Tuesday, July 14, 2009

“RECENTLY, I DID SOME CLINICAL WORK AT A METHADONE CLINIC”

This comment was a response to a posted blog in the Addictions Recovery Professionals group at Linked In (http://www.linkedin.com/). The original blogger is an addictions counselor discussing working at Methadone clinics. Please review the many comments at: http://www.linkedin.com/groupAnswers?viewQuestionAndAnswers=&gid=862107&discussionID=4887361&goback=%2Eanh_862107


Mr. Jenkins, others,

Thank you for concisely and clearly stating the facts regarding the unique physiology of opiate addiction. Pure science dictates the intractability of opiate addiction in the malfunction of opiate receptors. It has nothing to do with “will power”, but rather with changes that occur in the brain and neurological synapses.

For many years I advocated for medicated recovery, specifically Methadone, and was deeply involved and invested in the passage and implementation of the Drug Abuse and Treatment Act of 2001 (DATA). In addition to changing methadone rules, this Act allowed for the private physician use of Suboxone for opiate withdrawal and maintenance. In my research and advocacy since then, I have come to believe that Suboxone/ Buprenorphine/Naltrexone may be a better choice in many circumstances. Methadone is very effective for long term treatment of heroin addiction. Still, it has many drawbacks, specifically, the difficulty in withdrawal; however, the stigma of Methadone also cannot be underestimated in its effects on the clients social wellness. As such, Methadone should be used as a last resort, only after other avenues have failed, including abstinence programs.

True stabilization and reorientation into a non-drug seeking lifestyle can take many years, and even then, it is not unusual for heroin addicts to relapse, often after many years of abstinence. True, intractable heroin addiction may best be treated with life-long Methadone, in terms of the client’s well being and social harm reduction. Too many times, though, clients are accepted into Methadone clinics before other treatments have been attempted. Often, these patients may be opiate na├»ve in comparison to long-term heroin addicts seeking methadone maintenance. The methadone may get them off of their “drug of choice”, but only addicted to one that is even more difficult to overcome. In these cases, if abstinence is not an option, then Suboxone should be used. Using methadone in anything but the most severe cases, i.e., the patient is at risk of IV related disease and social degradation, is like swatting a fly with a sledgehammer.

I also agree that your “Counselors-in-relapse” is a valid paradigm, and one seen much too often in recovery. While some addicts in treatment may prefer to have a counselor that is also a recovering addict, the value of learning the pathology and physiology underlying opiate addiction an educated cannot be understated, nor can the value of certification. The best of both worlds, of course, would be ideal, and fortunately many recovering addicts have gone on to receive certification and/or college graduation. When I hear of recovering counselors who have been clean for less than two years working in methadone clinics, I worry that they are not only ineffective, still fighting their own battles, but they are also putting their own recovery at risk by being in a drug-centered environment before they have had a chance to put that environment behind them, and think themselves “well”.

Thursday, July 9, 2009

I Don't Like What You Wrote

Ellen Brandt, Ph.D., talks about her experience with the dark side of social media in this humorous article from June 12, 2009, at (www.elleninteractive.wordpress.com ).
Click here to read Dr. Brandt’s article:
I Don’t Like What You Wrote. You Should Be Poisoned, Garrotted, Stabbed With Stiletto Heels, Thrown Off A Tall Building, and Have Vultures Eat Your Liver June 12, 2009 by Ellen Brandt, Ph.D.
The vast majority of those one meets on the Internet through social networking are sane, well-educated, interesting, and often thoroughly delightful people one would be happy to meet for a hamburger or beer without bodyguards, one’s mother, or the Secret Service present.
But there are notable exceptions.

My response:


Dear Ellen,
Do you feel better? lol...that's quite a rant, luckily you have a gift for this gab, whereas many yahoos on social networking sites are still dragging their knuckles, let alone able to understand the value of your media research, and how lucky your followers were to be able to take the journey with you. And hey -- you won, soooo...you really get the last laugh.

I naively joined Facebook, thinking it would be a good professional networking site, but very quickly found out that the object of Facebook is to get the most "Friends". Not so with Linked In, and to keep it from turning in to "Facebook", I try to keep my contact list small and important. Although there are several contacts that I don't actually have personal contact with, they are (like you), at the top of their field. I, admittedly, am a life-long scholar, and as such want to surround myself with those who can inspire me and teach me. I thank you for offering this to so many. But when something becomes detrimental to my primary focus, it is time to re-examine my tactics.

One of the drawbacks to blogging, and submitting comments on blogs, is that people often feel bolder in expressing how they feel when they do not have to confront you face to face, and when they are "anonymous", while you have maintained full disclosure. They also tend to digress and rant on, when a concise and reasoned debate would be more effective. I try to avoid this by first writing my blog or comment in Word…and on that note, I respectfully close!

Tuesday, July 7, 2009

Crystal Ball Required to Earn ARRA Medicare EHR Incentives

Who Will Benefit from ARRA Medicare Incentives?


In 2011, Medicare and Medicaid incentive payments will start flowing to hospitals, clinics, and physicians. In addition, the American Recovery and Reinvestment Act (ARRA) appropriates $2 billion in funds intended to begin implementing healthcare IT, before the incentives take place, and clear requirements of “Meaningful Use” for the receipt of these payments has yet to be definitively identified, although drafts have been identified as probable definitions. (See link to CSC Update of Meaningful Use below).

This expensive endeavor by private physicians may turn out to be a risky and premature proposition, as long as the details of the promised massive health care reform are also undefined. It is also premature in that an IT infrastructure is being built prior to defining the grand new American healthcare design. Physicians are being asked to implement an expensive and complicated system with a large learning curve prior to knowing what type of health care system will eventually be in place.

According to CSC Update of Meaningful Use, physicians or groups implementing an EHR program solely for the Medicare Incentives may be making an expensive mistake, and the ROI of system implementation should be closely examined. In addition, the “meaningful use” requirements become more stringent every year, requiring vendors to guarantee that their system will meet all of the requirements for incentives (Health Data Management, April, 2009). The table of incentive payments is listed below, with nearly half of the payments available in years 1 and 2 (2011 and 2012), leaving little incentive for small practice physicians to make such a large investment in time and money.

Another concern is that simply implementing technology will not reverse the current healthcare crisis, or provide healthcare for the millions of uninsured/underinsured. A new healthcare system is imminent, and as some of the best minds in the country study foreign healthcare models, alternative business models, and even government models, we know very little of what health care in America will look like 5 to 10 years from now. Undoubtedly, it is time to implement healthcare technology into the system, and bring U.S. healthcare into the 21st century, reduce medical errors, and lower healthcare costs with IT.

Estimates of the time it will take to recoup the costs of implementing EHRs vary from 5 to 10 years, perhaps less for those who have already begun, and more for those who have not. Analysts also believe that it will be the small practice and rural physicians who will have the most difficulty implementing EHRs. During this same time period, discourses on various health plans, including a national plan, loom over the current free-market health care system. Implementation of EHRs before a healthcare reform plan has been created may be a waste of physicians resources that will never be recouped. Yet with so much change yet to come into the healthcare arena, planning the future of a small private practice may require a crystal ball.

MEDICARE/MEDICAID EHR INCENTIVE AMOUNTS
Year
Amount
Note
1
$18,000.00
15,000 if after 2012
2
12,000.00

3
8,000.00

4
4,000.00

5
2,000.00

Friday, July 3, 2009

OREGON CANNABIS TAX ACT

Oregon Cannabis Tax Act by Tee Oliver,

Oregon’s House of Representatives voted Monday night to legalize the cultivation of hemp, becoming the sixth state to do so just this year.Oregon’s Senate voted 27 to 2 in favor of the new law last week.

Monday’s 46 to 11 House vote means that the measure will become law, barring an unlikely veto by Governor Ted Kulongoski. The move is part of a rapidly growing nationwide trend to liberalize laws relating to marijuana.

Hemp is a botanical cousin of marijuana, traditionally used to make clothing, rope and other durable fiber goods.“Hemp is a versatile, environmentally-friendly crop that has not been grown in the U.S. for over fifty years because of a misguided and politicized interpretation of the nation’s drug laws by the Drug Enforcement Administration,” Vote Hemp President Eric Steenstra said in a statement.“While a new bill in Congress, HR 1866, is a welcome step, the hemp industry is hopeful that President Obama’s administration will recognize hemp’s myriad benefits to farmers, businesses and the environment.”

According to Vote Hemp, this year Maine, Montana, New Mexico, North Dakota and Vermont and ”all passed resolutions or memorials urging Congress to allow states to regulate hemp farming.”California is at the forefront of the marijuana debate, with a movement growing to decriminalize marijuana for personal use in the state by 2010.But in Oregon’s debate, politicians were careful to distinguish between hemp and weed, and to highlight the fact that the new law would allow farmers to cultivate hemp, not grow marijuana.Some members of Oregon’s legislature displayed t-shirts reading “Senate Bill 676 is about rope, not dope.”

c 2009 Tee Oliver

Oregon is 6th State to legalize Hemp cultivation!

Oregon Cannabis Tax Act by Tee Oliver,

Oregon’s House of Representatives voted Monday night to legalize the cultivation of hemp, becoming the sixth state to do so just this year.Oregon’s Senate voted 27 to 2 in favor of the new law last week.

Monday’s 46 to 11 House vote means that the measure will become law, barring an unlikely veto by Governor Ted Kulongoski. The move is part of a rapidly growing nationwide trend to liberalize laws relating to marijuana.

Hemp is a botanical cousin of marijuana, traditionally used to make clothing, rope and other durable fiber goods.“Hemp is a versatile, environmentally-friendly crop that has not been grown in the U.S. for over fifty years because of a misguided and politicized interpretation of the nation’s drug laws by the Drug Enforcement Administration,” Vote Hemp President Eric Steenstra said in a statement.“While a new bill in Congress, HR 1866, is a welcome step, the hemp industry is hopeful that President Obama’s administration will recognize hemp’s myriad benefits to farmers, businesses and the environment.”

According to Vote Hemp, this year Maine, Montana, New Mexico, North Dakota and Vermont and ”all passed resolutions or memorials urging Congress to allow states to regulate hemp farming.”California is at the forefront of the marijuana debate, with a movement growing to decriminalize marijuana for personal use in the state by 2010.But in Oregon’s debate, politicians were careful to distinguish between hemp and weed, and to highlight the fact that the new law would allow farmers to cultivate hemp, not grow marijuana.Some members of Oregon’s legislature displayed t-shirts reading “Senate Bill 676 is about rope, not dope.”

c 2009 Tee Oliver

2009-07-01 Green Party responds to Bill Maher's call for

2009-07-01 Green Party responds to Bill Maher's call for "an actual progressive party": We're here already!

GREEN PARTY OF THE UNITED STATEShttp://www.gp.orgFor Immediate Release:Wednesday, July 1, 2009Contacts:Scott McLarty, Media Coordinator, 202-518-5624, cell 202-904-7614, mclarty@greens.orgStarlene Rankin, Media Coordinator, 916-995-3805, starlene@gp.orgA Real Party for 'Real Time': Greens send an open letter to MaherWASHINGTON, DC -- The Green Party has sent an open letter to Bill Maher after a June 19 broadcast of 'Real Time' in which Mr. Maher said "[W]hat we need is an actual progressive party to represent the millions of Americans who aren't being served by the Democrats. Because, bottom line, Democrats are the new Republicans."The Green Party's reply to Mr. Maher: "Hey, Bill, we're over here! What you described is the GREEN PARTY! We already exist!"The progressive party sought by Bill Maher describes the Green Party: "Shouldn't there be one party that unambiguously supports cutting the military budget, a party that is straight up in favor of gun control, gay marriage, higher taxes on the rich, universal health care -- legalizing pot -- and steep, direct taxing of polluters?"The open letter urges Mr. Maher to acknowledge the Green Party and have a Green candidate or leader on the show. The text of the letter is appended below.The Green Party is currently preparing for its annual national meeting, to take place in Durham, North Carolina, from July 23 to July 26 (http://www.gp.org/2009-ANM http://ncgreenparty.org/2009-ANM.html). Reporters are invited to cover the meeting (http://www.gp.org/forms/media)."America's First Party" An Open Letter to Bill Maher from the Green PartyDear Mr. Maher,We were thrilled to hear you talk about us when you discussed the need for a new party -- a "first party" -- during the June 19 broadcast of 'Real Time.'The only part you left out were the words "Green Party."Here's what you said:"We don't need a third party. We need a first party. You go to the polls and your choices are the guy who voted for the first Wall Street bailout, or the guy who voted for the next ten.""Shouldn't there be one party that unambiguously supports cutting the military budget, a party that is straight up in favor of gun control, gay marriage, higher taxes on the rich, universal health care -- legalizing pot -- and steep, direct taxing of polluters? These aren't radical ideas. A majority of Americans are either already for them or would be if they were properly argued and defended.""[W]hat we need is an actual progressive party to represent the millions of Americans who aren't being served by the Democrats. Because, bottom line, Democrats are the new Republicans."Hey, Bill, we're over here! What you described is the GREEN PARTY! We already exist!Maybe you forgot about us because the major media have an aversion to mentioning the Green Party and our candidates. Maybe the FCC has banned "Green Party" along with the late George Carlin's seven dirty words, "Chomsky," "End the Drug War," and other language that offends delicate sensibilities.For the major networks, and apparently PBS and NPR too, the very idea of more than two candidates in an election makes talking heads explode.If Green candidates started getting elected to higher office, the radical ideas that aren't really radical would get a fair hearing and a chance of passage.Imagine if a few Greens got seated in Congress. Greens don't take corporate contributions, so they'd be immune to the influence of Exxon-Mobil, Goldman Sachs, Bank of America, Raytheon, Monsanto, etc. When Rep. Nancy Pelosi sends out orders not to seek a probe of Bush-Cheney officials who authorized torture dungeons, Greens could tell her to take a hike.A few Green congressional victories would cause a seismic shock to the political landscape. Democrats would no longer have Republicans as their sole competition. The scope of national debate would no longer be Dems on the left, Repubs on the right, a phony middle ground between them, and a narrow range of political ideas comparable to the corner grocery limiting your choice of beverage to Coke or Pepsi.With some Greens in Congress:Democrats couldn't pretend to be the antiwar party while voting for more war funding.Single-payer national health care would be on the table and might even pass. President Obama and most Democrats already know single-payer is the best proposal. But they feel compelled to appease the health insurance, pharmaceutical, and other lobbies and find common ground with Republicans who believe the free market has sufficient mojo to cure every illness and injury.We'd hear the truth: that "emissions trading" is a license for corporate polluters to keep polluting, that "clean coal" is a plot to turn West Virginia into a crater, that the trillion-dollar Wall Street bailout and confiscation of savings and pension money are the greatest transfer of wealth from working people to big banks in history. There's a bipartisan consensus that corporate profit margins always take precedent over Americans facing financial ruin over a health emergency or credit card debt or a mortgage or a lost job. Whenever you hear the word "bipartisan" on the evening news, check the silverware.What are we going to do about this situation, Bill? If you really want a "first party" for America, will you throw us a bone on your show? Will you have a Green candidate or Green leader on once in a while? (Ralph Nader doesn't count -- he's not a member of the Green Party.)How about Rev. Billy Talen of the Church of Life After Shopping (http://www.revbilly.com)? Rev. Billy is now a Green candidate for Mayor of New York City (http://www.voterevbilly.org).Rosa Clemente, our 2008 vice-presidential candidate, said that the Green Party "is more than an alternative, it's an imperative." Based on your comments, Bill, it sounds like you might agree with Rosa.We look forward to hearing back from you. You can see what we're up to on our web site (http://www.gp.org).Sincerely,The Green Partyhttp://www.gp.orgMORE INFORMATIONGreen Party of the United States http://www.gp.org202-319-7191, 866-41GREENFax 202-319-7193Green candidate news http://www.gp.org/2008-elections/candidate-news.phpGreen candidate database http://www.gp.org/elections.shtmlGreen Party News Center http://www.gp.org/newscenter.shtmlGreen Party Speakers Bureau http://www.gp.org/speakersGreen Party ballot access page http://www.gp.org/2008-elections2009 Annual National Meeting of the Green Party, Durham, NC, July 23-26 http://www.gp.org/2009-ANMMedia credentialing page http://www.gp.org/forms/mediaGreen Pages, Vol. 13, No. 1The official publication of record of the Green Party of the United Stateshttp://gp.org/greenpages-blog~ END ~
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