CUA. SSS 561 Drug Abuse: Treatment, Its Effectiveness, Policy and Politics Spring 2012 (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 561 Drug Abuse: Treatment, Its Effectiveness, Policy and Politics Spring 2012 (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 treatment 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 treatment, its effectiveness, policy and politics; the focus of SSS 560 is the conflict between individual and societal rights; and the focus of SSS 562 is current policy issues, their effect on clients, and the national debate. 11/3/11 Page 1

2 II. EDUCATIONAL OBJECTIVES A. To introduce students to the ideology underlying drug abuse and dependence treatment and related policies to understand why society treats treatment for drug abuse and dependence differently from that for 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 consider the dichotomy between the disease concept of drug addiction and the concept of acceptance of personal responsibility for one's behavior in terms of treatment readiness, acceptance, and acceptability. C. To make students aware of the public health versus the public safety considerations attendant to drug policies and science versus ideology as policy drivers in issues such as treatment effectiveness and to provide the knowledge and skills necessary to advocate that drug abuse, as a public health problem, should be treated comparably to other medical conditions. D. To consider the conflict between individual autonomy and personal responsibility to society through the study of compulsory drug testing policies, civil commitment, and compelled therapy. E. To consider illegal drugs, treatment, and medicine through the lens of the national debate on medical marijuana. F. To familiarize clinical concentrators on content on and analysis of treatment and treatment policies to understand the full range of issues faced by clients and their families and to prepare them to best advocate 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. 11/3/11 Page 2

3 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 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 drug treatment policy issue. Issues may include, but are not limited to, treatment versus incarceration for drug offenders, the regulatory schema for the medical prescription of methadone maintenance therapy, harm reduction approaches, and ethical issues relating to vaccine development. 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: March 16, 2012, which is two weeks after the last class. Papers are to be submitted electronically. F. Grading Policy 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 date, or an otherwise agreed upon date determined prior to the due date of the assignment, will be downgraded). 11/3/11 Page 3

4 Active participation and involvement in discussions 40% Written Paper 60% G. 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. 11/3/11 Page 4

5 Class Schedule Class Topics and Readings 1 Treatment Effectiveness, Part 1. Public health versus public safety; treatment versus incarceration, treatment in the criminal justice system during (and after?) incarceration; drug courts. Treatment of users who take drugs to feel good versus treatment of users who take drugs to feel better. Cohen, Chapter 16, pp , Goldstein, Chapters 15,16, and 10, pp Justice Policy Institute (2008). Substance Abuse Treatment and Public Safety. Access at National Institute on Drug Abuse (2009). Principles of Drug Addiction Treatment: A Research Based Guide. (2 nd ed.). Access at National Institute on Drug Abuse (2007). Principles of drug addiction treatment for criminal justice Populations: A research-based guide. Access at Recommended Reading Justice Policy Institute (2011, March). Addicted to courts: How a growing dependence on drug courts impacts people and communities. Access at final.pdf Prendergast, M.L. (2009). Interventions to promote successful re-entry among drugabusing parolees. Addiction Science & Clinical Practice, 5(1), Leukefeld, C., Oser, C.B., Havens, J, Tindall, M.S., Mooney, J., Duvall, J., & Knudsen, H. (2009) Drug abuse treatment beyond prison walls. Addiction Science & Clinical Practice, 5(1), Kleiman, Chapter 6 2 Treatment Effectiveness, Part 2. Treatment versus ideology. Goals of treatment. Defining treatment effectiveness. Measuring treatment effectiveness. Methadone maintenance. Cohen, Chapter 16, pp Goldstein, Chapter 10, pp American Society of Addiction Medicine (2011). Public policy statement: Definition of addiction. Access at 11/3/11 Page 5

6 LongVersion.html Substance Abuse and Mental Health Services Administration (2011, October). Length of time from first use to adult treatment admission. Access at Baca, L. & Beck, C. (2010, July 7) Restore methadone funding. California Progress Reporter. Access at Whitten, L. (2011) More opioid replacement therapy in correctional facilities might yield public safety and health benefits. NIDA Notes, 23(5). Access at The Partnership at Drug Free.org (2011, May 3). New veterans drug court in Miami- Dade county part of nationwide movement. Access at JT+Daily+News%3A+School+Nurse%3A+It%27s+Not+OK+to...&utm_mediu m= Substance Abuse and Mental Health Services Administration. (n.d.). Welcome to the National Center on Trauma-Informed Care. Access at 3 Harm Reduction. What is it? Compare decriminalization, legalization and medicalization. Medical marijuana. The special case of methadone. Cohen, Chapter 15 Goldstein, Chapters 12 and 18 American Society of Addiction Medicine (2010). Public policy statement on medical marijuana. Access at ProCon.org (2011, September 19). 16 legal medical marijuana states and DC. Access at Los Angeles Times (2011, July 13). Medical marijuana: Research, not fear. Access at The Seattle Times (2011, June 9). You can be fired for using medical marijuana, justices rule. Access at Global Commission on Drug Policy (2011). War on drugs: Report of the global commission on drug policy. Access at 11/3/11 Page 6

7 4 Drug Abuse and Ethical Issues: Developing Vaccines against Drugs of Abuse. Issues raised by the potential availability of a cocaine vaccine or of a nicotine vaccine via genetic tests that can show vulnerability to drug use. Potential for harmful labeling of a target population and resultant negative consequences attributable to the fact that the presence of antibodies will identify those who have received the vaccine. Issues related to harnessing the science of chemical neurotransmitters to develop smart drugs. D Souza, M.S., & Markou, A. (2011) Neuronal mechanisms underlying development of nicotine dependence; Implications for novel smoking-cessation treatments. Addiction Science & Clinical Practice, 6(1), 4-16 Shields, A.E. (2011). Ethical concerns related to developing pharmacogenomic treatment strategies for addiction. Addiction Science & Clinical Practice, 6(1), Long, M. (2011, May 3). Quest for vaccines to treat addiction. The Wall Street Journal. Access at 2-lMyQjAxMTAxMDAwMzEwNDMyWj.html The Economist (2011, May 19). Combating addiction: Can a vaccine stop drug abuse? Access at Quenqua, D. (2011, October 3). An addiction vaccine, tantalizingly close. Access at Jabr, F. (2011, July 25). Anti-addiction drugs face more than medical issues. New Scientist. Access at campaign=76c0fe22a2- JT+Daily+News%3A+Rising+Number+of+Babies...&utm_medium= Recommended Reading Cohen, P.J. (1997). Immunization for prevention and treatment of cocaine abuse: legal and ethical implications. Drug and Alcohol Dependence, 48 (3), /3/11 Page 7