Tuesday, July 17, 2012
Advocates Seek to Exclude Death Penalty for Defendants With Fetal Alcohol Syndrome
By Join Together Staff | July 16, 2012 | Leave a comment | Filed in Alcohol,Community Related, Legal & Mental Health
A growing number of murder cases nationwide seek to exclude the death penalty for defendants with fetal alcohol syndrome (FAS), The Seattle Times reports.
In one such case, advocates are trying to prevent the death penalty for Mark Anthony Soliz, a convicted murderer on death row in Texas. His mother drank heavily, used drugs and sniffed paint while she was pregnant, the article notes.
Those who favor eliminating the death penalty for people with fetal alcohol syndrome point to the U.S. Supreme Court decision to abolish the death penalty for defendants with mental retardation. “The damage to the executive functioning of the brain is as severe as someone who is intellectually disabled,” said John Niland, Director of the Capital Trial Project with the Texas Defender Service.
Victims’ advocates and prosecutors say such a decision would let killers off easy. “FAS should not be used as an excuse for intentionally and knowingly murdering another person,” victims’ rights advocate Andy Kahan told the newspaper. “Clearly, the defendant has been able to make law-abiding decisions on a daily basis, and they obviously know right from wrong. FAS is yet another hurdle for surviving family members of homicide to overcome to secure justice for the coldblooded murder of their loved ones.”
Another Texas death-row inmate, Yokamon Laneal Hearn, who was also diagnosed with fetal alcohol syndrome, is set for execution Wednesday. He was convicted in the shooting of a stockbroker during a robbery. Amnesty International is urging a letter-writing campaign for clemency to Texas Governor Rick Perry. The article notes the U.S. Supreme Court has already rejected a request to review a fetal alcohol case, which involved Louisiana death-row inmate Brandy Holmes, who was named after her mother’s favorite liquor.
Monday, July 16, 2012
Commentary: Affordable Care Act Does Little to Increase Addiction Care Access
By Dr. Stuart Gitlow | July 13, 2012 | 1 Comment | Filed in Government,Healthcare, Insurance, Legislation & Treatment
The demand for addiction treatment is high. The supply of addiction specialists is comparatively low. Yet unlike traditional economic models where money is the obstacle, in our field, the obstacle is time.
There are two factors involved: the time required to provide reasonable quality of care, and the time required to produce a specialist who has the ability to provide that care. These limitations restrict the number of patients that can be seen per day by all available addiction specialists. While increasing pay for care would result in an increased interest in the field, development of appropriate training and the years of training necessary would result in only slow growth of available treatment.
Because addiction specialists are not currently sitting idly at their desks surfing the Internet, access to treatment is not limited by financial factors but rather by availability factors. There simply isn’t a great enough supply of specialists to meet the demand of patients.
In 20 years of practice, I have worked in an academic setting as a staff physician in an addiction specialty unit, as a medical director of a community mental health center (CMHC) and as a private practice physician specializing in addiction. In each setting, I have turned no patient away. At the private practice, as is the common practice here, we do not take insurance but always work out a fee arrangement that is compatible with a patient’s needs. The CMHC also utilized a sliding scale for patients, and in the academic center, patients who could not pay were seen by a fellow with oversight from faculty. Patients have roughly equal access to at least one part, if not all parts, of the system. But availability of service, not fiscal issues, always proved the greatest constraint. “We’re happy to see you, Miss Smith, but our next opening is in 2015.”
That’s not to say there is no fiscal issue: my CMHC lost money on physician-provided care for nearly 20 years. Expenses were more than my hourly wage, and included collection costs, billing, insurance reviews and audits, with the revenues limited to copays and insurance payments. Things got much worse a few years ago. Collections dropped, audit rates increased and ultimately the CMHC could no longer afford my services. Did I mention that the CMHC I worked for is in Massachusetts? The community no longer has an addiction specialist and was recently featured in the news due to increased problems associated with substance use.
But the fiscal issue does not represent an access constraint because we clinicians can easily practice outside the employed environment. Looking at my case above, I left the CMHC and took most of my existing patients with me into my private practice in an adjoining state. Because I do not take insurance yet charge a reasonable rate, my expenses are quite low and patients do not have a significant financial burden in comparison to the CMHC model. Thus payment again did not end up being a significant limitation to access.
Now let’s come to the headline of the hour: the recent Supreme Court ruling. In many ways, the ruling was a non-event in that it simply supports, largely, what had already passed in Congress. The Affordable Care Act does very little to increase access to addiction care because it does not solve the primary obstacle we’ve discussed. It promises to increase the number of those who have insurance coverage, but as I’ve pointed out, coverage has not represented a significant obstacle in long-term outpatient addiction treatment. And long-term outpatient treatment is the key to avoiding higher levels of care. Outpatient care is where addiction treatment truly takes place since the higher levels of care are limited to the acute manifestations of substance use (e.g. detox, rehabilitation, and medical/psychiatric sequelae) and not the chronic issues related to addictive illness.
The Act promises that substance use disorders will be covered at parity as part of the essential health benefit. But any expectation that this will lead to coverage of long-term outpatient treatment is misguided. Because the primary limiting factors – time – is not being addressed, we will see no significant improvements. Given my experience in Massachusetts, however, we may see a significant alteration in how services are provided, with greater numbers of independent clinicians moving away from an employed model and into private practice and fewer clinicians accepting insurance. Too, there may be higher charges because of the higher taxes in place now due to the very Act that is supposed to increase access. This is a good thing as costs are much lower in private practice due to the reduced administrative burden and overhead. The overall cost of health care will drop.
Remember pendulums swing both ways. Just as the past decade saw a decline in private practice, the Affordable Care Act, should it not be repealed, will likely prove an economic force in the other direction insofar as bio-psycho-social-spiritual treatment of addiction is concerned.
Stuart Gitlow MD MPH MBA is a member of the American Medical Association’s Council on Science & Public Health, and Acting President of the American Society of Addiction Medicine. This Op-Ed represents his personal opinion and does not imply any position or policy taken by either the AMA
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Sunday, July 15, 2012
Simulation Program Teaches Teens About Drunk and Distracted Driving
By Join Together Staff | June 21, 2012 | Leave a comment | Filed in Alcohol,Prevention, Young Adults & Youth
A new simulation program is teaching young drivers about the risks of drunk and distracted driving. The program is designed to demonstrate what can happen if they have an accident while they are driving under the influence or texting while driving.
One Simple Decision, made by Virtual Driver Interactive (VDI), combines simulated driving with video footage of interactions with law enforcement, judges and emergency medical personnel, USA Today reports.
The Ohio Department of Transportation bought four VDI simulators, at a cost of $42,000. It uses them at schools, football games and county fairs, the article notes. “We recognized that there is an issue, especially among young drivers, with paying attention to the road,” spokeswoman Melissa Ayers told the newspaper. “We started using it last year. We’ve gotten really good feedback. The kids realize after they’ve used it, ‘I really can’t do two things at once (while driving).’”
A government report issued in December found an estimated 31 percent of driving deaths were linked to alcohol in 2010, compared with nine percent of deaths caused by distracted driving. The National Highway Traffic Safety Administration’s report found that overall, highway deaths fell last year to the lowest level in six decades, even though Americans are driving more
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Saturday, July 14, 2012
“Drug Tourists” Increase States’ Challenges in Fighting Prescription Drug Abuse
By Join Together Staff | July 13, 2012 | Leave a comment | Filed in Community Related, Legal, Prescription Drugs & Prevention
States’ efforts to crack down on prescription drug abuse are being made more difficult by people who travel to states such as Florida and Georgia to obtain painkillers, the Associated Press reports. These so-called “drug” or “prescription” tourists are transporting huge amounts of drugs across state lines, according to the AP.
Trying to stop drug tourists involves complicated prosecutions that cross a number of state lines, the article notes. Drug tourists travel to states with many “pill mills,” where they obtain a large amount of painkillers and then return home to sell them for as much as $100 per pill.
Florida was long known as a prime destination for drug tourists. Now that the state is cracking down on pill mills, Georgia is becoming a more popular destination for those who want to find easy access to painkillers. They come from adjacent states, and from more distant states such as Nebraska and Arizona.
“They’re like a swarm of locusts,” said Richard Allen, Director of the Georgia Drugs and Narcotics Agency. “Once they have a script, they’ll hit every pharmacy in the state trying to get them filled.”
Earlier this year, the Drug Enforcement Administration announcedsales of oxycodone fell 20 percent last year in Florida. Officials said the drop was mainly due to the closure of some of the state’s biggest pill mills and the arrest of some of the clinics’ operators and doctors. Florida pharmacies and doctors sold about 498 million doses of oxycodone in 2011, compared with a record 622 million doses the previous year.
In June 2011, Florida Governor Rick Scott signed into law a bill designed to cut down on prescription drug abuse by controlling pill mills in the state. The law authorized the creation of a prescription-drug monitoring database to reduce doctor-shopping by people looking to collect multiple painkiller prescriptions. The legislation also imposed new penalties for physicians who overprescribe medication and imposes stricter rules for operating pharmacies.
Friday, July 13, 2012
Bill Aims to Reduce Teen Abuse of Cough Syrup
By Join Together Staff | July 12, 2012 | 3 Comments | Filed in Drugs, Legal,Prevention & Youth
Two senators introduced a bill this week designed to prevent the abuse of cough syrup by teenagers. The bill restricts the sale of products containing the cough syrup ingredient dextromethorphan (DXM) to those older than 18, Drug Store News reports.
Senator Bob Casey of Pennsylvania and Senator Lisa Murkowski of Alaska sponsored the measure, known as the Preventing Abuse of Cough Treatments (PACT) Act of 2012. The PACT Act also places limits on the purchase of bulk (unfinished) DXM, so that only manufacturers registered with the Food and Drug Administration or relevant state agencies have access to DXM in its raw form. Currently, there are no national restrictions on sales or purchase of DXM in this form.
The 2011 Monitoring the Future survey found that 5 percent of teens report abusing cough medicine. Abuse of DXM can cause hallucinations, confusion, blurred vision and loss of motor control.
The Consumer Healthcare Products Association (CHPA) notes that DXM is a safe and effective cough suppressant found in more than 100 cough and cold medicines. The legislation “will give parents an additional tool to prevent abuse, while ensuring access for the millions of adults and families who responsibly use products containing DXM to relieve cough symptoms,” CHPA President and CEO Scott M. Melville said in a news release.
“By addressing easy access to purchasing cough syrup for teens, the main cause of the harmful trend of its abuse, my bill will help keep our children safe and lessen the strain cough syrup abuse has put on families, hospitals and law enforcement,” Senator Casey said in astatement. “My common-sense legislation will prevent kids from purchasing a drug that has dangerous consequences when abused to get high, while also ensuring it is available to those with a legitimate need for it.”
Thursday, July 12, 2012
CDC: One-Third of Prescription Painkiller Overdose Deaths Caused by Methadone
By Join Together Staff | July 9, 2012 | Leave a comment | Filed in Addiction,Drugs, Prescription Drugs & Treatment
Methadone causes 30 percent of prescription painkiller overdose deaths, according to a new report from the Centers for Disease Control and Prevention (CDC). Some doctors are now prescribing methadone to treat chronic problems such as back pain, which is making the drug more widely available.
According to the CDC, methadone and other extended-release opioids should not be used for mild pain, acute pain, “breakthrough” pain, or on an as-needed basis. “For chronic noncancer pain, methadone should not be considered a drug of first choice by prescribers or insurers,” the report noted.
In an effort to cut down on abuse of drugs meant to treat addiction, Titan Pharmaceuticals plans to file for Food and Drug Administration approval for an implant of buprenorphine, which eases withdrawalsymptoms. The Wall Street Journal reports that buprenorphine currently comes in pills or strips, which can be used to get high, or used more heavily than they should be to relieve symptoms of withdrawal. The pills are crushed and then injected or snorted.
The implant, called Probuphine, is inserted just under the skin in the upper arm. It releases continuous, small amounts of the drug over six months. “You cannot easily remove these implants from the arm,” Titan Senior Vice President Katherine L. Beebe told the newspaper.
A study conducted by Titan and published in the Journal of the American Medical Association in 2010 found that among people with opioid dependence, users of Probuphine had significantly less illicit opioid use, and fewer symptoms of withdrawal and craving, compared with those who received a placebo implant.
Wednesday, July 11, 2012
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About
Working as a family to overcome addiction.
DescriptionThe heart of True Teen Recovery lies in the treatment of not just the individual adolescent suffering from behavioral issues and addiction, but the entire family. The consistent success of our program is directly linked to incorporating family treatment as part of our Intensive Outpatient Program.
3737 Camino del Rio S. Suite 205
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Company OverviewThe Anchor Recovery Community Center is a safe, supportive environment for people in all stages of recovery. At the Anchor, you will find a community of people who have changed their lives for the better and want to help other people find a new way of living through meaningful relationships, activities and a sense of community. The Anchor doesn’t just help people maintain their recovery, it helps people build a new life.
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249 Main Street
Pawtucket, RI 02860
401-721-5100info@anchorrecovery.org
Company OverviewThe Anchor Recovery Community Center is a safe, supportive environment for people in all stages of recovery. At the Anchor, you will find a community of people who have changed their lives for the better and want to help other people find a new way of living through meaningful relationships, activities and a sense of community. The Anchor doesn’t just help people maintain their recovery, it helps people build a new life.
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Obama Signs Legislation Banning Synthetic Drugs
By Join Together Staff | July 10, 2012 | Leave a comment | Filed in Drugs,Legislation & Prevention
President Obama on Monday signed legislation that bans synthetic drugs. The law also expedites the Food and Drug Administration’s (FDA) approval of new drugs and medical devices.
The law bans harmful chemicals in synthetic drugs such as those used to make synthetic marijuana and “bath salts,” according to the Star Tribune. While more than 30 states have banned various compounds in synthetic drugs, new ones are continually being created, the newspaper notes.
“In Minnesota and across the country, we are seeing more and more tragedies where synthetic drugs are taking lives and tearing apart families,” Senator Amy Klobuchar of Minnesota said in a statement. “Today’s action means that this critical legislation to give law enforcement the tools they need to crack down on synthetic drugs is finally the law of the land.” Senator Klobuchar co-sponsored bills banning synthetic drugs, which were included in an amendment to the FDA’s Safety and Innovation Act.
Synthetic drugs are readily available online. The law outlaws sales of synthetic drugs by both retail stores and online retailers.
In December, the National Institute on Drug Abuse released new information indicating that one in nine high school seniors had used “Spice” or “K2” over the past year, making synthetic marijuana the second most frequently used illicit drug, after marijuana, among high school seniors. Poison control centers operating across the nation have also reported sharp increases in the number of calls relating to synthetic drugs.
President Obama on Monday signed legislation that bans synthetic drugs. The law also expedites the Food and Drug Administration’s (FDA) approval of new drugs and medical devices.
The law bans harmful chemicals in synthetic drugs such as those used to make synthetic marijuana and “bath salts,” according to the Star Tribune. While more than 30 states have banned various compounds in synthetic drugs, new ones are continually being created, the newspaper notes.
“In Minnesota and across the country, we are seeing more and more tragedies where synthetic drugs are taking lives and tearing apart families,” Senator Amy Klobuchar of Minnesota said in a statement. “Today’s action means that this critical legislation to give law enforcement the tools they need to crack down on synthetic drugs is finally the law of the land.” Senator Klobuchar co-sponsored bills banning synthetic drugs, which were included in an amendment to the FDA’s Safety and Innovation Act.
Synthetic drugs are readily available online. The law outlaws sales of synthetic drugs by both retail stores and online retailers.
In December, the National Institute on Drug Abuse released new information indicating that one in nine high school seniors had used “Spice” or “K2” over the past year, making synthetic marijuana the second most frequently used illicit drug, after marijuana, among high school seniors. Poison control centers operating across the nation have also reported sharp increases in the number of calls relating to synthetic drugs.
Tuesday, July 10, 2012
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Monday, July 9, 2012
Life, Liberty and the Pursuit of... Drunkenness?
On our nation's 236th birthday, The Fix reveals a very subjective ranking of the booziest Founding Fathers. The results might give you a historic hangover (we're looking at you, George).
07/03/12
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Contrary to the subdued oil paintings depicting the signing of the Constitution, the birth of our country was actually far from a sober affair. In fact, according to documents, in the days before the Founding Fathers signed the document in 1787, the 55 delegates to the Constitutional Convention found themselves at a Philadelphia tavern, where, for lack of a better phrase, they partied their asses off. The bar tab included: 54 bottles of Madeira, 60 bottles of claret, eight of whiskey, 22 of porter, eight of hard cider, 12 of beer and seven bowls of alcoholic punch." By the calculus of historian Stanton Peele, that’s "more than two bottles of fruit of the vine, plus a few shots and a lot of punch and beer, for every delegate."
Impressive, but unsurprising, considering that beer was more common than drinking water in parts of the Colonies. So who were the biggest drinkers at the Convention? Here's a very subjective ranking, from steadiest to most likely to fall asleep in his porter, of our nation's Founders.
10. James Monroe
There's no better way to train for a lifetime as a heavy drinker than by serving as an aide to one. That's what Monroe did during the Revolutionary War as General Stirling’s right hand man and drinking partner. Once in the White House, Monroe kept up the habit and employed fellow founder Thomas Jefferson as his wine advisor.
9. Thomas Paine
Before he was the author of "Common Sense" and a radical revolutionary, Thomas Paine was a failed businessman, a crappy teacher and a two-time divorcee. One of the only joys during the first half of his life involved gulping wine at the local tavern and debating politics. In his middle age Paine became an integral part of the American Revolution and though he drank, it was always in moderation. That changed when we get older, though, when an absent-minded and socially isolated Paine began throwing back wine and brandy with unfettered ferocity.
8. James Madison
According to legend, the man who drafted the Bill of Rights downed a pint of whiskey a day. Of course, drinking booze was often safer than drinking water in the late 18th century, but a pint a day was still excessive. At least that’s what lesser-known Founding Father Gouverneur Morris thought. The author of the preamble to the Constitution, Morris once called Madison "a fool and a drunkard." Madison's commitment to the bottle was so intense that even the influence of Benjamin Rush, a prohibitionist and fellow Founder who inspired many in Washington to dry out, couldn't stop him from imbibing.
7. Ethan Allen
The war hero, businessman, writer and philosopher whose name would one day be stolen by a furniture company, was a prodigious drunk known widely for his affinity for stonewall, a mixture of rum and hard cider. During the war Allen and his Green Mountain Boys would prepare for battle with the British by limbering up with the potent drink. Allen's legend as a drunkard was so well known that tall tales started to get passed around. According to one, he and a cousin fell asleep in the woods after a long day of drinking. His cousin woke to the sounds of a hissing snake biting Allen over and over. Before he could fight the snake off, the cousin watched it slither away, disoriented and burping. Soon Allen woke up cursing the mosquitoes biting him in his sleep.
6. John Hancock
Before he was known for that flamboyant signature, John Hancock was known as a rum runner. His involvement with the sauce extended far beyond smuggling it into the country, though. Hancock was a staple at Boston's taverns where he and patriots like Sam Adams helped sow the seeds of rebellion. Hard cider was Hancock's drink of choice and the two-time governor of Massachusetts was such a well-known bar patron that it's been suggested the claim "John Hancock drank here" could be made much more often than the popular "George Washington slept here."
5. George Washington
After losing his first election to the Virginia House of Burgesses, America's first president harnessed the power of booze in his second election and distributed 144 gallons of rum, wine, cider and beer to voters. He won. After lots of arguably necessary battlefield drinking, Washington became the country's first president on April 30, 1789. The occasion called for a party and that meant Washington needed rum, which he had developed a taste for while spending time in Barbados as teen. Despite laws prohibiting importing the booze, Washington had a barrel of rum at his inauguration. Eventually Washington's drinking started to take a toll on his body, but not in a traditional way. According to a letter from his dentist, the President's love of port wine was staining and softening his ivory teeth. After leaving office and retiring to Mount Vernon, Washington found that booze was good for more than just drinking. He began using extra grain from his farm to distill whiskey and in short order became one of the biggest distillers in the country, producing 11,000 gallons of whiskey a year.
4. John Marshall
Like many of his fellow Founders, John Marshall was a noted fan of Madeira, the strong Portuguese wine with an ability to withstand extreme temperatures. After his appointment to the Supreme Court in 1801 the Virginian began having his fellow Justices over for dinners, which were always "lubricated with a well-chosen Madeira," according to a biography. Marshall's love of wine was no secret in Washington. In fact wine companies in the District began to sell their best bottles under the name The Supreme Court, as a nod to Marshall's proclivities. The Chief Justice’s love of wine was as inherent to his persona as his love of Federalism. As Justice Joseph Story once wrote, Marshall was brought up on Federalism and Madeira, and he was not a man to outgrow his early prejudices.
3. John Adams
At 15, the future second president enrolled at Harvard and quickly found a breakfast that was to his liking—bread and beer. Of course, this is a man who started smoking at eight so a little morning brew wasn't too big of a deal. Adams would eventually outgrow beer and move on to the more popular hard cider. A descendent of his once wrote, "To the end of John Adams' life, a large tankard of hard cider was his morning draught before breakfast." No need to rely on the words of others, though. During a trip to Philadelphia, Adams wrote a letter to his wife, Abigail, about the city’s horrible selection of alcohol. "I am getting nothing that I can drink, and I believe I shall be sick from this cause alone," he wrote.
2. Thomas Jefferson
While his peers tended toward cider and beer, Thomas Jefferson was all wine all the time. Described by The New York Times as "a lifelong oenophile," Jefferson once took a trip to France to better his health. That's what he said at least. Turns out Jefferson started his three-month journey by drinking all the wine in Burgundy. Jefferson made no secret of his love of wine while in the White House. Instead he flaunted it by holding regular wine-soaked get-togethers that led to him earning the title "inventor of the presidential cocktail party." All told, he racked up an $11,000 wine bill in the eight years he was in office. Jefferson didn't slow down in his post-Presidential years. His estate at Monticello was home to a brewery, which Jefferson eventually stopped using, and vineyards that never proved able to produce wine-bearing grapes. Jefferson wasn't discouraged though. Instead of getting down about his inability to cultivate Monticello wine, he had a dumb waiter installed between his cellar and dining room to ensure the fastest delivery possible.
1. Benjamin Franklin
Benjamin Franklin's reputation as a boozer is preceded by his reputation as a scientist. The man who once published a list of more than 200 euphemisms for "drunk," spent a lot of his time that way. His love of wine, cider and the occasional beer didn't just extend to drinking it, though. He also wrote songs, poems and letters on the subject. They contained lines such as "Wine makes daily living easier, less hurried with fewer tensions and more tolerance." During the Constitutional Convention Franklin reportedly had a personal bodyguard follow him around so he wouldn't get into trouble at local taverns. A noted lover of Maderia, which he first tried at 19, Franklin's personal wine cellar is said to have contained more than a thousand bottles. He was such a fan of the drink that he once joked he should be buried in it. "I should prefer to an ordinary death, being immersed with a few friends in a cask of Madeira," he wrote. In the end though, Franklin wouldn’t blame wine for the gout that hobbled him. Instead, it afflicted him, he wrote, because he ate a "hearty supper, much cheese and a drank a good deal of champagne."
Frequent Fix contributor Adam K. Raymond draws the line at a mere 2 bottles of claret per meal, and yet still suffers from gout.
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