Monthly Archives: January 2022

Bangkok, Jan 5 (EFE).- Philippine President Rodrigo Duterte said in a cabinet meeting with experts he will never apologize for the thousands of deaths derived from the violent war on drugs he promoted since he took power in 2016.

I will never, never apologize for those deaths () Kill me, send me to prison, I will never ask for forgiveness, the president said Tuesday night during a televised meeting.

More than 6,200 people, alleged traffickers or drug addicts, have died during the anti-narcotics campaign, according to official data, while human rights organizations say the figure could be between 27,000 and 30,000 dead.

Duterte, whose sole six-year term expires in mid-2022, defended the actions of authorities, who shoot to kill in situations where drug suspects may have attacked them during raids.

In September, the International Criminal Court gave the green light to an investigation for crimes against humanity into the campaign promoted by Duterte. It temporarily suspended the investigations in November at the request of the Philippine government, which is conducting its own investigation of the operations.

The Philippine Justice Department said in October that medical analyzes of many of the 52 cases investigated would deny the official version that suspects drew their pistols before being killed by police.

Following this official report, Duterte assumed full responsibility for the acts, but said that he would only be tried by a court in his country. EFE

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Duterte says he won't apologize for his deadly war on drugs - La Prensa Latina

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Activists Who Are Risking All to End the War on Drugs - TheTyee.ca

A main point of conflict for lawmakers is whether tax revenue should go to restorative justice or law enforcement

In late December, Pennsylvania Gov. Tom Wolf took to Twitter to light a fire under the state legislature to end cannabis prohibition statewide.

Pennsylvanians have spoken, and they want to see us legalize recreational marijuana, Gov. Wolf wrote via his official social media account. But its the how of the matter that has lawmakers in the Keystone State divided.

Wolf has steadily pushed for efforts to restore justice to Pennsylvanians who have been over-punished for marijuana offenses. And his recent tweet included a signal to residents that hes not the one stalling progress toward recreational sales. Im for it I just want to be sure we also include measures to restore justice to those who have been harmed by the War on Drugs, he added, before saying: Legislators, lets get this done for PA.

Lawmakers in PA are mostly in agreement that weed should be legal. They just cant agree on how to structure a recreational market. The main disagreement centers around how to allocate the tax revenue that recreational weed will generate.

Right now, there are three separate frameworks for legalization, with six different representatives carving paths to the same destination.

First, there were individual Co Sponsorship Memoranda put forth by Senator Mike Regan (R), a former US Marshal. When he was a member of the state House of Representatives, Rep. Regan participated in the development of the states medical marijuana program. Now a state senator, Regan will work closely with Rep. Amen Brown (D), who wants to make cannabis reform a reality for all citizens of the state, not just corporations and consumers. Brown represents Philadelphia, and hes intent on making sure comprehensive cannabis reform rectifies the harm done by drug laws in his and other cities.

In September 2021, a different pair of state lawmakersReps. Jake Wheatley (D) and Dan Frankel (D)revealed H.B. 2050. According to Wheatley, H.B. 2050s approach to legalization is aimed at facilitating direct participation in the cannabis industry by individuals in communities that have been disproportionately impacted by the criminalization of marijuana, and by small diverse and disadvantaged businesses, laying the foundation for enhancingsocial and economic equity for individuals and communities that have been and continue to be adversely impacted by the criminalization of marijuana.

In October 2021, ahighly-anticipated bipartisan billwas also formally introduced. After months of buildup, Sens. Dan Laughlin (R) and Sharif Street (D) unveiled a nearly 240-page bill months afterfirst outlining key detailsback in February 2021.

But is it possible that all of this brainpower would be better consolidated on one bill? Is this divided approach the reason why even bipartisan efforts to legalize have stalled on the path to ratification?

Neighboring states like New York and New Jersey have been among the leaders in legalization on the East Coast. Both of Pennsylvanias neighbors to the east are prioritizing access and protections for medical and recreational users as they roll out their adult-use markets. New York has even gone so far as to make it illegal for most employers to drug test for marijuana. In New Jersey, Gov. Phil Murphy has already signed three different bills into law outlining the states legal framework for adult usage.

Pennsylvania, on the other hand, has yet to take a definitive step toward legalizing marijuana, in part because of its Republican-dominated General Assembly.

Sens. Laughlin (R) and Street (D) proposed SB 473 with a focus on safety and social equity. They made sure to note that the state would be missing out on between $400 million and $1 billion in new tax revenue if the general assembly doesnt make it happen.

But tax revenue isnt enough for some conservative lawmakers to endorse the idea of freeing, forgiving, and employing former cannabis offenders.

Sen. Street, Rep. Brown, and Gov. Wolf all want robust social equity measures to be written into the law from day one. But the right-leaning legislature is more likely to favor Sen. Regans (R) approach. While Regan wants a bill that funnels money from legalization to police departments, Brown wants to ensure the money being brought in from legalization would go towards social programs.

Some hope the addition of Sen. Brown will make Sen. Regans plan more balanced. Since the two members of the general assembly are coming from very different perspectives, they could find an honest middle ground that moves the state toward a cohesive and effective legal weed market. But its also possible that squabbling over tax allocations could be a long-term barrier that stalls all three of these proposed approaches.

If you live in Pennsylvania, you have the right to contact your local representatives to remind them of why this is such an important issue.

Its exciting to read news of these proposed bills, but Laughlin and Streets S.B. 473 hasnt moved at all since being referred to the Law and Justice Committee on Oct. 18th.

With a Democratic governor and a Republican-dominated general assembly, the probability of ratifying progressive legislation that upholds social justice feels low. And with Gov. Wolf on his way out of his final term, the state could swing back to a Republican executive, which could also dim the chances of legalization. However, there is always the potential of the states general assembly members shifting on the matter.

As more information from neighboring markets and 420-friendly voter data surfaces, the decision to legalize seems more and more like a no-brainer. But authoring a bill that is fair to all of the states citizens will clearly take more than just a few sharp legislative minds stepping up to the plate.

Luckily, Pennsylvanians have at least one governor and six lawmakers who are currently taking a swing at it. The question is: Can they find a way to legalize access statewide while also paying dues to citizens most harmed by the failed War on Drugs?

Sarah Gethers

Sarah Gethers is currently an au pair in Milan, Italy. Gethers has run for local public office in Harrisburg, PA, as well as worked for state government. She has a B.A. in Corporate Communication from Duquesne University.

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Pennsylvania Gov tells lawmakers to stop stalling legalization, but will it help? - Leafly

Its no secret that diabetes is becoming the scourge of America. It plagues one in 10 Americans, and every one of us probably knows someone who struggles with the disease.

In 2017 the U.S. mortality rate for diabetes was 42% higher than the average among 10 other industrialized countries. Thats a poor showing for America.

Many of those Americans are taking insulin, a drug discovered a century ago. Sales of drugs to treat diabetes have increased about 212% from $24 billion in 2011 to $75 billion in 2020, second in total revenue only to drugs used to treat rheumatoid arthritis and other inflammatory diseases.

With all that money spent on pharmaceuticals to control the disease, you would think the U.S. was getting a loud bang for its buck. Thats not the case.

Reporters at Reuters, the global news service, have just produced an amazing series about diabetes in America revealing that disease has produced a medical catastrophe.

One of the series authors, Chad Terhune, told me the U.S. had been making a lot of progress until around 2010-2011 when complications from the disease seem to have rounded a corner in middle-aged adults.

Diabetes has followed the obesity crisis, Terhune told me. It has a lot to do with healthy lifestyles and health disparities. Its a reflection of income inequality. Sedentary lifestyles, unhealthy diets and lack of consistent medical care for many people also contribute to the halt in progress in improving outcomes for people with the disease.

We also know some patients ration their diabetes medications and skip doctors appointments because they dont have the money to pay the large deductibles and other out-of-pocket costs.

Ironically, it was the insurance industry that pushed those onerous costs onto policyholders to discourage them from seeing doctors. The goal was to impose high cost sharing by their insurance policies in the hope that if people had to pay more out-of-pocket, theyd be less inclined to go to the doctor for every minor ailment. The goal was to lower the overall cost of health care for the country and, of course, benefit insurance companies through fewer claims to be paid out.

Some 20 years after that cost-containment strategy surfaced, the strategy seems has backfired harming thousands of diabetic patients. Delays in care simply impose higher costs because people dont show up for treatment until they are much sicker.

One study of lower-income workers and their family members who had diabetes had 22% more emergency room visits for preventable complications after they had switched to high deductible plans.

Reuters reporters didnt just interview patients, researchers, and experts in diabetes care. They examined the rates of potentially avoidable hospitalizations related to diabetes tracked by the federal Agency for Healthcare Research and Quality.

They found from 2016 to 2017, the most recent year of available data, hospitalization rates increased for short-term complications, long-term complications, and lower-extremity amputations. When reporters asked for more recent state-specific data, only eight states responded.

One was Indiana. Rates of short-term diabetes complications and amputations increased in all responding states, except Indiana. Rates of controlled diabetes without mention of complications decreased nationally from 2011 to 2015 and in six states that responded through 2018. Indiana, however, reported an increase. So Indiana results are mixed making it hard to judge how well Indiana is doing in preventing diabetes complications.

The Reuters series on diabetes illustrated the three evils in Americas health system: underuse, overuse, and misuse of medical services. It serves as a warning not just for diabetics but for the rest of us who inevitably will need health care in our lives.

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Why the U.S. is losing the war on diabetes - Evening News and Tribune

A sense of dj vu has descended all across concert venues in Houston and the culprit is omicron.

The fast-moving strain of the COVID-19 virus has been wreaking havoc on the live music scene, leading to a handful of cancellations. It was likely the cause behind the postponement of the much anticipated New Year's Eve homecoming show for Houston-based world-beaters, Khruangbin, at the 713 Music Hall.

The seemingly exponential rise in cases leaves any early-2022 show a crapshoot, raising concerns over future concerts whether it's due to staffing issues or bands rescheduling shows out of an abundance of caution.

That leaves it up to ticketholders to check the latest status of gigs, not only to make sure they are still a go, but whether COVID safety measures are in place at the venues. In other words, have those vaccination cards and 72-hour COVID test results handy before heading out.

Hopefully, the following January shows will still happen as we have a full slate ahead. CultureMap's best shows of the month are as follows:

Clay MeltonThursday, January 6The Big Barn at Dosey Doe

Equally influenced by Stevie Ray Vaughan and John Mayer, Houston-based Clay Melton is establishing himself as one of the hottest blues-rock acts in the Lone Star State. Simply put, the talented young guitarist-vocalist can shred and is an extremely fun watch, backed by a rock-solid unit in his longtime drummer, Zach Grindle, and bassist Zach Cox.

Hell be recording a live album from the unique confines of The Big Barn at Dosey Doe in Spring alongside a whos-who in the local music scene, including Sir Earl Toon of Kool & the Gang, Evelyn Rubio, and Sarah Grace. That follows the well-received 2021 EP, Back to Blue.

Tickets start at $15 plus fees. Doors open at 6:30 pm.

CultureMap Local Show of the Month: BowiElvis FestivalSaturday, January 8The Continental Club and Big Top Lounge

January 8 holds a special place in the hearts of music fans across the globe as the day produced two of the greatest pop icons in modern musical history: David Bowie and Elvis Presley. Those two cultural forces will meet at the return of BowiElvis Festival.

The 13th edition is back after a one-year hiatus and will feature a number of acts celebrating the late-singers, including Graveltooth, Johnny Falstaff, India Tigers in Texas, Sara Van Buskirk, Elise Morrison, Yaupon, and a burlesque performance by Dem Damn Dames.

Bands will play Bowie and Elvis cover songs in addition to original tunes, and guests can participate in face painting and a costume contest alongside catering that features "The King" Elvis's favorite banana and peanut butter sandwich and "The Bowie," a croque madame with Gruyre, ham, and a fried egg.

Tickets start at $20 plus fees in advance, $35 at the door. Doors open at 7 p.m.

CultureMap Recommends: TWRP with Rich AucoinSunday, January 9White Oak Music Hall (Upstairs)

Hailing from the frosty hinterlands of Canada, fans of high-energy weirdness are in for a real treat when TWRP (formerly Tupperware Remix Party) and Rich Aucoin take over White Oak Music Hall. Both hail from the creative Halifax, Nova Scotia scene and are getting huge accolades not only for their synth-driven indie sounds, but their insane live performances. TWRP's concert gear recalls Power Rangers mixed with Devo, Daft Punk, and manga comic books.

The secret weapon on this bill is Aucoin, a genius-level multi-instrumentalist whose exuberant intellect is expressed in award-winning videos and movie-synched live shows that include actual surfing on crowds and crazy-fun dance parties underneath a elementary school parachute. His latest album,United States, is a amazing listen as well, an ultimately uplifting treatise on modern America. This show is sold out but is worth every penny on the resale market.

Tickets are sold out but there is a waitlist. Doors open at 8 pm.

Washed Out Thursday, January 13Warehouse Live

One of the leaders of the late-2000s chillwave movement alongside luminaries such as Toro Y Moi, Neon Indian, Small Black and others, Ernest Greenes Washed Out project is a vibe unto itself.

Combining dream pop with 80s synths and gentle vocals, Washed Out first garnered major notice with his 2009 EP Life of Leisure,lead single Feel It All Around becoming the title credits song for the hit comedy show, Portlandia.

The song is seemingly now ensconced on the playlist at any and every upscale eatery. His latest is 2020s Paracosm.

Tickets start at $25 plus fees. Doors open at 8 pm.

Maze featuring Frankie Beverly with The Isley Brothers and LeVelleSaturday, January 15Toyota Center

Classic soul and funk gets a major spotlight with a Toyota Center bill that includes Maze, led by Frankie Beverly. Originally from Philadelphia, Maze first made waves when they hooked up with Marvin Gaye in the '70s, scoring hit songs such as "Joy and Pain," "Before I Let Go," and "Happy Feelin's" [sic].

They'll be joined by the timeless, former Motown act, The Isley Brothers, who are instantly recognizable with the hits "This Old Heart of Mine (Is Weak for You)," "Shout," and "Twist and Shout," famously covered by The Beatles.

Tickets start at $69.50 plus fees. Doors open at 6:30 pm.

CultureMap Show of the Month: Sir Elton JohnFriday, January 21 and Saturday, January 22Toyota Center

The last time Sir Elton John rolled through town with his Goodbye Yellow Brick Road tour to perform to a sold-out Toyota Center crowd, it was under the guise of being his last tour before setting off into the sunset. That show included a roll-call of greatest hits that would be a wonderful bookend to a storied career (read the CultureMap review here).

But alas, the icon had second thoughts and is back for a two-show encore, perhaps bolstered by the fantastic hit Dua Lipa/PNAU collaboration, "Cold Heart," that resulted in John's biggest hit song in years, reaching No. 1 in the U.K. and No. 11 in the U.S.

Expect a look back on his biggest hits, a stellar live band, and eye-popping visuals for John fans, or music fans in general, this show is a must-see.

Tickets start at $69.50 plus fees. Doors open at 7 pm.

Shawn ColvinFriday, January 21Heights Theater

We were set to recommend the Lucinda Williams concert at Heights Theater this month but that one is sold out. For those looking for a fantastic singer-songwriter, Shawn Colvin will also appear in the intimate venue.

Colvin got her start in the Midwest and quickly garnered attention when she joined the famed Greenwich Village folk circuit in New York. A tour with Susanne Vega led to a recording contract and since then, she became a fixture at the Lilith Fair tours and racked up three Grammy Award wins, including two for her hit song, "Sunny Came Home," which picked up Record of the Year and Song of the Year.

Her latest isThe Starlighter, a collection inspired by the children's music book,Lullabies and Night Songs.

Tickets start at $28 plus fees. Doors open at 7 p.m.

The War on Drugs with Lo MoonWhite Oak Music Hall (Lawn)

Finding that sweet spot between Bruce Springsteen and Bob Dylan juxtaposed with layered indie guitars, The War on Drugs developed a distinctly American rock sound that recalls vast landscapes and gritty stories of the everyman, set to a sonic palette made for today's audiences.

Led by Adam Granduciel, the band initially started after he struck up a friendship with psych-rocker Kurt Vile. But it wasn't until Vile departed that the band truly took off with 2014'sLost in the Dreamachieving modern classic status and catapulting the act to festival headliners.

The 2017 releaseA Deeper Understanding and last year'sI Don't Live Here Anymore were critical smashes, solidifying The War on Drugs as a touring force.

Tickets start at $46 plus fees. Doors open at 8 pm.

Cat PowerThursday, January 27House of Blues

Cat Power's Chan Marshall has had a strange career. Starting off as an unassuming indie darling most noteworthy for the excellent 1998 full-lengthMoon Pix, the demands of the road proved at times too much for the Atlanta-based singer-songwriter. Show performances were erratic and oftentimes awkward with her deeply personal lyrics at odds with rowdy crowds.

Thankfully, with her social anxiety issues behind her, Marshall has gained new confidence not only as a frontwoman but also as a recording artist, producing excellent albums over the last decade and touring with the likes of Alanis Morissette. She'll be releasing a covers album this year.

Tickets start at $35 plus fees. Show starts at 7 pm.

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9 coolest concerts to ring in the new year in Houston this January - CultureMap Houston

At a time when drug addiction is on the rise, villagers in quaint Jharag have waged a war on chitta, a highly addictive synthetic drug made from heroin and other substances.

The panchayat of Jharag in Shimla districts Jubbal and Kotkhai assembly segment has brought a resolution to reward people providing information about drug peddlers active in the area. Jharag is famous for its local deity Nageshwar Devtas temple and has a population of about 1,800. The panchayat comprises five villages.

For quite some time, reports have been pouring in about drug peddlers from nearby areas trying to lure the youth from our panchayat to buy drugs. Some unknown vehicles which do not belong to the locals have been frequenting the villages as well, said panchayat pradhan Ashok Sarta, adding that drug addiction was certainly a cause of concern

The panchayat passed a resolution with unanimity to fight the drug menace and also expose the peddlers from nearby villages and panchayats, he said. The panchayat will reward those giving information about the drug peddlers. We have also formed a team of teenagers from different wards to keep tabs on the addicts as well as the local smugglers and suppliers, Sarta added.

The use of drugs has increased manifolds in the urban as well as rural regions of the state. According to a survey of the National Drug Dependence Treatment Centre at All India Institute of Medical Sciences (AIIMS), Delhi, the prevalence of the usage of charas and ganja is 1.2% in the country, while its higher than the national average at 3.2% in Himachal Pradesh. Similarly, the use of opioids is 2.8% in Punjab, 2.5% in Haryana, 2% in Delhi and 1.7% in Himachal Pradesh against the national average of 0.7%.

But a dangerous trend in recent years has been the shift of the users to chemical drugs. According to the health departments reports, there are nearly 1,170 patients (drug users) lodged in 27 de-addiction centres in HP.

The count of those addicted to chitta (also called diacetylmorphine, a semi-synthetic adulterated form of heroin) has surpassed that of cannabis (charas) and other hard drugs as 34.61% of the addicts in the centres are chitta consumers.

Another major cause for concern, according to the same report, is that the highest number of addicts are in the age group of 15-30 years.

There been a significant rise in the consumption of synthetic drugs among the youths. Not only boys, but girls too are falling prey to addiction, said Dinesh Sharma, head of psychiatry department in the states premier institute Indira Gandhi Medical College (IGMC).

The hospital runs a special outdoor patient department (OPD) for addicts on Saturdays. The trend of using injectable drugs is growing among the youth, particularly in the age group between 17 and 25 years, he said. It is also leading to increase in liver-related diseases like hepatitis C, he added.

With illicit drug trade on the rise, Himachal Pradesh Police had re-devised its strategy to catch smugglers and keep track of addicts.

HP director general of police Sanjay Kundu added Register 29 in all police stations to track addicts and offenders booked under the Narcotic Drugs and Psychotropic Substances (NDPS) Act.

The station house officers (SHOs) concerned maintain the register and create a database for analysis and better prevention of drug trafficking.

The prevalence of drug addiction and trafficking is more among those aged between 26 and 35 years, who comprise 37% of the total people booked under the NDPS Act.

Gaurav Bisht heads Hindustan Times Himachal bureau. He covers politics in the hill state and other issues concerning the masses. ...view detail

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Panchayat in Shimla district wages a war on chitta and its users - Hindustan Times

As people of color make up an increasing number of the people who misuse and develop an opioid addiction, those who receive treatment remain overwhelmingly white. (AdobeStock)

John Woodyear is a primary care physician who specializes in addiction treatment. On most days, his waiting room at the Family Care Clinic & Associates is filled with patients waiting to get their prescription for buprenorphine, a medication to treat opioid substance use disorder (SUD) sold under the brand names Subutex and Suboxone.

Research shows that the medication can reduce the risk of overdose by half and double a patients chances of entering long-term recovery.

Woodyear estimates that more than 90% of his SUD patients are white. That would be expected in the nearly all-white counties in the western part of the state that have been hardest hit by the opioid crisis, or even if Woodyear was white.

But the 68-year-old physician is Black and practices in Troy, a town in Montgomery County that is 36% Black. The racial make-up of his patient population represents a disturbing fact about opioid addiction treatment: as people of color make up an increasing number of the people who misuse and develop an opioid addiction, those who receive SUD treatment remain overwhelmingly white.

Since the current opioid crisis started unfolding in the late 1990s, addiction has increasingly been spoken of as a public health concern. The white, middle-class, suburban and rural populations that were most affected are portrayed as victims, both of overzealous prescribing of prescription opioids and unscrupulous pharmaceutical companies, who are deserving of compassion and care.

Even the language used to describe addiction is less stigmatizing; patients with substance use disorder are no longer referred to as addicts or junkies.

This is a marked contrast to the national response to the crack cocaine epidemic of the 1980s and the war on drugs, declared by Richard Nixon in 1971. For decades, addiction has been considered a personal moral failing that needs to be addressed by punitive measures and incarceration.

Those efforts criminalized substance use, particularly in Black communities. That more punitive approach was on display in the distinctions made between Black and white drug users prosecuted for possession of crack cocaine and powder cocaine in the 1980s. Black people were prosecuted more frequently for crack cocaine, which carried longer and harsher sentences, than were whites for cocaine, which carried lesser penalties, even for greater quantities of drugs.

Attitudes around substance use only began to change once white communities started experiencing high rates of dependence and death from opioids. There are signs, however, that this more enlightened attitude and view of addiction does not extend to all opioid victims.

The gap between the rates at which Black people and white people use and die from opioid overdoses has narrowed steadily in recent years. While the most recent NC DHHS data shows that white North Carolinians overdose deaths were twice the rate of members of the Black community, the rates were comparable on a national scale (19.0 and 17.1), according to data compiled by the Kaiser Family Foundation.

Those numbers flipped during the COVID-19 pandemic, according to preliminary data from the Centers for Disease Control and Prevention (CDC). For the first time in more than 20 years, the rate of Black overdose deaths surpassed that of whites.

So how and why did opioids, substances derisively called hillbilly heroin, become the drug of choice for Black people? The Agency for Healthcare Research and Quality (AHRQ) says virtually every street drug is now contaminated by synthetic opioids such as fentanyl and carfentanil, which are cheaper and more powerful.

Shuchin Shukla, a faculty physician and opioid educator at the Mountain Area Health Education Center in Asheville, says the North Carolina General Assemblys refusal to expand Medicaid has crippled the states ability to address addiction and overdose deaths with treatment.

Theres plenty of research showing how overdose rates changed in states that expanded Medicaid, says Shukla. One way or another, the taxpayers are paying for this. We can pay through outpatient treatment, which is relatively cheap and medically and ethically sound, or we can pay for jails and prisons, ER visits, ambulance rides, HIV and Hepatitis C treatment.

That is what North Carolina is currently doing.

Much of substance use treatment services are funded by grants and philanthropic entities, which are inadequate to cover the need. As a result, a substantial share of federal grants are diverted to provide services that would otherwise be covered by Medicaid.

But even those grants are not distributed equitably. A $54 million federal grant allowed the state to provide treatment to 12,000 people, only 7.5% of whom were Black and less than 1% were American Indian, the population most devastated by the opioid crisis.

Many addiction medicine specialists see medication-assisted therapy (MAT) treatment as the best hope for curbing opioid misuse and overdose. Because MAT drugs are also opioids, they satisfy the opioid craving and stave off withdrawal without producing that euphoric high. A variety of studies have found that MAT can cut the all-cause mortality rate among addiction patients by half or more.

In Charlotte, officials and advocates in the substance abuse field gathered for a groundbreaking at a new Wellpath Community Care Center scheduled to open in north Charlotte in early 2022. The care center, located at the corner of West Sugar Creek Road and Hunter Avenue in the Derita neighborhood, will implement MAT programming and outpatient substance use disorder treatment for people struggling with opioids or other substances including alcohol, tobacco, methamphetamine, fentanyl, and cocaine.

Its a comprehensive approach to substance abuse treatment, Wellpath Vice President Melissa Bishop told Queen City Nerve at that event. Well be providing services not only for substance use but also co-occurring services for people struggling with anxiety or depression, which will help in their engagement and treatment and stability. Its a one-stop shop rather than having to make them go to multiple providers.

There are many barriers to accessing this treatment in North Carolina, one of 11 states where buprenorphine prescribers per opioid death rates are well below the national average. Doctors are required to complete an eight-hour training program and get a waiver from the federal Substance Abuse and Mental Health Services Administration (SAMHSA) to prescribe buprenorphine for addiction; physician assistants and nurse practitioners require 24 hours of training.

The spike in overdose mortality during the pandemic, particularly among Black and Latino communities, led to several new initiatives and additional funding to train more health care providers to prescribe the drug. But getting more doctors on board remains a challenge.

Woodyear is federally certified to prescribe buprenorphine to up to 275 patients, the maximum allowed, and has tried to recruit more MAT providers to the closest population center, Pinehurst, without much success. He said he believes doctors have a prejudice bias toward treating people with addiction.

They dont want them in the office with their middle-class, upper-class patients, he said. They dont want their waiting room looking like an arraignment court.

Blake Fagan is chief education officer at UNC Health Sciences at MAHEC. He once vowed hed never prescribe MAT because he saw it as substituting one addiction for another. After some tragic experiences with his patients, he changed his tune. These days, Fagan not only prescribes MAT, he sees that primary care doctors in residency programs in North Carolina are qualified to prescribe the drug, too.

Despite the widespread acknowledgement that SUD is a crisis irrespective of race and/or ethnicity, there are vast disparities in who has access to quality treatment and care. Few people of any race identified as needing SUD treatment actually receive it but the numbers are most abysmal for people of color: just 10 and 8% of Black and Latino individuals with substance abuse disorder, respectively according to data from SAMHSA. A 2019 national study published in JAMA Psychiatry reported that more than 97% of people prescribed buprenorphine in an in-office setting were white.

Medicare or Medicaid paid for the visits in only 19% of the cases.

Even people with private insurance encounter barriers to opioid addiction treatment. A cohort study published in JAMA Network Open found that only 16.6% of commercially insured patients obtained follow-up treatment after a nonfatal opioid overdose; Black patients were half as likely as whites to obtain a treatment referral.

The numbers are even more dismal for those who are uninsured or on Medicaid who have fewer options for opioid addiction and substance use treatment. Although the Medicaid program covers the drug, low reimbursements discourage many providers from accepting patients who have the coverage.

Woodyear says he is one of the few providers of medications for opioid use disorder who accept Medicaid.

Buprenorphine and the once-a-month injectable Vivitrol are available in regular outpatient settings and mostly to people with private insurance. This was always the plan, says Tracie Gardner, senior vice president of policy advocacy at Legal Action Center which seeks to end punitive measures for health conditions like addiction.

When people observed the uptick in opioid use disorder among white people, they determined that an office-based approach would be preferable because of the belief and stereotypes we have constructed around methadone maintenance, says Gardner. Methadone has been highly racialized and has a very complex and complicated history. It is still under the purview of the Drug Enforcement Agency whereas buprenorphine is treated like a medication to be offered through a health care provider.

The racial disparities also extend to treatment outcomes. Only 28% of clients completed treatment, and the survey results indicate that Black and Latino people are less likely to complete treatment compared to whites. The lack of racial diversity among treatment providers is also a factor. There is a dearth of treatment providers who can address the needs of racially marginalized patients and offer treatment services that take their cultural identity into account.

Drug overdose deaths topped 100,000 in a one-year period during the pandemic for the first time ever, according to provisional data released by the CDC in mid-November.

Thats probably way underestimated just like the number of deaths from COVID is probably way underestimated, Woodyear said. Were dealing with an epidemic that we need to bring the same energy to treating as we have brought to the pandemic.

This article originally appeared at North Carolina Health News, an independent, non-partisan, not-for-profit, statewide news organization dedicated to covering all things health care in North Carolina. This story is part of a reporting fellowship on health care performance sponsored by the Association of Health Care Journalists and supported by The Commonwealth Fund.

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Opioid Addiction Treatment in NC Not Separate but Still Unequal - qcnerve.com