Wednesday, August 15, 2012
Bonuses for Therapists Increase Thoroughness of Teen Substance Abuse Treatment
By Join Together Staff | August 14, 2012 | 1 Comment | Filed in Addiction,Alcohol, Drugs, Healthcare, Research, Treatment & Youth
Therapists who treat adolescents for drug and alcohol abuse deliver more complete treatment when they are offered monetary rewards based on the quality and quantity of care they deliver, suggests a new study.
However, the study did not find more thorough treatment by therapists resulted in better results for teens. Those who saw therapists participating in the “pay-for-performance” program were not any more likely to stop using drugs and alcohol, compared with their peers whose therapists did not participate in the program.
Pay-for-performance rewards are becoming more common throughout the healthcare system, according to Reuters.
The study included 29 community-based drug treatment organizations, which were chosen to start using a teen behavioral treatment program. Some of the programs were given monetary incentives for therapists who thoroughly implemented the program’s strategies.
About 100 therapists and more than 900 teenagers were included in the study. Most of the teens were boys being treated for alcohol or marijuana use.
Therapists in the financial incentives group were given $50 for each month they demonstrated their treatment met program guidelines. They received an additional $200 for each patient with whom they discussed specific topics and used a range of treatment tools, such as talking about the teens’ social life, and their progress toward treatment goals.
Therapists who received the incentives tended to deliver more complete care, compared with their colleagues who did not receive incentives. While pay-for-performance therapists gave 17 percent of patients the full recommended amount of treatment, less than 3 percent of therapists not receiving incentives did so. “Relatively small incentives led to very large improvements in performance,” said lead researcher Bryan Garner of Chestnut Health Systems in Normal, Illinois.
Between 41 and 51 percent of patients seen by both groups of therapists improved during the study, and had not used drugs or alcohol for at least a month before their last check-in, the researchers reported in the Archives of Pediatrics & Adolescent Medicine.
Tuesday, August 14, 2012
Some Veterans Coping with Drug Abuse, PTSD Lose Health Benefits
By Join Together Staff | August 13, 2012 | 3 Comments | Filed in Addiction,Alcohol, Drugs, Mental Health, Military & Treatment
More than 20,000 U.S. veterans have left military service during the past four years with an other-than-honorable discharge, which can restrict their disability and veterans health care benefits, The Seattle Times reports. Many of these men and women are struggling with drug abuse and/or post-traumatic stress disorder.
According to federal law, veterans who are not honorably discharged because of misdeeds must submit to a review of whether they engaged in “willful and persistent misconduct,” and whether that behavior disqualifies them for health care or disability benefits. These rules leave some veterans struggling to find treatment, the article notes.
Officials from the Department of Veterans Affairs told the newspaper the department has no way to track how many reviews are conducted, how long they take, or what the outcomes are.
“I would go so far to say that, when we speak of Army values, leaving no soldier behind, there is almost a moral obligation,” said Major Evan Seamone, Chief of Military Justice at Fort Benning, Georgia. “We are creating a class of people who need help the most, and may not be able to get it. And, when you do that, there are whole families torn apart, and higher levels of crime. It’s a public-health and public-safety issue.”
Major Tiffany Chapman, a former Army prosecutor, said some soldiers who are dishonorably discharged were troubled before they joined the military, while others appeared to be relatively stable before they faced combat. “You just don’t know how you are going to react once you have been to war,” she said.
Monday, August 13, 2012
"Caravan For Peace" Sets Out to End Drug War
Mexican and American organizations unite to search for non-violent solutions across the US, starting Sunday.
"Giving a voice to the families of victims." Photo via
By Chrisanne Grise
08/10/12
With death toll of the bloody Mexican drug war rising as high as 71,000, dozens of Mexican and American organizations will embark on a month-long “Caravan for Peace” on Sunday, August 12. Its aim is to spread awareness and open dialog about non-violent solutions with citizens and leaders in both countries. Ideally, the caravan—which is purposely timed between the two nations' presidential elections—will revise their relationship, promoting a view of Mexico as a neighbor, not a threat.
“We are dedicated to giving voice to the families of victims of this violence and to publicizing the real costs of this war,” says Javier Sicilia, a poet who was named one of Time’s 2012 “Person of the Year” activists; cartel members murdered his son in 2010. He's joining the Movement for Peace with Justice and Dignity (MPJD) to lead the caravan. “We have made it clear that the Mexican state must stop denying its responsibilities, which it does by criminalizing the victims of violence,” he says. “Instead, it must accept that there are victims, and that it is the Mexican government’s responsibility to provide justice and reparations to them. With this in mind, we have asked for a change from the current security strategy to one focused on human security.” That said, the goal is also to influence American drug-war strategy; Sicilia says he hopes to promote discussion about US policies in areas such as gun trafficking, alternatives to drug prohibition, combating money laundering and bilateral cooperation over human rights and security.
The trek will cover 6,000 miles and stop in 20 US cities, starting in San Diego on Sunday and arriving in Washington, DC, on September 10. Each stop along the way will feature rallies and debate. Other organizations involved in the initiative include the National Association for the Advancement of Colored People (NAACP), Law Enforcement Against Prohibition (LEAP) and the Drug Policy Alliance (DPA). A similar caravan crossed Mexico last year, and is credited with pushing the drug war up the country’s political agenda. Anyone interested can join the caravan as a volunteer, track the route online, or register to ride on one of the caravan buses or to follow along in your own car.
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Chrisanne Grise
Sunday, August 12, 2012
6 Hid Drugs in Diplomas and Candy, Officials Say
By ERIC P. NEWCOMER and VIVIAN YEE
Published: August 7, 2012
Drug traffickers have been widely known to employ extreme and inventive measures to smuggle narcotics into the United States, but six people arrested on Tuesday may have won a prize for creativity.
Prosecutors accused the six of smuggling narcotics from Ecuador by stuffing cocaine inside empanadas and heroin inside sesame candy. But the real find, the authorities said, was a stack of what looked like diplomas from a scuba-diving school that had been soaked in more than three pounds of liquid cocaine.
“The techniques employed were extremely sophisticated,” New York City’s special narcotics prosecutor, Bridget G. Brennan, said.
During the investigation into the reputed drug operation, the authorities said they discovered that the man they called the ringleader, Jorge Guerrero, was also stealing valuables from lost luggage that he was supposed to deliver to airline passengers after it was found.
“He was just such an opportunist,” Ms. Brennan said. “His day job was stealing from lost luggage.”
Mr. Guerrero, 39, was indicted on charges of conspiracy and attempted criminal possession of a controlled substance. The penalty for the possession charge is up to 20 years in prison. He pleaded not guilty on Tuesday.
Law enforcement officers said Mr. Guerrero’s operation could buy 2.2 pounds of cocaine in Ecuador for about $2,000 and sell it for $25,000 to $30,000 in the United States. William Novak, an assistant district attorney, described Mr. Guerrero as the “main receiver” of the drug shipments sent as freight and the mastermind of the smuggling ring. Mr. Novak argued for holding him without bail, claiming that Mr. Guerrero was a flight risk because he had many relatives in Ecuador.
“If he flees, he’s never coming back,” Mr. Novak said.
Mr. Guerrero’s lawyer, Frank Rothman, portrayed him as a married man with three children who was unlikely to flee. He said the police had not found drugs in Mr. Guerrero’s home.
Judge Bonnie G. Wittner ordered him held without bail.
Mr. Guerrero’s wife, Cecilia Guerrero; Riqui Perez; Noe Fernandez; Luis Amable Caisa Altamirano; and Judy Campos were also arrested. The authorities charged that Ms. Guerrero often helped her husband with the smuggling operation and the luggage thefts. She was charged with conspiracy and criminal possession of a controlled substance.
During a search of the Guerreros’ home in Jamaica, Queens, officers said they found 13 suitcases, over 50 designer handbags, 20 cameras and 50 watches.
The authorities said a six-month investigation had tied the defendants to drug trafficking.
Over three months, agents confiscated more than 11 pounds of narcotics in New York and New Jersey that they said was linked to the defendants.
On May 3, agents discovered more than a pound of cocaine hidden inside chocolate bars and more than half a pound of cocaine concealed in chocolate candies. On May 28, over three pounds of cocaine was found stuffed inside empanadas. On June 8, they said, they seized the sesame candy, with more than a pound of heroin in it. On June 25, a pound of cocaine was discovered at the bottom of a container of homemade sugar and cookies. On July 12, the diplomas were found.
Law enforcement officials estimate the cocaine and heroin were worth about $150,000 on the wholesale market in the United States.
Michael Levine, who worked for the Drug Enforcement Agency for 25 years, said liquid cocaine could be converted back into a solid form. But a significant portion of the cocaine is typically lost in the process. He added that small- to midlevel traffickers have soaked liquid cocaine in clothes. But he said he never heard of it being soaked in paper.
A GOOD CAUSE
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Saturday, August 11, 2012
Take-Home Naloxone Has Vital Role in Addiction Treatment
By Dr. Sharon Stancliff | August 10, 2012 | 1 Comment | Filed in Addiction,Prescription Drugs & Treatment
Opioid-related overdose deaths are a leading cause of mortality across the United States. Naloxone, the drug carried by ambulances to reverse overdoses, is also available in some states to be administered by trained members of the general public who might be present when an overdose occurs. Many lives have been saved by bystanders, and increasingly, notice is being taken of community-based naloxone distribution. The Food and Drug Administration held a public workshop in April, the Substance Abuse and Mental Health Service Administration will soon be distributing an “Overdose Prevention Tool Kit” featuring it and in June, the American Medical Association passed a resolution supporting it.
Naloxone is a safe and effective antidote to opioid overdose, restoring respiration and reversing sedation, though it also precipitates withdrawal in dependent people. It may legally be prescribed to anyone at risk of overdose, and many jurisdictions allow for it to be administered to persons other than the prescription holder. A brief training in naloxone use includes hands-on practice with the naloxone device (either an intramuscular injection or an intranasal spray) and a kit contains two doses. A recent CDC Morbidity and Mortality Weekly Report reported that, as of June 2010, more than 50,000 individuals had received naloxone kits and that more than 10,000 overdoses had been reversed.
Take-home naloxone has a vital role to play in addiction treatment because relapses after treatment are so common, and in the setting of loss of tolerance frequently, it can lead to overdose. The New York State Offices of Alcohol and Substance Abuse Services (NYS OASAS) were early adopters of take-home naloxone and have urged all the programs they license to do the same. Samaritan Village, the first therapeutic community to offer take-home naloxone, provides overdose prevention training during orientation. Patients are assured there will be a place for them if they return after relapse, and naloxone increases the likelihood that they will be able to.
Some say that the introduction of naloxone into treatment sends the wrong message to the patients: “You will fail”. But in fact, it tells them that the program cares about their lives even if they relapse, a very positive message for someone at a low point in life. It also implies that they are important members of the community with the power to save a life. An OASAS patient relapsed following a 28-day rehab and during the relapse reversed his friend’s overdose; this was a profound experience for him, and renewed his commitment to sobriety.
Naloxone programs have been very effective in targeted populations, as has been shown by the 47 percent reduction in heroin overdose death rates in New York City in the first five years of that program, where distribution was mostly through syringe exchange programs. Opioid analgesic users have been much harder to reach, but regularly turn up for treatment. Provision of naloxone should become a standard of care in drug treatment programs. Treatment providers can become powerful advocates for legislation and funding facilitating community-based distribution programs.
Dr. Sharon Stancliff, MD
Medical Director
Harm Reduction Coalition
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