Marvin D. Seppala
Special to CNN

Prescribed opioids - pain medication - have become the fastest-growing addiction problem in the United States. They are second to marijuana as the most commonly used illicit substances.

Vicodin and OxyContin lead the way among our youth; the 2008 "Monitoring the Future Study" by the National Institute on Drug Abuse found that 9.7 percent of high school seniors have misused Vicodin and 4.7 percent OxyContin.

There is a naïve consensus that these are safe medications because they are prescribed by physicians. However, they are extremely reinforcing, highly addictive and in the same class of drugs as heroin.

Keep reading...

Program Note: For more on the medical marijuana controversy,  tune in to America's High, an AC360° special program, on Friday, July 24 at  11pm ET.

Justin Scheck and Stu Woo
Wall Street Journal

Sellers of marijuana as a medicine here don't fret about raids any more. They've stopped stressing over where to hide their stash or how to move it unseen.

Now their concerns involve the state Board of Equalization, which collects sales tax and requires a retailer ID number. Or city planning offices, which insist that staircases comply with the Americans With Disabilities Act. Then there is marketing strategy, which can mean paying to be a "featured dispensary" on a Web site for pot smokers.

After years in the shadows, medical marijuana in California is aspiring to crack the commercial mainstream.

"I want to do everything I can to run this as a legitimate business," says Jan Werner, 55 years old, who invested in a pot store in a shopping mall after 36 years as a car salesman.

State voters decreed back in 1996 that Californians had a right to use marijuana for any illness - from cancer to anorexia to any other condition it might help. But supplying "med pot" remained risky. The ballot measure didn't specify who could sell it or how. The state provided few guidelines, leaving local governments to impose a patchwork of restrictions. Above all, because pot possession remained illegal under U.S. law, sellers had to worry about federal raids.

But in February, the Justice Department said it would adhere to President Barack Obama's campaign statement that federal agents no longer would target med-pot dealers who comply with state law. Since then, vendors who had kept a low profile have begun to expand, and entrepreneurs who had avoided cannabis have begun to invest.

READ MORE...

Elizabeth Landau
CNN.com Health Writer/Producer

The general anesthetic Diprivan (propofol) has been making headlines as questions about Michael Jackson’s death abound. A nurse who had worked for the singer told CNN that Jackson requested the drug because he had trouble sleeping, and The Associated Press reported that it had been found in his home. Diprivan is not approved as a sleep aid by the Food and Drug Administration. Read more about propofol.

It turns out that propofol, used routinely for surgeries and procedures such as colonoscopies, has been a point of concern among some anesthesiologists because of the potential for abuse by health care workers. A 2007 study published by the International Anesthesia Research Society found that about 18 percent of the 126 academic anesthesia programs in the United States had at least one reported instance of propofol abuse within the previous 10 years.

Researchers also found that six out of 16 residents (about 38 percent) who abused propofol died from it. While these are small numbers, lead author Dr. Paul Wischmeyer, professor of anesthesiology at the University of Colorado, believes this is indicative of a larger problem.

Keep reading...

Patients undergoing surgery may receive Diprivan to keep them sedated during the procedure.

Elizabeth Landau
CNN

Diprivan is a powerful I.V. anesthetic drug used for patients undergoing certain surgeries and diagnostic procedures.

The drug is making headlines with the claim from a nurse who worked for pop icon Michael Jackson that the singer, who died June 25, had repeatedly asked her about the drug. Nurse Cherilyn Lee told CNN that Jackson had brought up Diprivan about three months ago, saying he needed it for insomnia and that his doctor said it was safe.

"He said, 'I am so sleepy. I cannot sleep. I want to have at least eight hours of sleep,'" Lee told CNN's Anderson Cooper.

The medication, whose generic name is propofol, renders the patient unconscious for as long as doctors deem necessary. The patient wakes up almost immediately after the infusion is stopped, experts say.

But treating sleep disorders is not an approved use of the drug. The U.S. Food and Drug Administration says Diprivan should be given only by people trained in the administration of general anesthesia and who are not involved in the conduct of the surgery or diagnostic procedure.

Keep reading...

Program Note: Join us tonight on AC360º at 10 P.M. ET to hear Dr. Sanjay Gupta speak more on Michael Jackson's on-going medical examination.

For toxicology screenings, blood samples are drawn from the leg and heart, as drugs can circulate around the body.

Madison Park
CNN

Unlike television crime shows in which machines can instantly spit out results, toxicology testing to determine what drugs are in a person's body can be a long and painstaking process.

The Los Angeles County coroner's office estimates that toxicology tests on the body of Michael Jackson could take six to eight weeks. The results are needed to determine the singer's cause of death, a spokesman for the coroner said. The singer's autopsy last week was inconclusive, although officials said there were no indications of external trauma or foul play.

Identifying drugs in the human body requires a lengthy sequence of tests and confirmations that can take weeks and even months, forensic experts said.

Questions about the possible role of prescription medications in Jackson's death have swirled since Thursday, when the singer was found unconscious. Edward Chernoff, attorney for Dr. Conrad Murray, who tried to revive Jackson at the singer's rented home, said the doctor was not aware of any prescription drug abuse by Jackson.

Keep reading...

Actress Farrah Fawcett had been battling anal cancer on and off for three years.

Program Note: For more on actress Farrah Fawcett and her battle with anal cancer, tune in tonight,  AC360° at 10 p.m. ET 

American Cancer Society &
National Cancer Institute

Anal cancer is fairly rare - much less common than cancer of the colon or rectum. The American Cancer Society estimates that in 2009 about 5,290 new cases of anal cancer will be diagnosed in the United States. The number of new anal cancer cases has been on the rise for many years.

Lifetime Risk
Based on rates from 2004-2006, 0.16% of men and women born today will be diagnosed with cancer of the anus, anal canal, and anorectum at some time during their lifetime. This number can also be expressed as 1 in 624 men and women will be diagnosed with cancer of the anus, anal canal, and anorectum during their lifetime. These statistics are called the lifetime risk. See Fast Stats for more detailed statistics, and Probability of Developing and Dying of Cancer for methodology.

Keep reading

Program Note: Tune in tonight to for our special coverage of the debate around the legalization of marijuana, 'America's High: The case for and against pot,' on AC360° at 10 p.m. ET.

Allison Margolin
Criminal Defense Attorney

Charles Lynch, a dispensary operator from Morro Bay, California, who was indicted and convicted in federal court for activities related to selling marijuana to medical patients, received a sentence last Thursday of a year and a day.

John Littrell, Lynch’s attorney, indicated that Lynch received what is known as the “safety valve.” This is a federal statute that allows for a defendant who is otherwise subject to mandatory minimum sentences to have a reprieve and be sentenced outside of them. In order to qualify for the so-called 'safety valve,' the defendant cannot be the “leader” of the organization. Littrell indicated the judge would issue a written order amidst objection by the U.S. Attorney to the safety valve in part on that basis.

He also indicated that Lynch was sentenced to 366 days in order to qualify for good time credits that would reduce Lynch’s sentence to around 10 months.

It is refreshing and fabulous that Judge Wu has liberally interpreted the safety valve to help reduce the prison exposure of a defendant who would have a medical defense in state court. Although the attorneys were precluded from mentioning the medical defense during Lynch’s jury trial, it is clear that his medical defense, though not technically available, motivated the court to sentence the defendant far below the 10-year-mandatory minimum that would otherwise apply to his convictions.

I believe that defense attorneys should use this case as well as USA v. Landa, 281 F. Supp. 2d 1139 (2003) , in which the district court contemplated compliance with state law as a basis for a downward departure in the guidelines (although that case lacked evidence of state law compliance), to argue that state law has a place in contemplating punishment when the state and federal law differ and the state gives more rights than the federal government.

I drafted a motion like this for Stephanie Landa on her appeal. For anyone interested, the argument is that the 10th Amendment is violated by the federal enforcement of marijuana’s Schedule I status in the medical states.

A few weeks ago, the New York Times Magazine published an article, “Obama’s Judicial Philosophy Analyzed,” by Charlie Savage, about what the author perceived to be Obama’s judicial philosophy and the one he believed Supreme Court justices appointed by Obama would follow.

The article suggested that Obama is interested in a court who articulates rights that many states (maybe a super-minority) have recognized, and pushes the other states along. That is why the recent legalization of medical marijuana in Rhode Island should be celebrated as a victory and replicated in more states.

Then we can use federal marijuana cases as a vehicle to go back to the U.S. Supreme Court and ask that the use of marijuana for medical purposes be recognized as a right that is held superior to the ban of the conduct by the Controlled Substances Act, the statute that regulates controlled substances and places marijuana in a category that has no medical use, Schedule I.

Editor's Note: Harvard-educated Lawyer Allison B. Margolin is now a practicing criminal defense attorney in Los Angeles. She is often referred to as 'L.A.'s 'dopest' attorney.

Jeffrey A. Miron
Special to CNN

Government spending on health care is growing at an alarming rate.

If recent trends continue, the two main government programs, Medicaid and Medicare, will increase from 6 percent of the nation's Gross Domestic Product now to about 15 percent by 2040.

This means that, without policy changes, the United States faces enormous budget deficits, substantially higher taxes, or huge cuts in non-health spending.

No one wants higher deficits or taxes, and there is no consensus about cutting other spending. The only way to avoid some combination of these outcomes, however, is to reduce the growth rate of what we spend on health. The question, of course, is how?

Keep Reading...