A Crucial Element of Democracy

This is a blog by Robert Gutierrez ...
While often taken for granted, civics education plays a crucial role in a democracy like ours. This Blog is dedicated to enticing its readers into taking an active role in the formulation of the civics curriculum found in their local schools. In order to do this, the Blog is offering a newer way to look at civics education, a newer construct - liberated federalism or federation theory. Daniel Elazar defines federalism as "the mode of political organization that unites separate polities within an overarching political system by distributing power among general and constituent governments in a manner designed to protect the existence and authority of both." It depends on its citizens acting in certain ways which Elazar calls federalism's processes. Federation theory, as applied to civics curriculum, has a set of aims. They are:
*Teach a view of government as a supra federated institution of society in which collective interests of the commonwealth are protected and advanced.
*Teach the philosophical basis of government's role as guardian of the grand partnership of citizens at both levels of individuals and associations of political and social intercourse.
*Convey the need of government to engender levels of support promoting a general sense of obligation and duty toward agreed upon goals and processes aimed at advancing the common betterment.
*Establish and justify a political morality which includes a process to assess whether that morality meets the needs of changing times while holding true to federalist values.
*Emphasize the integrity of the individual both in terms of liberty and equity in which each citizen is a member of a compacted arrangement and whose role is legally, politically, and socially congruent with the spirit of the Bill of Rights.
*Find a balance between a respect for national expertise and an encouragement of local, unsophisticated participation in policy decision-making and implementation.
Your input, as to the content of this Blog, is encouraged through this Blog directly or the Blog's email address: gravitascivics@gmail.com .
NOTE: This blog has led to the publication of a book. The title of that book is TOWARD A FEDERATED NATION: IMPLEMENTING NATIONAL CIVICS STANDARDS and it is available through Amazon in both ebook and paperback versions.

Friday, August 17, 2018

OTHER FEDERAL MEASURES


[Note:  This posting is a continuation of a report on the development of a civics unit of study.  This unit is directing students to formulate informed positions on the opioid epidemic.  It is being developed in real time.  Writer wants to express gratitude to Wikipedia for identifying the bulk of the research this blog has used in the development of this unit.[1]]
This blog is currently reviewing the various reactions by the federal government in relation to the opioid crisis.  This posting will continue this review by listing further factoids.  Here are those factoids:
·        In the last posting, Tom Marino was identified as being nominated by the Trump Administration to be the new “drug czar.”  This was disrupted, on October 17, 2017, when Marino withdrew his name for further consideration.  He cited the fact he had had a long-lasting relationship with the drug industry and this could be used to accuse him as having a conflict of interest.[2]
·        Scott Gottlieb, FDA commissioner, finally declared, in July 2017, that dispensing and prescribing agents – pharmacists, nurses, and doctors – were to have appropriate training in prescribing opioids.  The commissioner cited the epidemic problem and summarized his concern by classifying opioid addiction as the “FDA’s biggest crisis.”[3]
·        Also, as one could judge over-due, the Department of Health and Human Services (HHS), issued a strategy to meet the crisis.  Its “Opioid Strategy” identified five aims.  Here are those aims as stated by HHS:
-         Improve access to prevention, treatment, and recovery support services to prevent the health, social, and economic consequences associated with opioid addiction and to enable individuals to achieve long-term recovery;
-         Target the availability and distribution of overdose-reversing drugs to ensure the broad provision of these drugs to people likely to experience or respond to an overdose, with a particular focus on targeting high-risk populations;
-         Strengthen public health data reporting and collection to improve the timeliness and specificity of data and to inform a real-time public health response as the epidemic evolves;
-         Support cutting-edge research that advances our understanding of pain and addiction, leads to the development of new treatments, and identifies effective public health interventions to reduce opioid-related health harms; and
-         Advance the practice of pain management to enable access to high-quality, evidence-based pain care that reduces the burden of pain for individuals, families, and society while also reducing the inappropriate use of opioids and opioid-related harms.[4]
·        Using another approach, the FDA began to regulate the producers of long-acting opioids.  These businesses were required to provide educational programs so that prescribers would have the information to prevent off-label[5] and to prevent over-prescribing.  Despite this move, there does not seem to be sufficient evidence that this stated policy has been effective.[6]
·        The reported grant program (reported in the last posting), SAMHSA begins administrating it in July 2017.  It did this by issuing plans developed by the National Academy of Sciences.  In that report, the academy points out that 91 people die every day of the opioid addiction epidemic.[7]  Eventually in 2017, SAMHSA started issuing grants.  The whole program is set up for a two-year run and provides grants totaling $485 million to states and territories of the US.  As the authorizing legislation – the 21st Century Cures Act – sets out, the aim of the grants is to prevent and combat opioid over-use and the resulting addiction.[8]
          That ends what this blog is prepared to report regarding the federal government’s reaction to the opioid crisis.  Next, the blog will address various countermeasures in the form of medical practices.


[1] The writer also wants to state that where possible, he has checked the sources and has at times added to the listed research.

[2] Peter Baker, “Tom Marino, Drug Czar Nominee, Withdraws in Latest Setback for Trump’s Opioid Fight,” The New York Times, October 17, 2017, accessed August 16, 2018, https://www.nytimes.com/2017/10/17/us/politics/trump-says-drug-czar-nominee-tom-marino-withdraws-from-consideration.html?_r=0 AND Bill Whitaker (correspondent), “Ex-DEA Agent:  Opioid Crisis Fueled by Drug Industry and Congress,” CBS’ 60 Minutes, October 17, 2017, accessed August 16, 2018, https://www.cbsnews.com/news/ex-dea-agent-opioid-crisis-fueled-by-drug-industry-and-congress/ .

[3] “FDA’s Scott Gottlieb:  Opioid Addiction Is FDA’s Biggest Crisis Now,” CNBC, July 21, 2017, accessed August 16, 2018, https://www.cnbc.com/video/2017/07/21/fdas-scott-gottlieb-opioid-addiction-is-fdas-biggest-crisis-now.html .

[4] Nora Volkow (presenter), “Federal Efforts to Combat the Opioid Crisis:  A Status Update on CARA and Other Initiatives,” National Institute on Drug Abuse, October 25,2017, accessed August 16, 2018, https://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2017/federal-efforts-to-combat-opioid-crisis-status-update-cara-other-initiatives .

[5] Google defines “off-label” as follows:  relating to the prescription of a drug for a condition other than that for which it has been officially approved.  See https://www.google.com/search?q=what+does+the+term+off-label+mean&oq=what+does+the+term+off-label+mean&aqs=chrome..69i57j0l5.13540j1j4&sourceid=chrome&ie=UTF-8 , accessed August 16, 2018.

[6] Andrew A. Kolodny, David T. Courtwright, Catherine S. Hwnag, Peter Kreener, John L. Eadie, Thomas W. Clark, and George Caleb Alexander, “The Prescription Opioid and Heroin Crisis:  A Public Health Approach to an Epidemic of Addiction,” Annual Review of Public Health, vol. 36, 559-574, 2015, accessed August 16, 2018, https://www.annualreviews.org/doi/10.1146/annurev-publhealth-031914-122957 .

[7] Dina Fine Maron, “Major Science Report Lays Out a Plan to Tamp Down Opioid Crisis,” Scientific American, July 13, 2017, accessed August 16, 2018, https://www.scientificamerican.com/article/major-science-report-lays-out-a-plan-to-tamp-down-opioid-crisis/ .

[8] Nora Volkow (presenter), “Federal Efforts to Combat the Opioid Crisis:  A Status Update on CARA and Other Initiatives.”

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