Top Federal Drug Official Claims Marijuana Businesses Are Taking ‘Lessons’ From Big Tobacco And Alcohol

A top federal drug official says marijuana businesses have learned “lessons” from the alcohol and tobacco industries to market their products. The demographic that’s seeing the most rapid increase in usage rates are elderly people 65 and older, who are being “targeted” with messaging about the therapeutic benefits of cannabis, she says.

In a blog post published last week, National Institute on Drug Abuse (NIDA) Director Nora Volkow broadly argued that commercial interests are driving up rates of drug use and substance misuse disorder. While she’s long expressed concerns about criminalization as a policy, she raised a number of complaints with the commercial marijuana market that’s expanded as a result of the state-level legalization movement.

Although lawmakers and health agencies have seen progress in combating the use of other legal substances like tobacco, Volkow said the marijuana industry has “presented new opportunities for commercial interests to drive drug consumption across all ages and demographics.”

“Cannabis products are often sold in colorful packages that mimic kid-friendly snack foods, for example, making them appealing to children and to young people. Adolescents exposed to cannabis marketing have greater odds of using the drug,” she said. “The legalization of cannabis by the states and the diversification of cannabis products have led to significant increases in the number of users and the amount of cannabis consumed by them in the U.S.”

Volkow has previously recognized that data shows rates of youth marijuana use have remained stable despite her concerns about the potential impact of legalization, evidenced by multiple federally funded surveys, for example. And though she said in this latest blog post that certain cannabis products might be designed in a way that’s enticing to youth, she notes that young adults 18-30 have the highest usage rates, and there’s been a unique rise in consumption among the oldest demographic.

“This older age group is being targeted with advertising touting cannabis’ alleged therapeutic benefits,” the NIDA director said. “As expected, the expanded use of cannabis and the higher doses used have resulted in an increase in the number of individuals suffering from adverse health consequences from these exposures.”

Part of the problem, Volkow argued, is the commercial marketing of marijuana in states that have enacted legalization.

“Lessons learned from alcohol and tobacco are also being applied to the sale, marketing, and taxation of cannabis products in states that have legalized the drug for adult use, but policies vary widely by state,” she said, drawing a parallel in a way that echoes a common prohibitionist talking point about the emergence of “Big Marijuana.”

🆕 Nora's Blog: #NIDA Director Dr. Nora Volkow discusses how commercial interests are among the social determinants that contribute to substance use and addictive behaviors. https://t.co/YZEZKsL9n1pic.twitter.com/ep5SaVX8H1

— NIDAnews (@NIDAnews) September 27, 2024

“Needed is much more research to understand the potential risks and therapeutic applications of cannabis and to inform policy approaches that minimize cannabis’s harms, reduce the social and racial inequities associated with its criminalization, and ensure safe access for those who may benefit from it therapeutically,” she said.

“History has shown that businesses often put profits over public health, too often with tragic consequences. As we confront the rapidly evolving landscape of addictive and potentially addictive products and technologies, it is imperative that we conduct research to understand how commercial interests affect public health and individual health and well-being. Such research can help guide policies as well as inform the development of evidence-based prevention and treatment interventions.”

Volkow’s position on the potential harms of a commercial marijuana market isn’t new. But while advocates are in favor of taking steps to mitigate underage cannabis use, they feel the regulated state markets have proven effective at deterring such behavior, with safeguards such as ID checks in place to prevent access.

In any case, Volkow has maintained her stance that criminalization is not an effective alternative.

She’s previously said that the drug war “created a structurally racist system” in which Black people are treated “worse” than others. And she’s called on the government to move “away from criminalization,” arguing that the country’s failure to offer drug treatment to incarcerated people only exacerbates the ongoing opioid overdose crisis.

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Top Federal Drug Official Wants U.S. To Move ‘Away From Criminalization’ And Focus On Treatment

A top federal drug official is calling for the government to move “away from criminalization” under the drug war, saying that the country’s failure to offer drug treatment to incarcerated people only exacerbates the ongoing opioid overdose crisis.

“It remains a common belief that simply stopping people from taking drugs while in jail or prison is an effective approach to treatment,” Nora Volkow, director of the National Institute on Drug Abuse (NIDA) wrote in a new opinion article. “But that belief is inaccurate and dangerous.”

In fact, drug overdose “is the leading cause of death among people returning to their communities after being in jail or prison,” Volkow continued. “Providing addiction treatment in these settings could change that.”

In addition to calling for wider access to medication-assisted treatment—using the Food and Drug Administration (FDA)-approved drugs methadone, buprenorphine and naltrexone—the NIDA leader also said a shift away from the criminal drug war could help improve outcomes and help families.

“Fundamentally, an individual’s best or only option to receive addiction treatment should not have to be during incarceration,” Volkow wrote in the piece, which appeared last week in the life sciences publication STAT and was republished Monday on NIDA’s website. “In an ideal world, treatment and prevention systems in the U.S. would proactively address social drivers of health and mental health needs to stop the cycle between addiction and incarceration.”

“Moving away from criminalization of substance use disorders toward a public-health approach would remove a key structural practice that perpetuates equalities,” she said. “It would improve lives for people and their families.”

🆕 @statnews op-ed in Nora's Blog: #NIDA Director Dr. Nora Volkow & colleague Dr. Tisha Wiley discuss how the overdose crisis impacts people in jails or prisons, and the importance of providing addiction treatment in criminal justice settings. @jcoinctchttps://t.co/nlqpzAEvKdpic.twitter.com/muUAXr2Hog

— NIDAnews (@NIDAnews) July 15, 2024

As for medication-assisted treatment for incarcerated people with opioid use disorders, Volkow argues in the piece that it “benefits public health and public safety. It’s cost-effective. It can help break the cycle of recidivism. It can reduce the burden on the wider health care system, including emergency departments.”

“Programs across the country are underway to offer naloxone and medications for opioid use disorder in jails and prisons, paired with instruction, training, and social support,” she wrote. “Federal agencies have launched programs to help people manage withdrawal in jails and provide financial health care support for people who are about to reenter the community. A recently published revised methadone rule now allows any jail or prison registered as a hospital or clinic to dispense medications for opioid use disorder in certain circumstances.”

A study in Rhode Island estimating that deaths could be reduced by 30 percent in the state if incarcerated people had access to all three FDA-approved medications, Volkow noted. But nationwide, fewer than half of jails and a tenth of state prisons offer all three medications.

“All three are effective, safe, and lifesaving. But they are woefully underused, particularly in criminal justice settings,” she wrote. “Studies also show that people who receive these medications while in jail or prison are less likely to return to substance use and more likely to continue with treatment in the community afterward.”

Roughly 60 percent of people who are incarcerated have a substance use disorder, Volkow added, citing a 2017 Department of Justice report.

Even those charged with enforcing drug laws are “starting to see how addiction treatment increases safety for everyone,” the article says, referencing a Massachusetts sheriff, Chris Donelan, whose jail is one of a small number with a licensed opioid-treatment program:

“When someone is booked into our facility, often we are the first treatment provider the person has seen in years,” Donelan told his University of Massachusetts research partners. “These treatments save lives and help people enter into recovery. Treatment makes the work of our facility much easier. We have less fights, less contraband, and a much safer facility.”

While there’s still a long way to go, Volkow wrote, she drew attention to the National Institutes of Health’s work funding partnerships “to figure out how to link people with addiction to care during and after their time in the corrections system. These researchers are poised to share new evidence as it emerges that will help other communities make data-driven changes so they can implement what is most efficient in justice settings.”

Despite the federal government’s apparent stubbornness to drug reform, Volkow, director of NIDA since 2003, has been a frequent critic of the status quo and a voice in favor of rethinking the country’s criminal approach to substances.

Late last year, for example, she said that taking an abstinence-only approach to drug treatment was “magical” thinking that “costs a lot of lives.”

She’s also said that drug criminalization has “created a structurally racist system” in which Black people are treated “worse” than others.

As for marijuana, Volkow has said there’s “no evidence” that occasional marijuana use is harmful for adults. And at a 2022 D.A.R.E.-sponsored event hosted by an anti-marijuana advocacy group, she reiterated that data showed youth marijuana use had remained stable “despite the legalization in many states.”

Volkow said at a congressional hearing in May, meanwhile, that there’s “tremendous excitement” about the therapeutic potential of psychedelics. However, she cautioned that while the treatment option is “very promising,” people should understand that “it’s not magic” and needs more rigorous research.

The federal official has repeatedly discussed her interest in psychedelics therapy, acknowledging not only the potential but the societal impact of local and state reform potentially encouraging more people to use substances such as psilocybin outside of a clinical context.

She said in 2022 that the “train has left the station” on psychedelics amid the policy reform movement. Volkow discussed the issue in an earlier interview with Marijuana Moment as well.

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Top Federal Health Official Says Drug Criminalization Is Contributing To Stigma And Overdoses During And After Pregnancy

A top federal drug official is blasting the criminalization of drug use by pregnant people and new parents, arguing that the resulting stigmatization is harming families and contributing to the overdose crisis.

National Institute on Drug Abuse (NIDA) Director Nora Volkow become a vocal critic of drug criminalization in the past several years, noting racial disparities in enforcement and the ineffectiveness of treating addiction as criminal, rather than public health, matter.

In a recent op-ed published by STAT, Volkow focused on the consequences of criminalizing pregnant women over substance misuse disorders. She said that this population needs “support, not criminalization.”

There’s been a demonstrable increase in overdose deaths among people during and immediately after pregnancy, and it’s now the leading cause of death during or shortly after pregnancy, ranking higher than “excessive bleeding, cardiovascular conditions, or other well-known complications of pregnancy,” Volkow said.

“These stunning data highlight just how important it is to ensure access to substance use disorder treatment for pregnant and postpartum people, including the need to eliminate barriers that interfere with this treatment,” she wrote.

“People seeking treatment for addictions face additional obstacles, especially if they have children. Only a small minority of treatment facilities provide child care, creating yet another obstacle on top of securing transportation, housing, food, and other necessities, all of which can be more difficult for people who are also supporting children. The barriers get even higher for pregnant people.”

Fear of criminal punishment deters many pregnant people from seeking help for drug or alcohol problems. Read more on this in #NIDA Director Dr. Nora Volkow's op-ed in @statnews: https://t.co/p4Ny1xVNL6pic.twitter.com/3bVAtVGVkd

— NIDAnews (@NIDAnews) February 17, 2023

“Fear of criminal punishment deters many pregnant people from seeking help for drug or alcohol problems,” the director added. “Many U.S. states have punitive policies in place related to substance use in pregnancy, which may include regarding it as potential child abuse, or grounds for commitment or being charged with a criminal act. Penalties for substance use in pregnancy can include fines, loss of custody, involuntary commitment, or incarceration.”

Volkow wrote that “punitive policies cause pregnant people to fear disclosing their substance use to their health care providers or to avoid seeking treatment for a substance use disorder,” and they “may also cause them to avoid or delay getting obstetric care.”

“Decades of research show that addiction is a chronic but treatable condition that drives people to use substances even if it harms their health, careers, and relationships. Punitive policies are not effective at addressing substance use disorder and, if anything, only exacerbate its societal risk factors, including worsening of racial health disparities. Punitive approaches also lead to more negative outcomes for parents and their children…

Having a substance use disorder during pregnancy is not itself child abuse or neglect. Pregnant people with substance use disorders should be encouraged to get the care and support they need—and be able to access it—without fear of going to jail or losing their children. Anything short of that is harmful to individuals living with these disorders and to the health of their future babies. It is also detrimental to their families and communities, and contributes to the high rates of deaths from drug overdose in our country.”

#NIDA Dr. Volkow's op-ed in @statnews highlights the barriers that pregnant people face to receive substance use treatment.

"Pregnant people with substance use disorders should be encouraged to get the care & support they need — & be able to access it." https://t.co/p4Ny1xVNL6pic.twitter.com/qlYftG4fVq

— NIDAnews (@NIDAnews) February 13, 2023

Relatedly, an Alabama bill that moved through a Senate committee last year would have required women “of childbearing age” to present proof that they’re not pregnant in order to purchase medical cannabis products—a proposal that faced sharp resistance from drug policy and civil rights activists.

For her part, Volkow has been an outspoken advocate against criminalization, repeatedly encouraging an alternative approach to drug use that removes stigma and provides people with the treatment resources they need to recover.

Drug criminalization has “created a structurally racist system” in which Black people are treated “worse” than others, the official said in an interview late last year.

She also talked about the relationship between racial prejudice and drug criminalization in 2021, saying the U.S. is “currently reckoning with a long history of discriminatory and racist policies, many of which still continue today.”

Last year, Volkow said in a blog post that there’s an urgent need to reshape addiction treatment, specifically by putting more resources towards identifying “pre-addiction” to get people help before the disease.

In a separate essay in 2021, the health official reiterated that the current federal drug policy leads to disproportionate enforcement against communities of color and can actually increase the risk of overdose deaths. She stopped short of explicitly endorsing decriminalization, but signaled that it was time for that kind of an approach to effectively combat addiction and overdoses.

Volkow also discussed survey data last year and said that people are going to keep using psychedelics like psilocybin—especially as the reform movement expands and there’s increased attention being drawn to the potential therapeutic benefits—and so researchers and regulators will need to keep up.

The director separately participated in a panel hosted by a prohibitionist group and sponsored by D.A.R.E.—and she reiterated that data shows youth marijuana use has remained stable “despite the legalization in many states.”

She said the same at a Senate hearing last year, much to the surprise of a GOP senator who said he expected otherwise based on alcohol-related trends.

Also last year, Volkow also said that she’s yet to see evidence that occasional marijuana use by adults is harmful.

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