» Is Scanning Inmates' Mail To Stop the Spread Of Drugs Legal?
22/02/19 22:45 from The Fix

A trial is underway in Pennsylvania to decide whether a new prison policy involving the opening and scanning of inmates' mail to prevent drug smuggling is legal. State prisons began the new mail procedure in 2018 after a number of inmates and staff were hospitalized from synthetic cannabinoid exposure.Dangerous drugs like K2 were being smuggled into prisons after being mixed with ink or used to coat letter paper. The substances are colorless and odorless, making them difficult or impossible to detect through normal means.According to officials, more than 50 prison staff members and 33 inmates were hospitalized over a period of three months in western and central Pennsylvania. Since the implementation of the new mail policy, the amount of synthetic cannabinoids entering the prisons has plummeted.However, the legality of the policy was challenged in October by the American Civil Liberties Union (ACLU), and arguments are now being heard by a judge. The policy requires staff members to remove letters from friends, family, and legal counsel from envelopes, scan them, and pass along the copies to inmates. The originals are kept in a box for 45 days, at which point they can be destroyed.Lawyers are alleging that this procedure violates attorney-client privilege and inmate right to privacy. They argue that there is no way to prevent staff from reading letters containing legal strategy and other sensitive information, intentionally or not. "The practices they've implemented are tremendously disruptive, and in fact are prohibiting a lot of lawyers from being able to use the mail to communicate with their clients," said Pennsylvania ACLU legal director Vic Walczak.Many lawyers have therefore stopped sending their imprisoned clients anything in the mail and are having difficulty finding alternative methods to communicate privately with inmates.According to Leane Renee, assistant federal public defender for the U.S. Middle District Court, inmates are only allowed 15 minutes at a time on the phone and lawyers are not always allowed to bring documents into face-to-face meetings.Even if they are, legal teams are often located hours away from the prisons where their clients are held. This has reportedly caused a backlog in legal phone call requests that prisons can’t accommodate.At the same time, although the Pennsylvania Department of Corrections has claimed that all documents are stored and disposed of properly in order to prevent privacy violations, there have been reports of “legal documents piled on desks or heaped into trash bags,” according to Philadelphia's The Inquirer. "We've gotten reports from dozens of lawyers who are involved in criminal appeals and civil issues, who can't communicate with their clients, and these individuals' cases are being harmed and delayed," said Pennsylvania Institutional Law Project lawyer Alexandra Morgan-Kurtz.There have also been allegations of missing pages from legal packets and staff failing to use protective equipment while handling mail possibly contaminated with synthetic cannabinoids.The ACLU is not challenging the use of this new mail procedure when it comes to mail from friends, family, or anyone other than legal counsel.

» World Health Organization To UN: Reclassify Cannabis
22/02/19 20:30 from The Fix

The World Health Organization is calling on the United Nations to change the classification of cannabis to acknowledge that the drug does have some medicinal purposes. According to Futurism, cannabis is currently considered a Schedule IV drug by the UN. This designation is the most tightly controlled, and reserved for drugs that show “particularly dangerous properties.” It was set by an international drug treaty passed in 1961. However, according to information published in the journal BMJ, the World Health Organization is calling for the classification to be updated to reflect the medical uses of marijuana. “The World Health Organization has proposed rescheduling cannabis within international law to take account of the growing evidence for medical applications of the drug, reversing its position held for the past 60 years that cannabis should not be used in legitimate medical practice,” the report's authors wrote. According to the report, the WHO Expert Committee on Drug Dependence started reconsidering marijuana’s classification last year. The committee released a report with its findings and recommendations. “The Committee concluded that the inclusion of cannabis and cannabis resin in Schedule IV is not consistent with the criteria for a drug to be placed in Schedule IV,” the report reads. It goes on to recommend that marijuana and its compounds be reclassified as Schedule I or II drugs, which are less tightly controlled. The recommendations could be voted on by the United Nations member countries as soon as March, which would change the way that marijuana is handled under international law.However, it would have no bearing on how cannabis is scheduled federally in the United States, which uses an entirely different system of classification.Still, marijuana advocates, including U.S. Air Force veteran Michael Krawitz, says that the reclassification is long overdue. “The placement of cannabis in the 1961 treaty, in the absence of scientific evidence, was a terrible injustice," he told Forbes. "Today the World Health Organization has gone a long way towards setting the record straight. It is time for us all to support the World Health Organization’s recommendations and ensure politics don't trump science.”Kenzi Riboulet Zemouli, the head of research at Paris-based non-profit For Alternative Approaches to Addiction Think & Do Tank, told Leafly that the measure is “a beginning of a new evidence and health-oriented cycle for international Cannabis policy.”“This is the best outcome that WHO could possibly have come up with,” Riboulet Zemouli said. 

» FDA May Recommend Naloxone Be Co-Prescribed With Opioids
22/02/19 18:00 from The Fix

The Food and Drug Administration (FDA) is considering recommending that people who receive an opioid prescription are also offered a prescription for naloxone, the opioid overdose reversal drug. The move is intended to reduce deaths from opioid overdose, but some people say that the effort is misguided. The so-called co-prescribing recommendation would apply to patients who are at high risk of overdose, including people who take a high-dose opioid, have a history of addiction or have sleep apnea, according to CNN.Kristy Shepard, a Virginia patient who uses opioids, didn’t know that she had a naloxone prescription waiting for her at the pharmacy. She said that her doctor didn’t give her a heads up about the state’s new co-prescribing recommendations. Other states, including California and Ohio have made similar recommendations, but Shepard doesn’t understand why. "It's so silly. I didn't feel like I needed it. Unless I plan to hurt myself, I'm not likely to overdose," she said. However, Dr. Nathan Schlicher, who is on Washington state’s opioid task force and works as an emergency medicine physician, said this is a common misunderstanding. "You can take pain meds responsibly, and you can be at risk for an accidental overdose even when you're doing everything right,” he said. Washington also has a co-prescribing recommendation. If the FDA recommends co-prescribing, the need for naloxone would increase by 48 million dosages annually, according to an FDA report. That could be a big financial incentive to drug makers, who have spent money lobbying for similar efforts at the state level, especially in California. Some opponents point out that having naloxone on hand only works if the people taking opioids have someone around who could administer the drug if they overdose. Katie O’Leary, who deals with pain, said that talking about overdose risk and carrying naloxone should be a conversation between individual providers and their patients, not a federal requirement. "So many patients already jump through so many hoops to get their meds," she said. "And if you live alone and don't have family or friends to take care of you, the naloxone might not be something that could actually help." Dr. Farshad Ahadian, medical director at the University of California San Diego Health Center for Pain Medicine, agreed, saying, “Most providers probably feel that it's better for physicians to self-regulate rather than practice medicine from the seat of the legislature. The truth is there's been a lot of harm from opioids, a lot of addiction. It's undeniable that we have to yield to that and to recognize that public safety is critical."

» Are Relapse Dreams More Prevalent In Early Recovery?
22/02/19 15:30 from The Fix

Relapse dreams—characterized as dreams that center around the experience of a primary addictive substance or activity—can be a common occurrence for individuals in recovery. Little is known about their meaning or cause, beyond the obvious connection to the dreamer's dependency, or in regard to their relation to relapse during conscious hours.But a new study has suggested that those who have experienced more severe dependency issues may also have more relapse dreams. The frequency of such experiences decrease as the individual gains more time in recovery.The study—conducted by researchers from Massachusetts General Hospital Recovery Research Institute, and published in the Journal of Substance Abuse Treatment—sought to determine, from a demographic and clinical standpoint, who experienced relapse dreams and if their rate of frequency was lessened by time in recovery.To that end, the researchers employed an address-based sampling method that randomly selected individuals from 97% of U.S. households. Participants were determined by those respondents who were 18 years of age or older and answered positively to the screening question—"Did you used to have a problem with drugs or alcohol, but no longer do?"More than 25,229 respondents were ultimately chosen for the survey.The survey, which was administered over a period of 19 days between July and August 2016, asked participants if they had experienced a relapse dream while in recovery, and if so, how recently it had occurred.They were also asked 15 questions about the types of substances they had used, as well as age of first use, frequency of use, if they were still using or no longer using that substance, and if they considered themselves in recovery. If they answered yes to the latter, the participants were asked about the type of recovery (inpatient/outpatient, 12-step program).Upon analyzing the responses, the researchers found that approximately one-third of respondents reported experiencing a relapse dream after entering recovery.Those who did report having recurring relapse dreams tended to have more severe substance use histories."We found that the individuals in recovery who reported at least one such dream had received help from treatment and mutual-help organizations in the past, reflecting a more serious clinical disorder and impact on the central nervous system," said lead author John F. Kelly, PhD, founder/director of the Recovery Research Institute.They also found that for those participants that did report having at least one dream, the length of time spent in recovery appeared to have an impact on the decreasing frequency of these dreams. That association suggested that "as the body and mind gradually adapt to abstinence and a new lifestyle, psychological angst about relapse diminishes," said Kelly.

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