CUA. SSS 562 Drug Abuse: Current Policy Issues, Their Impact on Clients, and the National Debate Spring 2013 (1 credit) Richard A. Millstein, J. D.

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1 CUA THE CATHOLIC UNIVERSITY OF AMERICA National Catholic School of Social Service Washington, DC Fax SSS 562 Drug Abuse: Current Policy Issues, Their Impact on Clients, and the National Debate Spring 2013 (1 credit) Richard A. Millstein, J. D. This course outline is the property of NCSSS and the instructor and may be distributed with written permission. I. COURSE PURPOSE This course provides essential knowledge and engages students in critical thinking about drug abuse and dependence and related public policies and their impact on individuals, families, and communities. It introduces students to the impact on clients and their families, especially ethnic minority populations, of disparate intent and impact of law, regulation, policy, and practice. Students will be introduced to the pervasive consequences of drug abuse and addiction upon the individual user attendant to associated problem behaviors, social problems, medical conditions, and even drug abuse history. Students will examine the consequences of policies that distinguish illegal drug abuse from abuse of tobacco and alcohol in terms of how the implementation of these policies affects their well-being and that of their family. Implications for accessing services for clients and advocating on their behalf will be addressed. This course is one of a series of three one-credit companion courses in drug abuse, each of which can be taken independently, with no prerequisite. Each has a different focus. The focus of this course is current policy issues, their effect on clients, and the national debate; the focus of SSS 560 is the conflict between individual and societal rights; and the focus of SSS 561 is treatment, its effectiveness, policy and politics. Page 1

2 II. EDUCATIONAL OBJECTIVES A. To introduce students to the ideology underlying drug abuse and dependence and related policies to understand why society treats drug abuse and dependence differently from other public health problems, including addictions to other substances, and the impact of this distinction on the poor, the underserved, and on minority populations. B. To make students aware of the effect of science versus ideology as policy drivers in issues such as health insurance parity for substance abuse and to provide the knowledge and skills necessary to advocate that client with drug abuse problems should be treated comparably to individuals with other medical conditions, including in terms of reimbursement policies. C. To have essential knowledge about the distinction between drug abuse history, status and behavior, addiction as a disability, and to understand the implications of a drug abuse history on eligibility for or exclusion from student loan programs, SSI and other disability benefits, and public housing. D. To understand the bilateral interrelationship between trauma and drug abuse behaviors, and what role social workers can play. E. To understand the relationship between service-related injuries, mental health issues, and substance abuse. F. To familiarize clinical concentrators on content on and analysis of policies to understand the full range of clinical issues faced by clients and their families and the need for advocacy on their behalf. III. COURSE REQUIREMENTS A. Required Texts Cohen, P. J. (2004). Drugs, addiction, and the law: Policy, politics, and public health (2 nd ed.). Durham, NC: Carolina Academic Press. Goldstein, A. (2001). Addiction: From biology to drug policy. New York, NY: Oxford University Press. B. Recommended Texts Mignon, S.I., Marcoux Faiia, M., Myers, P.L., & Rubington, E. (2009). Substance use & abuse: Exploring alcohol & drug issues. Boulder, CO: Lynne Rienner Publishers, Inc. Kleiman, M.A.R., Caulkins, J.P., & Hawken, A. (2011). Drugs and drug policy: What everyone needs to know. New York, NY: Oxford University Press. C. Required Journal and Other Articles Because of the intense and ongoing public debate related to issues of drug abuse, public health, and public safety, the content of this course is updated during the semester. Accordingly, additional readings or citations to websites, beyond the Page 2

3 required readings that are listed in the Class Schedule for each class, are distributed in class for review and discussion. D. Other Recommended Readings Musto, D. F. (1999). The American disease: Origins of narcotic control (3 rd ed.). New York, NY: Oxford University Press. Henningfield, J. E., Santora, P. B., & Bickel, W. K., Eds. (2007). Addiction treatment: Science and policy for the twenty-first century. Baltimore, MD: The Johns Hopkins University Press Campbell, N. D. (2007). Discovering addiction: The science and policy of substance abuse research. Ann Arbor, MI: The University of Michigan Press. Dupont, R.L. (2000). The selfish brain. Center City, MN: Hazelden. E. Course Assignments Participation: Each student is responsible for active oral class involvement on weekly assigned readings and interactive discussions on materials distributed in class for group exercises. Presentation of point of view and the arguments supporting them are expected and encouraged at each class. Due Date: each class Written Assignment: Each student will develop a 7- to 10-page original paper examining how a current policy may negatively affect clients. Issues may include, but are not limited to, the effect of drug use or conviction upon receipt of SSI benefits, welfare, and student loans; health policy coverage for substance abuse; parity for substance abuse disorders; the interrelationship between trauma and substance abuse; or special issues affecting military personnel, whether active or retired, and their families. If a student chooses to write on one of these topics, no approval is needed. If a student chooses to write on another topic, prior consultation with and approval of the instructor is needed. Due Date: May 3, 2013, which is two weeks after the last class. Papers are to be submitted electronically. F. Grading Policy Active participation and involvement in discussions 40% Written Paper 60% Grades for this course are based on the University grading system. The grade is based on content (substance, attention to assignment, attention to page limit), style (scholarly writing style, APA format), and timely submission (assignments submitted later than the assigned or date, or an otherwise agreed upon date determined prior to the due date of the assignment, will be downgraded). Page 3

4 G. Attendance and Participation Students are required to attend classes and are expected to participate meaningfully in class discussions. Active involvement and presentation by each student of his or her point of view and the arguments supporting them are expected and encouraged at each class. The grade for attendance and participation will be lowered unless the student notifies the instructor and requests an excused absence before the class. H. Course and Instructor Evaluation NCSSS requires written evaluation of this course and the instructor. Forms for this purpose will be distributed at the last meeting of the class. Additional, informal written or verbal feedback to the instructor during the semester is encouraged and attempts will be made to respond to requests. IV. CLASS EXPECTATIONS A. Scholastic Expectations Please refer to NCSSS Announcements, or appropriate Program Handbook for Academic Requirements, including scholastic and behavioral requirements. All written work should reflect the original thinking of the writer, cite references where material is quoted or adapted from existing sources, adhere to APA format, and should be carefully proofread by the student before submission to the instructor for grading. B. Academic Honesty Joining the community of scholars at CUA entails accepting the standards, living by those standards, and upholding them. Please refer to University Policy and appropriate Program Handbooks. C. Accommodations Students with physical, learning, psychological or other disabilities wishing to request accommodations must identify with the Disability Support Services (DSS) and submit documentation of a disability. If you have documented such a disability to DSS that requires accommodations or an academic adjustment, please arrange a meeting with the instructor as soon as possible to discuss these accommodations. Page 4

5 Class Schedule Class Topics and Readings 1 Legal Consequences of Drug Use or Conviction of a Drug-Related Crime. Implications of drug use or a drug conviction for receipt of SSI and disability benefits, welfare, and student loans. The role of trauma as explanatory or exculpatory. Required Reading Cohen, Chapter 13 Zornick, G. (2011, May 10). GOP bill would require drug testing of welfare recipients. The Nation. Access at The Partnership at Drugfree.org (2011, July 14). Missouri governor signs bill authorizing drug testing for welfare recipients. Access at JT+Daily+News%3A+Senate+Bill+Would+Require+Doctor...&utm_medium=e mail CNN (2011, June 1). Florida governor signs welfare drug-screen measure. Access at The Partnership at Drugfree.org (2011, September 8). Lawsuit challenges Florida law requiring drug testing for welfare recipients. Access at JT+Daily+News%3A+Marijuana+Use+on+the+Rise...&utm_medium= The Partnership at Drugfree.org (2011, October 12). Almost 1600 welfare applicants in Florida decline to undergo drug testing. Access at JT+Daily+News%3A+Smoking+at+Current+Levels...&utm_medium= Coyne, T. (2011, October 31). Indiana first to require drug test for job training. Post- Tribune. Access at Sulzberger, A.G. (2011, October 10). States adding drug test as hurdle for welfare. The New York Times. Access at Letters to the Editor, Samuels, P. N.; Dupont, R.L.; Foster, S.E.; & Schwartz, J. (2011, October 14. Four separate letters.). Testing state aid recipients for drugs. The New York Times. Access at f6- Page 5

6 JT+Daily+News%3A+Technology+Shows+Promise+in...&utm_medium= Rees, S., Silove, D., Chey, T., Ivancic, L., Steel, Z., Creamer, M., Forbes, D. (2011). Lifetime prevalence of gender-based violence in women and the relationship with mental disorders and psychosocial function. Journal of the American Medical Association, 306(5), Access abstract at Medical News Today (2011, August 2). Anxiety, mood and substance abuse disorder higher among female victims of gender based violence. Access at Recommended Reading Gostin, L.O. (1991). Compulsory treatment for drug dependent persons: Justifications for a public health approach to drug dependency. Milbank Quarterly, 69, Health Insurance Coverage for Substance Abuse. Medicaid and implications of potential Medicaid changes. The effect of the Patient Protection and Affordable Care Act and its Parity Act provisions for substance abuse treatment, and the implications of potential changes or repeal. Military and VA substance abuse coverage. Required Reading Greenfield, S.F. (2005). Is parity for the treatment of substance use disorders really sensible? Psychiatric Services, 56(2), American Psychological Association (January 2011). Resources on the mental health parity act. Access at Parity Implementation Coalition (September 2010). Parity toolkit for addiction and mental health consumers, providers & advocates: Simplifying the appeals process: Strategies for winning disputes with your health plan. Access at Read pages 4 8 and skim the remainder of the Toolkit. Barry, C.L. & Huskamp, H.A. (2011). Moving beyond parity Mental health and addiction care under the ACA. New England Journal of Medicine 365, Access at National Association of State Alcohol and Drug Abuse Directors (February 2011). Policy brief: Health reform implementation priorities. Access at Priorities.pdf Buck, J.A. (2011). The looming expansion and transformation of public substance abuse treatment under the affordable care act. Health Affairs, 30(8), Access abstract at Lacey, M., Sack, K, & Sulzberger, A.G. (2011, January 20). States budget crises cut deeply into financing for mental health programs. The New York Times. Access at Zoroya, G. (2011, March 24). Miscommunication hinders vets care, study finds. USA Page 6

7 Today. Access at veterans_n.htm?loc=interstitialskip Jones, J. (2010, May 6). Improving health care for veterans. [Web log blog]. Access at U. S. Government Accountability Office (2011) VA mental health: Number of veterans receiving care, barriers faced, and efforts to increase access. Access at Recommended Reading Coalition for Whole Health (August 2011) Recommendations on coverage of mental health and substance use disorder services in the essential health benefits package. Access at pdf 3 Unemployment, Substance Abuse, and Other Health and Social Problems. Implications of unemployment for substance abuse behaviors. Relationship of unemployment and discontinuation of health insurance benefits. Interrelationship of a cascade of negative behaviors. Role of the military services and the VA in the treatment of active and retired service personnel and their families. Required Reading U. S. Department of Labor (2011). Labor force statistics from the current population survey: Unemployment Rate 01/01 01/11. Access at Doty, M.M., Collins, S.R., Robertson, R., & Garber, T. (2011). Realizing health reform s potential When unemployed means uninsured: The toll of job loss on health coverage, and how the affordable care act will help. The Commonwealth Fund. Access at Briefs/2011/Aug/When-Unemployed-Means- Uninsured.aspx?view=print&page=all Indiviglio, D. (2010, September 16). How do unemployment claims relate to the national rate? The Atlantic. Access online at Kochhar, R. (2011).Two years of economic recovery: Women lose jobs, men find them. Pew Research Center, Pew Social & Demographic Trends. Access at Holahan, J., & Garrett, A. B. (2009). Rising unemployment, medicaid and the uninsured. Kaiser Commission on Medicaid and the Uninsured. Access at Kottke, T.E., & Pronk, N. P. (February 2009). Taking on the social determinants of Page 7

8 health: A framework for action. Minnesota Medicine. Access at 009/tabid/2826/Default.aspx Recommended Reading Haughen, S. E. (March 2009). Measures of labor underutilization from the current population survey. U.S. Department of Labor, U.S. Bureau of Labor Statistics, BLS Working Paper 424. Access at 4 Principles Guiding Rational and Humane Policies. Social workers as advocates, change agents, and cross-disciplinary thought and action leaders. Required Reading Goldstein, Chapter 20 Cohen, page 335 Recommended Reading Kleiman, Conclusion, pages Page 8