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The first big update to U.S. methadone regulations in 20 years is poised to expand access to the life-saving drug starting next month, but experts say the addiction treatment changes could fall flat if state governments and methadone clinics fail to act. For decades, strict rules required most methadone patients to line up at special clinics every morning to sip their daily dose of the liquid medicine while being watched. The rules, built on distrust of people in the grip of opioid addiction, were meant to prevent overdoses and diversion — the illicit selling or sharing of methadone. The COVID-19 pandemic changed the risk calculation. To prevent the spread of the coronavirus at crowded clinics, emergency rules allowed patients to take methadone unsupervised at home. Research showed the looser practice was safe. Overdose deaths and drug diversion didn’t increase. And people stayed in treatment longer. With evidence mounting, the U.S. government made the changes permanent early this year. Oct. 2 is the date when clinics must comply with the new rules — unless they’re in a state with more restrictive regulations. Alabama — where about 7,000 people take methadone for opioid use disorder — plans to align with the new flexible rules, said Nicole Walden, a state official overseeing substance use services. “This is a step toward the country — and everybody — saying this is not a bad thing,” Walden said. “People don’t have to show up every day to get a medication that can help save their lives.” Methadone, an opioid itself, can be dangerous in large amounts. When taken correctly, it can stop drug cravings without causing a high. Numerous studies have shown it reduces the risk of overdose and the spread of hepatitis C and HIV. But it cannot be prescribed for opioid addiction outside of the nation’s 2,100 methadone clinics, which on a given day treat nearly 500,000 U.S. patients with the drug. The new federal rules allow stable patients to take home 28 days’ worth of methadone. Colorado, New York and Massachusetts are among states taking steps to update their rules to align with the new flexibility. Some others have not, including West Virginia and Tennessee — the states with the nation’s highest drug overdose death rates. “Where you live matters,” said University of Arizona researcher Beth Meyerson, who studies methadone policy. Phoenix resident Irene Garnett, 44, would welcome more take-home methadone doses. Her clinic now requires her to come in twice a week, even though she’s been a patient there more than 10 years, “which is just bonkers,” she said. Garnett, who works as a grant manager for a harm reduction agency, lives 25 minutes away from the clinic. She said 28 days of take-home methadone, the maximum allowed under the new federal rules, would give her more freedom to travel and a “more normal quality of life.” “This is the only medication where you have to disrupt your life by going someplace every day,” she said. Under the new rules, which Arizona plans to embrace, clinics will have broad discretion about which people qualify for take-home doses. Ideally, such decisions will be made jointly between doctors and patients. But money will play a role too, experts said. Frances McGaffey, who researches substance use treatments for the nonprofit Pew Charitable Trusts, said payments to clinics are sometimes tied to in-person dosing, which can discourage take-home treatment. “States should be looking at their payment policy and see what kind of care they’re incentivizing,” she said. In Arizona, clinics now get $15 per in-person dose from the state’s Medicaid program vs. about $4 per take-home dose. The state is considering options including making those amounts equal or adopting what’s called “bundled payment,” a model that reflects the overall cost of treatment. New York’s Medicaid program uses a bundled payment model so there’s no financial incentive for in-person dosing. Longtime methadone patient David Frank, a 52-year-old New York University sociologist, gets four weeks of take-home methadone in wafer form from his clinic. “I never in a million years could have gone back to school, got my Ph.D., done research or taught — any of that stuff — if I had to go to a clinic every day,” Frank said. “It’s night and day in terms of your ability to live a stable, happy, quality life.” The methadone clinic system dates to 1974, when the U.S. saw fewer than 7,000 overdose deaths a year. Some longtime patients — including Garnett and Frank — are organizing a movement to “liberate methadone” as annual overdose deaths now top 107,000. They support legislation to allow addiction specialist physicians to prescribe methadone and pharmacies to fill those prescriptions. The new federal rules don’t go that far, but they include other changes, such as: — In states that adopt the rules, methadone treatment can start faster. People will no longer need to demonstrate a one-year history of opioid addiction. — Counseling can be optional instead of mandatory. — Telehealth can be used to assess patients, improving access for rural residents. — Nurse practitioners and physician assistants — not just doctors — can start people on methadone. “It really is up to states to adopt these changes in order to increase access to care,” said Mark Parrino, president of the American Association for the Treatment of Opioid Dependence. Tennessee officials have drafted new rules that are stricter than the federal government’s. The state’s proposal would increase random urine drug screening, make counseling mandatory for many patients and obligate clinics to hire pharmacists if they want to dispense take-home doses. The state’s proposed rules “are duplicative, contradictory, prescriptive, rigid, and written in a way that seeks to punish versus heal people living with an opioid use disorder,” wrote Zac Talbott, who operates four methadone clinics in Tennessee, Georgia and North Carolina. In states that do adopt the federal rules, the changes will be a heavy lift for some clinics, experts said. Some clinic leaders may disagree with the patient-centered philosophy behind the changes. Some may balk at the legal liability that goes with judgment calls about which people can safely take methadone at home. “Not all opioid treatment programs are created equal,” said Linda Hurley, CEO of Rhode Island’s oldest methadone program, CODAC Behavioral Healthcare. Clinics are used to operating within a highly restrictive environment, said Meyerson, the University of Arizona researcher. “We have regulated them into a corner for years,” Meyerson said. The new rules allow the clinics to put the well-being of patients at the center of care. “The question is,” she said, “can they do it?” ___ The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content. Brought to you by www.srnnews.com
WASHINGTON (AP) — Washington is getting a new tourist stop that offers visitors the next best thing to being in the Oval Office: an identical replica of President Joe Biden ‘s office, right down to his desk, the armchairs in front of the fireplace and the weathered family Bible resting on a side table. And when Biden’s successor takes office next year, the full-scale replica Oval Office at “ The People’s House: A White House Experience ” will be redecorated to look exactly like the new president’s office, said Stewart McLaurin, president of the White House Historical Association, which is opening the doors of its technology-driven education center to the public on Monday. A separate space in the center called the “Immersive Theater” uses technology to transform into some of the more notable rooms in the White House every five minutes. “A terrific thing about this Oval Office, unlike the current Oval Office, is if you’re visiting us you can come and you can sit in this chair and be the president of the United States,” McLaurin said, talking about the desk chair as he led The Associated Press on a tour of the center before Monday’s opening. Few people ever set foot in the Oval Office. It is not on the White House public tour route. But at “The People’s House,” not only will visitors get to see what one of the most famous offices in the world looks like, they can experience it, too. “You can take a call from Mr. Putin or anybody you’d like to receive a call from, have your photo taken there,” McLaurin said. “You can sit on the sofas or in the president’s chair as you’ve visualized him sitting there and you see him on the news talking with a visitor or a head of state. You can do the same thing right there in front of the fireplace.” The wallpaper, draperies, rug, furniture, paintings and other artwork are exact replicas of the furnishings as they are currently in the Oval Office. The plan is to change the decor with each future president. “It is exactly like President Biden’s, exactly,” McLaurin said. “Even the family Bible with the weathered elements are duplicated.” Except for the “digital column” in the center of the room that shows visitors how the physical office has evolved throughout the presidency. It also turns into a mirror so visitors can see themselves standing in the Oval Office. Technology is also used to transform the “Immersive Theater” every five minutes into each of the five rooms on the White House State Floor: the East Room, the Red, Blue and Green Rooms, and the State Dining Room. Images on the walls in each room were chosen by the association’s historians. Visitors can touch the walls to unlock information about the art, furniture or other history that happened there. “We want people to feel they are in that room of the White House,” McLaurin said. Leaving the theater, visitors will walk to the replica Oval Office along a stone path resembling the White House colonnade with a view of art made to represent the Rose Garden. Another exhibit shows how presidents use the White House for work, family and social functions. Visitors can attend Cabinet meetings and vote on a course of action for the president, sit at a table set as it would be for a state dinner to learn how presidents use these glitzy events to conduct diplomacy, or settle into a seat in the family movie theater. In a separate gallery, the head groundskeeper, florist, lead military aide and chief usher are among White House staff members featured on video explaining what they do. After entering the education center, visitors will come upon a large model of the south side of the White House, listen to an audio greeting from first lady Jill Biden and watch an orientation film narrated by Martin Sheen, who played a president on television’s “The West Wing.” The back side of the model looks like a dollhouse, exposing cutaways of the ground, state and residence floor rooms. Visitors can tap electronic kiosks to learn more about the rooms. The education center covers three floors of an office building at 1700 Pennsylvania Ave., one block from the White House. Technology is used throughout to help teach the history of the executive mansion, the presidents and the families who have lived there, and the staff whose work keeps it functioning in its multiples roles as a workplace, a residence and a museum. McLaurin said the center was designed to be an enhancement to the White House public tour, not a replacement. But with White House tour tickets hard to get, he expects “the vast majority of the people who have the opportunity to visit here will not have the privilege to visit the White House itself.” Jill Biden visited twice during construction and has planned an event on the White House lawn on Saturday to celebrate next week’s opening. “This new immersive education center will take visitors on an incredible journey using technology and innovation to bring White House history to life,” said the first lady, a community college professor. “Especially as an educator, I’m so excited to see it opening to the public.” Admission is free, but visitors must request timed tickets. The association is planning for 800 visitors every day, with most staying a little over an hour. The association raised $60 million for construction and initial operating costs, and is working to build a $50 million endowment to sustain operations, McLaurin said. The White House Historical Association was created in 1961 by first lady Jacqueline Kennedy to help preserve the museum quality of the interior of the White House and educate the public. It is a nonprofit, nonpartisan organization that receives no government funding. It raises money mostly through private donations and merchandise sales, including an annual Christmas ornament. Brought to you by www.srnnews.com
General Motors is recalling more than 449,000 of its SUVs and pickup trucks because the electronic brake control module software may fail to display a warning light when a loss of brake fluid takes place. The National Highway Traffic Safety Administration said Friday that the recall includes certain 2023-2024 Cadillac Escalade and Escalade ESVs, 2023 Chevrolet Silverado 1500, 2023-2024 Chevrolet Tahoe and Suburban 1500, 2023 GMC Sierra 1500, 2023-2024 GMC Yukon and Yukon XL models. The agency said that without the warning light, a vehicle may be driven with low brake fluid, which can reduce braking performance and increase the risk of a crash. A free software update will be provided to vehicle owners. Owner notification letters are expected to be mailed Oct. 28. Vehicle owners can contact GMC customer service at 1-800-462-8782, Chevrolet customer service at 1-800-222-1020, or Cadillac customer service at 1-800-458-8006. Brought to you by www.srnnews.com
WASHINGTON (AP) — For the first time since she ascended to the top of the Democratic ticket, Vice President Kamala Harris is set to give a speech focused squarely on abortion rights and she’ll do so in Georgia, where news reports have documented women’s deaths in the face of the state’s six-week ban. “It is a time of mourning, but it’s also a time where great action can come out of this,” said Park Cannon, a Georgia state lawmaker and a doula who provides guidance and support to pregnant woman during labor. ProPublica reported this week that two Georgia women died after they did not get proper medical treatment for complications from taking abortion pills to end their pregnancies. Harris, who will be in the Atlanta area on Friday to address the issue, on Thursday night heard from the mother and sisters of one of the women who died. During a livestreamed campaign event hosted by Oprah Winfrey and attended by Harris, Shanette Williams, the mother of Amber Thurman, tearfully told viewers that “people around the world need to know that this was preventable.” Williams said she initially did not want to go public about her daughter’s 2022 death but ultimately decided it was important for people to understand her daughter “was not a statistic. She was loved.” Harris told the family, “I’m just so sorry. The courage you all have shown is extraordinary.” The vice president added: “This story is a story that is, sadly, not the only story of what has been happening since these bans have taken place.” Dozens of pregnant patients have faced delayed care or been turned away from hospitals amid medical emergencies over the last two years, a violation of federal law, since Roe v. Wade was overturned by the U.S. Supreme Court. Violations occurred in states with and without abortion bans. But an AP analysis earlier this year found an immediate spike in some states with abortion bans, including Texas, following the ruling. Harris was the administration’s chief spokesperson on abortion rights when President Joe Biden was running for reelection, headlining rallies across the nation, and she is the highest-ranking U.S. official to make a public visit to an abortion clinic. Since becoming the nominee, though, she’s broadened her focus to a wider range of issues. Harris’ campaign is hoping that reproductive rights will be a strong motivator for Democrats in the November election. Republican nominee Donald Trump, meanwhile, continues to take credit for appointing three of the conservative Supreme Court justices who voted to overturn Roe. About half of voters say abortion is one of the most important issues as they consider their vote – but it’s more important to women who are registered voters than to male voters, according to a new AP-NORC poll. About 6 in 10 women voters say abortion policy is one of the most important issues to their vote in the upcoming election, compared to about 4 in 10 male voters. The gender gap doesn’t stop there. About 6 in 10 women voters trust Harris more than Trump to handle abortion, while about 2 in 10 women have more trust in Trump. Half of male voters, by contrast, trust Harris more than Trump on abortion, while about one-third trust Trump more than Harris. Democrats point to a series of electoral wins when abortion rights have been on the ballot, and advocates believe Harris is a strong messenger. During the Sept. 10 presidential debate she gave a forceful answer on how the bans have affected even women who never intended to end pregnancies. Harris has a long history of fighting for reproductive health issues, especially Black maternal health. Since taking over the top of the ticket, others have toured the nation talking about reproductive rights, including her husband, Doug Emhoff. In Georgia, Thurman had waited more than 20 hours at the hospital for a routine medical procedure known as a D&C to clear out remaining tissue after taking abortion pills, even as she developed sepsis. Family members told ProPublica that the other woman who died was afraid to seek help for the pain she was experiencing after taking abortion pills. She also had a lethal combination of painkillers in her system. Dr. Nisha Verma, an OB-GYN in Georgia, said the six-week ban has caused a “massive environment of fear and confusion and uncertainty” for the medical community. “Medicine is a gray area,” she said. Laws, though “are a blunt instrument.” She said Republican legislators who are now blaming hospitals and doctors are seeing the ramifications of the laws playing out in real time. “The law is preventing us from being able to provide evidence-based care without having to think about the risk of criminal prosecution,” she said. Harris lays the blame on Trump, saying in a statement that, “This is exactly what we feared when Roe was struck down.” During the presidential debate earlier this month, Trump leaned heavily on his catchall response to questions on abortion rights, saying the issue should be left up to the states. He said he would not sign a national abortion ban. But he has also repeatedly declined to say whether he would veto such a ban if he were elected again. Harris was making a campaign stop later Friday in Wisconsin following her visit to Georgia. Trump had no public events scheduled for Friday. ___ AP Polling Editor Amelia Thomson-DeVeaux contributed to this report. Brought to you by www.srnnews.com
SANTA ANA, Calif. (AP) — Eight firefighters were injured Thursday in a severe highway crash involving a fire truck in Southern California, authorities said. Chief Brian Fennessy of the Orange County Fire Authority said the truck overturned on the California State Route 241 just north of Portola Hills. The vehicle was transporting a ground crew after a 12-hour shift fighting a massive wildfire in Orange County called the Airport Fire. A ladder in the road caused the truck to swerve, strike a guard rail and overturn, Fennessy said. At least one firefighter was flown by helicopter with others transported by ambulance to hospitals. “All of our crews that were involved are going through a formal critical incident stress debriefing at our headquarters right now,” Fennessy said. “You can only imagine how traumatic it is for their brother and sister firefighter to see them injured like that on the freeway.” Brought to you by www.srnnews.com
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