DOL Rule May Impact Postdoc Pay and More in Science and Tech Weekly Summary 28

Check out our August Recess Guide so you can petition your local congressperson on science and technology and other policy issues! It’s your 1st amendment right to hold your congressperson accountable. Don’t let them relax while they’re on recess!

Also, the Week 28 in Science and Technology Policy Newsletter from RISE Stronger  is now out! (Sign up for the Weekly S&T Summary here.)

I contributed the piece below on a Department of Labor rule than can have a huge impact on Postdoc pay.

Fate of Department of Labor rule may impact postdoc pay

On May 23, 2016, the Department of Labor (DOL) announced a new rule allowing overtime pay for certain professionals making less than $47,476, including most postdoctoral researchers. The rule would effectively incentivize a pay increase for postdocs making less than $47,476. Indeed, after the announcement, the National Institutes of Health (NIH) adopted a new pay scale for one of its most widely awarded postdoctoral fellowships. However, the rule, which was supposed to take effect December 1, 2016, was blocked by a federal judge in Texas on November 22, 2016. The rule, along with the potential postdoc pay raise, has been frozen, awaiting further determination by the court ever since.

On Wednesday, July 26, 2017, the DOL published a Request for Information (RFI) in the Federal Register seeking responses to a series of detailed questions concerning this rule, likely in anticipation of pending legal action (the legal challenge to the rule is currently being reviewed by the Fifth Circuit Court of Appeals). According to the DOL, “the RFI is an opportunity for the public to provide information that will aid the department in formulating a proposal to revise these regulations.” The future of the much-anticipated increase in postdoc pay may depend on the legal fate of this rule. Public comments must be submitted on or before September 25, 2017, and additional instructions can be found at Regulations.gov referencing the Regulatory Information Number 1235-AA20. Read more about the rule and the RFI in RISE Stronger’s policy and action brief on this topic.

 

 

 

Weekly Science Policy Summaries from RISE Stronger (Week 27)

I recently became involved with the science advocacy group RISE Stronger. The group’s Mission is to “To build a dynamic, strategic movement of politically engaged communities that demand a responsible and accountable government which serves the interests of the people.”

One component of organization is the Science and Technology Working Group, which acts as a watchdog group for science in government. Every week we compile and release a newsletter on developments in Science Policy and reporting on any actions the Trump Administration or Congress have taken in the previous week that may impact the use of science in policy making or government actions on science issues. I am happy to have contributed a story on the opioid epidemic to last week’s summary.

Check out last week’s Science and Technology Policy Summary.

Or Sign Up to the Weekly Science Summaries using the link below (I’ll also post the links here as well).

https://tinyletter.com/rise-science-tech/

Stay informed! Stay active! Enjoy!

Senate Rebukes Attorney General Jeff Sessions on Medical Marijuana

(from wikipedia.org)

Since taking over at the Department of Justice (DOJ), Attorney General Jeff Sessions has been attempting to reignite the “War on Drugs” (for example, he issued a memo to federal prosecutors calling for the them to seek the harshest possible sentence when dealing with low-level drug offenders, the exact opposite of Obama-era guidance).

Sessions now has his sites on state-run medical marijuana programs (marijuana is still listed as a Schedule 1 illegal drug according to the DEA, the most severe categorization for drugs). In May, Sessions tried to pressure Congress to not stop him from authorizing the DOJ to prosecute medical marijuana clinics and patients.

Sessions attack on medical marijuana would be extremely harmful to not only the patients that benefit from medical marijuana but may even increase opioid overdose deaths in those states (there’s actually a growing body of scientific evidence that opioid overdose deaths are reduced in states with legalization of marijuana; I plan to write a more detailed post on this in the near future).

Thankfully the Senate has taken measures to prevent Sessions from being able to take action against medical marijuana. A bipartisan committee approved an amendment to the 2018 Commerce, Justice and Science appropriations bill. The amendment does not allow DOJ to use funds to prevent states from “implementing their own state laws that authorize the use, distribution, possession or cultivation of medical marijuana.” In essence, even if Sessions instructed Federal law enforcement agents to target medical marijuana clinics and patients, they would be unable to do so because it would be illegal to use any federal dollars to carry out this action.

Time will tell what other ways Sessions will try revive antiquated drug policy (if he survives his tenure as AG that is). A study in the Lancet last year examined the public health impact of  drug policy throughout the world (future post on this too) and concluded, among other things, that “policing practices undertaken in the name of the public good have demonstrably worsened public health outcomes.” Clearly, Sessions didn’t read this report…

Response to the June 2017 New Yorker Article on the Opioid Epidemic

At this point, I would think that knowledge about the vastness and seriousness of the prescription opioid and heroin epidemic, the biggest threat to American health and well being since the HIV/AIDS epidemic, would be common knowledge. Of course, given the abundance of shiny Internet things to tantalize easily distracted Americans, this is unfortunately not necessarily the case. Thankfully the New Yorker, with their characteristic excellence in reporting, has just released a superb and humanizing article on the opioid epidemic in their June 5 & 12, 2017 issue.

Read the article here.

The piece puts a much-needed human face to the horrors and misery of opioid addiction and the too-frequent death by overdose. Margaret Talbot, the article’s author, zeroes in on Berkeley County, West Virginia, in the heart of a region of the country hardest hit by the epidemic. I don’t want to give away much (because you should actually just read the article) except that the stories are heart wrenching yet balanced, and thorough in way that only the New Yorker can deliver. While the article is largely about the lives of people affected by and fighting against the epidemic, I was disappointed with a couple of points that were either made incorrectly, weakly, or not at all.

First, the article barely talks about how the epidemic arose in the first place. It mentions Purdue pharmaceuticals, the bastards behind Oxycontin (drug name: oxycodone), and that prescription opioid abuse led to heroin addiction but does not describe how the surge in addiction to prescription opioids occurred in the first place. The article describes the main problem with Oxycontin is that it can be crushed and snorted but a 2010 formulation of the drug reduced this risk. While this is indeed true, the article neglects to mention that when someone is first prescribed an opioid like Oxycontin for chronic pain (as was the case in the late 90s and early 2000s despite any evidence for the effectiveness of opioids in the treatment of chronic pain), the addictive potential of opioids often led to opioid substance abuse disorder in people who took it as prescribed (see this comprehensive article for more info). This is the big point, many of the people that eventually abused opioids started down that road by taking the drug as prescribed! Talbot incorrectly frames the big picture problem but she then goes on to correctly describe how those addicted to prescription opioids found their way to the cheaper and more abundant heroin.

The article goes on to mention the CDC’s release of guidelines on opioid prescription but fails to cite that this guidance came out as late as March, 2016, well after the epidemic had already taken root and thousands were already addicted and dying of overdose (I wrote an article on the CDC’s guidelines last year and highly recommend you read that article too if you want to learn more). The CDC’s guidance is mainly about the point I made above, that the over-prescription of opioids is the real cause of the epidemic, not just the crushable version of Oxycontin, and the limitation of opioid prescription is one of the huge policy interventions that is needed.

Later in the article, Talbot introduces us to Dr. John Aldis, a retired U.S. Navy Physician and resident of Berkeley County, WV who took it upon himself to educate people on how to use Narcan (generic drug name: naloxone), the treatment for opioid overdose. Dr. Aldis makes the critical point about the importance of medication-assisted treatments such as Suboxone (generic drug name: buprenorphine) and methadone. I appreciated the point made in the article that some patients may need these vital treatments long-term, or even for life, to combat the all-consuming single-mindedness of opioid addiction. However, beyond this passing mention, I felt that medication-assisted treatment was only weakly covered. There is still a great deal of ignorance about these treatments. Indeed, current HHS secretary Tom Price falsely characterized them as “replacing one opioid with another” and was majorly criticized by addiction experts. The reality is that there is overwhelming scientific evidence (I’ve written plenty on this site) describing the effectiveness of methadone and buprenorphine at 1) keeping addicts off of heroin, 2) allowing them to be able to live their lives without suffering from withdrawals and cravings, and 3) most importantly, keeping them alive. Talbot could have done a much better job of really hammering these points home but she seemed reticent, for some reason, to discuss it in detail in this article.

Finally, the article repeatedly emphasizes the importance of rehab clinics and tells the story of a huge victory for Martinsburg, WV (a town in Berkeley County) when the city council agrees to open a clinic in the town itself. I do not want to discount the importance of an addict assessing their addiction and taking an active role to end it, but this article does miss another critical point: rehab clinics only exist because addiction medicine is not part of medical school curricula and most hospitals are ill-equipped to treat those suffering from addiction. I feel this article could have really made the case for the importance of training for doctors in addiction medicine and the necessary shift that needs to happen for addiction treatment, a move away from overpriced (and often ineffective) private rehab facilities, and to public hospitals. Unfortunately, this point was not made.

Despite these missed opportunities, I commend Talbot and the New Yorker for a well-written article and thank them for this important piece that I encourage all to read.

 

Presidential Candidates Support an End to Addiction Stigma

(© Alan Cleaver flickr https://www.flickr.com/photos/alancleaver/4104954991)
(© Alan Cleaver flickr https://www.flickr.com/photos/alancleaver/4104954991)

Something remarkable is occurring in the way politicians are speaking about addiction (I’ve written about this previously). The discussion has shifted to focus on addiction as a disease and addicts as human beings requiring treatment, opposed to addicts as criminals requiring punishment or incarceration. Importantly, this shift away from the “war on drugs” rhetoric reaches across the political spectrum.

During the Democratic presidential debate held in December, Bernie Sanders called addiction “a disease and not a criminal activity” while Hilary Clinton and Martin O’Malley expressed similar sentiments.

New Hampshire, a state that has been particularly hard hit by the opioid epidemic sweeping the nation, recently held an Addiction Policy Forum at Southern New Hampshire University. Several GOP candidates attended the forum, including Jeb Bush, Chris Christie, Carly Fiorina, and John Kasich. The candidates spoke personally about addiction, humanized addicts, and referred to addiction as a disease. Particularly moving was Carly Fiorina’s tragic story regarding her step-daughter’s struggle with addiction.

Despite these encouraging remarks, no candidate at the forum issued a call to increase accessibility to medication-assisted treatment of addiction.

NPR’s report on the forum offers an important analysis that I had not previously considered. One reason why the attitude in addiction is changing may be that the current opioid epidemic effects affects nearly every strata of society, including every race, whereas other drug epidemics in the past (such as the crack cocaine epidemic of the 80s and 90s) primarily affected only minority communities. NPR reports that some people refer to this as “the gentrification of the drug crisis.”

Even GOP candidate John Kasich of Ohio said, “This disease knows no bounds, knows no income, knows no neighborhood, it’s everywhere. And sometimes I wonder how African-Americans must have felt when drugs were awash in their community and nobody watched. Now it’s in our communities, and now all of a sudden we’ve got forums, and God bless us, but think about the struggles that other people had.”

A more political spin on the recent trend posted on the Hill blog discusses the rise of the “recovery voter”, an increasingly vocal group of people that place addiction as their number one issue. Clearly the presidential candidates are responding to the call for increasing governmental action on addiction.

I am cautiously optimistic about these positive trends but will reserve judgment until either Democratic or Republican candidates outline specific policy details.

Why We Outlive Our Pets

The family dog, Bella. Perhaps she's contemplating aging? (Photo © Derek Simon 2015)
The family dog, Bella. Perhaps she’s contemplating aging? (Photo © Derek Simon 2015)

I decided to take a little break from my typical serious and lengthy addiction/neuroscience blog posts and talk about something a little lighter (and cuter)…dogs and cats! Or to be more specific, the biology of pet aging.

A recent special issue on Aging in the journal Science included a news article by David Grimm on aging of our pets and other animals and what it may mean for the biology of aging.

Grimm aging article Science

Did you know the oldest cat ever, Crème Puff, was reported as 38 years old and the oldest dog, Bluey, was 29?! Both lived twice as long as average. These types of impressive feats of longevity have never been achieved in humans, not even close (the oldes human was 122 but every heard of a 140 year old?). But what can pet aging tell us about animal aging or aging in general?

If you plot animal size versus animal age you get a trend that has been known for years: bigger animals live longer than smaller animals.

In fact, this is the only correlation that’s predictive of animal longevity. Numerous theories have been generated as why this is.  One theory says that the higher metabolic rate in small animals  leads to increased amounts of damage-causing and age-inducing free radicals. But not much evidence exists to support this idea or others like it.

Dr. Steven Austad  of the University of Alabama, an expert on animal aging, thinks it probably has to do with millions of years of evolutionary pressure that favored a slower lifespan for larger animals. From the Science article:

“Whales and elephants can afford to take their time growing because no one is going to attack them, he explains. And that means they can invest resources in robust bodies that will allow them to sire many rounds of offspring. Mice and other heavily preyed-on small animals, on the other hand, live life in fast-forward: They need to put their energy into growing and reproducing quickly, not into developing hardy immune systems, Austad says.”

One interesting turn is that when you compare land mammals to birds, smaller birds tend to outlive their land-locked counterparts. But the same argument can apply: flight is a great way to avoid predators so a similar kind of slowed-down aging may have also evolved in birds for the same reason as in whales and elephants.

Angry female naked mole rat. Credit: Buffenstein/Barshop Institute/UTHSCSA
Angry female naked mole rat.
Credit: Buffenstein/Barshop Institute/UTHSCSA

Similarly, the naked mole rat and the bat also defy their predicted lifespan given their small size but the mole rat lives most of its life underground and the bat can fly away from danger of course. No need to live hard and fast for these guys (or at least to evolve that type of lifestyle).

However, pets sort of flip the size trend upside down. Cats (both domestic and in the wild) tend to live longer than dogs (or their ancestors wolves). Austad argues this may be due to the incredible resilience of cats whereas dogs are more social and therefore may be more susceptible to communicable disease.

Equally strange is that small dogs live much longer than large dogs, which likely has nothing to do with evolutionary pressure (most dog breeds are only a few hundred years old). One argument involves hyper-secretion of hormones such as insulin-like growth factor 1 (IGF1), which may act a double-edged sword. Big dogs may get a greater boost in growth from IGF1 but accelerated aging too.

A trend that many pet owners should be happy about is that pets live longer today than ever before. And like humans, health care and diet have improved drastically for pets. Plenty of TLC for pets has surely increased their life spans!

However, much is still unknown about pet aging (and aging in general).

Perhaps pet aging can even unlock secrets to human aging. Or as Dr. Daniel Promislow of the Dog Aging Project at the University of Washington says, “If we can understand how to improve the quality and length of life, it’s good for our pets and it’s good for us. It’s a win-win.”

See these other sites for some more tidbits on animal longevity:

Or check out these review articles for topics on aging (all are open access):

New York City’s Failure to Care for Recovering Addicts

(From wikipedia.com)
(From wikipedia.com)

A new investigative report in the New York Times reveals a corrupt and virtually unregulated system of housing that preys on those that suffer from addiction and mental disease. Called “three-quarter” homes, there may be as many as 600 of these privately owned residences in NYC that act as a limbo between inpatient hospital care and shelters. The article tells the story of a group of homes owned by a single landlord and a few of the unfortunate residents trapped within this system. Disturbingly, reputable hospitals and treatment centers often refer patients to these homes. Landlord’s profit off of their tenant’s state-provided subsidies, which are insufficient for any other type of housing. The landlord collects the government assistance checks provided to the tenants provided that they regularly attend treatment centers. This has the unexpected consequence of incentivizing a landlord to encourage his tenants to relapse and thus remain in treatment…and in the three-quarter home. This vicious cycle is perfectly encapsulated in the articles headline “A Choice for Recovering Addicts: Relapse of Homelessness.” Read the full article for more details.

However, the article neglects the opportunity to elucidate the root cause of the existence of these three-quarter homes: lack of a sufficient, standardized and coordinated health care system for the treatment of addiction and other mental diseases. A critical problem in the American healthcare system is the lack of adequate inpatient medical treatment for people suffering from addiction, and is why people get referred to the three-quarter homes in the first place.

Addiction is a complex mental health disorder that requires an individual treatment plan that may involve medication, counseling, group and/or individual therapy, and other options. Without a well-funded, evidence-based, medical treatment program formulated for an individual’s addiction, they are likely to fall into the purgatory of three-quarter homes or even worse, the streets or prison. Ultimately homes likes these are allowed to exist due to the lack of adequate treatment options and facilities for addicts.

 And of course, the medical and treatment culture of addiction cannot be changed until the stigma against addicts and addiction is changed. Addiction is a medical disease and needs to be treated as such.

 

Under Reporting of Deaths from Heroin Overdose

(Image from www.thefix.com)
(Image from http://www.thefix.com)

“If you don’t know how many people are dying from it, how do you know how to combat it?”

 This question, posed by Stacy Emminger, a woman her lost her son to heroin overdose, is at the heart of an article reported on NPR today.

Many states do not maintain accurate, detailed records of deaths due to overdose. As was the case for Emminger’s son, the death certificate states the cause of death as “multiple drug toxicity, accidental”. The problem with such a vague statement is that you have no idea what the person actually died from. This prevents identification of the full scope of the heroin (or other drug) problem and makes the availability of antidotes for overdose (like naloxone) or treatments (like methadone or buprenorphine) that much more difficult.

Read the whole article on NPR:

http://www.npr.org/2015/05/21/405936768/states-lack-accurate-statistics-on-widespread-heroin-use

Or listen to the story:

http://www.npr.org/player/embed/405936768/408407236

Optogenetics in the New Yorker

Optogenetics1Excellent new article on optogenetics in The New Yorker. Optogenetics is a powerful, cutting-edge tool developed by Karl Deisseroth’s lab (profiled in the article) and is one of most significant advances in neuroscience research in decades. I recently spent two months learning the technique and we will be implementing it in the lab I work in at Rockefeller University. Optogenetics allows researchers to turn specific neurons “on” and “off” and see how those neurons are directly involved in a particular behavior. The article does a great job of profiling Deisseroth himself and explaining a little bit of the history of optogenetics and other developments in the Deisseroth lab. Enjoy!

http://www.newyorker.com/magazine/2015/05/18/lighting-the-brain