We're starting soon, please join us! bit.ly/DPACOVIDSeries3 Follow along this thread for live tweets. #DPACOVIDSeries
Kima Taylor of @urbaninstitute shares her issue with how treatment is framed as solving a problem & how that ignores the history of racism and other forms of oppression. #DPACOVIDSeries
Kima Taylor of @urbaninstitute challenges us to widen our frame of understanding what treatment is. Lots of people don't need what we call treatment and treatment can encompass a lot of services. #DPACOVIDSeries
Kima Taylor of @urbaninstitute mentions that because jails & prisons were not meant to treat substance misuse, success cannot and should not be defined by criminal punishment system. #DPACOVIDSeries
Kima makes the point that we cannot compare effectiveness of treatment to incarceration; it compounds racism and structural inequities. #DPACOVIDSeries
Kima highlights how quickly #COVID19 forced the healthcare system to change. She gives examples of how methadone treatment changed, but racial disparities in treatment remain. #DPACOVIDSeries
"Trickle down economics didn't work with Reagan and it doesn't work with treatment" -Kima Taylor of @urbaninstitute #DPACOVIDSeries 
Overall, Kima shows us that there's been a slow interest in expanding treatment access and only because there was embrace for white people; black people remain stigmatized in accessing MAT and or medications for chronic pain. #DPACOVIDSeries
We need to think of the MOST vulnerable populations in this moment and what THEY need. -Dr. Kima Taylor @urbaninstitute #DPACOVIDSeries
We need a patient centered equitable continuum, so that patients can have the best health ever whether they’re using drugs or not - Dr. Kima Taylor, @urbaninstitute #DPACOVIDSeries
We're happy to have @losanjalis of @CasadesaludNM where they offer comprehensive treatment services in Albuquerque, NM. @losanjalis shares how New Mexico has the highest amount of for-profit prisons in the U.S.
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New Mexico also has the highest rates of police brutality across the country. #DPACOVIDSeries mappingpoliceviolence.org/states
Shame is such a big part of why people are triggered to begin or continue drug use. This makes it important for people to choose their own recovery path. - @losanjalis of @CasadesaludNM #DPACOVIDSeries
@losanjalis has had patients tell her"I've come so far in my treatment but I'm not where I need to be in this time" #COVID has worsened social isolation. #DPACOVIDSeries
Before #COVID, 1 in every 3 doses of #narcan that @casadesaludNM distributed was used to reverse an overdose. since COVID, that number has doubled! @losanjalis #DPACOVIDSeries
"In COVID we've had to become really good telehealth treatment providers. Sometimes we observe people take suboxone, if they want that." - @losanjalis of @casadesaludnm #DPACOVIDSeries
Dr. Roopa Sethi joins us from Kansas University Addictions Clinic. Like @losanjalis at @casadesaludNM, she says they've had to shift in large part to telehealth during COVID-19. #DPACOVIDSeries
Dr. Roopa said that their patients are generally doing well, despite not using regular urine tests for accountability. She questions whether urine tests are as helpful a tool as they are claimed to be. #DPACOVIDSeries
“Most patients are doing well after being dispensed a 7 day prescription of methadone,” says Dr. Sethi. This is chance to move from rigid daily dosing to more infrequent dosing. #DPACOVIDSeries
"Our healthcare practices and treatment have mirrored the surveillance of criminal justice systems. It is starkly clear when you look at the process for treatment & prescriptions for substance use disorder." - @pugleesa #DPACOVIDSeries
Lisa Puglisi @pugleesa thinks addiction should be looked at via a chronic care model, and that people ought to be able to access treatment in the ways they want to. #DPACOVIDSeries
.@pugleesa states that the healthcare system is infantilizing. "You have to be good. And if you’re good, you get a prize. And that prize is your life back.” #DPACOVIDSeries
"I am relieved that I don't have to go for a urine check or that I don't have to find child care" says patients about the barriers to treatment that have been reduced during COVID-19 @pugleesa #DPACOVIDSeries
Surveillance undermines "deep care plans" and damages engagement. Less surveillance has made @pugleesa's job better. #DPACOVIDSeries. @pugleesa asks, "What can deep community treatment look like for people with substance use needs?"
For @pugleesa, it's alarming how her patients can be swept up into criminal justice-oriented treatment programs as a result of a "dirty urine." That's stopped during COVID, and she feels like she can actually practice deep care plans with people. #DPACOVIDSeries
Decerceration must be coupled with reentry & care for people who use drugs. journalofethics.ama-assn.org/article/what-d… @pugleesa #DPACOVIDSeries
@pugleesa agrees with Kima Taylor: there needs to be a robust, coordinated program of care for people entering treatment. "To decease spread of COVID in jails and prisons, you need to release AND you need a community robust enough to care for them." #DPACOVIDSeries
"We should see any lack of coordination between services that causes pain for the person seeking treatment as absolutely unacceptable. Coordination has been improved during #COVID, but it should be the standard." - @Pugleesa #DPACOVIDSeries
Our panelist, Richard Rawson works in Vermont, setting up treatment for patients with stimulant use disorder in 12 different states. #DPACOVIDSeries
Want to effectively treat people with stimulant use disorders? Focus on being patient-centered, not solely following protocols, says Dr. Rawson. #DPACOVIDSeries drugpolicy.org/resource/stimu…
Richard Rawson has found that "contingency management" is a very effective treatment approach for people who use stimulants. "Motivational interviewing should be put in the drinking water--it's a first step to patient-centered care" says Dr. Rawson #DPACOVIDSeries
Richard Rawson shares that the most crucial thing for treatment providers is getting people engaged in the treatment process, maintaining relationship, and building a rapport. #DPACOVIDSeries
Richard mentions that he's encouraging the medical community to look at the bigger picture. There's hysteria over methamphetamine use but cocaine use is being ignored around the country. #DPACOVIDSeries
Richard Rawson thinks that contingency management is to stimulants as methadone & buprenorphine is to opioids. #DPACOVIDSeries
Dr. Sethi address how #telehealth has its limitations, as many of her patients do not own a laptop or even a smart phone. With #telehealth, it's hard to pick up on non-verbal cues as well. #DPACOVIDSeries
Dr. Kima Taylor brings up the issue of pregnant women being criminalized and how they're often left out of the treatment conversation. #DPACOVIDSeries
.@losanjalis suggests that #COVID19 brings an opportunity for us to revamp the metrics that we use for treatment. We can do away with "archaic ways of seeing success." #DPACOVIDSeries
Dr. Kima Taylor of @urbaninstitute says that medicine is moving towards more value-based model. Knowing that, how do we change our metrics for substance use? #DPACOVIDSeries
@losanjalis mentions how many of our systems are tied in surveillance and the legal system, so we have to be cautious not to replicate those harmful practices. #DPACOVIDSeries
@pugleesa shouts out @DrAyanaJordan for her work on creating treatment programs for Black people and tying that to faith and involving the community. #DPACOVIDSeries
“We need to understand how many of our systems are deeply involved in surveillance, racialized care happens in every field.” Dr. Anjeli Taneja @losanjalis #DPACOVIDSeries
We're moving to Q & A now. Thank you, panelists! @pugleesa @losanjalis @urbaninstitute #DPACOVIDSeries
QUESTION: As front line workers with individuals suffering from addiction, I’m interested in where you would like to see academics direct their research attention?👀👀hint: Follow @DrugPolicyNerds. #DPACOVIDSeries
.@pugleesa answers the question about academics...There needs to be community based research. "Let the community guide the research. It will be impactful on a different level because it was driven by the people." #DPACOVIDSeries
In 2018, @DrugPolicyNerds hosted a convening entitled Ethics, Experience, & Expertise where they discussed the importance of meaningful engagement with impacted communities & developed. #DPACOVIDSeries Check out the resources here: drugpolicy.org/event/ethics-e…
QUESTION: How are healthcare providers responding to how #COVID19 is impacting the Navajo people? Are there any innovative methods being used? #DPACOVIDSeries
.@losanjalis said the responses have been limited, but there have been some approaches like providing isolated housing for people sick with #COVID19 and opening access to alcohol. #DPACOVIDSeries
QUESTION: Are we seeing an increase in housing being integrated in to care models? #DPACOVIDSeries
Richard Rawson highlights how housing first has proven to be very promising but it isn't a component of care that @NIDAnews funds typically. #DPACOVIDSeries
QUESTION: What are some suggestions to mitigate barriers to treatment & avoid the "revolving door" of outpatient treatment & residential care? #DPACOVIDSeries
Kima Taylor answers that there's a lot of treatment providers who don't want the status quo to change, so we must better advocate for the change that we want to see. @urbaninstitute #DPACOVIDSeries
.@losanjalis Healthcare workers have been galvanized in a new way bc of #COVID19. There's an increasing amount of awareness of what we need to do, we have been advocating for the changes that need to be made especially for issues around structural determinants. #DPACOVIDSeries
Kima Taylor leaves us with "This November, please vote." #DPACOVIDSeries
@losanjalis gives gratitude for this DPA panel. Dr. Sethi says that the #telehealth structure that increased during #COVID19 should stay for good. #DPACOVIDSeries
.@pugleesa asks that we keep the people most impacted at the core of the work and have them guiding the work. #DPACOVIDSeries
Richard Rawson says that in the comment section of our webinar, there are a lot of good ideas and insights to the holes in our system. He urges everyone to write those ideas down and keep them going even after #COVID19. #DPACOVIDSeries
Thank you all for joining our discussion today, please join us again for our next webinar on 6/25/2020. #DPACOVIDSeries
