Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.
The 2015 National Drug Threat Assessment (NDTA) Summary, a comprehensive strategic assessment of the threats posed to our communities by transnational criminal organizations and the illicit drugs they distribute throughout the United States. This annual assessment provides policymakers, law enforcement personnel, and prevention and treatment specialists with relevant strategic drug intelligence to assist in the formulation of counterdrug policies, establish law enforcement priorities, and allocate resources. The trafficking and abuse of illicit drugs pose a monumental danger to our citizens and a significant challenge for our law enforcement agencies and health care systems. The Centers for Disease Control and Prevention reported that 46,471 of our citizens died of a drug overdose in 2013, the most recent Letter from the Acting Administrator year for which this information is available. Drug overdose deaths have become the leading cause of injury death in the United States, surpassing the number of deaths by motor vehicles and by firearms every year since 2008. Overdose deaths, particularly from prescription drugs and heroin, have reached epidemic levels.
This report presents a comprehensive strategic assessment of the threats posed to our communities by transnational criminal organizations and the illicit drugs they distribute throughout the U.S. This annual assessment provides policymakers, law enforcement personnel, and prevention and treatment specialists with relevant strategic drug intelligence to assist in the formulation of counterdrug policies, establish law enforcement priorities, and allocate resources. The dangerous and highly sophisticated Mexican transnational criminal organizations (TCOs) continued to be the principal suppliers of cocaine, heroin, methamphetamine, and marijuana. Domestically, affiliated and violent gangs, which put drugs on the street and have become crucial to the Mexican cartels, are increasingly a threat to our safety and security. Figures. This is a print on demand report.
All across the United States, individuals, families, communities, and health care systems are struggling to cope with substance use, misuse, and substance use disorders. Substance misuse and substance use disorders have devastating effects, disrupt the future plans of too many young people, and all too often, end lives prematurely and tragically. Substance misuse is a major public health challenge and a priority for our nation to address. The effects of substance use are cumulative and costly for our society, placing burdens on workplaces, the health care system, families, states, and communities. The Report discusses opportunities to bring substance use disorder treatment and mainstream health care systems into alignment so that they can address a person's overall health, rather than a substance misuse or a physical health condition alone or in isolation. It also provides suggestions and recommendations for action that everyone-individuals, families, community leaders, law enforcement, health care professionals, policymakers, and researchers-can take to prevent substance misuse and reduce its consequences.
Significant changes have taken place in the policy landscape surrounding cannabis legalization, production, and use. During the past 20 years, 25 states and the District of Columbia have legalized cannabis and/or cannabidiol (a component of cannabis) for medical conditions or retail sales at the state level and 4 states have legalized both the medical and recreational use of cannabis. These landmark changes in policy have impacted cannabis use patterns and perceived levels of risk. However, despite this changing landscape, evidence regarding the short- and long-term health effects of cannabis use remains elusive. While a myriad of studies have examined cannabis use in all its various forms, often these research conclusions are not appropriately synthesized, translated for, or communicated to policy makers, health care providers, state health officials, or other stakeholders who have been charged with influencing and enacting policies, procedures, and laws related to cannabis use. Unlike other controlled substances such as alcohol or tobacco, no accepted standards for safe use or appropriate dose are available to help guide individuals as they make choices regarding the issues of if, when, where, and how to use cannabis safely and, in regard to therapeutic uses, effectively. Shifting public sentiment, conflicting and impeded scientific research, and legislative battles have fueled the debate about what, if any, harms or benefits can be attributed to the use of cannabis or its derivatives, and this lack of aggregated knowledge has broad public health implications. The Health Effects of Cannabis and Cannabinoids provides a comprehensive review of scientific evidence related to the health effects and potential therapeutic benefits of cannabis. This report provides a research agendaâ€"outlining gaps in current knowledge and opportunities for providing additional insight into these issuesâ€"that summarizes and prioritizes pressing research needs.
This book is our sixth Small Wars Journal—El Centro anthology, covering writings published between 2016 and 2017. The theme of this anthology pertains to the rise of the narcostate (mafia states) as a result of the collusion between criminal organizations and political elites—essentially authoritarian regime members, corrupted plutocrats, and other powerful societal elements. The cover image of the mass demonstration concerning the disappearance of the forty-three Ayotzinapa Teachers’ College students held at Mexico City’s Zócalo Plaza in November 2014 provides an archetype of this anthology’s theme. This anthology includes the following special essays—Preface: “New Wars” and State Transformation by Robert Muggah, Igarapé Institute; Foreword: Crime and State-Making by Vanda Felbab-Brown, The Brookings Institution; Postscript: Crime, Drugs, Terror, and Money: Time for Hybrids by Alain Bauer, CNAM Paris; and Afterword: The Rise of the Oligarchs by Col. Robert Killebrew, US Army (Ret.). Dave Dilegge (SWJ, Editor-in-Chief)
A four-year investigation into the world of synthetic drugs—from black market factories to users & dealers to harm reduction activists—and what it revealed. A deeply human story, Fentanyl, Inc. is the first deep-dive investigation of a hazardous and illicit industry that has created a worldwide epidemic, ravaging communities and overwhelming and confounding government agencies that are challenged to combat it. “A whole new crop of chemicals is radically changing the recreational drug landscape,” writes Ben Westhoff. “These are known as Novel Psychoactive Substances (NPS) and they include replacements for known drugs like heroin, cocaine, ecstasy, and marijuana. They are synthetic, made in a laboratory, and are much more potent than traditional drugs” —and all-too-often tragically lethal. Drugs like fentanyl, K2, and Spice—and those with arcane acronyms like 25i-NBOMe—were all originally conceived in legitimate laboratories for proper scientific and medicinal purposes. Their formulas were then hijacked and manufactured by rogue chemists, largely in China, who change their molecular structures to stay ahead of the law, making the drugs’ effects impossible to predict. Westhoff has infiltrated this shadowy world. He tracks down the little-known scientists who invented these drugs and inadvertently killed thousands, as well as a mysterious drug baron who turned the law upside down in his home country of New Zealand. Westhoff visits the shady factories in China from which these drugs emanate, providing startling and original reporting on how China’s vast chemical industry operates, and how the Chinese government subsidizes it. Poignantly, he chronicles the lives of addicted users and dealers, families of victims, law enforcement officers, and underground drug awareness organizers in the United States and Europe. Together they represent the shocking and riveting full anatomy of a calamity we are just beginning to understand. From its depths, as Westhoff relates, are emerging new strategies that may provide essential long-term solutions to the drug crisis that has affected so many. “Timely and agonizing. . . . An impressive work of investigative journalism.” —USA Today “Westhoff explores the many-tentacled world of illicit opioids, from the streets of East St. Louis to Chinese pharmaceutical companies, from music festivals deep in the Michigan woods to sanctioned ‘shooting up rooms’ in Barcelona, in this frank, insightful, and occasionally searing exposé. . . . Westhoff’s well-reported and researched work will likely open eyes, slow knee-jerk responses, and start much needed conversations.” —Publishers Weekly “Our 25 Favorite Books of 2019” —St. Louis Post-Dispatch “Best Books of 2019” —Buzzfeed “Best Nonfiction of 2019” —Kirkus Reviews “50 Best Books of 2019” —Daily Telegraph “Best Nonfiction Books of 2019” —Tyler Cowen “Best Books of 2019” —Yahoo Finance
The Model Rules of Professional Conduct provides an up-to-date resource for information on legal ethics. Federal, state and local courts in all jurisdictions look to the Rules for guidance in solving lawyer malpractice cases, disciplinary actions, disqualification issues, sanctions questions and much more. In this volume, black-letter Rules of Professional Conduct are followed by numbered Comments that explain each Rule's purpose and provide suggestions for its practical application. The Rules will help you identify proper conduct in a variety of given situations, review those instances where discretionary action is possible, and define the nature of the relationship between you and your clients, colleagues and the courts.
