Answer to a reader question

A Buzz reader asked about our marijuana-legality story yesterday: “Isn’t marijuana still schedule 1? Doesn’t federal law trump state law? So how can states legalize it?”

The short answer: Yep, it still is C-I, right up there with heroin. And yes, federal law would supersede any of these state laws … but.

Since at least the Obama administration, the feds have kept their hands off states when it comes to enforcing pot laws. That could change, of course, with a different administration — something that keeps marijuana-company stockholders up at night*. It’ll take Congress to make a nationwide change.

* They really need to find a way to relax.

Well there you go

The Russians say the Sputnik V vaccine is 97.6 percent effective; the also want to remind you that they have always been at war with Eastasia.

Bring out your drugs

It’s that time of year again: DEA National Prescription Drug Take Back Day!

Tell your patients! Tell your friends! Click here to find a dropbox location!

And remember, this is for unused drugs — even the DEA doesn’t want your used medication. Eew.

The opioid crisis

Trial starting: AbbVie, Endo, Johnson & Johnson, and Teva are about to go on trial in California, accused of “help[ing] cause the deadly U.S. opioid epidemic by deceptively marketing their drugs and downplaying their addictive risks.”

The companies are on the hook, potentially, for a mere $50 billion (“plus penalties”). Money quote: “You won’t hear from a single doctor who was ever misled,” said Collie James, Teva’s lawyer.

Narcan rival: Nasus Pharma is about to seek FDA approval for its FMXIN001 — a nasal spray formulation of naloxone that it designed, thanks to “microsphere technology,” to be absorbed better than Narcan.

The nicotine crisis

The Biden administration is considering cutting the amount of nicotine allowed in cigarettes — down to a level that’s no longer addictive.

The nicotine-reduction policy under consideration would lower the chemical in cigarettes to nonaddictive or minimally addictive levels, aiming to push millions of smokers to either quit or switch to less harmful alternatives such as nicotine gums, lozenges or e-cigarettes

It’s also considering a ban on menthol cigarettes. Cigarette makers, of course, say the more important issue is the livelihoods of their stockholders and of tobacco farmers.

PBM shenanigans

Did you know that Cigna/Express Scripts is offering patients $500 to switch away from secukinumab and over to ixekizumab for their psoriasis? Now you do.

One thinner is enough, thanks

If one blood thinner is good, two must be better, right? WRONG. If a patient is taking an anticoagulants like apixaban, dabigatran, edoxaban, or rivaroxaban, adding aspirin to the mix doesn’t help … and could even hurt.

“The patients on combination therapy were more likely to have bleeding events but they weren’t less likely to have a blood clot. [I]t’s important that patients ask their doctors if they should be taking aspirin when they are prescribed a direct oral anticoagulant.”

Reason to sleep

A group of European researchers has a good reason for you to sleep in: Apparently getting too little sleep can increase your risk of dementia.

It followed nearly 8,000 people in Britain for about 25 years, beginning when they were 50 years old. It found that those who consistently reported sleeping six hours or less on an average weeknight were about 30 percent more likely than people who regularly got seven hours sleep (defined as “normal” sleep in the study) to be diagnosed with dementia nearly three decades later.

The study (say the authors) also answers the question of whether too little sleep leads to dementia, or dementia leads to less sleep. “Short sleep is something that we have control over, something that you can change,” they say, clearly never having lived in a home with children.

Today’s “game changer”: Weekly insulin

Two trials of a once-a-week insulin treatment found that it’s as safe and effective as daily insulin injections — what the University of Texas said “could be a game-changer” for people with type 2 diabetes.

The studies involved The total of about 359 people in a whole bunch of countries, and was sponsored by Novo Nordisk. Next up: a large phase 3 clinical trial program — already underway, in fact.

Breaking phosphate-stone news

Sure, sodium bicarbonate might increase urinary pH, but a new study out of Oregon Health & Science University found that — contrary to rumor — it doesn’t seem to increase the risk of phosphate stones. Why not? Because it’s also raising citrate levels, of course.

The Long Read: Brain implants

“Do Brain Implants Change Your Identity?” It’s like a strange version of the Ship of Theseus: If an implant makes changes to your brain that affect who you are and how you act, are you still … you?

As neural devices proliferate, so do reports of personality changes, foundering relationships, and people who want to leave their careers.

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1,000 Internet Points if you get the reference.

Medical shocker out of Utah

“Communities Living Near Polluted Superfund Sites Have Lower Life Expectancy”