Effort to remove Medicaid prior authorization for bupe in NJ advances

You're a health care provider, and your patient is interested in cannabis — perhaps for pain, for anxiety, for depression or even for trying to quit drinking or using drugs. You think it could help him or her. Or, rather, it might — you really have no idea, because you didn't learn about it in medical school (except that it's illegal and addictive), but you know it's now legal in your state and you want to know how to respond to your patient's request.     

Daily,high‐potency cannabis linked to first psychosis

Daily use of marijuana (cannabis) is associated with a greater than three times increased risk of psychotic disorder compared to never users, according to a study published in Lancet Psychiatry. This risk increased to nearly five times if high‐potency cannabis was used. Across the 11 sites included in the study, if high‐potency cannabis were not available, 12.2 percent of cases of first‐episode psychosis could be prevented, rising to 30.3 percent in London and 50.3 percent in Amsterdam.     

Onslaught against 42 CFR Part 2 continues in Congress

With the opposition of the American Medical Association (AMA) last fall, any moves in Congress and the federal government to weaken the patient consent provisions of 42 CFR Part 2, the regulation protecting the confidentiality of substance use disorder (SUD) treatment records, were stopped in their tracks — and in the nick of time (see ADAW, Oct. 1, 2018; Oct. 15, 2018). But the groups promoting the complete abandonment of 42 CFR Part 2, replacing it with the Health Insurance Portability and Accountability Act, which itself is targeted for at least partial destruction (see ADAW, Jan. 21, Jan. 28, Feb. 25), are back. There's a new push to try to overhaul 42 CFR Part 2.     

SAMHSA urges treatment programs to test for HIV

Last month, the federal Substance Abuse and Mental Health Services Administration (SAMHSA) called on public health and substance use disorder (SUD) treatment providers to help make sure patients who are negative for human immunodeficiency virus (HIV) stay that way, and that those who are HIV‐positive are tested, receive antiretroviral treatment and stay “adherent” to the treatment. The directive came in the form of a “Dear Colleague Letter” from SAMHSA Director Elinore F. McCance‐Katz, M.D., Ph.D., assistant secretary for mental health and substance use for the Department of Health and Human Services.     

NP,PA bupe prescribers driving increase in rural provider availability

Across the country, lucky patients who got their treatment paid for thanks to grants from the federal government – and never really knew how long that grant would last – are angrily asking why they now have to pay, or be kicked out of treatment, ADAW has learned. It's a communications problem, and a problem of not knowing for sure when and where any more money will be available. We were able to talk to one program which has been handling this situation the right way – but even that is difficult due to lack of guidance.     

Prenatal use of cannabis associated with preterm birth

Self‐reported cannabis use by pregnant women was associated with a significant increase in the rate of preterm birth, even after adjustment for confounding, researchers reported in the Journal of the American Medical Association.     

What happened in 2018: Funding and more funding

2018 saw continued funding for the opioid crisis, mainly in the form of grants from the Substance Abuse and Mental Health Services Administration (SAMHSA). There was also an upswing in interest in harm reduction. Opioids, as in past years, led the news. Finally, the move to get rid of the confidentiality regulation (42 CFR Part 2) got stronger than ever. What follows is a brief summary of some of the many stories that ran in our 48 issues last year.     

New generation of harm‐reduction workers: Helton's concerns

Tracey Helton has been running peer programs for a decade, and involved with harm‐reduction work for two. Her “real” day job is working for San Francisco, a job that includes benefits and enables her to support her children. But it also allows her to run harm‐reduction services “from my closet,” as she puts it. We called her because we wanted to learn more about how she views the field.     

Breaking the Food Chains: An Investigation of Food Justice Activism*

This article develops the concept of food justice, which places access to healthy, affordable, culturally appropriate food in the contexts of institutional racism, racial formation, and racialized geographies. Through comparative ethnographic case studies, we analyze the demands for food justice articulated by the Karuk Tribe of California and the West Oakland Food Collaborative. Activists in these communities use an environmental justice frame to address access to healthy food, advocating for a local food system in West Oakland, and for the demolition of Klamath River dams that prevent subsistence fishing. Food justice serves as a theoretical and political bridge between scholarship and activism on sustainable agriculture, food insecurity, and environmental justice. This concept brings the environmental justice emphasis on racially stratified access to environmental benefits to bear on the sustainable agriculture movement's attention to the processes of food production and consumption. Furthermore, we argue that the concept of food justice can help the environmental justice movement move beyond several limitations of their frequent place‐based approach and the sustainable agriculture movement to more meaningfully incorporate issues of equity and social justice. Additionally, food justice may help activists and policymakers working on food security to understand the institutionalized nature of denied access to healthy food.     

Media,Politics and Climate Change: Towards a New Research Agenda

Climate change is one of the most pressing issues of our time, and the media have been demonstrated to play a key role in shaping public perceptions and policy agendas. Journalists are faced with multiple challenges in covering this complex field. This article provides an overview of existing research on the media framing of climate change, highlighting major research themes and assessing future potential research developments. It argues that analysis of the reporting of climate science must be placed in the wider context of the growing concentration and globalization of news media ownership, and an increasingly ‘promotional culture’, highlighted by the rapid rise of the public relations industry in recent years and claims‐makers who employ increasingly sophisticated media strategies. Future research will need to examine in‐depth the targeting of media by a range of actors, as well as unravel complex information flows across countries as media increasingly converge.