Random Life Things

Highlights From The President’s Commission on Combating Drug Addiction and the Opioid Crisis

Not everyone has time to read through a 138 page document produced by The President’s Commission on Combating Drug Addiction and the Opioid Crisis, but fortunately/unfortunately, I do.  The Commission gave 56 recommendations for what to do to help with the crisis, but the President just can’t seem to get a grip on any of them.  Instead of listening to his own Commission, he has decided to focus on enforcing opioid laws instead of providing opioid treatment.  Here’s a rundown of what the commission had to say.

Roster of Commissioners

Governor Chris Christie, Chairman
Governor Charlie Baker
Governor Roy Cooper
Congressman Patrick J. Kennedy
Professor Bertha Madras, Ph.D.
Florida Attorney General Pam Bondi

Introductory Letter

“Our people are dying.  More than 175 lives lost every day.  If a terrorist organization was killing 175 Americans a day on American soil, what would we do to stop them?  We would do anything and everything.  We must do the same to stop the dying caused from within.”

“Without comprehensive action, including your national public health emergency, the death count will continue to rise.”

“It is time we all say what we know is true: addiction is a disease.  However, we do not treat addiction in this country like we treat other diseases.  Neither government nor the private sector has committed the support necessary for research, prevention, and treatment like we do for other diseases.”

“The recommendations herein, and the interim recommendations submitted by the Commission in July, are designed to address this national priority.  These recommendations will help doctors, addiction treatment providers, parents, schools, patients, faith-based leaders, law enforcement, insurers, the medical industry, and researchers fight opioid abuse and misuse by reducing federal barriers and increasing support to effective programs and innovation.”

“We recommended that all law enforcement officers across the country be equipped with life saving naloxone.”

“We recommended full enforcement of the Mental Health Parity and Addiction Equity Act to ensure that health plans cannot provide less favorable benefits for mental health and substance use diagnoses than physical health ailments.”

“Today, only 10.6% of youth and adults who need treatment for a substance use disorder receive that treatment.  This is unacceptable.  Too many people who could be helped are falling through the cracks and losing their lives as a result.”

“One of the most important recommendations…is getting federal funding support more quickly and effectively to state governments, who are on the front lines of fighting this addiction battle every day.  Bureaucracy, departmental silos, and red tape must not be accepted as the norm when dealing with funding to combat this epidemic.  Saving time and resources, in this instance, will literally save lives.”

“Accordingly, we are urging Congress and the Administration to block grant federal funding for opioid-related and SUD-related activities to the states. . This was a request to the Commission by nearly every Governor, regardless of party, across the country.

“The Commission also identifies the need to focus on, deploy, and assess evidence-based programs that can be funded through these proposed block grants.”

“From its review of the federal budget aimed at addressing the opioid epidemic, the Commission identified a disturbing trend in federal health care reimbursement policies that incentivizes the wide-spread prescribing of opioids and limits access to other non-addictive treatments for pain, as well as addiction treatment and medication-assisted treatment.”

“The Department of Labor must be given the real authority to regulate the health insurance industry.  The health insurers are not following the federal law requiring parity in the reimbursement for mental health and addiction.  They must be held responsible.”

“We are recommending that a drug court be established in every one of the 93 federal district courts in America.  It is working in our states and can work in our federal system to help treat those who need it and lower the federal prison population.  For many people, being arrested and sent to a drug court is what saved their lives, allowed them to get treatment, and gave them a second chance.”

“Drug Courts are known to be significantly more effective than incarceration, but 44% of U.S. Counties do not have an adult drug court.”

“The Commission recommends enhanced penalties for trafficking of fentanyl and fentanyl analogues and calls for additional technologies and drug detections to expand efforts to intercept fentanyl before entering the country.”

“The time to wait is over.  The time for talk is passed. 175 deaths a day can no longer be tolerated.  We know that you will not stand by; we believe you will force action.”

What This Administration Has Already Done:

  • Announced the launch of a new policy to overcome a rule that prevents states from providing more access to care at treatment facilities with more than 16 beds.
  • Directed all federally employed prescribers to receive special training to fight this epidemic.
  • The DOJ has continued its efforts to stop the flow of illicit synthetic drugs into this country through the U.S. Postal Service
  • NIH DIrector Dr. Francis COllins has been partnering with pharmaceutical companies to develop non-addictive painkillers and new treatments for addiction and overdose.  THe Commission worked with Dr. Collins to convene a meeting with industry leadership to discuss innovative ways to combat the opioid crisis.

 

 

Random Life Things

Privilege

If you identify as white and you are reading this, chances are it’s going to make you a little uncomfortable.  But discomfort isn’t always a bad thing.  Discomfort can be a place where learning and enlightenment happen.  It has been for me in the past and continues to be for me in the present.  Anyways, today I want to talk about white privilege.

Yesterday, I posted a graphic on Facebook.  It said:

dear white people

It got a few likes, but what really stood out was the person I have known for over eighteen years commenting on it and claiming that white privilege isn’t real but that people are racist against this person all the time for being white.  I tried to be patient.  I tried to be kind.  I tried to explain that white privilege doesn’t make you a bad person or mean that you don’t have difficulties or that no one is prejudiced against you, it just means that you started your life (and live your life) with several advantages over people of color.

I tried to explain that reverse racism isn’t real because we, as white people, have not been oppressed on an institutional level for hundreds and hundreds of years.  We have not been enslaved in the millions because of our skin color.  We didn’t have to suffer through the indignities of Jim Crow.  We haven’t been lynched because of our skin color in the thousands (though some white people have been lynched for siding with and helping people of color).  We are statistically less likely to be incarcerated.  We have representation in all forms of media that look like us.  It’s easy to go into a store and find a barbie or doll that looks like us.  Most of our favorite tv shows and movies have main characters that look just like us.  The vast vast majority of “heroes” are white.  We get to learn about many many people of our own race in school.

Our parents don’t have to give us “the talk” about police safety because we are less likely to be shot and killed by police officers.  According to Vox, “An analysis of the available FBI data by Vox’s Dara Lind found that US police kill black people at disproportionate rates: Black people accounted for 31 percent of police killing victims in 2012, even though they made up just 13 percent of the US population. Although the data is incomplete because it’s based on voluntary reports from police agencies around the country, it highlights the vast disparities in how police use force.”

Someone may have biases or prejudices against you because you are white, but that is not racism.  (Please see video #2 if you are having a hard time with this concept).  I tried to put it in simple terms that could be easily understood, but this person continued to argue with me, at which point I ran out of spoons and had to end the conversation.  I just didn’t have the energy to continue at that time.  I unfriended the person for a variety of reasons, but one of them is that we aren’t that close to begin with and I really have no desire to be friends with someone who won’t even entertain the idea that white privilege exists even though it has been explained and pointed out to them.  I wish that I hadn’t unfriended them.  I wish I had said, “this is emotionally exhausting work for me and I need to take a break and come back to it.”  But that isn’t what I did and, as a result, I had an even harder than usual time falling asleep last night, wondering if I had just been able to come up with the right sentence, if maybe I could have changed this person’s mind.

I know it’s possible, because I, too, once didn’t believe in white privilege and was very defensive the first time someone tried to explain it to me.  I know it’s hard to believe now, but I was actually in the College Republicans my freshman year at WCU and used to call Feminists “Feminazis.”  I’m not proud of the person I was, but I’m proud of the person that my college professors (Dr. Pete and Dr. Herzog), graduate school friends (Monica, Hanna, Jen, and Shyra), and graduate school professors (Lisen, Russ, Heather, Phyllis, Melody, and Valerie) helped shape me to be.  I care about others, I’m empathetic, and I understand that my ability to even type this up on a computer and post it to the internet with my name on it reeks of privilege.  I could tell you of so so many instances where white privilege has benefited me, but I find myself again running out of spoons.  Perhaps I’ll revisit this post later.  Just in case I don’t, please do me a favor and watch these three videos:

 

Adventure

River the Wonderdale

I realized recently that I’ve talked a lot about service dogs, service dog etiquette, and River being a service dog in general but that I’ve never actually acknowledged what specific tasks she does for me, which people may (or may not) be curious about.  Though I have Bipolar I, River’s tasks are all related to my Generalized Anxiety Disorder and Panic Attacks.

But first, a little background.  According to the ADA,  “a service animal means any dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual, or other mental disability.   Tasks performed can include, among other things, pulling a wheelchair, retrieving dropped items, alerting a person to a sound, reminding a person to take medication, or pressing an elevator button.”  Providing comfort is not considered a task under the ADA.

“Emotional support animals, comfort animals, and therapy dogs are not service animals under Title II and Title III of the ADA. Other species of animals, whether wild or domestic, trained or untrained, are not considered service animals either. The work or tasks performed by a service animal must be directly related to the individual’s disability. It does not matter if a person has a note from a doctor that states that the person has a disability and needs to have the animal for emotional support. A doctor’s letter does not turn an animal into a service animal.”

In addition to being task trained, service dogs should also be completely potty trained, have a lot of public access practice hours logged, and have basic obedience down.  River is a full blown service dog (As opposed to a Service Dog in Training or SDiT), but she will always be in training as she will always continue to learn new things.  Although all online registries for service dogs are fraudulent and DO NOT make your dog a service dog, some states, including NC, have a voluntary registry.  Ours is through the Department of Vocational Rehabilitation and River has a special tag on her collar acknowledging her status as a trained service animal.  You may hang out with me a lot and never see her task or you may hang out with me a little and see her task a lot.  It really depends on how I am doing on a given day.  Here are some of the tasks River is currently trained to do:

DPT (Deep Pressure Therapy): When I am sitting or lying down and River senses me getting anxious OR when I say “Alert” to her, she climbs up and puts the front half of her body across my lap.  It’s like having a really heavy weighted blanket for anxiety and helps to calm me down.

Grounding: When I am standing up and River either senses me getting anxious or I give her the command “ground” she lays her body across my feet to provide grounding for anxiety.

Tactile Stimulation: When I become anxious or give the command “kisses”, River licks the tops of my feet or my hands (depending on what she can reach) to provide tactile stimulation and grounding.  When I have a panic attack, River will lick my face until it stops.

Blocking: When I am in a crowded area, River will lay down in front of, next to, or behind me to keep people from getting too close.  I am in the process of teaching her to lay down behind me every time I stop walking.

She has recently shown a few behaviors that I would like to shape into tasks, but she hasn’t been formally trained to do them yet.  For example, I’ve been struggling with depression for a few months now and this week there have been a few times when I did not want to get out of bed and she licked me until I finally got up.  She also got her leash off the ground and went to the front door and waited for me to take her out on a walk.  By themselves, these behaviors are not tasks, but they could be shaped to become tasks.

If you have questions, please feel free to comment or e-mail me at catherinecottamwrites@gmail.com .