Fresh NEWS in Florida SB 808 and HR735

I received the news from the Florida Medical Association:

The Florida Medical Association on the syringe exchange legislation proposed for the 2013 legislation session. The bills are HB 735 by Rep. Mark Pafford and SB 808 by Sen. Gwen Margolis. At this point, session officially begins next Tuesday. The House and Senate bills received their committees of reference last week. Unfortunately, both received 4 committee assignments each which isn’t a great sign but not totally unsuspected either. The main hurdle at this point is getting the bills heard in their first committees of reference.

Email Gwen Margolis margolis.gwen.web@flsenate.gov
and  Mark Pafford http://flhouse.gov/Sections/Representatives/emailrepresentative.aspx?MemberId=4435&SessionId=64

Thanks them let them know that substance use treatment requires quality assurance like expected of all other medical services.


My response:

I have a grave concern, which I would like to see how it can be incoporated in the bill. That is need for quality assurance. It is unfortunately but substantial number of professionals in social science has been ignoring both ethics and appropriate medical protocol and best practice. Often taking upon them to create policies and practices that is inconsistent with the best interest of their clients or patients, mostly for their own convenience.

As you may know by now, that has been a great concern of late Dave Purchase who just passed away, and numerous professionals associated with the harm reduction practice. We are all very concern to assure scientifically based practices which has been ignored by the Substance Use Disorder treatment community. This professionals seem to think that they do not need to follow the same scientific standards expect of all other medical fields. You might have received from NASEN documents associated with science and best practice. If you do not have them, I can provide them to you as they have given me the courtesy of sending me copies.

As you might know, syringe exchange will only but one service. This could be the opening to health system to a disfranchised population that we have been everything but ignoring, discriminate, stigmatized and even acted with bigotry. I assert that this manner of acting toward these individuals is consistent with racism.  Perhaps this is the reason that we are not making much head way with appropriate treatment of this population.

I am concern for patient’s safety and rights, and to tell you the truth neither the State of Florida Depatment of Children and Family who are suppose to license the facilities nor the treatment  facilities seem to be joyfully oblivious to the needs of this type of patients. Their professional behavior is more consistent with self-preservation and convenience than patient’s needs.

What we call substance abuse residential "treatment" today is only so by long term declaration, and is not supported by quantitative empirical research. As far as I Know it is neither effective and I suspect (without any data) that it causes relapse and possibly other bad habit. I like to avoid stating patients safety and syringe exchange program by people who have political and funding sources but not the require appropriate medical skills to provide quality assurance work. Unfortunately, having an education and a license is not guaranteeing it.

I also have copies of a draft of a bill that is being worked in North Carolina. As far as I can tell me and
have been the only two underground clean syringe programs in South Florida and doing our best at providing safe syringe and information.

I will look for the bills and see what suggestion or respond further.

In Memoriam: Dave Purchase, Needle Exchange Pioneer

From Stop theWar.org  http://stopthedrugwar.org/

http://stopthedrugwar.org/chronicle/2013/feb/21/memoriam_dave_purchase_needle_ex

Needle exchange pioneer Dave Purchase died last month in Tacoma, Washington, where he had long resided and where he began handing out sterile syringes to prevent the spread of AIDS among intravenous drug users back in the summer of 1998. Purchase died on January 21 of complications from pneumonia. He was 73.

Dave Purchase

Purchase is widely cited as having started the first needle exchange in the country, although that is difficult to verify.


While the most dominant treatment use in the United States is a violation of the 1st Amendment of

the constitution as 7 court cases concluded that the 12 Steps of Narcotics Anonymous is substantially religious. Fact is that there is no scientific support for the 12 Step programs that are so forcefully pushed on patients with an extremely low rate of "recovery".

Comparably, syringe exchange program makes a point of evidence based on science, and Dave Purchase have created protocols and best practice documentation to run these programs. Unfortunately some of this Syringe Exchange programs are not all together scientifically base and make their policies and regulations and treatment protocols basically on capriccios speculations. Harm Reduction have put their nose to the grind where science is concern. They will make mistakes, but will take correction when needed. That is one of the signs of good science, another is bending themselves backwards proving themselves wrong.

'Good Samaritan' Laws Could Help Overdose Victims—If Only People Knew They Existed

'Good Samaritan' Laws Could Help Overdose Victims—If Only People Knew They Existed

http://www.theatlantic.com/national/archive/2012/10/good-samaritan-laws-could-help-overdose-victims-if-only-people-knew-they-existed/263850/


I Have yet to see one newspaper or a Television or radio station mentioning this new law where they exist. People are being informed by word of mouth and people are still hessitent. We really need to get the media on the ball to save some lives.

In New York and other states, drug users are supposed to be granted immunity when they call 911 to save their friends' lives. But the police and the public have yet to get the message.

Number of Deadly Drug Overdoses Rises for 11th Year

This article comes from Joint Together a web based newletter.

 

Number of Deadly Drug Overdoses Rises for 11th Year

http://www.drugfree.org/join-together/prescription-drugs/number-of-deadly-drug-overdoses-rises-for-11th-year?utm_expid=37310244-0   This article comes from Joint Together a web based newletter.

The number of deadly drug overdoses in the United States increased for the 11th consecutive year, according to new government data. More than 22,000 people died of overdoses involving

Treatment for Opiate Dependent individuals

You can get a copy of this TIP43 by calling 1-877-726-4727

http://www.ncbi.nlm.nih.gov/books/NBK64164/


The State Methadone Treatment Guidelines


Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs



Treatment Improvement Protocol (TIP) Series, No. 43

Center for Substance Abuse Treatment.
Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2005.
Report No.: (SMA) 05-4048

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Order print copy from SAMHSA



This TIP, Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs, incorporates the many changes in medication-assisted treatment for opioid addiction (MAT) that have occurred over the most active decade of change since the inception of this treatment modality approximately 40 years ago. The TIP describes the nature and dimensions of opioid use disorders and their treatment in the United States, including basic principles of MAT and historical and regulatory developments. It presents consensus panel recommendations and evidence-based best practices for treatment of opioid addiction in opioid treatment programs (OTPs). It also examines related medical, psychiatric, sociological, and substance use disorders and their treatment as part of a comprehensive maintenance treatment program. The TIP includes a discussion of the ethical considerations that arise in most OTPs, and it provides a useful summary of areas for emphasis in successfully administering MAT in OTPs.

Emergency Room because of Buprenorphine

This article comes from an email I received from

I have not yet, evaluated this article using my critical thinking skills I learned by reading Critical Thinking About Research: Psychology and Related Professions, written by Dr. Julian Meltzoff  I highly recommended to advocates, patients and professionals who wants to improve their skills as consumers of research documents in psychology and related professions (i.e. social worker, counseling, psychiatric nurse, etc). 
This is not a book on research design or high level statistics. I consider it a book of concepts 
and ways of evaluating scientific documents.  I am alarmed by the little number of professionals that actually understand Evidence Based Treatment (which really means Scientific Researched modalities for validity and reliability.  Clinicians in mental health know next to nothing about science.  They sound like they do by throuhing around some statistics and using buzzwords and impressive language. But in close examination, I have come to realized they are actually in full of rubbish (to put it mildly).  Another book that open my eyes on this Evidence Based Treatment movement, which I see may clinicians holding it or taking it as if it was another fad. Which is actually how they now practice. Clinicians are currently practicing by fads and agreement not by evidence. The other book is "Whores of the Courts: Fraud of Psychiatric Testimony and the Rape of American Justice by Dr. Margaret A. Hagen. both books are not fad, but the a growing number of scientifically based well researched, cited and documented record of the practice of a health system going nuts. Ignoring not only the science they claim to practice but the critical Code of Ethics necessary for the welfare of their patients.
 
Clinicians are actually joyfully oblivious to the harm they are producing to substance use and mental health patients. Unfortunately it is not an exception, but a rule, the conditions are prevalent not only a few examples.

Please help me think about this article, and make some comments on what you read.

Emergency Departments Report Jump in Visits Linked to Buprenorphine

Emergency departments reported a significant rise in the number of visits related to the opioid addiction medication buprenorphine between 2005 and 2010, according to a new government report.

Emergency