Substance Abuse Newsletter November 2016

November 22, 2016

The following is a compendium of news reports over the past month that may be of interest to our AG offices who are dealing with substance abuse issues. Neither the National Association of Attorneys General nor the National Attorneys General Training & Research Institute expresses a view as to the accuracy of news accounts, nor as to the position expounded by the authors of the hyperlinked articles.

Opioids

U.S. Surgeon General Vivek H. Murthy published a landmark report on a health crisis affecting every community in our country. Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health is a comprehensive review of the science of substance use, misuse, and disorders. Nearly 21 million people in America have a substance use disorderinvolving alcohol or drugs, an astonishing figure that is comparable to the number of people in our country with diabetes and higher than the total number of Americans suffering from allcancers combined. But in spite of the massive scope of this problem, only 1 in 10 people with a substance use disorder receives treatment. The report is available online at http://addiction.surgeongeneral.gov

Responding to the imminent threat to public health and safety, the U.S. Drug Enforcement Administration (DEA) has placed U-47700 into Schedule I of the Controlled Substances Act, effective on November 14, 2016. Emergency scheduling of dangerous drugs such as U-47700 on a temporary basis is one of the most significant tools DEA can utilize to address the problems associated with deadly new street drugs. DEA has received reports of at least 46 confirmed fatalities associated with U-47700. Thirty one of those fatalities occurred in New York and 10 in North Carolina. From October 2015 to September 2016, DEA has received 88 reports from State and local forensic laboratories of U-47700 submissions.

This scheduling action will last for 24 months, with a possible 12-month extension if DEA needs more data to determine whether it should be permanently scheduled.

U-47700 is a novel synthetic opioid, and its abuse parallels that of heroin, prescription opioids, and other novel opioids. Law enforcement agencies report seizures of the drug in powder form and counterfeit tablets that mimic pharmaceutical opioids. Because substances like U-47700 are often manufactured in illicit labs overseas, the identity, purity, and quantity are unknown, creating a “Russian Roulette” scenario for any user. The Federal Register notice will include the DEA's 3-factor analysis of the drug as required by the Controlled Substances Act, including DEA’s analysis of U-47700, which includes the drug’s chemical structure; history and current pattern of abuse; scope, duration and significance of abuse; and risk to the public health. The Final Order may be accessed here.

Hospitalizations for pediatric opioid poisonings almost doubled from 1997 to 2012, according to a retrospective analysis published online in JAMA Pediatrics. The highest hospitalization rates occurred among older adolescents, but the largest increase in hospitalizations over time was seen in children aged 1 to 4 years. Mortality rates attributed to opioids are also alarming. Retail sales of prescription opioids rose fourfold from 1999 to 2010, and deaths attributed to opioid overdose increased by the same amount among 15- to 64-year-olds. However, deaths increased six-fold in those aged 15 to 24 years. The researchers analyzed US pediatric hospital discharge data for 13,052 hospitalizations from January 1, 1997, through December 31, 2012, to examine trends in hospitalizations for opioid poisonings in children and adolescents.

The Journal of the American Medical Association has published an informative article concerning the FDA’s approval of buprenorphine implants (probuphine) for opioid dependence. The article may be accessed here.

The Commonwealth of Virginia announced the launch of a new website developed as an informational tool for the fight against prescription drug and heroin abuse in Virginia. VaAware.com features specific pages for parents, healthcare providers, law enforcement and those seeking help with addiction. It came about as a recommendation of the governor’s Task Force on Prescription Drug and Heroin Abuse in the Commonwealth. The website is the result of collaboration between four Virginia agencies: the Department of Health Professions, the Virginia Department of Health, the Department of Criminal Justice Services, and the Department of Behavioral Health and Development Services.

Medical/Marijuana Issues

Maine residents have voted tolegalize marijuana for recreational use in their state. Maine joins California, Nevada and Massachusetts, which passed similar measures this year. Arizona rejected a similar measure. Recreational marijuana was already legal in Colorado, Oregon, Washington and Alaska.

Four states passed medical marijuana initiatives on the November ballots: Florida, Arkansas, Montana and North Dakota.

Marijuana dispensaries in Oregon sold more than $160 million worth of recreational marijuana products in the first nine months of 2016, according to sales tax figures released by the state Department of Revenue. The agency received $40.2 million in recreational marijuana sales tax payments from dispensaries between the start of January and the end of September, suggesting that about $160.8 million worth of recreational pot products were sold in Oregon. State-regulated medical marijuana dispensaries selling recreational marijuana charge a 25 percent sales tax to customers for all flower, edible and other marijuana items. This month, the Oregon Liquor Control Commission licensed the first retailers in its recreational marijuana program. The retailers charge a 17 percent state sales tax for all recreational marijuana products.

A new Gallup poll shows 60 percent of American adults now say that marijuana should be legal, the highest level of support in nearly a half-century of polling on the question. The Gallup poll tracks closely with numbers from the Pew Research Center released last week showing 57 percent support for legalization. As Gallup notes, support for legalization has soared in the past decade among nearly every demographic group. Close to 80 percent of 18-to-34 year olds now favor legal weed, up from 44 percent in 2003 and 2005. Gallup finds that Americans age 55 and older are now the only age group with less than majority support for legalization.

The D.C. Council has approved a measure that would allow medical marijuana users from other jurisdictions to use their out-of-state registration cards to purchase cannabis in the District. The bill received unanimous support from the council. With passage of the Medical Marijuana Reciprocity Amendment Act, the District joins Michigan, Nevada, New Hampshire, Rhode Island, Arizona and Maine in allowing some level of reciprocity for out-of-state registered medical marijuana users. In Michigan, Nevada and New Hampshire, medical cannabis users can lawfully purchase pot with their out-of-state cards with no restrictions. Rhode Island recognizes cards from other jurisdictions, but only for conditions that are approved for medical marijuana use in the Ocean State itself. Arizona and Maine allow out-of-state card holders to possess marijuana but not purchase it at state-authorized dispensaries.

The EPA has not authorized the use of any pesticides on marijuana plants, causing concern about potential health risks connected to Alaska's newest cash crop. Under current Alaska regulations, samples of each marijuana harvest must pass through the scrutiny of a testing facility before approved for retail sale. These testing facilities are required to identify THC potency, harmful microbial such as E. coli and salmonella, residual solvents, poisons or toxins, harmful chemicals, dangerous molds, mildew or filth and pesticides. Contest is currently the only operating testing facility in the state. Although the business received a license to begin processing marijuana products, owner Mark Kalagadi said Contest doesn't have the necessary equipment to test for pesticides. As regulations are currently written, there isn’t a need for testing facilities to monitor pesticide use. Unlike the legalized states of Colorado, Washington and Oregon, Alaska has no regulations banning specific pesticides, insecticides or herbicides from being sprayed on cannabis crops.


Joanne Thomka is the Editor of Substance Abuse News and may be reached at 202-326-6269. Substance Abuse News is a publication of the National Association of Attorneys General. Any use and/or copies of this newsletter in whole or part must include the customary bibliographic citation. NAAG retains copyright and all other intellectual property rights in the material presented in this publication. For content submissions or to contact the editor directly, please e-mail jthomka@naag.org.

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