AMA COVID‐19 recommendations: MAT,pain and harm reduction

Last month, the American Medical Association (AMA) made recommendations to help guide policymakers in reducing the stress experienced by patients with opioid use disorder (OUD) and pain, and urges the support of harm reduction.     

Long‐term use of methylphenidate continues to confer benefits

Patients continue to receive benefits from treatment for attention‐deficit/hyperactivity disorder (ADHD) with methylphenidate after long‐term use, researchers have found. Some patients may be withdrawn from the medication, however. Therefore, all patients should be assessed periodically to determine whether they continue to need the medication. The study, published in the American Journal of Psychiatry, was conducted because, while long‐term use of methylphenidate for children with ADHD is frequent clinical practice, its benefits are unclear. They looked at whether the medication remains beneficial after 2 years. Methylphenidate, a stimulant, has been controversial in some quarters because it is a controlled substance, However, the first‐line treatment for ADHD is psychostimulant medication, such as methylphenidate. How long children should take is is a question, but 60% of children receive stimulant treatment for ADHD for more than 2 years, and this is increasingly common, extending even into adolescence and adulthood. This is partly due to the awareness that ADHD is not a pediatric‐only condition. The study, “Continued benefits of methylphenidate in ADHD after 2 years in clinical practice: A randomized placebo‐controlled discontinuation study,” was published online May 21 by the American Journal of Psychiatry.     

Study finds MAT combined with 12‐Step residential treatment is effective

To those who might assume a federal lawsuit seeking class status for treatment providers wronged by insurance company actions would be receiving immediate and universal acclaim in the provider community, a little caution may be in order. While the latest lawsuit against United Behavioral Health (UBH) certainly will be interpreted by some addiction treatment providers as an opportunity to recover payments that were inappropriately denied (see ADAW, Sept. 23), the case also could launch a broader discussion of how best to guarantee that insured patients receive the care to which they are entitled.     

Under 2% of Medicaid‐covered youths get MAT after OD: Study

Fewer than one‐third of youths receive addiction treatment after an opioid overdose, and only one in 54 receive pharmacotherapy (methadone, buprenorphine or naltrexone), a study published in JAMA Pediatrics reports. The researchers urge interventions to link these youths to treatment after an overdose, and call for improving access to medications: methadone, buprenorphine, and naltrexone.     

AATOD,supporter of the MATE Act,fact‐checks the MAT Act

It's no secret that the American Association for the Treatment of Opioid Dependence (AATOD) is opposed to the Mainstreaming Addiction Treatment (MAT) Act — S. 2074 and H.R. 2482.     

Multi‐type maltreatment and the long‐term adjustment of adults

Multi‐type maltreatment refers to the experience of more than one form of child maltreatment (sexual abuse, physical abuse, psychological maltreatment, neglect and witnessing family violence). Researchers have largely ignored the presence of other types of child abuse and neglect when examining the adjustment problems associated with a particular form of maltreatment. The association between ‘multi‐type maltreatment’ and adjustment was explored in the current study. Retrospective data were obtained on (a) the degree to which maltreatment types co‐occurred, (b) childhood family characteristics and (c) adjustment problems in adulthood in an Australian self‐selected community sample (N=175). As hypothesized, a large degree of overlap was reported in the experience of the five types of maltreatment. Family characteristics—particularly family cohesion and adaptability—discriminated between respondents reporting single‐type and multi‐type maltreatment. Greater adjustment problems were associated with reports of a larger number of different maltreatment types. Multi‐type maltreatment should be recognized as a crucial aspect of the nature and impact of child maltreatment and considered in the development of programmes for the prevention and treatment of child abuse and neglect. Copyright © 2000 John Wiley & Sons, Ltd.     

SAMHSA plans changes to NSDUH: DSM‐5 updates

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced last week that it will start collecting data on vaping, marijuana withdrawal symptoms, synthetic marijuana, and updates to accord with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5) to focus on craving, in the annual National Survey on Drug Use and Health (NSDUH).     

Measuring long‐term trends in policy coherence for development

This article measures long term trends in policy coherence for development. Based on result chains, it develops a counterfactual methodology, and then applies it to assess changes in inputs, outputs and outcomes over time. While the literature does not indicate any significant change in policy coherence for development over the last decade, this research finds that, if the time scale is lengthened to 50 years, an overall increase in policy coherence for development of the Dutch government, vis‐à‐vis the DR Congo, in the domains of finance and security, can be detected. These changes in policy coherence for development inputs seem to have contributed, in conjunction with similar policies from other countries, in some instances, to positive outcomes in the DRC.     

Non‐job work/unpaid caring: Gendered industrial relations in long‐term care

This article explores the operation of gender and industrial relations in long‐term care work or nursing home work, ‘from within’ the experience of the predominantly female workforce in seven unionized facilities in Canada. Drawing on qualitative case study data in non‐profit facilities, the article argues that the main industrial relations challenges facing long‐term care workers are that their workplace priorities do not fit within existing, gendered, industrial relations processes and institutions. This article starts from the experience of women and threads this experience through other layers of social organization such as: global and local policy directions including austerity, New Public Management, and social and healthcare funding; industrial relations mechanisms and policy; and workers’ formal [union] and informal efforts to represent their interests in the workplace. The strongest themes in the reported experience of the women include: manufacturing conditions for unpaid work; increasing management and state dependence on unpaid care work; fostering loose boundaries; and limiting respect and autonomy as aspects of care work. The article extends the feminist political economy by analysing the links between the policies noted above and frontline care work. Building on gendered organizational theory the article also introduces the concept of non‐job work and suggests a fourth industrial relations institution, namely the needs and gendered expectations of residents, families and workers themselves, operating within the liminal spaces in care work.     

Inter‐professional working in child protection with families with long‐term and complex needs

Within the United Kingdom there is growing awareness of the need to identify and support the small number of children who are living in families experiencing multiple problems. Research indicates that adverse experiences in childhood can result in poor outcomes in adulthood in terms of lack of employment, poorer physical and mental health and increases in social problems experienced. It is acknowledged that most of these children are known to child welfare professionals and that some are referred to social services, subsequently entering the child protection system. This paper reports research conducted with 28 experienced child welfare professionals. It explores their views about families known to the child protection system with long‐term and complex needs in relation to the characteristics of children and their families; the process of intervention with families; and the effects of organisational arrangements on practice. The research indicates that these families are characterised by the range and depth of the problems experienced by the adults, such as domestic violence, mental health difficulties and substance misuse problems, and the need for professionals to have good inter‐personal skills and access to specialist therapeutic services if families are to be supported to address their problems. Copyright © 2008 John Wiley & Sons, Ltd.     

Philadelphia‐based harm‐reduction advocate joins CleanSlate

Brooke Feldman is well‐known to the Philadelphia world of drug users as a peer counselor active in harm‐reduction work. But starting this week, she will be Center Manager for two sites owned by CleanSlate Centers, a treatment program focused on opioid and alcohol addiction. Feldman has a master's in social work and is able to bridge the “street” world and that of the established treatment center—but acknowledges that there was a leap of faith involved in joining the treatment field.     

‘Recovery work’ and ‘magic’ among long‐term mental health service‐users

Based on an extended period of qualitative research with mental health service‐users in north‐east England, this article considers the various forms of ‘magical work’ and ‘recovery work’ that emerge in the lives of people living with severe mental health problems. Given the now sizeable body of literature which seeks to problematize traditional conceptual boundaries of work, the article asks to what extent these hidden and unusual work‐forms might also be considered legitimate members of the category. Rather than argue for the expansion of the construct to accommodate these activities, the paper attempts simply to problematize the extent to which so‐called ‘mad’ forms of work are irresolvably different to more conventional forms of occupation. In challenging notions of the psychiatric patient as inevitably inactive, new vocabularies for service‐user work are explored. Concluding remarks are also directed to recent policy debates concerning ‘back‐to‐work’ welfare reform for long‐term out of work service‐users.     

Visual short‐term memory for overtly attended objects during infancy

We investigated limitations in young infants’ visual short‐term memory (VSTM). We used a one‐shot change detection task to ask whether 4‐ and 8.5‐month‐old infants (N = 59) automatically encode fixated items in VSTM. Our task included trials that consisted of the following sequence: first a brief (500 ms) presentation with a sample array of two items, next a brief (300 ms) delay period with a blank screen, and finally a test array (2,000 ms) identical to the sample array except that the color of one of the two items is changed. In Experiment 1, we induced infants to fixate one item by rotating it during the sample (the other item remained stationary). In Experiment 2, none of the items rotated. In both experiments, 4‐month‐old infants looked equally at the fixated item when it did and did not change color, providing no evidence that they encoded in VSTM the fixated item. In contrast, 8.5‐month‐old infants in Experiment 1 preferred the fixated item when it changed color from sample to test. Thus, 4‐month‐old infants do not appear to automatically encode fixated items in VSTM.     

Long‐term employment intensity of sectoral output growth in Tunisia

This article examines the long‐term ability of Tunisian industries to generate employment opportunities. Using a panel data set of 15 industries over 1983–2010, the authors estimate their long‐run output–employment elasticities, using the “mean group” estimator. They argue that economic policy should target the most labour‐intensive industries, particularly service industries and export manufacturing industries. After demonstrating the inability of the mining industry to absorb labour, the authors highlight the long‐run jobless growth in the hotel, bar and restaurant industry and suggest that future investment in this industry will yield no results and that future tourism policy should focus rather on para‐tourism activities.