Despite the narrative of a meth overdose crisis, on some level the public understands that people using fentanyl are at risk in a way that people using just meth are not, because it’s not quite okay to openly demonize the victims of a mass death situation. But if you want to openly demonize meth users, that’s okay. And yet, if we take a closer look at meth in the context of the larger unregulated drug supply, we can see that public opinion has gone a little off course.

Most meth overdose isn’t physically harmful; occasionally someone might have a seizure, but it won’t hurt them. The supply is consistent. The supply is pure. The global supply chain is decentralized.

Meth has a withdrawal process, kind of, but nothing gastrointestinal. It’s shelf-stable dry or in liquid for months, probably years. It’s rural but also urban. It’s health care amid an Adderall shortage. It’s working class. It’s gay. It’s trans. It’s pretty. It’s invisible. It’s cheap.

Like it or not, meth is the people’s drug. It’s there for the people who need to stay awake when it’s not safe to sleep, or when their jobs won’t allow them to sleep. It’s there when people can’t afford food. It’s there for the people who can’t access antidepressants. It’s there to facilitate sex work. It’s there to give people the energy to carry their stuff around. It’s there to let people feel alive—or numb, depending—even in the most miserable of circumstances where they’re supposed to feel only bad things.

And the state hates that. You go and make all these laws to ban certain people from every place they could possibly try to get a job, get a home, go to sleep, go to the bathroom, you cut every social support out from under them and chase them out of anywhere they try to rest, but no matter what you do to get them to finally just lay down and die, meth picks them up and keeps them going.

I have some bias. I used meth for three or four years, every day, and while it made a lot of things in my life harder I’m not sure how else I could have managed the things it made easier. Plus when meth causes problems for people I don’t interpret that as the meth being, like, sinister, it’s just a function of whatever else people have going on in their lives at that time. I also never would have met my husband if meth hadn’t kept him alive for the decade or so when the rest of the world was trying to kill him, so even though it’s not part of my life anymore (or his) I default to a warm opinion of anyone who is using it. 

People look down on meth like it’s the drug you do when you’ve given up on life, which bugs me because I do not see that at all. I always saw it as something people use to participate. And in pretty much any context, but especially with anyone who doesn’t have housing, it always seems like meth is what people use when it’s hard to keep going, but they want to.

Opioid users hear all day long about how the supply is dangerous because it’s adulterated. Meth users are punished because the supply is pure. Even though consistent purity and potency are traditionally good qualities for a drug supply to have, from a public-health perspective.

“[M]ethamphetamine is less physically dangerous or addictive than heroin or cocaine, yet methamphetamine is now punished more severely than any other drug,” the National Association of Criminal Defense Lawyers wrote to the United States Sentencing Commission in 2025, referring to federal meth sentencing being determined by purity rather than by weight the way it is for other drugs. “Not only do the current methamphetamine guidelines lack a legislative basis, they also lack any empirical justification … sentences now receive massive arbitrary enhancement based entirely on whether the methamphetamine received laboratory testing [to establish purity], something that is obviously beyond the control, and unrelated to the culpability, of any defendant.” 

And then there’s police violence, which benefits from the same bias driving the narrative of a meth overdose crisis—once you say someone used meth, nobody questions why they died. They were unarmed and police shot them 10 times? Well, they were on meth. It’s so potent these days.

“We started to see a pattern of kind of irrational, aggressive behavior on the part of the people that were being shot or shot at,” a special prosecutor in a New Mexico told Colorado Public Radio of rising meth use in 2020, describing the case above. “It didn’t make any sense to us.”

Okay. 

In 2024, a Black man died after 40 minutes naked in a Wyoming county jail restraint chair, with two straps across his chest in addition to the restraints on his limbs, saying he couldn’t breathe. The forensic pathologist found no evidence of restraint-related death, but instead cited “methamphetamine overdose and the cardiac effects of excited delirium.” Remember excited delirium? The racist and unscientific diagnosis has been rejected by the medical establishment as a valid cause of death, because it was just how cops covered up excessive force. But this is “excited delirium due to methamphetamine overdose.” So it’s different.

Over the past decade the US harm reduction movement has been defined by the overdose crisis, and so services and policies have been designed for people who use opioids, then retrofitted for people who use stimulants.

Which is understandable; opioids are straightforward. We have methadone and buprenorphine, we have naloxone, we have the policy goal of overdose prevention centers and eventually safer supply. We have a clearly defined mechanism of overdose death, and we have a target demographic that—broadly speaking—uses fentanyl in similar settings and for similar reasons.

Stimulants are less straightforward. They interact with a wider range of systems in the brain and body, they produce a wider range of physical and psychological effects, and meth specifically appears in extremely different contexts in different people’s lives—chemsex, sex work, shift work, street homelessness, studying. Daily daytime use, monthly nighttime bingeing. And so on. It’s more difficult to categorize meth users and pin down what common services they need. If they need housing there’s only so much that harm reduction groups can do, and if they need a harm reduction resource other than sterile syringes and fentanyl test strips, whatever it is probably hasn’t been legalized yet anyway.

We’ve organized around access barriers to methadone and buprenorphine for opioid use disorder. But for stimulant use disorder this would require a policy leap more in the direction of safer supply, and so rather than organizing around stimulant agonist medications we just observe that we don’t have any. Instead we have contingency management, the practice of telling meth users that if they do a good job peeing in a cup they will be eligible for Walmart gift cards. And, now that they have something to look forward to, they don’t have to get their dopamine rush from stimulants anymore.

The movement hasn’t known what it’s supposed to offer meth users because it approaches the problem through a fentanyl lens, thinking in terms of meth’s physical effects and risks and harms. When it shouldn’t really be looking at meth, but at the people who use it. Queer communities, Indigenous communities, sex workers, people living with HIV, people living outside, people cycling through the criminal-legal system. The harms that the movement can reduce for meth users come primarily from being overpoliced. And from really bad public relations.

Artwork by Brooke Alexandria Paine. First inset image via County of Fresno. Second inset image (cropped) via Reentry Council of the City & County of San Francisco.

The post Big Shoutout to Meth appeared first on Filter.

Emerging evidence suggests that violence perpetrated against women who use and inject drugs may be worse than previously expected. In our recent investigation, “Violence Against Women Who Inject Drugs,” published in JAMA Network Open in March, my colleagues and I found that experiencing violence was nearly universal for women who inject drugs in Melbourne, Australia. Eighty-two percent had been assaulted at some time. Nearly 2 in 5 women had been sexually assaulted. 

Australia is often seen as a world leader in harm reduction, with strong systems to reduce drug-related harm and social supports that can help people access income, housing, and services for domestic and family violence. However, as with many high-income countries, women who use drugs are invisibilized in policies to end violence against women. Despite facing much higher risk of abuse than other marginalized groups, they are not recognized as a key priority population in Australia’s 10-year plan to end violence against women and children.

Women described major barriers to engaging in care. They feared stigma from their health care provider—or, more frightening still, that their children would be put at risk of removal.

While much violence is suffered alone and women are often reluctant to access medical care in the aftermath, nearly one in four women who inject drugs, according to our paper, presented to the emergency department due to assault over a 10-year period. Most of these women had severe enough injuries to be admitted to hospital. 

Only one in three women reported accessing medical health care after an assault, however, and this was typically contact with a counselor. In in-depth interviews, women described major barriers to engaging in care for their assault. They feared stigma from their health care provider about their drug use, for example—or, more frightening still, that their children would be put at risk of removal. 

Women who inject drugs are also often marginalized in other ways, and sometimes lack access to a phone or money for transport to engage with violence services that they need. 

This all heightens vulnerability when drug acquisition in unregulated markets and use under prohibition can be weaponized against women as a method of control. In these circumstances, control of access to methamphetamine, which is commonly smoked in Australia, may play a particularly sinister role in sexual coercion, according to past research.

My colleagues and I have been following up on these issues. In research examining violence against people who smoke meth, which has not yet been published, we found that two in three women reported recent assault over an 8.5-year period—at an average of six separate occasions of recent violence. Nearly one-third of women reported that the person who used violence against them was a current or ex-partner. One in six of the women had presented to an emergency department after being assaulted.  

Women who use substances rarely conform to society’s perspective of the “perfect victim.” Public and institutional ideals about who is believable, deserving of sympathy or worthy of protection are often shaped by entrenched stigma towards people who use drugs. 

In many countries, responses to violence against women still fail to account for how stigma, substance use, and gendered power intersect.

When a woman is known to use drugs, signs of abuse can be dismissed, minimized or interpreted through criminality and disorder, rather than vulnerability. Consequently, violence towards this population is somehow seen as expected or even deserved. Alternatively, women are at risk of being misidentified as the primary aggressor in an abusive situation.

For many women, children become a powerful tool of coercive control. Partners can threaten to report drug use and manipulate child protection or custody fears. Women may stay in dangerous relationships, avoid health care or withdraw from support services not because they do not need help, but because seeking it, or disclosing the complete context of their situation, can be too high-risk.

The invisibilization of women who use drugs is also reflected in drug and violence policy. Resourcing and attention are more likely to be paid to those groups identifiable within formal policy documents and commitments. In Australia, harm reduction policy does not adequately address the issue of violence and ending-violence policy does not adequately identify people who use substances. And Australia is unlikely to be unique. 

In many countries, responses to violence against women still fail to account for how stigma, substance use and gendered power intersect, leaving some of the most vulnerable women outside of public discourse, unsupported and alone.

Photograph (adapted) via the CDC

The post We Need to Focus on Violence Against Women Who Use Drugs appeared first on Filter.

A few of us got together to conceive Filter in 2017. Our mission, as we framed it, was “to advocate through journalism for rational and compassionate approaches to drug use, drug policy and human rights.” Our aims included countering dominant, damaging media narratives about drugs and people who use them. We wanted to challenge stigma and misinformation by platforming important voices, stories and issues that are routinely ignored. We wanted to expose the drug war for what it really is—a war on people—and influence the public conversation for the better.

For the eight years since we pushed the site live in 2018, Filter has had the distinction of being a news organization dedicated to covering harm reduction. We have published thousands of articles—investigative reports, news briefs, interviews, essays, opinion and much more—to that end, documenting a period when the movement evolved rapidly and entered mainstream policy discussions in the United States.

We have debunked drug myths, provided information about safer use, highlighted overlooked needs and perspectives, explored the history and culture of harm reduction, and deconstructed policy developments. We have broken news and analyzed it. We have charted the trajectory of the North American overdose crisis, and the harm reduction interventions that have—and haven’t—been implemented to mitigate it, while never losing sight of prohibition’s role in creating the crisis to begin with.

Nationally and internationally, we’ve routinely and in depth covered practice and policies around stimulants, psychedelics, cannabis, alcohol, medications for opioid use disorder and more—coverage often authored, importantly but far too unusually, by people who actually use the drugs in question.

We’ve regularly drawn the links from drug policy to a raft of intersecting issues, from policing to sex work, from mental health to the housing and climate crises. The fact that our heavy focus on mass incarceration has been spearheaded by a group of dedicated incarcerated journalists, one of whom won an award for his work, is a source of pride.

Filter has also stood out by centering tobacco harm reduction—concerning the world’s biggest source of drug-related deaths—and showing why it’s crucial to integrate it with wider public health and human rights causes. Back when we launched, it was highly unusual for “drug” harm reduction organizations to do this, though thanks in part to our advocacy that is now changing.

Filter’s work has been read by many millions of people around the world. It has been picked up and cited by major legacy media; republished and translated by international blogs; referenced in academic papers, court cases, books and more; and praised by many entities and individuals in this space. We’ve achieved this with a staff ranging from just three to five people over the years—but there are so many people we need to thank.

Our extraordinary writers—a diverse mix including professional journalists, advocates and activists, academics, health care practitioners and people whose expertise is based on their lived experience—have been the lifeblood of this publication. It has been an honor to work with hundreds of writers, of all backgrounds, whose passion and knowledge of the issues are such that one of my key roles as editor has been to get out of the way.

I’m also awestruck by the talent and dedication of Filter’s staff, who have produced outstanding work week after week, often in difficult circumstances, because of how much they care about our issues. That’s Deputy Editor Kastalia Medrano, who has helped lead the site since 2020; Senior Editor Helen Redmond, who was deeply involved in its conception; and our honorary team member, Tobacco Harm Reduction Fellow Kiran Sidhu. It has been a privilege to work with them, and the links on their names will give you some idea of how they’ve shaped this publication with their distinctive styles and beats. Others have filled staff roles with great distinction in the past—the likes of Sessi Kuwabara Blanchard, Alex Norcia and Alexander Lekhtman. I’m indebted to them all.

That equally goes for all of Filter’s funders—from large foundations and companies right through to the many individual readers who were kind enough to make regular or one-off donations. Some of them even responded to our recent financial difficulties by increasing their support. It’s humbling when anyone believes in your project enough to part with actual money. Without these generous contributors, Filter would never have existed, let alone grown into what it was.

Something similar could be said of our organizational allies, such as Knowledge-Action-Change, the Drug Policy Alliance, the Global Forum on Nicotine, the National Harm Reduction Coalition, the Law Enforcement Action Partnership and Marijuana Moment, which have collaborated with us or supported our work in various other ways.

All of us who’ve worked for Filter want to express our gratitude to the board of The Influence Foundation, our nonprofit entity—latterly Sheila Vakharia, Diane Goldstein, Morgan Godvin, Christine Rodriguez and Treasurer Phil Hur. We’ve been steered through periods of growth and choppy waters alike by their wisdom and expertise, which they’ve selflessly volunteered. I’ve personally been grateful year after year for their constructive guidance and support. Some of them wished to share a few words at this moment.

“I found Filter when I’d been out of prison barely a year, at a time when I still felt profoundly powerless,” Morgan said. “Filter treated the experiences that had so often been used to diminish people like me as expertise—it turned isolation into community and lived experience into public knowledge. The stories I wrote and read connected me with people all over the country and gave me friendships I still carry. My heart is heavy to lose Filter, but I will be proud of what we built here for the rest of my life.”

One of the board’s final tasks has been to arrange for Filter to stay online for some years after we end our operations, as a community resource. So if you’re here at some unknown point in the future, I hope you’ll dig through the archives and benefit from what you find.

Finally, a publication is nothing without its readers, and Filter’s have been exceptionally intelligent, engaged and committed. We have always appreciated your sharing and discussions, your feedback (of all kinds!) and your loyalty—which says some deeply encouraging things about the strength of support for harm reduction and human rights.

Filter’s journey is ending, but that doesn’t mean the journey wasn’t worth making. And when we look around us, we can only conclude that the ideas that drove it remain in inspiring hands.

“I helped build Filter because I believe people who use drugs deserve to be seen with dignity, not judged from a distance,” Diane said. “I never expected it would also become the place that helped me carry my brother’s memory. Watching it close feels like losing a piece of my own family—but everything it stood for, and everyone it reached, will outlast it.”

Thank you all for coming with us. 

The post A Statement About Filter appeared first on Filter.

Fentanyl Is in Everything

Around 2013, fentanyl started percolating in the United States street opioid supply, which was heroin-based at that time. Over the next few years it steadily pushed heroin out of the East Coast, and once the COVID-19 pandemic hit it rapidly did the same on the West Coast. As crackdowns have pushed the drug supply to evolve more quickly and chaotically, fentanyl has gradually begun showing up with non-opioid drugs.

Media and law enforcement, however, tend to describe it as an additive that predatory distributors mix into whatever they’re distributing—cocaine, meth, heroin, marijuana, vapes, pills that look like pharmaceuticals.

Fentanyl sometimes ends up in meth and cocaine supplies, probably not intentionally. This varies a lot by region and isn’t as common as most local news stories would have you believe, but is important to be aware of.

A pressed pill sold as Percocet or Oxycodone might not contain fentanyl, but you should assume that it does, if you don’t have the means to check. Same goes for anything sold as Xanax. A pressed pill sold as Adderall could conceivably contain fentanyl, but that would make it a pretty significant anomaly; what you should assume that it contains is meth.

We tend to fixate on whether something does or does not contain fentanyl, but that binary distinction isn’t what determines the risk. Someone opioid-naive who buys a fentanyl pressed pill that they believe to be real Percocet will still be okay if the amount of fentanyl in the pill is small enough. Conversely, someone who smokes what they know to be fentanyl pills off foil every day will be overdosing within minutes if they get one with more fentanyl than they were expecting.

Has fentanyl been found in marijuana? It has not. Periodically there are news stories or other vaguely credible-sounding claims to this effect, but none of them ever stand up to scrutiny. The one that got arguably the most traction was a 2021 statement from Connecticut health officials, announcing “the first lab confirmed case of marijuana with fentanyl in Connecticut and possibly the first confirmed case in the United States” and citing 39 incidents “where only marijuana use was reported but naloxone was required.” Later it turned out that this boiled down to a single case of minor, accidental cross-contamination among people who also used opioids.

You can immediately write off any claims of fentanyl being smoked with marijuana, or smoked with anything else using a combustion process rather than a vaping process. Fentanyl can’t be smoked with an open flame; it gets burned and rendered inactive.

A very small number of vapes appear to have tested positive for fentanyl. For one thing, this would probably happen with literally any physical object that school boards across the country started continuously testing for fentanyl. But the important takeaway is that the more credible claims involve vapes that had clearly been modified intentionally for personal use, not vapes that had been designed that way and marketed to children. You can still pick out any news story that describes a middle- or high-school student nearly dying from using a “fentanyl-laced vape”—even the stories circulated by elected representatives—and reliably find that it has either since been debunked or does not mention any actual laboratory confirmation of fentanyl, despite whatever the headline said. Usually the source for the claim is the student or their mom.

Higher-Potency Opioids Need Extra Doses of Naloxone

Naloxone works by binding to your mu receptors—the specific protein molecules that opioids also bind to—and kicking off whatever opioids might already be there. The clinical dose of naloxone, 0.4 mg/mL, is what’s usually sufficient to reach about 50 percent of your mu receptors, or enough to reverse an overdose. That’s why 0.4 mg/mL is the dose contained in a vial of generic intramuscular naloxone.

A Narcan nasal spray contains a 4-mg dose of naloxone. Intranasal administration can’t be directly compared to intramuscular, but it’s the less efficient of the two and so Narcan is designed to deliver more than the clinical dose. A 4-mg Narcan was more than enough for most heroin overdoses, is still more than enough for most fentanyl overdoses, and is also still more than enough for most overdoses involving fentanyl analogs, nitazenes, orphines and whatever novel synthetic opioids are found in the supply next. Naloxone’s effectiveness doesn’t change based on the opioid’s potency, since it acts on the mu receptors rather than on the opioids themselves.

When cops or well-meaning bystanders share stories about someone needing five doses of Narcan to wake up, and how this just shows how much more potent the supply is these days and how naloxone doesn’t cut it anymore, this almost always comes from the same mistaken assumptions about overdose reversal.

Naloxone takes two or three minutes to kick in, which is why it’s important to administer rescue breathing while you wait. But because the two minutes that you’re supposed to wait before administering a second dose can understandably feel like an eternity, especially to anyone not experienced in these situations, the temptation is often to pump in a second dose pretty quickly. Or a third dose, or fourth, or fifth, and so on until the person wakes up. When someone wakes up after a fifth Narcan, what you’re really seeing is the first dose kick in. All the extra naloxone did nothing to help, and for people with a physical tolerance to opioids it can precipitate withdrawal and put them at increased risk of overdosing again. At a proper dose, reversing an overdose with naloxone doesn’t require waking the person up at all.

In 2021, the 8-mg Kloxxado nasal sprays hit the market and marked the beginning of the naloxone arms race. In the five years since then, the Food and Drug Administration has approved a 5-mg intramuscular autoinjector—meaning it delivers about 12.5 more naloxone than the clinical dose—a 10-mg nasal spray that launched earlier in 2026. It’s also moved beyond naloxone to a different, longer-acting opioid antagonist, nalmefene. The first nalmefene nasal spray, Opvee, has already been followed by a nalmefene auto-injector. And government contracts investing in nalmefene as a preventative measure for fentanyl nuclear war. And biased research inventing meaningless metrics that are supposed to justify any of this as necessary.

Naltrexone Is Safe and Effective

Technically, the US has three approved medications for opioid use disorder (MOUD). In reality, we have two MOUD that are shown to be safe and effective, and we have naltrexone. Methadone and buprenorphine (Suboxone) decrease overdose risk. Naltrexone’s labeling is required to carry a warning that it increases fatal overdose risk.

Naltrexone is commonly known by brand name Vivitrol, the injectable formulation touted in county jails and other correctional settings. While methadone and buprenorphine are opioid agonists, naltrexone is an opioid antagonist—like naloxone and nalmefene. It purports to work by blocking the effect of opioids, so that even if a patient tries to use opioids they won’t feel anything.

What this effectively does is reduce tolerance, which is why the FDA labeling has to warn that deaths have been documented “at the end of a dosing interval, after missing a scheduled dose, or after discontinuing treatment.” The warning about risk of fatal overdose from “[a]ttempts to overcome blockade” is similar to the warning carried by the two approved nalmefene products, Opvee and Zurnai.

Unlike methadone and buprenorphine, naltrexone requires detoxing prior to initiating the medication—going into withdrawal for at least a week, maybe two. That alone makes it a non-starter for a substantial portion of people at risk. A recurring theme with research supporting naltrexone’s efficacy is that it doesn’t count the people who tried to start the medication and weren’t able to get through the detox process, preferring to factor in only the cases where people did manage to onboard. Or it uses the framing that once detox is out of the way, “naltrexone is about as effective as buprenorphine,” which still isn’t true.

People stabilize on methadone and buprenorphine because those MOUD help manage cravings and withdrawal symptoms. But studies tracking naltrexone outcomes never show anything long-term. Conclusions that it reduces cravings come from short-term data, and any evidence of its efficacy is based on negative urine drug screens after a few weeks or at most a few months. This research is never concerned with what happens after that. The idea of naltrexone remains popular because it fits an abstinence mentality, it’s punitive and it’s an easy out for corrections departments. Not because it’s helpful.

Syringe Litter

As popular as it is to demonize syringe service programs (SSP), the arguments against them don’t see too much innovation. There’s the complaint that SSP increase “crime,” which is not true. There’s the complaint that they increase drug use, which is not true. The most substantive complaint is that they increase “syringe litter.” This is also not true.

Neighborhoods that open SSP are overwhelmingly associated with a decrease in publicly discarded syringes, for a few different reasons. They’re often more convenient than sharps-disposal bins in parks, which require people to make a separate trip just to have fewer syringes than before. They provide portable sharps containers that are small enough for people to carry around, and larger ones people can keep at home. And they employ peer workers who do daily walkabouts picking up any syringes they see on sidewalks or other public areas.

At the heart of the syringe litter myth is the suggestion that children are at risk of contracting HIV from stepping on a needle while playing at the park. This is an easy one to debunk: It has never happened. There has never been a single documented case of anyone, child or adult, contracting HIV from a publicly discarded needle. It’s just another myth.

The human immunodeficiency virus is very fragile and relies on our immune cells to survive. Once outside the body, exposed to air, it dries up and dies almost immediately. This is why the only confirmed HIV needlestick transmissions have all involved health care workers in hospital settings, and even then they’re extremely rare. For the public, transmission risk is limited to situations involving blood, semen, vaginal or rectal fluids, or breastmilk delivered directly to a mucous membrane or into the bloodstream.

The hepatitis C virus can actually live for several weeks outside the human body, but globally there have been maybe three documented cases of hep C transmission from accidental needlesticks in community settings; none in the US nor involving children. Hep C can be easily and painlessly cured with oral medication, and doesn’t begin to damage the body for years or even decades.

As often as the media runs stories about syringe litter, you might notice that the accompanying photos often show a syringe with the front and back cap still on, sterile as the day it was born, thoughtfully arranged in the middle of a ditch. I was going to make a joke about how eventually they’ll show one of those individually packaged 27-gauge 1 cc syringes still in its individual package, but this has already happened.

Secondhand Overdose From Drugs in Prison Mail

After that viral video with the San Diego County Sheriff’s Department deputy in 2021, the online harm reduction community got the rare satisfaction of rallying around a talking point—you cannot overdose from touching fentanyl—and seeing the media actually take notice. A lot of news stories will now add some kind of disclaimer when referencing passive exposure, though this remains pretty hit or miss. You can’t overdose from skin contact. You can’t overdose from breathing in fentanyl molecules floating around in the air; fentanyl has a very low vapor pressure and barely releases any molecules into the air anyway. You can’t overdose from any other kind of passive exposure. The public is now moderately more aware that there is no such thing as secondhand fentanyl overdose. However, like everything else in harm reduction, this development has not made it into the prison system.

US prisons and jails have a completely different drug supply than the free world. There is fentanyl, but the mainstays are generally synthetic cannabinoids (K2; Spice) meth, Suboxone, tobacco and strips, a catch-all term for the ubiquitous strips of paper soaked with what could be anything, but is often synthetic cannabinoids or household solvents like insecticide. In recent years, many facilities have seen synthetic cannabinoids and/or strips replace meth or other contraband similarly to the way fentanyl replaced heroin in the outside drug supply.

Countless press releases and Facebook announcements have described how corrections officers required Narcan (multiple doses!) and were hospitalized following exposure to dangerous synthetic cannabinoids and other drugs concealed in incoming mail. This does not mean the officers were harmed. It does not mean the officers were ever in harm’s way. It does not even necessarily mean the officers were exposed to any drugs. It means that officers gave themselves Narcan and took themselves to the hospital. Synthetic cannabinoids are not opioids and are not affected by Narcan, but the whole situation is so far beyond logic that we don’t have time to stop for this.

The only one of these incidents that’s ever cited actual harm was in 2024 at USP Atwater, when mailroom supervisor Marc Fischer reported feeling ill and then died at a hospital about two hours later. Initially the cause of death was undetermined, pending toxicology, which gave media outlets across the country an opening to run headlines about “possible fentanyl exposure.” The Merced County Sheriff’s Office did not respond to Filter’s February 2025 coroner records request, which is fine because a week later documents filed in US District Court for the Eastern District of California revealed that the cause of death was a heart attack. Neither the AP nor the Los Angeles Times nor any other media outlet that ran a “possible fentanyl exposure” headline ever published anything further. The Bureau of Prisons, Correctional Peace Officers Foundation and various other agencies continue to honor Fischer’s memory by not acknowledging the autopsy, and praising his sacrifice in the line of duty while handling synthetic drug-soaked mail.

There is no evidence to suggest that secondhand exposure to synthetic opioids or cannabinoids poses any kind of risk. Many corrections officers know this, since they’re the ones bringing in most contraband drugs anyway. But they continue to bravely share their stories, and Occupational Safety and Health Administration investigations conclude that mailroom staff need head-to-toe personal protective equipment and HEPA-filtered biosafety cabinets, and federal corrections officers unions use those findings to call for the expansion of digitized mail-scanning.

And that’s what all of this is really about: understaffing and the nationwide push to privatize prison mail services, and cut incarcerated people off from receiving physical letters. Along with in-person visitation, and book donations, and any other “privilege” whose physical form can be replaced with a digital service conveniently offered by a handful of for-profit contractors. More than three out of four people incarcerated in US prisons no longer have access to physical mail.

At this moment, somewhere in the US another corrections department is drafting another press release breathlessly recounting how over the weekend one or more officers were hospitalized following exposure to deadly synthetic drugs, and pleading for Congress to recognize that no one should have to risk their life just to do their job of opening other people’s mail. Media and legislators will circulate it with no scrutiny whatsoever. To date, there are no confirmed reports of any corrections officers ever having been harmed by exposure to drugs in the mail.

Meth Overdose Crisis

Opioid overdose is potentially fatal because opioid molecules can bind to the brainstem receptors that regulate breathing; the mechanism of death is respiratory depression. Meth, like synthetic cannabinoids and various other stimulants like cocaine, doesn’t have any particular mechanism of death that accompanies overdose in the same way.

Stimulant overdose, or overamps as they’re sometimes called, don’t necessarily produce stereotypical symptoms like paranoia or hyperactivity. Often they make people fall asleep. Occasionally they might cause seizures. But then they resolve, and that’s that. The harms tend to come from exposure to law enforcement, rather than the physical ordeal itself.

Meth-involved overdose deaths in the US began rising more noticeably around 2019, peaking in late 2023 before starting to gradually drop back down; the same trajectory as fentanyl-involved deaths, but less drastic. It’s clear that more people are using meth compared to a decade ago, which means more people have meth in their system at the time that they die. But it’s not quite clear that meth is what’s causing them all to die, at least not on the scale being suggested by the media.

US death investigations are a mess. Depending on the state, they might be carried out by medical examiners, elected county coroners or local law enforcement. In Nebraska, for example, cause of death is determined by prosecutors. In most California counties, the coroner is also the sheriff. Forensic pathologists are still required to sign off on the death certificate, but there are only a few hundred of them in the whole country and many jurisdictions now use forensic pathologists who aren’t board-certified. In Canada and other wealthy countries full autopsies are considered standard for suspected overdose deaths, but in the US they’re rare. Where not mandated by state law, they’re pretty much reserved for cases where law enforcement could potentially use the evidence to prosecute someone, or the family could afford a private one.

In suspected overdose cases, the death investigation often consists of toxicology and an external examination—medical history plus a long look at the body and any evidence found at the scene. None of these can reveal a heart attack, or heat stroke, or pneumonia. But they can reveal meth, and even without fentanyl that’s all that’s needed to wrap the investigation, particularly for people who die without housing. No available medical history? Well, clearly their medical history is that they used meth.

“If they had a heart death, I think [any meth] is going to get attributed as a cause of death. Because that is the bias of the system,” a toxicologist who signs off on drug death reports told Filter in 2023. “It’s like: Here’s someone that was found in a tent, we can’t contact their next of kin, we did a [urine drug screen]. They’ve got meth in their system; keep it moving. We’re not going to do an autopsy.”

Some research has suggested that meth is linked to about two out of three US deaths among people without housing. Local-level studies have found similar patterns in places like California and Oregon.

Deaths attributed to just meth, with no fentanyl present, tend to be among people who were over 45 and had a history of cardiovascular disease. To which chronic meth use may have contributed, but it wouldn’t have been the only thing. When a non drug-user dies from a heart attack in a hospital, we say they died from a heart attack—not from a sedentary lifestyle or refined carbohydrates. When a meth user dies from a heart attack and they weren’t in a hospital, their cause of death was a heart attack. But we might say it was meth, if drugs were the only thing we checked for.

Novel Synthetic Opioids, Even Deadlier Than Fentanyl

No matter how much we sensationalize fentanyl and its potency, after hearing about it for so many years the public has somewhat acclimated to the idea. So fentanyl headlines lose their power, and the only way for media outlets to combat this is with something even more potent than fentanyl.

First it was fentanyl analogs, followed by nitazenes and most recently orphines. All have the potential to be more potent than fentanyl (as well as less potent, not that this is of interest to anyone). The problem with news outlets pouncing on each novel synthetic opioid (NSO) as it hits the supply isn’t so much that they misrepresent the potency; it’s that they misrepresent the prevalence. Each NSO is presented as a harbinger, like behind the first couple of reports is a dam about to break, unleashing the substance that will replace fentanyl the way fentanyl replaced heroin. That will usher in the next wave of the overdose crisis all on its own.

Outside of North America the emergence of NSO could have a very different significance, if fentanyl hasn’t already saturated the opioid supply the way it has here. But at the moment, there’s no real reason to think that any fentanyl analogs, nitazenes or orphines are poised to overtake fentanyl in the US supply. Some of them, like carfentanil or cychlorphine, have become more recognizable names, but we’re still talking about substances linked to a very small portion of overdose deaths, and that’s including the cases where they were detected at all not just the ones where they were detected alone or determined to be the cause of death.

Most of these substances arrive mixed in with fentanyl—though some are occasionally found on their own—and aren’t really distinguishable from fentanyl, from a user perspective. Health departments will take whatever one or two talking points exist , which are probably just the location where it was detected and how many times more potent than fentanyl it’s supposed to be, and stretch them over a public bulletin that doesn’t help the public do anything differently. There’s a NSO in the supply. It’s been detected six times, in these two states; you can’t test for it and it’s not distinguishable from fentanyl. You should still use naloxone and take the precautions you were taking for fentanyl. This kind of thing is for the benefit of website traffic and re-election campaigns, not the public.

Not all recent additions to the supply are interchangeable. Xylazine and medetomidine, both non-opioid veterinary tranquilizers, have come with distinct complications and forced harm reduction groups to evolve overdose response protocols around each of them specifically. NSO have certainly reshaped how we criminalize the supply, but they haven’t really reshaped the supply itself. Even carfentanil, which has been in the US about as long as fentanyl and remains the most potent opioid we know of, has ebbed and flowed at the edge of the supply and never grown into something with a market of its own. None of them have.

No matter how potent, a substance can’t really be more deadly than fentanyl if it isn’t causing more people to die.

The post The Drug War Myths People Still Believe appeared first on Filter.

Considering what I do more closely reveals a kind of paradox, however.

If I view tobacco harm reduction (THR) from the outside, it seems as if nothing changes. The task—to inform and convince policymakers that THR is simply harm reduction, and that we already have the tools to dramatically reduce the world’s biggest cause of preventable death—is ostensibly a simple one. But the message seems incomprehensible, inconvenient or plain unwelcome to those in power. 

If something’s not stagnant, there is hope: Change requires movement.

If, on the other hand, I step inside the THR world to report on it, I’m never short of things to write about. Why? Because despite the ubiquitous common obstacles, the detailed landscape is mercurial—there’s always something happening. And if something’s not stagnant, there is hope: Change requires movement. Reflecting on this made me realize how much there is to be optimistic about.

Nicotine consumers are at the heart of this optimism, just as they’re at the heart of the THR movement. They’re bombarded with misinformation, stigmatized for their choices and faced with many barriers to accessing products that could save their lives. Yet despite all this, despite the knee-jerk, reactionary anti-THR policies, as many as 150 million people worldwide now use safer alternatives like vapes, snus and pouches or heated tobacco products.

The vast majority have adopted these safer nicotine options in order to quit (or reduce) smoking. In many other cases, the availability of these options for people who may have a “common liability” to nicotine use means they will never pick up cigarettes in the first place.

Yes, the message that safer nicotine products save lives would have gotten through much faster, and to far more people, if governments and health authorities wholeheartedly promoted THR instead of blocking and denigrating it. Yet it is getting through to an extraordinary degree in these circumstances—and given the power of peer-to-peer word of mouth, that is likely to accelerate.

This thought is almost guaranteed to stop me feeling enervated—and that’s just as well.

My THR reporting for Filter stands in stark contrast to the stories published in giant media outlets, which again and again contradict powerful evidence and ignore the human agency of people who smoke, in favor of narratives rooted in hardened ideology. Plenty of times, I’ve wondered if there’s any point in my work when my colleagues and I are up against this misinformation juggernaut. It’s David-and-Goliath when you’re fighting to be heard over the din of the World Health Organization and organizations backed by Bloomberg millions. It’s hard not to feel small and insignificant amid the cacophony of voices hellbent on telling you you’re wrong.

Writing about THR is also about celebrating its wins, which are just as important to report—after all, this is why the movement exists.

But before I get too disillusioned, along comes the news that Sweden has become the world’s first “smoke-free” country because of safer nicotine products. News like that, I’ve always felt, is a privilege to report. This is THR in action: Saving lives, improving quality of life, keeping families together, reducing health inequalities, and carrying special value for populations that have been most sidelined and ignored—such as people with mental health conditions and people who use banned drugs. 

These are stories that need to be written and read. And they remind me that being a journalist in this space is not just about correcting flawed science that somehow managed to get published, or criticizing bad policies, of which there is a never-ending supply. Writing about THR is also about celebrating its wins, which are just as important to report—after all, this is why the movement exists. And there are enough positive stories, even in the last few months, to convince even the most hardened of cynics that the times they are a-changin’.

In July, for instance, I wrote an article on how nicotine pouches are becoming increasingly popular in the United Kingdom. Anti-vape sentiment plays a role here, but the adoption of a new safer nicotine option is a good thing; choice is key. And with women leading the way, I can’t help but be optimistic that perhaps, in the not so distant future, we Brits might replicate Sweden’s success.

In May, I was able to report on how Argentina ended its 15-year prohibition of vapes and other safer nicotine products. Sure, further improvements need to be made, but it’s a big step in the right direction. Things are happening and moving: The landscape is mutable.

That same month, I wrote about calls to integrate THR routinely in HIV care. And yes, much of that article concerned stigma and other barriers to this common-sense approach. Yet in speaking with experts who have witnessed the trajectory of improved HIV care over decades, it was impossible not to entertain the idea that THR, delivered to high-smoking populations, might similarly have a better future.

THR advocates have faced derision, ostracization and slander. They have made things happen all the same. The victories belong to them.

And in April, I reported on an uplifting project, built by consumer advocates, to systematically collate the kind of lived experiences of safer nicotine use that are almost entirely absent from media narratives.

I am not an advocate in the strictest sense of the word, nor (by any stretch!) a scientist. I’ve seen myself as a conduit between the world of THR and those who are open to knowing more about it. To play that role at all effectively requires the help of experts, and I’ve gotten to know many who have inspired me.

People like THR maven Clive Bates, consumer advocate Skip Murray, Michael Siegel of Tufts University School of Medicine and Damian Sweeney of European Tobacco Harm Reduction Advocates (ETHRA) have been integral to my own learning. Their incredible knowledge and perspicacity, generously shared, have helped readers and me to understand nuances of THR, the repercussions of ill-conceived policies and so much more. In a field that can often feel bleak, the passion of these experts, and many others, makes me feel that the future of THR is bright.

THR advocates have fought against the odds for a better world. They’ve faced derision, ostracization and slander. They have made things happen all the same. The victories belong to them—to a whole ecosystem of scientists, policy experts, smoking-cessation advisers and consumer activists determined to help others benefit as they have. This fills me with hope. Sometimes, change comes almost imperceptibly—or perhaps, “gradually, then all at once.” I think we’re on our way. 

Photograph via PublicDomainPictures.net

The post Finding Optimism in the Tobacco Harm Reduction Maelstrom appeared first on Filter.

The proposal falls under the Workforce Innovation and Opportunity Act. It would direct Acting Department of Labor Secretary Keith Sonderling to send state and local governments information on “evidence-based and promising practices” to mitigate economic harms related to SUD, including how to apply for relevant federal funding. And it would broaden eligibility for National Dislocated Worker Grants to include career training in SUD, mental health care and pain management in any jurisdiction “that, as a result of widespread substance use, addiction, and overdoses, has higher-than-average demand for such activities that exceeds the availability of State and local resources to provide.”

The legislation would add a new category of eligibility that’s specific to SUD, and would apply to dislocated workers; people who have been long-term unemployed; people who work or are looking for work as treatment providers for SUD, mental health or pain; and people who are  “unemployed or significantly underemployed as a result of widespread substance use in the area.”

McCormick’s office did not respond to Filter’s inquiry.

Drugs and the people who use them have long been scapegoats for economic underinvestment.

“If we’re going to help more people recover, we need enough skilled workers to provide that care,” McCormick stated in his announcement. “This bipartisan bill gives communities more tools to train that workforce so more people can get the help they need.”

Drugs and the people who use them have long been scapegoats for economic underinvestment, and the language used in the Act and by its proponents sort of conjures an image of a small town where the “scourge of addiction” has wiped out all the jobs. Or conceivably it could refer to people who are struggling to find work because first they need to access treatment, but aren’t able to due to overwhelming demand on the few providers in their area. Or to people who are unable to work because they’re surrounded by too much drug use to escape it. But one way or another, a lot of the workforce harms the legislation is concerned with probably don’t come from drug use so much as they come from drug-testing, and the larger drug war. 

While it’s certainly true that people have lost jobs because their SUD negatively impacted their performance or their behavior in the workplace, that’s also a stereotype obscuring the larger picture of people losing their jobs due to drug use. Often urinalysis testing is the barrier to remaining at or returning to work, rather than conduct or ability. Research indicates that workplace drug-testing is not an effective means of either reducing drug use or increasing productivity. A larger barrier to employment—and to recovery—is the criminalization of drugs and the unwillingness of many employers to hire candidates with felony records.

The proposal is the latest of many cosponsored by McCormick and Fetterman, who are often touted for their bipartisanship, although Fetterman has also prompted serious conjecture about whether he intended to switch parties and recently had an apparent Freudian slip in which he told NewsNation that he was a Republican. He did not make his own announcement about the legislation, but on August 5 did appear The Weekly Show with Jon Stewart to espouse some right-of-center views on socialism and the existence of genocide in Gaza.

Image via Coon Rapids, Minnesota

The post Federal Bill Would Add SUD Category to Dislocated Worker Grant Eligibility appeared first on Filter.

Hemp derivatives with less than 0.3 percent delta-9 THC on a dry-weight basis were federally legalized under the 2018 Farm Bill that President Donald Trump signed during his first term in office. But in late 2025, the president signed new legislation containing provisions that will redefine hemp to make it so only products with 0.4 milligrams of total THC per container will remain legal after November 12.

Leaders of the Senate Appropriations Committee recently released the text of a continuing resolution to extend funding for federal agencies through December 11, past the end of the current fiscal year on September 30. Included in the legislation are provisions that will also delay the planned prohibition on most hemp products until December 11—although there is a carve-out that will allow the immediate recriminalization on November 12 of synthetic cannabinoids “that are not capable of being naturally produced by a Cannabis sativa L. plant.”

While the White House supports the delayed ban on THC products, Sen. Ted Budd (R-NC) and several GOP cosponsors filed an amendment that seeks to strip those hemp provisions out of the bill and keep the planned prohibition on schedule.

“‘Closing the loophole’ is prohibition.”

Now, groups on both sides of the issue are weighing in as the Senate seeks to wrap up its business for the August recess.

“Allowing this deadline to proceed without a comprehensive regulatory framework will not result in improved public safety,” said a letter from Wine and Spirits Wholesalers of America, National Association of Convenience Stores and American Beverage Licensees. “It will produce the opposite: a thriving illicit market, weakened state enforcement, economic disruption for more than one million American workers, and less safety for the very consumers Congress is committed to protecting.”

Supporters of the forthcoming ban have said it will close a “loophole” in the prior Farm Bill, but the new letter, which is also signed by the Hemp Beverage Alliance, Coalition for Adult Beverage Alternatives, Beverage Wholesalers for Responsible Regulation and Beverage Alcohol Merchants Coalition, says that “‘Closing the loophole’ is prohibition.”

“Prohibition would be a failure and risk to Consumer Health & Safety. The November 12 deadline does not create a safer, better-regulated hemp market. It creates no legal market at all, while creating an illicit market,” it says. “This is not regulation. This is prohibition.”

“The historical record is consistent: prohibition does not eliminate consumer access, improve product safety, or reduce youth exposure. Bad actors will not disappear when the legal market closes, and many consumers will have no regulated alternative. The choice before Congress is not between a ‘loophole’ and safety—It is between regulation and prohibition. We urge Congress to choose regulation.”

Meanwhile, Veterans of Foreign Wars of the United States (VFW) and its Auxiliary, representing nearly 1.4 million veterans, also sent a letter urging hemp regulation over a ban, saying that THC products “could offer a real alternative to the heavy prescription drugs so many of our veterans are given for PTSD, anxiety, pain, and sleep problems.”

“Every day, doctors hand out strong sedatives and psychoactive meds to help veterans cope. They work for some, but too many end up hooked, numb, or dealing with brutal side effects,” the letter said. “We’ve all watched good men and women get trapped in a cycle of pills that dull the pain but don’t fix the problem.”

“A blanket ban on hemp cannabinoids would make it nearly impossible for researchers and VA hospitals to study these compounds legally.”

“It’s time to look harder at safer options. Early research on certain hemp compounds shows promise for managing symptoms and reducing physical pain without the same addiction risks … This isn’t proof of a miracle cure, just clear signs we should keep studying.”

“But sweeping moves to ‘close the hemp loophole’ could slam that door shut,” VFW wrote. “A blanket ban on hemp cannabinoids would make it nearly impossible for researchers and VA hospitals to study these compounds legally. It would also hurt veteran-owned small businesses already playing by the rules. Critically, it would drive veterans looking for relief straight to black-market junk, making things riskier, not safer.”

On the other side of the debate, however, the National Sheriffs’ Association sent a letter urging lawmakers to let the ban on hemp THC products take effect as scheduled.

“This loophole was never intended to create a parallel, unregulated marketplace for intoxicating products, and it should be allowed to close rather than be renewed,” it said. “These products are marketed and sold without meaningful safeguards. Many intoxicating hemp products are available in gas stations, convenience stores, vape shops, and online with limited or no age verification, inconsistent product testing, and no standardized potency limits. Consumers often have no assurance regarding product safety or contaminants.”

The law enforcement letter also argues that hemp products are “easily accessible to minors,” saying that “sheriffs across the country continue to report concerns about these products finding their way into schools and communities.”

“Closing this loophole would not eliminate legal access to cannabis products where states have chosen to regulate them, it would simply end an unregulated shadow market that undermines public health and circumvents the very state-level frameworks that were designed to protect consumers,” the sheriffs’ letter said. We urge you to let this hemp provision expire and to support comprehensive regulation of intoxicating cannabinoid products.”

Earlier in the week, a bipartisan coalition of 35 state and territory attorneys general sent a letter calling on Congress not to reverse the hemp THC product ban, saying that lawmakers’ move to enact the forthcoming prohibition “protected consumers, provided much-needed regulatory clarity, and preserved legitimate industrial, agricultural, and nonintoxicating hemp markets.”

A number of lawmakers from both chambers and both parties have filed or are circulating a bills to prevent the scheduled federal recriminalization of hemp THC drinks and other products.

In June, the House of Representatives passed its own version of a continuing resolution to keep federal agencies funded into December, but it did not have any provisions to alter the planned hemp product ban. As such, if the Senate passes its new provision it would then still need approval by the other chamber before being sent to the president.

Meanwhile, a number of lawmakers from both chambers and both parties have filed or are circulating a bills to prevent the scheduled federal recriminalization of hemp THC drinks and other products later in 2026. Until now, none of those proposals have gained traction with congressional leaders.

For example, Rep. James Comer (R-KY), who chairs the House Oversight and Government Reform Committee, is circulating legislation that would delay a planned federal ban on hemp THC products and institute some regulations—including packaging requirements, testing rules and age limits.

Separately, Rep. Andy Barr (R-KY), filed a lengthier proposal to prevent the federal recriminalization of hemp THC products and put in place a number of regulations for manufacturing, labeling, sales and taxation of hemp-derived products, including an age limit of 21.

A press release from the congressman’s office claimed that the White House supports the legislation, which is cosponsored by Rep. Angie Craig (D-MN), but the administration has not specifically endorsed it despite generally calling for hemp regulations and backing a prior similar amendment filed by Barr.

Trump and White House officials have in recent weeks repeatedly pressed Congress to delay, alter or reverse the ban.

In a letter to House Speaker Mike Johnson (R-LA) in June, for example, White House Office of Management and Budget (OMB) Director Russell Vought said the Trump administration wants lawmakers to “ensure the fair treatment of hemp products”—specifically citing Barr’s earlier amendment to keep many hemp products legal while adding regulations and taxes.

In April, the president urged congressional lawmakers to again redefine hemp to avoid recriminalization of full-spectrum CBD products.

The administration “welcomes the opportunity to work with the Congress to, at a minimum, update the statutory definition of final hemp-derived cannabinoid products to allow Americans to benefit from access to appropriate full-spectrum CBD products,” OMB separately said in June, “while preserving the Congress’s intent to restrict the sale of products that pose serious health risks.”

Also in April, the president himself urged congressional lawmakers to again redefine hemp to avoid recriminalization of full-spectrum CBD products.

“I am calling on Congress to update the Law to ensure that Americans can continue to access the full-spectrum CBD products they have come to rely on, and that help them, while preserving Congress’s intent to restrict the sale of products that pose Health risks,” Trump said in a Truth Social post.

“We must get this done RIGHT and FAST, especially for those who saw that CBD helps them,” he said. “Plus, I am told it will also help our GREAT FARMERS, who we love, and will always be there for.”

Industry advocates say that the law as enacted last year not only threatens to prohibit intoxicating and synthetic cannabinoid products but also stands to remove popular full-spectrum CBD products that many Americans use therapeutically from the market.

“ONE in FIVE adults used it in the past year, and many say it improved their chronic pain enormously,” the president said in his social media post, adding that hemp-derived CBD “has made a HUGE difference for so many people.”

He also referenced an initiative the administration launched in April to cover up to $500 worth of hemp-derived products each year for eligible Medicare patients. The program being implemented by the Centers for Medicare & Medicaid Services (CMS) focuses largely on CBD but also allows products to have up to 3 milligrams of total THC per serving. A federal judge granted the government’s motion to dismiss marijuana legalization opponents’ lawsuit challenging the initiative, but that is being appealed.

“In December, I signed a very important Executive Order calling for Research and Innovation for Hemp-derived CBD,” Trump said. “Our wonderful Dr. Mehmet Oz moved fast to follow the directive in the Executive Order, and launched a model for some Seniors earlier this month. But more must be done!”

“Please get it done, and SOON,” the president said in reference to a congressional fix for the broad recriminalization set to take effect in November. “Thank you for your attention to this matter!”

Wine and Spirits Wholesalers of America issued praise for Barr’s bipartisan hemp regulation bill, but said the measure’s tax provisions require “continued discussion.”

Hemp policy observers expect to see a Senate companion bill to Barr’s proposal filed soon, likely from Sens. Tim Sheehy (R-MT) and Amy Klobuchar (D-MN).

Sheehy recently cited hemp legislation as an area where Republicans and Democrats can work together in an otherwise “hyperpartisan time.”

A new poll from NuggMD found that most cannabis consumers say that state-level hemp product bans that lawmakers are enacting in line with the planned federal recriminalization move are causing them to shift their purchases toward licensed marijuana businesses.

The National Restaurant Association recently sent a letter urging congressional leaders to delay the federal recriminalization of hemp THC beverages and replace it with a regulatory framework that “ensures consumer safety while meeting growing market demand” for the products as an alternative to alcohol.

Major retailer Target, meanwhile, recently moved to expand its sales of hemp THC drinks into more states.

Photograph by UK College of Agriculture, Food & Environment via Flickr/Creative Commons 2.0

This story was originally published by Marijuana Moment, which tracks the politics and policy of cannabis and drugs. Follow Marijuana Moment on X and Facebook, and sign up for its newsletter.

The post Groups Press Congress Over Impending Hemp Ban appeared first on Filter.

The 95-percent stat itself isn’t accurate; it’s from the early 2000s, and hasn’t been true for a long time. Today it’d be around 84 percent, and that’s with the extremely conservative assumption that the only people who won’t come home are the ones serving 50 years or longer. The United States Sentencing Commission considers a de facto life sentence to be anything over 39 years and two months. Which is about the average sentence length for prisoners in Georgia right now. Lifers aren’t the outliers that they used to be.

Mandatory minimums, “three strikes” or “repeat offender” laws, truth-in-sentencing laws, sentence stacking and the formal or informal elimination of parole were all already underway by the turn of the century, and even as the size of the United States prison population has changed trajectories a few times since then the proportion of people serving life has continued to grow. (This refers to people sentenced to life with parole, life without parole, de facto life, and the death penalty.)

Since 2020 when corrections officers across the country quit in droves amid the COVID-19 pandemic, lifers—specifically the long-timers who’ve already been in prison a while—have been the ones keeping the peace at their facilities, relatively speaking. But as their role becomes more critical, corrections departments are simultaneously treating them as more expendable. Moving the older and vulnerable folks into gang-controlled units to see if that diffuses the violence; skipping over them for basic resources and programming because they don’t factor into recidivism statistics.

For example, lifers are generally ineligible for medication for opioid use disorder (MOUD), just by virtue of being lifers; if a prison has a Suboxone program at all, it’s likely considered a re-entry service and only made available to people with release dates in the next few weeks or months. Even the more traditional, non-MOUD treatment programs, which mostly consist of group meetings with limited capacity, will prioritize the people whose counselors wrote it into their re-entry plan, or who were steered toward it by the parole board.

As the only people who have to stay in the system, lifers the only ones with any real reason to make it better. Or who know how anything works.

Jobs are also considered re-entry preparation. Meaning that on wait lists—rarely do prisons have enough jobs to go around—people are in some cases bumped up or down by release date. Lifers are already ineligible for many if not most of the best-paying jobs, because they can’t go to work-release camps. Even in states that don’t pay prisoners at all, lifers who are barred from those jobs can still find themselves cut off from basic resources that went with them.

Work assignments, educational or vocational programming, pretty much any meaningful way to pass the time—these things only exist in the context of re-entry, family reunification, public safety and reducing recidivism.

The few officers who do show up, to work 16-hour shifts while they bring in contraband to offset the low pay, are rookies who will quit in a few months. The private kitchen contractors, whose job is to spend less on food than the state would have, will continue to shrink the portions of the meal-replacement powders they serve instead of food because future health care costs aren’t their problem. The private health care contractors can deny necessary surgeries and stop ordering everyone’s blood-pressure medication so they can pass the savings to their shareholders, because they’re not sticking around either. So there is an obvious need to invest in lifers. As the only people who have to stay in the system, they’re the only ones with any real reason to make it better, and the long-timers are the only ones who’ve been around long enough to know how anything works.

Though lifers build up so much expertise about the prison system they live in, they’re rarely able to compare notes with lifers in other systems, or see how the forces affecting them fit in with what’s happening in the rest of the country. The following is a discussion between three lifers who’ve each been incarcerated for around 30 years, each in a different state and different type of prison environment. It was not conducted in real time but in stages, as each contributor’s responses were relayed back and forth. As such, certain responses have been organized for readability rather than reproduced in strict chronological order.

Tony Vick, in Tennessee Department of Correction custody since 1997, serving life without parole: In Tennessee the biggest way lifers are hurt is, we can’t get into any of the good prisons. All the good prisons are short term-only prisons, 10 years or less. So we can’t get to a prison that has good [programming], and less violence, because they’re all short-time prisons. They call a prison like this one a time-building prison, and they’re the worst prisons. Might as well call it a death-waiting facility.

Jonathan Kirkpatrick, in Washington State Department of Corrections custody since 1995, serving a 60-year sentence: In this state I think custody plays a bigger role than length of time. [But] length of time is factored into your custody, so for example I reached Minimum but they have a special designation, Long-Term Minimum and this is the lowest security level I can get. So we can be classified as Minimum, but we can only go to Medium-capable facilities. So we have to have two fences between us and freedom, is what that means. Some Minimum facilities, like [work-release] camps, don’t have any fences, some have one fence, but nobody Long-Term Minimum can go to those facilities.

Jimmy Iakovos (pseudonym), in Georgia Department of Corrections custody since the early 1990s, serving life with parole: Politicians with no experience with prisons make policy calls totally contrary to all that is known to work. That pressure recently caused [a mass transfer of lifers from Medium-security Calhoun State Prison] to make room for short-timers. Consider that the lifers there had earned Medium security and were accepting of the terrible heat and insects of Deep South Georgia, because they were left alone to live as comfortable as they could make it with phones and whatnot. 

Now [Calhoun] is full of short-timers who know they are leaving in X amount of months. They are tearing the place apart because they have no reason not to.

Vick: I would dare say that the most change the younger inmates passing through, the most education and positive change they get are from the old-timers taking them under their wing and trying to help. That’s more than what the state will do for you. I say that without any hesitation. That’s why you have to invest in lifers, too. They are your constant support, constant teachers, constant moral police, constant peacemakers … lifers are the Ted Talks of the prison system.

The current ideology of what Americans think about prisons, it’s going more and more toward retaliation and less toward rehabilitation. They’re giving such long sentences, they want to just forget about you. They want you to go off to prison and they don’t have to think about you anymore. So the only reason they have to think about you is if you’re gonna come out, so they’re trying harder and harder to not let that happen. Get you sent in there once and for all, and then we don’t have to worry about you no more; we just have to build more prisons. 

Iakovos: When I first began we had Pell grants for four-year degrees available. The education director at the prison then turned me down saying, You have a fresh life sentence. You have plenty of time to get that degree. I got one year in before the Pell grant was cancelled. It’s back now, but none of the colleges are jumping at the chance to get involved. 

Kirkpatrick: That’s really similar here. In the first few months of my sentence we had Pell grants, before the feds took it. Now they’re back but there’s this real emphasis on [younger folks] with this FAFSA thing. I don’t know what it stands for, but I was starting my associate degree and got a few classes in and then the college said they needed me to fill out the FAFSA grant stuff and I got denied. It’s really common, here at least, to not get anything … this quarter the Black Prisoners’ Caucus is gonna give me a couple of classes, that’s really the main way that guys are doing it. If you’re doing any amount of time here you’re not getting classes through government grants.

Vick: If there are new computer coding programs or things like that, they don’t want anybody not getting out in there. They don’t bother putting you in a program for a good-paying job, or any self-improvement type of programming, or in any class with a certificate—what do you need that class for if you don’t need the certificate to show the parole board?

Iakovos: Lifers [in GDC] are not outright denied programs, classes, vocational training etc, but we are out at the back of the line … Our superpower is waiting lists. We naturally stick around long enough to make an issue if we have been waiting patiently. Educational aide jobs do not require long-timers, but those are the ones who have been on the waiting list the longest, so 90 percent of the time are the ones that get the job.

GDC only issues raincoats, thermal underwear and knit skull caps (AKA toboggans) to people assigned to work outside details. [Lifers are no longer assigned to those details, so that change] denied us [winter] clothes. Outside of very picky shakedowns or transfers, once I’m issued an item it’s mine until I choose to get rid of it. I had a thermal top that was 16 years old before it developed a hole in it. Because I needed it for two months a year. But without it, those two months are a misery. 

Now granted, I am able to buy my own clothes. But there are lifers older than I, who have served longer than I, who have [no money] coming in. Of course we—other lifers—look out for these men as we can, but that should not be required for survival.

Vick: [Correctional industries here] no longer hires anybody .. who doesn’t have a possibility of getting out in the next 25 years. Because of all their re-entry programs that they have now. They want people to be able to count toward their statistics. And here’s the problem, some people spend years learning those big six-color [printing press] machines that cost $1 million. You can’t learn those in a year or two. I can understand them wanting a mixture of people there. And we [lifers] even advocated for that, saying, Listen, you should at least have like 20 people who have long sentences so you can have some continuity. But …

Iakovos: The Braille transcribing program here specifically requires at least five years [served], and five remaining to serve in order to be considered … most short-timers never get in. Sometimes one will be foisted upon the group through connections to administration. Worthless for the business.

A lot of people who come in with marketable job skills are reluctant to give their skills away for free. At first. Over time they get bored and or decide to keep skills sharp and gravitate to the job near their field.

Kirkpatrick: Here you can go to correctional industries for seven years. But [these days] a regular job you can only spend two years, and have to get extensions approved by an associate superintendent or above. Reason is the same, don’t want prisoners to get comfortable. But that logic doesn’t stand … it’s the officers who get comfortable in their positions and let people do things they shouldn’t. And that’s the problem. It’s not because I live here and I’m gonna be exposed to the same thing every day, day in and day out for the rest of my life. How am I supposed to not get familiar with things? This is where I live. The officers are the ones who need to get moved around so they don’t get complacent and comfortable. My opinion at least.

Vick: Yes, that’s a good point. Because if the officers are following policy, it shouldn’t matter what the inmates are doing. It’s the officers being corrupted.

Kirkpatrick: Back when I was at Stafford Creek, where they have a lot of jobs, there was a short minute where they didn’t care who worked there. Then all of a sudden everybody doing more than 20 years got fired. Took us four or five years but then it was brought to everybody’s attention that they were supposed to have 10 percent of the population that works there be lifers, it’s supposed to reflect the population of prisoners. But they hated having lifers because their whole gig is, We’re building people for getting out. They like it when people doing a really long time come in at the end of their sentence, and then what they do is, Look, we reformed this person!

Vick: About 10 years ago they started a policy of rotating certain jobs every year, out of fear that inmate and staff would get too close. It seemed ridiculous, because you got all this skill associated with jobs you have to learn. Usually lifers or long-timers were the ones that had those jobs, because they had the most knowledge. You wait your whole life to get a job like that in prison, then all of a sudden you can’t have it no more. They diminish your skill, make you feel like it doesn’t matter if you know anything or not. You’re just a number. We’ll just move you around on a spreadsheet. We’ll just put another cow in the field.

The staff here stopped following that policy to tell you the truth. Maybe sometimes, depending on the warden or job coordinator, but they haven’t really been doing it here. I think they saw that they were supposed to take people with all this experience and [replace them] and just realized, My goodness, we can’t do that or we will never pass an audit.

Kirkpatrick: Maybe it’s different in other states, but here almost all the guys who have been around for a long time—we just want to chill. Most of the time, 90 percent of us just want to chill. And if they put us in the same place it’s going to be a real mellow institution, right? And they never do that, just let us all chill out. And I sort of understand why. In a way, the old-timers are also the most dangerous, right? They have the most experience and know-how. So I understand. But there are a lot of us that, given the opportunity to go to a lower custody level, it’d be nothing but good for [DOC] and it’d be less money spent on keeping us incarcerated.

Vick: If they put all of us [lifers] in one pod they would never even have to have an officer come in. All we want is to have peace and get along. But they know if they did that the rest of the prison would be so much more violent and chaotic, they gotta disperse us. Just using us old folks to mellow it out, keep the peace. While causing us more harm, putting us in danger, denying us programming.

Lifers are often the stability in the unit. They try to keep it clean, keep it maintained. The newcomers don’t really give a flip. They don’t regard it as any sort of home, they’re just passing through. And when I first come to prison you’d see guards here 20 years, 30 years, who retired in this industry. Now very seldom do you see guards who’ve been here more than five years, and the new ones coming in, of course, they don’t have any respect for where they are. They’re just trying to collect a paycheck and clock out, and I don’t blame them.

Iakovos: The difference is, this is a lifer’s home. We are not just visitors. Lifers are invested in prisons being comfortable, and in being left alone by the guards. 

Meanwhile, the Close security prisons that those [Calhoun] lifers were sent to have become chill, because of the overwhelming chill attitude of a bunch of lifers just trying to do the time unfucked with. We know that the police have to respond to the trouble areas. So the Close security prisons are becoming the least staffed. Completely contradictory of any planned best use of resources excusing the higher cost of higher-security prisons. Lol.

Top and first inset image (cropped) via Washington Office of the Corrections Ombuds. Second inset image via They Have No Voice. Third inset image via Tennessee Department of Correction/YouTube.

The post Three Lifers on Why Prisons Need Re-Entry Support for the Prisoners Who Aren’t Coming Home appeared first on Filter.

The survey covers mental illness, substance use, treatment and recovery for respondents ages 12 and up. The 2025 NSDUH, published in late July, reflects 60,447 completed interviews in person or online; in recent years it’s typically reached around 70,000.

Based on the 2025 respondents, SAMHSA projects that 69.8 million people—around 24 percent of the population over age 12—used at least one unregulated drug at least once within the past year. This refers to marijuana, hallucinogens, cocaine, methamphetamine, heroin, and “misused” prescription opioids, stimulants or tranquilizers/sedatives.

The 2022 NSDUH was the first to include street fentanyl. But it instituted a weirdly nonintuitive format that keeps street fentanyl siloed from the main section on opioids—effectively framing it as an afterthought while keeping the focus on prescription analgesics and heroin.

Respondents aren’t asked about street fentanyl until after they’ve completed the section covering substance use disorder, so the SUD statistics intentionally exclude that data. The same is true of opioid use disorder statistics, which are designed to include “misuse” of prescription fentanyl but nothing about street fentanyl. This format has been repeated in each subsequent NSDUH, including the 2025 edition.

The data show that past-year use of street fentanyl averaged around 660,000 people between 2022 and 2024, then jumped to 768,000 people for 2025. This represents a change from about 0.2 percent of the population over age 12 to 0.3 percent. However, you wouldn’t know that without looking at supplementary materials or data from previous years. The 2025 NSDUH itself simply states that for each year from 2021 to 2025, and across all age demographics, there was no change in the number of people using street fentanyl.

“[Q]uestions about the use of illegally made fentanyl (IMF) have appeared after SUD questions in the NSDUH questionnaire since 2022. For this reason, overall SUD, drug use disorder, and opioid use disorder measures do not capture disorders arising solely from the use of IMF,” the report states. “As discussed in the Illegally Made Fentanyl Use section, however, the estimate of IMF use in the past year among people aged 12 or older was low in 2025 (0.3 percent or 768,000 people).”

The “Illegally Made Fentanyl Use section,” which totals four paragraphs out of the 157-page report, acknowledges that this is “almost certainly an underestimate of true IMF use.” But it discusses street fentanyl almost as a novel opioid emerging in the heroin supply, rather than the one that emerged a decade ago.

In several places, the commitment to the five-year trend framework effectively erases any conclusions one might have otherwise drawn about 2025. For example, take the following graphic illustrating past-year cocaine use:

You might say it shows use among the 18-25 demographic decreasing for several years, then in 2025 going back up. SAMHSA’s characterization of the data, however, is that from 2021 to 2025 cocaine use decreased among the 18-25 demographic, and other than that there was no change.

The same thing happened in the broader section on “misuse” of central nervous system stimulants.

The NSDUH is pretty much the gold-standard citation for statistics on SUD and drugs, but the survey has always been marked by awkward data taxonomies that skew the results further away from real life than they would have been already. And by ambiguous language that makes it difficult to interpret even the more straightforward parts. After respondents “who reported ever using heroin or prescription pain relievers” were asked whether they’d been prescribed medication for opioid use disorder (MOUD), for example, and shown a comprehensive and accurate list of different formulations of methadone, buprenorphine and naltrexone, the report proceeds to state that MOUD “do not include the use of medications that are prescribed to manage withdrawal symptoms.”

The survey purports to represent the national scope of drug use and mental illness, but barely acknowledges that it isn’t offered to the populations most impacted by those things. It isn’t offered to people living outside or in their cars, for example, or in jail or prison.

The 2025 NSDUH does include data on whether people received treatment while in prison, jail or juvenile detention, though it doesn’t say what kind.

Top and inset images (cropped) via Substance Abuse and Mental Health Services Administration

The post SAMHSA Reframes National Drug Use Survey, Leaves Fentanyl Problem Intact appeared first on Filter.

“For too long, we have kept methadone—an evidence-based, life-saving medication—locked away, far from many of the people who need it,” Markey said. “The Modernizing Opioid Treatment Access Act 2.0 of 2026 would take a carefully considered step forward in expanding access to this medication by allowing the most highly trained addiction physicians in the country to prescribe methadone for their patients to pick up at a pharmacy. We must knock down barriers to treatment for people at risk of opioid overdoses—not build them up.”

He’s right that knocking down barriers to methadone is long overdue. But would MOTAA 2.0 unlock access for everyone who needs it? The answer is no. Nothing in the updated bill addresses the fundamental problems in the 2023 version.

“We know that there aren’t enough addiction medicine physicians and psychiatrists in the country.”

As Filter reported at the time, the first iteration of the bill contained fatal flaws. Limiting non-clinic prescribing to physicians board-certified in addiction medicine would exacerbate racial disparities in access to medications for opioid use disorder (OUD). It’s also just not nearly enough. There are about 6,400 doctors with this certification. About 600,000 patients currently take methadone.

“We know that there aren’t enough addiction medicine physicians and psychiatrists in the country to expand care to everyone who needs it,” a representative from the office of Sen. Markey told Filter.

“The goal of the bill is to expand the universe of providers who can prescribe methadone,” they continued. “It starts this expansion by allowing health care providers with the greatest expertise in addiction treatment—board-certified addiction medicine physicians and addiction psychiatrists—to prescribe methadone outside of an OTP.”

When it comes to prescribing methadone for OUD specifically, however, doctors board-certified in addiction medicine have no more experience than other doctors—because none of them have been able to do it. The law has restricted this to physicians who work in opioid treatment programs (OTP). There are approximately 2,100 OTP in the US, the majority concentrated in urban centers.

“One of the main changes in MOTAA 2.0 compared to the version introduced last Congress is the addition of language to allow the HHS Secretary to designate providers able to prescribe methadone outside of an OTP setting, in addition to board-certified addiction medicine physicians and addiction psychiatrists,” Sen. Markey’s representative said. “These providers would need to be licensed and registered to prescribe controlled substances.”

But who are these other providers? The representative didn’t say. The bill itself states that they would be “otherwise determined by the Secretary, under standards established by the Secretary.” The language is troublingly vague.

We still don’t know who the “future licensed providers” would be, nor any timeline. And what’s to stop HHS using its new “flexibility” to do precisely nothing?

The American Society of Addiction Medicine (ASAM) interprets the sentence to mean, “The HHS Secretary could add other qualified prescribers, who would remain subject to applicable state scope-of-practice laws…” But who are the “other qualified prescribers”?

Kelly M. Corredor, chief advocacy officer at ASAM, confirmed via email to Filter that the organization was involved in drafting the updated bill. But when asked who the other qualified prescribers would be, she wouldn’t specify.

According to a press release from Rep. Donald Norcross (D-NJ), a sponsor of the bill in the House this provision means, “flexibility for the Department of Health and Human Services to authorize future licensed providers without Congress needing to pass a separate law.”

But we still don’t know who the “future licensed providers” would be, nor any timeline on which this might happen. And what’s to stop HHS using its new “flexibility” to do precisely nothing?

MOTAA 2.0’s inclusion of more providers, however ambiguously, is a direct response to methadone reform activists’ criticisms of the original MOTAA. But its terms offer no guarantee that the HHS secretary will ever allow more prescribers.

Unfortunately, other provisions that helped doom the original MOTAA made it into 2.0. Participating doctors would need a special registration from the Drug Enforcement Administration (DEA)—extra surveillance that will deter some as has been the case with buprenorphine. The other poison pill is that any state attorney general could stop registering new providers and revoke or deny a registration.

“We cannot allow ourselves to become embroiled in territorial turf wars over prescribing privileges under the guise of ‘modernizing.’”

ASAM is the leading advocate for MOTAA 2.0. This conservative medical society has done almost nothing to end three decades of a crisis that has seen over 1 million people die from an opioid-involved overdose. It’s notable that ASAM had zero interest in reform prior to the pandemic. Given this abysmal track record, on what basis should its members have the exclusive right to prescribe methadone outside of clinics?

“The urgency of providing access to life-saving medications for people dealing with substance use disorders, particularly opioids, cannot be overstated,” Jerry Otero, who takes methadone and is the manager of the Drug User Health Hub at St. Ann’s Corner of Harm Reduction, told Filter. “We cannot allow ourselves to become embroiled in territorial turf wars over prescribing privileges under the guise of ‘modernizing.’”

In 2023, Dr. Stephen M. Taylor, then president-elect of ASAM, (now president), testified to a US Senate committee: “MOTAA is not methadone for everyone, prescribed by anyone. It represents a responsible expansion in methadone access for OUD.”  Taylor’s statement shamefully carried no sense of urgency to save lives. The incremental, “responsible” expansion he advocated would free very few patients from the carceral clinic system.

ASAM’s description of MOTAA 2.0 as having strong federal and state oversight and safety guardrails” plays into the worst discrimination against methadone patients—the notion that they can’t be trusted and must be continuously monitored.

ASAM’s one-pager on the new bill has a section titled, “Improve Patient Safety and Address Diversion.” Diversion isn’t a major problem; lack of access is. This DEA framing panders to the idea that methadone is a uniquely dangerous medication. It’s not.

The first bullet point states that ASAM supports the terrible idea of DEA special registration of doctors. This is the DEA that has kept methadone under lock and key as people die; the DEA that has made the unregulated opioid supply exponentially more dangerous by pursuing its deadly drug war. Yet instead of campaigning to get these killer drug warriors out of addiction medicine, ASAM cosies up to them and rarely, if ever, criticizes their actions.

The second bullet point endorses the use of prescription drug monitoring programs (PDMP) for methadone dispensed through community pharmacies. According to those who’ve studied them, PDMP are tools of law enforcement and often harm patients.

“There is one thing that prescription drug monitoring programs are really good at, and that is bringing down prescribing rates,” said Dr. Elizabeth Chiarello, author of, Policing Patients: Treatment and Surveillance on the Frontlines of the Opioid Crisis. “But overdose is through the roof.”

Other ASAM bullet points welcome MOTAA 2.0’s ideas of states setting dispensing limits, which many will do to the detriment of patients, and prescriptions being written for “supervised use”—meaning pharmacists would be required to watch certain patients swallow methadone, just as clinic nurses do.  

“This bill, in action, will keep methadone out of reach for the patients who need it the most.”

The Modernizing Opioid Treatment Access Act 2.0 doesn’t modernize access to methadone. It’s designed to fail by handing a small group of doctors a monopoly on prescribing to a small group of patients, who will skew wealthier and white. And it gives states veto power over new providers—states like West Virginia, which is so hostile to methadone that it’s had a moratorium on opening new clinics for 19 years.

In line with the DEA narrative, MOTAA 2.0 emphasizes diversion control and surveillance of patients; it reinforces stigma.

“This bill, in action, will keep methadone out of reach for the patients who need it the most,” Otero said, “by overcomplicating who can prescribe.”

A bill to truly modernize access to methadone would abolish the clinic system and permit all provider prescribing.

The obfuscating language in MOTAA 2.0 that might, maybe mean more providers can prescribe sometime in the distant future—who knows!—is an insulting trick to make methadone reform advocates believe 2.0 is a different bill from its predecessor. It’s not.

Instead, believe Dr. Taylor when he says, “MOTAA is not methadone for everyone, prescribed by anyone.” 

Image by Helen Redmond

The post MOTAA 2.0 Is Not Real Methadone Reform appeared first on Filter.