The father of a nine-month old baby girl who went missing overnight this past July is facing multiple felony charges because police say he was inside his dealer’s house buying drugs when his car, left running with his baby inside, went missing out of the driveway.
According to the Parrish Police Department, 9-month-old Harlow Freeman was first reported missing on Monday, July 10 by her father, 30-year-old Madison Jo Rilee Freeman of Jasper, Alabama.
“On July 10th, 2023, the Parrish Police Department was notified of a 9-month-old child that was left inside of a vehicle located at 311 Crest Avenue in Parrish. The father, Jo Rilee Freeman, reported to officers that he left the child inside the running vehicle while he went inside to visit his friends,” said the Parrish Police Department in a Facebook post.
Police said the results of their months-long investigation revealed Freeman had lied about what he had been doing inside the house and he had actually been inside purchasing a prescription anxiety medication called Xanax, which is often abused for its extremely sedative and tranquilizing effects.
“The investigation has revealed the father, Jo Rilee Freeman, drove to 311 Crest Avenue and was conducting a drug transaction with Rodney Thomas while inside the residence,” Parrish Police said. “The father was made aware while he was inside the residence that his car was no longer in the driveway. He drove around for several minutes looking for his car then notified the police. A handgun and other narcotics were recovered from the residence.”
An AMBER alert was issued and according to Police Chief Danny Woodard, over 100 law enforcement units arrived to help find Harlow within 30 minutes of the alert.
“The child was located inside the vehicle 12 hours later. The vehicle was approximately 80 yards down a steep embankment across the street from the house completely covered in kudzu,” Parrish Police said.
What happened to little Harlow between the time her father went into his suspected dealer’s house and the time she was found the next morning is still relatively unclear. The vehicle was found just across the street down a steep ravine the next morning, shrouded from view by thick patches of vines. Parrish Police have said they do not have a suspect in custody for the suspected kidnapping or car theft.
“It was impossible to see,” Chief Woodard said about the location of the vehicle. “The area was searched multiple times through the night.”
Harlow was dehydrated but ok when they found her, according to police. In a stroke of blind luck for the infant, a rear window of the vehicle had been broken in a previous and completely unrelated incident so the baby had plenty of fresh air overnight. She was taken to the hospital to be evaluated but was in “good” condition when Chief Woodard gave a press conference update to the situation in July.
“Considering the situation this was the best case scenario for us to find the child alive and well, dehydrated, but going to [have] a 100 percent recovery.” Chief Woodard said.
I found a lot of speculation saying the Dad forgot to apply the parking brake and the vehicle rolled into the ravine backwards but I also found plenty of speculation saying that didn’t happen and Chief Woodard has given few details other than to say that “Anything is possible, and everything is being evaluated.” Police also said they received many reports of the vehicle in question leaving the area at a high rate of speed.
Warrants were issued and subsequent arrests made for Madison Jo Rilee Freeman and his alleged dealer, Rodney Thomas as well as a third person, 19-year-old Mason Chappel whose involvement in the case was not immediately clear.
Freeman was charged with conspiracy to commit a controlled substance crime and endangering the welfare of a child. Thomas was charged with conspiracy to commit a controlled substance crime and unlawful possession of a controlled substance. He also had six grams of meth and assorted prescription pills on him when he was arrested. Chappel was charged with interfering with governmental operations. A call to the Parrish Police Department to inquire who Chappel is and what he had to do with this case was not returned in time for publication.
“I would like to thank all the agencies and the Walker County District Attorney’s for the many hours of hard work that went into this investigation. While we are still seeking answers to this case the investigation will continue,” Chief Woodard said.
Sub-anesthetic ketamine infusions, which are already used for treatment-resistant depression (TRD), may also help people through benzodiazepine withdrawal, new research published in Neuropsychopharmacology reports.
Benzodiazepines (often abbreviated as “BZDs” or better known as “benzos”) are a class of psychoactive drugs that treat anxiety, insomnia, seizures, and muscle spasms. They include Xanax, Klonopin, and Ativan. And, as anyone who has taken any of those knows, benzos also feel really, really, good.
Benzos work on the neurotransmitter called gamma-aminobutyric acid (GABA) in the brain, which has inhibitory effects on the central nervous system. As a result, pills like Xanax lull you into calm and sedation and melt away worries like magic. For people with anxiety and panic disorders, there’s no shame in taking them, ideally on an as-needed basis and under a doctor’s supervision.
Benzos are delicious and dangerously so. They’re also super physically addictive, and benzo withdrawal is hell. Like, in addition to making your body hurt, giving you panic, anxiety, and insomnia (basically everything you started to take them for), you can also have heart palpitations and even seizures if not done correctly. The experience makes you feel like you’re not put together right and is so brutal that plenty of people end up right back on them. There’s also some evidence that long-term use could lead to cognitive decline. But, as it turns out, ketamine could not only offer patients with PTSD, anxiety, and depression an alternative to benzos but also help them safely and comfortably wean off them.
In the recent study, 22 patients who have been taking benzos long-term (> six months in this case, which some reading this may say is nothing; plenty of people use benzos for years), with severe unipolar or bipolar treatment-resistant depression received a course of six subanesthetic ketamine infusions over four weeks. The researchers investigated the rates of successful BZDRs (benzos) deprescription, trajectories of acute psychological withdrawal symptoms, and subsequent BZDRs abstinence during a mean follow-up of one year.
They also looked at significant deteriorations in depression, anxiety, sleep, and/or suicidality during the acute BZDR discontinuation phase.
Of the 22 participants, 91% (20 out of 22) successfully discontinued all benzos by the end of the four weeks, which the researchers medically confirmed with a urine analysis. Less than 25% of the patients experienced any significant worsening of anxiety, depression, sleep difficulties, or suicidality during treatment, which is quite miraculous.
Furthermore, during the follow-up, with a mean duration of 12 [three – 24] months), 64% (14 out of 22) of patients remained abstinent from any benzos. Such findings suggest that ketamine infusions for TRD may also help people get off benzos, even if patients are still experiencing depression and anxiety, insomnia, and all the other comorbidities that come with it.
It’s worth noting that one of the first things a ketamine provider will tell you, if you’re already on benzos, is to try to take as little as possible around the time you get an infusion, as benzos could make the depression-busting effects less effective.
While ketamine therapy has shown to be revolutionary, whether treating depression or weaning one off benzos, it’s not without its own side effects. If you abuse ketamine, you can risk hurting your bladder or kidneys with ketamine bladder syndrome. Another, perhaps more immediate, concern regarding ketamine infusions is its accessibility. Ketamine infusions can cost a few hundred to thousands of dollars per session. The regimen for treatment-resistant depression is typically six sessions over two weeks; this study had its participants do the six sessions over four weeks) so there’s also a major time commitment; many people can’t get away from work that often. Because if you’re wondering if a nice ketamine infusion in the middle of the day can make it tricky to want to go back to the office, the answer is yes, yes, it can.
Ketamine nasal spray is also available, famous for being the first psychedelic (it’s technically a dissociative anesthetic with hallucinogenic properties). The FDA-approved version is actually “esketamine,” the S enantiomer of ketamine, rather than regular ole’ ketamine, simply because that’s how Johnson & Johnson could patent and sell it under the brand name Spravato. Some doctors prescribe an off-label ketamine nasal spray that one can pick up at a compound pharmacy and use in the comfort of their home rather than trekking to a clinic. Although, of course, do this with someone around in case you take too much and need support or supervision.
Ketamine is already valuable because it treats depression rapidly (SSRIs can take up to six weeks, while ketamine gets to work in a matter of hours). The news that it can also help people comfortably kick a Klonopin dependency is a much-needed and welcome breakthrough in treating mental health conditions.
As someone who was born in the Netherlands and moved to the United States as a teenager, I am often asked what I feel is the biggest difference between America and Europe. To their surprise, it’s not the fact that people on this side of the Atlantic can own semi-automatics, unironically order breakfast at McDonald’s, or have to be 21 to legally drink beer.
It’s that, whenever you turn on the television, there’s a good chance you’ll run into a commercial for some kind of prescription medication. Antidepressants, immunosuppressants, antipyretics, analgesics, antiseptics, even those DIY colon cancer screeners are advertised alongside cars and Coca-Cola cans. They also all follow the same formula: a Lynchian mix of sappy music, sappier scenes of picnicking families and honeymooning lovers, and long, hastily-read lists of severe and possibly life-threatening side effects. Watching them makes you feel a little ill, and that’s probably the point.
No one, we are told in an episode of Netflix’s Painkiller, was better at marketing drugs than the Sacklers, the family at the head of the disgraced but for some unfathomable reason still operational pharmaceutical company Purdue Pharma. Between 1990 and 2020, this family earned an estimated $10 billion in profits pushing OxyContin. During the same time, OxyContin, an extremely addictive painkiller, killed upwards of 564,000 people.
Painkiller, whose 6 episodes premiered on August 10, explores the link between these two statistics and the unresolved legal battle they sparked. Matthew Broderick stars as Richard Sackler, nephew of the diseased patriarch Arthur Sackler who rebranded OxyContin – initially synthesized by German researchers in 1916 – from an end-of-life painkiller into a wonder cure for ailments both major and minor. Uzo Aduba is Edie Flowers, a fictionalized version of several real-life attorneys that went after derelict doctors, negligent FDA employees, and, finally, the Sacklers themselves. Last but not least, Taylor Kitsch crawls inside the skin of one Glen Kryger, yet another composite character, this one representing the Sacklers’ countless victims. Glen is a friendly-neighborhood mechanic with a loving wife, a young daughter, and good-for-nothing employees whose perfectly imperfect life is turned upside down when one of said employees accidentally breaks his back. An overly friendly and charismatic doctor then prescribes Glen some opioids, to which he inevitably becomes addicted.
As a work of film and storytelling, Painkiller seems well-crafted enough. Dialogue is layered and impactful. Production quality is high but not overindulgent. Scenes were evidently put together with a sense of purpose. In the opening, Richard Sackler is woken up by a malfunctioning smoke alarm, which he cannot reach because the ceilings in his mansion are too high. The meaning seems obvious: that there is a price to pay for his insane wealth, and also that he is oblivious to warning calls sounding around him. Also worth noting is the introduction of Glen, which takes its time to familiarize the audience with his world before the rather suspensefully executed accident takes place.
As a treatment of one of the country’s biggest and most recent tragedies, however, Painkiller leaves a lot to be desired. At certain points, it feels like you’re watching Succession but for the Sacklers instead of the Roys. There’s a focus on family drama and a slight fetishization of their wealth, power, and even their lack of humanity that clashes with the Edie’s and especially Glen’s perspective: the perspective of the victims. Then again, although documentaries like Heroin(e) and Recovery Boysapproached the subject much more respectfully, Painkiller stands poised to attract more eyeballs, raise more awareness about the epidemic, and further antagonize the Sacklers – which are all good things.
Don’t get me wrong, a lot of fucked up and sickeningly unjust things happen in Europe, but the stuff you see in Painkiller – doctors stealing from Medicare and prescribing medication like they’re selling snake oil – are just such uniquely American phenomena. I like to think I know and trust the healthcare professionals I interact with here in the underserved town in rural Georgia where I am currently based, but the problem is that in a for-profit system you can never be 100% sure that others have your best interests at heart.
Built-in structures to incentivize jacking up drug prices in pharmacies, and prey on seniors, could soon be whittled down.
Sens. Maggie Hassan (D-NH) and Bob Menendez (D-N.J.) were among those who voted Wednesday to advance a bipartisan bill she personally helped develop to reduce the rocketing cost of prescription drugs and the way pharmacy managers benefit from rising drug prices.
The Modernizing and Ensuring PBM Accountability (MEPA) Act, which passed the Finance Committee July 26 on a bipartisan basis, reduces the cost incentive for pharmacy benefit managers (PBMs) to prioritize more expensive drugs because they receive higher payouts for higher priced drugs.
Drugmakers say that the rising rebates they must pay PBMs are forcing them to jack up prescription drug prices. According to a recent analysis, drugmaker rebates to PBMs increased from $39.7 billion in 2012 to $89.5 billion in 2016, partially offsetting list prescription drug price increases. PBMs say, however, that they have been passing along a larger share of the money to insurers.
“Last year, we took on Big Pharma by giving Medicare the ability to negotiate drug prices, and we must continue to stand up to the health care industry and help people afford the medications that they need,” said Senator Hassan. “This bipartisan legislation will ensure that pharmacy benefit managers don’t push people to more expensive drugs just so that they can get a larger payout, saving seniors their hard-earned money while also saving taxpayer dollars.”
HIV drugmaker Gilead Sciences was slammed for its PBM Express Scripts because it jacked up the prices of its lifesaving hepatitis C cures Sovaldi and Harvoni. But Gilead later changed its tune and joined a chorus of drugmakers—turning on PBMs. “I have never met, in this entire experience, a PBM or a payer outside of the Medicaid segment that preferred a price of $50,000 over $75,000 and a rebate back to them,” Jim Meyers, executive VP of worldwide commercial operations for Gilead toldBloomberg in 2017. “We have a system that’s incentivized upon rebate revenue.”
What Would Change Under The Modernizing and Ensuring PBM Accountability Act
The bill would lower prescription drug costs and is estimated to save $1.7 billion in taxpayer dollars. It makes a few adjustments to common PBM practices and transparency requirements under Medicare Part D, which the Senator outlined as follows:
PBMs often prioritize coverage of more expensive drugs because part of their compensation is calculated through the list prices of drugs. This legislation will break the link between drug prices and how much pharmacy benefit managers are paid, so there is no longer a financial incentive for these companies to push patients to buy more expensive medication.
This legislation will ban the practice of “spread pricing” in Medicaid, in which pharmacy benefit managers negotiate a lower price with a pharmacy but charge a higher price to the health plan, pocketing the difference.
The legislation also includes a bipartisan measure that Senator Hassan led to ensure that pharmacy benefit managers report transparently on how they price low-cost generics and biosimilar medications, allowing more visibility into whether people can easily access these generics.
Sen. Menendez (D-N.J.), a senior member of the U.S. Senate Committee on Finance, said the Modernizing and Ensuring PBM Accountability (MEPA) Act includes his own inclusion, the Patients Before Middlemen (PBM) Act, joined by Marsha Blackburn (R-TN), alongside Senate Finance Chairman Ron Wyden (D-OR), Senate Finance Ranking Member Mike Crapo (R-ID), Sen. Jon Tester (D-MN), and Sen. Roger Marshall (R-KS).
“For too long, PBMs have held a vise grip over the prescription drug supply chain—price gouging hardworking families and seniors alike. Through the current incentive structure, whereby they turn a profit as a percentage of the list price of a prescription, PBMs wield their influence to have health insurers cover more and more expensive drugs—even when cheaper options are available,” said Sen. Menendez. “My Patients Before Middlemen Act, which I’ve introduced alongside Senators Blackburn, Wyden, Crapo, Marshall, and Tester, would replace the complicated scheme of opaque rebates and administrative charges with a flat fee—one that is negotiated before entering into a contract. By delinking PBM compensation from drug prices, we help lower prescription drug costs for Medicare Part D beneficiaries and better align incentives in the market. Our bipartisan Patients Before Middlemen (“PBM”) Act would curb the biggest abuses in the PBM industry today.”
My dog has been through several rounds of hell over the last year and a half while overcoming paralysis from a damaged back. But nothing tested her or I more than the brief period she was on a prescribed combination of codeine and a non-steroidal anti-inflammatory.
My last 15 or so months have been primarily focused on recovering my now-five-year-old dog, Delly, an 18-pound beagle-Jack Russell mix. Depending on which day you catch me, she’s either named after delicatessens, a city in India, or, my favorite response, Australian basketball player Matthew “Delly” Dellavedova.
No matter the fake origin story, her past year and a half has shaped both of us in immense ways.
On the night of April 5, 2022, I was preparing dinner after taking Delly to the park. As I chopped some bell peppers, one of her favorite snacks, I noticed she was walking awkwardly, almost like she’d been drugged, crossing her back legs with every step. When walking, she tailed hard to one side or the other, like a badly aligned car.
In less than an hour, her back legs would worsen. Pain coursed through her, leaving her grunting and whining in ways I’d only heard once before after a collision with an adult bloodhound at the park. The pain persisted when she stood or laid down. Soon after, she lost the use of her back legs.
My girlfriend and I rushed the dog to a nearby animal emergency room. Doctors admitted her right away. Thirty or so minutes later, a doctor told us she had grade 4 IVDD, or Intervertebral Disc Disease, a disorder caused by a herniated disc in her lower back. The severity of the injury meant Delly had to go into surgery the following day. From there, she’d face an uncertain future where we’d have to wait several months to see if she would ever walk or control her bowels again.
CBD Plays A Part In My Dog’s Recovery
Required to stay in bed for six weeks post-surgery, Delly laid immobile while given medications like gabapentin, an anticonvulsant, and carprofen, a non-steroidal anti-inflammatory. I mashed pills into the wet food she was fed bedside every morning and evening.
One month into recovery, Delly was able to start taking “walks” outside. Essentially, I’d hold her lower body in a harness, allowing her to drag her legs in the grass in an attempt to stimulate and rehabilitate her damaged nerves.
Around that time, I started introducing a roughly 2-4mg dose of CBD to her regimen to help with any pain or muscle inflammation. We had tested CBD on her before during long trips, which allowed me to anticipate how she’d react this time around. In previous uses, Delly never had any negative reactions to CBD. I picked up a pump-based oil oral dispenser from Green Gorilla. Full disclosure: Green Gorilla sent me products once or twice long before this injury, and my dog liked them, so I stuck with them for this endeavor. Grab whichever product you and your vet deem best.
I can’t say precisely what the results were early on, due in part to the additional drugs still in her regimen. But over time, as CBD became her only supplement, I did notice subtle effects, including continued deep rest and some body pain relief the day or two after some exhaustive therapy sessions.
Muscle inflammation and soreness would certainly be the norm as we stepped up her rehab efforts over the following months. I knew Delly was in good hands at her rehab facility, Water4Dogs. One of the first things that put me at ease about the place was their support for CBD. The facility recommended CBD along with other meds and supplements to aid dogs with bad backs, knees and other mobility and rehab needs.
Allow me to digress for one moment. If anyone is scoffing at the absurd, possibly bougie, levels I went to rehab my dog, I hear you loud and clear. I never thought I’d do this for anyone, much less have the funds to front the thousands of dollars for my pet. But thankfully, I had some money from my writing and more importantly I had pet insurance. It may sound like another bougie thing you don’t need. But pet owners, trust me, it paid off immensely, saving me around $10,000 over the past year. Without it, I don’t know if any of this could have been affordable. I shudder to think what might have been our outcome without.
Back to the point at hand: I felt CBD could help keep any rehab pain in check with therapy sessions going on every week through the summer. I thought it could also help with appetite stimulation. But my dog is a food-driven little goblin, so eating wasn’t an issue during her recovery.
By June, two months after the injury, Delly took her first steps post-surgery. From there, she blew past expectations that continue to astound her doctors.
We continued the CBD regimen, stopping sometime in the fall after several months when her recovery was in a good enough place. Around that time, rehab sessions began to happen two to three weeks apart.
Getting to that point took a lot of work. Setbacks certainly occurred along the way. There were many instances early in the recovery process when bathroom accidents happened multiple times a day. Sometimes she still poops in her bed or pees when she gets excited, but we’ll take it in exchange for her life.
She may never be able to play much again, or walk up stairs or jump, but she’s doing great otherwise. Today, Delly can walk/run, hike, swim and even high five with relative ease. She also wears pink protective Croc-like shoes on her back paws when walking on concrete. I’ve modified them with grip tape to increase their durability because she occasionally drags her paws. They’re a real crowd pleaser in the neighborhood.
…CBD Steps In When Prescribed Drugs Go Wrong
Delly’s recovery journey has been long and arduous but certainly worthwhile. But no two days tested us more than November 18th and 19th, 2022, when she was on codeine and a non-opioid drug for an unrelated medical issue.
During a routine heartworm pill check up, Delly’s vet found she had fractured a tooth some time ago. Thankfully she wasn’t in pain but needed another surgery or risk further oral health issues. The surgery went normally, leaving her a bit groggy but otherwise fine. I took her home and did as instructed that night, giving her a 15mg tab of prescribed codeine and 1.5 mg of Metacam, a non-steroidal anti-inflammatory used for stiffness and pain in dogs.
The following morning, I woke up to find something akin to melted cacao all over my dog’s bed.
By month eight of her recovery, seeing some accidents in the bed was an occurrence I’d gotten used to. With Delly’s injury, controlling her backside was not what it used to be. But what came out of her that night was of a magnitude and of a brown-black hue I hope to never see again. The cleanup of the dog, her bed and the bathtub afterward took well over an hour.
“But hey, all’s well,” I said to myself. “The worst usually occurs overnight. The day can only get better from here.”
Yeah, that didn’t happen at all.
I underestimated what drugs can do to a mammal. Let’s start with the usual suspect and source of the concern: the opioid. Like most medications, Codeine has many similar adverse effects on canines and other mammals as it has on humans. The vet’s discharge form mentioned sedation may happen. It did not cite a list of other possible side effects, including:
Constipation
Collapse
Trouble breathing
Increased excitement
Tremors
Seizures
Constipation certainly wasn’t our issue. That became further evident after two more incidents that day. In our home, we now call this day “The Brownout.”
By the end of the night of the 18th, I knew the medication, be it the codeine, metacam, or both, was causing her issues. My gut said it was the opioid and not the non-steroidal anti-inflammatory. Foolishly, I didn’t research and went with my gut, accusing opioids, because of course that kind evil would do something to my dog. But after the third accident, I learned it was the metacam that came with a diarrhea and soft stool side effect warning.
I let doctors know on the 18th that something wasn’t right. They empathized but suggested I keep up the medication regimen that was supposed to last another several days. They also pointed out that codeine is sometimes used to treat diarrhea. Reluctantly, I agreed.
The next morning, it looked like the dog had once again curled up to a leaking soft-serve chocolate ice cream machine. Two pees in the house by that afternoon, and I was at my wit’s end. Frustrated and determined to resolve this problem, I pushed on as my Irish-Catholic elders taught me: First, I made fun of the situation, then I took action. So, after giving Delly the nickname “The Heinous Anus,” I again phoned the vet.
I told them that neither she nor I could continue like this. I no longer asked if CBD was an option. I insisted on it. Typically, I’m not one to rebel against my doctors, mostly because I have no idea about medicine. This time around, I wasn’t going to let up. It’s not like I needed their permission but I would feel better having medical opinions on my side.
To the vet’s credit, they didn’t push back on the CBD pivot. And while it looked like Metacam was the cause, they did not specify which medication or effects led to the diarrhea. The doctor then told me to do what a pet owner should do with any medication: keep a close eye on your pet and monitor for any warning signs.
Thankfully, after the switch to CBD, Delly was pain-free, resting and maintaining her stomach contents.
Choose Your Treatments Wisely
I’m not saying Metacam, codeine and other drugs don’t have a place in recovery. Sometimes you need substantial medication to help with acute pain that cannabis probably can’t address.
Experts typically feel that opioids work best when managing pain for short periods, with some recommendingless than a week of use. Metacam follows similar dosing guidelines, with most vets suggesting that dogs take it for a few weeks at most, unless recommended otherwise.
And while Metacam’s list of adverse effects suggest it made my dog sick, I couldn’t help but shake the worries of opioids. We know the damage it does to humans, so why shouldn’t I be worried about my dog? At this point, I don’t care which it was. Going forward, I’ll do my best to avoid them both.
Research continues to assess the impact of opioids on animals with limited to no conclusive decisions made. However, one recent study suggested that injectable opioids are more effective for dogs. Another study has led some to believe that animals can become addicted to opioids.
It’s important to remember that I’m only speaking from my experience. Neither High Times nor I are offering any medical advice for readers or their pets. With the sum of lab studies currently inconclusive, making any sort of definitive statements would be risky. As always, medical choices should be made by you and trusted professionals.
With my dog, it feels like CBD may have a place in her long-term recovery and maintenance. I wouldn’t have relied on CBD alone to treat the severe pain of the first few weeks, but now I feel like it is more than capable of addressing any future muscle soreness and stiffness. IVDD is a lifelong condition, so CBD may come back into play at some point to help her with muscle inflammation, body pains or to help her rest. Right now, she seems okay on her own, but you never know what life will bring next.
Members of the Sackler family–the wealthy owners behind Purdue Pharma and OxyContin—paid upwards of $19 million in donations to The National Academies of Sciences, Engineering and Medicine, a powerful institution that advises U.S. opioid policy, according to a bombshell report by The New York Times.
The Times outlined a series of events that pose a possible conflict of interest. Dr. Raymond Sackler, his wife, Beverly, and the couple’s foundation started donating large sums of money to the Academies in 2008, according to treasurer reports. They died in 2017 and 2019, respectively. Dame Jillian Sackler also made millions of dollars’ worth of donations to the Academies beginning in 2000. The Academies invested the funds, growing to over $31 million by the end of 2021.
The allegations continue: The Pain Care Forum, a group co-founded by Burt Rosen, the Purdue lobbyist at the time, pushed for legislation introduced in 2007 and 2009 that included plans calling for an Academies report to “increase the recognition of pain as a significant public health problem.”
If the allegations are true, they present a serious conflict of interest. So the Times called upon Michael Rehn Von Korff—a medical researcher who studies the treatment of chronic pain, among other fields, for insight on the matter.
“I didn’t know they were taking private money,” Von Korff told The New York Times. “It sounds like insanity to take money from principals of drug companies and then do reports related to opioids. I am really shocked.”
Last Prisoner Project founder Steve DeAngelo posted the report on Instagram and called the revelations “disgusting.” Medical cannabis is frequently used as an alternative to opioids for some situations.
According to the U.S. Department of Health & Human Services, (HHS) over 760,000 people have died since 1999 from a drug overdose, with nearly 75% of drug overdose deaths in 2020 involving an opioid. The Centers for Disease Control and Prevention reports that the number of drug overdose deaths “quintupled since 1999.”
A 2011 The National Academies of Sciences, Engineering and Medicine report claims that 100 million Americans suffered from chronic pain—one-third of the entire U.S. population—and while that’s often cited by government organizations, now that number is being challenged as preposterous. That report influenced the U.S. Food and Drug Administration to approve at least one powerful opioid, Zohydro, which is a slow release hydrocodone.
In 2016, just months after the National Academies scooped up a $10 million Sackler family donation, the F.D.A. asked the institution to form a committee to create new recommendations on opioids. But the Academies were blamed for having sketchy ties to opioid makers, including Purdue Pharma. Four people were removed from the panel after that incident.
The National Academies of Sciences, Engineering and Medicine was created by Abraham Lincoln, and U.S. laws are shaped by the data it releases. For the past few decades though, the academy was utilized to combat the American opioid crisis.
The opioid crisis is complex and it’s difficult to distinguish between people who are addicted and people who genuinely have high levels of pain. But the overdose death toll is impossible to ignore as it surpasses death toll numbers from war and sickness. In 2017, the HHS declared the opioid crisis a public health emergency.
There is also another side to the story. Megan Lowry from the National Academies told The New York Times that the Sackler donations “were never used to support any advisory activities on the use of opioids or on efforts to counter the opioid crisis,” and that they are prevented from returning the Sackler donations because of legal restrictions.
To date, legal cannabis in America has been understood one of two ways: medicine, or fun. There’s medical marijuana, requiring a qualifying condition and a doctor’s recommendation before any legal weed can be accessed; and then there’s adult-use cannabis (or recreational), requiring nothing but a government-issued ID proving one’s age.
But what if there’s a third way—or, what if, as the late activist Dennis Peron used to say, all marijuana use was medical, or at least part of a general wellness strategy? Recent research that demonstrates a drop in prescription-drug use in states that legalized adult-use cannabis—which, as a convenient bonus, is generally more easily and more widely available than medical—suggests this may be the case.
Weed Up, Pills Down
In the past, the passage of medical cannabis laws has been associated with a drop in prescription pharmaceuticals. The effect of adult-use cannabis laws—no small deal in East Coast states such as New York, where the medical program is small and difficult to access thanks to tight restriction around physicians and qualifying illnesses–-is less studied.
So, researchers looked at Medicaid prescriptions filled between 2011 and 2019 in all 50 states. And in states that legalized adult-use cannabis, they found “significant reductions” in prescriptions filled for drugs meant to treat “pain, depression, anxiety, sleep, psychosis and seizures,” according to a research article published in April in the journal Health Economics.
Or, put another way, legalization seems to present a significant medical benefit along with the familiar arguments for social justice and new sources of tax revenue.
People are self-medicating with cannabis, and while it’s hard to say for certain whether they’re achieving the same results, the fact that they don’t seem to be returning to pharmaceuticals is suggestive, as study co-author Shyam Raman, a PhD student at Cornell University’s Jeb E. Brooks School of Public Policy, said in a recent interview.
“What [adult-use cannabis] legalization does is open up an opportunity to self-medicate without seeing a doctor and potentially be denied because your sickness isn’t on the qualifying condition list,” said Raman, who stressed that while only Medicaid data was studied, these results are applicable to the general population. “There’s some real evidence people are self-medicating, and people aren’t switching back to pharmaceuticals.”
Cannabis for Anxiety, Depression and Insomnia
Among the drug classes studied, Raman and study co-author Ashley Bradford, a researcher and PhD student at Indiana University, saw the steepest drops in demand for anxiety, depression, insomnia and psychosis, with drops of 12.2%, 11.1%, 10.8% and 10.7%, respectively.
In addition to potential cost-savings for Medicaid programs, adult-use cannabis legalization may present an additional harm-reduction benefit, the researchers found, with people dropping or reducing reliance on pharmaceutical drugs with nasty side effects as easier-to-access “over-the-counter” recreational cannabis becomes available.
“We believe that quite strongly, that people are doing it because the side effects of pharmaceuticals are really frustrating,” Raman said.
The findings suggest adopting both a more sophisticated and expansive understanding of adult-use cannabis legalization—and never neglecting the fact that no matter what you call it, cannabis generally may be a wellness product, a fact that advocates pushing for adult-use cannabis legalization on the state and federal levels shouldn’t neglect.
“The adult-use cannabis market in most states is just easier to utilize, because patients don’t have to pay for a patient card and they don’t have to get a doctor’s recommendation,” said Debbie Churgai, executive director of Americans for Safe Access, arguably the country’s leading medical-first cannabis policy advocacy group.
But, as always, it’s also a reminder that cannabis is badly under-researched. Key questions including dosage and regimen remain unanswered, leaving “patients”—regardless of whether they’re official enrollees in their state’s program—to figure it out for themselves.
“We still don’t know how to regulate cannabis as a medicine,” Raman said. “How are we in a position to say, ‘This is medical,’ without being able to say, ‘This is the amount you take for therapeutic use’?”
Always Medical, Or Wellness Benefit?
So, is cannabis always medical, or is all recreational cannabis also medical, or is a third way of understanding cannabis the best classification? It’s hard to say for certain—and ultimately it may not matter.
“I don’t like to compare [medical and adult-use cannabis],” Churgai said. “I think this is a great example of how people are feeling the effects of the medicine whether they recognize it or not.”
But what this does suggest is that certain forces in the cannabis industry might need to re-evaluate their messaging and branding. Don’t forget about the medical cannabis patients: they’re part of your adult-use market segment, too.
“If you go to these business conferences, you barely even see or hear the word ‘patient’ in any presentation,” Churgai said. “I do think that’s being lost more and more as our industry gets bigger. They think the adult-use cannabis market would be bigger than the medical marijuana market.”
But, as this research suggests, the differences aren’t nearly as sharp and distinct as we might have thought. Medical and adult-use cannabis just might turn out to be precisely the same exact thing.
The legalization of recreational cannabis reduces the demand for prescriptions filled through state Medicaid programs, according to a study by researchers affiliated with Cornell University and Indiana University. The researchers also documented a significant decrease in the number of prescriptions for types of drugs commonly prescribed to treat pain, depression, anxiety, sleep, psychosis, and seizures.
Shyam Raman, a doctoral student in the Cornell Jeb E. Brooks School of Public Policy, and Indiana University doctoral student Ashley Bradford conducted an analysis of data obtained from the Centers for Medicare and Medicaid Services for all 50 states from 2011 to 2019. The timing of the research coincided with the legalization of cannabis in nearly a dozen states.
“These results have important implications,” Raman told the Cornell Chronicle. “The reductions in drug utilization that we find could lead to significant cost savings for state Medicaid programs. The results also indicate an opportunity to reduce the harm that can come with the dangerous side effects associated with some prescription drugs.”
In states that had legalized recreational cannabis, the researchers saw a significant change in the number of prescriptions to treat sleep and anxiety disorders. But they did not see a meaningful impact on the number of prescriptions to treat nausea.
The study, “Recreational Cannabis Legalizations Associated with Reductions in Prescription Drug Utilizations Among Medicaid Enrollees,” was published on April 15 in the journal Health Economics. The researchers noted that other studies have focused on the impact legalizing medical cannabis has on the use of opioids. But this is one of the first studies that focused on how legalizing cannabis for use by adults can influence the use of a broad range of prescription drugs. The researchers noted that the decline in prescriptions may be influenced by a reduction in visits to primary care providers when patients begin treating medical conditions with cannabis.
Cannabis and Opioids
In March, a study from researchers at Thomas Jefferson University in Philadelphia showed that osteoarthritis patients filled statistically fewer prescriptions for opioids six months after beginning medical cannabis compared to six months before treatment. Additionally, one-third of the study subjects stopped filling opioid prescriptions completely. The researchers also reported improvements in the patients’ overall quality of life.
And earlier this month, a separate study found that CBD and THC do not enhance the rewarding effects of opioids, suggesting that the risk of addiction is not increased when the compounds are used in conjunction with one another. Lawrence Carey, Ph.D., a postdoctoral fellow at the University of Texas Health Science Center in San Antonio who conducted the study, said a combination of compounds may be a safer alternative for patients with chronic pain.
“There is intense interest in using medical marijuana in patients with chronic pain because compounds in marijuana like CBD and THC may produce pain relief themselves or enhance the pain-relieving effects of opioids,” Carey said in a statement about the research. “This means people could potentially use lower doses of opioids and still get relief from pain. Taking less pain medication could also lead to a lowered risk of addiction or physical dependence to opioids.”
Carey noted that research is continuing to determine if THC and CBD can help reduce the symptoms of opioid withdrawal.
“A big reason why people continue to take opioids after they become addicted is the appearance of withdrawal symptoms,” he said. “We are using what we learned from this study to determine whether these doses—which didn’t alter choice for food or drug rewards—may help relieve opioid withdrawal or decrease relapse and drug seeking behavior following periods of abstinence.”
The research comes as the nation continues a dramatic spike in overdose deaths spurred by the opioid crisis. In November, the CDC reported that more than 100,000 people had died of an overdose over a 12-month period, the highest number of deaths ever recorded in the span of a year. More than 75% of the reported overdose deaths were related to opioids.
A drug interaction happens when two or more compounds come in contact with each other and create an effect. Because of its broad range of effects, cannabis can cause a variety of interactions with pharmaceutical drugs. In this article, we will provide you with a general idea of how cannabis can interact with some of […]
