Monthly Archives: April 2016

20Apr/16

Insults that people have said to me when they don’t like my positions

On my Greenagel Counseling Services Facebook Page today I wrote about the recent Saturday Night Live fake ad about Heroin AM (click here to see the video):

There was a fake commercial for “Heroin A.M.” on Saturday Night Live this past weekend and all kinds of people are freaking out over it. I think satire is an important part of communication, education and advocacy. Ford Vox wrote a nice piece on it.

“”Heroin A.M.” did a great job elevating awareness that many seemingly “normal” and high-functioning people are abusing opioids. This skit is savvy satire that portrays the medicalization and commercialization of a “street drug,” and that seemingly absurd scenario speaks to the underlying truth that a haywire medical system ruled by corporate greed, bad regulations and complacent doctors actually generated this problem in the first place.” (to read Mr. Vox’s CNN article, click here)

One woman disagreed with me and voiced her displeasure thus: “First you drank the Kool-Aid from Partnership for Drug Free Kids and now you talk about “satire” and a heroin epidemic. I hope to God your following is as small as it should be. Oh and I do understand satire and irony. I also understand the word “dangerous” and your posts are exactly that.”

This got me thinking about other insults and diatribes against me over the years.

When I wrote “The Suboxone Problem That No One is Talking About” for Hazelden-Betty Ford, I received the following emails:

a) I hope you die a fiery death

b) You have no understanding of addiction or recovery

c) You are in the pockets of the pharmaceutical industry

d) You’re a fucking asshole

After “Why Colleges and Universities Need Naloxone,” I received a message that colleges would be better served “if they just let the junkies die” and another one that said “why should we worry about saving scum bags when there are so many good kids on campus that have real needs?”

After several deaths and negative incidents in the fall of 2014, I wrote two articles on why colleges should shut down fraternities and sororities on their campuses. I received dozens of missives, including:

a) You don’t know how to have fun

b) You have no understanding of college

c) Your an asshole!!! (their grammar, not mine)

d) You better not ever come to Alabama

Back in 2012 when we held the NJ Opiate Task Force Hearings, I was called some nasty things by other professionals and advocates in the field of addiction/recovery that disagreed with me. I could go on and on and make this a 10,000 word article, but you get the idea. Don’t feel bad for me and certainly don’t get defensive – I am both used to it and have thick skin. One of the key lessons that I work on with my students at the Rutgers School of Social Work is to not demonize those that you disagree with and try to find common ground. I explain that you not only fail to win people over that you are arguing with, but you may lose those that might have otherwise been sympathetic towards your cause (I have seen Michael Moore do this for much of his career). Part of the alarming aspect of American society and our political discourse is the nasty language and hyperbolic rhetoric that so many use. Regardless of what side of the political aisle you sit, you might recognize that members of your party accuse the other side of either “trying to fundamentally destroy America” or “not caring about the people.” Those who utter statements like that are both wrong. More often than not, both sides care and want good things but are coming from different perspectives and have a variety of view points.

I’ll conclude with my favorite insult I’ve ever received, and it was sent to me this past February by a recovery advocate after I criticized a program for not having enough training or supervision:

I’m glad the Vikings lost. You are both losers.

11Apr/16

My Spring and Summer Speaking Tour

This is a list rather than an article. I get a number of emails and messages each week asking about upcoming speeches, conferences, panel discussions, webinars, and other events, so I put this together as a tool for those individuals.I’m a huge music fan, and have recently purchased summer tickets for the Dandy Warhols, Grateful Dead (w/John Meyer but no Phil Lesh), Lumineers, and the star studded show of Cheap Trick-Heart-Joan Jett, so I was inspired to label this my tour (private speeches and trainings that are not open to the general public are not included here).

April 20: Life After Incarceration for NAADAC. Free Webinar. This webinar is aimed at professionals working with clients either currently or formerly involved in the criminal justice system. This includes prison, jail, parole, probation, intensive supervised probation (ISP), and drug court. This session will cover the current state of our national criminal justice system, including statistics that show that America is the number one jailer in the world. The costs of maintaining county, state and federal jails/prisons will also be covered. We will review current reforms in a few forward thinking states. Participants will discuss the top three ways to avoid recidivism: education, treatment and employment. Participants will receive a toolkit of concepts, topics and strategies that they can engage in with their clients. Recommended readings will be offered to help participants gain a strong foundation in the American criminal justice system. Statistics will also be provided regarding the number of people, crimes and costs. The need for reform will be presented, including discussion of problems and inequities within the system that need to be addressed, such as the impact that heroin and prescription drugs have had on the criminal justice system. The webinar will also cover soft and hard skills that we need to teach our clients in order for them to lessen their chances of recidivating, along with examples of success. Participants who have clients in the criminal justice system will leave the webinar with a plan for work with clients and an understanding of the clinician’s role in the work of criminal justice clients. To register, go here.

April 28: What is the Responsible Marijuana Policy for Our Veterans? at SAM/NJPN. Conference in Atlantic City, NJ. I’m going to lay out the evidence that details the damage that marijuana causes service members and veterans and detail the lack of data on how marijuana helps vets (whenever you read or hear about this, it’s just anecdotes). All day registration (10 to 4, plus lunch) costs $100. To register, go here.

May 3: Substance Abuse Keynote Panel and Life After Incarceration for NASW-NJ. Conference in Atlantic City, NJ. I am facilitating a panel discussion on addiction and recovery that will cover prevention, treatment, recovery support services, policies and medication assistance. The panelists include Dr. Louis Baxter, Jass Pelland and Patty DiRenzo (I handpicked them). This will go from 9 to 11 am. I will present on the criminal justice system in the afternoon. To register, go here.

May 25: College Recovery’s 1st Client Graduation Ceremony. New Brunswick, NJ. Back in 2014, I helped a few concerned individuals create a new treatment program for young adults in order to combat the opiate epidemic and provide newly sober individuals with supportive housing and an entree into higher education. I stepped away from full time work with them in 2015, but I have continued to run the family program there, which is work that is very near and dear to my heart. Sometime this June, they will be having a graduation ceremony for the first half dozen clients that have completed a year of treatment (among other successes). This is free and open to interested individuals. To learn more about College Recovery, go here.

June 15: NJTV Roundtable Discussion on Opiates. Busch Campus, Rutgers in Piscataway, NJ. Healthy NJ: New Jersey’s Drug Addiction Crisis is a new year-long, multi-platform community engagement initiative designed to raise awareness about the state’s drug problems and solution. The community forum will focus on prevention and education strategies in the fight against drug addiction.The forum will include interactive presentation and informational tables from prevention and education facilities, treatment providers and other experts in the field of drug addiction. We’re expecting close to 150 individuals who would like to recognize, deter and prevent substance abuse from a loved one or colleague to attend the event. The event will be livestreamed on NJTV’s njdrugcrisis.org website.

July 10: The Opiate Epidemic and the Medical Industrial Complex for the Rutgers Center of Alcohol Studies. Keynote in New Brunswick, NJ. I’m going to talk about the history of opium, heroin and opioids. I’ll discuss how Big Pharma, doctors, insurance companies, marketers, the FDA, the government and consumers are each responsible for the current epidemic. They are all guilty, though some moreso than others. I’ll also mention policies that are still causing problems and I’ll conclude with policies and programs that are working and should be copied or expanded. To register, click here

July 11 – 15: 21st Century Drugs and Working with the Military and Veterans at the Rutgers Center of Alcohol Studies. Conference in New Brunswick. These are 10 hour classes that I’m teaching over five days. They count for initial CADC/LCADC education or CEUs for a variety of health care professions. To learn more about 21st Century Drugs, go here. To learn more about Working with the Military, click here.

August 18: The History of Marijuana Policy at the National Conference on Addiction Disorders. Conference in Denver, CO. This session provides a detailed history of US drug laws, especially as they pertain to marijuana. We will cover the mid-17th century to the present. A strong focus on state laws will be provided from the 1990s to the present, with a particular examination of California, Massachusetts, Colorado and Washington. The push and pull between the federal government and the states will also be discussed. While the main thrust of this session is on history and policy, interventions at the individual and group level with clients will be discussed. (I may have military duty at this time or another obligation, so I’m only 50/50 for actually making this). To register, go here.

 

07Apr/16

Jesus Smoked Weed

I didn’t make this photo, and I am not trying be offensive, sacrilegious, nor blasphemous. I was shocked to find this photo and a series of other images, articles, ads, rants, and blog pieces about how “Jesus smoked weed.” Let’s back up to the original plan for where I wanted to start this article.

Historically, people, organizations, institutions and industries in America have used four major images or concepts to argue or sell their point (or product). They are:

1) The Bible

2) Dogs

3) Babies (or little children)

4) The American flag, now most often represented by current service members and veterans.

Think how often these major images and themes are used to sell a product or justify a political platform. Over the last dozen plus years, all of these have also been used to push agenda of the very for-profit marijuana industry. You would be shocked to find out how many people claim that marijuana helps dogs with “late stage cancer” (I tried to find the article from NJ.com that was published a few years ago, but alas, I could not).

Last fall, there was a news story in NJ about a woman who was not allowed to bring medical marijuana to her child at school (some people thought it unjust – snide aside here, I doubt those individuals have experienced real injustice). I’m a well-known critic of Governor Chris Christie (I didn’t like him LONG before it was cool to dislike him), but we do agree that marijuana should not be legalized (of course, he talks about it with his typical diplomatic flourish). It is easy to find CNN pieces on how marijuana helps children with seizures. The Huffington Post seems like a house organ for the for-profit marijuana industry. Another site site calls it “pot for tots.”

For me, the most offensive manipulation of the American public is when things are described as good for soldiers or veterans. The proliferation of articles on how medical marijuana can benefit the military and veterans is astounding; the one thing they all have in common is a lack of data. Amazingly, Congresspeople have told the VA they should consider giving marijuana to vets. An ambitious reporter should see if any of those politicians received donations from the for-profit marijuana industry. Bernie Sanders has said that he would end the military’s ban on marijuana – it’s an awful policy proposal and shows his clear failure to understand some aspects of addiction and drug policy. The Veterans Administration released an excellent article citing evidence from several studies that marijuana does not help people with PTSD – in fact, it causes further harm. Two years ago, I sat on a panel where a paid advocate for the for-profit marijuana industry said that he knew of a veteran who benefited from using marijuana. It was an anecdotal story – we need to be very careful of these. One will find that most arguments for how marijuana can help soldiers and veterans is anecdotal.

My original plan was to end this piece by stating that one day we may see the Bible or Jesus used to justify or sell marijuana. And then I spent five seconds poking around with Google and learned that we are already there.

05Apr/16

Partnership For Drug Free Kids, Revisited

continuing care parent teen addiction treatment

Back in February, I wrote a critique on the Partnership for Drug Free Kids (PDFK – formerly the Partnership for a Drug Free America). I was prompted to research PDFK and write the article after witnessing the empty testimony of an executive from the Partnership for a Drug Free NJ at a State Senate hearing. I mistook one Partnership for the other (if you are sufficiently confused, then you are now experienced with the problem of similarly named agencies within the same field). While I stand by the research and data from that article, I do want to clarify and expand upon it (eventually, I need to get around to examining the Partnership for a Drug Free NJ, but that’s a piece for another time).

In early March, I had a lengthy conversation with PDFK President Marcia Lee Taylor (noted marijuana policy expert and my friend Kevin Sabet told me she was a decent and well-meaning professional). During our talk, she stated that:

1) Partnership for Drug Free Kids is “completely separate from Partnership for a Drug Free NJ” and that they are often confused. She said that local programs often do the legwork to secure advertising on television and then both the local and national programs will put their names on public service announcement (PSAs).

2) The $100 million budget was made up of 80-90 million in donated advertising time and that it wasn’t “actual money” and that their operating budget was closer to $7M.

3) Ms. Taylor said that when the organization changed its name from Partnership for a Drug Free America to Partnership for Drug Free Kids in 2014, the focus changed to educating parents about drug problems and providing information and support to families. She was very clear that they are not an advocacy organization, but that people (like me) often confuse them for one based upon their history and PSAs.

4) “Everyone at PFDK is against marijuana legalization but studies show that 50% of parents are for legalization and we do not want to alienate them.” That is why, she said, that they do not take a hard stance against marijuana on their website or in their materials.

5) They use a news aggregator to report prevention and substance abuse issues on their site. They do this so people don’t spend lots of time each day hunting down different stories; rather, they can get their information in one place.

6) Ms. Taylor stated that the “families’ help” is the work they are most proud of. They have a toll free hotline that is staffed by bi-lingual licensed clinical social workers (LCSWs) during the work week. These LCSWs walk people through the website, provide them support, and refer them to volunteer parent coaches (who have been through this themselves). She reported that PFDK has over 80 parent coaches. These coaches have been trained by the Hilton Foundation.

 7) In an email correspondence a few days later, I asked Ms. Taylor about any metrics or evaluations that they had (or were aware of) about the effectiveness of their work. I will provide her full answer here:

Please note that proving a causal relationship between advertising exposure and a behavioral outcome is always difficult –there are so many variables that impact behavior- but a few of these studies have demonstrated a positive relationship between exposure to Partnership messaging and strengthened anti-drug attitudes as well as reduced substance use.

American Journal of Public Health (August 2002) – Evaluation of effectiveness of drug education messaging from PDFA from 1987 through 1990 – found that anti-drug advertising associated with a reduced probability of marijuana and cocaine / crack use among adolescents.  Team of researchers from Yale, NYU and elsewhere concluded that by 1990, “after three years of PDFA ads, approximately 9.25% fewer adolescents were using marijuana.”

Previously, the February 2001 issue of AJPH reported on a NIDA-funded study conducted by Philip Palmgreen at U of Kentucky that tracked impact of ad campaigns (mainly Partnership’s) running in selected counties in Kentucky.  Study showed a 26.7% decline in marijuana use among sensation-seeking teens exposed to the advertising.

In the same journal, in 1995, “The Impact of Anti-Drug Advertising” reported on a study by the Johns Hopkins University School of Medicine finding that teens’ perceptions of anti-drug advertising “suggest that anti-drug advertising serves as a deterrent to [middle and high school] youth substance abuse.”

Reporting on positive teen inhalant abuse data in Monitoring the Future (U of Michigan’s annual survey of teen substance use),  Dr Lloyd Johnston observed in 1996 that “the turnaround in inhalant use and beliefs about its harmfulness corresponds exactly with the start of the Partnership for a Drug-Free America’s anti-inhalant ad campaign… We are inclined to credit much of the improvement in inhalant use to that intervention.”

“Above the Influence” – the teen targeted program developed by the Partnership and ONDCP, has been shown in three separate studies (attached here) to be effective in reducing teens’ intention to use, and actual reported use, of marijuana.  (It should be noted that ATI was created initially, in 2005, as part of the National Youth Anti-Drug Media Campaign.  (The earlier incarnation of that campaign, “My Anti-Drug”, was evaluated independently between 1999-2004 and found to be ineffective.  I personally have never bought that conclusion –teen marijuana use declined dramatically over that period.  In any case,  ATI was developed after that evaluation was completed.)

The Partnership is currently working with the Consumer Healthcare Products Association to prevent OTC cough medicine abuse among teens via “intercept” digital messaging and content.  Ongoing evaluation of the messaging by Hall & Partners (independent research company) has shown that target (“fence sitter”) teens exposed to the messaging have stronger anti-cough medicine attitudes and lower intent to use.

In 2011, an independent evaluation of our Parents360 community education program that found it was effective in increasing parent knowledge and self-efficacy to address their child’s drug use.

Lastly, I think it’s worth pointing out that in-market “effectiveness” (as opposed to a controlled test of a PSA), requires both media tonnage and strategic “rightness” – something that rarely happens in the real world.  We can point to the period between 1987 and 1992 when Partnership advertising was most strongly supported by the media (hitting $350 million in 1991) and teen drug use declined significantly –not just cocaine, which was the drug most often featured in our messages, but all drugs including marijuana.

I followed up the conversation with President Taylor with a long phone call and email exchange with Denise Mariano, a parent of a young person in long term recovery who has become an effective advocate in NJ. She was a 2013 NCADD-NJ Advocate Leader, is a naloxone trainer and a member of the Morris County Opiate Task Force. She was recognized at the White House last year as one of the 2015 Office of National Drug Control Policy (OCDCP) advocates. She has been a volunteer for the Partnership for Drug Free Kids for four years and credits them with changing her life. When her child was struggling with addiction, she said she called and emailed over 50 different programs/resources and only two responded to her – one was the Partnership. She is extremely proud of the Parent Support Network and was trained as a peer-to-peer coach in 2014. When pressed for measurable data that showed the effectiveness of the peer-to-peer program, she said it was still early but that she had personally seen it help a number of people.

After these phone calls and some further reading/study, I have refined my stance on the Partnership:

1) There is a name problem. The fact that there are multiple “Partnerships for a Drug Free …..” is extremely confusing. I don’t think changing their name for a second time in three years is the optimum solution, but the Partnership does need to differentiate themselves better. Additionally, keeping the name makes it harder to shake off the failures of the 1985-2014 Partnership for a Drug Free America’s work (which I went into detail in my previous piece).

2) The $80M to $90M a year in free advertising is extremely significant (one need only look at the Trump 2016 GOP primary to see how valuable free media air time is). I am still dissatisfied with the PSAs and would like to see that free advertising used more effectively.

3) While I understand the political nature of the Partnership’s public marijuana stance (so that they don’t alienate parents they might otherwise reach), part of leadership is setting the tone and changing public perception. The best public stewards are those that are willing to lead people in the right direction, even if it means taking unpopular positions and irritating other stakeholders and people in power. Ideally, I would like to see them change their position on their website and donate some of the airtime to anti-marijuana legalization groups like Smart Approaches to Marijuana (SAM).

4) By using a news aggregator to publish industry stories on their website, it gives off the appearance that they are supporting policies, programs, companies or industries when they may not be. For example, when they publish articles about the pharmaceutical industry, it can appear that they support them. I have urged them to clearly delineate what is news and what they support.

5) Each spring, I teach one to two senior seminars at the Rutgers School of Social Work. It is the last class before they graduate, and I spend much of the semester teaching them the importance of data, evaluations and how success is measurable. While I appreciate both President Taylor’s and Ms. Mariano’s answers regarding the effectiveness of the Partnership and the limited evaluations metrics they have, I stridently urge them to work harder on getting both internal and external measures on the effectiveness of the Partnership’s work. Anecdotal stories are wonderful and often touching, but they are not reasons to support a program. The Partnership has a prominent role in our national battle against substance addiction and receives a great deal of free advertising – for that, they need to invest in better evaluation tools.

6) It was evident that Denise Mariano’s life has been transformed by the help that the Partnership provided several years ago, and she has helped numerous families since then. I know of a few other parents who have also dedicated their time, energy and hearts to the Partnership – I am aware of how hard they work and how much they truly care (and how they do this all for free). The strength and value of the Partnership is obviously in their volunteers and in their parent support network. Their work is real and should be commended. For my part, I am sorry for concluding my previous piece with saying the Partnership “needs to go away.” It was a flippant remark from someone who tries to take a middle-of-the road approach and seeks nuance. I will do better.