SF 'Opens The Door' To Supervised Drug Consumption Sites

 by Brad Jones via The Epoch Times,

Supervised drug consumption sites may be coming to San Francisco despite California Gov. Gavin Newsom’s veto of legislation with a similar plan by state Sen. Scott Wiener (D-San Francisco) last year and widespread opposition to the idea.

The San Francisco County Board of Supervisors unanimously voted on Feb. 28 to allow nonprofit groups to run supervised injection sites with private funding. Because ordinances require two readings, the supervisors will cast their final vote on March 7.

San Francisco Mayor London Breed and Supervisor Hillary Ronen introduced the proposal last month to abolish “a recently identified permitting barrier” to proceed with an overdose prevention plan - while the City awaits federal guidance on whether or not it can legally fund such programs with taxpayer dollars, the mayor said in a statement.

The legislation “opens the door for non-profits to operate drug overdose prevention sites in San Francisco,” according to the press release.

The drug crisis in San Francisco has killed nearly 2,000 people since 2020, and the city’s infamous Tenderloin district is known to be a hotspot for illicit drug deals.

“This legislation is part of our work to bring down the number of fatal overdoses and tackle the challenges driven by fentanyl head on,” Breed said.

“We will continue to work with our non-profits partners who are trying to open overdose prevention sites, fully implement our health strategies to help those struggling with addiction in our streets, and work with law enforcement to close the open-air drug markets.”

Ronen said San Francisco needs overdose prevention sites to save lives and “solutions to open-air drug use and chaotic conditions on the streets.”

‘Negative Impacts’

Jacqui Berlinn, co-founder of Mothers Against Drug Addiction and Deaths, whose son is addicted to fentanyl, said she opposes the creation of so-called safe injection sites.

Berlinn told the Epoch Times via text message on March 2 that the supervisors haven’t done their due diligence to research and visit safe injection sites in New York City and Vancouver to see “the negative impacts” they’ve have had on surrounding communities.

“It’s also important to talk to community members, as well as those with substance use disorders and the people who love them,” she said.

“Governor Newsom understood this when he vetoed Senate Bill 57 last year. The [San Francisco Board of Supervisors] incorrectly believes they know better even after witnessing the abject failure of the Linkage Center in [the Tenderloin district].”

The Tenderloin Center for the homeless in San Francisco. (Courtesy of the City of San Francisco)

The Tenderloin Linkage Center, which provides services to the homeless, last year dropped the word “linkage” from its name after very few people were linked to drug recovery services and other programs connected with the site.

Wiener’s Senate Bill 57 would have permitted the creation of overdose prevention programs, including safe injection sites, where addicts could use illegal drugs at supervised facilities in Oakland and cities in Los Angeles and San Francisco counties.

“The unlimited number of safe injection sites that this bill would authorize—facilities which would authorize well into the later part of this decade—could induce a world of unintended consequences,” Newsom said in his veto message on Aug. 22.

While “it is possible that these sites would help improve the safety and health of our urban areas,” the chance they could fail and make California’s drug problem worse “is not a risk we can take,” Newsom said in his veto message in September.

Homeless people gather near drug dealers in the Tenderloin District of San Francisco, Calif., on Feb. 22, 2023. (John Fredricks/The Epoch Times)

Newsom said at the time he would be open to discussion with local officials to come back to the table with a proposal for a “truly limited pilot program” and “comprehensive plans for siting, operations, community partnerships, and fiscal sustainability that demonstrate how these programs will be run safely and effectively.”

City Takes Matter ‘Into Its Own Hands’

Wiener issued a statement on Aug. 22 saying the veto was “tragic.”

“With two successive Governors vetoing this bill, it’s crystal clear the State isn’t going to step up. San Francisco needs to take matters into its own hands & open up safe consumption sites to save lives,” Wiener wrote on Twitter.

But, Berlinn disagrees.

“The leaders of the city need to prioritize treatment and recovery before implementing sites like these that only perpetuate the open-air drug markets,” she said.

“San Francisco can’t even keep the area in front of methadone clinics clear of drug dealers and users. My own son has to walk through this toxic environment every day that he goes to the clinic for his treatment. He is actively trying to get well and free from his addiction, but the city isn’t able to keep the route to these clinics safe.”

Members of Mothers Against Drug Deaths hold a chain of posters in front of the Tenderloin Linkage Center in San Francisco on Feb. 5, 2022. (Cynthia Cai/The Epoch Times)

Recently, Berlinn helped form a new group called North America Recovers, a nonpartisan coalition of more than 20 American and Canadian community leaders, parents of the homeless, and recovering addicts seeking federal, state, and local actions that “support addiction recovery—not addiction enablement,” including untreated mental illness and homelessness.

Federal and state laws currently prohibit supervised injection sites from using government funds to operate. San Francisco’s 2020 ordinance would allow them, but only with state approval which the city has—so far—failed to achieve.

In 2021, New York established a privately funded overdose prevention site which allows addicts to bring illegal drugs such as fentanyl and heroin and use them under the supervision of trained staff. They also provide counseling.

“The opioid epidemic continues to take an immense toll on our City and claim the lives of far too many San Franciscans,” said San Francisco City Attorney David Chiu said in a statement. “To save lives, I continue to support a non-profit moving forward with New York City’s model of overdose prevention centers. Repealing this ordinance is one step towards that goal.”

https://www.zerohedge.com/political/san-francisco-opens-door-supervised-drug-consumption-sites

Global Food Prices Slide For Eleventh Month And Could Soon Show Up In Supermarkets

 Inflation re-accelerated in the US and Europe last month, highlighting sticky price pressures that keep central banks ultra-hawkish and committed to increasing the terminal rate. Interest rate markets are still repricing the 'about face' in the disinflation narrative, which has caused cross-asset turmoil. Despite the lingering inflation storm, there is good news: global food prices in February declined for the eleventh consecutive month. 

The United Nations' Food and Agriculture Organization's Food Price Index fell .6% last month to 129.8. Last month's decline was driven by the price of slumping cooking oils and dairy products, while grain and meat prices were flat, and sugar prices climbed. 

According to the data, the food supply crisis triggered by the Covid pandemic and the conflict in Ukraine is showing signs of improvement. The FAO's index reached an all-time high following the Russian invasion of Ukraine, but prices have since dropped by 18% from their peak. Nevertheless, prices are still 42% higher than their levels during the onset of the Covid outbreak.

Although global food prices peaked one year ago, consumers have complained supermarket prices are still high. This is because it takes time to filter through, while supermarkets deal with elevated transportation, energy, and labor costs. 

However, there is more promising news. The largest US meat company, Tyson Foods, missed Wall Street estimates for quarterly profit last month for operating margins this year in the face of falling - yes, falling - beef prices, easing demand for pork, and an ongoing crash in chicken prices as a result of overproduction.

Fast food restaurant chain Wendy's Co. reported commodity inflation in the mid-single digits this year and beef prices to be deflationary in its current fiscal year. And Kraft Heinz Co. said there would be no more price hikes in North America, Europe, Latin America, and Asia. 

Unless there is another global supply chain disruption or worsening of the war in Ukraine, food prices might not have just peaked, but declines could soon show up in supermarkets.

https://www.zerohedge.com/commodities/global-food-prices-slide-eleventh-month-and-could-soon-show-supermarket-savings

MedPage Poll: Did COVID Leak From a Lab?

 Johns Hopkins surgeon Marty Makary told a House committee that the lab-leak theory for the origin of COVID-19 was a "no-brainer."

Do you agree with the lab-leak theory?

Yes - 72%

No - 28%

Total Votes: 323

Medpage Today® surveys are polls of those who choose to participate and are, therefore, not valid statistical samples, but rather a snapshot of what your colleagues are thinking

13 Comments

https://www.medpagetoday.com/surveys/103372

Antibody-Drug Conjugates Take Breast Cancer Field by Storm

 Antibody-drug conjugates (ADCs) have taken the field of breast cancer by storm and appear poised to expand their reach into earlier lines of therapy and early-stage disease, a breast cancer specialist said here.

ADCs offer an "exciting and effective drug delivery system" for multiple subtypes of metastatic breast cancer, and ongoing clinical trials are exploring whether the agents' benefits extend beyond the metastatic setting. The success of trastuzumab deruxtecan (T-DXd, Enhertu) and sacituzumab govitecan (Trodelvy) have helped spur development of more ADCs, some of which have begun phase III clinical evaluation, said Hope Rugo, MD, of the University of California San Francisco, at the Miami Breast Cancer Conferenceopens in a new tab or window.

"[ADCs have] taken the world by storm, and it's really not an overstatement. It's perhaps an understatement," said Rugo. "This has had a huge impact on the treatment of patients with HER2-negative metastatic breast cancer, and it continues to expand."

ADC technology and its "smart-bomb effect" on cancer date back to the introduction of ado-trastuzumab emtansine (T-DM1, Kadcyla), which the FDA approved in 2013opens in a new tab or window for metastatic HER2-positive breast cancer. New-generation ADCs have improved technology, said Rugo: more plasma-stable linkers; more membrane-permeable toxins, which potentially allows the payload to leak out of the center cell but also makes for a more potent payload; and less cumulative toxicity.

Trastuzumab Deruxtecan

T-DXd changed the treatment landscape for HER2-positive (HER2+) breast cancer by unseating T-DM1 as the ADC choice for previously treated HER2+ disease in the DESTINY-breast 03 trialopens in a new tab or window, more than doubling the 12-month progression-free survival (PFS).

Traditional HER2-targeted therapies have activity only against HER+ cells (IHC3+). The design of T-DXd incorporated a cell membrane-permeable payload that not only kills the target cell and but passes through the membrane to produce a bystander effectopens in a new tab or window on adjacent tumors cells, irrespective of HER2 expression level. Preclinical studies confirmed T-DXd's antitumor activity in a variety of tumor cell types, including those with low HER2 expression (IHC1/2+).

In an early clinical trial

opens in a new tab or window involving patients with heavily pretreated HER-low metastatic breast cancer, T-DXd resulted in a "remarkable" median PFS of 11.1 months and an objective response rate of 37%. The trial provided the impetus for the DESTINY-breast04 trialopens in a new tab or window, which showed significant improvement in overall survival (OS) and PFS in patients with metastatic HER2-low breast cancer, irrespective of hormone receptor status. The FDA subsequently made T-DXd the first targeted therapy indicated for the newly recognized HER2-low breast canceropens in a new tab or window subtype.

Subgroup analysis showed a consistent advantage with T-DXd, including a small group of patients with HER2-low triple-negative breast cancer and patients with prior CDK4/6 inhibitor treatment, Rugo noted.

The most common toxicity associated with T-DXd is nausea, which requires prophylaxis and continued antiemetic therapy after T-DXd treatment, she continued. Bone marrow suppression has been minimal thus far. Interstitial lung disease (ILD) is not common but can be severe and even life-threatening, requiring continual monitoring.

"In patients with asymptomatic ILD ... you have to hold the drug and you should consider low-dose steroids," said Rugo. "Three weeks later we repeat the noncontrast CT, and I've been able to successfully restart the drug in almost all patients. For symptomatic ILD, you must permanently discontinue the drug and immediately begin steroids and then start the work-up.You don't want to wait and do a big work-up to look for infection and wait on the steroids, because this is, I think, where we are seeing fatalities."

Testing for HER2 status remains a key issue. In DESTINY-breast04, 78% of HER2-low results by local testing were confirmed centrally by use of the PATHWAY HER2 4B5 assay. Among the discordant samples, 88% were scored as IHC0 by central testing.

"Some of them, actually 12%, were HER2-positive by central testing, so you have to be careful about testing for HER2 because we want to know who is HER2-positive," said Rugo. "Regardless of whether you use the primary sample or a metastatic sample, or even an older sample, all predicted benefit from T-DXd, so that is really encouraging for clinical practice."

Next up, T-DXd will be evaluated in HER2 "ultralow" (IHC0-1) breast cancer in the DESTINY-breast06 trial that will involve patients with hormone receptor-positive/ICH0 tumors and no prior chemotherapy.

Sacituzumab Govitecan

The Trop-2-targeted ADC sacituzumab govitecan received the first FDA-approved indication for HER-negative metastatic breast canceropens in a new tab or window and subsequently demonstrated "remarkable" PFS and OS in heavily treated metastatic TNBCopens in a new tab or window, said Rugo.

Sacituzumab was evaluated in a difficult patient population in the phase III TROPiCS-02 trial: patients with metastatic HR+/HER2- breast cancer, 4 years from diagnosis, 95% with visceral metastases, a median of three prior lines of chemotherapy for metastatic disease, and prior exposure to CDK4/6 inhibition. The ADC significantly improved PFS and OS versus physician's choice of chemotherapy. The efficacy did not differ by Trop-2 expression status.

Evaluation of sacituzumab is ongoing in several clinical trials including first line for PD-L1-negative TNBC, first-line HR+ breast cancer, in combination with pembrolizumab (Keytruda) or without in metastatic TNBC and in the setting of post-neoadjuvant residual TNBC.

The most common toxicity associated with the ADC is neutropenia, which requires growth factor support about half the time. Diarrhea also is common but can be managed in most cases with dose reduction and anti-propulsive agents, said Rugo. The drug is not associated with ILD or cardiotoxicity.

Datopotamab Deruxtecan

An "intriguing and efficacious" ADC, datopotamab deruxtecan (Dato-DXd) consists of an anti-Trop-2 antibody linked to a topoisomerase inhibitor. The drug has a lower antibody:drug ratio but higher potency toxin delivery, said Rugo.

In a phase I trial opens in a new tab or windowof metastatic HR+ and HR-/HER2- breast cancer, dato-DXd produced a response rate of 32%, but most patients with TNBC or HR+ disease had some degree of tumor shrinkage. The study revealed a new type of toxicity with ADCs -- stomatitis, which occurred in 75%-80% of patients but was mostly grade 1/2. Two-thirds of patients had nausea and 39% of patients reported vomiting.

Dato-DXd was evaluated in combination with durvalumab (Imfinzi) as first-line treatment for TNBC. Three-fourths of patients had objective responses, which were durable in 82% of cases. Responses occurred in patients with PD-L1 low or high expression.

Ongoing and planned studies will evaluate Dato-DXd as second/third-line treatment for metastatic HR+/HER2- breast cancer, first-line treatment for metastatic, PD-L1-negative TNBC, and as post-neoadjuvant therapy in TNBC, said Rugo.

Patritumab Deruxtecan

An anti-HER3 antibody linked to a topoisomerase toxin, patritumab deruxtecan has shown antitumor activity in HR+ disease regardless of HER3 expression status. The ADC was evaluated in a phase I/II trialopens in a new tab or window of metastatic HER3+ breast cancer and produced objective responses in 23%-43% in HR+/HER2-, HER2+, and TNBC subtypes and median duration of response ranging from 5.9 to 8.3 months.

The most common toxicities in the trial were gastrointestinal and hematologic, including grade 3 thrombocytopenia (another new toxicity for ADCs) in a fourth of patients.

Current evaluation of the drug focuses on EGFR-mutated non-small cell lung cancer, but additional studies in early-stage HR+ breast cancer have been planned, said Rugo.

"Antibody-drug conjugates are an exciting and effective drug delivery system that have an established role in all of the [traditional] subsets plus a new subset of breast cancer in the metastatic setting," she said in closing. "There is a huge potential in early-stage disease, and I think that antibody-drug conjugates are likely to replace giving naked chemotherapy in the not-to-distant future. Toxicity management is critical as we treat our patients with these highly effective new drugs."

Disclosures

Rugo disclosed relationships with AMBRX, Astellas, AstraZeneca, Daiichi Sankyo, F. Hoffmann-La Roche, Genentech, Gilead Sciences, GlaxoSmithKline, Merck, Novartis, OBI Pharma, Pfizer, Pionyr Immunotherapeutics, Seattle Genetics, Semonix, Taiho Oncology, Veru, Puma, NAPO, and Blueprint.

Primary Source

Miami Breast Cancer Conference

Source Reference: opens in a new tab or windowRugo HS, "Antibody-drug conjugates for HER2-negative breast cancer in clinical practice: Improved drug delivery and efficacy takes the world by storm" MBCC 2023.

https://www.medpagetoday.com/meetingcoverage/mbcc/103390

The Most Important Factor in Successful Relationships

 As I emphasized in the Trading Psychology 2.0 book, research in psychology is clear that we are most productive, creative, and successful when we experience high levels of happiness, fulfillment, energy, and closeness to others.  This is an important reason why burnout is such a risk in high performance fields.  Once we prioritize tasks over our well-being, we drain ourselves of the very things that we need to be at our best.  Imagine if someone cared about you and said, "I want to spend more time with you" and you responded, "I don't have time for you!"  That would never happen in a truly loving relationship, but it's basically how many of us relate to ourselves.  

Abraham Maslow, the well-known psychologist, made the distinction between deficit needs and being needs.  A deficit need is one in which I try to fill something missing in myself.  For example, if I don't feel that I am lovable as I am, I may seek a partner who is so needy that they will stay with me.  I am filling a gap in my life--and in my self-esteem.  If I am secure and want to maximize my life, I will seek a partner for their values, strengths, and achievements.  Indeed, in a good relationship, a partner typically possesses strengths that we lack.  That is how relationships make us better:  we absorb the positive qualities of who we are with.  If, however, I'm threatened by the strengths of the other person, I will respond to them with insecurity and defensiveness and, eventually, the relationship will fail.

Good relationships are built on a foundation of positives.  Unsuccessful relationships are fundamentally self-focused, using other people to (vainly) fill our gaps.  When we seek out people based on their needs, their growth and development become threats to us.  That is how many marriages end.

This is as true in work relationships as personal ones.  A great hire for a team is someone who makes everyone else better with unique skills and experience.  A secure manager looks for people who make them better; an insecure manager looks for people who won't leave them.  A secure leader celebrates the successes of others; an insecure manager responds with envy.

The most important factor in successful relationships is the desire to find people who are better than us in some areas of life.  We become who we surround ourselves by.  Our approach to relationships can either become an engine of growth or a prison of insecurity.

 Brett Steenbarger, Ph.D

http://traderfeed.blogspot.com/2023/03/the-most-important-factor-in-successful.html

China to promote vaccine development, new medicines

 China will prevent and control health outbreaks in a more scientific, precise and efficient way, and upgrade vaccines and develop new medicines to ensure enough supply for the public, Premier Li Keqiang said on Sunday.

The country was battered with a surge in COVID-19 cases after it abruptly abandoned its zero-COVID policy in early December, unleashing the virus on its 1.4 billion population. The government put a top priority on getting its most vulnerable vaccinated, including the elderly.

Last month, China's top leaders declared a "major victory" over COVID, claiming the world's lowest fatality rate, although experts have questioned that data.

Li said in a government work report at the opening of China's annual parliament meeting that the country will continue to focus on epidemic control and medical treatment for the elderly, children and groups with underlying diseases.

The world's second-largest economy will also continue to increase the vaccination rate among elderly, and promote the expansion and upgrade of critical care resources, China's state planner, the National Development and Reform Commission (NDRC), said in a separate report.

Beijing has been largely resistant to Western vaccines and treatments, having relied on locally-made shots. During last year's parliament meeting, the government said the country would speed up research and development of vaccines and drugs.

On Sunday, the NDRC also said China will make continuous efforts to ensure the production, distribution and supply of key medical supplies.

Major drugstore chains and internet platforms will play a bigger role in raising efficiency of drug distribution and delivery, it said. 

https://www.yahoo.com/lifestyle/1-china-promote-vaccine-development-041659981.html

Nearly A Ton Of Cocaine Washes Up On French Beach

 by Efthymis Oraiopoulos via The Epoch Times,

Maritime police in northwest France found nearly a ton of cocaine washed up on a beach on the English Channel on Feb. 26.

The drugs were found near the town of Reville on the Cotentin Peninsula, according to France’s maritime authority for the English Channel and North Sea.

The cocaine, weighing about 1,875 pounds (850 kilograms) in total, was found in two large packages linked by a rope, the authorities said on Feb. 28.

Police are trying to determine whether the drugs fell from a ship or were intentionally floated to the shore for traffickers to pick up.

Another report by AFP citing unnamed sources said more drugs were found washed up on the northern French coast on March 1.

Drug Smuggling Surge

There has been a surge in cocaine and crack smuggling into Europe, accompanied by unprecedented drug violence in some areas.

The North Sea port cities of Antwerp in Belgium and Rotterdam in the Netherlands have become the main gateway for Latin American cocaine cartels into Europe.

On Feb. 14, two Dutchmen, aged 27 and 46, were arrested by Belgian police, and almost 8,818 pounds (4,000 kilograms) of cocaine were seized.

Police found an address in a navigation app used by the two men. That address led police to a hangar with a container filled with 68 bags of cocaine.

Police also arrested seven other men found in the hangar.

Cocaine was found in over 1,700 tins of wall filler, after German authorities seized more than 16 tons of cocaine in the northern port city of Hamburg, Germany, on Feb. 24, 2020, in Europe’s largest cocaine haul to date. (Cathrin Mueller/Reuters)

Narcotics production is growing in Europe, according to an estimate published in January by the EU drugs agency, which warned of a proliferation of new psychoactive substances being sold and consumed on the continent.

The EU drugs agency said that new evidence was emerging of rising drug production in Europe, confirming its earlier warning about the continent turning into a global hub for narcotics and no longer just a consumption market.

“Synthetic drug production continues to increase in Europe,” the report warned, noting that illegal laboratories in Europe churn out huge amounts of amphetamine, methamphetamine, and other synthetic drugs for local consumption and export outside Europe.

Drugs and the chemicals needed to produce them are still largely imported into Europe from other parts of the world, including South America and Asia.

More than 350 labs for synthetic drugs were detected and dismantled in 2020 in Europe, the latest year for which data is available, the EU agency said.

https://www.zerohedge.com/medical/nearly-ton-cocaine-washes-french-beach