US border agency says it’s made biggest-ever fentanyl bust
By ANITA SNOW
Friday, February 1
PHOENIX (AP) — U.S. Customs and Border Protection officials announced Thursday their biggest fentanyl bust ever, saying they captured nearly 254 pounds (114 kilograms) of the synthetic drug that is fueling a national epidemic of fatal opioid overdoses from a secret compartment inside a load of Mexican produce heading into Arizona.
The drug was found hidden Saturday morning in a compartment under the rear floor of a tractor-trailer after a scan during a secondary inspection indicated “some anomalies” in the load, and the agency’s police dog team alerted officers to the presence of drugs, Nogales CBP Port Director Michael Humphries said.
Most of the seized fentanyl with an overall street value of about $3.5 million was in white powder form, but about 2 pounds of it (1 kilogram) was contained in pills. Agents also seized nearly 395 pounds (179 kilograms) of methamphetamine with a street value of $1.18 million, Humphries said.
“The size of a few grains of salt of fentanyl, which is a dangerous opioid, can kill a person very quickly,” Humphries said. The seizure, he said, had prevented an immeasurable number of doses of the drug “that could have harmed so many families.”
President Donald Trump praised the bust in a tweet Thursday, writing: “Our great U.S. Border Patrol Agents made the biggest Fentanyl bust in our Country’s history. Thanks, as always, for a job well done!”
The Drug Enforcement Administration said the previous largest U.S. seizure of fentanyl had been in August 2017 when it captured 145 pounds (66 kilograms) of the drug in a Queens, New York, apartment that was linked to the Sinaloa Cartel. Before that, the largest recorded fentanyl seizure was 88 pounds (40 kilograms) nabbed from a pickup truck in Bartow County, Georgia.
Mexican traffickers have been increasingly smuggling the drug into the United States, mostly hidden in passenger vehicles and tractor-trailers trying to head through ports of entry in the Nogales, Arizona, and San Diego areas.
Doug Coleman, the DEA’s special agent in charge for the Phoenix division, expressed admiration for the size of the recent bust, emphasizing that it was not the product of any intelligence from his agency but rather “pure, old fashioned police work” by the agent who pulled the truck over.
“It was totally a cold hit” based on the agent’s hunch, Coleman said.
Fentanyl has caused a surge in fatal overdoses around the U.S., including the 2016 accidental death of pop music legend Prince, who consumed the opioid in counterfeit pills that looked like the narcotic analgesic Vicodin.
U.S. law enforcement officials say the illicit version of the painkiller is now seen mostly as a white powder that can be mixed with heroin for an extra kick as well as blue pills that are counterfeits of prescription drugs like oxycodone.
The legal prescription form of the drug is used mostly to provide relief to cancer patients suffering unbearable pain at the end of their lives.
DEA officials have said that while 85 percent of the illicit fentanyl entering the United States from Mexico is seized at San Diego-area border crossings, an increasing amount is being detected on the border with Arizona, a state where the Sinaloa cartel controls the drug trade and fatal fentanyl overdoses are rising.
The federal Centers for Disease Control and Prevention says in a recent report that fentanyl is now the drug most often involved in fatal overdoses across the country, accounting for more than 18,000, or almost 29 percent, of the 63,000 overdose fatalities in 2016.
Family made billions on opioid as crisis raged, filing says
By ALANNA DURKIN RICHER and GEOFF MULVIHILL
Friday, February 1
BOSTON (AP) — Newly public court documents show the family behind OxyContin raked in billions as they pushed to keep patients on the powerful painkiller longer, even as evidence grew that the drug was helping fuel a national opioid crisis.
Details made public this week in a lawsuit filed by the state of Massachusetts against Purdue Pharma and the family that owns the company claim the Sackler family brought in more than $4 billion in a little more than a decade.
The state says the company used discounts to keep people taking its drugs longer despite their risks.
The allegations were made in a lawsuit filed last year. Purdue lost its fight this week to keep some of the allegations secret. The company says the state is taking documents out of context.
Jury set for deliberations at US trial of El Chapo
By TOM HAYS
Monday, February 4
NEW YORK (AP) — After nearly three months of testimony about a vast drug-smuggling conspiracy steeped in violence, a jury is due to begin deliberations Monday at the U.S. trial of the infamous Mexican drug lord Joaquin “El Chapo” Guzman.
A federal judge in Brooklyn was giving instructions to jurors before they will be asked to begin deciding the verdict for Guzman, who faces life in prison if convicted.
The jury has heard months of testimony about Guzman’s rise to power as the head of the Sinaloa cartel. Prosecutors say he’s responsible for smuggling at least 200 tons of cocaine into the United States and a wave of killings in turf wars with other cartels.
Guzman, 61, is notorious for escaping prison twice in Mexico. In closing arguments, prosecutor Andrea Goldbarg said he was plotting yet another breakout when was he was sent in 2017 to the U.S., where he’s been in solitary confinement ever since.
The defendant wanted to escape “because he is guilty and he never wanted to be in a position where he would have to answer for his crimes,” Goldbarg said. “He wanted to avoid sitting right there. In front of you.”
The defense claims Guzman’s role has been exaggerated by cooperating witnesses who are seeking leniency in their own cases. In his closing, defense attorney Jeffrey Lichtman assailed the case as a “fantasy” and urged the jury not to believe cooperators who “lie, steal, cheat, deal drugs and kill people” for a living.
Last week, newly unsealed court papers revealed disturbing allegations not heard by the jury – that Guzman had sex with girls as young as 13. A Colombian drug trafficker told investigators the kingpin paid $5,000 to have the girls brought to him, and that he sometimes drugged them, the papers say.
The start of the proceedings on Monday were briefly delayed after two jurors indicted to the judge they were aware of reports about the alleged sex crimes. He questioned both behind closed doors before allowing them to remain on the jury.
The unsealing of the documents came at the request of The New York Times and Vice News. U.S. District Judge Brian Cogan had ordered prosecutors to review the material – originally sealed because it was deemed unrelated to the drug charges – and make portions of it public within four days of the government resting its case against Guzman.
Guzman’s attorneys said their client denies the allegations.
Bill Cosby victim settles defamation suit with ex-prosecutor
By MARYCLAIRE DALE
Friday, February 1
PHILADELPHIA (AP) — The victim in Bill Cosby’s criminal sex-assault case has settled a defamation lawsuit against a former prosecutor who said she added details to her story over time.
Andrea Constand’s suit against Bruce Castor had been set for trial in April in Philadelphia after a federal judge refused to dismiss it. The case then settled this week, court records show.
Constand’s lawyer, Dolores Troiani, said Thursday that the terms are confidential and both sides had agreed not to comment.
Castor had declined to charge the actor when Constand went to police in suburban Philadelphia in 2005 to say “America’s Dad” had drugged and molested her a year earlier. In a statement, he said that both parties could be portrayed in “a less than flattering light.”
When the criminal case was reopened a decade later, Castor defended the decision to The Associated Press.
“If the allegations in the civil complaint were contained with that detail in her statement to the police, we might have been able to make a case out of it,” Castor said. Troiani demanded a public apology, saying Castor had revictimized her client.
“This is outrageous that a victim of a crime could be treated this same way — twice — by the same man,” Troiani said at the time.
A new prosecutor arrested Cosby in 2015 after documents from her 2005 civil suit against Cosby were unsealed, revealing Cosby’s damaging testimony about sexual encounters with Constand and others. He was convicted this year of sexually assaulting Constand and is serving a three- to 10-year sentence at a state prison near Philadelphia.
Castor and his lawyers did not immediately return messages late Thursday.
Cosby settled Constand’s civil lawsuit for nearly $3.4 million.
Measles: Why it’s so deadly, and why vaccination is so vital
February 1, 2019
Author: Paul Duprex, Professor of Microbiology and Molecular Genetics, University of Pittsburgh
Disclosure statement: Paul Duprex receives funding from Zoetis LLC, the National Institutes of Health (NIH) and Defense Advanced Research Projects Agency (DARPA).
Partners: University of Pittsburgh provides funding as a member of The Conversation US.
On the darkest day of 2018, the winter solstice, we at the Center for Vaccine Research at the University of Pittsburgh tweeted, with despair, a report in the Guardian that measles cases in Europe reached the highest number in 20 years.
Why was this a cause for concern? Europe is far away from the United States, and as some people apparently believe measles is a benign, childhood disease that causes a bit of a rash, a dribbling nose and a few spots, right? What was all the fuss about?
Well as George Santayana said, “Those who cannot remember the past are condemned to repeat it.” Collective amnesia about the virulence of this disease has driven us to forget that measles virus has killed tens of millions of infants throughout history. Now, with several ongoing outbreaks across our own country, this unnecessary threat is back.
Measles is a highly contagious and sometimes deadly disease that spreads like wildfire in naive populations. The virus played its part in decimating Native American populations during the age of discovery. Since these people groups had no natural immunity to the diseases brought to the New World by Europeans, some estimates suggest up to 95 percent of the Native American population died due to smallpox, measles and other infectious diseases.
In the 1960s, measles infected about 3-4 million people in the U.S. each year. More than 48,000 people were hospitalized, and about 4,000 developed acute encephalitis, a life-threatening condition in which brain tissues become inflamed. Up to 500 people died, mainly from complications such as pneumonia and encephalitis. This was why vaccine pioneers John Enders and Thomas Peebles were motivated to isolate, weaken and develop a vaccine against measles that is truly transformative for human health. Parents who knew the reality of the disease were quick to vaccinate their children. Uptake skyrocketed and the number of cases, and associated deaths, plummeted in the developed world.
By 1985, when John Enders died, over 1 million of the world’s kids were still dying because of this infection. However, now measles was a disease preventable by vaccine, and there was a huge impetus to address that tragedy by the World Health Organization.
When I started working on the virus in 1996, there were still over 500,000 children dying of measles each year worldwide. Such big numbers can be hard to digest. So to put it into perspective, if you’ve ever been on or seen a Boeing 747 jumbo jet, you will know it’s a pretty big airplane. Think of over three of these planes full of infants crashing every day of the year with 100 percent of the people on board dying. January, February, March … the summer solstice, the autumnal equinox … November, back to the winter solstice in December … one rhythmic year. That’s the reality of measles – over half-a-million lives were lost globally every year in the nineties.
Thanks to vaccination, however, between 2000 and 2016 there was an 84 percent decrease in measles mortality, and over 20 millions deaths were prevented due to vaccination. What an achievement!
Near universal adoption of the vaccine in the developing world meant that measles infections and concomitant deaths became very rare. By 2000, the led to measles being eliminated from the United States. The last person to die of the infection here was in 2015.
The effectiveness and irony of vaccination
These successes don’t mean the measles is gone or that the virus has become weak. Far from it. Seeing the virus up close and personal over all these years and knowing what happens when it runs rampant in an infected host gives me such respect for this minuscule “little bag of destruction” whose genetic material is 19,000 times smaller than ours. It’s also ironic how losing sight of the disease because of the success of vaccination has brought new societal challenges.
What’s important to realize is those millions of kids who died of measles each year in the nineties, for the most part were not living in the developed world. In those days here in the United States and in Europe, there was a widespread appreciation that #vaccineswork, meaning that the vast majority of people received the measles, mumps and rubella (MMR) vaccine and were well and truly protected. Two doses of the vaccine are 97 percent effective at stopping the infection.
What one of the most infectious pathogens on the planet can do to an unvaccinated person in 2019 is biologically incredible. Yes, that’s right, an unvaccinated human. But why would anyone decide not to get vaccinated or refrain from protecting their children?
That’s because forgetting the past has precipitated selective amnesia in our post-measles psyche. Ignoring scientific facts has tragically brought us to a place where some people fail to appreciate the values and utility of some of the most phenomenal tools we have created in our historical war on infectious disease. Unsubstantiated claims that vaccines like MMR were associated with autism, multiple sclerosis, Crohn’s disease, etc., etc., and ill-informed celebrities have wreaked havoc with vaccination programs. Genuine, caring parents unaware of the realities of diseases they had never seen decided that since the viruses were gone from this part of the world shots were so last millennium. Put simply, some people have given up on vaccines.
This has created the perfect storm. Since the measles virus is so infectious and Europe, Africa, South America, and South East Asia are not really that far away by jumbo jet, a case somewhere in the world can lead to an infection anywhere in the world. Failure to vaccinate large groups of people is helping measles come back. From California, to New York from Washington state to Minnesota and Georgia, measles is back with a vengeance. Now we can only live in hope that the last death from this deadly disease in the U.S. remains from 2015. Unfortunately, that is not a given.
Vincent J.: There will always be ignorant, foolish, and stupid people on earth, therefore there will always be pockets of preventable diseases.
Who’s smoking now, and why it matters
February 1, 2019
Author: Kenneth E. Warner, Professor Emeritus of Public Health, University of Michigan
Disclosure statement: Kenneth E. Warner is a member of the Tobacco Products Scientific Advisory Committee of the US Food and Drug Administration; a member of the Interagency Committee on Smoking and Health of the US Department of Health and Human Services; and a member of the Scientific Advisory Committee on Vaping Products of Health Canada. He also serves on a number of other national and international advisory boards related to public health but not directly related to the subject matter of this article. Dr. Warner’s work has been supported by numerous federal government and foundation grants and contracts, none of which is directly relevant to this article.
Partners: University of Michigan provides funding as a founding partner of The Conversation US.
Suppose you were told that there is something responsible for nearly 1 of every 5 deaths of Americans, and that it is completely avoidable. Would you believe – today – that “something” is cigarette smoking?
If you’re a college graduate, you might not believe it. You don’t smoke. Your friends and colleagues don’t smoke. You never see smoke in your workplace, nor in the restaurants and bars you frequent. Like many of the nation’s most educated citizens, you may well regard the problem of smoking as largely solved. Because the educated population is also the most politically engaged, cigarette smoking has virtually disappeared from the nation’s health policy agenda.
I’m not a smoker, although like many of you I was one (45 years ago, in my case). As a student of tobacco policy for over 40 years, I have helped to document the remarkable progress we have made against smoking. But I also appreciate why smoking remains our nation’s most avoidable cause of disability and premature death. The lack of policy attention to smoking is a public health tragedy.
The good news and the bad news
No one can deny the extraordinary victories against smoking. Since the 1964 Surgeon General’s report on smoking and health, adult smoking prevalence has dropped by two-thirds, from 43 percent to 14 percent.
The decrease among young people has been even more substantial. For example, since smoking peaked among high school seniors 20 years ago, smoking prevalence in the past 30 days has plummeted by nearly 80 percent.
Prompted by tobacco control initiatives, Americans’ decisions to quit smoking and not to start in the first place avoided 8 million premature deaths from 1964 to 2012. The Centers for Disease Control and Prevention considers tobacco control one of the 10 greatest public health achievements of the 20th century and of the first decade of the 21st.
That’s the good news. The bad news is that 1 of every 7 adults still smokes. And smoking kills nearly 500,000 Americans every year. That number exceeds – by a lot – the sum total of all deaths caused by the opioids and other drugs, alcohol, motor vehicle injuries, homicide, suicide, HIV/AIDS and fires.
Who smokes now? The role of education
What accounts for the divergence between common perceptions about smoking and the dismal reality? In large part it is remarkable changes in who is smoking. Increasingly, today’s smokers are those with lower education, lower income and – importantly – a higher incidence of mental illness.
Consider this: In 1966, the smoking rate of Americans who hadn’t graduated high school was just 20 percent greater than that of college grads. By 2017, in contrast, the smoking prevalence of the least educated was nearly four times greater than that of the most educated.
Smoking has declined substantially at both ends of the education spectrum but to a much higher degree among college graduates: by half among Americans lacking a high school degree, but by 85 percent among college graduates.
For college grads, the rate of smoking in 2017 was vanishingly small. For those without a high school degree, and indeed for high school grads too, fully 1 out of 5 remain smokers. The difference matters. Research attributes a fifth to a third of a large education-related gap in life expectancy to differences in smoking.
A similar pattern of smoking holds with respect to income classes, themselves highly correlated with educational attainment. According to the latest data, Americans who live below the federal poverty level were three times more likely to smoke than Americans with incomes at least 400 percent above the federal poverty level. The gap has widened since the early 1990s.
There is an enormous difference in life expectancies between the nation’s richest and poorest citizens. Smoking is again a significant factor in this disparity.
Mental health does, too
An enormously important factor in smoking today is that the smoking prevalence of people suffering from serious mental illness is more than double that of the population not so afflicted (28 percent and 13 percent, respectively, in 2014). People with mental health problems or substance use disorders constitute a quarter of the U.S. population but consume 40 percent of all cigarettes smoked. They have more difficulty quitting smoking.
Rates differ by mental illness condition. In 2007, nearly 60 percent of schizophrenics smoked. That was three times the rate of the general population. Smokers with serious psychological distress (SPD) lose 15 years of life expectancy. Nonsmoking victims of SPD lose five years. Research has thus attributed up to two-thirds of the life expectancy reduction of SPD victims who smoke to their consumption of cigarettes.
Sexual orientation, race and ethnicity
Smoking also disproportionately afflicts members of the LGBT community. Among racial/ethnic groups, American Indians and Alaskan Natives had the highest smoking rates in 2016, while Asian Americans and Pacific Islanders had the lowest.
In general, women have substantially lower smoking rates than men. The exceptions are American Indians/Alaska Natives, among whom women have slightly higher smoking prevalence than men, and non-Hispanic whites, among whom men smoke at slightly higher rates.
As these data indicate, the principal victims of smoking are members of marginalized populations. Despite the enormous continuing importance of smoking in U.S. health, the issue is submerged. Smoking no longer afflicts the nation’s most economically advantaged population, and those it does burden lack an effective voice in the nation’s political life.
Besides, smokers tend to blame themselves for the behavior.
In point of fact, smoking is a tenacious addiction, one that the vast majority of smokers acquired in their youth. They were assisted in so doing by an avaricious tobacco industry that marketed aggressively to young people. Kids have been referred to as “replacement smokers,” the new smokers needed to replenish the industry’s customer base as its most loyal customers succumb to smoking-produced diseases.
Restoring tobacco control to the nation’s public health agenda
What can be done? The simple – and incomplete – answer is “more of the same.” Public education has contributed to decreased smoking, as have policy interventions: cigarette taxation, smoke-free workplace laws, prohibitions on product advertising and promotion, and media anti-smoking campaigns. Evidence-based smoking cessation treatments can help as well. Interventions increasingly need to be targeted to specific high-risk groups.
These evidence-based measures are unlikely to be enough, however. A potentially complementary tool may lie in a highly controversial recent development: the emergence of e-cigarettes. Novel reduced-risk nicotine delivery products like e-cigarettes may serve as alternatives to smoking, especially for those smokers otherwise incapable of quitting cigarettes.
Vaping may hold the potential to help significant numbers of Americans to quit smoking. The risks of vaping are clearly substantially less than those of smoking. At the same time, however, there are concerns about the attraction of e-cigarettes to young people and uncertainty about the health effects of long-term vaping.
While the ultimate impacts of e-cigarettes and other novel non-combusted tobacco products remain to be seen, there is widespread agreement that it is the burning of tobacco – primarily in the form of cigarette smoking, with its 7,000 chemicals – that is by far the most deadly method of consuming tobacco.
The enormous successes of tobacco control notwithstanding, smoking remains Public Health Enemy No. 1. Today, the burden of smoking falls primarily on marginalized populations – the poor, the poorly educated, and those suffering from mental health problems. A compassionate public would renew the battle against smoking with a vigor not seen in decades.