GROWING SCHOOL DRUG-TESTING PROGRAMS

The Star Ledger of New Jersey reported on the debate over which labs should be relied on to carry out the State’s “growing school drug-testing programs” (July 17). Those who believe that random urine tests serve as a deterrent to drug use should, for consistency, impose precisely the same testing procedures for all teachers, administrators and other employees of the Department of Education. Furthermore, whatever sanctions the school system imposes on students who test positive, logic dictates that for staff there should be “zero tolerance.” This logical extension of the program would guarantee reliability of testing that is as close to 100% as is humanly achievable – assuming the champions of testing don’t have a 180-degree change of heart when they, along with students, are the targets.


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IN SCOTLAND THEY STILL DON’T GET IT: ADDICTION IS A CHRONIC MEDICAL DISEASE

Recent editorial comments and news articles reflect a new wave of attacks in Scotland on what’s described as the “quick methadone fix” (editorial, The Scotsman, 22 July), and the “’Black cloud’ of methadone use” (Scotsman 24 July). The current vitriol is occasioned by the tragic death of a two-year old who ingested her mother’s methadone, at a time when revised estimates suggest there are 21,000 opiate-dependent individuals who receive methadone maintenance, 7,000 of whom live in households with children under age 16. This has occasioned the leader of the Tories, Annabel Goldie, to urge a “programme that eradicates, rather than manages, the problem…”, and Fergus Ewing, the safety minister, “…promised to improve service provision to get people off methadone.”

Imagine politicians promising to “get people off insulin,” or dismissing medication that “manages” but fails to “eradicate” hypertension, asthma, arthritis, AIDS, etc! Consider attacking Alcoholics Anonymous because while it has helped countless alcoholics remain abstinent, it adamantly refuses to accept the notion that the disease of alcoholism can be “cured.”

Addiction is a chronic medical disease; get used to it! The good news is that it can be treated, often with extremely positive results, and the more people who need treatment that get it, the better.

OHIO: THE DEVIL'S IN THE DETAILS

"Bill pushes therapy, not jail. Prisons officials: Drug-offender option would ease overcrowding". Thus reads the July 15 headline of a Columbus Dispatch article. The idea is to "...give judges far more latitude in sentencing non-violent offenders to drug and alcohol treatment or to community programs instead of prison."

Compared to prison, of course, almost anything sounds great - but the concept of judges "sentencing" people to "treatment" is frightening. Presumably the premise is that drug use is a condition (apparently, a "disease") that lends itself to treatment. This is a highly questionable assumption (consider the tens of millions of Americans who are subject to arrest and prosecution for smoking pot). But even if one assumes all those non-violent offenders of drug laws are "sick" and might benefit from "treatment," how will the system respond when that treatment is ineffective and clients/patients continue to use illicit substances? Logically, they are the ones demonstrating greatest need for continued help - but will they get it, or will they simply to tossed into jail?

When laws not only fail to benefit society but actually create an impossible burden, they should be reconsidered and repealed. "Sentencing to treatment" those accused of illegal acts maintains, rather than corrects, a fundamentally flawed system.

The Columbus Dispatch (Ohio)

PAIN DOCTOR RE-SENTENCED TO 57 MONTHS:

Everything’s relative, and the 57 month prison term imposed on “pain doctor” William Hurwitz is indeed a welcome reduction from the 25 year sentence following the first trial. (Washington Post, July 14, 2007) And yet, Judge Brinkema’s sentence seems at odds with her conclusion that “An increasing body of respectable medical literature and expertise supports those types of high-dosage, opioid medications” that Dr. Hurwitz prescribed. So what was the rationale for adding another 27 months to the 30 months Dr. Hurwitz has already been incarcerated?

Criminal prosecutions rarely have much of a deterrent value, but this case is an exception. The threat of severe criminal sanctions will deter many compassionate, ethical physicians from ordering the amount of pain-killing medication that patients need to be freed of chronic, incapacitating pain.

EXPERT PANEL ASSESSES “SUBSTITUTION” IN GERMANY

Methadone treatment was illegal in Germany until 20 years ago; Today 70,000 patients receive this or other opiate agonist medication.

The bottom line conclusion of the panel (which convened in Feb. 2007): “Substitution” is a recognized long-term pharmacological treatment for opiate dependence. It serves to stabilize health and improve quality of life. Medication is not to be viewed merely as a path toward abstinence.

Among the panel’s recommendations: treatment of addiction should follow the same guidelines and standards that apply to management of all other chronic illnesses; and “take-home” of up to a month’s supply of medication should be permitted.

More information available from akzept e.V.:
akzeptbuero@yahoo.de

HOPE FOR HOLDING THE LINE ON HARM REDUCTION IN THE NETHERLANDS :

A Washington Post article on 23rd of June noted that “in cities across the Netherlands mayors and town councils are closing down shops where marijuana is sold . . . shuttering the brothels . . . considering a ban on the sale of hallucinogens.” The prospect seems real that the “orthodox Christian political party in the government for the first time” might also threaten needle/syringe exchanges, safe injection sites and methadone treatment.

The good news: a physician colleague who is a long-time leader in the area of harm reduction as it relates to substance use believes there will be no drastic changes in the status quo, and states quite explicitly: “Definitely methadone is not in danger and even medical prescription of heroin is safe-guarded in the [current] coalition government.” Sounds good!

GET READY FOR A “MISSION ACCOMPLISHED” PHOTO OP...

Under the headline “Drug war leaders optimistic about drop in U.S. use” (July 6) the Sacramento Bee states, “One war appears to be going well for the United States and its allies these days: the drug war.”

Antonio Maria Costa, executive director of the UN Office on Drugs and Crime, is quoted as saying, “We seem to have reached a point where the world drug situation has stabilized and been brought under control." While “some experts chide Costa as reading too much into small fluctuations in short-term supply and ignoring grimmer long-term forecasts . . . U.S. drug czar John Walters, the director of the White House Office of Narcotics and Drug Control Policy, shares Costa's optimism.”