Network for Public Health Law

Los Angeles, CA, United States

Network for Public Health Law

Los Angeles, CA, United States
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Beletsky L.,Northeastern University | Beletsky L.,University of California at San Diego | Davis C.S.,Network for Public Health Law | Davis C.S.,East Carolina University
International Journal of Drug Policy | Year: 2017

More than a decade in the making, America's opioid crisis has morphed from being driven by prescription drugs to one fuelled by heroin and, increasingly, fentanyl. Drawing on historical lessons of the era of National Alcohol Prohibition highlights the unintended, but predictable impact of supply-side interventions on the dynamics of illicit drug markets. Under the Iron Law of Prohibition, efforts to interrupt and suppress the illicit drug supply produce economic and logistical pressures favouring ever-more compact substitutes. This iatrogenic progression towards increasingly potent illicit drugs can be curtailed only through evidence-based harm reduction and demand reduction policies that acknowledge the structural determinants of health. © 2017 Elsevier B.V.


Davis C.S.,Network for Public Health Law | Carr D.H.,Network for Public Health Law
Substance Abuse | Year: 2017

Background: A relatively large number of “pill mills,” in which physicians prescribed and sometimes dispensed controlled substances without medical justification, operated in Florida beginning in the mid-2000s. Investigations into these operations have resulted in the arrest and conviction of dozens of physicians for activities related to illegal trafficking in controlled substances. Methods: Using information from the federal Drug Enforcement Administration, the Florida Department of Health, and court records, we constructed a database of Florida-licensed medical doctors who had been indicted or convicted of crimes related to illegal prescribing of controlled substances in Florida during 2010–2015. We then determined whether and when physicians in this data set were temporarily or permanently barred from practicing medicine in the state. Results: We identified 43 physicians who faced criminal action for prescribing-related crimes during the study period. Twenty-eight of these physicians had been convicted or pled guilty as of September 30, 2016, of which 25 (89%) had been permanently barred from practicing medicine in the state. Only 1 of the 25 physicians permanently lost their license before they had been convicted or pled guilty. On average, physicians did not lose their license to practice for more than 9 months (291 days) after being convicted and 587 days after being indicted of a crime directly related to illegal prescribing of controlled substances. Seventeen physicians (68%) maintained their licenses for at least 1 year after being indicted. Conclusions: This review suggests that the adoption of a more proactive and streamlined process may reduce the time from when physicians are indicted or convicted of illegally prescribing or dispensing controlled substances to board investigation and potential sanction, potentially reducing opioid-related adverse events in the state. © 2017 Taylor & Francis Group, LLC


Seeff L.,Centers for Disease Control and Prevention | Hale D.,CHE Trinity Health | O'Brien D.J.,Network for Public Health Law
Journal of Law, Medicine and Ethics | Year: 2015

This article explores how the ACA's community health needs assessment requirement and the Community Reinvestment Act can encourage collaboration among tax-exempt hospitals, public health agencies, financial institutions, and communities to improve population health through aligned health improvement planning and initiatives to address social, economic, and environmental factors that affect health. © 2015 American Society of Law, Medicine & Ethics, Inc.


Burris S.,Temple University | Ashe M.,ChangeLab Solutions | Levin D.,Network for Public Health Law | Penn M.,Centers for Disease Control and Prevention | Larkin M.,Robert Wood Johnson Foundation
Annual Review of Public Health | Year: 2016

Public health law has roots in both law and science. For more than a century, lawyers have helped develop and implement health laws; over the past 50 years, scientific evaluation of the health effects of laws and legal practices has achieved high levels of rigor and influence. We describe an emerging model of public health law that unites these two traditions. This transdisciplinary model adds scientific practices to the lawyerly functions of normative and doctrinal research, counseling, and representation. These practices include policy surveillance and empirical public health law research on the efficacy of legal interventions and the impact of laws and legal practices on health and health system operation. A transdisciplinary model of public health law, melding its legal and scientific facets, can help break down enduring cultural, disciplinary, and resource barriers that have prevented the full recognition and optimal role of law in public health. Copyright © 2016 by Annual Reviews. All rights reserved.


Silverman B.,Brandywine Counseling and Community Services Inc | Silverman B.,Social Work Research | Davis C.S.,Network for Public Health Law | Graff J.,American Civil Liberties Union Foundation of Delaware | And 3 more authors.
Harm Reduction Journal | Year: 2012

Introduction: Improving access to sterile injection equipment is a key component in community-based infectious disease prevention. Implementation of syringe access programs has sometimes been complicated by community opposition and police interference.Case description: In 2006, the Delaware legislature authorized a pilot syringe exchange program (SEP). A program designed to prevent, monitor, and respond to possible policing and community barriers before they had a chance to effect program implementation and operation. A program designed to prevent, monitor, and respond to these barriers was planned and implemented by a multidisciplinary team of legal practitioners and public health professionals.Discussion: We report on an integrated intervention to address structural barriers to syringe exchange program utilization. This intervention employs community, police and client education combined with systematic surveillance of and rapid response to police interference to preempt the kinds of structural barriers to implementation observed elsewhere. The intervention addresses community concerns and stresses the benefits of syringe exchange programs to officer occupational safety.Conclusions: A cohesive effort combining collaboration with and educational outreach to police and community members based on the needs and concerns of these groups as well as SEP clients and potential clients helped establish a supportive street environment for the SEP. Police-driven structural barriers to implementation of public health programs targeting populations engaged in drug use and other illicit behavior can be addressed by up-stream planning, prevention, monitoring and intervention strategies. More research is needed to inform the tailoring of interventions to address police-driven barriers to HIV prevention services, especially among marginalized populations. © 2012 Silverman et al.; licensee BioMed Central Ltd.


Green T.C.,Inflexxion | Green T.C.,Rhode Island Hospital | Bowman S.,Inflexxion | Davis C.,Network for Public Health Law | And 3 more authors.
Drug and Alcohol Dependence | Year: 2015

Background: State prescription monitoring programs (PMPs) purport to address the prescription opioid epidemic, but have evidenced limited effect on reducing opioid-related mortality. Methods: We systematically reviewed publicly available, PMP web-based materials from December, 2012 to October, 2013, to assess the degree to which overdose prevention was articulated in state PMP goals, mission statement, and accessible educational materials. The sites and available resources of 47 state PMPs with a web presence were reviewed by two independent coders for use of "overdose" and related terms. Website materials were further coded to capture five general thematic orientations: supply reduction-therapeutic, supply reduction-punitive, demand reduction, public health/research, and harm reduction oriented in content. Results: Twenty-nine of 47 (62%) PMPs did not address overdose or related terms in available online materials; six (12.8%) contained overdose-oriented messaging; and two included specific overdose prevention tools for providers. There were a median of three thematic orientations represented on the 18 state PMP websites mentioning only the term overdose, compared with a median of 4.5 thematic domains on the six PMP websites with overdose-oriented content. Conclusions: A more comprehensive, public health orientation for PMPs that explicitly and publicly articulates their application and role in overdose prevention may increase PMP effectiveness and use. © 2015 Elsevier Ireland Ltd.


Davis C.S.,Network for Public Health Law | Carr D.,Network for Public Health Law
Drug and Alcohol Dependence | Year: 2015

Background: Opioid overdose, which has reached epidemic levels in the United States, is reversible by administration of the medication naloxone. Naloxone requires a prescription but is not a controlled substance and has no abuse potential. In the last half-decade, the majority of states have modified their laws to increase layperson access to the medication. Methods: We utilized a structured legal research protocol to systematically identify and review all statutes and regulations related to layperson naloxone access in the United States that had been adopted as of September, 2015. Each law discovered via this process was reviewed and coded by two trained legal researchers. Results: As of September, 2015, 43 states and the District of Columbia have passed laws intended to increase layperson naloxone access. We categorized these laws into three domains: (1) laws intended to increase naloxone prescribing and distribution, (2) laws intended to increase pharmacy naloxone access, and (3) laws intended to encourage overdose witnesses to summon emergency responders. These laws vary greatly across states in such characteristics as the types of individuals who can receive a prescription for naloxone, whether laypeople can dispense the medication, and immunity provided to those who prescribe, dispense and administer naloxone or report an overdose emergency. Conclusions: Most states have now passed laws intended to increase layperson access to naloxone. While these laws will likely reduce overdose morbidity and mortality, the cost of naloxone and its prescription status remain barriers to more widespread access. © 2015 Elsevier Ireland Ltd.


Davis C.S.,Network for Public Health Law | Pierce M.,American University of Washington | Dasgupta N.,University of North Carolina at Chapel Hill
American Journal of Public Health | Year: 2014

Objectives. We sought to collect and characterize all laws governing the operation of prescription monitoring programs (PMPs), state-level databases that collect patient-specific prescription information, which have been suggested as a tool for reducing prescription drug overdose fatalities. Methods. We utilized a structured legal research protocol to systematically identify, review, and code all PMP statutes and regulations effective from 1998 through 2011. These laws were then abstracted along eleven domains, including reporting provisions, data sharing, and data access. Results. PMP characteristics vary greatly among states and across time. We observed an increase in the types and frequency of data required to be reported, the types of individuals permitted to access PMP data, and the percentage of PMPs authorized to proactively identify outlier prescribers and patients. As of 2011, 10 states required PMPs to report suspicious activity to law enforcement, while only 3 required reporting to the patient's physician. None required linkage to drug treatment or required all prescribers to review PMP data before prescribing. Few explicitly address data retention. Conclusions. State PMP laws are heterogeneous and evolving. Future studies of PMP effectiveness should take these variations into accoun.


Hammer M.S.,Network for Public Health Law
Environmental Forum | Year: 2014

Environmental professionals can lead the way toward protecting the public from hazardous noise pollution, as powerful but abandoned federal statutes leave state and local governments without guidance. Noise is not being addressed as consistently or urgently in the human population, but people suffer from excessive levels too. For urban dwellers, noise is more likely to come from a neighbor's leaf blower or the routine traffic on residential streets. The louder the noise, the more it affects the nervous system, causing a flight-or-fight response in the bodies. Children are more sensitive to noise than adults. And while it may seem obvious, it is important to note that only noise reduction can eliminate the adverse noise effects. Kids are learning to communicate and less experienced in appraising threats from stressors in their environment. As a result, children exposed to environmental noise pollution experience unique communication difficulties, increased arousal and impaired attention and learning.


Hodge Jr. J.G.,Arizona State University | Hodge Jr. J.G.,Network for Public Health Law
Biosecurity and Bioterrorism | Year: 2012

The decade following the terrorist attacks on September 11, 2001, and ensuing anthrax exposures that same fall has seen significant legal reforms designed to improve biopreparedness nationally. Over the past 10 years, a transformative series of legal changes have effectively (1) rebuilt components of federal, state, and local governments to improve response efforts; (2) created an entire new legal classification known as "public health emergencies"; and (3) overhauled existing legal norms defining the roles and responsibilities of public and private actors in emergency response efforts. The back story as to how law plays an essential role in facilitating biopreparedness, however, is pocked with controversies and conflicts between law- and policymakers, public health officials, emergency managers, civil libertarians, scholars, and others. Significant legal challenges for the next decade remain. Issues related to interjurisdictional coordination; duplicative legal declarations of emergency, disaster, and public health emergency; real-time legal decision making; and liability protections for emergency responders and entities remain unresolved. This article explores the evolving tale underlying the rise and prominence of law as a pivotal tool in national biopreparedness and response efforts in the interests of preventing excess morbidity and mortality during public health emergencies. © 2012 Mary Ann Liebert, Inc.

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