Briefly Noted

The biennial International Drug Policy Reform Conference, sponsored by the Drug Policy Alliance and held Nov. 7–9 in St. Louis, Missouri, was full of varying sessions on harm reduction and reform — 45 of them in all. An article by Filter editor Will Godfrey summed up his perspective — he was the only print reporter so far to have covered the entire conference. We asked him what his feeling was about the prospects for treatment and harm reduction working together, as they have in the past. “There's plenty of friction, but there can and should be rapprochement between the harm‐reduction and traditional treatment communities,” he told ADAW. “Many people in the harm‐reduction movement pursue traditional recovery, and there are treatment folks who support harm reduction. All should be trying to save lives and empower people. Harm reductionists' legitimate concerns about mainstream treatment include its coercive or controlling deployment, its frequent eschewal of evidence‐based practices and its promotion of abstinence at the expense of stigmatizing people who use drugs. Treatment advocates often overlook that most people who use drugs are fine. And in any case, everyone must be free to choose their own path.” But the fact that two approaches — one more radical than the other — coexist still is bound to make some treatment providers uncomfortable. After all, some of the speakers said that even supervised consumption sites are unfair to drug users, who have no need to be “supervised,” and instead should be free to use drugs. All viewpoints were there. “There's constant debate in the harm‐reduction movement about working to change systems that inflict harm from the inside, versus calling for radical reforms from the outside,” said Godfrey. “I think both approaches are simultaneously necessary.” Not everyone saw the conflict. “I have to say that I didn't see an anti‐public health movement there at all,” Maia Szalavitz, who is writing a history of harm reduction and is respected in both harm reduction and some, at least, treatment camps, told ADAW. “There has always, of course, been tension between activists and researchers and between people who want to fight within the system and those who want to tear it all down.” For the Filter article, go to https://filtermag.org/drug‐policy‐reform‐movement/ .     

Discovery or Construction? Theorising the Roots of Adult Protection Policy and Practice

This paper outlines two models for understanding the roots of adult safeguarding/adult support and protection (ASP) policy and practice, and considers the strengths and limitations of each model in an educational context. The ‘discovery’ model understands ASP policy to be a response to a growing societal awareness of a phenomenon called ‘harm’ to ‘adults at risk’. It understands ASP practice to be triggered by the discovery of an instance of that phenomenon. The ‘construction’ model understands ASP policy to reflect a particular characterisation of the problem(s) at stake, contingent on particular historical, cultural and political influences. It understands ASP practice to be actively engaged in re-constructing ‘harm’, ‘adults at risk’ and ‘ASP’ itself. The discovery model is argued to be useful in delivering a clear, basic message to practitioners about harm and abuse, particularly where time and the potential for interaction in educational contexts are limited. The construction model is argued to be useful in connecting more deeply with practitioners’ lived experiences, promoting political engagement and developing professional judgement informed by ethical debate.     

When pricing treatment,know your costs and set your profit margins

Billing, ethics and parity have been hot‐button issues for substance use disorder (SUD) treatment centers for years, but the National Association of Addiction Treatment Providers (NAATP) is getting closer to finding solutions. At its annual leadership meeting in Washington last month, members, not to be deterred by a surprise lawsuit on opening day from American Addiction Centers (see ADAW, May 20, https://onlinelibrary.wiley.com/doi/10.1002/adaw.32368 ), gathered to hear from experts on how to properly conduct billing in a dynamic new environment.     

VOTING FOR INCOME‐IMMISERIZING REDISTRIBUTION IN THE MELTZER–RICHARD MODEL

This paper argues that income received via redistributive transfers, unlike labor income, requires no direct sacrifice of leisure; this makes it attractive to many voters even if it leaves them poorer. This point is made within the classic Meltzer and Richard (1981) model wherein heterogeneous voters evaluate an income‐redistribution program that finances a lump‐sum transfer to all via a distorting income tax. The political‐equilibrium policy under majority rule is the tax most preferred, utility‐wise, by the median voter. Ironically, this voter, and many poorer voters, may support a redistribution policy that leaves them poorer in income terms but with higher utility. (JEL H2, E6, D72)     

Determining risk for child physical harm through the classification of economic insecurity

Children in economically insecure families are more likely to experience physical harm compared with children in economically secure families. It is unclear, however, if particular combinations of economic insecurity are more or less predictive of child physical harm. This study aimed to 1) identify and describe the prevalence of distinct combinations, or classes, of economic insecurity (public and private income transfers, bill-paying, housing, food, and medical hardships), 2) and to associate these classes with child physical harm (spanking, hitting, slapping, shaking, pinching). We employed latent class analysis with age 5 data from the Fragile Families and Child Well-Being Study (N = 4133), finding that four latent classes of economic insecurity differentially predict the prevalence and chronicity of physical harm behaviors. Mothers who reported hardship perpetrated more child physical harm than mothers who received income transfers but reported no hardship. Implications for research, policy, and practice are discussed.     

Cutting to Live: A Phenomenology of Self‐Harm

This exploratory study utilizes a phenomenological methodology as described by Moustakas (Phenomenological research methods, Sage Publications, 1994). Data were gathered via qualitative face‐to‐face interviews from a midsize southwestern community. Eleven participants, ten females and one male, were included in this study. Data suggested three categories that described the participants’ experiences of self‐harm: Self‐harm is Misunderstood, Self‐Harm has a Role, and Advice to Professionals. Among these categories, 11 themes emerged, including Self‐Harm is Not Suicide, Self‐Harm is an Addiction, Individuals Who Self‐Harm are Traumatized, Help That’s Not Helpful, Self‐Harm is a Release, Physical Pain versus Emotional Pain, Self‐Harm IS Control, and Need to be Punished. Advice to professionals who work with individuals who self‐harm is offered by the participants. The study concludes with a discussion of the phenomenon of self‐harm, as well as clinical and training implications for professionals. Future directions for research are also discussed.     

Protecting the Welfare of Children and its Causal Effect on Limiting Mother's Labour Migration

In June 2013 Sri Lanka introduced a new policy, the Family Background Report (FBR), to restrict mothers migrating for domestic work. This article performs an impact evaluation of the FBR using monthly departure statistics of female migrant workers from January 2012 to December 2014 in a difference‐in‐difference methodology. The identification is based on the inter‐temporal variation between the treatment and control groups. As anticipated, the FBR has a negative causal effect on female departures for foreign employment in the range of 449–812 departures per month. The findings are robust to placebo and sensitivity tests. Although successful in restricting females migrating for domestic work, this policy promotes migration outside the institutional framework of Sri Lanka and thereby increases their vulnerability at destination. For the policy initiative to be effective, its myopic focus has to be transformed into a long‐term plan to support those deterred from migrating.     

College students' perceptions of risk and addictiveness of e-cigarettes and cigarettes

Background: As conventional cigarette use is declining, electronic cigarette (“e-cigarette”) use is rising and is especially high among college students. Few studies examine dual use of e-cigarettes and cigarettes among this population. This study explores the relationship between dual and exclusive e-cigarette / cigarette use and perceptions of harm and addictiveness of both products. Methods: This is a cross-sectional analysis of data from students attending 24 colleges in Texas (n=5,482). Multinomial logistic regression was employed to test the association between current e-cigarette / cigarette use and perceived harm and addictiveness of both products. Three tobacco groups were included: cigarette only users, e-cigarette only users, and dual users. Results: Dual users reported lower perceived harm of e-cigarettes most consistently (p<0.001, all comparisons). Perceived harm of cigarettes was significantly lower among cigarette only and dual users only, compared to non-users (p<0.001, all comparisons). Compared to non-users, all three groups reported significantly lower perceived addictiveness of e-cigarettes (p<0.001, all comparisons). The same finding was observed for perceived addictiveness of cigarettes, though findings were less consistent for the e-cigarette only group (p<0.02, all comparisons except one). Conclusion: Findings demonstrate that among college students, perceptions of harm and addictiveness of e-cigarettes are lower than those for conventional cigarettes. For both products, perceptions of harm and addictiveness were lower among exclusive and dual users, compared to non-users.     

A SIMPLE MODEL OF OPTIMAL HATE CRIME LEGISLATION

We present a simple model of the effects of hate crime legislation. We show that even if the direct harm to victims of hate crime is the same as for other crimes, because of other differences in the effects it may still be optimal to exert a different level of law‐enforcement effort to deter or prevent hate crime. These differences also have previously unrecognized effects on the optimal level of effort by potential hate crime victims to avoid being victimized, thus affecting the efficiency of government policies that encourage or discourage such effort. In some cases, the optimal level of government effort may be lower for hate crimes than for other crimes. Our analysis suggests a role for policy tools that influence individual avoidance effort directly. We discuss the implications of our results for similar types of crime, including terrorism. (JEL K42, K14, D02)     

Beyond policy agenda-setting: political actors’ and journalists’ perceptions of news media influence across all stages of the political process

Although the relationship between politics and the media is a key topic in political communication research, the media’s role during times of routine policy-making has rarely been addressed. Furthermore, studies of routine policy-making have generally focused on one policy stage, usually agenda-setting, whereas few have analysed the media’s impact on the whole policy process. Still, the general view is that the news media matter in the early stages of the policy cycle but are non-influential during the formulation, implementation, and evaluation stages. This study queries these assumptions by taking a closer look at the news media’s influence on all stages of the political process at both the theoretical and the empirical level. A quantitative survey explored how members of the German Bundestag, administration officers, associations and NGOs, researchers, PR staff, and journalists involved with energy policy (N?=?338) perceive the media’s influence across all policy stages. The results confirm that media coverage does indeed strongly influence the political agenda. However, the subsequent formulation, evaluation, and termination of policy stages are also affected, with only the implementation stage being less susceptible to media influence. The different groups of political actors and journalists surveyed mainly agreed upon the estimations of the strength of the media effects.     

Climate Change Counter Movement Neutralization Techniques: A Typology to Examine the Climate Change Counter Movement

The Climate Change Counter Movement has been a topic of interest for social scientists and environmentalists for the past 25 years (Dunlap and McCright, 2015). This research uses the sociology of crime and deviance to analyze the numerous arguments used by climate change counter movement organizations. Content analysis of 805 statements made by climate change counter movement organizations reveals that the theory Techniques of Neutralization (Sykes and Matza, American Sociological Review 22(6):664, 1957) can help us better understand the arguments adopted by these organizations. Taking two observations from two time points, the author examine not only the composition of the messaging adopted by Climate Change Counter Movement (CCCM) organization, but how these messages have changed over time. In all, there were 1,435 examples of CCCM neutralization techniques adopted by CCCM organizations across these two points in time. This examination of the movement provides valuable insight into the CCCM and the subsequent environmental harm that is partly facilitated by their actions.     

TAX POLICY AND INCOME INEQUALITY IN THE UNITED STATES, 1979–2007

This paper assesses the effects of U.S. tax policy reforms on inequality over around three decades, from 1979 to 2007. It applies a new method for decomposing changes in government redistribution into (1) a direct policy effect resulting from policy changes and (2) the effects of changing market incomes. Over the period as a whole, the tax policy changes increased income inequality by pushing up the income share of high‐income earners (the top 20%). (JEL H23, H31, H53, P16)     

THE EFFECTS OF AUTOMOBILE RECALLS ON THE SEVERITY OF ACCIDENTS

The number of automobile recalls in the United States has substantially increased over the last two decades, and after a record of over 30 million cars recalled in 2004, in the last few years it has consistently reached between 15 and 17 million, and in 2010 alone 20 million cars were recalled. Toyota's recall crisis in 2010 illustrates how recalls can affect a large number of American drivers and the defects connected to them can result in loss of life and serious accidents. However, in spite of the increase in public concern over recalls and the loss of property and life attached to them, there is no empirical evidence of the effect of vehicle recalls on safety. This paper investigates whether vehicle recalls reduce accidental harm measured by the severity of injuries in vehicle accidents. The results of our analysis show that if a recall for a new‐year model is issued, then the severity of injuries of accidents continuously diminishes during the first year after the recall, something we do not find among cars not subject to recalls. This is because defects are repaired over time but also because drivers react by driving more carefully until the defects are fixed. To minimize the losses attached to having dangerously defective cars on our roads, both quick and timely recall issuance are needed and more detailed information on defects should be delivered to owners of defective vehicles. The latter can be made possible through simple but important policy changes by the U.S. government regarding recall information sharing with drivers and insurance companies. (JEL L51, L62)     

What Is The Purpose of Neonatal Drug Testing?

Controversy over neonatal drug testing may be due to a lack of agreement on the purposes for such testing. This article examines six issues: (1) the purpose of neonatal testing; (2) the selection of infants for testing; (3) the requirement for parental consent; (4) the concept of prenatal harm; (5) the standard of conduct required of a pregnant woman; and (6) the practical application of such a standard in designing a testing policy. It is argued that maternal consent does not need to be required for testing provided that: (1) adequate drug treatment services are available for the mother and infant; and (2) test results are excluded from use in legal proceedings. If intervention, therapy and research (rather than punishment) guides a neonatal testing policy, the sporadic testing of an infant's urine for the presence of illicit substances clearly falls short of the desired goals.     

Advocacy Tactics and Policy Outcomes of Sex Offender Rights Organizations

Social movement organizations for sex offender rights work to reduce harm to registrants and their family members by influencing sex offender registration and community notification policies. This study draws on two theories of social movement organizations—organizational emergence and political opportunities—to investigate the capacity (i.e., structure, resources, knowledge and skills) of these organizations to bring about policy changes. Data were gathered using in-depth, telephone interviews with 19 leaders of state-level advocacy organizations in the United States. Two types of strategies emerged, distinguishing organizations as proactive or reactive in their approach to policy change. Proactive organizations contribute to policy amendment, development or adoption, whereas reactive organizations focus on blocking policy. These two types of organizations have similar tactical repertoires; however, more proactive organizations report the use of networking and coalition building and media stories, and more reactive organizations report the use of legislative testimony and research and policy analysis tactics. This study informs social work policy and practice by highlighting effective and ineffective tactics used by highly stigmatized advocacy organizations.     

Methadone Maintenance as Last Resort: A Social Phenomenology of a Drug Policy

Drawing on qualitative interviews with drug addicts in Copenhagen, Denmark, this article offers a phenomenological reading of a methadone maintenance program. The program is set within the principles of harm reduction, meaning that its aim is not to cure the participants’ addiction but to keep them stable on substitution medicine and slow the deterioration of their lives. We analyze the program’s implications for participants’ sense of agency and constraint and for their orientations toward the past, present, and future. A major concern is with the program as a last resort policy that challenges neoliberal ideals of self‐governance and self‐development. While the program increases the participants’ sense of stability by providing them with methadone and by allowing them to better address their economic, housing, and other needs of everyday life, it also represents a context of physical, emotional, and social dependence. The interviews cast the program as a paradox that simultaneously increases participants’ sense of stability and vulnerability. In essence, the Danish methadone program has the effect of both helping the participants by reducing the drug‐related harm in their lives and of fostering conditions of inferiorization and enduring nonbecoming.     

Going tobacco-free on 24 New York City university campuses: A public health agency's partnership with a large urban public university system

ABSTRACT

The New York City Department of Health and Mental Hygiene partnered with the nation's largest university system, the City University of New York (CUNY), to provide technical assistance and resources to support the development and implementation of a system-wide tobacco-free policy. This effort formed one component of Healthy CUNY—a larger initiative to support health promotion and disease prevention across the university system and resulted in the successful introduction of a system-wide tobacco-free policy on all CUNY campuses. Glassman et al (J Am Coll Health. 2011;59:764–768) published a blueprint for action related to tobacco policies that informed our work. This paper describes the policy development and implementation process and presents lessons learned from the perspective of the Health Department, as a practical case study to inform and support other health departments who may be supporting colleges and universities to become tobacco-free.     

Mitigating Harm: Considering Harm Reduction Principles in Work with Sexually Exploited Young People

A growing awareness of child sexual exploitation (CSE) in the United Kingdom and throughout the world has prompted human service and legal/policy professionals to seek ways of engaging young people experiencing sexual exploitation, although much remains unknown regarding effective practice, and whether or not current knowledge regarding best practices with young people can be expanded to address CSE. This paper considers how principles of harm reduction, a public health approach widely used to engage adults and young people in help‐seeking behaviours, can be considered as part of a children's rights‐centred approach to policy and practice with young people experiencing CSE.     

WEIGHING THE MILITARY OPTION: THE EFFECTS OF WARTIME CONDITIONS ON INVESTMENTS IN HUMAN CAPITAL

Serving in the military is an important vehicle through which young Americans invest in their human capital. As such, changes in the desirability of military service may affect the attainment of enlistment requirements, such as a high school degree or equivalent. Using American Community Survey data, we find that exposure to home‐state combat fatalities during the Iraq and Afghanistan Wars decreased the probability of high school completion, and increased the probability of general equivalency diploma completion. Using military data, we confirm that exposure to home‐state fatalities selectively deterred some individuals from enlisting. The results suggest military service and educational investments are complements. (JEL I20, I26, J24)     

Making ends meet,in the household and on the planet

Policy‐making in relation to sustainable development is usually at the national (or, in relation to climate change, the global) level, yet the consumption it seeks to modify takes place at the household level. If households all ‘made ends meet’ in the same way then the much‐relied‐upon notion of per capita consumption would be valid and we could use ‘top‐down’ modelling to guide policy. Cultural Theory, however, predicts that there are five socially viable ways of making ends meet, and that all of them will be found (in varying proportions) within any nation. This prediction has been tested on a sample of 220 British households and shown to be well supported. Top‐down modelling, it is argued, has to give way to constructive interplay between the reflexive policy‐maker and a plurally responsive citizenry.