And in the two weeks following their release, former prisoners are 129 times more likely to die from overdose than members of the general population. This is despite the fact that we have robust evidence showing that we can decrease the incidence of relapse, overdose, drug-related health complications like HIV transmission, criminal activity after release and recidivism by offering treatment.And unequivocal data highlights that medication-assisted therapy — that is, treatment with methadone or suboxone — in prisons saves lives. A study published recently in the journal Addiction showed that offering medication-assisted treatment in prisons reduced drug-related overdose deaths by 85 percent in the four-week period following prisoner release and reduced mortality from all causes by 75 percent over the same period.Few other medical interventions have demonstrated such success. Unfortunately, however, the majority of correctional facilities in the United States do not offer programs for people addicted to opioids.Out of the 3,200 U.S. jails, only 23 provide maintenance therapy to inmates. Categories: Editorial, OpinionMultiple leaders across the nation, including Maryland Gov. Larry Hogan and even President Donald Trump, have declared states of emergency in response to the opioid epidemic.Policymakers claim to be battling this public health crisis on all fronts, but one arena continues to be conspicuously ignored: our prisons and jails. Roughly half of all incarcerated individuals suffer from addiction. And if we want to save lives on the streets, we cannot send people out of prisons untreated and abandon them when they are the most vulnerable to overdose.If we’re serious about addressing the opioid epidemic, we have to pay attention to the evidence demonstrating that opioid treatment in jails and prisons is highly effective.And we must act by quickly expanding such treatment to many more facilities around the country. Current programs offering in-facility treatment should guide the nation, serving as examples of how we can provide vulnerable, disenfranchised people with the care they deserve as fellow humans and members of our society.If we claim, whether as a community, a state or a nation, to be fighting the opioid crisis on all fronts, let us not forget one that offers undeniable evidence of a way to save lives. Dr. Justin Berk is a combined internal medicine/pediatrics resident in urban health at Johns Hopkins Hospital.More from The Daily Gazette:Foss: Should main downtown branch of the Schenectady County Public Library reopen?EDITORIAL: Beware of voter intimidationEDITORIAL: Urgent: Today is the last day to complete the censusEDITORIAL: Find a way to get family members into nursing homesEDITORIAL: Thruway tax unfair to working motorists This is a critical public health issue, and the benefits of the therapies we can offer to people with opioid addiction who are currently incarcerated reach far beyond those individuals.Our communities benefit too when we help those suffering from addiction get the care they need to survive and live healthy lives. Skeptics will argue against such treatment by asserting that it is too expensive, or that it will be “diverted“ and used inappropriately, or that the people with addictions who end up incarcerated should have taken more personal responsibility.But these interventions have been shown to be cost-effective.Diversion can be minimized, while treatment could actually improve security.And moralizing arguments against a well-recognized psychiatric disorder are antiquated, demonstrating poor knowledge of evidence-based treatment, if not also little compassion for a vulnerable population. I have seen first-hand that suboxone allows many people to concentrate on their lives instead of their addictions upon their release from jail or prison. And out of the 50 state prison systems, only four offer such treatment.This means that people who are fortunate enough to be part of a treatment program before their incarceration are, upon their entrance to a jail or prison, often taken off their medications and forced to endure cruel, painful and dangerous periods of withdrawal. This is not a problem of resources.Many incarcerated patients currently receive appropriate care for other chronic conditions, including diabetes, HIV, cancer and even more-newly-recognized disorders, like gender dysphoria.Our federal and state corrections systems have the capacity to offer this treatment — a treatment defined as “essential medicine“ by the World Health Organization.The inability to access medical treatment with such established benefits is an unacceptable violation of prisoners’ constitutional right to basic health care.But this is not just an issue of rights, and this is not just about prisoners.
On a normal day, 58-year-old Agustinus Bataona, a tour guide in West Manggarai, East Nusa Tenggara (NTT) province, would be quite busy leading tourists from as far away as New Zealand, Australia, the United States, and Europe on his Komodo Overseas Tour.Usually in a single month, he and his colleagues conducted five to seven tours to explore Komodo Island and the beauty of the surrounding islands. Meanwhile, they handled three or four tour packages, including overland trips, per month. On a busy day, he and his colleagues often met cruise ships that had between 1,000 and 1.500 tourists on board.“But that was before the COVID. Now, everything is so different. It is very quiet, nothing to do. In February we only handled two tours, while in March, there are none,” Agustinus who is also the regional NTT head of the Indonesia Tour Guide Association, told The Jakarta Post on Monday. As fears over the spread of the COVID-19 coronavirus grow, significantly fewer tourists are visiting major destinations in NTT, such as Labuan Bajo, Komodo National Park and Flores. To date, about 45,000 tourists have canceled their plans to visit the world-renowned destinations from January to May.“This definitely affects the livelihoods of the tour guides in East Nusa Tenggara, especially on Flores and Komodo. We lost our daily income because tourism is our main source of income,” said Agustinus.Agustinus said at least 511 licensed tour guides in NTT are affected by the cancellations. Because of them, many tour guides have to stay at home.The secretary-general of the Indonesian Travel Agents Association (Astindo), Pauline Suharno, who is also the director of Elok Tours, said there are many tourist workers at the grassroots level who have been indirectly affected by the COVID-19 pandemic, which has caused numerous cancellations. In addition to guides, other workers who rely heavily on the tourism industry for their livelihoods, such as tour drivers, are also in difficult circumstances, she said. Meanwhile, Pauline said many travel agencies have to “reorganize” to reduce their employee numbers for efficiency.“Some implement unpaid leave; there is no hiring of contract workers and there is no new recruitment. Job termination cannot be avoided if the condition remains the same or worse,” Pauline said on Thursday. Indonesia Hotel and Restaurant Association (PHRI) chairman Hariyadi Sukamdani also reported that many hotels in Indonesia started striving for cost efficiency amid the hard times to generate cash flow because of the drop in hotel occupancy rates caused by a decline in tourist visits.“Today, many daily workers in the hotel are not employed any more. The daily workers usually work depending on occupancy rates, such as the cleaning staff. Meanwhile, many contract and permanent employees are starting to work in shifts for efficiency,” he said.The growing fears over the spread of COVID-19 have hit tourism-related businesses like travel agents, hotels and other accommodations across the country.Pauline said ticket sales for inbound and outbound flights fell sharply, not only to those traveling for holidays but also for Muslim pilgrimages to Mecca. Many trips such as study tours and business trips have also been canceled following the government instruction to limit travel, movement and events.As of March 12, Astindo recorded a nearly 90 percent drop in sales following booking cancellations caused by fears over the coronavirus pandemic. Meanwhile, in February, Astindo members recorded potential losses of Rp 4 trillion.“In the hard times, our members are still burdened with operational costs, such as office leasing fees, bank interest rates, employee salaries, electricity charges, telephone expenses and others. This is a hard time for us,” said Pauline.Meanwhile, the PHRI reported the country’s overall occupancy rate had fallen below the low season average of 50 to 60 percent to 30 to 40 percent since the outbreak of the coronavirus in China in early January. In Bali, the occupancy rate had dropped to 20 percent, especially in areas visited by individual travelers such as Kuta, Sanur, Legian, Ubud and Jimbaran.Topics :
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