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Julie Netherland

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Julie ("Jules") Netherland, PhD, is an emerging leader in the critical study of drugs, medicine, science and addiction. She has published over a dozen peer-reviewed journal articles, including, "White Opioids: Pharmaceutical Race and The War on Drugs that Wasn’t," (with Helena Hansen), in Biosocieties. She is also the editor of the Critical Perspectives on Addiction (Emerald Press, 2012). She holds a PhD in sociology from The Graduate Center, CUNY, a Masters in Social Work from Boston University, and B.A. from Bryn Mawr College.

Netherland currently teaches drug policy at John Jay College of Criminal Justice (CUNY). She is the director of the Office of Academic Engagement at the Drug Policy Alliance (DPA), where she previously served as the deputy state director for the New York Policy Office. She works on a number of issues, such as helping academics become more effective policy advocates, creating legal access to medical marijuana for seriously ill patients, advancing supervised injection facilities, and promoting a public health approach to drug policy.

Previously, she served as deputy director of health policy at New York Academy of Medicine (NYAM), where she worked on an array of policy and research projects with a specialization in substance use and HIV/AIDS. At NYAM, she also coordinated a multi-site national study looking at the integration of buprenorphine (a pharmaceutical used to treat opioid dependence) into HIV care settings, which resulted in a special supplement on buprenorphine and HIV in the Journal of Acquired Immune Deficiency Syndromes.

Her current project, with Helena Hansen (Anthropology and Psychiatry, NYU), examines how current media discourse, clinical interventions, medical technologies, and policy responses to the opioid epidemic are racialized. The work highlights sociological research on whiteness in ways that expose the racialization of drug policy as well as the strategic deployment of structural versus individualized understandings of addiction. This work draws on and adds to current debates about pharmaceuticalization, medicalization, and colorblind racism.

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Papers by Julie Netherland

How the war on drugs impacts social determinants of health beyond the criminal legal system

Annals of Medicine

Letter to the Editor re: “Why are white death rates rising?”

Principles and Metrics for Evaluating Oregon’s Innovative Drug Decriminalization Measure

Journal of Urban Health, 2022

Im Trying to be Butch: Gay and Bisexual Men, Masculinity, and Health

Heroin and Painkiller Deaths Require Public Health Policies

“Getting Turned On”: Using ICT Training To Promote Active Ageing In New York City

The Journal of Community Informatics, 2012

The purpose of this mixed-method study was to examine how participation in a senior’s technology ... more The purpose of this mixed-method study was to examine how participation in a senior’s technology training program influences the social environments and active ageing of older New Yorkers. Findings demonstrate increased and sustained use, improved ability and confidence with computer and Internet technology, and a substantial and positive effect on social connectedness, access to information, and social and civic participation among participants. Authors conclude with a discussion of how comprehensive, community-based ICT training programs (such as OATS) can support the ongoing engagement and re-engagement of older adults within society by building, maintaining and restoring their place within their various communities.

Physicians as Policy Advocates: From the Clinic to the State House

Structural Competency in Mental Health and Medicine, 2019

Though few clinicians are trained on how to influence policy, the policy environment has an enorm... more Though few clinicians are trained on how to influence policy, the policy environment has an enormous impact on patient health. Government policies – whether federal, state, or municipal – shape everything from the delivery of healthcare to the patient’s physical and social environment. From insurance reimbursement to food quality and access to clean air and water, health is affected daily by the decisions of policymakers. Another policy arena that profoundly impacts health – one that should be of great concern to medical providers – is drug policy. Historically, battles over drug policy have been framed by two, often competing, ideologies: one which sees drug use a moral failing and a crime that should be punished and another which sees it as an illness or disease requiring compassion and treatment. The question of who “owns” the problem of drug use – law enforcement or medicine – has been debated for decades. More recently, harm reduction – an approach that seeks to minimize the harms associated with drug use and our drug policies – has gained some traction. Because they are well respected, knowledgeable, highly credentialed, and can speak directly to the impact of policies on their patients, the voices of physicians as drug policy advocates are both powerful and desperately needed. Unfortunately, few physicians are equipped or have the time to engage in policy advocacy. Can physicians become effective policy advocates? And if so, how?

Finding common ground: Academics at the intersection of addiction and criminal justice

Addictive Behaviors, 2018

The academic community disagrees over the etiology and definition of addiction. • Academics must ... more The academic community disagrees over the etiology and definition of addiction. • Academics must advocate for addressing addiction outside of the justice system. • It is time for the scientific community to oppose criminalization of drug users. The Pew Charitable Trusts, 2017). Research has shown that adverse childhood experiences, mental illness, physical and psychological trauma, disadvantage, isolation, unemployment, and hopelessness contribute to the addiction and overdose crisis.

Developing a Transformative Drug Policy Research Agenda in the United States

Contemporary Drug Problems, 2018

Despite its strengths, drug policy scholarship in the United States has deficiencies and systemic... more Despite its strengths, drug policy scholarship in the United States has deficiencies and systemic biases that contribute to misinformation about drugs and people who use drugs. Factors ranging from funders’ biases to an overemphasis on abstinence-only outcomes limit the scope and focus of drug policy research. These deficiencies and the highly politicized nature of drug policy reform have led U.S. decision-makers to largely reproduce the uninformed thinking that epitomizes failed drug policies. In an effort to address some of these limitations, we designed Unbounded Knowledge: Envisioning a New Future for Drug Policy Research, a project to engage researchers in thinking about how U.S. drug policy research should be transformed. The project involved a diverse group of multidisciplinary drug researchers and clinicians in a focused collaboration to identify what drug research should be—but is not—studying in the U.S. It consisted of: (1) a preliminary series of interviews with research...

The War on Drugs That Wasn’t: Wasted Whiteness, “Dirty Doctors,” and Race in Media Coverage of Prescription Opioid Misuse

Culture, Medicine, and Psychiatry, 2016

The past decade in the U.S. has been marked by a media fascination with the white prescription op... more The past decade in the U.S. has been marked by a media fascination with the white prescription opioid cum heroin user. In this paper, we contrast media coverage of white non-medical opioid users with that of black and brown heroin users to show how divergent representations lead to different public and policy responses. A content analysis of 100 popular press articles from 2001 and 2011 in which half describe heroin users and half describe prescription opioid users revealed a consistent contrast between criminalized urban black and Latino heroin injectors with sympathetic portrayals of suburban white prescription opioid users. Media coverage of the suburban and rural opioid "epidemic" of the 2000s helped draw a symbolic, and then legal, distinction between (urban) heroin addiction and (suburban and rural) prescription opioid addiction that is reminiscent of the legal distinction between crack cocaine and powder cocaine of the 1980s and 90s. This distinction reinforces the racialized deployment of the War on Drugs and is sustained by the lack of explicit discussion of race in the service of "color blind ideology." We suggest potential correctives to these racially divergent patterns, in the form of socially responsible media practices and of clinical engagement with public policy.

Is the Prescription Opioid Epidemic a White Problem?

American Journal of Public Health, 2016

Becoming normal: The social construction of buprenorphine & new attempts to medicalize addiction

Drawing on theories about the social construction of knowledge and the sociology of the body, thi... more Drawing on theories about the social construction of knowledge and the sociology of the body, this dissertation analyzes the social construction of buprenorphine, a medication being used to treat addiction to opioids, to better understand the processes of medicalization. Buprenorphine was central the passage of the Drug Addiction Treatment Act of 2000, a law which overturned an almost one hundred year prohibition preventing physicians from prescribing narcotics for the treatment of addiction in an office-based setting. Buprenorphine is seen by many as central to moving addiction treatment into the medical mainstream. Using documents from government regulators, industry, and addiction researchers, I show that there are many different-buprenorphines,‖ each being strategically constructed and deployed to serve different political and economic interests. I also use qualitative interviews with individuals taking buprenorphine to examine the ways in which their embodied experiences of the medication shape and are shaped by different discourses about buprenorphine, addiction, and addiction treatment. I show how buprenorphine and medical theories of addiction act as a new system of constraint, while allowing new possibilities for agency and action. I conclude with a discussion of how the discourses about and embodied experiences of those taking buprenorphine challenge but also v reflect the larger sociopolitical context in which they are contained. This research builds upon and challenges existing theories about the medicalization of social problems. vi Acknowledgements Several years ago in the middle of my long career in public health, I enrolled as a non-matriculated student in a medical sociology class. Each week, I sat enthralled as a talented professor taught me an entirely new way of thinking about health and medicine. That professor was Barbara Katz Rothman, who has not only supported me throughout each step of my academic career since but has profoundly shaped my professional career for the better. I owe her deep thanks for her unfailing humor and support, thoughtful insights, generosity, and most of all for leading me down the medical sociology path-where I have been engaged, challenged and delighted. I am also indebted to Victoria Pitts-Taylor, an enthusiastic supporter who strengthened my love of theory and taught me how the subjective and embodied experiences of individuals can deepen and enrich the field of sociology. I knew starting my dissertation that I would need focus, rigor and clarity, and I knew that Juan Battle could deliver these. He did, and I am grateful to him. I cannot thank Ruth Finkelstein enough. She was a tireless champion, had confidence in me when I had none, engaged in endless and important conversations about drugs, and performed acts of incredible selflessness so that I could succeed. I hold her personally responsible for my ability to research and write about any topic in under an houra skill that served me well in graduate school. Thanks to all of my colleagues at The New York Academy of Medicine, especially James Egan and Linda Weiss. Rebecca Tiger has been a friend, mentor, and an inspiration. Soniya Munshi, Lauren Jade Martin, Danielle Jackson, and Wilma Borelli have been my stalwart advisors on everything from the profound to the mundane. My parents have supported me in all things, and the gift of an excellent education is one for which I will always be in their vii debt. The Major oversaw every page and word, offering precious little insight but lots of comfort, perspective and amusement. Hazel and Norm have been true friends, unflagging in their encouragment.

“We haven't Sliced Open anyone's Brain yet”: Neuroscience, Embodiment and the Governance of Addiction

Advances in Medical Sociology, 2011

Neuroscientific technologies have begun to change the ways in which we understand, respond to, an... more Neuroscientific technologies have begun to change the ways in which we understand, respond to, and treat drug addiction. According to addiction researchers, neuroscience marks a new era because of its potential to locate the causes of addiction within the brain and to treat addiction through altering neurochemistry. However, little is known about how addiction neuroscience and new neurochemical treatments shape individuals' experience of addiction and constitute new arrangements of knowledge and power that shape subjectivity and governance. This chapter addresses these domains by drawing on an analysis of scientific literature about addiction neuroscience and qualitative interviews with people being treated for addiction with buprenorphine, a pharmaceutical treatment for opioid dependence. The chapter charts four major themes in the addiction neuroscience literature (pleasure and the limbic system, rationality and the role of the prefrontal cortex, theories of plasticity, and the role of volition) and explores how each of these is incorporated, adapted, or rejected by individuals being treated for addiction with a pharmaceutical. This analysis demonstrates how neuroscientific ideas are mediated by the lived experiences of those being treated under a neuroscientific model. It also suggests that while neuroscientific interventions, like pharmaceuticals, shape the experience of those being treated for addiction, so too do many other forces, including social circumstances, moral frameworks, the drive for autonomy, and the quest to be “normal.”

Introduction: Sociology and the Shifting Landscape of Addiction

Critical Perspectives on Addiction, 2012

So much has been written about addiction, one can reasonably ask why we need another volume on th... more So much has been written about addiction, one can reasonably ask why we need another volume on the subject now. The pieces gathered here take up a number of current trends that make this exactly the right time to take a fresh look at addiction. These include: debates over the nosology of addiction as part of the revision to the Diagnostic and Statistical Manual of Mental Disorders (DSM); the expansion of addiction's meaning and spheres of control beyond alcohol and illicit substances; the rise of neuroscience; the increasing ‘pharmaceuticalization’ of everyday life and new pharmaceutical treatments for addiction; growing awareness about the intersection of the drug war and the mass incarceration of people of color; and new theoretical frameworks for understanding the role of addiction as a fundamental technique of social control. These trends are reshaping addiction in both new and not-so-new ways that warrant the interrogation this volume provides.

White opioids: Pharmaceutical race and the war on drugs that wasn’t

BioSocieties, 2017

The US 'War on Drugs' has had a profound role in reinforcing racial hierarchies. Although Black A... more The US 'War on Drugs' has had a profound role in reinforcing racial hierarchies. Although Black Americans are no more likely than Whites to use illicit drugs, they are 6-10 times more likely to be incarcerated for drug offenses. Meanwhile, a very different system for responding to the drug use of Whites has emerged. This article uses the recent history of White opioidsthe synthetic opiates such as OxyContin ® that gained notoriety starting in the 1990s in connection with epidemic prescription medication abuse among White, suburban and rural Americans and Suboxone ® that came on the market as an addiction treatment in the 2000s-to show how American drug policy is racialized, using the lesser known lens of decriminalized White drugs. Examining four 'technologies of whiteness' (neuroscience, pharmaceutical technology, legislative innovation and marketing), we trace a separate system for categorizing and disciplining drug use among Whites. This less examined 'White drug war' has carved out a less punitive, clinical realm for Whites where their drug use is decriminalized, treated primarily as a biomedical disease, and where their whiteness is preserved, leaving intact more punitive systems that govern the drug use of people of color.

Assessment of health care utilization, perceptions and needs for individuals released and soon-to-be released from New York State Prison: Focus Group Findings

ABSTRACT

Community consultations and the development of a public health approach to drug policy

ABSTRACT

Age-friendly New York City: A New Way to Address and "Old" Problem

ABSTRACT

Integration of counseling among physicians providing office-based buprenorphine treatment

BACKGROUND: Drug counseling can improve outcomes in office-based buprenorphine treatment. However... more BACKGROUND: Drug counseling can improve outcomes in office-based buprenorphine treatment. However, medical and behavioral health care systems often operate independently. We investigated how physicians meet the counseling needs of buprenorphine patients. METHODS: We recruited buprenorphine prescribers from states with the highest opioid use prevalence. Using a web-based survey (N=195) and qualitative interviews (N=33), we investigated the provision of counseling, services types/locations, and perceived barriers. RESULTS: Almost all physicians felt that counseling was essential to opioid dependence treatment; the majority required counseling for buprenorphine patients (60% for some, 33% for all). Counseling was provided through differing arrangements including onsite by physician (60%), onsite by staff (45%), offsite through contracted individuals/organizations (17%), referrals (60%), online (4%), and resource lists distribution (40%). Most reported having support-staff to assist wit...

Years of Heroin Use Predicts Abstinence in HIV-Infected Patients Receiving Buprenorphine

Background: Integration of buprenorphine treatment of opioid dependence into HIV care settings pr... more Background: Integration of buprenorphine treatment of opioid dependence into HIV care settings provides an opportunity to expand treatment access and improve outcomes. However, little is known about which HIV+ patients are most likely to benefit from this new mode of care. Methods: We analyzed data on 124 HIV+ opioid dependent patients who received office-based buprenorphine treatment in a HRSA/SPNS project studying integration of buprenorphine treatment into HIV care (BHIVES). Data included self-reported socio-demographics, general health measures, and substance use. We compared heroin use (HU) at baseline and after 90-days of treatment. Reported years of HU at baseline was recoded into 4 groups (≤5, 6-10, 11-20, or >20 years). Bivariate and multivariate analyses focused on years of HU as a predictor of HU in previous 30-days. Results: Most patients were over 40 years old (77%); unemployed (75%); and HIV+ for ≥10 years (59%). Prior month HU decreased at 90-days compared to basel...

How the war on drugs impacts social determinants of health beyond the criminal legal system

Annals of Medicine

Letter to the Editor re: “Why are white death rates rising?”

Principles and Metrics for Evaluating Oregon’s Innovative Drug Decriminalization Measure

Journal of Urban Health, 2022

Im Trying to be Butch: Gay and Bisexual Men, Masculinity, and Health

Heroin and Painkiller Deaths Require Public Health Policies

“Getting Turned On”: Using ICT Training To Promote Active Ageing In New York City

The Journal of Community Informatics, 2012

The purpose of this mixed-method study was to examine how participation in a senior’s technology ... more The purpose of this mixed-method study was to examine how participation in a senior’s technology training program influences the social environments and active ageing of older New Yorkers. Findings demonstrate increased and sustained use, improved ability and confidence with computer and Internet technology, and a substantial and positive effect on social connectedness, access to information, and social and civic participation among participants. Authors conclude with a discussion of how comprehensive, community-based ICT training programs (such as OATS) can support the ongoing engagement and re-engagement of older adults within society by building, maintaining and restoring their place within their various communities.

Physicians as Policy Advocates: From the Clinic to the State House

Structural Competency in Mental Health and Medicine, 2019

Though few clinicians are trained on how to influence policy, the policy environment has an enorm... more Though few clinicians are trained on how to influence policy, the policy environment has an enormous impact on patient health. Government policies – whether federal, state, or municipal – shape everything from the delivery of healthcare to the patient’s physical and social environment. From insurance reimbursement to food quality and access to clean air and water, health is affected daily by the decisions of policymakers. Another policy arena that profoundly impacts health – one that should be of great concern to medical providers – is drug policy. Historically, battles over drug policy have been framed by two, often competing, ideologies: one which sees drug use a moral failing and a crime that should be punished and another which sees it as an illness or disease requiring compassion and treatment. The question of who “owns” the problem of drug use – law enforcement or medicine – has been debated for decades. More recently, harm reduction – an approach that seeks to minimize the harms associated with drug use and our drug policies – has gained some traction. Because they are well respected, knowledgeable, highly credentialed, and can speak directly to the impact of policies on their patients, the voices of physicians as drug policy advocates are both powerful and desperately needed. Unfortunately, few physicians are equipped or have the time to engage in policy advocacy. Can physicians become effective policy advocates? And if so, how?

Finding common ground: Academics at the intersection of addiction and criminal justice

Addictive Behaviors, 2018

The academic community disagrees over the etiology and definition of addiction. • Academics must ... more The academic community disagrees over the etiology and definition of addiction. • Academics must advocate for addressing addiction outside of the justice system. • It is time for the scientific community to oppose criminalization of drug users. The Pew Charitable Trusts, 2017). Research has shown that adverse childhood experiences, mental illness, physical and psychological trauma, disadvantage, isolation, unemployment, and hopelessness contribute to the addiction and overdose crisis.

Developing a Transformative Drug Policy Research Agenda in the United States

Contemporary Drug Problems, 2018

Despite its strengths, drug policy scholarship in the United States has deficiencies and systemic... more Despite its strengths, drug policy scholarship in the United States has deficiencies and systemic biases that contribute to misinformation about drugs and people who use drugs. Factors ranging from funders’ biases to an overemphasis on abstinence-only outcomes limit the scope and focus of drug policy research. These deficiencies and the highly politicized nature of drug policy reform have led U.S. decision-makers to largely reproduce the uninformed thinking that epitomizes failed drug policies. In an effort to address some of these limitations, we designed Unbounded Knowledge: Envisioning a New Future for Drug Policy Research, a project to engage researchers in thinking about how U.S. drug policy research should be transformed. The project involved a diverse group of multidisciplinary drug researchers and clinicians in a focused collaboration to identify what drug research should be—but is not—studying in the U.S. It consisted of: (1) a preliminary series of interviews with research...

The War on Drugs That Wasn’t: Wasted Whiteness, “Dirty Doctors,” and Race in Media Coverage of Prescription Opioid Misuse

Culture, Medicine, and Psychiatry, 2016

The past decade in the U.S. has been marked by a media fascination with the white prescription op... more The past decade in the U.S. has been marked by a media fascination with the white prescription opioid cum heroin user. In this paper, we contrast media coverage of white non-medical opioid users with that of black and brown heroin users to show how divergent representations lead to different public and policy responses. A content analysis of 100 popular press articles from 2001 and 2011 in which half describe heroin users and half describe prescription opioid users revealed a consistent contrast between criminalized urban black and Latino heroin injectors with sympathetic portrayals of suburban white prescription opioid users. Media coverage of the suburban and rural opioid "epidemic" of the 2000s helped draw a symbolic, and then legal, distinction between (urban) heroin addiction and (suburban and rural) prescription opioid addiction that is reminiscent of the legal distinction between crack cocaine and powder cocaine of the 1980s and 90s. This distinction reinforces the racialized deployment of the War on Drugs and is sustained by the lack of explicit discussion of race in the service of "color blind ideology." We suggest potential correctives to these racially divergent patterns, in the form of socially responsible media practices and of clinical engagement with public policy.

Is the Prescription Opioid Epidemic a White Problem?

American Journal of Public Health, 2016

Becoming normal: The social construction of buprenorphine & new attempts to medicalize addiction

Drawing on theories about the social construction of knowledge and the sociology of the body, thi... more Drawing on theories about the social construction of knowledge and the sociology of the body, this dissertation analyzes the social construction of buprenorphine, a medication being used to treat addiction to opioids, to better understand the processes of medicalization. Buprenorphine was central the passage of the Drug Addiction Treatment Act of 2000, a law which overturned an almost one hundred year prohibition preventing physicians from prescribing narcotics for the treatment of addiction in an office-based setting. Buprenorphine is seen by many as central to moving addiction treatment into the medical mainstream. Using documents from government regulators, industry, and addiction researchers, I show that there are many different-buprenorphines,‖ each being strategically constructed and deployed to serve different political and economic interests. I also use qualitative interviews with individuals taking buprenorphine to examine the ways in which their embodied experiences of the medication shape and are shaped by different discourses about buprenorphine, addiction, and addiction treatment. I show how buprenorphine and medical theories of addiction act as a new system of constraint, while allowing new possibilities for agency and action. I conclude with a discussion of how the discourses about and embodied experiences of those taking buprenorphine challenge but also v reflect the larger sociopolitical context in which they are contained. This research builds upon and challenges existing theories about the medicalization of social problems. vi Acknowledgements Several years ago in the middle of my long career in public health, I enrolled as a non-matriculated student in a medical sociology class. Each week, I sat enthralled as a talented professor taught me an entirely new way of thinking about health and medicine. That professor was Barbara Katz Rothman, who has not only supported me throughout each step of my academic career since but has profoundly shaped my professional career for the better. I owe her deep thanks for her unfailing humor and support, thoughtful insights, generosity, and most of all for leading me down the medical sociology path-where I have been engaged, challenged and delighted. I am also indebted to Victoria Pitts-Taylor, an enthusiastic supporter who strengthened my love of theory and taught me how the subjective and embodied experiences of individuals can deepen and enrich the field of sociology. I knew starting my dissertation that I would need focus, rigor and clarity, and I knew that Juan Battle could deliver these. He did, and I am grateful to him. I cannot thank Ruth Finkelstein enough. She was a tireless champion, had confidence in me when I had none, engaged in endless and important conversations about drugs, and performed acts of incredible selflessness so that I could succeed. I hold her personally responsible for my ability to research and write about any topic in under an houra skill that served me well in graduate school. Thanks to all of my colleagues at The New York Academy of Medicine, especially James Egan and Linda Weiss. Rebecca Tiger has been a friend, mentor, and an inspiration. Soniya Munshi, Lauren Jade Martin, Danielle Jackson, and Wilma Borelli have been my stalwart advisors on everything from the profound to the mundane. My parents have supported me in all things, and the gift of an excellent education is one for which I will always be in their vii debt. The Major oversaw every page and word, offering precious little insight but lots of comfort, perspective and amusement. Hazel and Norm have been true friends, unflagging in their encouragment.

“We haven't Sliced Open anyone's Brain yet”: Neuroscience, Embodiment and the Governance of Addiction

Advances in Medical Sociology, 2011

Neuroscientific technologies have begun to change the ways in which we understand, respond to, an... more Neuroscientific technologies have begun to change the ways in which we understand, respond to, and treat drug addiction. According to addiction researchers, neuroscience marks a new era because of its potential to locate the causes of addiction within the brain and to treat addiction through altering neurochemistry. However, little is known about how addiction neuroscience and new neurochemical treatments shape individuals' experience of addiction and constitute new arrangements of knowledge and power that shape subjectivity and governance. This chapter addresses these domains by drawing on an analysis of scientific literature about addiction neuroscience and qualitative interviews with people being treated for addiction with buprenorphine, a pharmaceutical treatment for opioid dependence. The chapter charts four major themes in the addiction neuroscience literature (pleasure and the limbic system, rationality and the role of the prefrontal cortex, theories of plasticity, and the role of volition) and explores how each of these is incorporated, adapted, or rejected by individuals being treated for addiction with a pharmaceutical. This analysis demonstrates how neuroscientific ideas are mediated by the lived experiences of those being treated under a neuroscientific model. It also suggests that while neuroscientific interventions, like pharmaceuticals, shape the experience of those being treated for addiction, so too do many other forces, including social circumstances, moral frameworks, the drive for autonomy, and the quest to be “normal.”

Introduction: Sociology and the Shifting Landscape of Addiction

Critical Perspectives on Addiction, 2012

So much has been written about addiction, one can reasonably ask why we need another volume on th... more So much has been written about addiction, one can reasonably ask why we need another volume on the subject now. The pieces gathered here take up a number of current trends that make this exactly the right time to take a fresh look at addiction. These include: debates over the nosology of addiction as part of the revision to the Diagnostic and Statistical Manual of Mental Disorders (DSM); the expansion of addiction's meaning and spheres of control beyond alcohol and illicit substances; the rise of neuroscience; the increasing ‘pharmaceuticalization’ of everyday life and new pharmaceutical treatments for addiction; growing awareness about the intersection of the drug war and the mass incarceration of people of color; and new theoretical frameworks for understanding the role of addiction as a fundamental technique of social control. These trends are reshaping addiction in both new and not-so-new ways that warrant the interrogation this volume provides.

White opioids: Pharmaceutical race and the war on drugs that wasn’t

BioSocieties, 2017

The US 'War on Drugs' has had a profound role in reinforcing racial hierarchies. Although Black A... more The US 'War on Drugs' has had a profound role in reinforcing racial hierarchies. Although Black Americans are no more likely than Whites to use illicit drugs, they are 6-10 times more likely to be incarcerated for drug offenses. Meanwhile, a very different system for responding to the drug use of Whites has emerged. This article uses the recent history of White opioidsthe synthetic opiates such as OxyContin ® that gained notoriety starting in the 1990s in connection with epidemic prescription medication abuse among White, suburban and rural Americans and Suboxone ® that came on the market as an addiction treatment in the 2000s-to show how American drug policy is racialized, using the lesser known lens of decriminalized White drugs. Examining four 'technologies of whiteness' (neuroscience, pharmaceutical technology, legislative innovation and marketing), we trace a separate system for categorizing and disciplining drug use among Whites. This less examined 'White drug war' has carved out a less punitive, clinical realm for Whites where their drug use is decriminalized, treated primarily as a biomedical disease, and where their whiteness is preserved, leaving intact more punitive systems that govern the drug use of people of color.

Assessment of health care utilization, perceptions and needs for individuals released and soon-to-be released from New York State Prison: Focus Group Findings

ABSTRACT

Community consultations and the development of a public health approach to drug policy

ABSTRACT

Age-friendly New York City: A New Way to Address and "Old" Problem

ABSTRACT

Integration of counseling among physicians providing office-based buprenorphine treatment

BACKGROUND: Drug counseling can improve outcomes in office-based buprenorphine treatment. However... more BACKGROUND: Drug counseling can improve outcomes in office-based buprenorphine treatment. However, medical and behavioral health care systems often operate independently. We investigated how physicians meet the counseling needs of buprenorphine patients. METHODS: We recruited buprenorphine prescribers from states with the highest opioid use prevalence. Using a web-based survey (N=195) and qualitative interviews (N=33), we investigated the provision of counseling, services types/locations, and perceived barriers. RESULTS: Almost all physicians felt that counseling was essential to opioid dependence treatment; the majority required counseling for buprenorphine patients (60% for some, 33% for all). Counseling was provided through differing arrangements including onsite by physician (60%), onsite by staff (45%), offsite through contracted individuals/organizations (17%), referrals (60%), online (4%), and resource lists distribution (40%). Most reported having support-staff to assist wit...

Years of Heroin Use Predicts Abstinence in HIV-Infected Patients Receiving Buprenorphine

Background: Integration of buprenorphine treatment of opioid dependence into HIV care settings pr... more Background: Integration of buprenorphine treatment of opioid dependence into HIV care settings provides an opportunity to expand treatment access and improve outcomes. However, little is known about which HIV+ patients are most likely to benefit from this new mode of care. Methods: We analyzed data on 124 HIV+ opioid dependent patients who received office-based buprenorphine treatment in a HRSA/SPNS project studying integration of buprenorphine treatment into HIV care (BHIVES). Data included self-reported socio-demographics, general health measures, and substance use. We compared heroin use (HU) at baseline and after 90-days of treatment. Reported years of HU at baseline was recoded into 4 groups (≤5, 6-10, 11-20, or >20 years). Bivariate and multivariate analyses focused on years of HU as a predictor of HU in previous 30-days. Results: Most patients were over 40 years old (77%); unemployed (75%); and HIV+ for ≥10 years (59%). Prior month HU decreased at 90-days compared to basel...