Zoned Out: “NIMBYism”, Addiction Services and Municipal Governance in British Columbia.

Zoned Out: “NIMBYism”, addiction services and municipal governance in British Columbia.

Int J Drug Policy. 2013 May 13;
Bernstein SE, Bennett D

In Canada, Provincial Governments have jurisdiction over delivery of healthcare including harm reduction services and Methadone Maintenance Therapy (MMT). While policy directives and funding come from the provincial capital, individuals’ access to these services happens in neighbourhoods and municipalities spread out across the province. In some cases, public health objectives targeted at people living with addictions and the rights to equitable access to healthcare are at odds with the vision that residents, business associations and other interest groups have for their neighbourhood or city. This paper looks at the cases of four British Columbia municipalities, Mission, Surrey, Coquitlam and Abbotsford, where local governments have used zoning provisions to restrict access to harm reduction services and drug substitution therapies including MMT. This paper will contextualize these case studies in a survey of zoning and bylaw provisions related to harm reduction and MMT across British Columbia, and examine the interplay between municipal actions and public discourses that affect access to healthcare for people living with addictions. Finally, this paper will explore possible legal implications for municipalities that use their zoning and permitting powers to restrict access to health care for people with addictions, as well as public engagement strategies for healthcare advocates that have the potential to reduce resistance to health services for people living with addictions in communities across the province. HubMed – addiction

EZH2: An Epigenetic Gatekeeper Promoting Lymphomagenesis.

Cancer Cell. 2013 May 13; 23(5): 563-5
Heyn H, Esteller M

In this issue of Cancer Cell, Béguelin and colleagues highlight EZH2 as an essential regulator for B cell activation and report an addiction of germinal center-derived neoplasms to EZH2 activity. This reversible process is specifically targetable and hence presents high translational value for lymphoma therapy. HubMed – addiction

Randomized clinical trial examining duration of voucher-based reinforcement therapy for cocaine abstinence.

Drug Alcohol Depend. 2013 May 13;
Kirby KC, Carpenedo CM, Dugosh KL, Rosenwasser BJ, Benishek LA, Janik A, Keashen R, Bresani E, Silverman K

BACKGROUND: This is the first study to systematically manipulate duration of voucher-based reinforcement therapy (VBRT) to see if extending the duration increases abstinence during and following VBRT. METHODS: We randomized cocaine-dependent methadone-maintained adults to Standard (12 weeks; n=62) or Extended (36 weeks; n=68) VBRT and provided escalating voucher amounts contingent upon urinalysis verification of cocaine abstinence. Urinalysis was scheduled at least every 2 weeks during the 48-week study and more frequently during VBRT (3/week) and 12 weeks of Aftercare (2/week). RESULTS: Extended VBRT produced longer durations of continuous cocaine abstinence during weeks 1-24 (5.7 vs 2.7 weeks; p=0.003) and proportionally more abstinence during weeks 24-36 (X(2)=4.57, p=.03, OR=2.18) compared to Standard VBRT. Duration of VBRT did not directly predict after-VBRT abstinence; but longer continuous abstinence during VBRT predicted abstinence during Aftercare (p=0.001) and during the last 12 weeks of the study (p<0.001). Extended VBRT averaged higher monthly voucher costs compared to Standard VBRT ($ 96 vs $ 43, p<.001); however, the average cost per week of abstinence attained was higher in the Standard group ($ 8.06 vs $ 5.88, p<.001). Participants in the Extended group with voucher costs exceeding $ 25 monthly averaged 20 weeks of continuous abstinence. CONCLUSIONS: Greater abstinence occurred during Extended VBRT, but providing a longer duration was not by itself sufficient to maintain abstinence after VBRT. However, if abstinence can be captured and sustained during VBRT, then providing longer durations may help increase the continuous abstinence that predicts better long-term outcomes. HubMed – addiction

Perceived pubertal timing and recent substance use among adolescents: a longitudinal perspective.

Addiction. 2013 May 16;
Cance JD, Ennett ST, Morgan-Lopez AA, Foshee VA, Talley AE

AIMS: To determine the longitudinal associations between perceived pubertal timing and recent substance use between the ages of 11 and 17 years. DESIGN, SETTING AND PARTICIPANTS: A school-based cohort sequential study of adolescents in rural North Carolina, USA (n?=?6892, 50% female) in the 6-8th grades at baseline and interviewed across five consecutive semesters. MEASUREMENTS: Self-administered questionnaires in a group setting measured perceived pubertal development using the Pubertal Development Scale and adolescents reported past 3-month use of cigarettes, alcohol and marijuana. Latent class growth analysis determined the longitudinal relationships between perceived pubertal timing (early, on-time and late) and use of the three substances. FINDINGS: A negative quadratic model was the best-fitting model for all three substances. Higher proportions of early developers had used cigarettes and marijuana within the past 3 months at age 11 compared with on-time (P??0.050). CONCLUSIONS: Adolescents who believe they are more advanced in puberty than their peers are more likely to have used cigarettes, alcohol and marijuana recently compared with adolescents who believe they are on-time or late developing; these findings are mainly due to differences in use at age 11. HubMed – addiction