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Saving Lives With ‘Safer Opioids’




By Amy Norton HealthDay Reporter

TUESDAY, Sept. 20, 2022 (HealthDay News) — As opioid overdose deaths continue to soar, a Canadian program points to one way to save lives: providing “safer” opioids to people at high risk of overdose.

That’s the conclusion of a study evaluating Canada’s first formal “safer opioid supply,” or SOS, program. Such programs aim to prevent overdoses by giving vulnerable people an alternative to the increasingly dangerous street supply of opioids.

In this case, the London, Ontario-based program provided clients with a daily dose of prescription opioid tablets, as well as basic health care, counseling and social services.

The result was a rapid drop in emergency department trips and hospitalizations among the 82 clients studied, the researchers found. And over six years, there was not a single overdose death.

“I think this is a landmark study,” said Thomas Kerr, director of research at the British Columbia Centre on Substance Use, in Vancouver, Canada.

Kerr, who was not involved in the study, acknowledged that SOS programs are controversial and have their critics. Concerns have included the possibility of opioid pills being sold, or people crushing the tablets and injecting them, which carries the risk of overdose or infection.

But criticisms of safer supply have been made in the absence of data, Kerr said.

“The whole conversation has been clouded by misinformation,” he said. “When we’re talking about matters of life and death, we can’t rely on people’s opinions.”

Kerr said he hoped the new findings “will mute some of the misinformation.”

The study was published Sept. 19 in the CMAJ (Canadian Medical Association Journal). Itcomes amid an ever-worsening opioid epidemic.

In the United States, opioid overdose deaths have been on the rise for years, and the situation worsened after the pandemic hit. In 2020, nearly 92,000 Americans died of a drug overdose — largely involving opioids, according to the U.S. Centers for Disease Control and Prevention.

The crisis has mainly been driven by illegally made versions of the painkiller fentanyl, a synthetic opioid that is 50 times more potent than heroin, health officials say. Illicit fentanyl is sold in various forms, including pills made to look like other prescription opioids. It’s also commonly mixed into other illegal drugs, like cocaine and heroin, to boost their potency. The result is that users are often unaware they’re taking fentanyl.

Safer supply programs are based on the principle of harm reduction — that overdoses, infections and other consequences of opioid addiction can be prevented, without requiring people who misuse drugs to be completely abstinent.

The new findings come from a program begun in 2016 at London InterCommunity Health Centre. It provides clients with hydromorphone (Dilaudid) tablets, dispensed daily, as well as many other services — including primary health care, treatment for infections like HIV and hepatitis C, counseling, and help with housing and other social services.

The researchers, led by Tara Gomes, of Unity Health Toronto, looked at data on all 94 clients who entered the program between 2016 and March 2019. They compared 82 of those people against 303 individuals diagnosed with opioid addiction who did not take part in the program.

Over one year, the study found, emergency department visits and hospitalizations fell among program clients, while remaining unchanged in the comparison group. And while clients had medication costs — covered by Ontario’s prescription drug plan — their yearly health care costs outside of primary care plunged: from about $15,600, on average, to $7,300.

Again, there was no substantial change in the comparison group.

Dr. Sandra Springer is an associate professor at Yale School of Medicine, in New Haven, Conn., who has helped craft practice guidelines for the American Society of Addiction Medicine.

“This study is further evidence that programs that meet patients where they are and provide easy access to clinical care for treatment of opioid use disorder can save more lives and reduce health care costs,” said Springer, who was not involved in the research.

Opioid dependency itself can be treated with medication-assisted therapy, which involves counseling and medications like buprenorphine, methadone and naltrexone.

“While this SOS program did not provide traditional medications for the treatment of opioid use disorder to all participants, those medications were available to patients through the program,” Springer noted.

And, she said, other research has shown that when people who use drugs are offered “compassionate care,” they are more likely to accept “evidence-based treatment.”

The extent to which SOS programs will spread remains to be seen. In 2020, Health Canada announced funding for several additional pilot programs. And last year, New York City opened two overdose prevention sites — where people with opioid addiction can use the drugs in a clean, supervised setting, and be connected with health care and social services.

The sites are the first publicly recognized overdose prevention centers in the United States.

Kerr said that in the face of an opioid crisis that is only worsening, “the status quo response is not sufficient.”

“We have to try new approaches,” he said, “and scientifically evaluate them.”

More information

The U.S. National Institute on Drug Abuse has more on opioid use disorder.

SOURCES: Thomas Kerr, PhD, director, research, British Columbia Centre on Substance Use, professor, social medicine, University of British Columbia, Vancouver, Canada; Sandra Springer, MD, associate professor, medicine, Yale School of Medicine, New Haven, Conn.; CMAJ, Sept. 19, 2022, online

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Health Care

Congress Under Pressure: Colorado Officials Push for Cannabis Banking Reform




With the end of Congress’ session just around the corner, marijuana advocates, stakeholders and lawmakers continue to push for marijuana banking policy change.

This time, Colorado Gov. Jared Polis (D) joined forces with Lt. Gov. Dianne Primavera (D), Attorney General Phil Weiser (D), Treasurer Dave Young (D) and Department of Public Safety (DPS) Executive Director Stan Hilkey in urging congressional leaders to revisit the issue, reported Marijuana Moment.

In a letter sent on Monday to both House and Senate leaders, Colorado officials focused on the impact which a bipartisan marijuana banking bill will have in terms of public safety and industry equity,

“The lack of safe banking and financial services for the cannabis industry in the State of Colorado has become a dire public safety issue for highly regulated cannabis businesses operating in compliance with state …

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New Data Shows Weed Legalization a Boon for Real Estate, New Jobs and Tax Revenue




A new report from the Federal Reserve Bank shed light on the economic impact marijuana legalization has had in recent years, reported Marijuana Moment. Policy changes on the state level have resulted in increased commercial real estate demand, as well as a surge in tax revenues while creating more jobs.

According to an analysis from the Kansas City arm of the Central Bank, which collected data from several states under its jurisdiction, the Tenth Federal Reserve District, the cannabis industry has become one of the main economic sectors positioned to grow substantially in the coming period.

“Overall, the marijuana industry has had a significant effect on the economies of Tenth District states in the initial years after legalization,” the report said. “The emergence of the industry has …

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Will Missouri Legalize Cannabis? Amendment 3 Suffers Another Attack This Time by State NAACP




Cannabis legalization efforts in Missouri are under attack once again, this time by The Missouri State Conference of the NAACP.

What Happened

The Missouri NAACP, breaking with chapters in the St. Louis area is urging its members to vote against Amendment 3 on the Nov. 8 ballot, reported the Saint Louis Post-Dispatch.

The group announced Thursday that it believes recreational marijuana legalization, as it is proposed under Amendment 3, would prevent minorities from entering the cannabis industry. 

“Marijuana possession should not be a constitutional crime. Additionally, for years now, Black people, other minorities, and people who have been criminalized by marijuana laws in the past have been unable to enter the medical marijuana market,” the Missouri NAACP wrote. “That is not right. In an effort to prevent the permanent exclusion of minorities from the cannabis industry in the state of Missouri, the NAACP calls upon every voter to reject the criminalization of marijuana possession, de facto racist regulation of the cannabis market, and the wool being pulled over our eyes by the supporters of Amendment 3.”

Under Amendment 3, the first “comprehensive” cannabis business licenses would be provided to existing medical marijuana companies. 

The state’s chapter highlighted that the amendment “does not increase the number of available full market licenses” and claims that giving “micro” business licenses to disadvantaged groups makes a “very limited” program. 

According to Nimrod “Rod” Chapel Jr., president of the Missouri NAACP, members agreed last week …

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