RESOURCES
Problematic “Safety” Protocol in Lancaster Co. Jail’s Addiction Treatment Program
Health Policy Network is investigating a concerning safety protocol at Lancaster Prison. Detainees receiving medication for opioid use disorder are restrained with handcuffs behind their backs as a “safety” measure. HPN is working with experts to educate officials on alternative methods to manage addiction treatment programs. We believe that stigmatizing people engaged in lifesaving medical care is counterproductive and could result in costly civil rights litigation.
- MAT/ MOUD in Jails & Prisons: Policy Guidelines /Best Practices / Toolkits/ Research
- RE: Handcuff protocol for all participants in a local jail MAT / MOUD program
- Six Key Strategies to prevent MOUD diversion in jail-based programs (JCOIN, 2022)
- April 18, 2024, Lancaster County Prison Board Meeting, video (1 hour 29 minutes)
See discussion of LCP’s handcuffing protocol beginning at 47:35 – 1:04
at 1:06 (request for withdrawal management protocol)
at 1:08 – 1:11 handcuffing protocol and ADA
at 1:20:05 – 1:27:30 , late dosing grievances (MAT), more handcuffing protocol, ADA,
Civil Rights, the ADA, and Addiction
- Justice Department Issues Guidance on Protections for People with Opioid Use Disorder under the Americans with Disabilities Act, (updated Nov. 2022) US DOJ Office of Civil Rights
- To Protect People with Addiction from Discrimination, the Justice Dept. Turns to a Long-Overlooked Tool: The ADA, (June 2022) STAT, Andrew Joseph
- MAT/ MOUD (medications for opioid use disorder) Advocacy Toolkit (Nov. 2022) Legal Action Center
Drug-Induced Homicide Prosecutions
- Charging “Dealers” with Homicide: Explained, The Appeal (2018) Jacob Siegal and Leo Beletsky
Fentanyl: Policy vs. Panic
- Policy: Five Pillars of a U.S. Response to Illegally Manufactured Synthetic Opioids (Feb. 2022) Related article: Synthetic Opioids are an EVERYTHING Problem (June 2022)
- A blue-ribbon, bipartisan federal commission spent 12 months studying the national crisis of deadly fentanyl poisoning. Commission members included Congressional leaders from both parties, a former DEA administrator, law enforcement agents, drug policy and addiction agency leaders, and skilled research staff from the nonpartisan RAND Corp. They interviewed hundreds of experts, and studied classified and unclassified reports. I read the 94-page report, released in February 2022, so you won’t have to.
- The TL:DR: it offers 21 recommendations, spread out over five “pillars’ or domains, to address the crisis. They divided the recommendation between supply interdiction recommendations and demand interdiction recommendations. The report emphasizes that the only way to address the flood of deadly illicit drugs is to coordinate policies on a federal and international level. The Five Pillars:
- Demand reduction and public health, which notably features harm reduction along with expanding treatment and recovery supports.
- Policy coordination & implementation to include fixing outdated regulatory frameworks.
- Strong international relationships and cooperation are required.
- Research and monitoring programs to fill the many gaps in our data and surveillance.
- Supply reduction is the longest section, with a 6 requirements to disrupt supply. (None of which includes “border control” between the U.S. and Mexico, because that doesn’t work.)
- Panic: There is evidence that trainings for first responders often overstate the risk of accidental exposure to fentanyl. Even the CDC has mistakenly shared inaccurate information: CDC Nixes Misleading Video About Cops’ Risk of Fentanyl Overdose: “Video removed due to ‘concerns that parts of this video may mischaracterize the risks,’ CDC says”.
- Top resource addressing myths of casual exposure to fentanyl. Media reports have fueled misinformation. A recommended FAQ here.
- Fear, Loathing, and Fentanyl Misinformation— Misleading fentanyl narratives are pervasive and cause very real harm, Ryan Marino, MD, MedPage Today, Nov. 2022
- Fentanyl panic goes viral: Research on the spread of misinformation, Beletsky, et. al, (2020) International Journal of Drug Policy
Harm Reduction
- A Greater Focus On Harm Reduction Will Save Lives, Health Affairs (2022) Bryce Pardo and David Luckey
- Considering Heroin-Assisted Treatment and Supervised Drug Consumption Sites in the United States, a RAND Research Report, (2018) RAND Corporation, Beau Kilmer, et. al.
- PAHRN harm reduction resources: Resources to support your advocacy for effective legislation in PA to address substance use and overdose prevention. Civil Rights, the ADA, and Addiction
Justice System / Criminal-Legal System
- More Imprisonment Does Not Reduce State Drug Problems: Data show no relationship between prison terms and drug misuse (2018) Pew Research Issue Brief
- Making Deflection the New Diversion for Drug Offenders, Ohio State Journal of Criminal Law (2021) Kay Levine, Joshua Hinkle, Elisabeth Griffiths, 45 pp. Disentangling substance use services from criminal-legal control– focusing on helping people with low-level drug offenses before they are arrested or prosecuted.
- Today’s fentanyl crisis: Prohibition’s Iron Law,revisited, International Journal of Drug Policy (2019) Beletsky and Davis (full text pdf)
- We Can’t Arrest Our Way Out of Overdose: The Drug Bust Paradox, American Journal of Public Health (2023) Dr Nabarun Dasgupta’s editorial (pdf here) accompanies new research confirming a geographic correlation between opioid-related seizures by law enforcement (i.e. drug dealer arrests) and overdose deaths in the same neighborhood afterwards.
- “They found that within a six-minute walk (500 m) of each drug arrest, opioid overdose deaths doubled. Elevated fatal and nonfatal opioid overdoses were sustained over one, two, and three weeks….
- These examples call into question whether US policing, as it currently stands, is a reliable agent of drug harm prevention. There is growing scientific evidence to support what many on the street already know: the narrow mission of law enforcement may exacerbate drug harms.”
- The study referenced above: Spatiotemporal Analysis Exploring the Effect of Law Enforcement Drug Market Disruptions on Overdose, Indianapolis, Indiana, 2020–2021 American Journal of Public Health (July 2023) Ray, Korzeniewski, Mohler, Carroll,
Language: Substance Use and Addiction
- The AP Style book updated it’s recommendations in 2017 on appropriate terminology, yet some journalists to this day are still using “addict” as a noun, or other language that elicits bias. We can all do better.
- Changing the Narrative, the Action Lab at Center for Health Policy and Law: The Tired Narratives of Drug Policy: resources to accurately report on drug policy issues
- Words Matter: Guide from the Action Lab. I recommend the RECOVERY DIALECTS “checklist” here, by Ashford, Brown & Curtis, Drug & Alcohol Dependence (2018). Their research showed that some terms used by people referring to themselves in private, like in a mutual aid meeting, did not elicit the same level of negative bias associated with stigmatizing terms used in public or by medical professionals
- Reporting on Addiction – new resource for journalists, educators, and experts. Download their condensed style guide
- Language Matters in the Recovery Movement, Faces & Voices of Recovery. Another source for the 1-page infographic RECOVERY DIALECTS “checklist” (2018) by Ashford, Brown & Curtis.
- Study Suggests Calling Myself an ‘Addict’ Is Different Than You Calling Me One (2019) Institute for Research, Education & Training in Addiction (IRETA), short essay by Jessica Williams
Language about persons who are justice-involved
- What Words We Use —and Avoid— When Covering People and Incarceration 2021, The Marshall Project, Nonprofit journalism about criminal justice
- The Prison Studies Project: Eddie Ellis asks for humanizing, person-first language, and to stop using the terms: offender, felon, prisoner, inmate and convict
Opioid Settlement Funds
- Primer on Spending Funds from the Opioid Litigation, A Guide for State & Local Decision Makers, Nine evidence-based abatement strategies. Here is how to choose programs to fund!
- From the War on Drugs to Harm Reduction: Imagining a Just Response to the Overdose Crisis. Expert Recommendations for the Use of Opioid Settlement Funds, (Dec. 2020) FBX Center for Health & Human Rights at Harvard
- * INFOGRAPHIC on the Report*
- A Chance in a Lifetime: Using Opioid Settlement Funds Creatively to Help Older Adults (July 2023) Cassie Cramer, Deborah Steinberg, and Lina Stolyar, Legal Action Center
Peer Support/ Recovery Support
- Peer Support Services in Justice and Public Safety Settings – a Planning and Implementation Toolkit (Jan. 2023) The Legislative Analysis and Public Policy Association (LAPPA)
Pharmaceutical Marketing
- PharmedOut Pharma Marketing Hub: links to fact sheets and summaries of articles, from the pioneering program by Adrian Fugh-Berman, MD, based at Georgetown University Medical Center
- Model Act to License Pharmaceutical Representatives— Legislative language, and a Q&A on Licensing, National Academy for State Health Policy (NASHP) July 2020
- Big Pharma in the Overdose Crisis: A Former Drug Rep Speaks Out, Gail Groves Scott, TEDxLancaster 2021 – 16 minute You-Tube video, posted in 2023
Substance Use Disorders and Opioids
- Curated Library about Opioid Use for Decision Makers (CLOUD) Collection of resources that include: Substance Use, Addiction and Treatment, Recovery, Recovery-Friendly Workplaces, Peer Support, and Law Enforcement Diversion Programs
- Opioid Crisis: No Easy Fix to Its Social and Economic Determinants American Journal of Public Health (2018) Dasgupta, Beletsky, and Ciccarone ( full text pdf ) Authors provide evidence supporting the need for policies addressing social and structural root causes of the overdose crisis, rather than our historic over-focus on supply-side interventions.
- Access to Evidence-Based Treatments for Opioid Use Disorder, Policy briefs, analysis & articles, O’Neil Institute for National and Global Health Law, Georgetown Law
- The Legislative Analysis and Public Policy Association (LAPPA): Model Laws, Research and Analysis on public safety, health, the criminal justice system and substance use disorders