Alcohol prohibition. Taxes. Quality standards. Potency regulation. What can healthcare policy learn from alcohol and tobacco and apply to today's cannabis market?

David Jernigan, PhD, is a Professor of Health Law, Policy and Management at the Boston University School of Public Health, and senior policy advisor for CityHealth, a project of the de Beaumont Foundation that provides leaders with a package of evidence-based policy solutions that will help millions of people live longer, better lives in vibrant, prosperous communities.

Dr. Jernigan is best known for his action-research approach to the issue of alcohol advertising, marketing, and promotion and its influence on young people. His work has led to better advertising regulations and a clearer understanding of the evolving structure of the alcohol industry. His work is policy relevant and scientifically rigorous. Dr. Jernigan has been very active in translating research findings into policy and practice. He testifies regularly at city, state, and national levels around alcohol advertising and youth, alcohol availability, and taxation. He also trains advocates around the world using the best evidence.

Cannabis: Moving Forward, Protecting Health

Disease burden is the impact of a health problem as measured by financial cost, mortality, morbidity or other indicators. When it comes to drugs, we are always talking about overdoses and deaths. The CDC predicted deaths in the US for the 12 months preceding March 2024, are over 103,000. That is horrible and unacceptable. Death is just the tip of the iceberg. For every death there are many more with a substance use disorder, as well as a host of medical and mental health conditions associated with drugs.

There are proponents of judging drugs like we do other health problems like injuries or cardiovascular disease. That is looking at the total disease burden, not just deaths.

For example, disability for depression and back pain rated much higher in disease burden compared to diabetes, emphysema and asthma combined. Yet we know emphysema is more lethal than back pain. In this episode we will discuss the disease burden of drugs and alcohol.

Vaughan Rees, pHD

Dr. Rees is Director of the Center for Global Tobacco Control, whose mission is to reduce the global burden of tobacco-related death and disease through training, research, and the translation of science into public health policies and programs. He directs the Tobacco Research Laboratory at the Harvard Chan School, where the design and potential for dependence of tobacco products are assessed. Studies examine the impact of dependence potential on product use and individual risk, to inform policy and other interventions to control tobacco harms. Current research uses conventional and innovative strategies to evaluate new and novel tobacco products. Examples of these products include modified risk tobacco products such as e-cigarettes; reduced ignition propensity cigarettes; hookah (tobacco waterpipe); and novel smokeless tobacco products such as snus. Clinical research methods are used to evaluate the influence of tobacco product design features on consumer responses, and their role in promoting initiation or maintenance of use among targeted populations. Findings have been used to inform tobacco control policy, develop resources for communicating risks of tobacco products, and to enhance understanding of factors that contribute to tobacco dependence.

Other research involves development of strategies to reduce secondhand smoke (SHS) exposure in domestic environments, with a focus on evaluating interventions for reducing domestic SHS exposure among children. Dr. Rees also leads an NIH funded study which seeks to reduce secondhand smoke exposure among children from low income and racially/ethnically diverse backgrounds. This research utilizes the principles of community based participatory research (CBPR) to develop and evaluate a cognitive behavioral intervention to help caregivers maintain a smoke free home environment. He has conducted studies on SHS emissions of tobacco waterpipe, and SHS monitoring in indoor environments, including private homes and cars.

Dr. Rees' academic background is in health psychology (substance use and dependence), and he trained at the National Drug and Alcohol Research Centre at the University of New South Wales in Sydney, Australia, and did postdoctoral training through the National Institute on Drug Abuse. He has also published research on the role of cue reactivity in tobacco and alcohol abuse and dependence; and clinical trials on interventions for alcohol and cannabis dependence.

Towards a Comprehensive Measure of Drug Attributable Harm, JAMA

Connor Kubeisy

Connor Kubeisy is a Policy Analyst with the Foundation for Drug Policy Solutions and its sister organization, Smart Approaches to Marijuana, after having joined them as a Communications and Policy Associate in January 2022. He began his career as an intern in the White House Office of National Dru...

Dr. Nora D. Volkow, M.D., is the longest residing Director of the National Institute on Drug Abuse (NIDA) at the National Institutes of Health since 2003.

She is the world's go to person when it comes to the issue of drugs, and commonly known as the mother to the science demonstrating that drug addiction is a brain disorder.

Dr. Volkow continues her tradition of starting the High Truths podcast season with reflections and hopes in the issue of drugs.

Hello and Welcome to Season 5 of High Truths on Drugs and Addiction. What an honor and joy I have from hosting High Truths. Each episode I have great discussions with fascinating and knowledge people who get me thinking and teach me something new. It is like the Talmudic saying in Ethics of our Fathers, Who is Wise, One who learns from every person. And you and I learn so much from our High Truths guest. Talmudically speaking - I guess that means we are all wise.

Can you believe that we already had 210 conversations with fascinating people? I love it. But more importantly, the conversations we have - lead to action, drug policies and solutions.

Talk is great, but as the saying goes, Action speaks louder than words. Keeping with our High Truths tradition, this first episode of Season 5 will be just me sharing with you my monologue for the year.This is the one and only time of year where you hear just from me, and the rest of the season is dialogue with my guests. Here is what I want to cover with you today.

• First Reflections about this High Truths Podcast
• Then a state of the union on the drug data.
• And ending with hopes for our future with solutions and action.

So here I go...

The High Truths Season Finale airs the live conversation from December 13 with Drs. Bertha Madras, Libby Stuyt and Aaron Weiner. The experts share their reflections on 2024, hopes for 2025, and advice for the new Trump administration.

Cannabis Use Disorder and Cannabis Induced Psychosis is a common diagnosis of adolescent psychiatrist. Listen to Dr. David Rettew's tips in diagnosis and how to speak to young people about marijuana.

David Rettew, MD is a child & adolescent psychiatrist who currently works as the Medical Director of Lane County Behavioral Health in Eugene, Oregon. He is also a clinical faculty member in the Psychiatry Department at OHSU. Before moving to Oregon in 2021, he worked as a tenured associate professor of psychiatry and pediatrics at the University of Vermont Medical Center and was Medical Director of the child and families division of the Vermont Department of Mental Health. He was also past president of the Vermont Association of Child and Adolescent Psychiatry. Dr Rettew built and then acted as first Training Director of UVM’s child psychiatry fellowship program. He is the author of over 60 peer reviewed journal articles on a variety of mental health topics as well as two books, including Parenting Made Complicated: What Science Really Knows About the Greatest Debates of Early Childhood. He has served as the co-chair of the American Academy of Child & Adolescent Psychiatry’s (AACAP) Health Promotion and Prevention committee and was previously on their journal’s (JAACAP’s) editorial board. Dr. Rettew did his general psychiatry and child & adolescent training at Harvard Medical School within the combined Massachusetts General/McLean Hospital programs. Dr. Rettew writes a regular blog on Psychology Today that has over one and a half million views.

The United States's Drug Czar is in charge the nation's drug policy. We can learn from the historical perspectives of our prior leaders. Gil Kerlikowske shared his insights.

I served as the Commissioner of U.S. Customs and Border Protection (CBP), having been nominated by President Obama and confirmed by the Senate in March, 2014. Having left office in January 2017, I will be the only confirmed CBP Commissioner during President Obama’s administration.

CBP was formed as part of the Department of Homeland Security in 2003 as a result of the recommendations issued by the 9/11 Commission. Its dual responsibilities are to secure America’s borders and facilitate lawful travel and trade. CBP is the second-largest contributor of funds to the U.S. Treasury, collecting $46 billion in Fiscal Year 2015. As the nation’s largest law enforcement agency, CBP employs 60,000 people at and between 328 ports of entry nationwide as well as in 40 countries around the world, with an annual budget approaching $13 billion.

One of my chief accomplishments at CBP was realigning an organization that had 21 direct reports to the Commissioner. The new organization streamlines decision-making and gives CBP’s workforce more efficient access to resources and information. I also oversaw the restructuring of the U.S. Border Patrol (which comprises 21,000 personnel), including the appointment of the first Border Patrol Chief from outside the organization since its founding in 1924. Under my leadership, CBP has made significant changes its use of force policies, incorporating new training at its academies and implementing robust internal affairs review and investigation authorities, which CBP did not have previously.

In addition, during my tenure CBP has expanded the use of technology to make it faster and easier for lawful travelers and cargo to enter the country securely – contributing to both national and economic security. Regarding travel, I oversaw the expansion of CBP’s Preclearance facilities overseas, placing Customs officers in key foreign cities to pre-inspect travelers destined to the United States, thereby adding a layer of security to our borders while facilitating the arrival of travelers from these cities. Regarding trade, I oversaw the enforcement of laws prohibiting goods derived from forced or child labor, counterfeit goods, or products that violate trade agreements and could harm the U.S. economy or consumers.

CBP also has an important global presence; I lead the U.S. delegation to the 180-member World Customs Organization and I travel extensively internationally. As a veteran of the United States Army – having served in the Army’s military police from 1970-1972 – I oversaw the creation of CBP’s National Frontline Recruitment Center which is designed to attract and recruit military veterans.

Before I was named CBP Commissioner, I served for five years as President Obama’s drug policy advisor as Director of the Office of National Drug Control Policy (ONDCP), a Senate-confirmed cabinet level position. When I started at ONDCP in May 2009, the growing abuse of and addiction to prescription drugs was not widely known by the general public. Besides authoring the ONDCP’s annual National Drug Control Strategy, I initiated the first Prescription Drug Strategy.

During my tenure at ONDCP, law enforcement began using Naloxone to save victims of opiate overdoses. In addition, hospitals began changing their emergency department standards on pain medication, and physicians and dentists began receiving better guidance on the problem of prescription drug abuse and addiction. Non-governmental organizations and advocacy groups were welcomed into the drug policy conversation, which expanded from purely a law enforcement-centric discussion to include the necessary focus on public health. I received the Nathan Davis public service award from the American Medical Association, and I als...

Ben traveled to China to buy some fentanyl precursors. What he learned shapes health policy to this day. Now he is banned from China travel.

Ben Westhoff is an award-winning investigative reporter whose books are taught around the country and have been translated around the world, including Fentanyl, Inc.: How Rogue Chemists Created the Deadliest Wave of the Opioid Epidemic, the bombshell first book about the fentanyl epidemic. He has advised officials at the top levels of government about the opioid crisis, writes the Substack newsletter Drugs + Hip-Hop, and is currently directing a film about the opioid treatment drug naltrexone, called Antagonist. His book Original Gangstas: Tupac Shakur, Dr. Dre, Eazy-E, Ice Cube and the Birth of West Coast Rap is the definitive book about West Coast Hip-Hop. He has written for The New York Times, The Atlantic, The Wall Street Journal, Rolling Stone, and the Guardian, and been interviewed as an expert commentator on CNN, NPR, and CSPAN, and on full, dedicated episodes of Fresh Air and the Joe Rogan Experience.