Treating Substance Misuse in America: Scams, Shortfalls, and Solutions
Finance, Treating Substance Misuse in America: Scams, Shortfalls, and Solutions, October 24, 2019
Opioids
This national pandemic has been gaining strength for a long time, starting in rural America and expanding nationally. Any family can be victimized by this scourge. It is now magnified by the ability to get even stronger versions through the Internet from Chinese suppliers.
Recent information lays the blame for much of the opioid crisis on the manufacturer and its owners. I am sure we all hope that the bankruptcy judge assigned to the Purdue Pharmaceutical case can find a way to claw back the funds looted from the company prior to expected legal actions.
Bankruptcy Law
Bankruptcy should not be used to reward the guilty. Allow me to provide a scenario from comments to the Ways and Means Subcommittee on Oversight on how the tax code subsidizes hate crimes, held on September 19, 2019.
While the First Amendment precludes content regulation, that does not prevent the Southern Poverty Law Center from suing them into obscurity. The problem is that the same characters simply pop-up on YouTube (sometimes literally), overnight. One solution is to change bankruptcy law to make obligations follow successor companies. This would also be helpful in labor and tort cases (especially the extant case against Purdue Pharma).
Mandating Treatment
Treatment modalities need to be improved to fight this crisis. They should have been long ago. Access to both initial and continuing treatment is vital to both addition and mental health care, as addiction can often uncover pre-existing psychiatric conditions. Even for non-alcoholics, once addiction has been turned on by opioids, the patient can never drink safely again and even moderate or heavy drinking previously will have to end, along with any medicinal effect it had.
For initial treatment, the question is not just access for willing patients, but mandated treatment for the unwilling. The liberalization of commitment laws in the 1970s has likely gone too far. Our first clue was mental patients, especially veterans, living on the street. Even when forced into treatment, taking a sober breath in a few days, treatment plan or no, resulted in release and resumption of the previous lifestyle. This is not freedom or health.
State laws or one overarching federal standard must make it easier for families, police, doctors and social service agencies to begin mandatory treatment, with the outcome being assignment to medical care if required and housing beyond shelter space if not already possessed. While some will not need the latter, those who do, especially our nation’s seniors, disabled and veterans, should not be sent back to the cold.
Early addiction after-care with an HMO provided two sessions a week after partial hospitalization. Medicare and Medicaid should as well. If relapse is detected during this period, the addiction specialist should be empowered (and the patient funded) to go back into treatment, possibly in a more intense setting than originally. The therapist should be similarly empowered, even with patients with long-term sobriety.
Synergies Provided by Employee Ownership
Companies who hire their own doctors and pharmacists, whether as part of a cooperative purchase program or as an offset to a single-payer program (whether it is Single Payer Catastrophic or Medicare for All) have an advantage in providing treatment. Their health plans would be much less likely to prescribe their employees into drug misuse and could more effectively monitor abuse when it occurred. This purchasing and monitoring would also include franchise and 1099 employees brought into employee status. Community is the best solution to recovery. The community most important to most is work.
Attachment One - Tax Reform, Center for Fiscal Equity, September 13, 2019
Attachment Two
A. Employee-Ownership, March 7, 2019
B. Hearing on the 2016 Social Security Trustees Report
Opioids
This national pandemic has been gaining strength for a long time, starting in rural America and expanding nationally. Any family can be victimized by this scourge. It is now magnified by the ability to get even stronger versions through the Internet from Chinese suppliers.
Recent information lays the blame for much of the opioid crisis on the manufacturer and its owners. I am sure we all hope that the bankruptcy judge assigned to the Purdue Pharmaceutical case can find a way to claw back the funds looted from the company prior to expected legal actions.
Bankruptcy Law
Bankruptcy should not be used to reward the guilty. Allow me to provide a scenario from comments to the Ways and Means Subcommittee on Oversight on how the tax code subsidizes hate crimes, held on September 19, 2019.
While the First Amendment precludes content regulation, that does not prevent the Southern Poverty Law Center from suing them into obscurity. The problem is that the same characters simply pop-up on YouTube (sometimes literally), overnight. One solution is to change bankruptcy law to make obligations follow successor companies. This would also be helpful in labor and tort cases (especially the extant case against Purdue Pharma).
Mandating Treatment
Treatment modalities need to be improved to fight this crisis. They should have been long ago. Access to both initial and continuing treatment is vital to both addition and mental health care, as addiction can often uncover pre-existing psychiatric conditions. Even for non-alcoholics, once addiction has been turned on by opioids, the patient can never drink safely again and even moderate or heavy drinking previously will have to end, along with any medicinal effect it had.
For initial treatment, the question is not just access for willing patients, but mandated treatment for the unwilling. The liberalization of commitment laws in the 1970s has likely gone too far. Our first clue was mental patients, especially veterans, living on the street. Even when forced into treatment, taking a sober breath in a few days, treatment plan or no, resulted in release and resumption of the previous lifestyle. This is not freedom or health.
State laws or one overarching federal standard must make it easier for families, police, doctors and social service agencies to begin mandatory treatment, with the outcome being assignment to medical care if required and housing beyond shelter space if not already possessed. While some will not need the latter, those who do, especially our nation’s seniors, disabled and veterans, should not be sent back to the cold.
Early addiction after-care with an HMO provided two sessions a week after partial hospitalization. Medicare and Medicaid should as well. If relapse is detected during this period, the addiction specialist should be empowered (and the patient funded) to go back into treatment, possibly in a more intense setting than originally. The therapist should be similarly empowered, even with patients with long-term sobriety.
Synergies Provided by Employee Ownership
Companies who hire their own doctors and pharmacists, whether as part of a cooperative purchase program or as an offset to a single-payer program (whether it is Single Payer Catastrophic or Medicare for All) have an advantage in providing treatment. Their health plans would be much less likely to prescribe their employees into drug misuse and could more effectively monitor abuse when it occurred. This purchasing and monitoring would also include franchise and 1099 employees brought into employee status. Community is the best solution to recovery. The community most important to most is work.
Attachment One - Tax Reform, Center for Fiscal Equity, September 13, 2019
Attachment Two
A. Employee-Ownership, March 7, 2019
B. Hearing on the 2016 Social Security Trustees Report
posted by Michael Bindner at 9:00 AM
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