Not Drug Czar -- Ramstad Now Wants to Head Treatment Agency. Just Say No!

Our coverage of the possible nomination of Rep. Jim Ramstad as "drug czar" has kicked up quite a fuss, spurring many comments here and a sign-on letter by addiction professionals that was cited by John Tierney in this week's New York Times.

Nearly 300 leaders in the addiction treatment field so far have added their signatures. Now, the Minnesota Independent is reporting that Ramstad's real ambition is to serve as the head of the Substance Abuse and Mental Health Services Administration (SAMHSA).

While that sounds better than having him in charge of drug policy overall as "drug czar," in fact, it is a position in which he could possibly do more damage by replacing evidence-based treatment with ideology "behind the scenes."

Let's look once at his record. With politicians, I find that support for needle exchange tends to be a good proxy for whether you "follow the data" or follow the political winds of ideology. As we know, Ramstad went with ideology -- and even when he had a recent chance to revise his position to allow Washington, DC to use its own money for such programs, he remained firmly stuck in the past and voted to try to block that.

Then, there's methadone and other maintenance treatments. Against the weight of an Institute of Medicine study -- the Institute of Medicine is the agency charged by Congress with resolving medical controversies with data -- he opposed maintenance so much that he didn't want to give insurance parity for coverage.

In other words, while parity would have advanced all other addiction treatments, if his early parity bills had passed, the best-supported treatment for heroin addiction would have become harder to get.

Is someone who opposes what the science says is the best treatment for heroin addiction really someone we want in charge of the agency which is supposed to help disseminate evidence-based care?

And, of course, there's his earmark and other support for Teen Challenge. This is a "treatment provider" which claims that addiction is a sin, not a disease -- and the only help it offers for addicts is conversion to a particular form of Christianity. No medication, no evidence-based therapies, no credentialed counselors -- it doesn't even advise participation in 12-step programs, which is the one treatment modality we know Ramstad favors!

Ramstad sponsored a bill to change the name of the National Institute on Drug Abuse to the National Institute on Diseases of Addiction. As I wrote yesterday, either he really doesn't believe addiction is a disease -- in which case, he's a hypocrite and not someone we want running a treatment agency or he doesn't vet programs that he supports, in which case he's also not a good choice to head an agency that funds various kinds of treatment and initiatives [pdf] for promoting the best care.

The head of SAMSHA should be someone who promotes evidence-based treatment -- not someone who only supports the science when it bolsters his personal beliefs.

[And, so that I don't have to write this piece ever again, Ramstad should not be considered as head of the National Institute on Drug Abuse -- the agency in charge of research on addictions at NIH, no matter what name it turns out to be given -- either!]

Comments

[MplsPaul]

The Minnesota Independent, which has been covering Ramstad's national ambitions and his MN Teen Challenge earmark, got a nearly identical letter from MNTC's director. MnIndy's Andy Birkey suggests that a $500k earmark for the program sponsored by Sen. Amy Klobuchar may be behind the organization's letter-writing campaign.

The offending article:
http://minnesotaindependent.com/19501/ramstads-recovery-policy-included-faith-based-earmark

MNTC's letter:
http://minnesotaindependent.com/20042/mn-teen-challenge-responds-to-mnindy-coverage

The new $500k earmark:
http://minnesotaindependent.com/20334/know-the-truth-cannot-evade-scrutiny

[frausimo]

Anyone experiencing soma dependency needs immediate addiction treatment. The irreversible physical damage of chronic abuse demands a strong response, and most inhalant abusers will require addiction treatments to learn how to live drug free. Soma recovery treatments options include residential care, such as therapeutic wilderness programs, therapeutic boarding schools or residential rehabs, or outpatient options.
http://www.addiction-treatments.com/

[creator92]

To the extent that we treat addiction as a public health problem rather than a criminal justice problem, and allocate our resources that way, we will improve the situation. However, very few illicit drug users are actually addicted and would benefit from treatment. Cannabis is the leading cause of treatment "presentations," because consumers given a choice between punishment and treatment understandably opt for treatment, wasting scarce criminal justice and treatment resources. It's like forcing all fast food consumers, be they young or old, fit or fat, into weight loss programs.

Drug prohibition drives a wedge between parents and children, doctors and patients, cops and citizens. Zero-tolerance prevents us from acknowledging the spectrum of risks between substances, dosages and methods of ingestion, impeding honest drug education.

That is why I am endorsing Dr. Ethan Nadelmann as our next Drug Czar. Please join me.

http://drugczarofmydreams.com/

[Angels4DrugAwareness]

The truth is, there is not one way to treat the disease of addiction, and to believe so would be wrong. There are people who have changed their lives through abstinence, and there are people who cannot. There are people who can change their lives through medical-assisted treatment. Romstad's views are his own, and he has been in politics long enough to witness the actions of the past drug czars. We all remember what happened with McAffrey, right? He's now on the board of one of the largest clinic-owning groups in the country. Do you think he's there because of evidenced-based results? Not a bit. He's there because there's money to be made. So maybe Romstad isn't going to buy into the for-profit medical-assisted treatment methods that are currently being used in the U.S. based on what he has witnessed. Has anyone thought about that? We don't have medical-assisted treament in the U.S. today. We have medication-based. But either way, the automatic reaction of so many today when methadone isn't the only priority in the treatment of addiction will not aid in convincing others to believe what point is attempted to be made, but instead result in people seeing these reactions as being fear-based, and made by those with a motive.

[schatsie]

That is ridiculous, there used to be no way to treat DIABETIS AND CANCER... this is stupid, we need more research and NOT THAT being done by the greedy PHARMs...in 100 years people will look back and say either we were idiots ('Just Say NO and Abstinence, and faith based stuff) or they will say we did what was necessary to understand these issues...

Which way shall we go?, the way of science or the fundamentalist Satan's poor philosophy (you really don't deserve to have your issues addressed, if God meant you to have shoes and bread, he would have given them to you.)

[TRYKER]

If Obama's admin's approach to drug addiction and treatment doesn't veer away from prison industries and law enforcement favors, he will fail before he begins.
He could go down in history if he instituted treatment on demand and scrapped altogether the totally bogus "war on drugs" bullshit that has corrupted the problem beyond the point of no return.
Stop already with the criminalization of herb smokers that cost states $45,000 a yr to house! How insane is that?! Pot smokers on the outside can live on a third of that incidentally...HINT HINT.
This is one area that needs CHANGE we can believe in, and without real change, his admin will be lumped in with all the other failures...simply from ignorance and ideology.

[niceguy2]

I am a recovering person. While I can understand some of what has been questioned regarding Ramstad's past stance on needle exchange, supporting Teen Challenge, and the point in this article about his parity solutions not being perfect in the past.
Have you ever thought that maybe Ramstad didn't want to upset his constituents he was representing the times he didn't vote for needle exchange? Have you ever thought that Ramstad supporting Teen Challenge is just Ramstad supporting something that does work for some people. (While I don't agree with Teen Challenge, I recognize this point.)
THERE IS NOT ONE WAY TO RECOVER FROM ADDICTION!
Different things work for different people, he isn't forcing anything on anyone by supporting Teen Challenge, he is embracing a concept that is apparently impossible for many of you to truly embrace. OPEN-MINDEDNESS.
Ramstad is a champion for recovery from addiction, and is one who whole-heartily understands the concept of disease more than any doctor who isn't an addict or alcoholic could ever understand.
Unfortunately, I think many of you opposing Ramstad are missing the clarity, and recognition of what this man has done for people in recovery and continues to do.
As a recovering person, I wouldn't want anyone else at the head of one of these most important positions.

[zenith15]

Amen, Maia, and Dr Tatarsky! You are so right on this! I hope Obama realizes that a compromise here will lead to an enormous step backwards in the treatment of addictive disease, and that science, not religion, must lead the way.

[jhNY]

Drug addiction is a profit center for addiction professionals and the prison industry, and for law enforcement, whose number is legion, mostly because of the always failing, always funded War On Drugs Without End. But that's just the way it is, and will be. Your zero-tolerance employer demands abstinence from his workers as a condition of employment, and will insist on it till he can't use you anymore, at which time I guess you could say he will have broken his addiction to your labor. Usually cold turkey. Or two weeks' notice.

[andrewtatarsky]

I am the psychologist with 30 years treating patients with mental health and substance use disorders who, in collaboration with many colleagues, organized the letter opposing Ramstad as a choice for Drug Czar because of his ideological, regressive, non-science based perspectives. In contrast to the statement in the Minnesota Independent that mental health and substance abuse professionals are more favorable to him than public health advocates, our letter of 300 of his crowd, many of whom are leaders in the field, is proof to the contrary. You can view the letter and its signers at www.andrewtatarsky.com. We want America's drug policy to be guided by evidence-based, compassionate treatment for people struggling with substance use problems not the tired old failed one-size-fits all system that sets up failure and despair and leads to escalatations in substance use and increased incarceration. Good science-based treatment rather than incarceration is good for substance users and good for America.