Texas pharmacist works with harm reduction on STR naloxone distribution

Legislatively, Texas may have its problems in addressing opioid overdoses and evidence‐based treatment, but the Texas Targeted Opioid Response (TTOR) grant, from the Opioid State Targeted Response (STR) from the Substance Abuse and Mental Health Services Administration (SAMHSA), is changing all of that. “We have amazing folks in the TTOR department at the Texas Health and Human Services department who are aggressively minded and are focused on trying to do the right things with the money,” said Lucas Hill, Pharm.D., clinical assistant professor in the University of Texas at Austin College of Pharmacy and director of Operation Naloxone, which is funded by TTOR.     

Stop Stigma Now plans for future

Stop Stigma Now is planning to combine the names of NDRI‐USA and Stop Stigma Now, in a move that the organization hopes will give it more gravitas. Stop Stigma Now is a growing force in the methadone treatment patient community, which has been eclipsed by the general move to buprenorphine and naltrexone in media coverage.     

Properties of the weighted log‐rank test in the design of confirmatory studies with delayed effects

Proportional hazards are a common assumption when designing confirmatory clinical trials in oncology. This assumption not only affects the analysis part but also the sample size calculation. The presence of delayed effects causes a change in the hazard ratio while the trial is ongoing since at the beginning we do not observe any difference between treatment arms, and after some unknown time point, the differences between treatment arms will start to appear. Hence, the proportional hazards assumption no longer holds, and both sample size calculation and analysis methods to be used should be reconsidered. The weighted log‐rank test allows a weighting for early, middle, and late differences through the Fleming and Harrington class of weights and is proven to be more efficient when the proportional hazards assumption does not hold. The Fleming and Harrington class of weights, along with the estimated delay, can be incorporated into the sample size calculation in order to maintain the desired power once the treatment arm differences start to appear. In this article, we explore the impact of delayed effects in group sequential and adaptive group sequential designs and make an empirical evaluation in terms of power and type‐I error rate of the of the weighted log‐rank test in a simulated scenario with fixed values of the Fleming and Harrington class of weights. We also give some practical recommendations regarding which methodology should be used in the presence of delayed effects depending on certain characteristics of the trial.     

The other side: Pro‐cannabis physicians dispute SG advisory

Last week (see ADAW, Sept. 9), we wrote about the advisory from U.S. Surgeon General Jerome Adams, M.D., recommending against marijuana use by pregnant women or adolescents ( https://www.hhs.gov/surgeongeneral/reports‐and‐publications/addiction‐and‐substance‐misuse/advisory‐on‐marijuana‐use‐and‐developing‐brain/index.html ).     

ADA settlement exposes liability when providers refuse MAT patients

Gov. Andrew Cuomo of New York has added opioid use disorders (OUDs) to the list of approved conditions for which medical marijuana could be prescribed in the state, following the lead last month of New Jersey Gov. Phil Murphy, who limited such use as an “adjunct” to medications like methadone and buprenorphine (see ADAW, Jan. 28).     

Senate Appropriations Committee hears about funding needs for SAPT block grant

The opioid epidemic is persisting, calling for the need for more funding, according to testimony on Capitol Hill last month. Mark Stringer, director of the Missouri Department of Mental Health and single state authority (SSA) for the state's Substance Abuse Prevention and Treatment (SAPT) block grant. In addition, it's important to transition from opioid‐focused funding to general funding for substance use prevention and treatment in general, via increasing the block grant, he said.     

Wage and Non-Wage Compensation Among Young Alcoholic and Heavy Drinking Women: A Preliminary Analysis

The association between drinking and selected job characteristics among women aged 24 to 31 is examined. Using the 1989 NLSY, women are classified as alcohol abusers or dependent based on DSM-III-R criteria or as heavy drinkers based on reported frequency of six or more drinks. Heavy drinking is negatively associated with wage and non-wage compensation. These effects diminish when human capital measures are controlled. Current alcoholism and current and past heavy drinking are strongly negatively associated with years of schooling. The association between alcoholism and job compensation and characteristics is not as strong as that seen for heavy drinking. It is not known if this is a consequence of errors in identifying alcoholic women in population-based surveys.     

Lives in limbo: Temporary Protected Status and immigrant identities

The United States formulates much of its immigration and refugee policy to match economic and political circumstances. We interpret these policy shifts as a set of graduated positions on immigration and refugee flows that attempts to discipline the lives of newcomers and, in so doing, shapes immigrant identities. In this article, we analyse the interplay between the US government and Salvadoran asylum applicants negotiating procedures that grant only temporary relief from deportation via the policy of Temporary Protected Status (TPS). We find that each policy shift results in the strategic renegotiation of asylum applicants’ identities so as to achieve the best opportunity for a successful outcome. Based on Foucault’s ideas of governmentality and Ong’s concept of flexible citizenship, we argue that what appears more superficially as a patchwork strategy of immigration laws and asylum practices may be theorized more deeply as a set of flexible responses by the state that turn on identity construction at different scales, and that aim to mediate transnational relations.