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Center for Alcohol and Addiction Studies

PLNDP Physician Associate UPDATE
November 1998

Dear Colleagues,

Welcome to the second PLNDP Physician Associates Newsletter. It is our hope that this newsletter will keep you current on the activities of the PLNDP. Our most exciting news is that we now have a videotape which makes a powerful statement about the nature of addiction and the effectiveness of addiction treatment. As you can see from the description of the videotape on the enclosed card, some of the leading figures in science and medicine have participated in what we believe will be an important tool for the education of the medical profession and the public. It is consistent with the following portions of the PLNDP consensus statement:

“It is time for a new emphasis in our national drug policy by substantially refocusing our investment in the prevention and treatment of harmful drug use. This requires reallocating resources toward drug treatment and prevention, utilizing criminal justice procedures which are shown to be effective in reducing supply and demand, and reducing the disabling regulation of addiction treatment programs.”

“Concerted efforts to eliminate the stigma associated with the diagnosis and treatment if drug problems are essential.  Substance abuse should be accorded parity with other chronic, relapsing conditions insofar as access to care, treatment benefits, and clinical outcomes are concerned.”

 We have suggested to the members of the PLNDP that they use this videotape to facilitate discussions within local chapters of national professional organizations and state and county medical societies, and we encourage you to do the same. The videotape has been used effectively both for individual presentations and as part of a panel discussion. It is an effective trigger tape which elicits lively and constructive discussions about addictions and  treatment.  The videotape makes a case for the desirability of achieving support for addiction treatment similar to the support given to other chronic diseases. Thus, this report could be an advocacy tool for greater access to and parity of benefits for addiction treatment. For more information about parity advocacy, I suggest that you contact “Legal Action Center” and “Join Together” (they help coordinate information among community constituencies, and administer the Robert Wood Johnson Fighting Back Program). Their web sites and contact information are as follows:

Legal Action Center    http://www.lac.org

Join Together  http://www.jointogether.org

In order to receive a copy of the videotape, which is complimentary, thanks to the support of the Robert Wood Johnson Foundation, all you need to do is to indicate a specific educational use for which you plan to use the videotape. As soon as we receive your request, we will be pleased to mail you a copy of the tape.  You can reach us by phone at (401) 444-1817, fax (401) 444-1850 or through e-mail at plndp@brown.edu .

In closing, let me again express the appreciation of the PLNDP membership for your commitment to our project and your willingness to help initiate a positive change in our national drug policy.

Sincerely,

June E. Osborn, M.D.    
Chair
Lonnie R. Bristow, M.D. 
Vice-Chair
David C. Lewis, M.D.
Project Director

Research Activities

The “Health, Addiction Treatment, and the Criminal Justice System” research report, focusing on the interface between the criminal justice system and the provision of medical care, is well under way.  We have had the good fortune of recruiting very well established researchers, and their reports are shaping up to be excellent summaries of the current research.

We will distribute copies of the research reports to the panel of PLNDP members who will participate in our November 10th meeting in Washington, DC, where the reports will be presented.   Craig Love, Ph.D., of the Center for Alcohol and Addiction Studies, is facilitating the collection and organization of these documents. He is working with the leading researchers in the following areas:

Coercion and Treatment: Douglas Anglin, Ph.D. and David Farabee,   Ph.D., UCLA Drug Abuse Research Center

Drug Courts: Steven Belenko, Ph.D., National Center on Addiction and Substance Abuse, Columbia University

Prisons: Douglas Lipton, Ph.D., National Development and Research Institutes, Inc.

Police: Peter Manning, Ph.D., School of Criminal Justice, Michigan State University

Community Corrections: Dwayne Simpson, Ph.D. and Kevin Knight, Ph.D., Institute of Behavioral Research, Texas Christian University

Adolescent Services: Ken Winters, Ph.D., Center for Adolescent Substance Abuse

In addition, respondents to the research presentations will include: Professor Norval Morris of the Law School of the University of Chicago who will discuss coercion, ethics, and the legal environment; Carol Shapiro of La Bodegia in New York City who will analyze the reports from a provider perspective; Coinstance Weisner of the Alcohol Research Group in Berkeley who will review the treatment outcome research, and Donald Shepard of the Institute for Health Policy at Brandeis University who will examine health care economics in the correctional system.

Policy Initiative

Washington Policy Legislation

Insurance “parity” coverage for substance abuse, one of the most significant drug policy bills before Congress, was pulled in the end of the legislative session logjam. However, Republican and Democratic supporters say this important bill has growing support and could be moved early next year when the 106th Congress takes office.

Under the parity bill, insurance companies would be required to cover substance abuse treatment with the same annual and lifetime benefits now provided for other medical conditions.  The chief sponsors are Representative Jim Ramstad (R-Minnesota) and Senator Paul Wellstone (D-Minnesota).

A major proponent of the parity bill is Representative Bob Portman (R-Ohio), who also holds the important position of co-chair of Speaker Gingrich’s Task Force for a Drug-Free America. A few states now require parity; however, nationwide the number of treatment centers has dropped significantly, due partly to the restrictions on insurance coverage brought on by managed care.

In the Senate, the Labor and Human Resources Committee had a hearing on July 28th on the bill.  David C. Lewis, M.D., Project Director for PLNDP, was a principal witness on the efficacy of treatment.  “In addition to considerable savings in short and long term medical costs,” Dr. Lewis testified before the Senate committee, “addiction treatment leads to major savings to the individual and society resulting from significant decreases in crime, interpersonal conflicts, accidents, and health care costs and an increase in work productivity.”

In 1999, the PLNDP expects to work with other members of Congress, as well as Representative Portman, to explain the efficacy of treatment in the context of the parity bill which would be a major step forward in reducing substance abuse.

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