The Big News

For the third straight year, life expectancy in the U.S. has fallen, driven by higher mortality among young and middle-aged adults. The main culprits, once again: overdoses, suicides, obesity, and alcohol-related illnesses. Deaths from alcohol-related liver disease are at their highest levels since 1999 and have risen every year since 2006 in nearly every racial, ethnic and age group. All of this despite the U.S. spending more on health care than any other country. In contrast, other wealthy nations have generally experienced continued progress in extending longevity. The question is: What’s going on? One professor alluded to broken spirits, telling the Washington Post: “People are feeling worse about themselves and their futures, and that’s leading them to do things that are self-destructive and not promoting health.”

A new, first-of-its-kind study found that many adults in recovery from addiction still experience discrimination as they navigate life in recovery, experiencing both minor or “micro” forms of discrimination such as personal slights, and major or “macro” discrimination such as violation of their personal rights. Such experiences are associated with increased distress and lead to both diminished quality of life and a decrease in resources needed to successfully sustain recovery.

Victims of the opioid crisis, including those who have found recovery, are worried the stigma of addiction may also limit potential damage awards and justice as opioid lawsuits proceed.

New data from the National Youth Tobacco Survey show that 6.2 million teens (roughly a third of them) use tobacco, the highest level since 2000—thanks largely, but not exclusively, to the popularity of e-cigarettes. Teenagers are also smoking other items like cigarillos.

Massachusetts recently enacted the country’s toughest flavored-tobacoo ban, and New York became the largest U.S. city to ban all vaping flavors. Lost amid the focus on vaping-related injuries is whether e-cigarettes can even help reduce deaths from traditional smoking. One problem, as we’ve noted many times, is insufficient clinical evidence.

Another problem is that people are vaping more than nicotine. From New York City to Nebraska farm country to California, authorities have seized at least 510,000 marijuana vape cartridges and arrested more than 120 people in the past two years. And regulated marijuana vapes were linked to more lung illnesses last week.

Prevention makes great sense. Everyone wins when substance use disorders are prevented. But what does it look like? A new TV report out of Boston provides a great example of an effective prevention program called Buliding Assets Reducing Risks, which we publish.

This week’s featured media also has a prevention component. It’s a new episode in our award-winning Let’s Talk Addiction & Recovery podcast series, with host William C. Moyers talking to Stephen Delisi, M.D., about Adverse Childhood Experiences (ACEs) and their long-term effect on health, resilience and the risk for addiction. Watch, listen or read.  

After taking in the podcast, get your own ACE score here.

(Also, congratulations to William, producer Lisa Stangl and everyone else involved in the Let’s Talk podcast, which has earned another recognition—this time an eHealthcare Leadership Award.)

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Treatment Industry Issues and Reforms

Three doctors argue in the Annals of Internal Medicine that a Congressional bill to deregulate the buprenorphine prescribing process and remove training requirements is well-intended but short-sighted and against the best interests of patients with opioid use disorder. Learn more →

Our colleague Jerry Moe talked about our Children’s Program in another prominent piece about the new Sesame Street in Communities initiative around parental addiction, as well as Jerry’s role as a consultant to the initiative and the need for more children’s services throughout the addiction treatment field.

The Philadelphia DA has a new plan to drop low-level drug charges in favor of addiction treatment.

Cannabis Minnesota state Rep. John Lesch hosted a community forum on marijuana legalization, which looks to be a hot topic in the upcoming legislative session.

This writer was a panelist, arguing against expanded legalization, and is pictured at far left with (L to R) recovery advocate Randy Anderson, Smart Approaches to Marijuana advocate Michael Daub, Rep. Lesch and recovery advocate John Howard. Learn more →

As marijuana becomes a family affair for some people during the holiday season, new research suggests that teens and young adults whose parents use it are at an increased risk of using pot, alcohol and tobacco themselves.

Marijuana legalization loses steam in New Hampshire.

The marijuana company Leafly published an interesting series on the billion-dollar race to patent cannabis.

Many hotels in Chicago will continue to ban smoking on-premises after marijuana is legalized on Jan. 1, meaning Chicago tourists will be hard-pressed to find a place to legally get high next year.

Not surprisingly, a new study finds young adults who are heavy pot users are more likely to seek medical marijuana cards.

Opioids

Opioids have spared relatively no one in Scioto County, Ohio, where everyone appears to know someone whose life has been affected by addiction—as evidenced by a powerful report on dozens of members of the Minford High School Class of 2000. Learn more →

Unsealed court documents reveal how drug companies ramped up opioid sales during the overdose epidemic. Here is how opioid manufacturers and pain groups are responding to the revelations.

Tufts University has removed the Sackler name from five facilities and programs over the family’s role in the opioid epidemic. The Smithsonian also rebranded its Freer Gallery of Art and Arthur M. Sackler Gallery as the National Museum of Asian Art, although it said the move has nothing to do with the controversy over the Sacklers.

In Boston, a counterterroism tool is now being used to analyze fentanyl test strips and prevent drug users from accidentally taking something laced with the deadly substance.

Some are rankled that a bankruptcy judge cleared Purdue Pharma to pay out $35 million in employee bonuses and is still weighing whether to allow a $1.3 million bonus to the CEO.

In Scotland, homeless drug users will now be allowed to inject pharmaceutical-grade heroin twice a day under the supervision of medical officials as part of a new program intended to reduce drug deaths and H.I.V. infection.

A new study provides insights into factors that contribute to opioid dependence and addiction in cancer survivors.

The President donated his third-quarter salary to help address the opioid crisis.

Our chief medical officer offers a word of caution to people thinking of turning to kratom as an alternative to opioids for pain relief: “I'd tell them this is not well-studied, it does cause intoxication, and that if they have addiction that runs in the family, it could trigger something like that in them. I'd tell them, it's just as dangerous as the illegal substances. People think it seems safe and must be safe because it's legal, and that's not necessarily true.”

The FDA is proposing that doctors learn more about acupuncture for pain management.

The judge presiding over the giant consolidated opioids case in Ohio announced that the trial against pharmacy defendants will be held Oct., 13, 2020. Many of the other defendants in this first case have already settled, but a global settlement has not been reached with the thousands of communities suing the drug companies, and more than 500 local governments have opted out of the massive litigation in favor of pursuing their own lawsuits.

Meanwhile, federal prosecutors are now investigating at least six opioid makers and distributors in what—if criminal charges result—could become the largest prosecution yet of drug companies alleged to have contributed to the opioid epidemic.

Our chief medical officer spoke with Behavioral Healthcare Executive about the organization’s historic decision seven years ago to integrate the optional use of buprenorphine and naltrexone into our treatment for opioid use disorder.

Check out this update on how local journalists are using the DEA’s data on pain pills.

Alcohol

Binge drinking rates are on the rise for nearly all groups of Americans. Learn more →

With binge drinking rates up; life expectancy down due to crisis-level overdoses, suicides and alcohol-related illnesses; and growing mental health concerns, it’s an awkward time to celebrate progress on American wellness. But some believe we may look back one day on 2019 and say the so-called sober-curious trend was the beginning of a wellness-informed sea change in America’s drinking culture. As we’ve discussed here often, mocktails and alcohol-free bars and events have gained popularity, and sobriety has become rather hip and cool—especially among some young people. But perhaps progress won’t be realized in public health data until the current generation of youth comes of age.

This article on the popular Marie Claire website describes sober-curious women as “far from alcoholics and not quite abstainers—who have discovered a healthier high in drying out.” A few questions that come to mind about this trend … Why would anyone change their relationship with alcohol unless it were problematic in some way? Is the sober-curious trend simply about healthy people getting healthier? Or is this trend providing people with mild substance use disorders a social framework for course-correcting without the stigma of a label or diagnosis? It seems positive either way, or both ways—but what do you think? Will it have any impact on the population that is most vulnerable to addiction? Will it last? Send your thoughts!

When it comes to giving up casual drinking, women may benefit more than men, according to a study.

France has replaced plans to promote “Dry January”—a UK initiative to stay off the booze for a month—with “Janvier Sobre,” encouraging people to limit their intake to two glasses a day. Advocating abstinence in a country like France is complicated.

With alcohol companies making more N/A options, what’s happening to all the alcohol they’re sucking out of their beer? Here’s a hint: soap suds.

For those watching digital solutions in our space, here are a few mobile social networks attempting to capitalize on the sober-curious trend.  

White Claw—a hard seltzer, or spiked sparkling water—is one of the fastest-growing American brands and a symbol of the alcohol industry’s reaction to the sober-curious trend. It’s a successful strategy to sell booze, remarkably, under the brand of wellness. Indeed, this writer’s spouse accidentally bought White Claw, thinking it was flavored water, and took it to work in her packed lunch—only to discover from colleagues that she had been mistaken. We have shared many laughs about that, but it’s also a reason health experts in the UK are calling for a ban on such drinks using the word “water” to describe themselves.

South Korea is considering a ban on celebrity endorsements of alcoholic drinks, in a bid to end the glamorization of drinking culture and cut rates of consumption among young people.

Even moderate alcohol consumption may increase the risk for cancer, according to new research out of Japan. Meanwhile, researchers in Boston have uncovered a new association between more restrictive alcohol policies and lower rates of cancer mortality.

Nearly 30% of all vehicular-crash deaths in the U.S. last year were alcohol-related, and the number of such deaths has stayed about the same for the past decade. The Governors Highway Safety Association says new approaches are needed.

The World Health Organization is calling for more restrictions on alcohol.

Alcohol-fueled hazing is suspected in the death of a Cal State-Fullerton student.

Findings from a new study suggest that increasing a firefighter’s actual and/or perceived ability to withstand emotional distress may reduce PTSD symptoms and decrease the use of alcohol as a coping mechanism.

Australia is setting out to reduce harmful alcohol consumption by 10% over 10 years, but its new plan comes with controversy after accusations that the alcohol industry meddled in its development.

In Ireland, a court considers whether alcohol use disorder can diminish one’s culpability in committing murder.

Researchers continue to look at ketamine as a potential treatment for alcohol use disorder.

Health Care Reform and Parity

The Washington Post spotlighted the disappointing recent report showing backward movement on parity, contrasting it to the urgent need to do more to confront the nation’s opioid crisis, rising suicide rates and surging rates of teen depression and anxiety. Learn more →

The health disparities between urban and rural areas aren't getting any better.

Former Congressman Patrick Kennedy talks to Managed Care Magazine about parity and calls for more action.

Americans spent $3.65 trillion on health care in 2018 — 4.6% more than the year before. That growth also was higher than the 4.2% rate from 2017, according to revised figures from independent federal actuaries

Bipartisan efforts to protect patients from “surprise” medical bills are regaining momentum after stalling out over the summer. According to Axios, people having surgery or receiving mental health and substance use treatment at an in-network hospital are the most likely to experience a surprise bill from an out-of-network provider.

Federally-funded health researchers have reported more than 8,000 financial conflicts of interest since 2012 that are worth at least a collective $188 million, ProPublica reported.

Hospitals are suing the Administration over its requirement that they disclose their negotiated rates.

Advocate Spotlight A star recruit who disappeared into the “fog” of opioid addiction after football injuries at Notre Dame has emerged full of gratitude and is back on campus with his treasured dog, Hank, completing the degree that eluded him. Learn More →

Listen to two of our favorites—Dax Shepard and Andrew Zimmern—on Shepard’s excellent podcast, Armchair Expert.

Tucker R. and Mike H. shared their recovery stories in a new public television documentary called The Opioid Fix, which also caught up with them on the golf course.

From the Recovery Almanac: On Dec. 7, 1987, the US Supreme Court heard arguments in Traynor v. Turnage, looking at whether the V.A. could deny benefits to vets with primary alcoholism by defining it as “willful misconduct.”' NAATP filed a brief arguing that alcoholism is not willful misconduct. However, in April of the following year, the Supreme Court upheld the V.A. regulation that defined primary alcoholism as just that. Watch two recovery advocates at the center of the case.

Congratulations to our friend Jonathan Goyer, who is the new director of the Recovery Friendly Workplace initiative, a program brought forth by Rhode Island Governor Gina Raimondo and housed at Rhode Island College.

What’s the biggest driver of our country’s addiction crisis? According to Shatterproof founder & CEO Gary Mendell, it’s the unjust stigma associated with substance use disorders. He recently joined with addiction experts at the Milken Institute's Future of Health Summit to discuss solutions. Watch.

Wendy Zimprich and Chelsea Luger are advocating for recovery in North Dakota.

Miscellaneous Musings Comedian Moe Yaqub has been added to the bill for our upcoming Minneapolis event, “Resolution 2020: A Zero Proof New Year’s Eve,” joining popular Twin Cities musicians HALEY and Lydia Liza.

Co-presented with Dissonance at The Parkway Theater, it will be the most buzzed-about, booze-free holiday party of the season. Learn more and get tickets →

• Roughly 25% of youths experience depression, anxiety, poor sleep and high stress due to “problematic smartphone use,” according to new research.
• In Colorado, a quarter of all mental health-related emergency department visits were for children in 2018.
• Could removing ‘likes’ from Instagram help our mental health?
• A lot of young people are leaving their jobs for mental health reasons.
• Think children are too young for mindfulness? Think again.
• Australian authorities seized $820 million worth of meth.
• Some Oregon advocates are seeking to decriminalize small amounts of all drugs through a ballot initiative.
• Here’s a deep dive into the sad fact that a racial double standard has been hard-wired into the nation’s drug laws and criminal justice system since the crack epidemic and continues today amid the opioid crisis.
• In Hindman, Ky., the Appalachian School of Luthiery, which teaches people how to build wooden stringed instruments, is helping the community overcome addiction.
• Paul Mayor Melvin Carter and Tom Farley, brother of the late actor and comedian Chris Farley, will be among those at our upcoming event, Fueling the Strong and the Brave: Responding to Our Emergency Responders.
• A new analysis of people who use supervised injection sites in Vancouver suggests that such sites may help prevent deaths from all causes, not just drug overdose.
• With suicide rates surging in the U.S., there’s a growing need to help and support the people left behind.
• People who vape could be subject to higher life insurance rates or find themselves excluded from coverage, as global reinsurers push warnings on the potential risks of vaping.
• Here’s an interesting—if unsurprising—list of the “18 most addictive foods” and “17 least addictive.” Spoiler alert: cucumbers are safer than pizza.
• William White remains on a break from his blog … we invite you once again to dive into his three lectures on recovery-oriented systems of care (ROSC), delivered 10 years ago—well ahead of their time. We think lectures 1, 2 and 3 are must-sees for anyone working in addiction treatment and/or recovery.
• Thank you for reading. What do you think? Send us a note anytime, and have a great week!