This Week's News in Substance Use: 2/9/18

Trump Says He Will Focus On Opioid Law Enforcement, Not Treatment, NPR

“The president now says that to combat opioids, he's focused on enforcement, not treatment.

“Trump spent just over a minute of his 80-minute State of the Union address talking about opioids. In a speech this week in Cincinnati, he had a few more comments. The opioid epidemic, he said, ‘has never been worse. People form blue ribbon committees. They do everything they can. And frankly, I have a different take on it. My take is you have to get really, really tough, really mean with the drug pushers and the drug dealers.’

“The president's mention of ‘blue ribbon committees’ sounds like a slam on one he convened last year, chaired by former New Jersey Gov. Chris Christie — the President's Commission on Combating Drug Addiction and the Opioid Crisis. The commission issued more than 50 recommendations. The administration has so far followed up on just a few of those recommendations.’

Kellyanne Conway’s 'Opioid Cabinet' Sidelines Drug Czar’s Experts, Politico

“President Donald Trump’s war on opioids is beginning to look more like a war on his drug policy office.

“White House counselor Kellyanne Conway has taken control of the opioids agenda, quietly freezing out drug policy professionals and relying instead on political staff to address a lethal crisis claiming about 175 lives a day. The main response so far has been to call for a border wall and to promise a ‘just say no’ campaign.

“Trump is expected to propose massive cuts this month to the ‘drug czar’ office, just as he attempted in last year’s budget before backing off. He hasn’t named a permanent director for the office, and the chief of staff was sacked in December. For months, the office’s top political appointee was a 24-year-old Trump campaign staffer with no relevant qualifications. Its senior leadership consists of a skeleton crew of three political appointees, down from nine a year ago.”

In One Night, She Lost Two Sons to Opioids. She’s On a Mission to Spare Others That Unfathomable Pain, STAT

“President Trump suggested last week that teens could be dissuaded from trying drugs if adults would just tell them that opioids are “really bad for you in every way.” Attorney General Jeff Sessions has talked about reviving D.A.R.E., the anti-drug program that sent uniformed police officers into classrooms around the country starting in the ’80s to preach about the dangers of narcotics.

“But the grief of a mother who lost two sons in one night carries a different kind of weight.”

FDA Declares Popular Alt-Medicine Kratom an Opioid, NBC News

“Kratom is used by some as a home remedy for opioid addiction — and by others just for fun. It has a passionate following.

“’Kratom should not be used to treat medical conditions, nor should it be used as an alternative to prescription opioids. There is no evidence to indicate that kratom is safe or effective for any medical use.’

“Last November, the FDA cautioned people not to use kratom.

“Supporters of kratom use have been fighting to keep it legal for years. The Drug Enforcement Administration temporarily listed kratom as a Schedule 1 controlled substance last August, but withdrew the decision after an outcry and a targeted petition effort.”

Alabama Targets OxyContin Maker Purdue Pharma in Opioid Suit, NPR

“Alabama filed a lawsuit in federal court on Tuesday against OxyContin producer Purdue Pharma LP claiming the drug company is fueling the opioid epidemic by deceptively marketing prescription painkillers.

“The state alleges that Purdue failed to accurately portray the risks and benefits of opioids, which enabled doctors to widely prescribe them in the treatment of pain. Alabama becomes the latest in a flood of lawsuits by states, counties and cities against drug makers in response to the opioid crisis.”

The Surprising Geography of Opioid Use Around the World, Quartz

“The pattern of opioids use varies widely around the world. In the United States, one daily dose of opioids was prescribed for every 20 people from 2013-15. In similarly wealthy Japan, one daily dose was prescribed for every 800 people over the same period.

“As part of international drug-control conventions, countries report the use of narcotics—like opioids, cocaine, and cannabis—for legal medicinal and scientific use to the United Nations each year. Opioids include such drugs as morphine, oxycodone, and fentanyl. (Heroin is also an opioid, but is not reported on here because it is not used legally.)

“The UN’s 2017 report on narcotic use reveal that the US, currently facing a crisis of opioid overuse, is an extreme outlier. US opioid use is the highest of any country in the world, and more than 50% higher than Germany, the second-ranked country of the twenty most populous countries.”

$6 Billion Allotted to Fight Opioid Epidemic — Here's How We Should Spend It, The Hill

“In December 2016, President Obama presided over his last official bill signing ceremony. The bill before him was the 21st Century Cures Act, a bill that authorized $1 billion to tackle the opioid epidemic. At the time, the figure was an unprecedented sum.

“In February 2018, over a year and almost 100,000 overdose deaths later, Congress has called the $1 billion and raised it. The U.S. Senate announced that it reached a budget agreement, which includes $6 billion over a two-year period for the opioid epidemic.

“Once passed, Congress must appropriate these funds for specific programs. The guiding principle for spending this money must be how will it decrease overdose deaths.”

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