Opioid discontinuation as an institutional mandate: Questions and answers on why we wrote to the Centers for Disease Control and Prevention.

On March 6, 2019, a self-designated committee sent a public letter to the Centers for Disease Control and Prevention (CDC) urging the agency to address the widespread misapplication of its 2016 guideline on prescribing opioids. Three hundred and eighteen health care professionals, and three former Directors of the White House Office of National Drug Control Policy (Drug Czars) signed the letter, as did the parent organization for Substance Abuse Journal, the Association for Multidisciplinary Education and Research on Substance use and Addiction. The letter reflected concern about a wide range of initiatives and policies by payers, quality metric agencies, health care organizations, and other regulators enforced to strongly incentivize or mandate forced opioid dose reductions on long-term opioid recipients who were otherwise stable.

Delivering services to individuals with severe mental illness: SAMHSA falls short.

In the wake of the December 2012 mass shooting at an elementary school in Newtown, Connecticut, the Subcommittee on Oversight and Investigations of the Committee on Energy and Commerce of the U.S. House of Representatives held a hearing on the Substance Abuse and Mental Health Services Administration (SAMHSA) and its role in caring for people with severe mental illness.

Addiction and the brain-disease fallacy.

From Brainwashed: The Seductive Appeal of Mindless Neuroscience by Sally Satel and Scott Lilienfeld, copyright © 2013. Reprinted by permission of Basic Books, a member of The Perseus Books Group. The notion that addiction is a "brain disease" has become widespread and rarely challenged.

Incentives for organ donation: proposed standards for an internationally acceptable system.

Incentives for organ donation, currently prohibited in most countries, may increase donation and save lives. Discussion of incentives has focused on two areas: (1) whether or not there are ethical principles that justify the current prohibition and (2) whether incentives would do more good than harm. We herein address the second concern and propose for discussion standards and guidelines for an acceptable system of incentives for donation.

In defense of a regulated system of compensation for living donation.

Purpose Of Review: The organ shortage is the major problem in kidney transplantation today. Despite aggressive organ procurement efforts, the supply of donated kidneys, living and deceased, has not matched the growing demand; as a consequence, more and more qualified candidates are suffering on dialysis and then dying before being transplanted. Herein, we provide justification for a regulated system of compensation for donation.

Is caffeine addictive?--a review of the literature.

The common-sense use of the term addiction is that regular consumption is irresistible and that it creates problems. Caffeine use does not fit this profile. Its intake does no harm to the individual or to society and its users are not compelled to consume it.

The Institute of Medicine report: too quick to diagnose bias.

The Institute of Medicine report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, claims that medical studies document a systematic causal relationship between race and disparities in health inputs and outcomes among individuals of different races. This article argues that the majority of studies are not powerful enough to establish a causal link, since they do not sufficiently control for differences among patients that happen to correlate with race, and it outlines a powerful audit study that could isolate any effect of race on health care decisions. Even if there are race-based disparities in health inputs, evaluations of welfare and policy prescriptions should be based on health outcomes, since the relationship between care and health is, at least in some cases, weak.