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      Overdose deaths in San Francisco hit 200 in three months: ‘A crying shame’

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      Drug-related deaths surged by 41% in San Francisco in the first quarter of this year – with one person dying of an accidental overdose every 10 hours, as the fentanyl crisis continues to ravage the US west coast.San Francisco saw 200 people die of overdoses in the past three months compared to 142 in the same months a year ago, according to reports by the city’s medical examiner.Those living on the streets were particularly hard hit – with twice as many unhoused people dying of overdoses between January and March compared to a year earlier.Fentanyl was detected in most of the deaths. The city’s minority populations were particularly hard hit. A third of the overdose victims were Black, despite Black people making up only 5% of the city’s population.“It’s a crying shame that a city as wealthy as San Francisco can’t get its act together to deal with overdose deaths,” said Dr Daniel Ciccarone, a professor of addiction medicine at the University of California San Francisco, who said the city’s increasingly punitive approach to handling drug users has only heightened their overdose risks.“We’re a politically divided city between the people who have a lot of money and want the streets swept and those who think a compassionate, science-based, health approach is appropriate,” he said.The spike in deaths began in December and was particularly apparent in January, when 82 deaths put the city’s overdose fatalities at an all time high. This came just after the city government closed a key outreach center, where drug users were using with medical supervision, and increased policing in San Francisco’s drug-plagued Tenderloin district.Last summer, voters recalled the city’s liberal district attorney and the San Francisco mayor London Breed appointed a new district attorney, Brooke Jenkins, who vowed to take a law-and-order approach to the problem and has since stepped up arrests of drug dealers.Then in December, Breed closed the Tenderloin Center, a facility designed to provide daytime shelter for the unhoused, along with housing referrals, food, addiction treatment and health services. The center had unofficially allowed drug use in a supervised outside area. Attendants used Narcan to reverse more than 330 opiate overdoses in the 11 months the center was open, according to city data.The center, which served more than 400 people daily, was opposed by some in the community, who said it was drawing drug users to the already-impacted neighborhood.Breed said in December she had been disappointed by the low number of visitors at the center who ultimately accepted help to get off of drugs. According to the San Francisco Chronicle, fewer than 1% of visits resulted in someone getting connected to addiction treatment services.Since closing the center, Breed has sought $25m to increase police overtime with the priority of arresting drug dealers.“We are dealing with multiple serious public safety challenges locally, from a fentanyl-driven overdose epidemic, open-air drug dealing, property crime in our residential and commercial neighborhoods, increasing gun violence and prejudice-fueled incidents,” she said in a March letter seeking more federal help in policing and prosecuting cases.Last week, the California governor, Gavin Newsom, promised to send in resources and personnel from the national guard and the California highway patrol to bolster policing.Gary McCoy of HealthRIGHT 360, the nonprofit that ran the drug overdose prevention portion of the Tenderloin Center, said the government’s law-enforcement focused approach is backfiring and is instead pushing drug users into isolation, where they are more at risk of overdose deaths.“Something that has been sold to folks as a strategy that is going to work and help tackle the overdose crisis is having the exact opposite effect,” said McCoy, adding that the police tactics create dangers that go beyond the fact that health officials no longer have the chance to witness and reverse overdoses at the Tenderloin Center.“When people don’t have a safe place to go, when they’re using in doorways and public places and they’re afraid of getting caught and put in jail, they tend to rush and use more substance,” he said. “And when they rush, there’s a higher risk of overdose.”Ciccarone said other safe use centers around the world, including one in Melbourne Australia that opened five years ago, have shown to reduce overdoses, bring drug use off the streets and help get addicts into treatment. But he cautioned it takes far longer than 11 months to see the results.“People expected too much from it too soon,” he said of San Francisco’s center. “It gave the outward appearance that people were congregating to consume drugs. But here we have it closed for three months and the first three months show a tremendous rise in overdose deaths.”The city’s supervisors have pushed to replace the Tenderloin Center, which was designed as a temporary measure, with 12 smaller “wellness hubs” around the city. These would provide health and shelter services, as well allowing supervised drug use to prevent overdose deaths.But last summer, Newsom vetoed legislation that would have allowed supervised drug use centers in three California cities, including San Francisco. And the plan for the wellness hubs stalled, after San Francisco’s city attorney raised the objection that the city could wind up bearing significant legal liability.Breed has said she supports the wellness hubs.“These are difficult situations because this involves legal advice, significant criminal liability which we cannot just ignore,” said the mayor, according to KTVU news. Nonprofits are now seeking a way to fund the overdose prevention portions of their operations without city funding.In a statement, the San Francisco Department of Health (SFDPH) said it has undertaken a host of measures to prevent overdoses, including adding hundreds of new beds for addiction recovery treatment, expanding neighborhood street care teams and making Narcan and medication-assisted addiction treatment options more available.“SFDPH recognizes that any overdose death is one too many and mourns the loss of each of these lives,” the department said. It added the department is also looking for legal ways to open supervised use clinics. “These deaths drive us to find more ways to prevent overdoses and reduce the harms caused by fentanyl.”Breed and the new district attorney have touted increased arrests and jail time for drug dealers. In a April blog post, the mayor said police made 162 arrests for drug possession for sales in the last three months of 2022, an 80% increase, and are seizing dozens of kilograms of narcotics.“These enforcement actions will continue, while our street outreach teams continue to go out and offer services and treatment,” wrote Breed.But Alex Kral, an epidemiologist at the independent nonprofit research institute RTI International, who led an evaluation of the Tenderloin Center, said the drug dealing arrests actually make the drug supply more dangerous by forcing users to go to people they don’t know for their drug supply and forcing users into hiding.“You’re making an unpredictable drug market even more unpredictable,” he said.“We’ve spent the last 50 years trying to arrest our way out of this and it’s clearly not working. The conditions on the streets are getting worse, the drugs are becoming more dangerous and the health of the community is much, much worse with increased policing.”According to San Francisco supervisor Hillary Ronen, who has championed the idea of wellness hubs, the city has failed to come up with any new tactics to deal with a “horrific crisis”.“We closed the Tenderloin Center with no plan in place to replace it,” she said. “Fentanyl is corrupting every part of the drug supply and all the social problems that underlie the drug addiction crisis continue – widespread poverty, trauma with no access to mental health care, inequality, and homelessness.”“What did we expect to happen?” More

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      FDA approves overdose-reversing Narcan for sale without prescription

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      The US Food and Drug Administration on Wednesday approved selling naloxone without a prescription, setting the overdose-reversing drug on course to become the first opioid treatment drug to be sold over counters in the US.It is a move some advocates have long sought as a way to improve access to a life-saving drug, though the exact impact will not be clear immediately.The best-known form of naloxone is Narcan, an approved branded nasal spray made by Emergent BioSolutions in Gaithersburg, Maryland. It can reverse overdoses of opioids, including street drugs such as heroin and fentanyl and prescription versions including oxycodone.Making naloxone available more widely is seen as a key strategy to control the US overdose crisis, which has been linked to more than 100,000 deaths a year. The majority of those deaths are tied to opioids, primarily potent synthetic versions such as fentanyl that can take multiple doses of naloxone to reverse.Advocates believe it is important to get naloxone to people who are most likely to be around overdoses, including people who use drugs and their relatives. Police and other first responders often carry it.Emergent BioSolutions said Narcan would become available over-the-counter by late summer. Other brands of naloxone and injectable forms will not yet be available over the counter, but could be soon.Harm Reduction Therapeutics, a non-profit which has funding from the OxyContin maker Purdue Pharma, has an application before the FDA to distribute its version of spray naloxone without a prescription.Even before the FDA’s action, pharmacies could sell naloxone without a prescription because officials in every state have allowed it. But not every pharmacy carries it. And buyers have to pay for the medication – either with an insurance co-pay or for the full retail price. The cost varies, but two doses of Narcan often go for around $50.The drug is also distributed by community organizations that serve people who use drugs, though it is not easily accessible to everyone who needs it.Emergent has not announced its price and it is not clear yet whether insurers will continue to cover it as a prescription drug if it is available over the counter.However, the FDA decision clears the way for Narcan to be made available in places without pharmacies, including convenience stores, supermarkets and online retailers.Jose Benitez, lead executive officer at Prevention Point Philadelphia, an organization that tries to reduce risk for people who use drugs with services including handing out free naloxone, said over-the-counter access could help a lot for people who don’t seek help or who live in places where it is not available.Now, he said, some people are concerned about getting naloxone at pharmacies because their insurers will know they are getting it.“Putting it out on the shelves is going to allow people just to pick it up, not have stigma attached to it and readily access this life-saving drug,” he said.The US Centers for Medicaid and Medicare Services, which now covers prescription naloxone for people on government insurance programs, says coverage of over-the-counter naloxone would depend on the insurance program. It has not given any official guidance.Maya Doe-Simkins, a co-director of Remedy Alliance/For the People, which launched last year to provide low-cost and sometimes free naloxone to community organizations, said her group would continue to distribute injectable naloxone.One concern is whether people who buy Narcan over the counter will know how to use it, said Keith Humphreys, a Stanford University addiction expert, though the manufacturer is responsible for clear directions and online videos.One benefit of having pharmacists involved, Humphreys said, is that they can show buyers how to use it. Humphreys also said there are fears that if the drug is not profitable as an over-the-counter option, the drugmaker could stop producing it. More

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      US agency to reverse Covid-19 policy for frequently abused prescription drugs

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      US agency to reverse Covid-19 policy for frequently abused prescription drugsPatients using Adderall, OxyContin and other medicines with ‘high potential for abuse’ will be required to physically visit a doctorThe US Drug Enforcement Administration has proposed rules that would again require patients to visit doctors in-person to obtain prescriptions for certain medications that are frequently abused.What does the Adderall shortage in the US mean for ADHD patients?Read moreThe announcement seeks to reverse policy changes made during the Covid-19 pandemic which allowed doctors to prescribe controlled drugs such as Adderall and OxyContin through virtual tele-health appointments.On Friday, the DEA said that patients would be required to physically visit a doctor at least once in order to get a prescription on drugs that have been categorized as schedule II substances by the government. Those substances, which the government says have a “high potential for abuse”, include Adderall, OxyContin, Vicodin and Ritalin.The proposed rules are on track to affect thousands of Americans who have relied on tele-health services throughout the pandemic in order to more easily access their medications. But they do not affect tele-health appointments which do not require doctors to prescribe controlled medications.They also do not affect consultations by doctors who have previously conducted an in-person medical examination of a patient.“The DEA is committed to ensuring that all Americans can access needed medications,” agency administrator Anne Milgram said in a statement.She added: “The permanent expansion of telemedicine flexibilities would continue greater access to care for patients across the country, while ensuring the safety of patients. The DEA is committed to the expansion of telemedicine with guardrails that prevent the online overprescribing of controlled medications that can cause harm.”The proposed rules would also allow doctors to prescribe a 30-day supply of buprenorphine through tele-health appointments to treat opioid use disorder.“Medication for opioid use disorder helps those who are fighting to overcome substance use disorder by helping people achieve and sustain recovery, and also prevent drug poisonings,” Milgram said. She added: “The telemedicine regulations would continue to expand access to buprenorphine for patients with opioid use disorder.”The DEA plans to implement the proposed rules prior to the expiration of the federal Covid-19 public health emergency declaration on 11 May.Despite the convenience of tele-health services, some critics argue that their expansion has allowed for certain companies to take advantage of the flexibility and in turn prescribe unnecessary medications.“Both sides of this tension have really good points,” a drug historian at the University of Buffalo, David Herzberg, told the Associated Press.“You don’t want barriers in the way of getting people prescriptions they need. But anytime you remove those barriers it’s also an opportunity for profit seekers to exploit the lax rules and sell the medicines to people who may not need them.”Additionally, the DEA’s announcement comes amid a still raging opioid overdose crisis across the country which has in recent years been fueled by illicitly manufactured fentanyl, a synthetic opioid. And it arrives as patients have reported problems filling nearly every type of ADHD medication prescription for reasons that haven’t been clear.TopicsUS newsUS politicsDrugsnewsReuse this content More

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      Biden pardons thousands with federal convictions of simple marijuana possession

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      Biden pardons thousands with federal convictions of simple marijuana possessionPresident urges governors to follow suit with state offenses in a step toward addressing disproportionate arrests for people of color President Joe Biden has announced a pardon of all prior federal offenses of simple possession of marijuana in a move welcomed as “long overdue” by criminal justice advocates.“There are thousands of people who have prior federal convictions for marijuana possession, who may be denied employment, housing, or educational opportunities as a result. My action will help relieve the collateral consequences arising from these convictions,” Biden said in a statement released on Thursday afternoon.“Sending people to prison for possessing marijuana has upended too many lives and incarcerated people for conduct that many states no longer prohibit. Criminal records for marijuana possession have also imposed needless barriers to employment, housing, and educational opportunities. And while white and Black and brown people use marijuana at similar rates, Black and brown people have been arrested, prosecuted, and convicted at disproportionate rates,” he added.Sadiq Khan launches commission to examine cannabis legalityRead moreAdministration officials said that the pardon could benefit about 6,500 people, the Hill reports.“It’s time that we right these wrongs,” Biden said.He went on to urge all governors to do the same with regards to state offenses, saying, “Just as no one should be in a federal prison solely due to the possession of marijuana, no one should be in a local jail or state prison for that reason, either.”The president also called on the secretary of health and human services and the attorney general to begin the administrative process to review how marijuana is scheduled under federal law.Marijuana is currently classified in schedule 1 of the Controlled Substances Act under federal law. Drugs classified under this schedule have “no currently accepted medical use and a high potential for abuse”.This classification puts marijuana in the same schedule as for heroin and LSD and even higher than the classification of fentanyl and methamphetamine, two drugs that are fueling the ongoing overdose epidemic across the country.Advocacy groups praised Biden’s announcement, with Kassandra Frederique, the executive director of the Drug Policy Alliance, saying the organization was “thrilled”, but adding “this is incredibly long overdue”.“There is no reason that people should be saddled with a criminal record – preventing them from obtaining employment, housing and countless other opportunities – for something that is already legal in 19 states and DC and decriminalized in 31 states.”The Rev Al Sharpton, the president of the National Action Network, said Biden’s “righteous action today will give countless Americans their lives back”. But he added, “The United States will never justly legalize marijuana until it reckons with the outdated policies that equated thousands of young Black men with hardened drug pushers.”The move also fulfils one of the top priorities of the Democratic nominee in one of their party’s most critical Senate races, as Pennsylvania’s, lieutenant governor, John Fetterman, has repeatedly pressed Biden to take the step, including last month when they met in Pittsburgh.Fetterman, in a statement, took credit for elevating the issue on Biden’s agenda and praised the decision, calling it “a massive step towards justice”.“This action from President Biden is exactly what this work should be about: improving people’s lives. I commend the president for taking this significant, necessary, and just step to right a wrong and better the lives of millions of Americans,” he said.The Associated Press contributed to this reportTopicsBiden administrationDrugsDrugs policyRaceUS politicsnewsReuse this content More

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      Arresting Michael K Williams’ alleged drug dealers won’t solve the US addiction crisis | Akin Olla

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      Arresting Michael K Williams’ alleged drug dealers won’t solve the US addiction crisisAkin OllaAs a country we refuse to pursue policy reforms that might have saved the beloved actor and the many thousands of others who are dying of overdoses I cried the night Michael K Williams joined the over 100,000 Americans who died of an overdose in 2021. When I heard that Williams, the actor best known for his role as Omar, the queer, gun-toting rogue in The Wire, had suffered an accidental overdose in his apartment, I felt a deep sense of dread. The knowledge that another Black man not too dissimilar from myself had passed before his time mingled in my mind with my bitter memory of the moment when I learned that my best friend, Joseph Rodriguez, had overdosed at the age of 19.I am grateful, I suppose, that by the time Joe had died, in 2009, the public narrative around drug users had begun to evolve. Young suburban white kids had started dying, and the country quickly shifted to protect its most prized possessions. Teens were sent to rehab, and drug dealers, like those who allegedly sold Williams his final dose, were rounded up and blamed for what is clearly a broader societal issue.Last week four men in Brooklyn were charged with having sold fentanyl-laced heroin to Williams and others. This hollow act is part of the problem. The US has long chosen mass incarceration as the solution to substance abuse. Arresting people didn’t prevent Williams’ overdose, and arresting more now won’t prevent future ones. And given Williams’ stance on the war on drugs, it is doubtful he would have endorsed this action.There are many solutions that could have helped keep Williams alive. While it is unlikely that the US will rid itself of many of the underlying drivers of drug addiction – such as violence, systemic racism and the inequalities of capitalism – anytime soon, the country, and the federal government in particular, has long ignored policy reforms that could help address the worst of our current addiction epidemic. The most important reform, decriminalization, has gained steam in some places, like Oregon, but remains far away as a federal reform.Williams was a one-of-a-kind man and artist, but not unique in his struggles with drugs: according to the 2020 National Survey on Drug Use and Health, 14.5% of Americans – roughly 40.3 million people – had a substance use disorder in 2020. A couple hundred of those people die of an overdose every day. This is a long-term trend that continues to explode over time; while over 100,000 Americans died of an overdose last year, the number was roughly 17,000 in 2000. As someone who has been involved with drug policy reform since 2010, roughly a year after my friend died, it is difficult to maintain hope as the bodies pile up, especially as solution after solution is ignored by the federal government.There are an embarrassingly large number of policies that could be backed by the federal government and implemented nationwide to save lives and nudge addicted people towards healing. Rather than concentrating power in the police through criminalization, most of these policies involve treating drug users like human beings worthy of love and care. One of the simplest ways to save lives is to make drug testing kits easily available for drug users. Williams was reportedly poisoned by fentanyl, a synthetic opioid mixed into cocaine and heroin as a means for illicit manufacturers to increase profits. Drug testing kits, like fentanyl test strips, let consumers ensure that they know what they’re putting into their bodies. While these strips are available for free in some places, such as New York City, they are still illegal in many states because they’re considered drug paraphernalia.Another potentially life-saving intervention? Supervised consumption sites. These are locations where people can consume drugs safely, with the support of medical staff that can ensure the purity of what is being used while being on call to intervene in the event of accidental overdoses. These locations can also connect people with treatment services and safer alternative drugs. If this all feels unfamiliar, think of bars as a crude version of these sites: bartenders administer doses to clients and can cut them off if they are too intoxicated. If anyone drinks too much, bartenders can call an ambulance and have them hospitalized. Creating robust supervised consumption sites could save lives, and destigmatizing those sites could save even more.All of these interventions would be made more effective and possible if the federal government took the important leap to decriminalize the possession of small amounts of all drugs. Total decriminalization may seem extreme, but there is evidence that it could save lives, reduce drug use, and prevent more unnecessary incarceration and harassment of those who use drugs, particularly Black Americans. Living in New York City, Williams did have access to some harm reduction resources but, like many drug users, may have felt too much stigma to seek help.Portugal decriminalized all drugs, in small amounts, in 2001. The country has also radically expanded its capacity to treat substance use disorders. According to the US-based Drug Policy Alliance, overdose deaths in Portugal decreased by more than 80% after decriminalization. By contrast, in 2017, “there were more than 72,000 overdose deaths in the US. If the US overdose death rate were on par with Portugal’s, there would have been fewer than 800 overdose deaths that year.” By 2008, three-quarters of those suffering from substance use disorder in Portugal were in treatment.The deaths of Michael K Williams and Joseph Rodriguez were perfectly preventable if we’d wanted them to live. Addiction is inevitable in our present society. Capitalism is a system that necessarily involves the commodification of human beings and the reduction of the individual into a tiny cog that exists to work and create profit. This dehumanization, exacerbated by racism, is probably why there are strong relationships between poverty and addiction, and why Black men are now the people most likely to overdose and die.The reality is that there will be many more deaths like Williams’. I expect to lose more friends; it would be naive to think that I won’t. In recent years both Democrats and Republicans have slowly shifted closer to the kind of drug reforms that could save lives. But for some of the people I love it is too little, too late and, without a comprehensive federal plan that includes decriminalization, we may as well brace ourselves for more tearful phone calls and funerals.
      Akin Olla is a contributing opinion writer at the Guardian
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      A new study shows more Americans are dropping acid. Why? | John Semley

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      In 1995, Jerry Garcia, singer/guitarist of the Grateful Dead and a figure almost singularly associated with America’s psychedelic subculture, died. Then something weird happened: a nationwide downturn in LSD consumption. It was no coincidence. As the author Jesse Jarnow notes in Heads: A Biography of Psychedelic America, for decades the Grateful Dead’s expansive, coast-to-coast live concert infrastructure was “the distribution network for LSD”. No Jerry meant no Dead tours, which meant, for many, no LSD. Garcia’s death effectively signalled the end of the Psychedelic Sixties.But now, drugs like LSD and psilocybin (the active ingredient in magic mushrooms) are enjoying a vogue. They’re finding second lives as clinical tools in the pharmacological battle against depression and anxiety. They’re also being illicitly gobbled in sub-hallucinogenic “micro-doses” as daily supplements, reportedly boosting energy and creativity. In November, Oregonians will vote on whether to legalize psilocybin therapy statewide. And a new study in the July issue of the international journal Drug and Alcohol Dependence reports that LSD use increased 56% between 2015 and 2018 (including a rather massive 223% increase among people aged 35 to 49). It’s all part of what’s being termed the “psychedelic renaissance”.This revival is curious. It doesn’t seem to be about restoring the bygone heyday of hippie-era psychedelic culture, as renaissance art of the 14th century turned back to the glories of antiquity. For some, the sun setting on this subculture was just as well. The concept of “the sixties” – with its long hair and wide-eyed, pupil-dilated idealism – has sometimes proved an impediment. Michael Pollan, whose bestseller How To Change Your Mind popularized the current resurgence, notes that the very word psychedelic “carries a lot of countercultural baggage”. Mind-expansion, we’re being told, may be beneficial – but please leave the tie-dye shirts and frilly vests and marching teddy bear bumper stickers in the past. More

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      Ousted US government scientist files whistleblower complaint over Covid-19 concerns

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      Rick Bright says he was reassigned to lesser role because he resisted pressure to allow widespread use of hydroxychloroquine Coronavirus – live US updates Live global updates See all our coronavirus coverage Rick Bright opposed broad use of hydroxychloroquine, pointing to a lack of scientific evidence to support its use in coronavirus patients. Photograph: Kevin […] More

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      Trump sows confusion with claim coronavirus drug will be ready soon

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      President said malaria drug would be available ‘almost immediately’ but officials say chloroquine must still be tested Coronavirus – latest updates See all our coronavirus coverage Donald Trump has sown fresh confusion about the US government’s response to the coronavirus pandemic by claiming that a therapeutic drug will be available “almost immediately” – only to […] More