Tag: substance use disorder

baby feet

If You Give a Law Student a Baby

Bobby Stroup Leave a comment

Editor’s Note: Congratulations, Bobby, and welcome to the world, baby Stroup!

By Bobby Stroup

If you give a law student a baby, they’re going to look for legal risk. And if they live in the Bay State, they’re going to want a class on ‘MILK’ (Massachusetts Infant Legal Knowhow). 

Then, after learning about the relevant law and policy, they’re probably going to want to write a legal blog post. They’ll need to do additional research to see how they can legally imitate a popular children’s book. Their research will show that “fair use” allows them to parody the book series by exaggerating its format in a new story.  Read More

Hand arranging wood block pyramid with health icons on each block.

Does the ADA Protect People with Substance Use Disorder from Health Care Discrimination?

Hannah Rahim Leave a comment

By Hannah Rahim

The Americans with Disabilities Act (ADA) prohibits health care organizations that provide services to the public from discriminating against persons with disabilities. Although substance use disorder can be a disability under the ADA, there are limitations in the scope and enforcement of these ADA protections. Further action is needed to prevent discrimination in health care services towards persons with substance use disorder.

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Drug test strips.

Synthetic Cannabinoids and the Lack of Substance Use Disorder Treatment in Carceral Settings

The Petrie-Flom Center Staff Leave a comment

By Aaron Steinberg, Ada Lin, Alice Bukhman, LaToya Whiteside, and Elizabeth Matos

The inability of prisons and jails to address the drivers of and treat substance use disorders, especially during the pandemic, is leading to underexplored health ramifications for prisoners, and particularly for prisoners who identify as Black, Indigenous, or other people of color (BIPOC), who already had comparatively poorer health outcomes.

This article focuses on one substance of growing popularity in carceral settings: synthetic cannabinoids (SC), which are frequently referred to as K2 or spice.

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WASHINGTON MAY 21: Pro-choice activists rally to stop states’ abortion bans in front of the Supreme Court in Washington, DC on May 21, 2019.

Restricting Reproductive Rights During the War on Drugs: Intersectional Regimes of Surveillance and Criminalization That Harm Us All

The Petrie-Flom Center Staff Leave a comment

By Taleed El-Sabawi, Jennifer J. Carroll, and Bayla Ostrach

Health law and policy in the United States are, in many senses, driven by a desire to control. When that control is enacted to impose anti-scientific but deeply moralized social norms, suffering always follows. Consider, for example, the decision in Dobbs v. Jackson Women’s Health Organization, which ended a constitutionally recognized right to abortion. This decision allows states to exert near-total control over pregnant people and their bodies — and many are already experiencing physical and emotional harm as a result.

This suffering at the hands of the state is compounded by existing drug law and policies, which also prioritize control over bodies above personal wellbeing and autonomy. Pregnant people who use drugs (including alcohol) are often subject to both of these coercive regimes, facing head-on the harmful synergism between drug criminalization and the criminalization of abortion.

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Suboxone.

Prior Authorization Insurance Requirements: A Barrier to Accessing Lifesaving Treatment for Opioid Use Disorder?

Temple University Center for Public Health Law Research Leave a comment

By Juan M. Hincapie-Castillo and Amie J. Goodin

Policies to mitigate the drug overdose crisis continue to fall short, as evidenced by increasing rates of opioid-involved overdoses and deaths in the United States. The COVID-19 pandemic has exacerbated this overdose crisis, and efforts are urgently needed to mitigate harm.

Individuals who have problematic opioid use are most frequently involved in opioid-involved overdoses, meaning that the use of a prescription opioid, or much more commonly a non-prescription opioid (such as non-medically sourced fentanyl or heroin), is used in a way that adversely affects the person’s life. Problematic opioid use may lead to a diagnosis of opioid use disorder (OUD). The medication buprenorphine has been proven to reduce opioid-involved overdose and harms and is one of few OUD treatments available as a prescription that can be dispensed by community pharmacies rather than from specialized facilities or specialty providers.

The federal government and several states have implemented strategies to improve and promote OUD treatment access, especially for the relatively inexpensive and effective medication buprenorphine. However, there are significant barriers that remain that preclude adequate and timely access to buprenorphine.

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WASHINGTON, DC - OCT. 2, 2021: Women's March in Washington demanding continued access to abortion after the ban on most abortions in Texas, and looming threat to Roe v Wade in upcoming Supreme Court.

How the Dobbs Ruling Will Affect People with Substance Use Disorder

The Petrie-Flom Center Staff Leave a comment

By Hayfa Ayoubi and Karishma Trivedi

At the young age of 21, Regina McKnight unexpectedly suffered a stillbirth due to umbilical inflammation. She was a grieving mother, but to the state of South Carolina, she was a killer. In 2001, prosecutors charged McKnight with homicide allegedly caused by her use of cocaine while pregnant. The jury in the case returned a guilty verdict after deliberating for thirty minutes. It was not until years later in 2008 that her wrongful conviction was overturned by the state’s Supreme Court. 

Unfortunately, McKnight is one of many marginalized women of color who make up the majority of individuals criminally prosecuted for substance use during pregnancy. Now that the constitutional protection for abortion under Roe v. Wade has been overturned, more women like McKnight will have the full power of the state brought to bear on them through forced procedures, surveillance, and jail sentences solely because they happened to get pregnant. 

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police cars lined up.

Policing Public Health: Carceral-Logic Lessons from a Mid-Size City

The Petrie-Flom Center Staff Leave a comment

By Zain Lakhani, Alice Miller, Kayla Thomas, with Anna Wherry

When it comes to public health intervention in a contagion, policing remains a primary enforcement tool. And where a health state is intertwined with carceral logics, enforcement becomes coercive; emphasis is placed on the control of movement and behavior, rather than on support and care.

Our experience in New Haven during the first few months of the COVID-19 pandemic well illuminates this, while also revealing a logic of exceptional force lying dormant in municipal health practices.

Attending to the local is all the more important, albeit difficult, for fast moving and intensely quotidian practices, as COVID in the U.S. seems to be settling in as a pandemic of the local.

Our experience as activist-scholars working with a New Haven-based sex worker-led harm-reduction service and advocacy group, SWAN, suggests that by focusing on municipal practices, we can better understand what public health police power actually is. By orienting our scholarship toward the way social movements engage with local politics, we can then address how these police powers complicate the ability of those most at risk of both disease exposure and police abuse to engage with local authorities. Absent this engagement and critique, progressive policies for constructive state public health powers may be more vulnerable to attack from the right.

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doctor holding clipboard.

Transformation of Behavioral Health Care Through Section 1115 Waivers

The Petrie-Flom Center Staff Leave a comment

By John Jacobi

As the Biden administration works to improve health access and transform health delivery, behavioral health reform should be at the front of the queue.

People with severe mental illness and opioid use disorder are dying young for lack of routine health care. Much of the work that needs to be done in behavioral health is developed or developing at the state level. But the Biden administration has a powerful tool for encouraging state-level innovation in the § 1115 Medicaid waiver process.

Reform through state waivers

Section 1115 waiver authority permits the Department of Health and Human Services to approve pilots and demonstrations if they are found likely to promote the objectives of the Medicaid program. Waivers, which do not require Congressional or formal regulatory enactments, permit relatively rapid cycling of innovation, in contrast to the lumbering pace of legislative or regulatory change.

While applications for waivers originate with the states, presidents have set the agenda by signaling what categories of waivers will be looked upon favorably, offering the administration the ability to put its stamp on the development of care for low-income and disabled people.

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Healthcare concept of professional psychologist doctor consult in psychotherapy session or counsel diagnosis health.

The Case for Non-Police Response to Behavioral Health Crises

The Petrie-Flom Center Staff Leave a comment

By Jennifer J. Carroll and Taleed El-Sabawi

People who use drugs continue to die at staggering rates, due not only to overdose from contaminated drug supply, but also due to our persistent reliance on the carceral system to respond to behavioral health crises.

This approach stems from the state-sanctioned violence of the War on Drugs. It takes various forms, including the use of police officers as first responders to behavioral health crises (including welfare checks), the excessive police use of force, and the use of potentially lethal restraint methods to subdue agitated persons. It also manifests in police officers’ use of jail cells as tools for forced “detox” believing that coerced withdrawal while in custody will reduce overdose risk or help someone “go clean” (it very clearly does not).

Evidence-based alternatives to police response for behavioral health crises exist. However, despite being both feasible and effective, these alternatives to police intervention remain the exception, rather than the rule.

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medical needles in a pile

How Supervised Injection Sites Can Help Address the Overdose Crisis

The Petrie-Flom Center Staff Leave a comment

By Carly Roberts

Supervised injection sites, also known as safe injection sites, are among the most effective, evidence-based harm reduction tools available to counter the opioid overdose crisis.

Supervised injection sites are legally sanctioned locations that provide a hygienic space for people to inject pre-obtained drugs under the supervision of trained staff. Safe injection sites often provide additional services including needle exchanges, drug testing (especially important for detecting lethal fentanyl-laced drugs and preventing “mass overdose” events), and referral to treatment and social services.

The opioid overdose crisis in the U.S., which had a death toll of over 45,000 in 2018, and which is predicted to worsen amid the COVID-19 pandemic, warrants a bold, brave, and thorough response. Harm reduction programs, including supervised injection sites, should be integrated into opioid epidemic response strategies in order to save lives and improve individual and community outcomes.

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