Thursday, October 11, 2007

News of the Day, Thursday, October 11, 2007

  • Stateline has a thorough summary, complete with pretty graphs, of the general fiscal downturn facing most of the states in the next year or more. “The forecast is looking pretty grim,” Sujit M. Canaga Retna, a state tax expert for the Council of State Governments, said. “The implications for states are serious.” Do I need to spell out the implications for corr sent policies and expenses?
  • Tulsa Manufacturing Academy--a nice overview of a new reentry program being tried with city-state partnerships in Tulsa, focused on turning gang members. Too new to have been evaluated yet, but good to see the local officials taking an active interest and giving support. And Pam Clifton at Think Outside the Cage has a good catch of a transition facility for females in CA here.
  • We’ve made this point before, but context has a tremendous impact on substance abuse and its capacity to damage users. Which means that the whole “instantly addicted” and “the devil gets you” horror stories are mainly there for entainment value. Here’s a new article that once again backs it all up: The anticipation of a cocaine fix and the actual craving to abuse the drug are two closely related phenomena, according to new evidence published in the journal Substance Abuse Treatment, Prevention, and Policy. The study, by Rinah Yamamoto and colleagues at McLean Hospital in Belmont, Massachusetts assessed the suspected link by contrasting reactions to varying perceived availability of the drug. The researchers suggest that more appropriate care could be given if the degree of dependency and abuse were assessed in a natural environment with a potential access to the drug, rather than in a clinical setting. Yamamoto explains that craving, is an intense and often irrepressible urge to seek and consume the drug, which can result in relapses even after extended periods of abstinence. In searching for effective therapies, understanding how craving, cognition and motivation are entwined is essential. . . . The findings suggest that the cocaine expectancy state modulates the user's subjective and objective responses to the drug. These data are consistent with the previous studies demonstrating that drug-induced elevated dopamine concentrations in the brain may prime drug users to associate the cues around the source of dopamine boost (e.g., cocaine) with the pleasure experienced once the drug is taken.
  • Constitutionality of Jessica’s Law on child sex offender residency restrictions now taken up in CA, too, with the state supreme court there, just like what’s happening as we speak in OH. The US Sup Crt needs to start getting ready.
  • Control pain? Go to prison. That’s what doctors are saying about law enforcement’s cluelessness about the latest medical practices. Taken together, the results from the three surveys suggest that medical board members' understanding of pain management issues, especially regarding addiction and the legality of prolonged opioid prescription, has improved over the years. The findings also indicate that strides have been made in the last 15 years regarding regulatory policy development. In particular, medical boards have adopted guidelines, regulations, and policy statement designed to guide licensees in the use of opioid analgesics. As noted, many of the respondents believed that federal and state law enforcement agencies are increasing their investigations and prosecutions of physicians who prescribe opioid analgesics. "Over the last 15 years, state medical boards and their members have increasingly recognized inadequate pain control as a significant healthcare problem, and have attempted to communicate this to practitioners," the authors conclude. "Now it seems that they must not only strive to alleviate physician fears of regulatory scrutiny, but they also have the opportunity to engage in a positive exchange with law enforcement about the possibility of unwarranted criminal prosecutions." Yeah, good luck with that. Just talk to the med pot folks. BTW, I love the literal nature of the journal this came from—The Journal of Pain. I’d recommend it for other publications but only the fastest could use The Journal of Crap.

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