NAMA and AATOD warn Senators not to raise cap

Last week, Mark W. Parrino, president of the American Association for the Treatment of Opioid Dependence (AATOD), and Zachary Talbott, president of the National Alliance for Medication Assisted Recovery (NAMA Recovery), wrote a letter to Congress warning against raising the DATA 2000 (buprenorphine prescribing) patient cap from 275 to 500 during the pandemic. The letter to Senators Ed Markey (D‐Mass.), Jeanne Shaheen (D‐N.H.), Maggie Hassan (D‐N.H.), Elizabeth Warren (D‐Mass.) and Dianne Feinstein (D‐Calif.) was in response to an April 17 letter from the senators to Health and Human Services Secretary Alex Azar and Assistant Secretary Elinore McCance‐Katz urging them to increase the cap.     

DEA proposal for mobile methadone finally released

The federal Drug Enforcement Administration (DEA) has issued a long‐awaited proposed rule that would allow opioid treatment programs (OTPs) — treatment programs that use methadone — to transport the medication to patients via “conveyances” (such as vans). This means that patients would no longer have to go to the brick‐and‐mortar OTP.     

AATOD paper confronts methadone controversies

A policy paper released this month by the American Association for the Treatment of Opioid Dependence (AATOD) focuses on some of the challenges facing opioid treatment programs (OTPs) today. For example, it cites an article published in the New England Journal of Medicine (July 5, 2018) by Michael Botticelli that promotes the idea of methadone being available in primary practice settings for the treatment of opioid use disorder (OUD) (see ADAW, July 16, 2018). “AATOD recommends that this proposal should only be considered after careful, conservative, and thoughtful evaluation,” according to the policy paper. “As history and our policies have shown, we do not reject the public health model for increasing access to care for OUD, nor are we ignoring what has been learned about clinical standards of care to treat this illness. It is important to understand, however, the complexity of inducting a new patient into methadone maintenance treatment when developing policies for increasing access to medication assisted treatment.”     

Parrino perspective from 2019 AATOD conference: Positives and negatives

Opioids have put the American Association for the Treatment of Opioid Dependence (AATOD) front and center when it comes to medication‐assisted treatment with methadone in particular, but also with buprenorphine and naltrexone. Mark W. Parrino, AATOD president, told the 2,000 or so attendees at the AATOD conference in Orlando last week about the positives and negatives that have occurred in the past year. Amid all the festivity and “magic” of Disney and the deluxe Coronado Springs Resort, there are very serious issues facing the field in terms of growth and patient care.     

服务外包业的合作发展和优化分析

通过审视当前服务外包业的发展趋势,对长江三角洲地区发展服务外包的自身优势、劣势及长三角环境机遇、挑战进行简略分析,提出优化建议。     

Evidence-based ergonomics: a model and conceptual structure proposal

In Human Factors and Ergonomics Science (HFES), it is difficult to identify what is the best approach to tackle the workplace and systems design problems which needs to be solved, and it has been also advocated as transdisciplinary and multidisciplinary the issue of "How to solve the human factors and ergonomics problems that are identified?". The proposition on this study is to combine the theoretical approach for Sustainability Science, the Taxonomy of the Human Factors and Ergonomics (HFE) discipline and the framework for Evidence-Based Medicine in an attempt to be applied in Human Factors and Ergonomics. Applications of ontologies are known in the field of medical research and computer science. By scrutinizing the key requirements for the HFES structuring of knowledge, it was designed a reference model, First, it was identified the important requirements for HFES Concept structuring, as regarded by Meister. Second, it was developed an evidence-based ergonomics framework as a reference model composed of six levels based on these requirements. Third, it was devised a mapping tool using linguistic resources to translate human work, systems environment and the complexities inherent to their hierarchical relationships to support future development at Level 2 of the reference model and for meeting the two major challenges for HFES, namely, identifying what problems should be addressed in HFE as an Autonomous Science itself and proposing solutions by integrating concepts and methods applied in HFES for those problems.     

Homelessness: a proposal for a global definition and classification

On the base of an analysis of the definitions of homelessness currently in use, first a change of the notion “homelessness” to “houselessness” is proposed. Houseless persons are then defined as those sleeping rough or using public or private shelters. To better understand the causes of houselessness, its environment is involved in this classification under the notion of inadequate shelter. This comprises the following non-exclusive categories: risk of houselessness, concealed houselessness and substandard housing situations. This classification has the advantage to be adaptable to regional and national differences, while at the same time providing a global basis for data collection and comparison.     

The health and development of children whose mothers are on methadone maintenance

The health and development of a group of children aged 3-7 years born to and reared by mothers who abused opiates when pregnant and who remain on methadone maintenance was compared to a group of age and socially matched control children. There was no difference between the two groups in terms of health and development although the children whose mothers were on methadone had smaller head circumference measurements than the controls. More than half of the index children had been on the child protection register during infancy; all but one were off the register at the time of the study. The results suggest that drug-abusing women who are on methadone maintenance and attending a drug dependency unit may rear and care for their children as well as parents from a similar social background who are not drug abusers.     

Pathological gamblers in methadone treatment: A comparison between men and women

This article uses data from interviews with 462 individuals enrolled in methadone treatment programs in New York City to compare the gambling and gambling-related drug use and criminal activities of those males (N=72) and females (N=27) found to be pathological gamblers. Both the male and female pathological gamblers were and continue to be actively involved in various forms of gambling. A greater proportion of males had engaged in almost all specific types of gambling, although differences between males and females were not all statistically significant. Males and females were very similar in terms of their patterns of drug and alcohol use and the substances they used when gambling. Males and females shared some reasons but also had separate reasons as to why they used heroin when they gambled. Males especially may participate in a variety of criminal and hustling activities to have the money to be able to gamble or to pay gambling debts. The implications of this research are discussed.This study was supported by grant 1RO3-DA08348, Prevalence of Gambling Problems Among Methadone Patients, from the National Institute on Drug Abuse, awarded to National Development and Research Institutes, Inc. Points of view or opinions in this report do not necessarily represent the official opinions or policies of the United States Government, National Development and Research Institutes, Inc., John Jay College of Criminal Justice/CUNY, Illinois State University, or Abt Associates. The authors wish to thank Leila Cahill and Michelle Silverman for their assistance with this research.     

A model-guided process evaluation: Office-based prescribing and pharmacy dispensing of methadone

This article presents an exemplar of a model-guided process evaluation that specifies the treatment model, assesses its implementation, monitors the fidelity of the model throughout the project, assesses model exposure and absorption, and helps understand the program's intermediate effects (proximal outcomes) as well as final effects (distal outcomes). The New Mexico study on office-based prescribing and community pharmacy dispensing of methadone is a research demonstration project that phases a small group of female methadone maintenance patients out of methadone clinics and into a program where they will obtain their scheduled doses of methadone at pharmacies that work in collaboration with physicians and a social worker.The patient's methadone treatment will in this way become part of their overall health care. Early detection of problems of implementation (e.g., the omission of program content or the delivery of inaccurate information) enables the researcher to make adjustments before the problems become unmanageable and the integrity of the original research design is compromised. A model-guided process evaluation can critically inform health services research demonstrations designed for enabling continuous, ongoing feedback and improvement of client-related services.     

当前房地产市场形势及对策建议

2012年,上海房地产业在面临"史上最强的调控政策"后发生了较大变化,主要表现为:房地产增加值占GDP的比重、房地产开发投资建设及住宅销售情况均表现出明显的下降趋势。国家宏观调控已取得一定的成效,达到了限制房价过快上涨的目的。但鉴于房地产业在国民经济体系中的重要作用,如何在进一步巩固调控成果的同时,对房地产业进行合理的引导,促进其健康、稳定的发展也是一个重要的议题。据此,在详细分析上海当前房地产的市场形势后,提出制定相关房地产调控政策一些方向性建议。