06April
Insurance Parity
On Tuesday, April 4, Deirdre, Carrick and I are hitching a ride on a bus hired by Long island Recovery Advocates to travel to Albany to advocate for Timothy's Law, the legislation that would mandate parity in insurance coverage for substance abuse and mental illness in New York.
Timothy's Law is named after Timothy O'Clair, a 12-year-old boy with a long history of mental illness. Despite his father's better-than-average insurance coverage, the family was not able to afford the treatment that Timothy needed. His family was advised to place Timothy in the New York State foster care system so he could get adequate care. Timothy hung himself in his closet on a visit home a few weeks before his 13th birthday.
We are going to pay a visit to our representatives Tuesday, particularly Sen. Nick Spano, who is widely viewed as the third most powerful legislator in the senate. He narrowly won re-election in 2004 in a surprising near-upset, and he is facing a stiff challenge again this November from Democratic state assemblywoman Andrea Stewart Cousins. Until the last election, I voted for Spano, even though he is a Republican and I am a Democrat. Bottom line: He delivered the bacon to our district, and seemed accessible.
But Spano is also a part of the Senate leadership that has attempted to water down Timothy's Law in past years. The result is that the legislation perennially stalls in the Senate, despite overwhelming support in the Democrat-controlled assembly. Informed sources tell us that Spano is poised to introduce a Senate version of the bill that will again water down the coverage that Timothy's Law provides.
The main argument against insurance parity legislation is that it is an "unfunded mandate" that will be a burden on small businesses. Just in the Nick of time for our meeting, a new study has determined that parity does not raise insurance costs. Read Join Together's story, which also reports that that "parity did not result in greater utilization of services when coupled with managed care." An abstract of the study itself is available on the New England Journal of Medicine site; you must be a subscriber to read the full text.
The study did not consider the cost benefits of providing coverage for chemical dependancy issue. The U.S. Substance Abuse and Mental Health Services Administration, however, has summarized the economic benefits of providing access to treatment and insurance parity for substance abuse.
Last week I posted the testimony that Deirdre delivered in support of the passage of Timothy's Law at a Senate hearing in 2003. Insurance parity is law in 35 states, but some have unfortunate exclusions. If there's no parity in your state, consider advocating and rattling the cages of your elected officials to make it happen.
I'll keep you posted on how things go on Tuesday. I hope Sen. Spano sees the light. Last election, we limited our campaigning to close friends and relatives. Deirdre's mother, for example, who was married to the late founder of the American Eagle Republican Club in the Bronx, voted for Stewart-Cousins, the Democrat, because of her support for Timothy's Law. There are a lot of things we'd rather do this fall than spend our time making Timothy's Law a major issue in this election campaign.
Sites Cited
I just want to mention two websites I've come across in my travels recently that may be useful to you.
Helpguide is an excellent, tightly written and easy-to-navigate primer on mental illnesses and addiction. I'd recommend to to anyone who's asking "what's wrong with me?" or "why is so-and-so acting that way?"
Managing Chronic Pain does a good job of covering some issues that arise in our discussions from time to time. There are many links to stories about pain management in journals and other sites. It's part of the Common Sense for Drug Policy network. Among other positions regarding currently illicit drugs, CSDP "advocates clear federal guidelines for the practice of pain management so that physicians need not fear unwarranted law enforcement scrutiny of medical practices."
I'm 100% in favor of that — until I think of the doctors who, for example, apparently have written scripts for Oxycontin that get in the hands of teenagers — even though there is another side to the story.
Like most issues, this one's not as black and white as it appears to advocates on either side of the issue, but two things are for sure as far as I'm concerned. People who need pain medication ought to be getting it, and people with addictions should not be "treated" in a jail cell.
Addict in the Family
I came across a concise, well-done e-book today out of Australia titled Addict in the Family: How to Cope With the Long Haul. It is targeted to the parents of young heroin users, and approaches the topic from a nonjudgemental, harm-reduction point of view. It is written by Dr. Andrew Byrne, a physician in Sydney who is an authority on methadone maintenance. If you're addicted to opiods, or care about someone who is, I recommend that you take a look.
Users Teach Doctors
In 2001, the Robert Wood Johnson Institute published an excellent compendium of research and data titled Substance Abuse: The Nation's Number One Health Problem. In a nutshell, "there are more deaths, illnesses and disabilities from substance abuse than from any other preventable health condition," the report stated.
Despite this fact, substance abuse is given short shrift in most medical schools — a matter of a few hours of teaching, in some cases.
"Only a small percentage of physicians consider themselves 'very prepared' to diagnose alcoholism (19.9%), illegal drug use (16.9%), and prescription drug abuse (30.2%)," according to a survey of primary care physicians and patients conducted for The National Center on Addiction and Substance Abuse at Columbia University (CASA) in 2000. As a result, "more than nine out of ten — 94% — of primary care physicians fail to diagnose substance abuse when presented with early symptoms of alcohol abuse," CASA reported.
Yesterday's New York Times carried a promising story, "Drug Users' Hard Lessons Become Tools To Teach Doctors."
"In the Albert Einstein College of Medicine's residency program at Montefiore Medical Center, substance abuse training may include lessons from those with firsthand experience," the Times reported. "Since January, three pairs of patients, called Peer Educators, have come monthly from among five methadone clinics in the Bronx to lead 90-minute courses for internal medicine interns through a program called Project Grow (Giving Resources and Options to Women)."
One intern said, "You can read about drug abuse, but if you've never seen it the way it really is, you won't recognize it."
Hopefully, this type of program will catch on in medical schools across the country.
Alcohol Awareness
April is Alcohol Awareness month.
It was heartening to see that, despite a snowstorm, more than 100 parents showed up for a town meeting on underage drinking this week in Douglas County, Nev., the same area where no parents showed up for a symposium on teen drug use last week. The poor attendance at the latter event led to an excellent editorial, "Parents Must Be Involved," that was posted on the home page of The Record-Courier'.
About 1,200 town meetings about underage drinking, in fact, were held around the country last week, funded by grants from SAMSHA.
Awareness for this issue is growing, and not a moment too soon.
We were cleaning out our 1993 Taurus station wagon today because it's being donated to charity on Monday. Duncan has been using the car for the past six months. I found a beer bottle cap in the well. He claimed he had no idea where it came from, but he was sure that it wasn't his.
"It must be a friend's," he said.
I gave — perhaps yelled is a better word — a lecture about need to have the guts to tell his friends that they could not ride in the car if they were going to drink. The consequences are that he cannot drive with any passengers for a month, and I expect him to spread the word why. If I just took away driving privileges, I don't think the real reason why would get out there. If I do find out that he has had a passenger — and word tends to get around in this small village — he'll lose his driving privileges for two months.
I'm more worried about teens having a few beers and driving than I am about them using heroin like Carrick did. Most will resist the latter; few have the gumption to tell their friends not to drink. It's part of the culture, particularly among jocks like Duncan's buddies. I found a story about the Duke lacrosse team in today's New York Times both insightful and disturbing. A black woman who was hired to be an exotic dancer at a team party has charged that three players raped her. According to the Times:
"A lot of people are saying, 'That's awful, but not a complete shock,' " said Mike Van Pelt, the sports editor of The Chronicle, Duke's student newspaper. "They go out a lot, drink a lot. Rowdy party behavior is not uncharacteristic."
You'll notice, starting today, that our site is carrying some public service advertising banners. They will rotate in the top right corner. The first is a link to a petition that you can send to your local representative asking them to "Get Serious About Alcohol Policies That Save Teens Lives." The second in a link to the Silent Treatment: Addiction in America website, which went live this morning. I'll be writing more about this project in the future but, in a nutshell, I am writing the lead article for a five-part series that will be available free to newspapers across the country starting in August, and Carrick will be blogging on the website beginning May 1.
Finally, Happy Birthday, Jim Jude, my main man. No joke (but I'm thinking of a few).