Prince had exceedingly high level of fentanyl in body when he died

Lead prosecutor will make decision in the near future on whether to charge anyone over Princes death

A toxicology report from Prince’s autopsy, obtained by the Associated Press, demonstrates he had what multiple experts called an” exceedingly high” concentration of fentanyl in his body when he died.

Prince was 57 when he was received alone and unresponsive in an elevator at his Paisley Park estate on 21 April, 2016. Public data released six weeks after his death presented he died of an accidental overdose of fentanyl, a synthetic opioid 50 times more powerful than heroin.

A confidential toxicology report offer some insight into just how much fentanyl was in his system. Experts who are not connected to the Prince investigation said the numbers leave without doubt that fentanyl killed him.

” The amount in his blood is exceedingly high, even for somebody who is a chronic pain patient on fentanyl patches ,” said Dr Lewis Nelson, chairman of emergency medication at Rutgers New Jersey medical school. He called the fentanyl concentrations” a pretty clear smoking gun “.

The report says the concentration of fentanyl in Prince’s blood was 67.8 micrograms per litre. Fatalities have been documented in people with blood levels ranging from three to 58 micrograms per litre, research reports says.

It adds that the level of fentanyl in Prince’s liver was 450 micrograms per kilogram, and notes liver concentrations greater than 69 micrograms per kilogram” seem to represent overdose or fatal toxicity occurrences “.

There was also what experts called a potentially lethal quantity of fentanyl in Prince’s stomach. Dr Charles McKay, president of the American College of Medical Toxicology, said the findings suggest Prince took the drug orally, while fentanyl in the blood and liver indicate it had some time to circulate before he died.

Experts say there is no” lethal level” at which fentanyl can kill. A person who takes prescription opioids for a very long time builds up a tolerance, and a dose that could kill person or persons might help another.

Search warrants released about a year after Prince’s death demonstrated authorities saw numerous pills in various containers around his home. A lab report proves many of the pills tested positive for fentanyl. Info released publicly indicates the source of those drugs has not been determined.

Last week, the leading attorney in the county where Prince succumbed said he was reviewing law enforcement reports and would make a decision’ in the near future’ on whether to charge anyone.

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The hard truth about back pain: dont rely on drugs, scans or quick fixes | Ann Robinson

Most treatment is wasteful, wanton and wrong, tells the Lancet. The key is to try to keep walking and work, tells the GP Ann Robinson

Back pain is the biggest cause of disability globally, and most of us will have at least one nasty bout of it. But treatment is often wasteful, wanton and wrong,according to a series of papers in the Lancet.” Worldwide, overuse of inappropriate tests and therapies such as imaging, opioids and surgery means patients are not receiving the right care, and resources are wasted ,” it says.

It’s perfectly understandable to want a quick-fix solution to construct the pain go forth and maybe a scan to set your intellect at rest. But there isn’t a reliable instant answer. Scan don’t construct you better, and painkillers can be harmful. The vast majority of low back ache is musculoskeletal– caused by damage caused to ligaments, joints and muscles surrounding the spine. A tiny percentage is due to a serious or dangerous underlying cause that it was necessary to specific diagnosis and intervention- such as cancer, infection or a fracture.

An underlying cause is more likely if you have so-called red-flag symptoms; previous or current diagnosis of cancer, fever, unexplained weight loss and sweats, night ache, ache in the middle of your back rather than lower, inability to stand, urinate or open your bowels, or severe and unremitting pain that is getting worse.

The good news is that if your backache is musculoskeletal- and it usually is- 90% of cases will be better within six weeks. And that is irrespective of what you do. There’s no good evidence that interventions, ranging from Tens machines( which use a mild electric current ), acupuncture, physio, osteopathy and chiropractic to epidural injections and surgery, significantly affect the outcome. Prolonged bed rest- still advocated in some countries- is positively dangerous, as it can cause blood clotting( thrombosis) and builds recovery from back ache less likely.

The
‘ The evidence may not be great but it’s cheap, safe and happens to work for me .’ A Tens machine. Photograph: Alamy Stock Photo

It’s seducing to want a scan or special investigations if you develop back ache. But scans don’t correlate well with symptoms; you can have a dire-looking scan with no symptoms or a somewhat normal-looking one with dreadful ache. A scan is useful for surgeons if you need an operation, and other imaging is important if an underlying fracture is suspected. If your back pain is associated with an underlying inflammatory condition like Crohn’s, ulcerative colitis or psoriasis, you will need investigation and referral to a rheumatologist.

The key to recovery is to try to keep walking and run. Different approaches help different people; it’s good to find the least risky option that suits you. My own favourite is a Tens machine: the evidence may not be great, but it’s cheap, safe, and happens to work for me.

Painkillers can be useful in the short term, if that’s the only way you can keep moving. There are two main groups of effective analgesics, and they both come with health warnings: non-steroidal anti-inflammatories, ( NSAID ) such as ibuprofen, and opioids such as tramadol. There is already an epidemic of opioid overuse and addiction in the US, with Europe and lower-income countries catching up fast. NSAIDs are less addictive but can cause heart, kidney and intestine injury if used for more than a few days at a time.

Prof Nadine Foster of Keele University, one of the authors of this series of newspapers, says:” In many countries, analgesics that have restriction positive effect are routinely prescribed for low back ache, with very little emphasis on interventions that are evidence-based, such as workouts. As lower-income countries respond to this rapidly rising cause of people with disabilities, it is critical that they avoid the waste that these misguided practices necessitate .”

One in three people who has an episode of low back ache will have a recurrence in the following year. So it is important to look at adaptations to the workplace, avoiding heavy lifting and concentrate on core muscle strengthening with pilates, swimming and some types of yoga once you recover from the acute attack.

Prof Jan Hartvigsen, of the University of Southern Denmark, who also contributed to the Lancet series, tells:” Millions of people across the world are getting the incorrect care for low back ache. Protection of the public from unproven or harmful approaches to managing low back pain requires that governments and health-care leaders tackle entrenched and counterproductive reimbursement strategies, vested interest, and fiscal and professional incentives that maintain the status quo … Funders should pay merely for high-value care, stop funding ineffective or harmful testing and therapies, and importantly intensify research into prevention, better tests and better treatments .”

He’s right, of course, but there is no phase withdrawing funding without any explain. Healthcare professionals need to take the time to explain to patients that it’s not vindictive cost-cutting that is behind the restriction of access to scans and drugs. It’s in everyone’s best interests that we stop seeking bad medicine and invest in detecting better and safer solutions to this global problem, which is likely to affect all of us sooner or later.

* Ann Robinson is a GP

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Jeff Sessions says US prosecutors will not pursue small-time marijuana cases

Law enforcement lacks resources to take on routine cases and will focus on gangs and larger conspiracies, attorney general says

Federal attorneys will not take over small-time marijuana suits, despite the Trump justice department’s decision to lift an Obama-era policy that discouraged authorities from cracking down on the trade in countries where the drug is legal, Jeff Sessions, the us attorney general, said on Saturday.

Federal law enforcement lacks the resources to take over” routine lawsuits” and will continue to focus on gangs and larger conspiracies, Sessions told students after a speech at Georgetown law school.

In January, the Trump administration hurled the burgeoning marijuana legalization motion into uncertainty by reversing the largely hands-off approach of the Obama administration, saying federal prosecutors should instead handle marijuana suits however they see fit.

The Obama-era policy permitted the trade to flourish, with eight countries decriminalize marijuana for recreational use.

The reversal under Trump added to embarrassment about whether it’s OK to grow, buy or use marijuana in states where it is legal, since long-standing federal statute prohibits it. And it caused concern that prosecutors would feel empowered to jail someones for marijuana possession.

” I am not going to tell Colorado or California or someone else that possession of marijuana is legal under United States statute ,” Sessions said. But, he added, federal prosecutors” haven’t been working small marijuana instances before, they are not going to be working them now “.

Of particular interest are problems that federal authorities have tried for years to tackle, such as illegal marijuana-growing operations on national parklands and gangs that peddle marijuana along with most harmful drugs.

Some law enforcement officers in legal nations argue the legal trade has caused unintended problems like black-market marijuana growing and dealing by people who don’t even try to conform to the legal framework.

It remains to be seen whether prosecutors will seek to punish state-sanctioned industries. Some have indicated they have no plans to do so.

” Those are the kinds of things each one of those US attorneys will decide how to handle ,” Sessions said.

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Antidepressants work but we need to talk, too | Rhik Samadder

A study proving the effectiveness of drug was no surprise. But the news that talking therapies can be as effective as medications was a striking detail

The results of a comprehensive, six-year study confirmed last week what I’ve known a long time: antidepressants work. I know this because half the people I know are on them- and that’s only the half I know about. Antidepressants saved my life, they tell me, and I believe them. I don’t say:” The only thing you’ve swallowed is propaganda, mate, straight from Big Pharma’s chalky teat .” I would have to be a maniac to do that. And I’m not a lunatic. At least , not in that way.

I’ve been on antidepressants at various points in my life. And I’ve always been one of the 80% who come off them within a month, looking for another way. I quickly tire of the tweaking of drugs and dosages required to find the appropriate prescription. I freak out at the initial side-effects- the flaccidness in my brain, the absence of ideas in my underpants. More than that, I’ve always had been uncomfortable accepting there is something medically incorrect with me.

To some extent, I stand by that. Our social structure perpetuate inequality, our media feeds feelings of inferiority, while our politics is an accelerated zoetrope of horror. I feel unnerved when I satisfy someone who isn’t depressed. What’s wrong with you, I want to ask. Still, while it’s not wrong to feel viscerally offended by many aspects of the modern world, when the strength of those impressions stops you living their own lives, it’s not a solution, either.

What struck me from that study, below the headline, was another of its findings: that talking therapies are equally as effective at treating moderate to severe depression. I’ve surely found that being open about my mental health- not just to professionals, but also people I trust- has been an incalculable force for good in my life. Whether you’re on medication or not, we should all be talking about feelings more. We should talk about them as much as we talk about Brexit or dirty burgers or Blue Planet II. We should talk about them route too much, only to get the habit.

Because, at first, it feels impossible. Sadness can wall you in and seem too vast to communicate. I recollect trying to explain that to person; to talk about my inability to talk. I felt like a robot, taking off his breastplate to reveal the fizzing, severed wires inside and a voided warranty stamp that simply read” All Broken “. But there are good reasons to keep trying.

First, the purposes of the act of being honest with yourself, while altering nothing externally, will change utterly everything. Being a fugitive from your own truth gives you no place to be at ease. Second, being honest with people in your life is a generous act. They will feel closer to you and better able to help. It also gives them a chance to be open with you. All my most important relationships have deepened, in run, relationship and love, after talking candidly about feelings. Even the ones I’m ashamed of. Especially those.

It’s astounding how many people can be down there with you, and you would never know. Since used to describe my depression, strangers of every background have written to me to share their experiences. It can be overwhelming to confront how much unhappiness we’re swimming in. There are no magic bullet, drug included. But for me, the connection that comes from expressing the problem is like a big part of the answer.

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Jonathan Van Ness, Tan France, Antoni Porowski, Bobby Berk and Karamo Brown of Queer Eye. Photo: Roy Rochlin/ Getty Images

Queer Eye’s view of the world is more than scalped deep

I wish there were a Tv channel dedicated to humen opening up emotionally. Clearing their throat while holding a photograph of their parent, losing control of their lower lip five hours into a Bruce Springsteen concert, bellowing at the births of their daughters. All of that stuff. In its absence, I will blithely rewatch the Netflix reboot of the makeover demonstrate Queer Eye.

In the indicate, five gay lifestyle consultants make improvements to the life of a usually straight man. The division of labour between the five is way out of whack, it has to be said. While Tan wades through decades of mountain-man plaid and male defensiveness and Bobby redecorates an entire house, handsome Karamo is in charge of” generally having a swaggy stance “. Food and wine expert Antoni’s main undertaking is to demonstrate the subjects what an avocado is, like Sir Walter Raleigh presenting the potato at court.

But it’s not really about avocado, or copper accents in the kitchen. What the presenters are really good at is emotional diagnosis and support. This series takes place in the US state of Georgia, full of self-described rednecks, and the resulting conversations between differently modelled different forms of masculinity are beautiful to watch.” You can’t selectively numb feeling. If you try to numb vulnerability you will also numb elation ,” is a typical thing that Jonathan, there to dispense pomade, might say.

That manipulative emotional “beat”- that surface improvements are a conduit to self-love- is part of all reality displays. But Queer Eye commits to the truth of it in a way that’s more than cosmetic.

There are challenging dialogues on Black Lives Matter, heterosexual stereotypes of homosexual relationships and why Nascar racing is the most boring sport ever devised; all delivered with compassion, sass and exfoliating tips-off. It’s the blueprint for a better tomorrow for us all.

Curler
Curler Alexander Krushelnitsky, an Olympic athlete from Russia. Photo: Valery Sharifulin/ Tass

Pointless in Pyeongchang: chemically-assisted curling

While we’re talking about controversial narcotics, I am confused by the story of Alexander Krushelnitsky, the Russian curler found guilty of doping. The component that mystifies me is which part of curling beg for chemical assistance. Shoving what looks like a cheddar truckle along a gently curved trajectory? Managing the little sweep? The part of it, which is all of it, that is basically shuffleboard on ice? It’s like having a bionic limb installed so you can drink a cup of tea more efficiently. And Krushelnitsky and his wife still finished third in the mixed doubleds, so not that efficiently. Utterly mystifying.

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Antidepressants: Please, PLEASE, do not just abandon your meds!

Despite what you may have read in the furore surrounding Johann Haris new book, its very dangerous to stop antidepressants without professional advice

Tom Petty died of accidental drug overdose, says family

Musicians wife and daughter say a fractured hip led to over utilize of drug and voice hope report will contribute to opioid discussion

Might as well do the white line: Liam Gallagher, still caning it at 45

The former Oasis singer admitted in an interview that he still takes medications. Which may make it a bit tricky to caution his children off them, he says

Canadian marijuana advocate blasts hypocrisy of ex-police cashing in on cannabis

Former public servants and police officer are determining opportunities in the countrys fledgling industry including some who were once adamantly anti-pot

One of Canada‘s more prominent marijuana activists has taken aim at former police officers who have entered the country’s fledgling cannabis industry, saying it was ” hard to belly” that those who spent years sending people to incarcerate for pot offences are now poised to profit as the country moves towards legalisation.

” It’s a mix of hypocrisy and pure profiteering ,” Jodie Emery told the Guardian.” They made a living off tax dollars for trying to keep people out of the cannabis business and now they’re going to stance themselves to cash in .”

Her remarks come as legislation aimed at legalising recreational marijuana by 1 July 2018 was passed in the House of Commons. The bill will now head to the Senate, paving the way for Canada to become the first country in the G7 to fully legalise the drug.

Former public servant, politicians and law enforcement officers have gravitated towards the sector, which analysts say could eventually be worth somewhere between C$ 5bn and C $10 bn annually.

The most controversial of these would-be entrepreneurs is Julian Fantino, a former Toronto police chief who once likened the decriminalisation of marijuana to legalising murder and, only two years ago, proclaimed his complete opposition to legalisation.

Julian
Julian Fantino was opposed to legalisation- but now is aiming to profit from the likely billion-dollar industry. Photograph: Steve Russell/ Toronto Star via Getty Images

Fantino recently announced that he would helm a company that connects patients to medical cannabis among other services. Medical marijuana is already legal in Canada.

A former Conservative MP, Fantino was also part of a government that sought to crackdown on marijuana offences, passing legislation stipulating mandatory incarcerate hour for those working capture with six plants or more.

At the launch of his company, Aleafia, last month, Fantino waved off questions about his past positions.” Days gone by, we all had a certain attitude and certain perception of things being what they are and what they were ,” he told reporters.

Fantino said he had embarked on a” fact-finding mission” after being approached by Afghan war veterans who wanted access to marijuana to treat post-traumatic stress disorder and ache. “[ I] learned a lot about this whole space and medical marijuana and that to me was the conversion, if you will, to enable us to be more helpful to people who are not presently attaining the kind of results from their drug, which is usually opiates .” Fantino did not respond to a request for an interview with the Guardian.

Emery described Fantino’s message as profoundly offensive.” I’m always happy to see our foes admit that we were right by adopting our messaging and what we’ve been saying for so long ,” she said.” But it’s hard to stomach when he isn’t saying that he’s sorry for arresting people for cannabis, he’s not saying sorry for ruining lives and trying to prevent access to patients and veterans for all those years .”

Emery- who along with her husband Marc own the Cannabis Culture brand, which at one point included more than a dozen marijuana dispensaries across Canada- was arrested in March on charges of trafficking in narcotic drugs and possession.

Her arrest came amid warns by government and law enforcement officials that despite the legislation snaking its way through parliament, recreational marijuana remains illegal in the country.

The charges bar Emery, who has been released on bail but faces life in prison, from participating in the marijuana industry once it is legalised.” So it’s sad to think that not only are we not allowed to compete against the policemen getting in the pot business, but we’re still eternally branded criminals ,” she said.

The government is currently mulling whether those convicted of minor narcotic offences should be allowed to work in key sectors.

Emery said at the least 11 high profile former police officers were now tied to the pot industry, including a former second-in-command with the Royal Canadian Mounted Police who had joined forces with Fantino to head Aleafia.

Others include a former West Vancouver police chief who has for years consulted for medical marijuana companies and a former deputy of the Toronto police who, after 38 years in law enforcement, began working with marijuana businesses in 2012. The Liberal government’s plans for legalisation are being led by Bill Blair, another former Toronto police chief.

Emery described the situation as unfair.” They not only enforced the law against people in a way that’s recognised as racially biased, targeting poor, marginalised people but they actively resisted reform to the law ,” she said.” It’s like a creationist being put in charge of teaching evolution in university .”

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Mark Zuckerberg says extent of opioid crisis was biggest surprise of US tour

Speaking about his 30 -state tour that triggered rumors of a presidential run, the Facebook CEO added: We have a responsibility to remain optimistic

The” biggest surprise by far” from Mark Zuckerberg’s listening tour of America is the extent of the opioid crisis, the Facebook CEO said on Friday.

” It’s really saddening to assure ,” he said, referencing the 64,000 people who died from drug overdoses last year.

” That’s more people than died as a result of Aids at the peak of the Aids epidemic. That’s more Americans that died in the whole of the Vietnam War. It’s more people than die of automobile collisions and gun violence I guess combined, and it’s growing rapidly ,” he added.

Zuckerberg’s eyes welled up as he spoke about his encounters with communities affected by the crisis. He described sitting down with a group of recovering heroin addicts in Dayton, Ohio, and hearing a woman say how when she was an addict her objective with shooting up was to get as close to death as she could without dying. He mentioned another man whose thought upon find his friend overdose was ” I wonder who that guy’s merchant is because that must be really good stuff “.

” So this is like … merely intense ,” said Zuckerberg, speaking in a 50-minute Q& A at the University of Kansas.

Zuckerberg constructed his comments about opioid craving the day after former Facebook president Sean Parker use the language of addiction to criticize the social network, stating that features such as the “like” button were designed to give users” a little dopamine reached “.

The Facebook CEO also highlighted potential impacts of opioid craving on the broader community, including the strain on police resources and the employable workforce, referencing an Alabama shrimp fisherman who couldn’t find people to work on his barge because so many people were hooked on opioids.

The” good news”, he added, is that there is a roadmap for dealing with these kinds of crises- as demonstrated by France, which had its own opioid crisis in the 1990 s and 2000 s.

Zuckerberg and his wife Priscilla Chan have pledged billions to tackling illnes through their philanthropic organization the Chan Zuckerberg Initiative. The Guardian contacted the organization to find out if it would be allocating any funds to address the opioid crisis, but received no response.

The tech CEO’s photogenic trip-up around 30 states in America to meet people in communities outside of his Silicon Valley bubble has led many to speculate that he plans to run for chairperson- something the CEO and the company have repeatedly denied.

For Zuckerberg, many of the answers lie not in government, but in the vague conception of “community”- which conveniently ties into the company’s updated mission statement, announced in February.

The year-long trip around the country has had a profound impact on how Zuckerberg views himself and his approach to tackling complex problems.

” I started this year as an engineer and now I’m wrapping it up thinking of myself as more of a community builder too ,” he said.

Being a community builder as well as an technologist necessitates the ability to not only solve problems but to” share values” and” support people”, he explained.

Zuckerberg highlighted some of the positive communities on Facebook that bringing parents or sufferers of rare illness together, without mentioning the way that the social network offer a handy route for neo-Nazis to organize.

The tech billionaire’s failure to acknowledge the downsides to technological development has led some, including Elon Musk on the topic of artificial intelligence , to criticize him as naive. However, towards the end of the session Zuckerberg explained where his relentless optimism comes from.

” Optimists tend to be successful and pessimists tend to be right ,” he said.” If you think something is going to be terrible you are going to look for data points to prove you are right. You will find them. That’s what pessimists do.

” But if you believe something can work […] you are going to look for a style to make it happen. Even when you build mistakes, even when people doubt you, you are going to keep pushing forward and make it happen .”

” The world is full of pessimists right now. There’s no doubt we face a lot of challenges and we have a lot of responsibility and work to do. But we also have a responsibility to remain optimistic so we can solve these problems because optimists are the only ones that will .”

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Trump says he’ll declare the US opioid crisis a national emergency ‘next week’

Trump taunts major proclamation, likely next week, on the narcotic crisis two months after declaring opioid craving was a national emergency

Donald Trump on Monday taunted a long-awaited announcement on address the crisis of opioid addiction. He also suggested his selection to lead to lead the National Office of Drug Control Policy might be under review.

More than two months after Trump said at his Bedminster, New Jersey, golf club” the opioid crisis is an emergency “, the president said he would probably formally declare it a national emergency with an event next week.

Speaking in a Rose Garden press conference with the Senate majority leader, Mitch McConnell, Trump said:” We’re going to have a major proclamation, probably next week, on the narcotic crisis and on the opioid massive problem .”

He added:” This country and, candidly, the world has a drug problem … and we’re going to something about it .”

Drug overdoses due to opioid utilize increased 21% in 2016; 64, 070 Americans died as a result of opioid use in the last year. On the campaign trail, Trump talked about combating opioid addiction. He has touted his border wall between the US and Mexico as one route of combating it.

Trump also weighed in the topic of the Pennsylvania congressman Tom Marino, his picking for a position informally known as” drug czar “.

Marino was the subject of a joint report by the Washington Post and 60 Minutes on Sunday about his role as the sponsor of a bill that critics say undermined federal enforcement efforts against the opioid outbreak. The bill made it far more difficult for the DEA to crack down on narcotic companies that built suspicious the transport of opioids.

Although he called Marino” a good guy” on Monday, he added:” I did consider research reports. We’re going to look into the report. We’re going to take it very seriously .”

The president left open the possibility of withdrawing Marino’s nomination. Trump said he planned to speak to Marino soon.

He said:” If I think it’s 1% negative to doing what we want to do, I will make a change .”

Senator Joe Manchin of West Virginia, a conservative Democrat in a state ravaged by opioid addiction, has called on Trump to withdraw Marino’s nomination.

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