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ROSENTHAL REPORT - AUGUST 2020

Rosenthal Reports
SPECIAL REPORT: TELEHEALTH TRANSFORMS DRUG TREATMENT

The COVID-19 pandemic and subsequent lockdowns and social distancing have led to a radical shift in healthcare delivery in America—from personal visits between patients and medical professionals to virtual interactions. Drug treatment has also changed: Loosening strict federal regulations in response to the corona virus has already made it easier for patients to secure addiction-withdrawal medications and receive treatment remotely. With these new practices becoming more commonplace, we spoke with treatment providers across the country—at Phoenix House, Horizon Health, Odyssey House and Outreach—about the benefits and possible drawbacks.

There is more access to treatment “from anywhere”

Before COVID-19, telehealth was rarely utilized for drug treatment. But as social distancing and stay-at-home orders took effect, providers quickly adopted platforms to provide treatment via Zoom, FaceTime, webcams and smartphones. Providers say this has strengthened access to treatment, especially in rural areas of the country, and improved outcomes. Patients are generally satisfied with the care they receive via telemedicine, and especially appreciate the convenience that remote therapy provides—whether from home, a shelter or even a car. Most patients do not encounter major hurdles using the new technologies.  

The peer dynamic is diminished

Despite these encouraging developments, removing face-to-face contact and group interaction can be problematic. Isolation is a critical issue for those who suffer from addiction, and therefore interacting solely on Zoom or by texting poses challenges: Patients say they miss collaborating with other patients and seeing their providers in person. Peer-based counseling and the therapeutic alliance are critical elements of treatment best done in person—as are wellness checks and mental health assessments.

Telehealth offers advantages, but it is not a panacea

Addiction professionals agree that teleheatlh is here to stay—and the relaxed rules enacted during the pandemic should remain in place. As telemedicine becomes more widely available, patients will find it easier to get access to treatment—wherever they are—and adapt to the new ways of interacting with counselors and therapists. At the same time, providers say they are open to trying new approaches and further integrating viable technologies into treatment practices.

They caution, however, that telehealth should not be regarded as a substitute for in-person treatment, especially long-term residential care. Evidence gathered so far suggests telemedicine appears to work well for some segments of the population, but not for everyone. As such, the providers we spoke with foresee a flexible, hybrid model emerging that blends in-person with on-screen modes of treatment, depending on the patient and the severity of their addiction.

For telehealth to become a valuable component of treatment, we must ensure the following: all patients have access to appropriate treatment, providers are trained to incorporate these new tools, regulations are established to offer uniform, quality service, and financial reimbursement is on par with in-person visits. There are no easy solutions to the country’s drug crisis, but the advent of these new technologies is a promising new dimension.

31st July 2020
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2020 Rosenthal Center Cannabis Perceptions Poll

Other
6th July 2020
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Politicians must recognize Americans' changing perceptions of marijuana

Articles
6th July 2020
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ROSENTHAL REPORT - JULY 2020

Rosenthal Reports
Rosenthal Cannabis Study Highlights Changing American Attitudes Toward Marijuana

Amid growing concerns over the risk marijuana poses to public health, the 2020 Rosenthal Cannabis Study finds strong public support for slowing the rush to legalize marijuana and tightening controls on commercialization and sales—even as more and more Americans consume the drug. This issue of the Rosenthal Report provides an in-depth look at the results of our exclusive marijuana survey in the context of the COVID-19 pandemic and the movement for much-needed criminal justice reform.

An unexpected consequence of both the corona virus outbreak and Black Lives Matter protests has been the spotlight they have put on the nation’s evolving—and often contentious—marijuana policy. Cannabis consumption during the COVID-19 lockdown led to debate over whether retail sales of the drug should continue as an “essential service.” Meanwhile, many are using marijuana decriminalization/legalization as a way to promote racial justice in communities of color—which have suffered disproportionately high incarceration rates as a result of the war on drugs. And with increasing economic losses, many states are looking to plug budget deficits with tax revenue from marijuana sales.

Marijuana’s increasingly prominent role in American society, and therefore in shaping public policy, raises important questions concerning what Americans really think about cannabis—and in line with these shifting perceptions, how we should move forward as a nation with legalization and subsequent commercialization. Our Cannabis Study, conducted by Schoen Consulting, offers surprising insights into these attitudes—especially concerning the risks and dangers such legalization poses.

For example, more than half of the respondents in the Cannabis Study believe today’s more-powerful marijuana—including edibles, and other intensely concentrated forms of the drug with high levels of THC—are potentially harmful, especially to adolescents. Furthermore, 60 percent are certain or at least somewhat sure cannabis is addictive, and 6 in 10 are concerned about its effects on pregnant women. The study also found that nearly half of those surveyed favor pausing legalization until more research can determine the long-term effects of use.

These findings dovetail with a growing number of clinical studies that detail the downsides of marijuana use, and the consequences of legalization. These include the negative impact of the drug on adolescent cognitive abilities and fetal development, and the difficulties of withdrawal for those diagnosed with cannabis use disorder. In addition, a recent report by the University of Michigan found an increase in cannabis-related hospitalizations and emergency room visits since medical marijuana was legalized 14 years ago in the state—as well as a tripling of fatal car crashes in which the driver was under the influence of marijuana.

It was no surprise then that our survey found two-thirds of Americans support curbs on the commercialization of marijuana, and 78 percent want to see warning labels (similar to those on alcohol and tobacco) on pot products.

Respondents also favor local-level control, with more than 40 percent saying communities should have the right to opt out of allowing medical and recreational cannabis in their neighborhoods. And roughly 80 percent endorse mandating marijuana dispensaries be located at least 1,000 feet away from schools, parks and playgrounds.

Given these growing doubts and fears, the Rosenthal Center again urges policymakers to pause the legalization process in order to better assess both the risks and possible benefits of marijuana. And as legalization invariably moves ahead—in one form or another—we must make sure there are proper, fact-based rules in place to regulate the marijuana market and access to it.

Reforming the criminal justice system and helping cash-strapped states raise tax revenues in the post-pandemic period are worthy goals. But they should not come at the cost of safeguarding public health and well-being. The notion that marijuana legalization could be an antidote for a number of the nation’s most pressing problems is not only overly simplistic—it’s potentially harmful.

2nd July 2020
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- Dr. Mitch S. Rosenthal

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