Ben & Jerry’s announces plans to make CBD-infused ice-cream

Ice-cream maker to include cannabidiol to its items as quickly as it is legislated at the federal level

Usually individuals grab the ice-cream after consuming marijuana. Now hippie-capitalist ice-cream maker Ben &Jerry’s is wanting to speed the entire procedure up by producing CBD-infused ice-cream.

Long understood for stoner-hinting tastes such as Bonnaroo Buzz, Phish Food and Half Baked, the United States business’s choice to include CBD to its items as quickly as the plant extract is legislated at the federal level comes as the marketplace of cannabinoids-infused items has actually blown up over the previous a number of years.

CBD, brief for cannabidiol, is a chemical substance from the marijuana plant . Its fans declare it produces relaxation and calm, however unlike its cousin tetrahydrocannabinol (THC), CBD is not psychedelic and will not get a user high.

As its stands, the United States Food and Drug Administration (FDA) forbids including CBD to food and drinks, through the regulation is gently, if ever, imposed, and the regulative body has actually revealed a public hearing on the legalization on the problem for 31 May.

Ben &Jerry’s, which has actually sent discuss the problem, is motivating fans of its items to get in touch with the FDA throughout a public assessment duration on using CBD in food now through July.

The regulator has stated it prepares to utilize the general public remarks to notify a federal working group looking “to check out possible paths for traditional foods and/or dietary supplements including CBD to be legally marketed”.

According to the Unilever-owned business’s site, Ben &Jerry’s is checking out sustainably sourced CBD from Vermont, where the company has actually been based considering that its very first shop was opened in a refurbished gasoline station in Burlington in 1978.

The statement guides Ben &Jerry’s strongly into the most popular pattern in food. A current study released by the National Restaurant Association discovered that 3 in 4 chefs called CBD– and cannabis-infused food– as a hot pattern in 2019.

“We’re doing this for our fans,” stated Ben &Jerry’s CEO, Matthew McCarthy. “We’ve listened and brought them whatever from non-dairy extravagances to on-the-go parts with our Pint Slices. We desire like our fans more than they like us and we wish to provide what they’re searching for in an enjoyable, Ben &Jerry’s method.”

Efforts to reschedule CBD as a legal food supplement have actually been collecting speed as more states have actually legislated marijuana. Mostly stemmed from hemp, a close relative of the marijuana plant, CBD is ascribed a wide variety of health advantages, from enhanced sleep to minimized stress and anxiety and discomfort relief.

While scientific research studies stop working to support most declares for CBD, the political push to legislate remains in part in a response to the opiate dependency crisis that swept throughout the United States that has actually rendered health authorities rushing for palliative options, untried or nevertheless improbable.

New Frontier Data , a Denver-based analytics company that studies the marijuana market, approximates CBD item sales deserved $390m in 2018, a figure that might triple to more than $1.2 bn by 2022.

In December, Donald Trump legislated the growing of hemp, which had actually been noted as a Schedule I drug under the illegal drug act, that in turn set off a wave of financial investment, consisting of by the drug store giants Walgreens and CVS .

In a declaration in 2015, Coca-Cola stated while it had “no interest” in cannabis or marijuana, the business was “carefully seeing the development of non-psychoactive CBD as an active ingredient in practical health drinks all over the world. The area is progressing rapidly. No choices have actually been made at this time.”

Key to more growth of the hemp market depends upon how far the FDA is prepared to raise market limitations for the substance. That choice, in turn, will impact farmers, especially in states like Kentucky, much of whom have actually seen their organisations struck by Chinese tariffs on imports of soybeans and other fruit and vegetables.

Kentucky’s farming commissioner, Ryan Quarles, informed United States public radio he desires CBD to be noted as a dietary supplement due to the fact that of the increase it might offer to hemp farmers.

“We acknowledge the FDA has a large range of possibilities with what they can do with these items. We ask them not to control this growing market to death,” Quarles informed NPR this week.

Read more: https://www.theguardian.com/food/2019/may/30/ben-and-jerrys-cbd-ice-cream-legalized-federal-level

Why smelling good could come with a cost to health

Fruity, flower, musky from candle lights and cleansing items to creams, soaps, lipstick and perfume, we reside in a fragrant world. What is hiding in the air?

A bout 4,000 chemicals are presently utilized to scent items, however you will not discover any of them noted on a label. Scent formulas are thought about a “trade trick” and for that reason safeguarded from disclosure– even to producers or regulators. Rather, one word, scent, appears on components lists for many cosmetics, individual care and cleansing items. A single fragrance might consist of anywhere from 50 to 300 unique chemicals .

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“No state, international or federal authority is controling the security of scent chemicals,” states Janet Nudelman, policy director for Breast Cancer Prevention Partners (BCPP) and co-founder of the Campaign for Safe Cosmetics. “No state, worldwide or federal authority even understands which scent chemicals appear in which items.”

Three-quarters of the harmful chemicals discovered in a test of 140 items originated from scent, reported a 2018 BCPP research study of individual care and cleansing brand names. The chemicals determined were connected to persistent health problems, consisting of cancer.

“When we took a harder take a look at appeal and individual care items we discovered that numerous chemicals of issue were concealing under the word ‘scent’,” stated Nudelman.

While essentially all Americans are exposed to scent chemicals daily, ladies have a higher body problem, mainly from appeal and cosmetics items taken in through the skin. The typical American female utilizes 12-16 items a day, numerous consisting of scent.

Besides typical responses to scent– about 35% of individuals report migraines or breathing issues since of scent– health supporters have more major issues. Could scent chemicals, integrated with the other chemical mixed drinks discovered in life, be forming major illness patterns?

“There are chemicals in scents that do trigger [cancer and reproductive impacts], we understand this from animal research studies,” states Alexandra Scranton, director of Science and Research for Women’s Voices for the Earth (WVE), a ladies’s health not-for-profit. “Do individuals who utilize a great deal of scent get more cancer than those who do not? Nobody actually understands since nobody has actually taken a look at that.”

It smells great, however is it great for you?

More than 1,200 scent chemicals presently in usage have actually been flagged as recognized or prospective “chemicals of issue”, according to a 2018 report from WVE. These consist of 7 carcinogens, 15 chemicals forbidden from usage in cosmetics in the EU and others pointed out in different worldwide caution lists. Endocrine disrupters, which imitate human hormonal agents, are of specific issue to lots of scientists and supporters, as they can have impacts in the smallest dosages.

Proponents of the scent market– which is predicted to reach $92bn internationally by 2024– state that even if much of their components appear on harmful chemical lists, security come down to a concern of direct exposure. “The direct exposure to any specific scent active ingredient in an item is incredibly low– well listed below 1%,” a representative for the Fragrance Creators Association, the market’s primary trade company in North America, stated in an emailed declaration. “Fragrance components are not harmful based upon use.”

But Scranton mentions spaces in basic security screening, such as examining chemicals in seclusion and private direct exposure distinctions, as factor for a more preventive method.

“There are a great deal of unknowns– a lot of the toxicological research study is one chemical at a time. And we’re never ever exposed to one chemical at a time,” she stated, including: “Because there are numerous chemicals integrated, and you’re exposed over your life time, it amounts to something huge.”

The scent market, just like the more comprehensive cosmetics market, is mostly self-regulated. Given that 1966, the research study arm of the International Fragrance Association (IFRA), the leading international trade group has actually set voluntary safe usage requirements for chemicals. The Research Institute for Fragrance Materials (RIFM) has actually evaluated more than 1,500 active ingredients given that 2014, under a brand-new, more detailed evaluation system, with an objective to evaluate all 4,000 active ingredients in usage by 2021. (About 2,000 chemicals have actually been evaluated considering that the 1960s under less strict requirements.)

While RIFM states it utilizes conservative quotes based upon the leading 5% of users in customer studies, research studies have actually revealed large variations in direct exposure for so-called scent “incredibly users”. Specific artificial musk substances exist in concentrations as much as 10,000 times higher in super-users , compared to low-use cases, according to a 2007 research study by university scientists in Belgium. Artificial musks, a few of which are restricted by the IFRA, have actually been discovered in human tissue and breast milk.

There are likewise direct exposure distinctions throughout racial lines. Black females and kids have actually been discovered to have greater levels of endocrine-disrupting chemicals, which might be connected to direct exposure from hazardous chemicals in hair items. A 2018 research study by the Silent Spring Institute evaluating 6 kinds of African American hair items discovered 45 endocrine-disrupting or asthma-causing chemicals , with a scent marker called diethyl phthalate amongst the greatest concentrations. Greater chemical direct exposures, specifically at a young age, might be connected to specific health variations in between white and black ladies, some scientists think .

“Personal care items entirely aren’t viewed as a racial justice or an ecological justice problem, however things are affecting our neighborhoods daily in big methods,” states Marissa Chan, ecological research study and policy supervisor for Black Women for Wellness (BWW), a Los Angeles-based public health and ecological justice company. She includes that public opinion– and in some cases prejudiced policies at school or work — are an element pressing black ladies to utilize more appeal items usually.

“A mom is needing to resemble a chemist,” Chan stated. “It’s sadly our task and it should not be.”

What’s a concerned customer to do?

Trying to prevent scent chemicals is possibly among the trickiest contemporary customer obstacles. Even items identified as odorless might have some scent to mask the odor of other chemicals. Guard dogs likewise warn that even items declaring to be “natural” or “natural” might still be harboring damaging scents.

The California Toxic Fragrance Chemicals Right to Know Act is backed by customer health advocacy groups such as BWW, bcpp and wve. If passed, the costs would be the very first in the nation to need makers to report any harmful chemical utilized to taste or scent any individual care and cosmetic items offered in the state.

At the federal level, the Safe Cosmetics and Personal Care Products Act of 2018 is likewise looking for complete chemical disclosure and a restriction on carcinogens.

But there are resources for buyers pursuing a fragrance-free way of life, and the choice of odorless items continues to increase. The Environmental Working Group keeps databases on safe cleansing items and individual care items , consisting of scents. BWW uses a pocket guide for black customers and hair salon employees on the top chemicals to prevent. BCPP motivates customers to purchase odorless items from business dedicated to chemical disclosure, prevent items with scent or parfum on the label, and use protective equipment when dealing with fragranced cleansing items.

Nourbese Flint, policy director and program supervisor at BWW, has one last suggestion for worried customers: “If you are taking a look at labels and discover yourself disappointed, discover a company to take advantage of,” she stated. “Get associated with the discussion about policy … That’s the only method we will see genuine modification.”

Read more: https://www.theguardian.com/us-news/2019/may/23/fragrance-perfume-personal-cleaning-products-health-issues

US medical group that pushed doctors to prescribe painkillers forced to close

American Pain Society, implicated of being pawn of huge pharma, dealt with multitude of suits over Americas worst drug epidemic

A leading medical society, explained by a United States Senate report as a pawn of the pharmaceutical market for its popular function in pressing physicians to recommend opioids, is to close down in the face of claims blaming it for America’s worst drug epidemic.

The American Pain Society led the project to promote the idea of “discomfort as the 5th essential indication”, which led to health centers throughout the United States presenting smiley-face discomfort scales into seeking advice from spaces in the 2000s and needing medical professionals to focus on discomfort treatment.

Doctors stated the policy led to clients in impact composing their own prescriptions due to the fact that medics dealt with disciplinary action, consisting of principles hearings, if they did not please needs for discomfort relief even in cases where it threatened clients.

The APS is among a group of allegedly independent medical advocacy companies that critics declare were caught by the drug market and utilized to drive sales of narcotic pain relievers that turned into a multibillion-dollar-a-year market.

Last year, a Senate report called the APS as part of a web of companies it stated were developed into “cheerleaders for opioids” by drug producers’ loan. The society took almost $1m from the leading opioid makers over the 5 years to 2017, consisting of Purdue Pharma, the maker of OxyContin– the drug that started an epidemic that has actually declared more than 400,000 lives.

This week, the APS was called in another report , by 2 members of Congress, that implicated Purdue of corruptly affecting the World Health Organization into motivating making use of opioids.

A multitude of claims by cities and states have actually targeted the APS along with opioid producers, suppliers and drug stores for apparently driving the epidemic. Today, the society’s board stated it had actually chosen to close the company with a “aching heart”.

It stated: “APS has actually been called as an offender in various spurious claims and goes through many subpoenas. In spite of our best shots, APS was not successful in its efforts to deal with these suits with the requirement for what will be pricey and prolonged lawsuits.”

The subscription, mainly discomfort experts, is anticipated to vote to verify the declare insolvency and closure next week.

The news of the APS’s death was grieved by some experts who stated it had actually been necessary in assisting to money research study and promoting the interests of discomfort clients. Its track record was dented by its close association with the opioid market.

Through the 1980s, the society was at the leading edge of promoting a broad technique to discomfort treatment and bewared about using opioids. Modifications in management led the APS and comparable groups to take a various position in favor of narcotics for discomfort relief.

In 1996, the society released a prominent declaration stating opioids were reliable and safe for treatment of persistent discomfort which the danger of dependency was low, a claim that has actually given that been challenged. The co-author of the declaration and chair of the committee that concurred it was a physician, David Haddox, who was a paid speaker for Purdue Pharma. Haddox went on to end up being the business’s vice-president of health policy and a leading supporter for recommending OxyContin.

Former APS presidents consist of Dr Russell Portenoy, a discomfort expert who has actually given that confessed to overemphasizing claims for the security and efficiency of opioids in order to break down what he considered as baseless resistance within the medical occupation to recommending them. Portenoy was then paid by Purdue Pharma to assist drive sales of OxyContin. He has actually now consented to affirm versus the drugmaker and other business, and implicated them of overemphasizing the advantages and downplaying the threats of opioids.

But the APS’s biggest effect remained in promoting the treatment of discomfort as a 5th essential indication together with high blood pressure, respiration, temperature level and pulse rate, introduced by its then president, Dr James Campbell, in 1996.

The society even copyrighted the expression: “Pain: the 5th Vital Sign.”

The Joint Commission for Accreditation of Healthcare Organizations, which certifies medical facilities, utilized client fulfillment studies to determine whether individuals felt they were getting appropriate discomfort treatment. Since medical facilities feared that disappointed clients might cost them their licenses, medical professionals stated that contributed to press to recommend.

By 2012, more than 250m opioid prescriptions a year were given in the United States, enough to supply every American grownup with 30 days of tablets.

Read more: https://www.theguardian.com/us-news/2019/may/25/american-pain-society-doctors-painkillers

Five more US states sue Purdue Pharma over its role in opioid crisis

Wisconsin, Iowa, Kansas, Maryland and West Virginia sign up with a number of lots other states, declaring business pressed incorrect claims

Five more US mentions took legal action against the pain reliever maker Purdue Pharma on Thursday, declaring misbehavior in the marketing and sales of opioids such as the business’s extremely rewarding OxyContin narcotic.

Wisconsin, Iowa, Kansas, Maryland and West Virginia submitted comparable however different claims, bringing the variety of states taking legal action against the pharmaceutical business to 45, over its supposed function in the United States opioids crisis that has actually triggered countless drug overdose deaths. Pennsylvania took legal action against the business 2 days back, while New York’s Metropolitan Museum of Art on Wednesday signed up with a host of scholastic and cultural organizations in revealing it would stop accepting philanthropy from the Sackler member of the family behind Purdue Pharma.

The 5 states that submitted on Thursday are likewise taking legal action against Richard Sackler , who was formerly Purdue’s co-chairman and president and is among the leading members of the Sackler household who entirely own the personal business.

Sackler has actually been taken legal action against in a number of other such suits in current months and Purdue is likewise being taken legal action against by more than 1,500 cities and counties from all throughout the United States.

West Virginia’s suit declares Purdue Pharma strongly pressed misleading practices and incorrect claims, even in the previous training brand-new marketing staff members with the marketing slogan: “We offer hope in a bottle.”

“This claim exposes several years of painstaking examination,” West Virginia’s chief law officer, Patrick Morrisey, stated. “The ridiculous death and destroyed lives of unknown thousands should stop.”

Purdue Pharma and Richard Sackler have consistently and strenuously rejected the claims in the different claims versus them, and all misdeed.

In Wisconsin, opioids cost 916 lives in the state in 2017, the state’s match stated.

“The opioid epidemic has actually shattered lives and stretched neighborhoods throughout the nation and the state,” stated Wisconsin’s chief law officer, Josh Kaul. “Today, we submitted fit … declaring that they misinformed the medical and public experts about both the advantages of and the threats postured by OxyContin and other opioids, which the opioid epidemic is partially attributable to their conduct.”

Wisconsin’s suit, submitted in Dane county circuit court, looks for an irreversible injunction, reduction of the general public annoyance, and civil charges. It declares that the business entities Purdue Pharma LP and Purdue Pharma Inc, and Sackler consistently made misleading and incorrect claims relating to opioids, consisting of OxyContin.

Purdue Pharma’s incorrect and misleading marketing produced a shift in the understanding of the efficiency and threat of opioids, the problem declares. “In order to fight the issues about opioids being mistreated, Purdue released an aggressive marketing project that looked for to increase sales of OxyContin, while altering the accepted standards about opioid prescribing.”

The Wisconsin problem even more declares that, after a 2007 settlement in a federal criminal case versus Purdue and a few of its leading executives, in a case that did not consist of any charges versus any members of the Sackler household, Purdue continued to take part in incorrect, deceptive and misleading marketing practices in relation to its prescription pain reliever and the threats of abuse, death and dependency.

Kaul declares that Purdue and Richard Sackler were completely familiar with the prospective earnings of OxyContin.

OxyContin was introduced in the mid-90s as an advancement in discomfort relief, due to the fact that of its formula for regulated, continual release of its active component, which is originated from the opium poppy.

Iowa’s chief law officer, Tom Miller, stated: “Purdue Pharma is accountable for a public health crisis that has actually exceptionally impacted clients, their households, our neighborhoods, and our health care system,” Miller stated. “The business and its executives were recklessly indifferent to the effect of their actions, regardless of ever-mounting proof that their deceptiveness were leading to an epidemic of dependency and death.”

Purdue Pharma released a declaration on Thursday, stating: “Purdue Pharma strongly rejects the claims in the claims submitted today and will continue to protect itself versus these deceptive attacks.”

The business indicated the substantial current advancement in its favor that North Dakota’s state claim versus it was tossed out previously this month, and kept in mind that: “As the judge mentioned in his choice, one business can not be held responsible for a complicated public health concern such as the opioid crisis.”

The North Dakota attorney general of the United States is appealing versus the choice.

On Thursday, in action to the current flurry of suits, Purdue included: “These problems become part of a continuing effort to attempt these cases in the court of popular opinion instead of the justice system. The states can not connect the conduct declared to the damage explained, therefore they have actually created strikingly over-broad legal theories, which if embraced by courts, will weaken the bedrock legal concept of causation.

Read more: https://www.theguardian.com/us-news/2019/may/16/purdue-pharma-states-sue-opioids-crisis-role

‘I dont want to overdose and die:’ one woman’s death, one country’s shame

Saige Earley, who was found dead of a heroin overdose in a toilet stall at Syracuse airport, is the face of real people devastated by the worst drug epidemic in American history

Saige Earley was gone in stages.

To her mother, Ellen, the 22-year-old grew increasingly detached within weeks of returning from the dentist with a fateful prescription for opioid painkillers. The young woman with long dark hair and a broad toothy smile was gone physically a few months later when she walked out on her young son and left Ellen wondering if her daughter was even alive.

Then last September, Saige was gone for good, found dead of a heroin overdose in a toilet stall at Syracuse airport, clutching a plane ticket to drug rehab in California.

Whether she escaped in her insatiable appetite for books, dancing till exhausted, headphones blaring music, walks upon walks, or the drugs that cut her life so terribly short, she simply needed to run, Saiges father, Jason, wrote in a moving and frank obituary. But she always wanted to return, to make us laugh, to love her baby, to show us this cruel yet fascinating world through her eyes.

The obituary caught the eye of the New York attorney generals office as it built a sweeping lawsuit filed against the opioid industry last month. The legal action singled out Saige Earley as the face of real people devastated by the worst drug epidemic in American history.

An epidemic fomented in board rooms

The New York lawsuit drew a clear line between the dentist prescribing Saige Earley opioids after he removed her wisdom teeth in the spring of 2017 and the heroin overdose that claimed her life 18 months later. But her reality was messier, and in its own way a deeper indictment of the lengths the drug industry went to blame Saige and other victims of the epidemic for their deaths.

Topping a long list of accused in the New York action is Purdue Pharma, the maker of OxyContin, and those members of the Sackler family who owned and ran the company.

The lawsuit reveals an email written by Dr Richard Sackler, Purdues head of marketing who ramped up sales of OxyContin by downplaying the risks of addiction from its high dose of narcotic. As overdoses and deaths escalated, Sackler painted the victims as criminals to blame for their own condition.

They get themselves addicted over and over again, he wrote in a 2001 email. They engage in it with full, criminal intent. Why should they be entitled to our sympathies?

Sackler has apologised for using insensitive language in what he said was his frustration at illegal drug use. But it was more than a passing outburst. Blaming the victims evolved as a central strategy as Purdue and other opioid makers sought to keep the door open to the mass prescribing earning billions of dollars a year even as it fuelled an escalating human tragedy that has claimed about 400,000 lives over the past two decades.

The manufacturers, their lobbyists and well funded industry front organisations played on societys stigma against those sucked into addiction by powerful narcotic drugs to blame the person, not the pill. Addiction was painted as a lifestyle choice, and those who made it as degenerates.

But for Saige Earley, it was a struggle for survival.

At times she kept a diary. A year after she walked out of the dentists office, opioids were testing her will to live.

I dont want to overdose and die. Thats not for sure though because it changes all the time. Sometimes I do want to, she wrote.

Protesters
Protesters stage a die-in at the Solomon R Guggenheim Museum in Manhattan, New York, against its funding by the Sackler family, the owners of Oxycontin manufacturer Purdue Pharma. Photograph: Yana Paskova/The Guardian

When Richard Sackler spoke about criminal addicts, Saige was exactly who he had in mind. Her family too. Saiges mother, Ellen, was buying black market opioid painkillers in the 1990s before much more powerful and addictive OxyContin hit the market. Her father, Jason, was also struggling with substance abuse.

Ellen was able to walk away from the narcotics when she became pregnant with Saige. She taught dance and reckoned her daughter was a natural. The family lived in a roomy wooden house in Cazenovia, a prosperous upstate New York village with a sense of history and well-preserved 19th century architecture.But Saige struggled with mental health issues as a teenager, something Ellen links to a history of bipolar disorderon Jasons side of the family.

Saige began coming home drunk and then took to marijuana. She skipped school and cut herself. In time, Ellen noticed her daughter developing what she regarded as a less savoury set of friends. The two clashed. Ellen tried to get help but said counsellors put the confrontations down to mother daughter stuff.

I was relating it to my own teenagerhood and thinking I did some crazy things and I was hanging out with some absolutely wrong people, and I survived, said Ellen. But I have two other kids that Im trying to raise by myself and this chaos was too much. We had a year of just chaos.

By then Ellen and Jason were divorced and she gave Saige an ultimatum: get help or go live with your father. At 17, Saige moved in with Jason. She continued to use alcohol and marijuana, and didnt speak to her mother much for a couple of years. But then Saige became pregnant and asked to move back home. Ellen agreed.

I was young when I was pregnant too and I thought Ill never greet a pregnancy with negativity. So thats great. She said she was very happy about it but she was young and she knew from my life experience that single parenthood is difficult, she said.

Saige asked if she could move back in because heres a safe place. There is no drinking or drugging. She was absolutely sober for the entire pregnancy. She found a new focus.

Ellen describes the birth as whacky because it took a while for Saige to realise she was in labour and they only made it to the hospital with minutes to spare.

Saige was clean for a while after her son Julian was born but was still troubled and was drawn back to alcohol. Months later she wrote about it in her diary.

When I picked up that first drink after having my son I did not think I was chasing alcohol over loving Julian. I really figured I could just drink some nights to relieve stress like other people do. Like other moms do all the time. 1 turned to 3 turned to every single night, she wrote.

Still, Ellen said Saige largely kept it together and was focussed on her baby.

Then came the dentist. Saiges wisdom teeth were impacted and causing pain. Ellen thought it was contributing to her daughters general unhappiness and encouraged her to have them removed. But she advised against having all four teeth extracted at once because it would be so painful.

Photographs
Photographs of Saige with her family in Julians room. Photograph: Maranie R Staab/The Guardian

The dentist said the insurance company would only pay for Saige to have the teeth removed in one sitting. He said it would be fine. He would give her painkillers to take home.

By the time Saige went to the dentist two years ago, the extent of the opioid crisis was beyond doubt. The Centers for Disease Control and Prevention (CDC) established the close link between the sharp rise in opioid prescribing and increasing overdose deaths more than a decade ago. In 2012 alone, doctors and dentists wrote 255m opioid prescriptions enough to supply every American adult with a month of pills.

But even as the epidemic revealed itself, the drugmakers worked hard to keep the door to mass prescribing open.

In 2005, Burt Rosen, a vice-president of government affairs at Purdue Pharma and the companys chief lobbyist in Washington, co-founded the Pain Care Forum (PCF) with other opioid manufacturers. The forum spent close to three-quarters of a billion dollars over the following decade pushing opioid friendly policies, writing legislation, and funding elected officials across the country.

The PCF exploited the longstanding stigma against those who become addicted to opioids, particularly heroin, to tell congressional briefings and Food and Drug Administration hearings that there must be no curbs on prescribing because the people Sackler portrayed as criminals should not be allowed to deprive legitimate patients of desperately needed opioids.

Very often though, they were one and the same. People like Saige Earley who began on a prescription and ended up buying on the black market to feed their addiction.

The PCF claimed opioids were safe for those who took them as prescribed and had no history of addiction. To Congress and the FDA, the industry painted a picture of doctors closely interrogating their patients about their vulnerability to addiction and monitoring for evidence of dependence. But most primary care physicians had little training in using narcotics for pain relief, and the drugmakers were instrumental in shaping a medical policy in which hospitals and insurance companies pressured doctors and dentists to default to opioids.

Ellen
Ellen holds a family photograph taken on their last vacation together in Myrtle Beach. It was the greatest vacation I think any of us have ever had. Photograph: Maranie R Staab/The Guardian

Dr Russell Portenoy, the Purdue-funded pain specialist who led the way in breaking down the medical professions decades-long caution about prescribing narcotics, recently said in a court deposition that drug manufacturers deliberately understated the risks of opioids, particularly the risk of abuse, addiction and overdose to boost sales. Opioid makers even told doctors that it was safe to ratchet up doses without risk of addiction.

Saiges history of addiction, and that of her parents, should have been a red flag to any medical professional prescribing opioids. But Ellen said her daughter was not asked if she might be vulnerable. Instead she was sent home with a weeks worth of the opioid hydrocodone hydros with a refill for another week. There would be no monitoring.

Ellen saw that the drugs would be pushing against an open door with Saige.

I felt awful because she was an adult. In the middle of the night I was thinking how can I switch those pills so that she wouldnt know, so that she wouldnt feel like I was trying to control the situation? she said.

Ellen gave her daughter the drugs and cautioned her. Saige shrugged it off.

And then she was gone

The CDC warns that opioid painkillers can get a grip on a person in as little as five days.

I had oral surgery, under anesthetic felt great, Saige told her diary. Then got some dumb hydros that I really thought nothing of and like without a second thought I had abused them and was looking for more pain pills. Huge consequence for this.

On the back of her history of other addictions, Saige rapidly fell into dependence on opioids. When the prescription ran out, she found a new set of friends to supply her with pills. Within a few weeks she hooked up with a man with a long history of heroin use.

And then she was gone, said Ellen.

It was very quick. Her personality changed. Up until that point, even with the pain from the wisdom teeth, she had a lot of patience with Julian. She was working. But then she was just miserable, consistently miserable. She didnt want to be around us. The baby all of a sudden became really difficult for her. Can you just take him? I cant deal with it.

Saige walked out of her mothers house on Independence Day 2017, three months after the visit to the dentist. Julian was 16 months old.

We had our big July 4th party and then she left with this man and left the baby here, said Ellen.

Desperate to at least know her daughter was alive, each night Ellen checked Saiges cell phone billing for evidence she was sending text messages.

Then the texts stopped. No nothing. No activity on her phone. It was terrifying, she said.

Ellen has been able to reconstruct only a part of the picture of the life Saige was living at that moment.

There was some really bad stuff involving sex trafficking. She wound up in Poughkeepsie, New York. She called her best friend who called me and said I cant really understand what shes saying. Shes being kept by some guy, said Ellen. There was something really bad that happened and it was fast.

Saiges father, Jason, finally tracked her down and got her into rehab in Florida that October. She made it through the initial programme and into a halfway house. Six months later, Saige went out drinking.

Came home to halfway black out drunk and got kicked out, she told her diary. I had spent the night in the hospital and was sober and couldve gotten into 1/2way but instead I continued drinking and drugging for a week til I ran out of resources.

A month later, she was back in rehab.

divider

In his emails, Richard Sackler said that it was necessary to hammer on the abusers in every way possible. They are the culprits and the problem.

Sackler was angry that OxyContin was getting the blame for rising overdoses This vilification is shit and claimed that it was factually untrue that addicts dont want to be addicted.

For Saige, it was not nearly so straightforward. A single page of her diary lays bare her struggle to resist being sucked back into using opioids. In rehab in Florida, she wrote: Ive accomplished a lot. Ive changed a lot.

But a few lines later, she is resisting the drag of the past.

I feel like going back to the same people, places, things at this point Ill relapse on old behaviors and thought patterns which will lead to a relapse on drugs, she wrote.

I
I miss my baby boy so much. My soul aches for him. Its like a missing limb. But more important. Like missing an organ. Photograph: Courtesy of the Earley family

She writes about how she just really wanted to get high and the pull of just one more fix against medical advice, or AMA.

Monday I ran into dirty Mike and was like triggered af (as fuck) whatever that means but like I was seriously considering AMAing right then and there.

Saige was also struggling with life without Julian.

I miss my baby boy so much. My soul literally aches for him. Its like a missing limb. But more important. Like missing an organ. Like my body cant function without him. I cant function without him. Yet here I am. Living life, without Julian. Happy a lot of the time, she told her diary.

Finally in August 2018, Saige said she had a handle on her addiction and wanted to come home. Ellen wasnt sure it was a good idea. She thought her daughter needed more time under the direct oversight of rehab but it would mean Julian would have his mother back and so she agreed.

In Cazenovia, Saige joined Alcoholics Anonymous and recorded her daily struggle.

Showered, got dressed. Stayed sober. Theres so much more I need to be doing and I could have done today but thinking about how much I failed does absolutely nothing. So Im trying to focus on the good I did accomplish. Loving my son, being here for him. Meetings every night, she recorded in the diary.

For the first time in years, Ellen and Saige took a holiday together to Myrtle Beach with their children.

It was the greatest vacation I think any of us have ever had. We had a lot of fun. Came back and within five days she was gone, said Ellen.

While she was away, one of Saiges friends overdosed and died. On her return she went to the calling hours to view the body. As the evening wore on, and Saige failed to return home, her mother grew anxious. Ellen shot Saige a text. However hard it is, she said, focus on Julian. You have him and he needs you.

Days later, Saige contacted friends from rehab in Florida who helped get her into a recovery programme in California. A friend in Syracuse bought the plane ticket.

With it, he gifted her a bag of heroin. A last hit before she made another attempt to get clean.

On 16 September 2018, Ellen opened the door to a policeman she happened to know.

I had just sat down. Saige and I were watching Shameless together. There was a new episode on and I almost picked up the phone to text her and say youre missing the new Shameless and we got a knock on the door, she said.

He said you need to sit down. I knew what was coming. I didnt want to know but I knew. He said, we believe that we have Saige at the airport and she isnt alive anymore.

Chris McGreal is the author of American Overdose, The Opioid Tragedy in Three Acts

Read more: https://www.theguardian.com/us-news/2019/apr/29/i-dont-want-to-overdose-and-die-one-womans-death-one-countrys-shame

Opioid crisis: FDA’s own staff demand agency halt approval of new painkillers

Top professionals state firms precariously lacking oversight is continuing to sustain an epidemic that claims 150 lives a day

The United States Food and Drug Administration is dealing with a need from a few of its own experts to stop the approval of brand-new narcotic pain relievers since they state the firm’s “precariously lacking oversight” is continuing to sustain the opioid epidemic.

Dr Sidney Wolfe, a previous member of the FDA’s drug security committee, and Dr Raeford Brown, today chair of the company’s opioid advisory committee, on Thursday started an official procedure to require the FDA to discuss or suspend opioid approvals why not.

The 2 experts stated the FDA stopped working to appraise the general public health crisis and intensifying death toll brought on by the flood of opioid prescriptions over the previous 20 years even as the company authorized lots of brand-new narcotics. Wolfe and Brown have actually sent a petition to the FDA, a relocation that needs the firm to react, requiring it put in location a procedure that thinks about the effect of pain relievers on the opioid epidemic prior to anymore are authorized.

“It is a nationwide emergency situation,” stated Wolfe. “There’s not one opioid that’s been authorized in the last 10 or 20 years that has any substantial benefit in discomfort relief over existing ones and does not simply contribute to the likelihood of individuals getting addicted and abusing the drug.”

The call for a moratorium on brand-new opioid approvals shows aggravation and anger within parts of the medical neighborhood over what is viewed as the FDA’s consistent failure to confront its part in an epidemic declaring about 150 lives a day.

The company authorized 27 brand-new opioids for sale in between 2009 and 2015. Among those drugs, Opana ER, was at the centre of an HIV and liver disease C break out amongst individuals who injected it, requiring the FDA to press the producer to pull it from sale. Brown stated that Opana expense countless lives.

Wolfe stated the FDA declines to take obligation for its errors and goes on making them.

“When Opana was removed the marketplace, the FDA did not acknowledge any blame, any duty, for having actually enabled it to go on the marketplace in the very first location,” he stated.

The outbound FDA commissioner, Scott Gottlieb, has actually consistently promised to reform the approvals procedure however has yet to carry out a brand-new system. The company’s approval of an extremely high strength opioid, Dsuvia, in November triggered a new age of criticism. Brown, a teacher of anesthesiology at the University of Kentucky, implicated the FDA of compromising American lives.

Wolfe, a creator of the general public Citizen Health Research Group, stated the FDA had actually been provided every chance to act however “can no longer be relied on” since it is greatly swayed by the drug market which offers the bulk of the financing for the FDA’s drug approval department.

In 2016, the FDA asked the National Academy of Medicine for suggestions on how to control opioids due to the epidemic. A year later on, the academy released a report stating that the FDA had too narrow a view of the opioid approval procedure which stopped working to consider problems such as dependency and the truth that great deals of prescription narcotics wind up on the black market.

It noted a series of actions towards tightening up the approval of opioids in the future and suggested that the FDA evaluation whether those currently on the marketplace ought to still be offered. The academy stated it was “extremely not likely that all of these items would be evaluated reliable and safe under the brand-new drug approval structure” being proposed.

Two years later on, the FDA has yet to carry out the suggestions or to pull existing drugs off the marketplace.

“The FDA should enforce a moratorium on approval of opioids up until the regulative structure imagined by the National Academies remains in location,” Wolfe and Brown stated in a letter to Gottlieb and the health and human services secretary, Alex Azar, accompanying the petition.

The FDA is required to react to the petition and Wolfe and Brown strategy to utilize it to create assistance from within the medical occupation and Congress to put pressure on the FDA.

The FDA stated it is evaluating the petition and will react straight to Wolfe and Brown.

Read more: https://www.theguardian.com/us-news/2019/mar/21/fda-opioid-approvals-halt

‘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

Hawaii’s evacuees on why they live under a volcano: it’s affordable

As the Kilauea volcano erupts, Puna district residents reflect on the threat to an area of affordable housing and great beauty

Imago Mana had always wanted to move to Hawaii. But it was mostly a dream for the computer technology teacher from Virginia, who put it in the back of her mind.

I always thought: I cant do that now, Hawaii is too expensive. Then, around the age of 50, she began getting debilitating migraines. She lost her job, her house, her car. She moved back in with her mother. As she was trying to figure out what to do next, a friend told her about a part of Hawaii where life was a little different, a little wilder. In the district of Puna, Mana found a raw vegan commune where she could work in exchange for living in an off-the-grid hut on 50 acres of jungle. She bought a one-way ticket and boarded a plane four days later.

The minute I got off the plane I knew I was home, Mana said.

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  • A lava flow on Makamae Street in Leilani Estates.

Mana, now 59, has since moved out of the commune and was among those evacuated on Thursday because of the continuing eruptions of the looming Kilauea volcano. Dramatic videos of lava slowly pouring through streets and inching over the land have attracted international attention.

Mana has lived in the Leilani Estates subdivision, which is located in Pahoa, for three years rent-free as a caretaker. Its one of the reasons she has been able to live on her $1,400-a-month disability checks. Now, shes one of many trying to replace the affordable housing she lost in Pahoa where many depend on the low cost of living. In exchange for living in the lava zone, often without infrastructure such as city water or sewer lines, she and others have been able to make a life for themselves without much money.

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Puna district and the town of Pahoa, where homes have been destroyed by lava, are among the least expensive places to live in the islands. Its common for three-bedroom, two-bath houses on an acre of land to sell for around $250,000, according to Cathy Fedak, a realtor from Pahoa who also lived in Leilani Estates.

There are a lot of literally starving artists here, said Amedeo Markoff, who opened the Puna Gallery and Gift Emporium in March to sell handcrafted wood pieces and local art. Markoff added that with news of the volcano scaring off tourists, a community where many struggle to make ends meet is in even greater peril.

Markoff said for the residents, businesses and artists, affordable housing is key.

There are a lot of reasons why people want to live in Puna, he said But the No 1 reason is the beauty. The No 2 reason is that real estate is priced so that your average Joe can live here.

Thats certainly the case for Corey Hale, who came to Pahoa from California nearly four years ago and purchased a one-acre plot of land just outside Leilani Estates for $15,000.

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  • Top: a fissure eruption fountains more than 200ft into the air, consuming all in its path, near Pahoa. Bottom: video of more volcanic damage.

Hale, who is 54 and a former crisis counselor, intended to build a house on her thickly forested jungle plot at some point, but needed to wait until she got the money together. In the meantime, she lived in a gypsy wagon given to her by a neighbor, went to work fixing leaks and building an outdoor shower out of old wood pallets, and lit oil lamps to see at night.

But having her own land and an inexpensive off-the-grid lifestyle became even more important when she became disabled and saw her monthly income reduced to $340 in food stamps and $338 in cash. Luckily, Hale said, she never went hungry because of the abundance of avocado, mango, papaya and banana trees around her property.

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I created a really good life for myself, she said. It was simple, but it was good life is messy here, but its real and its beautiful.

Hale, who was evacuated on Thursday, said she hoped shed be able to return home soon. For now, shes staying at a Red Cross shelter in Pahoa. Shes been reluctant to make plans because no one knows how long the eruption will continue or how long residents will be kept out of their neighborhoods. And on Tuesday, just as things had become quiet, Hale got another shock when two new volcanic fissures opened up near her property. She fears that even if she can return, the eruption will have changed the place she knew and loved.

With lava, after its gone, its like you come back to a different planet, she said. I had to say goodbye to my land when I left, and my heart hurts.

Henrietta Kaonohiokalani Jeremiah, a musician, retiree and native Hawaiian, also lives in Leilani Estates and is waiting to see if and when she will be able to go back home. She purchased her one-acre plot of land for about $20,000, then built a multi-sided home, similar to a yurt, on the property.

Read more: https://www.theguardian.com/us-news/2018/may/10/hawaiis-evacuees-on-life-by-the-volcano-people-think-were-crazy-to-live-here

How the most vulnerable workers are targeted for sexual abuse

Long read: Isolated, unprotected and scared to speak out some workers are particularly vulnerable to harassment. Who finds the cases of sexual assault no one else is looking for?

The southern California sky dims as Vicky Mrquez zooms south along Interstate 5 in her Honda SUV, with syrupy Spanish-language love songs blasting from her stereo. The satnav on her phone is directing her through a monotonous landscape of Orange County office parks, and Mrquez is racing against rush hour, dodging between lanes and swerving with inches to spare. Im kind of a crazy driver, she admits.

Mrquez works for a little-known non-profit organisation with the pressing goal of fighting labour exploitation among night-shift janitors an industry that operates in obscurity, with workers sent to anonymous buildings rarely visited by government regulators. With her glasses, curled-under fringe and pastel sweater, Mrquez looks more like a retired librarian than a labour rights activist. On tiptoe, she stands under 5ft tall. On this particular late winter evening, Mrquez is on the road to the first of half a dozen office parks where she will make surprise visits, making sure that cleaners are being treated fairly by their bosses.

It is a job that few government agencies bother to do, but it is work that Mrquez believes in. For 16 years after moving to the US from El Salvador, where she left her husband and three children behind she too worked as a janitor. The work was rough, and she had to put in more hours than she was paid for, but she still managed to send money back home.

After 40 frenetic minutes on the road, Mrquez arrives at her first destination, near the city of San Clemente. She climbs out of the car carrying a bulging black bag stuffed with papers and tests the front door of the office. Tonight, she has arrived early enough that the door swings open. Mrquez has other strategies for when they are locked: she might station herself near the service exits or the dumpsters, where she knows the night-shift cleaners will eventually present themselves. In supermarkets or guarded high-rises, she will sweetly ask for the janitor. If the person she is talking to assumes that shes looking for a job, so be it.

Tonight her first move is to look for bathrooms or supply closets two places she knows she is likely to find a janitor. She moves past the elevators to a rear hallway, where she finds Mara Garca, a cleaner, holding a mop next to a bucket of murky, citrus-smelling water. Mrquez greets her in Spanish. Garca is on the clock and responds brusquely, almost warily. Mrquez doesnt waste time on small talk. Setting her large bag on top of a drinking fountain, she extracts a packet of papers and passes them to the cleaner. Mrquez explains that she works for an organisation called the Maintenance Cooperation Trust Fund (MCTF), which helps janitors make sure they get paid what they are owed, and helps them solve problems with issues such as immigration.

When she has Garcas attention, Mrquez asks a few more questions: does Garca get paid in cash, or with a cheque on a regular basis? A cheque every two weeks, Garca says. Mrquez nods. Is she given regular breaks? Yes. Does she have to pay for her own cleaning supplies? Garca says that sometimes what the company gives her is not enough, so she has to buy a few more bottles of bleach. Mrquez tells her it is the companys responsibility to provide her with the supplies she needs.

Then Mrquez goes in to close the deal. Tu telfono, mija? Mrquez asks. Mrquez scribbles the number into a black notebook. Y tu direccin? Mrquez then takes down Garcas address.

Gathering workers contact information is Mrquezs ultimate aim. The MCTF is one of only a handful of organisations in the US keeping careful tabs on the practices of non-union cleaning firms some of which operate entirely in the black market. Through these impromptu meetings, the organisation has generated a database of workers who can give first-hand testimony about whether these companies are following labour laws. Since 1999, the MCTF has helped collect more than $26m (19m) for janitors who were being abused at work.

Garca doesnt know it yet, but Mrquez will later call or visit her at home in the early afternoon, when most night janitors have not yet left for work. At these follow-up meetings, Mrquez will remind Garca that she is there to help her solve any problems she may be facing at work. If Garca doesnt pick up or answer the door, Mrquez will keep trying until she makes contact with her a second and then a third time. This process can take months, but such is the long, slow dance necessary to build trust among workers in low-paying and invisible industries people who are unlikely to ever make formal complaints.

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A 2016 protest in Sacramento, California, in support of a bill to protect female workers from sexual harassment. Photograph: Rich Pedroncelli/AP

As a reporter who has investigated these industries for several years, I have been forced to conclude that low-wage immigrants labouring in isolation are at unique risk of sexual assault and harassment. It is an open secret in these industries that immigrant women in financially precarious jobs many of whom are undocumented are targeted for sexual abuse by their superiors. While it is not possible to know how often these abuses happen, they are not anomalies. Federal government figures estimate that about 50 workers are sexually assaulted each day, and in the industries that hire newcomers to the country in exchange for meagre paycheques, such assault is a familiar workplace hazard. And yet there have been few meaningful efforts to prevent it before it starts. Instead, we expect women with the most to lose to seek recourse by reporting the problem after the fact but the reality is that if these workers face abuse from a superior, the combination of uncertain immigration status, financial constraint and shame often conspires to keep them silent.

The same unfortunate pattern plays out among farm workers and domestic workers those who cook, clean and care for families behind the locked doors of private homes. Their vulnerability to sexual violence echoed what I had heard from janitors: in their isolated workplaces, it was often their direct employers who groped them or propositioned them for sex.

In her work as an advocate for cleaners, Vicky Mrquez has discovered that a lot can happen in places no one is looking but she didnt realise the full extent of it until she met a young cleaner named Georgina Hernndez.


Many low-paid jobs share similar risk factors. Every day vast numbers of women often hired via a complex web of barely accountable subcontractors find themselves working in isolated locations across the US. With few other people around and those that are often battling poverty and eager to keep their jobs they can become the perfect target for predators.

Hernndez was working at a cinema sweeping up popcorn when Mrquez first met her. For the first month and a half on the job, Hernndez never received a pay cheque, and worked more hours than she was being paid for. She hadnt complained because she thought that, as someone without immigration papers, she was easy to replace. She still recalls the way Mrquez spoke to her gently, like an understanding aunt. Before Mrquez left, she took down Hernndezs phone number and told her she would check in with her again.

On her next visit, Mrquez looked at Hernndezs pay stubs and compared them to the working hours she had written down in a notebook. They didnt match up. When Mrquez asked why Hernndez hadnt written down any time for breaks, she said it was because she wasnt given any. Mrquez and the MCTF eventually helped Hernndez and some of her co-workers file a complaint with Californias labour commissioner, which led to a $1m fine from the state of California against the two cleaning companies that had employed Hernandez: for failing to pay minimum wage and overtime, and for not giving their workers rest or meal breaks.

But when Hernndez moved to a new, higher-paying job as a hotel cleaner, there were even bigger problems. Early on, she says, her supervisor flirted with her and tried to convince her to have sex with him. She rebuffed him, and he retaliated by giving her more work. When his advances didnt stop, she tried to hide from him, but he would follow her or call her on her cellphone to find out where she was.

His demands quickly became violent. Less than a week into the new job, Hernndez says he told her that he needed to talk to her privately about her work in his car. This made her uncomfortable, but he said: You need this job, dont you? He instructed Hernndez to meet him in the parking garage. Worried about losing her job, she went. When she got there, he told her to get into the vehicle. She hesitated, but he was the boss. She did what she was told. The supervisor drove them to a higher, darker floor of the garage. After he parked, he began to touch her legs. She told him she didnt want to continue, and he replied that he would give her more days off and better pay. Hernndez told him she didnt want more days off she had taken the job because she wanted to work. When he began touching her breasts, she became afraid. Then he took off her trousers. As he forced himself on her, she panicked and froze.

Afterwards, the supervisor asked her to put in a request for an extra shift that week, so he could take her to a hotel. Hernndez told him she couldnt. He assured her there would be perks: he would pay her for the shift, and make sure she received seven shifts that week. Youre delicious, he told her before driving her to a lower level of the parking garage. He told her to go into the building first. He followed a while later.

Hernndez never requested an extra shift. She didnt immediately tell anyone what her supervisor had done. The shame of it was too much, and she knew it would not be easy to find a new job as an undocumented worker who couldnt read or write.

About a week later, Hernndezs supervisor told her to meet him again. When she said no and tried to quit, he threatened to hurt her and her daughter. He added that if she wanted to stay in the country, she needed to keep him happy. This time he drove them to a motel.

On one of her nights off, Hernndezs supervisor called her incessantly until she picked up the phone. He said he needed her to work that night and that he was on his way to pick her up. Hernndez hurried to get herself ready for work, but once she was in his car, he drove to the motel. Hernndez cried and tried to climb out of the car, but he pulled her into a room by her hair, where she says he forced her to have sex with him again. He later warned her not to tell anyone what had happened but she would have stayed silent anyway. She thought her family and friends would never believe her, or would think she had brought it on herself.

Hernndez says that, at the time, she didnt think there was a way out of her supervisors trap. Theres no way to defend yourself, she says. Theres no way to say no. When you need the job, you become the victim. Thats why you deal with all the harassment, the discrimination, everything because you need the job.

For the next few weeks, she reported to work at the hotel as usual, making a point to avoid her supervisor. But he managed to find her, either to remind her how much she needed the job, or to chastise her for being so cold during their encounters. Finally, he came to her with an ultimatum: she had to decide whether she wanted to keep her job or not. If she did, he would continue to have certain expectations of her.

Hernndez felt hopeless. She was having migraines and panic attacks. She dreaded his next demand. When he confronted her again, she told him she would not have sex with him to keep her job. Then began his revenge. He yelled at her in front of co-workers and disciplined her for supposedly leaving used tissues in the lobby. Then, she says, he started to sabotage her work, making a mess of places she had cleaned and disciplining her for it.

The rapes had been horrific violations, but they had happened in private. Now her supervisor was publicly impugning her work, and her job was still at risk. She felt lost and compromised, but she swallowed how she felt and continued to drag herself to work.

She later decided to speak to the cleaning company about the assaults. She had seen her supervisor try to hug and flirt with another cleaner, so together the two women called human resources to make a complaint, but nothing changed. Almost two months into the job, Hernndez called in sick one evening. The next day, the supervisor fired her.


Hernndez didnt leave the house for days. She had headaches and couldnt sleep. Her nausea continued to intensify. The truth was hard to face: she was pregnant. Depleted and sobbing, she sought out the only person she could trust. Vicky Mrquez remembers how Hernndez sounded that day. She was crying and her voice was anguished. Mrquez had rushed to Hernndezs apartment, but the cleaner said they could not talk there. I dont want anyone to hear me, she said.

They talked in Mrquezs car. Something has happened that I dont want to have to tell you, Vicky, Hernndez began. Something terrible. She was inconsolable. Mrquez told her: We can find a lot of help for this. Dont be scared. But in truth, Mrquez had no idea what she could do. She called Anel Flores, a colleague who was an attorney, to ask for help. Flores suggested Mrquez bring Hernndez to their office. For the next two hours, Hernndez shared fragments of her experience, until Flores was able to piece the whole story together, from the rape in the parking lot to being forced into sex at the motel. Finally, Hernndez told Flores that she was pregnant from one of the rapes, and that she had already made an appointment for an abortion. I cannot have this baby, she said.

She added that she was worried people would find out she was pregnant, and that she would be judged and blamed for everything. Flores tried to reassure her: Its not your fault. You did not do anything wrong. Youre not a bad person. Hernndez eventually agreed to let Flores share some of what had happened with Mrquez, and with Lilia Garca, the executive director of the MCTF. They told Hernndez they would help her address the problem step by step, and would become her confidants and support network.

When Hernndez terminated the pregnancy a few days later, Flores picked her up from the clinic and took her home. After an attorney specialising in sexual harassment suggested that Hernndez file a police report, Flores and Mrquez drove Hernndez to the police station, and Flores sat with her as she was interviewed.

Reassured by the support of the women from the MCTF, Hernndez became determined to push back against what had happened. With the help of the lawyer she had met through the organisation, Hernndez filed a sexual harassment lawsuit against the cleaning company. In the legal filing, Hernndez accused the company of failure to prevent sexual harassment, wrongful termination and retaliation, negligent supervision, intentional infliction of emotional distress, and assault and battery. Within months, the company paid a financial settlement to close the case, though it did not admit any liability in the process. It also fired the supervisor.

Hernndez says the outcome of the case can never make up for the rapes, but she is proud that she set aside her fears to challenge what had happened to her. She had tolerated too much for too long because she didnt know how to get help, and she might have been stuck with the same problems if Mrquez hadnt found her. I would have guarded all of this pain, she says. I wouldnt have known how to speak out about what happened.

Mrquez says the isolation of the job and the demographic of the workers makes night-shift cleaners such as Hernndez easy targets for abuse. It is because the supervisors always think the worker needs work and they have work to give, Mrquez says. So they commit these abuses. And there are many who knows how many hundreds or thousands of cases that remain in the shadows because no one knows. Many women dont say anything out of fear. Theyre afraid that society will realise that they have been forced to sleep with someone. They are afraid that they will lose their job.


Mrquez knows that it is rare to uncover cases such as Hernndezs. For each janitor the MCTF reaches, it can take months of calls and visits before a worker will begin to think about speaking up about their problems. In matters of sexual assault, it takes even more work and time. How many cases are there in this country that we dont know about? Mrquez says.

Across the US, immigration status and poverty are used as leverage against female workers to hold them hostage in jobs where they are being sexually abused. Labour enforcement is predicated on the idea that workers already know their rights, and thus it is logical to expect them to make a complaint to bosses or the government if problems arise. These laws do not take into consideration the experiences of low-wage immigrant workers and what their options really are if they have been sexually assaulted at work.

The legal system through filing a civil lawsuit or a criminal case is often viewed as the clearest way to demand accountability. Workers can also go to their employers or unions to demand redress. Making a formal complaint helps emphasise that there can be consequences for this type of abusive conduct. But these approaches are only part of the solution, and are inherently reactive, requiring the confrontation of systemic roadblocks such as deeply flawed notions of credibility that often get in the way of satisfactory outcomes. Meanwhile, we know that prevention is possible. Decades of empirical research offers clear direction. While there are some heartening efforts to incorporate this research into worker training and advocacy programs, employers and policy makers have largely chosen not to use it.

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Supporters of the Justice for Janitors campaign at the Sacramento protest. Photograph: Rich Pedroncelli/AP

In addition, advocates for female workers have tried for decades to make the case that sexual assault at work should not be dismissed or marginalised by employers and the government because it has historically been perceived as a womens issue. Instead, they argue, gender-based violence should be viewed in the same way as other forms of on-the-job physical violence, so that prevention plans are implemented, the government takes a proactive role in enforcement and workers have an avenue for demanding accountability.

Sexual assault can happen to anyone, anywhere, but if there is a perfect storm of factors that put workers at risk, night-shift janitorial work is its epicentre. Nearly every office building relies on after-hours cleaners, but we rarely see the people who do the vacuuming and mopping. The work is scheduled to happen at night or during the early morning, when few people are around. They are expected to be invisible.

This is also emblematic of a wider trend. Before the 1980s, most businesses had their own cleaning staff. Then, as institutional investors purchased high-rises and retailers grew into chains with premises all over the country, it became more efficient and cost-effective to outsource such work to independent companies. A wide range of low-paid, unskilled industries have followed suit.

This business model has become even more opaque with the rise in subcontracting. While one contractor might land the official cleaning contract for a large retail chain or high-rise office block, it might then hire a subcontractor to do the actual cleaning. Some of those subcontractors might then subcontract some or all of the work to a third business. Building owners, retailers and businesses award contracts to the lowest bidder, so cleaning companies both big corporations and small subcontractors have to keep costs as low as possible. Human labour is the largest expense in this business, and where the firms look first to trim costs.

The way you make money in this industry is to cheat, because the profit margin is so thin, says Stephen Lerner, who led the Justice for Janitors campaign with the Service Employees International Union in the 1980s. Larger companies are not without their problems, but they are easier to track, and most provide regular pay cheques and benefits to workers. But at the other end of the spectrum are an unknown number of black-market subcontractors, where misconduct largely stays hidden.


In many ways, the MCTF is doing for cleaners what the state could be doing for all vulnerable workers. The reality is that there are very few or no enforcement agencies who do this work, says Lilia Garca, underlining the fact that the many of the cases her organisation brings would probably go unreported if the job were left solely to the government.

In some states, including California, there is a push to create regulations regarding workplace violence that would address everything from physical attacks to sexual assault. At the federal level, the US Occupational Safety and Health Administration (OSHA) acknowledges that it has a responsibility to address sexual assault on the job. In reality, though, the OSHA doesnt do much to tackle the issue. It took on its first case of workplace sexual assault in 2016.

For now, it is up to organisations such as the MCTF to do the tough work of finding the cases that no one else is looking for. There is not [much information] in these work sites of where to call if youre in trouble, of what you can do if a right is violated or if youre attacked, says Garca. They were almost like these lost islands, just operating in the middle of the night, for years and years and years. Were actually connecting them with society, and letting them know that their working conditions are wrong or that an attack on their person was wrong and theres something that they can do about it.

Sexual assault in the workplace is a crime and an extreme form of sexual harassment. It is outlawed by the US Civil Rights Act of 1964. Nevertheless, companies do not have to disclose how many sexual harassment complaints they receive internally, whether the claims were physical and violent, or how they handled them.

Complaints made to government agencies are often kept confidential until one party decides to file a lawsuit. Most sexual harassment complaints received by the federal government never result in litigation. They are processed and then stored in filing cabinets or databases.

Even lawsuits dont always reveal much about what is really happening. If a worker threatens to file a sexual harassment suit, the company can buy the persons silence by offering a confidential settlement before the case is filed and becomes public information. Cases that do make it to court can be kept under wraps through quick settlement agreements, which include confidentiality clauses that silence the worker and sometimes their attorneys.

Of course, some workers dont want their personal business known to everyone. Meanwhile, companies argue that keeping these claims out of the public eye is necessary. They say they settle cases as a way to end an embarrassing complaint, even when they dont truly believe the harassment happened. As a result, they worry that these lawsuits can sometimes become a kind of extortion by disgruntled or dishonest employees.

Advocates such as Garca, however, argue that it is difficult enough to convince women to come forward about far less sensitive problems being paid less than the minimum wage, for example. On the dozens of occasions when her organisation has unearthed cases involving sexual violence, the abused workers, for the most part, havent wanted to move forward with formal complaints because they didnt want anyone to know what had happened to them.

They internalise the shame and the wrongdoing, and the embarrassment is just overpowering, Garca says. They choose not to talk about it to any of their relatives. They really have no other support outside of whatever our organisation can provide.

When sexual assault happens among invisible workers in industries that few are monitoring, it becomes a crime that can be denied, a problem that never receives accountability or prevention. The repercussions of ignoring the realities of vulnerable workers are clear: if on-the-job sexual violence rarely comes to light, then the problem goes unaddressed and the perpetrator is free to abuse again.

This is an adapted extract from In a Days Work: The Fight to End Sexual Violence Against Americas Most Vulnerable Workers by Bernice Yeung, published by The New Press. Buy it at guardianbookshop.com

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Read more: https://www.theguardian.com/news/2018/mar/13/how-the-most-vulnerable-workers-are-targeted-for-sexual-abuse

The search for the perfect painkiller

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Millions of Americans are hooked on painkillers thousands die as a result. Scientists are striving to design a new, safer generation of opioids

Read more: https://www.theguardian.com/us-news/2018/jan/28/opioids-the-search-for-the-perfect-painkiller-tens-of-thousands-us-deaths-g-protein-coupled-receptor