2createYourMD

2009 Drug Abuse Course at GW

2010-03-05T15:27:00.003-05:00

Substance Abuse: Prevention, Intervention & Public Health
(Public Health 209.27: 5/20/2009 - 7/22/2009; Wednesdays 6:10 - 8:40 PM; Ross Hall 224)

COURSE DESCRIPTION: The epidemiology, pathology and physiology of substance abuse and its treatment will be reviewed, with emphasis on the preventable complications and sequelae of the different stages of use, abuse and addiction. Substance abusers will be examined as a key population for biopsychosocial interventions to protect them, their families, communities and the general public. Various public health interventions will be explored at all possible points of contact with drug abusers, both in and out of treatment. Current national initiatives relevant to drug abusers and related public health issues will be reviewed.PROFESSOR: Alan Trachtenberg, MD, MPHOFFICIAL COURSE SYLLABUS
COURSE ANNOUNCEMENTS: Announcements will be placed here. Please try to check this area each Tuesday night or Wednesday morning. Any last minute changes to Wednesday evening's session will be posted, as will other current events at the intersection of substance abuse and public health and new resources for class use;FOR INSTANCE:7/9/2009:SESSIONS 7-8 HANDOUT POSTED: SESSIONS 7-8: Addiction Treatment Slides 7/1/2009: CLASS PRESENTATIONS ASSIGNED- All students will be asked to present an informal 5-10 minute presentation on their final project during the 8th or 9th Class session, either 7/8/2009 or 7/15/2009. Presentations should contain all the main elements of the project, but no slides or handouts are expected. 6/29/2009:SESSION 5-6 HANDOUTS POSTED: SESSION 5-6: Drug Classes and Routes of Administration. 6/13/2009:NEW HANDOUT POSTED: Psychiatric & Behavioral Aspects of Alcohol & Drug Abuse; Initiation & Progression. 5/16/2009:EVIDENCE BASED PREVENTION INTERVENTIONSThis searchable database (http://casat.unr.edu/bestpractices/search.php) includes interventions that have been shown to be effective in preventing substance abuse and/or the risk factors for substance abuse. Information is provided regarding training, technical assistance and/or materials that facilitate replication of each practice. Use the check boxes to indicate on which variable(s) you would like to conduct a search of evidence based drug prevention interventions. When you click the button near the bottom of the page ("Find Matching Practices"), an 'OR' search will be completed. Select as many attributes that interest you. The results will be ranked based on how many programs have attributes matching the criteria you specify.
More resources for finding evidence-based prevention programs can be found at http://captus.samhsa.gov/national/resources/evidence_based.cfm.7/31/2008:Differential brain changes documented in rats trained to self-administer cocaine, versus animals trained to self-administer natural rewards such as food: The brain changes due to cocaine training persisted for up to three months of abstinence, but the changes in response to natural rewards dissipated after only three weeks. Rats receiving cocaine only passively (whenever the other, trainee, rat pressed the lever) demonstrated neither transient nor long lasting changes, demonstrating the essential role of self-administration in causing the brain changes of addiction. See NIDA press release at http://www.nida.nih.gov/newsroom/08/NR7-31.html.TO CONTACT THE PROFESSOR (for GW or class business):Please call in the evenings: 301-984-8843; EMAIL using: 2create.yourMD@gmail.com;OR PREFERABLY:Please use the confidential web-based messaging function on the 2Create homepage (in the upper right-hand corner, you may have to scroll to the right to see it) or try going directly to the Sign Up New User Page .OUTSIDE OF CLASSROOM HOURS, questions on class content are best addressed on the 2Create Blog at: (http://2createyourmd.blogspot.com/) . This is intended to facilitate an ongoing, web-based class discussion for everyone to benefit from everyone else's questions. Email questions of a non-private nature will generally be answered on the Blog, or in class, rather than by reply email. Questions of a private nature will be received and answered via the web-based messaging function on the 2Create website. Remember that (as always) regular email is NEVER confidential.GRADING METHOD: Grading will be based on classroom participation, timely completion of assignments, one quiz, and a brief student paper on a public health or treatment program intervention against drug abuse or defined health consequence(s) of drug abuse. Optional assignments for extra credit will also be made available at the bottom of this page. REQUIRED READINGS: Links to all readings will be found on the class schedule below, underneath the session for which they are due. Please try to read them prior to that class session.OTHER ASSIGNMENTS: Are also noted on the class schedule below. Assigned work (other than reading) is due by the beginning of the class following when it was assigned. QUIZ: The quiz will be based on both the required readings and class sessions. The quiz format will be short answer, multiple choice and/or True/False type questions. The quiz will be difficult, but graded on a curve.FINAL PAPER: This can be thought of as kind of a mini-proposal, in which you will define a specific population and a health outcome relevant to the course (something to do with substance abuse and/or its sequelae) and propose an intervention to be applied to your defined population. The intervention should be expected to beneficially affect that outcome. Specifically, your paper must:1) Justify the health outcome chosen (prevalence, morbidity, mortality, cost, etc.) as the target of the intervention;2) Specify the population to whom you plan to apply your intervention, and how you will find/access/reach/identify them;3) Give the rationale for the intervention, including a summary of the evidence base for it (How does it work? How well does it work?);4) Describe the intervention, including the resources needed, target population, expected effectiveness, any risks involved and setting (pick a specific agency, program or institution from which you would be conducting the intervention);5) Describe how the intervention could (and whether it should) be evaluated;6) Include adequate references appropriate to the topic, with correctly formatted citations that contain adequate information for the reference to be retrievable by the reader from the primary source. (At least a few references are expected to the peer-reviewed literature. To ease their retrievability, weblinks to their abstracts in Medline or on the Journal site are appreciated. Citations from the popular press or ".com" websites are suitable for events or quotations, however, not for claims of scientific or biomedical evidence. Citations from other websites will be evaluated on an individual basis as to their credibility.);7) Have correct spelling, punctuation and grammar; and8) Be as long as necessary, but no longer than is necessary, to address items 1-6.You can choose anything from a prenatal or school-based program for primary prevention of drug abuse to a harm reduction intervention to a treatment-based tertiary prevention approach against HIV progression. You may want to approach the paper as if you are working in a particular agency that has some jurisdiction or mission related to the problem. For instance, a city public school system, an addiction treatment program or a state or county health department. Placing your project in an agency you have worked in or would like to work in might make your paper more relevant and interesting for you. OR, you can choose to place yourself wherever you can best conduct and/or evaluate the intervention in which you are most interested.EXAMPLES OF PREVIOUS PAPERS ARE POSTED AT: Papers on Public Health Interventions in Substance Abuse NOTE: Format, grammar, spelling and other aspects of the written presentation of your ideas are very important to the success of those ideas in the real world of public health and/or policy. Please take advantage of the GWU Writing Center if you have any potential concerns in these areas. The GWU Writing Center conducts free, one-on-one, 50-minute conferences with highly trained undergraduate and graduate students to assist you with course assignments, term papers, theses, applications, and resumes. They can help students at all stages of the writing process.The George Washington University Writing Center550 Rome Hall; Phone: (202)994-3765gwriter@gwu.edu (http://www.gwu.edu/~gwriter) DISCLAIMERS & DISCLOSURES: Professor Trachtenberg offers the following opinions, analyses and data under the doctrine of academic freedom; NOT as a representative of any agency with which he is, or may have ever been, associated. What follows is a synthesis of what I believe to be the most current materials from the best experts in the fields of addiction medicine and public health, as seen through the lenses of my own clinical and public health experience. All opinions are subject to change without notice. Stay tuned...CLASS SCHEDULE & ASSIGNMENTS:(Wednesday evenings, 6:10-8:40 PM. Attendance will be taken).Session 1 - 5/20/2009 Topics: Welcome, syllabus, introductions, disclaimers, overview of topic, neurophysiology and pharmacology of substance abuse.SYLLABUS OVERVIEW OF SUBSTANCE ABUSE IN PUBLIC HEALTH (handout for sessions 1 & 2) ASSIGNMENTS - Due by the beginning of session 2:1. Establish username and password for confidential, HIPAA-compliant web-based messaging w/instructor at http://www.2create.yourmd.com/. See log-in area at upper right corner of front page (you may have to scroll to the right to see it) or try going directly to: sign up. Click on the instructor's name, then provide some basic information. Please do include Date of Birth (or at least Year of birth). Do not enter your social security number. Once you are registered, use the "general" message category to send the instructor a message with a couple of sentences about your particular interests in substance abuse or why you wanted to take this class. (Ignore the site's information on paid consultation; You have already paid GW.)2. Carefully review the instructions for the final class paper and examine one or more examples of the previous class papers posted at: Papers on Public Health Interventions in Substance Abuse. Questions on these will be entertained at the beginning of session 2.Session 2 - 5/27/2009 Topics: Overview of drugs, drug classes, drug schedules, drug agencies and drug regulation in the US; Drug Abuse Epidemiology and History; Discussion of final projects.REQUIRED READING:Addiction as a Chronic Disorder; White WL and McClellan AT;http://www.comproviders.com/files/Addiction-as-a-Chronic-Disorder.pdf Comorbidity: Addiction and Other Mental Illnesses / NIDA 12/2008 (http://www.nida.nih.gov/researchreports/comorbidity/index.html)NIDA: Commonly Abused Drugs OR(local PDF of NIDA Table)Addiction Versus Dependence in DSM-V by O'Brien, Volkow & Li -Am J Psych 163:764-765, May 2006 OR(LOCAL PDF COPY) Drug Schedules and the Controlled Substances Act (CSA) pp 1-9 (http://www.usdoj.gov/dea/pubs/abuse/1-csa.htm) DEA Introduction to Drug Classes (Note: In general, DEA publications should be taken with a grain of salt,but these are not too bad.)"Narcotics" (Opioids, really: The term "Narcotics" is a legal one sometimesmisused interchangeably with "Opioids." [+/- cocaine])Stimulants Depressants Cannabis Drugs of Abuse Chart "How Do They Measure Up?" Examining Drug Use Surveys and Statistics: Sources (Part 1) & Problems (Part 2) by Earth & Fire Erowid. (Erowid Extracts. Nov 2005; 9:12-21) OPTIONAL READING:
Historical Themes in Chemical Prohibition By William L. White; From:Drugs in Perspective, National Institute on Drug Abuse, 1979Session 3 - 6/3/2009Topics: Overview of drugs, drug classes, drug schedules, drug agencies and drug regulation in the US; Drug Abuse Epidemiology and History (continued); Sources of data and information on substance abuse in the US; Resources for Online Data Analysis of Drug Abuse Related Data. REQUIRED READINGS:NIDA 2007 Publication: Drugs, Brains, and Behavior - The Science of Addiction OR(Local PDF: The Science of Addiction; NIDA 2007) NIDA Research Report: Hallucinogens and Dissociative Drugs.Pathology of Drug Abuse (NOTE: The statement in this reading about MDMA causing brain damage is unsubstantiated)(http://library.med.utah.edu/WebPath/TUTORIAL/DRUG/DRUG.html) NIDA Research Report: Prescription Drugs: Abuse and Addiction.NIDA Research Report: Inhalant Abuse.OPTIONAL READING:A Drug War Carol: the History of American Drug Control in Comic Book Form FDA, DEA and the Drug Approval & Scheduling Process Session 4 - 6/10/2009QUIZ on readings for this week and 1st three classes.Topic: Epidemiology and Medical Complications of Drug Abuse.REQUIRED READING:Underage Drinking: Frequency, Consequences, and Interventions by RW Hingson et al (Traffic Injury Prevention 5:228-36, 2004). Medical Consequences Of Substance Abuse by MD Stein in Psychiatric Clinics of North America; June, 1999. 22(2):351-70.Managing Addiction as a Chronic Condition by M Dennis & CK Scott: NIDA Addiction Science & Clinical Practice 4(1) 45-55 (http://www.drugabuse.gov/ascp/vol4no1.html).Public Health and Injection Drug Use. MMWR 5/18/2001 Vol 50, No MM19;377 Epidemiology of HIV/AIDS --- United States, 1981--2005MMWR 6/2/2006 Vol 55, No MM21;589 CSAT Treatment Advisory: Anabolic Steroids.OPTIONAL READING:Preventable Causes of Death in the United States. Danaei et al (2009).(http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000058) ASSIGNMENT for session 5: Use the web-based messaging function to send the instructor your proposed topic for the final paper and receive a reply with your quiz grade. Your topic proposal should specifically describe: 1) The intervention you plan to apply; 2) The population you plan to apply it to and how you will find/access/reach them; 3) The health outcome you plan to prevent/affect & how you will measure it; and 4) Categorize your outcome intervention as universal, selective, indicated and/or primary, secondary or tertiary prevention.Session 5 - 6/17/2009Topics: Epidemiology and Medical Complications of Drug Abuse (continued); Discussion of paper topics.REQUIRED READING:Alcoholism and Substance Abuse by Donald Warne (chapter from Rakel's INTEGRATIVE MEDICINE, 2nd Edition, 2007). Increasing deaths from opioid analgesics in the United States by Paulozzi et al (pharmacoepidemiology and drug safety 2006; 15: 618-27).CDC Fact Sheets on Substance Abuse Treatment: 6 items, 22 pages total OPTIONAL READING:Nestler E: The Neurobiology of Cocaine Addiction.NIDA Science & Practice Perspectives Volume 3, Number 1 - December 2005 Ira Marion: Methadone Treatment at Forty Neurobiology of Opioid Dependence-Implications for Treatment Session 6 - 6/24/2009 Topics: Substance Abuse Treatment and Prevention; Discussion of paper topics. REQUIRED READING:NIDA: Principles of Drug Addiction Treatment: A Research Based Guide NIAAA Alcohol Alert #66: Brief Interventions (2005) [ PDF ]National Voluntary Consensus Standards for the Treatment of Substance Use Conditions: Evidence-Based Treatment Practices (National Quality Forum) (http://www.qualityforum.org/pdf/reports/sud/sudexesummary.pdf)ORLOCAL PDF COPY NIDA Research Report: Therapeutic Community.12-Step Participation as a Pathway to Recovery OPTIONAL READING:Principles of Drug Abuse Treatment for CRIMINAL JUSTICE POPULATIONS:A Research Based Guide Session 7 - 7/1/2009 Topics: Substance Abuse Treatment and Prevention (continued).REQUIRED READING:NIDA: Preventing Drug Abuse among Children and Adolescents, A Research Based Guide Safety First: A Reality-Based Approach to Teens and Drugs; by Dr. Marsha Rosenbaum ORhttp://www.safety1st.org/images/stories/pdf/safetyfirst.pdfSession 8 - 7/8/2009Topics: Substance Abuse Treatment and Prevention (continued); Drug testing; Harm reduction. Discussion of extra credit requests.REQUIRED READING:CDC: Access to Sterile Syringes CDC: Syringe Disinfection for Injection Drug Users CDC: Drug Users and the Structure of the Criminal Justice System, August 2001 CDC: Women, Injection Drug Use, and the Criminal Justice System; August 2001 Testing Drugs vs. Testing For Drug Use: Private Risk Management In The Shadow Of The Criminal Law by Dr. Robert MacCoun. OR(LOCAL PDF COPY)ASSIGNMENT: CLASS PRESENTATIONS ASSIGNED - All students will be asked to present an informal 5-10 minute presentation on their final project during the 8th or 9th Class session, either 7/8/2009 or 7/15/2009. Presentations should contain all the main elements of the project, but no slides or handouts are expected.Session 9 -7/15/2009Topics: Harm Reduction; Drug Policy.REQUIRED READING:Drug Use Prevention & Education (And Comments on DARE) by Dr. Jeff Ratliff-Crain OPTIONAL READING:Beyond Zero Tolerance: A comprehensive, cost-effective approach to high school drug education and student assistance Session 10 - 7/22/2009Topics of special class interest; Evaluations; Turn in final papers; Fond farewells...Extra Credit Exercises for the Student:1. Psychosis After Ultrarapid Detox & Switch Methadone to Hydrocodone for 12 Days / SHREERAM, McDONALD & DENNISON; Falls Church, VA2. Use online data analysis of drug abuse related data from 1-3 primary sources (surveys or datasets) to make an interesting point or support a hypothesis about the epidemiology of substance abuse or it's consequences. Twice as much credit for using 2 sources and three times as much for using three such sources (for supporting the same point). Document your work with URLs used and copies or screen shots of relevant search strategies and results. Other web-based data may also be used to support the arguments from your online data analysis. Examples of sources to use can be found at: Resources for Online Data Analysis of Drug Abuse Related Data. Final product should be emailed to the instructor.

AAUP Journal of Academic Freedom

2010-01-27T16:51:00.001-05:00

the AAUP Journal of Academic Freedom. Scholarship on academic freedom—and on its relation to shared governance, tenure, and collective bargaining—is typically scattered across a wide range of disciplines. People who want to keep up with the field thus face a difficult task. Moreover, there is no one place to track the developing international discussion about academic freedom and its collateral issues. Edited collections and special issues of journals have helped fill the need for many years, but there has been no single journal devoted to the subject. Now there is. It is published by the organization most responsible for defining academic freedom, the American Association of University Professors (AAUP).

Drug & Alcohol Dependence (CPDD journal) Volume 107, Issue 1 (1 February 2010): NIDA History

2010-01-27T10:59:00.002-05:00

Online Resources for Science Teachers

2010-01-19T09:05:00.001-05:00

What a Great Site: Online Resources for Teachers

There are many excellent on-line education resources for Biotechnology and Genetics. Here are a few to get you started…

Access Excellence is the National Health Museum’s site for “health and bioscience teaching and learning”. Many ideas and interactive activities.http://www.accessexcellence.org/

The website for the American Society of Human Genetics has a list of educational resources and descriptions of careers in genetics.http://www.ashg.org/education/

BioEd Online: This website includes streaming video presentations, slide sets and lesson plans, along with a continuous science news feed from Nature, and free on-line web based workshopshttp://www.bioedonline.org/

The EXCITE (Excellence in Curriculum Integration Through Teaching Epidemiology) program from the Centers for Disease Control is really about epidemiology, however this includes some interesting classroom materials for teachers, including middle school science curriculum about scientific method, statistics, microbiology and disease transmission. The main CDC website (http://www.cdc.gov/) has lots of great disease information also. You can get short, understandable summaries of major disease outbreaks in the US – a good way to keep curriculum relevant.http://www.cdc.gov/excite

Colorado State University provides Transgenic Crops: An Introduction and Resource Guide, including articles, slide presentations and assignments to facilitate learning about transgenic crops. http://www.colostate.edu/programs/lifesciences/TransgenicCrops/index.html

The Dolan Learning Center at Cold Spring Harbor provides a wealth of resources for educators. These include on-line laboratories, free-access databases (Bioservers) used by scientists and educators world-wide, and the wonderful Biology Animation Library (Great PCR animation!) – found under the Resources section. You may have to download free software from Macromedia to run the animations, the Dolan site links you to the downloads.http://www.dnalc.org/

The Genetics Education Center at the University of Kansas Medical Center has LOTS of lesson-plans, including a simulated genetic counseling session.http://www.kumc.edu/gec/

The Genetic Science Learning Center web site at the University of Utah has a wide selection of teacher resources including virtual labs.http://learn.genetics.utah.edu/

The Howard Hughes Medical Institute provides an opportunity for kids and adults to ask biology questions.http://www.askascientist.org/

The National Human Genome Research Institute has an incredible list of on-line educational resources links.http://www.nhgri.nih.gov/Education/

The National Institute of Health curriculum supplement series has extensive materials in various formats on current areas of research including: Using Technology to Study Cellular and Molecular Biology, Cell Biology and Cancer, and Human Genetic Variation, among others.http://science.education.nih.gov/

The National Institute of Standards and Technology website is an excellent source of information about short tandem repeats used in forensic DNA analysis and human identity testing.http://www.cstl.nist.gov/div831/strbase

The National Science Teachers Association organizes URLs by grade level, content using the National Science Education Standards. It also includes lesson plans and other teacher support materials.http://sciguides.nsta.org/

Oklahoma City Community College offers an incredible web resource designed for high school teachers teaching about biotechnology! The College received grant money to develop this extensive site organizing/categorizing Biotech Internet resources, including on-line labs, curriculum, etc. CHECK IT OUT!http://www.okc.cc.ok.us/biotech

Promega CorporationLinks for educational units and the company's the training support program (50% discount) are provided. In addition, the tabs at the top are useful too; “Resources” includes many technical service resources such as protocols, MSDS sheets, “Profiles in DNA” (with interesting descriptions of forensic applications) and even training videos. The “Products” tab is useful for ordering.http://www.promega.com/education/

The University of Nebraska at Lincoln Ag Biosafety Education Center website provides good background information for teachers on the biotechnology of transgenic plants. Includes links to several lesson plans.http://agbiosafety.unl.edu/education.shtml

Virginia Commonwealth University has compiled the best video segments (to download for free) from the PBS series “Secrets of the Sequence”, along with accompanying lesson plans.http://www.vcu.edu/lifesci/sosq

Why FilesA Wisconsin Resource! The Why Files is a free online magazine from UW that explores the science behind the headlines (example: Stem Cells). It includes Teacher Activity Pages and resources. A new article is featured each week.http://www.whyfiles.org/

Zicam Cold Remedy Nasal Products (Cold Remedy Nasal Gel, Cold Remedy Nasal Swabs, and Cold Remedy Swabs, Kids Size)

2009-07-12T21:34:00.000-05:00

From: FDA MedWatch [mailto:fda@service.govdelivery.com]
Sent: Tuesday, June 16, 2009 12:21 PM
To: Trachtenberg, Alan (IHS/HQE)
Subject: MedWatch - Zicam Cold Remedy Nasal Products: Reports of permanent loss of sense of smell with use of these nasal gel or swab products

http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm166996.htm

Zicam Cold Remedy Nasal Products (Cold Remedy Nasal Gel, Cold Remedy Nasal Swabs, and Cold Remedy Swabs, Kids Size)

Audience: Consumers

FDA notified consumers and healthcare professionals to discontinue use of three Zicam Nasal Gel/Nasal Swab products sold over-the-counter as cold remedies because they are associated with the loss of sense of smell that may be long-lasting or permanent. The FDA has received more than 130 reports of loss of sense of smell associated with the use of the three Zicam products. In these reports, many people who experienced a loss of smell said the condition occurred with the first dose; others reported a loss of the sense of smell after multiple uses of the products. People who have experienced a loss of sense of smell or other problems after use of the affected Zicam products should contact their health care professional. The loss of sense of smell can adversely affect a person’s quality of life, and can limit the ability to detect the smell of gas or smoke or other signs of danger in the environment.

Read the complete MedWatch 2009 Safety Summary, including links to the Public Health Advisory and Consumer Update page, at:

http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm166996.htm

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Health Affairs Special on Mental Health-May/June 2009 - Volume 28, Number 3 Mental Health Care: Better, Not Best

2009-07-12T19:50:00.000-05:00

May/June 2009 - Volume 28, Number 3

Mental Health Care: Better, Not Best

Supplemental Data is available for this issue:

[Original Table Of Contents For This Issue]

From the Editor

Mental Health Care In America: Not Yet Good Enough
Susan Dentzer
[Extract] [Full Text] [PDF] [Reprints & Permissions]

Where We Are Now

Better But Not Best: Recent Trends In The Well-Being Of The Mentally Ill
Sherry A. Glied and Richard G. Frank
[Abstract] [Full Text] [Figures Only] [PDF] [Appendices] [Reprints & Permissions]

Trends In Mental Health Cost Growth: An Expanded Role For Management?
Richard G. Frank, Howard H. Goldman, and Thomas G. McGuire
[Abstract] [Full Text] [Figures Only] [PDF] [Appendix] [Reprints & Permissions]

Perspectives

PERSPECTIVE: After Parity—Whats Next
David L. Shern, Kirsten K. Beronio, and Henry T. Harbin
[Abstract] [Full Text] [PDF] [Reprints & Permissions]

PERSPECTIVE: Implementing Mental Health Parity: The Challenge For Health Plans
Keith Dixon
[Abstract] [Full Text] [PDF] [Reprints & Permissions]

PERSPECTIVE: Voluntary Patient Assistance Programs: Additional Federal Oversight Unwarranted
Ken Johnson
[Abstract] [Full Text] [PDF] [Reprints & Permissions]

PERSPECTIVE: Reforming Patient Assistance Programs: Perfect World Meets Real World
Myrl Weinberg
[Abstract] [Full Text] [PDF] [Reprints & Permissions]

PERSPECTIVE: Patient Assistance Programs: Information Is Not Our Enemy
Niteesh K. Choudhry, Joy L. Lee, Jessica Agnew-Blais, Colleen Corcoran, and William H. Shrank
[Extract] [Full Text] [PDF] [Reprints & Permissions]

Care Continuum

PROLOGUE: Along The Care Continuum
[Extract] [Full Text] [PDF] [Reprints & Permissions]

The Changing Role Of The State Psychiatric Hospital
William H. Fisher, Jeffrey L. Geller, and John A. Pandiani
[Abstract] [Full Text] [PDF] [Reprints & Permissions]

Mental Illness In Nursing Homes: Variations Across States
David C. Grabowski, Kelly A. Aschbrenner, Zhanlian Feng, and Vincent Mor
[Abstract] [Full Text] [Figures Only] [PDF] [Reprints & Permissions]

Improving Quality And Diffusing Best Practices: The Case Of Schizophrenia
Marcela Horvitz-Lennon, Julie M. Donohue, Marisa E. Domino, and Sharon-Lise T. Normand
[Abstract] [Full Text] [Figures Only] [PDF] [Reprints & Permissions]

State Variations In The Out-Of-Pocket Spending Burden For Outpatient Mental Health Treatment
Samuel H. Zuvekas and Chad D. Meyerhoefer
[Abstract] [Full Text] [PDF] [Reprints & Permissions]

Report From The Field

REPORT FROM THE FIELD: Starvation Diet: Coping With Shrinking Budgets In Publicly Funded Mental Health Services
Steve Bogira
[Extract] [Full Text] [PDF] [Reprints & Permissions]

Perspective

PERSPECTIVE: Hospital Psychiatry For The Twenty-First Century
Steven S. Sharfstein and Faith B. Dickerson
[Abstract] [Full Text] [PDF] [Reprints & Permissions]

PERSPECTIVE: Mental Health Crises And Public Policy: Opportunities For Change?
Michael F. Hogan and Lloyd I. Sederer
[Abstract] [Full Text] [PDF] [Reprints & Permissions]

Pharmaceuticals

PROLOGUE: Pharmaceuticals & Psychotropic Drugs
[Extract] [Full Text] [PDF] [Reprints & Permissions]

Pediatric Antidepressant Use After The Black-Box Warning
Susan H. Busch and Colleen L. Barry
[Abstract] [Full Text] [PDF] [Reprints & Permissions]

Antidepressant Reformulations: Who Uses Them, And What Are The Benefits?
Haiden A. Huskamp, Alisa B. Busch, Marisa E. Domino, and Sharon-Lise T. Normand
[Abstract] [Full Text] [PDF] [Appendix] [Reprints & Permissions]

Dual Eligibles With Mental Disorders And Medicare Part D: How Are They Faring?
Julie M. Donohue, Haiden A. Huskamp, and Samuel H. Zuvekas
[Abstract] [Full Text] [Figures Only] [PDF] [Reprints & Permissions]

Federal Policy

PROLOGUE: Transforming Federal Policy
[Extract] [Full Text] [PDF] [Reprints & Permissions]

Social Security And Mental Illness: Reducing Disability With Supported Employment
Robert E. Drake, Jonathan S. Skinner, Gary R. Bond, and Howard H. Goldman
[Abstract] [Full Text] [PDF] [Appendix] [Reprints & Permissions]

Mental Health Care For Iraq And Afghanistan War Veterans
M. Audrey Burnam, Lisa S. Meredith, Terri Tanielian, and Lisa H. Jaycox
[Abstract] [Full Text] [PDF] [Reprints & Permissions]

Improving Mental Health Treatments Through Comparative Effectiveness Research
Philip S. Wang, Christine M. Ulbricht, and Michael Schoenbaum
[Abstract] [Full Text] [PDF] [Supplemental Bibliography] [Reprints & Permissions]

State Policy

PROLOGUE: Evolution In State Policy
[Extract] [Full Text] [PDF] [Reprints & Permissions]

Mental Health System Transformation After The Virginia Tech Tragedy
Richard J. Bonnie, James S. Reinhard, Phillip Hamilton, and Elizabeth L. McGarvey
[Abstract] [Full Text] [Figures Only] [PDF] [Reprints & Permissions]

The Millionaires Tax And Mental Health Policy In California
Saul Feldman
[Abstract] [Full Text] [PDF] [Reprints & Permissions]

Racial Disparities In Involuntary Outpatient Commitment: Are They Real?
Jeffrey Swanson, Marvin Swartz, Richard A. Van Dorn, John Monahan, Thomas G. McGuire, Henry J. Steadman, and Pamela Clark Robbins
[Abstract] [Full Text] [Figures Only] [PDF] [Reprints & Permissions]

Health Tracking

MARKETWATCH: Drug Company–Sponsored Patient Assistance Programs: A Viable Safety Net?
Niteesh K. Choudhry, Joy L. Lee, Jessica Agnew-Blais, Colleen Corcoran, and William H. Shrank
[Abstract] [Full Text] [Figures Only] [PDF] [Reprints & Permissions]

MARKETWATCH: Financial Penalties For The Unhealthy? Ethical Guidelines For Holding Employees Responsible For Their Health
Steven D. Pearson and Sarah R. Lieber
[Abstract] [Full Text] [PDF] [Case Study] [Reprints & Permissions]

MARKETWATCH: Colombias Universal Health Insurance System
Ursula Giedion and Manuela Villar Uribe
[Abstract] [Full Text] [PDF] [Appendix] [Reprints & Permissions]

MARKETWATCH: How Much Do Patients Preferences Contribute To Resource Use?
Denise L. Anthony, M. Brooke Herndon, Patricia M. Gallagher, Amber E. Barnato, Julie P.W. Bynum, Daniel J. Gottlieb, Elliott S. Fisher, and Jonathan S. Skinner
[Abstract] [Full Text] [Figures Only] [PDF] [Appendix Exhibits][Erratum] [Reprints & Permissions]

Narrative Matters

Unrecognized Vulnerabilities
Jane Pauley
[Extract] [Full Text] [PDF] [Reprints & Permissions]

Coming Out Of The Shadows
Fred Frese
[Extract] [Full Text] [PDF] [Reprints & Permissions]

DataWatch

Wealth, Income, And The Affordability Of Health Insurance
Didem M. Bernard, Jessica S. Banthin, and William E. Encinosa
[Abstract] [Full Text] [PDF] [Technical Appendix] [Reprints & Permissions]

Measuring Efficiency: The Association Of Hospital Costs And Quality Of Care
Ashish K. Jha, E. John Orav, Allen Dobson, Robert A. Book, and Arnold M. Epstein
[Abstract] [Full Text] [PDF] [Reprints & Permissions]

GrantWatch

GRANTWATCH REPORT: Addressing Homelessness Among People With Mental Illnesses: A Model Of Long-Term Philanthropic Effectiveness
Ruth Tebbets Brousseau
[Abstract] [Full Text] [PDF] [Reprints & Permissions]

GrantWatch: Outcomes
[Extract] [Full Text] [PDF] [GrantWatch Online 28 May] [Reprints & Permissions]

Book Reviews

BOOK REVIEWS: Cause And Coincidence In Autism
Rick Mathis
[Extract] [Full Text] [PDF] [Reprints & Permissions]

Obesity: Global Causes Require Global Solutions
Cliona Ni Mhurchu
[Extract] [Full Text] [PDF] [Reprints & Permissions]

Overtreated, Or Overregulated?
Richard A. Epstein
[Extract] [Full Text] [PDF] [Reprints & Permissions]

Letters

Medicare And Mental Health Parity
Laysha Ostrow and Ron Manderscheid
[Extract] [Full Text] [PDF] [Reprints & Permissions]

Rewarding Innovation In Drug Discovery
Gilberto Lopes
[Extract] [Full Text] [PDF] [Reprints & Permissions]

Patient Choice: Critical For Obtaining Value
Randall Walker
[Extract] [Full Text] [PDF] [Reprints & Permissions]

Infrastructure For A Learning Health Care System: CaBIG
Kenneth H. Buetow and John Niederhuber
[Extract] [Full Text] [PDF] [Reprints & Permissions]

CaBIG: The Author Responds
Lynn Etheredge
[Extract] [Full Text] [PDF] [Reprints & Permissions]

Medical Device Market: If It Aint Broke, Dont Fix It
Stephen J. Ubl
[Extract] [Full Text] [PDF] [Reprints & Permissions]

Medical Device Market: An Author Responds
Jeffrey C. Lerner
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The Evidence Dilemma And Cultural Change
Neil A. Holtzman
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Evidence Dilemma: The Authors Respond
Muin J. Khoury
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Goals Of Postgraduate Physician Training
Roger K. Howe
[Extract] [Full Text] [PDF] [Reprints & Permissions]

Medicine As A Job, Not A Calling?
Mark Hutchins
[Extract] [Full Text] [PDF] [Reprints & Permissions]

Being There For Patients: Another View
Kimberly D. Manning
[Extract] [Full Text] [PDF] [Reprints & Permissions]

Culture Changes In Teaching Hospitals
Ronen Marmur
[Extract] [Full Text] [PDF] [Reprints & Permissions]

Work Hours: A Residents View
Teri Sanor
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Disappearing Doctors: The Author Responds
Janet R. Gilsdorf
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Errata

Erratum
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Web Exclusives

Beyond Incrementalism? SCHIP And The Politics Of Health Reform
Jonathan B. Oberlander and Barbara Lyons
(published online 17 March 2009)
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INTERVIEW: Eliminating Neglected Diseases In Poor Countries: A Conversation With Andrew Witty
Susan Dentzer
(published online 19 March 2009)
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Affording Shared Responsibility For Universal Coverage: Insights From California
Rick Curtis and Ed Neuschler
(published online 24 March 2009)
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Designing Health Insurance Market Constructs For Shared Responsibility: Insights From California
Rick Curtis and Ed Neuschler
(published online 24 March 2009)
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The Long And Winding Road: Reflections On Californias Year Of Health Reform
Marian R. Mulkey and Mark D. Smith
(published online 24 March 2009)
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Early Results From Thailands 30 Baht Health Reform: Something To Smile About
Kannika Damrongplasit and Glenn A. Melnick
(published online 31 March 2009)
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Which Households Are At Risk Of Catastrophic Health Spending: Experience In Thailand After Universal Coverage
Tewarit Somkotra and Leizel P. Lagrada
(published online 31 March 2009)
[Abstract] [Full Text] [PDF] [Annex 1] [Reprints & Permissions]

Reducing Health Care Hazards: Lessons From The Commercial Aviation Safety Team
Peter J. Pronovost, Christine A. Goeschel, Kyle L. Olsen, Julius C. Pham, Marlene R. Miller, Sean M. Berenholtz, J. Bryan Sexton, Jill A. Marsteller, Laura L. Morlock, Albert W. Wu, Jerod M. Loeb, and Carolyn M. Clancy
(published online 7 April 2009)
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Beyond Parity: Primary Care Physicians Perspectives On Access To Mental Health Care
Peter J. Cunningham
(published online 14 April 2009)
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Will Americans Support The Individual Mandate?
Tara Sussman, Robert J. Blendon, and Andrea Louise Campbell
(published online 21 April 2009)
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TRENDS: Trends In Medicaid Physician Fees, 2003–2008
Stephen Zuckerman, Aimee F. Williams, and Karen E. Stockley
(published online 28 April 2009)
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Guidelines for Authors

Mental health, resilience and inequalities Dr Lynne Friedli of the World Health Organization (WHO)

2009-07-12T19:32:00.001-05:00

http://www.euro.who.int/document/e92227.pdf

Summary
‘Although the risks and contradictions of life go on being as socially produced as ever, the duty and
necessity of coping with them has been delegated to our individual selves.
Zygmunt Bauman 2007a p. 14
This report explores the wealth of evidence that mental health influences a very wide range of outcomes for individuals and communities. These include healthier lifestyles; better physical health; improved recovery from illness; fewer limitations in daily living; higher educational attainment; greater productivity, employment and earnings; better relationships with adults and with children; more social cohesion and engagement and improved quality of life. These outcomes are not just or necessarily a consequence of the absence of mental illness, but are associated with the presence of positive mental health, sometimes referred to as ‘wellbeing’. Improving mental health is a worthwhile goal in itself: most people value a sense of emotional and social wellbeing; in addition, good mental health has many other far reaching benefits.
Mental health is a fundamental element of the resilience, health assets, capabilities and positive adaptation that enable people both to cope with adversity and to reach their full potential and humanity. Mental health is also the key to understanding the impact of inequalities on health and other outcomes. It is abundantly clear that the chronic stress of struggling with material disadvantage is intensified to a very considerable degree by doing so in more unequal societies. An extensive body of research confirms the relationship between inequality and poorer outcomes, a relationship which is evident at every position on the social hierarchy and is not confined to developed nations. The emotional and cognitive effects of high levels of social status differentiation are profound and far reaching: greater inequality heightens status competition and status insecurity across all income groups and among both adults and children. It is the distribution of economic and social resources that explains health and other outcomes in the vast majority of studies. The importance of the social and psychological dimensions of material deprivation is gaining greater recognition in the international literature on poverty and informs current efforts to develop indicators that capture the missing dimensions of poverty.
For this reason, levels of mental distress among communities need to be understood less in terms of individual pathology and more as a response to relative deprivation and social injustice, which erode the emotional, spiritual and intellectual resources essential to psychological wellbeing. While psycho-social stress is not the only route through which disadvantage affects outcomes, it does appear to be pivotal. Firstly, psychobiological studies provide growing evidence of how chronic low level stress ‘gets under the skin’ through the neuro-endocrine, cardiovascular and immune systems, influencing hormone release e.g. cortisol, cholesterol levels, blood pressure and inflammation e.g. C-reactive proteins. Secondly, both health-damaging behaviours and violence, for example, may be survival strategies in the face of multiple problems, anger and despair related to occupational insecurity, poverty, debt, poor housing, exclusion and other indicators of low status. These problems impact on intimate relationships, the care of children and care of the self. In the United Kingdom, the 20% - 25% of people who are obese or continue to smoke are concentrated among the 26% of the population living in poverty, measured in terms of low income and multiple deprivation of necessities. This is also the population with the highest prevalence of anxiety and depression.
III
Summary
Mental health, resilience and inequalities
A greater understanding of inequalities is also crucial to recognizing the limits of what promoting positive mental health can achieve. Positive mental health does confer considerable protection and advantage, but it does so predominantly among those with equal levels of resources. In other words, among poor children, those with higher levels of emotional wellbeing have better educational outcomes than their equally poor peers. However, richer children generally do better still, regardless of emotional or cognitive capability. Among well off students, high positive affect is associated with improved employment outcomes, but among poorer students, parental income is a more significant determinant. Emerging evidence suggests that the same pattern may be true for resilient localities: high levels of social capital may help to explain why one poor neighbourhood has lower mortality than other equally deprived areas, but these poorer, resilient communities still tend to have higher mortality than affluent areas.
The significance of mental health and its role in our survival confirms the importance of humans as social beings: levels of social interaction are universal determinants of wellbeing across all cultures. But the unique nature of each person’s mental character also reminds us of the power of the individual: “no one survives without community and no community thrives without the individual”. Progress in improving public mental health will also mean drawing on lessons from the user/survivor and recovery movements, with their emphasis on empowerment and respect for what each individual needs to hold on to or regain a life that has meaning for them.
This report highlights the importance of policies and programmes to support improved mental health for the whole population. Just as we know that a small reduction in the overall consumption of alcohol among the whole population results in a reduction in alcohol related harm, so a small improvement in population wide levels of wellbeing will reduce the prevalence of mental illness, as well as bringing the benefits associated with positive mental health. Priorities for action include:
• social, cultural and economic conditions that support family and community life
• education that equips children to flourish both economically and emotionally
• employment opportunities and workplace pay and conditions that promote
and protect mental health
• partnerships between health and other sectors to address social and economic
problems that are a catalyst for psychological distress
• reducing policy and environmental barriers to social contact.
While there is much that can be done to improve mental health, doing so will depend less on specific
interventions, valuable as these may be, and more on a policy sea change, in which policy makers across all sectors think in terms of ‘mental health impact’. It is already evident that the relentless pursuit of economic growth is not environmentally sustainable. What is now becoming clear is that current economic and fiscal strategies for growth may also be undermining family and community relationships: economic growth at the cost of social recession. This means that at the heart of questions concerning ‘mental health impact’ is the need to protect or recreate opportunities for communities to remain or become connected.
IV
Summary
Mental health, resilience and inequalities
Across the 53 Member States of the WHO European Region, tackling inequalities is the major challenge. Understanding the importance of mental health can help us to think more critically about the limits of economic growth and what wealth can achieve and to promote greater awareness of the benefits of reducing inequalities. This is not about utopian visions: the comparison between Sweden and the United Kingdom shows that relatively small differences in levels of inequality can have very significant effects on health. While there is no evidence that people can adapt psychologically to high levels of inequality, there is considerable evidence that opportunities for co operative social relationships are protective and that this is the case across all social classes. Both high and low income populations benefit in more equal societies.
A focus on social justice may provide an important corrective to what has been seen as a growing over-emphasis on individual pathology. Mental health is produced socially: the presence or absence of mental health is above all a social indicator and therefore requires social, as well as individual solutions. A focus on collective efficacy, as well as personal efficacy is required. A preoccupation with individual symptoms may lead to a ‘disembodied psychology’ which separates what goes on inside people’s heads from social structure and context. The key therapeutic intervention then becomes to ‘change the way you think’ rather than to refer people to sources of help for key catalysts for psychological problems: debt, poor housing, violence, crime. There is a need to think more critically about the relative contribution to mental wellbeing of individual psychological skills and attributes (e.g. autonomy, positive affect and self efficacy) and the circumstances of people’s lives: housing, employment, income and status. This also involves recognizing that ‘happiness’, ‘positive thinking’
and ‘trust’ are not always adaptive responses.
How things are done (values and culture) and how things are distributed (economic and
fiscal policy) are the key domains that influence and are influenced by how people think,
feel and relate. Mental health promotion has made and continues to make a significant contribution
to our understanding of the wider determinants of health and the crucial relationship between
social position and emotion, cognition and social function or relatedness. Evidence to this
effect needs to inform current thinking about how individuals (including children) respond
to stressors and appropriate promotion, prevention and treatment strategies across the spectrum
of mental health problems.
Mental health is fundamental to the future of the countries of Europe. Mental health underpins the social and intellectual skills that will be needed to meet the new challenges of the 21st century. It is also becoming increasingly clear, notably in campaigns on the environment and sustainable development, that communities across Europe place a high value on wellbeing. The limitations of consumerism are being more widely reflected upon, especially in relation to children and family life and the basis of civic society. We will have to face up to the fact that individual and collective mental health and wellbeing will depend on reducing the gap between rich and poor. At the same time, reducing inequality is not a sufficient policy response, important as that is. What is also needed is
a shift in consciousness and a recognition that mental health is a precious resource to be promoted and protected at all levels of policy and practice.

1. Introduction
This report sets out the contribution that mental health and mental illness make to a wide range
of health and social outcomes and shows how a greater focus on mental health as a determinant can help to explain outcomes, for individuals and for communities, which cannot be wholly accounted for by material and other factors. The limitations of classical risk factors e.g. health behaviour, lifestyle and low income have prompted a growing interest in what protects health in the face of adversity and in the determinants of health, as distinct from the determinants of illness (Harrison et al 2004; Bartley et al forthcoming). This report aims to contribute to that literature by looking at mental health as a fundamental element of resilience, health assets and the capabilities that moderate risk and influence life chances and outcomes for individuals, families and communities.2
It is already well established that mental illness, across the spectrum of disorders, is both a direct cause of mortality and morbidity and a significant risk factor for poorer economic, health and social outcomes, although these adverse outcomes vary by type of disorder and socioeconomic status (WHO 2005; 2006).3 However, it is now becoming clear that the presence or absence of positive mental health or ‘wellbeing’ also influences outcomes across a wide range of domains. These include healthier lifestyles, better physical health, improved recovery, fewer limitations in daily living, higher educational attainment, greater productivity, employment and earnings, better relationships, greater social cohesion and engagement and improved quality of life (WHO 2004b; Barry and Jenkins 2007; Jane-Llopis et al 2004).
The importance of mental health as a determinant raises a number of questions. Firstly, there is a need for a greater understanding of why mental health is so significant: what are the key pathways through which mental health and wellbeing influence so many different dimensions of the lives of individuals and communities and how do these intersect with other determinants? Secondly, what conditions are necessary to create optimum mental health and wellbeing and what policy initiatives and interventions will produce these conditions?
Some of the factors to consider in assessing the significance of mental health relative to other influences are evident in reflecting on a familiar scenario: the long haul flight (Lynch et al 2000). Clearly, there are important differences in the experience of first class and economy travellers.
The question is, what influences outcomes for passengers in each class? For those in economy, is it the material fact of less space, poorer food, limited leg room, proximity to others, sleeping upright rather than reclining, limited opportunities for walking around etc. that makes the difference? Or, is it the knowledge that other people are enjoying first class status and perks, while you are not doing so, combined perhaps, with subtle differences in the attitude of the cabin crew in economy class?
To what extent is our experience of material conditions mediated by our emotional and cognitive responses? What is the contribution of the psychobiological pathways through which stressful social conditions are written on the body, becoming evident in cholesterol, cortisol and blood pressure levels? What role do individual genetic and life histories, expectations, aspirations, religious and
cultural beliefs play in how we interpret and react to adversity or advantage? What difference does
2 Amartya Sen defines capabilities as people’s real freedoms to enjoy beings and doings that they value and have reason
to value (Sen 1985; see also Zavaleta 2007)
3 Outcomes may vary significantly by country, for example people with schizophrenia may have better outcomes in some
developing countries (WHO 2003).
Introduction
Mental health, resilience and inequalities
02
it make if discomfort and difficulties are shared by everyone?4 These questions lie at the heart of current debates about the social determinants of health, the relative contribution of material,
psycho-social and biological factors and the effects of inequalities (Lynch et al 2000; Wilkinson and Pickett 2006; Dahlgren and Whitehead 2006).5
A growing body of international data shows strong contextual effects for material factors, for example people at the same level of income will have lower mortality if they are in more, rather than less, equal states (Wilkinson and Pickett 2007a). One explanation for this and for the strong social gradient in health is that relative deprivation is a catalyst for a range of negative emotional and cognitive responses to inequity. These are both conscious and unconscious reactions, influencing health through physiological reactions, through the impact of low status on identity and social relationships, as well as through a range of damaging behaviours that are a direct or indirect response to the social injuries associated with inequalities (Wilkinson 2005; Rogers and Pilgrim 2003). In this analysis, mental health is fundamental because levels of inequality have a strong impact on how people feel and how people feel, their emotional wellbeing, is a powerful indicator:
“How people feel is not an elusive or abstract concept, but a significant public health indicator;
as significant as rates of smoking, obesity and physical activity”
United Kingdom Department of Health 2001
Although definitions vary, positive mental health is generally seen as including:
• emotion (affect/feeling),
• cognition (perception, thinking, reasoning)
• social functioning (relations with others and society)
• coherence (sense of meaning and purpose in life).
These individual attributes and skills can be measured through a range of wellbeing scales and a growing number of longitudinal studies confirm their power to predict outcomes, for example, longevity, physical health, quality of life, criminality, drug and alcohol use, employment, earnings and pro-social behaviour (e.g. volunteering) (Pressman and Cohen 2005; Lyubomirsky et al 2005; Dolan et al 2006). These findings have inspired considerable optimism about the role of positive psychological attributes in enabling people to flourish, notwithstanding adverse circumstances, and to a renewed interest in cognitive behavioural therapies, with their focus on transforming how a person thinks about their life (Diener and Seligman 2002; Seligman 2003; Ryan and Deci 2001; Ryff and Singer 2002).6
4. Responses to adversity are strongly patterned by culture, with notable differences between individualistic and collectivist traditions (Christopher and Hickinbottom 2008)
5 “Under a psychosocial interpretation, these health inequalities would be reduced by abolishing first class, or perhaps by mass
psychotherapy to alter perceptions of relative disadvantage. From the neo-material viewpoint, health inequalities can be
reduced by upgrading conditions in economy class.” (Lynch et al 2000)
6 For a series of papers reflecting critically on these issues and the concept of a ‘disembodied psychology’ see Clinical
Psychology Forum 162, June 2006
Introduction
Mental health, resilience and inequalities
An extensive body of research suggests that psychological assets do confer resilience and protection and do so at both an individual and an ecological level (Bartley 2006; Fagg et al 2006; Sacker and Schoon 2007). The optimism, self esteem, self efficacy and interest in others that contribute to a child’s success at school are also characteristics of resilient neighbourhoods and communities, where norms of trust, tolerance, support, participation and reciprocity may provide some protection from the effects of deprivation. At the same time, there are significant and important caveats: emotional and cognitive advantages are generally trumped by material advantage. Such evidence highlights the importance of moving beyond an exclusive focus on individual mental health status, to identify and understand the context for people’s emotional and cognitive responses. Surveys of positive affect,
self efficacy, subjective wellbeing or life satisfaction also need to provide a context for considering the potential sources of these attributes and feelings. For example, Alkire has argued that the literature on agency has focused too much on ‘own’ rather than ‘other regarding’ agency (Alkire 2007). Others have suggested that an undue emphasis on the individual self reflects cultural bias and a limited world view (Christopher and Hickinbottom 2008).
The wide range of benefits associated with mental health demonstrates the relevance of wellbeing to sectors beyond health, notably those concerned with the policy challenges presented by education, social cohesion, demographic change, sustainable economic development and environmental protection across the WHO European Region. It is hoped that this report on understanding mental health as a determinant will provide renewed evidence of the crucial importance of mental health to policy and practice, will strengthen existing efforts to tackle factors already known to be toxic to the mental health of populations and will contribute to wider debate about effective strategies for achieving social justice.
The report is structured as follows:
• Section Two outlines the aims and objectives
• Section Three describes the policy environment for mental health in Europe and the contribution
promoting public mental health can make to ongoing policy challenges
• Section Four looks at mental health in relation to current debates about the social determinants of health and the work of the Commission on the Social Determinants of Health
• Section Five provides definitions of key terms and concepts widely used in the literature
on mental health and positive mental health
• Section Six summarises the outcomes associated with positive mental health
• Sections Seven, Eight and Nine describe the contribution that mental health makes to outcomes
by exploring three different pathways of influence: resilience, the life course and inequalities
• Section Ten concludes the report and makes some recommendations for future action

The unintended consequences of drug policies Report 5 By: Peter H. Reuter

2009-07-12T19:30:00.000-05:00

http://www.rand.org/pubs/technical_reports/TR706/

The unintended consequences of drug policies

Report 5

By: Peter H. Reuter

Drug prohibition and enforcement aim to reduce the extent of drug use and the associated harms. The evidence that they succeed is heavily contested. However it is clear that prohibition and enforcement have many consequences other than the intended ones. Many of these negative consequences play a major role in the discussion of drug policy, particularly in face of weak evidence that the principal component of current policy in most countries, namely the enforcement of prohibition, does indeed much reduce drug use.

This report is a first effort to provide systematic analysis of the unintended consequences as a group. It distinguishes between those consequences that arise from prohibition per se, such as the lack of quality control, and those that are a function of the intensity and characteristics of enforcement. It identifies seven mechanisms that can generate unintended consequences: behavioural responses of participants (users, dealers and producers), behavioural responses of non-participants, market forces, programme characteristics, programme management, the inevitable effects of intended consequences and technological adaptation. The report relates this analysis to a recent discussion of the same phenomenon by the Executive Director of UNODC, showing the complementarity of the two approaches for thinking about consequences. This analysis has implications both for policy making and for assessment of policies.

The Economic Cost of Methamphetamine Use in the United States, 2005

2009-07-12T19:28:00.000-05:00

http://www.rand.org/pubs/monographs/MG829/

By: Nancy Nicosia, Rosalie Liccardo Pacula, Beau Kilmer, Russell Lundberg, James Chiesa

This first national estimate suggests that the economic cost of methamphetamine (meth) use in the United States reached $23.4 billion in 2005. Given the uncertainty in estimating the costs of meth use, this book provides a lower-bound estimate of $16.2 billion and an upper-bound estimate of $48.3 billion. The analysis considers a wide range of consequences due to meth use, including the burden of addiction, premature death, drug treatment, and aspects of lost productivity, crime and criminal justice, health care, production and environmental hazards, and child endangerment. Other potential harms of meth, however, could not be included due to a lack of scientific evidence or to data issues. Although meth causes some unique harms, many of the primary cost drivers are similar to those identified in economic assessments of other illicit drugs. Among the most costly elements are the intangible burden of addiction and premature death, which account for nearly two-thirds of the economic costs. The intangible burden of addiction measures the lower quality of life experienced by those addicted to the drug. Crime and criminal-justice costs also account for a significant share of economic costs, as do lost productivity, removing a child from the parents' home, and drug treatment. One unusual cost captured in the analysis is that associated with the production of meth, which requires toxic chemicals that can result in fire, explosions, and other negative events.

Assessing the Operation of the Global Drug Market

2009-07-12T17:28:00.001-05:00

http://www.rand.org/pubs/technical_reports/TR705/

By: Peter H. Reuter

Illicit drugs, predominantly cocaine and heroin, now generate a substantial international and domestic trade. For these two drugs, production is concentrated in poor nations and the bulk of revenues, though not of consumption, is generated by users in wealthy countries. Earnings have an odd shape; most of the money goes to a very large number of low level retailers in wealthy countries while the fortunes are made by a small number of entrepreneurs, many of whom come from the producing countries. Actual producers and refiners receive one or two percent of the total; almost all the rest is payment for distribution labour. The industry is in general competitive, though some sectors in some countries have small numbers of competing organizations. While it is not difficult to explain why cocaine and heroin production occurs primarily in poor countries and only a little harder to understand why the accounting profits are downstream, almost everything else about the trade presents a challenge, both descriptively and analytically. This report is an attempt to address these challenges and reviews what is known about the operation of these various markets. It offers a theoretical account for a number of the features.

MONITORING THE FUTURE NATIONAL RESULTS ON ADOLESCENT DRUG USE Overview of Key Findings, 2008

2009-07-12T17:17:00.000-05:00

http://www.monitoringthefuture.org/pubs/monographs/overview2008.pdf

SUPPORTIVE HOUSING: The Most Effective and Integrated Housing for People with Mental Disabilities

2009-07-12T17:06:00.001-05:00

SUPPORTIVE HOUSING:
The Most Effective and Integrated Housing for
People with Mental Disabilities1
Introduction
People with mental disabilities can successfully live in the community like
everyone else, as envisioned by the Americans with Disabilities Act. Supportive
housing makes this possible. Supportive housing gives them their own apartment
or home while making available a wide variety of services to support recovery,
engagement in community life and successful tenancy.
A growing body of evidence confirms that supportive housing works for people
with mental disabilities, including those with the most severe impairments.
Indeed, these individuals may benefit the most from supportive housing.
Supportive housing gets much higher marks than less integrated alternatives;
research confirms that people with disabilities vastly prefer living in their own
apartment or home instead of in group homes or buildings housing primarily
people with disabilities. Moreover, supportive housing is less costly than other
forms of government-financed housing for people with disabilities. Studies have
shown that it leads to more housing stability, improvement in mental health
symptoms, reduced hospitalization and increased satisfaction with quality of life,
including for participants with significant impairments, when compared to other
types of housing for people with mental disabilities.2 Supportive housing has
been endorsed by the federal government, including the U.S. Department of
Housing and Urban Development,3 the Surgeon General,4 the U.S. Department
of Health and Human Services5 and the National Council on Disability.6
The Basic Principles of Supportive Housing
Three basic principles guide supportive housing.7 First, supportive housing gives
participants immediate, permanent housing in their own apartments or homes.
Unlike most other housing for people with disabilities, there is no limit on how
long the person can stay in the residence, and temporary absences do not lead
to disenrollment. Treatment compliance or sobriety is not a requirement for
receiving or remaining in housing.8 Supportive housing participants have the
same rights and responsibilities as any other tenant. They may lose their unit, for
BAZELON CENTER FOR MENTAL HEALTH LAW
SUPPORTIVE HOUSING PAGE 2
example, for disruptive behavior or drug use. Supportive housing staff, however,
try to avoid this situation by providing supports and the accommodations
necessary to help ensure successful tenancy.
Supportive housing provides housing first, allowing participants the opportunity to
focus on recovery next. Adequate, stable housing is a prerequisite for improved
functioning for people with mental disabilities and a powerful motivator for people
to seek and sustain treatment.9 Studies find that providing immediate, permanent
housing leads to more long-term housing stability when compared to housing
conditioned on treatment.10
Second, individuals in supportive housing have access to a comprehensive array
of services and supports, from crisis mental health services to cooking tutors.11
Services are provided as needed to ensure successful tenancy and to support
the person’s recovery and engagement in community life. Services and supports
are provided in the home and other natural settings, allowing individuals to learn
and practice skills in the actual environment where they will be using them.12
Services are available whenever people need them, including after working hours
and on weekends when necessary. Service providers are highly flexible and
supports are highly individualized. A creative “whatever it takes” approach is
pursued. No “program” attendance is required and services are increased,
tapered or discontinued as decided by the individual in consultation with the
provider. As a result, individuals “buy in” to the treatment plan—the most
important predictor of plan success.13
Available services and supports include mental health and substance abuse
treatment and independent living services, including help in learning how to
maintain a home and manage money as well as training in the social skills
necessary to get along with others in the community. Medication management,
crisis intervention and case management are also available. Peer-support
services are especially effective in securing good results.14 For individuals who
are unable to do certain tasks, such as cooking and cleaning on their own,
personal care and/or home-care services are provided until no longer needed.
Assertive Community Treatment (ACT) teams serve the clients with the greatest
challenges, including individuals with serious mental illnesses who have coexisting
problems such as homelessness, substance abuse or involvement with
the judicial system.15 ACT teams are interdisciplinary and mobile, typically
including a social worker, psychiatrist, substance abuse counselor, nurse,
vocational counselor and housing specialist. They develop individualized
treatment plans with their clients and provide services around-the-clock in
consumers’ homes and in the community. Among the services ACT teams may
provide are: case management, initial and ongoing assessment, psychiatric
services, rehabilitation services, employment and housing assistance, family
support and education, substance abuse services, and other supports critical to
an individual’s ability to live successfully in the community. ACT teams have
BAZELON CENTER FOR MENTAL HEALTH LAW
SUPPORTIVE HOUSING PAGE 3
been widely recognized as one of the most effective ways to provide services to
individuals with mental illnesses. They can be covered by Medicaid.16
Third, supportive housing facilitates full integration into the community.
Individuals are encouraged to integrate into the community through employment,
volunteer work and social activities. People are encouraged to participate in
neighborhood activities or become members of community organizations of their
choosing. Vocational training, training in managing symptoms in the workplace
and conflict-management skills are available to those ready to seek employment.
Research has shown that employment can be critical to recovery; it helps
individuals with mental disabilities live autonomously, build meaningful personal
relationships, become integrated into society, improve self-esteem and learn to
control symptoms.17 Moreover, unlike the case with traditional disability housing,
supportive housing participants do not live and interact only with other mental
health clients; nor are they in an identifiable mental health program.18
Supportive Housing Works
Supportive housing is effective for various reasons. First, housing is a key aspect
of well-being and recovery.19 People with mental disabilities cannot be expected
to succeed without a safe, secure home, particularly if they are struggling to
recover from a mental illness.20 Moreover, stable housing can act as a motivator
for people to seek services and supports and to engage in and sustain
treatment.21
Second, supportive housing is built around individuals’ preferences and
strengths. Client-driven planning provides an opportunity for individuals to gain
control over their lives and determine their own path of recovery. Supportive
housing participants are involved in the process of choosing their housing unit,
rather than unilaterally being placed in a residence.22 The services offered are
highly flexible and individualized to meet the participant’s needs and preferences,
rather than defined by a “program.” Research shows that greater choice of
residence not only correlates positively with consumer satisfaction but also is a
significant predictor of housing stability.23 It also establishes that consumer
choice and buy-in to service plans is a great predictor of success. A “good” plan
that is not accepted by a consumer is not likely to work.24
Supportive housing takes advantage of the clear preferences of people with
mental disabilities about how they want to live. Studies show that consumers
prefer living in their own homes, either alone or with one or two roommates,
rather than in congregate settings with many other people with mental
disabilities, particularly when they receive supports to help them engage socially
in their own communities.25 “They want to be able to choose, among other things,
the type of housing in which they live, the neighborhood, with whom they live (if
they choose not to live alone), what and when to eat, whether or not to
BAZELON CENTER FOR MENTAL HEALTH LAW
SUPPORTIVE HOUSING PAGE 4
participate in mental health services (and, if they want services, to choose the
ones they want) and how to schedule their days.”26
Hence, it is no surprise that study after study has found that supportive housing
programs work for people with mental disabilities, even those who are hardest to
house, such as chronically homeless individuals with mental illnesses.27
Research has shown that providing immediate, permanent housing leads to more
long-term housing stability when compared to traditional housing programs.28
Other positive outcomes for supportive housing participants include reduced
hospitalization, decreased involvement with the criminal justice system,
participants’ greater satisfaction with their quality of life and improvement in
mental health symptoms.29
Supportive Housing Reduces Costs
Supportive housing is less costly than other forms of government-financed
housing for people with disabilities. Even for clients with the greatest challenges,
quality supportive housing, including necessary community treatment and
support services, compares favorably with the cost of traditional mental health
housing and services.30 Supportive housing also costs far less than other places
where people with mental disabilities end up: The cost of serving a person in
supportive housing is half the cost of a shelter, a quarter the cost of being in
prison and a tenth the cost of a state psychiatric hospital bed.31 Moreover, most
of the cost of supportive housing can be funded through existing programs,
including Medicaid and federal housing and rental assistance programs.32
Supportive housing reduces costs in several ways. It saves money by
utilizing apartments or houses available for rent on the market. Unlike other
housing for people with disabilities, such as group homes or buildings designated
exclusively for people with disabilities, supportive housing does not require
investment for new construction or purchase and rehabilitation. Moreover,
supportive housing’s use of scattered-site rental units avoids the delay and
expense of fighting neighborhood opposition to the siting of permanent housing
for people with disabilities, as often occurs.33 In addition, supportive housing
saves money by reducing participants’ use of expensive resources, such as day
programs, shelters, inpatient psychiatric hospitals, public hospitals, and prisons
and jails, which can cost tens of thousands of dollars per person in a year.34
Implications
Supportive housing should be the primary housing option available though
mental disability service systems. In most communities, this will require a
substantial shift, including replacing existing congregate settings with scatteredsite
supportive housing. Public officials and stakeholders should work to ensure
that housing, when provided as a service, has the following characteristics:
BAZELON CENTER FOR MENTAL HEALTH LAW
SUPPORTIVE HOUSING PAGE 5
• Housing units are scattered-site or scattered in a single building.
• A wide array of flexible, individualized services and supports is available to
ensure successful tenancy and support participants’ recovery and
engagement in community life.
• Services are delinked from housing. Participants are not required to use
services or supports to receive or keep their housing.
• Participants have a say in choosing their housing unit, any roommates (if
they choose not to live alone) and which services and supports (if any)
they want to use.
• Participants have the same rights and responsibilities as all other tenants.
They should be given any accommodations necessary to help ensure
successful tenancy.
To achieve this end, mental health systems must play an active role, both by
contracting with supportive housing providers and helping them secure rental
subsidies and by declining to finance or support the expansion of congregate
housing, including through building purchases.
Conclusion
Supportive housing is what people with disabilities want. It is the most integrated
type of housing and helps people with mental disabilities be a successful part of
the community—an opportunity to which they are entitled under the Americans
with Disabilities Act. Supportive housing programs are the most clinically and
cost-effective and offer the most integrated housing available for people with
mental disabilities. Public officials and stakeholders should push for supportive
housing and turn into reality the desire of people with mental disabilities to live in
the community like everyone else.

_________________________________________________

1 This paper was developed by the Bazelon Center for Mental Health Law under a grant to the University of
Pennsylvania from the Department of Education, NIDRR grant number H133B080029 (Salzer, PI). However,
the contents do not necessarily represent the policy of the Department of Education, and you should not
assume endorsement by the Federal Government.
2 See Rogers, Sally, et al., Systematic Review of Supported Housing Literature 1993-2008, The Center for
Psychiatric Rehabilitation, 2009.
3 U.S Dept. of Housing and Urban Dev. Office of Policy Dev. and Research. The Applicability of Housing
First Models to Homeless Persons with Serious Mental Illness. July 2007: 102-03. Available at
http://www.huduser.org/publications/homeless/hsgfirst.html.
4 U.S. Surgeon General. Mental Health: A Report of the Surgeon General. 1999: chapter 4. Available at
http://www.surgeongeneral.gov/library/mentalhealth/chapter4/sec6.html#human_services.
5 U.S. Dept. of Health and Human Services. Substance Abuse and Mental Health Services Admin.
Transforming Housing for People with Psychiatric Disabilities: Report. 2006.
6 National Council on Disability. Inclusive Livable Communities for People with Psychiatric Disabilities, 17
Mar. 2008: 17-26. Available at http://www.ncd.gov/newsroom/publications/index.htm.
BAZELON CENTER FOR MENTAL HEALTH LAW
SUPPORTIVE HOUSING PAGE 6
7 There is not consensus about the name for this service – some people use the term “supportive” housing
while others call it “supported” housing. Fidelity to the basic principles set out in this paper – not the
terminology – is what is important. In many communities, much of the housing that is called “supportive” or
“supported” does not follow these basic principles.
8 The strict admission criteria and program rules of traditional mental health housing often deny housing to
those most in need. Pathways to Housing, Inc. “Providing Housing First and Recovery Services for
Homeless Adults with Severe Mental Illness.” Psychiatric Services, 56.10 (2005): 1303.
9 Tsemberis, Sam, Leyla Gulcur, & Maria Nakae. “Housing First, Consumer Choice, and Harm Reduction for
Homeless Individuals With a Dual Diagnosis.” American Journal of Public Health, 94:4 (2004): 655.
10 Tsemberis, Sam & Ronda F. Eisenberg. “Pathways to Housing: Housing for Street-Dwelling Homeless
Individuals with Psychiatric Disabilities.” Psychiatric Services 51:4 (2000): 487; Burt, Martha R. & Jacquelyn
Anderson. “AB2034 Program Experiences in Housing Homeless People with Serious Mental Illness.” Corp.
for Supportive Housing. (2005): 3. Available at
http://www.csh.org/index.cfm/?fuseaction=Page.viewPage&pageID=3621.
11 In some communities, existing “supportive” or “supported” housing is of uneven quality because the full
array of necessary services and supports is not available.
12 Tsemberis. supra note 10, at 488.
13 Id. Nelson, Geoffrey, John Lord, & Joana Ochocka. Shifting the Paradigm in Community Mental Health:
Toward Empowerment and Community. Univ. of Toronto Press. 2001.
14 Surgeon General, supra note 4.
15 Some supportive housing providers have their own dedicated ACT teams, while other individuals in
supportive housing receive ACT services through the mental health system.
16 U.S. Dept. of Health and Human Services. Medicaid Support of Evidence-Based Practices in Mental
Health Programs. (2005): 6-7. Available at
http://www.cms.hhs.gov/PromisingPractices/HCBSPPR/itemdetail.asp?filterType=none&filterByDID=-
99&sortByDID=1&sortOrder=ascending&itemID=CMS030888&intNumPerPage=2000.
17 “Promoting Independence and Recovery through Work: Employment for People with Psychiatric
Disabilities.” Briefing Document for the National Governors Association, Center for Best Practice (NGA)
Webcast Transforming State Mental Health Systems: Promoting Independence and Recovery through Work:
Employment for People with Psychiatric Disabilities. 31 July 2007. Rogers, S.E., et al. “A Benefit-Cost
Analysis of a Supported Employment Model for Person with Psychiatric Disabilities.” Evaluation and
Program Planning (1995). Bond, G.R., et al. “Implementing Supported Employment as an Evidence-Based
Practice.” Psychiatric Services, Mar. (2001).
18 National Council on Disability, supra note 6, at 23.
19 Id.
20 Id.
21 Tsemberis, supra note 9, at 655.
22 The federal government has recognized the importance of consumer choice in housing and the role of
housing in promoting recovery. U.S. Substance Abuse and Mental Health Services Administration. Blueprint
for Change: Ending Chronic Homelessness for Persons with Serious Mental Illnesses and Co-Occurring
Substance Use Disorders. Rockville, MD: SAMHSA, 2003. Available at
http://mentalhealth.samhsa.gov/publications/allpubs/sma04-3870/Chapter6.asp#C6TocEvidence.
BAZELON CENTER FOR MENTAL HEALTH LAW
SUPPORTIVE HOUSING PAGE 7
23 Srebnik, Debra et al. “Housing Choice and Community Success for Individuals with Serious and Persistent
Mental Illness.” 31 Community Mental Health J. 31(1995): 139.
24 Tsemberis. supra note 9, at 651. Nelson, supra note 13, at 160.
25 Yeich, Susan et al. “The Case for a “Supported Housing” Approach: A Study of Consumer Housing and
Support Preferences” Psychosocial Rehabilitation J. 18.2 (1994): 75-77. Tanzman, Beth. “An Overview of
Surveys of Mental Health Consumers’ Preferences for Housing and Support Services.” Hosp. & Community
Psychiatry 44 (1993): 450-55. National Council on Disability, supra note 6, at 21.
26 National Council on Disability, supra note 6, at 22-23. This paper is not intended to imply that all people
with mental disabilities prefer supportive housing. Some do not. Individuals with disabilities should have
choices, like everyone else, about their living options.
27 Id. at 654-55. U.S Dept. of Housing and Urban Dev., supra note 3, at 80-104.
28 Tsemberis. supra note 9, at 654-55.
29 U.S Dept. of Housing and Urban Dev., supra note 3, at 82-84. Culhane, Dennis P. Culhane, Stephen
Metraux, & Trevor Hadley. "The Impact of Supportive Housing for Homeless People with Severe Mental
Illness on the Utilization of the Public Health, Corrections, and Emergency Shelter Systems: The New York-
New York Initiative" Housing Policy Debate 13.1 (2002): 137-38. Available at:
http://works.bepress.com/metraux/16. National Council on Disability, supra note 6, at 23. U.S. Dept. of
Health and Human Services, supra note 5, at 25.
30 Based on a survey of costs in several states.
31 Houghton, Ted, The New York/New York Agreement Cost Study: The Impact of Supportive Housing on
Services Use for Homeless Mentally Ill Individuals, (May 2001) 6-7. Available at
http://www.csh.org/index.cfm/?fuseaction=Page.viewPage&pageID=3251.
32 These include the Section 8, Section 811, Home, Shelter Plus Care, and Hope VI programs. See
www.nationalhomeless.org/publications/facts/Federal.pdf
33 Id. at 4. U.S. Dept. of Justice. “Department Sues Florida County for Refusing to Allow the Operation of Six
Homes for Individuals with Mental Illness and a History of Substance Abuse.” Disability Rights Online News
Aug. 2006. Available at http://www.ada.gov/newsltr0806.htm. U.S. Dept. of Justice. “Department Intervenes
to Secure Site for Adults with Mental Illness.” Disability Rights Online News Feb. 2006. Available at
http://www.ada.gov/newsltr0206.htm.
34 See Culhane, supra note, at 135-41.

federal agencies who have expertise with NATIONAL data sets

2009-07-12T16:17:00.000-05:00

http://childstats.gov/datasources/

Topic Contacts

Welcome to the Childstats contacts page. This page contains contact information for staff from federal agencies who have expertise with NATIONAL data sets.

Within each area, staff members are identified by their field of specialization. To open each field click on the field name or use the menu to the right. Any open field will automatically close when you click on the next field.

SPECIALTY	AGENCY	NAME & E-MAIL
FAMILY AND SOCIAL ENVIRONMENT
ECONOMIC CIRCUMSTANCES
HEALTH CARE
PHYSICAL ENVIRONMENT AND SAFETY
BEHAVIOR
EDUCATION
HEALTH
Activity Limitation	NCHS	Patricia Pastor PPastor@cdc.gov
Asthma	NCHS	Lara Akinbami LAkinbami@dhs.ca.gov
Birth Certificate Data	NCHS	Joyce Martin jmartin@cdc.gov
Birth Certificate Data	NCHS	Stephanie Ventura sjv1@cdc.gov
Birth/ Death Records	NCHS	Marian Mac Dorman mfm1@cdc.gov
Children's Health	NCHS	Susan Lukacs srl2@cdc.gov
Contraception	NCHS	Joyce Abma Jabma@cdc.gov
Disability	NIH	Louis Quatrano lq2n@nih.gov
Doctor Visits/ Emergency Room Visits	NCHS	Cathy Burt cwb2@cdc.gov
Family Planning Services	NCHS	Gladys Martinez gmartinez@cdc.gov
Fetal Mortality	NCHS	Joyce Martin jmartin@cdc.gov
Growth and Nutrition	NCHS	Cynthia Ogden cao9@cdc.gov
Health Care Access	NCHS	Robin Cohen rzc6@cdc.gov
Healthy People 2010	NCHS	Richard Klein rjk6@cdc.gov
Infant and Child Health	NCHS	Susan Lukacs srl2@cdc.gov
Life Tables	NCHS	Robert Anderson rca7@cdc.gov
Low Birthweight Infants	NCHS	Amy Branum zvl5@cdc.gov
Mental Health	NIMH	Shelli Avenevoli shelli.avenevoli@nih.gov
Mental Health	SAMHSA	Lisa Colpe Lisa.Colpe@SAMHSA.hhs.gov
Mental Health	NCHS	Patricia Pastor PPastor@cdc.gov
Overweight	NCHS	Cynthia Ogden cao9@cdc.gov
Perinatal Outcome/Maternal Nutrition and Weight Gain	NCHS	Joyce Martin jmartin@cdc.gov
Pregnancy & Health	NCHS	Anjani Chandra ayc3@cdc.gov
Pregnancy/ Family Planning Services/ Contraception	NICHD	Susan Newcomer newcomes@hd01.nichd.nih
Prenatal Care & Delivery Payment	NCHS	Anjani Chandra ayc3@cdc.gov
Preterm Births	NCHS	Joyce Martin jmartin@cdc.gov
Sexual Activity	NCHS	Joyce Abma Jabma@cdc.gov
Sexual Activity	ACF	Susan Jekielek susan.jekielek@acf.hhs.gov
Sexual Activity and Fertility	NCHS	Anjani Chandra ayc3@cdc.gov
Teen Pregnancy	NCHS	Stephanie Ventura sjv1@cdc.gov
Teen Sex/ Teen Pregnancy	NCHS	Joyce Abma Jabma@cdc.gov

THE WELL-BEING OF MARYLAND PARENTS AND THEIR CHILDREN: DIFFERENCES BY INCOME STATUS AND FAMILY STRUCTURE By Richard Wertheimer, Ph.D., Kristin Anderso

2009-07-12T16:13:00.000-05:00

http://www.childtrends.org/Files/Child_Trends-2009_4_30_RB_MDfamilies.pdf
THE WELL-BEING OF MARYLAND PARENTS AND THEIR CHILDREN:
DIFFERENCES BY INCOME STATUS AND FAMILY STRUCTURE
By Richard Wertheimer, Ph.D., Kristin Anderson Moore, Ph.D., and Jordan Kahn, B.A. May 2009
OVERVIEW
When compared with their higher-income counterparts, on average, parents in low-income Maryland
families (that is, those with incomes that are less than twice the official poverty threshold)1 have less advantageous
environments for raising children, and both the parents and their children experience fewer
positive outcomes. Similarly, when compared with their counterparts in families headed by two biological
or adoptive parents, families headed by single mothers are associated with less advantageous environments
for raising children and fewer positive outcomes for both parents and children. When family structure
and income are jointly taken into account, family circumstances and child outcomes are often dramatically
different.
BACKGROUND
Research studies based on statistics for the United States as a whole have documented differences in child
and family well-being between children in low-income families and children in more affluent families2 and
between children in single-parent families and children in two-parent families.3 However, researchers have
not explored differences in well-being in these families at the state level because of a lack of state-level
data. The National Survey of Children’s Health (NSCH) provides representative data at both the national
and state levels on several important areas (or domains) of parental and family functioning and well-being.
Child Trends drew on these data for 2003 to analyze differences in well-being by family income and family
structure in Maryland, thus illustrating the richness of this new source of statistical information. This
Research Brief presents our findings.
Our analyses focused on child and family well-being in five different domains:
• Parent characteristics4 and well-being;
• Parenting and family processes;
• Child’s environment;
• Child’s activities; and
• Child’s health and well-being
Although we found that most children and their parents in Maryland are functioning well in most domains,
significant differences exist in many important measures of child and family well-being between children
and their parents in low-income families and their counterparts in higher- income families.5 Similarly, significant
differences exist in many measures of child and family well-being between children and their parents
in families headed by single mothers and families headed by two biological or adoptive parents. In
particular, the often-substantial contrasts between low-income single-parent and higher-income two-parent
families serve as a telling reminder of the difficulties faced by children in households with both of these
family risk factors.
2
The results of Child Trends’ analyses, as presented below, are statistically significant, after taking account
of the child’s gender, age, and race/ethnicity and the better educated parent’s educational attainment. However,
the percentages and the differences themselves have not been adjusted for these factors. (It should be
noted that, prior to imposing these basic demographic controls, many of these differences were statistically
significant.) Comprehensive results are presented in Table 1 at the end of this brief.
PARENT CHARACTERISTICS AND WELL-BEING IN MARYLAND: KEY FINDINGS
We examined four measures in this domain: the level of aggravation the parent experienced in parenting;
the status of the parent’s physical health; the status of the parent’s mental health; and the frequency with
which the parent exercised regularly or played sports.
Low-income vs. higher-income families. Among single-mother families, mothers in low-income families
were at a disadvantage in three of the four measures of parental well-being, when compared with their
higher-income counterparts (see Figure 1) and after controlling for the child’s gender, age, and race/
ethnicity.
• Among single-mother families, 20 percent of mothers in low-income families were in fair or poor
physical health, compared with 6 percent of mothers in higher-income families.
• Similarly, among single-mother families, 19 percent of mothers in low-income families were in fair or
poor mental health, compared with 9 percent of mothers in higher-income families.
• About 53 percent of mothers in low-income single-mother families regularly exercised or played sports
in the past month, compared with 67 percent of mothers in higher-income single-mother families.
However, among two-parent biological or adoptive families, parents in low-income families were not at a
statistically significant disadvantage in any of the four measures, after controlling for the child’s gender,
age, and race/ethnicity and the better educated parent’s educational attainment (see Table 1).

Break the Cycle State-by-State Report Card on Teen Dating Violence

2009-07-12T16:00:00.003-05:00

http://www.breakthecycle.org/pdf/2009-state-report-cards/state-report-card-full-report-2009.pdf
STATE-BY-STATE REPORT CARD HIGHLIGHTS FOR 2009
• Break the Cycle refined its scoring system in order to better assess the
way that state civil domestic violence protection order laws address the
needs of teen victims of domestic violence.
• Eight states’ grades improved – Illinois, Minnesota, Mississippi, Florida,
Delaware, Wisconsin, Maryland, New York, and Iowa.
• Two states received “A” grades for the first time – Illinois and Minnesota.
• Four states that received “F” grades last year improved their grades –
Wisconsin (“B”), Maryland (“C”), New York (“C”), and Iowa (“D”).
• New York changed its civil domestic violence protection order law to
include dating and cohabitating relationships, better protecting teen
victims of domestic violence.
• Florida expanded its definition of domestic abuse to include dating
violence and increased protections for victims of dating violence,
allowing many teens greater access to civil remedies.
• New Mexico added sexual assault and stalking to its definition of
domestic abuse, expanding protection for all victims of domestic
violence.
• The District of Columbia passed legislation increasing legal protection
for minor victims of domestic violence, including clarifying when minors
may petition for protection on their own behalf and holding minor
perpetrators accountable and providing appropriate interventions.
3
STATE-BY-STATE REPORT CARD
EXECUTIVE OVERVIEW
As the leading voice for teens on the issue of dating violence, Break the Cycle advocates for
policy and legislative changes to better protect the rights and promote the health of teens
nationwide. Engaging, educating and empowering youth through prevention and intervention
programs, Break the Cycle helps young people identify and build safe, healthy relationships.
One in three teens will experience some form of abuse in a dating relationship. Teens who
suffer from abusive relationships exhibit increased rates of substance abuse, high-risk sexual
behaviors, eating disorders and suicidality. Teen victims are substantially more likely than
classmates to bring weapons to school and three times as likely to be involved in a physical fight.
Sadly, teens face overwhelming obstacles to getting help such as limited access to basic
securities like money, shelter and transportation. Exacerbating the barriers for teens are the
widespread statutory restrictions that exist because so few states recognize teens as victims of
domestic abuse. In fact, teens experience abuse at extremely high rates and young women
between the ages of 16 and 24 exhibit the highest rates of abuse—above any other age group.
Break the Cycle believes that minor teens should be able to access the same legal protections
as adult victims of domestic violence, including civil domestic violence protection or restraining
orders, and that state domestic violence laws should explicitly state the rights and
responsibilities of minors under the law. Break the Cycle believes that all teens over the age of
12 should have the right to petition for protection on their own behalf and that domestic violence
protection orders should be available against minor abusers.
To call attention to this critical situation, Break the Cycle set out to assess the climate of each
state’s civil domestic violence protection order laws and their impact on teens seeking protection
from abusive relationships. Initially, the aim of the research was to compile an up-to-date single
location of this state-by-state information for teens and those who care about them.
However, after the preliminary research was completed, Break the Cycle identified a series of
common trends (both negative and positive) that called for further analysis. The factors were
then grouped into larger categories, which were placed in order from most adverse to most
protective. Point values (ranging from -5 to +5) were assigned to each category depending on
whether the statute language was helpful or harmful in the protection of minors.
When a state’s law was ambiguous or unclear with regard to the treatment of minors, Break the
Cycle’s scoring system assigned negative points. If a discrepancy existed between the text of
the statute and the application of the law to minor victims of domestic violence, Break the Cycle
relied on the guidance of domestic violence organizations from within that state to clarify the
law. In cases where such clarification was not possible, final scores reflect the text of the statute
only.
Once final scores were tallied, the numbers were converted to percentages with the following
distribution:
4
A ≥81%
B 71% - 80%
C 63% - 70%
D 55% - 62%
F ≤54% or automatic failure
Only five states received A’s—California, Illinois, Minnesota, New Hampshire and Oklahoma.
Eleven states failed, with ten of those states receiving an automatic failure.
Break the Cycle hopes these grades will spur action among state legislatures throughout the
country and activism among our nation’s youth. It is essential that dating violence and the needs
of minor victims be specifically addressed within state domestic violence statutes. Lawmakers
have a responsibility to address this issue and to propose legislation that will ensure the
protection of all victims of domestic violence—regardless of their age.
5
STATE-BY-STATE REPORT CARD
FACTORS CONSIDERED FOR EVALUATION & GRADING
Positive Factors Negative Factors Automatic Failure
• The statute includes various lesser
offenses within its definition of abuse
that make it easier for a victim to get a
protection or restraining order (e.g.
cyberstalking, harassing phone calls,
sexually oriented offenses, stalking,
emotional abuse, animal cruelty)
• Generally, the length of the
restraining order lasts for one year.
Anything more than one year is
positive and longer than two years is
extremely positive.
• The statute provides the victim with
various kinds of compensation (e.g.
medical expenses, injuries, insurance,
moving expenses, lost earnings,
reimbursement for meals, pain and
suffering).
• The statute allows minors to file a
protection or restraining order without
an adult’s involvement.
• The statute recognizes extended
degrees of family members under the
group that may get a protection or
restraining order on behalf of a minor
or are protected by the order (e.g.
step, grandparent, child, second
cousin).
• The statute allows a victim to obtain a
protection or restraining order against
minors within a certain age limit.
• Sexual abuse is not included within the
definition of abuse.
• The statute does not include a stay
away order.
• Dating is not recognized but sexual
relations are recognized.
• The statute specifically identifies
heterosexual relationships as the only
group afforded domestic violence
protection.
• The statute does not include personal
relationships in which the parties are
residing together.
• The statute does not provide for child
custody, child or spousal support for
the victim requesting a protection or
restraining order.
• The statute requires a minor to get
parental permission when seeking a
protection or restraining order.
• The statute does not protect other
individuals under the protection or
restraining order (i.e. family members,
children, and/or other household
members).
• The statute does not specify who files
for a petition on behalf of a minor
(because minors cannot file on their
own).
• Generally, the length of the restraining
order lasts for one year. Anything less
than one year is negative.
• The statute does not allow restraining
orders to be filed against someone
under 18 years of age.
• Dating relationships are not specifically
recognized as valid domestic
relationships for obtaining restraining
orders.
• Protection orders and restraining orders
are not available to minors.
Please note: This analysis of state laws was conducted by looking only at state civil domestic violence protection or restraining order laws. While
teens may be able to seek protection and other remedies through other types of protection or protection orders or through the criminal law, these
laws were not included for the purpose of this analysis.
6
STATE-BY-STATE REPORT CARD
SUMMARY OF FINDINGS
Below is a summary of findings1 on how state civil domestic violence protection order laws
address the circumstances teen victims2 face.
Dating Relationships
• Thirty-nine states and the District of Columbia allow victims of domestic violence who are
dating their abuser to apply for a civil domestic violence protection or restraining order.
These states are: AK, AR, CA, CO, CT, DC, DE, FL, HI, IA, ID, IL, IN, KS, LA, ME, MA, MI,
MN, MS, MO, MT, NE, NV, NY, NH, NJ, NM, NC, ND, OK, PA, RI, TN, TX, VT, WA, WV, WI
and WY. Not all of these states use the word “dating” in the law or define dating in the same
way. But, all thirty-nine include protection for victims in a dating relationship.
• Eleven states do not allow a victim who is in a dating relationship to apply for protection
under their civil domestic violence protection or restraining order laws. These states are: AL,
AZ, GA, KY, MD, OH, OR, SC, SD, UT and VA.
• One of these states, Oregon, allows a victim who is in a sexual relationship with the abuser
to apply for a protection or restraining order.
Co-Parents
• All but four states, LA, NH, TN, and VT, explicitly allow victims of domestic violence who
have a child with their abuser to apply for a protection or restraining order. However, each of
those four states includes at least some protection under the law for teens that are or were
dating, living with or in an intimate relationship with their abuser.
• Illinois goes farther than other states, allowing victims of domestic violence to apply for a
protection or restraining order against an abuser who is allegedly the parent of their child.
Restrictions for Same-Sex Relationships
• There are five states that in some way restrict protection under the civil domestic violence
laws to opposite-sex couples only. Three of these states, MT, NC and SC, specifically offer
protection only to opposite-sex couples.
• Louisiana law specifies that to qualify for a domestic violence protection order as a
cohabitant, the victim must be living with an abuser of the opposite sex.
• In Idaho, the text of the civil domestic violence law does not exclude same-sex couples;
however, when the law was adopted, the Idaho legislature stated that the law was intended
for opposite-sex couples.
1This Report Card and the information it contains is not legal advice and does not create an attorney-client relationship. While great
care was taken to provide current and accurate information, Break the Cycle is not responsible for inaccuracies in the text.
2 The relationship categories discussed in this section apply to all petitioners regardless of age, but are particularly relevant to teens.
7
Restrictions on Protection for Minor Victims
• New Hampshire is the only state where the law specifically allows a minor of any age to go
to court by themselves to apply for a protection order.
• In Missouri, domestic violence protection orders are only available to adults.
• Nine states, CA, CT, MN, NJ, OK, OR, UT, WA and WY, allow minors to obtain protection or
restraining orders without the involvement of a parent, guardian or other adult if they meet
certain requirements. These requirements include being a certain age (e.g. over 16) or
having a certain relationship with the abuser (e.g. having a child in common with the
abuser). Three of these states, CT, NJ, WY, do not specify how a minor victim can apply if
they do not meet the age or relationship requirements.
• Four states, AZ, ID, IA, and NV, explicitly require that a minor must have a parent or legal
guardian involved in the process of applying for a protection or restraining order.
• More than half of states do not explicitly specify the minimum age of a petitioner.
• 16 states do not specify who can file for a minor
CO,CT,DE,DC,MA,NE,NJ,MN,NY,NC,ND,RI,TN,VA,WY, and SD.
• Tennessee does not specify who can file for a minor; however, a minor must have one
signature from a parent or legal guardian.
Restrictions on Protection from Minor Abusers
• Seven states impose explicit age restrictions on the person against whom a protection or
restraining order is obtained: AZ, CO, MI, MO, NV, NJ, and OK. Many state laws are silent
on the issue of obtaining protection or restraining orders against minors.
• In Missouri and Nevada, a victim cannot get a protection or restraining order against anyone
who is a minor. In New Jersey, the abuser must be 18 years old or emancipated.
• Four state laws allow protection or restraining orders against some, but not all, minors. In
Oklahoma, a victim cannot get a protection or restraining order against someone under the
age of 13; in Arizona the abuser must be 12; and, in Colorado and Michigan, the abuser
must be at least 10.

State Estimates of Substance Use and Mental Health from the 2006-2007 National Surveys on Drug Use and Health

2009-07-12T15:49:00.000-05:00

http://oas.samhsa.gov/2k7state/TOC.cfm

Full report:

PDF format (recommended for printing)
HTML format (contains additional tables not found in printed or PDF versions)

Links to specific States

State Trends: Change in prevalence rates by States

All data on States

Full report (HTML format):

Additional detailed tables for this report (HTML format):
Tables B.1 to B.24 in the printed report contain percentages. The following contain the estimated numbers in the population for Tables B.1 to B.24:
Estimated Numbers for Persons Aged 12 or Older, 12 to 17, 18 to 25, and 26 or Older by State
The following contain the percentages and estimated numbers in the adult population age 18 or older:
Percentages and Estimated Numbers for Persons Aged 18 or Older by State
Contents in printed version:

Cover
List of Figures (Maps)
List of Tables
Highlights
1. Introduction
1.1 Summary of NSDUH Methodology
1.2 Format of Report and Presentation of Data
1.3 Measures Presented in This Report
1.4 Other NSDUH Reports and Products
2. Illicit Drug Use
2.1 Illicit Drugs
2.2 Marijuana
2.3 Perceptions of Risk of Marijuana Use
2.4 Incidence of Marijuana Use
2.5 Illicit Drugs Other Than Marijuana
2.6 Cocaine
2.7 Pain Relievers (Nonmedical Use)
3. Alcohol Use
3.1 Alcohol
3.2 Binge Alcohol Use
3.3 Perceptions of Risk of Binge Alcohol Use
4. Tobacco Use
4.1 Tobacco
4.2 Cigarettes
4.3 Perceptions of Risk of Heavy Cigarette Use
5. Substance Dependence, Abuse, and Treatment Need
5.1 Alcohol Dependence or Abuse
5.2 Illicit Drug Dependence or Abuse
5.3 Alcohol or Illicit Drug Dependence or Abuse
5.4 Needing But Not Receiving Treatment for Illicit Drug Problems
5.5 Needing But Not Receiving Treatment for Alcohol Problems
6. Mental Health Problems
6.1 Serious Psychological Distress among Adults
6.2 Major Depressive Episode
References
Appendix:
A. State Estimation Methodology
B. Tables of Model-Based Estimates (50 States and the District of Columbia), by Measure
C. Tables of Change between the 2005-2006 and the 2006-2007 Model-Based Estimates (50 States and the District of Columbia), by Measure
D. Other Sources of State-Level Data
E. List of Contributors

Federal Drug Data Sources

2009-07-12T15:47:00.000-05:00

Federal Drug Data Sources

(Modified from ONDCP)

This table identifies Federal sources of drug data, while highlighting the frequency of data sets, the sponsoring agencies, target populations and areas of coverage. Additional sources of relevant data, especially on co-morbidity, have been added to the original ONDCP list. See also: Inventory of Federal Drug-Related Data Sources.

(* Key drug epidemiology resources)

General Information

Coverage

Dates

Title

Agency

Description

Population

Geographic Area

Frequency

Drug Use

National Survey on Drug Use and Health (NSDUH)
Formerly called the * “National Household Survey on Drug Abuse.”

SAMHSA

The primary source of information on the prevalence, patterns, and consequences of drug and alcohol use and abuse.

General U.S. civilian non- institutionalized population, age 12 and older.

National

Regional

State

Annually

Started 1976

Most Recent 2005

*Monitoring the Future (MTF)

NIDA

An ongoing study of the drug-related behaviors, attitudes, and values of American secondary school students, college students, and young adults.

8^th, 10^th, 12^th, College Students, and Young Adults

National

Annually Started 1972

Most Recent 2006

Survey of Health Related Behaviors Among Military Personnel

DoD

Provides a comprehensive worldwide assessment of the prevalence of substance use and other health-related behaviors among military personnel.

Active-duty military personnel in the Army, Navy, Marines, and Air Force.

U.S. military bases worldwide.

Every 2 to 4 years. Started 1980; Most Recent 2002

Community Epidemiology Work Group (CEWG)

NIDA

Provides ongoing community-level surveillance of drug abuse through analysis of quantitative and qualitative research data.

Data gathered from public health agencies, medical and treatment facilities, criminal justice and correctional offices, law enforcement agencies, and other sources unique to local areas

Local, Multi-jurisdictional

Semi-Annually

Started 1976

Most Recent
June 2006

Arrestee Drug Abuse Monitoring Program (ADAM)Formerly called “Drug Use Forecasting (DUF)”

NIJ

Traced trends in the prevalence and types of drug use among booked arrestees in urban areas.

Adult arrestees and juvenile detainees.

Local, Multi-jurisdictional

No longer conducted Started 1997 Last report: 2003 (DUF 1986 to 1996)

*National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)	NIAAA	Details alcohol & drug disorders as well as co-morbid psychiatric Diagnoses (DSM-IV)	General US Civilian Household Population Ages 18 & older	National	Every four years (so far) Started: 2001-2 Most recent: 2004-2005
*National Comorbidity Survey (NCS) and NCS Replication (NCS-R)	NIMH	Prevalence and correlates of DSM-III-R (APA) disorders including the prevalence of substance use and other healthrelated behaviors	General US Civilian Household Population Ages 18 & older	National, but Replication Planned worldwide	First: 1990-1991 Second: 2001-2002
Epidemiologic Catchment Area (ECA) Study	NIMH	1st large population-based survey of mental disorders (DSM-III)	General urban population, Ages 18 & older; not nationally representative	New Haven, CT; St Louis; Durham, NC; Baltimore & Los Angeles	1980-1985
Web-based Injury Statistics Query and Reporting System (WISQARS)	CDC	Non-fatal injuries and poisonings treated in U.S. hospital emergency rooms 2000-2005; Mortality data for 1981-1999 from death certificates	General population	National	Annual Non-fatal: 2000-2005 Mortality: 1981-1999
Indicators of School Crime and Safety	National Center for Education Statistics (NCES)	Information drawn from a variety of independent data sources, including national surveys of students, teachers, and principals,	School Populations	National	Annual

General Information

Coverage

Dates

Title

Agency

Description

Population

Geographic Area

Frequency

Consequences of Use

Economic Cost of Drug Abuse in the United States

ONDCP

Details the economic damage illegal drugs inflict on the American economy.

N/A

National

Every four years
Started 2001
Most recent: 2002

*Youth Risk Behavior Surveillance System (YRBSS)

CDC

Monitors priority health-risk behaviors which contribute to the leading causes of mortality and morbidity among youths and adults

School Aged Youth grades 9 through 12

Multi-jurisdictional

Every two years

Started 1998 Most Recent:
2005

*National Vital Statistics Report (NVSR)

CDC

Provides data on drug-induced deaths based on information from all death certificates filed in the 50 states and the District of Columbia.

General population

National

Annual Started: 1979

Most Recent:
2004

Drug Abuse Warning Network (DAWN)*Emergency Department Component*Mortality Component

SAMHSA

Monitors drug abuse patterns and trends and assesses the health hazards associated with drug abuse by involvement of drugs in deaths and emergency department episodes

Drug-related deaths and emergency department episodes.

Multi-jurisdictional

Annually

Started 1972

Most Recent: ED - 2005 ME - 2003

General Information

Coverage

Dates

Title

Agency

Description

Population

Geographic Area

Frequency

Treatment

Alcohol and Drug Services Study (ADSS)

SAMHSA

ADSS is a nationally representative survey of substance abuse treatment facilities and clients. The data were collected to estimate the client length of stay and the costs of treatment as well as to describe the post-treatment status of clients.

Substance abuse treatment facilities and their clients.

National

Three phases that began in October 1996

National Survey of Substance Abuse Treatment Services (N-SSATS)

SAMHSA

Collects information on location, characteristics, and services offered by treatment facilities.

Formerly Uniform Facility Data Set (UFDS).

A component of Drug and Alcohol Services Information System (DASIS)

Treatment facilities listed in the Inventory of Substance Abuse Treatment Services (I-SATS).

National

State

Annually

UFDS Started 1980

N-SSATS Started 2000

Most Recent
2005

Treatment Episode Data Set (TEDS)

SAMHSA

Provides data on the demographic and substance abuse characteristics of admissions to substance abuse treatment.

A component of Drug and Alcohol Services Information System (DASIS)

Admissions to substance abuse treatment, primarily at facilities receiving public funds. Excludes Federally owned facilities.

National

State

Continuous

Started
1992

Most Recent
2005

General Information

Coverage

Dates

Title

Agency

Description

Population

Geographic Area

Frequency

Source and Volume of Illegal Drugs

International Narcotics Control Strategy Report (INSCR)

DOS

Provides a report on illicit drug-control and money laundering activities in more than 140 countries.

N/A

International

Annually

Started 1996

Most Recent 2007

Federal-Wide Drug Seizure System

DEA

Provides information about drug seizures made by and with the participation of DEA, FBI, Customs Service, Border Patrol, and Coast Guard.

N/A

National

Annually

Started 1998

Most Recent
2004

National Drug Threat Assessment

NDIC

Synthesizes all federal, state, and local counterdrug reporting into a single source of information regarding national-level drug trafficking and abuse trends.

N/A

National

Annually

Started 2001

Most Recent 2007

General Information

Coverage

Dates

Title

Agency

Description

Population

Geographic Area

Frequency

Enforcement

Uniform Crime Reports

FBI

Presents data on the number of offenses, including drug related offenses known to the police, arrests, and clearances.

City, county, and State law enforcement agencies that represent 94 percent of the general U.S. population.

National

Regional

State

Local

Annually

Started 1930

Most Recent
2005

Automation of Reports and Consolidated Orders System (ARCOS)

DEA

(Diversion Control)

An automated system which monitors the flow of DEA controlled, licit substances; from point of manufacture through commercial distribution to point of sale at the dispensing level - Included: All C I and C II material; C III narcotic and GHB and selected C III & IV psychotropic drugs (manufacturers only).

N/A

National

Ongoing

Law Enforcement Management and Administrative Statistics (LEMAS)

BJS

Provides national data on the management and administration of law enforcement agencies including the existence of laboratory testing facilities, drug enforcement units, and drug education units.

Law enforcement agencies

National

Periodically

Started 1987

Most Recent 2000

General Information

Coverage

Dates

Title

Agency

Description

Population

Geographic Area

Frequency

Drug Offenders

Juvenile Court Statistics

OJJDP

Describes cases and juveniles processed for drug related delinquency by the juvenile courts in the United States.

Juveniles in U.S. courts.

National

Annually

Started 1927

Most Recent 2001–2002

*Survey of Inmates in Local Jails

BJS

Describes the characteristics of inmates in local jails by drug and alcohol use, criminal history, current offense, health care, and socioeconomic status.

Jail Inmates

National

Periodically

Started 1978

Most Recent 2002

*Survey of Inmates in State and Federal Correctional Facilities

BJS

Describes the characteristics of inmates in Federal and state correctional facilities by drug and alcohol use, criminal history, current offense, health care, and socioeconomic status.

Federal and State prison inmates.

National

Every 5 years

Started 1974 for State and 1991 for Federal

Most Recent 2004

*Census of Juveniles in Residential Placement

OJJDP

Monitors juvenile custody facilities and residents with drug related offenses.

Replaced Children in Custody (CIC) census.

Private and public juvenile custody facilities.

National

Biennially

Started 1997

Most Recent 2002

Other Resources

	Drug Data Summary This fact sheet summarizes current drug use estimates, drug-related law enforcement activities, data on drug offenders in the criminal justice system, drug availability estimates, and the historical and current Federal drug control budget.
	*Drug-Related Statistics Resources Provides links to other sources of drug-related data.
	Federal Drug-Related Data Systems Inventory: Report of the Drug Control Research Data, and Evaluation Committee (PDF) This report presents an inventory of current drug-related data sources from a variety of Federal agencies.
	Inter-University Consortium for Political and Social Research (ICPSR) Substance Abuse Data Archives. This is an ICPSR search on “substance abuse.” ICPSR maintains and provides access to a vast archive of social science data sets for research and instruction.
	Substance Abuse & Mental Health Data Archive (SAMHDA) SAMHDA provides access to substance abuse research data to promote the sharing of these data among researchers, policymakers, service providers, and others.
	Sourcebook of Criminal Justice Statistics Brings together data from more than 100 sources about all aspects of criminal justice in the United States.

Federal Agencies

White House

Office of National Drug Control Policy (ONDCP)

Department of Justice (DOJ)

Drug Enforcement Administration (DEA)

Federal Bureau of Investigation (FBI)

National Criminal Justice Reference Service

Department of Health & Human Services (HHS)

Food & Drug Administration (FDA)

National Institute on Drug Abuse (NIDA)

Substance Abuse & Mental Health Service Administration (SAMHSA)

Center for Substance Abuse Treatment (CSAT)

Government Printing Office (Code of Federal Regulations)

Government Printing Office (Federal Register Notices)

National Technical Information Service (NTIS) – Registrant Information

Office of Personnel Management (OPM) Career Opportunities

FIRSTGOV – U.S. Government search site

Small Business Administration (SBA)

SBA - Office of the National Ombudsman

National Association of Boards of Pharmacy (NABP)

National Association of State Controlled Substance Authorities (NASCSA)

Federation of State Medical Boards (FSMB)

Industry Links

This section contains hyperlinks to web sites created and maintained by other government agencies and organizations relating to the control of and adherence to the Controlled Substances Act.

American Association of Nurse Anesthetists (AANA)

American Association of Nurse Practitioners (AANP)

American Academy of Physician Assistants (AAPA)

American Association for the Treatment of Opioid Dependence (AATOD)

American College of Nurse - Midwives (ACNM)

American Dental Association (ADA)

American Hospital Association (AHA)

American Medical Association (AMA)

American Osteopathic Association (AOA)

American Pharmaceutical Association (APHA)

American Psychological Association (APA)

American Society of Addiction Medicine (ASAM)

American Society of Consultant Pharmacists (ASCP)

American Society of Health - System Pharmacists (ASHP)

American Veterinary Medical Association (AVMA)

Food Marketing Institute (FMI)

Healthcare Distribution Management Association (HDMA)

National Association of Chain Drug Stores (NACDS)

National Association of Chemical Distributors (NACD)

National Association of State Alcohol/ Drug Abuse Directors (NASADAD)

National Community Pharmacists Association (NCPA)

National Association of Convenience Stores (NACS)

National Council for Prescription Drug Programs (NCPDP)

Pharmaceutical Research Manufacturers of America (PRMA)

Online tools for quick analysis of certain Federal data sets

There are a number of online tools for quick analysis of certain Federal data sets of interest in the epidemiology of drug abuse and its antecedents and consequences. Here are some of the most useful:

Substance Abuse & Mental Health Data Archive (SAMHDA)* (http://www.icpsr.umich.edu/SAMHDA/using-data/sda.html):
Provides access to substance abuse research data to promote the sharing of these data among researchers, policymakers, service providers, and others.

SAMHSA Office of Applied Studies (OAS) Quick Data Tables on Substance Abuse: Conduct Your Own Analysis (http://oas.samhsa.gov/quick.cfm):
Provides direct access to OAS data.

Youth Risk Behavior Surveillance System (YRBSS) (http://apps.nccd.cdc.gov/yrbss/):
Monitors priority health-risk behaviors among youth and young adults. The YRBSS includes a national school-based survey conducted by the CDC and state, territorial, tribal, and local surveys conducted by state, territorial, and local education and health agencies and tribal governments.

Behavioral Risk Factor Surveillance System (BRFSS) (http://www.cdc.gov/brfss/):
The world's largest, on-going telephone health survey system, tracking health conditions and risk behaviors in the United States yearly since 1984.

Web-based Injury Statistics Query and Reporting System (WISQARS)(http://www.cdc.gov/ncipc/wisqars/default.htm):
An interactive database system that provides customized reports of injury-related data.

CDC Wide-ranging Online Data for Epidemiologic Research (WONDER)(http://wonder.cdc.gov/):
An easy-to-use, menu-driven system that makes the information resources of the CDC available and provides access to online databases with an ad-hoc query system for the analysis of public health data. Reports and other query systems are also available.

Fatality Analysis Reporting System (FARS)
(http://www-fars.nhtsa.dot.gov/QueryTool/QuerySection/SelectYear.aspx):
Contains data on all vehicle crashes in the United States that occur on a public roadway and involve a fatality. This FARS Query System provides interactive public access to fatality data.

National Archive of Criminal Justice Data (NACJD)(http://www.icpsr.umich.edu/NACJD/das.html):
The primary activities of NACJD are the archiving and distribution of computer-readable crime and justice data collections to facilitate research in criminal justice and criminology, through the preservation, enhancement, and sharing of computerized data resources and through the production of original research based on archived data.

Data Ferret (http://dataferrett.census.gov/):
A tool from the US Census Bureau built to access TheDataWeb, a network of online data libraries. Data topics include, census data, economic data, health data, income and unemployment data, population data, labor data, cancer data, crime and transportation data, family dynamics and vital statistics data.

HCUPnet (http://hcupnet.ahrq.gov/):
HCUPnet is a free, on-line query system based on data from the Healthcare Cost and Utilization Project (HCUP). It provides access to health statistics and information on hospital inpatient and emergency department utilization.

* FYI, OAS has released another short report that illustrates use of the OAS online data analysis system (SAMHDA). Using heroin as an example, this report shows how SAMHSA's TEDS public use data files can be analyzed to show trends from 1995 to 2000 and how to graph the results. The report is: The DASIS Report: Graphing Multi-Year Analyses of TEDS at:http://www.samhsa.gov/oas/2k3/MultiYr/MultiYr.cfm Other helpful reports on the SAMHDA can be found at: http://www.samhsa.gov/oas/tutorial.cfm and;
http://www.samhsa.gov/oas/samhda.htm

Seeking Persons Committed to Spiritual Development to Participate in a Research Study of Mystical Experience, Meditation and Spiritual Practice

2009-07-12T15:42:00.000-05:00

http://www.bpru.org/spiritual-practice/

Seeking Persons Committed to Spiritual Development to Participate in a Research Study of Mystical Experience, Meditation and Spiritual Practice

In recent years, scientists at some U.S. universities have been conducting studies usingentheogens, resuming research in pharmacology, psychology, creativity, and spirituality that was suspended following the drug excesses of the 1960s.

Entheogens (roughly meaning God-evoking substances) include the peyote cactus used by the Native American Church, the psilocybin-containing mushrooms used as sacraments in Mesoamerica, and certain other plants and chemicals. Such substances have been used for thousands of years in cultures from the Amazon to ancient Greece as a means of inducing non-ordinary states of consciousness for spiritual or religious purposes.

These states of consciousness are most widely known in connection with practices such as meditation and prolonged fasting. Scientists have found, however, that the entheogens sometimes bring about states that are indistinguishable from the mystical and visionary states reflected in the sacred texts and poetry of the world's religions.

Context seems to play a major role in shaping entheogen experiences and their consequences. Despite the well-known problems that can arise in unstructured settings, the risks of entheogens in research and ritual contexts have proven to be very small.

Researchers at the Johns Hopkins University are seeking volunteers who have an active interest in exploring and developing their spiritual lives to participate in a scientific study of the combined effects of meditation, spiritual practice, and the entheogen psilocybin, a psychoactive substance found in mushrooms used as a sacrament in some cultures.

The study will take place over 6 to 8 months during which volunteers will be encouraged to initiate or maintain daily meditation and spiritual awareness practices. Volunteers will also receive careful preparation and 2 or 3 sessions in which they will receive psilocybin in a comfortable, supportive setting. Structured guidance will be provided during the session and afterwards to facilitate integration of the experiences. The study complies with FDA regulations.

Volunteers must be between the ages of 21 and 70, have no personal history of severe psychiatric illness, or recent history of alcoholism or drug abuse, have someone willing to pick them up and drive them home at the end of the two or three psilocybin sessions (around 5:00 PM).

For more detailed information about the study, see www.bpru.org/spiritual-practice. If you would like to discuss the possibility of volunteering, please call 410–550–5990 or emailspiritual-practice@bpru.org and ask for Mary, the study’s research coordinator. Confidentiality will be maintained for all applicants and participants.

Principal Investigator: Roland R. Griffiths, Ph.D., Protocol: NA_00020767

Herbal Link Listings from Herbmed.org (http://www.herbmed.org/links.asp)

2009-07-12T04:10:00.003-05:00

RELATED LINKS

The following is a categorized listing of most of the main herbal sites and information resources on the World Wide Web. It is not intended to be fully comprehensive. Many of the sites provide hyperlinks to other related resources so that it is possible to access may more from just a few key sites.

INDEX:

Structured Databases - Searchable - Non-Searchable - Glossaries
Herbal Monographs and Information Resources
Online Journals, Libraries, and Citations
Mailing Lists
Professional and Trade Associations
Related Links
Cultivation & Conservation Issues
Illustrations
Virtual Gardens
Education, Research & Training - Associations
Adverse Effects - Safety and Standards
Legal & Regulatory Information

Databases - Searchable:
Structured databases are available online at these WWW sites.

AGRICOLA:
http://www.nalusda.gov/general_info/agricola/agricola.html
AGRICOLA (AGRICultural OnLine Access) is a bibliographic database of citations to the agricultural literature created by the National Agricultural Library, USA

American Indian Ethnobotany Database
http://herb.umd.umich.edu/
Foods, drugs, dyes and Fibers of Native North American Peoples. Dr. Moerman's resource from University of Michigan

Carotenoid Database for US Foods
http://www.nal.usda.gov/fnic/foodcomp/Data/car98/car98.html
Collaborative effort between the USDA and the Nutrition Coordinating Center at the University of Minnesota. Mainly pdf files. The complete database can be downloaded.

HerbMed
http://www.herbmed.org
Categorized, evidence-based resource for herbal information, with hyperlinks to clinical and scientific publications and dynamic links for automatic updating, produced by the nonprofit Alternative Medicine Foundation.

IBIDS
http://ods.od.nih.gov/showpage.aspx?pageid=48
International Bibliographic Information on Dietary Supplements (IBIDS) is a database of published, international, scientific literature on dietary supplements, including vitamins, minerals, and botanicals, produced by the Office of Dietary Supplements at the National Institutes of Health.

LIGAND Database
http://www.genome.ad.jp/htbin/www_bfind?ligand
Ligand chemical database from GenomeNet, Kyoto University.

Patents Database
http://www.uspto.gov/patft/index.html
The US Patent and Trademark Office full-text and full-page image database includes many entries related to botanical medicine.

Plants for a Future
http://www.scs.leeds.ac.uk/pfaf/D_intro.html
From Leeds University, UK, the Species Database contains nearly 7000 plants, either edible, have medicinal properties or have some other use such as fibres, oils or soaps. Three websites for searching and downloadable version.

Poisonous Plants Informational Database
http://www.ansci.cornell.edu/plants/index.html
Reference resource from Cornell University that includes plant images, pictures of affected animals, presentations of the botany, chemistry, toxicology, diagnosis and prevention of poisoning of animals by plants and other natural flora.

PubMed
http://www.ncbi.nlm.nih.gov/PubMed/
National Library of Medicine's search interface to access the 10 million citations in MEDLINE, and Pre-MEDLINE, and other related databases.

Phytochemical and Ethnobotanical Databases
http://www.ars-grin.gov/duke/
Dr. Duke's Phytochemical and Ethnobotanical Databases, Agricultural Research Service of the US Department of Agriculture.

Tropical Plant Database
http://rain-tree.com/plants.htm
Each plant file contains taxonomy data, phytochemical and ethnobotanical data, uses in traditional medicine, and clinical research from Raintree Nutrition, Inc, Austin, Texas.

Non-Searchable:
Only description and access information are provided at the WWW sites.

CABI - CAB ABSTRACTS: CAB INTERNATIONAL, Oxford, UK
http://www.cabi.org/Publishing/Products/Database/Abstracts/Index.asp
Bibliographic database compiled by CAB International. It covers agriculture, forestry, aspects of human health, human nutrition, animal health and the management and conservation of natural resources.

Lloyd Library and Museum
http://www.lloydlibrary.org/
The 200,000 volume collection contains pharmacy, botany, and horticulture rare books and other collections.

NAPRALERT
http://www.ag.uiuc.edu/~ffh/napra.html
Large relational database of worldwide literature on ethnomedical, chemistry, pharmacology of plant, microbial, and animal extracts from University of Illinois.

See also the Rosenthal Center Directory of Databases for other relevant databases.

Glossaries:

Dictionary of Botanical Epithets
http://www.winternet.com/~chuckg/dictionary.html
Searchable glossary

Garden Gate Glossary of Botanical Names
http://www.prairienet.org/ag/garden/botrts.htm
Useful resource on primarily a gardening site.

Ohio State University Interactive Plant List
http://www.hcs.ohio-state.edu/plants.html
Dictionary of plants - includes medicinal plants.

Plantas Medicinais
http://www.ciagri.usp.br/planmedi/planger.htm
Alphabetical listing of medicinal plants and their characteristics.

Go to Index

Herbal Monographs and Information Resources

Although they are often described as databases, the following resources are primarily sets of monographs. They are all quality evaluated or compiled from a particular perspective. It is important to question the criteria underlying the collection and presentation of these resources.

Publicly available:

HerbData New Zealand
http://www.herbdatanz.com/index.htm
It is not clear what organization is behind the site. Seems to be mainly the work of one individual, Ivor Hughes, who has authored most of the monographs. Others are abstracted from reputable sources. Also provides list of articles, Online Campus chat room, and search capability. CD Rom sold on site.

Longwood Herbal Task Force
http://www.mcp.edu/herbal/
Monographs, patient and professional information from the faculty, staff and students of the Children's Hospital, the Massachusetts College of Pharmacy and Health Sciences and the Dana Farber Cancer Institute. No longer maintained.

Memorial Sloan-Kettering Cancer Center- Herbs, Botanicals, & Other Products
htttp://www.mskcc.org/mskcc/html/11570.cfm
Provides information evaluated by oncologists and healthcare professionals at MSK, including a clinical summary for each agent and details about constituents, adverse effects, interactions, and potential benefits or problems.

Phytotherapies.org Monographs
http://www.phytotherapies.org
Free service to practitioners registered with this Australian site, sponsored by Herbworx Corporation.

Subscription-based:

American Botanical Council
http://www.herbalgram.org/
ABC member benefits include access to HerbClip Online, Complete German Commission E Monographs, and Clinical Guide to Herbs.

HealthGate
http://www.healthgate.com
General medical information and herb monographs, aimed at licensing for commercial outlets. Advisory board and sources of information specified on web site.

HealthNotes
http://www.healthnotes.com/
UK based company provides consumer information on health, food, and lifestyle information for in-store touchscreen kiosks. States that all information is verified by compilers in peer-reviewed journals.

Herb Research Foundation
http://www.herbs.org/index.html
HRF provide a search service from their specialty research library containing more than 300,000 scientific articles on thousands of herbs.

Intramedicine
http://www.intramedicine.com/
Management team and advisory team specified on web site. Provides a Chinese herbal database as part of resources. Professional pharmacist and patient oriented.

Natural Medicines
http://www.naturaldatabase.com
Large collection of monographs aimed at medical professionals generally. Also available in book format. Editorial team listed.

Natural Standard
http://www.naturalstandard.com/
Monographs compiled by a multidisciplinary team. High profile advisory team. Methodology, selection criteria, and evaluation clearly described. Primarily oriented to clinicians and pharmacists.

Go to Index

Online Journals, Libraries, and Citations:

Bibliography from Bastyr University
http://www.bastyr.edu/library/bibliographies/botmcore.htm
A collection of citations from the literature on herbals from the Bastyr library. The categorized listing is extensive and also cites the journals used for the compilation.

Cathay Herbal Library
http://www.cathayherbal.com/library/index.htm
Collection of articles on Traditional Chinese Herbal Medicine for western doctors and TCM practitioners from the Cathay Herbal Laboratories Education Department.

David Winston, Herbalist AHG
http://www.herbaltherapeutics.net/
Click on the Herbal Therapeutics Research Library for full text pdf files of rare and out of print manuscripts from the extensive research library.

European Phytojournal
http://www.ex.ac.uk/phytonet/phytojournal/
Official newsletter of ESCOP, the European Scientific Cooperative on phytotherapy

Fitoterapia
http://www.weizmann.ac.il/InfoUnit/F.html
Phytotherapy journal published by Elsevier Science for Indena, Italy, a private company specializing in botanical derivatives for the pharmaceutical, cosmetic and food industries. Abstracts available. Click on Fitoterapia.

International Journal of pharmacognosy
http://sun.swets.nl/sps/journals/ijp.html
Research on the bioactivity of plants and extracts from all parts of the globe.

Journal of Ethnopharmacology
http://www.elsevier.nl/inca/publications/store/2/7/3/
http://www.elsevier.nl/inca/publications/store/5/0/6/0/3/5/
Interdiscipliniary journal from Elsevier devoted to research on biological activities of plant and animal substances used in traditional medical systems.

Journal of Natural Products
http://pubs3.acs.org/acs/journals/cover_art.page?incoden=jnprdf
Joint publication of the American Chemical Society and the American Society of Pharmacognosy, for natural product chemists,biochemists, taxonomists, ecologists, and pharmacologists.

Journal of Naturopathic Medicine
http://www.healthy.net/library/journals/naturopathic/index.html
lOfficial publication of the American Association of Naturopathic Physicians.

Medical Herbalism
http://www.medherb.com/MHHOME.SHTML
A full text clinical newsletter for the herbal practitioner.

Natural Products Reports online
http://www.rsc.org/is/journals/current/npr/npcon.htm
Published by the Royal Society of Chemistry, UK.

Pharmaceutical Biology
http://www.szp.swets.nl/szp/frameset.htm?url=%2Fszp%2Fjournals%2Fpb.htm
Formerly the International Journal of Pharmacognosy. Research on the bioactivity of plants and extracts from all parts of the globe.

Phytochemistry
http://www.elsevier.nl:80/inca/publications/store/2/7/3/
Published by Elsevier, covers research on all aspects of plant chemistry, plant biochemistry, plant molecular biology and chemical ecology.

See also the American Society of Pharmacognosy listing of related journals
http://www.phcog.org/journals.html

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Mailing Lists:
Instructions on how to join or leave lists are provided at the urls below.

Centre for International Ethnomedicinal Education and Research
http://www.cieer.org
CIEER is an international network of ethnobotanical researchers and provides a public discussion forum and listserv to exchange information on the safe and effective use of medicinal plants.

Herb Bulletin Board
http://www.algy.com/herb/
Click on The Green House for entry to an unmonitored, Web based, open discussion group.

Medicinal and Aromatic Plants Discussion List
http://sunsite.unc.edu/herbmed/archives.html#mediherblist
Three lists are featured at this site: The Medicinal Herblist; The Culinary Herblist; and The HerbInfo-list archives. There is also a newsgroup: Alt.folklore.herbs.

Medicinal Plants Working Group
http://www.nps.gov/plants/medicinal/workinggroup.htm
A consortium of federal agencies and groups concerned with native plant extinction, native knowledge, and habitat resoration. Anyone can join by contacting and subscribing.

Paracelsus
http://www.healthwwweb.com/paracelsus.html
Email based, clinical practice mailing list. Free subscription required to join.

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Professional, Membership, and Trade Associations

American Botanical Council
http://www.herbalgram.org/
ABC's main mission is to educate the public on the use of herbs and phytomedicinals. ABC publishes HerbalGram and has an extensive collection of information and research resources for members.

American Herbal Products Association
http://www.ahpa.org
Trade Association providing information on the botanical products industry for companies and public.

American Herbalists Guild
http://www.americanherbalistsguild.com/
Non-profit educational organization representing herbalists. AHG also provides a large database of certified herbalists, educational programs, and publications.

Council for Responsible Nutrition
http://www.crnusa.org/
CRN is a Washington-based trade association representing ingredient suppliers and manufacturers in the dietary supplement industry.

HerbNET
http://www.herbnet.com/
Herb growing and marketing network.

Herb Research Foundation
http://www.herbs.org/index.html
Information resource for the worldwide use of herbs for health, environmental conservation and international development.

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Related Links:

Algy's Home Page
http://www.algy.com/herb/
One of the earliest herb sites on the Web. Click on The Apothecary for information on medicinal herbs.

Alternative Nature Online Herbal
http://www.altnature.com/index.html
Miscellany of links and resources for herbalists.

American Herbal Pharmacopoeia
http://www.herbal-ahp.org/
The goal of AHP is to produce authoritative herbal monographs containing accurate, critically reviewed information on botanicals to provide guidance in the appropriate use of herbal therapeutics.

Botanical.com
http://www.botanical.com/
Collection of resources and links on botanicals. Features a hyper-text version of A Modern Herbal, 1931, by Mrs. M.Grieve:
http://www.botanical.com/botanical/mgmh/mgmh.html

Center for Botanical Dietary Supplement Research in Women's Health
http://www.uic.edu/pharmacy/research/diet/content/scont_about.htm
Center at University of Chicago, funded by NIH, studies botanicals with potential benefits for women's health.

Eclectic Medical Publications
http://www.eclecticherb.com/emp/
Collection of books and articles by Francis Brincker and other naturopathic herbalists.

Environmental Estrogens (Phytoestrogens)
http://www.tmc.tulane.edu/ecme/eehome/basics/phytoestrogens/default.html
Scientific information on environmental estrogens and other hormones.

Flavornet
http://www.nysaes.cornell.edu/flavornet/index.html
Compilations of aroma compounds sorted by their chromatographic and sensory properties - from Cornell University.

Henriette's Herbal Homepage
http://sunsite.unc.edu/herbmed/
Collection of medicinal and culinary herb resources.

Herbal Bookworm
http://www.herbological.com/bookworm.html
Herbal book reviews by Jonathan Treasure. Idiosyncratic and insightful.

Howie Brounstein's Home Page
http://www.teleport.com/~howieb/howie.html
Collection of sites and resources.

Natural Products Branch
http://dtp.nci.nih.gov/branches/npb/index.html
National Cancer Institute's Natural Products Branch tests and screens crude natural products for anti-cancer activity.

Medherb.com
http://medherb.com/
Categorized links to information on medicinal herbs and herbalism in the clinical setting from the journal, Medical Herbalism.

Michael Moore's Home Page
http://www.rt66.com/hrbmoore/HOMEPAGE/HomePage.html
Mounted by the Director of the Southwest School of Botanical Medicine, features a collection of publications and images.

Michael Tierra's Planetary Herbology
http://www.planetherbs.com
Idiosyncratic, lively site to explore.

Phytochemistry of Herbs
http://www.herbalchem.net/
Focuses on the phytochemistry of popular herbal medicines.

Phytotherapies.org
http://www.phytotherapies.org
A reference resource for herbal practitioners.

Robyn's Recommended Reading
http://www.rrreading.com
Quarterly review of literature on herbalism and phytotherapy from Robyn Klein, herbalist.

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Cultivation and Conservation Issues

Directory of forest Products, Wood Science, and Marketing
http://www.forestdirectory.com/
Resource compiled by Steve Shook from the University of Idaho.

Ecocrop
http://pppis.fao.org/
Information resource for plants, environments, uses, and environmental requirements.

Herb Society of America
http://www.herbsociety.org/
Membership organization, founded in 1933. Concerned with the cultivation of herbs and the study and history of their uses, past and present. The Society is committed global environmental protection and encourages the practice of environmentally sound horticulture.

Horizon Herbs
http://www.chatlink.com/~herbseed/
Source of roots and seeds for medicinal plants

Isoprene and Monoterpene Emitting Species Survey
http://www.es.lancs.ac.uk/cnhgroup/download.html
Resource from Lancaster University, UK

Laboratory of Ethnobotany
http://www.umma.lsa.umich.edu/Ethnobotany/Ethnobotany.html
The Ethnobotany laboratory houses extensive collections of domesticated plants from around the world as well as specimens recovered from archaeological sites.

MedPlant
http://source.bellanet.org/medplantnet/
A global network committed to the sustainable and socially equitable use of medicinal plants.

National Center for the Preservation of Medicinal Herbs
http://www.ncpmh.org/
Research on conservation of at-risk botanicals

National Plant Germplasm System
http://www.ars-grin.gov/npgs/
NPGS is a cooperative effort by public (State and Federal) and private organizations to preserve the genetic diversity of plants.

Non-Timber Forest Products
http://www.sfp.forprod.vt.edu/special_fp.htm
Marketing and utilization of specialized non-timber forest products.

Non-Timber Forest Products - US
http://www.ifcae.org/ntfp/index.shtml
Conservation and development information on commercial, recreational, and subsistence extraction of non-timber forest products in the US.

People and Plants Online
http://www.rbgkew.org.uk/peopleplants/
International initiative in applied ethnobotany, focusing on the interface between people and the world of plants. It promotes sustainable use of plant resources, and the reconciliation of conservation and development.

Plant Conservation Alliance
http://www.nps.gov/plants/
The PCA is a consortium of 10 federal government member agencies and over 145 non-federal Cooperators: biologists, botanists, habitat preservationists, horticulturists, resources management consultants, soil scientists, and enthusiastic supporters, working to solve the problems of native plant extinction and native habitat restoration.

PLANTLAX
http://www.geocities.com/florbach/red.htm
PLANTLAX is a pioneering organization in Mexico with an emphasis on organic herb products under a sustainable management.

PLANTS
http://plants.usda.gov/
National resource from the USDA generates categorized data reports on natural resources and conservation issues.

United Plant Savers
http://www.plantsavers.org/
The mission is to protect native medicinal plants of the US and Canada and their native havitat while ensuring an abundant renewable supply of medicinal plants.

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Illustrations:

Botany
http://www.ncsa.uiuc.edu/SDG/Experimental/vatican.exhibit/exhibit/g-nature/Botany.html
Texts and images from the Vatican Library herbal collection.

CalPhotos
http://elib.cs.berkeley.edu/photos/flora/
Searchable database of over 21,000 images from University of California, Berkeley.

Southwest School of Botanical Medicine
http://chili.rt66.com/hrbmoore/HOMEPAGE/HomePage.html
Scroll down to Michael Moore's collection of Medicinal plant images.

Rare Books from the MBG Library
http://ridgwaydb.mobot.org/mobot/rarebooks/
Missouri Botanical Garden rare books collection has been scanned and made available - includes medicinal plants and their uses.

Wild Herb Medicinal Flowers
http://www.altnature.com/gallery/index.html
Herb pictures, medicinal plans, wild flower photos and descriptions of uses in alternative medicine.

Virtual Gardens:

Missouri Botanical Garden
http://www.mobot.org/welcome.html
Bioprospecting and Dinosaur Safari.

New York Botanical Garden
http://www.nybg.org/
A virtual garden from the New York Botanical Garden in the Bronx.

University of Washington
http://www.nnlm.nlm.nih.gov/pnr/uwmhg/
Hypertext tour of a medicinal herb garden.

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Education, Research & Training:

American Herbalists Guild
http://www.americanherbalistsguild.com/
Continuing Education Guidelines and legislative updates for the professional herbalist.

Association of Natural Medicine Pharmacists
http://www.anmp.org/index.htm
Professional nonprofit association serving pharmacists and those interested in the field of natural medicines.

Bastyr University - Dept. of Botanical Medicine
http://www.bastyr.edu/academic/botmed/
Courses on medicinal use of plants, fungi and extracts for naturopathic medical students. Conducts research in botanical medicine.

CyberBotanica
http://biotech.icmb.utexas.edu/
Online botany education resource from Indiana University's BioTech Project.

NaturalHealers
http://www.naturalhealers.com/
Listings of herbal schools, or any school of the natural healing arts, along with further information on schools, programs, certification, careers and licensing requirements.

Office of Dietary Supplements (ODS)
Training and Career Development
http://ods.od.nih.gov/showpage.aspx?pageid=93
List of courses that offer continuing education credits kept updated by the ODS at National Institutes of Health.
Grant and Funding Opportunities
http://ods.od.nih.gov/funding.aspx
List of NIH Centers for Dietary Supplement Research, funding and partnership opportunities.

Rocky Mountain Center for Botanical Studies
http://www.herbschool.com/
Vitalistic approach to earth-centered herbal education and conservation.

Rocky Mountain Herbal Institute
http://www.rmhiherbal.org/
Chinese herbology education and courses.

Tropical Agricultural Research and Higher Education Center
http://www.catie.ac.cr/english/
The mission of the Tropical Agriculture Research and Higher Education Center (CATIE), Costa Rica, is the generation and dissemination of sustainable management practices for tropical ecosystems.

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Adverse Effects/ Safety and Standards:

Botanical Dermatology Database
http://bodd.cf.ac.uk/
Electronic version of book. Search on plant families or main index.

Food and Drug Administration - CAERS
http://vm.cfsan.fda.gov/~dms/caersltr.html
The FDA, Center for Food Safety and Applied Nutrition is developing a new system for tracking and analysing adverse event repors involving dietary supplements to replace the former contraversial Adverse Event Monitoring System. Details in this announcement.

Canadian Poisonous Plants Information System
http://sis.agr.gc.ca/pls/pp/poison?p_x=px
Information resource from Agriculture and Agri-Food, Canada

ConsumerLab
http://www.consumerlab.com/
Independent laboratory testing of health and nutrition products.

ESCOP
http://www.ex.ac.uk/phytonet/escop.html
European Scientific Cooperative on Phytotherapy contains the herbal adverse drug reactions database, PhytoNet.

FDA: Poisonous Plant Database (PLANTOX)
http://vm.cfsan.fda.gov/~djw/readme.html
Little known resource compiled by D. Jesse Wagstaff, DVM, with plant names and citations accessable from an alphabetical listing.

HerbMed
http://www.herbmed.org
HerbMed hyperlinks to the evidence on contraindications, toxic and adverse effects, and drug/herbal interactions.

Herbs and Pregnancy
http://www.gardenguides.com/herbs/preg.htm
Information on herbs helpful and counterindicated in pregnancy from GardenGuides.com.

Index of Poisons
http://www.botanical.com/botanical/mgmh/poison.html
From Mrs. M. Grieve: A Modern Herbal.

MedWatch
http://www.fda.gov/medwatch/index.html
FDA Safety Information and Adverse Event Reporting Program, serves healthcare professionals and the public by providing information on medical product safety issues including dietary supplements and medical foods.

Ohio State University - Herb and Drug Interactions
http://ohioline.osu.edu/hyg-fact/5000/5406.html
Table of possible herb-drug interactions - referenced and authored.

PhytoNet
http://www.ex.ac.uk/phytonet/pseng.html
Adverse event reporting system maintained by the University of Exeter, UK. See also ESCOP above.

Quackwatch - The Herbal Minefield
http://www.quackwatch.com/01QuackeryRelatedTopics/herbs.html
It is always useful to know what the Quackbusters are saying about the use of medicinal herbs.

Review of Herb-Drug Interactions: Docmented and Theoretical
http://www.uspharmacist.com/NewLook/DisplayArticle.cfm?item_num=566
Review article with look up tables published in US Pharmacist.

ToxAgents
http://www.ansci.cornell.edu/plants/toxicagents/toxagent.html
Information resource from Cornell University.

Toxic Plant Database
http://www.library.uiuc.edu/vex/toxic/Format.htm
Compilation from the veterinary Medicine Library, UIUC

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Legal and Regulatory Information:

American Herbal Products Association
http://www.ahpa.org
Information on the botanical products industry for companies and public.

Herb World News Online
http://www.herbs.org/current/topnews.html
Latest herb related news from the Herb Research Foundation, includes legal updates.

Codex Alimentarius
http://waffle.nal.usda.gov/agdb/codexali.html
Information on Codex Alimentarius from the USDA.

Controversial Herbs and Natural Products
http://sunsite.unc.edu/herbs/controv.html
From the Herb Research Foundation Home Page

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