The Big News

A new study from New York University School of Medicine found that cannabis use disorder was 25% higher among teens in states where recreational marijuana is legal. And an analysis by the Insurance Institute for Highway Safety found that car crashes have increased 5% to 6% in pot-legal states. These findings are not surprising, and more public health consequences can be expected if the legalization trend continues.

… What’s interesting is that the prospect of such outcomes has ever been in question. It seems that when industry and the news media began to frame marijuana as a medical issue, not only did support for legalization increase, but the public health risks somehow became questionable.

… Now, studies are beginning to highlight the predictable problems of commercializing another mood-altering substance alongside alcohol and nicotine. And many of the anticipated benefits are not materializing.

… As a result, we’re starting to see more nuance—some might argue, confusion—in public attitudes and perceptions. While two-thirds of Americans now say the use of marijuana should be legal, cities in states across the U.S.—from California to Michigan to Massachusetts—are banning recreational sales. For example, Detroit just did so last week, joining 79% of Michigan municipalities that have decided against allowing sales—only a year after voters in the state supported legalization.

… Will Jones III of Smart Approaches to Marijuana says the dichotomy is evidence that, “When people say they want legalization, what they really want to see is criminalization ended, but they don't want commercialization and stores. If the public were given real policy options, no state would have legalized.”

In other news, a new analysis estimates the opioid crisis placed 2.2 million children and adolescents in crisis as of 2017 and could affect 4.3 million youth by 2030, at a financial cost of $400 billion. Of course, millions more are affected by other substance use in the family, underscoring yet again the significant need for solutions like our Children’s Program and the new parental addiction resources available at Sesame Street in Communities, as well as evidence-based youth development programs like Building Assets Reducing Risks. The analysis maps out the impact on children state by state.

Apple says it is removing 181 vaping-related apps from its App Store. Meanwhile, a doctor questions whether vaping bans will help or hurt. A temporary vape sales ban in Massachusetts is set to expire on Christmas Eve. But lawmakers there are already looking ahead, voting last week to permanently ban the sale of flavored vaping and tobacco products—including mint and menthol cigarettes. Their bill also would impose an excise tax on e-cigarettes and harsh penalties for people who “knowingly” buy or possess certain of the banned products.

… The CDC says over 2,100 Americans have now been sickened by vape-related lung illnesses, while 42 have died. Despite the risks, more people are making their own vaping juices and interacting with online marketing. Our own Dr. Joseph Lee told a reporter last week that he likes to emphasize a more socially conscious approach when talking to young e-cigarette users. “The industry is making suckers of young people, basically, but so many don’t see it,” he said. “What they are seeing is the flavors. They like the feeling they get from it. They don’t see that they might be hooked on it 10, 20 years later, but many of them will.’”

This week’s featured media is the latest episode in our award-winning Let’s Talk podcast, with host William C. Moyers talking to educator and recovery advocate Joseph Skrajewski about burnout in the healthcare field, including the increased risk of developing addiction, and practical prevention strategies to ensure well-being. Watch, listen or read.

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Treatment Industry Issues and Reforms A group of students who participated in Hazelden Betty Ford’s 2019 Summer Institute for Medical Students (SIMS) surprised our colleague Joseph Skrajewski last week with a moving video about their experience.

On the day he was keynoting at the University of North Texas Health Science Center - Texas College of Osteopathic Medicine for its Addiction Awareness Week, the lights dimmed and the video began. It featured students who had completed the weeklong immersive experience of SIMS, which Joseph oversees as our executive director of medical and professional education, and demonstrated the potency of learning alongside and directly from patients, as well as our professionals. Watch →

The owner of a now-defunct chain of addiction treatment centers in southern California has been indicted on federal charges of attempting to bilk millions of dollars from Affordable Care Act programs in several states.

Cannabis

A psychiatric nurse based in Liverpool: “I have seen the damage cannabis does.The idea that the drug is a benign, relaxing intoxicant is dangerously out-of-date.” Learn more →

In the UK, the National Institute for Health and Care Excellence says there is no evidence to show that cannabis is beneficial for people suffering chronic pain.

The Boston Globe is the latest to take a close look at cannabinoid hyperemesis syndrome, a horrific but hard-to-diagnose illness that affects a small proportion of heavy marijuana consumers and produces prolific vomiting.

Backtracking on the law they passed last spring, Illinois lawmakers voted to sharply restrict where people will be able to consume cannabis once it becomes legal in January.

A grand jury in Massachusetts is investigating local corruption related to the state’s burgeoning cannabis industry.

The AP uncovered the story behind illegally spiked CBD vapes that last year poisoned about 50 people in the Salt Lake City area.

Some say Boston’s process for picking marijuana operators is slow, opaque, and subject to political influence. The City Council is now poised to vote on a proposal that would overhaul the process.

Anyone receiving federal housing assistance in Chicago could face eviction if caught smoking or possessing pot, according to the city’s Housing Authority.

Canadian-born musician Neil Young wants to vote in America’s 2020 elections, but his marijuana use may get in the way.

Opioids

An end does not appear in sight soon for the Purdue Pharma bankruptcy case. And, while states, counties and tribes have welcomed the opioid maker’s offer to cover their growing legal fees, the company’s promised emergency fund for victims continues to stall. Learn more →

This thorough article by Pew Charitable Trusts includes everything you need to know about the idea of safe injection sites, which may be coming soon to Philadelphia.

A Massachusetts jail is the first in the country to become a licensed methadone treatment provider.

The state of Michigan announced it will begin providing medication-assisted treatment to prisoners who have opioid use disorder, with the goal of having it available in all prisons by 2023. It also will provide more support for needle exchange programs to reduce HIV and Hep C.

A new book by anthropologist and physician Kimberly Sue tells the stories of women navigating opioid addiction during and after incarceration. The author thinks it's a huge mistake to put people with substance use disorders behind bars.

To deal with chronic pain, this woman’s morning routine now includes stretching and meditation at home and far less opioids.

Alcohol

Binge drinking among U.S. adolescents precipitously declined from 1991 to 2018, but depressive symptoms have sharply increased since 2012. For the first time in the past 40 years, binge drinking and depressive symptoms among adolescents are no longer associated. Learn more →

It’s been 100 years since Prohibition began with the enactment of the Volstead Act, a law named after Minnesota Congressman Andrew Volstead. On Friday, Twin Cities Public Television profiled the Congressman, highlighting other aspects of his interesting legacy.    

Sweeping alcohol advertisement restrictions will take effect in Ireland this week.

It’s Alcohol Awareness Week in the U.K., so mainstream media there are publishing stories on all sorts of topics, including guidance on how many drinks are too many and how alcohol use can lead to weight gain. 

San Diego State University is taking a hard look at its fraternities after the death of a student.

Health Care Reform and Parity

Thirty-four million Americans say they know someone who died after they couldn't afford health care. Learn more →

The Office for Civil Rights in the Department of Health and Human Services is investigating the data-sharing relationship between Google and not-for-profit hospital system Ascension. Apparently, Google has shared health data on millions of Americans, and Ascension is attempting to crunch it in hopes of discovering new ways to improve care. Experts say the project appears HIPAA-compliant, but lawmakers and consumer advocates continue to express concerns about this kind of data sharing—especially with Google recently purchasing Fitbit and gaining access to millions more records. Get ready—Big Tech’s entrance into health care is just beginning.

CMS issued a rule requiring more price transparency on hospital procedures, but hospitals—worried that insurers will use the info to collude against them—are planning a legal challenge.

Could in-home supportive care—an emerging strategy for patients with other serious illnesses—also be a good strategy for some patients with a substance use disorder?

Colorado released a final plan to create a public option, offering insurance for all via a public-private partnership that will start in 2022.

This podcast episode includes an interesting discussion about addressing social determinants of health.

Advocate Spotlight If you’ve ever shared your recovery story or other intimate details of your personal life publicly, you probably remember the first time. It’s not easy, but it’s so worth it.

MPRC: The National Recovery Conference was held last week in Punta Gorda, Fla. Convened by the Connecticut Community for Addiction Recovery (CCAR), a state-based recovery community organization with a nationwide impact, the event’s keynotes and workshops focused on multiple pathways of recovery, recovery coaching, advocacy and self-care. Speakers included Don Coyhis and William White as well as former Congressman Patrick Kennedy, Jan Brown, Neil Campbell, Ryan Hampton and Greg Williams, among others. (Why Florida? So White, who lives nearby and no longer travels, could attend.) See photos.

North Dakota held its third annual Recovery Reinvented conference last week, spearheaded by First Lady Kathryn Burgum, who serves on our board. Check out the event recap, which includes two videos featuring some of the state’s faces and voices of recovery.

In a remarkable piece, pro skateboarders share candidly about their experiences with alcohol and other drugs, and overcoming the problems associated with that lifestyle.

A new White House Historical Association article digs into Betty Ford’s activism.

Comedian Artie Lange reflects on his longest stretch of continuous sobriety and the creative clarity it has brought.

Earl Breland says he started drinking to “kill the feeling of being lonely” when he was in the Army. Sober for 20 months, he is now employed as a sanitation worker and hopes to finish his college degree. And, the New York Times profiled his recovery story!

In the latest episode of a podcast called Legal Speak, recovery advocate and former big-law attorney Lisa Smith challenges popular myths and offers tips to use in setting boundaries and staying mentally healthy in the demanding legal industry.

A Forbes Q&A with Scott Strode, founder of The Phoenix, a nonprofit combining physical activity and fellowship to help people recovery.

Congratulations to our friends at Twin Cities Recovery Project on the grand opening of its new space in Minneapolis this past weekend.

Miscellaneous Musings The first patient underwent surgery in a new clinical trial utilizing a brain implant to try to treat severe substance use disorder. The lead doctor calls the implanted device a sort of “pacemaker for the brain.” Learn more →

• State policies that punish pregnant women for disclosing substance use disorder can have negative consequences for infants, leading to significantly higher rates of neonatal abstinence syndrome, according to this interesting new study.
• At the Drug Policy Alliance's International Drug Policy Reform Conference last week, attendees discussed the latest in harm-reduction practices, how the media frames drug issues, equity in the marijuana industry, drug education in public schools, and paths toward decriminalizing the use and possession of all drugs.
• The CDC released a report on the jobs with the highest rates of suicide. Screenings in emergency rooms could help doctors stem the suicide crisis, but our ERs need resources.
• Self-injury among teenagers, an indication of higher suicide risk, is on the rise, especially among adolescent girls.
• Thankfully, collegiate recovery programs continue to get more mainstream support.
• It feels like we’re making some progress on stigma, but it’s always tenuous. When it comes to mental illness, for example, a new study suggests recent progress on stigma may be stalling due to associations with mass shootings. At work, depression, anxiety, and other conditions still go largely undiscussed, but corporate America is trying to change that. Why? Because it costs so much.
• Silicon Valley's latest obsession: dopamine fasting.
• The nonprofit the Art for All People brings the arts to veterans and other people affected by incarceration, addiction, mental illness, human trafficking and homelessness.
• Here’s a deconstruction of the addiction v. dependence
• A new study found that e-cigarettes may be worse for the heart than combustible cigarettes, and some cardiologists are among those who think it should be banned.
• The Star Tribune urged the President not to back off his plan to ban flavored vapes. However, it appears he’s doing just that.
• Cigarette smoking in the U.S. is at all-time low, but can it stay that way after vaping scare?
• Last week marked the 79^th anniversary of AA’s founding in Minnesota, an event interestingly tied to University of Minnesota football.
• To all our readers working in health care: Nike has shoes for you.
• The Star Tribune highlighted the new Harvard-adapted program for rising Minnesota leaders, for which our own Emily Piper was selected to participate.
• Since William White is on a break from his blog, we invite you this week to dive into his three lectures on recovery-oriented systems of care (ROSC), delivered 10 years ago—well ahead of their time. White’s YouTube channel has playlists for ROSC Lecture 1, Lecture 2 and Lecture 3. These are must-see for anyone working in addiction treatment and/or recovery. Just get through the first six minutes of Lecture 1 and see if you can stop watching.
• Thank you for reading. What do you think? Send us a note anytime, and have a great week!