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Science Policy Around the Web – July 16th, 2019

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By Allison Cross, PhD

Source: MaxPixel

Are dinosaur fossils ‘minerals’? The Montana Supreme Court will decide high stakes case

A property rights dispute over fossils found on a Montana ranch is now in the hands of the Montana Supreme court and the decision could have wide-spanning implications, affecting how fossil hunters operate and putting into question the ownership of fossils currently in private and public collections around the world. 

The dispute began over a piece of land in Garfield County, Montana previously owned by George Severson.  The property is located inside the Hill Creek Formation, a famous and extensively studied dinosaur fossil site spanning through Montana, the Dakotas and Wyoming.  In 2005, Severson’s sons sold the surface rights of their property to another family, the Murrays, while retaining the mineral rights.  Since this sale, the Murrays and an amateur fossil hunter, Clayton Phipps, began excavating the land.  They unearthed multiple rare fossils including the complete fossils of two dinosaurs that appear to have been fighting when they died, a triceratops foot and skull, and a complete T. rex.    

The discovery of these rare and valuable fossils sparked an ownership dispute among the Severson (who have the minerals rights to the land) and the Murrays (who hold the surface rights).  Historically, fossils have been considered part of the surface property and when the Murrays filed a lawsuit seeking ownership of the fossils the district court sided on their behalf.  The Seversons then appealed to the 9th circuit, who in a surprising decision, sided on their behalf. This decision concerned many, including the Society of Vertebrate Paleontology, the Field Museum of Natural History in Chicago, and the Museum of the Rockies. The 9th circuit was asked to reconsider the case and, after granting the rehearing, the court vacated their earlier decision and sent the question up to the Montana Supreme Court. 

The Severson vs. Murray dispute over fossil ownership has left many worried about ownership challenges to important fossils currently in academic, museums, and private collections. In April, Montana enacted a law stating that fossils are not minerals and therefore belong to the surface estate.  This law, however, but does not apply to existing disputes. 

(Jeremy P. Jacobs, E&E News, Science)

Potential Causes of Irreproducibility Revealed

Scientists and the public have long been concerned about how experiments performed in the lab will translate to patients.  These concerns are heightened by the recently acknowledged lack of reproducibility within science, particularly in the biological sciences.  If scientists in different labs are unable to reproduce the same in vitro data, we should not be surprised when these findings fail to translate to humans.  

In an attempt to explore some of the factors affecting reproducibility, five research labs in the NIH LINCS Program Consortium performed the same experiment and compared results.Each lab aimed to quantify the responsiveness of mammalian cells in culture to anti-cancer drugs. Drug response assays like those performed by these labs are considered relatively simple and are standard during drug development.  

The results of this multi-lab study, along with analysis of the technical and biological factors affecting reproducibility between the five labs, were recently published in Cell Systems. In the published study, each lab received the same detailed protocol and were provided cells, media, and drugs from the same source.  Despite this, initial experiments performed by the five groups revealed drug potencies that varied as much as 200-fold. 

Researchers were able to identify some technical factors contributing to the inconsistent data, including differences in the method used for cell counting and edge effects and non-uniform cell growth in the culture plates.   The groups were able to improve their replicability by using more standardized protocols and randomizing locations of controls and technical replicates in the cell culture plates to reduce biases introduced by edge effects and uneven cell growth.  Though these changes did result in more consistency, the replicability remained higher within groups than between groups.  

Though this study demonstrated that controlling for variability is helpful in obtaining reproducible data, James Evans, a University of Chicago researcher not involved in the recent study argues “the point isn’t just to get reproducible effects.” In order to improve the translation of preclinical findings, Evans explains “We want reproducible effects that are going to be robust to subtle changes in the experiment.” 

(Abby Olena, The Scientist) 

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July 16, 2019 at 4:42 pm

Science Policy Around the Web – July 12th, 2019

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By Mohor Sengupta, Ph.D.

Source: Maxpixel

CDC made a synthetic Ebola virus to test treatments. It worked

During the 2014-2016 Ebola outbreak in Guinea, West Africa, infectious samples containing the virus were shared by local government with international scientific communities. Using these materials, Dr. Gary Kobinger and his team developed and tested the efficacy of a monoclonal antibody vaccine at the Canadian National Laboratory. The same vaccine, ZMapp, and other therapies are currently being deployed in the most recent Ebola outbreak, which is the second largest outbreak so far. Beginning in ] 2018 in the Democratic Republic of Congo (DRC), this outbreak is still on the roll. Unfortunately, the Centers of Disease Control and Prevention (CDC) did not have any viral samples this time, meaning they were unable to test the efficacy of ZMapp and other drugs against the recent viral strain. 

Scientists at the CDC, led by Dr. Laura McMullan, constructed an artificial virus from the sequence of the current strain shared by DRC’s National Biomedical Research Institute (INRB). The group used the sequence data to perform reverse genetics and generate the authentic Ebola virus that’s currently infecting scores of people in Ituri and North Kivu provinces of DRC. 

“It takes a lot of resources and a lot of money and a lot of energy to make a cloned virus by reverse genetics. And it would be so much easier if somebody had just sent the isolate”, Dr. Thomas Geisbert, who is not involved in the work, said. 

The CDC group established the efficacy of current treatments (a drug called Remdesivir and the vaccine ZMapp) on the viral strain by using their artificial virus for all the tests. Their work was published Tuesday in the journal Lancet.

For all four Ebola outbreaks that the DRC has seen, healthcare authorities have not shared viral specimens with foreign Ebola researchers. Instead, the whole genome sequence was provided every time. With the whole genome sequence data, the Lancet paper noted that there are at least two Ebola strains in DRC that have independently crossed into the human population.  

Reasons for not sharing viral samples by DRC are not known but it is a roadblock to rapid and efficient treatments in affected geographical regions. McMullan said that shipping of samples across such large distances is often a logistical issue and requires permission from several authorities and coordination of many people. 

 (Helen Branswell, STAT)

Plastic Has A Big Carbon Footprint — But That Isn’t The Whole Story

We are all too familiar with ghastly images of dead whales with plastic-filled stomachs. These images are compounded by pictures of how much waste is generated, such as a picture of a twenty-story high mound of plastic trash in a developing country that appeared in a recent news article. While there is worldwide concern about how to eliminate use of plastics, there is very little discussion about the environmental impact of the materials that will replace plastic. 

Plastic has a high carbon footprint. In a recent report the Center for International Environmental Law (CIEL) has broken down the individual steps of greenhouse gas production, from the beginning of plastic production until it ends up incinerated as a waste. Manufactured from oil and natural gas, plastic production adds to carbon footprint right from its cradle when gases and oils leak into the environment. Subsequently, delivery of raw materials to the production sites further add to the burden. Being among the most energy intensive materials to produce, plastic production takes a heavy toll on energy, water and electricity. Finally, when plastics are incinerated, greenhouse gases end up in the environment. 

But what about the materials that commonly substitute for plastic, such as paper, compostable plastic, canvas or glass? What is their carbon footprint in production stages? Research by several independent groups has revealed that these materials leave an even larger carbon footprint during their production. Data have shown that polyethylene plastic bags not only used lesser fuel and energy throughout production, they also emitted fewer global-warming gases and left lesser mass of solid wastes, when compared with paper bags and with compostable plastic bags. Being more durable than other materials, use of polyethylene bags are more energy friendly than use of paper bags. 

Research done on behalf of the American Chemistry Council has shown that replacing plastic would eventually do more harm to the environment than their use. Finally, consumer habits count. If people don’t reuse plastics, then its advantages over paper cease to exist. Of course, the problem of permanent waste and global health consequences are issues that cannot be overlooked. The solution might lie in using plastics more wisely and re-using them as much as possible. 

(Christopher Joyce, NPR

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July 12, 2019 at 3:18 pm

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Homegrown Apocalypse: A Guide to the Holocene Extinction

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By: Andrew Wright BSc

Homegrown Apocalypse: A Guide to the Holocene Extinction

One of the unifying factors of mass extinctions is a rapid change in global average temperature. The end-Ordovician extinction, the second largest, occurred when newly forming mountains made of silicate rock quickly absorbed atmospheric CO2. The global average temperature plunged, leading to the formation of enormous glaciers, drastically lower ocean levels, and much colder waters. Since complex life was still relegated to the oceans, this killed 86% of all species. The most well-known extinction is the end-Cretaceous or K-Pg event caused in part by a massive asteroid impact in Chicxulub, Mexico. The immediate impact, roughly one billion times stronger than the atomic bombings of Japan, was devastating in its own right. However, the subsequent ejection of sulfate-bearing rock into the atmosphere was the real killer, dropping global temperatures by 2-7°C, inhibiting photosynthesis, and acidifying the oceans. Coming right after a period of global warming, this extinction killed about 76% of all species.

            These extinctions pale in comparison to the end-Permian extinction, also known as the Great Dying. When Pangea was the sole continent, an enormous pool of lava called a flood-basalt plain slowly erupted over what is modern-day Siberia. Over 350,000 years, magmatic rock up to a mile thick solidified and covered an area roughly half the size of the United States. This igneous cap forced underground lava to move sideways and spread in paths called sills. As the lava traveled, it vaporized increasing amounts of carbonates and oil and coal deposits, leading to an immense build-up of CO2. Once the sills reached the edge of the cap, these gases were violently expelled, ejecting up to 100,000 gigatons of CO2. The immediate effect was a global average temperature increase of roughly 5°C. Subsequently, oceanic methane hydrate (or methane clathrate) crystals, which become unstable at high temperatures, broke down. Since methane is 20-80 times more potent than CO2as a greenhouse gas, global average temperature increased a further 10°C, bringing the total to 15°C. This left the planet barren, desertified most of Pangea, strongly acidified the oceans, killed 96% of marine life, and 90% of all life on Earth.

            We are currently living through the beginnings of the sixth mass extinction event, known as the Holocene. Species are dying off 10-100 times faster than they should and that rate is accelerating. Insects, including pollinators, are dying off so quickly that 40% of them may disappear within decadesOne in eight birds are threatened with extinction, 40% of amphibians are in steep decline, and marine biodiversity is falling off as well. At current rates, half of all species on Earth could be wiped out by the end of the century. 

What is the commonality between our present circumstances and the past? As with previous mass extinctions, global average temperature has increased. Since 1880, global average temperature has increased by 0.8°C and the rate of warming has doubled since 1975. This June was the hottest month ever recorded on Earth, with global average temperature reaching 2°C above pre-industrial levels. Greenland lost two billion tons of ice in one day. This increase in temperature is because we are currently adding 37.1 gigatons of CO2 per year to the atmosphere, and that number is rising

            From the most recent International Panel on Climate Change (IPCC) report, we know that the best outcome is to keep the increase in global average temperature below 1.5°C. Instead, let us consider what would happen if current trends stay the same and CO2 emissions continue to increase at similar rates until 2100. This is known as the RCP 8.5 model. Under this paradigm, atmospheric CO2 levels will rise from 410 parts per million (ppm) to 936 ppm. The global average temperature will increase by 6°C from pre-industrial levels. That puts the Earth squarely within the temperature range of previous mass extinction periods. 

Given this level of warming the following can be expected to occur: first and foremost, the extreme heat on the planet will massively decrease glaciation, causing a surge in ocean levels. Since water expands as it gets warmer, ocean levels will increase even further to about 12ft higher than current levels. This means most coastal areas will perpetually flood while others will be completely underwater. Unfortunately, non-coastal areas won’t be free from hardship as high air temperature will cause desertification, crop die-off, drought, and widespread wildfires. Secondly, as the ocean absorbs CO2 from the atmosphere, it will become increasingly acidic. So far, the pH of the ocean has only changed by 0.1, but under an RCP 8.5 model, that decrease could be as high as a 0.48 reduction in pH. Since this measurement is on a logarithmic scale, this means that the oceans will be acidic enough to break down the calcium carbonate out of which shellfish and corals are built. Warmer water cannot hold oxygen as effectively as cold, meaning many water-breathing species will suffocate. In combination, these two factors will serve to eliminate a huge source of the human food supply. Finally, since weather patterns are based on ocean and air currents and increasing temperatures can destabilize them, massive hurricanes, dangerously cold weather systems, and flood-inducing rainfall will become the norm. 

One parallel to the end-Permian extinction might result as well. Over millions of years, methane clathrate re-stabilized in the permafrost of Siberia and in the deep ocean floor. But in what has been termed the clathrate gun hypothesis, if methane clathrate destabilizes again at high temperatures, then the resultant methane emissions and planetary warming could form a positive-feedback loop, releasing even more crystallized methane until we end up in another “great dying”. While short-term warming probably won’t cause a runaway temperature increase, a 6°C increase in global average temperature might. New research suggests methane release may not even be necessary as the ocean is reaching a critical point in the carbon cycle where it could rapidly expel an amount of CO2on par with flood-basalt events. Moreover, like the end-Permian extinction, anthropogenic climate change is occurring on a near instantaneous geological time scale and species, including our own, will not have the requisite time to adapt.

Of course, none of these effects exists in a vacuum. They will be alongside increasing deforestation for agriculture, plastic and chemical pollution, and resource extraction. The end result would be a planet with less space, little food, mass migration, and devastating weather. So, what can be done to stop this scenario from coming true? The latest IPCC report essentially places humanity at an inflection point. Either CO2output is cut in half by 2030 and humans become carbon neutral by 2050, or the planet is irrevocably thrust past the point of no return. 

This timeframe may seem short, but it takes into account that even if civilization were to completely stop emitting greenhouse gasses today, it would take hundreds of years for global average temperature to  go back down since it takes time for the ocean to absorb CO2from the atmosphere. Like any problem of scale, there is no one solution to reaching carbon neutrality and it will take a multivariate approach. Some solutions include enacting carbon tax measures, subsidizing and implementing renewable energy (while divesting from new coal and oil production), an increased reliance on nuclear power, large-scale reforestation, livestock reduction, and carbon-sequestration technology. Some of these efforts have come a long way and some have gone in the wrong direction.

This is, of course, a global problem to be solved. At a time when the United States has signaled its intention to withdraw from the Paris Climate Accord as soon as possible and states are rejecting carbon cap-and-trade measures, other nations are moving ahead with unprecedented boosts in renewable energy and bold commitments to reducing greenhouse gas emissions. India, the third-largest polluter after the United States, is on track to surpass its Paris Accord commitments. Should the United States re-engage with and lead the international effort to tackle what is an existential threat, then it is not improbable that the end of this century could be a pleasant one. So, if the idea of living through a global extinction event is disconcerting, one can be assured that the problem is still just barely a solvable one. 

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July 11, 2019 at 4:24 pm

Science Policy Around the Web – July 3rd, 2019

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By Neetu Gulati, Ph.D.

Image by Arek Socha from Pixabay 

The US opioid epidemic is driving a spike in infectious diseases

Opioid use has skyrocketed in the US in the past 20 years, and addiction kills tens of thousands of people each year. Now, opioid use has been linked to an increase in infectious diseases as well, which may pile on to an already extreme public health concern.

One cause for concern is that opioids themselves may be making people more susceptible to infection, though the reason for this is unclear. One study found that people treated at veterans’ health facilities who took medium or high doses of prescribed opioids for pain management were more susceptible to pneumonia, for example. Another cause for concern is that unsafe injection practices may mean that users of illicit opioids could lead to an increase of infections. Bacterial infections, such as those caused by Staphyloccocus aureus, can enter the bloodstream of opioid users through non-sterile needle usage or unclean sites of injection. If these bacteria reach the heart, it can lead to damage and possibly the need for a transplant. For example, a study done in North Carolina found a tenfold increase in heart infections among drug users in the state over a 10-year period.

As if the increase in infections was not bad enough, another major challenge is that the pattern of outbreaks associated with drug use may not be the same as that of non-drug-affiliated outbreaks, meaning it is difficult to predict where and when infections might occur. Furthermore, as Georgiy Bobashev, a data scientist at RTI International, pointed out, drug users “don’t have good practices and they don’t have good connections with people who have been injecting drugs for a long time.” In tackling the problem, it will be important to consider the social component of predicting outbreak patterns among drug users. It will also be important to treat opioid use as a disease without stigmatizing drug users, commented Carlos Del Rio, a global-health researcher at Emory University.

(Sara Reardon, Nature)

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July 3, 2019 at 3:13 pm

Science Policy Around the Web – June 25th, 2019

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By Ben Wolfson, Ph.D.

Image by Darwin Laganzon from Pixabay 

North Korea claimed to be free of HIV. But infections appear to be surging

Since its first diagnosis 1981, HIV/AIDS (Human immunodeficiency virus infection and acquired immune deficiency syndrome) has infected more than 70 million individuals worldwide and resulted in 35 million deaths.

HIV/AIDS is classified as a pandemic, with infected individuals found throughout the world. However, as of a December, 2018 World AIDS Day event, North Korea reported no known cases, crediting this to widespread testing and prevention methods.

A new paper has reported that these data were false, and that in fact following a North Korean “patient zero” in 1999, HIV/AIDS infections have slowly ballooned. These findings come from a collaboration between North Korean scientists and DoDaum, a nonprofit in North America that runs health and education projects in North Korea. While officials originally asked DoDaum not to discuss the increasing prevalence of HIV/AIDS in North Korea, the North Korean Ministry of Public Health felt they had to overcome traditional reticence in order to seek help in targeting HIV/AIDS.

While both a cure and vaccine remain elusive, widening usage of Pre-Exposure Prophylaxis (PrEP), also called Truvada, has the potential to significantly reduce new HIV infection. PrEP has been shown to be more than 90% effective at preventing new HIV infections, and remains underutilized in most countries, including the USA. This is in part due to cost, a factor which is the subject of a new bill introduced in the Senate that would make PrEP free to most patients.

(Richard Stone, Science)

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June 25, 2019 at 5:37 pm

Science Policy Around the Web – June 21st, 2019

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By Neetu Gulati Ph.D.

Image by Kathy Bugajsky from Pixabay 

Tech disorder? Smartphones linked to bizarre horn-like skull bumps

Two Australian researchers published a study inScientific Reports this year with an unusual discovery: people are growing horn-like bone spurs at the base of their skulls. They found these protrusions on around 400 adults aged 18 to 86, and larger growths were found among younger people. Bone spurs usually do not cause pain or require treatment, but if they become too large can become a problem.

While the study originally did not get much press, it has broken headlines recently after a BBC article covering how modern life is transforming the human body. The authors in the original research article hypothesized these bone spurs could be due to “sustained aberrant postures associated with the emergence and extensive use of hand-held contemporary technologies, such as smartphones and tablets.”

While the article has led to sensationalized media accounts, some experts have questioned the validity of the conclusions, saying the study lacks a control group and cannot prove cause and effect between the spurs and technology. Furthermore, there may be bias in the study because the subjects are people with enough neck problems to warrant visiting a chiropractic clinic, where the authors of the study work.

Regardless of the exact cause of the bone spurs, numerous cases of “texting neck” ailments and similar problems have occurred as technology use as increased since the early 2000s. Dr. David Geier, an orthopedic surgeon, commented that the study “isn’t going to convince people not to use their phone. But small changes like putting pillows under our laptops and holding the phone or tablet higher up and away from our laps can promote better posture.” Others, such as Dr. Evan Johnson, an assistant professor and director of physical therapy at the New York-Presbyterian Och Spine Hospital, commented that the bone spur “is a really big ‘So what?’ moment… The fact that you have this little bony projection in your skull, that means nothing.” It will be important to see if these projections get worse over time, to the point of leading to pain.

(Dr. Shamard Charles, NBC News

Type A blood converted to universal donor blood with help from bacterial enzymes

Donor blood plays a critical role in the healthcare system. However, there is a constant shortage of blood for transfusions around the world. Blood shortages are made more complicated because blood transfusions cannot be done with just any blood, the patient and donor blood types must be compatible or else the recipient’s body can have a deadly immune response to the donor blood. The immune system recognizes specific sugar molecules on the surface of red blood cells, which denote blood as one of the four types: A, B, AB, or O. Blood type O is coveted as universal donor blood, because it lacks these unique sugar molecules, also known as antigens, so they are not recognized as “foreign” in a patient’s body, even when given to people with other blood types. 

Now, researchers have discovered a way to convert type A blood to type O, using a combination of two bacterial enzymes to remove the “A-defining” antigens. Harvey Klein, a blood transfusion expert at the National Institutes of Health, commented on the work, “this is a first, and if these data can be replicated, it is certainly a major advance.”

Previous attempts by researchers to remove the A-defining antigens from blood have had limited success, because the enzymes used were not very efficient. In the most recent study, bacterial enzymes identified from a human stool sample removed the sugars in human blood efficiently using only tiny amounts of the enzymes. If these findings can be translated to practical application, the amount of universal donor blood could nearly double, as type A blood makes up approximately 1/3 of the blood supply. To get to that point, more work needs to be done to confirm that these enzymes are not altering anything else in the blood.

(Elizabeth Pennisi, Science)

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June 21, 2019 at 2:59 pm

Science Policy Around the Web – June 18th, 2019

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By Allison Dennis, B.S.

Source

Congress is debating-again-whether genes can be patented

The last time the U.S. government issued an official guidance on human gene patenting, it was from the Judicial Branch in 2013. By a unanimous decision, the Supreme Court ruled that two genes whose DNA sequence can be used to predict the probability of a patient developing breast or ovarian cancer, BRCA1 and BRCA2, could not be patented. Companies are still free to pursue patents manipulating or mitigating the effects of specific genes, but the ruling invalidated the patents held by Myriad Genetics for these two genes and opened the door for clinical labs to begin widely testing patient samples for mutations across a wide variety of disease predicting genes that might have otherwise been patented.

Insurance claims filed in 2004 indicate that only one in four women received a BRCA mutation test before being diagnosed with cancer. By 2014, more than 60% of these tests were administered diagnostically, allowing women confirmed to be at risk to pursue prevention and early detection of breast and ovarian cancer before developing either. The effect of the 2013 Supreme Court ruling to dramatically reduce testing costs in combination with technological developments and public health awareness have been attributed to this shift.

Now lawmakers in the legislative branch are weighing in. Senators Thom Tills and Chris Coons filed a bipartisan draft bill that would expand the types of inventions eligible for a U.S. patent to include previously restricted subject matter falling under “abstract ideas,” “laws or nature,” or “natural phenomenon,” which could be interpreted to include human genes. While Tillis has since made clear that it was “was never the intent” to again give companies ownership over single human genes, the changes could allow companies to limit examination of specific genetic variants like those most likely to cause disease. Supporters of the bill feel it is necessary to provide companies with sufficient intellectual property to incentivize their research into isolated natural products. Many point to less-restrictive patent codes abroad, which they feel put the U.S. at a disadvantage.  

Following two weeks of Congressional hearings, and a letter signed by 170 scientific organizations, nine nobel prize winners along with 74 leading physicians and scientists have weighed in by urging lawmakers to more carefully consider the proposed changes. The level of concern or eagerness expressed for the bill seems largely up to the interpretation of the reader, suggesting that much more work is needed for the bill to achieve its stated goal of reducing frustration and confusion generated by the Supreme Court rulings.

(Megan Molteni, Wired Magazine)

Federal Grants Restricted To Fighting Opioids Miss The Mark, States Say

Of the 70,237 drug overdose deaths captured by the CDC in 2017, nearly a third involved cocaine, psychostimulants, which include MDMA and methamphetamine, or both. The CDC cites “changes in the drug supply, mixing of substances with or without the user’s knowledge, and polysubstance use” as emerging threats. Yet the opioid-focused way grant money is allocated may be restricting the ability of states to adapt.

At the frontlines of the opioid epidemic are state officials dedicated to making the most of federal grants designed to offer struggling states a financial lifeline. For example in 2017, Arizona used funds from a State Targeted Response grant to train 9,197 individuals in Naloxone usage and purchase 8,798 Naloxone kits, allowing first responders to perform 5,649 overdose reversals. Many states are using the money to implement the hub-and-spoke model, first developed and demonstrated to be effective by Vermont, in which intensive addiction treatment is offered at a limited number of hubs connected by a local network of outpatient addiction programs and primary care physicians. Through this structure, the hub-and-spoke model can make at least one licensed mental health or addiction counselor accessible per 100 patients.

While the framework provided by the hub-and-spoke model may intuitively help address addiction beyond the specific use of opioids, they rely on Medication Assisted Treatment, an intervention that has only been approved for opioid addiction. Similarly the use of Novaxalone is only effective in reversing opioid overdoses, in the case of cocaine overdose it is ineffective. Additional research is underway to develop parallel treatments for other substances, but these efforts have been eclipsed by the national focus on opioids.  

In 2017, opioids accounted for less than half of the overdoses suffered in eleven states, including Pennsylvania, Texas, and California. This may point to the effectiveness in opioid specific treatment, but it also the persistent dangers of drug-use. Currently, the funding opportunities are insufficient to address the gaps in the mental health system needed to more completely help patients living with addiction. The pathways leading to drug-abuse, no matter the current drug of choice, may provide a common point of intervention resilient against the so called “emerging threats” of substance abuse.

However, similar to the shift seen as users transitioned from OxyContin to Heroin, public health fear that the next shift will turn to drugs not classified as opiods and therefore ineligible to be combated with the funds. In 2017, eleven states

(Carmen Heredia Rodriguez, Elizabeth Lucos, and Orion Donovan-Smith, Kaiser Health News)

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June 18, 2019 at 5:22 pm