With pancreatic cancer, what Stephen needs is legalised cannabis

A year into his cancer treatment, Stephen heard about the benefits of medical marijuana and CBD oil, but it has proven difficult to get

I was lying face down when I first heard about Stephen Schulman. Id been feeling sorry for myself, complaining of an aching wrist and back the vestiges of an age-inappropriate roller-skating accident – while my massage therapist Elisa worked to soothe my pain.

Eventually, our conversation turned to her friend Stephen. At only 41, just months after marrying the love of his life, Stephen had gone to the doctor complaining of stomach pains and the inability to keep anything down. He re-emerged with a diagnosis: stage-3 pancreatic cancer, inoperable due to a very large tumor wrapping itself around a major artery in his abdomen.

In essence, a death sentence.

Elisa had been buying Stephen sublingual CBD oil $89 for one ounce because it proved to be the only thing effectively alleviating the tingling and numbness that had recently consumed his fingers and toes. He and his husband Wades savings had been bled dry by their $2,400-a-month insurance premium plus general expenses. Stephen is unable to work since his life has become a blur of excruciating pain, treatments, hope, fear and heavy doses of opioids like fentanyl and oxycodone.

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Stephen first heard about the reported pain relief benefits of medical marijuana and CBD oil for cancer patients a year into his treatment. When he asked his doctors about applying for a medical marijuana card, their reluctance confused him. Still, he persisted and when he started using both, he found they controlled his symptoms as well or, in some cases, better than opioids. He also found out that no insurance company covers their high costs.

As Elisa told me Stephens story, I considered how the small discomforts Id come in with made it harder for me to get around in the day or to sleep well at night. How they made me feel irritable and fragile. And how I could pay a negligible amount of money to a lovely woman to help soothe them for me. My ailments were absolutely nothing by comparison with Stephens, yet what he needs is elusive at best, prohibited at worst.

Politicians have been embroiled in contentious debates for years about the morality and logistics of legalizing medical marijuana despite reputable studies, like the Rand study, which supports its efficacy. In the meantime, people like Stephen suffer.

I decided to document Stephens life because his story had something valuable to remind us all about the gap between the abstract moralizing of politicians and the needs of the people they represent.

These pictures were taken between January and August 2019.

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Wade is a freelance hairstylist. Once in a while, he sits Stephen down in the chair in his home salon and treats him to a haircut, shave and facial mask.

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Stephen remembers clearly what it felt like to be diagnosed: It just hits you like a ton of bricks: Everything is about to change. Your life is going to be about doing chemo, radiation, things you wouldnt normally do and its going to be a hard, uphill battle.

Stephen

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Wade adds Osmolite formula, a therapeutic nutrition for patients with increased calorie and protein needs, to a drip every other night to help Stephen maintain a healthy weight. The procedure takes eight hours and is very uncomfortable. Lack of appetite and nausea leading to unhealthy weight loss are common for pancreatic patients. The use of medical marijuana has helped Stephen greatly with these symptoms.

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Artist Jason Naylor, whose self-described mission is to spread color and positivity across the globe, heard about Stephens plight through social media and made him the Love painting, which he hand-delivered to the couple, that hangs above Stephen and Wades bed.

Overwhelmed by medical expenses, Stephen and Wade accepted the offer of a friend to set up a GoFundMe page for them.

We have to lean on each other, trust one another, and be up front about how were doing and feeling every single day, Stephen says of his relationship. Theres no way I would have been able to get through this diagnosis without Wade. I appreciate him more every day. I know that sounds corny, but its true.

Clyde,

Clyde, one of the couples two cats, the other is Bonnie (both male), watches as Stephen tries on his kickboxing gloves. Kickboxing was something Stephen enjoyed with friends before his diagnoses when he was 40 pounds heavier. Now, there are some days hes too weak to get out of bed.

Stephen

Stephen describes the current state of his disease; Stage 3-pancreatic cancer without the possibility of the Whipple procedure because of the placement of the tumor. They do a CT scan every three months and determine the next steps based on those results. A very risky surgery I believe its only performed by one doctor in the US at the Mayo Clinic in Rochester, Minnesota is my only option and were hoping to make that happen. But insurance has, so far, refused to pay for it or the chemotherapy Ill need beforehand, and it is astronomically expensive.

It

It makes me smile a little to wear fun, colorful socks, Stephen says in reference to the cock socks he wears to physical therapy.

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I think its funny, Stephen remarks, that in America youre able to buy alcohol, which is known to cause all these problems, but CBD oil and medical marijuana are more regulated and looked down upon. Its sad because theyve definitely helped me immensely.

In New York state, medication comes primarily in the form of pills, vapes, oils and lotions. Dispensaries cant distribute edibles because its much harder to control the doses a patient receives in them. Every dose at Columbia Care New York is consistent and titrated, meaning its increased, if need be, slowly over time.

dr reed

Tricia Reed, PharmD, Columbia Care New Yorks lead pharmacist, describes the purported benefits of some of their products.

High THC products are good for nausea, vomiting and severe pain, giving more of an opiate-type pain relief. THC is a good muscle relaxer and helps with sleep. CBD is a great anti-inflammatory, works well for nerve pain, and is an anti-convulsant so its good for seizures.

Every dose has to deliver the exact milligram per milliliter as prescribed. Each time you take an inhalation from the vapor, it gives you a specific mg.

When

When a patient visits Columbia Care for the first time, they meet with a pharmacist who takes them through a full consultation to determine what products they may respond to best.

In the higher-THC products, Reed explains, there can be a euphoric feeling which might not be so bad for patients going through a hard time. Its similar to the side-effects youd get from other meds like Valium. I encourage patients to think of it that way. Its just a side-effect similar to those of other medications they may have already taken. There is still that sense of taboo or stigma that goes along with marijuana. A lot of what weve been trying to do is to de-stigmatize it.

Rosemary Mazanet, an oncologist by original training, is chief scientific officer for Columbia Care. When I think about the disconnect between the enormous promise that cannabis products bring and the fact that theres such an air about it that makes it tawdry, it comes down to the fact that its federally illegal.

Read more: https://www.theguardian.com/society/2019/sep/04/with-pancreatic-cancer-what-stephen-needs-is-legalised-cannabis

How big pharma is targeting India’s booming opioid market

As India loosens its stringent narcotics laws, US companies including Johnson & Johnson, Abbott Laboratories and a network affiliated with Purdue Pharma are rushing in

Pain, like death, is a universal phenomenon.

The grimace on the womans face, registering her agony to Dr GP Dureja in his East Delhi office, would be recognized anywhere. Slouched shoulders, pinched forehead. She wore a willowy black kurta and cast a disapproving glance at the five pain physicians-in-training huddled behind Dureja, the founder of the Delhi Pain Management Centre and one of Indias pioneering pain physicians.

The five trainees, participants in the centers acclaimed pain fellowship program, recorded the womans consultation on their smartphones, eager to see Indias famous pain doctor do his work. After their fellowships, they will return home, to Chennai, Kashmir, Rajasthan, ready to forge careers in Indias exploding pain industry.

The woman had been under Durejas care for some time now; he diagnosed her with fibromyalgia, a chronic neurological disorder that causes pain throughout the body. But the regimen of Paracetamol and tramadol, an opioid analgesic, was not working and she was beyond fatigued. She wanted more relief.

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Dr GP Dureja, surrounded by medical trainees, talks to a patient at the Delhi Pain Management Centre. Photograph: Saumya Khandelwal/The Guardian

Indians once thought of pain relief as an indulgence of the west, Dureja said after the woman left his office gripping her new prescriptions. The old way of thinking was, Nobody has time to complain about pain in our country. But Im getting five to seven new patients per day.

For-profit pain clinics like Delhi Pain Management Centre are opening by the score across Mumbai, Kolkata, Bangalore and other cities in this nation of 1.3 billion people. After decades of stringent narcotics laws, borne of debilitating opium epidemics of centuries past, India is a country ready to salve its pain.

And American pharmaceutical companies architects of the opioid crisis in the United States and avid hunters of new markets stand at the ready to fuel that demand.

For Indian cancer patients who once writhed in agony, there are fentanyl patches from a subsidiary of Johnson & Johnson.

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For the countrys vast army of middle-class office workers wracked with back and neck pain, there is buprenorphine from Mundipharma, a network of companies controlled by the Sackler family, the owners of Connecticut-based Purdue Pharma.

And for the hundreds of millions of aging Indians with aching joints and knees, there are shots of tramadol from Abbott Laboratories.

Palliative care advocates, who recount stories of patients enduring excruciating cancer pain or dying in agony, have persuaded reluctant government officials to allow high-powered opioid painkillers into doctors offices and on to chemists shelves.

But what began as a populist movement to bring inexpensive, Indian-made morphine to the ill has given rise to a pain management industry that promises countless new customers to American pharmaceutical companies facing a government crackdown and mounting lawsuits back home.

The lure of a pain-free life is a revelation in a country where incomes are rising for many city dwellers and 300 million to 400 million people are approaching the middle-class. Newly-minted pain doctors promise aspiring Indians that life has more to offer in a body free from pain.

Dont listen to your forefathers, Dureja said, a mantra for the shifting mindset. They said you should tolerate pain, you should not complain, you should not take painkillers. Now, everybody wants to get rid of pain early.

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Dr GP Dureja performs a procedure on a patient in the operation theatre at the Delhi Pain Management Centre. Photograph: Saumya Khandelwal/The Guardian

As major pharmaceutical companies look to capitalize on the opportunity, the playbook unfolding in India seems familiar. Earnest advocates share heartbreaking stories of suffering patients; physicians and pharmaceutical companies champion pain relief for cancer patients and persuade regulators to grant greater access to powerful opioids; well-meaning pain doctors open clinics; shady pain clinics follow; and a spigot of prescription opioids opens first addressing legitimate medical uses but soon spilling into the streets and onto the black market.

A looming deluge of addictive painkillers terrifies some Indian medical professionals, who are keenly aware that despite government regulations most drugs are available for petty cash at local chemist shops.

Are people going to figure out every trick in the game to make [opioid painkillers] widely available? asked Dr Bobby John, a leading Indian public health expert based in New Delhi. Of course it will happen.

Pharmacy
Pharmacy shops at Bhagirath Palaces pharmaceuticals market in Old Delhi, India. Photograph: Saumya Khandelwal/The Guardian

The market for pain is good

The headquarters of the Pain Clinic of India operates out of a closet-size office in Chembur, a tree-lined suburb in eastern Mumbai. The companys presence on the internet is so prominent that Dr Kailash Kothari, the clinics founder, has turned down requests from people inSouth Africa, Australia, Europe and the United States seeking prescription opioids.

Down an alleyway, the clinics small white-red-and-blue sign is difficult to spot. Around the side of a faded-pink building is a larger sign showing a shirtless, muscular white man gripping his back, another gripping his neck, another clutching his knee; a white woman with an excruciating headache presses her forehead and another grabs her shoulder. Back Pain. Neck Pain. Headache. Knee Pain. Shoulder Pain. Cancer Pain. The sign promises Towards Pain Free Life.

One of the principal architects of pain medicine in India, Kothari runs several clinics in Mumbai, consults at numerous hospitals and flies to his clinic in Goa once a week. He co-founded the Indian Academy of Pain, an educational branch of the Indian Society for the Study of Pain that aims to create standardized training for pain medicine. Asserting control over who can call themselves a pain medicine doctor in this fledgling industry is an urgent question. Spread across the subcontinent are nearly 10 million licensed physicians and a massive number of untrained medical providers. (In rural India, 70% of healthcare providers have no formal medical training.)

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A man carries boxes of medicines to a shop in Bhagirath Palaces pharmaceuticals market, Old Delhi, India. Photograph: Saumya Khandelwal/The Guardian

General practitioners have started prescribing these drugs, Dureja said. And were not educating the population on when to use and not to use.

At Durejas clinics, as at most medical offices in India, patients pay cash for services and prescriptions. Delhi Pain Management charges $10 for a consultation; $10 for a Johnson & Johnson fentanyl patch; $10 for a Mundipharma buprenorphine patch. Durejas office takes a 15% cut of sales.

There are hints of American pharmas fingerprints in a glass cabinet in the waiting room of his East Delhi clinic: awards from Johnson & Johnson honoring Dureja for symposia on pain management; a plaque for his valuable contribution as a speaker about tapentadol, an opioid marketed by Johnson & Johnson in 2009. The dispensing counter does a brisk business in Ultracet, branded tramadol tablets made by a Johnson & Johnson subsidiary.

Each year, some 20 fellows attend Kotharis three-to six-month training programs, and by his calculation, he has trained 150 aspiring pain doctors. There are more than 50 people who already have their pain clinics in different parts of India, he said.

Kothari remembers when only a few hospitals in Mumbai treated cancer patients and had access to opioids. But every year, we are accessing more of these kinds of drugs, he said. Many chemists, hospitals and medical shops started acquiring the licenses for keeping these drugs, and availability is much, much better. Opioids are available in not just oral, but injectable, patches, syrups.

Photo collage

Most large Indian hospitals have added pain management as a specialty in recent years. At the insistence of the professional societies that accredit hospitals in India, Kothari said, nurses and doctors now are required to assess pain as a fifth vital sign, along with pulse, temperature, breathing and blood pressure.

The pharmaceutical industry has kept pace. Twenty years ago only a few pharmaceutical companies marketed pain medicines in India, Kothari said. Today, almost every company is having pain management as a separate division.

A salesman for Sun Pharma, Indias largest drugmaker by sales, echoed the point during an interview in Chandigarh, the capital of Punjab and Haryana.

Now everyone has a car, and [they get] back pain, and now they take medication. Growing obesity rates in India were also fueling demand, he said, as patients look for relief from weight-related knee and back pain. So the market for pain is good.

Abbott Laboratories and Johnson & Johnson did not respond to requests for comment for this report.

Manmohan Singh, a vice-president at Modi-Mundipharma in New Delhi, said opioid pain medications are an important therapeutic option, especially for cancer pain. He also said company promotions stress that physicians should familiarize themselves with product safety information and the potential for adverse effects. Patients should be made aware of the clear treatment goals related to pain and function, as well as the potential opioid side effects and the potential for misuse, abuse and addiction, he said in a written statement.

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A man buys medicine from a shop at Bhagirath Palaces pharmaceuticals market in Old Delhi. Photograph: Saumya Khandelwal/The Guardian

One false step

The ascendance of pain management in India comes at a fortuitous political moment. Ahead of his reelection earlier this year, the prime minister, Narendra Modi, invested heavily in healthcare. Last fall, the Indian government launched the worlds biggest public health insurance program, called Ayushman Bharat. Dubbed Modicare, it guarantees half a billion poor Indians nearly $7,000 in hospital expenses, paid to private insurers, and, by 2020, the government is to open 150,000 primary care centers. The government has set aside $484m to fund Modis signature program.

None of this would have been possible without the loosening of Indias strict narcotics laws.

The International Narcotics Control Board, established in 1968, and the Narcotic Drugs and Psychotropic Substances Act of 1985 codified the bureaucratic thicket for any doctor who wanted to prescribe opioid painkillers. Physicians feared fines, jail sentences and losing their medical license if they skirted regulations.

Dr MR Rajagopal was a young medical student in Thiruvananthapuram at the time and remembers a neighbor with advanced cancer. I [had] seen him screaming his way over weeks to death, Rajagopal said. It was horrendous, and there was nothing being done about it. He chose to become an anesthesiologist because it was the only specialty then focused on pain.

Rajagopal is widely viewed as the father of palliative care in India; whispers of a Nobel prize follow him. For decades, he has worked assiduously to convince national and state lawmakers that opioid medicines are not an indulgence, but a humane refuge, and it is largely a function of his advocacy that morphine and other painkillers can be prescribed in India. Two generations of doctors had not seen a tablet of morphine, he said.

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Indias pain management industry promises countless new customers to US pharmaceutical companies facing mounting lawsuits back home. Photograph: Saumya Khandelwal/The Guardian

The Narcotic Drugs and Psychotropic Substances Act, as amended in 2014, recognized that the need for pain relief was an important obligation of the government. The revised law created a class of medicines called the essential narcotic drugs list, which includes morphine, fentanyl, methadone, oxycodone, codeine and hydrocodone.

Rajagopals days are filled with the tedious work of building a movement: speaking at colleges and public forums, penning editorials and medical papers about palliative care and overseeing Pallium India, a not-for-profit medical center and training institute that is singularly focused on palliative care.

Palliums pharmacy is a testament to Rajagopals persistence. Drugs once banned now fill the shelves: fentanyl injections and patches, oral morphine and, most recently, methadone, approved for pain relief in 2018.

Rajagopal seems aware that one false step would invite the government to clamp down on the availability of opioids, reversing decades of his work. He does not advise using oxycodone or hydrocodone, though they are included on the essential narcotic drugs list, and he does not accept funding from pharmaceutical companies, instead putting his hand out to temple trustees and donations from families cared for by Palliums home visiting teams.

But the pharmaceutical industry is a wily adversary. American activists made many of the same arguments decades ago as they sought relief for dying patients. Drugs now commonly prescribed for chronic pain were first approved for use by cancer patients. One of the first formulations of fentanyl, for example, was a lollipop because chemotherapy left cancer patients too nauseated to eat. In India, pain physicians now prescribe fentanyl patches to patients with chronic muscular pain.

Purdue Pharmas international affiliate, Mundipharma, is very good at co-opting regulators, said Keith Humphreys, a professor of psychiatry at Stanford University. As happened in the US, they are easily converted into useful idiots.

  • Coming tomorrow: The next opioid crisis? Addiction on the rise in India as US drugmakers push pain meds

  • Kaiser Health News (KHN) is a not-for-profit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation that is not affiliated with Kaiser Permanente.

Read more: https://www.theguardian.com/world/2019/aug/27/india-opioids-crisis-us-pain-narcotics

Illegal drug classifications are based on politics not science report

Global Commission on Drug Policy requires a reclassification of drugs consisting of heroin, marijuana and drug

Illegal drugs consisting of drug, heroin and marijuana ought to be reclassified to show a clinical evaluation of damage, according to a report by the Global Commission on Drug Policy.

The commission, that includes 14 previous presidents from nations such as Colombia, Mexico, Portugal and New Zealand, stated the global category system underpinning drug control is “prejudiced and irregular”.

A “deep-lying imbalance” in between enabling and managing compounds gain access to for medical functions had actually triggered “civilian casualties”, it stated. Such damage consisted of clients in low- and middle-income nations required to go through surgical treatment without anaesthetic, to go without necessary medications and to pass away in unneeded discomfort due to absence of opioid discomfort relief.

Other unfavorable effects were the spread of contagious illness, greater death and the worldwide jail overcrowding crisis, the report stated.

“The worldwide system to categorize drugs is at the core of the drug control program– and regrettably the core is rotten,” stated Ruth Dreifuss, previous president of Switzerland and chair of the commission. She required a “critique” of the category system, prioritising the function of the World Health Organization (WHO) and clinical research study in setting requirements based upon advantages and damages.

Restrictions on milder, less hazardous drugs need to likewise be loosened up, the commission stated, to consist of “other genuine usages”, consisting of conventional, social or spiritual usage.

Some controlled substances, consisting of drug, marijuana, heroin and marijuana resin, were examined as much as 30 years ago or have actually never ever been assessed, Dreifuss stated, which seriously weakens their worldwide control.

Asked whether these drugs need to be reclassified, Juan Manuel Santos, the previous president of Colombia, responded “yes”. “The clinical basis is non-existent,” Santos informed reporters at an online instruction to go over the commission’s report.

“It was a political choice. According to the research studies we’ve seen over previous years, compounds like marijuana are less damaging than alcohol,” he stated. “I originate from Colombia, most likely the nation that has actually paid the greatest rate for the war on drugs.”

After 50 years, the war on drugs has actually not been won, Santos stated. It had actually triggered “more damage, more damage” to the world than an useful method that would control the sale and usage of drugs in a “great way”.

The WHO approximated in 2011 that 83% of the world’s population resided in nations with non-existent or low access to opioid discomfort relief .

The commission’s current report checks out how “prejudiced” historic category of compounds, with its focus on restriction, has actually added to the world drug issue. Under the existing system, in location considering that 1961, choices on categorizing drugs are taken by the Commission on Narcotic Drugs (CND), a body of UN member specifies developed by the UN Economic and Social Council. The WHO Expert Committee on Drug Dependence offers suggestions to the CND. The suggestions are then voted on by the CND members, leaving them open to political choices.

Helen Clark, the previous prime minister of New Zealand, stated the WHO must make choices on drug category based upon health and health and wellbeing. More hazardous drugs would need a greater level of intervention, she stated.

“The worldwide neighborhood ought to acknowledge that the system is broken,” stated Clark. “They ought to acknowledge the disparities and it ought to set off an evaluation.”

Risk limits, such as those utilized for alcohol, ought to be utilized for controlled substances instead of the “outright preventive concept”, she stated.

The commission contacted the global neighborhood to move towards the legal guideline and usage of drugs. In January, the WHO identified the medical advantages of marijuana and suggested it be re classified world large .

Michel Kazatchkine, French doctor and previous executive director of the Global Fund to eliminate Aids, Tuberculosis and Malaria, stated that 75-80% of the international population do not have access to medications and “all of the factors are connected to repression and prohibition-based control systems”.

“These limiting policies under worldwide control have actually been hindering and are continuing to restrain medications that are not just required, however are on the WHO list of vital medications.”

He stated a “crisis of policy” in the United States had actually resulted in the “awful repercussions” of the opioid crisis, as an outcome of which 72,000 individuals passed away in 2017 .

“We require to think about these things with a fresh outlook,” stated Anand Grover, the previous unique UN rapporteur for health, India. “We can’t opt for the cultural predispositions of the west.”

Read more: https://www.theguardian.com/global-development/2019/jun/26/illegal-drugs-classifications-based-on-politics-not-science-cannabis-report-says

‘I don’t think I look like a stoner’: the women changing the face of the cannabis industry

US cannabis laws are slackening, and a number of enterprising women are tapping into female interest in the drug through magazines, cooking, health and fashion. Candice Pires reports

As weeds legal status loosens across the US, the way cannabis is being marketed, sold and celebrated is evolving. An industry that has been dominated by men is finding a female voice in consumers and new business owners. Search #womenofweed on Instagram and youll find a female chef drizzling cannabis oil on to a soup, and a woman relaxing in a rose-petalled bath with a spliff in hand. These are women who are celebrating cannabis as an important part of their lifestyles an aid to their health, as much as their creativity.

The legality of using cannabis differs from state to state (and within states) in the US. In California, youre able to possess an ounce if youre aged 21 or over. In Indiana, possessing any amount could land you up to 180 days in jail. (In the UK, being caught with cannabis in small doses comes with a fine or warning, but production and supply can lead to a prison sentence.)

Still, new business opportunities are emerging. There are now yoga retreats, workouts, day spas, parties, conferences all for women who like weed. One female artist is making gold-trimmed porcelain hash pipes that look more sculptural than functional. Whoopi Goldberg has started a line of cannabis products, including body balms and bath soaks, that help with PMT.

As the weed market continues to grow, women are shifting perceptions of the drug and its users. Stoner stereotypes are being knocked back and women are talking openly about the place weed has in their lives. Ideas of community and equitable access to the industry are held as highly as enjoyment of the leaf. And aesthetic representations are being made through a female lens.

Anja Charbonneau

Editor of womens weed magazine Broccoli

Anja
Women see Broccoli as an invitation to communicate about this really private part of their lives: Anja Charbonneau. Photograph: Jules Davies for the Observer

In Portland, Oregon, a city in one of the nine states to legalise recreational marijuana, Anja Charbonneau recently launched Broccoli (a slang term for the drug). Broccoli looks like a design publication and calls itself a magazine created by and for women who love cannabis. The cover of the first issue featured weed ikebana, where a stylist crafted cannabis leaves according to the rules of the ancient Japanese art of flower arranging. Inside issue two, Donisha Prendergast, granddaughter of Bob and Rita Marley, speaks about her grandparents legacy. And theres a photo story set in an imaginary cannabis dispensary for cats. Since Broccolis inception, other design-focused cannabis magazines have appeared.

The idea for Broccoli came from cannabis dispensaries and seeing the little stacks of free magazines. I noticed they were all for men, by men, Charbonneau explains. Last summer she decided to test her idea of creating a weed magazine for women. She began by speaking to other women who enjoyed cannabis, as well as women in the industry, asking if theyd be interested in a magazine aimed at them. I almost didnt have to ask, she says. As I was explaining what I wanted to do, I was met with this resounding, Yes! Please do that, we want it. She got together a couple of ex-colleagues from the slow-living lifestyle magazine Kinfolk: a writer she knew and an editor shed admired online. Because cannabis is so new as a legal industry, it feels like theres this opportunity to make womens voices heard while its being built and thats pretty much never, ever happened with any other industry.

Charbonneau has been receiving hundreds of messages of support from women sharing stories of their relationships with weed. It seems women felt like they didnt have permission to talk about this really private part of their lives, she says. Theyve seen Broccoli as an invitation to communicate about it, and theyre like, Let me tell you about my life. Its unlocked something.

Andrea Drummond

The marijuana chef

Andrea
I hope Im bringing some normalcy to cannabis: Andrea Drummond. Photograph: Amanda E Friedman for the Observer

Andrea Drummonds path into the cannabis industry was rocky. Despite her religious upbringing, she tried cannabis aged 12 or 13, but the experience made her uncomfortable and after getting into a fight with a friend, she ended up doing community service. That made me think that if you smoke marijuana, you end up in jail, she says.

For the bulk of her adult life, Drummond worked largely in roles advising kids to say no to drugs. But when she moved to California in her mid-30s, she looked at people around her and came to the conclusion that cannabis wasnt the gateway drug it had been touted as. I worked for a successful attorney who was an avid user and I became more open-minded.

At 37, Drummond decided to follow her passion to become a chef and signed up for Le Cordon Bleu culinary school, later honing her craft at top Los Angeles restaurants and starting her own catering company. One evening, a friend asked her to make him some brownies from leftover cannabis leaves. I took it on as a challenge, Drummond says. It smelled so beautiful and Im not really big on sweets so I thought, This wants to be something else. Drummond made a cannabis butter for bruschetta. It completely enhanced the flavour of the dish, she says. Another friend insisted Drummond needed to sell her creation. That night in 2012, while high on bruschetta, the trio hatched a plan to start a cannabis catering company: Elevation VIP Cooperative.

After obtaining a medical licence, they were able to serve anyone who held a California State Medical Marijuana ID Card, which werent difficult to acquire, but It wasnt received well, says Drummond. People were afraid and I was begging them to come for dinner at ridiculously low prices, like $30 a head for five courses. But Drummond kept at it, starting a side business in cannabis education to help people understand the plant better. For a while she was homeless and slept in her car. Then, one day, while working on the business from a Starbucks, she received a call from Netflix. They wanted her to cook for a documentary series called Chelsea Does, where host Chelsea Handler would be doing drugs. The exposure led to a flood of enquiries.

On a personal level, she started using cannabis to treat the sciatica shed developed while working in kitchens. I didnt want to take prescription drugs but there were times I was completely immobile, she says. But as soon as I tried cannabis I knew it was the alternative for me.

Last year Drummond published a cookery book, Cannabis Cuisine. I hope Im bringing some normalcy to cannabis with it, she says. I dont think I look like a stoner, she adds. Hopefully that helps normalise it, especially for other women.

Tsion Sunshine Lencho and Amber Senter

Supernova Women, marijuana advocacy organisation

Portrait
The plant can be used to heal our communities: Amber Senter, above right, with Tsion Sunshine Lencho of Supernova. Photograph: Winni Wintermeyer for the Observer

In Oakland, California, Amber Senter focuses daily on getting other women into the cannabis industry. Her own introduction to weed came via pain relief. As an adult, Senter was diagnosed with lupus, and credits smoking with alleviating sore joints and digestive issues. Her medical condition led her to research the plant extensively and gave her a career in the industry.

In 2015 Senter was working for a consulting firm that helps entrepreneurs apply for cannabis dispensary and cultivation permits. At a networking event she met Tsion Sunshine Lencho, an African-American, Stanford-educated lawyer who was looking for a job in the industry. Senter recruited Lencho and the two began working closely together. We noticed that the groups that we were writing applications for were all well-funded, all male and very white, she says. This is an industry that was built on the backs of black and brown people. We thought, Man, were gaining all this knowledge and essentially gentrifying our industry.

The pair decided to start Supernova Women, to help people in the black community get into the cannabis industry. They recruited two other women with existing cannabis-delivery businesses, Nina Parks and Andrea Unsworth, and the four now work in advocacy, education and networking, primarily for women of colour.

The biggest barrier to the cannabis industry is funding, says Senter. And all the people who know each other with money are white guys. Were teaching women of colour how to raise money and how to be good negotiators. The women we work with are equipped with the skills to run businesses they just dont have the resources or the pathways to money.

On 1 January 2018, cannabis went from being medically to recreationally legal in California. There is a finite number of dispensary licences available. Supernova is now working with city councils on equity legislation for creating licensing programmes that give priority and assistance to marginalised groups.

Ultimately, Supernova wants money made from the industry pumped back into the communities its affected. We dont just want people in the community becoming owners we also want to see the money reinvested in social programmes and education, says Senter. The plant can be used to heal our communities, she says, even though its been used to destroy them.

Harlee Case & Co

Ladies of Paradise, cannabis creative agency

Harlee
We want to help remove the stigma: Harlee Case, above left, with Jade Daniels, both of Ladies of Paradise. Photograph: Evie McShane for the Observer

Harlee Case started smoking behind her super-religious, strait-laced parents backs when she was 17. She had grown up around cannabis without knowing it. Her small hometown of Central Point in southern Oregon is surrounded by land and perfect cannabis-growing conditions. Now I understand why everyone had these big farms in their back yards, says the 26-year-old, and why people always had cash.

Case is one third of Ladies of Paradise, a women-in-cannabis blog and creative agency. The collective, which includes co-founder Jade Daniels, 30, and new recruit Leighana Martindale, 23, creates cannabis marketing for the female gaze.

Case and Daniels met three years ago. Danielss boyfriend was buying a cannabis farm in southern Oregon and the couple moved to work on it. Both Case and Daniels had fashion backgrounds and large online followings through their Instagram shops, which led them to collaborate on photography and styling.

Last autumn, working the harvest season on the farm and burnt out from their online work, they decided they wanted to redirect peoples eyes to the cannabis industry in a female-driven way, says Case. Our first idea was to spotlight women working in the industry by interviewing them about what theyre doing and styling them in a unique way. They took Danielss online jewellery shop, Ladies of Paradise, and set it off in a new direction. It felt risky and we lost a few followers, but most people were really up for it, says Daniels.

Having recruited Martindale, who had been managing a cannabis dispensary, the trio now work with small cannabis brands that want to bring a female perspective to their photography, styling and events. When a vape pen company approached the women for a revamp of their Instagram feed, the first thing Case decided had to go were the bong girls. Theyre all over the internet, she explains. Case, whos a photographer, likes to feature different types of women. Its about women being women. When we do boudoir stuff, its for us. Not men.

They are keen to broaden the appeal of cannabis among more women. Ideally, if youre my mum and youve never smoked cannabis, seeing a photo of a woman your age with a joint might make it seem less intimidating, says Case. We want to help remove the stigma.

Read more: https://www.theguardian.com/society/2018/aug/12/i-dont-think-i-look-like-a-stoner-the-women-changing-the-face-of-the-cannabis-industry

Is marijuana a medical miracle? The truth is, we still don’t know

Whats the evidence behind medical cannabis? While many attest to its healing powers, research into the full potential has long been legally restricted

Is marijuana a medical miracle? The truth is, we still don’t know

Is marijuana a medical miracle? The truth is, we still don’t know

Whats the evidence behind medical cannabis? While many attest to its healing powers, research into the full potential has long been legally restricted

Read more: https://www.theguardian.com/society/2018/jan/15/medical-marijuana-does-it-work-miracle-drug-evidence

Top 10 Most Abused Prescription Drugs

Kids, just say no to drugs. Welcome to WatchMojo.com, and today we’re counting down our picks, for the “Top 10 Most Abused Prescription Drugs”. For this list, we’re looking at pharmaceutical drugs that are often prescribed by doctors, but which are also sought-after on the black market. The rankings are based on how commonly they’re used for recreational purposes, and how dangerous they are. Please note: WatchMojo does not condone drug use. Dilaudid is an opioid class painkiller often prescribed by doctors for treating moderate to severe pain, as an alternative to morphine. In fact, it’s actually considered eight times stronger than morphine.

Recreationally, it’s used as a substitute for heroin, and, the preferred way to consume it, is intravenously, Where it produces a euphoric rush and enhances feelings of happiness. Users can often build a dependency and an addiction to Dilaudid, as many who abuse the drug feel rapid mood swings, and a need to increase their dosage. In 2008, there were over 14,000 deaths due to Dilaudid overdoses in the United States alone, and, with many abusers mixing Dilaudid with heroin or cocaine, the results can often be deadly. This muscle relaxant doesn’t have a reputation as one of the more dangerous prescription drugs, which is why, it’s so often abused. According to the National Survey on Drug Use and Health, over 3 million Americans have used Soma for recreational purposes, at some point in their lives. Because it’s addictive, it’s usually prescribed for short time use only. However, it often gets abused when people take it for longer than their doctor recommends, it’s also often mixed with alcohol and other drugs in order to enhance its effect. There are plenty of nicknames associated with common Soma combinations, including the “Soma Coma” which mixes it with a narcotic, codeine, or the “Holy Trinity”, which sees Soma blended with Vicodin and Xanax.

With over 40 million prescriptions per year in the US alone, this hypnotic drug is administered to help ease insomnia, and when used as recommended, it’s considered safe and non-addictive. Using more than the prescribed dose however, can cause dangerous results. Recreationally, Ambien is taken as a sedative with psychoactive qualities, and feelings of euphoria and tranquility, as well as an increased sex drive for some. Taken in large quantities, Ambien can lead to a fatal overdose.

However, most Ambien-related deaths are caused when it’s ingested with other sedative drugs or alcohol. While it’s most often taken orally in its traditional pill form, recreational users often snort it for quicker results. When it entered the market in the 1960’s, Valium quickly became the safe, miracle cure for anxiety and panic attacks, and, it was the highest selling drug from 1968 to 1982. However, by the 1970’s, doctors realized that Valium wasn’t harmless, as many patients were reporting problems with dependency and addiction.

Building a tolerance to the medication can be quick, and withdrawal from it can be very difficult. People who take Valium enjoy the feeling of mild euphoria, especially when used with other sedative drugs. When the Valium pill is ground into a powder and snort it, its effects are even quicker and more intense, while taking Valium with alcohol, can lead to deadly results. It’s one of the strongest opiates on the market, much stronger than morphine or heroin. Fentanyl (Fentanil) is administered or prescribed by doctors for breakthrough pain, which is pain that persists when a patient is already on a painkiller or anesthesia. It’s so strong, that if administered intravenously by someone who is not a doctor, overdose is a likely result.

When it’s prescribed to cancer patients to deal with pain, it comes in the form of a lollipop or a patch to prevent overdose, people who use Fentanyl feeling anesthetized, free of problems and concerns. But the euphoria doesn’t last long, and, you quickly build a tolerance to it, so you need higher and higher dosages to get the same effect, which can be lethal to abusers. Xanax is the number one prescribed psychiatric medication, and one of the most prescribed drugs in general in the United States.

More and more people are being prescribed Xanax, with nearly 50 million prescriptions in the US in 2013.. While it very rarely can be deadly by itself, it is highly addictive, especially when mixed with drugs or alcohol. A tolerance to the medication is built quickly, and abusers can become physically dependent on it, as it also has severe withdrawal symptoms, especially when someone stops taking it abruptly. According to the Substance Abuse and Mental Health Services Administration, the number of ER visits involving Xanax in the US, has significantly increased, with over 120,000 visits in 2011. The majority of the entries on this list are used by adults. However, this drug is almost exclusive to teens and… college-aged students. With properties similar to Ritalin (Methylphenidate), Adderall (amphetamine and dextroamphetamine) is a central nervous system stimulant, used to help people who have ADHD (Attention-deficit/hyperactivity disorder). And its on the rise according to IMS Health, has approximately 16 million prescriptions were written for stimulants like Adderall in 2012, which is triple the amount written in 2008.

By far the most common place to find Adderall being used recreationally is on college campuses, where students often use it, as a study drug. However, this drug isn’t just for students looking for an A, as many are using it to party and stay up late. There are plenty of dangers associated with Adderall, besides addiction, abusing it can lead to anxiety, depression, and seizures. Codeine is an opioid that is generally used to treat mild to moderate pain, recreationally, codeine produces feelings of euphoria and relaxation, but it’s much less intense than what’s experienced with heroin or morphine. Heroin users sometimes use codeine as a temporary substitute, when they’re unable to get their usual opiate. Another popular use for codeine is to take it, as part of a narco cocktail, also known as a “codeine-based cough syrup”, which is known as “Lean” (a.k.a Sizzurp, Purple Drank, Syrup). Misusing the drug, as well as mixing it with other substances, can be dangerous, causing seizures, respiratory depression, memory loss and…

Death from overdose. One of the most commonly prescribed opioids in the United States, Vicodin is a combination of hydrocodone and acetaminophen, used to treat moderate to severe pain. The hydrocodone properties of Vicodin make it highly addictive, and prolonged use, requires an increase in dosage to get the same effect. Abuse of prescription opiates has increased dramatically in the United States, especially since it’s so highly prescribed, with 136 million prescriptions in 2013, according to the Drug Enforcement Administration.

Experts believe that the recent increase in heroin use, is due in part to the large number of people who become addicted to opioids, such as Vicodin. And then… graduate to heroin. Before we unveil our number one pick, here are some honorable mentions. (a.k.a. Acetaminophen and Oxycodone) This pain relieving prescription opioid is… extra powerful, but extra dangerous when abused. Unlike some of the other opioids on this list, OxyContin (a.k.a. OxyCotton), also known as “Oxy”; boosts higher amount of pain blockers, and… it’s controlled release tablet last a longer period of time, supposedly, 12 hours. Oxycodone is classified as a “Schedule II” drug, since it’s highly addictive, with extremely severe withdrawal symptoms.

When taken recreationally, it’s either taken orally, crushed and snorted, or diluted in water and injected intravenously. When a user builds a tolerance to their dosage they start taking more, which starts a dangerous, and sometimes deadly cycle. Do you agree with our list? What do you think is the most abused prescription drug? For more addictive Top 10’s published everyday, be sure to subscribe to WatchMojo.com..

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The truth about the US opioid crisis prescriptions arent the problem | Marc Lewis

The overdose crisis is owned by illegal usage of drugs not those provided on prescription for clients in requirement, states neuroscientist and author Marc Lewis

T he news media is awash with hysteria about the opioid crisis (or opioid epidemic). Exactly what precisely are we talking about? If you Google “opioid crisis”, 9 times out of 10 the very first paragraph of whatever you’re checking out will report on death rates. That’s right, the overdose crisis.

For example, the lead short article on the “opioid crisis” on the United States National Institutes of Health site starts with this sentence: “Every day, more than 90 Americans pass away after overdosing on opioids.”

Is the opioid crisis the like the overdose crisis? No. One pertains to dependency rates, the other with death rates. And dependency rates aren’t increasing much, if at all, other than possibly amongst middle-class whites.

Let’s look a bit deeper.

The overdose crisis is apparent. I reported on a few of the data and triggers in the Guardian last July. I believe the most striking truth is that drug overdose is the leading cause of death for Americans under 50. Some individuals swallow, or (regularly) inject, more opioids than their body can manage, which triggers the breathing reflex to close down. Drug overdoses that consist of opioids (about 63%) are most typically triggered by a mix of drugs (or drugs and alcohol) and most typically consist of unlawful drugs (eg heroin). When prescription drugs are included, methadone and oxycontin are at the top of the list , and these drugs are infamously obtained and utilized illegally.

Yet the most bellicose reaction to the overdose crisis is that we should stop physicians from recommending opioids. Hmmm.

Yes, there has actually been a rise in the prescription of opioids in the United States over the previous 20 to 30 years (though prescription rates are presently reducing). This was a reaction to an underprescription crisis. Chronic and serious discomfort were grossly undertreated for the majority of the 20th century. Even clients passing away of cancer were delegated wriggle in discomfort up until prescription policies started to reduce in the 70s and 80s. The cause? An opioid scare project very little various from exactly what’s taking place today. (See Dreamland by Sam Quinones for information.)

Certainly some medical professionals have actually been recommending opioids too kindly, and a couple of are encouraged entirely by revenue. That’s a small piece of the huge photo. A close relative of mine is a family practitioner in the United States. He and his coworkers are usually terrified (and upset) that they can be censured by licensing bodies for recommending opioids to individuals who require them. And with all the hassle in journalism today, the pockets of overprescription are quickly vanishing.

But the news media seldom trouble to compare the genuine prescription of opioids for discomfort and the diverting (or taking) of pain killer for illegal usage. The stats frequently reported are a hodge-podge. Take the very first sentence of a post on the CNN website published on 29 October: “Experts state the United States remains in the throes of an opioid epidemic, as more than 2 countless Americans have actually ended up being depending on or mistreated prescription pain killer and street drugs.”

First, why not clarify that the majority of the abuse of prescription pain killer is not by those for whom they’re recommended ? Amongst those for whom they are recommended, the beginning of dependency (which is typically short-term) has to do with 10% for those with a previous drug-use history, and less than 1% for those without any such history. Keep in mind likewise the oft-repeated maxim that most heroin users start on prescription opioids. A lot of scuba divers start as swimmers, however many swimmers do not end up being scuba divers.

Second, would not it be practical for the media to identify street drugs such as heroin from pain killer? We’re discussing drastically various groups of users.

Third, essentially all specialists concur that fentanyl and associated drugs are owning the overdose epidemic. These are lot of times more powerful than heroin and far more affordable, so drug dealerships typically utilize them to lace or change heroin. Since fentanyl is a manufactured pharmaceutical recommended for extreme discomfort, the media frequently explain it as a prescription pain reliever– nevertheless it reaches its users.

It’s extremely careless to disregard these differences then utilize “amount overall” stats to frighten physicians, policymakers and evaluation boards into badly restricting the prescription of pain killer.

By the method, if you were either addicted to opioids or required them severely for discomfort relief, exactly what would you do if your prescription was quickly ended? Heroin is now simpler to get than ever, partially since it’s readily available on the darknet and partially due to the fact that contemporary circulation networks work like independent cells instead of monolithic gangs– much more difficult to bust. And, obviously, increased need causes increased supply. Dependency and discomfort are both severe issues, severe sources of suffering. You ‘d attempt your finest to get relief in other places if you were affected with either and could not get assist from your physician. And your chances of overdosing would increase astronomically.

It’s physicians– not political leaders, reporters, or expert evaluation bodies– who are best geared up and inspired to choose exactly what their clients require, at exactly what dosages, for exactly what amount of times. And the huge bulk of medical professionals are diligent, ethical and accountable.

Addiction is not triggered by drug schedule. The plentiful schedule of alcohol does not turn all of us into alcoholics. No, dependency is triggered by mental (and financial) suffering, particularly in youth and teenage years (eg abuse, overlook, and other terrible experiences), as exposed by huge connections in between unfavorable youth experiences and later on compound usage. The United States is at or near the bottom of the industrialized world in its record on kid well-being and kid hardship. No surprise there’s a dependency issue. And how simple it is to blame medical professionals for triggering it.

Marc Lewis is a neuroscientist and author on dependency

Read more: https://www.theguardian.com/commentisfree/2017/nov/07/truth-us-opioid-crisis-too-easy-blame-doctors-not-prescriptions

The U.S. Opioid Crisis Hits Tasmanias Poppy Farmers

Glynn Williams, a fifth-generation Australian farmer, is feeling the effect of a public health crisis unfolding 8,000 miles away. His household plants potatoes and raises livestock on Tasmania &#x 2019; s wind-swept northwest. Williams, 48, likewise grows poppies, the plants that produce the raw opiate in such prescription drugs as&#xA 0; oxycodone, &#xA 0; which are blamed for &#xA 0; an &#xA 0; epidemic &#xA 0; of overdose deaths in the United States

With the United States enforcing more stringent guidelines on making use of &#xA 0; pain relievers, need for the raw product has actually toppled. Poppy growers in Tasmania &#xA 0; have actually reacted by downsizing or quiting on the crop completely. &#xA 0; The state is the source of about half of international &#xA 0; supply, thanks to a 1971 contract with the Commonwealth of Australia &#xA 0; that gave it &#xA 0; a decades-long monopoly on poppy growing.

Six years earlier, poppies covered about &#xA 0; a sixth of Williams &#x 2019; s 255-hectare( 630-acre )farm. In 2015 &#xA 0; he planted some 14 hectares of the pink-flowering crop and has actually called that back to about 10 hectares this season. &#xA 0; &#x 201C; We &#x 2019; ve stated, &#xA 0; &#x 2018; No,we can &#x 2019; t pay for to take the danger, &#x 2019; &#x 201D; he states. &#x 201C; We &#x 2019; ve needed to recalibrate our farm substantially. &#x 201D;

Tasmanian farmers like Williams are reeling from the effect of federal government and business&#xA 0; efforts &#xA 0; to stem the abuse of prescription pain relievers and their unlawful knockoffs. The volume of opioid-based medications recommended in the United States has actually dropped 28 percent considering that 2012 following relocations by the Drug Enforcement Agency to tighten up gain access to, inning accordance with a &#xA 0; report &#xA 0; released last month by Bloomberg Intelligence. &#xA 0; &#x 201C; The prescription branded-opioid market is at its floor in practically a years, &#x 201D; Bloomberg Intelligence experts &#xA 0; Curt Wanek &#xA 0; and &#xA 0; Elizabeth Krutoholow &#xA 0; composed.

Poppy seeds all set for planting in Launceston, Tasmania.
Photographer: Christina Simons/NYTNS

On Sept. 21,&#xA 0; CVS Health Corp. , among the biggest pharmacy chains in the United States, revealed&#xA 0; a series of steps targeting opioid abuse, consisting of a brand-new seven-day limitation&#xA 0; for specific prescriptions of the addicting drugs. Containing&#xA 0; 5 percent of the world &#x 2019; s population, the United States takes in a projected&#xA 0; 80 percent &#xA 0; of the world&#x 2019; s opioids, &#xA 0; Angus Deaton, a British-American economic expert and 2015 Nobel laureate, informed a Senate committee in June.

Thebaine &#x 2014; drawn out from poppy straw &#x 2014; is the primary opiate alkaloid in oxycodone, and Australia is its biggest manufacturer, representing 80 percent of worldwide supply in 2015, inning accordance with the most current information from the International Narcotics Control Board, a firm that keeps track of compliance with United Nations conventions on drugs. Australia &#x 2019; s production of poppy straw&#xA 0; plunged to 172 loads in 2015, from 268 heaps a year previously.

Tasmanian farmers will plant about 12,000 hectares of poppies this season, less than half the 2013 harvest of about 28,000 hectares, inning accordance with&#xA 0; Poppy Growers Tasmania Inc. , a trade group that represents about 90 percent of the state &#x 2019; s manufacturers. The&#xA 0; decrease shows a high drop in exactly what processing business want to pay: The crop gathered in January and February of this year deserved about A$ 35 million ($27 million) at the farm gate, compared to about A$ 100 million after&#xA 0; the 2013 harvest.

&#x 201C; Growers are now taking a look at the cost decreases and asking whether it &#x 2019; s a practical operation, &#x 201D; states&#xA 0; Keith Rice, ceo of Poppy Growers Tasmania, which approximates its subscription has actually been up to about 450 from 850 in 2013. He decreased to state what does it cost? his members normally get for their crop.

Tasmania is dealing with more competitors: Three states on the Australian mainland have actually alleviated limitations on poppy growing recently. Farmers such as&#xA 0; Williams are likewise needing to compete with modifications along the supply chain, as 2 of the nation &#x 2019; s 3 certified poppy processors have actually gone through ownership modifications over the last few years.&#xA 0; GlaxoSmithKline Plc &#xA 0; offered its service to Sun Pharmaceutical Industries Ltd. , India &#x 2019; s biggest drugmaker,&#xA 0; in 2015. &#xA 0; SK Capital Partners LP , a New York-based personal equity company, purchased&#xA 0; Johnson &&Johnson &#x 2019; s Tasmanian Alkaloids subsidiary in 2015. Costs were not divulged in either deal.

An alerting indication at a poppy field in Tasmania.
Photograph: Age Fotostock/Alamy

Sun Pharma decreased to discuss prepare for its opiates service. Tasmanian Alkaloids states it &#x 2019; s checking out options to opiates. In May, it formed a collaboration with&#xA 0; AusCann Group Holdings Ltd. , a medical cannabis business from Adelaide, in South Australia, to disperse and produce marijuana items.&#xA 0; &#x 201C; Demand has actually softened, however Tasmanian Alkaloids is a varied business that likewise offers non-controlled ended up products &#x 201D; such as products that are utilized to make treatments for conditions aside from discomfort, consisting of weight problems and irregularity, stated Managing Director Doug Blackaby&#xA 0; in an emailed action to concerns. &#x 201C; We are actively taking a look at various chances to diversify our client and item variety. &#x 201D;

The tiniest Australian poppy processor, Melbourne-based&#xA 0; TPI Enterprises Ltd. , likewise is&#xA 0; thinking about moving into cannabis: It was just recently given licenses by&#xA 0; Australia &#x 2019; s Department of Health for medical marijuana growing and research study.

The business isn &#x 2019; t quiting on opioids, however.&#xA 0; On Oct. 3 &#xA 0; it finished theacquisition of the &#xA 0; opiate components and tablets company of Norway &#x 2019; s Vistin Pharma ASA for A$ 25.6 million. The only Australian-based processor that &#x 2019; s openly traded, TPI will have earnings of A$ 48.9 million in the year ending Dec. 31, 2018, inning accordance with expert price quotes assembled by Bloomberg, up from A$ 10.5 million in 2016. Handling Director Jarrod Ritchie states that in spite of the opioid reaction in the&#xA 0; U.S., business like his still have space to grow.&#xA 0; &#x 201C; Ninety percent of the world &#x 2019; s population doesn &#x 2019; t get access to the most inexpensive discomfort relief item, which is morphine, &#x 201D; he states.&#xA 0;

As they wait on a rebound in need, Tasmania &#x 2019; s poppy farmers have to concentrate on ending up being more effective, inning accordance with Rice of Poppy Growers Tasmania. Some growers have actually handled to increase their yields to approximately about 40 kgs of active basic material per hectare, up from 25 kgs 5 years back. &#x 201C; It is a truly, truly hard market out there, and it doesn &#x 2019; t appear like it &#x 2019; s enhancing, &#x 201D; he states. &#x 201C; The only thing at today time to make it practical is increasing efficiency. That &#x 2019; s the message we &#x 2019; re providing our individuals. &#x 201D;

    Read more: http://www.bloomberg.com/news/articles/2017-10-24/the-u-s-opioid-crisis-hits-tasmania-s-poppy-farmers

    One drug dealer, two corrupt cops and a risky FBI sting

    The long read: Davon Mayer was a smalltime dealer in west Baltimore who made an illicit deal with local police. When they turned on him, he decided to get out but escaping that life would not prove as easy as falling into it

    On a humid summer day in 2004, Davon Mayer stepped out of his house on Bennett Place in the heart of Baltimore. Sixteen years old, Davon was short, plump and baby-faced, still more of a kid than an adolescent. Like many other boys in his neighbourhood, he had long since stopped going to school and was dealing drugs full-time.

    On any other day, Davon would have been busy by this hour, trading vials of crack for cash on the pavement, keeping an eye out for the police. But this morning, he was on his way to meet with a narcotics detective named William King. Weeks earlier, the detective had arrested Davon after catching him selling drugs. He had taken Davon to the police station and then let him go, asking that Davon call him. When Davon failed to call, King had paid him a visit to let him know he wasnt playing around.

    As Davon walked to a nearby strip mall where King had arranged to meet, his mind was weighed down by anxiety. What could a city detective possibly want from a small-time drug dealer such as himself? The only answer Davon could think of was that King wanted him to become an informant. The more Davon dwelled on that possibility, the more panicked he got. Where he came from, there was nothing worse than helping the police. To snitch on fellow drug dealers was to invite death.

    He got to the malls parking lot and saw Kings pickup truck. King was sitting behind the wheel, dressed in sweatpants and a T-shirt. He asked Davon to get in the back seat and turned on the engine. I have been watching you, King said, as they drove around. I like the way you do business.


    Growing up, Davons parents werent around much. His father, Marvin Bunk Nutter, spent much of his sons childhood in jail on robbery and murder charges. Davons mother, Tonya, spent some of those years in jail, too, for drug possession, and the rest on the streets, sustaining her crack addiction with prostitution. Davon reserved the word Ma for his grandmother, Norma, who had raised him, along with his sister and a cousin.

    Norma was a small woman with a big presence, a matriarch to the entire block. She had fought her own battle with drug addiction when she was younger; at one point, her kids had been taken away by social services. When she finally overcame her addiction, she committed herself to discipline and order, toiling from morning till night to take care of her husband, a factory worker, and three grandkids. The entire block could be dirty and dishevelled but the front of 947 Bennett Place was always spick and span.

    What Davon didnt know at the time was that Norma couldnt remain insulated from the world of drug dealing herself. Even though her husband earned enough for her to be able to feed and clothe the kids, she struggled to find the money to take care of their wants toys for Christmas, gifts on birthdays, an occasional afternoon out to the movies. And so she had to make a few bucks on her own. There were drug dealers in the neighbourhood who trusted Norma to keep their money safe for them, to provide a place where it wouldnt be stolen or discovered in a police raid. Dealers usually paid her a small amount for the service.

    Davon
    Davon Mayers old neighborhood in west Baltimore. Photograph: JM Giordano for the Guardian

    Despite Normas best efforts, by the time Davon was about 11, he began to feel the pull of the drug business. He was growing more and more conscious of all the things he wanted that his grandmother couldnt give him. All the boys he knew in the neighbourhood seemed to own a pair of Nike Air Jordan sneakers, but not even in his wildest dreams could he ask Norma for the $100 it would cost to buy a pair.

    Davon told a friend, AC, who worked for a dealer in west Baltimore, that he wanted to make some money. One morning, AC took Davon to see one of the dealers men, LJ, outside a row of apartment buildings on Pennsylvania Avenue. Davon felt himself trembling a little as LJ looked him over from head to toe. Then he handed Davon a sandwich bag with 50 vials of crack, each capped with a purple top.

    Davon slid the pack of vials into his pocket as LJ and AC walked off. He stood nervously in the fenced passageway leading to the door of the apartment building, wondering what he would do if the cops came. Minutes later, a young woman with a sickly pallor came out of the apartment building; recognising him right away as the seller, she asked him for a vial. After Davon had sold to her, he turned around to find a crowd of at least a dozen other buyers waiting on the sidewalk. The pack was gone within minutes.

    LJ gave him another pack, which Davon dispensed with in short order. At the end of his first days work, Davon had $750 in dollar bills. It was more cash than he had seen before. He was allowed to keep $75. Walking back to Bennett Place, Davon felt a sense of exhilaration.

    Over the summer, as Davons shoebox savings grew, he couldnt resist the Jordans, deluding himself that they would somehow escape notice at home. But one night, when he was sitting in the living room talking on the phone, his mother Tonya overheard him bragging about the sneakers.

    Davon, where did you get these shoes from? Tonya asked him.

    I got them from Bunk, he answered, without skipping a beat. His father had got out of jail the previous year, and came around every few days.

    Tonya didnt believe him. She called Bunk, and he came over the next day to take the shoes away and give Davon a beating. He warned Davon to stay off the streets. But Davon was back on Pennsylvania Avenue the very next day. He was hooked on the money he was making. A few weeks later, he packed up his things and left home.


    As he built up a reputation for hard work, Davons boss gave him more drugs to sell and his earnings went up to more than $500 a day. He had moved into the apartment building where hed been selling drugs, living with an addict named Lisa who let him stay in a spare bedroom in exchange for her daily fix of crack. At night, he would lie on the floor of his bare room, longing for the comfort of the bed he had left behind at Normas house. Sometimes, staring out of the window, he would feel so overcome by loneliness that he would break down and cry.

    One afternoon in August 2000, Davon was caught selling drugs by police. He felt a tingle of excitement as he was marched into a police van. He would finally be able to brag about having been to jail. The price of this glory would be minimal, too: as a minor, he expected to be let off lightly.

    Davon was released later that day, returning home with his mother. Over the next few days, he mulled over whether to return to Pennsylvania Avenue. He didnt want to go to prison and decided he was better off going to school, which was about to reopen after the summer break. He was also concerned about Norma, who had been diagnosed with breast cancer.

    From the very first day of school, Davon felt a restlessness that quickly transformed into a yearning for his old life. At school, the popular kids were much better dressed than he was. The girls he liked paid him no attention. Davon felt he had taken a big step down in status.

    Police
    Police on patrol in Baltimore. Photograph: Rob Carr/AP

    Frustrated, he decided to dip his toe back into the drug business. After school let out in the afternoon, he would go over to a street three blocks from Bennett Place and hustle for a couple of hours before coming home. By the winter, he had saved enough money to buy his first car, an old Grand Marquis. He didnt want Tonya or Norma to see it, so he parked it a few blocks away and walked the rest of the way home.

    Throughout the summer and autumn of 2001, Normas health worsened. She would spend most of her time in bed. One day in November, after Davon had started in 10th grade, he went into Normas bedroom to check on her. She looked like she was napping, but he touched her, and she was cold.

    Two years later, Davon lost another family member, when his father was shot in a revenge killing. That night, for the first time in his life, Davon got drunk. Sitting by himself, he wept uncontrollably, although he would never quite understand why he felt so much grief over the loss of a father who had barely been present in his life.

    By this point, Davon had long since quit school and his drug-dealing career was taking off. He had seen smalltime dealers in his neighbourhood remain stuck at the bottom of the pyramid, and he hustled day and night to move up. Once he realised there was more money to be made from selling heroin than crack, he branched out into a neighbourhood west of Bennett Place. He was making more than $1,500 a day.


    When Davon was arrested and let off by the narcotics detective William King in the summer of 2004, he had no idea what King wanted. Now, weeks later, sitting in the back of Kings pickup truck, he silently took in Kings compliment on how he did business, trying to divine Kings intentions. He wasnt used to hearing praise from a cop.

    Softly spoken and reserved, King did not have the kind of intimidating presence that some of his colleagues did. But after joining Baltimores narcotics squad in the late 1990s, he had quickly gained respect for his skill at cultivating informants and collecting intelligence. King usually worked with a partner named Antonio Murray, who was shorter and stockier in physique, and more aggressive. The duo were feared by drug dealers, who knew that King and Murray didnt mind bending the rules if it suited them.

    After driving around for a few minutes, going nowhere in particular, King finally came to the point. If Davon could tell him where other dealers in the area were hiding their stash, he would raid them. So far, it sounded exactly like what Davon had been worrying about the detective wanted him to be an informant. But King went on. After the raids, he would turn only some of the confiscated drugs over to the authorities. The rest he would sell to Davon wholesale, at a price significantly lower than the market rate.

    Davon studied Kings face in the rear view mirror. Was this a set up? He saw nothing in Kings expression to make him doubt that the proposition was serious. As the seconds passed, Davon was overcome with the giddy realisation that if this arrangement actually worked out, it could catapult him into the stratosphere of Baltimores drug trade.

    Absolutely, Davon said finally. Absolutely.

    A few days later, Davon got a phone call from King telling him to come to the parking lot of a McDonalds in east Baltimore. When Davon arrived, he recognised Kings black SUV. He had expected King to be alone but his partner, Murray, was in the car, too.

    In the back of the truck were four or five boxes, filled with plastic bags of marijuana. There were four different grades, King told him, 5kg (12lb) in all. King wanted to know if Davon could take the marijuana and wholesale it.

    Ive got to advertise it first, Davon said. Ill need a sample.

    Davon left the parking lot with four Ziploc bags containing the different kinds of weed, and told King that he would call him. He met with a dealer in his neighbourhood, and they settled on a price of $12,000 for all of it. A couple of days later, the dealer brought the cash over to Davons house, handing it to him in the presence of Tonya, who had long given up on trying to stop her son from selling drugs.

    Once again, Davon met King and Murray at the McDonalds. He had negotiated them down to a purchase price of $7,000 for the drugs. Davon transferred the boxes from the back of the SUV into his car, and drove out of the parking lot, experiencing a sense of security he had never imagined he would feel under the gaze of two police officers.

    Davon
    Davon Mayer between the business centre and the Rite Aid where he met Detective King for the first time. Photograph: JM Giordano for the Guardian

    In the weeks following the marijuana deal, King began calling Davon every few days. They would meet at the Rite Aide parking lot, across from the western district police station. King would hand Davon whatever drugs he and Murray had confiscated typically crack or heroin, occasionally marijuana. Davon would take the drugs back to Bennett Place or Pennsylvania Avenue and offload them as quickly as he could.

    Davon could usually guess who King and Murray had seized particular batches from. He had been in the business long enough to know which dealers were selling what line of vials the red tops, purple tops, green tops, blue tops. To reduce the risk of being linked to King and Murray, Davon would repackage the drugs before selling them.

    Once the drugs were sold, he would text King to let him know that he was coming over to deliver the money. Within weeks, both of them had got so comfortable with the arrangement that there were times when they didnt even meet in person. Davon would simply walk over to the parking lot, get into the unlocked SUV and drop off money for King, or collect the drugs King had left for him while King worked his shift at the police station less than 200 yards away.


    King was not a man of expensive tastes, but he was bad at managing his money. By the middle of 2004, even with the cash that was rolling in from the secret venture that he and Murray were running on the side, King fell behind on the monthly payment toward his SUV. By comparison, Davons finances were remarkably robust. He sensed an undertone of jealousy in the comments King made when he showed up wearing a new shirt or a new pair of shoes. Somebodys looking good these days, King would say.

    Toward the end of the summer, King became desperate to make more money. He and Murray were not having as much luck as before in making seizures, as their raids had already put some smaller dealers, the softer targets, out of business. They began to turn up the heat on Davon, secretly keeping track of who he was meeting with. They often showed him pictures of dealers that they knew to be among his friends and associates.

    Do you know this guy? King asked one day about a particular dealer.

    Yeah, Davon answered uneasily.

    Well, I want him, King said.

    I cant help you with that, Davon replied.

    Well, when they go down, youll go down with them. And we cant do nothing to help you, King told him.

    Davon had entered into the partnership believing it was a deal between equals. The veiled threats from King broke that illusion. The difference between a drug dealer like himself and a pair of drug-dealing cops, he realised, was that they could operate with impunity where he couldnt. When King and Murray began actively targeting Davons friends in the drug world, he interpreted it as a warning.

    Things were about to get worse. One autumn evening, police picked Davon up as part of a street sweep operation a few blocks from Bennett Place. He was taken to the western district police station, where he found himself in an interrogation room with King. The detective looked at him with an even gaze, as if he were facing a stranger.

    You want to stop yourself from going down with the others? King asked. You will tell us who the bosses are. Tell us whos who here and whats going on.

    I cant help you with that, Davon said.

    Davon was released without charge, but Kings threat could not have been any clearer.

    When he got home, Davon began looking for a way to overcome the sense of powerlessness he had experienced. Not long after, he looked up the website for the FBIs Baltimore field office. Over the following days, he called the number a few times but always hung up at the last minute, worried about the possible consequences for himself if he reported the matter to the FBI. Turning it over in his mind, he finally concluded that the legal risk he faced would be minimal because he was 17 still a minor.

    He called the number again. This time, he didnt hang up.


    One day in November, Davon approached a silver Buick parked in Lexington Terrace, a neighbourhood of housing projects and row houses similar to his own. A tall FBI agent named Richard Wolf was sitting inside with a colleague, the only two white faces on the street. Davon glanced at them through the window and climbed on to the back seat.

    Davon told the agents how he had been recruited by King and what he had been doing for the cop since the summer. Wolf wanted to know why he had decided to turn on his former partners. I dont trust King, Davon said. He was worried that the detective could put him in jail whenever he pleased, if Davon didnt do his bidding. And there was another reason he had contacted the FBI, he explained. He wanted to get out of selling drugs for the sake of his newborn daughter. Becoming an informant, he reasoned, could give him a safe exit from the world of dealing.

    Wolf was struck by how self-assured Davon was. As a special agent, he knew it often took some coaxing to help whistleblowers and informants overcome their nervousness. But Davon didnt seem nervous at all. Wolf proceeded to lay down a condition: Davon would be paid to help the FBI develop a case against King and Murray, but he would have to stop hustling. If he got caught dealing drugs while working as an informant, he could face federal charges. Davon nodded.

    Every year, the FBI investigates dozens of complaints of corruption by public employees. Since turf battles between the FBI and local law enforcement agencies around the country are not uncommon, federal agents tasked with investigating police officers have to be especially careful about pursuing charges of wrongdoing, lest they be perceived as pushing a hidden political agenda. The agents must also restrict knowledge of their investigation to an unusually small circle, since a cop, especially a guilty one, would be more likely to sniff out an ongoing probe and move to cover their tracks. Wolf, who was joined by a fellow agent named Wendy Munoz, was keenly aware of these sensitivities as he followed up on the information Davon had provided.

    The first step toward building the case was to collect evidence of a drug deal between King and Davon. It was Davon who came up with the plan. He would tip King off to a stash of crack hidden in an alley off Bennett Place, enabling King to confiscate the stash and give it to Davon to sell. But this time the crack would have to be fake, since the FBI couldnt knowingly allow real drugs to be exchanged for money.

    Through a Baltimore police sergeant, Wolf got hold of a recipe for baking a fake crack pie, which involved mixing Anbesol, the pain-relief medication, with baking soda and water, and heating it in the microwave. The resulting product was meant to have the yellowish colour and the grainy texture of crack. But when Wolf and Munoz attempted the recipe, in the FBIs office kitchen, the results left something to be desired. What they had made looked nothing like crack.

    Wolf called the sergeant again to tell him, with some embarrassment, that the recipe hadnt worked. The sergeant gave him an easier alternative: macadamia nuts. Wolf went out and bought a bag of macadamias from the store, and Munoz spent hours splitting them into slivers with her fingernails. The agents made up 160 yellow plastic baggies and showed them to Davon, who gave his enthusiastic approval. In casual handling, he said, the bags could easily pass off as the real thing.

    Drugs
    Drugs and cash seized by Baltimore police. Photograph: Rob Carr/AP

    A week later, on 30 December 2004, the agents met Davon again. He put the bags of fake crack in a McDonalds paper bag and stashed it in the alley. At 11.50am, King parked his car near Bennett Place, entered the alley and phoned Davon, who guided him to the stash. Davon and the agents heard rustling noises as King searched. I got it, he said, finally. I got it.

    Shortly after noon, Davon walked over from Wolfs car to meet King at the Rite Aid parking lot, across from the police station. In his trouser pocket was a digital recorder. King handed him the McDonalds bag. He wanted the crack sold as quickly as possible. Need some money, King said.

    A few hours later, Davon met up with the agents again and gave them the bag. Wolf gave him $750, all in crumpled singles and five- and 10-dollar bills, as would be expected if the money had come from peddling crack on the street. Near the bottom of each bill, Wolf had scribbled his initials RJW with an ultraviolet pen. Davon gave King another call.

    I got that dough, he said.

    You for real? King said, surprised that the crack had sold so quickly.

    The shit jumped off, Davon said.

    Minutes later, he met up with King and delivered the cash.

    By mid-February, the FBI had received court authorisation to tap King and Murrays phones. From the calls, the FBI agents could deduce that the detectives were forcing dealers they nabbed into their vehicle and, after talking to them, letting them out. But Wolf and Munoz had no evidence of what was transpiring inside the Chevrolet Lumina. They needed a microphone in the car.

    One night in late March, after King and Murray had ended their shift, leaving the Lumina in the Rite Aid parking lot by the police station, FBI agents drove up in an identical Lumina and parked it next to King and Murrays vehicle. Next, they swiftly unlocked King and Murrays and drove it away, leaving the decoy in place. To a casual observer inside the police station, which the agents knew was staffed 24 hours a day, nothing would have looked amiss. A couple of hours later, the agents brought King and Murrays car back to the lot now rigged with microphones and GPS trackers and drove away the stand-in car.

    Now the FBI began listening in on conversations King and Murray were having with dealers picked up from the street. Some of the dealers appeared to know what to expect, thanks to the reputation the cops had earned. Threatened with arrest, the dealers surrendered their cash and drugs meekly, sometimes pleading to get a few dollars back.

    By early May 2005, Wolf and Munoz along with other officials were convinced they had enough evidence to wrap up the investigation. Later that month, the FBI invited King and Murrays squad to their office for a meeting whose stated goal was to form a taskforce aimed at fighting drugs in Baltimore. As soon as King and Murray got there, agents put them in handcuffs and informed them that they were being arrested on federal drug charges. In separate interviews with the two men, agents played back recordings of the some of the incriminating phone calls. King listened, crestfallen. I really think I should have my attorney, he said, nervously. Dont you think I should have my attorney?


    When the case went to trial in March 2006, Davon was one of the first witnesses to take the stand. King and Murray watched from across the courtroom as Davon described how their partnership began and what he did to enable the FBIs sting operation. Up to that moment, Davon hadnt shared the secret of his collaboration with anybody, not even his girlfriend, Keisha.

    After word got out about his appearance in court, the FBI moved Davon to a hotel in a suburb of Baltimore for his own safety. He got threatening phone calls. Keisha was stopped on the street by gang members. Tell him were going to kill him, they said. Even Tonya, who was still living at Bennett Place, was angry that her son had helped the feds. He had violated a sacrosanct rule of where he had grown up: you never work with the police, because law enforcement can never be your friend.

    As the trial proceeded, the evidence against King and Murray mounted. Since the duo were carrying police-issued guns while shaking down dealers for drugs and cash, the jury found them guilty on multiple counts of armed robbery, in addition to several other counts of extortion and possession of drugs with intent to distribute. The judge sentenced the men to a combined 454 years in prison.

    Throughout the investigation and the run-up to the trial, Davon had not thought much about what would happen after it was all over. He had vaguely imagined getting a lot more help from the government, taking his cue from movies in which the FBI relocated witnesses and bought them houses. The reality was somewhat different. After the trial ended, the FBI helped Davon to move into a rental apartment, giving him $1,500 to put down as a deposit. As the case was over, Wolf explained to Davon, the bureau could no longer justify paying him as an informant.

    He was now on his own, without much cash to support himself. At one point, he had made a substantial amount of money dealing drugs, but he had ultimately squandered it, and now had nothing to show for the drug-dealing career he had had: no house, car or significant savings.

    Davon
    Davon Mayer on the steps of his old home in west Baltimore Photograph: JM Giordano for the Guardian

    Davons girlfriend, Keisha, worked for the county government and had a daughter from a previous relationship. Davon didnt want to be financially dependent on her, and he eventually found work at a Wal-Mart, making $9 an hour unloading trucks at the stores warehouse. After all those years of making quick money, the backbreaking labour was an unpleasant dose of reality. The inside of the trucks felt like an oven. The Wal-Mart was more than 20 miles from where he lived, and since he no longer had a car, he had to pay an acquaintance a few dollars a day to take him to work. He had to ask Keisha to pick him up at the end of his shift. It felt humiliating. Of the $1,300 or so he made a month, more than $1,000 went toward paying rent and bills. How do people survive off of this? he asked Keisha.

    As the months passed, he felt his patience for this new way of life depleting. The only way out, Davon decided, was to get back into hustling. But he had no capital to invest and there was no way anybody would front him drugs.

    Bit by bit, he saved up a few hundred dollars. Then he called his grandfather, Ford, who reluctantly helped him re-establish contact with a couple of suppliers. Davon began selling to dealers who had bought from him before but didnt know his real name. Within weeks, he was back to making $300-$400 for work that took no more than a few minutes. Shortly after, he quit working at Wal-Mart. The job was slowing down the hustle, he told me.

    When the lease on his apartment ended, he moved in with Keisha, but he kept her in the dark about the extent to which he had resumed his drug dealing. The black hole had pulled him back in.

    In January 2009, Keisha and Davon had a baby girl, who they named Daylyn. Up until this point, Keisha had downplayed the consequences of his drug dealing in her mind, accepting it as something he simply couldnt get out of. But now, after having become the mother of his child, and after Davon had another close call with the police, she gave him an ultimatum. You have to make a choice, she said. The streets or family. You cant have both.

    Davon had already lost his grandmother Norma, and his mother had died earlier that year. The only family he had left was Keisha. He agreed to give up his drug dealing. Over the next year-and-a-half, Davon began making a small income by working at bars and giving haircuts on the side. He and Keisha divided the household expenses down the middle. The house was in Keishas name; Davon paid her a part of the mortgage in the form of rent. Then, one day in the fall of 2011, after weeks of growing increasingly distant and quiet, he told Keisha he didnt have the money that month.

    What happened to your paycheck? You just got paid, she asked. He admitted that he had given the money to a dealer, but the guy had been arrested. The money was gone.

    Keisha was furious. She was convinced that Davon was incapable of shaking his addiction to the easy money that drug dealing brought. Im not going to live like this anymore, she said. She told him he was going to have to find another place to live. Davon knew that it wasnt an empty threat. He had to make a lasting change.


    A week before Thanksgiving in 2011, I met up with Davon at a mall in Towson, Maryland, about 25 miles from Baltimore. I had made contact with him earlier that year after learning about the King and Murray investigation, which had left me wondering how things had turned out for him since. When I made my way through a throng of holiday shoppers into the restaurant, Davon rose from the table where he was seated with Keisha and Daylyn, and greeted me with a handshake, flashing a grin that revealed two gleaming gold teeth. Although he was nearing his 26th birthday, he still looked boyish.

    He described how poor he felt now every time he walked into a mall with Keisha. I used to spend $1,000 at a mall in the blink of an eye, he said. He ruminated about how things might have turned out if he had chosen to continue working with King and Murray instead of going to the FBI. I know if I had chosen to go down the path that I was on, and if I werent in jail right now, I would be at the top of the game, he told me. I would be untouchable right now.

    We stayed in touch over the following months, and in March 2012, Davon got a job with a company specialising in lead and asbestos abatement. The work was gruelling but Davon seemed happy. But keeping the past at bay had not been easy, he told me one day that spring when we met up for lunch at a mall in Columbia. Some of his old friends kept asking him to join them. I get offers all the time, he said. Because I still know guys who are pretty high up. They think that I know how to avoid a lot of stuff with the police. That I got some kind of deal. His bond with both his daughters had been growing stronger each day, he told me. Thats what kept him straight.

    Reporters are supposed to stay neutral about their subjects, but the more I got to know Davon, the more I slipped into the role of a supportive confidante. As we continued to meet over the next two years, I began rooting for his success, not least because I wanted to see his story end in redemption and hope rather than failure. He would call me every few weeks to share his dreams of starting his own business one day.

    When I was at the beach on Memorial Day weekend in 2013, he called me to tell me that his cousin and that cousins one-year-old child had been murdered in downtown Baltimore. He was immensely troubled by this news. A few months later, Keisha called me to tell me that Davon had suffered a panic attack. He had called her from the highway crying hysterically and saying that he was lost. He had managed to drive to the nearest hospital, which transferred him to a psychiatric ward.

    When Davon was released three days later, his mental health was still fragile. He often called me for support, and I worried that he would unravel. I urged him to look into college. He passed a test for admission into preparation classes for a high-school equivalency qualification from Baltimore City Community College. Davon was short of money, and despite knowing that I was about to breach the barrier that is supposed to always keep a reporter separate from his subject, I paid the $80 fee he needed to register in the fall.

    After he began attending class, he returned to his optimistic self. In December, I lent him $150 so that he could take his exams. He scored one of the highest in his class, and sent me a joyous text in January to say that he had been accepted into the ITT Technical Institute in Baltimore county to pursue an associate degree in network systems administration. While taking courses toward that degree over the next year, he began working as a contractor specialising in hooking up internet cables and other infrastructure for computer networks at government departments and private businesses. For the first time in his life, he had what he saw as a viable career.

    In our conversations over the past two years, during which Davon continued to thrive, we had occasion to reflect on his lifes arc. The endless hours he spent telling me about his childhood and teenage years appeared to have given him an understanding of his story that he had never had before an appreciation of the complex interplay between the circumstances he found himself in at various points in his life and the choices he had made along the way. He might not have become a drug dealer if he hadnt grown up on Bennett Place. Nor would he have considered giving up that career if circumstances hadnt led him to become an FBI informant. Yet, without Keisha to hold him to account and to a lesser extent, my desire to tell a story I had always imagined to be one of redemption he could have easily slipped back into the black hole. The more perspective he gained about his own journey, the more he realised how impossible it was for many with his kind of background to climb out of their situation.

    One morning not long ago, Davon took time out to give me a tour of his old neighbourhood. We walked down Bennett Place, past boarded-up houses. The sidewalks were deserted, and there were no signs of drug activity anywhere. We sat on the steps of a townhouse a couple of doors down from the one he had grown up in. It saddened him to think that there were so many like him on these streets who had suffered what he had but didnt have a way out.

    I hate it when people say you have a choice, he said. It angers me. What choice do you have when your mother is out prostituting herself to feed her drug habit and your father is out murdering people?

    We walked toward my car. He turned back to take another look at his grandfathers townhouse. Thats our house, he said. His plan was to buy it and turn it into a safe space for teenagers, off the streets. It would just be for the community, he said. You dont have a place to stay? You can come here. That would make my grandmother proud.

    Main photograph: JM Giordano for the Guardian

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    Read more: https://www.theguardian.com/news/2017/oct/19/one-drug-dealer-two-corrupt-cops-and-a-risky-fbi-sting

    More than 25 million people dying in agony without morphine every year

    Concern over illegal usage and dependency is putting morphine out of reach for countless clients internationally who require it for discomfort relief

    More than 25 million individuals, consisting of 2.5 million kids, pass away in pain every year all over the world, for desire of morphine or other palliative care, inning accordance with a significant examination.

    Poor individuals can not get discomfort relief in numerous nations of the world since their requirements are neglected or the authorities are so concerned about the possible illegal usage of addicting opioids that they will not permit their importation.

    “Staring into this gain access to void, one sees the depth of severe suffering in the vicious face of hardship and injustice,” states an unique report from a commission established by the Lancet medical journal .

    In Haiti, for example, states the report, there are no retirement home or hospices for the passing away and a lot of need to suffer without discomfort relief in the house.

    “Patients in discomfort from injury or malignancy are treated with medications like ibuprofen and acetaminophen,” states statement from Antonia P Eyssallenne of the University of Miami School of Medicine. “Moreover, nurses are unpleasant providing high dosages of narcotics even if bought to do so for worry of being “accountable” for the client’s death, even if the client is terminal.

    “Death in Haiti is harsh, raw, and devastatingly early. There is frequently no description, no compassion, and no peace, specifically for the bad.”

    A medical professional in Kerala, India, which has a palliative care service, informed of the arrival of a male in pain from lung cancer. “We put Mr S on morphine, to name a few things. A few hours later on, he surveyed himself with shock. He hoped neither had nor envisaged the possibility that this type of relief was possible,” stated Dr M R Rajagopal.

    But when he returned, morphine stocks were out. “Mr S informed us with external calm, ‘I will return next Wednesday. I will bring a piece of rope with me. If the tablets are still not here, I am going to hang myself from that tree’. He indicated the window. I thought he indicated exactly what he stated.”

    The commission’s three-year questions discovered that almost half of all deaths internationally– 25.5 million a year– include major suffering for desire of discomfort relief and palliative care. An additional 35.5 million individuals deal with persistent discomfort and distress. Of the 61 million overall, 5.3 million are kids. More than 80% of the suffering happens in middle-income and low nations.

    Jim Yong Kim, president of the World Bank, stated things needed to alter. “Failure of health systems in bad nations is a significant factor that clients require palliative care in the very first location. More than 90% of these kid deaths are from preventable causes. We can and will alter both these alarming scenarios.”

    Morphine is difficult to acquire in some nations and practically unobtainable in others. Mexico fulfills 36% of its requirement, China fulfills 16%, India 4% and Nigeria 0.2%. In a few of the world’s poorest nations, such as Haiti, Afghanistan and numerous nations in Africa, oral morphine in palliative care is essentially non-existent.

    Injectable and oral morphine runs out patent, however expenses differ extensively and it is more affordable in upscale nations like the USA than in bad nations. A 2nd concern is “opiophobia”– the worry that enabling the drugs to be utilized in health centers will cause dependency and criminal activity in the neighborhood.

    “The world suffers a terrible discomfort crisis: little to no access to morphine for 10s of countless grownups and kids in bad nations who pass away and live in avoidable and horrendous discomfort,” states Professor Felicia Knaul, co-chair of the commission from the University of Miami, calling it “among the world’s most striking oppressions”. When she was working to enhance access to cancer treatment in low-income nations, #peeee

    Knaul states she just understood that lots of individuals suffered without discomfort relief. “I was stunned. I had no concept. When individuals were revealing me the information I believed it cannot remain in this world,” she informed the Guardian.

    She had actually likewise experienced the requirement for morphine herself after a mastectomy for breast cancer. “When I awakened I could not breathe since the discomfort was so bad. If they had not gotten here with the morphine I do not know how I would have made it through it.” And as a girl in Mexico, she needed to view her daddy suffer as he passed away without discomfort relief.

    “I do not believe that we have actually cared enough about bad individuals who have discomfort,” she stated. “It does not make them live any longer. It does not make them more efficient. It is just the human right of not suffering anymore discomfort and we do not care about that for individuals who are bad.”

    The commission advises that nations put in location a fairly affordable bundle of efficient palliative look after end of life conditions that trigger suffering, consisting of HIV, cancers, cardiovascular disease, injuries and dementia.

    One of their most emphatic suggestions, states Knaul, “is that immediate-release, off-patent, morphine that can cost simply cents need to be offered in both injectable and oral solutions for any client with medical requirement. The variation and gain access to void in between the have-nots and haves is a medical, public health and ethical oppression that can be efficiently dealt with by the commission’s suggestions.”

    Read more: https://www.theguardian.com/science/2017/oct/12/more-than-25-million-people-dying-in-agony-without-morphine-every-year