog or cat has a stroller, a backpack and an outfit.”

Read it all.

The pet drugs vets are now prescribing look a lot more like human medications https://t.co/FWzmo1Cro8

— CNBC (@CNBC) March 5, 2024

Not long ago, sobriety was broadly understood to mean abstaining from all intoxicating substances, and the term was often associated with people who had overcome severe forms of addiction. These days, it is used more expansively, including by people who have quit drinking alcohol but consume what they deem moderate amounts of other substances, including marijuana and mushrooms.

“Just because someone has a drinking problem doesn’t mean they have a problem with every single thing,” Mr. Reed said.

As some drugs come to be viewed as wellness boosters by those who use them, adherence to the full abstinence model favored by organizations like Alcoholics Anonymous is shifting. Some people call themselves “California sober,” a term popularized in a 2021 song by the pop star Demi Lovato, who later disavowed the idea, saying on social media that “sober sober is the only way to be.”

Approaches that might have once seemed ludicrous — like treating opioid addiction with psychedelics — have gained broader enthusiasm among doctors as drug overdoses kill tens of thousands of Americans each year.

Read it all.

What Does Being Sober Mean Today? For Many, Not Full Abstinence. More younger Americans are shunning alcohol while embracing cannabis, ketamine and psychedelics, shaking up the field of addiction medicine. https://t.co/K8m4zrRc3H

— Carl Hindy, Ph.D., HSP, Clinical Psychologist (@DrCarlHindy) February 5, 2024

Using a type of artificial intelligence known as deep learning, MIT researchers have discovered a class of compounds that can kill a drug-resistant bacterium that causes more than 10,000 deaths in the United States every year.

In a study appearing in Nature, the researchers showed that these compounds could kill methicillin-resistant Staphylococcus aureus (MRSA) grown in a lab dish and in two mouse models of MRSA infection. The compounds also show very low toxicity against human cells, making them particularly good drug candidates.

A key innovation of the new study is that the researchers were also able to figure out what kinds of information the deep-learning model was using to make its antibiotic potency predictions. This knowledge could help researchers to design additional drugs that might work even better than the ones identified by the model.

“The insight here was that we could see what was being learned by the models to make their predictions that certain molecules would make for good antibiotics,” said James Collins, the Termeer Professor of Medical Engineering and Science in MIT’s Institute for Medical Engineering and Science (IMES) and Department of Biological Engineering, a core faculty member of the Wyss Institute for Biologically Inspired Engineering at Harvard University, and an institute member at the Broad Institute of MIT and Harvard. “Our work provides a framework that is time-efficient, resource-efficient, and mechanistically insightful, from a chemical-structure standpoint, in ways that we haven’t had to date.”

Read it all.

We are thrilled to announce the latest discovery by our partners at the Collins Lab: a novel class of antibiotics with activity against MRSA! Read more about the team's "explainable AI" approach underlying this groundbreaking discovery.https://t.co/o8PRSLULwM

— Phare Bio (@PhareBio) December 21, 2023

A recently unsealed federal indictment in South Florida opens a rare window into the source of nitazenes: manufacturers in China that officials say sell the drugs online and ship them to dealers in the United States. Prosecutors allege that a Deerfield Beach, Fla., man used WhatsApp and bitcoin to purchase nitazenes to mix with fentanyl or heroin, to stretch out his supplies of opioids and make an “ultra powerful substance.”

“The nitazenes can make [a drug mix] stronger than fentanyl,” said Anthony Salisbury, the special agent in charge of the Homeland Security Investigations field office in South Florida. “As if we needed something stronger than fentanyl.”

The South Florida case from October included indictments against a Chinese chemical sales company and an employee of that company. According to one of the indictments, the Chinese company selling nitazenes used websites, social media accounts and messaging apps to sell chemicals such as protonitazene and metonitazene to customers in the United States, Europe, Asia and South America. As part of the investigation, a U.S. Postal Inspection Service agent posing as a buyer ordered nitazenes from the company, according to the indictment.

It was among the first criminal prosecutions to target an overseas source of nitazenes, Salisbury said.

Read it all.

Novel opioids can be many times more powerful than fentanyl and can complicate overdose revivals and addiction treatment. The increasing presence of nitazenes adds another layer of health concerns as users often don't know they are consuming those opioids. https://t.co/mNmgMGXhW2

— The Washington Post (@washingtonpost) December 10, 2023

We have now had years of headlines talking about new research into using psychedelic drugs for therapy and, along with it, an increase in spiritual seekers.

Studies about the use of psychedelic drugs for therapy have been growing for years, with increased institutional involvement from universities, Congress, and the US Department of Defense to name just a few.

Outside of clinical trials, psychedelic use among young adults has nearly tripled in the past decade. Religious leaders—including hospital chaplains and religious psychotherapists—are also exploring the use of these drugs, as recently reported by NPR and Esquire. Ordained clergy are even conducting underground retreats that blend psychedelics with Christian worship with an emphasis on “healing.”

While I believe there are likely legitimate-use cases for psychedelic therapy that will bear out in time, I want to raise awareness of the many psychological risks of psychedelics that are often underemphasized in the research. And as a pastor, I feel an urgency to inform Christians of the serious spiritual risks of psychedelics—including the idolatry of spiritual experience.

Read it all.

“As a pastor, I feel an urgency to inform Christians of the serious spiritual risks of psychedelics—including the idolatry of spiritual experience.”

From @revjoewelker: https://t.co/HcusnXPudl

— Christianity Today (@CTmagazine) November 16, 2023

Americans are more negative about U.S. progress in dealing with the problem of illegal drugs than at any prior point in Gallup’s trend, which dates back to 1972. For the first time, a majority of U.S. adults, 52%, say the U.S. has lost ground in coping with the illegal drug problem, while a record-low 24% say it has made progress. Another 23% believe it has stood still.

Drug overdose deaths in the U.S. have risen sharply in recent years, with much of the increase due to synthetic opioids like fentanyl. But overdoses linked to other types of drugs, including cocaine and methamphetamines, have also grown since 2019.

Gallup has updated its trend on progress in addressing the illegal drug problem periodically since the mid-1990s, after some initial measurements in the 1970s showed mixed views on the question.

Read it all.

Americans are the most pessimistic they have been about U.S. progress on the illegal drug problem. https://t.co/VuD58In42u

— GallupNews (@GallupNews) November 10, 2023

It was a phrase he repeated to himself several times each day when his patience started to wane and he could feel the frustration hardening in his chest: They were all doing their best. The police officers whose active patrol force had shrunk by 20 percent to crisis levels because of attrition, recruiting challenges and the impact of calls to defund the police. The people sleeping on sidewalks as rents soared to record highs and shelters filled to capacity. The addicts who could either wait in line at 6 a.m. for the outside chance of a spot in rehab or numb their pain with another fentanyl pill for the going price of 50 cents. They were all suffering together through the morass of a damaged society.

“Our entire first responder system in this city, according to the people who run it, is 20 years behind the ball and critically understaffed,” the mayor said last year at a City Council meeting. The city itself had increasingly turned to the same Band-Aid fix as everyone else, spending more than $4 million a year on private security guards to help protect parks, water treatment facilities, parking garages and city hall.

The booming industry was nobody’s idea of a perfect or comprehensive solution. More than a dozen security guards in Portland had been accused of assault or harassment, and one was convicted of murder earlier this year after fatally shooting a customer outside of a Lowe’s store. Guards in Oregon were sometimes trained and certified in as little as 16 hours, and more than 100 companies operated in downtown Portland on any given night under different policies and company rules.

Echelon was one of the most proactive, with more than 75 guards who patrolled the city 24 hours a day. At least 400 fed-up local businesses paid Echelon a monthly fee to run interference with homeless people by building relationships, offering resources to people with addictions and mental illness, buying their breakfasts, replacing their shoes, reversing their overdoses and de-escalating their episodes of psychosis.

Bock’s previous security job had been at a company that stationed him outside a grocery store as a deterrent to shoplifting and told him to avoid interacting with customers. “A human scarecrow,” was how Bock described that role, so he chose to move to Echelon in 2021 despite the long hours and middle-class pay, because he wanted to be part of the glue that pieced his hometown back together.

Read it all.

"How can any of this be considered normal?" Another stunning @elisaslow story from the front lines of the urban unraveling, on one of the countless private security guards being hired to patrol American cities: https://t.co/kfYK1qGbNa

— Alec MacGillis (@AlecMacGillis) October 2, 2023

For the past two and a half years, Oregon has been trying an unusual experiment to stem soaring rates of addiction and overdose deaths. People caught with small amounts of illicit drugs for “personal use,” including fentanyl and methamphetamine, are fined just $100 — a sanction that can be waived if they participate in a drug screening and health assessment. The aim is to reserve prosecutions for large-scale dealers and address addiction primarily as a public health emergency.

When the proposal, known as Measure 110, was approved by nearly 60 percent of Oregon voters in November 2020, the pandemic had already emptied downtown Portland of workers and tourists. But its street population was growing, especially after the anti-police protests that had spread around the country that summer. Within months of the measure taking effect in February 2021, open-air drug use, long in the shadows, burst into full view, with people sitting in circles in parks or leaning against street signs, smoking fentanyl crushed on tinfoil.

Since then, Oregon’s overdose rates have only grown. Now, tents of unhoused people line many sidewalks in Portland. Monthslong waiting lists for treatment continue to lengthen. Some politicians and community groups are calling for Measure 110 to be replaced with tough fentanyl possession laws. Others are pleading to give it more time and resources.

Read it all.

Oregon’s experiment to curb overdoses by decriminalizing small amounts of illicit drugs is in its third year, and life has changed for most everyone in the city of Portland: “At four in the afternoon the streets can feel like dealer central” https://t.co/K6ziIxzbBV

— Jim Russell (@ProducerCities) August 1, 2023

Several studies have shown that chronic cannabis use is linked to a higher incidence of schizophrenia among men in their early 20s, the age when the disease is usually diagnosed. The first paper on the topic, a Swedish study published in 1997, found that heavy cannabis use was associated with a sixfold increase in schizophrenia risk. In the decades since, social scientists have unearthed a strong link between heavy cannabis use and other severe psychological illnesses, including clinical depression and bipolar disorder.

Now a new longitudinal study has examined the medical records of all citizens of Denmark over the age of 16, some 6.5 million people in all, for patterns of diagnosis, hospitalization and treatment for substance use between 1995 and 2021. In the paper, published in the journal JAMA Psychiatry in May, Dr. Oskar Hougaard Jefsen of Aarhus University and colleagues showed that people who had previously been diagnosed with cannabis use disorder were almost twice as likely to be diagnosed later with clinical depression. According to the Centers for Disease Control and Prevention, cannabis use disorder is characterized by craving marijuana, using it more often than intended, spending a lot of time using it, and having it interfere with friends, family and work.

Even more dramatically, the paper also found that people with cannabis use disorder were up to four times as likely to be diagnosed later with bipolar disorder with psychotic symptoms.

Read it all.

Reefer madness, literally: A new study involving the entire adult population of Denmark found a clear link between cannabis abuse and mental illness, writes Susan Pinker. https://t.co/AdnvFvGN8Y via @WSJ

— Gary Rosen (@garyrosenWSJ) July 6, 2023

It was the dead of winter in February 2022 when I first met Marwa, a 38-year-old opium addict, sitting huddled under a blanket in the women’s drug rehabilitation center in Kabul with two of her children. Mina, age 2, had just woken up and was writhing in pain, lifting her small head to see her new visitors.

Marwa’s other daughter, Zahra, age 15, was sitting by the edge of the bed. I first mistook her for a boy as she was dressed in boys’ clothing. Her mother said dressing as a boy made it easier for her to buy drugs. Zahra had been wearing the outfit when she was picked up by the hospital’s field team from under Pul-e-Sukhta, a bridge in western Kabul that has transformed into a gathering place for drug users and sellers.

Dr. Shaista Hakeem, director of the 150-bed National Center for the Treatment of Addiction for Women and Children in Kabul, introduced me to her patients that day, telling me the family had been at the hospital for more than a week. They were seeking treatment for opium addiction, which consisted of 15 days of medication and 15 days of counseling, awareness, and skill training. It was an ordeal, especially for the children, who suffered withdrawal symptoms despite regular doses of medication. The effectiveness of treatment varies from patient to patient, Hakeem added.

Marwa had been taking opium and heroin, a more refined opioid, for 10 years, and had passed on her addiction to her youngest child, Mina, through breast milk.

Read it all.

'The % of women reporting drug addiction rose to 9.5% in 2015 from 3% in 2009. Furthermore, 9.2% of children up to 14 years old tested positive for drugs and were likely to be engaged in active drug use' '#Afghanistan's #opium tragedy' https://t.co/fvRJYb7pAX via @NikkeiAsia

— Kenneth Maxwell (@Kenny_Maxwell) June 21, 2023

We are engaged in a massive national experiment, making all schoolchildren fit one behavioral mold; the results speak for themselves. Reading and math scores have not risen, but mindless acceptance of orthodoxy certainly has. The dream of certain educational reformers for centuries, it is only in the past couple decades that factory education has become reality, thanks to the power of Big Pharma. When students of the past did not fit, there was not that much even the most authoritarian teacher could do about it. Today, however, the choice is starker: Conform or be drugged. We used to make dystopian movies about it; now we make our children live it.

The medicine is the message. The nature of your discourse depends upon the popularity of your prescriptions. Once we have obedience in a tablet—a drug that makes students sit still and attend to whatever faddish nonsense their teacher may be spouting—society can be independent no longer. By making pharmaceuticals an integral part of the modern educational project, it is not simply the stimulant-taking students who become docile and obedient, but the unmedicated ones as well.

Read it all.

If Ritalin did not exist, neither would ADHD; the treatment conjures the disease. https://t.co/Rl4h992jxz

— First Things (@firstthingsmag) March 17, 2023

I came to Manhattan in 1990 because I was young and ambitious. To my good fortune, a humming economy and effective policing techniques based on the broken-windows theory made it relatively easy for me to start a family and a business here. Today, however, it feels as if the conditions that made New York a destination for businesses and families in the 1990s are no more.

There may be no greater symbol of decay than the ubiquitous stench of marijuana. I smell it when I leave my apartment building at 6:45 a.m. and when I come home at night. As the health of public finance declines in societies, so does private virtue. This is often because enterprising politicians find it easier to use vice as a source of public funding instead of making sober fiscal choices.

Read it all (registration or subscription).

There may be no greater symbol of decay in New York City than the ubiquitous stench of marijuana, writes Jason De Sena Trennerthttps://t.co/eJT4sJfZ7g

— Wall Street Journal Opinion (@WSJopinion) March 8, 2023

At 82 years old, with an aggressive form of blood cancer that six courses of chemotherapy had failed to eliminate, “Paul” appeared to be out of options. With each long and unpleasant round of treatment, his doctors had been working their way down a list of common cancer drugs, hoping to hit on something that would prove effective—and crossing them off one by one. The usual cancer killers were not doing their job.

With nothing to lose, Paul’s doctors enrolled him in a trial set up by the Medical University of Vienna in Austria, where he lives. The university was testing a new matchmaking technology developed by a UK-based company called Exscientia that pairs individual patients with the precise drugs they need, taking into account the subtle biological differences between people.

The researchers took a small sample of tissue from Paul (his real name is not known because his identity was obscured in the trial). They divided the sample, which included both normal cells and cancer cells, into more than a hundred pieces and exposed them to various cocktails of drugs. Then, using robotic automation and computer vision (machine-learning models trained to identify small changes in cells), they watched to see what would happen.

In effect, the researchers were doing what the doctors had done: trying different drugs to see what worked. But instead of putting a patient through multiple months-long courses of chemotherapy, they were testing dozens of treatments all at the same time.

The approach allowed the team to carry out an exhaustive search for the right drug. Some of the medicines didn’t kill Paul’s cancer cells. Others harmed his healthy cells. Paul was too frail to take the drug that came out on top. So he was given the runner-up in the matchmaking process: a cancer drug marketed by the pharma giant Johnson & Johnson that Paul’s doctors had not tried because previous trials had suggested it was not effective at treating his type of cancer.

It worked. Two years on, Paul was in complete remission—his cancer was gone.

Read it all.

On average, it takes more than 10 years and billions of dollars to develop a new drug.

Incorporating AI into the drug development pipeline could help create cheaper pharmaceuticals faster. https://t.co/xYVZFyA5fY

— MIT Technology Review (@techreview) February 15, 2023

Fentanyl’s catastrophic surge came after the Drug Enforcement Administration cracked down on the excesses of the U.S. opioid industry. Millions of Americans who had become addicted to prescription pain pills suddenly found them difficult or impossible to get.

Mexican cartels stepped in to fill the vacuum. Traffickers, who relied for decades on plant-based drugs such as heroin, cocaine and marijuana, are now using chemicals in clandestine laboratories to manufacture fentanyl powder and pills to meet the ever-increasing demand in the United States.

Fentanyl is 50 times more potent than heroin, and its compactness makes it far easier to smuggle. The synthetic opioid is so powerful that a year’s supply of pure fentanyl powder for the U.S. market would fit in the beds of two pickup trucks.

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Fentanyl’s recent surge came after the DEA cracked down on the U.S. opioid industry.

Millions of Americans who had become addicted to prescription pain pills then found them difficult or impossible to get.

Mexican cartels stepped in to fill the vacuum. https://t.co/UnPmsHY5Z2

— The Washington Post (@washingtonpost) December 12, 2022

Almost 35 years ago American drug regulators approved Prozac, the first in a series of blockbuster antidepressants known as selective serotonin re-uptake inhibitors (ssris). Prozac and its cousins were lauded by patients and doctors as miracle drugs. They lifted low moods quickly and seemed to have no drawbacks. Divorce, bereavement, problems at work—a daily pill was there to help with that, and anything else which made you sad. Many people have stayed on these drugs for life. In Western countries today between one person in seven and one in ten takes antidepressants.

The shine of ssris has worn off. A growing number of studies show that they are less effective than thought. Drug companies often publish the results of clinical trials selectively, withholding those in which the drugs turn out not to work well. When the results of all trials submitted to America’s medicines regulator between 1979 and 2016 were scrutinised by independent scientists, it turned out that antidepressants had a substantial benefit beyond a placebo effect in only 15% of patients.

Clinical guidelines have been revised accordingly in recent years. No longer are drugs the recommended first line of treatment for less severe cases of depression. For these, self-help guidance, behavioural therapy and recommendations for things like exercise and sleep are preferable. For work burnout, a sick note for time off may suffice. The drugs are to be reserved only for more severe depression, where they can be truly life-saving.

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Lots of people who do not need antidepressants are already on them, refilling prescriptions written years or even decades ago. They should be helped to get off the drugs https://t.co/Rbz8cN9ogl

— The Economist (@TheEconomist) October 20, 2022

Adm. Craig Faller, a senior U.S. military leader, told Congress last year that Chinese launderers had emerged as the “No. 1 underwriter” of drug trafficking in the Western Hemisphere. The Chinese government is “at least tacitly supporting” the laundering activity, testified Faller, who led the U.S. Southern Command, which oversees military activity in Latin America.

In an interview with ProPublica, the now-retired Faller elaborated on his little-noticed testimony. He said China has “the world’s largest and most sophisticated state security apparatus. So there’s no doubt that they have the ability to stop things if they want to. They don’t have any desire to stop this. There’s a lot of theories as to why they don’t. But it is certainly aided and abetted by the attitude and way that the People’s Republic of China views the globe.”

Some U.S. officials go further, arguing that Chinese authorities have decided as a matter of policy to foster the drug trade in the Americas in order to destabilize the region and spread corruption, addiction and death here.

“We suspected a Chinese ideological and strategic motivation behind the drug and money activity,” said former senior FBI official Frank Montoya Jr., who served as a top counterintelligence official at the Office of the Director of National Intelligence. “To fan the flames of hate and division. The Chinese have seen the advantages of the drug trade. If fentanyl helps them and hurts this country, why not?”

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This story is about the convergence of two of the top security threats to the United States: Latin American drug cartels and the authoritarian regime in China. https://t.co/BYk0iZkI5L

— ProPublica (@propublica) October 12, 2022

Americans are evenly split in their views about marijuana’s effect on society, with 49% considering it positive and 50% negative. They are slightly more positive about the drug’s effect on people who use it, with 53% saying it’s positive and 45% negative.

People’s own experience with marijuana is highly related to their views on both questions.

Large majorities of adults who say they have ever tried marijuana — which is nearly half of Americans — think marijuana’s effects on users (70%) and society at large (66%) are positive.
Conversely, the majority of those who have never tried marijuana think its effects are negative: 72% say this about its effect on society and 62% about its effect on users.

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Americans Not Convinced Marijuana Benefits Society https://t.co/4zwuZA6yb4

— Riccardo C. Gatti (@RiccardoGatti) August 17, 2022

After a catastrophic increase in 2020, deaths from drug overdoses rose again to record-breaking levels in 2021, nearing 108,000, the result of an ever-worsening fentanyl crisis, according to preliminary new data published on Wednesday by the Centers for Disease Control and Prevention.

The increase of nearly 15 percent followed a much steeper rise of almost 30 percent in 2020, an unrelenting crisis that has consumed federal and state drug policy officials. Since the 1970s, the number of drug overdose deaths has increased every year except 2018.

A growing share of deaths continue to come from overdoses involving fentanyl, a class of potent synthetic opioids that are often mixed with other drugs, and methamphetamine, a synthetic stimulant. State health officials battling an influx of both drugs said many of the deaths appeared to be the result of combining the two.

Drug overdoses, which long ago surged above the country’s peak deaths from AIDS, car crashes and guns, killed about a quarter as many Americans last year as Covid-19.

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Breaking News: U.S. deaths from drug overdoses again rose to record-breaking levels in 2021, nearing 108,000, according to preliminary data from the CDC.

The increase of nearly 15% followed a much steeper rise of almost 30% in 2020.https://t.co/GX3AR3TlR0

— The New York Times (@nytimes) May 11, 2022

Treatment for opioid use disorder (oud) is woefully inadequate across the country, but African-Americans often face extra barriers. Studies have found that medications for treating oud, as well as naloxone (a life-saving medication that reverses opioid overdoses), are doled out unevenly. A study of data from Medicaid, the government insurance programme for the poor, across several states with some of the highest opioid-overdose rates found that between 2014 and 2018 black people with oud were 28% less likely to use oud medications.

Studies in various cities, including San Francisco and Los Angeles, suggest that African-Americans have less access to naloxone, too. In Detroit between 2019 and 2020, white addicts received 28% of naloxone administrations, though they accounted for 17% of the city’s opioid overdoses; although 80% of overdoses were among black people, they received only 67% of naloxone administrations. This does not necessarily mean black addicts are being denied naloxone. Those who use opioids alone, are homeless or live in communities with little trust in first responders might be less likely to call for help.

Such disparities strengthen the case for local interventions that deal with the unique hurdles certain communities face. Other solutions are more sweeping, like expanding access to Medicaid and reducing red tape around oud medications. But underlying all these is a straightforward calculus that applies to all Americans, black or white: “It has to be easier to get treated than it is to continue using,” says Dr Kolodny. “You have to flip it.”

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African-Americans used to be far less affected. But that has changed https://t.co/lyAbakVt5M

— The Economist (@TheEconomist) April 9, 2022