UCLA issues new report on Prop. 36

Dear Colleague,

I am copying below a very interesting and timely report on the effectiveness of California's Prop. 36, a ballot measure approved by California voters in 2000 that offers treatment instead of incarceration for nonviolent drug offenders. The report finds that the ballot initiative is being undermined by inadequate funding, participants dropping out of treatment, and increased arrests for drug and property crimes. The good new is that the initiative has saved taxpayers millions of dollars, several promising new programs have the potential to improve Proposition 36's results, and violent crime arrests have decreased more in California than nationally since the proposition's implementation.

Califonia's experience has much to teach us as we plan for the changes in NY State that will result from Rockefeller reform. We don't want to repeat their mistakes s w anticipate a much greater referral to treatment of arrested non-violent drug users. We will need a well-funded system that has the re-training to handle this somewhat new population. Without the knee-jerk reaction to send patients who continue to use substances in treatment back to prison, we will need a system that has a greater appreciation of the complex challenges these patients bring and face and the sophistication and time often required to help many problem users begin to make positive change in their use of substances.

This system must be committed to sophisticated psychological, substance use and medical evaluation and treatment that considers substance use in the context of the whole person in their context. Effective treatment is attractive and relevant to patients (or else why should they stay in treatment?) It is highly individualized and has as essential ingredients motivational enhancement, offering patients goal choice, understanding that continued use, slips and relapses are part of the change process and not evidence of failure and that people must begin the treatment process with treatment that truely starts where they are to maximize therapeutic alliance and retention in treatment. It is too long that the system has held patients accountable for "treatment failure" and not sufficiently looked at how limitations of funding, sophistication and creativity set up patients and clinicians to fail seeming to justify incarceration.

I welcome any feedback and discussion around these critically important issues.

Andrew Tatarsky, PhD

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Public release date: 14-Oct-2008
Contact: Mark Wheeler
mwheeler@mednet.ucla.edu
310-794-2265
University of California - Los Angeles

UCLA issues new report on Prop. 36

Treatment alternative for drug offenders has had mixed success

The effectiveness of Proposition 36, a ballot measure approved by California voters in 2000 that offers treatment instead of incarceration for nonviolent drug offenders is being undermined by inadequate funding, participants dropping out of treatment, and increased arrests for drug and property crimes.

The good news, however, is that the initiative has saved taxpayers millions of dollars, several promising new programs have the potential to improve Proposition 36's results, and violent crime arrests have decreased more in California than nationally since the proposition's implementation.

These are some of the key findings from UCLA's latest report on Proposition 36, also known as the Substance Abuse and Crime Prevention Act (SACPA) of 2000. The measure, which went into effect in July 2001, allows nonviolent adult drug offenders to receive substance-abuse treatment with supervision as an alternative to incarceration or supervision without treatment. The law also calls for an independent evaluation of the program, which is being conducted by UCLA's Integrated Substance Abuse Programs at the Semel Institute for Neuroscience and Human Behavior.

According to the report, under Proposition 36, more than 30,000 drug offenders enter treatment each year and about half of them are being treated for the first time. Most receive outpatient care, which is less expensive than residential treatment but is also less effective for heavy drug users. Although the number of available residential treatment beds has increased since the measure's enactment, the increases have not been able to meet the rising need. Stakeholders interviewed in focus groups indicated that this was due to limited funding and infrastructure.

The report also found that drug and property crime arrests were higher among Proposition 36 participants than among a comparison group of pre-Proposition 36 drug offenders, the latter having spent more days in custody and fewer days "on the street" during which they could get arrested. However, despite early concerns by critics of SACPA that the law would result in an increase in violent crime, the rate of violent crime dropped more in California (12 percent between 2001 and 2005) than nationally (9 percent over the same period).

While the Proposition 36 group was more likely to be rearrested, the measure has been a much less expensive alternative to jail or prison time. By reducing incarceration, Proposition 36 has helped save taxpayers about $2 for every $1 invested in the program. To improve Proposition 36's implementation, the report calls for greater use of narcotics-treatment programs, employment assistance and residential treatment, as well as graduated sanctions, ranging from more drug-test requirements to short jail stays, for those participants who fail to comply with the program's provisions.

Better integration of substance-abuse and mental health services for the mentally ill homeless population and more restrictive management for offenders with many prior convictions are also recommended in the report. While additional funding would likely be needed to implement some of these recommendations — and the use of jail sanctions would require a change in the law, since Proposition 36 forbids it — other recommendations could be implemented now and at low cost.

One such low-cost recommendation was demonstrated in a recent pilot project. Currently, about 15 percent of those convicted in California who agree to Proposition 36's provisions never show up to be assessed. But according to a Los Angeles County study, treatment programs that adopted a set of "process improvement" practices borrowed from the business world showed a dramatic 80 percent reduction in the number of assessment no-shows.

"It is particularly exciting to find a tool like this in the current environment of budget cuts," said Darren Urada, the principal investigator on UCLA's Proposition 36 evaluations. "Funding for Proposition 36 has been insufficient and shrinking over the years, and this has eroded stakeholders' ability to adequately treat and monitor offenders. Furthermore, the unpredictability in funding from year to year has undermined long-term planning efforts."

Proposition 36 funding was cut further last month when Gov. Arnold Schwarzenegger vetoed 10 percent of the program's funding in response to the state's fiscal problems. Funding for the voter-mandated evaluation of the measure, which includes research on ways toimprove the program, has also been suspended.

UCLA's evaluation reports may be of particular interest to voters this year, given that a closely related measure, Proposition 5 (the Nonviolent Offender Rehabilitation Act), will be on November's ballot. If passed, this proposition would integrate Proposition 36 into a tiered system of treatment and supervision for nonviolent drug offenders. According to the official summary provided by California's attorney general, the new initiative would allocate $460 million annually to improve and expand treatment programs for those convicted of drug and other offenses; limit court authority to incarcerate offenders who commit certain drug crimes, break drug-treatment rules or violate parole; substantially shorten parole for certain drug offenses; divide California Department of Corrections and Rehabilitation authority between two state secretaries; and create a 19-member board to direct parole and rehabilitation policy.

###

UCLA's reports on Proposition 36 are available at www.uclaisap.org/prop36/html/reports.html.

The UCLA Integrated Substance Abuse Program, part of the Semel Institute for Neuroscience and Human Behavior, is an interdisciplinary research and education institute that serves to advance the knowledge base on drug problems and to improve the delivery of drug-abuse treatment services through an array of projects. The Semel Institute is devoted to the understanding of complex human behavior, including the genetic, biological, behavioral and sociocultural underpinnings of normal behavior, and the causes and consequences of neuropsychiatric disorders.

Press Release: Open Letter to President-Elect Obama Regarding the Selection of the Administrator of Substance Abuse and Mental Health Services Adminis

Dear Colleagues:

The letter regarding the importance of professional leadership of SAMHSA is now off to Presdent Obama. You can still sign on if you haven't and view the list of signatories at www.andrewtatarsky.com/samhsaletter/.

Please disseminate the press release that is copied below and attached to any press you think may be interested in covering this story.

Thank you for your continuing support of this very important issue.

Andrew Tatarsky, PhD
www.andrewtatarsky.com
212-633-8157

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For Immediate Release:
March 23, 2009

Contact: Andrew Tatarsky, PhD (212) 633-8157

Dozens of prominent substance use and mental health treatment and research professionals urge President Obama to break with recent administrations and appoint a professional with expertise in the science of substance use, mental health and public health to direct the Substance Abuse and Mental Health Services Administration (SAMHSA). They urge the President to appoint a leader to SAMSHA who supports evidence-based and theoretically sound treatments and will make decisions based on science rather than ideology and politics.

To fix SAMHSA’s chronic dysfunction, strong scientific and professional credentials are seen as key to insure that the agency’s $3.3 billion budget is best spent to effectively address the treatment and prevention of mental illness and addiction. The past two decades have seen dramatic scientific advances in understanding mental illness and addiction which have led to the development of effective treatments and prevention programs. Unfortunately, these treatments are not reaching the vast majority of the public who need them. It is noted that the United States spends about $120 billion on behavioral health care but a government review of SAMHSA, the agency responsible for overseeing this area of healthcare, rated the agency’s programs as largely ineffective and that much more could be accomplished with this money. Only 1 out of every 4 of these dollars is spent on evidence-based care with the rest going toward treatments and programs of questionable value. Many politicians including Congressman and Senators who sit on relevant oversight committees have never heard of SAMSHA, despite the fact that SAMSHA is on the same organizational level in the Public Health Service as CDC and FDA.

One major reason for SAMSHA’s obscurity and dysfunction has been the failure to appoint a person with significant scientific and professional expertise to lead the agency. Past administrators have been drawn from the ranks of state government with experience in community action, but without recognized high level scientific mental health, addiction, and public health expertise. These professionals say that it is essential to have the highest caliber professional leading the agency in the fight to improve the lives of all those who struggle with mental health problems and the consequences of substance abuse and to assure that government money works for the benefit of all Americans. They call on the Obama transition team to appoint a professional with a national reputation of excellence as a scientist and innovator in implementing science-based and theoretically sound mental health, addiction and public health programs in communities.

To view the letter and view the list of signatories, go to: www.andrewtatarsky.com/samhsaletter/

For further information or to arrange interviews with Andrew Tatarsky, the organizer of this campaign, or any of the other signatories call 212-633-8157 or email atatarsky@aol.com.

Dare to Act - New Website from the Hungarian Civil Liberties Union

Dear All,

As many of you know, on March 11-12 a High Level Segment of the Commission on Narcotic Drugs will review the implementation of targets adopted by the UNGASS in 1998. HCLU launched a new campaign to raise awareness on the unintended consequences of the international drug control system and mobilize people to ask for change.

Please have a look at our brand new campaign site and make sure you send this link to as many people as possible: http://daretoact.net/

We also launched a new YouTube group profile where people can upload their own messages to the governmental delegates - this intro video explains why and how:



Best wishes,

Peter Sarosi
Drug Policy Program Director
Hungarian Civil Liberties Union
Tel.: +36 1 279 2236
www.drugreporter.net

Upcoming Trainings on Integrative Harm Reduction Psychotherapy for Problem Substance Use

Dear Colleague:

I copy below information about two training opportunites coming up in the near future on Integrative Harm Reduction Psychotherapy. Next Thursday, March 26th, I will be giving a free introductory talk on my work at the Washington Square Institute down in the Village. The following Friday afternoon, April 3rd, I will be offering a three hour workshop at the et Ellis Institute on 65th Street in which we will have more time to explore the theory and techniqe of my approach with an emphasis on how you can integrate it into your therapy practice. I would welcome case material and clinical challenges that you have come up against to bring to the discussion.

I hope to see you!

Best,
Andrew Tatarsky, PhD

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Free introductory talk on Integrative Harm Reduction Psychotherapy (IRP)

Thursday March 26, 2009 @8:30-10pm
Scientific Meeting

Washington Square Institute
41-51 East 11th Street
New York, NY 10003
212-477-2600

Free to Public

RSVP: registrar@wsi.org , 212-477-2600

Effective Psychotherapy for Drug and Alcohol Users: Theory and Technique of Integrative Harm Reduction Psychotherapy

The treatment of patients with drug and alcohol problems has been dominated by an anti-psychological disease model which promotes the view that such patients cannot benefit from psychodynamic psychotherapy and instead require authoritarian treatment. Experienced and well-intentioned psychotherapists have been influenced by this view and avoid treating this population of 35 million in the USA.

I will introduce Integrative Harm Reduction Psychotherapy (IHRP) as an alternative approach to effective treatment of substance using patients. IHRD is based on a multifaceted view of problem substance use as reflecting the interplay of biology, personal and interpersonal dynamics and social context. IHRD integrates a relational psychoanalytic approach with active skills building to support positive changes in substance use and related issues.

I will discuss clinical challenges and limitations of traditional treatment and the clinical rationale for harm reduction as an alternative paradigm for helping substance users. I will define the harm reduction model, give a little history and discuss its application to psychotherapy. I will discuss the theoretical basis for IHRP including a biopsychosocial process view of addiction, the multiple meanings of substance use as points of engagement and the stages of motivational change model and will explore how to use these ideas to create a collaborative, negotiated therapeutic alliance. Fina lly, I will present an overview of IHRD’s 7 therapeutic tasks with emphasis on therapeutic process and technique.

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Integrating Harm Reduction Psychotherap y Into Your Practice

HALF-DAY WORKSHOP emphasizing theory and technique at The Albert Ellis Institute

Friday, April 3, 2009, 1:30-4:30pm

The Albert Ellis Institute
45 East 65th Street
New York, NY
(212) 535-0822

The Workshop will:

Explore the main tenets of the clinical philosophy of Integrative Harm Reduction Psychotherapy

Identify the three main theoretical bases of this approach: a biopsychosocial process model of problem substance use, the multiple meanings model and the stages of motivational change

Discuss the three domains of IHRP: the therapeutic alliance sets the stage for the therapeutic process, active skills building for assessment, goal-setting and working toward positive change and exploration of the multiple personal and social meanings of substance use

Describe the seven key therapeutic tasks, including managing the therapeutic alliance, therapeutic relationship as healing agent, facilitating capacities for change, assessment as treatment, embracing ambivalence, goal setting, and working toward positive change

TUITION

Regular Registration: $50.00

F/T grad students (with proof of status) $40.00

Call to register: (212) 535-0822

Bio:

Dr. Andrew Tatarsky has specialized in the field of substance use treatment for almost 30 years as psychotherapist, supervisor, program director, trainer and author. He holds a doctorate in clinical psychology from the City University of New York and is a candidate in20New York University’s Post-doctoral program. He is Co-Director of Harm Reduction Psychotherapy and Training Associates; founding board member, Division on Addictions of NYSPA, Chairman of the board of Moderation Management and founding board member, Association for Harm Reduction Therapy. His book, Harm Reduction Psychotherapy: A New Treatment for Drug and Alcohol Problems, now in paperback, has been published in the United States and Poland. Dr. Tatarsky is in private practice in New York City and trains nationally and internationally.

Obama's Odd Drug Control Plan: Appoint Qualified People

20.03.2009
The New Republic
Harold Pollack

Harold Pollack is a public health policy researcher at the University of Chicago's School of Social Service Administration, where he is faculty chair of the Center for Health Administration Studies. He is a regular contributor to The Treatment.

I'm not a fan of the Office of National Drug Control Policy (ONDCP), the "Drug Czar's" office. I wish the office would moderate its near-exclusive focus on illicit drugs to pay greater attention to alcohol, tobacco, and prescription drugs. Of course ONDCP should place greater emphasis on treatment, harm reduction interventions for street users, and measures to reduce the large-scale incarceration of so many drug users and drug sellers.

Ironically, these ideological matters mask a larger problem: ONDCP has done a bad job at what it is trying to do. The office's self-marginalization under Bush-43's John Walters exemplified the dysfunction, but the problem is deeper than any one person or administration.

Some excellent people have worked at ONDCP and have done some good. (I will do them the courtesy of not naming them, given the broadside I am now delivering.) By and large, however, ONDCP has been an obvious hindrance in efforts to form and communicate effective policies, even in areas that fit the office's narrow policy agenda.

If a congressional aide or a reporter needed a sensible take on (say) the effectiveness of Mexican drug interdiction or the operational challenges of retaining street drug users in treatment, ONDCP would not make the first round of calls--unless, that is, one were seeking the predictable red meat from an extreme use-reduction perspective. It is almost impossible to imagine an academic making that call.

There is something fundamentally amiss here. This is not (wholly) a question of partisan politics, though the capture of ONDCP by cultural conservatives is an aggravating factor. Maybe things would have turned out differently had William Bennett enjoyed less success in making needle exchange and other matters a profitable front in the culture wars. We'll never know. Somehow, drug policy brings out the worst in American politics.

I may be sensitive because I spend much of my day researching health policy. However much I disagree with conservatives such as Gail Wilensky and Douglas Holz-Eakin, I cannot doubt their expertise and their good faith. Yeah, there are plenty of health policy hacks out there, but the serious players on all sides are generally expected to be conversant with a large and growing body of evidence and to make some minimum of sense.

For years, Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, has been America's de facto AIDS Czar. Last year, he spent a day on our university campus fielding questions from students and faculty about AIDS research and care. He spoke with evident mastery about virtually every major challenge ranging from the molecular biology of proposed vaccines to the prevention challenges of "treatment complacency" to the politics of needle exchange and Ryan White CARE Act funding, to the cultural, political, and implementation challenges facing PEPFAR in different countries. The contrast over time in expertise, sustained commitment, high-level access, and sheer civility between him and his ONDCP counterparts is damning.

Things are looking up, though. The new Drug Czar, Gil Kerlikowski combines the credibility of a big-city police chief with a solid reputation for pragmatic and decent law enforcement practices. More important are those being brought in to back him up, particularly on clinical and scientific matters beyond the Chief's personal experience.

Sources report that Tom McClellan will be Kerlikowski's deputy director, and second-in-command. McLellan's appointment is part of a weird pattern of hires made by the Obama administration: Appoint people who actually know what they are talking about rather than ideologues or the President's smiling and funny roommate from boarding school.

Moreover, Kerlikowski and his superiors might actually listen to him. McClellan isn't the first drug policy expert to hold that post. William Bennett had at-hand an authentic treatment authority, Columbia's Herb Kleber. As Mark Kleiman tartly notes, Bennett was content to trade on Kleber's reputation without allowing Kleber's expertise to interfere with his culture-warring.
You probably have never heard of McLellan. He doesn't blog or banter on the Daily Show. He is a household name within the worlds of substance abuse treatment and drug policy. He's spent the last few decades tending the vineyard of evidence-based treatment practices. A prolific researcher, he edits the flagship Journal of Substance Abuse Treatment. He directs the University of Pennsylvania's Treatment Research Institute. He was a major development of the Addiction Severity Index, the standard assessment tool for entering treatment clients. He worked with Vietnam veterans returning home facing complex challenges alongside their substance use. Sadly, this work is especially timely.

He was also lead author of one of the most widely-cited articles ever published on substance abuse, which argued that drug dependence is a chronic medical disorder which should be insured, treated, and evaluated in similar fashion to asthma, type-2 diabetes, and hypertension. In its understated way, this remains an important, humane, and pragmatic statement of the challenges facing clinical practice and public policy in this difficult area.

Kerlikowski and McLellan have their work cut out for them. They will operate in a DC environment that breeds bad drug policies and that fails to provide needed resources for programs of proven value. The recent stimulus debate was sadly typical: Substance abuse treatment received kind words in the final legislation. Yet these services received almost no money to offset cutbacks imposed by state governments.

As the presumed point-man on matters of demand reduction, Dr. McLellan faces a particularly daunting challenge. He must challenge politicians to provide greater treatment resources. He must challenge the treatment community itself to provide better, more-accessible, more effective and evidence-based services. So often, treatment falls far short of what we can do. Most Americans with drug or alcohol disorders will never access formal treatment. We need to find better ways to serve them in other ways. Prevention programs raise similarly serious concerns.

Perhaps most important, McLellan and his boss must nurture ONDCP as a serious and capable organization, creating an environment in which good people not only visit, but stay to do good work. A depressing number of Drug Czars and staff quickly move on to greener pastures.
These are hard problems, and one shouldn't expect too much. At least the President has assigned good people to the task.

--Harold Pollack

Click here for article source

Rethinking Drinking

This website and booklet from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) provides evidence-based information and interactive tools about risky drinking patterns, signs of an alcohol problem, and ways to help people cut back or quit drinking.

Click here to visit Rethinking Drinking

Publication Year: 2009

Publisher:
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
5635 Fishers Lane, MSC 9304
Bethesda, md 20892
Phone: 301-443-3885
Website: http://www.niaaa.nih.gov/

Do You Drink Too Much? How to Know When You're a Booze Hound - 'Rethinking Drinking' Uses Interactive Tools to Warn Users of Their Alcohol Habits

ABC News
By EMILY FRIEDMAN
March 11, 2009

Whether you're a college student prone to binge-drinking or a professional who regularly drinks a glass of wine with dinner, specialists are encouraging drinkers of all kinds to pause and consider whether their imbibing could be a precursor to alcoholism.

The National Institute of Alcohol Abuse and Alcoholism launched a new Web site dubbed "Rethinking Drinking" to help Americans gauge whether their boozing could lead to trouble.

"The goal of the site is to provide information to people and to help them identify if they're drinking too much," said Dr. Mark Willenbring, the director of treatment and recovery research at the NIAAA, which is part of the National Institute of Health.

Using fact sheets and interactive tools, such as a drink calculator and a survey that tells users how their drinking habits compare with their peers, Willenbring hopes the site will alert drinkers to the risks of over-indulging.

In any given year, about 30 percent of U.S. adults ages 18 and up will drink an excess of the maximum recommended daily alcohol limits, but only 4 percent of those are considered to be alcoholics, according to Willenbring.

Women should have no more than three standard drinks in a day or seven in a week, and a man should have no more than four in one day or 14 in a week, according to the site.

For those who exceed these limits, Willenbring said that one in four already suffers from alcoholism or alcohol abuse and the remainder are at an increased risk for these and other problems.

CLICK HERE TO SEE HOW YOUR DRINKING HABITS MAY BE AFFECTING YOUR HEALTH

"Most people don't know when they're drinking at a risk level," he said. "When most people think of someone who has a drinking problem, they think of an individual whose life is falling apart, but that only really occurs with the most severe alcoholics."

"The idea is to identify the problems at an earlier stage and change them before they develop more severe problems," said Willenbring.

Click here to continue reading article at ABC News.com

Letter to President Obama regarding the Importance of Appointing a Nationally Recognized Professional with a Strong Science Background to be the Admi

Dear Colleague:

I am copying below a letter from leading substance use and mental health professionals to President Obama calling on him to appoint a director of SAMHSA who is a respected professional with a scientific background in mental health, substance use disorders and public health. The letter discussed the agency's dysfunction in previous years under leadership lacking in this expertise.

If you support our point of view, please distribute the letter to your colleagues, listserves, blogs,contacts in the media and government and others with an interest in this critically important appointment. I am getting the letter to President Obama through several channels. Let's get the message to President Obama in as many ways as we can.

It is time for real change in how our government ensures high quality, evidence-based and theoretically sound treatment for all Americans struggling with substance use and mental health issues. Please support this effort!

Best,

Andrew Tatarsky, PhD


Letter to President Obama regarding the Importance of Appointing a Nationally Recognized Professional with a Strong Science Background to be the Administrator of Substance Abuse and Mental Health Services Administration (SAMHSA)

March 9, 2009

Dear President Obama

Virtually every family in America is affected by mental illness or addiction. The cost in personal suffering and economic loss is staggering. Part of the tragedy of mental illness and addiction is that these disorders typically strike in late adolescence and early adulthood, between 18-25 years of age. By contrast, most major medical illnesses occur much later in life. The World Health Organization found that mental illness and addiction were the leading causes of disability among Americans ages 18-45, confirming that these diseases rob young Americans of their most productive years.

The last two decades have witnessed dramatic scientific advances in understanding mental illness and addiction which have led to the development of effective treatments and prevention programs. Unfortunately, unlike standard protocols for advances in other areas of medicine, these treatments are not reaching the vast majority of the public who need them. For example, the United States spends about $120 billion annually on behavioral health care [1]. Yet, less than 25% of this care is evidence-based, with 75% of questionable value. The result of the mediocre quality of behavioral health care is that many Americans are suffering needlessly and some are dying because they are not receiving treatment has been shown to work.

What can be done to solve this problem? Most advocacy groups call for increased spending. While lack of resources is part of the problem, increasing funding alone will not solve the problem. Currently, Americans are not receiving adequate value for the $120 billion that are spent annually and much more could be accomplished using existing resources. This is the main conclusion of a landmark report on the state of behavioral healthcare issued by the Institute of Medicine of the National Academy of Science in 2006.

The federal government’s response to this situation has been woefully inadequate. The federal agency responsible for overseeing the quality of behavioral health care and prevention is the Substance Abuse and Mental Health Services Administration (SAMSHA). SAMSHA has a $3.3 billion budget. An OMB review of this agency rated the agency’s programs as largely ineffective; an assessment shared by most mental health and addiction experts. Many politicians including Congressman and Senators who sit on relevant oversight committees have never heard of SAMSHA, despite the fact that SAMSHA is on the same organizational level in the Public Health Service as CDC and FDA.

One major reason for SAMSHA’s obscurity and dysfunction has been the failure to appoint a person with significant scientific and professional expertise to the lead the agency. Past administrators have been drawn from the ranks of state government with experience in community action, but without recognized high level scientific mental health, addiction, and public health expertise. By contrast, the recent heads of FDA and CDC have been nationally prominent scientists with accompanying expertise and stature to effectively lead their agencies.

President Obama, you have a unique opportunity to improve the treatment and prevention of mental illness and addiction by breaking with the past tradition of placing a political appointee with regulatory and administrative experience as the Administrator of SAMSHA. Instead, your transition team should seek a professional with a national reputation of excellence as a scientist and innovator in implementing science-based mental health and addiction programs and public health models in communities. This move would be consistent with your approach to attracting the highest caliber professionals into government, has the potential to improve the lives of many Americans, and would elicit uniform praise from advocates, the scientific community, and the press.

[1] Behavioral health care means addiction and mental health services combined.

Respectfully,

Andrew Tatarsky, PhD, Founding board member and past president, Division on Addiction, New York State Psychological Association, New York, NY; Co-director, H
arm Reduction Psychotherapy and Training Associates

John H. Halpern, M.D., Assistant Professor of Psychiatry, Harvard Medical School, Director of the Laboratory for Integrative Psychiatry, Division of Alcohol and Drug Abuse, Associate Director of Substance Abuse Research, Biological Psychiatry Laboratory, Alcohol and Drug Abuse Research Center, McLean Hospital, Belmont, MA

Mark B. Sobell, Ph.D., ABPP, Professor, Center for Psychological Studies, Nova Southeastern University, Fort Lauderdale, Florida

Jon Morgenstern, Ph.D., Professor & Director, Substance Abuse Services, Department of Psychiatry, Columbia University Medical Center, New York , NY

Reid K. Hester, Ph.D., Director, Research Division, Behavior Therapy Associates, LLP
Albuquerque, NM

Linda C. Sobell, Ph.D., ABPP, Professor, Center for Psychological Studies, Nova Southeastern University, Fort Lauderdale, Florida

William R. Miller, Ph.D., Emeritus Distinguished Professor of Psychology and Psychiatry, The University of New Mexico, Albuquerque, NM

Richard Juman, PsyD, Representative to Council, Division on Addictions , New York State Psychological Association, New York, NY

Ernest Drucker PhD, Professor, Montefiore Medical Center, Albert Einstein College of Medicine and Columbia University Mailman School of Public Health, New York , NY

Debra Rothschild, PhD, CASAC, Past President, Division on Addictions, New York State Psychological Association, New York, NY

Tom Horvath, Ph.D., ABPP, Practical
Recovery, La Jolla, CA

Joe Ruggiero, Ph.D., Assistant Clinical Director, Addiction Institute of New York, Director,Crystal Clear Project, New York, NY

G. Alan Marlatt, Ph.D. , Professor and Director, Addictive Behaviors Research Center University of Washington, Dept. of Psychology, Seattle, WA

George H Northrup, PhD, President, New York State Psychological Association, New York, NY

Scott Kellogg, PhD, Department of Psychology, Faculty of Arts and Sciences, New York University, New York, NY

John Rotrosen, MD, Professor, Department of Psychiatry, NYU School of Medicine, New York, NY

Nicholas Lessa, Chief Executive Officer, Inter-Care, LTD, New York, NY

Randy Seewald, MD, Beth Israel Medical Center MMTP, Medical Director, Beth Israel Medical Center, New York, NY

Alexandra Woods, PhD, Psychologist/psychoanalyst in private practice, Board of Directors, Division on Addictions, New York State Psychological Association

Karen Frieder, PhD, Executive board member, Addiction Division, New York State Psychological Association, Private Practice, New York, NY

Ana Kosok, Ed. D., Executive Director, Moderation Management Network, New York

Julie Barnes, PhD, CASAC, private practice, Executive board member, Addiction Division, New York State Psychological Association

Genata Carol, PhD, Director of Mental Health Services, AIDS Service Center of Lower Manhattan New York, NY

Patt Denning, PhD, Director of Clinical Services and Training, Harm
Reduction Therapy Center, San Francisco, CA

Jeannie Little, CSW, Executive Director, Harm Reduction Therapy Center, San Francisco, CA

Laura Kogel, LCSW, The Women's Therapy Centre Institute, New York, NY.

Bryan Fallon, PhD, Clinical supervisor in mental health for Prison Health Services. New York, NY

IDPC press release - United Nations drug policy review: out of ideas and out of touch

For immediate release

United Nations drug policy review: out of ideas and out of touch

As political leaders from around the world gather this week in Vienna to review the last decade of international drug control, and set a framework for the next ten years with the signing of a Political Declaration, any hopes for progress or a new pragmatism in approaches to the world drug problem are fading fast.

The UN High-Level Meeting on the 11 and 12 March is a culmination of a two-year review of progress against the objectives and commitments made by the UN General Assembly in 1998. It is now clear that the key objective of a decade ago - ‘eradicating or significantly reducing…’ the scale of global markets for illegal drugs such as heroin, cocaine and cannabis has not been met. The market in illicit drugs has not been reduced and indeed, in many parts of the world, the market and the problems associated with it are spiralling out of control.

The Commission on Narcotic Drugs (CND), the UN body20responsible for drug policy, is
demonstrably out of touch…

…with reality:

• the UN’s own figures suggest there are over 200 million current users of illegal drugs (this tally is itself widely considered as an underestimate )
  
• the global drugs market produces annual profits of over $300 billion for increasingly powerful organised crime groups.
  
• democratically elected governments in countries as diverse as Afghanistan, Mexico and Guinea-Bissau struggle to maintain control of their own territories due to the impact of the drug trade and associated criminal activities.
  
• over 80% of the world’s population have no access to cheap and simply produced
  painkilling medications because of the controls placed on them by UN conventions on illicit drugs.

Despite these and many other irrefutable problems, the CND seems poised to agree a declaration that claims satisfying progress, and proposes no new strategies.

…with the rest of the UN system:

• successive reviews of the global evidence on HIV/AIDS prevention have concluded that harm reduction approaches are the best way to tackle epidemics related to injecting drug use.
  
• harm reduction approaches are accepted and promoted by the entire public health profession, all the multilateral bodies charged with fighting the global AIDS pandemic – UNAIDS, the World Health Organisation, the Global Fund to fight AIDS, Malaria and Tuberculosis – and all other UN agencies and Commissions.

Despite this evidence-based consensus, the CND, in a stubbornly isolationist move, has voted to exclude any mention of harm reduction from its declaration. The CND appears determined to deny the very existence of a set of practices that are successfully implemented in over 80 countries around the world.

Over 300 non-governmental organisations (NGOs), working across the spectrum of drug prevention, treatment and policy, have presented a consensus call for drug use to be addressed by20the UN as a public health and human rights issue, rather than a criminal justice one. Many senior UN figures - the heads of UNAIDS and the Global Fund, and the Special Rapporteurs on Torture and Health, have made similar calls in recent months. All have been ignored by the CND.

Fortunately, some governments have challenged this complacency, and are planning to register objections to some aspects of the Political Declaration this week.

The IDPC calls on all national delegations in Vienna to go further still, by refusing to endorse the declaration, and issuing a call for further efforts across the UN system to find a more effective response to the world drug problem.

Mike Trace, Chair of the International Drug Policy Consortium and former deputy UK drugs tsar, said today:

"This high level review should have been an opportunity for the international community to balance, modernise and humanise the drug control system; we need to move away from the
‘war on drugs’ in order to focus on reducing the health risks and social harms associated with drug use and drug markets. "

“Unfortunately, the negotiations have produced a weak and incoherent Political Declaration
that calls for more of the same ineffective and often counterproductive strategies, ensuring
this opportunity for progress – this opportunity to save thousands of lives - will be lost. "

“The Commission on Narcotic Drugs has shown itself to be out of step with the rest of the UN
system, with professional and expert opinion, and with the reality experienced by millions of
ordinary citizens around the world.’’

ENDS

Notes to editors:

For further information or to arrange interviews with the Chair of the IDPC, or other spokespersons in our network, please contact Ruth Goldsmith, Communications Manager at DrugScope (IDPC member) at ruthg@drugscope.org.uk, or on 020 7520 7559 or 07801 845192.
The IDPC have developed a media pack in preparation for this week’s High Level Meeting, containing articles written by experts in drug policy, human rights and public health and exploring key issues around the failings of current international drug policy.

If you would like a copy, please email ruthg@drugscope.org.uk

About the IDPC
The International Drug Policy Consortium (IDPC) is a global network of 32 national and
international NGOs that specialise in issues related to illegal and legal drug use. IDPC promotes objective and open debate on the effectiveness, direction and content of drug policies at national and international level, and supports evidence-based policies that are effective in reducing drug-related harm. To find out more, visit http://www.idpc.info/

About the CND
To find out more about the 52nd session of the Commission on Narcotic Drugs, visit
http://www.unodc.org/unodc/en/commissions/CND/session/52.html

Letter from The Global Drug Policy Program, Open Society Institute

Dear all,

Negotiations over the Political Declaration to be adopted next week at the UN High Level Meeting in Vienna are coming to an end. We are saddened that a number of countries, including the United States, Russia, Japan, the Vatican, Italy, Sweden, Cuba and Colombia, have rejected all mention of harm reduction and human rights of drug users.

Taking into account the global HIV epidemic - increasingly fuelled by injecting drug use - this stance is extremely short-sighted and irresponsible. The last ten years of international drug policy have also led to an increase in the production of illicit drugs, high levels of incarceration, and countless human rights violations.

Should you wish to protest to your government, please contact your National AIDS Program, Drug Control Program and Ministry of Foreign Affairs.

With kind regards,

The Global Drug Policy program, Open Society Institute

International Drug Policy: Animated Report 2009

Produced by an Oscar-winning studio for the Global Drug Policy Program of the Open Society Institute, International Drug Policy: Animated Report 2009 highlights some of the disastrous effects of drug policy in recent years and proposes solutions for a way forward.

In the run-up to the March 2009 UN Commission on Narcotic Drugs meeting—where the future path of international drug policy will be determined—this film seeks to show that pursuing a "drug-free world" can lead to more harm than good.

Click here for video and information source at SOROS.org

Red Wine and Marijuana against Alzheimer's?

From DrWeil.com

Two new studies suggest that red wine and marijuana may help to prevent or slow Alzheimer’s disease and other age-related memory loss.

An article first published at miller-mccune.com on November 21, 2008, points out that at the November, 2008 meeting of the Society of Neuroscience in Washington, D.C., Ohio State University researchers reported that THC, the main psychoactive substance in the cannabis plant, may lower inflammation in the brain, and even stimulate formation of new brain cells.

And in the Nov. 21, 2008, issue of the Journal of Biological Chemistry, neurologist David Teplow of the University of California, Los Angeles reported that naturally occurring components of red wine called polyphenols can block the formation of proteins that build the toxic plaques thought to destroy brain cells. In addition, these substances can reduce the toxicity of existing plaques. Both actions can slow memory loss.

Neither of these findings surprises me. That marijuana has medical efficacy against a variety of conditions is firmly established scientifically, and the health benefits of moderate red wine consumption are also becoming clearer with each passing year. As of November, 2008, 15 states had laws with provisions for medical marijuana on the books, and I hope more states enact enlightened policies in this regard. In the meantime, if you enjoy an occasional glass of red wine, continue to do so as part of an overall healthy diet.