09/25/19 Doug McVay Program Century of Lies Date 25 September, 2019 Guest Doug McVay Link(s) Drug Policy Facts This week on Century: a House subcommittee looks at e-cigarettes and the outbreak of lung disease that may be related to vaping, and the UN's Commission on Narcotic Drugs looks at rescheduling cannabis and cannabis products. Audio file TRANSCRIPT TRANSCRIPT CENTURY OF LIES SEPTEMBER 25, 2019 DEAN BECKER: The failure of the drug war is glaringly obvious to judges, cops, wardens, prosecutors, and millions more now calling for decriminalization, legalization – the end of prohibition. Let us investigate the Century of Lies. DOUG McVAY: Hello and welcome to Century of Lies. I am your host, Doug McVAY, Editor of drugwarfacts.org. One Monday, September 23rd, the U.N.’s Commission on Narcotic Drugs held an intersessional meeting in Vienna, Austria. They discussed recommendations made by the World Health Organization’s Expert Committee on Drug Dependence on the rescheduling of cannabis and cannabis products. We are going to hear audio from that meeting later in the show. First, on Tuesday, September 24th, the Economic and Consumer Policy Subcommittee of the House Committee on Oversight and Reform held a hearing on e-cigarettes and the outbreak of lung disease that’s believed to be associated with vaping. The hearing was entitled, “Don’t Vape – Examining the Outbreak of Lung Disease and CDC’s Urgent Warning Not to Use E-Cigarettes”. We are going to hear opening statements from the Subcommittee Chair and Ranking Member. First voice will be Representative Roger Krishnamoorthy, Democrat from Illinois; he is followed by Representative Michael Cloud, Republican from Texas. REP. RAJA KRISHNAMOORTHY: We are here to amplify the recent health warnings issued by the Centers for Disease Control (CDC) related to 530 e-cigarette related incidence of lung disease in 38 states and the U.S. Virgin Islands. First I want to make clear that we did not plan to have this emergency hearing at the beginning of this congress, let alone this time last month but on August 23rd, officials from my home state of Illinois reported the first death due to a mysterious vaping related lung illness, and since then a total of eight individuals have tragically died in this outbreak. In response to this crisis, CDC is warning the American public to consider not using e-cigarettes of any kind. Because this subcommittee has investigated the youth vaping epidemic and the companies behind it, we feel that it is our duty to draw attention to recent government health warnings about the dangers of e-cigarette use. The long-term health effects of continued vaping is unknown but what we do know should give us all pause. State health departments continue to conduct retroactive analysis of patient records to better understand exactly when this outbreak began as they do, the number of affected people will grow. Unfortunately, illness related to e-cigarettes is not new. The FDA has received 127 reports of seizures and other neurological conditions caused by e-cigarettes. When a product is released on to the market without safety testing or clinical trials this is what we fear. This is a problem exacerbated by e-cigarette companies that make what appear to be unfounded and illegal claims that their products are safer and healthier than combustible cigarettes. People trust and rely on those claims even when there is no evidence to back them up. That is why this subcommittee wrote a detailed letter to the FDA outlining our findings about Juul illegally marketing its product as safe, healthy, and a smoking cessation device. FDA agreed with us and days after our letter, responded with its own letter to Juul declaring that Juul had broken the law. Juul’s response is due next week on September 30th. After that the FDA will have the opportunity to act. I encourage all of you to follow that development closely – we certainly will. Just days after the FDA responded to our letter, the Administration, in part citing our investigation announced that it would move to ban all e-cigarette flavors including mint and menthol. The fact that flavors hook kids is a point this subcommittee hammered home over our two days of hearings in July. The Administration cited our hearing in rolling out its proposal. We should all be encouraged that democrats and republicans are coming together when the health of our nation’s youth comes under attack. Today as we focus on the tragic outcomes of this lung disease outbreak, we must view it as another chance to come together to protect public health. At the heart of the recent vaping related outbreak are families being blindsided. With us today is Ruby Johnson, a mother of seven from near Chicago. This August as she prepared to drop her oldest daughter off to start college – already a stressful time, the Johnson family faced a terrifying health scare. Instead of moving in to a dorm room her daughter moved in to a hospital bed far from home where she stayed for what would have been her first week of classes. Ruby’s daughter could have died. Thankfully, she recovered enough from her bout of lung disease to be released, but she still has trouble breathing and doctors cannot tell her how much longer that may last. Mrs. Johnson, thank you for coming to share your families harrowing experience. We are also joined by leaders from the Public Health Community to provide a neutral assessment of the outbreak and provide their advice to the public they serve. We have Dr. Ann Schuchat from the CDC; Dr. Angosi Eseke of the Illinois Department of Public Health; and Dr. Albert Rizzo of the American Lung Association. Thank you all for joining us today. We look forward to learning more about how we can avoid more preventable deaths. REP. MICHAEL CLOUD: It’s been clear that users of certain vaping products have become very ill, some tragically and to the point of death. Mr. Chairman, I do greatly appreciate your desire to utilize this committee’s authority to get to the bottom of what is causing these mysterious illnesses. In the Center for Disease Control’s Prevention September 19 Update, the number of those sick reached 530 and eight deaths have been confirmed. This is very concerning and it is clear that we need to examine the cause and what can be done to prevent it. To the best information available, many of these cases seem linked to the use of products that present themselves to be something they are not. Based on the limited data available about those impacted by this mysterious lung illness, approximately 16% are under 18 years of age and while each life affected is important these recent incidents also serve to further bring attention to what has become an epidemic increase in teen vaping with currently 20% of high school student’s vaping. Add to that the decade’s long epidemic of addiction to traditional tobacco smoking that will leave five people dead by the end of these opening statements. As a father of three, this is very concerning. I wish we had a quick fix to ensure that each child is protected, that no American finds themselves bound by a substance, and that all of us are able to find complete personal fulfillment in experiencing the purpose for which we were created. Today we are here to discuss what should be the appropriate response to the lung illnesses associated with certain vaping products. Complicating this discussion is a lack of scientific data and studies available, counterfeit products, untraceable supply lines, a lack of enforcement that allows players to pass the buck of accountability. For example, data available leads us to believe that many of the recently reported 530 cases involved vaping cannaboid products. I hope today we are able to do the good work for which this investigative committee exists. I believe there is a lot of bipartisan support for addressing this situation. I appreciate the Chairman’s heart in this to the point of examining this to find a solution and our desire to end teen vaping there is unity. Please know my heart goes out to those impacted and my condolences to those who have lost loved ones. Again, I appreciate the Chairman’s work on this issue and will look to a productive discussion today. DOUG MCVAY: You’ve just heard Representative Michael Cloud, Republican from Texas, Ranking Member of the Economic and Consumer Policy Subcommittee of the House Committee on Oversight and Reform. He was preceded by Representative Raja Krishnamoorthy, Democrat from Illinois, and the Chair of that subcommittee. They were giving their opening statements before a hearing on Tuesday, September 24th, the hearing was entitled, “Don’t Vape – Examining the Outbreak of Lung Disease and CDC’s Warning Not to Use E-Cigarettes”. Now let’s hear from their first witness, Ann Schuchat, M.D., is Principal Deputy Director at the Federal Centers for Disease Control. DR. SCHUCHAT: I want to make four key points. First, as soon as we learned about the initial cases of lung injury, CDC has been working 24/7 hand in hand with the FDA and our state and local public health partners to find the cause. Secondly, our ability to do this type of investigation relies on a critical underlying public health infrastructure, including data systems that need modernization and a trained public health workforce. Third, the CDC has made important recommendations to the public including the following: while this investigation is ongoing people are who are concerned about lung disease associated with e-cigarette use or vaping should consider refraining from using e-cigarette products or vaping. People should not buy these products off the street and should not modify them further. Adults who use e-cigarettes or vaping products because they have quit cigarette smoking should not return to smoking cigarettes. We have a need to address the epidemic of youth use of e-cigarettes and this current outbreak reinforces the need to address the broader youth e-cigarette epidemic. What do we know so far? As you’ve heard, several hundred cases have been reported from nearly all states. We’ve had a number of deaths. The cases are occurring in young people. One half of all cases are less than 25 years old. People present with cough, shortness of breath, chest pain, and sometimes with symptoms like nausea and vomiting, fatigue or fever. Most of the cases with information so far have reported use of either THC or THC and nicotine containing products, some have reported nicotine only. There may be some challenges with the histories of exposure in some subset of the patients. What do we not know so far? Probably the most important thing we don’t know the cause. No single product, brand, substance, or additive has been linked to all cases. This investigation is ongoing and it’s very dynamic. What are we doing to respond? CDC is working closely with state and local public health with the FDA and clinical community to get to the bottom of this. We have deployed staff through what we call Epi-Aids – assistants to help states with their investigations. We provided technical assistance, developed a case definition, standardized clinical guidance and the reporting system and are working every day on coordinating the parts of the investigation and response. We set up an Incident Management System and activated our Emergency Operations Center as we do in other public health urgent situations, and we’ve convened the public health clinical and media numerous times to share what we know and don’t know and how they can be part of the solution. One such example is a clinical outreach and communication activity call that we held in the past few days that had 2,500 lines active and clinicians around the country listening to the latest information. We are working very closely with the FDA on the laboratory aspect of trying to trace back and study the products from affected patients. There are challenges with this response including the nature of the outbreak itself. Many states – some of the cases report using illicit products and may not be fully forthcoming. The marketplace for e-cigarettes is wide and diverse with a multitude of products and it may be very complicated to tease out the problematic exposures and our public health data collection systems are in need of an upgrade. In terms of youth e-cigarette use, we are seeing an epidemic and then in the questions I’d be happy to go in to many more details about that but our most recent for 2019 is continuing to be concerning. I will just leave you with this, CDC is dedicated to working around the clock together with the FDA and the state and local health officials to identify the cause or causes of the outbreak and will continue to update you during the course of the investigation. DOUG MCVAY: That was Dr. Ann Schuchat, Principal Deputy Director at the Federal Centers for Disease Control. She was testifying before the Economic and Consumer Policy Subcommittee of the House Committee on Oversight and Reform on Tuesday, September 24th at a hearing entitled, “Don’t Vape – Examining the Outbreak of Lung Disease and CDC’s Urgent Warning Not to Use E-Cigarettes. You are listening to Century of Lies, I am your host, Doug McVay, Editor of DrugWarFacts.org. Turning from domestic to international news. The U.N.s Commission on Narcotic Drugs held an intersessional meeting on Monday, September 23rd in Vienna, Austria. At this meeting they discussed recommendations by the World Health Organization’s (WHO) Expert Committee on Drug Dependence to reschedule cannabis and cannabis products. Dr. Gill Forte works for the World Health Organization in Geneva as their Coordinator of Policy, Access, and Use in WHOs Essential Medicines and Health Products Department. DR. FORTE: So the recommendations seek the recommendation for whether or not the substance should be scheduled. They seek to prevent harms caused by the use of psychoactive substances that are being reviewed. In those recommendations, there is an important concern of preventing harm to health and these recommendations (UNINTELLIGIBLE) whether or not those substances should be made available because they have a unique impact on health. One of the major objectives of those recommendations is to make sure that they will protect health from those psychoactive substances but also this recommendation will be made to ensure that those psychoactive substances that are reviewed and that have the (UNINTELLIGIBLE) are not presented for being accessible to who need them. These recommendations as we said before, are based on science and therefore it is the responsibility of the (UNINTELLIGIBLE) Secretariat and the expert committee on drug dependence to take in to account the most updated information available on those substances with respect to harm but also with respect to (UNINTELLIGIBLE). I would like to mention here that the level of international control that (UNINTELLIGIBLE) recommended by the (UNINTELLIGIBLE) should be considered as a minimal requirement. It is of the discretion of the (UNINTELLIGIBLE) states to implement (UNINTELLIGIBLE) more stringent levels of control depending on the specific country context. This is a very important point to understand what (UNINTELLIGIBLE) recommends in terms of scheduling. It should be considered as a minimum requirement. It is up to the members to decide if they want a regulation that is more stringent or not. (HEAVY ACCENT. PLEASE GO TO SHOW FOR REMAINDER OF SPEECH) I have been your host, Doug McVay, Editor of DrugWarFacts.org. The Executive Producer of the Drug Truth Network is Dean Becker. Drug Truth Network programs are available by podcast the URL’s to subscribe are on the network homepage at drugtruth.net. The Drug Truth Network has a Facebook page, please give it a like. Drug War Facts has a Facebook page, too. Give it a like, share it with friends. Remember, knowledge is power. You can follow me on Twitter; @dougmcvay and of course, @drugpolicyfacts. We’ll be back in a week with 30 more minutes of news and information about drug policy reform and the failed war on drugs. This is Doug McVay saying, so long. For the Drug Truth Network, this is Doug McVay asking you to examine our policy of drug prohibition, the Century of Lies. Drug Truth Network programs are archived at the James A. Baker, III Institute for Public Policy.