Category Archives: Drug Addiction

How police tracked down a suspected heroin dealer after a rash of overdoses in Nicholasville


By Karla Ward

kward1@herald-leader.com

 

When a narcotics detective with the Nicholasville Police Department heard about a surge in heroin overdoses in Jessamine County this week, he got busy.

The detective, also a task force officer with the U.S. Drug Enforcement Administration, notified Nicholasville Emergency Medical Services Tuesday that if there were more suspected heroin overdoses, he wanted to be notified. Within two hours, he got a call about a crash involving a suspected overdose.

Court records show that the police work that followed resulted in a federal charge Thursday against a suspected drug dealer. Jeffrey James Ruggiero was charged in U.S. District Court in Lexington with possession of heroin with intent to distribute. His first court appearance was scheduled for 1 p.m. Friday.

According to an affidavit, the chain of events began when emergency workers arrived on Southbrook Drive in Nicholasville at 7:02 p.m. Tuesday and found a driver, Nathaniel Brezeale, “in obvious distress with agonal breathing and eyes closed.”

Suspecting an overdose, they administered 3 milligrams of Naloxone, and the man revived.

Brezeale’s girlfriend told investigators “that he had a substance abuse problem” and that before the accident, they had been to a double-wide mobile home in Garrard County, where Brezeale went inside alone and stayed for about 10 minutes.

While driving back to Nicholasville, Brezeale began to act strangely, so she asked him to pull over. When he did, the vehicle’s front wheels went over a curb. Passersby called emergency crews.

Two DEA task force officers went to St. Joseph Jessamine and interviewed Brezeale, who told them that he had called Ruggiero that night and asked about buying heroin. He had bought from Ruggiero before, he said.

When Brezeale got to the mobile home, he told investigators, he paid $25 for a tenth of a gram of heroin, which he said Ruggiero took from a larger plastic bag of heroin. Ruggiero placed the heroin onto a piece of paper, and Brezeale snorted it before he left.

A DEA special agent went to Lancaster, found the mobile home and began surveillance about 9:40 p.m., according to the affidavit.

About five minutes later, a Chevrolet Impala left the mobile home heading toward Nicholasville, and the special agent followed. He called Nicholasville police and asked for help. Officers clocked the Impala going 64 mph in a 55 mph zone.

The Impala was stopped, but the driver wouldn’t cooperate. However, “a Nicholasville K-9 was presented to the vehicle and a positive alert was noted. A subsequent search of the vehicle resulted in a quantity of suspected heroin being seized,” the affidavit states.

After that, a search warrant was obtained for the mobile home on Carlotta Drive.

Just before midnight Tuesday, about five hours after Brezeale’s accident, officers from the DEA in Lexington, the Nicholasville police detective bureau and Kentucky State Police went to the mobile home and detained Ruggiero while they searched the home and outbuildings.

Police seized about 1 gram of suspected heroin, plus prescription medication, several sets of digital scales and packaging material, and Ruggiero admitted that he had sold heroin to Nathaniel Brezeale earlier in the day, according to the affidavit.

Emergency crews responded to nine overdoses in Jessamine County in a 24-hour period Monday and Tuesday.

Karla Ward: 859-231-3314, @HLpublicsafety

Read more here: http://www.kentucky.com/news/local/crime/article126283869.html#emlnl=Morning_Newsletter#storylink=cpy

Apparent overdose in Ohio McDonald’s parking lot captured on Facebook live


 

 

 

Alyssa Raymond, WKYC 12:30 PM. CST November 19, 2016

SANDUSKY – A desperate search for help from the man seen in a Facebook Live stream who overdosed in a McDonald’s Parking lot in Sandusky Thursday evening.

The video and the man’s story are a powerful reminder of the heroin and opioid epidemic here in Northeast Ohio. The problem is real and so we want to warn you that we wanted to show you a clear picture, which some of you may find hard to watch. 

But the man on the ground and his family say they are glad this video is out there.

This is real life and people are dying. 

There have been 30 overdoses in 30 days in Sandusky.  Four people died. 

The family of the man you see on the ground wants everyone to share this story and this video.  They want the truth about heroin out there.

In an eleven and a half minute Facebook Live stream, you see a 27-year-old man gasping for air after overdosing on heroin.  That man lying there, seemingly lifeless, is Michael Williams.  Like so many, he watched the video over and over again.

“I was fighting back the tears,” said Michael Williams.  “I got goosebumps and teary eyed.  Like I said, I am a strong individual, and it was hard to watch.”

His older sister, Amber Roesch, found it hard to watch too.

“Watch that video and share it because that is terrifying,” said Roesch.

She hopes users all over the country see what happened to her brother.

“I do not want to have to bury him,” said Roesch.  “He needs help now.”

Amber says a week ago he told her he needed help, and he said it again today.

“I definitely have a problem,” said Williams.  “If I could get the help right now, I would definitely go.  I need it I want it.”

Michael’s family expected the worse when they received that phone call.  But EMS and Narcan saved his life.  Amber says they tried to thank everyone including Eddie Wimbley, the man who recorded it all.

“I hope it is like a wakeup call,” said Wimbley.  “I just do not understand how people can do something knowing that they could possibly die.”

Michael says he started using heroin four months ago.  Before that, he drank a lot and took pain pills.  But when he lost his job, he turned to something cheaper.  Michael will tell you, he never thought it would happen to him, but it did.

You might be wondering why Williams can’t just go out and get the help he needs.  He says he recently lost his job so he does not have insurance and he was told a lot of places would not take Medicaid.  His family told me it costs around $800 a day for him to go to an inpatient facility, which they say that’s what he needs, but cannot afford.

CONTINUE READING AND TO SEE VIDEO!

The Law of Unintended Consequences: Illicit for Licit Narcotic Substitution


Image result for heroin plant

Originally written July 15, 2014 at LINK below

Martin R. Huecker, MD and Hugh W. Shoff, MD, MS

 

The dealers will not use it. Heroin dealers have explicit knowledge of the addictive properties of their product. The heroin addict is no longer the desperate character living under a bridge. She is a 17-year-old high school senior who runs out of her grandmother’s oxycodone. He is the stockbroker who weighs the economics of purchasing one oxymorphone on the street for $100 or ten doses of heroin for $200. Because these people are ingesting and injecting products of unknown composition and unfamiliar potency, they can potentially overdose. If lucky, they end up in the emergency department rather than the morgue.

Kentucky ranks third in the nation in drug overdose mortality rate per 100,000 persons, with opioid pills making up the majority.1 In response to these statistics, the State of Kentucky passed House Bill One (HB1) in April 2012, effective October 2012. Also known as “the pill mill bill,” HB1 contains provisions intended to limit opioid prescriptions by pain management physicians and by other acute care providers such as emergency physicians. To prescribe narcotic pain medications, physicians must perform a full history and physical, prescribe only a short course, educate the patient on risks of controlled substances, and obtain a report from a statewide prescription monitoring program (PMP) (Kentucky All Schedule Prescription Electronic Reporting [KASPER]).2

As a result, the number of registered KASPER users in Kentucky has gone from 7500 to 23,000 from December, 2011 to November, 2012. Reports are up from 3300 to 17000 in the same time frame.3 According to the same press release, Kentucky witnessed a decrease of 10.4% total prescriptions in the first six months since HB1 was enacted.3

Mandating PMP reports, as sixteen states currently do, leads to an increase in reports, but so far no statistical difference in opioid overdose mortality.1,4,5,6 In fact, this legislation may not even lower the rate of opioid consumption, rather may shift which opioids are being prescribed.6

Researchers in Ohio looked at the impact of real time PMP information on opioid prescriptions. With PMP data, providers changed prescriptions in 41% of cases; 61% giving fewer opioids but 39% prescribing more opioids.7

House Bill One was intended to and has reduced opioid prescriptions in Kentucky. Forty-four pain clinics in Kentucky closed overnight.8 Preliminary analysis at a large, metropolitan emergency department has shown a decrease in prescriptions for hydrocodone and oxycodone, along with a decrease in ED administration of these medications. This type of “pill mill” legislation has been passed in Louisiana, Florida, Texas and California with varying results.9

Florida had a sharp decrease in opioid prescriptions after similar legislation. Having 90 of the top 100 physicians on the Drug Enforcement Agency (DEA) 2010 list of top opioid purchasers, Florida saw the number decrease to 13 in 2011, and zero as of April 2013.10 In 2011, Ohio passed a “pill mill bill” to crack down on pain management clinics.11 This legislation led to seizing of 91,000 prescription pills with 38 doctors and 13 pharmacists losing their medical licenses. In the end, 15 medical professionals were convicted on diversion charges.11 With all of this, pill overdose deaths began to decline, but heroin overdoses “skyrocketed.”11

The unintended but foreseeable consequence of such measures has been increase in distribution, abuse, and overdose of heroin. Heroin has gained market share in a similar way in the past. In 2010, Purdue Pharma began manufacturing a reformulated OxyContin after a $600 million fine for misrepresentation.12 Endo Pharmaceuticals Inc. followed in 2011 with an Opana ER reformulation. This resulted in making the pills harder to crush into powder for snorting or injecting.13,14 States such as Florida, Ohio, Minnesota, and Utah have seen patients turn to heroin after crackdown on prescription opioid availability.11,14

The New England Journal of Medicine warned us of what would be a two-fold increase in heroin use after the reformulation of Oxycontin.15 In the 2010 ODLL report, the United States DEA also attempted to warn health care organizations that Oxycontin users might switch to heroin.16,17 The first paper we know of to report this warning was published 3 years later in 2013.16 This paper, a qualitative study of the transition of opioid pill users to heroin users, provides insight into the economic and convenience factors associated with the switch. The researchers interviewed a small sample of heroin users, forty-one in all. All but one of the 19 heroin users aged 20–29 started with pills and progressed to heroin – “termed pill initiates.”16

Numerous popular news reports directly implicate decreased opioid pill availability in the rise of heroin abuse and overdose.16 However, very little discussion of this phenomenon has entered the emergency medicine literature.

The drug cartels have capitalized on the United States opioid appetite and now decreased supply of pills. The route from Mexico to Detroit, then south through Ohio, ends up in northern and central Kentucky. The Kentucky State Police recovered 433 samples of heroin in 2010. In 2012 the number was 1349.13 In Lexington, KY, the eight total heroin arrests in 2011 exploded into 160 in the first 6 months of 2013.18,19 Undercover narcotics officers in Lexington find it easier to buy heroin than marijuana.

Heroin-related overdoses in Kentucky increased from 22 cases in 2011 to 143 cases in 2012, and 170 in the first 9 months of 2013.8,20,21 Kentucky’s percentage of overdose deaths involving heroin went from 3.2 in 2011 to 19.5 in 2012 and up to 26 in 2013.8.21 This phenomenon has occurred in Florida, California, Massachusetts, New York, Oregon, Washington and Ohio.11,2224

The emergency medicine literature has minimal recent discussion of heroin overdose management in the ED; nor have we discussed secondary prevention. Supportive therapy suffices in the ED, with liberal naloxone use and airway protection. State and federal actions to curb heroin deaths can be effective. Good Samaritan laws, present in only one third of states, protect from prosecution those lay individuals attempting to help themselves or companions in overdose situations.

Also present in only one third of states are laws to expand community access to reversal agents such as naloxone. Twenty-two states have laws requiring or recommending education for opioid prescribers. Medicaid expansion to cover substance abuse treatment has occurred thus far in less than half (24) of states.1

As more states enact measures intended to reduce total opioid prescriptions, legislators and healthcare providers alike must be aware of the predictable and devastating rise in heroin sales, abuse, and overdose. Funding for this legislation should include monies allocated toward substance abuse treatment programs and availability of naloxone. Similarly, pill mill bills could universally be coupled with Good Samaritan laws in anticipation of the increase in parenteral opioid overdoses. Funds could be allocated to lay population education via public service announcements. Stricter punishments for drug traffickers could accompany such legislative changes. Many of these measures have been presented as interventions to combat prescription opioid abuse and can now be applied to the subsequent heroin abuse and overdose dilemma.9

At the first line of medical care, emergency physicians must be involved in efforts to minimize collateral damage in this long-term process of curing America’s addiction to opioid drugs and their horrible consequences.

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Black market fentanyl use increasing in Kentucky


  • Deborah Highland
  • Aug 15, 2016
  • ent3

    Fentanyl, an opioid painkiller 50 to 100 times more powerful than morphine, was found in the toxicology screens of 420 people who died in Kentucky last year of drug overdoses.

    That’s a 247 percent increase from 2014, when 121 people who died of drug overdoses had fentanyl in their toxicology screens, according to numbers provided by Van Ingram, executive director for the Kentucky Office of Drug Control Policy.

    “We’re seeing a huge uptick in fentanyl in Kentucky,” Ingram said.

    Pharmaceutical fentanyl is used in hospitals during surgery and is also provided in pain patches to people with severe, chronic pain, such as a cancer patient. But unlike opioid pain pills that have been diverted to the black market for years, pharmaceutical fentanyl isn’t what street dealers or drug abusers are using, Ingram said.

    “We’re not seeing pharmaceutical fentanyl being diverted but instead it is being produced out of the country and being smuggled in,” Ingram said.

    The drug is being made in clandestine labs primarily in Mexico and China, he said.

    “We’ve not seen a lot of labs in the United States, although there have been a few. The real danger of fentanyl is it is so powerful that skin exposure or powder exposure through the mouth and nose can put law enforcement at great risk,” Ingram said.

    Recently, the DEA sent out a warning to law enforcement agencies urging officers not to conduct field testing on suspected fentanyl and to instead package it and send it off to a crime lab for testing, he said.

    Most often when police encounter fentanyl, it’s found in heroin or being sold as heroin. But with the availability of pill presses, some dealers are using fentanyl to make pills that look like real pharmaceutical products such as oxycodone. 

    “If an individual buys pills off the street, there is really no assurance that what it says on the pill is really what they are getting because of the black market use of pill presses and other drugs,” Bowling Green-Warren County Drug Task Force Director Tommy Loving said. “By buying pills on the street, it could actually turn out to be a fatal error in judgment.”

    The DEA has seized pills all over the country that look like one drug but in reality contain illegally produced fentanyl, Ingram said.

    “It’s really scary stuff with people making their own opioids and shipping them across the country,” he said.

    “What we’re seeing is a lot of fentanyl analogs as well. It’s not the same chemical compound you would find in pharmaceutical fentanyl. You don’t know what you’re getting, or how powerful it is,” Ingram said.

    Narcotics investigators in Warren County haven’t seen much of the drug, Loving said.

    “But we’re very much aware of it, and it’s dangerous,” he said.

    “It’s much more potent than heroin and there are different versions of it being manufactured. … A little bit of this powder, if you come into contact with it on your fingers or skin or happen to breathe a little bit of it, can be fatal. And we are looking into obtaining Narcan for all of our detectives in part due to this danger that they may now be exposed to,” Loving said.

    Narcan is a drug that counteracts the effects of an opioid overdose.

    South Central Kentucky Drug Task Force Director Jacky Hunt already has Narcan for his investigators, who unknowingly encountered the drug last year during an undercover drug buy. Officers thought the purchase was of heroin. 

    When Hunt received the lab testing results of the substance his agency bought, the drug turned out to be fentanyl instead.

    “My guys handled fentanyl and didn’t even know it,” Hunt said.

    The drug is most often seen with heroin in Kentucky or sold as heroin, Ingram said.

    Ingram’s office has written some grant requests to try to obtain Narcan for law enforcement in an attempt to save as many lives as possible, he said.

    — Follow Assistant City Editor Deborah Highland on Twitter at twitter.com/BGDNCrimebeat or visit bgdailynews.com.

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    Cannabis

    UK gets $6 million grant to research cocaine addiction


    Saturday, November 21, 2015 

     

    Posted: Saturday, November 21, 2015 12:22 AM

    By Linda B. Blackford Lexington Herald-Leader

    LEXINGTON – A group of University of Kentucky researchers has won a $6 million grant to further develop a potential treatment for cocaine abuse.

    UK College of Pharmacy professor Chang-Guo Zhan, along with UK professors Fang Zheng and Sharon Walsh, and Wake Forest University professor Mei-Chuan Ko, are researching new therapies for overdose and addiction.

    "Dr. Zhan’s groundbreaking work in this field cannot be overstated," interim dean Kelly M. Smith said. "There currently is no FDA approved treatment for cocaine overdose or cocaine addiction, and Dr. Zhan and his research team are trying to change that. Developing such therapies would be a major breakthrough for health care."

    Previously, Zhan’s team designed and tested CocH1, an enzyme that breaks down cocaine in the bloodstream without producing harmful byproducts in the body.

    CONTINUE READING…

    Coca & The Curing Of Drug Addiction


    Professor Palmer, of the University of Louisville, Kentucky, has an article upon this subject in the Louisville Medical Journal, for 1880, and he therein narrates three cases in which he found the Coca a complete and easy substitute for the opium or morphine which had been habitually taken. One sufferer had been in the habit of taking thirty grains of morphine daily, and yet abandoned that drug wholly, and at once, and without the slightest difficulty, by resorting to the fluid extract of Coca whenever the craving attacked him.  Nor can this be considered simply an exchange of masters, since the uniform testimony of even those who have used Coca for a long time, and continuously, is that abstention from its employment is perfectly easy, and is not accompanied by any feelings of distress or uneasiness whatever.  Were Coca of no other use than this it would be a boon to afflicted humanity such as no one who has not been bound hand and foot in the slavery of opium can appreciate.”

     

     

    Coca & The Curing Of Drug Addiction.

    The Golden Triangle was recently replaced as the world’s dominant opium producer by a new regional power known as the Golden Crescent,


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    Asia’s opium hubs

    The opiates that addicts swallow, snort and inject often begin their journey to India from the Golden Triangle and the Golden Crescent. The former is Southeast Asia’s primary hub for opium cultivation. Located along the Mekong river, where the borders of Myanmar, Laos and Thailand converge, the illicit trade thrives — exceeding $16.3 billion per year, according to a 2014 UN report. Though eradication efforts in the late ’90s and early 2000s caused the area’s opium cultivation to decline, it began surging again in 2006, partly because improvements in transportation made it easier to move the drug from place to place.

    The Golden Triangle is currently the world’s second-largest opium producer. A 2014 report by the UN Office on Drugs and Crime estimated the region’s opiate poppy cultivation rose to 63,800 hectares last year, compared with 61,200 hectares in 2013, nearly triple the amount harvested in 2006. Myanmar is the region’s leading opium cultivator.

    Poverty and a lack of economic opportunity fuel illicit opium farming throughout the Golden Triangle, say researchers. In one survey in Burma, village farmers said they cultivated opium poppy just to provide for basic essentials such as food, education and housing. Researchers say economic development in these areas may be the best way to prevent opium growing.

    The Golden Triangle was recently replaced as the world’s dominant opium producer by a new regional power known as the Golden Crescent, an area comprising Afghanistan and Pakistan. Afghanistan is the world’s largest opium producer and Pakistan primarily serves as an illicit drug trafficking route.

    A 2014 World Drug Report said war-torn Afghanistan accounted for 90 per cent of global opium production. In 2013, the country cultivated an estimated 5,500 tons of oven-dried opium, which translates into roughly four per cent of the country’s Gross Domestic Product. Further, the already substantial opium cultivation area is growing. According to the report, the farming area increased by 36 per cent from 154,000 hectares in 2012 to 209,000 hectares in 2013. This uptick in Afghanistan’s opium cultivation continues despite the fact that the USA has invested more than seven billion dollars to combat the issue. A 2014 report from the US Special Inspector General for Afghanistan Reconstruction described how the country’s opium cultivation was at an all-time high, despite more than a decade of US-led counter-narcotics efforts.

    Afghanistan’s illicit opium production and trafficking is a multibillion-dollar industry where the Taliban-funded terrorist organisations reap the most profit. The UN Office on Drugs and Crime estimates that in 2009 the Afghan Taliban earned around $155 million from the illicit opium trade, while Afghan drug traffickers acquired $2.2 billion — a grim reminder of how drugs fuel crime and terrorism as well as addiction.

    Read more at http://www.thestatesman.com/news/supplements/asia-s-opium-hubs/67888.html#vzM0UJoVOcxbDmA7.99

    Afghanistan: Democracy with the flavor of narcotics


    Submitted by TwoCircles.net on 24 May 2015 – 9:32pm

    By Dr Mohammad Nazrul Bari and Milad Alimoradian,

    Afghanistan has been the core of exhaustive research and analysis. This great landlocked country with an excellent ancient history has seen lots of difficult and different situations, especially in the last century; it suffered massively from several external and internal issues such as political, sociological, religious, etc. However, by looking at the internal issues we see that it’s linked to external interventions, which are not proliferating and productive for the country. This simply means that the external elements created the major devastating issues in the country: exploitation in all various forms can be seen as one of the main issues.

    Due to the unique tangible and intangible sources of Afghanistan, the political merchants always had their eyes on this land and tried their best to exploit its society by all means. However, one of the greatest essential elements that has been missed in the political system and culture of this country is democracy.

    There is no doubt that democracy is an essential element for the present society and contemporary world-order. Without democracy the system will lead to a closed dark era in which a number of civil rights will be sacrificed by the ruling power, and the social and public welfares will be replaced by personal agendas and motives. However, the question is how should democracy be implemented in a political system that was far away from it? How should it adjust with traditions, customs and norms of the society? Does the use of force make it a liberal country without giving birth to any other internal issue? Or should it be achieved, step by step, through a social process? An analysis of all these concerns needs more space and research. Considering its limitations, this article focuses on the trade of narcotics in the hurdles in the way of democracy in Afghanistan before and after the invasion by the US forces.

    Resilient Afghans come out in large number despite Taliban threats

    A man being frisked by security force outside a polling booth in Kabul on April 5, 2014 Presidential Election. Courtesy: Aaquib Khan

    The 9/11 was a land mark in the history of the United States of America. In fact, it initiated a new era in the world history. Since that time the doctrine of Bush (former US President) became the agenda of foreign policy of USA all over the world. According to this policy, the United State has a right to defend itself against countries that harbour or give aid to the terrorist groups.

    The first target of the US became Afghanistan because it was under Taliban rule and, more significantly, al-Qaida had sufficient backup from them. Statistically, at the time of attack, the al-Qaida had only 200 active and trained jihadists. Thanks to CIA, now most of the Islamic terrorists groups are named al-Qaida or associated to al-Qaida. This scenario has three reasons: first, the one way journalism policy of the west in which the news corporation follows only one dimensional lead; second, the socio-cultural thinking of western individuals; and the last, the framing and marketing of foreign policy of western politics that became a strategy in the political structure of policy making of the West.

    For example, what the world faced during the Cold War before 1991 is a structure of ideologies and world-views of the Communists threatening the West. As a result, it became the main enemy of the West, but, later on, it was replaced by the menace of Islamic fundamentalism.

    However, when the Taliban gets defeated within few days, the call for democracy becomes the agenda for development of Afghanistan as US did in the past and doing it in the West Asia. After the elapse of 14 years, still the concept of democracy is grappling with complex and inhumane issues for the civil-rights of the citizens of the country.

    The recent Presidential election in Afghanistan took too much time, and in second ballot, Abdullah didn’t accept the result of election and declared the election a coup. Finally, both opponents came together for a resolution that resulted as a new form of practical bureaucratic system in which Abdullah will act as a semi kind of Prime Minister known as Chief Executive Officer. From another point-of-view, it took a long time for the president,Ashraf Ghani Ahmadzai to introduce his cabinet to the Parliament. All these facts show the internal difficulties for the new government in the way of democracy.

    Narcotics are one of the beneficial businesses all over the world. Opium as the mother of drugs and ancient types of narcotics has been introduced by the invasion of Alexander to minor Asia. For the first time, it was cultivated in Mesopotamia and later on brought to Egypt and from Egypt to Cyprus and from there came to Asia Minor by Alexander. Now in present day, Afghanistan is the major producer of opium not only in minor Asia but all over the world.

    Taliban banned the cultivation of opium but the post-Taliban era gave a new opportunity to the people of this region to cultivate injurious drugs. Fortunately or unfortunately, under the internal chaos of the country, they would be able to produce more and more. One of the reasons for cultivation of opium is that it doesn’t need much water or care. It’s easy to cultivate and always has good market. According to the UN report of 2012, Afghanistan, the biggest producer, produced 74% of the total opium of the world. According to Din Mohammad Mobarez Rashidi, Minister of Counter Narcotics, drug mafia’s benefit is USD 80 billion each year, of which only USD 1 billion goes to the farmers. The so called Prophet of democracy, the United States spends USD 7.5 billion against narcotics in Afghanistan.

    According to Special Inspector General for Afghanistan Reconstruction (SIGAR), cultivated fields of Opium poppy (Papaver Somniferum) cultivation takes up 2,09,000 hectares (516,230 acres) of land in Afghanistan, a 36% increase since 2012. About 1.3 million Afghan adults were regular drug users in 2012, which is 1 million additional to the data of 2009; the regular opium users grew to 2,30,000 in 2009 from the 1,30,000 in 2005. Another fact is the population of Afghanistan is just under 32 million. Helmand and Kandahar provinces are major producers of opium in Afghanistan. In other words, Afghanistan produces 75% of the world’s opium. According to the inspector, the reason of this massive growth in production is due to the withdrawal plan of American forces from the region. In consequence, the drug lords have safe and secure lands for their business.

    However, it has another face, and the statement of the inspector has been criticized by others.

    According to Le Monde magazine, there is indirect cooperation between the American forces and these drug mafias in recent years. Further Le Monde writes that drug mafia and US army are using the Taliban forces for the protection of their business lines.

    The majority of American forces have left the country by the end of 2014, and this act shows the reluctant motivation of Americans in countering narcotics way. The continuous growth of narcotics shows that the Americans are not able to control these phenomena despite expending billions of dollars. Drug mafia produced 5,500 tons opium in 2013 but only 41,000 of this scale has been captured by the anti-narcotics forces.

    The prevailing corruptions and loss of the sensibility of righteousness at the high level have brought down the country into a deep-state. The National Officials have closed their eyes on the activity of drug lords by receiving bribes from them. They don’t share their intelligence with counter narcotics forces and therefore it slows the process. On the other hand, there are reluctant feelings between Americans and local forces for collaboration in this regards. The scenario gets worse when most of the drug mafias are officials in the government of Afghanistan. Therefore, even Americans turn away, because first of all they supported Hamid Karzai government and now the present one. Moreover, it’s not directly related to anti-terrorism agenda. According to Thomas Schweich, the Ex U S State Department Principal Deputy Assistant Secretary for the Bureau of International Narcotics and Law Enforcement Affairs, almost all political parties’ hands are dirty in this trade. The benefit of this trade created a situation in which both the government and the Taliban are involved, and reluctance of the government in counter narcotics actions is a proof for this involvement.

    For example, on October 28, 2010 agents of Russia’s Federal Service for the Control of Narcotics joined Afghans and Americans anti-drug forces in an operation to destroy a major drug production site near Jalalabad. In the operation 932 kilograms of high quality heroin and 156 kilograms of opium, with a street value of US$ 250 million, and a large amount of technical equipment were seized. This was the first anti-drug operation to include Russian agents. According to Viktor Ivanov, Director of Russia’s Federal Service for the Control of Narcotics, this marks an advance in relations between Moscow and Washington. Conversely, the statement of Afghan President Hamid Karzai shows another tendency. He called the operation a violation of Afghan sovereignty and international law.

    The West and its allies should be more honest in their efforts to make Afghanistan as war free zone in south Asia without getting involved in the profit of opium trade. True democracy can only be established when the people of Afghanistan start thinking above the selfish and self-centric approach.

    Dr Mohammad Nazrul Bari is associated with Department of History, School of Social and Behavioral Sciences, Central University of Karnataka, Kalaburagi, India (He can be reached at: albari31@rediffmail.com)

    Milad Alimoradian is an expert in international relation and national security, Iran (He can be reached at: milad.alimoradian@gmail.com)

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    Can medical marijuana curb the heroin epidemic?


    Author

    1. Miriam Boeri

      Associate Professor of Sociology at Bentley University

    Disclosure Statement

    Miriam Boeri does not work for, consult to, own shares in or receive funding from any company or organisation that would benefit from this article, and has no relevant affiliations.

    The Conversation is funded by Howard Hughes Medical Institute, Robert Wood Johnson Foundation, Alfred P Sloan Foundation and William and Flora Hewlett Foundation. Our global publishing platform is funded by Commonwealth Bank of Australia.

     

    In the 1930s, Harry J. Anslinger, the first head of the Federal Bureau of Narcotics, embarked on a fierce anti-marijuana campaign. Highlighted by the 1936 anti-marijuana film Reefer Madness – where marijuana is depicted as a dangerous narcotic that makes good kids become sex-crazed killers – his propaganda efforts also maliciously linked marijuana use to African Americans and ethnic minorities.

    Attitudes towards marijuana have changed since 1936, when the Federal Bureau of Narcotics released Reefer Madness. Wikimedia Commons

    By 1970, legislation codified cannabis as one of the nation’s most dangerous drugs: the Controlled Substance Act classified marijuana as a Schedule 1 drug, meaning it possessed high potential for abuse and had no acceptable medical use. Over 40 years later, the classification remains.

    But research has shown that marijuana, while still criminalized at the federal level, can be effective as a substitute for treating opioid addicts and preventing overdoses. Massachusetts, which recently legalized medical marijuana – and where heroin overdoses have soared – could be a fertile testing ground for this potentially controversial treatment.

    The medical case for marijuana

    Before being criminalized, marijuana was used in the US to cure depression and a variety of other mental health ailments. Many studies have supported the therapeutic benefits of cannabinoids, along with the ability of marijuana’s psychoactive ingredients to treat nausea, help with weight loss, alleviate chronic pain, and mitigate symptoms of neurological diseases.

    Other research, however, contradicts claims regarding the benefits of cannabidiol treatment. Some say marijuana actually poses a risk for psychosis and schizophrenia. Although the FDA has approved some synthetic cannabinoids for medical treatment, federal agencies do not support marijuana as a legitimate medicine until more clinical studies have been conducted.

    The scientific debate over the harms and benefits of marijuana has impeded federal lawmakers from moving forward on marijuana legislation reform. As a result, in 23 states, medical marijuana has become legalized by popular vote.

    Marijuana policy dilemma

    With each state crafting unique medical marijuana regulations, we find ourselves at a crucial turning point in drug policy. Public health professionals claim the road map used by “big tobacco” will be copied with legal marijuana, and addiction rates for marijuana will increase to those we see for tobacco. Others warn that if medical marijuana is used indiscriminately and without focused education on the uses and forms of medical marijuana, a prescription pain pill-like crisis could occur.

    Among drug treatment specialists, marijuana remains controversial. Although some research has shown marijuana to be an alternative treatment for more serious drug addiction, addiction treatment specialists still view marijuana as highly addictive and dangerous. These views handicap policy reform, but despite its status as a Schedule 1 drug, recent research shows marijuana could be part of the solution to the most deadly drug epidemic our country has seen in decades.

    Massachusetts: a case study

    In 2012 Massachusetts became the 18th state to legalize medical marijuana, though the first 11 dispensaries are not scheduled to open until sometime in the coming year. This situation presents an opportunity to implement sensible, research-based policy.

    Massachusetts, like many states across the US, has seen a dramatic rise in opioid addition fueled by the increase in opiate prescription pills. In Boston, heroin overdoses increased by 80% between 2010 and 2012, and four out of five users were addicted to pain pills before turning to heroin.

    Meanwhile, the leading cause of death among the Boston’s homeless population has shifted from AIDS complications to drug overdoses, with opiates involved in 81% of overdose deaths. This is an alarming finding given recent expansion in clinical services for the city’s homeless.

    Addiction specialists and health care professionals in Boston have been at the forefront of integrating behavioral and medical care. Naloxone and methadone are currently the main solutions to address the growing opiate addiction and overdose problem. But Naloxone is an overdose antidote, not a cure or a form of preventative therapy.

    Methadone, like heroin and other opioids, has a very narrow therapeutic index (the ratio between the toxic dose and the therapeutic dose of a drug). This means that a small change in dosage can be lethal to the user. Marijuana, however, has one of the safest (widest) therapeutic ratios of all drugs.

    Research shows that marijuana has been used as a form of self-treatment, where users take cannabis in lieu of alcohol, prescription opiates, and illegal drugs. That’s one reason why researchers are calling for marijuana to be tested as a substitute for other drugs. In this capacity, marijuana can be thought of as a form of harm reduction. While researchers don’t seek to discount some of the drug’s potential negative effects, they view it as a less damaging alternative to other, harder drugs. Despite these findings, marijuana is rarely incorporated in formal drug treatment plans.

    A recent study might change this policy. Comparing states with and without legalized medical marijuana, it found a substantial decrease in opioid (heroin and prescription pill) overdose death rates in states that had enacted medical marijuana laws. In their conclusions, the researchers suggested that medical marijuana should be part of policy aimed to prevent opioid overdose.

    Outside marijuana’s harms and benefits, missing in this discussion is the social environment of drug use. Drug use is social in nature. Where and with whom drugs are used influences why and how they are used. Socially acceptable or moderate use of drugs can be learned through social rituals in socially controlled settings.

    Studies in the Netherlands found that using marijuana in Amsterdam coffeehouses encouraged a “stepping-off” hard drug use. These studies also found that when young people used marijuana in a controlled coffeehouse setting instead of a polydrug-using environment, they learned to use marijuana moderately without combining with other drugs. Along with providing access to marijuana, it’s important to instruct users on safe and effective medical marijuana consumption.

    Since Massachusetts has not yet opened its medical marijuana dispensaries, it is too early to see if medical marijuana legislation will help reduce opiate addiction in the Commonwealth. Using recent research findings, Massachusetts policymakers have a unique opportunity to implement medical marijuana policies that address its contemporary opiate overdose. Medical marijuana could be part of drug treatment for heroin and opiates.

    For homeless people, however, getting a marijuana card is expensive and buying medical marijuana from a dispensary is beyond their economic means. Street drugs are more prevalent in their social setting, easier to obtain, and can be much cheaper. From a policy perspective, addressing the alarming rates of overdose deaths among the homeless in Boston could mean distributing medical marijuana cards to homeless addicts for free and providing reduced cost medical marijuana.

    What if medical marijuana cards were offered to homeless addicts? Wikimedia Commons

    Formerly demonized and later legislated as a Schedule 1 substance, marijuana could diminish the damage wrought by harder drugs, like heroin. While opioid use is a nationwide epidemic, Massachusettes – long at the forefront of developing scientifically based public policy – has the opportunity to be at the forefront of cutting-edge, socially-informed drug policy.

    This is the second in a series of three articles on alternative strategies to treat addiction. To read the first in the series, click here.

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    Gov. Beshear, First Lady Beshear and Attorney Gen. Conway Announce Funding for Heroin Overdose Reversal Kits


    Tuesday, 01 06, 2015

    Kerri Richardson
    Terry Sebastian
    502-564-2611

    FRANKFORT, Ky. – Gov. Steve Beshear, First Lady Jane Beshear and Attorney General Jack Conway today announced that heroin overdose reversal kits will be purchased for Kentucky hospitals with the highest rates of heroin overdose deaths. Overdose patients will receive a kit free of charge when they leave the hospital, so they or a loved one can prevent another overdose event and possibly save a life. The funding is provided through the Substance Abuse Treatment Advisory Committee (SATAC).

    “Heroin has harrowing impacts on people who use it, as well as on their families and their communities. Many hospitals in Kentucky see multiple overdose victims every day,” said Gov. Beshear. “These kits, once in the community, can allow a friend or family member to reverse a heroin overdose almost immediately. It’s a literal lifesaver as families forge a path toward recovery.”

    Gov. Steve Beshear created SATAC by executive order to oversee the KY Kids Recovery grant program and distribution of the $32 million in settlement funds that Attorney General Conway secured from two pharmaceutical companies. The judge required the settlement funds be used to expand treatment in Kentucky. Attorney General Conway chairs the committee and First Lady Jane Beshear serves on the committee.

    The committee is providing $105,000 to purchase approximately 2,000 Naloxone Rescue kits for the University of Louisville Hospital, the University of Kentucky Hospital in Lexington, and the St. Elizabeth Hospital system in Northern Kentucky. The kits will be provided free of charge to every treated and discharged overdose victim at the pilot project hospitals. SATAC hopes to expand the program to 17 more Kentucky hospitals or hospital systems.

    “This project will allow us to get this medicine into the hands and homes of the people who need it most – heroin users and their families,” Attorney General Conway said. “Heroin and opiate abuse is killing Kentuckians, and these kits will save lives and provide a second chance for people to seek treatment for their addictions. I hope the legislature will follow our lead by putting partisan politics aside and passing meaningful heroin legislation that will stiffen penalties for large scale traffickers, increase treatment funding, provide for a Good Samaritan defense, and get Naloxone kits into the hands of first responders and limit the civil liability of those responders.”

    Naloxone, which is also known as Narcan, has no potential for abuse and immediately reverses the effects of a heroin overdose by physiologically blocking the effects of opiates. Right now, it is not covered by Medicaid or many private insurance companies, which means even if users currently receive a prescription they likely never fill it because they cannot afford it. Naloxone is available in injectable or nasal mist forms. The nasal mist form must still be approved by the FDA. When it is approved, health experts believe most insurance companies and Medicaid will begin to cover it.

    “Narcan kits are critical, lifesaving tools that can help put people on the road to recovery,” said Mrs. Beshear. “As Kentuckians expand access to mental health treatment, including addiction recovery, it’s more important than ever to have community access to tools like Narcan. Often, an overdose experience is what finally drives people suffering from addiction to seek help.”

    In 2013, 230 Kentuckians died from heroin overdoses. The final numbers for 2014 are not currently available, but officials do expect an increase in the number of heroin overdose fatalities.

    History of SATAC
    Gov. Steve Beshear created SATAC to administer $32 million in settlement funds that Attorney General Conway secured from two pharmaceutical companies.

    The committee created KY Kids Recovery grants to help expand adolescent treatment in Kentucky. The 19 programs it is funding are located in every region of the state and encompass all aspects of evidence-based, substance abuse services for adolescents, including prevention, outpatient counseling, intensive outpatient and residential services.

    For a complete list of the 19 grant recipients, visit KyKidsRecovery.ky.gov.

    In addition to the $19 million in KY Kids Recovery grants, the settlement is providing $500,000 to complete construction of a Recovery Kentucky center in Carter County, $2.5 million for almost 900 scholarships to Recovery Kentucky centers, and $560,000 to create 14 drug-free homes for people completing and transitioning out of residential substance abuse treatment programs.

    The following entities are also receiving funds from the settlement:

    $6 million to administer and upgrade KASPER, Kentucky’s electronic prescription drug monitoring program.
    $1 million to support substance abuse treatment for pregnant women by Chrysalis House in Lexington and Independence House in Corbin.
    $1.5 million to the University of Kentucky to develop best practices for adolescent substance abuse treatment providers.
    $1 million to develop a school-based substance abuse screening tool with the Kentucky Department of Education to intervene with at-risk children before they enter judicial or social services systems.
    $250,000 to create a database to evaluate outcomes of adolescent treatment.
    For more information about Attorney General Conway’s efforts to fight substance abuse, visit http://www.ag.ky.gov/rxabuse.

    Substance Abuse Advisory Committee
    In addition to Attorney General Conway and Mrs. Beshear, committee members include Cabinet for Health and Family Services Secretary Audrey Tayse Haynes, Justice and Public Safety Secretary J. Michael Brown, Kentucky Office of Drug Control Policy Director Van Ingram, Kentucky Housing Corporation Executive Director/CEO J. Kathryn Peters and Dr. Allen Brenzel, Clinical Director of the Department for Behavioral Health, Developmental and Intellectual Disabilities.

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