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Thug Drugs: Policy | Pain Pod · Pharmacy Podcast Network

0:05
Speaker 1: You are listening to the global network of podcasters dedicated
0:09
Speaker 1: to the pharmacy profession. Welcome to the Pharmacy podcast Network.
0:22
Speaker 2: This is the Pain Pod.
0:25
Speaker 1: You want to see pain look at me?
0:34
Speaker 2: Welcome to the Pain Pod, the podcast for all things
0:39
Speaker 2: pain management, hosted by the pain Guy, doctor Mark Grow.
0:48
Speaker 3: We'll be collaborating with numerous pain management experts, talking about
0:52
Speaker 3: substance usage disorders, the latest treatment modalities and the most
0:57
Speaker 3: important important focusing on the pain of our patients as
1:01
Speaker 3: leading providers of pain care. And now here's our host,
1:08
Speaker 3: a man wanted in all fifty states, a suburban city
1:12
Speaker 3: like Mountain man without the beard, from the hills of
1:17
Speaker 3: West Virginia and certified in weapons.
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Speaker 1: Of mass destruction response. Yes, doctor Mark say, welcome back
1:35
Speaker 1: Pain pod Nation. Today we're well, we're gonna build off
1:39
Speaker 1: our most recent episodes where we went over well, opioid everything,
1:43
Speaker 1: the opioid story, opioid ology. Right, We're going to kind
1:48
Speaker 1: of segue into, uh, well, the other land. Right, We're
1:51
Speaker 1: going to go back into our miniseries here on the
1:53
Speaker 1: Pain Pod of Thug Drugs. This time we're going to
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Speaker 1: review thug drugs policy. How do things get set up?
2:01
Speaker 1: As far as regulations and enforcement thereof in our country
2:06
Speaker 1: and beyond for that matter. So let's dive in. Okay,
2:11
Speaker 1: we got to keep in mind, I guess right out
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Speaker 1: of the gates that well, there are times when we
2:16
Speaker 1: have one substance with a different origin and you end
2:22
Speaker 1: up with legal or illegal substances. Right. You know, a
2:25
Speaker 1: couple examples come to mind, like heroin, for instance, it's
2:30
Speaker 1: illegal in our country, but in other countries when it's
2:33
Speaker 1: within the healthcare supply chain, so pharmas are going to
2:36
Speaker 1: manufacture hospital you name it, utilization legal, right, the United
2:43
Speaker 1: Kingdom comes to mind, a couple other countries. Meth is
2:46
Speaker 1: an interesting one, right, it's a c two in our country,
2:50
Speaker 1: but there's you know, different origin. When it's of the
2:53
Speaker 1: illicit background, then it's illegal. Right. So that's you know,
2:58
Speaker 1: kind of right out of the gate, a little tricky,
3:00
Speaker 1: and then you know, we all gosh, if you ever
3:02
Speaker 1: need a circular conversation, talk to folks about drug regulation. Right,
3:08
Speaker 1: there's so many different points of view out there and
3:11
Speaker 1: different countries doing different things. We have gotten our act
3:14
Speaker 1: together across the globe before. We'll touch on that in
3:18
Speaker 1: a little bit here. When we kind of you know,
3:20
Speaker 1: go over the bigger picture as far as what the
3:23
Speaker 1: world and of course our country have has done with
3:26
Speaker 1: drug regulation. But there was one study. It had a
3:29
Speaker 1: beautiful visual, I know folks were listening to a podcast here, right,
3:34
Speaker 1: but the bottom line was that it was you know,
3:36
Speaker 1: an X X and Y graph okay, up and down
3:40
Speaker 1: all around and had a you okay, the y axis
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Speaker 1: going up and down was harm, harm to the individual
3:47
Speaker 1: and society, and it basically illustrated you know, you there
3:51
Speaker 1: was more harm on the extreme ends. So with prohibition,
3:54
Speaker 1: there's more harm. If you say to a human you
3:57
Speaker 1: can't do that, we want to do that. If you
4:01
Speaker 1: say to a human, you know what, no worries, do
4:03
Speaker 1: whatever you want. We're going to do whatever we want,
4:06
Speaker 1: right And you know, somewhere in the middle there is
4:09
Speaker 1: the special sauce, the Sunday sauce, right, legalization, decriminalization, strict regulations,
4:17
Speaker 1: few restrictions along the way, you name it. But it
4:21
Speaker 1: all comes down to, you know, what the regulations are
4:24
Speaker 1: and of course what the enforcement and the market demand.
4:30
Speaker 1: Right now. For a long time, a little bit over
4:33
Speaker 1: fifty years in our country, from back in the seventies
4:36
Speaker 1: when we had the Controlled Substance Act. We've had controlled
4:39
Speaker 1: substance classes one through five generally speaking, kind of a
4:46
Speaker 1: straightforward to a complicated criteria for different classes. But the
4:52
Speaker 1: bottom line is do things generally accept the medical use
4:56
Speaker 1: and the abuse or addiction potential. That's how you get
4:59
Speaker 1: the differences between I mean, see one, two, three, four,
5:02
Speaker 1: and five along the way. But it doesn't end there.
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Speaker 1: That's the legal side. Legal side does not always include
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Speaker 1: the clinical side. For instance, safety okay. What that doesn't
5:12
Speaker 1: include is things like therapeutic index. What the heck is
5:16
Speaker 1: that you say, Well, therapeutic index the way that I
5:19
Speaker 1: would say it is difference between what will help you
5:20
Speaker 1: and want to harm you or what'll kill you. Right
5:24
Speaker 1: by the way, you want more wiggle room. You want
5:26
Speaker 1: a larger difference, a larger therapeutic index between what will
5:29
Speaker 1: help you and what will kill you as far as
5:32
Speaker 1: dosage for a particular substance goes. You want more wiggle room.
5:35
Speaker 1: It's interesting that some of even a illegal or controlled
5:39
Speaker 1: substances fall into the well, more wiggle room, wider therapeutic index,
5:44
Speaker 1: things like cannabis, LSD, psilocybin. That's the kind of the
5:51
Speaker 1: top of the crew there those three also have you know,
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Speaker 1: safety ratios, so different way of going about therapeutic induring,
6:00
Speaker 1: but difference between the effective dose and the lethal dose.
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Speaker 1: Those three have the highest numbers. Pun always intended as
6:07
Speaker 1: far as safety ratios as well. So you know, as
6:10
Speaker 1: our as you've heard from me before, our father of toxicology, Paracelsus,
6:15
Speaker 1: of course say it with me, folks, He said, solar
6:17
Speaker 1: dose is faster than in them. Basically, the dose makes
6:20
Speaker 1: the poison, right. I always say, it's all about the dosage, baby,
6:25
Speaker 1: and the distribution and the law. So let's start diving
6:31
Speaker 1: a little bit more intently into the law the policy. Okay, Now, folks,
6:36
Speaker 1: I can use a word that these days just provokes
6:38
Speaker 1: a lot of conversation. Okay, but it's just it's not
6:41
Speaker 1: to be political. It is just a reality. Okay. We
6:45
Speaker 1: start out with the eighteen thirty two terror fact I've
6:48
Speaker 1: warned you that exempted opium from import duties. Okay, long
6:52
Speaker 1: time ago we had a lot more boats. Okay. A
6:55
Speaker 1: decade later we also had another terror fact that added opium.
6:59
Speaker 1: Back in twenty years later, we had another ar fact
7:01
Speaker 1: that added morphine in more tariffs. Right then, in nineteen
7:06
Speaker 1: oh six, we had the Food and Drug Act that basically,
7:08
Speaker 1: in one way, shape or form, basically said, hey, the
7:10
Speaker 1: label's got to be correct, can't be having misbranding or adulteration.
7:15
Speaker 1: And here we are today wondering that with things like
7:16
Speaker 1: cannabis and other substances. Right then we had a big one,
7:20
Speaker 1: the nineteen fourteen Harrison Narcotics Tax Act. That was where
7:24
Speaker 1: you know, the government and taxes and substances really joined
7:29
Speaker 1: together or collided. Big, big, big, big idea there right Well,
7:37
Speaker 1: right after that, we had a good number of other ones.
7:40
Speaker 1: Oh heck, nineteen twenty seven, guy by the name Harry
7:43
Speaker 1: Anslinger was put in charge of the Federal Bureau of Narcotics,
7:46
Speaker 1: So might say, hey, that eventually became kind of like
7:49
Speaker 1: the DEA. Maybe not. Nineteen twenty nine we had the
7:52
Speaker 1: Poor Di Act that established some narcotic prisoner farms in
7:55
Speaker 1: Kentucky and Texas. Nineteen thirty nine we had the Vehicle
7:59
Speaker 1: Seizure Act, where, well, if you were transporting illegal drugs
8:01
Speaker 1: audios to your car. Then we had nineteen forty two
8:05
Speaker 1: we had the Opium Poppy Control Acts that basically said
8:08
Speaker 1: you can't grow your own opium anymore, at least without
8:10
Speaker 1: a license. You might be thinking, today, who does that?
8:13
Speaker 1: Well there was that act? Right? Oh well, last I
8:17
Speaker 1: actually skipped over one, the big one, nineteen thirty seven
8:21
Speaker 1: Marijuana Tax Act. You might be thinking, why is he
8:25
Speaker 1: saying it that way? Well, that's spelled with an H
8:28
Speaker 1: in the middle instead of a J. It was actually
8:30
Speaker 1: a stigmag term that was derived from Mexican Spanish, and
8:33
Speaker 1: basically we said, okay, we're gonna have these tax stamps
8:36
Speaker 1: now one dollar, five dollars, you name it. Farmers could
8:39
Speaker 1: purchase the stamps to grow cannabis. Prescribers and dispensers were
8:44
Speaker 1: taxed on the sales. Thereof interesting, right Keith it in
8:49
Speaker 1: mind from a further conversation on that one later. But
8:52
Speaker 1: I canna take a little pivot. Okay, let's sketch you
8:55
Speaker 1: on the edge of your seats here unless you're driving.
8:58
Speaker 1: I guess who's watching Stranger Things? Oh that one kind
9:03
Speaker 1: of came on? Or what about wormwood or the born
9:05
Speaker 1: Identity or get this one, the men who stare at goats?
9:09
Speaker 1: What are these all have in common? Interesting screenplay? Right,
9:14
Speaker 1: they're all referencing mk ultra or casually based upon mk ultra,
9:20
Speaker 1: and some of you may have known that authors are
9:23
Speaker 1: thinking what the heck is that? Well, the overall idea
9:25
Speaker 1: for mk ultra was that it was this effort in
9:27
Speaker 1: our country to create a truth serum that could be
9:29
Speaker 1: used in the Cold War one, to know what the
9:32
Speaker 1: Russians were up to. Okay, we had experiments multiple cities,
9:37
Speaker 1: college campuses, hospitals all across the country. The general idea
9:40
Speaker 1: was that stimulant was injected in one arm, sedative in another.
9:44
Speaker 1: Hypnosis was involved, kind of see what happens. People had
9:48
Speaker 1: a lot of babbling. Of course, it's kind of like
9:50
Speaker 1: waking up for anesthesiology team being there. Of course, at
9:54
Speaker 1: least I've been there. My wife said it was hilarious.
9:58
Speaker 1: I believe her. But you know, but back to then,
10:01
Speaker 1: paletr I digress. So the US sanctioned it supposedly in
10:04
Speaker 1: nineteen fifty three, and then twenty years later the CIA director
10:08
Speaker 1: ordered all the files destroyed. Whoa files being destroyed. Two
10:15
Speaker 1: years later, the President ford A commissioned an investigation into
10:19
Speaker 1: CIA activities. I was actually the Church Committee and the
10:22
Speaker 1: Rockefeller commissioner. I'm sure you've heard of that. And two
10:26
Speaker 1: years later in nineteen seventy seven, the Freedom of Information
10:29
Speaker 1: Act requested that the twenty thousand documents found were made
10:34
Speaker 1: publicly available. And now here we are watching those shows. Right.
10:39
Speaker 1: When it comes to Stranger Things, Well, it took me
10:41
Speaker 1: a little bit longer. I guess I wanted to make
10:43
Speaker 1: sure that it was a really good show, so I
10:45
Speaker 1: waited till the thing was darned near over before I
10:48
Speaker 1: started watching. But really, it only takes that first episode
10:51
Speaker 1: for most folks. Anyways, what about the world overall? Okay,
10:54
Speaker 1: now we're in the sixties. In nineteen sixty one, we
10:58
Speaker 1: held the first single convention on our Arctic drugs. Basically
11:01
Speaker 1: got together as a globe one hundred and eighty four
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Speaker 1: countries and it basically the idea when everybody walked out
11:07
Speaker 1: with some printed documents saying there was four schedules of drugs,
11:10
Speaker 1: things like cannabis, cocopioids, you name it. Okay, but we
11:14
Speaker 1: got we got the whole world together on that. We're
11:17
Speaker 1: going to have a couple mentions of that and the
11:19
Speaker 1: timeline here in decades to come. All right. We also
11:24
Speaker 1: had basically you know, the next decade, having nineteen seventy
11:29
Speaker 1: controlled substance Act. Perhaps one of the biggest things right again,
11:33
Speaker 1: that's forming the controlled substance classes and whatnot. Now, interestingly enough,
11:39
Speaker 1: that was you know, under the administration or President Nixon.
11:43
Speaker 1: One of top advisors, John Erlickman, is on the record
11:48
Speaker 1: basically saying that a lot of the driver was racism.
11:52
Speaker 1: Go figure. So when you were talking about drug utilization,
11:56
Speaker 1: there was there was some of that involved. That's been printed,
12:01
Speaker 1: that's been published in different places. So we have our receipts. Right,
12:06
Speaker 1: interesting spend on thug drug policy when you think about
12:10
Speaker 1: it in the big picture. All right, around the same
12:13
Speaker 1: time in nineteen seventy one, we got the band back together.
12:16
Speaker 1: We got the Convention on Psychotropic Substances to add psychotropic
12:19
Speaker 1: substances to that list from nineteen sixty one. All right,
12:24
Speaker 1: we're keeping our timeline here, We're going to come back
12:26
Speaker 1: to America. Well, nineteen seventy three, the DEA was established,
12:30
Speaker 1: the Drug Enforcement Agency. It was a President Nixon executive order.
12:35
Speaker 1: You know, the DEA. It comes across as like this
12:38
Speaker 1: soul entity, but of course it is part of our
12:41
Speaker 1: US Department of Justice, like many other entities. For instance,
12:46
Speaker 1: you know a lot of times there'll be evidence that's
12:48
Speaker 1: shared acquired by the DEA, shared with US attorneys to
12:51
Speaker 1: have the actual court cases overall. But there's multiple, many
12:56
Speaker 1: parts of the DOJ. The DJ is part basically led
13:01
Speaker 1: by the Attorney General, who will have a seat at
13:03
Speaker 1: the President's cabinet. Okay, and that's a big thing. That's
13:08
Speaker 1: the top folks in our country. Okay, all right. Here's
13:11
Speaker 1: a little curve ball for us, particularly for our student
13:14
Speaker 1: pharmacists out there the later year ones. Here's one that
13:17
Speaker 1: could be on your log exam for licensuring whatever state.
13:21
Speaker 1: The Orange Book, the DEA Orange Book. What is that? Well,
13:27
Speaker 1: the DEA Orange Book is the book of the listing
13:30
Speaker 1: of controlled substance schedules. If you are in the book,
13:35
Speaker 1: you are a controlled substance. If you're a CS one
13:38
Speaker 1: in the book, you're illegal. If you're not in the book,
13:40
Speaker 1: you are not illegal. Does that make you legal, Well,
13:44
Speaker 1: it makes you not legal. I'll end it at that, folks,
13:48
Speaker 1: all right. I wanted to build off of that because
13:51
Speaker 1: then we had the nineteen eighty six Anti Drug Abuse Acts.
13:53
Speaker 1: Lots of stuff going on with that Act. One main
13:56
Speaker 1: thing stands out to me anyways, it was one of
13:58
Speaker 1: these subtitles. You know, another section within it, so Controlled
14:02
Speaker 1: Substance Analog Enforcement Act basically said if a chemical is
14:05
Speaker 1: substantially similar two a CS one or CS two to
14:10
Speaker 1: an illegal substance or controlled substance, then it's going to
14:13
Speaker 1: be treated like that. So those analogs would be often
14:17
Speaker 1: referred to as designer drugs. But you know there'll be
14:19
Speaker 1: challenges to that. We'll get there a couple couple of
14:22
Speaker 1: years in our timeline here, all right, So keep that
14:26
Speaker 1: one in the back of your mind. But then we
14:28
Speaker 1: had the nineteen eighty eight convention where we got the
14:30
Speaker 1: band back together again, one hundred and eighty eight countries
14:32
Speaker 1: this time, and it basically got everybody together to say, hey,
14:38
Speaker 1: the precursors to the previously identified from nineteen sixty one
14:41
Speaker 1: to nineteen seventy one conventions, we're going to include those
14:43
Speaker 1: in the list too. All right, now that the band
14:47
Speaker 1: has concurred, let's kick it back to our country here,
14:52
Speaker 1: just say no drug abuse, resistance education. This is your
14:58
Speaker 1: brain an egg, This is your brain on drugs and
15:01
Speaker 1: egg thrown into a skillet and cooked and sizzling. You
15:05
Speaker 1: guessed it. What is nineteen eighty eight? So the end
15:08
Speaker 1: of the eighties Reagan administration. Actually, the first Lady Nancy
15:13
Speaker 1: Reagan was one of the largest efforts, of course, within
15:17
Speaker 1: the Just Say No partnership. Overall, there's lots of different
15:21
Speaker 1: observational studies out there of whether that in that all
15:24
Speaker 1: all those efforts worked or not. But you know, for
15:28
Speaker 1: some enough for others overall. I even remember this, this
15:32
Speaker 1: one's a little more personal, but when I first started driving,
15:36
Speaker 1: I had a black vehicle. I'm going to tell you
15:39
Speaker 1: the making model because that'll be some security question somewhere,
15:42
Speaker 1: of course, But anyways, I had a black car and
15:43
Speaker 1: I wanted a black license plate because in my state
15:45
Speaker 1: of Pennsylvania, there was a DARE license plate and it
15:49
Speaker 1: was black. So I was like, that looks cool. I'll
15:51
Speaker 1: get that. And I had multiple people ask me, are
15:54
Speaker 1: your parents law enforcement? How do you get that license plate? Good? Golly,
15:58
Speaker 1: So different ways to spread the knowledge, of course, but yeah,
16:03
Speaker 1: that was the drug abuse resistance education. And here we
16:05
Speaker 1: are today talking about education and policy specifically, right, all right,
16:10
Speaker 1: So in that same year, in nineteen eighty eight, of course,
16:12
Speaker 1: we had the Office of National Drug Control Policy formed,
16:17
Speaker 1: and we still hear about that today because well, the
16:20
Speaker 1: leader of it is generally referred to as the US
16:22
Speaker 1: Drugs Are, which is now a cabinet level status since
16:26
Speaker 1: President Clinton in nineteen ninety three elevated the Drugs ARE
16:30
Speaker 1: to the cabinet, the presidential cabinet. All right, now, remember
16:35
Speaker 1: I mentioned keeping in the back of your head here
16:37
Speaker 1: that Federal Controlled Substance Analog Act. Okay, in the nineties,
16:41
Speaker 1: and turn the central we get two challenges to that, Okay,
16:44
Speaker 1: two main ones. First one was in nineteen ninety two
16:47
Speaker 1: is the United States versus Forbes. I was basically looking
16:50
Speaker 1: at multiple psychedelic substances and analogs to say, hey, are
16:54
Speaker 1: these similar, because then you know the newer one would
16:57
Speaker 1: be legal. Then right, well, the court said nope, not
17:00
Speaker 1: similar enough, and that was the law of the land.
17:04
Speaker 1: Then right alas stay tuned. In two thousand and three
17:08
Speaker 1: we had United States versus wash Them. You had a
17:12
Speaker 1: GHB and an analog that ultimately the court said was similar.
17:17
Speaker 1: And that's the last major case. So that's the standing
17:20
Speaker 1: idea now is that if something looks like a duck,
17:23
Speaker 1: sounds like a duck, it's a duck. And if that
17:25
Speaker 1: duck is in the Orange book, then enlisted as a
17:28
Speaker 1: C one, it's illegal, So that duck would be illegal.
17:31
Speaker 1: And if that duck has an analog, you know, another
17:35
Speaker 1: feathered friend. Maybe it's a different couple of different colored feathers,
17:38
Speaker 1: or maybe a couple of longer feathers, well that's illegal too. Okay.
17:43
Speaker 1: I know I took a little liberty there, but the
17:46
Speaker 1: general idea is that if it's close enough as an analog,
17:50
Speaker 1: then as of these days, it stands okay, all right,
17:54
Speaker 1: Taking a little pivot here Turing the century, two thousand
17:57
Speaker 1: and three, we had the Rave Act, and that basically said, well,
18:01
Speaker 1: if you have you're doing anything associated with the manufacturing, storing, distributing,
18:07
Speaker 1: or utilization thereof for a controlled substance, you're guilty as well.
18:12
Speaker 1: So basically, if somebody owned the land where a rave
18:14
Speaker 1: was held, they were going to have to pay a
18:15
Speaker 1: fine of a quarter million dollars or even twice. Whatever
18:18
Speaker 1: the event took in, think about that. That had some impact.
18:23
Speaker 1: Pretty quick overall. Doesn't mean always, but pretty quick, all right.
18:28
Speaker 1: Next up is one of all of our favorites, of course,
18:31
Speaker 1: the two thousand and five Combat Methamphetamine Epidemic Act c MEA. Now,
18:38
Speaker 1: what does this ultimately mean. It means the last time
18:40
Speaker 1: that I had congestion, I had to practically give my
18:43
Speaker 1: right kidney and first born and show an ID to
18:47
Speaker 1: get a decongestion that would actually work. Right false, But anyways,
18:52
Speaker 1: you probably get where I'm going with that. So this
18:55
Speaker 1: put a limit on the amount quantity, limits on the
18:58
Speaker 1: amount of pseudo an that could be sold to an individual,
19:02
Speaker 1: because at the time there was people going and buying
19:05
Speaker 1: cases of pseudo afedron to make metho out of it.
19:07
Speaker 1: We can't have that happening, right well, we cracked down
19:11
Speaker 1: on that, right pun always intended. The trouble is that
19:17
Speaker 1: the street chemist said, oh, look at you. You're playing
19:21
Speaker 1: checkers and we're over here having fun playing chess. There's
19:25
Speaker 1: multiple ways to make meth. Back in the day, they
19:28
Speaker 1: use P two P to make it. That got old
19:30
Speaker 1: cracked down on that, started using pseudo afhedron with all
19:33
Speaker 1: these reductive reactions for our og okem nerds out there,
19:40
Speaker 1: me too, and then here we are. We cracked down
19:43
Speaker 1: on that, and they said, all right, fine, we'll just
19:46
Speaker 1: use the precursors to P twop, import those from other
19:48
Speaker 1: countries that will provide them and we'll go forth and
19:52
Speaker 1: make the cheapest yet most pure important myth that the
19:55
Speaker 1: world has ever seen. And here we are today. So
19:58
Speaker 1: the question is, with you know, all the limits of
20:00
Speaker 1: pseudoephedrin sales, did we get the win? Usually it's viewed
20:07
Speaker 1: as we won the battle, but what about the war?
20:10
Speaker 1: Right now? It doesn't mean get rid of that, and
20:11
Speaker 1: it wasn't nope, nope, nope, nope, but we got to
20:14
Speaker 1: keep that in mind overall. Okay, all right, then let's
20:19
Speaker 1: see back into the time I twenty twelve, we had
20:21
Speaker 1: the Synthetic Drug Abuse Prevention Act that basically said, ah,
20:24
Speaker 1: about over two dozen varieties of synthetic cannabinoids and cathdones
20:27
Speaker 1: were adding them in there for yeah, they're illegal too.
20:31
Speaker 1: That leads us up to the two thousand and eight
20:33
Speaker 1: you know this one farm bill, the Agricultural Improvement Act.
20:36
Speaker 1: It was actually a budget. So the Farm Bill basically
20:39
Speaker 1: removed him for cannabis sativa and derivatives with THHC concentrations
20:44
Speaker 1: no more than zero point three percent tc. I always
20:49
Speaker 1: have to ask, what does that actually mean? What is
20:51
Speaker 1: zero point three percent? What is that? It's it's not
20:55
Speaker 1: a number that's you like useful when purchasing a right,
21:01
Speaker 1: so join me, About five to ten milligrams of THC
21:05
Speaker 1: you can typically cause intoxication, euphor you you know. Uh,
21:09
Speaker 1: So let's take a couple of products. First thing would
21:11
Speaker 1: be like a little bottle called thirty mls of CBD extract, Okay,
21:15
Speaker 1: probably gonna have about eighty one milligrams of THC. You
21:18
Speaker 1: might have thought I was gonna say aspra, but nope.
21:20
Speaker 1: And you know, two the little dropper fools, you know,
21:22
Speaker 1: low dose might have like less than a third of
21:25
Speaker 1: a milligram in them. So well, that's far from five
21:28
Speaker 1: to ten milligrams causing intoxication. So no worries there, right,
21:31
Speaker 1: at least for a single dose. What about the gummies? Ooh,
21:35
Speaker 1: I'm sure the tone nailed it. So you got a
21:37
Speaker 1: four gram CBD gummy that could contain twelve milligrams of
21:40
Speaker 1: THC and by the way, there's like thirty of them
21:42
Speaker 1: in the container, right, Well, twelve milligrams is definitely more
21:46
Speaker 1: than five to ten milligrams. And all of a sudden,
21:48
Speaker 1: then escalated quickly, Right, what was everyone thinking with this
21:53
Speaker 1: zero point three percent thing? It's like we didn't see
21:56
Speaker 1: it coming or something good, Gully so much more. Ado.
21:59
Speaker 1: I'm convinced that we have a specific special report paint
22:02
Speaker 1: pod episode when we get the new classification, you know,
22:08
Speaker 1: regulatory status for cannabis in our country. But how does
22:12
Speaker 1: that actually go down in general? Well? Two ways. The
22:15
Speaker 1: first way is Congress passes legislation. That's it, wipe the hand,
22:21
Speaker 1: We're done. Then the other way is, well, it involves
22:25
Speaker 1: the Attorney General with a petition and then HHS Department
22:29
Speaker 1: of Health and Human Services, the FDA comes back to
22:32
Speaker 1: the Attorney General. If it involves economics, which it always will,
22:35
Speaker 1: the White House gets involved, so executive branch involvement, and
22:38
Speaker 1: eventually we have a resolution. Or again, the first option
22:41
Speaker 1: was Congress passes legislation, so you know, we'll we'll see.
22:45
Speaker 1: But that's the general la land for any controlled substance.
22:49
Speaker 1: But what about cannabis specifically? So what are the actual
22:51
Speaker 1: outcomes of becoming a seat three? Okay, two things I'm
22:54
Speaker 1: gonna go over here. First one is we'll see within
23:00
Speaker 1: our federal regulations, there's a very specific one titled Dispensing
23:04
Speaker 1: without Prescription. What it basically says is that a controlled
23:08
Speaker 1: substance CE two through five, which is not a prescription
23:12
Speaker 1: drug under you know better Old Food Drug and Cosmetic
23:15
Speaker 1: Act does not have to be approved. May be dispensed
23:19
Speaker 1: by a pharmacist without a prescription as long as it
23:21
Speaker 1: hits these handful of criteria. What are the criteria, you ask, Well,
23:27
Speaker 1: only a pharmacist can dispense. There's maximums on quantity and
23:34
Speaker 1: as being an adult with ID, you had to record
23:37
Speaker 1: the dispensing in a in a bound book. So much
23:40
Speaker 1: for electronics, I guess and central fill or mail order
23:43
Speaker 1: pharmacies cannot be utilized. So kind of little hanging fruit.
23:48
Speaker 1: Does this mean that you know, if it's becomes a
23:50
Speaker 1: C three that well, we'll see compounding and dispensing in pharmacies.
23:53
Speaker 1: It means that it's potentially possible, but we'll see right
23:58
Speaker 1: where the real meat and potatoes are at or with
24:00
Speaker 1: tax deductions. Okay, right now, you got your dispensaries that
24:04
Speaker 1: you know you've seen, actually you've heard here before in
24:07
Speaker 1: the pain Pot episode for thug drugs cannabis back in
24:09
Speaker 1: the day. You know, the revenue from cannabis or cannabinoid sales. Right.
24:15
Speaker 1: One of the things, though, is that if it becomes
24:17
Speaker 1: a C three, then state legal cannabis businesses would be
24:24
Speaker 1: able to claim the standard federal tax deduction. It involves
24:27
Speaker 1: this section two eighty e to be specific. Not too
24:31
Speaker 1: sure folks are worried about that one. But bottom line
24:34
Speaker 1: of typical dispensary would probably rake in an extra quarter
24:37
Speaker 1: million a year from the tax deductions. That's pretty profound, right,
24:43
Speaker 1: all right, so we shall see. Let's go a little
24:47
Speaker 1: bit larger here. Let's go across the globe again, a
24:49
Speaker 1: big picture. You know, how does how do different countries
24:52
Speaker 1: go about this whole policy idea? Right, Well, you have
24:56
Speaker 1: our extremes. There's the death penalty. More more are active
25:00
Speaker 1: in parts of Asia, Middle East, you name it. Philippines
25:05
Speaker 1: actually also, for instance, have a death penalty, you know,
25:08
Speaker 1: in regards to drugs as well. Singapore is another example
25:12
Speaker 1: where you know, just trafficking, say more than I think
25:16
Speaker 1: it's thirty grams of coke or even five hundred grams
25:19
Speaker 1: of cannabis, so you know it's a substantiated amount, or
25:22
Speaker 1: manufacturing any of the substances even could end up in
25:26
Speaker 1: the death penalty. Think about that, the death penalty. Wow. Conversely,
25:32
Speaker 1: there's also decriminalization. One of the first questions that comes
25:35
Speaker 1: up from a lot of folks. Not everybody would be
25:37
Speaker 1: what is that? So the general idea is that, you know,
25:41
Speaker 1: there's reprecautions to possession of drugs or use thereof, but
25:45
Speaker 1: it's not gonna typically be being locked up, you know,
25:47
Speaker 1: put in jail. Overall, it's decriminalized. Okay. There's instances with
25:53
Speaker 1: multiple countries across our globe. One of the most famous
25:55
Speaker 1: ones with Portugal to turn of the century. It's a
25:58
Speaker 1: while ago. Back in two thousand and one, they decriminalized everything. Okay,
26:03
Speaker 1: and you can be thinking, well, how'd that go? Well,
26:06
Speaker 1: you also got to think about what their goal was. Okay,
26:09
Speaker 1: we'll get there. But after decriminalizing all drugs, drug use continued. Well,
26:15
Speaker 1: so then was it not a win? Hold on hold
26:18
Speaker 1: on HIV incidents also decreased, and overdose deaths decreased as well.
26:23
Speaker 1: They were in it for reducing the harm to their
26:26
Speaker 1: society and that was a victory, but drug use did continue, so,
26:32
Speaker 1: you know, different viewpoints. Overall, we see other instances. Even
26:36
Speaker 1: our neighbors to the south, Mexico, they have a small
26:39
Speaker 1: scale drug law. Basically there's a three strike system on
26:43
Speaker 1: that third strike for being caught with possession you're gonna
26:47
Speaker 1: have mandatory treatment. Kind of interesting. Speaking of interesting, I
26:51
Speaker 1: got a couple more up my sleeve here, folks. Let's
26:53
Speaker 1: say Berlin, Okay. Over in Germany, they came up with
26:58
Speaker 1: this idea small scale to on roads, a couple of roads,
27:04
Speaker 1: paint an area with like the outline of it with
27:08
Speaker 1: pink spray paint, and if you're within that area, you
27:13
Speaker 1: could use drugs. Okay, think about that now. If that
27:16
Speaker 1: gets you wondering, I'd like to share. I used to
27:19
Speaker 1: live in Baltimore, Okay, and I distinctly remember driving through
27:23
Speaker 1: Baltimore in some particular neighborhoods where we'd always see these
27:26
Speaker 1: blue lights up on light posts and thinking, what is that.
27:29
Speaker 1: I'd do something with law enforcement because we saw the
27:31
Speaker 1: bad you know, the symbol the emblem there for you
27:34
Speaker 1: know law enforcement. Turns out, uh, The general idea was
27:38
Speaker 1: that on corners within town, you know, intersection two roads,
27:43
Speaker 1: on corners where there was known drug sales, they put webcams.
27:47
Speaker 1: But I'd be fair, and you gotta announce that you
27:49
Speaker 1: have a webcam there, so you had to put a blue.
27:50
Speaker 3: Light on it.
27:52
Speaker 1: Well, think about that. If you're a drug dealer and
27:54
Speaker 1: you then illegal drug dealer and you see the blue light,
27:57
Speaker 1: You're gonna waddle on down to the next block. Right,
28:00
Speaker 1: So then they kept putting more and more webcams with
28:02
Speaker 1: the blue lights on them. I wish I could show
28:04
Speaker 1: you the map. You could picture very easily though. Just
28:07
Speaker 1: about every major blockhead a blue light on it. Go figure.
28:12
Speaker 1: So that's pretty interesting. But alas, there's one more folks,
28:18
Speaker 1: All right, how many of you I've mentioned different shows
28:20
Speaker 1: and movies before, but how about The Wire? How many
28:23
Speaker 1: folks watched The Wire? Like twenty years ago on HBO.
28:26
Speaker 1: In a later season couple episodes, they had this thing
28:29
Speaker 1: called Hamsterdam. What was that? Well, they basically said, okay,
28:34
Speaker 1: this like say, two block area, We're not going to
28:36
Speaker 1: regulate it, We're not going to enforce it. Do whatever
28:39
Speaker 1: you want, use all the drugs you want. In the
28:42
Speaker 1: fake story within the store the show called The Wire
28:46
Speaker 1: on HBO. Well, that was a lot of chaos ensuing, right,
28:50
Speaker 1: But you might be thinking how the writers come up
28:53
Speaker 1: with that? Ah bang, guys, got your back. Y'all heard
28:56
Speaker 1: about Krakelandia. Yeah, it's in Sapollo, Brazil, real life in St. Paulo, Brazil.
29:04
Speaker 1: They blocked off a couple of blocks, We'll say two
29:07
Speaker 1: and said have at it. Do whatever you want. Picture
29:10
Speaker 1: lots of tents, those ten by ten tail getting ones
29:13
Speaker 1: up everywhere, people utilizing whatever they wanted, doing whatever they wanted.
29:17
Speaker 1: Each subsequent administration of the country was not really down
29:22
Speaker 1: with that. So, you know, one that was against it,
29:24
Speaker 1: after one that was for it. The one that was
29:26
Speaker 1: against it said, all right, we got to get the
29:27
Speaker 1: people out of here. So they literally went in with flamethrowers,
29:30
Speaker 1: and you know what the people did. They laughed. Obviously
29:33
Speaker 1: those fame flamethrowers. You know where they went a couple
29:36
Speaker 1: of blocks away. Once that decision is made to go
29:40
Speaker 1: down these novel, unique routes hard to turn back, right,
29:44
Speaker 1: and in the end, you know, what are we really
29:46
Speaker 1: doing here? You know? As far as decriminalization or legalization,
29:51
Speaker 1: you know, it's all within the illicit drug supply chain.
29:53
Speaker 1: The leaders there, of course, are the cartels. Turns out
29:56
Speaker 1: that cartels are diversified businesses. Okay, it's not all illegal drugs,
30:00
Speaker 1: and it takes an appreciation of that to get someone.
30:03
Speaker 1: So one of the common questions is like, oh, well,
30:05
Speaker 1: if we decriminalize everything, when the cartels go away, probably
30:10
Speaker 1: not so much. They're into logistics. You think upsynthetics are good.
30:16
Speaker 1: These guys know what they're doing. Okay. It's all about
30:19
Speaker 1: the distribution routes all throughout our country. Large distribution routes
30:23
Speaker 1: down to smaller veins, right. And it's not just illegal drugs.
30:26
Speaker 1: There's avocados, same route, cigarettes, iron you name it. Okay,
30:33
Speaker 1: So that's got to be appreciated when we're thinking about
30:35
Speaker 1: how we go about addressing the drug concerns. Right. Because
30:41
Speaker 1: in the end, folks, and this is what I really
30:43
Speaker 1: want to end with it, it's all about perception, particularly perception
30:46
Speaker 1: of risk, Okay, regardless of what the policies are and
30:50
Speaker 1: the enforcement thereof are and the distribution is regardless of
30:54
Speaker 1: all that, perceived risk is extremely important. There's a good
31:00
Speaker 1: number of studies out there that go over this, and
31:02
Speaker 1: typically they're with a specific population or you know, age range.
31:07
Speaker 1: You know, one came to mind, particularly with like high
31:10
Speaker 1: school seniors and cannabis utilization, and the bottom line was
31:15
Speaker 1: whenever perceived risk, they followed them throughout the years. Whenever
31:19
Speaker 1: perceived risk was low, utilization was increased. And conversely, when
31:24
Speaker 1: perceived risk or harm was high pun always intended utilization
31:30
Speaker 1: was low. It's always in verse. So the education, the perceptions,
31:37
Speaker 1: that's where it's at. Okay. That's why Peyton Gayla loves
31:41
Speaker 1: to be an educator here and a podcaster for that matter.
31:44
Speaker 1: It really comes down to, you know, to inform policy, yes,
31:48
Speaker 1: but even beyond that the education and spreading the knowledge
31:52
Speaker 1: when it comes to all things drugs. Okay. So I
31:55
Speaker 1: really hope that you enjoyed this episode of the Pain
31:57
Speaker 1: Pod as we did thug drugs policy. We'll have some
32:03
Speaker 1: follow up things once we get some changes with the
32:05
Speaker 1: cannabis realm, of course, but hopefully this was worth your
32:09
Speaker 1: time or even more. And as always, folks, I wish
32:13
Speaker 1: you a great day every day.
32:18
Speaker 3: If you'd like to join Mark on the Pain Pod,
32:21
Speaker 3: send us an email to publish your at Pharmacy podcast
32:24
Speaker 3: dot com and make sure to share the show and
32:28
Speaker 3: subscribe on your favorite podcast directory.
32:31
Speaker 1: Thanks for listening.