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The Rosenthal Report - June 2016

Rosenthal Reports
Good News and Bad

Good news for kids comes from the Journal of Clinical Child & Adolescent Psychology, reporting research findings that show children with attention-deficit problems improve faster when they first receive behavioral treatment (i.e. talk therapy) rather than the current standard practice of starting with prescription stimulants such as Adderall or Ritalin (which more than four million children and adolescents now receive).  The bad news comes from Washington where $920 million of the $1.1 billion President Obama wants to fight the nation’s opioid addiction epidemic is earmarked specifically for medication-assisted treatment. Resorting to drugs (methadone, buprenorphine, LAAM, and naltrexone)—not as aids to treatment but more often as treatment itself and subsequent maintenance—means that we will create an ever-growing population of permanently addicted men and women.

 

More News Good and Bad

Here the good news comes from the DEA crediting tighter control of hydrocodone prescriptions for reducing the prescription rate for this highly addictive opioid painkiller by 26.3% and reducing the number of pills consumed by roughly one billion. The bad news however, is the simultaneous rise in overdose deaths reported in just about every one of the nation’s counties as former oxycodone addicts turned to heroin. Looking ahead, it is not unreasonable to expect the CDC’s “Start Low and Go Slow” guidelines, recommending nonopioid alternatives for chronic pain to be accompanied by similar boosts in heroin consumption and overdose deaths.

Keeping Pot at Arm’s Length—Not Quite

Marijuana may be legal in Colorado, but not within 1,000 feet of a school.  That’s the law. But it’s not the practice. Reporters for the Denver Post have found 25 marijuana shops operating well within the thousand-foot exclusion zone.

Heroin Injection Sites: Good Intentions Often Go Awry

What should thoughtful policy makers make of proposals to open legally sanctioned heroin injection sites in San Francisco, New York City, and Ithaca? While the sites can provide access to treatment, direct evidence of harm reduction is scant. Studies of legal injection sites in Vancouver, Sydney, and throughout Europe have found no significant reductions in HIV or hepatitis infection or the sharing of syringes. More significantly, the evaluations found no solid evidence of overdoses being averted. As Toronto, Ottawa, and Montreal, plan to follow Vancouver’s example with programs of their own, one journalist for the Toronto Star reported on the program in Oslo, Europe’s overdose capital with the continent’s highest overdose death rate. In Oslo, he writes, “the existence of safe injection sites has neither discouraged users to take it off the streets nor significantly persuaded users to avail themselves of rehabilitation.’  Ten years after the Oslo program began, the overall mortality rate is just where it was a decade ago. “Good intentions,” he writes, “can lead to bad consequences. One need look no further than the Slab, an area leading from the Oslo train station directly to the city’s main street. Emaciated addicts gather in the area every day, every night, slumping against the walls of derelict warehouses around the docks, openly injecting heroin, knowing police won't move in unless it becomes necessary to quell a significant public disturbance.”

1st June 2016
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