The 에볼루션 바카라 Weekly for April 22nd, 2025

This Week in the 에볼루션 바카라 Weekly

It's not often we showcase a publication that focuses on trust — let alone on trust being an outcome, rather than a precursor, of a local government's harm reduction policies in highly-impacted, rural localities in the US. This week we do, and what's remarkable is that the results are (likely) not generalizable — and that's the point ().

Locality plays an important role in understanding crises. After all, the overdose epidemic is a collection of “mini-epidemics” that evolved over time and space becoming the crisis that it is. Developing a response to these “mini-epidemics” will depend on local data, which are often collected from “advanced surveillance systems” at the national level (). And if we don’t support or fund these national surveillance systems, it will be like one of those trust exercises where you fall but there’s no one there to catch you () and it keeps happening because no one even knows there’s a problem ().

That’s why we keep an eye out for problems, find (and fund) solutions, and adjust based on the evidence. But we must also be careful not to jump to conclusions. The underwhelming results of drug decriminalization in British Columbia aren’t a repudiation but rather an indication for deeper consideration (). So consider it like this: just as detox alone is not treatment, decriminalization alone is not harm reduction. 

As few things in addiction work well on their own, we’re at our best when we do things together. Take for example, this week's  — there won’t be any trust exercises, but there will be plenty of people you know and trust.

Thanks for reading,

Nicholas Athanasiou, MD, MBA, DF에볼루션 바카라
Editor in Chief

with Co-Editors: Brandon Aden, MD, MPH, F에볼루션 바카라; John A. Fromson, MD; Jack Woodside, MD

Lead Story 

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Harm Reduction Journal

Implementation of harm reduction intervention policies by local governments may be met with caution because of concern about potential backlash from communities and erosion of public trust. The authors conducted two studies to assess the influence of perceptions of government support for comprehensive drug policies (including harm reduction) on public trust in local government. In both a field study and an experimental study, the authors found that public trust was positively associated with increased perception of government support for comprehensive drug policies. The authors note residents recognized harm reduction policies as a step to address the issue of drug use, and these findings may ease some concerns about public pushback for local government officials when considering these policies. 

Research and Science 

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The Lancet Regional Health - Americas

Substance use disorder (SUD)-related mortality has been increasing for decades, first primarily due to prescription opioids, followed by heroin, synthetic opioids, and polysubstance use. In this study, researchers conducted spatiotemporal analysis from 2005 to 2020 to look for SUD mortality clusters and shifts in regional mortality. Over the study period, the authors identified 27 clusters and noted that in the western US clusters primarily occurred in rural areas, while in the eastern US they were more evenly distributed between urban and rural areas. Over the study period, there was a shift in the epicenter from the western to eastern US and from rural to more urban areas. Overall, mortality was higher in White populations but increased notably in Black populations after 2013. The authors note the need for real-time surveillance to identify shifting trends and strategies tailored to rural and urban areas. 

Drug and Alcohol Dependence

D8-THC is present in small quantities in cannabis, is a partial agonist at cannabinoid receptors, and therefore has effects like D9-THC. It is easily synthesized and D8-THC use is increasing. This study compared the subjective “high” and cognitive/psychomotor effects in 19 adult, occasional users of cannabis. In a randomized, blinded study participants received oral doses of either placebo, D9-THC 20 mg, or D8-THC 10 mg, 20 mg, or 40 mg. The subjective “high” and cognitive/psychomotor impairment of 40 mg D8-THC was similar to 20 mg of D9-THC, and 10 mg D8-THC was similar to placebo. Both had similar pharmacokinetics with peak blood concentrations 2-4 hours after the oral dose. Although often perceived as less harmful, D8-THC at higher doses differed little from D9-THC.

Learn More 

JAMA Psychiatry

In response to a worsening drug-related health crisis, regions like Portugal, Oregon, and British Columbia (BC) have shifted away from strict drug prohibition. Portugal’s 2001 decriminalization succeeded due to strong public health support, while Oregon’s 2020 attempt failed and was repealed in 2023 due to rising overdoses and lack of infrastructure. BC’s 2023 law decriminalized small quantities (up to 2.5 g) of several drugs but did not impact trafficking. A study found a 57% drop in possession incidents post-law but no change in drug-related deaths or hospitalizations. Potential reasons include the possession limit being too low, incomplete law enforcement shifts, short evaluation period, passive public health engagement, continued harm from unregulated drug supply, and the wrong metrics used to measure success. Decriminalization alone is not enough to address this crisis; long-term success requires robust public health systems, treatment access, and time, echoing Portugal’s more comprehensive and sustained approach.

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JAMA Psychiatry

This cohort study examined if cannabis is associated with the same midbrain dopamine pathway involved in psychosis. The study included 61 individuals with cannabis use disorder who exhibited increased neuromelanin magnetic resonance imaging signals in specific voxels of the substantia nigra/ventral tegmental area (SN/VTA). This subregion has previously shown elevated signals associated with untreated psychotic symptoms. Increased dopamine functioning in the SN/VTA may be associated with the risk of psychosis in people with cannabis use disorder.

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Proceedings of the National Academy of Sciences

Scientific interest in alcohol’s biological effects, especially ethanol, dates back centuries, but systematic alcohol research began in earnest with Benjamin Ward Richardson’s 1869 lecture. His work led to the formulation of Richardson’s law, which states that the acute toxicity of straight-chain monohydroxy alcohols increases proportionally with their carbon chain length. Though this principle was largely forgotten over time, it has recently been rediscovered through manual citation tracking. Modern quantitative analysis confirms the law’s accuracy (R² = 0.96) across alcohols with 1–13 carbon atoms. Remarkably, Richardson’s law remains one of functional biology’s oldest and most robust, yet underrecognized, scientific findings.

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PLOS One

In this cross-sectional survey, researchers assessed a potential association between psychedelic use and connectedness, affect, life satisfaction, creative performance, and involvement in creative activities. Overall, psychedelic use was associated with an increased feeling of connectedness (to the world, others, and self), and increased creativity and participation in creative activities. Psychedelic use was not associated with increased life satisfaction or improved affect. The authors suggest that the increased feeling of connectedness to self may be part of how psychedelics increase creativity. The authors do note psychedelics may be associated with maladaptive effects, which may be related to increased creativity and imaginings around potential threats or harms.

In the News 

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Reuters

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Forbes

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POLITICO

The New York Times

The New York Times

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The Associated Press