Pubdate: Mon, 30 Jul 2012
Source: Gazette, The  (Cedar Rapids, IA)
Copyright: 2012 Gazette Communications
Contact: http://thegazette.com/guidelines/#gform_fields_26
Website: http://thegazette.com/
Details: http://www.mapinc.org/media/3847
Author: J.T. Rushing

IOWA GETS FUNDS TO STOP DRUG ABUSE BEFORE IT STARTS

Program Will Stress Treatment, Counseling

The White House's announcement last week of a new drug control policy 
puts Iowa at the forefront of a decades-long debate over how to treat 
substance abuse and crime - and may affect the case for legalizing 
medical marijuana in the state.

President Barack Obama's administration announced a $22 million grant 
program in Iowa, Arizona and New Jersey that aims to identify 
potential substance abuse problems before they becomes full-blown 
disorders. In doing so, the program eschews decades of a war-on-drugs 
philosophy based primarily on law enforcement in favor of increased 
prevention and treatment.

The Screening, Brief Intervention and Referral to Treatment grants 
would go to four federally qualified health centers across Iowa as 
well as Camp Dodge, home to the state's National Guard. Iowa applied 
to participate in the program; states were selected based on 
proposals they sent which were independently reviewed.

"We want to identify problems that are lurking and might be going 
unaddressed," said Pamela Hyde, administrator of the Substance Abuse 
and Mental Health Services Administration. "High-risk patients are 
referred to specialty care, but there are others that can achieve 
treatment earlier."

Members of Iowa's congressional delegation said they were open to the 
new approach.

"I've always believed that prevention is the cheapest and best 
approach," said Sen. Tom Harkin, D-Iowa, who also said many law 
enforcement organizations have long supported more prevention efforts.

"When you look at how long the war on drugs has taken place in our 
country, and the continuing problem we have with drugs that have 
negative and disastrous implications in people's lives, it's 
reasonable to look at alternatives that try to focus on keeping 
people from becoming addicted to drugs," Rep. Bruce Braley, D-Iowa, 
told The Gazette.

Loebsack cautious

Only Rep. Dave Loebsack, D-Iowa, was wary, saying that emphasis 
shouldn't shift away from law enforcement.

"It's not a matter of replacing one approach with the other," he 
said. "In the short term, law enforcement is absolutely necessary. 
But I am certainly open to new ways to accomplish our goals."

In the announcement, Obama administration officials made it clear 
that medical marijuana would still be classified as illegal under the 
program which would identify users for intervention.

Gil Kerlikowke, director of the White House Office of National Drug 
Control Policy - the administration's so-called 'drug czar' and a 
former Seattle police chief - said only drugs that have been approved 
by the Food and Drug Administration would be allowed.

"And of course marijuana has never gone through that process," 
Kerlikowke said. "When you're talking about screening and substance 
misuse, one misuse could be medical marijuana."

Medical marijuana

Legally prescribed and legally used medical marijuana would be 
allowed, the officials said, if it were in a state that has approved 
the practice. But Iowa isn't one of them. The issue is actually at a 
stalemate. In 2010, the state Board of Pharmacy said the state should 
allow it's use for medical purposes, and referred the matter to the 
Legislature.

But lawmakers said they shouldn't have to act, and that the pharmacy 
board already has the authority to set up guidelines and a system.

The board, in reply, has insisted it needs legislative authority. 
Attempts at a resolution were unsuccessful in the 2011 and 2012 
legislative sessions.

Among Eastern Iowa's four congressmen, Harkin and Braley said they 
would support a legalized system for medical marijuana.

"It's appropriate from a medical standpoint for certain diseases," 
Braley said. "If it's legally prescribed and heavily regulated, and 
it's for medically appropriate reasons, there ought to be an option 
available for pain management.

Only Sen. Chuck Grassley, R-Iowa, said he opposed legalizing medical marijuana.

"Prescribed medicine should have the approval of the FDA," Grassley 
said. "And there's been no attempt to get the FDA to make a decision 
about this, and until you do, it shouldn't happen. I've also seen 
dozens of studies that show there's no benefit, so I'm going by 
science-based decisions."

How program works

The Screening, Brief Intervention and Referral to Treatment program 
would work by establishing screening centers in a variety of 
inpatient and outpatient medical clinics as well as non-traditional 
locales such as tribal areas and military bases.

Patients who are determined to be potential risks would be given a 
short, 10-minute interview to evaluate the possibility of a future 
substance abuse problems. The interviews would avoid a lecture-style 
or judgmental approach, officials said.

"It's about challenging the paradigm, not dividing the world into two 
groups," said Daniel Alford, medical director for the Massachusetts 
Screening, Brief Intervention, Referral and Treatment Program, which 
received federal grants from 2007 to 2012. "There's a group in the 
middle that we can intervene with."

Alford, too, said medical marijuana will be one of the drugs for 
which clinicians will look.

"We're screening for unhealthy use, so if it's being done well and 
legally, in a state where it's allowed, it's no problem," he said. 
"If it's being used in a way that's not prescribed, that will get identified."
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MAP posted-by: Jay Bergstrom