15Oct/14

Governor Christie sets aside .0037 of 1% of the State Budget for Prevention and Treatment in a BIG Announcement Today

Governor Christie announced that he is setting aside $12 million for prevention and treatment services in NJ. You can read about it here.

This is a good start. FAR more funding is needed, but again, he continues to say the right things and at least he has put some money up (before people get too excited, this is for 12 million dollars – the NJ State budget is 32.5 billion, so this is .00003692307 of our budget).

 

10Oct/14

Governor Christie’s Sound and Fury, Which Signifies Nothing

… a poor player that struts and frets his hour upon the stage And then is heard no more…

On September 17th, Senator Joe Vitale introduced 21 bills to combat the heroin and opiate painkiller epidemic and provide better prevention and treatment services. Governor Christie has not only failed to support those bills, he hasn’t even acknowledged their existence.

On September 30th, there was a celebration regarding the opening of the first recovery high school in NJ. Governor Christie was not there. Nor has he directed any state funding towards the school. That same day, the Governor held a summit at the New Hope Baptist Church in Newark about reducing the stigma associated with treatment and recovery from addiction. He said a lot of nice things, but didn’t talk at all about the new recovery high school opening up down the road nor offer up any substantive support on Vitale’s bills.

On October 7th, Governor Christie appeared at Robert Wood Johnson Hospital in New Brunswick to announce a partnership with neighboring states to share prescription drug monitoring program (PMP) information. This was a positive move, but it was also something that his Deputy Attorney General recommended in 2012. The Governor also continued to refuse to mandate NJ’s PMP, despite the fact that the GCADA’s Task Force report suggested it earlier this year (and also despite the fact that over 20% of other states have mandated PMP’s).

On October 9th, the Governor appeared in Trenton to announce the formation of yet another Task Force to fight drug addiction. He did not comment on any of Vitale’s 21 bills, the recovery high school or offer any funding for programs that he has claimed to support (drug courts, prisoner education, PMP’s).

And he won’t anytime in the future. He will now fall back on the fact that he has created a Task Force and that he needs to let them operate for awhile, hold hearings and gather information. They will need time to release a report, and he will say that this is a serious public concern that requires time, deliberation and careful consideration of the multifaceted issues and various stakeholders involved. He will delay legislation and the funding of any current or new programs. It’s all sound and fury, and it gets him a lot of positive press while he actually does very little to change things. The saddest and most frustrating aspect of this is that he already had a Task Force that did this, and we released a report too (you can read it here). Despite serving on the Governor’s Council, I have been highly critical of the Governor’s bluster on these issues. I understand that almost no one will win or lose an election based on how they handle drug policy. In Chapter 18 of The Prince, Machiavelli wrote:

Pope Alexander VI had no care or thought but how to deceive, and always found material to work on. No man ever had a more effective manner of asseverating, or made promises with more solemn protestations, or observed them less. And yet, because he understood this side of human nature, his frauds always succeeded.

It applies perfectly to Governor Christie, at least when it comes to his drug and alcohol policies. I’ve quoted Shakespeare a few times in this piece, and I’ll provide the full quote from Macbeth from whence I grabbed the title. Interestingly enough, it both describes and quotes Christie:

it is a tale told by an idiot, full of sound and fury, which signifies nothing

 

 

08Oct/14

What You Can Do To Help

We need YOU to help foster recovery.

Every week, at least a half dozen people approach me, email me or call me asking for advice about what they can do to help address drug and alcohol problems in their town, county, state or country. I’m always happy to answer those questions, but I decided that it was time for me to write out a list of options and directions for people to look at and work off of. Here are 12 suggestions:

(1) Every town that has over 10,000 people should have a prescription drug drop box (Usually they are at police stations. To learn more about them, click here. For help getting one put in your town or county, click here).

(2) We need advocates to tell their stories to politicians, government officials, school administrators, parent groups, students and a host of professionals. In NJ, there is an Advocacy Leadership Program that takes a new class every year. You don’t have to be a person in recovery to have a story worth telling – you can be the parent or spouse or child or friend of someone who found the joys of recovery or died from this public health problem.

(3) We don’t really need new organizations. Join an existing one. Many municipalities and most counties have anti-drug coalitions that engage in a lot of prevention work. This is a great point of entry into the field, an easy way to make a difference and a fantastic way to build your network if you want to eventually do more.

(4) Let’s say you have a lot of money and want to make your own organization. Talk to your lawyer and accountant. Then find some influential people in your county and state to talk to. They should be able to give you some good advice about existing programs. I strongly urge you to join an already established group. There are plenty of 501C3 organizations that have some good people working there but they need better organization skills, publicity and/or more funding.

(5) You still want to create your own organization. You better find a really great person with a lot of experience to run it. And you need to be prepared for the fact that you are probably going to lose money.

(6) There are a lot of great programs that need fundraising help. I can steer you towards them in NJ or wherever you live. Of course, one of my favorites is the Rutgers ADAP and Recovery House program. If you want to raise money or donate to them, I’ll be happy to put you in touch with the right people.

(7) If you have been clean and sober for two years and have decided that you want to work in this field, I suggest that you get an entry level job (part time or full time) at a halfway house or in-patient program. Work several months on nights and weekends. Interact with clients. Drive them to appointments and meetings. Sit in on groups and watch great and lousy counselors. Accept the fact that the hours are long and the pay is bad (and will be for a long time if you decide to continue this work). For those of you that don’t have an addiction disorder but want to do this work, you can still follow this advice step by step.

(8) Take a couple of professional courses (in NJ, they are called CADC courses; in NY they are CADAC courses). The Rutgers Center of Alcohol Studies offers courses year round on Thursdays and has a one week summer school. You will be exposed to new ideas and meet a number of other people like you (some of whom will be further along and can offer you their experience in this process).

(9) Middle school and high school curricula do a poor job at addressing the prescription drug problem. You can urge your local school board to bring in some programming (for students, for faculty and staff, and for parents) that educates people on these issues. This is an area where you can EASILY make a big impact.

(10) Contact your town council, county executive (or freeholder) and state legislator and let them know that you care about these issues. If you are wondering what issues are out there, keep reading my website (and look for extra articles that I link to on the Facebook version of my site) and read the health section of the New York Times each day.

(11) If you really want to engage in direct service work, you need to get your Bachelors and Masters degrees and then get a license. Consider getting a Masters in Social Work (the quickest way to a powerful license) or getting a Masters in Addiction Counseling from Hazelden. You will be a much better candidate for these programs, a better student and a better prospective employee if you followed my advice in point (7). Once you have a Masters level license, you can teach, train workers, take on interns, run programs and cast a much wider influence. It’s a long road, but worth it.

(12) If you need additional help or guidance, feel free to contact me.

 

28Sep/14

Understanding NJ’s 21 Heroin Treatment Bills

In March, the Governor’s Council on Alcoholism and Drug Abuse (GCADA) released its Task Force report on the Heroin epidemic. It charged the state to combat the problem by mandating the Prescription Drug Monitoring Program (PMP) along with over 20+ other suggestions. I have continually written about how the heroin epidemic is not new, that our lack in dealing with it in the past is rooted in racism and that Big Pharma should be held accountable. I have been publicly critical of Governor Christie and have urged him to approve legislation and fund a number of cost-effective programs. Now, a NJ leader has stepped up to the plate to truly address this issue. On September 17, Senator Joe Vitale led the way in proposing 21 bills to address the heroin and other opiate epidemic in NJ.

Stephen Sterling of the Star Ledger wrote an excellent summary of the bills the day they were released. With thanks to him, I am reprinting that summary here and have commented (in red) on each one below :

S-2366, sponsored by Senators Weinberg and Vitale, would ensure parents and patients are aware of the dangers of certain prescription drugs by requiring practitioners to inform them of their nature.
Good. This will explain the addictive nature of certain prescription drugs (not just opiates, but stimulants and benzodiazapines as well) and their numerous side effects. Consumers should be able to make better decisions when armed with proper information.

S-2367, sponsored by Senator Codey, would update New Jersey’s core curriculum on substance abuse to make sure that our students are receiving effective prevention education.

Fantastic. Students in middle school and high school need to get a comprehensive education on prescription drugs. The marijuana curriculum needs to be overhauled as well in the face of growing social acceptance. These programs should begin at age 10. If the state can’t pass this, then local school boards should address it.

S-2368, sponsored by Senator Rice, would increase state funding for substance abuse prevention efforts by $5 million.

This money is appreciated. That said, $5 million is a pittance in terms of a state budget.

S-1998/A-3129, sponsored by Senators Weinberg and Vitale/ Assemblymen Conaway and Lagana, Assemblywoman Angelini, Assemblyman Benson and Assemblywoman Sumter, would require all physicians to register for the state Prescription Monitoring Program, which helps identify individuals who are doctor shopping for opiates and would help identify rogue prescribers operating “pill mills.”

Exceptional. Like vaccines and the concept of herd immunity, the PMP is only effective if it is mandated. Over a dozen other states have some form of a mandated PMP. Our Task Force, under the guidance of the Attorney General’s office, suggested that masters-level and above mental health and addiction treatment providers have access to the PMP as well. This is one of the most important bills. It also has a low likelihood of being approved by the Governor. (My only concern with this version is that there may be language in it that doesn’t require all prescribers to access the PMP each time they are giving someone a prescription – to work, there has to be a mandate).

S-2029, sponsored by Senators Turner and Vitale, would enhance data collection and resource targeting by government agencies by allowing, with parental permission, for students to participate in voluntary surveys such as anonymous substance abuse surveys.

Fine.

S-2369/A-2859, sponsored by Senators Whelan and Kean/ Assemblymen Eustace and Benson and Assemblywoman Vainieri Huttle, would increase the number of places individuals can drop off unused prescription drugs by expanding “Project Medicine Drop” locations to every State Police barrack, every county sheriff’s office and in county and municipal police departments that chose to participate.

Good. This should be effective when combined with former Attorney General Eric Holder’s recent announcement that hospitals and pharmacies should take back drugs as well.

S-2370/A-709, sponsored by Senators Whelan and Kyrillos/ Assemblywoman Angelini, Assemblyman Benson and Assemblywoman Sumter, would increase public awareness of safe disposal of prescription drugs by requiring pharmacists and prescribers to notify patients of proper and safe disposal options.

Good. Easy to do. Not controversial.

S-2371, sponsored by Senator Barnes, would improve our understanding of overdose trends by requiring the state poison control to establish a clearinghouse of drug overdose information.

Good. Easy to do. Inexpensive. Not controversial.

S-2372/ A-1436, sponsored by Senators Madden and Oroho/ Assemblywomen Caride and Mosquera, would create a Statewide Opioid Law Enforcement Task Force to identify, investigate and prosecute illegal sources and distribution of opiate drugs and to provide training for law enforcement, physicians, pharmacists and other health care professionals to detect and divert drug abuses.

The State Attorney General’s Office and State Office of Criminal Investigations (SCI) have already been doing this. This is a fine idea as long as it isn’t redundant and/or doesn’t lead to fights between different parts of the government.

S-2373, sponsored by Senators Vitale and Addiego, would provide consumers with a better understanding of treatment options by requiring the Department of Mental Health and Addiction Services to annually compare and rank substance abuse providers.

It’s a good concept. I’m not sure how DMHAS would identify what is good or bad or how they would report it. We probably need an independent watchdog to do this.

S-2374, sponsored by Senators Vitale and Singer, would increase the rate that Medicaid providers are reimbursed for evidence-based behavioral health care to the going market-rate, which in turn will increase the number of practitioners willing to take Medicaid patients.

I have no idea where they will get the money for this.

S-2375, sponsored by Senator Vitale, would remove red tape that keeps ambulatory care facilities from providing behavioral health care services without multiple licenses.

I’m wary of this one. Those facilities need to be required to have a LCADC that can provide the necessary treatment; otherwise there will be a degradation of care.

S-324/A-2266, sponsored by Senator Gordon/ Assemblywoman Vainieri Huttle and Assemblyman Lagana, would create a Behavioral Health Insurance Claim Advocacy Program to provide assistance and advocacy in navigating insurance bureaucracy to those with behavioral health care conditions.

When the state government fights with insurance companies, the insurance companies usually win. I’m skeptical that a new bureaucracy could effectively do this.

S-2180/A-3450, sponsored by Senator Gordon/ Assemblywomen Vainieri Huttle and Pinkin, would ensure that those with behavioral health care conditions are eligible through their insurance to receive services prescribed by licensed physicians, physician assistances, psychologists, clinical social workers and certified advance practice nurses by prohibiting insurance companies to deny coverage through their own utilization management review.

This is the Holy Grail. The insurance companies need to be brought to heel. They have continually either provided a lower level of care than is required, shortened the length of suggested treatment or denied coverage all together. When insurance companies have to pay claims, some of them internally call it a medical loss. They are a business, and they make money by paying as little as possible for treatment. The Affordable Care Act and the Parity Laws have attempted to address this, but the insurance companies are still not following through in many cases. This will have to be fought out through litigation, and will probably end up in the Supreme Court.

S-2376, sponsored by Senators Vitale and Gordon, would help doctors coordinate with specialists through telecommunications rather than expensive face-to-face patient visits by creating a grant in the Department of Health to expand remote medical consolations.

I don’t know enough about this to offer up an opinion.

S-2377, sponsored by Senators Barnes and Vitale, would require New Jersey’s colleges and universities to provide substance abuse recovery housing options.

This is a nod to the amazing work that Rutgers has done with its ADAP and Recovery Housing programs. By requiring recovery housing, schools are also required to have at least one full-time licensed clinical alcohol and drug counselor (LCADC). Schools should have at least one for every 5,000 students. Community Colleges should also employ at least one LCADC.

S-2047, sponsored by Senators Kyrillos and Vitale, would ensure that the Department of Human Services have regulatory oversight of substance abuse treatment facilities;

Will they monitor halfway houses for people coming out of the criminal justice system too? Probably not. Governor Christie’s buddies make too much money on that. Recovery Houses are unregulated and need to be overseen by the state as well.

S-2378, sponsored by Senators Vitale and Singer, would extend the
Overdose Prevention Act to provide immunity to law enforcement professionals for delivery of an overdose antidote and would require all syringe access programs to carry and dispense the antidote to needle exchange participants.

Great idea. Easy.

S-2379, sponsored by Senators Vitale and Lesniak, would create a three-year pilot program to enroll pre-trial incarcerated individuals in Medicaid, providing more individuals with coverage and eligibility to enroll in court supervised substance abuse treatment programs.

This only works if they greatly increase the amount of money that Medicaid pays for treatment services.

S-2380, sponsored by Senators Vitale and Lesniak, would ensure that inmates are receiving treatment approved by the agency with the most appropriate expertise and experience by requiring joint regulatory authority over prison-based mental health and substance abuse programs between the Department of Corrections and the Division of Mental Health and Addiction Services.

Great idea. Treatment (and education) will reduce recidivism and save the state a large amount of money. Governor McGreevey has been one of the champions of this idea for several years.

S-2381, sponsored by Senators Vitale and Lesniak, would permit successful completion of certain drug treatment programs operating in state prisons and prohibition drug court programs for those who are using certain medication assisted treatment such as methadone.

Another good concept. I expect the Drug Courts will fight this. Using methadone to describe this is an error, for that drug has negative connotations. Buprenorphine and Vivitrol are more effective and less controversial. But the theme of the idea is a good one. 

 

 

25Sep/14

Xanax and Valium Linked to Alzheimers Disease

In the 60′s, we started hearing reports that tobacco use caused cancer. Big Tobacco denied this. Reports are now coming in that links benzodiazepines (Xanax, Valium, Mick Jagger’s “Mothers Little Helpers”) to Alzheimer’s Disease. Nothing is conclusive yet, but the correlation is alarming.

The reaction to it is startling to. The power of denial continually amazes me.

Here is a link in The New York Times to the study links anxiety drugs to alzheimers disease.

22Sep/14

Governor Christie Must Walk His Big Talk

When Governor Christie took office in 2010, it was the first time that NJ had a Republican Governor since Governor Whitman resigned in 2001 in order to head up the EPA under President Bush. Christie had been the US Attorney for NJ, so I was not expecting much out of him in the areas that I have the most expertise in: education, criminal justice, and mental health and addiction treatment.

Early on, there were promising signs. In 2011, Eric Arauz and I were named to the Governor’s Council on Drug Abuse and Alcoholism. We were told that Christie had once served on the Board of Directors for Daytop Mendham, an adolescent in-patient treatment facility in Morris County. Apparently a young man who had graduated from Daytop had moved Christie with his story of addiction to crack and how he attended college and then law school in recovery. In 2012, the GCADA put together a Task Force to investigate the heroin and opiate epidemic (after a lot of political nonsense and delay, our report was released in March of 2014).

In July, 2012, Governor Christie signed a bill into law that expanded the NJ Drug Courts. It costs $55,000 to incarcerate someone in NJ but only $12,000 to put them on drug court and give them treatment. Treatment is better than punishment, and even if you don’t agree with that statement, it comes in at about 22% the cost. Even though I disagreed with the Governor on a number of issues, I was thrilled that he had taken action on addiction treatment. It was helpful that he was a Republican and a former US Attorney; if a Democrat had pushed the Drug Court expansion she would have been viewed as a bleeding heart liberal and soft on crime. Christie could do it and not have to deal with much political or public backlash.

After a few months, I heard rumblings that even though Christie had signed the bill, he hadn’t provided actual funding for it. I was told that it was an old political trick: publicly supporting something and then not funding it. I was getting an interesting education in Trenton. I was discouraged, but I hoped that the Governor hadn’t just funded it yet, and that once he addressed the state’s budgetary issues he would pour money into prevention, treatment and recovery support services.

The first sign of real trouble appeared in the fall of 2012, when Christie vetoed the Good Samaritan Bill, which would have helped prevent a number of overdose deaths. He vetoed it despite the impassioned pleas of hundreds of parents of kids who had died from overdosing (in 70% of overdose deaths, the evidence at the scene shows that people were not alone when they died, but no one called for fear of getting into trouble). Policy makers and those parents were distraught and sought to create a groundswell at the local level. Websites were made, petitions signed and municipalities passed proclamations in support of the Good Samaritan Bill. Christie refused to budge. Then, Jon Bon Jovi’s daughter overdosed at Hamilton College in upstate New York. Because New York had already passed their Good Samaritan Law, Ms. Bon Jovi did not die. Advocates called on Jon Bon Jovi, who agreed to reach out to the Governor. On May 2, 2013, Governor Christie announced that he had “changed my mind” and signed the Overdose Prevention Act.

My father is an Eisenhower Republican and my mother has usually voted for Republicans. I tend to like moderate Republicans (Governor Tom Kean, President Nixon, President Ford, John McCain circa 2000), but they are a highly endangered species. I hadn’t voted for a major Republican candidate in well over a decade, but decided to cast my vote for Governor Christie in the fall of 2013. He talked a good talk about addiction. I was hoping that he would walk it.

This spring, he spoke before a group of doctors and urged them to use the state’s PMP. But he wouldn’t require doctors to use it, despite the fact that our Task Force report suggested it (at the behest of his Attorney General’s office) and that nine other states had mandatory PMP’s. A few days later, Christie met with a number of ex-offenders whose lives had been improved by going to college. Studies show that providing a college education reduces recidivism by more than 50% and therefore, makes a tremendous amount of economic sense. Christie said that it was a great idea but that he would not publicly fund it (I don’t hold this against him…it is extremely difficult for a politician to back this with public funds). The Governor had developed a new playbook that had him make appearances, talk about how he cared about the issue, that he was rooting for people and then he would leave without any promise of making any real change or providing funding.

Despite this, I was (for the most part) pleased with his stance on marijuana. I am very much opposed to outright legalization and I’m appalled at how Democratic officials are supporting legalization without a better understanding of the issues.

Last week, Senator Joe Vitale of Woodbridge introduced 21 new bills to tackle the heroin and opiate epidemic. Some highlights:

(1) mandate the PMP

(2) improve middle and high school curriculums to address prescription drug abuse

(3) insurance reform

(4) create treatment programs inside of NJ prisons

(5) improve oversight of treatment programs to ensure better service

(6) require all NJ colleges to have Recovery Housing programs

These are good ideas. Passing and funding them can go a long way to addressing the Heroin epidemic in NJ, as well as a improving substance abuse prevention and treatment. Governor Christie has deservedly earned a lot of praise for his stance on these issues. He talks a good talk and says all the right things. He connects with people and claims to care. But when it comes time to pass laws and fund programs, he comes up lacking. Over and over.

This is his moment. I hope he chooses wisely. Governor Christie: please walk your big talk.

 

 

 

22Sep/14

It’s Time To Shut Down Fraternities and Sororities

On Sunday morning at 3:19 am, Caitlyn Kovacs, a 19-year-old sophomore at Rutgers died after going to a “small gathering” at the Delta Kappa Epsilon (DKE) Fraternity House on College Avenue in New Brunswick. Nothing has been confirmed yet, but the speculation is that Ms. Kovacs died of alcohol poisoning. Over the next few weeks, we will see a renewed discussion about the dangers of college drinking and what can be done to address a problem that has gone on for centuries.

In 1997, The Harvard Crimson published a high-profile history of on-campus alcohol deaths. One of those incidents involved a Rutgers student in 1988:

James Callahan, an 18-year-old Rutgers University student, dies after consuming 24 ounces of hard liquor in less than an hour as part of a pledging ritual at the Lambda Chi Alpha fraternity, according to an April 26 article in The Record. A separate article reported on Aug. 28 that this incident prompted a five-year shutdown of his fraternity.

Ten years later, during my sophomore year at Rutgers, another Fraternity student died in an alcohol-fueled incident:

A Rutgers University junior who suffered serious head injuries when he fell down a flight of stairs at his Fraternity house after several hours of drinking at an off-campus bar was removed from life support early yesterday. Jason Greco, 20, a Riverton native and former captain of the Palmyra High School football team, was declared clinically dead Sunday morning at Robert Wood Johnson University Hospital in New Brunswick.

The article, which I’ve linked to on the young man’s name, has a number of familiar quotes and brings up some disturbing points:

As family and friends mourned Greco’s death yesterday, the accident brought attention once again to how tightly alcohol is woven into the fabric of college life. Despite alcohol prevention and education programs offered at Rutgers and other universities in the region, the level at which college students consume beer and liquor continues to concern administrators.

“We have long recognized that underage drinking and dangerous drinking has been an issue that colleges face,” said JoAnn M. Arnholt, dean of fraternity and sorority affairs at Rutgers. “I hope people learn a lesson from this, that no one is immune from an accident like this.”

Rutgers is requiring all fraternity houses to be substance-free by 2000. Rutgers administrators said Greco’s death had forced the school to continue to scrutinize whether its policies are allowing students to fall through the cracks, and whether its policies can prevent tragedies such as the death of Greco.

Three students died in alcohol and fraternity related deaths. Each time the student was mourned by friends and family and the college culture of drinking was cited as a difficult problem to address. College administrators expressed concern. Clearly, Rutgers failed in making fraternity houses substance-free by 2000. These stories read like Groundhog Day on deja vu steroids.

After Mr. Greco died at Rutgers in 1998, Rutgers told the Fraternities that they had to remove the bars from the Frat-House basements. The New York Times reported that:

One fraternity, Alpha Delta Epsilon, has challenged the university’s order, contending that it should be exempt. Its alumni president, Matthew R. Schutz, a lawyer from Flemington, N.J., believes the fraternity’s bar should be retained because the fraternity’s alumni have deemed it a memorial to members who have entered government service, or the fraternity should be compensated for its loss.

The Fraternities didn’t get it then, and they don’t get it 25 years later. Mr. Schultz’s claim was as farcical as it was short-sighted and irresponsible.

In 1989, The New York Times ran a story about how Rutgers had created a number of positive programs to address the drinking culture, including (1) the presence of the Center of Alcohol Studies, one of the premier research institutions in the world; (2) the Rutgers Recovery House, the first on-campus recovery house program in the world; and (3) outpatient counseling services available at the on-campus counseling center.

Despite the presence of these avant-garde programs, alcohol and drug problems keep erupting out of Fraternity and Sorority Houses at Rutgers. This also holds true around the country. Members of Greek Life argue that they request annual training on alcohol and drug problems, but former Rutgers Vice-President W. David Burns had this to say about that:

Mr. Burns added that education and awareness programs are sometimes requested disingenuously by student groups to make it appear that they are concerned with curbing their drinking habits.

Nationwide, the yearly statistics related to college drinking are staggering and harrowing:

- Approximately 1,800 student deaths
- 600,000 unintentional injuries
- 700,000 assaults (100,000 sexual assaults)
- Lower grade point average
- 31% met criteria for alcohol abuse or dependence
- $53 billion social cost for underage drinking
- 100,000 students report having been too intoxicated to know they consented to having sex

College drinking and curbing Fraternity life has been in the news this week, even before Ms. Kovacs died at the Rutgers Fraternity yesterday. On September 16, NPR ran a story about how Frostburg State University is trying to combat underage and binge drinking on campus.  FSU has extra police working on the weekends and they have paid for off-campus bar workers to learn how to better spot fake ID’s. They have also increased the number of Friday morning classes and have doubled the number of alcohol-free events offered on campus during traditional drinking hours.

Today, Wesleyan University announced that it was putting an end to all-male Fraternities. Disappointingly, they are only forcing them to admit women rather than completely shutting them down. This move was made of because of the high number of alcohol-related problem-incidents and the “rape parties” that the Fraternities have held on campus over the last few years.

Schools should offer more alcohol-free events and continue to work on changing the culture with PSA’s and social norms campaigns, like RU Sure. But there is a bigger step to be taken. Wesleyan is on to something, but they need to take the training wheels off of their plan.

Fraternities and Sororities, which make up Greek Life, contribute to a huge number of significant problems on campus without bringing much to the table. Before a Greek Life supporter cites the charity work that they do, I’d like to point out that Donald Sterling donated a lot of money to the NAACP and that Philip Morris donated money to teenage anti-smoking ads. Ray Rice will probably end up taking part in Domestic Violence Awareness messages. Whatever good that Greek Life adds to the school is disproportionately offset by the tremendous negativity, irresponsibility and flat out harm they inflict upon the rest of the student body.

The Greek Life hit list (please click on each link):

(1) They are bastions of sexual assault. Google search college fraternities and sexual assaults and see what comes up. Sexual predators in those Frats have weaponized alcohol and drugs.

(2) They hold racist parties. Partygoers are encouraged to dress up as Asians at Duke University, Mexicans at Randolph Macon, and black thugs at Arizona State on Martin Luther King Jr.’s birthday.

(3) They have fought integration. It was only in the last year that the University of Alamba Greek chapters finally integrated.

(4) They haze people. Again, another horrible story out of my Alma Mater from 2010: “At Rutgers, six members of Sigma Gamma Rho were arrested in January and charged with aggravated hazing, a felony, after a pledge reported that she had been struck 200 times over seven days before she finally went to the hospital, covered with welts and bloody bruises.”

(5) They are often involved in cheating scandals.

(6) Women are sexually objectified. Even more so than is typical in American culture.

(7) Despite sexual objectifying women, they “slut shame” non-Greek women and hold them to a different standard.

It’s time to end the horror that is perpetrated by the Fraternities and Sororities on the rest of the student body. You want progress. Shut them down.

 

08Sep/14

Do Employers Have The Right to Screen Employees For Drugs?

Yes. They do. But…with recent legislation in Washington and Colorado, that might change.

I think one would be hard pressed to find a business owner or manger who doesn’t have concerns about the performance (not to mention the attendance or quickness) of employees on drugs.

Here is a fascinating article about a man in Colorado who had a legal, medical marijuana prescription but was fired in 2010 for having a positive urine screen for marijuana. He explained his situation to his employer, but his employer maintained that they have the right to enforce a drug free work zone. Additionally, his employer stated that if they don’t maintain a drug free work zone, they are in violation of federal law. The case will go to the Colorado Supreme Court on September 30th. It’ll be interesting to see what happens.

You can read more about it in the New York Times: Legal Use of Marijuana Clashes With Workplace Testing.

Clearly, I think businesses should have the right to screen for drugs and deny employment to someone who tests positive and does not want to go to treatment for it.

29Aug/14

Why I Rejoined the United States Army at age 38

When I was 19 years old, I signed an eight year contract with the United States Army. I went to basic and advanced training at Ft. Knox, KY and studied to be a tanker on the M1A1 Abrams Tank. I was our platoon leader throughout basic and earned an Excellence in Armor award. I eventually went home and served in the NJ National Guard. I drilled at Ft. Knox, Ft. Drum and Ft. Dix. In 1999, I received the Army Achievement Award. In 2001, my unit was activated a few weeks after 9/11 and we were sent to guard the Hudson River crossings (Holland, Lincoln, Path and the GW) during a time of great national mourning and anxiety. Afterwards, I desired to travel abroad and get further schooling, and I was granted my Honorable Discharge in 2004.

There were a few individuals I really liked (Drill SSG Moses, Drill SFC McCottrell, MSG Spadoni, SGT Geleta, Cadet Tese, Major Manfre) and a number that I was less enthusiastic about. There were good things and bad things about the military. I felt a great sense of pride in serving in the same branch as Washington, Grant, Sherman, Roosevelt, Eisenhower, Patton and Robinson. I enjoyed wearing the uniform, but wasn’t thrilled about shaving or shining my boots (my other likes and dislikes are unimportant and best kept to myself).

The Army served me well. I know that it made me more organized and more adaptable, and people that interviewed me tended to value it. I used my GI Bill to pay for part of my undergraduate degree and I bought a house with a VA Loan. When I became a therapist, I found that veterans usually felt comfortable speaking to me. During my five years at Rutgers CAPS and the Rutgers Newark Counseling Center, I worked with a decent amount of veterans. I enjoyed talking with them, encouraging them and helping them in whatever ways I could.

———-

One of my students at Rutgers was a Marine who served in the Middle East. While over there, he was wounded. He experienced PTSD and had trouble sleeping. The unit doctor prescribed him with Xanax and Oxycotin. He was able to sleep better and return to the field, for a time. Eventually, he became addicted and was discharged under other than honorable conditions (those with an other than honorable discharge are usually denied various VA benefits). My student returned to NJ and quickly moved on from pills to heroin. He ended up on the streets of Paterson. He almost died. He went to some NA meetings and eventually got clean. He returned to work and became an electrician. After doing that for a few years, he decided to go back to college. He went to a community college and graduated with a 4.0. Last fall, at seven years clean and sober, he transferred to Rutgers to further his education. A few days before he was supposed to move in, he decided that he did not want to live with three 18 year olds whose notion of college probably differed from his. He made the decision to commute from Paterson each day. That commute took 80 minutes each way; by mid-October, it had taken its toll. The Marine contacted the Rutgers Veterans’ House and spoke with Col. Stephen Abel who sent him to me. He told me his story and that he was looking for a safe place to live on campus. Normally, I would interview students two to four times and spend 30 to 60 minutes with them each time before deciding whether or not to accept them into the Rutgers Recovery House. Ten minutes into his story, I told him “to shut up and get your things. You can move in immediately.”

He moved in within the next couple of days and the other students, despite being, on average, over a decade younger than him, took to him. He was a likeable role model. In December, I had him speak before the Governor’s Council on Alcoholism and Drug Abuse. After he told his story, Council members asked him a number of questions. He told them that his story was common and that many of his fellow Marines were discharged under similar circumstances. He described sub-par treatment and non-existent therapy. The Council was aghast.

Over the next few days, I called a number of Army bases and talked to a variety of commanders and medical officers. I offered up my services as a national expert on addiction and recovery issues and told them that I was an Army veteran. I was told that the Army almost never employed outside trainers. I called my friend and college roommate, Captain Gabriel Tese, an Army lawyer currently serving at Ft. Hood, Texas. He told me that my student’s story was common and that a majority of the cases he prosecuted involved soldiers with substance abuse problems, and that prescription drug abuse was a massive issue. Eventually, I talked to an active duty Colonel who said, “How old are you son?”

I told him that I knew where his question was leading and that I wasn’t interested.

“You are interested. This is an issue that you care about and that you are able to do something about. If you are as good as you say you are, you can make a real difference. The Army will be good to you and for you.”

I thanked him and hung up the phone. Two days later, I went down the rabbit hole and read about the Army Medical Corps and the position of Behavioral Science Officer.

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Back in May, I wrote about how America Fails Its Veterans. America also fails her active military personnel: those with PTSD, traumatic brain injuries, prescription drug addictions, alcohol dependence or other problems are often given sub-standard care. In 2007, the scandal at Walter Reed Hospital dominated the news for more than a few cycles and it seemed that America might turn the corner on how it treated members of the Armed forces. Then we saw this VA scandal in 2009 and this one in 2014. Despite aggressively wearing flag pins and sending troops into war zones, the Republican party (again) voted down benefits for military personnel and veterans in 2014. Soldiers and veterans are ubiquitous at professional sporting events, and the crowds always stand and cheer for them when they walk onto the field or appear on the jumbo tron. That tends to be the extent of the support they get from the public, aside for some Facebook appreciation and hashtag activism. People need to do more than say “thank you for your service,” cheer for veterans during sporting events or share a meme on Facebook (I don’t want to minimize these things though. They are helpful gestures and are appreciated. We just need to do more). We need them to tell their Congressman to vote for more military and veterans benefits, like basic, timely medical service.

The aforementioned Colonel told me that the military also needs highly trained professionals to give of themselves and their unique abilities. They need doctors, nurses, social workers, psychologists and members of the clergy to support the troops.

I have my hands in many things, a lot of work obligations and a large number of hobbies that I like to partake in. I’ve already served in the military. I can make more money doing other things.

If not me, than who? If not now, then when?

———-

On August 29, 2014, I rejoined the United States Army as a First Lieutenant. My old friend, college roommate and fellow guardsman, Captain Gabe Tese swore me in. The brief ceremony was performed on the Rutgers campus next to the WWII and Vietnam memorials. My Dad, wife and a few friends bore witness. Most significantly, that Rutgers Marine who caused all of this was there too.

I will serve as a Behavioral Science Officer in the Pennsylvania National Guard. Of course, I will help whomever I can that suffers from PTSD and/or substance abuse problems. But I also plan on helping soldiers with other aspects of their lives and encouraging those of all ages to go to college, whether it is veteran friendly schools like Rutgers or somewhere else.

I’ve thrown my hat back in the ring. I hope others will follow.

2014 0830 Army (3)

Captain Tese and me, shortly after the ceremony on Voorhees, Mall, Rutgers.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

25Aug/14

Vicodin (and all other forms of Hydrocodone) Becomes a Schedule II Drug

Great news from the DEA. In 45 days, all forms of Hydrocodone will be reclassified from Schedule III to Schedule II. Its most common forms are Vicodin and Norco. A few years ago, Vicodin became the most prescribed drug in America. Not only is it highly prescribed, but it is also highly abused (and easier to get than schedule II painkiller and superking, Oxycodone). Drug users only complaint about it is that it is weaker than Oxycodone, so they just take larger doses of it.

In 2012, rumors about Zohydro’s introduction to the market started to float out of the mainstream press. Drug companies liked the idea of selling Zohydro because it is 10x as strong as regular Vicodin. This caused a great deal of concern and consternation among addiction treatment providers and some doctors. The FDA approved the drug for release in 2014, and almost immediately 29 states filed a complaint with the Federal Government. The approval of this drug by the FDA was incongruous with their statement in 2013 that Hydrocodone was dangerous and highly abused and should be moved to Schedule II.

The DEA Schedule of Drugs can be viewed here, but I’ll list them from their website. Clearly, there is a big difference between Schedule II and Schedule III (key parts bolded by me). It’s not a major victory that will cause a sea change in drug use, misuse, prevention or treatment, but it is a sound policy. Good job, US Government.

Schedule I

Schedule I drugs, substances, or chemicals are defined as drugs with no currently accepted medical use and a high potential for abuse. Schedule I drugs are the most dangerous drugs of all the drug schedules with potentially severe psychological or physical dependence. Some examples of Schedule I drugs are:

heroin, lysergic acid diethylamide (LSD), marijuana (cannabis), 3,4-methylenedioxymethamphetamine (ecstasy), methaqualone, and peyote

Schedule II

Schedule II drugs, substances, or chemicals are defined as drugs with a high potential for abuse, less abuse potential than Schedule I drugs, with use potentially leading to severe psychological or physical dependence. These drugs are also considered dangerous. Some examples of Schedule II drugs are:

cocaine, methamphetamine, methadone, hydromorphone (Dilaudid), meperidine (Demerol), oxycodone (OxyContin), fentanyl, Dexedrine, Adderall, and Ritalin

Schedule III

Schedule III drugs, substances, or chemicals are defined as drugs with a moderate to low potential for physical and psychological dependence. Schedule III drugs abuse potential is less than Schedule I and Schedule II drugs but more than Schedule IV. Some examples of Schedule III drugs are:

Combination products with less than 15 milligrams of hydrocodone per dosage unit (Vicodin), Products containing less than 90 milligrams of codeine per dosage unit (Tylenol with codeine), ketamine, anabolic steroids, testosterone

Gregory House, MD, was a fictional character on TV for eight years who was addicted to Vicodin. His drug use caused him a number of problems, but the TV show still glamorized much too much.