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“Punishing Those With Uteruses More Severely”: The States Sending Pregnant Addicts to Jail, Not Rehab

In response to a nationwide heroin epidemic, some Cincinnati hospitals are starting a new program to test all mothers or their infants for opiates, not just those deemed to be at risk based on their background.

The program is intended to help physicians identify newborns who could suffer from Neonatal Abstinence Syndrome (NAS), a group of symptoms related to drug withdrawal including excessive crying, irritability, diarrhea, and seizures. Mothers who test positive will be referred to treatment while their newborns receive extended care.

It’s a bold approach to a growing problem but it may only be effective in a state like Ohio, which, unlike many states, does not punish pregnant women who suffer from drug addictions. Women already bear the brunt of the heroin epidemic and they may face additional criminal and civil consequences if they become pregnant while using drugs.

According to the Centers for Disease Control and Prevention (CDC), heroin use has more than doubled among adults ages 18 to 25 in the last decade, and heroin-related overdose deaths have nearly quadrupled between 2002 and 2013. Among women, heroin use has increased by a staggering 100 percent from 0.8 to 1.6 users per 1,000 people, as compared to a 50 percent increase among men across the same time period.

Over roughly the same time period, the prevalence of NAS has increased from 1.2 to 3.39 per 1,000 hospital births, becoming a pressing public health problem in neonatal ICUs.

In light of the spike in heroin use, the CDC recommends that states increase access to treatment for drug addiction. But some states seem to believe that the best way to help NAS newborns is by threatening their mothers with jail time instead of providing treatment and social support.

In 2014, a Tennessee law went into effect allowing pregnant women who take narcotics while pregnant to be charged with aggravated assault, which could result in a 15-year prison sentence. In so doing, the state earned the dubious honor of becoming the first to pass a specific law that would punish drug-addicted pregnant women.

Weeks after it went into effect, a 26-year-old mother who admitted to using meth before childbirth became the first woman to be charged under it.

“Hopefully it will send a signal to other women who are pregnant and have a drug problem to seek help. That’s what we want them to do,” a county sheriff told the local ABC affiliate.

But critics including the American Civil Liberties Union (ACLU) and The American Congress of Obstetricians and Gynecologists (ACOG) say that such measures do not encourage women to seek help but rather discourage them from seeking prenatal care. Some medical experts even believe that legal prohibitions on pregnancy during drug use may increase abortions among women who would feel pressure to terminate their pregnancies in order to avoid prosecution.

And if Tennessee lawmakers are truly concerned about the welfare of drug-addicted pregnant women, perhaps they should consider funding a specific program to help them recover.

As it turns out, the states that punish drug-addicted pregnant women and the states that prioritize their welfare have a disappointingly narrow intersection. According to the Guttmacher Institute (PDF), 19 states have created or funded targeted drug treatment programs for pregnant women. Tennessee does not number among them. Nor do 10 of the 18 states where it is considered child abuse, although five of them do give pregnant women priority access in general programs.

Of the 15 states that require mandatory reporting to the state when substance abuse is suspected, only six have created or funded treatment programs for pregnant women.

Including Tennessee, a handful of states have gone beyond state reporting requirements and standard definitions of child abuse.

In 2013, the Alabama Supreme Court upheld the conviction of two mothers who had used drugs while pregnant and ruled that drug use during pregnancy constituted chemical endangerment of a child because “the plain meaning of the word ‘child’ in the chemical endangerment statute includes unborn children.”

With this ruling, Alabama joined the South Carolina Supreme Court, which ruled in 1997 that a viable fetus was a “person” and that “maternal acts endangering or likely to endanger the life, comfort, or health of a viable fetus” could be considered criminal child abuse.

Neither Alabama nor South Carolina has funded specific substance abuse treatment programs for pregnant women.

Reuters reports that five other states have tried to pass legislation similar to Tennessee’s new law. In March, for example, North Carolina legislators pushed for a law that would classify drug use while pregnant as assault, a class 2 misdemeanor in the state.

But women who use drugs while pregnant have also been charged under the “fetal harm” and “fetal homicide” laws that are already found in a majority of states. Last year, a chronically depressed and uninsured Wisconsin woman named Tamara Loertscher spent 17 days in jail because clinic discovered methamphetamines and marijuana in her system when she went in for a pregnancy test. Loertscher said that she stopped using drugs as soon as she suspected she was pregnant but it was too late.

Many “fetal homicide” laws were originally intended to punish those who injured or killed pregnant women—now they are being applied to punish and demonize pregnant women themselves.

As ACOG notes, several major medical and public health organizations in the United States have argued that states should try to curtail drug and alcohol use during pregnancy through treatment rather than criminal prosecution. The American Medical Association fought the 2013 Alabama Supreme court ruling and opposes legislation that criminalizes drug use during pregnancy. And the American Psychiatric Association said in a 2001 position statement that “societal resources [should] be directed not to punitive actions but to adequate preventive and treatment services for these woman and children.”

Even new universal testing initiative in Cincinnati is not without controversy. As Reuters reports, some advocates would prefer a screening program for pregnant women to mandatory testing. But if mandatory testing can be effective anywhere, it would be in a state like Ohio where there are no criminal consequences for drug-using pregnant women, no mandatory reporting requirement, and state-funded treatment available for pregnant women.

What a novel idea: Help people recover from drug addiction instead of punishing the ones who have uteruses more severely.

 

By: Samantha Allen, The Daily Beast, August 12, 2015

August 13, 2015 Posted by | Abortion, Drug Addiction | , , , , , , , | Leave a comment

“Who Owns Most Of The Guns? ‘The Base!”: Overlapping Circles Of A Hard Core Of Dangerous Folks

It’s a research finding that is startling but not really surprising (per a report from NBC’s Maggie Fox):

A new study aimed at figuring out who owns gun in the United States and why suggests that about a third of Americans have at least one.

Most are white males over the age of 55, and a “gun culture” is closely linked with ownership, the team at Columbia University reports.

The study, published in the journal Injury Prevention, is one of several trying to pin down the number of gun owners in the United States. No agency keeps statistics on gun ownership and many pro-gun activists advocate keeping gun ownership private because of fears about potential future laws that might take guns away.

Yeah, well, if you really buy into the idea that good people like us need to stockpile weapons in case we need to overthrow a tyrannical socialist regime supported by those people, then I guess you want to present a moving target, eh? But I digress. The study also even less surprisingly shows a geographical gulf in gun ownership:

[Gun ownership percentages ranged] from 5.2 percent in Delaware to 61.7 percent in Alaska,” they wrote in their report. “Gun ownership was 2.25 times greater among those reporting social gun culture than those who did not,” they added.

In the Northeast, gun ownership rates ranged from 5.8 percent in Rhode Island to 28.8 percent in Vermont.

In the Midwest, rates ranged from 19.6 percent in Ohio to 47.9 percent in North Dakota. In the South and mid-Atlantic, rates ranged from 5.2 percent in Delaware to 57.9 percent in Arkansas. And in the West, California had the lowest rate of gun ownership at 20 percent, while nearly 62 percent of Alaskans said they had a gun.

Now this rural habit of disproportionate gun ownership is often related to the opportunity for and interest in hunting, and of a “gun culture” (to use the Columbia report’s terminology) in which social life revolves around gun-related activities. Both these factors are undoubtedly important. But there is something more basic than that: isolation. The first time in my life I really thought about owning a gun was one night when I was awakened at 2:00 AM in my central Virginia home at the end of a two-mile dirt road by approaching–and then extinguished–headlights. At that moment, I wasn’t real confident in the safety offered by a baseball bat, a Bichon Frise, and police officers who were at least 30 minutes away.

On the other hand, even then I didn’t really want an assault rifle, and I would have probably regretted firing hundreds of rounds at that parked car which in the end probably contained teenagers messing around or smoking pot.

Putting aside for a moment geography or the objective advisability of owning some sort of gun for self-protection, there is something fundamentally disquieting about the fact that the Americans most likely to own guns are also the Americans most likely to embrace a political rationale for gun ownership and most likely to believe they’re getting outvoted by people who don’t share their values. Somewhere in these overlapping circles is a hard core of dangerous folks who are being told constantly by Republican politicians that they are losing or have already lost their most fundamental rights. And this is why political extremism is a bad thing even if its devotees lose most elections.

 

By: Ed Kilgore, Contributing Writer, Political Animal Blog, The Washington Monthly, June 30, 2015

July 3, 2015 Posted by | Gun Control, Gun Ownership, Public Safety | , , , , | 1 Comment

“Supreme Court; If It’s Worth It For Corporations, Pollution May Be Okay”: EPA Can Only Regulate Pollution When It’s Cost-Effective

While LGBTs and healthcare reformers are still nursing their celebratory hangovers, the final Supreme Court case of the 2014-15 term just junked twenty years of environmental regulations.

The case, Michigan v. EPA, specifically dealt with the EPA’s regulation of mercury emissions from power plants under the Clean Air Act—a long, twenty-year process that has been opposed by industry at every turn, even as mercury air pollution from coal-fired power plants has ++irreparably poisoned the Great Lakes .

Today, the clock has been set back. In its third 5-4 decision of the day, with Justice Kennedy again providing the swing vote, industry has prevailed. Writing for the court, Justice Scalia held that the EPA had to factor in costs in deciding whether to regulate, not just how to regulate.

If you think about it, this is an impossible task practically and philosophically.

Practically speaking, the regulatory process for mercury has lasted twenty years—in large part because the EPA weighed dozens of options, evaluating the costs and benefits of each. Today’s decision requires the EPA to balance costs and benefits at the very beginning of the process, before either the costs or the benefits are known.

EPA’s position was that, while costs must, of course, be taken into account in deciding how to regulate toxic chemicals like mercury, the initial decision of whether to regulate them should not be dictated by how much it costs to do so. What matters at that point—whether regulation is “appropriate and necessary” under the statute—is only whether public health is at stake.

In policy-speak—as I wrote in a law review article twenty years ago—the difference is between “risk assessment” and “risk management.” Risk assessment is when you notice a leak in your basement, and decide you have to do something about it. Risk management is when you evaluate your options, and decide what to do.

The difference is obvious, and intuitive. But it does mean that the initial decision may not take cost into account.

Thus the EPA argued that the words “appropriate and necessary” do not imply a balancing of costs and benefits, only a determination of public health. Justice Scalia said this was not “reasonable decisionmaking.” As Justice Kagan said in her dissent, the EPA took costs into account later in the regulatory process. But Justice Scalia said that is not enough—the initial decision, too, must include costs.

This is as incoherent philosophically as it is practically. Think about it this way: Who owns the right to your health?

In the EPA’s reasoning, you do. Under the Clean Air Act, if someone else’s activities are going to meaningfully endanger your health, the government is entitled to stop them.

In Justice Scalia’s reasoning, now the law of the land, the toxic chemical emitters do. If it is economically efficient to poison you with mercury—if the costs to them outweigh the benefits to you, calculating an economic value of your health—then they get to do it.

If this seems outrageous, it’s because it is. Justice Scalia had to focus exclusively on the first sliver of the regulatory process in order to make his argument. “EPA’s interpretation precludes the Agency from considering any type of cost,” he writes. But that’s only true at the initial decision of whether to regulate or not (risk assessment). In subsequent decisions of how to regulate (risk management), cost was taken into account many times.

Which is what makes sense philosophically, as well as practically. Deciding whether to regulate a toxic substance should not be an economic decision. Deciding how to do so should be—of course, the government should choose the most efficient method of regulation, and balance costs and benefits appropriately. But the decision of whether a toxic substance is toxic is a matter of science, not money.

Zooming back a bit, Michigan v. US now starts to look a lot like the corporations-are-people cases like Citizens United and Hobby Lobby. In this growing body of cases, corporate interests have been equated with individual ones. Corporations have rights to free speech and the free exercise of religion.

Now their right to make money running dirty power plants is equated with the right of human beings to breathe free of mercury pollution. Your rights, their rights—what’s the difference?

Ironically, Justice Scalia’s originalism—which last week had him arguing that if a practice could be banned in 1868, it could be banned in 2015—would have cut the other way here, if he took it seriously. For the first hundred years of US history, there were no corporations as we know them today. Corporate charters were time-bound, limited, and revocable. Only in the Gilded Age did they attain “legal personhood” as we know it today.

This is the point conservatives often miss in decrying the growth of government and regulation. Yes, government has grown well beyond anything the Founders could have imagined. But the Founders could not have imagined today’s mega-corporations either.

Peabody Energy, one of the primary backers of the current lawsuit, has an annual revenue of $6.79 billion. In 1812, the largest non-banking corporation in America, the American Fur Company, was worth about $1 million—about $17.2 million in 2015 dollars.

In other words, just one of the corporations fighting the EPA’s mercury regulations is worth 394 times the largest US corporation in existence two centuries ago. While the growth in governmental power since then, represented by regulations like the Clean Air Act, has indeed been significant, it is dwarfed by the growth in corporate power.

Michigan v. US now stands for the principle that corporate interests are equal in kind to human interests. Whether the EPA should regulate mercury depends on whether it’s cost-effective to do so, treating the costs to industry and the benefits to health equally.

Because corporations are people, right?

 

By: Jay Michaelson, The Daily Beast, June 29, 2015

July 1, 2015 Posted by | Clean Air Act, Environment, Michigan v EPA | , , , , , , , | 1 Comment

“The Right To Be Free From Guns”: Those Who Want To Live, Shop, Go To School, And Worship In Gun-Free Spaces Also Have Rights

Advocates of a saner approach to guns need a new strategy. We cannot go on like this, wringing our hands in frustration after every tragedy involving firearms. We said “Enough” after Sandy Hook. We thought the moment for action had come. Yet nothing happened. We are saying “Enough” after Charleston. But this time, we don’t even expect anything to happen.

What’s needed is a long-term national effort to change popular attitudes toward handgun ownership. And we need to insist on protecting the rights of Americans who do not want to be anywhere near guns.

None of this should mean letting Congress off the hook or giving up on what might be done now. So kudos to Sens. Joe Manchin (D-WV) and Pat Toomey (R-PA) for saying on Tuesday that they are looking for ways to bring back their proposal that would require background checks for gun sales. In 2013, it failed to get the needed 60 votes and won support from only three Republicans besides Toomey.

Lest anyone doubt that gun-control measures can work, a study released earlier this month by the Center for Gun Policy and Research at Johns Hopkins University found that a 1995 Connecticut law requiring a permit or license contingent on passing a background check was associated with a 40 percent drop in gun homicides.

But as long as gun control is a cause linked to ideology and party — and as long as the National Rifle Association and its allies claim a monopoly on individual rights arguments — reasonable steps of this sort will be ground to death by the Washington Obstruction Machine.

That’s why the nation needs a public-service offensive on behalf of the health and safety of us all. It could build on the Sandy Hook Promise and other civic endeavors. If you doubt it could succeed, consider how quickly opinion changed on the Confederate flag.

My friend Guy Molyneux, a progressive pollster, laid out how it could happen. “We need to build a social movement devoted to the simple proposition that owning handguns makes us less safe, not more,” he told me. “The evidence is overwhelming that having a gun in your home increases the risks of suicide, domestic violence, and fatal accidents, and yet the number one reason given for gun purchases is ‘personal safety.’ We need a public health campaign on the dangers of gun ownership, similar to the successful efforts against smoking and drunk driving.”

The facts were on the side of those who battled the tobacco companies, and they are just as compelling here. When we talk about guns, we don’t focus enough on the reality, reported in the 2015 Annual Review of Public Health, that nearly two-thirds of the deaths from firearms violence are suicides. Yes, people can try to kill themselves with pills, but there’s no coming back from a gunshot to the head. Those in the throes of depression who have a gun nearby are more likely to act on their darkest impulses.

Nor do we talk enough about accidental deaths when children get their hands on guns, or what happens when a domestic argument escalates and a firearm is readily available. The message is plain and simple: Households that voluntarily say no to guns are safer.

“The best way to disarm the NRA rhetorically is to make the Second Amendment issue moot,” Molyneux said. “This is not about the government saying you cannot own a handgun. This is about society saying you should not have a gun, especially in a home with children.”

Molyneux says his approach “does not imply giving up on gun control legislation.” On the contrary, the best path to better laws is to foster a revolution in popular attitudes. And this approach would finally put the rights of non-gun owners at the center of the discussion.

“Those of us who want to live, shop, go to school, and worship in gun-free spaces also have rights,” Molyneux says. “In what way is ‘freedom’ advanced by telling the owner of a bar or restaurant they cannot ban handguns in their own place of business, as many states now do? Today, it is the NRA that is the enemy of freedom, by seeking to impose its values on everyone else.”

The nation could ring out with the new slogans of liberty: “Not in my house.” “Not in our school.” “Not in my bar.” “Not in our church.” We’d be defending one of our most sacred rights: The right not to bear arms.

 

By: E. J. Dionne, Jr., Opinion Writer, The Washington Post; The National Memo, June 29, 2015

June 30, 2015 Posted by | Background Checks, Gun Deaths, Gun Violence, National Rifle Association | , , , , , , , , | 2 Comments

“I Am A Scientist, Man, But A Conservative One”: Vaccine Skepticism Isn’t A Conservative Problem, But It’s A Problem For Conservatives

Because New Jersey Governor Chris Christie recently quarantined a nurse in a large tent when he thought she might have had Ebola, you might have assumed that he of all people would seize upon a measles outbreakattributable to a movement of anti-vaccine reactionariesto lecture parents for putting children at risk. But when pressed to take a position on the view that parents should vaccinate their children, Christie hedged. “It’s more important what you think as a parent than what you think as a public official,” he said. “I also understand that parents need to have some measure of choice in things as well. So that’s the balance that the government has to decide.”

It’s tempting to attribute his sudden fondness for “balance” to lessons he over-learned during the Ebola panic he helped nurture. But it’s also mistaken.

Vaccine skeptics don’t mirror climate change deniers, who are overwhelmingly conservative and amplified by vast wealth. But the anti-vaxx movement nevertheless presents a greater political problem for Republicans than Democrats, who, like President Obama, are unafraid to make explicit declarations about the importance of vaccinating children. By and large, Republican politicians don’t tout their own ignorance of vaccine science or use it to shield themselves from substantive questions about immunology, public health, or child rearing. Vaccine skepticism and climate change denial are, again, more different as reactionary movements than they are alike.

But two facts about vaccine skeptics and the risks they pose make it difficult for Chris Christie and perhaps other Republicans to treat anti-vaxxers as brusquely as he’s happy to treat unionized teachers in Newark.

It’s not that Republicans must pretend to believe that vaccines cause autism. But a large, motivated population of vaccine skeptics begs for interventions Republicans can’t easily get behind. The two most straightforward ways to increase vaccination rates or otherwise reduce the risk of losing herd immunity are: Imposing government mandates and stigmatizing the white, affluent people who comprise the core of the anti-vaxx movement.

Hectoring white people and imposing mandates on their families doesn’t fit comfortably in the GOP wheelhouse these days, and Christie’s awkward walkback underscores the bind that places on conservatives exquisitely.

Christie’s office: “The governor believes vaccines are an important public health protection and with a disease like measles there is no question kids should be vaccinated. At the same time different states require different degrees of vaccination, which is why he was calling for balance in which ones government should mandate.”

Shorter Christie: I am a scientist, man. But a conservative one.

Conservatives and liberals are both overwhelmingly of the view that childhood vaccines carry important benefits; conservatives, however, are inherently skeptical of government interventions of any kind. Thus, Republican politicians who lean too heavily on the state action, even in the realm of something as essential to the common good as immunization, will run into problems.

A 2014 study by Dan Kahan for Yale Law School’s Cultural Cognition Project found that people with left-leaning political outlooks are likelier to support restricting non-medical exemptions for childhood vaccine requirements, likely reflecting “an ideological predisposition against government regulation independent of any ideological sensibility specific to childhood vaccination.”

This tendency might not hold if anti-vaxxers existed on the fringes of political life, or were overwhelmingly of foreign origin, or were monolithically liberal. Opposition to government intervention can be both reflexive and selective. But the available evidence suggests vaccine skeptics tend to be white, educated, affluent, and, per Kahan’s study, politically diverse.

It’s not that Republicans are in thrall to vaccine skeptics, but it can be difficult for them to confront vaccine skeptics in ways that don’t alarm conservatives for other reasons. And taken to an extreme, it becomes hard to tell the difference between the two.

 

By: Brian Beutler, The New Republic, February 2, 2014

February 6, 2015 Posted by | Chris Christie, Conservatives, Vaccinations | , , , , , , , | Leave a comment

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